by Amber Becht
My entire pregnancy was colored by seemingly constant appointments at Maternal Fetal Medicine, triage, and All About Women. Bleeding, concerns about advanced maternal age, and especially my shortening cervix, all caused my pregnancy to be considered “high-risk.” The shortened cervix caused me to be on modified bed rest and to have weekly appointments at MFM. Time went so slowly while I was on bedrest.
At week 21, when my cervix was completely gone, modified bedrest became “as much bedrest as possible.” We now feared that I would deliver early, and set a goal to make it to 28 weeks. As one doctor put it, delivering at 24 weeks would be a surviving baby, but 28 weeks would be a much better time frame.
At 30 weeks, my doctor called me a miracle mommy.
By 31 weeks, I was completely tired of being on bedrest, but having come this far, we were able to start taking classes. At breastfeeding class, we learned the holds, how to tell a good latch, and all about breast pumps. The instructor said we would even have the help of a lactation consultant if we needed it while we were in the postpartum rooms. I thought for sure breastfeeding would be as easy as that class made it seem. According to the class, Christiana didn’t really have any other options for feeding a baby. They were a “baby-friendly” hospital and breastfeeding was something they really encouraged every mother to do with her baby.
At 37 weeks, my water broke, and we headed to triage for the final time. After eight trips to triage, we were finally heading up to Labor and Delivery! It was the first time I actually felt relieved and that everything would be okay. We made it to full term.
I had never felt so numb, happy, exhausted, and every other feeling all at once. After 18 weeks of bedrest/modified bedrest, my baby was in my arms!
We did the 60 minutes of skin-to-skin and I just felt tingly all over. I’m sure part of it was drugs, but part of it was so emotional. I felt that I could barely talk, think, or do anything other than look at my beautiful baby.
Before we left Labor and Delivery, the nurse said that Madison should be ready to nurse, no problem. Little did I know, we weren’t even close! We were moved to a postpartum room at 6:30 and stayed up with Madison until 8:00. Madison just slept and slept and slept. The nurses would come in every once in a while to check on her and said to keep trying to nurse her but said that normally it doesn’t happen in the first 24 hours after birth. She was peeing and pooping regularly and then some.
By day two in the hospital, Madison still had not nursed. Michelle, the midwife from All About Women, came to check on me and said that if the baby wasn’t nursing to make an appointment with Katie Madden at The Birth Center. I thought we would be able to figure it out on our own; I mean, babies should know how to do this from birth, right? That is what all the movies and pamphlets said would happen.
We also met with Lisa from Lactation. She was showing me some things to try but also reinforced that I was doing everything right. Madison was just super stubborn and wouldn’t open her mouth. She was even clenching her jaw so we could barely put a finger in her mouth. Lisa didn’t really give me any hope. She kept saying to try skin-to-skin contact and trying to get her to nurse. Madison hadn’t eaten in almost 48 hours.
The next morning, the pediatrician came for a visit. I told her we noticed that Madison was having little shakes. I understand some muscle spasm would be natural but she had just started shaking that morning. The first thing Dr. Healy said was that we needed to get a nurse to check her sugar. Madison’s sugar had dropped below 50. We would end up staying in the hospital. The nurses set me up to start pumping, but my milk hadn’t really come in yet. I was barely getting three milliliters when I would pump. We were using a syringe to squeeze my milk into her mouth. Dr. Healy said we need to get her sugar up and it would need to be checked every time she ate. She would need to eat 30 milliliters (one ounce) at every feeding. We had a plan; things were starting to look up.
Lisa from Lactation returned. She probably spent about two hours total with us trying to get Madison to nurse. She was the one who suggested the syringes and not giving her any bottles or pacifiers. Everyone was worried about nipple confusion. They tried to give me a plan for when we went home, but we were still having trouble getting a nipple in her mouth from a bottle or otherwise. Lisa said just try to do more skin-to-skin, try to nurse, pump, then feed her. This whole process would take about two hours. Babies need to eat every two to three hours; there was no down time. I told Greg that I felt like the scientists in the biodome; they spent all their time in the farm/garden area and lost all kinds of weight because they weren’t able to make enough food to sustain themselves.
That first night at home, it wasn’t that Madison wouldn’t breastfeed, it was that she wouldn’t eat at all! Not even from a bottle! It’s extremely hard to keep it together when you are doing everything you can to feed your baby and it’s not working.
