Breastfeeding Troubles

 I always knew that I wanted to breastfeed any children I had.  All of the research talks about how much healthier it is for babies with the extra immunity protection from mom and great healing properties etc.  But honestly a large part of the reason I wanted to breastfeed was cost - Formula is expensive!!!

I also spent the last few years volunteering with the local Milk Bank through the Junior League of Norfolk-Virginia Beach.  We volunteer on Saturdays to man donation drop offs for the Milk Bank so that mom's have the opportunity to make breast milk donations outside of normal business hours.  Through this program we have really helped our milk bank grow and given lots of mom's more flexibility in when they can make donations, thus increasing the frequency of donations being made.  

Specifically I volunteer with The Kings Daughter's Milk Bank at CHKD and I highly encourage you check out their website if the idea of a human milk bank makes you a little squeamish or curious about why it is important.  For now I will just say that 1 ounce of human breast milk can provide 4 treatments for the average NICU infant and because of everything I learned while volunteering I was very hopeful that I would be able to not only feed my baby but be able to donate to help feed others as well.

After Little Dude's exciting entrance into this world we had more than our share of trouble getting started breastfeeding.  We started life on O2 and with a feeding tube, he was quickly transitioned from the feeding tube to a bottle but Little Dude was still unable to feed at the breast for his first couple of days.  I was pumping at the hospital but my milk was slow coming in so I wasn't able to pump nearly enough to cover his bottle feeds so he was receiving the .25-.5 ounce that I was able to pump followed by a bottle of formula.  After a couple of days we were able to attempt breastfeeding but we had a very rough time getting Little Dude latched and on more than one occasion I almost gave up.   

I will never forget one evening in the NICU trying to get him to latch, my husband was dripping sugar water down my breast to the nipple with a syringe to entice Little Dude to latch, one of the dear NICU nurses was next to me showing me how to hold my breast so that my nipple would fit more easily into Little Dude's mouth, another nurse was across from me cheering me on and tears were streaming down my face because I felt like such a failure.   

Luckily once my milk came in I was able to produce enough and we only opened 2 bottles of formula after we came home from the hospital and those were both only used to get him to latch onto me, not given to him in full but I honestly didn't think we would ever be as successful as we have been with breastfeeding after that rough start. 

By the time we brought Little Dude home from the hospital I was able to get him to latch with just my husband helping drip formula or expressed breast milk down my breast with a syringe (and sometimes into the corner of Little Dudes mouth to encourage him to start sucking) and by the time hubby went back to work I was mostly able to get him to feed on my own but it was painful and never quite felt "right".  After about a day I was in pain and by the second day home my nipples were chapped and starting to scab over.  

I was able to get an appointment with a IBCLC (International Board Certified Lactation Consultant) at the hospital where Little Dude was born and she was a life saver.   She helped ease my fears that he wasn't getting enough milk by doing a weighted feed, and showed me different positions to make breastfeeding a little easier.  She also was able to identify that he had a lip and tongue tie and wrote me a referral to get those fixed.

Using the tricks I learned from the IBCLC I was able to feed Little Dude successfully with less (though still some) torture to my poor abused nipples until we were able to get in with the dentist I chose to perform the tie release (generally the dentists who perform these releases use lasers which are less invasive than the cutting that is performed by ENT's and surgeons) was able to get us in.  After we had Little Dude's ties released it was like I was feeding an entirely different baby.  

I will admit I didn't do the best job with his stretches after we had his ties released and the lip tie has grown back slightly but it is significantly better than it was before the release and I am counting on a childhood fall to re-release it so that he doesn't have any long term cosmetic issues from the tie.  As for the tongue tie I believe I did a better job stretching it and it appears to still be fully released to my untrained eye.  Either way I no longer have any breastfeeding pain caused by the ties and we can just hope that if it has grown back any it isn't enough to cause any speech issues in the future.

