3 month update: Breastfeeding

I always knew that I would breastfeed. The nutritional and immunological benefits of breastfeeding can't be beat by something that modern science can create. But I definitely had some concerns about the realities of breastfeeding.

Before E was born, I was simply hoping that I would make enough milk for him. I was hoping that he would latch properly and get all of his nutrition at the breast. However, plans had to change when he came so early. Plans had to change immediately. We did not have the chance to do skin to skin due to his prematurity. He did not latch within the first hour as I had hoped. Finally, he was given a bottle of formula before I even made it to the NICU to see him.

first bottle

I was brought a pump in my recovery room and given some basic instructions to pump for 15 minutes every 2-3 hours. With a baby in the NICU, pumping every 2 hours was impossible, I never would have been able to see him. I pumped for 15 minutes every 3 hours around the clock the entire time he was in the NICU. Nate brought my pump to Las Vegas when he flew out, so I used that in the hotel room at night, and I used the pumps at one of two pumping stations they had in his pod in the NICU. I struggled initially with cracked and bleeding nipples, but had purchased some lanolin which Nate brought to me too. I was told that a little blood in the milk was ok, but I would pump about half an ounce and dump it if there was blood in it because it would stop after letdown. My nipples stopped bleeding and I stopped using the lanolin long before we headed back home, maybe after the first 5 days. However, it was uncomfortable to wear breastpads that stuck to the bleeding and cracking and then have to peel them off to pump. They mixed my milk with formula for 3 days until I had enough for a full feeding.

bottle feeding expressed milk in the NICU

Later in the NICU

I have since read that during the first 6 weeks after birth, your milk is essentially controlled hormonally, but after that is controlled by supply and demand. My hormones must have been telling my breasts that I had 5 children to feed because when my supply came in on day 4, I was constantly engorged for the next 3 weeks or so. I pumped colostrum only for the first 3 days, then produced yellow milk for about 5 days, then pumped appropriate fore and hind milk from then on. However, I pumped it in unheard of quantities. I could pump 6-8 oz every 3 hours when E was eating less than 2 oz ever 3 hours. So I brought my milk to the NICU and they stored it in their freezer and refridgerator. It was always their preference to use fresh milk, so they would take a bottle from me and freeze the remaining 2-3. They provided little plastic bottles that hold 2 oz of milk each. When we left the NICU on day 10, we bought a cooler and some ice to travel with the milk, but I could not believe how much they had in their freezer that we had to bring home! Unfortunately, my milk thawed on the ride and because it has to be used within 24 hours after thawing, I could only save about a dozen bottles that were still frozen, and ended up dumping out about 30 more bottles (that's 60 oz of wasted milk that I spent hours pumping!!!).

half of the milk I had to dump

Milk down the drain

When we got home, we continued bottle feeding the milk I was pumping for the next 4 days. Then I decided to try to breastfeed. Ethan had not latch up to that point. I had tried 2 times to breastfeed in the NICU, but we were encouraged to bottle feed him to get him out of there faster. He had only had an artificial nipple up until then. I really felt that my nipples were flat so I purchased a Medela contact nipple shield to try. Voila! he latched to that nipple shield like a pro. The only issue I had was my oversupply and overactive letdown. I had a fever and very sore breasts and back that whole day. I had to stop breastfeeding and pump to be anything close to comfortable. I called the local lactation consultant but got no response, so I contacted the local La Leche League and the leader said she'd come over the very next day. She confirmed my suspicions of flat nipples and recommended the nipple shield. She also confirmed my oversupply and overactive letdown. She recommended pumping after feeding and leaning back when breastfeeding.

[I had a very cute picture of his first latch here, but the husband vetoed it being on the blog]

After that we exclusively breastfed, no more pumped milk in bottles. I'd feed him for 15-20 minutes and then pump for another 15. Then I'd change his diapers, put him down for a nap and start over every 2 hours. I went from pumping 10 oz after feeding him, to not needing to pump at all, but it took nearly 3 months. Somewhere around 2 months, he went from a two hour schedule to a 3 hour schedule and right around 3 months he started sleeping for longer periods at night and now skips 2 feedings. He went from eating 12 times a day to eating 6-7 times a day.

