For my faithful blog followers who are clamoring for this post, here it is! Warning: it is long.
I wrote Part 1 of “Feeding My Baby” back in April. Then crazy time happened (crazy time = trips to Tennessee, California, Georgia, Wisconsin, and Michigan while moving internationally but first moving temporarily to two different locations in Tennessee, all with an infant). The motivation for these posts is one part sharing our life with you and another part commemoration of an important journey that has been more challenging for me than I anticipated. I intend to share the links to these posts with friends who are pregnant and thinking of breastfeeding in the future. Many women spend a lot of time reading birth stories, but there are fewer resources for new moms on the reality of those first challenging few days, weeks, and months.
In the last post, I covered our preparation for breastfeeding and the initiation of our breastfeeding relationship (“breastfeeding relationship” is an oft-used phrase in the lactation world) in the hospital. Now I will talk about the two major issues we faced in the first month.
The First Snafu
We were discharged from the hospital on a Saturday afternoon, and our first pediatrician appointment was the following Monday. We didn’t know much about going to the pediatrician, but we were feeling generally good about ourselves for surviving 2 whole days at home with no grandparents or overnight help. Our routine was something like: baby cries (or shows other earlier hunger cues), put her to the breast; baby falls asleep, momma tries to sleep. Repeat. All day and all night. She loved to be close to her momma, and it was difficult to set her down when sleeping, especially at night. But she was always happy on the breast.
The main thing the pediatrician’s offices always does is weigh the baby. From her birth weight of 9 lb 5 oz, she had gone down to 8 lb 10 oz. I knew that losing weight was normal, but I was a little surprised that she had lost almost a pound, around 8% of her body weight.
When the doctor came to see us, I was further surprised that he zeroed in on her weight loss and seemed very concerned. He asked me if my milk had “come in,” and I said it hadn’t. He said we’d need to start supplementing that night if it didn’t. He also asked if I was going to be one who puts up a big fight about breastfeeding and not supplementing. I had not really considered whether I was “one of those” or not. I just thought it was supposed to be normal, and normal = easy, right?
We left the office with instructions to return the next day to get set up with donor breastmilk from the hospital if my milk didn’t come in overnight and the tips to eat barley and oatmeal and to drink mother’s milk tea.
Back at home, I was pretty much a wreck. The way I understood the process of milk “coming in” is that the baby stimulates the breast over the first few days, and the original, thick colostrum turns into thinner, milkier milk. And you know that the milk has arrived by a change in the breast tissue, which will likely become very firm and painfully engorged.
At 7 A.M. on the morning after the pediatrician’s visit, my milk hadn’t come in, and I was losing it. By this time I had decided that yes, I was one of those ladies who wanted to avoid supplementation if at all possible. So I called in reinforcements. 7 A.M. was the earliest decent hour I figured one could call a private lactation consultant. I rang The BABES, but I couldn’t even finish a voice message without breaking down. I handed off the phone to T and said, “give them my number.” He said, “hello??” I cried harder, “It’s a message!! Leave our number!!”
Leah called back by 9 A.M. and came to see me that same day by noon. Can you say AMAZING? She took down a history of KLC’s weight and told me she’d do a weighed feeding to see if and how much the baby was eating. She also calmed me down 1000% and assured me that many healthy babies lose up to 10% of their weight, that the scales used were not the same so the comparison was more prone to inaccuracies, and that KLC looked and acted very healthy. As I fed KLC, Leah observed my latch and made helpful suggestions. Within the first minute or so of feeding, she had me unlatch the baby to show me something and look, there was milk, running down KLC’s face.
My milk was in. I never got engorged or felt any pain. Leah told me this was uncommon but within the normal range of experiences for breastfeeding mothers. I’ve never called a doctor’s office so quickly to cancel an appointment.