I have now successfully breastfed my baby for over a year.  I am still sending a sippy cup with expressed milk to daycare every day and breastfeeding multiple times when we are together (here's looking at you 03:00 wake ups!) I also have been able to make a few donations to the Milk Bank and gave some milk to a mom who wasn't producing enough that the Milk Bank couldn't take because it was pumped while I was sick with strep throat (they have VERY strict screening guidelines for every donation to protect the high risk NICU babies).  Now I am hoping that we will be able to make it to 2 years of breastfeeding at least twice per day to keep giving Little Dude the great immunity boost from my milk.  I plan to continue to pump until I go back to work in the office in January but am thinking that I will begin to wean myself off of the pump in December so that I no longer have to take time out of my in-office work day once we are back onsite.

If you want to breastfeed but are having troubles please do not hesitate to ask for help.  If you can't afford an IBCLC at least reach out to a local La Leche League   for free support and guidance.  And if you want to breastfeed but really aren't able to because of low production or medications or any of the 100's of other valid reasons don't feel guilty.  Formula is perfectly fine.  It is formulated specifically to meet the needs of a baby and many perfectly healthy, well adjusted adults (especially those born in the 70's-80's-and-90's) never had anything other than formula that was less advanced than what we have today.  But if you really want your child to have human milk you always have the option to check out Human Milk for Human Babies  which is a milk sharing network that helps put mom's with extra milk (me) in touch with moms in need of milk.   

All of this is to say - feed your baby - that's the important part :)

Real Talk

So I was under the crazy idea that once I had our Little Dude that I would get back into the blogging habit because I would have something interesting to talk about...
What I failed to consider is that I wouldn't have time to sit down for five minutes to write it all down.
Then I thought I would get back into it when my husband left on deployment, but out of an abundance of caution I didn't want to talk about my husband being deployed while I was home alone with little dude.  (He's still gone, but will be home soon)
Then I thought I would complete the Home Organization Challenge with A Bowl Full of Lemons this year and blog about that...but less than 1/2 way through (and only 1 blog post in) I had to go home to Kentucky to help my mom because she was having surgery.
After about 6 weeks going back and forth between Kentucky and Virginia with an infant and working remotely while I was at my moms I made it back to Virginia full time just in time to work a full week in my office before we started shutting down and sending people home to work remotely due to the COVID-19 Pandemic.
Now after 70+days at home Little Dude will be returning to daycare (a new daycare, but more on that later) on Monday while I remain working from home.
Sending Little Dude back to daycare wasn't a decision I reached lightly.  COVID-19 is still a very real virus and the new mutation that hits small children so hard is very scary.  Also Little Dude was on a ventilator in the NICU for a few hours when he was first born so I do have concerns about potential respiratory problems.  However I had to weigh those risks against what was necessary for my sanity and our combined health.
The daycare Little Dude will be attending is very clean and taking precautions also I feel confident that the health system in our area has taken the necessary steps to be able to properly care for patients even if there is a second spike.
On the flip side it is almost impossible to be productive all day with a 10 month old requiring constant care.   Little Dude is crawling and climbing and constantly discovering new things.  Every day it is something different and I can't imagine how much harder it is going to get as he gets more and more mobil and more and more curious.
In the end my friend Sara and I have developed a shared mantra when it comes to the pandemic and parenting - we are living in a world with no right answers and very few wrong ones, a world full of grey and it is harder than ever to know what the right choice for your family and your kids is.  We are all doing the best we can, but dammit we are doing it. 
So to all the other mom's out there - you're doing great.

My delivery experience

I want to end 2019 with an emotional purge of a sort.  It's taken a long time (5 months in fact) to be ready to share this with the world, but I feel like it needs to be shared.  I need to tell my story for myself, and I feel like there need to be stories like mine for others when they go through similar situations and need to feel like they aren't alone.

**warning** do not read this if you are a little squeamish, have never had kids but want them, or generally get freaked out by medical stuff - especially medical emergency stuff...

Yes, it really was that bad...

No really - if you want kids but haven't had them or are currently pregnant, move on nothing to see here....

