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.

It's The Little Things

On today, of all days, which happens to be the most difficult day on the calendar for me, I am choosing to distract myself with the little things I am loving right now that make life grand. Here's my list:
1. It's downright spring-y out there! Which means the neighborhood stroller brigade is out in full force. And while I am working at least 4 hours a day for the next 5 days, I will be able to join them. I can also bust out the Ergo carrier and away we go. To the park. For long walks. Window-shopping downtown. Hell, I don't care. We can go. And for the first time in a year, nobody is having a million contractions an hour or recovering from a c-section while the weather is nice.


2. International Delights coffee creamer. Seriously, folks. John likes Skinny Caramel Macchiato while I am partial to Skinny Vanilla Latte flavors. Both are fat free and delicious and eliminate my need to visit Starbucks daily. Speaking of Starbucks, the last time the entire fam went in there, by the time I tipped the barista, we dropped $20 on 3 drinks. Fo' reals. So I am loving this crap. And my fridge is stocked with it.





3. Reebok RunTone shoes. Now don't get me wrong: I am most definitely not a part of this new idiotic shoe craze. I do not believe for one second that a shoe is going to melt the fat on my ass, despite the fact that just about every major athletic shoe manufacturer has come up with their own version. But these were cute. And on sale for less than $100. And I needed new gymnies for work. And I bit. And tried them on. Helll-oooooo, Fat-Feet Heaven! And so they are mine.




4. Motherlove's More Milk Plus. Whoooooot! Because after the pumping debaucle at work last week (or lack thereof) this crap brought the supply back up in about 3 days. Well, that and me pumping like a madwoman again. Actually my pumping output tripled in that amount of time. And it replaced the gazillion other supplements I take because it has them all in it. I was taking 2 Goat's Rue, 3 Fenugreek, and 3 Blessed thistle capsules 3 times daily. Now I take 2 of these babies 3 times daily. For a third of the price. Holla!

5. A while back, I fell in love with Pediped baby shoes. And bought Zach 4 pair in th 0-6 months size. And they fit so well for so long that I was sure he wouldn't need a bigger size until he started walking, and thus ordered the next size up in the "walking" versions instead of soft-soled. But they were huge on him, and I ended up ordering 4 more pair in the 6-12 months size of the soft-soled and put these on a closet shelf. Now that Zachy is getting bigger and starting to explore pulling himself up to standing, I tried these on him and they fit. I have several pair, but these are just 2 of the styles I bought for him. A-freakin'-dorable! And so I felt justified in ordering the next size up, this time in sandals and other spring/summer styles. Shopping for shoes, even if they are baby shoes, makes everything better.


6. I'm working tonight. A little 4-hour "princess shift". This time yesterday, I was off work for today. Then my boss called to tell me a coworker, who has never called in in the time I have been there, called in sick for today. And so I gave up my full day off to help out. Why would this be on this list? Well, because it is difficult to think of your woes and feel sorry for yourself when you are running to codes or trying to keep people alive. Talk about a distraction!


7. My house is full right now, even though Ben is absent. It will never make up for it, but it is good to know. I get to hear the sounds of John playing with our boys. Of Evan's laughter in the house while he is off of school today (no idea why--not a holiday or Holy Day--hmmmmmm). Of Zach's squeals of delight.


8. Zach has learned to give Eskimo kises and it is too cute for words.

9. Still-toothless baby smiles. Don't get me wrong-I want him to cut his teeth. But there is just something so innocent, so pure, so new about a flash of naked gums when a baby smiles. And I am choosing to enjoy it while I can. It won't be much longer. (Incidentally, Evan took this picture of his baby brother just minutes ago while I was typing this. I love that you can get a true glimpse of Zachy's reaction to his big brother in the pic.)





