Ending for the Third Time

I am finished with breastfeeding/ exclusively pumping. It was great. It was real. We did it. I'm glad we did and despite all of the trouble, there is no doubt in my mind that I would do it all over again. I love him that much. But it's really over. I finally got myself down to where I can quit pumping. Yesterday, I pumped twice and only produced 1 ounce total, on both sides, for the day. Yes, I'm really done this time. And to tell you how really done I am.....(Erm, I should say "finished", because the mix-up of finished/ done, as well as the exchange of good/well are just two of my pet peeves.)

So anyway, I was about to explain how finished I am.

I am so finished that I made a phone call to a local breastfeeding boutique tonight to see how I could go about selling my pump. The big MamaJamma. The Symphony. The one that retails for $2K. And at first the woman didn't really believe that I bought one. She said that most people who have brought them in have stolen them, that they only own one themselves and the rest of theirs that they rent out are actually leases from Medela, etc. I gave her the serial number and she called Medela and discovered that it was indeed sold to a buyer by the name of Andrea XXXXX, that it is available for resale. And she offered me $1K (and another $200 in merchandise was thrown in), which I thought was pretty damned good considering I have used it for the better part of a year. And with my employee discount at the hospital, I only ended up paying $1600. So if you do the math, it cost me $400 to use my own Rolls Royce of breastpumps for 8 months. And so I met her this afternoon and sold my pump.

I sold it.

John couldn't understand why I teared up as I was packing it up. Because he is a man and just doesn't get it. I did everything. I really did. And we had a good run, Zach and I. I remember when he stopped nursing altogether and I thought it was over. And then the pride I felt when he drank a full bottle of my milk and seemed to prefer it to formula. When Zach was about 4 months old, I dropped down to where I was getting 1/2 an ounce total output for both sides and I thought it was over. And I kept on. We have toured every nook and cranny of Cincinnati in order to find obscure herbs recommended online by sites advising on increasing milk supply: teas and tinctures and capsules. I remember the day John went to run errands and came back to find me completely topless with Zach in just a diaper in his Moby Wrap while I was doing the dishes. Desperate for time to do Kangaroo Care in between my crazy pumping schedule, this was the only way I could manage to do it. He really did think I had lost my mind at that point. But if it was supposed to increase supply, I was going to do it. I didn't care what it was.

I sold my pump.

I hated the damned thing. Waking me up every 2 hours. Sucking the life out of me in more ways than one. Making it so my life was consumed with pumping schedules and ounces produced and ways to get more, more, more. But I loved the thing. Because you cannot convince me that it would not have been over when Zach was just 2 months old if I hadn't bought it. And I am so connected to this baby, and I believe this is why. Because while my body wasn't tough enough to maintain him during the pregnancy, damnit I was strong enough to feed us both.

I sold it because I knew that I would always try to do better, try to do more. That so long as my body kept making mere drops of milk, I would try to make ounces. I had to close this chapter.

I sold my pump. This chapter is closed. I love you, Zachary.

Another Chapter Ends

Where to start?

I remember when I started to get into the throes of my pregnancy with Zachary, and John and I started to make lists of the things we needed. And we got to feeding supplies, and we started to discuss whether we were going to go with breastfeeding. I wanted to with Evan, but his prematurity got in the way and neither of us ended up interested at all. Did I want to try it again? Not really, because I was kind of afraid to get myself invested in the idea. I had breastfed Ben for a couple of months, and when it didn’t work out, I remember crying the first time I gave him a bottle of formula. And with Evan, I just felt guilty that we didn’t give it more of an effort. But knowing how breastmilk is the best for the baby, and seriously thinking Zach was to be my last chance to do so successfully, I decided to give it a go. One more try.

Wow.

You start off with the idea of breastfeeding as being this remarkably bonding experience. With a mind full of rosy images of a tiny baby nuzzling at a mother’s chest. Of cuddling and warmth and a bond that can only be shared between mother and child. A bond that cannot be broken. And I think after the pregnancy horrors I faced, I really needed that. And then Zach was born.

