Feeding DS2

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Feeding DS2

Postby JennyD » Tue Jun 23, 2009 9:11 am

Hi everyone

The interest shown in my weaning thread viewtopic.php?f=29&t=40015 has inspired me to post the story of how we got here. It will probably take a few weeks to write it all out, after all it is two years of DS2s life. So here is the first installment.

May 2007

We headed for Perth on the 6th of May, bub was due on the 13th. Due to lack of obstetric services in our region, we had to go to Perth for the birth. Most mums are sent up 2 or 3 weeks before due date, but because my other 3 were all at least 9 days over, I convinced my GP to keep seeing me until one week before.

By the 22nd of May we were so over being in Perth that we agreed to an induction, there was no indication that bub was coming, so we just wanted to get it over with and go home. They did a stretch and sweep, but no go, nothing happened at all, so then it was the prostaglandin gel, not much fun, although interestingly the registrar was our old GP who had looked after me through DD2s pregnancy, nice to catch up. DH went back to the caravan park to get some sleep, and I slept in the delivery ward all night with gradual tightenings. However, nothing happened, and in the morning they broke my waters. I asked them to call DH, but they forgot, so when I realised they hadn’t called him, I called him, which was a good thing as DS2 was born half an hour later 3920g, 53 cm long and 34 cm head circumference, so labour from waters breaking to delivery was about an hour. DH got there just in time for transition and delivery.

DS2 fed a bit in the delivery room, but not a real feed, more just nuzzling the nipples, we moved to the ward and a couple of hours later DH rang my mother who brought the kids in. They had a lovely visit, and then went back. DS2 was very fussy, and unsettled, we fed a lot, and he did a heap of big meconium poos, one immediately after a bath, so it was straight back in, pity I had just let the water out.

We checked out when he was about 48 hours old, as hospital policy dictated, but I wasn’t happy with feeding, my nipples were grazed and I really didn’t think he’d got it. The staff weren’t over happy with his weight either, so we promised to go to the clinic on Monday, which we did. He still hadn’t gained anything, in fact he had lost a bit since leaving hospital. We organised for me to go back in a couple of days.
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Postby JennyD » Tue Jun 23, 2009 9:20 am

June 2007

DS2 kept losing weight. I was feeding him all day, he would sleep a bit, then wake and feed for a couple of hours and then fall back to sleep, then when he woke it would be back to the breast, he didn’t have content times, he was not a happy baby. I couldn’t put him down, I couldn’t go to the toilet. DH and DD1 helped by holding him for moments so I could do these things, I would take him for a walk to the clinic and he wouldn’t fall asleep in the pram, he would be straight back to the breast at the clinic, but he didn’t gain any weight. In fact he kept losing it.

By the time he was 13 days old he had lost 1kg, or 25% of his birthweight and my doctor, the child health nurse and I were all panicking. Why was this baby losing so much weight? We were sent to the major children's hospital to find out why. When I rang them the doctor hadn’t filled in the right forms, so I went to our hospital to ask them to contact him and get the right forms, he insisted he had filled in the right forms, and the midwife on duty took one look at DS2 and strongly suggested we go to Perth that night. So we drove to Perth that night, stopping regularly to feed the voracious, shrinking baby. DD1 said he looked like Grandad had the last time she saw him (the day before he died of cancer), we were very worried. We were admitted to hospital and at about 7am DS2 was admitted to PICU, he spent 48 hours there. They had him on a drip and were feeding him my EBM through a naso gastric tube. I think the first 6 hours or so he was on 90% drip 10% milk. I had expressed in emergency the night before, around 1am, and kept asking the staff if I could express, I didn’t have access to a pump, finally I got to express and they gave that to him too. I managed to keep ahead of his milk intake for that whole day, but when I went back to the hotel that night I didn’t have a pump, so they had to give him some formula over night. They also upped his milk intake to about 30%. As soon as I got back to the hospital I expressed and they dumped the formula and gave him EBM, but I never made enough while we were in hospital. I would express enough for the next three hours, and then they would increase his intake, so that I only had enough for 2 ½ hours. Then I would express again, but not enough for the next 3 hours etc.