I have told this story quite a few times in the last 5 months but really am just now processing it fully for myself.  To say Little Dude's delivery didn't go as planned is an understatement. Anyone who knows me was not surprised when I said I wanted an unmedicated childbirth, or that I wanted to avoid a C-Section and most people were amused at my reasoning for avoiding an epidural (I didn't want a catheter and wanted to be able to stand up).
And honestly, I think if I had been able to have a more typical labor process I probably would have accomplished those goals, but Little Dude and God had other plans.
Late in the evening on July 30 I started having infrequent contractions (I had had an exam that morning and was starting to dilate but nothing exciting at that point in time).  I started doing stuff around the house that I wanted to make sure was done before going to the hospital but didn't say anything to my mom-who was here in case I went into labor while hubby was at away for Navy stuff (more on that later possibly)- or hubby because I didn't want them to freak out.  When we were getting ready for bed that night I told hubby to be prepared to go to the hospital in the morning but I was fairly confident I would make it through the night.
I woke up, on my own, around 6 AM on July 31 and so I took a shower and timed my contractions, they were more regular but still super far apart and honestly not that painful - I have significantly worse period cramps on a regular basis.  I sent my boss a text message letting him know I wouldn't be in but that we weren't going to the hospital yet and proceeded to spend the day hanging out with hubby, mom, and the dogs.   Around 3PM my contractions were about 15 minutes apart and I told hubby I thought we should go to Portsmouth for an early dinner so that if things sped up we were already on that side of the water since the last thing anyone wants is to get stuck in traffic in a tunnel while they are in labor.  So we went to Portsmouth for dinner and by the time we were done eating my contractions were down to about 5 minutes apart. 
I called my doula and we went for a walk around downtown before driving onto base to the hospital.  When I checked in with labor and delivery they took me back to triage and after performing an exam and measuring my contractions the midwife told me I had not progressed much since the prior morning and that the intensity of my contractions was so mild that even though they were pretty frequent she didn't really want to admit me yet.  However on the other side of that argument I was scheduled to be induced two days later so she was inclined to just move up my induction to that evening and we could go ahead and get things started.
I went ahead and had them admit me and once my Doula arrived I talked through everything with her, I really wanted to avoid pitocin and didn't love the idea of having it given to me to speed things up when I knew I was already in labor, even if it was early stages and slow moving. Hubby and I decided to have the midwife discharge me and that we would come back when things started heating up.  At this point it was probably around 8 or 9 pm.  I called the midwife and talked through all of my options with her.   After talking about my concerns she asked if she could check me again before we made any decisions and I had progressed 1 CM from when I was initially admitted.  Because I was showing progression and my contractions were even closer together (about 3-4 minutes) though still not super intense she convinced me to stay the night without being induced and that we would start pitocin in the morning if I wasn't showing more progression. 
Hubby walked my mom and the doula out to their cars and went to get our overnight bag and I started to settle into the room for the night with the goal of getting some rest so that I was ready for the main event.  I knew they wouldn't let me eat but I wasn't worried - I had snacks fully prepared for me to sneak if I got hungry.
In the less than 30 minutes from the time hubby left the room until he got back I went from knowing when I was having contractions but barely feeling uncomfortable to being super antsy, unable to get comfortable, constantly moving from the bed to standing, to having to pee.  The nurse kept coming in because I was moving so much the heart rate monitor kept slipping and my blood pressure was elevated.  Shortly after hubby got back to my room (around 11:30/12PM) I started feeling actual pain.  I paged the nurse and asked for painkillers because I knew if I were supposed to rest I needed something to take the edge off because there was no way I would be able to sleep with what was going on in my body.
Since I had been barely dilated about an hour prior they gave me the narcotic painkillers without a second thought - I was nowhere near ready to push and the medicine would be far out of my body before the baby was born.
And things just went downhill from there.
After getting the narcotics I laid down to try and rest and kept falling asleep then waking up for contractions.  I asked my husband after what felt like forever but was apparently only about 15 minutes if I was sleeping between contractions or if they were really as frequent as it felt and he responded with "no, you're having a contraction about every 30 seconds" which I knew meant that something had to be happening but since I had been barely dilated before I still figured we were in for a long night.  I started crying because I felt like I had failed but I knew I couldn't handle the pain I needed an epidural so I paged the nurse and she had the anesthesiologist come back and by some sort of magic he managed to insert an epidural despite my inability to stay still.  By this time I was completely sobbing because things were going so differently from how I had imagined.  But the good news was when they inserted my catheter they checked me again and I had dilated significantly more and they started talking about breaking my water - which I declined - I was at least going to let that happen on it's own.
Even with the epidural they kept losing the babies heart rate so after a little while my midwife came in and told me that they needed to use an internal heart rate monitor for the baby and that they would have to break my water in order to place it.  Obviously my babies safety was most important so I consented and when she went to put the monitor in place she commented that I was almost fully dilated and effaced - which was quite shocking since it was only about 1 am at this point.  I had progressed from 3 CM dilated the prior day, to 5 CM dilated around 12/1am, to being almost completely dilated around 1:30/2am.  This was going way faster than normal.  She placed the heart rate monitor, there was meconium when she broke my water so we discussed the concerns and risks and what would need to be done then the midwife left the room.  Less than 30 minutes later about 20 people came into my room - never a good sign  - they were losing the babies heart rate on the internal monitor, which meant the babies heart rate was dropping, no way it was just me moving the monitor, since I couldn't move the monitor.  The baby needed to come out and he needed to come out now.
The midwife checked me again and I was fully dilated so she told me I had 3 pushes to get the baby out. 
About 1/2 way through my second push we all knew it wasn't happening.  They started dropping the rails on my bed and unlocking the wheels before I even fully knew what was happening while explaining to me and my husband that we had to get the baby out immediately. The anesthesiologist started to push a spinal block as I was rolled into the operating room.