10. This. This right here. Big Brother reading to Baby Brother. Because even in Ben's absence, this house is full. Of love. Of togetherness. Because Ben is the only one who could mke this better for me. Other than that, this is as good as it gets. Life with my two miracles and the love of my life. And because I can look at the boys, with their love of books, and see myself in them. I am there. And if I am there, then Ben is too, even if none of them realize it. And that is a beautiful thing.

Hell Hath No Fury...

...like Andrea pissed.
Seriously. (I think I may say "seriously" entirely too much. Kind of like the word "like" when I was a kid. Oh well. Roll with it because I am really pissed off.

Zach usually takes a bottle of evil formula at night before bed. One little 6-ounce bottle. Now, let me remind you that my boobs have been through sheer hell in the past (almost) nine months. I seriously cannot believe I have kept this shit up this long. (Oh, yeah, forgot to mention that you should expect profanity in this post because, once again, I am pissed.) Like the days where I found random black bruises on me. Or the plugged ducts. And how could I forget the days where I got as little as 2 ounces in 24 fricken HOURS. I didn't do this crap for fun. And it sure as hell has not gone as planned. I didn't want to take herbal supplements to keep the milk coming. I certainly didn't want to buy a hospital-grade pump. And I really, really had no intention of getting nice and intimate with a piece of equipment every two @#$%&* hours a day for at least a year. Okay, now with that being said...
You may or may not remember the early days when I returned from work a mere 5 weeks post c-section and all was sunshine and roses. We have the lactation rooms with the hospital grade pumps and leather recliners, etc. And if you have to pump, you have to pump. No questions asked. Period.
I have not pumped a single time at work in the past 4 days. And I am still doing the 12-hour shifts. In the wee hours of the morning when my boobs seem to be the most productive. So if I can't pump at work, it is a serious issue. And that issue has been my way of life for 4 days now. So while this time last week, Zach was taking one bottle of formula before bedtime, yesterday he only got one 5 ounce bottle of breastmilk all day. Because just one day of missed pumps is enough to do that to me. Now it is all but gone and I am back to killing myself practically in order to get my supply back up. One of my fave ER docs is working tonight and I am on the verge of asking him for another course of Reglan. It is that bad.
It went like this: I have had the ER, despite the fact that I told my boss that the ER, because of its lack of predictability, its distance from the lactation rooms, and the acuity of the patient population, is really difficult for me to cover while still breastfeeding. And she told me to have my coworkers help me and if anything came up, to let her know. I'm sure she doesn't really want me to do that. I would be in her office daily. Long ago, I stopped having someone cover my cell while I go to pump, which is really what I am supposed to do. It's just easier that way because I don't have to deal with the rolled eyes of my coworkers or have to explain why it is that I need this time to them. But the downside of that is that, when I get a call in the middle of a pumping session, I have to call my coworkers to get the patient seen. And the people I have worked with for the past 4 nights are not the type of people to help. For example, I was so busy in the ER last night that I didn't even get to attempt to pump until almost 7 hours into my shift (8 hrs. since the last pumping session). And when I finally got up there, as soon as I took my stuff out of my bag to get ready to do the deed, my phone rings. And it is a nurse who wants a PRN treatment for her patient because he is short of breath. I call the first coworker, who says she got called to a patient in the ICU. I have no reason to not believe her at this point, and so I call someone else. This someone else just happens to be the first girl's BFF. So the second one syas she is "up in the tower" ( a region of the hospital), not specifying which floor she is on, what she is doing, or anything else. I tell her what I need and her response was, "That doesn't sound urgent." And she hangs up. While it is entirely possible that she was correct in her assumption, we have no way of knowing this until someone lays eyes on the patient and does some sort of pulmonary assessment. And so I try to call a third coworker whose phone is saying he is "out of the zone", which means he is in an area of the hospital where his phone has lost signal. So I call the nurse back and let her know what is going on, and could she please give me specifics on the patient's status. She does and tells me he can probably wait until I am finished. So I start to pump. And literally 2 minutes into it, the phone rings again. 2 minutes. So of course the same therapists who were busy with the first call are still busy. And I have no choice. I stop pumping, throw my parts in my cooler without even washing/wiping them, and I go to the patient. Except on the way, I pass the first two girls, giggling and walking down the hallway. On the complete opposite side of the hospital from where I had assigned them at the beginning of their shifts. Together.It was all of 10 minutes after I had spoken with them and they were too busy to help me see one lousy patient. And so I was very pissed. And after that, I was just too busy to even leave the ER and never had another opportunity.
So tonight I report to work. For the first time all week, I am not in charge and so I do not make out the assignments. I told the one girl I can't do the ER tonight. Not after the issues that have gone on for the past 3 days. If I do, I will probably have no more milk for Zach. That's it. All of that work brought to an end like that. And she ignored me and put me there anyway. And in the morning I don't know what I'm going to do. Raise a stink? Go to HR? Post a printed copy of Kentucky breastfeeding laws on her locker? It's all enough to make me want to put in my notice, but my status as the breadwinner means that I need something else lined up first. Incidentally, my hospital was one of the first to recieve the Unicef designation as Baby-Friendly, meaning it makes extraordinary strides to foster breastfeeding. Pretty rich, isn't it?
Grrrrrrr.