He was discharged to the wards on the 3rd morning, so we were in a big ward and I now had a double pumping kit and a pump to myself, so I was expressing 3 hourly during the day, and whenever I woke over night. DS2 was now completely tube fed, but it was a constant flow, and only about 70% BM, I just couldn’t keep up. However, I had no privacy, other mums and dads were popping in and out, I also didn’t have a bed, I had to sleep in a recliner rocker. DS2 was still in the cot and because he was being fed constantly he basically slept and grew. At least he had stabilised and now they were trying to work out why he hadn’t grown. He grew really well with milk going straight to his tummy. DH and the kids went home, and I was now on my own, with a huge store of bottled water under DS2s cot. On day 5 they moved me to my own room, yay privacy and a shower in the same room as DS2. They were now feeding him 100mL every 3 hours and I was expressing about 80mL every three hours. He was being tube fed still, but rather than gradually all through the day, he got his 100mL in five minutes, so he woke up. It was wonderful to have him awake, but also it made pumping harder, I would feed him, get him off to sleep and then pump, sounds good, but sometimes it took half an hour to feed him, half an hour to get him to sleep, and then I spent half an hour fiddling with the pump, then got an hour and a half break before I was back to feeding again. The most I made during my hospital stay was 90mL in 3 hours, so for the whole stay he was on partial formula.

We went to see the LC at the major maternity hospital, she was wonderful. She thought he had a tight labial fraenulum, so I asked the paediatrician when we got back to the children's hospital he felt it was not a problem, so I didn’t take it further. The LC also gave me larger flanges for my pump, what a lifesaver, my supply gradually increased with the correct size flanges, pain was gone. She gave me an SNS, which I struggled with for a few days, it took DS2 40 minutes to get 50mL from it, and he didn’t actually get anything from the breast. We test weighed before and after each feed, he would only gain the 50mL from the SNS, nothing more, then I had to bottle feed him the rest as Dr didn’t want him wasting too much energy trying to feed. After a couple of days of this the paediatrician decided we would focus on getting the weight back on, so fully bottle feeding until he regained his birth weight. I cheated and continued to offer some milk through the SNS, but mostly he was on the bottle for the rest of our time in hospital.

The reason he was losing so much weight was simply starvation, he was not getting enough milk. The hospital never worked out why he couldn’t get the milk in, once they were sure he could gain on EBM they were happy. So once he regained his birth weight we were discharged. At least I could go home to my family. The big bonus was that once we got home I made enough milk for him. We didn’t give him another drop of formula from that day. The reason was simple, I would express as much as I could, then if we didn’t have enough, I would just keep expressing while DH fed DS2. So we got home and he was completely on EBM, we continued to try with the SNS, I would put 100mL in there and try to get him to drink it, at the end of half an hour I would pour what remained into a bottle and feed him that. He rarely drank more than 50mL in half an hour, and then downed the other 50 from the bottle in about 5 or 10 minutes. Why couldn’t he drink from the breast? We couldn’t work it out. He also developed a blister on his top lip. I wonder?
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Postby JennyD » Fri Jul 03, 2009 9:19 am

July 2007

I was expressing 8 times each day, 3 hourly and feeding DS2 3 hourly too. It was deadly. I would express, then I would set up the SNS, and feed DS2, then I would pour the remainder into a bottle and feed it to him, then wash everything up and it was almost time to start again. At nighttime we wouldn’t worry about the SNS, I would express and DH would bottle feed, which minimised the time out of bed. My doctor gave DH a medical certificate so that he could not be sent away overnight. She understood the hassle of it all and agreed that we should continue to try to get him back to the breast. School holidays came and I decided to give the SNS a break. During this time I managed to make more than he needed, I would expressed 120mL, so I had 20mL over. One day I was expressing and I noticed something black floating in the milk … mouse dirt. So I threw that bottle out, back to just having enough, that was my excess down the drain. I reorganised my bottles so that wouldn’t happen again. One day during July I realised I had enough milk for the next feed, then later enough for two more, so I decided to drop one expressing session. So now I was doing 3 hourly during the day and 4 over night. As it was school holidays I stopped trying with the SNS it was just too much. However, I was now managing to freeze a little excess every day, and I bought myself a new pump. We worked out that with the hire cost a new pump would pay for itself within 6 weeks and I really couldn’t see me not needing it in 6 weeks. So the hire pump went back when we went to see the paediatrician at the beginning of the holidays. He was happy with DS2s progress, not concerned about the blister on his lip and not worried that he wasn’t breast-feeding.

