By Jennifer Joy Ong
As a new parent, everyone wants to give the best for their baby. During my pregnancy, I was bombarded with information that “breast was best”. Thus, even before N, I was dead set on breastfeeding her. She came on 5 December 2007 after a fairly easy pitocin-induced delivery with epidural anesthesia. Within an hour after her birth, she had latched on and drinking up what little colostrum I was producing. During her first 24 hours, she had pooped out so much meconium that my husband Stan was converted into a diaper-changing machine.
Since I was normal delivery, we were discharged on the 3rd day and the next 2 weeks were filled with frenetic breastfeeding days. On discharge day, N weighed 5 pounds and 10 ounces. However, as a breastfed baby, we were informed that was normal and she should regain her birth weight on her second week check-up. We went to our pediatrician on 19 December 2007 for her second week check-up. N weighed 6 pounds and 9 ounces which was 4 ounces more than her birth weight. We were very happy! However, we were eventually dismayed to find out that she was jaundiced and even more so when we were informed that it was breast milk jaundice!! (For more information on breast milk jaundice, please read this handout from Dr. Jack Newman. He explains that breast milk jaundice is normal and does not require treatment or supplementation as long as the baby is gaining weight well and having lots of bowel movements. As always you should consult your doctor for medical advice.)
The pediatrician recommended that she be given 1-2oz of formula after nursing. By then, Stan and I were so paranoid that we decided that I exclusively pump so we could measure how much she was getting. This was the beginning of my endless pumping and worries of “will i have enough milk”? With the stress and sleepless nights, I wasn’t pumping enough and we had to supplement with formula. Also, as first-time parents, we didn’t know that there was an art to bottle-feeding the breastfed infant. So to force N to drink milk, Stan would pull on the bottle every time she stops sucking == end result?! Nipple confusion. Every time N would latch on to me, she would stay only for 5 minutes or less because she wanted faster flow and she was pulling on my breasts like it was a bottle nipple — resulting to my sore nipples and breasts. It was a vicious cycle. At this point, I was exclusively pumping and didn’t know long I would last. I even rented a hospital-grade pump and bought a double pump.
I was really determined to continue breastfeeding. When N was about 7 weeks, I felt that my supply had increased so I again decided to go back to direct breastfeeding. I had been told that direct breastfeeding extends the breastfeeding relationship – as compared to exclusive pumping. Again, I was plagued with sore and cracked nipples. At this point, I was ready to throw in the towel. I kept thinking, I was a formula-fed baby, hubby was FF, my siblings and everyone else I knew were FFed and we were doing great!
Maybe those die-hard breastfeeding advocates really got to me – I decided to continue giving N breast milk and go back to exclusive pumping. I guess I was also a masochist because after 2 days, when my nipples had healed, I again tried to do direct breastfeeding. And suddenly, everything became easier. Her latch had improved. There was still some pain on my right breast but it was tolerable. And I started thinking that I could do this! I continued direct breastfeeding for 2 weeks, not giving her any bottle for fear of a nipple confusion relapse. This meant I couldn’t go out without her and I couldn’t go out often since my mom wouldn’t let me take the baby out.
Then plugged ducts hit! I had been pumping and freezing breast milk when we had to go to Cebu. In Cebu, I didn’t bring my pump and failed to do my regular 3 pumps a day (in addition to nursing) — resulting in engorgement! Plus, the fact that we were staying in hotels and had to fulfill some familial duties probably added to my stress ending in plugged ducts! So upon going back to Manila, I went to see an ob-gyne who was a lactation consultant and had her prick my nipple to free up the plugged duct! Boy did it hurt and for 2 succeeding days, it hurt every time N fed on my right breast! I was determined not to quit and my right nipple did heal.
N went on to breastfeeding until past 3 years. Her breastfeeding gradually stopped and I asked her to completely stop when I was pregnant with our second baby, E. However, when E was born on 21 December 2011, whenever she had a chance, N would still ask to breastfeed. I guess it was due to the changes brought about by the new baby. N completely stopped when she was almost 4 and a half years old.
Given my experience with N plus considering that I had taken a breastfeeding counselor training and run the blog Chronicles of a Nursing Mom, you would think that I had it easy this time around? Well, not exactly. I knew how to make my milk plentiful and supply was not an issue. However, despite my research and training and knowing that I had the position and latch correct, I still ended up with sore (and bleeding) nipples! So what was the reason for it? I think it was the learning curve – that E had to “learn” how to breastfeed even if it was natural and instinctive. E’s mouth was also small that he could not help but latch just on the nipple. He was also quite stubborn. I position him and we get the correct latch initially then he would reposition himself to his preferred but incorrect latch! I just kept at it and kept repositioning him to teach him the correct latch. The soreness subsided at around day 7 and by day 10, E was nursing like a champ!
Aside from issues with the latch, I also had issues with jaundice. Since I had learned from my experience with N, I asked the pediatrician to keep a close watch on E and his yellow color. During our first doctor’s visit on day 6, E’s bilirubin levels were checked and it was at a high 18.7. The pediatrician asked us to come back the next day to do another test. At day 7, the levels were at 18.4. According to the pediatrician, the levels were still high but since it didn’t go higher, it was possible that the highest level had been reached and the bilirubin levels were tapering off. She said to continue observing E and when we return for his 2-week check-up, she will decide whether another bilirubin test would be needed.
E’s 2-week check-up was scheduled on January 5. The pediatrician noted that his color was better and she didn’t see the need for the test that day. She said that since E was on pure breastmilk, it was normal for his jaundice to be prolonged. Plus, I think the fact that E gained almost 2 lbs since hospital discharge also helped! When he was discharged, he weighed 6lbs, 5oz. At day 15, he weighed 8lbs and 2.6oz. The pediatrician informed us that the jaundice resulted in cosmetic issues (E’s yellow color) and that if we were still worried when E turned 1 month, we can bring him for another bilirubin level test. She said that the only way to eliminate jaundice would be to stop giving E breastmilk (which I definitely won’t do) at this point.
Compared to my breastfeeding experience with N, this time with E, I was more informed and more confident about my capacity to produce sufficient milk for my child. During E’s birth day, I constantly put him on my breast and did breast compressions. By the 3rd day, my transitional milk had come in. I also knew tricks such as breast compression to hasten milk flow and taking lecithin to avoid plugged ducts (since my milk was quite viscous).
To end, I really do encourage first time moms to persevere and get help when the breastfeeding challenges seem insurmountable. Breastfeeding each baby is a different experience but knowing how to face the challenges is a huge step in breastfeeding success. As you can read from my experiences with N and E, I experienced similar challenges whether or not I was a first time nursing mom or an experienced nursing mom. Thus, I can only tell moms the same advice that was given to me – that breastfeeding does get easier each day and to take it a day at a time.
**Jen blogs at Chronicles of a Nursing Mom