My Feeding Story, Part Two: In Which I Finally Get Some Answers!
After the difficulties I had with nursing my oldest son, which you can read about here, I was determined to do what I could to have a more successful experience with my second. During my second pregnancy, I read several books about breastfeeding, attended a breastfeeding class, and joined several breastfeeding discussion groups on Facebook. I hoped that being armed with more information would help.
My son, Rhys, was born late one October night in 2014. I had spoken at length with my midwife about my breastfeeding concerns and she offered to allow me to stay at the birth center for longer than normal so that she could help us get off to the best start possible. Rhys was at my breast and nursing like a champ almost right away. He and I stayed at the birth center for two days, just the two of us most of the time, so that we would have some time alone to bond without any distractions. When I left the birth center we weighed Rhys again and he weighed exactly what he had at birth. My milk even came in on day 3 and I felt the let down and engorgement, which was a big change from my experience with Julian, so I thought we were off to a great start!
However, by the time I took Rhys to his first pediatrician appointment at 5 days old, I was a little concerned. His latch was very painful and I always had to flip his top lip open. He wasn’t having as many wet diapers as he should have. He had lost some weight, but only about 5%, so that wasn’t too bad.
I called an IBCLC who came out the next day. After weighing him before and after a nursing session, she determined he was not transferring much milk. She helped me work on Rhys’s latch. After examining him, stated that she thought he had tongue and lip ties that were interfering with his latch and didn’t think he would be able to really latch on well until those were revised. She provided me with some referrals to pediatric dentists who could do a revision.
Although Rhys’s weight loss was less severe than Julian’s, I was worried that it seemed like history was repeating itself. However, when Julian was born, no one ever mentioned any possible ties and I didn’t know enough to ask. I wondered if, perhaps, that was what caused the breastfeeding problems with Julian. Still, I wanted to wait until Rhys’s two-week appointment before deciding whether or not to do the tie revision procedure because if things improved, I wasn’t sure I wanted to put him through it. In the meantime, we nursed for every 2 hours for about 45 minutes to an hour. At night, he slept so much that I actually had to set my alarm to wake up and feed him, which seemed odd.
When Rhys had his two-week appointment, we confirmed that breastfeeding was definitely not going well. In the 10 days between his pediatric appointments, he had only gained 3 ounces. I spoke with the doctor about the tongue and lip ties and she agreed that they should be revised ASAP because he was not getting the amount of nutrition that he needed. I called around and found a recommended pediatric dentist who could see us that same day. Rhys had his tongue and lip ties revised at 15 days old.
After the tongue and lip revisions were completed, we had a short nursing session in the office that felt better to me. However, by that evening Rhys was completely refusing to latch! I was not prepared for a nursing strike, because in all of my research on tongue and lip ties, nothing ever mentioned that as a likely outcome. I called the pediatrician for advice, and she suggested I start pumping and bottle feeding as she thought he may need a little time to start healing and feeling better. I was really worried about switching to bottle feeding, because once I started that with Julian, he never nursed again. But I knew Rhys had to eat, so I decided to do what had to be done.
I started pumping and bottle feeding. I tried to nurse, but Rhys continued to refuse to latch. I didn’t know if he was in a lot of pain from the procedure, or it was too traumatic for him, but something had definitely changed. I was really upset. I had the IBCLC come back out and we discussed how much I was pumping, which at that time was about 12 ounces over a 24 hour period. She advised me that 12 ounces was not enough nutrition for him and that he had probably not been doing a good job at stimulating my milk supply due to the latch issue. She suggested that I should start to supplement with formula until I could get my supply up. She had no other advice but to continue to try and get Rhys to latch in the hopes that things would get better once he had healed. She said she was sorry we were going though this and that, sometimes, breastfeeding will not be successful no matter what you do. I didn’t get the impression that she was very optimistic.
