Sorry kiddos- "The Little Engine That Could" is a crock of sh!t

I also thought about titling this blog entry "My Breastfeeding Woes," but the title I chose is much catchier.

I'm going to do my best not to belabor my breastfeeding journey by rambling on and on and on in "woe is me" fashion. But the truth is: I'm still bitter, disappointed and depressed that I couldn't breastfeed.  I'm simply not "over it."

I told my doctor and nurses in advance of Ryder's birth that I wanted to do skin-to-skin time immediately upon his entrance into the world.  In other words, I wanted them to place Ryder on my bare chest as soon as possible after he made his exit from the womb.  Immediate skin-on-skin time is supposed to aid in your breastfeeding efforts.  I got my skin-on-skin time and it was lovely.  I had also read (during my fairly exhaustive breastfeeding research) that you should allow your baby to try to nurse within an hour of birth.  No problem- I did this too. 

Once I was moved into my postpartum room, I found out that my overnight nurse used to be a full-time lactation consultant.  Whoopee- extra help!!  While at the hospital, I did all the "right things" to try to help my milk come in and encourage Ryder to nurse.  Those first few days are hard for everyone, so I really didn't think much of it. 

I had Ryder on Monday night and was released from the hospital on Wednesday.  My milk still was not in.  No big deal... it can take 2-5 days for a woman's milk to start flowing and it's typically a slower process when it's your first baby.  Ryder was 5 pounds, 13 ounces at birth and he was 5 pounds, 4 ounces when he left the hospital.  I spent my first couple of days at home, pumping like crazy and trying to let Ryder latch and nurse.  By Friday morning, I was still only getting drops of colostrum (no milk) and I was starting to worry about Ryder.  He wasn't really latching, and he wasn't having very many wet diapers. 

We took him to his scheduled newborn pediatrician visit that same day.  He weighed in at 4 pounds, 13 ounces.  Dr. Friedman (Ryder's pediatrician) thought he looked just a tad dehydrated and voiced initial concerns about his weight loss.  He briefly mentioned that I might need to start supplementing if my milk didn't come in pronto.

Boy can things unravel quickly.  Within a few hours of Ryder's pedi appointment, I started feeling anxious and I knew something wasn't right.  Ryder wasn't latching at all, and he seemed lethargic.  It was after-hours by that point, so I called the on-call nurse line.  They suggested that I immediately begin to supplement with formula.  As much as I wanted to breastfeed, I had NO PROBLEM with the idea of supplementing.  If someone had told me to do it earlier, I would have done it earlier.  But no one seemed to think there was a problem until the problem was staring us right in the face.  We had formula on hand, so I made a bottle for Ryder.  He wouldn't eat.  He did not seem interested in the bottle whatsoever.  His coloring was bad, his lips were chapped and peely and he was very lethargic.  I called the nurse line again, and they suggested that I try pedialyte.  The nurse said that if he wouldn't take the pedialyte, I should take him to the hospital.  At this point, my mom convinced me to call Dr. Friedman's cell phone even though it was after 9:00p.m.  I voiced my concerns to Dr. Friedman and he told us to forget the Pedialyte idea and go right to Cooks Children's Hospital's emergency room.

Thus began a horrific nightmare of a journey that consisted of a week-long stay in the NICU, but I'll save most of those details for a later blog entry dedicated solely to Ryder's NICU experience.  For now, suffice it to say that it was hell on earth.

It was day 5 and there was still no milk.  I stayed in the NICU with Ryder nearly 24/7 and I pumped every 3 hours around the clock.  The nurses brought me a hospital-grade pump, which stayed in the room with me, and they were very supportive of my pumping efforts.  They were also supportive of my breastfeeding efforts.  They allowed me to attempt to breastfeed Ryder every 3 hours before they gave him his formula bottle by mouth and/or feeding tube, depending on the point in his NICU stay.  Understandably, they only let me attempt to breastfeed him for a few minutes at a time because they didn't want Ryder to burn too many calories by struggling with his latch and sucking. 

So this is what my week in the NICU looked like:  (1) try to breastfeed Ryder until he seemed frustrated or began to cry (usually 1-5 minutes); (2) help feed Ryder his bottle; (3) pump for 20+ minute intervals after feeding Ryder. 

Rinse. Repeat.  EVERY 3 HOURS.

Now, if other breastfeeding mamas are reading this, they may be thinking that this doesn't sound like anything out of the ordinary when you are breastfeeding a newborn.  Feeding and pumping every 3 hours isn't out of the ordinary.  However, I was doing this in the NICU with a super sick teeny tiny baby, while sleeping on a crappy pull-out couch and scared for my baby's life.  AND, I still wasn't making any freaking milk!  That's the kicker.  It may suck to breastfeed and pump every 3 hours.  But trust me, it REALLY sucks to "breastfeed" and pump every 3 hours and end up with NOTHING to show for it.