At the end of the holidays I dusted off the SNS and set myself up to feed DS2 at the breast. He just screamed and screamed and wouldn’t have a bar of it. I kept trying for a couple of days and then gave up. I wasn’t over surprised it had taken him half an hour to drink 50mL at his best with the SNS he could easily drink 100mL in 30mins from the bottle. Only problem with bottles was the wind. He kept collapsing the teat and then having to release the suction to drink again, and each time he did this he would swallow air. Very frustrating. I continued to offer him the breast every few days, I would try having a bath, doing skin to skin, but he just wasn’t interested, he would scream at me. However, he was growing beautifully, a thriving breast milk fed baby.
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Postby marcal » Sat Jul 04, 2009 8:29 pm

I really enjoy reading your story. I was hanging out for you to post your 3rd installment! What an amazing journey you have been on and what a truly amazing job you have done.
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Postby JennyD » Sun Jul 05, 2009 8:57 am

Thanks marcal, it is slow in coming as I'm still putting it down on paper, not an easy job I can tell you. Still a lot easier now I'm at the end of my journey than the various times I tried to do it in the middle.
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Postby JennyD » Sun Jul 05, 2009 8:58 am

July 2007 Part 2

Reality was beginning to set in. The number of times I had to come home before I wanted to because I had to express, or because I had run out of milk. The logistics of organising anything around my pumping sessions was a real challenge. There was no way I could do roster at DD2s preschool, or in DSs class, I just couldn’t fit it in. Another challenge was putting him to sleep. When DS2 was overtired I couldn’t just put him to the breast and sooth him off to sleep, I had to pace the floor and sing songs to him, for hours some nights. We have some pictures of me exhausted walking around singing, he just wanted me, but I couldn’t feed him to sleep. I now began to understand so many of the posts on the forum about babies that won’t sleep. His favourite song was Kenny Rogers “The Gambler” so I would sing that for what felt like hours, it did work, and he would fall to sleep at last. I had a bleak vision of the inconsolable toddler, I had used the boob as an all-purpose cure all with his brother and sisters, what would I use with DS2. Luckily DH doesn’t have boobs, he already had tricks up his sleave, so I had to take lessons and learn from my husband the many ways of calming the crying baby. My future wasn’t so bleak after all, but no booby cuddles, no milky smiles, just a wonderful growing, glowing baby. Things weren’t so bad, but not what I had hoped and planned for.
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Postby JennyD » Wed Jul 08, 2009 11:03 am

You know, they say pride goes before the fall, and when I fell pregnant with DS2 I expected a great breastfeeding experience, I was going to feed him until he weaned himself, whenever that was. I was going to wear him in a sling, I expected all of these wonderful things. I did anticipate a bit of trouble in the early days, but knew that it would work out and I would feed my baby well past toddlerhood. Well it didn’t work out that way. When I had DD, I knew nothing about breastfeeding, I was just going to give it a go, and hope for about 3 months. I thought that would be nice round out the time I physically nurtured her until 12 months. She was a natural, she fed with ease in the delivery ward, and I really had no problems feeding her at all. So much so that at 3 months I pushed my deadline to 6 months, still no problems. So I just kept on going, and fed her for 2 ¾ years, I stopped when I fell pregnant with DS.

DS wasn’t the natural feeder his sister was, we had a bit of trouble with cracked nipples. It was funny, I completed my counsellor training just before he was born, I was a bit concerned that I wouldn’t make a good counsellor as I’d never had any feeding troubles, well DS solved that problem. I had quite a few problems with him, but we managed to resolve them and went on to feed until he was 3. Again we stopped while pregnant, he was down to 1 feed a day anyway, and it was his nap time feed. When we realised that he didn’t need a nap any more, it was keeping him up we cut it out and the feed went with it.

