Breastfeeding

The time has come to wean Sarah off breastfeeding. This is actually rather abrupt due to the requirement of myself needing to start medication to kill tuberculosis (it's currently dormant so I'm not contageous). Jonathan reminded me of some of the breasfeeding ups and downs we've had during these last 13 months or so. I realized I hadn't documented any of my breastfeeding woes and successes.

I did mention that after Sarah was born she seemed to latch on fine but that due to jaundice there were expectations that Sarah would feed often and quickly and she just didn't seem to want to be on that schedule. During our stay in the hospital the three days after she was born my focus was feeding Sarah. She was in the NICU so I was unable to practice changing her diapers, putting her to sleep, soothing her when/if she was upset, etc.

When we brought Sarah home, that first night was long (it's embarassingly comical now). I was basically irrational and super paranoid of harming her. Everytime I tried to put her down while she was sleeping, she would wake up. I ended up sitting in our recliner holding her the whole night. I wouldn't let myself go to sleep because of all the warnings that you could smother/kill your child if you sleep with them. I realized that in the NICU I never got to practice swaddling her and putting her to sleep because the nurses did that. Sarah always seemed more than willing to sleep in her little warming bed in the NICU. I decided that because I was having no luck putting her down to sleep I would just stay awake until the morning while holding my sleeping baby and then I would have my in-laws watch her while I slept. During this time the easiest thing was the breastfeeding. My milk seemed to have come in and I realized this was the only thing I practiced while in the hospital with her.

When she was a few weeks old, the metabolic doctors basically said my breastmilk contains the fat that could (in layman's terms) poison her cells and cause her to stop functoning and die if she has the disorder that she was flagged as possbly having by the NBS. I was told to stop breastfeeding and feed her the elixir. The elixir included some long-chain fats because the human brain requires it for development. Instead of using formula in the elixir I pumped, or expressed, my milk so as to keep my milk supply flowing because I was determined to breastfeed and I wanted to be able to still breastfeed if Sarah's NBS was a false-positive. I stored up lots of breastmilk in those days. Our freezer was stuffed with breastmilk (an overstatement, but it felt that way when the occasional solid bag of breastmilk would fall out on us when we opened the freezer door).

It was during this time that I had some emotional breakdowns because at that point breastfeeding was my most confident area of parenting. That was the thing I had down, and I felt like I was being robbed of it. I remember in particular watching the "First 5" video on basic infant care that was given to us when we left the hospital. Phylicia Rashad (the mom from the Cosby show) was on the video talking about the benefits of breastfeeding and how breastmilk was the best thing for your baby - I broke down because of the thought that my breastmilk could kill Sarah and it wasn't the best thing for her.

There was another time when Sarah was upset and I knew that breastfeeding her would calm her down, but I knew that I wasn't supposed to. It was during the time when I was supposed to alternate between breastfeeding and bottle feeding her elixir.  I can't remember exactly what the issue was but I was extremely upset and it ended with Jonathan just talking me into breastfeeding Sarah and it calmed both of us, Sarah and me, down.  I think it had to do with me once again fearing that by breastfeeding her, it could kill her, but feeling that breastfeeding was exactly what I was supposed to be doing. 

Due to the requirement that Sarah needed to eat every three hours and, later in her first year of life, every five hours, there were some stressful experiences when she just wasn't wanting to eat and so I would fight with her to eat.  The "fighting" looked like me basically trying to get my boob in her mouth and coaxing her to suck all the while she is flailing her limbs and turning her head away from the food source.  Those times usually ended with me giving up and figuring that she had enough energy to survive a little bit longer and I would just be aware that at the first sign of hunger she needed to be fed.  There were other times when she would bite me and so the breastfeeding session would end prematurely in order to teach her that biting her food source was unacceptable.

Through many of these situations I learned the importance of handing over my anxiety to God and asking for peace unless I needed to be worried.  My trust in God increased greatly during this time.  I learned that I had little control.

Our last breastfeeding sessions took place after Jonathan and I confidently felt that Sarah didn't have CPT II so I was feeding on demand (as opposed to scheduled feedings).  The last two days included about 4-6 relaxing and beautiful times of breastfeeding.  Our routine included Sarah twirling my hair in her fingers while we looked at each other, and often she would fall asleep.  I've heard some people talk about breastfeeding as though they LOVED it and found it extremely spiritual, I am not one of those people but I enjoyed that it was something special that Sarah and I shared together and it connected us.     

Sarah's Birth

July, 2008

Sarah was born four days past her due date. I was induced at about seven in the morning and Sarah was born at 1:44pm after about six pushes. Considering childbirth was one of my ultimate fears in life, I was very pleased with my labor and birthing experience. My husband, Jon, was an incredible coach throughout the experience. Shortly after she was born, we tried to get her to latch on to breastfeed and she did. I was relieved because I had heard horror stories from moms about breastfeeding.