It was never supposed to go like it has. I was not supposed to be separated from my baby immediately after his birth after only having a small glimpse of him over a surgical drape. And I remember John bringing pictures of him from the NICU for me to see while we were still separated, and it was so bizarre and surreal. I had endured so much for him and this is what I got? Some blurry images on a digital camera that John barely knew how to use? Was this little  person really my son? How could I be sure when I couldn’t hold him and touch him and smell his newborn scent? They said he was mine. And I could see a family resemblance, so it had to be true. He was beautiful, that was for sure. But really? I begged and begged for them to bring him to me. Everyone said he was doing great and had just needed a little longer to adjust to the outside world. So if he was fine, then he belonged with me. If he is mine, he belongs with me.

And just like that, he was with me. I kicked everyone but John out of the room as I stripped away layers of flannel blanket to look him over. So perfect. So so perfect. And then and there, we nursed. And all was right with the world. Suddenly it all was okay- the pregnancy, the time in the NICU. Suddenly, it was just Zach and I. I loved it. And I hated when the lactation consultant came in and told me he had to have formula and asked me what type I wanted them to give him. I hadn’t planned on that. And so my love/hate relationship with the pump began.

I hated that I had to pump at all. I hated that he got formula. I wanted to cry each time he took a tiny sip of it. 20 mL at a time at first. I gave him every bit of breastmilk I could. I wished they would have told me it was okay to stop the formula when my milk came in, but they didn’t until it was too late. And the supply issues started. I did everything I could and got most of it back. And then the latch issues happened, most likely a result of the bottle feeding he had received. Phrases like “nipple confusion” and “flow preference” entered my vocabulary. Still, I did everything. Always trying trying trying to get him off of the tiny amount of formula he was getting a day. And then when he wouldn’t nurse at all anymore and I learned what it meant to exclusively pump. And my reality became the breastpump, 15 minutes at a time, 8-10 times per day. I’ve kept that up since Zach was 4 months old. I hated it, but Zach was getting breastmilk. That was all that mattered. I still felt a deeper connection to him because of the months we spent together, nursing. That is how I spent the weeks of my maternity leave. And when I first returned to work, I would come home and Zach would nurse with me in the bed as I drifted off to sleep. Zach and Mommy. That’s all there was.

It has been such a difficult road. Difficult but rewarding. Worth it. I honestly can look at the differences in personalities between Evan and Zachary and I think the breastfeeding has something, if not everything, to do with it. Zach seems more content. More secure. I cannot help but think that this is because he had more of a connection to me.

So why am I writing this now? Because this afternoon, John helped me to gather up all of the supplies I have needed to exclusively pump. All of that equipment. And I cried as I made sure all of it was organized and packed away. This week and next, Zach will get what is left of my milk from the refrigerator and freezer, and that will be the end. When I initially started out, I said one year was my goal. In a perfect world, free from latch issues and prematurity, from supply issues and tongue-tie, I would have done one full year. I am pretty proud of myself that I made it this far in the face of all of the difficulties. By the time it is over, Zach will be 10 months old. He is to the point where he is getting more and more food from sources other than a bottle, and I feel like it is time to focus on enjoying the rest of his first year free from the stress of measuring every little ounce, from setting alarms to remind me to pump every 2 hours around the clock. I can spend time enjoying my baby boy and getting some well-deserved rest knowing that I gave him the best for 10 whole months.

So here is a picture for you. This is what thousands of dollars’ worth of breastpumps and equipment looks like. All of my work fits into this tote. Amazing. And the picture wouldn’t be complete without including in it the reason for it all.

Pump It, Baby!

No, this isn't an obscene post. It is more misadventures in breastfeeding.

