Every Baby is a New Beginning
Magnolia, Texas, USA
From: New Beginnings, Vol. 29 No. 4, 2009, pp. 23-24
When I was pregnant with my first child, I was sure I wanted to breastfeed, but less sure that it would be simple. As it turned out, I needn't have worried. When the midwife picked Patrick up after his birth, he opened his mouth big and wide, ready to latch onto her nose! With such a willing nursling, things went smoothly and Patrick breastfed until he weaned naturally during my pregnancy with his younger sister. From that experience I learned that babies were born to breastfeed.
I was convinced that my years of breastfeeding experience and my accreditation as a La Leche League Leader would give me immunity from any future breastfeeding problems. Imagine my surprise after my daughter Sarah's birth, when her tiny mouth didn't seem to be a good fit with my large, flat nipples, which became excruciatingly painful, cracked, and bleeding. With time, patience, and more than a few tears (along with some help from one of my LLL co-Leaders), we worked things out. Sarah continued to nurse until she weaned herself a few months before her younger brother was born.
From that experience I learned why mothers who plan to breastfeed sometimes don't. Without the confidence and knowledge from my prior breastfeeding experience, I would very likely have given up breastfeeding in the face of such a painful start.
Planning for my son Eric's birth, I felt I was ready for anything. I knew how to be proactive about addressing nipple pain early. Indeed, my experience starting breastfeeding with Eric proved to be a middle route between my two other breastfeeding experiences. For his part, Eric was an avid nursling who packed on eight ounces a week from week one. The challenges I had while nursing him came later.
When Eric was a little over a year old, I was diagnosed with an autoimmune kidney disease. This condition caused me to develop high blood cholesterol, hypertension, proteinuria, low potassium, and anemia, in addition to damaging my kidneys. The worst health crisis came in the form of a stroke, since the disease also caused my blood to coagulate more than was normal. Mercifully, I recovered readily from my stroke and continued to breastfeed through that time and despite being on several medications.
When Eric was three years old, the doctor wanted to change me from one immune suppressant drug, which was compatible with breastfeeding but was itself damaging to the kidneys, to another that was better for my kidneys, but not compatible with breastfeeding. It was with great sadness that I had to explain to Eric that because I needed to take "yucky medicine," we wouldn't be able to nurse any more. Fortunately, he was mature enough to understand, and we made it through the transition together. From that experience, I learned that not all breastfeeding challenges are in the early days and weeks, and that weaning can indeed be undertaken with respect for a child's needs and capabilities, even when it is sooner than he (or his mother) freely would have chosen.
My serious health problems, combined with the fact that I wasn't getting any younger, made it seem like my breastfeeding days were probably over. However, my health did gradually improve, and one by one I was able to stop taking my various medications. Finally, my nephrologist pronounced me in remission. We were still not seeking pregnancy (though maybe dreaming of it), so it was a great surprise when I learned days before my 40th birthday that I was expecting again.
Due to my complicated health history, we planned for the worst and hoped for the best, closely monitoring my blood pressure and proteinuria for any dramatic rises. I hoped to be able to avoid returning to any medication after the birth that might interfere with my being able to breastfeed. After a busy week crammed with my baby shower and about as many medical appointments as it is possible to schedule in a five-day period, I was ready to settle in and await the arrival of my baby, due in three weeks. Waking up to wet sheets, I soon discovered that my baby had no intention of allowing me the luxury of nesting. My water had broken, and within the hour, contractions started. I hadn't yet packed my bag. Since my labors tend to progress quickly, we didn't spend much time at home before loading up the whole family for the drive to the birth center, where baby Mark was born a little over an hour after we had arrived. While he didn't care to latch on immediately after birth, I knew that if I kept him close, soon enough he would show his interest.
As the midwife and nurse bustled about, they began to grow concerned. Despite his healthy size and general vigor, Mark's breathing didn't sound "right." We couldn't elicit a hearty cry from him. The midwife left to consult her medical support and I was finally able to tempt my baby to latch on and suckle at my right breast. Then the nurse returned and told me to stop breastfeeding. She had an oxygen tank and tube to blow oxygen into Mark's nose. An ambulance transported my baby and husband to the hospital.
As soon as I could, I followed them. Mark had a severe problem with either his heart or his lungs and was transported by a special team to Texas Children's Hospital in Houston. My husband and I followed in shock. The doctors there explained to us that while our baby's heart was well, his lungs were not. In addition to some hyaline membrane disease, our son suffered from persistent pulmonary hypertension of the neonate. His condition was serious and we had to sign papers giving permission for him to be placed on a heart-lung life support machine if it worsened. After that, I had my first date with a hospital grade breast pump. We went to sleep that night not knowing what we would find in the morning.
Little Mark proved to be a fighter. Overnight his condition stabilized. As days passed, he progressed from the high frequency oscillating ventilator, to a regular ventilator, to a nasal cannula, and finally to room air. While at first he was only fed intravenously, after about a week he began to be fed my expressed breastmilk via a naso-gastric tube, in ever increasing quantities. What a happy day it was when I was finally able to hold him again in my arms and happy were those rare times when we were allowed to practice "non-nutritive breastfeeding" for a few minutes. Meanwhile I pumped eight to ten times a day around the clock to collect enough milk to feed him and to establish my supply for the day when he would be able to feed at the breast. On dark days, I sustained myself by remembering his one time at my breast after birth and by imagining him as a happy toddler in the future.
When Mark was 17 days old we were able to move to a more local NICU so that he could be monitored while weaning off of narcotic medications and learning to feed orally. The hospital's lactation consultant was encouraging about that process and tried to reassure me that Mark would be able to learn both to breastfeed and to bottle feed (the hospital insisted on beginning nutritive feeds with a bottle and in bottle feeding him through the night). She recommended some breastfeeding-friendly bottles that I could purchase to use instead of the ones supplied to the hospital by the artificial baby milk manufacturers. I decided that I would do whatever it took to get him home sooner and that we would work out any breastfeeding problems caused by the bottles at that point.
Since I hadn't bottle fed any of my children, I was pretty clumsy at it. The hospital nurses were more practiced hands. During the daytime hours I would feed him at the breast on demand. At home at night, I would pump my milk and the nurses would bottle feed him. Finally, 26 days after his birth, I brought my baby home. I unplugged the rental breast pump and packed away the bottles for good.
Feeding exclusively, on demand, and around the clock at the breast was a change for us both. Nearly four weeks into his life, we went through those awkward first couple of weeks that a nursing pair often experiences right after birth. Freed from the restrictions of the hospital's three-hourly feeding schedule and thanks to the plentiful supply established by my pumping, Mark made up for lost time, gaining an impressive ten ounces a week for the first several weeks home. I was amazed that despite painful, orally invasive procedures, narcotic medications, and the introduction of bottle feeding before breastfeeding, Mark was able to transition so well to feeding at the breast.
Mark is now nearly two years old. He is that happy toddler I imagined during the long, lonely hours in the NICU. And he is still breastfed. I have remained well, and I have not had to return to using any medications. All signs point to Mark being able to nurse as long as he and I mutually desire.
And what did I learn from this last, and most challenging breastfeeding experience? I learned that with determination and hard work it is possible to breastfeed in the face of substantial medical challenges. I learned to take nothing for granted -- not my health, not my child's health, not breastfeeding -- but to appreciate them all as the miracles that they are. I learned how much breastfeeding means to me and to my family. And I learned that every baby and every breastfeeding experience is unique and represents a new beginning.