Ugh

Once again, I am awake on my night off while the rest of the world sleeps. I have worked night shift for years without having this problem, but ever since I returned to work from bedrest and recovery. I have been unable to sleep at night. I thik this is because before, I would have my premed classes demanding me to keep a normal schedule as often as possible.
Anywho...
Several days ago, after getting the sinking feeling that my supply was starting to drop, I reverted to keeping a log of my pumping sessions and milk production, and it turned out that I was correct. So after puming like crazy again, with no effect, I went on another course of Reglan. This time, instead of going to the Breastfeeding medicine doc, I just cornered my family doc in the halls at work and picked up the called-in script the next day. Only this time, instead of gradually increasing my dose over the span of a week, I just started the full dose from the word "go". The results have been much different this time. During the first course, I didn't see or feel any results or side effects until about 4 days after reaching the full dose. Not so this time. I have been taking it for 2.5 days and as of yesterday morning, I noticed a big difference. It started with me not really pumping any more than before, but about every 2 to 3 hours, I would feel like I was completely engorged, which I have not felt since Zach was a newborn. I would think the milk fairy had left me the motherload only to pump about 3.5 to 4 ounces. Usually that is the amount I get every 4 hours or so, and when I pump more frequently, I get lower amounts. Well, yesterday, I got that every 2 to 3 hours. (Keep in mind I haven't really been to bed yet, and my yesterday is really 2 days ago!) So today, after a busy night at work and limiting chances to pump, followed by the need to stop at the grocery store on the way home after a damned-near blizzard outside, I was pretty uncomfortable and so when I finally sat down to pump, I got over 6 ounces. I haven't done that since day 1! (I know it isn't exactly record-breaking, but this is a big deal for me!)
So today, I was off, and I have been feeling engorged every 2 hours. Again. And this is just the beginning. The start of day 3 of the Reglan. I probably won't reach peak until I've been on it for a week or so. Holy Milk, Batman!

Not Jumping Off A Rollercoaster Mid-Ride

I want to give up.
But I won't.
I'm almost halfway through my goal of one year. Halfway through the rollercoaster ride. Yeah, I'm talking about my boobs again. I was almost there. I had my production up. I'm back down to pumping less than 2 punces at a time. Again. A couple of busy days at work, and whoosh! There it goes. If milk production were solely based on effort, I would be able to feed the world. Damnit!