DD2 was a pretty good feeder, we had a few hassles in the early days until her mouth got big enough to fit my large nipples, but the main problem we had with her was recurrent mastitis. However, I learnt to recognise the early signs, so only ended up with about 4 bouts before I worked out how to prevent it from really flaring up, we never did work out what caused it, but I recognised the early signs, fed, fed, fed, used gravity to help drain the breast and didn’t get sick. Good thing too as DD was in school by now and DS was at kindy so my life was frantic racing from one school to another at pickup time. I couldn’t’ be sick.

So when I fell pregnant with DS2 I thought now is my chance to have the perfect breastfeeding experience and feed him for as long as he wanted, how wrong could I be? Still he is a lovely kid and his sisters and brother love him to bits as do the rest of us. I am lucky the others are so much older than him as it really gives them a chance to help me. I couldn’t’ have expressed for so long without them there to help me to look after him while pumping.
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Postby marcal » Fri Jul 10, 2009 2:04 am

I feel so sad for you Jenny, that your expectations were shattered :( .

It's interesting to read though because I always just expected that if I have a second baby, that breastfeeding will just come naturally for both of us like it did with our first son. We've never had any problems and he has always fed perfectly. That is obviously not always the case though, every baby is different.
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Postby KC » Fri Jul 10, 2009 7:12 am

I think it's really generous of you to share this story in detail here, Jenny. You've been so honest and given so much perspective. You've been an enormous inspiration to many of us on the forum, particularly those of us who have also walked the expressing road. I wonder if DS2 knows how famous he is ;)?
keep calm and carry on
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Postby DellaWellaWoman » Fri Jul 10, 2009 7:23 am

I couldn't have said it better marcal & KC.

It's interesting to read though because I always just expected that if I have a second baby, that breastfeeding will just come naturally for both of us


That was me until... 41 days ago :?
DD1 breastfed 6 years, 7 months
DD2 still going at 5 years :D
Honoured to have been storked by Capricious
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Postby JennyD » Sat Jul 11, 2009 12:24 pm

Hi everyone,

Thanks for your thoughts. I still have more to add. When I started this thread I decided I would cover the whole thing. So it will go until he is two years old, when it then skips across to my weaning diary, which is going strong right now.

It is so hard when things don't go according to plan or how we think they will. It always comes as a surprise too, which is odd, I should be used to it by now.

Jenny
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Postby JennyD » Sat Jul 11, 2009 12:26 pm

August 2007

August is a blur of more pumping. I was pumping 6 times in 24 hours, at 2am, 7 am, 10:30am, 2 pm, 5:30pm and 9pm, this fitted with DS2s sleeps and of course at this age I could still express while he was awake, I would just cradle him in my lap and feed him or put him in his little rocker while I pumped. This worked really well, my supply worked up to a maximum of 1500mL during August. I continued to offer him the breast, but it was very had to find time to do it these days. I was rushing the kids off to school, coming home trying to fit the shopping in some mornings, supposed to be helping out at school some days. I really couldn’t offer DS2 the breast often enough, but I had learnt to pump and surf the net, so when DS2 was asleep or someone else was looking after him I would read the ABA Forum and search the net for ways to get him back to the breast. I found a few ideas, all of which I tried, but I suspect most of them I found too late. DS2 really didn’t see my breast as any different to my elbow, so why did I keep trying to get him to put it in his mouth. I would express a bit of milk onto my nipple, or I would attach the SNS or I would try to express straight into his mouth, but he was 3 months old by now and very wriggly, I just couldn’t get him to realise that the breasts were the source of his nourishment. We were also showing his lip to every health professional we saw, they all agreed he had a tight labial frenelum, but couldn’t see that it could impact on his feeding. Not that we saw many health professionals, living in the bush, we saw the CHN who did her best, and our local GP who also did her best, but none of them had experience with this problem. However, I was spending 3 to 4 hours each day fiddling with milk, each pumping session was between 20 and 30 minutes long, then I had to put the milk into DS2s bottles, or freezer bags, and I had to wash up. No wonder I couldn’t find enough time to put DS2 to the breast. Very frustrating times.
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Postby JennyD » Sun Jul 12, 2009 10:21 am

