Tina M. Bremer
Ramrod Key FL USA
From NEW BEGINNINGS, Vol. 24 No. 3, May-June 2007, pp. 112-114
Nathan was born by a scheduled cesarean on July 21, 2006. My first boy and last baby to complete our family, I was delighted and relieved when he latched on beautifully after his birth. His suck was unusually strong and, for the first two weeks after his birth, I pampered my nipples.
Two days after Nathan's birth, we were discharged from the hospital. Although he was slightly jaundiced, the pediatrician was not deeply concerned and she recommended that my husband and I bring Nathan to the office should we become concerned about his condition. Three days after our hospital release, we were worried that his skin was yellowing even more, so we brought him into the doctor's office. The doctor reassured us that Nathan was fine, but it was the nurse who showed concern for his weight. His birth weight was seven pounds, six ounces and at this first doctor's visit at five days he only weighed six pounds, 14 ounces. Aware that all babies lose some of their birth weight, I was not worried. In fact, we left the office confident that Nathan's jaundice would go away on its own and that he would exceed his birth weight at his two-week checkup. What transpired after his two-week checkup proved to be an exhausting struggle for our family.
At Nathan's two-week checkup, he weighed seven pounds, one half of an ounce. Kris (my husband) and I were surprised. "How are you feeding him?" the pediatrician inquired. "I'm nursing him around the clock, every two hours. He nurses all the time." I replied. I further explained that I nursed him on one side until he was contented and then nursed him on the other side at the next nursing session. It was a nursing style that worked well for me with my two daughters and it was how I nursed Nathan. The pediatrician, concerned that supply was an issue, suggested that I nurse him on both breasts at each session. She wanted to see him weekly for weight checks until he regained his birth weight. I began nursing from both breasts at each session and even took it a step further should I really have a supply issue. For a few days I began switch nursing just to ensure that my milk supply was up. (Editor's note: switch nursing is when a mother switches breasts two or three times during each feeding.)
I increased my supply and Nathan was still nursing every two hours. At his three-week check up, he weighed six pounds and 15-and-a-half ounces. I was crushed. Our pediatrician suggested I consider supplementing with formula to try to get his weight up quickly. Although I understood that his gaining and losing weight could mean something was wrong, I did not want to supplement with formula. It was then that our pediatrician put me in touch with someone in my area from La Leche League.
"I just had a baby myself, but you are welcome to stop by my home," Eva, the Leader said. I went to her house, explained what was happening, and she observed Nathan as he suckled at my breast. "It looks good. His latch-on seems fine," she said. She inquired how long my daughters nursed and I explained that my first daughter nursed until she self-weaned at 19 months, and my second daughter was three-and-a-half years old when I weaned her from the breast. I weaned her seven months before Nathan's birth only because breastfeeding was painful during pregnancy. With that said, Eva was perplexed. She suggested I continue nursing him every two hours and to continue switch nursing to keep my supply up. She suggested I try pumping to see how much I could get and she also put me in contact with a lactation specialist, who I called a few days later.
Following Nathan's three-week checkup, Kris and I began taking Nathan to the hospital every other day for weight checks until his next appointment with the pediatrician at four weeks. In that time, his weight went from six pounds, 15-and-a-half ounces to seven pounds, one ounce. I had already spoken with the lactation specialist and she and I had arranged to meet so that she could help identify any obvious problems. It was at my four-week postpartum doctor's appointment that I was strongly encouraged by my doctor to immediately begin supplementing with formula. Both my OB/GYN and Nathan's pediatrician felt that too much time had lapsed without him gaining substantial weight and a can of formula was handed to me. I was devastated and I left both doctors' offices in tears. I never used bottles for my daughters, so I was not prepared. I went to a department store to purchase the first bottle for the formula I was to feed my baby boy.
Once home, I tearfully prepared the bottle of formula. I was deeply committed to breastfeeding my baby but, because his lack of gaining weight was presented as a critical issue, I felt that I had no choice but to supplement. At this time I had also cancelled the appointment with the lactation specialist because I felt hopeless. The bottom line was that Nathan had to gain weight with the formula. If he didn't, we knew there had to be a more serious health issue going on with him. The following days didn't get easier. I found myself crying every time I prepared and fed him a bottle. My world was turning into a nightmare and I felt myself slipping into a dark and empty place. My husband, fearful that postpartum depression could set in, encouraged me to reschedule an appointment with the lactation specialist. And because Nathan's weight had become an obsession for our family, we even purchased a baby scale to closely monitor his weight from home.