Right now, it is after 2 AM. I'm off work and my family is asleep, but I'm obviously not. Instead, I'm awake, fantasizing about throwing my pump out the window. If only it didn't cost so much, I probably would have by now. But no. I'm a slave to the stupid thing. I am in the midst of "cluster pumping" right now, heading into round 3. What the hell is "cluster pumping", you ask? Well, you pump every hour on the hour for 3 to 4 hours, twice a day. It has been proven to increase production. When I do this, I do it late at night/ in the wee hours of the morning, then I sleep for 4 hours and wake up to my normal pumping routine, only to do it again the following evening. I hate it but it has worked for me numerous times.

I hate this. I don't understand why I have had such a hard time. I'm sleep deprived because I never sleep more than 3 hours at a time. I might as well not sleep at all on the bad days. This time of night is particularly bad when I've had an off day. I sit and tally in my head how much I have pumped and if it is lower than the previous day, I worry and fret that this is it. My supply's drying up for good. So far, I have always bounced back, but each time could be the time. And so I do this to myself. Again.

I should note that today started as a good day. I slept in a little, only to have John wake me at 7AM because he was getting Evan ready for school and Zach had awakened and needed some attention in the form of a diaper change and, eventually, some form of breakfast. And so I changed him and made his bottle of my milk and waited a bit for cues that he was ready to eat, only to have him start nuzzling my chest and rooting. So I offered. And he nursed! The first time he had any interest in weeks. And he did again when it was time for his morning nap. I was so excited! And then the end of the day came.

I won't quit. I'm too stubborn for that. I will not jump off of the rollercoaster mid-ride.

Seriously???? That's All?

So I am trying to solve the plugged duct in my left nipple. (Oh yeah, I should have warned about the TMI coming up....) And I go from the 24mm breastshields to the 27mm ones. I use those for a couple of days, pumping 8 times per day, and something happens. Pain. And swelling of areas you do not want to be swollen. And I can't see because I am up close and personal. So I stand topless in the bathroom and call John in to see if he can see anything wrong. And he says, "Oh my God, Andrea, you're bruised!" Yep, my girls are bruised. Actually bruised. And so I make a 9-1-1, code-blue trip to the Women's Wellness Boutique at the hospital, which is where I buy all of my nursing paraphenalia (both because they either have anything I could possibly need, or can order it with just a phone call, and I get an employee discount). And they help me do some research. And we watch videos online of correctly fitting breastshields. And we realize that I have been using the wrong sizes all along.

So let's recap: Pump In Style Advanced ($300), Freestyle ($400), Reglan, Fenugreek, Blessed Thistle, Alfalfa, pumping pumping pumping, Breastfeeding Medicine specialists, visits to lactation, different bras thinking that the ones I had were cutting into me and causing the plugged ducts and thus decrease in supply. Lab test to check my thyroid. Biting the bullet and buying the $2K hospital-grade pump...

And I spend $10 on a set of shields in the next size up and actually pump double my average pumping yield in the first time I used them.

You have got to be kidding me.

I feel like a moron. And am having flashbacks of the first time I spoke to a LC about the drop in my supply. When we were puzzled that despite Zach's poor latch, my pumping with a good quality pump was not able to keep my supply up. And I started doing anything and everything to get it back up. And she aked me, "Andrea, do the flanges fit well?" And I said yes, thinking to myself, "Well duh!". But they didn't.

I found the solution. I'm glad it was such a simple one. I wish it had come sooner. I hope it isn't too late to fix it.

2/3rd's, The Shots, Scheduling Woes, and More

Today Zachy got his 4-Month immunizations. We couldn't have them done at his 4-month well-child appointment because it hadn't been exactly 2 months since his last round. He really is such an awesome baby. He cried a bit for the last ones, then did fine at home. No fussines or crankiness, no fever. I had the same expectations for these, and he did not disappoint. Though John said it was my turn to hold him for these. Neither of us like to be the bad guy, holding him down while pain is inflicted upon him. So I did. Fair is fair. But I cried right along with him, and both of us were instantly calmed when it as all over and I could pick him up and cuddle with him. My sweet, sweet baby boy.