September 2007

I continued pumping 6 times a day, including over night. I was now producing an average of 1650mL per day and DS2 was averaging 900mL per day, so I was nearly making twice his intake, but I found it really hard to slow down, I was still trying to get him to the breast, and we were still worried about the blister on his lip. It was not a good thing. We went to Perth so DS could have his hearing tested, and while we were there, we had DS2 and DD2 done too. They all have excellent hearing, but the GP we saw noticed Michael’s blister and when we mentioned his frenelum, suggested we have it fixed as it could impact on his speech and teeth later on. He referred us to an ENT who agreed that the tight frenelum probably was the cause of DS2s feeding problems. So on the 23rd of September, when DS2 was 3 months old he had major surgery. It was not fun to hand my little bub over, and then pump while he was away, but it had to be done. When he came back he had to try drinking water first, which he did well, and then it was back to breast milk, which I had expressed for him. The day went well, and when we got him home, we offered the breast, but no go. He simply wasn’t interested, he didn’t equate the boob with food at all, food comes from a bottle don’t you know. So maybe if we could have convinced someone that it was important in the early days we might have been successfully feeding DS2, but at least the blister on his lip resolved.

I was still obsessed with the amount of milk I was producing. In late August I started keeping track of milk production, it was really reassuring to see the numbers on my spreadsheet. I did a 10 day average as well so that I could see any trends, and at this stage the trend was still upwards. DH kept suggesting I cut out a pumping session, but I was so worried that I would run out of milk, he pointed out that I was making 1600ml and that had to be more than DS2 was drinking, so I started tracking Michael’s consumption from mid September and yes it was more, but I wondered if it would stay more, or what I would do if it dropped. Yes I was definitely obsessed with milk. Around this time I also bought an extra collection kit, so that I could leave it set up at night ready to use in the middle of the night, and still have a clean set ready for the early morning session, one less washing up session made a big difference.
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Postby JennyD » Tue Jul 14, 2009 11:16 am

October 2007

I started to regain my life. In October, I accepted that I really didn’t need to make so much milk, so I cut one session out, and in early October cut back to 5 sessions per day, still expressing once at night, and my supply actually increased. My average went up to 1650mL each day. I could believe it, I was now expressing at 1:30am, 7 am, 11:30am, 4pm, and 8:30pm, life was so much easier. After two weeks to make sure it wasn’t just some sort of aberration I cut out the night feed and moved the day ones around so I was still expressing 5 times, at 6:30am, 9am, 12 noon, 4pm, and 8:30pm, my production did drop a little, but it went back to 1600mL per day, not really significant and still way more than DS2 needed, he was still averaging 900mL per day, so I was putting 700mL per day aside, way over the top.

October was the month that I began to come to terms with the fact that expressing was a part of my life for the long term. One day we went out to the farm, to plant trees, I expressed in the car twice that day, and while we were there I composed the following:

Bottled Love

I grieve when I bottle feed my son
Because he is not breastfeeding.
I grieve when I express my milk
Because it is a machine not my baby.
I grieve when he is sad or tired
Because I cannot soothe him with my breast.
I grieve for that special relationship
That we will both miss.

All is right
As he sleeps in my arms at night,
All is good
When he chortles at the sight of me,
All is love
As I gaze into his eyes past the bottle.

I express milk for my son.
I feed my baby bottled love.
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Postby adk » Tue Jul 14, 2009 4:15 pm

That is so beautiful. It expresses exactly how i felt bottle feeding my son, but i did not even think of expressing and giving him breast milk, i thought i had to give him formula so i had that guilt also. You really write beautifully, your story is an inspiration. Thanks for posting it.
Back in the forum with surprise bub number 3!
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