I don't know if I've talked about pumps before, but I purchased a Medela Pump in Style while still pregnant. It was supposed to be the gold standard in pumps for working moms, so Iwas pleased. I used the Medela Symphony while in the hospital, when Zach was barely nursing, and my milk came in in full force, then tapered off. And so the drama started. I thought it may be my pump. So I bought a Medela Freestyle, also the gold standard, but with more bells and whistles. No improvement. There was a great increase in the amount I could pump that was mainly due to other things: consuming lactogenic foods, increased nursing/ pumping, taking galactogogues (Reglan, Fenugreek, Flaxseed, etc.). The Symphony is also the pump they use in the lactation room at the hospital where I work. I noticed a huge increase in what I can pump while there. At first I thought this was due to the fact that I have no choice but to go longer in between pumping breaks. It just isn't feasible to pump every 2 hours there. Another therapist has to hold my pager, my patients have to be all tucked in and in need of none of my services, and more. The most I can do is 3 breaks in a 12-hour shift. But I have tried to duplicate the pattern here at home and still get about half the amount I do at work. There is only one solution in my mind: I need to get my hands on a Symphony at home. Bring on the rental!

Well, around here, one can rent the Medela Symphony for about $110 per month. With Zach's latch issues and voracious appetite, I will need one for the duration I will be breastfeeding--at least one year. I want to give extended nursing a try but am creeped out by an older toddler reaching for my boob, so if I do it, it will only be with pumped milk. With that in mind, I would need the pump even longer. So if you do the math, it would be roughly $1.4 K to rent a pump for the next year. If I give up and go straight to formula feeding, it would be even more. So I made some phone calls, and the hospital for which I work has a Women's Wellness Boutique that carries or can order anything a nursing mother needs. And they can special order me a Medela Symphony. They even give me a 20% discount on purchases. So for about the cost of renting a Symphony, I can just buy my own. And they do payroll deduction, busting purchases up into 3 payments if desired. But this pump is costly, and it would equal about $500 per paycheck. Nah. So I called and called. I made my plea as to why I need this pump (preemie, latch issues, last resort), and they agreed to break it up into 8 payments just for me. Yay.

So this time next week, I will own my very own hospital-grade Medela Symphony Preemie Edition (It has a computer software card that, when inserted, will mimic the way Zach sucks). I'm excited, as I know it is just a effective as nursing a baby is. And the beauty is that she quoted me a price of $1500 on the phone, then when she ordered it with the preemie software, found out it is almost $2K, but she felt bad so is only charging me the $1500.

In the meantime, our trip pretty much did in the progress I was making on the supply issue. I was just too self-conscious about pumping and nursing. The business of it all had me forgetting doses of my supplements and medication. And I completely forgot my Fenugreek, and thus stopped it abruptly which can be detrimental. Between the three, I am almost back to square one. So I have to pull myself up by the bootstraps and go back to the pump-every-hour routine, which makes me want to cry. But at least I now know it can be done. Having the hospital-grade pump will certainly help in the next week or so.

All of this makes me think of the trip to B&N today. I was perusing the parenting section in search of a new copy of LLL's The Womanly Art of Breastfeeding when I saw this title:

Breastfeeding Sucks: What to Do When Your Mammaries Make You Miserable. Seriously, I about died laughing. And the cover is even better! (See right.) There was a whole line of "Sucks" books: Pregnancy Sucks, etc. Hilarious. I didn't buy any of them. They seemed entertaining, but I was there for more informative reading today. Now I am thinking about ordering it online.

So anyway, here we go. Again. The Misadventures of Ol' Bessie, the Milk Maker. Mooooooo!

Advice from a True Expert

So I saw the breastfeedng medicine doc yesterday. She examined both Zach and I. Zach is tongue-tied. His frenulum is thin in the front, so they would usually just snip it in the office, but his gets thicker as it goes back, so she wasn't comfortable. She said he had a great, strong, coordinated suck and all is well there, so if was worried about it, I could follow up with an ENT doc, but she didn't think it would impact breastfeeding at all.

