Thursday, December 18, 2008

Who would think you could love a nipple shield?

Well, it has been another challenging 2 days. After coming home from the hospital, Micah slowly grew more alert. For our 6:00 feeding, he was willing to latch but not nurse, so for our 9:00 feeding, I decided to try the breastfeeding supplement contraption. I was amazed - on his 2nd attempt, Micah latched, took the supplement tube, and he nursed for about 30 minutes and ate all his supplement! I thought we were home free.

Once again, however, Micah refused to nurse at his 12:00, 3:00 and 6:00 am feeding. I had to give up on the breastfeeding supplement contraption and go back to the syringe. My mom and I covered the 3:00 and 6:00 feedings so that DH could try and catch some needed sleep. It was a frustrating time - Micah kept getting so hungry and so upset that he was really hard to calm down, and I just couldn't get a successful latch at all.

We had to do the 9:00 feeding 1 hour early because we had an appointment to see the doctor. Unfortunately, Micah could barely stay awake for that feeding, and the breastfeeding didn't work out again. In better news, however, we got a great evaluation at the pediatrician appointment. Micah had gained about 5 ounces, his color was better and he was quite alert! The doctor asked us to come back for another weight check on Friday, but he thinks the worst of the jaundice is behind us.

We made it home in time for his next feeding . . . and once again, no latch and tons of frustration. We finally gave in and did this feeding by bottle - I tried to nurse him, he refused, then we gave him a combination of breast milk and formula in a bottle. Ironically, Micah rejected the bottle, too - he just does not like to latch! After some pushing and persistence, we convinced him to take the bottle. We tried again to nurse after he finished eating (no luck), then I went on to pump. The feedings continued to follow this pattern all afternoon, so I spent the rest of the day trying to find a lactation consultant to help us out. By 5:00 pm, I scheduled an appointment for early this morning.

The good news is that overnight, Micah did try to latch and nurse several times. He clearly showed an interest in nursing, but just couldn't seem to obtain and keep a latch. Even worse, when he has a good latch, he does not like the feel of it, so he closes his mouth down and uses his tongue and hands to push me out. I was a bit less frustrated because we had a system, but I was feeling disappointed that we just couldn't get the hang of nursing. One of my friends suggested we try a nipple shield, so DH ran out to pick one up at Target, and we tried that. I was so hopeful, but the shield just seemed a bit too big for Micah's tiny little mouth. Again . . . close, but no cigars :(.

DH & I went upstairs to try and sleep around 2:00 am. We had just fed, and Micah had latched and nursed for about 1-2 minutes after that. I still had this feeling he was hungry (he was not in his usual food coma) but we were trying to avoid increasing the formula, so we figured he didn't need any more and was probably just more alert because he was feeling better. We crawled into bed, and I had about 2 hrs to sleep before the next feeding. Just as I drifted off to sleep . . .. . . the wailing begin! We tried comforting him, we changed his diaper . . . still crying. I told DH to go down and get an extra 10 ccs of formula (we had been giving him 30 ccs ~1 oz - total combined with breast milk, and we were told he could take as much as 60 per feeding ~2 ozs) and we fed that to him. We figured with the extra food we could push his big feeding back 1 hour and get a bit more sleep. WRONG! He went right back to crying. He did much better when DH was cuddling him, but he still wouldn't sleep. We guessed he must be hungry since at that point we were just over 2 hours from his last real feeding, so I tried breastfeeding again. He latched and suckled a bit, but nothing substantial, and then DH went and got another bottle and he sucked that down. At this point, it was about 4:30, so we returned him to the bassinet and went to bed.

Naturally, 15 minutes later, the crying started again! I told DH it was my turn to sleep and he should stay up with the baby. He was great! He didn't get much sleep, but he spent the night cuddling and rocking the baby and keeping him quiet. The lactation consultant was scheduled to arrive at 8:00, and I was hoping to stretch Micah's feeding until she arrived. Because I was too tired (and it was too close to my last session), I skipped the 4:00 am pumping session, so I went downstairs before the appointment and pumped. I got over 20 ccs this time, so my milk is definitely increasing!

Luckily, Micah stayed quiet until the consultant showed up. She was a HUGE help - she evaluated Micah, took his weight naked and with a diaper, she evaluated my technique, and we tried a few different approaches. Nothing was working. She quickly realized (like the others) that Micah does not like to latch. I mentioned to her about the nipple shield we purchased last night, and she said she thought that would be a good option to try. I told her I wasn't sure if it was too big, and she told me she had smaller if we need it.

All I can say is who would think a little piece of silicone that covers your nipple needed special training to use? She showed me how to put it on, and she showed me how to get him to latch with it. It took us quite a few attempts, and we were just about to give up on the bigger size when he latched! He fed for over 1 hour! She showed me how to move into a more comfortable position (the LCs at the hospital told me I had to keep my breast mushed the whole time I was nursing and couldn't "relax" at all).

In even better news . . . he has continued to latch and nurse at every feeding since the LC left! We had a rough time getting latched at the 1:00 pm feeding, but we did it, and he nursed for about 1 1/2 hrs! We nursed again at 4:30 and again at 7:30, and so far, each time it has gone perfectly. I tried supplementing after the 1:00 feeding, and he took maybe another 5 or 10 ccs. I pumped again, and got about 12 ccs. He was in a food coma after the 4:30 feeding, so I didn't bother supplementing, and got just a little more from the pump to store. At this point, I can't decide if the pumping after each feeding is necessary/a good idea. If we don't need to supplement, it seems a bit much. Because I'm getting so little, I think Micah is doing a good job right now of draining my breasts, so I'm not sure the pump is really doing more to increase my milk supply. A "normal" breastfeeding mom would not need to pump with these feedings, so I've been a bit unsure what to do. I did just give Micah an extra 15 ccs after his 7:30 feeding because he seemed very alert after his last feeding, and last night that was a sign that he got famished about 30 minutes later. The extra breast milk has nicely placed him back into his food coma, so I think it was a good idea. I got so distracted, however, that I got all re-dressed and forgot to pump. I think I've decided to skip pumping this feeding - I'm just too darned tired and I've been pumping every 3 hours for 3 days straight now, and well . . . I'm SORE. I hope I'm not making a bad decision.

In other news . . . Micah's umbilical cord fell off tonight. Well, it might have had a little help . . . thanks to kisses from the dog. It looks fine, but I'm a bit worried that it had a little help falling off. We're planning to give him a bath tonight - should be interesting!

Tomorrow we go back to the doctor for another weight check. He is doing much better, but he is still pretty yellow. Hopefully all is progressing as it should.


Shannon said...

Tess, one thing that worked for me when I was nursing Cameron and he would fall asleep during is to take my index finger and rub it right above my nipple of the breast he was feeding over of. I would just rub about 2 inches above the nipple in a downward motion towards the nipple and it would wake him up. It was a trick that one of my nurses told me. Worked every time:)

Best of luck!

Krissy said...

The nurses told me to make the baby uncomfortable if he fell asleep nursing LOL. She said take his socks off, tickle his feet, rub his hands, whatever!

If you pump after each feedings you will become engorged. Trust me, I did this a few days before my surgery and would wake up with rock hard boobs. Bigger demand = bigger supply.

Congrats on getting a latch though!!! That's awesome! Rock on Micah!

Me said...

Krissy - I think the goal is to get me a bit engorged - my milk is in, but we aren't sure if my supply is enough for him yet - waiting to see if he starts gaining weight! I get him naked (well, down to his diaper) every time we nurse, and they told me to massage my breast to increase the flow to his mouth if he stops sucking. He has been doing well now that we can get him to latch.