At the pediatrician’s office the next day, Madison took the bottle no problem, like she had been doing it from day one! We joked that we would be bringing her back every three hours so Dr. Healy could feed her. She seemed to take the bottles a little better from then on. She then suggested we make an appointment with Katie Madden at The Birth Center, who evidently is some kind of “booby whisperer.”
I made my first appointment with Katie for Tuesday, June 2. On the phone, she told me to do what I can to maintain my milk and she’ll help connect the rest of the pieces at the appointment. Madison was still very sleepy and not really responding to the outside world. This went on for probably the first three appointments. We made jokes about her being a zombie baby; she would just hold her arms out but that was really the only movement she would make. If we laid her on her side to nurse, she would just fall asleep.
June 14, Madison’s due date, finally arrived. We thought for sure she would start responding more. She was still pretty sleepy, but there was such a change in her attitude. She was even more awake during her lactation appointment. We had started working with her using a nipple shield. She would start to suck, but not really trigger a letdown. She would just hold the shield in her mouth and let the milk fall to the back of her throat before she would swallow. She would only take about half an ounce during a 90 minute appointment. At that rate, I would have to keep her attached to my nipple 24/7 in order to sustain life!
Katie was helping me with pumping by asking how things were going. I was pumping about five times a day, but really just to feed Madison. We didn’t really have any back up, nor were we storing any milk. She helped us start building my supply and told me I needed to start pumping six times a day. That was really hard, since I already felt I was tied to the outlet next to bed, just as I had been trapped in bed during my pregnancy. It was so hard to pump if we needed to run errands or go out for any reason. It was super hard to visit friends and family, since I was constantly worried about when I would be able to pump next. I knew I needed to always pump but I think my husband didn’t realize how important it was to keep pumping. Katie helped us with a schedule and asked that we keep track of how much milk I was pumping at each session. Once Greg saw that my numbers were going down, he helped me with finding time and even found our car adapter to plug the pump into so I could at least always pump in the car if I needed to. Katie also told us that since I was pumping exclusively, we should take turns at night so we could get longer stretches of sleep.
When Madison was eight weeks old and I was still exclusively pumping, we returned from a family outing and got ready for bed; we turned the lights out and heard the sucking noises, so I tried to nurse Madison. She latched like a champ, like she had always been nursing, no nipple shield, no multiple attempts, just latch and eat! I was so surprised, I was fighting tears. This was the first time she really showed any interest and it was like magic. Once she was done nursing, we had been giving her a bottle. Since I didn’t trust breastfeeding, I felt that she would still need more. From this point on, if I let her breastfeed first, she was not able to finish her bottle. This is what really led me to start trusting breastfeeding. Each time, she would take less and less from a bottle. I was also still pumping after each feeding. I would pump about an ounce or so total after she was done.
As I started to breastfeed her more, I realized I was feeling some pain. I was really only able to nurse her about twice a day. When we went to see Katie the following week, I was so excited to show her our new trick we had learned. Katie was really supportive but suggested we see a specialist about Madison’s upper lip tie and a possible posterior tongue tie.
It took me about a week before I had the courage to make the appointment. I made sure to speak with both my pediatrician as well as my dentist. Both thought that the laser procedure would be the best option, but it was my choice as to whether I should get it done or not. I was so worried my baby would be in pain. The good thing about going to the dentist was we would have the consult and could decide to have the procedure done or we could opt to do it at a later date.
When our turn came, Madison had just woken up, so we fed her while waiting for Dr. Lance. They do the procedure while the baby is in her car seat. The dental assistant just holds her hands down. Madison started crying because she doesn’t like her hands to be restrained. Once the procedure started, she seemed to calm down.
The next day, we could tell that Madison was in some pain. She did not smile at all the entire day. We had to give her Motrin several times and she just cried if I tried to nurse her so we bottle fed her that day. By Friday, she was back to her normal self. The wound under her tongue was barely noticeable and my husband was doing the upper lip exercise. He said it was a little white. I never looked at it. I tried nursing her again and she latched properly with very little effort. I still seemed to have some pain. We also made another appointment with Katie.
At our very last lactation appointment, Katie thought the wound had healed really well. I told Katie I had been exclusively breastfeeding since Friday, August 7! She watched me breastfeed Madison and asked if I was having any pain and how often. Katie showed me some last latching tricks. I was finally feeling successful. Katie had worked her magic and helped us persevere! After 18 weeks of breastfeeding and ten weeks of exclusive pumping and bottle feeding, I officially had a breastfeeding baby!