In her opinion, my reduced supply is due to many little things. Stress: notice I didn't have any supply issues until the spina bifida scare. Sleep deprivation: the issue got worse when he started going through his little growth spurts and I started getting less and less sleep. And when I started to take action to increase my supply, myefforts were useless because I started taking progesterone birth control pills, getting even less sleep and more stress because of work. So I have a plan.

Continue the Fenugreek. We don't seem to be having any side effects from it. It's safe, so why stop?
Stop the birth control pills. For now, John will have to revert back to behaving like a pimply-faced teen nervously asking for Trojans that are behind the pharmacy counter.
Continue nursing and pumping as often as I can.
Add a daily bowl of outmeal to my diet.
More sleep.
Back to yoga. It is the only thing that has ever been able to relax my high-strung self. And daily walks.
And the last part? Well, this is a little worrisome. She prescribed Reglan. Designed for reflux, it was found to have the side effect of increasing Prolactin secretion in the body, which is the hormone needed to make milk. Thus increasing supply in most all who use it. It has even been used to induce lactation in adoptive mothers. But it has some nasty neurological side effects severe enough that the FDA has made the manufacturer put a black box warning on the label. These are seen more with longer periods of use, and she is only having me use it for one month, during which they will call and check on me often. The risks also increase with a history of certain medical conditions, of which I have none. So I am gambling a bit with my brain, but the risk is calculated and most all of the side effects (if experienced, even) reverse when treatment is stopped.
So that is the plan. Let's see if it works.

I Did It

I did it! I did it!

I worked 36 hours between Friday evening and Monday morning. And I slept during the days. And I can honestly say that my baby boy consumed nothing but breast milk the entire time! Now this may not seem like a big deal to many people, but when you are dealing with supply issues, this a big enough victory to make me cry tears of happiness. I worked my ass off for that milk! I literally pumped every hour for several days to try to rebuild my supply and everything. And last night at work, I was actually able to pump 4 ounces at a time, which is double what it was earlier in the week!

I still have my appointment with the Breastfeeding Medicine doc on Wednesday. There is a chance Zach has a mild tongue tie that has been causing a painful latch and could be the reason my supply came in so strong and then dropped off. When he nurses, he literally mashes my nipples into a crease that is blanched white from the pressure. His frenulum may be preventing him from latching deeply enough and that is what the result is. If so, they can fix it by snipping it. They say this is no more painful for the baby than a standard immunization, so I don't feel so cruel. And if it will stabilize his ability to nurse and reap the lifelong benefits of that, then it is worth it to me.

On to other boob news: I have had to pump very, very often. I was getting fed up. I already had my Medela Pump in Style, which is pretty much the pump of choice for working moms. I was looking for something to allow me to pump hands-free. They make bras for that, but have you ever tried to find those things in a 38G or H??? So I pretty much said "screw it" and took the plunge and bought the Medela Freestyle. It has adapters that allow it to connect to any standard nursing bra, has a rechargeable battery, a timer, is programmable for your favorite pumping pattern, and more. It feels so much different than the Pump in Style that I have to keep checking to make sure it is working. You can barely feel it. John asked me what I planned to do with the other pump,which has only been in use for 6 weeks and was pretty pricey. Well I set up a little station for me in my bedroom for when Evan is out and about and I need a quiet, private spot. I was able to use the Freestyle bag to set up a nursing bag for work, complete with the new pump, the cooler bag for milk, and another little bag with the parts for the Medela Symphony they have at work. This way, I don't have to pack and unpack a bag every day before I leave the house. I hated doing that this week. It was just a matter of time before I forgot something. And I plan to use the Freestyle for times when I need to be mobile, either around the house or in transit. We are actually taking a road trip in July and I get to try this new plan out. This may seem like overkill on the pumps, but I am prepared now for every pumping need I could have, which is a pretty big deal when you have to work so hard to keep your supply up like I do.