Everything from here on is how I remember it, the timelines are a little fuzzy and it still seems kind of a blur, partially due to all of the medication, partially because it was so rushed, but I think mainly because I had to disconnect myself from the situation as it was happening in order to survive.

When I entered the OR the surgeon called a time out to go over my medical history and the procedure being performed.  After going over the procedure quickly the surgeon asked the anesthesiologist if they were ok to cut and the reply was that it had only been 3 minutes since the spinal block was administered and that I needed at least 2 more minutes before I would be numb.  The surgeon replied that they needed to cut now and the anesthesiologist said ok.  He started using every medication he had on his cart and a second anesthesiologist who was in the room bent over by my head and started explaining to me what I would feel - and I felt everything.
As the surgeon made the first cut I jerked my arm (involuntarily) so hard that I broke the piece of the bed that it was scraped onto and someone else in the room had to hold it in place until they could get it reattached.

I then heard someone say that they needed to administer antibiotics just in case and I was coherent enough to yell that I was allergic to Zythromaicin (thankfully because that was one of the antibiotics they were going to give me), which I am sure they would have caught since I had a giant red allergy bracelet and it was on my chart but I am also sure I saved them a few seconds.  With the exception of that one moment of clarity throughout the entire ordeal I was screaming a single explicative...the word Fuck...It was the only thing I was capable of saying.  (My husband said that when he turned the corner with the nurse who was escorting him to walk down the hallway to the OR from my Labor & Delivery room he heard screaming, cracked a joke that someone was having a bad day, they realized I was the one screaming.  My heartfelt apologies go out to anyone who was in the Labor & Deliverly ward at the hospital the night of July 31/August 1 who had to listen to me, I am sure it was quite terrifying.)

Sometime in April Little Dude decided it would be a good idea to lodge his foot in my ribcage.  I swear his foot did not move from my ribcage until it was pulled out by the surgeon.  I felt it being removed, it was a very odd sensation.   They had trouble getting Little Dude out even once I was properly numb.  It seemed that even though my pushing was not productive the entire time from when I started pushing until they had me cut open he was trying to continue to pass through the birth canal.  It took 3 surgeons to get him out, and end the end they had to basically push his head back up the birth canal while pulling him out of my stomach feet first.  (One of his pediatricians who had been in the room told me later that I basically gave birth both ways and breech.)

