As promised, here is a riveting update on our breastfeeding saga…
As mentioned previously, we were on the precipice of giving up on breastfeeding due to the disappointment of investing extraordinary effort with insufficient results. When the pediatrician told us that Talia had been gaining only half an ounce a day despite our carefully calculated supplementation, I’d begun a grieving process of sorts over the possibility of abandoning my breastfeeding plans. I realize that sounds extreme, but I think it accurately describes how I felt. I was surprised at how hard it was to give up an ideal of how I thought I’d raise my baby. Visiting the lactation consultant felt kind of like a formality.
Before going to our appointment, Jonathan and I decided we needed the following information from the consultant:
- Is there hope? We didn’t want to continue with breastfeeding interventions if she couldn’t give us concrete hope that things would get better. In other words, we couldn’t continue our current efforts based only on faith that something mystical would happen at some indeterminate time in the future.
- Are there coping mechanisms? If there was reason to hope that we might still succeed, we needed ideas for dealing with the following specific issues:
- Sleepyhead Talia
- Fussypants Talia
- Shallowface Talia
- Are there alternatives? Before moving forward with any interventions, we wanted to know our options for not breastfeeding.
And, lo and behold, the consultant actually had information about all these things!
- Hope:Although it’s true that there’s not a magic age at which all babies suddenly respond to interventions and figure everything out, many babies apparently catch on when they reach 9 lbs. Talia’s still a couple weeks away from 9 lbs, so that might be too far away for us, but it’s a concrete milestone to watch for. Also, the consultant didn’t want us to continue our entire intervention plan because it’s clearly exhausting us, so given some recent success with using the SNS at the breast as intended, she gave us a weeklong plan for combining supplementation with nursing. Furthermore, she set a week as the maximum amount of time we’ll spend on that intervention.
- Coping Mechanisms: Even though the interventions alone seemed super demanding, we were particularly frustrated because Talia’s sleep behavior, fussiness, and poor latch exacerbated the situation significantly. Therefore, having a plan to cope with each of these made me really happy:
- Sleepiness – Surprisingly, the consultant agreed that on-demand feeding might be the best course of action for Talia, even if she doesn’t get 8 feedings in a day. We’d explained that, through a 24-hour experiment, we’d discovered how much happier and less-likely-to-fall-asleep-while-eating Talia was when we let her sleep as long as she needed to. The consultant responded with studies that this is kind of a proven phenomenon and that babies eat better when you give them this freedom. That attitude felt distinctly different from the miss-a-feeding, lose-an-ounce warning we’d received earlier in this process, but whatever. It’s interesting to compare last night and this night…both nights, Talia ate at 2 hour intervals. However, last night she was SO mad at us…every feeding was a battle. On the other hand, tonight has been mostly pleasant. She still cries to tell us she’s hungry, but she calms down when we feed her, and she doesn’t fall asleep mid-feeding.
- Fussiness – I’d come back around to the theory that a lot of Talia’s fussiness at the breast results from impatience; she’d be eating happily until a particular milk let-down finished, and then she’d start screaming. Wellll, now that we’re planning to use the SNS at every feeding, she should get immediate gratification when she latches on. We expect that to resolve a LOT of the fussiness.
- Latch – This one doesn’t really have a solution, but it does have an explanation. Although I’ve read all about how to get a good latch and watched a million videos of babies demonstrating a good latch, I couldn’t for the life of me get Talia to latch like all those babies. I’ve been begging people for advice about how to adjust my technique, but no one really had an answer. Well, the consultant reminded me about the tight jaw issue and explained that, until Talia grows, I shouldn’t expect a better latch than what I’m getting. Therefore, I don’t have to beat myself up about not getting the best latch for ideal milk transfer; as long as I can get something that’s not terribly painful, I’m doing fine for now. So that’s what I’m doing.
- Alternatives – The consultant explained a lot of details about exclusive pumping which was pretty enlightening. We had been concerned that, if we move to the pump this early, I’d never have a sufficient milk supply, and what I do have would dwindle pretty soon. Not so! If I continue pumping 8 times a day (for now), my supply will continue to increase, and over time I’d be able to cut back on the pumping sessions. Furthermore, the consultant has had many clients who went to exclusive pumping after their initial interventions failed only to successfully start nursing maybe a month later. So, deciding to pump wouldn’t even be a final decision.
- Feed Talia on demand, not letting her sleep more than 5 hours at a time.
- Use the SNS with every feeding. This will guarantee that Talia gets the extra calories that she needs while encouraging her to nurse at the breast by giving her instant gratification there.
- After next week, supplement with bottles as necessary and re-evaluate feasibility of breastfeeding. I won’t continue any extraordinary measures after Jonathan goes back to work.
We feel pretty good about the potential for different kinds of success with this plan. Jonathan will still have to wake up in the middle of the night to help me set up the SNS, but hopefully the entire intervention schedule will be a lot shorter AND more satisfying because Talia won’t be screaming throughout the entire thing.
And then, a surprise
So, after spending 1.5 hours discussing our concerns and hashing out the above plan, the consultant weighed Talia to update her records. Lo and behold, according to her scale, Talia had gained 8 ounces in 8 days…exactly what she was supposed to gain! It turns out that the past 24 hours of agonizing over how to proceed based on our failed interventions was COMPLETELY UNNECESSARY; the interventions had done exactly what they were supposed to. We decided that the pediatrician’s scale had been incorrect last Friday when it told us she’d gained 4 ounces overnight compared to the previous day’s weigh-in at the consultant’s. At the time, we’d attributed that crazy number to a difference between the pediatrician’s scale and the consultant’s scale. However, it now seems that, within the past week, the pediatrician had recalibrated her scale, causing it to return smaller, more accurate weights. Wow. It’s hard to believe that we were about to make some major decisions based on such incorrect information.
Nonetheless, we’re still proceeding with the SNS plan. It will be a good way to ween Talia off supplements. And I’m struggling a little bit to ungrieve; I’d made some progress looking at the bright side of exclusive pumping, so it’s a little jarring to backtrack :) In conclusion, though, both Jonathan and I feel happier now, and we had a nice evening of playing with a more rested Talia and studying her (instead of the alarm clock) for hunger cues.