On the breastfeeding front, things are going better and worse. I have managed to increase my supply a bit and am now producing about 2/3rds of his total intake. I now leave for work with more breastmilk in the fridge than he can eat in one night, and have a few days' worth built up in my freezer. Of course this progress comes at the cost of me being attached to a pump for what seems like all day. But in truth,I could be a lot better about it. I keep making plans to spend all of my off-time pumping at least every three hours and after feedings, but it seems like things always come up. Truly, I blame it all on my work schedule. We do self-scheduling, and we are currently working on the schedule I completed about 2 weeks after my big return to work after the 5-month hiatus. Instead of scheduling my days in a row, I scheduled myself for every other day. I did this not only because I had been off so long that I started to atrophy and didn't think I could physically handle long stretches of 12-hr. shifts, but also because I figured I would get no real sleep with a newborn who is breastfeeding. It turned out to be a mistake. Not only does Zach sleep like a champ, but I feel like I am never off of work and get even less sleep. Take today for example. I worked last night and had today off. By the time I got home and tried to sleep, most of the day was over. I really only got this evening off. And I spent that time doing things I needed to do. Plus the sleep I get is broken because I wake every few hours to nurse Zach or pump. Now it is 3:15 AM, my family is asleep and I am wide awake. I'll get more broken sleep tomorrow because I am back at it tomorrow night. Well, the next four nights, actually. I picked up 24 hours of overtime this weekend. For this next schedule that will be starting soon, I did the opposite: scheduled for three days at the beginning of one week and three days at the end of the following week, which means I have long 6-day stretches off in-between to rest and regroup and nurse and pump. My goal is to use this time to get Zach totally off of all formula supplements by the time he is 6 months old and ready to start solids. That seems lofty to me at this point but it really isn't when you do the math. For a baby eating solids, the average formula/ milk intake is about 24 oz. daily in addition to other foods. If I can pump just half an ounce more at each pumping session, that will put me way over that mark for daily output! And I will have all of those days off to do it! Ha! Finally!



On another Milk Maid note: It happened finally. I got a plugged duct. But not just any plugged duct. This is in a bad place. A very bad place. I had noticed I was a little more tender than normal. The LC has me hand-expressing after I pump because even the hospital-grade pump is leaving enough milk in there that it literally sprays out after a pumping session. So I do and it has become habit. But when I was doing my little ritual yesterday......oh bloody HELL!!! It hurt. Badly. Because I can't be normal and get a plugged duct on the side or something. Nooooooo! I get one actually inside of my nipple. And weirdest of the weird, you can actually feel the milk passages in there because there is about a 2-inch section of inflamed duct that feels all ropy and knotty. So tonight I waited and waited for Ev to go to bed so I could sit in my living room with a hot wet washcloth on my...well, you get the picture. It is still there. If it isn't gone in a couple of days, I am to see my doctor, according to the LC. Gah! I'm sure this all the result of my sucky schedule, business at work, and erratic pumping/ nursing schedule. I think I have come up with a solution: I bought that damned Freestyle that has the rechargeable battery. I might as well use it. I think I'm going to make its permanent home be my car, so when I am running errands or am out and can't nurse Zach, I can use it. No more excuses. And much handier than, say, lugging around the big pump of Herculean proportions. I don't een have an excuse to take it out of the car since I have a standard power outlet in my car's console and can just plug it in when the batt is dead. There!

So there you have the low-down on my issues once again. Now back to work.

Generalized Crap

Not much going on here except work, work, work, pump, work, nurse, pump, yell at Evan to do his homework, then repeat. I pretty much hate my new work schedule, even though it is what I asked for. After being off of work for over 5 months, thought I would need to get my chops back, and so I have tried to avoid signing up for several 12-hr. shifts in a row. Plus, with me waking every few hours to nurse a baby or pump, it makes it easier when there are days off in between. But.....I feel like I never have time off because the days don't come in stretches. That was, they didn't until this week. I am off until Friday night, with the exception of an 8-hour computer class on Wednesday for the new software the hospital is getting. Holy crap! So what's new?