After they removed his foot the next thing I remember a nurse asked if my husband could come in and the doctors said no.  I'm not sure why but something in the way they said it will always stick with me.  Never thought the entire process did I have any concern for Little Dude even though he was in distress and that was why we had to rush into surgery.  Instead the thought that went through my head was "I am going to die on this table," immediately followed by me hearing Little Dude cry.

Then I passed out.

It took less than 5 minutes from the time they started rolling me out of my labor & delivery room and when little dude was officially born.  It felt like a lifetime.  I remained in the Operating Room for at least an hour drifting in and out of consciousness because I was in such bad shape from the way they had to take Little Due out.  I lost a lot of blood and because he had a hard time getting out they had to make a longer cut than is normal.   I remember snippets of conversation as I drifted in and out and every time I came to I would ask if the baby was ok, someone would tell me yes, they would remind me that I heard him cry, then I would pass out again.  During this semi-conscious period I heard some very scary words and phrases, one that will always stick with me is hysterectomy.  When I finally came truly conscious in the recovery room I honestly expected to be told that my uterus had been removed and that I wouldn't be able to have anymore children.  But my baby was ok, and that was all that mattered.

Luckily that was not the case.  The doctors were able to stop the bleeding and get me stitched up properly without having to perform a hysterectomy.   Thought I did ask 3 different doctors during my recovery stay to verify that that was the case and that they hadn't just forgotten to tell me.  The only lasting effect of the surgery for me is that if/when I get pregnant again I will have to schedule an early C-Section because the additional cutting will make attempting to (or accidentally) labor naturally dangerous and put me at high risk for hemorrhage.

Little Dude ended up staying in the NICU for 5 days while he was weaned off of oxygen (he actually only needed it for a couple of hours but you can't just turn off O2 once you have a newborn on it.) We had some very minor issues with breastfeeding in the beginning that I think was at least in part because I was not able to actually meet Little Dude until he was 12 hours old and didn't get to hold him until he was almost 20 hours old or even attempt any type of latching until he was 2 days old.  Now he is a very healthy, very large, baby boy (he is in 9 month clothing, at 5 months old) He has been in the 92-95%tile since birth and is growing on his growth curve.  We are so lucky to have such a healthy baby since things could have been not so happy.

The one truly long term effect of his birth is that I believe the event gave me a slight case of PTSD.  I have historically been a little judgy about people who have claimed to have PTSD from events that "Weren't that bad" like this but now I feel sincere remorse for those feelings and nothing but empathy for those people.  One day about a month after Little Dude was born I got kind of spacey and hubby asked me if I was ok, I jokingly responded that I was having a Vietnam flashback, then stopped mid sentence and said "I think I have PTSD..." Hubby agreed with me and told me he would honestly be surprised if I didn't.  We talked about the possibility of me getting help and my husband encouraged me to do so but I honestly just never got around to it.  I was consumed with taking care of our Little Dude and as long as I had him within arms reach and safe any moments I had would pass.  In hindsight I think I probably should have been more proactive and probably should have talked to my doctor about getting a referral to a therapist but I also know that I didn't/don't need any sort of medication to help me.  I still wake up in the middle of the night occasionally (it has happened twice in the past 3 weeks) and check to make sure that the baby is ok and feel a little panicky but it isn't effecting my daily life and I have the coping mechanism that I need to keep it under control.  But I know if it ever starts to get worse I will need to make phone calls and get help immediately and I have taking the proactive step of figuring out what phone calls I need to make in order for that to happen.

To all the mama's out there who have suffered from postpartum PTSD-you are not alone, if it is affecting your daily life, please seek help, if you feel like you are out of control, please get help, if you feel alone, please get help, if you just want help, please get help!  Cowboying up is not the answer.  I didn't seek professional help but I did get a lot of help and support from my husband, family, and friends who knew the whole story.  Without that support I probably wouldn't have been ok.  Also, if you have even the slightest hint of postpartum depression or postpartum anxiety--Please get help.  These things are real, our hormones are insane, especially during the 4th trimester, it is not your fault and whatever you are feeling is real but just because you are feeling it and it is real doesn't mean you should suffer.