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8/20/13blog post

when breastfeeding DOESN'T work!

World Breastfeeding Week 2013 turned August 2013 into National Breastfeeding Month! With 2013’s focus on support for the mother to consider the breast, what about the estimated 12% women that are unable to produce enough breast milk, needing to choose formula in the end? We live in a world full of choices and we all strive to make the feeding choices best for our own baby. What we do know: each child is different, so each breastfeeding experience can be, too.

Sarah Zeola, Dayton Children’s Pediatric Registered Dietitian, shares her story of breastfeeding:

Sarah held Hannah, her first baby, right away and was able to nurse her within the first hour after birth. Things were starting well. During Sarah’s pregnancy, she had visions of her newborn nestling in her arms, happily nursing, as she sweetly hummed lullabies. However, throughout the first night, Hannah had some trouble latching, but it didn’t bother Sarah- she had read tons of books, watched lots of videos and attended the breastfeeding education class. Sarah worked with Hannah on her latch – sticking her pinkie in Hannah’s mouth to break her latch and then tried having her latch again. This seemed to work well…but Hannah seemed to have a shallow latch at least one to three times with each feeding. The lactation consultant came by each day and helped with positioning and reassured Sarah she was breaking the latch the right way and recommended using lanolin on her nipples, as Hannah’s incorrect latch began to cause nipple damage and pain. Before leaving the hospital Sarah was in a little pain, but she was committed to nurse.

At home, the poor latching and re-latching continued. Sarah remembered the lactation consultant reassured her that she was breaking the latch correctly and re-latching correctly, making her confident nursing would work. Sarah had super at-home support: her mother stayed with them for the first few weeks and her husband knew how determined she was to breastfeed. What could go wrong? Sarah’s nipple pain kept becoming worse so she kept using more lanolin! At Hannah’s two week visit, when she was 10 days old, Sarah stopped by to see the lactation consultant. She was given more lanolin and told how to use it correctly (like putting on lip balm, a very thin layer). Hannah had gained weight well so all assumed she was doing fine – figuring what they say: the first two weeks of breastfeeding are the hardest.

Sarah kept trying, but Hannah was hungry all day and night. Was this cluster feeding? The latching became worse. Hannah became frustrated. She would cry with every feeding and arch her back. Sarah started to cry with every feeding. So much for the blissful baby in my arms! Those pictures in the birthing center are all lies! Sarah called the lactation consultant and made an appointment to see her that day. She was amazing! She mentioned that Hannah was tongue-tied and that she had never seen a baby that young with such a strong neck. Sarah was given lots of tips, told her to relax and that Hannah can sense her worrying. Well, that night was another bad one – Hannah cried all night (and Sarah cried, too). Hannah would try to latch (it wouldn’t be the correct way) and would slide up or down and then would pop off the breast and scream. The pain felt to Sarah like she was ripping off her little fingernails. That was Sarah’s breaking point – she didn’t know what to do. Could Hannah still be hungry? Again? Already? Didn’t she just eat? She can’t be hungry. But she was. Sarah continued to try nursing her and they both cried. Why wasn’t this working? Was it really not working? Could we do this? Why doesn’t she want to latch? Does she not love me? If this were 100 years ago she wouldn’t survive! She needs to latch. We can do this! So, Sarah held her and while they both cried, her husband and Mom washed and sanitized a bottle. Her husband gave Hannah a bottle of formula and she stopped crying. And she looked blissful. She looked peaceful like the babies on the posters…in her husband’s arms…taking a bottle.

Hannah had her first bottle when she was just over two weeks old. She was born in December so it was right around Christmas time. Hannah and her daddy were very merry; Sarah felt like part of her had died the night of Hannah’s first bottle. Sarah thought: I CANNOT be the dietitian that doesn’t breastfeed! ALL dietitians are supposed to breastfeed! People will judge me. I am judging me! Her supply started to drop but she was not ready to give up. She scheduled another appointment with the lactation consultant – getting tons of good advice and some fancy breastfeeding devices. Sarah bought fenugreek and was excited to pump while still trying to nurse Hannah. She was still going to somehow give Hannah breast milk!

At her six-week post-partum visit, she mentioned her trouble with her milk supply. Could it be the mini-pill? She started taking it two weeks earlier. Could it be Hannah’s poor latch on? The provider assured her it was not the mini-pill affecting her supply; she just needed to feed at the breast more often – which was the challenge because of the poor latch on! Sarah continued to “stalk” the lactation consultant – calling, emailing and making numerous appointments. Sarah also shares that she would walk around topless with the lactation device around her neck all day long. She was really trying!!

Hannah stopped latching. She wouldn’t do it – not with a nipple shield, not with anything; she wanted the bottle and wanted it now. She started to cry when Sarah would hold her in her arms. Hannah would sit on her lap, they could play on the floor and she would be all smiles. But, when she picked her up and tried to cradle her it was all tears. Sarah felt awful. When Sarah decided to feed Hannah a bottle of pumped milk, it happened- Hannah finally looked blissful…in Sarah’s arms…just like the posters.

Sarah kept up with pumping and kept up with the fenugreek. Her supply was dwindling though and she was an emotional roller coaster. When Hannah was about four months old, Sarah’s milk supply was gone.

Sarah is currently nursing their son, Ryan, who eats like a champ. Every child has a different story!

Sarah’s tips

  • See your lactation consultant early and often.
  • Try to relax as much as possible, even when I was just pumping and felt like a failure I would pump more when I was calm.
  • Don’t feed a bottle yourself, use the lactation device that hangs around your neck with a nipple shield if you need to give formula, it helps stimulate your supply and feeds the baby at the same time. A win-win.
  • Ask for help/support from those that have breastfed. La Leche League is a great resource.
  • Don’t beat yourself up if things aren’t going well, stress will hinder your supply.

A big thank you to Sarah for sharing her story with us! What a wonderful testimony to having the commitment to breastfeeding! Sarah was truly successful – doing what a mom knows what to do – giving her best to their child. We all do our best, no matter how we feed our baby(ies).