Well, in my quest to turn myself into a one-woman dairy farm, I broke down and called our area La Leche League leader. She was wonderful, and we talked about what I could expect at the meetings and more. I gave her a brief synopsis of my breastfeeding woes and she advised me to start taking blessed thistle with my fenugreek. Ok. Done. I missed the month's meeting by 2 days, but found out they meet in my hospital! So I will be going to try it out for September's meeting. Yay! Maybe I'll meet others in the same boat.



Other than that, there is one more development. I've gone Bat-Shit Crazy! Yep, you read that correctly. As if I wasn't already an emotional minefield, I now have something new to add to the mix: I have started having nightmares. Crazy ones, too. And some that aren't terrible but just seem so....real. Yesterday I swore I woke up to the feeling of one of my progesterone injections. (This is where I admit that they hurt like HELL!) In my dream, Evan was the one giving me the shot instead of my RN, and I just kept thrashing, saying, "But I've already had my baby!" And when I awakened, I was crying. So yeah, I'm going to seek out somene to talk to. I'm starting with our hospital's EAP in the hopes that just a few sessions will be adequate, and in the event that it isn't, they can then refer me. I definitely want someone experienced in this sort of thing.


Other than this stuff, my days and nights blur together to where they are almost unrecognizable. I blame night shift. And my pump. I blame that too. It is the bane of my existence these days, especially since Iave realized that Ido not have the luxury of slacking off on this. My milk supply is too fragile. Very little increases it, but if I so much as skip one pumping or nursing session, it decreases. Unfair. But I have come to realize, with the help of Zach's weight gain and level on contentment, that each ounce of breastmilk I give him is a sort of gift. So for now, in light of all of the work it has taken, I am choosing to focus on the fact that I have been breastfeeding him for almost 4 months. One third of my goal of one year! Go Me!

On that note, I am going to pump! Ha!

Vacay?

"Nursing Vacation", that is. As in the one Zach and I took all day. Basically, Mommy and Baby hole up in bed all day together and the baby nurses as often and for as long as he likes. It is recommended to increase milk supply. But it is also just what the doctor ordered after a long weekend at work. I now hate doing several days in a row because it means work for 12 hours, sleep all day, then back to work, and so on. I miss my boys too much during these stretches. So Zach and I were due for some quality time together and we got just that today. The photo above is a Happy Zachary after he awakened from one of our many dozes today. Sweet, sweet baby boy!

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!

A Woman's Work

If this grosses you out, I apologize.

This is what I have been working toward all along.

To give Zachary a piece of myself each and every day, multiple times a day. To do what is best for him. And it has been harder than I could've imagined.

I've learned about galactogogues, and have consumed them in large quantities. I've had the herbal teas, and I don't like tea--not even sweetened iced tea. I am now eating a bowl of oatmeal daily, even though the texture gags me. I am taking a medication that could damage my nervous system, though it most likely will not. I have had many nights where I have set my alarm clock to wake me every hour so I could pump. I have cried when those efforts only produced as little as a half a ounce at one point. I have felt the thrill of the first night I left for work with 12 ounces of pumped milk in the refrigerator, enough to meet my baby's needs while I was away, even though it took 2 days of incessant pumping to produce that. I have felt joy that I was able to pump 2 ounces at a time, total, then felt the deep disappointment when I realized even this was inadequate.

But this? This is 4 ounces of pumped breastmilk. From one side. My production is sort of lopsided, so I only got 7 ounces total. But this? This is victory. This is my work for the past 2 months of my life. I am proud of myself for sticking with it when it would have been easier to give up.

The happiness, the relief, the joy, the heartbreak, the dedication, the perseverance, the resolve....Who could've know it could all fit in 4 fluid ounces?

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.

