Monday, January 27, 2014

Nine things I've learned the hard way about breastfeeding

Two-month-old Wilder. Such a cutie pie!

I started this post in December when Wilder was four weeks old, and as you'll see why, I waited to post it until I could end it on a positive note. FYI- don't read if you are squeamish about breastfeeding. You can just skip this post!

Confession time: Breastfeeding is really, really hard. But it gets better. I've had trouble with it since day 1. The one thing that has been constant is that Wilder gets plenty of milk and he's growing like a weed--so I have kept going. But it's really tough. I have read three books, consulted like 9 different professionals (multiple times) and read/watched countless articles and videos online. I have had moments where I am angry at the happy mom and baby in the video so easily latching and nursing with NO PAIN.

Many people have asked me how Wilder is sleeping. That was my biggest worry going into parenting, because I always felt I needed a lot of sleep. But after a few days, I kind of got adjusted to waking up several times a night to nurse. Zach also helps to get Wilder back to sleep and change his diaper, so we both share the duties at night. And now he sleeps 8 hours in a stretch! So sleeping hasn't been hard (SO FAR)-- breastfeeding was the one thorn in my side until very recently.

I'd like to share some things I've learned about breastfeeding in the last 8 weeks. I hope in doing so, I can help other new moms navigating these first few weeks. Please know these are my personal experiences. I'm not an expert on anything other than my own journey! My one regret is that because I had such a painful time, I holed up by myself a lot... Missing a lot of holiday celebrations. I also feel like the itty bitty newborn stage flew by while I was dealing with the pain and that makes me sad, because Wilder is on to the next stage and I feel like I missed out in enjoying that precious time.

So here we are, 9 things I've learned about breastfeeding:

1. Flat nipples can be temporary. Three lactation consultants at the hospital helped me with this during our stay. One gave me a nipple shield that I used for two weeks, which helped Wilder while my body got used to the shape it needed to be. However, few things incite more panic like losing track of a tiny clear bit of silicon in the middle of the night, when your baby is hungry... Zach hunted it down on multiple occasions. Eventually I learned to put it in a little pouch on my nursing pillow. I also learned the hard way that it's extremely important to clean the shield with hot soapy water after every feeding. Pain in the butt! But you don't want an infection. 

After two weeks, Wilder hated that shield with a passion and started pushing it aside, so even if I had wanted to use it to save me some pain later, he was over it. I also used an Evert-it a few times. I can't say if it worked that well. There are also ways you can manipulate your breast to make it easier for your baby to latch, which I found to be helpful. But overall, this problem went away in a few weeks.

 2. Tongue and lip ties can make or break your breastfeeding experience. A doula named Kathy O'Brien that encapsulated my placenta (ask me about it sometime :-)) told me an hour after Wilder was born that he had tongue and lip ties. The pediatrician in the hospital clipped his tie on the tongue on day 2, but it wasn't enough. This was our biggest ongoing problem because these made his latch too shallow and caused him to use his gums instead of his tongue and clamp down like a crab. My nipples became extremely damaged in two weeks and I didn't know why. I wasn't able to get help for days because of Thanksgiving and a massive ice storm. Wilder was nursing for 9+ hours a day during that time. I cried more during those days due to pain than I did during my 76 hour labor. 

Finally, my midwife friend Sarah was able to come see me and tell me he still had a tongue and lip tie. We made an appointment the next day with Dr. Oser, a dentist that specializes in tongue and lip tie removal--officially known as a frenulectomy. I wasn't supposed to have my appointment for an entire month and I was devastated. I had been counting down how many nursing sessions I had until I could get in--that's how bad it was. I could not have handled another month of nursing. Luckily, the office had a cancelation so we bundled up and Zach drove on ice to get us in that day. It was a quick cold laser treatment. The change in Wilder's latch was immediate, but the damage to my nipples was so severe it took a very long time for them to heal. He was also able to get more milk more quickly, which meant less time nursing.

3. Mouth therapy for your child post frenulectomy is SUPER IMPORTANT. I was instructed by the dentist to do several things for a few seconds 4x a day for four weeks to prevent Wilder's tongue and lip ties reattaching. He hated these exercises and screamed bloody murder every time. I felt AWFUL making my baby cry like this. He also didn't know how to use his tongue to suck properly, so I had to do other exercises to get him to suck on my finger to work his tongue and sucking instinct. Nursing was no fun because I had to do all this messing with his mouth and he hated it. Unfortunately, I wasn't doing the dentist exercises firmly enough... Or something. 