Leah returned a few days later for another weight check, and KLC was well on her way back to her birth weight, which she ultimately achieved right at the 2 week mark. Regaining the baby’s birth weight by 10 days – 2 weeks is considered normal and healthy. In retrospect, I see that our first two weeks were utterly normal. I would not panic in the same way with another child, and I know now that having an epidural and the attendant fluid administration affects both the mother and baby as they initiate breastfeeding: the baby’s birth weight is likely inflated by at least a few ounces from the fluids she takes on in utero, and the mother’s milk is often delayed due to fluid retention. I am still a bit surprised at our pediatrician’s alarm over an 8% weight loss, especially given his reputation for being natural parenting and breastfeeding friendly, but I also think that my subsequent distress was mostly due to my own hormonal state.
The Second Snafu
Breastfeeding firmly established and birth weight reachieved at the 2 week appointment, T and I welcomed his family the next day for a 5 day Christmas visit and then flew to Florida to spend 6 days with my T family. KLC charmed one and all, and we enjoyed showing off our lovely gift. As the time to return to Houston drew nearer, KLC seemed fussier day by day and stopped letting me put her down in her crib almost at all for several nights. I chalked it up to the abnormal amount of stimulation and did what I could to soothe her while still trying to maintain some sort of schedule (no eating for at least an hour after the last feed, more or less).
On New Year’s Eve we returned to Houston and visited the pediatrician again, this time for a re-do on her state lab work. Her newborn labs had triggered one red flag, so we were anxious to get the lab results back from the 2 week labs, but apparently the tech hadn’t drawn enough blood. We were annoyed to have to have her pricked again, but I wanted the results so I brought her in just hours after landing from Florida. After the lab work was complete, I asked to get her weight checked, which can be done any time at no charge in that office.
Normal weight gain in the first month or two is a little less than 1 oz per day or 4-7 oz per week. KLC had been weighed at her 2 week appointment 12 days before the visit on New Year’s Eve, and her weight gain was 2 oz. For 12 days. Suddenly my quick weight check turned into, “The doctor would like to see you,” which meant waiting an hour or more to get squeezed into his schedule. I could barely stay awake while waiting because I was so exhausted from our trip.
Gloriously, the doctor seemed less anxious about this lack of weight gain than he had been over the initial weight loss. Perhaps he could see that I took the lack of gain pretty hard and was already resolved to re-dedicate myself to feeding the baby whenever she so much as made a peep and to re-establishing a calm home environment. I didn’t need a lecture. We agreed that we would take a “wait and see” approach, and I made an appointment for another weight check one week out.
Re-enter Leah. I called her again to come visit us and make sure we were doing all we could to encourage the baby’s healthy growth. She once again was reassuring and mostly coached me on pumping. To maximize my production, I began to pump after KLC ate and then attempted to feed her the pumped milk as well as what she ate. I also began taking herbal milk supplements.
I gave up on the pumping/feeding pretty quickly because it was all so time consuming, and there was no easy way to feed the pumped milk to the baby without using a bottle. I was hesitant to start a bottle because I didn’t want to introduce any nipple confusion in the midst of an already difficult time. I did continue pumping about 1x/day to continue to stimulate production and to being saving a stash of milk for when I returned to work
Sure enough, without making any major changes except feeding on demand and un-stressing my world a bit, KLC began to gain normally again. We bought a scale to monitor her weight at home. Home scales aren’t recommended for everyone, but I decided that having some data would be better than having no data and getting surprised at the doctor’s office. Her weight has fallen nicely into the 50-60th percentiles for baby girls and has continued on that growth curve through her 6 month appointment.
My primary lesson learned from our snafus with breastfeeding is that it pays to know what resources are available to you before your child is born. In addition to Leah, who is worth her weight in gold, I availed myself of a free breastfeeding support group at a Houston-area hospital, a Facebook-based breastfeeding support group, and another lactation consultant provided through government funding who is available to all moms if you can come to them and in-home to moms on WIC. I felt a little strange about paying someone to come to our house for a consultation, but afterwards I would have paid 10x her fee. Having an in-home visit during that first emotional and exhausting week at home was so, so nice.
I am so grateful that our breastfeeding snafus were not real difficulties in the end and that KLC continues to grow as the picture of health. As I type, I am watching her show off her skills at pulling up on the coffee table and couch to her NaNa and Grandpa. In my next and final post on feeding my baby, I intend to write about breastfeeding and returning to work and what it has looked like to continue breastfeeding as life has sped ahead.