Nursing Woes

It would be an understatement to say that I did not have the birthing experience that I planned.  I wanted an all natural birth with very little medical intervention.  What I got was an induction, and epidural, and finally a c-section.

I thought I would at least be able to nurse the way that I wanted since nothing else had gone my way (besides the actual birth of my beautiful daughter, of course!).  Unfortunately, that didn't happen either.

Ellie was born at 37 weeks gestation, and we were told nursing would probably be difficult because babies don't develop the rooting and sucking instinct until 38-39 weeks.  I was prepared for the challenge, but feel like we were never really given the chance.  When Ellie was less than twelve hours old we were told we had to supplement with formula.  The neonatologists were worried about weight loss and jaundice.  All babies get a little jaundice, but because she was born with several bruises on her head and face (she really tried to engage -- for days! -- but just wouldn't fit, and she had the battle wounds to prove it) the doctors were worried that her jaundice would be worse than normal. 

Reluctantly, I agreed to supplement with formula, as long as we didn't have to use a bottle.  So, we learned how to use a feeding tube, and we established a very regimented schedule.  Every 2 hours I would nurse on both sides, pump, and then feed up to 10 ml of formula with the feeding tube, but at the breast so Ellie would associate food with my breasts.  I was really OK with this, until we were told on day 2 that she should be eating 30-60 ml of formula at every feeding.  It was hard enough to get her to eat the 10 ml; She obviously was not hungry enough to eat 30 ml!  I got really frustrated with this turn of events, but we were being threatened with bottle feedings and a return to the NICU if she lost any more weight or her jaundice got worse.  I certainly didn't want that, so again, we agreed.  Only, we changed from every 2 hours for feedings to every 3 hours.  I figured if she had more time to get hungry, then maybe she would eat more.

On day 3 they changed our routine once again.  We had to supplement with formula at the breast (for at least 30 ml of formula) and then pump for 15 minutes.  Whatever was collected with pumping would start the next feeding.  This meant that I no longer was able to nurse without any supplements at all.  I was not particularly pleased with this turn of events, but again agreed in order to keep her out of the NICU. 

We were discharged on day 4, under direct orders not to miss our pediatrician appointment that afternoon because of her jaundice (still not bad enough to require light therapy -- just slightly in the danger zone, but already going in the right direction).  When we made it to the pediatrician she asked me how breastfeeding was going I just burst into tears.  I told her I felt like I was force-feeding her and she never had an opportunity to get hungry so it was just frustrating to her.  I didn't want to be on a schedule, I wanted to feed her when she was hungry.  The doctor gave me a hug, told me it would be OK, and we started a new plan.  We would stop the formula feedings (yea!), and we would start feeding on-demand.  This meant that I didn't have to watch the clock anymore, instead I could watch my daughter and let her tell me when she was hungry.

We started that day, and it was an immediate change.  I know babies get more active and alert as they get older, but it was uncanny how her level of alertness increased with the induction of this new plan.  That afternoon I saw her eyes open more than I ever had, she was much more aggressive with feedings, seeking out my breast, not just waiting for me to give it to her.  Maybe it was just me, but she also seemed happier and less stressed or frustrated with the entire act of eating. 

The one good thing about having to formula feed was that Jeffrey was able to be a part of the feedings in a way he otherwise would not have been.  Finger feeding allowed him an opportunity to feel her latch and that was really exciting for him.  He is eagerly anticipating the start of bottle feeding in a couple of weeks so he can be more involved again.