Wilder went from nursing pretty well to hurting me again one week after his surgery. I was in San Antonio for my brother's graduation, and I couldn't figure out what was wrong. I didn't have access to any resources, so it was a long week of pain and longer nursing sessions. Once back in DFW, I had to get through Christmas and another week of time when people were unavailable before I could get to someone who diagnosed his latch and saw that it had reattached. Kathy also showed me that I was not doing the exercises with enough pressure--which could have attributed to his ties reattaching. It could have been a natural thing--not totally sure. 

That was on a Friday, and Monday morning I called Dr. Oser for an appt. I was again counting down nursing sessions, because my left nipple was extremely damaged (both were) and actually bleeding every time I nursed. The office was closed the entire week for New Year's! I cried. I was so angry at the holidays. I waited ANOTHER week and called that next Monday, but they only did those appointments on Fridays, so I had to wait till that Friday (our wedding anniversary) to get another appointment. That was exactly 4 weeks after his first surgery, and I'd been dealing with those ties for 3 of the weeks. Freaking holidays.

After that next surgery, you better believe I did the exercises properly after every single nursing session during the day. I am also taking Wilder to follow up appointments at the dentist every week until he is all healed because I don't want to take any chances. And as of right now, it hasn't reattached.

3. Homeopathic remedies can be extremely helpful. I'd planned to take Wilder to Mellanie Shepard, a lactation consultant, early on with my issues, but we got iced in so we had to cancel our appointment. I did eventually see her later, and she had some great remedies to help with Wilder's pain after his frenulectomy. I got them at Sprouts, and they are little balls that dissolve in your mouth. For Wilder, I added the balls to an ounce of water and squirted it in his mouth every 1-2 hours that first few days to help with pain. I can attest that he could do from crying to calm almost immediately after taking a 1/2 cc of this mixture. The homeopathics are:

During the time at Christmas between when Wilder's latch reattached (but I didn't know) and I couldn't get to any help, Wilder was fighting while nursing, he would fuss and twist and pull on me... Mama is not made of rubber! Sarah suggested two essential oils, and she graciously gave them to me: Inside Out oil for tummy indigestion and Millenia oil for his neck and back, because the chiropractor was closed for the holiday week and he was out of alignment. I mixed each separately with coconut oil. I massaged inside out oil on Wilder's tummy, and it helps in the evening if he is fussy with digestion issues. I still use it now occasionally. I rubbed millenia oil on his neck and back. It helped with tightness and pain.

4. Babies can see the chiropractor. It might seem crazy, but we have taken Wilder to the chiropractor several times since he's been born. Dr. Terry Garcia is a family chiropractor, and I saw her all throughout my third trimester. She has worked on Wilder and helped get his body in alignment after the trauma of delivery. She also helps with post-frenulectomy adjustments and she gently encouraged the plates in his head to align correctly. Much of what she does for babies helps them breastfed better. An adjustment also helped Wilder stop resisting nursing when his tongue and lip ties had reattached.

5. Mastering several nursing positions gives you an arsenal for any situation. I was pretty comfortable with the cross-cradle and cradle holds early on. I had the My Brest Friend pillow, and that saved me in the early days. Sarah showed me how to nurse with the pillow unclipped and wilder in between me and the pillow--it snugged Wilder in to me closer. When he got fussy, changing it up like this helped. Both Sarah and Mellanie, and my doula Ashleigh all helped with Wilder's latch. I found that you can watch all the videos and read all the books/articles you want, but sometimes you need face to face help.

While waiting to see the dentist for the second time, Kathy showed me two more positions. One of the reasons Wilder was clamping down and fussing was perhaps due to a strong letdown. Laid-back nursing was extremely helpful in slowing my letdown for him. It eased the pain for me as well. It is obviously inconvenient to nurse in public because you have to lie down, but it got me through a really hard time. The other position is side-lying nursing. I tried this early on and it was too difficult to get everything positioned in the right place. But Kathy showed me how to do it and it really saved me those weeks I was waiting to see the dentist. The position calmed wilder down from flailing around, it forced him to take the correct latch and it was really restful for both of us. I love this one for his nighttime feedings. It's not convenient or quick, but when I have the time, it's a nice experience.

Now that I have several positions I am comfortable with, if he gets fussy with one, I can easily switch to another.

6. There are a plethora of nipple soothing potions, and they help. I've had sore, injured nipples for 8 weeks. I have tried a medicine cabinet's worth of products. Here they are with my opinions:

  • Lanolin. This was too sticky and I abandoned it pretty quickly.
  • Calendula oil. This is my favorite, and I still use it after every nursing. It's bound with olive oil and vitamin e.
  • Coconut oil. I like this one because I already use it for stretch marks.
  • Polysporin. Mellanie recommended this or Manuka honey for my open wounds. I chose polysporin because it was way way cheaper. 
  • Vitamin E. Make sure to get natural, not synthetic. I used this every other time with polysporin.
  • Saline. I mixed 1/2 tsp with one cup warm water and soaked my nipples every other feeding. I think this helped prevent infection.

