Tuesday, October 15, 2013

Why breastfeeding hurts in the beginning and how lactations consultants make it WORSE

Hannah and Maggie started dance/gymnastics classes this fall. They love them. And I met a mom through Hannah’s class who just had her fourth kid. She totally makes me feel inadequate because I just have two, neither of whom are newborns, and I feel in over my head most days. So she shows up with all four kids yesterday, including a newborn. And I’m like, are you sure? Because our family has gotten like three stomach bugs since we’ve started at this place (I’m still trying to recover from one) and sometimes I want to ask the management if they sterilize their stuff? And with what? Toddler feces? Because….um. (In their defense there have been some massive stomach bugs going around lately, I’m sure it isn’t their fault. Life happens. Enough with the judging. JK, judging is the best.)

Anyway, she is bottle feeding her week-old baby breast milk and has this look of shame that only the God-awful "Breast is Best" campaign can inspire. So she asks if I breastfed and how it went. And I tell her I managed to give Hannah breastmilk until I got pregnant with Maggie at 9 months (when I quit because the morning sickness made it all too much for me) and Maggie breastfed until the ridiculously old age of one hundred in toddler years). And I told her about the time when Maggie was four days old and vomited CSI-amounts of blood, all mine, and all from breastfeeding. I told her how I took a three day nursing break and just pumped and she latched back on, no problem.  How it didn’t hurt anymore because all the lacerations had healed and how nipple confusion is total (look away, ye of virgin eye balls) bull sh*t. My friend looked so relieved, I thought she might cry.

Then I told her how nursing Hannah caused similar pain but I had an infection. And the lactation consultants were like, it’s your latch, it’s your latch. Because here is the deal. Lactation consultants can sort of be one-trick ponies. Low supply? Infection? Breast malformation? They will try to fix your stinking latch. And next, they will probably tell you about fake, made-up things like “nipple confusion” that are not only not  really supported by research, but there have actually been studies indicate that giving babies pacifiers and supplemental formula HELPS BREASTFEEDING (not to mention pacifiers cut SIDS risk by like 60 something percent). and yet! Some lactivists continue to try to pressure women to deny their babies these things*.  Because research and breastfeeding go to gather like oil and water, apparently. 

With Hannah I had a horrific infection. It went undiagnosed (because nurses don’t or at least shouldn’t diagnose, unless they are advanced degree nurses) until my six-week check up. Because my RN lactation consultant wrongly informed me it wasn’t an infection. She told me to work on my FREAKING LATCH. Meanwhile, I have scar tissue now. Yeah. Gross, right? It looked like a rabid beast attacked my freaking nipples. My OB and his nurse just stared at me, horrified that I had lived like this with a newborn for so long. Tears were streaming down my face because I developed secondary complications called Raynaud’s syndrome where my blood vessels would constrict with exposure to cold due to all the trauma to my nipples, and awesomely it caused even MORE PAIN. Like the fact that I didn’t develop postpartum depression JUST from breastfeeding complications is kind of a miracle.

Here’s my advice if you have a newborn and are experiencing pain

First of all, don’t feel like you are a failure if you want to quit. Your baby will be fine! The thing that made me cry more than anything was the thought that I was letting my baby down and not giving her “The Best™.” Screw. That. Know that no matter what you feed your baby, you are trying your hardest and giving your baby the best. 

Second, if you want to make this breast milk thing work, get a good breast pump. Rent a hospital-grade one if you just want to get through the early days or get one of the top of the line Medela ones if you are going for the long haul. The reason this hurts generally isn’t because your latch sucks. It hurts because your baby sucked your nipples raw trying to get milk from a basically dry well (there is not much colostrum, sorry, it is true, and they are mostly sucking for comfort/because that is about all they do at that age); and they probably left tiny lacerations on it. Sometimes they are so small you can’t even see them. When Maggie spit up all that blood (and it was A LOT), I couldn’t even see the cuts that she managed to get all the blood from. Pump exclusively for a few days and let the cuts heal. It is a total lie that a pump can’t replicate the baby’s suck. You just have to pump frequently. With Hannah, I was totally paranoid by these lies and pumped so much, I was making almost 60oz a day at one point (most babies only drink 30oz a day at their hungriest age) and finally asked on a pumping mother's online board if I quit pumping at night if I’d dry out? they were like, “stop! get some sleep! you’re boobs are going to explode! you only have one child, what are you doing!?” Here are some great tips on how to get enough milk. Make sure you pump at night, early in the morning, and pump until your boobs are empty.

Third, usually a three-day break from nursing is all it takes to let the little lacerations heal. And unless there are other issues with the baby/your boob, most kids will latch right back on. If you are still in pain after three days, go to your doctor to see if you have an infection like thrush. 

Fourth, you’re doing great! You’re an awesome mom. Your kid will be fine. And if anyone tells you otherwise, punch him/her in the throat for me.

*I want to say, not all lactation consultants can be painted in broad brush strokes. For example, although my LC did insist the freaking latch would solve everything, she was also very evidence based about nipple confusion and was okay with supplementing and giving pacifiers. So I know they come in all shapes and sizes. I just mean to write this more as a beware of the worst-case scenario of LCs/lactivists/etc. I’m all about breastfeeding and supporting breastfeeding moms. I am not, however, about shaming them or misinforming them.
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