On day 6, I started making milk.  And by milk, I mean drops of milk.  I would pump both boobs for 20 minutes and get 1/4 of an ounce total.  If that quantity doesn't mean anything to you, you can just trust me when I tell you that it's practically nothing.  The Cooks lactation consultant wasn't working over the weekend, so I had to wait for Monday to see her.  By Monday, I was still in the same boat.  I was barely producing any milk despite my efforts.  By that point, I had begun taking copious amounts of Fenugreek, an over-the-counter supplement which is supposed to help increase milk production.

The lactation consultant did her very best to encourage me.  She helped Ryder work on his latch and encouraged me to keep pumping every 3 hours.  She told me all the things that I already knew from my breastfeeding research during pregnancy.

By the end of our week-long stay in the NICU, I was able to make about a half an ounce of milk per pumping session.  Whoopdee-freaking-doo.  Don't get me wrong- I felt good that I could supplement Ryder's formula with my breastmilk so that he was at least getting something.  But what was wrong with my body!?!?!  I was doing everything in my power to make this thing work and it simply wasn't working.  The only advice from the lactation consultants that I couldn't fully heed was to relax and sleep as much as possible.  It's impossible to sleep (or relax) when (a) you have to wake up every 3 hours to pump and (b) your baby is laying in an incubator with wires and tubes protruding from every inch of his body.  But I did the best I could and I followed all of the other breastfeeding/pumping advice that was given to me.

My sweet little boy graduated from the NICU after 7 nights.  It took him that long to start gaining weight.  He was admitted to the NICU at 4 pounds, 8 ounces and left the NICU back over 5 pounds.

Over the course of the next 6 weeks my breastfeeding efforts consisted of the following:

-hiring yet another lactation consultant (making a grand total of 3 lactation consultants) to come to my house and work with me and Ryder
-continuing to take maximum quantities of Fenugreek
-trying breast massage, hot showers, oatmeal, dark beer and "mother's milk tea" (all recommended as things that can sometimes help increase milk production)
-continuing to pump every 3 hours around the clock
-convincing my OB to put me on Reglan, which is a drug that is ordinarily used to treat reflux but has been found to increase milk prodution in some women
-convincing my OB to put me on domperidone (once it was obvious the Reglan wasn't working), which isn't even approved by the FDA for use in the U.S.  So I literally had to convince/beg her to write me a prescription to take to a compounding pharmacy.  She actually said "no" at first, but she ended up researching the drug some more and finally gave into my pathetic begging.
-blood work to test thyroid, testosterone levels and prolactin levels (these were the tests recommended by one of my lactation consultants to look for underlying conditions that could explain the milk supply issues).  Thyroid and testosterone were normal.  Prolactin levels were abnormally high.  WTF.  High prolactin issues + no milk production = just plain weird.
-Lots and lots and lots of crying



By the end of those six weeks, I had maxxed out at a grand total of between 1 and 1.5 ounces per pumping session.  This translated to feeding Ryder one or two breastmilk bottles (out of 8) per day.  Ryder still wasn't wanting to latch (can you blame him when I was barely able to provide him with any milk?). I was exhausted, emotionally drained and completely fed up with my defective body.  My loved ones and even my pediatrician had been gently encouraging me to quit for weeks, and I finally gave in.  I had exhausted all options and the truth was before me: my body would not produce milk. 

Not once during those 6 weeks did I feel engorged.  Not once during those 6 weeks did I ever feel my milk "let down."  Not once during those 6 weeks did I leak.  Nothing had gone as it was supposed to.

I'm still struggling to accept that I'll never know why I couldn't breastfeed Ryder.  There are two possible theories:
       (1) the combined trauma of going into labor early and having a baby that was admitted to the NICU traumatized my body and prevented milk production (it has been shown that high levels of stress can inhibit milk production); or
       (2) for some unknown reason, my body is physically incapable of producing milk

I won't know which theory is right until I have another baby and see whether I make milk for that baby.

Everyone told me that once I quit I'd be able to put it all behind me and enjoy Ryder more.  I certainly LOVED giving up the pumping marathons every 3 hours.  But I'm still waiting for that feeling of peace that everyone assured me I'd feel.  I don't know why it's so difficult for me to move on.  I know that formula is 100% a-okay.  I was a formula-fed baby and I turned out just fine.  I have no problem with feeding my baby formula.  I DO have a problem with inexplicable body failure.  I want to know why it didn't work out. 

It's only been 3 months so perhaps I just need more time.  Time heals all. 

So the moral of this story is that you can repeat "I think I can, I think I can, I think I can" until you are blue in the face.  But sometimes you just freaking can't.  I'm sorry to post such a depressing blog entry... but this has been cathartic.  And I want to remember my struggles in the future.  So even if no one made it past the half-way point of this sad, sad tale, I'm still glad I shared my story on this blog.  The end.