At 15 weeks, I went back to work and back to pumping. I started pumping the weekend before to make sure that I wouldn't suffer a drop in supply. Currently my schedule is to breastfeed at 1 AM, sometimes 4 AM, and 7 AM, then Nate bottle feeds at 10 AM, 1 PM, and 4 PM, while I double pump at home at 7:00 AM after he eats then at work at 10:30 AM and 2 PM, then I breastfeed at 6 PM and 8 PM. We still use the nipple shield at every feeding.

dad's feeding him again when I'm at work

Breastfeeding on the couch this week

Here are some of the things that I have learned are absolute musts/must haves from my own personal experience that I never heard or read about before. I am not being compensated for promotion of any of the things below, they are simply the things that I have found to work and or love:

1. I keep a supply of white washcloths (about 20) that I bought at sam's club next to where I nurse. When I pull down my bra, I tuck an new dry one into my bra before each feeding. It catches anything that leaks (which is sometimes a lot) and then I use it as a burp/spitup rag. My oversupply leads to a lot of leaking during feeding and sometimes 2-3 oz of spitup. Sometimes, when Ethan turns his head he will pull off the nipple shield and I spray him in the face, the washcloth gets use then. The washcloth also protects my clothing (most of the time). They can be bleached clean and are cheaper than anything else. I have to wash all of them every 2-3 days. I toss them in our tub when they are dirty so that they can airdry. The milk and spit up will turn moldy if put into a hamper or really anywhere else.

2. I nurse in the same chair next to a nightstand in our room. I had set up a station in his room too, but only use it to read a story after I change him and put him in his PJs. Our room is just much more convenient. My pump sits there, the TV remote and my phone are all right next to me because I never know how long I will be there. I also keep a coaster for a drink and nail clippers for E's little daggers that need to be cut every 4-5 days or so. It would be nice to have a glider, or even just a footrest, but I have done without these things thusfar. The washcloths are int he drawer of the nightstand. I can not nurse in anything but the cradle hold, cross cradle, football and sidelying do not allow me to tip back and slow my letdown. So this chair works just fine. Also, I had to use a boppy initially, but now can do without as my arms are a little stronger. I usually do have it though. A boppy with a watterproof cover is also a must. I have two and I keep one for nursing and one for propping him during tummy/mat time.

3. Nursing pads are a must, but most of them suck. I had bought a dozen cotton reusable pads to use for nursing. They all sit in a drawer. Initially I leaked all the time and would let down at random times, like in walmart when I saw another mom with her baby, or when I rolled over in bed. I would leak right through those cotton pads because they did not have any backing protecting my bra and shirt. I immediately switched to disposable pads, which mostly also suck. I've tried most of the brands at walmart and walgreens and finally settled on Johnson and Johnson pads. They are the right shape, size, contour and absorbancy for me. Unlike Medela, lansinoh, nuk, avent and most of the others, they are not folded and glued to shape a cupped breast, but rather already cup shaped. All of them have a sticky pad on the back that is totally worthless, I don't even pull off the paper anymore before I put them in. I have stopped leaking during the day when I double pump, however, I still let down on both sides when I nurse E and must have a pad in place to catch the excess. I have seen the things that catch and let you use the extra milk, but that continues to encourage letdown on the opposite side. Buy a small supply of a variety of different brands to find what you like if you need to use nursing pads.

4. Pumping also sucks, but my life has been made so much easier since I bought a new invention called a Freemie. It attaches to my Medela pump, but instead of the traditional horn and bottle design, a cup fits around the horns and valves and catches the milk. This allows the whole thing to be inserted into a traditional bra and be used hands free. I also think they are easier to clean and fit better into my pump bag. It wasn't absolutely necessary when I was pumping at home, but back at work, I can sit at my desk and pump without removing or lifting my shirt. Also I can continue to work!

5. Co-sleeping has saved my sanity. I like having my baby close to me. I want to be attentive to his cries and able to comfort him. I also don't want to trapse across the house to check on him or get him. Initially we co-slept in the form of room sharing. We had his bassinette/co-sleeper in our room but not against our bed. I now have the co-sleeper tied to our mattress up on leg extensions. It would be nice to be able to just pull him into our bed to nurse at night, but I have to get up and go through the routine of the nipple shield and the washcloth.

 I wanted to document where we were 3 months in, but I also hope that some of our experiences help someone else. I hope to keep this up at 3, 6, 9 and 12 months.