Supply and Demand

For something that is supposed to be so easy and natural, breastfeeding has been insanely difficult. Somewhere around the time of the phone call from our doc about Zach's thyroid hormones, my milk supply started to drop off. Of course this was timed perfectly with one of Zach's growth spurts, which sucked. He wanted more milk, I was making less, and we had to rely on more and more supplements. And so the vicious cycle started. I tried everything. I tried to be stubborn and refuse to give him supplements, letting him nurse as often as every 30 minutes. I tried taking Fenugreek. I tried giving him supplements and just pumping every hour. I was seriously worried that my supply would be completely gone with the added stressor of my return to work. Unfortunately, none of these things seemed to improve the situation. It didn't worsen, either, so I guess it could be worse. I am only able to pump a pitiful 2 ounces each time, where before I was able to get anywhere up to 6 ounces. Huge drop. So back we went to the lactation consultant. It seems the only thing left to tweak is Zach's latch, which we worked on. If this doesn't do the trick, I am out of options.

While there yesterday, the lactation consultant asked, "Why don't you schedule an appointment at Children's?" Me? At Children's? She is of course referring to Cincinnati Children's Hospital Medical Center, which is all of 5-10 minutes' drive from my house. I have always felt lucky to have them there. An award-winning pediatrics center, known throughout the country. Ground-breaking research. State of the art care. Heaven forbid anything were to ever happen to either of my boys, but if it did, some of the best doctors, from every pediatric specialty, are just right there. But I had no idea there would be any reason for me to be seen there. Well, it turns out they have their Center for Breastfeeding Medicine. Breastfeeding Medicine????? Yep. I didn't even know that specialty existed. Apparently it is a team of pediatricians specializing in working with a lactating mother and her baby to determine the cause of, and correct the underlying issue with, virtually any breastfeeding issue that may arise. In my case, there is nothing physiologically wrong since I once had a huge supply. It just dropped off as a result of stress and poor management, and I have not been able to get it back. So I have an appointment there on Wednesday of this week.

In the meantime, Zach is eating like a pig. He would literally nurse for 24 hours a day with no break if I could do it. He is up to 9 pounds, 11 ounces as of yesterday. My little chubbers. This is such a huge difference from Evan, who weighed 16 pounds on his first birthday. He was happy and healthy, but just tiny. But we equate chubbiness in babies with health, so it is nice to see Zach packing on a little bit of weight. Regardless of the problems we are having, I know he is getting the nourishment he needs.

In the meantime, I am reading a book called The Breastfeeding Mother's Guide to Making More Milk by Diana West and Lisa Marasco. The lactation consultant recommended it, and so far it is very informative. It lays out the different causes of low supply so you can, detective-style, figure out what may be the culprit, since apparently any tiny detail could be a causative factor. This way, I am getting ideas to discuss with the doctor on Wednesday. I know them having me give Zach supplements after birth is a factor. I know stress has been a factor (and continues to be--a stressful situation caused the drop, then I got stressed about the low supply and trying to preserve the BF relationship, and so it goes...). But I am learning tons of new info, like progesterone lowers supply! Progesterone! As in the injections I got every 5 days up to the week of Zach's birth. Like the active ingredient in the birth control pills my OB gave me, which is ironically the only safe BCP for nursing mothers. So I am gathering all of these clues and will have a list for the doctor.

What I was not prepared for was the emotional attachment I would have to nursing Zach. This whole breastfeeding issue came up initially not only because it is healthiest for both of us, but because food allergies run rampant in my family. I am allergic to everything! Evan had eczema an is following in my footsteps. I wanted to avoid this all with Zach, and BFing is the best start for that. But now? Now I feel like a broken-down, deflated failure when we have to give him more after he nurses. And I am so protective of the milk I do have, fearful that there will come a day when it will be gone completely. So I am truly hopeful that they can fix this next week. If not, I'll just have to do the best I can with what I've got!