Rescheduling the appointment with the lactation specialist brought me much needed hope. After examining Nathan and finding nothing wrong with his mouth or tongue, she asked me to nurse him. His latch-on seemed right, his tongue was where it should be, and the movement of his jaw seemed fine, too. I let her know when I felt my milk letting-down and she continued to watch, nodding approvingly until she said, "There, he's not sucking." I described to her what his suck at that moment felt like and she asked me to take him off the breast. She inserted her finger into his mouth and found that although he seemed to be sucking strong at first, his suck continued to get weaker. Could he have a weak suck reflex? I latched him onto the other breast and again, Nathan did the same thing. When my milk let down he sucked strongly and enthusiastically but, a few minutes after my let down, his suck weakened and it was then that the problem was apparent. But as I found out later, his weak suck was only a small part of a much bigger problem.
If Nathan's ineffective suck was the cause of him not gaining weight, then my milk supply would be affected, too. The specialist hooked me up to a double electric breast pump and we found that my milk supply was dangerously low. She strongly recommended that I immediately begin pumping to increase my supply because the switch nursing I had been doing was not enough. Until I could obtain an electric double pump, all I had to work with was a single manual pump. The first week of manual pumping was exhausting, painful, and depressing. Between both breasts, I barely pumped half an ounce.
I began my second week of pumping with an electric double breast pump and I began pumping around-the-clock every two hours for 20 minutes. After several days and nights of pumping and growing increasingly frustrated with the small amount of expressed milk, the specialist encouraged me to rent a hospital grade pump. The difference between the hospital grade pump and the pump I'd been using was evident immediately. The rental pump was quiet. It also didn't hurt my already sore breasts.
However, after using the pump for a week, my milk supply was still very low. I was growing increasingly frustrated. The lactation specialist could not understand why my supply had not increased after several days of around-the-clock pumping. She encouraged me to keep going and to just be patient. Her reasoning was logical: it took four weeks to get to this point; it would take just as long to fix it. Through faith, countless prayers, and my husband's encouragement and support, I continued pumping despite the toll it was taking on our family and me. I was sleep deprived and exhausted because I did little else but nurse Nathan, feed him a bottle of formula, and pump. I maintained a daily journal to keep track of when I nursed, gave bottles, and pumped. I found myself constantly watching the clock and feeling tremendous guilt when something interfered with when I had to pump next. I kept in constant touch with the lactation specialist and by two weeks of pumping, I was only pumping 10 to 11 ounces of milk a day. The specialist agreed that my supply should have doubled, but it was nowhere even close.
While Nathan's intake on formula increased, the milk my body produced did not. Because I was pumping small amounts at each session, I began freezing my milk at the end of each day. The frozen supply in my freezer was growing and it was only then that I decided to begin using it. My "plan" was to use the frozen supply once I got my breasts to produce enough milk without having to pump religiously day and night, but that was not the case. So, when Nathan was eight weeks old, I defrosted enough milk for one bottle but sensed something was very wrong after I smelled it. It smelled "funny" and once I tasted it, I was filled with dread. I opened several more bags of frozen milk only to find that they all tasted worse than they smelled.
The lactation specialist explained that human milk contains Lipase, a natural enzyme that some women have too much of. It causes the milk to "sour" upon chilling or freezing, but she reassured me that my milk would not hurt my baby. But since I knew first hand how awful it tasted, I could not bring myself to feed it to Nathan. If I chose to continue my pumping quest, I would have to flash boil my milk before freezing it. It had been nearly four weeks of around-the-clock pumping when I made the sour milk discovery. With a heavy heart, I made the decision to stop pumping altogether.
My ambitious drive to give my baby the best that nature intended was crushed. I was physically exhausted and I found myself at the end of a hopeless journey. Everything I tried had failed. I felt deeply betrayed by my body, the very body that was capable of nourishing two babies before Nathan.
Nathan is now six months old and he weighs 15 pounds, six ounces. We continue to weigh him daily and I am still supplementing with formula. I am breastfeeding him, but only from one side because the other breast stopped producing milk. There are times when Nathan refuses a bottle and only wants to breastfeed. I cherish those times, few as they are. Although I know that he is not getting most of his nourishment from my milk, I know I am giving him something that no bottle or formula can compete with -- me!