Friday, September 12, 2008

Breasfeeding Redux - Meeting with LC

On Thursday morning Baby Nurse and I took the kids to meet with the lactation consultant (LC). She weighed the two kids (Ned is up to 5 lbs 7.6 ounces and Penny is 5 lbs 15.4 ounces) and we discussed my goals. Basically, I want to BF the kids during the day, do a top off of breastmilk at their 9 pm "bedtime" feeding and for now (while Baby Nurse is here) have formula feed at their approximately 2 am feeding.

The LC recommended both going to breast at each feeding. We tried to work on Ned's latch but he wasn't very good on either side (part of the problem might be I'm producing quite a lot and it is hard to get him to open wide). They are both a disaster on the left side. It is frustrating but I managed not to cry as we struggled. The kids are totally not ready to be on at the same time. Until I can manage to get them to latch on both sides I'll have to feed one, then the other.

Of course the LC said they need 8-10 feedings a day. Currently we are doing 6 (6/7 am, 10/11, 2/3 pm, 6 pm, 9 pm and 2/3 am). I am fully prepared for doing more - but so far (on Day 2 of the breast feeding) they have only wanted to eat every 4 hours. It could be in part because I know I have lots of supply and I'm letting them feed pretty long while we practice (about 45 mins each). Penny is better at it than her brother. I do use the nipple shield on the left side with Ned but try to avoid it with Penny. We alternate each kid on a different breast at each feeding. The LC recommended 1 breast per day for the child (and switch the next day) but that actually doesn't make sense from a supply perspective and since I record the feedings I can certainly remember who goes where.

If either are "routing" or "cueing" after the feeding withing a 1 hour window (of when the feeding finishes) then I am supposed to give them a bottle and pump for a few mins (to keep up supply). We had to do that yesterday but 2 feedings in today we have not had to (probably because I let them feed for so long). I suspect once my supply decreases (since I'm not pumping after each feeding, just middle of the night) they'll need to eat more often - but hopefully for less time since our feedings take more than an hour and a half for both of them right now. I also sometimes try to put Ned back on (I seem to feed him first because we struggle more) with Penny on the other side to practice tandem and to top him off since he never stops routing after a feeding without a pacifier (which gets in the way of me figuring out if he is hungry).

The hardest thing is that Husband is not supportive about this. He doesn't like that there will be so many feedings and that we can't measure how much the kids are getting. I haven't told him this but it is conceivable that they'd lose weight while we are sorting this out. Husband also hates that it is stressful on me - which it is but I still want to do it. I asked him to give me 2 weeks to see how it works before re-evaluating. As Goddess mentioned in her post today, it is important that Husband and I be on the same page and that it is normal to doubt ourselves and change our approach. This "changing" drives Husband crazy - he doesn't like the experimenting. Part of me wants to push him and Baby Nurse out of the house for 2 weeks so I can figure this out on my own. It's not like Husband really has it impact him that much - other than seeing me upset when it isn't working well and they aren't feeding well - he's at work. I tried to explain that I'm supposed to be emotional and that this is best for our kids but he is doubtful.

Do I think that if we switched to bottles and kept with the four-hour Baby Nurse schedule I'd have more time for myself? Absolutely. But that isn't what I was looking for - at least not right now. We'll see if I feel differently in 2 more weeks.

I had Baby Nurse come with me so she could hear the recommendation. Of course she has her own opinions - and she likes the schedule/bottles but she agreed that it was what I wanted that matters. As I pointed out to Husband trying to feed one the breast, another a bottle, then pumping at each feeding after Baby Nurse leaves will NOT be as easy as feeding them both at the breast. Obviously this means there is less for her to do but she helps prep the kids, changes diapers, does the middle of the night feed and is generally there which I think helps me from going into any sort of post-partum depression.


Liz Jimenez said...

Gosh, reading this just takes me back and reminds me how daunting I thought those same recommendations were at the time. And I'm pretty sure I DID cry in her office when Daniel wouldn't latch. And I totally remember that feeling of sort of wanting to be on my own so I could just do it instead of dealing with everyone else's input. Though being solo was challenging, I actually found I liked just being to do my own thing without having anyone else in the way.

Husband, I get your reservations, I really do. As NICU grads, we were major mL-counters. "Ooh, did she take 40 instead of 45?!" Honestly. But I promise, this will pay off. It's stressful now, but if you put in the work, it will become a lot less hassle than bottles in the long run. And the way to alleviate Mommy Esq's stress is to just keep bringing her babies and food and water and make sure everything else is taken care of.

If you just run with the assumption that a fussy baby is a hungry baby for right now, and nurse whenever and wherever, your supply will be spectacular, the kids will gain weight, and things will become easier. Chuck the clock along with the pump, and just roll with it.

You're absolutely right: the one-breast-one-bottle-go-pump thing will go STRAIGHT out the window when the nurse leaves. Not only because you'll have fewer hands, but because the babies will be awake and more demanding of your time than they are now. Trust me, as someone who attempted a similar system. So while it's nice to have the help right now, you have to figure out some kind of system that you'll be able to replicate when the help goes away.

