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The milky way is a rocky road

I have nursed nine children. Leave it to the ninth to turn everything I believed and practiced upside-down and inside-out. I have been humbled by nursing Oliver and he’s not quite three weeks old. It’s proof, once again, that pride flounces and the fall sticks out her foot.

Oliver is my third baby born at 36 weeks. My two earlier-early birdies were Beatrix and Archie. Beatrix nursed well from day one, despite her surprise early arrival and 6-pound-size. Archie nursed like a champ once he was released from the NICU. He had collapsed lung, which healed rapidly. I pumped milk for him which was fed through a tube threaded into his button nose and down his throat. We had to do this for a few days. When he was strong enough, I tried nursing him and he took to it immediately. Duck to water, pig to mud, dog to trash can.

But little Oliver has struggled from the first moment I introduced him to my milk. He was and is small. He was born via c-section. He was early. All of these are strikes against a strong nursing relationship but I believed none of these things would apply to us. Why should it? I brought 15 years of experience to the table.

While still flat on my back in the recovery room, I was told Oliver’s glucose would be monitored before every feeding for at least the first 24 hours. They cited his size and age, along with a “protocol” the hospital adopted regarding situations like ours. I was okay with this. I was also told after each nursing session, I should pump to encourage my milk to come in quickly. I mentioned with my last several babies, my milk arrived by day two. I’m not sure they believed me. Pat on the hand, just pump, mama.

Another recommendation was for us to supplement these feedings with formula delivered by my husband via small syringe and a gloved finger. He was to stick his finger in Oliver’s mouth while slowly squirting formula into his little cheek. This would encourage a stronger sucking mechanism and give him strength to nurse. The theory: He needed calories to be awake and have energy to nurse, which is tiring for early and little babies. This made sense to me. Also, anything I managed to pump would be fed to him via syringe as well.

I was very proud when my first attempt at pumping for him produced 1cc of colostrum. The lactation nurse clapped and told me there wasn’t another mom on the floor who could do that. I think that’s when pride smiled her widest and wickedest. This is going to be so easy, I thought.

But he struggled to latch. Once latched, he fizzled out immediately. It was hard to watch him eagerly slurp the formula from the syringe. But I kept telling myself it was working to make him perkier and stronger. Right? The good news is his glucose tests were all well within normal.

The nurses could tell I was growing more frustrated so they introduced me to nipple shields. I had heard of them. They were for women with flat or inverted nipples, which is not my situation. But they felt it would give him something more to latch on to. I was surprised it looked like a little traffic cone. Or a witch’s hat. Or something Madonna would cover in gold glitter. I began plotting what I’d do with my nipple shield once I was done with it—and that had to be soon, right? The first time I used it, the nurse squirted a bit of formula inside the hollow space. Oliver latched on and ate well. My hopes were restored! He would stimulate milk to come in. Soon, he wouldn’t want formula or need formula and everything would be fine.

Our routine became: Apply the traffic cone, work to get Oliver latched on. Feed. He passes out. I hand him to dada, who syringe feeds. I pump. Repeat every two hours around the clock.

But I wasn’t resting. At all. I was loopy from exhaustion. One of the nurses suggested a new approach. Why don’t I try the SNS? It stands for Supplemental Nursing System. It would stimulate milk production AND give him formula at the same time. I thought about it for a few minutes and then decided to give it a whirl.

What is a SNS? It’s basically an upside-down bottle you can fill with breastmilk or formula. You clip it to something like a pillow behind your head. The milk runs down a very thin, flexible silicone tube which is taped to your breast. In my case, the end of the tube was threaded under the nipple shield. Oliver latched on to the nipple shield and drank my milk (theoretically) and formula at the same time. It was very awkward, very messy, and very frustrating. I couldn’t feed my own baby without someone assisting somehow. The little tube would sometimes pop out, leaving us messy and wet. I couldn’t wait for my milk to just COME IN. All our issues would magically disappear. I asked friends to pray for my boobies.

My friend, M., asked if she could skip the laying-on of hands part. I said yes.

And then, Saturday night! It was late on Oliver’s Day 2. Just like I told the skeptical nurses, my milk came in.

My husband and I were watching the British version of “Death at a Funeral” which he set up on his laptop. I had Oliver at my chest, rebelliously nursing him without the contraptions. Suddenly, I realized I could feel liquid pouring down my abdomen from the opposite side I was nursing. My milk was in! I was so happy!

I told the nurse, who was happy for me! We would try nursing him without all the awkward business. Now that he could get the good stuff, we could back away from supplementing so much. By Sunday night, he was gaining weight. There was much celebrating. On Monday, we went home from the hospital. The lactation consultant stopped by and said how pleased she was with how everything worked out. Me, too. Pride.

