All Bottled Up

I have written about breastfeeding here, but I have not really told the whole story yet. There have been several obstacles with breastfeeding for me and they have really torn me apart because they were so easily preventable. I read many books on breastfeeding before I gave birth, I knew I wanted my son placed directly on my breast after birth, I knew I never wanted formula to touch his lips and I knew that genetically I was set to breastfeed. But no matter how much you plan and know- things happen.

On Day 2 of my son's life, I was told his bilirubin levels were too high and to start supplementing. I was distraught, but I knew I should listen to my doctor, and I started giving my son formula. Did any of the nurses offer to bring a pump in? No. Did they send a lactation consultant over? No. Did I ask for one? Yes. Did she ever show up? She agreed to, yet I was at the hospital for 5 more days and I never saw her. After my son was transferred to the pediatric ward, a pediatric nurse found a pump for me and taught me how to use it. A pediatric nurse! So for the first days of my son's life, I pumped and fed him a combo of formula and colostrum.

What's messed up about this: I didn't know that despite the jaundice, my son could have eaten only what came from my breasts. It would have taken a little bit longer for his jaundice to go away, but he didn't need the formula. He was never in the "danger zone" and all the precautions taken were more to avoid a lawsuit than anything else.

By Day 10 his bilirubin levels were low enough that I could start breastfeeding again. I was eager to do so, and he breastfed until his 3 week check up. His weight revealed a small 2 oz gain since his last appointment, so the doctor told me to start supplementing again. I was crushed, so I called up a lactation consultant (an idea I would have scoffed at during pregnancy). The lactation consultant then revealed to me that my son was tongue tied, explanation here
So once again, I was practically glued to a pump until my son got a frenectomy (first appt available was 3 weeks later) and even then it still took him another 3 weeks to learn to latch properly. Because I didn't find out until basically Week 4 that my son wasn't nursing correctly, my once abundant supply had dwindled to barely 10 oz a day. It took weeks of pumping every 2 hours to get my breasts back into full milk production, and to this day I still have to supplement with formula to ensure weight gain.

I still breastfeed, and I intend to until my son weans himself or my supply finally surrenders. Many women would have given up by now, and sometimes I am amazed that I have not. What irks me about this situation is that the following things could have prevented it:

1. The doctors or nurses should have known that jaundice is often a sign that a baby is not nursing properly since it means not enough food is entering their system to flush out the bilirubins. NO ONE TOLD ME THIS. I found out from the lactation consultant 3 weeks later.
2. If the hospital Lactation Consultant had bothered to show up after I called her several times, she would have discovered my son's tongue problems and I would have known to pump until he could get a frenectomy.
3. The doctors should not be so fomula happy this early. It's remarkable that my son still switched to the breast after being bottle fed at 2 days old.
4. I should have been given the option to pump and bottle feed exclusively my milk to ensure the baby was consuming enough if volume was a concern. I understand that formula flushes out bilirubin faster, but plenty of jaundiced babies are exclusively breastfed (my husband and his sister included)

Amazingly, the hospital I delivered at is considered one of the most supportive of breastfeeding. That really doesn't explain the look the nurse gave to me when I asked to hold my son after birth so I could nurse him. I'd hate to see less supportive hospitals, what do they do? Administer hormonal shots to prevent a woman's milk from coming in like they did in the 50s?

You might argue that I could have been more assertive about my wishes, and in retrospect I wish I had. However, my inclination is to listen to my doctor. How silly of me.