P.S. You're always welcome to come over for "playdates" at my house. Sometimes you just have to escape your own walls, and boobs are no problem... :-) And I promise not to let the dog lick your kids, even if she does it with love.

smirick said...
This comment has been removed by the author.
smirick said...

As a husband and father of 18 month old twins who were bf'ed until they were 1, I understand, to some extent, your husband's concerns. Bottles are a straight forward, controllable thing, and a way he can help with the feeding. Having you exclusively BF gives up some of that control, and limits some of his ability to help.

But - it's important to know that baby's are "designed" to BF. Assuming your kids are thriving and not still preemies, it doesn't matter if you can't measure how much they get - they'll let you know if they're hungry, and eat more. It's hard when you start, but as you, and the kiddos, get better at it, it becomes amazingly simple, and dramatically less stressful than mixing, packing, cleaning, sorting, and managing the bottles and mix. You'll get more supply, your kids will get better at it, and it will make everyone's life a lot easier.

If it's really hard, I'd suggest you get him to take a few days off, send the baby nurse away for a long weekend, and get it figured out together. I couldn't imagine having some stranger in our house when we were trying to get something new working. I bet that if you really try at it - and don't fall back on pumping, bottles, and formula - your kids should get it figured out by day 2 or so. They'll figure it out when they're hungry.

As for how he can help - When my wife was bf'ing our kids, my role was maitre d' - When a baby would cry, especially at night, I'd get up, change him/her if needed, and bring him in to Mom. I'd then snooze until he was done, and bring him back to the crib. By then, more often than not, the next kid would be hungry and we'd repeat the process. It allowed my wife to at least say in bed, and snooze a bit, and allowed me to grab a few winks in the 10-20 minutes it would take to feed the kid.

Oh, and if your Baby Nurse isn't supportive of you breast feeding, you might want to think about another nurse. You can do this. If this is something you want to do, she should make it easier, not harder.

LauraC said...

No advice here, just wanted to say I am really proud of you for saying what you want and standing up for yourself. People can give you loads of advice ahead of time but nothing truly prepares you for having a baby (or two). It is a long hard road and sometimes, you need to try something new, fail, and cry to understand why something works for you.

I ran into parents with 4 month old twins out to dinner last night. The parents ate dinner and talked to each other while their twins slept peacefully in the double snap n go. Me and Jon? We crammed food in our mouths and tried to keep Nate from throwing spoons, chased Alex who saw a friend and ran over to say hi, and spent a good ten minutes cleaning off the table.

This will be you soon! Eating while babies are peacefully sleeping and running into frazzled parents of older twins.

Anonymous said...

in today's world, it is amazing we get anything done with the amount of processing and planning and scrutinizing we make normal when it comes to mothering. You are doing great with just sticking to your instincts.....women have been successful at having babies for centuries and I believe that education mixed with intuition will get you exactly where you want to go. Stay the course on what seems right to you and your babies will be healthy and well adjusted for sure!

Anonymous said...

Goddess, thanks for saying what I was thinking. It bears repeating:

>If you just run with the >assumption that a fussy baby is a >hungry baby for right now, and >nurse whenever and wherever, your >supply will be spectacular, the >kids will gain weight, and things >will become easier. Chuck the >clock along with the pump, and >just roll with it.

Husband, I know you mean well, and you know I love you dearly, but you need to back off and just support Mommy, Esq. This is an amazing gift she is giving your children. You should unabashedly admire her commitment and tenacity. Many, many women would have thrown in the towel long ago, but she persists-- and she's doing an awesome job.

Mommy, keep up the good work. Little boys can be so lazy with their latches... Keep working with Ned and he will catch on, I swear it. Josh was almost 4 weeks before things began to "click" for him. By 6 weeks it was like we'd never had a problem. Just keep putting both of them on the breast as often as you can. The more they practice, the better they will get. I know 8-10 times a day sounds like a lot, but set up a couple of comfy spots (in your bedroom, on your couch) where you have the phone, the remote, books and magazines, snacks and water. Nap when they are napping and just nurse, nurse, nurse.

Call me anytime you need a phone-hug or some words of encouragement!

Anonymous said...

Kudos for sticking to what you want and what you believe! That's so-o-o hard to do when the ones around you are offering "advice" and opinions. Very much agree: just bf, sleep, eat and drink for awhile. Efficiency, doing other things, etc. just don't matter right now. You are doing great at a really challenging time. Way to go.

Nancy said...

I agree with everyone! (all the way from Goddess to my mom) You're kicking butt and should be totally proud of yourself.

No advice - just props :)

Eva said...

What you are doing now is so, so hard. But it sounds like you have a great attitude and you are doing what you need to do. While I was trying to establish breastfeeding with my kids I was exhausted and stressed out. And tandem didn't work for me until they were a fair bit bigger. But once the 3 of us got into a good routine, it really became so much easier, and I was so happy I stuck with it. You should be really proud of everything you've done so far!