Two days later, we took Oliver to his first pediatrician appointment. He was weighed. He lost weight—two ounces—which could easily be explained by an ill-timed poo and pee. Citing our experience and my previous nursing prowess, we were told to come back in five days. Surely he’d be up. But I was bothered. He was still extremely lazy and extremely tired. It was work getting him to latch and feed, even though my milk flowed like a river. I thought I’d try the nipple shield again, just to give him an extra boost.

He began feeding better with the nipple shield. I wasn’t happy because it’s messy, awkward, and I don’t feel comfortable using it in front of people. I was slightly optimistic because I figured we were turning things around. Five days passed. We took him to the doctor. I placed him on the scale, expecting to smile. His weight had stayed exactly the same. I was crushed. What was wrong with me?

The PA was so sympathetic. With tears in her eyes, she put her arm around me and said it was time to supplement with formula. Just one ounce after every feeding, just to give him energy and calories so that he could get bigger and become a better nurser. She said it was no reflection on me. I KNOW this, but it was hard to swallow. I don’t believe formula is poison or evil. Many of our kids drank formula, but they were much older.

I believed one thing about myself—I was a professional awesome nursing mama who could fatten up a baby in the blink of an eye—only to be faced with the fact that wasn’t me. It sounds stupid and prideful, but I’m being honest. We were told to come back in two days for another weight check.

We went home with three cans of formula. I nursed him. We cracked open a freebie Avent bottle I got from Motherhood Maternity early in the summer. Oliver nibbled at it a bit. He ate about a half-ounce and passed out. We had a terrible time waking him that day to feed. He seemed more tired than usual and he seemed irritated by the bottle.

The next day, we went bottle shopping, settling on Tommee Tippee. The flexible ribbed nipple seemed like a good idea. Thankfully, he took to it right away. He chugged his formula, nursed longer, and seemed more perky. And at his weigh-in (I swear I heard a timpani drumroll before I placed him on the scale) he gained 6 ounces! I was the happiest mother in a 459 mile radius. At least.

Cheeks

This is where we are: I am nursing Oliver, using a dumb nipple shield because he won’t latch on without it. I hope to train him away from having to use it because it is not travel or NIP-friendly. He drinks about 2 ounces of formula after every feeding. This drags out feeding time to epic lengths, but I know it’s not forever. Oliver is finally gaining weight. It’s visible. His preemie clothes are getting small. He graduated from preemie diapers to newborn. We have another weight check today.

I have no idea what the future will bring. My goal is to work back to 100% nursing and no formula, but if it doesn’t work out that way I know it’s not a reflection on me or on him. Making sure he is growing well and gaining strength every day is chief in my thoughts.

I welcome any advice regarding ditching the nipple shields and weaning him off formula without endangering his weight gain. I do not welcome second-guessing the hospital experience. That’s milk under the nipple shield. Gone. I’m focused on the next feeding, the next, and the next, all the way up until when he’s 16 and I watch him devour an entire pizza.

We will get there.

15 comments to The milky way is a rocky road

  • I had to use nipple shields with both my kiddos, because they weren’t latching properly and it was causing incredible pain and no milk to flow. I’m afraid I don’t have any advice for getting rid of them, we just kept letting the kids try bareback each time after the milk got flowing and eventually we all got the hang of it.

  • What a great post, Gretchen! Yay for gaining weight! (if only that sentiment applied to all of us…)

  • I don’t have any advice for you, but I do want to say “good for you!” I am glad that you didn’t give up, it will get better.

  • I feel for you Gretchen. I can totally relate to what you said here:

    I was a professional awesome nursing mama who could fatten up a baby in the blink of an eye.

    I hadn’t considered it until reading your post, but I felt pride when I think about how fat my babies got so quickly on my milk and that it came so easily to us. If I had another baby and it was a struggle, it would be a blow. Yes, I would know in my head that it wasn’t anything I was doing wrong, but my heart and pride would be hurt. I guess I say this to comfort you that it’s understandable to feel that way (or at least I would feel that way too) and it is NO reflection on your mothering skills or abilities. Oliver will grow and eat, and eat, and eat 🙂 and you will find the rhythm that works for both of you. You are a great mama! O is very lucky to be part of your family.

  • Jo

    My darling friend, you are doing the best thing for your entire family. So many people don’t listen to professionals – they doubt every word, and suffer. I respect your desire to do what you did with all the others, but also I admire your courage and respect for the professionals who are trying to help. I am so glad you appear to have medical people who understand the impact these decisions have on you as well as Oliver.
    Meanwhile, perhaps now it’s time to get access to the La Leche League? I know, weird because you’ve never really needed them in the past but now you have some questions that they will have dealt with. Also, I’m going to get you to speak to a BF counsellor I know. She will be familiar with this too.
    Plus, stop beating yourself up and see what we all see – you are an amazing mother, doing the best for your family. Love you Gretchen!

  • JoAnn

    Hey Gretchen, Brandon and I had to use the nipple shield for the first weeks. I really can’t remember. I didn’t have a need to NIP, but I know it would be not possible.