That night, my husband was unable to stay at the hospital with me because I was sharing a room with another new mom. He left at 10 P.M. During the night the nurses check all the newborns' weight and vital signs. They discovered that Sarah was jaundice and took her to the NICU. That was a sad moment for me to be alone in the hospital as they wheeled my baby off to the NICU. I was left in a room with another mommy and her crying baby. I knew jaundice was common and so I just tried to rest during the times I wasn't in the NICU trying to nurse. The next day the nurse commented to the lactation specialist that it was odd that Sarah was found to be jaundice within 8 hours of birth. They both reacted like it was unusual for a baby to be jaundice that soon.
In the NICU, I felt a lot of pressure to breastfeed Sarah quickly so that she could be put back under the bilirubin lights. As I learned in the breastfeeding class, newborns don't usually want to eat much during the first few days of life, they want to sleep. Sarah did not want to eat during the times the NICU nurses wanted her to eat. When I asked for help, the nurse held Sarah's face onto the boob. Sarah would cry. When she did latch on it seemed like she would choke or gag. I mentioned this to the nurse and she didn't react as though it was an issue. She didn't seem to listen to me. I felt like the daytime nurses acted as though we were a frustration and inept. The nighttime nurses were more relaxed but still wanted Sarah to be feed and under the bilirubin lights as much as possible.

Due to Sarah's unwillingness to breastfeed when they wanted and to encourage my breastmilk to come in more quickly, I was to express my breastmilk using a breastpump. The first time I pumped, barely anything came out. I set what little colostrum I had on the counter to bring with me when I returned to the NICU. I was told by the nurse to bring the milk to the NICU when I returned the next time.

We had family and friends in our hospital room visiting and I was watching the clock anxiously awaiting when I was to return to see Sarah. As soon as the clock clicked to the time when I was to leave, I got out of bed and said I was going to feed Sarah. I realized later that I didn't even say goodbye. I even left without Jon. I was quite the focused mommy.

When Jon arrived to the NICU he reminded me of the breastmilk. I mentioned to the nurse that I forgot the milk I had pumped and she questioned when I had pumped. As soon as she asked the question, I remembered that the milk needed to be refridgerated right after it was pumped. The little bit of colostrum was wasted. I felt frustrated that I didn't remember the refridgeration rules from the breastfeeding class and that the nurse hadn't mentioned it earlier when instructing me on the pumping procedure.

I focused on the task at hand, feeding Sarah. We tried and tried to get her to latch on, she just didn't seem to be eating enough. Finally, the nurse said that they would need to bottle feed her. Sarah didn't want the bottle. The nurse finally said that Sarah seemed to be having a gag reflex. I was once again frustrated. Now the nurse seemed to care that Sarah was gagging. Since Sarah needed to eat the nurse decided to try putting a tube down her throat. As the nurse tried to put the tube down, I couldn't watch. I just listened as Sarah cried. At that point, I could handle no more and I left.

I walked down the hall towards my room, willing myself not to cry. I kept telling myself to just keep it together until I made it back to my room, which was the last room at the end of the hall. As I entered my room I threw away the colostrum that I had forgotten earlier. I turned towards my bed and as I allowed myself to let my emotions go, a nurse, Joanie, entered my room and happily announced she was here to take my vital signs. I turned and said that I didn't think my blood pressure would be very good right now, then burst into tears. I told her about the milk and the tube and the gagging. She got all teary-eyed with me. I proceeded to say that Sarah was so beautiful and showed her the slideshow Jon and I had made of all the pictures we had from the birth and and other pictures. Later, Joanie came back with a plan so I could get some sleep and get my milk taken over as soon as it was expressed. That was the most emotional time for me and Joanie handled it with empathy and respect.

Jonathan came back to the room and informed me that the tube down Sarah's throat didn't work because she was gagging and they had to put the tube down Sarah's nose. Thankfully, Jon was able to stay that night in the hospital with me because my roommate had left earlier that day. Joanie came in throughout the night and woke me to pump my breastmilk. Before we left the hospital, the on-call pediatrician came in to talk about Sarah. She said that Sarah was a normal baby. That her bilirubin levels were in the normal range but that some of the nurses in the NICU were concerned about Sarah's intake and output (they weighed her diapers). The doctor said babies are created to sleep often while the mother's milk is coming in. She directed the nurses in the NICU to treat Sarah like a normal baby to see if she could function as such. It was refreshing to have someone official confirm our thoughts that other than the jaundice, which is very common, that Sarah was acting like a normal baby.

We had to leave the hospital without Sarah but we had it set up that the NICU nurse would call me as soon as Sarah showed signs of hunger so I could feed on demand. Jon slept at our home because he had to go to work the next day. I slept the night at my mom's house because it was closer to the hospital. I got it so that it would take 15 minutes to wake up to the phone call, drive with my mom to the hospital, enter through the ER (because it was afterhours) and get to the NICU. Sarah fed as she was supposed to.

The next morning I arrived at the hospital determined not to leave without Sarah. She met the requirements to leave the NICU. Due to her being jaundice they wanted her to visit the pediatrician in two days, when she was five-days-old. Sadly, Jon was at work, so Jon's parents, Clark and Kathy, and I took Sarah home.

Sarah was able to come home three days after she was born.