I started the same pattern of pumping, feeding, and supplementing that I had previously done with Julian. I started taking all of the supplements and, luckily, had some left over Domperidone on hand. Over the next 10 days or so, my supply increased until I was pumping 5-10 ounces more per day than he was drinking. I started freezing the leftover milk, which was something I had never been able to do with Julian. I tried to stay optimistic and hoped that if I had to exclusively pump again, then at least I seem to have a large enough supply this time that I wouldn’t need to supplement.
I also decided to see yet another IBCLC, to get a second opinion. This IBCLC didn’t usually make house calls, but had her own store. I made an appointment and went in. We sat down and talked over my history. She observed me try and nurse Rhys (he refused) and she also examined my breasts. She sat down with me and stated that she was fairly certain she knew why Rhys had been unable to transfer milk and that it had nothing to do with his ability to latch or his ties. She stated that my milk ducts are spaced a little further away from the nipple than normal, and that a newborn’s mouth simply cannot open wide enough to reach them and stimulate milk production. She said she had seen this situation a few times before and that, based on her previous clients with this same issue, she was optimistic that Rhys would be able to successfully begin to transfer milk when he was between 6 and 10 weeks old. This is because after the growth spurt that occurs around 6 weeks of age, his head and jaw should grow large enough to reach the milk ducts.
We came up with a plan. I would continue to pump and bottle feed. I would try to get him to latch and nurse no more than once a day, because the experience of trying to force it was too upsetting for both of us. She assured me he wouldn’t forget how to nurse in that short of a time period. I felt much better! Even though I was exclusively pumping again and Rhys was going through a nursing strike, I felt I finally had an answer as to why this kept happening. And because we knew why, we could come up with a solution. I remember saying that I felt very optimistic and that I was sure that this difficult period was going to be just a short blip in our nursing journey.
I pumped and bottle fed for about another month. Right about the time Rhys turned 6 weeks old, he started to latch again without crying. And, bonus, it was no longer painful for me! I took him in for another visit to the IBCLC who observed our nursing. She said his latch looked great but we determined that he was still not transferring any milk. So back home we went for another couple of weeks of nursing, pumping, and bottle feeding. At 8 weeks we went back again and after weighing him before and after the feeding we determined he had eaten almost 4 ounces! Finally! I was so happy and relieved that I cried. Because I was nervous that it was a fluke, I rented the scale from the IBCLC for a week and weighed Rhys before and after every feed to determine how much milk he got. Thankfully, he continued to transfer appropriate amounts of milk at each feeding.
At 8 weeks of age, after a month long nursing strike and 6 weeks of having to exclusively pump, I put the pump away and we finally began to nurse exclusively again. The freedom of not having to pump was awesome. I was so happy that it had all finally worked out!
I will forever be grateful to the IBCLC who gave me answers, and real, unwavering support and encouragement. Without her, we wouldn’t have been able to do it. I wish that I had found her when Julian was a newborn, as I wonder if things could have been different with him if I had just had the answers. But it was not meant to be.
Rhys is almost two years old now and a thriving toddler! Although he is always busy, he is still a very active nurser and will sign for milk every chance he gets. I’ve been asked how long I plan to breastfeed him, when we are going to wean, etc. I honestly don’t have an answer. I’ll admit to fantasizing about night weaning him one of these days because he still wakes often at night to nurse, but I haven’t gotten to the point where I want to put in the effort to force the change. What I usually say is that I don’t see us stopping any time in the near future and that we’ll continue to breastfeed until it is no longer working for, or desired by, one or the both of us.
The lessons I’ve learned from my breastfeeding journey are many. I’ve learned that not all IBCLC’s are created equal, or have seen the same things, and if the IBCLC you see cannot help you, find another! And then find a third, if need be. It took two kids, three years, and multiple visits with at least 4 different IBCLC’s before I found one whose experience could finally give me the answers that I so desperately needed. Family and community support is vital to breastfeeding success. I’ve learned not to judge others for their feeding choices. We are all doing the very best we can for our babies and what is right for one family is not necessarily right for another. Breastfeeding is not all or nothing. #fedisbest