    I think after Brandon got older, he did latch on. I don’t want to scare you but I think it was around 8 weeks. The worst part about the nipple shield for me, (not being able to NIP wasn’t it) was having to pump right after the nursing session….it was such a PIA. But nursing with the shield on doesn’t keep that milk bountiful.

    Good Luck! He will get there. He will! This too will pass, I just know it.

  • JoAnn

    But one good thing, I had oodles and oodles of bm in the freezer.

  • amyptucson

    My anti-spam word was “gentle,” and I am glad that you are being gentle on yourself through this experience! You are being a great mom to Oliver. That has not changed!

  • Kristy

    You are a great mama!

  • I’ve been supplementing with formula for Delaney since she was 3 days old. It’s not ideal to have to take the time to nurse and then bottle feed – it really does seem to take forever – but it is becoming more routine and easier with everyday.

  • Katy

    Gretchen,

    I’ve been reading your blog for a long time, but I rarely comment. This post really hit home for me. My first son also had a very hard time beginning nursing. I feel for you. It is so stressful and emotionally draining. We didn’t receive adequate support while in the hospital and were sent home with a baby who could not latch on. We ended up supplementing bottles for about a week all the while struggling to get my sweet boy to latch on at every feeding. Finally, I decided we needed help and we went to see a lactation concultant. She wasn’t able to get him to latch on either. So we used the nipple shield. That did the trick. I don’t remember exactly how long we had to use the shield. I know it was at least 4 weeks. I weaned him off of it by using it to get him to latch on. Then, once the milk was flowing I would take it off and he would then be more eager to nurse with the milk already flowing. We had to do this for about a week before he didn’t need it to latch on anymore. Hang in there he will get the hang of it.

  • Amy

    Oh, Gretchen. I feel your pain!

    My boy wasn’t early but he had trouble gaining weight too. He dropped 6 oz. of his 6 lb. 6 oz. birth weight in just three days and had to be hospitalized. I remember feeling so inadequate and horrified to realize that my baby was literally starving under my watchful eye. The stress of the situation killed my milk new supply and I was faced with the reality that I could only produce a few drops of milk per feeding.

    The lactation specialist at the hospital swooped in and saved me. I started pumping every few hours around the clock. Any milk I produced was fed to my boy along with formula. Lots of formula. I remember feeling like a cow, a milk machine during those first weeks. My entire life consisted of pumping and feeding, pumping and feeding. It was exhausting.

    I kept up this routine for 8 weeks. I probably could have stopped sooner, but I liked being able to see exactly how much my boy was eating. Since my boobs didn’t have a milk gauge, I looked at pumping as a safety net.

    By his 2 month checkup, my boy was round and healthy. Any health concerns I had in those first few weeks were gone. He was thriving. My milk supply was more than plentiful (it’s amazing how much milk a body can produce when pumping is involved). My heart felt at peace so I decided to ditch the bottles and give the whole breastfeeding thing another shot. He took to it immediately and that was that.

    My advise… Trust your gut instinct. I have a feeling that once Oliver gains a little weight, he will be nursing like a champ. His little body will start filling out and getting stronger and you will know when the time is right to try and ditch the pumping/bottles. Also, pumping is a great way to beef up your milk supply, but it is rougher on your body than regular nursing. Don’t be surprised if you start to feel a little sore. The good news is that any discomfort goes away as soon as you stop pumping. 🙂

  • ali

    I had a terrible time nursing my first born (a lot of tears were shed). She couldn’t latch so we used the shield. No matter how hard I tried I couldn’t ever get her to nurse without it. We kept it up for 7-8 months until we switched entirely to formula. Unfortunately I think it really hurt my milk supply. I worked full time so I could pump a fair amount during the day but she didn’t get much when she nursed. By five months we started supplementing because she was still only 11 pounds (7.2 at birth). I think you have to pump if you use the shield because it doesn’t stimulate as well. It is hard and exhausting, but I just reminded myself how good every drop was for my daughter.

  • Oh my first and last… worst nursers in the world but we prevailed… No excuse for both of them except the first one just didn’t know how!!! Couldn’t latch, wouldn’t latch… took a month of nursing, failing, expressing, papa with teaspoons, papa with a syringe and finally papa holding the syringe while he sucked it out… he finally nursed but it was always a “no distractions, dark room” kind of guy…. we made it through. Number 8 was a nightmare of flaying arms and screaming… seriously everyone else I nursed anywhere and he would make out like it was total murder… would have none of it for the first three days… couldn’t go anywhere for weeks… until he would latch flay and feed with out all the screaming… He still flays around like “now is the time for aerobics” but it is our last year of it and only at bedtime – so we have prevailed – but we have never had one of those peaceful “mother-baby nursing” kind of images ever with him!!! I wish you all the very best – I know it is so hard, especially when it has been such a breeze with others before!!!! Hugs across the ocean!!!

  • I love him! He’s awesome, Gretchen!!!! CONGRATULATIONS!

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