My chiro recommended emu oil, but I had so many products already I decided to stick with what I had. Some friends really like Lansinoh SOOTHIES, but I didn't find them as helpful as calendula

7. Find resources to help you. I could not have made it through these last few weeks without the support and help of professionals, friends and info online. I can't recommend enough the importance of finding help!! Online sources that I like include and Le Leche League International.

8. Take it easy, or your body will make you. Last week I got mastitis, which is an infection in the breast. It feels like the flu (fever, achiness) and a painful red hot spot on your breast where the duct is swollen. I'm starting to think it comes on sometimes if you push yourself too hard. I had just finished a full week of running and high intensity workouts--my first full week to exercise. I was in San Antonio, so I couldn't get in to my midwife. They called in a prescription for antibiotics, but it didn't go through before the offices closed (holiday, again). That turned our ok though. I started feeling bad Sunday night so I bulked up on vitamins and elderberry. Woke up Monday and realized I had mastitis, so I started drinking tons of water and coconut water. I started taking phytolacca (Sarah recommended it), as well as some of the other homeopathics I had gotten for wilder that treat fever and swelling. I also took lecithin. I rested and nursed as much as possible (yay side nursing) and massaged the knot. By Tuesday, the fever was gone, and by Friday the redness and knot was gone. If I had taken antibiotics, it would have knocked out the good bacteria and increased the chance of me or Wilder getting thrush. Something I did NOT want.

At first I was really upset. After everything we have been through, now I get mastitis?? But you know, the best cure was nursing a lot. And Wilder was a trooper. He nursed gently in whatever position I put him in. He was my little teammate.

9. Breastfeeding really is special, and worth the struggles. We are finally in a place where breastfeeding is easy and pain free. I love this closeness I have with my son. I love his expressions, and I love knowing I'm giving him something so vital. It is rewarding to have made it this far.

I hope I've been encouraging to somebody. I've had so much help, that I just wanted to share what I've learned! Now we are try to get Wilder to take a bottle... We've been trying for weeks! He liked it for 3 days and then just stopped. Wish us luck!


  1. Hey Abby! One thing that I use to prevent a plugged duct from turning into mastitis is to use gravity to your advantage by laying the baby flat on the bed in front of you. Get on your hands and knees and lean over him to nurse. Not comfy or relaxing, but it usually only takes once or twice of this to fix the problem. I haven't had mastitis since Hannah was tiny. That's pretty good considering I have nursed for 56 months and counting and had many plugged ducts over the years.

    Looks like you had many products, but just so you know Lanolin comes in a spray oil form.

    Never had one baby that would take a bottle, so no help there. Sorry! Good luck!

    Kelle Smith

    1. Thanks Kelle! I didn't mention the dangle nursing because it's kind of crazy… but I did actually do it, and I do think it helped. I'm so glad that worked for you too! It was kind of cool--a total partnership with Wilder. I had to trust that he wouldn't clamp down on me, and he had to trust that my milk wouldn't drown him. :-)

  2. Abby, this is almost identical to what I went through with Ailee, who also had both tongue and lip ties. I'm very thankful for the lactation consultant who identified them in the hospital (even after the dinosaur of an on-call pediatrician told me she absolutely didn't have them). Ailee was able to get hers "cut" (cauterized) at 5 days old by Dr. Cole at Clear Fork Dental in FW. Those 5 days before the procedure were some of the most painful, frustrating and disappointing of my life! Bleeding, scabbing, soreness, dryness and sharp pain during nursing led to the physical discomfort and my feelings of failure, helplessness and isolation led to the overwhelming emotional pain. Ailee never lost weight, thankfully – she chewed out plenty of milk! About a week after her procedure (and many desperate lactation consultations later) she finally learned how to latch. Because of over production and over-active let down, breastfeeding continued to be a challenge, and often times frustration, until about 5 months. I never imagined or prepared for this, and my advice to any first-time mom-to-be is to read up on breastfeeding and watch videos before baby is born. It doesn't come easy for everyone!
    All that being said, I'm so glad we stuck with it. It grew me as a mother and drew me closer to God. I grew to love the bond of feeding my child. And I truly believe Ailee benefited greatly. She nursed until 18 months old and only visited the pediatrician once outside of wellness appointments. And that was for a diaper rash. :)
    Thank you for sharing your story and for hanging in there! Your perseverance on behalf of your child will be a blessing to you both!

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    2. Thanks for sharing--I'm so glad I'm not the only one who had trouble! Good for you for sticking to it. I wish I had met up in person before birth with a LC or taken a class or something… books did not convey the message to me, I think I needed to see it in person. And experience it for myself. :-)