Tyler: Week 4

July 14-July 20, 2010 (3w-3w6d old)

Well Visit:

Tyler had his well visit at 21 days old.  We got room #7 again.  The doc checked his circumcision and said it looked really good.  The nurse weighed and measured him.

Weight:  7 lbs - 5th %tile (the seven's just continue to keep following us)
Length: 20.5" - 24th %tile
Head Circumference: 13.5" - 4th %tile

The doc addressed some concern about Tyler's weight.  While he gained 6 oz since his last visit, he should have gained a little more.  He asked how breastfeeding was going so I told him about the issues we've been having.  He suggested a lactation consultant to help us get this latch issue resolved and in the meantime, to pump and supplement with breast milk in addition to breastfeeding.  He also suggested bumping up the feedings from every 3 hrs to every 2.  Considering each nursing/pumping session currently lasts 1.5 hrs, that means a 30 min break in between sessions.  Whew, I'm going to have to fine tune this process and become more efficient or I'm going to drop over from exhaustion.

Breastfeeding:

Well, according to the well visit, it hasn't been going well at all.  I had no idea Tyler hadn't been getting enough milk since my boob doesn't have a gage on it and he pees all the time.  I came back from Tyler's appt with shear determination to make this work.  I upped the breastfeeding and pumping sessions.  I started researching the heck out of breastfeeding solutions till 2 am.  This is when I came across the evil nipple shield article.

Basically the nipple shield gives the illusion that all problems have been dealt with when in fact they have only been covered up.  It doesn't allow baby to latch on properly, they suck the nipple like a bottle and do not take in the areola which compresses the milk out.  This limits the amount of milk the baby gets and slowly decreases your milk supply.

Appearance:  Tyler was getting enough milk as he was content after nursing.
Reality:  Tyler was tired from sucking, not from getting enough milk.

Appearance:  Tyler was getting most of my milk since I only got a small amount when I pumped after nursing.
Reality:  My milk supply was diminishing.

Appearance:  Tyler was gaining weight.
Reality:  Tyler was gaining some weight as I was supplementing in addition to nursing with the evil nipple shields.

It wasn't until we saw his weight that we realized there was a problem.

This whole thing threw me in a tailspin.  I felt like a horrible mother who was starving her baby.  I threw out the nipple shields and tried to nurse without them.  Tyler would bite so hard I was literally in tears.  I didn't care, he needed to learn how to latch properly.

Around 3 am, I opened up the SNS (supplemental nursing system) I had ordered.  I filled the bottle with expressed breast milk and taped the tubing down my chest and to the edge of my nipples.  This is supposed to give baby immediate gratification at the breast to keep them there.  I woke up Tyler and gave it a go.  It was a disaster.  Tyler was frustrated, his flailing arms were ripping the tubing off my nipples, milk from the tubes were leaking all over us and now I was frustrated too.  We both just sat there crying our heads off.  I gave up and let him suck the milk from the tubes.  I don't know how Kerry managed to sleep through it.

The next morning I told Kerry what had all happened.  He gave me a hug and said don't worry, we'll get this taken care of.  I continued to work on Tyler's latch all day, again it was all frustration and tears.  Kerry called me a little later from work.  He had called our midwife and got a referral for a lactation consultant.  Supposedly this LC was well known and could fix any issue.  He got me an appt for the next morning.  I was asked to bring in all my feeding/pumping supplies and to bring Tyler in hungry.

At the appt, she went through all my supplies.  She grabbed the First Years Breastflow bottle and said, that's junk.  She grabbed the Born Free bottle and said, that's not good.  She then grabbed the Dr. Brown's bottle and said that was the best of the bunch.  She then recommended the Medela special needs (formerly Haberman) bottle as it will allow the best transition going between breast and bottle.  I ordered one when I got home.

She asked me to remove my shirt and to get comfortable in the recliner.  She examined my boobs and manipulated my nipples.  She said there was nothing wrong with my nipples and that they were perfectly fine for nursing.  She then examined Tyler.  She confirmed that he is not tongue tied.  She held him in different positions to check for his reaction.  She checked to make sure his ears were even and checked his jaw.  She felt his suck and examined how he used his tongue.  She then weighed him for a pre-feed weight.

She labeled Tyler as an archer.  He arches his head and back while feeding and it worsens if you put your hand on his head or back to guide him.  I always thought he was fighting me when I tried to "help" guide him in.  Apparantly the sensation of pushing on his head or back causes a arch reflex in him.  She said he also has a weak latch and attaches to just the nipple.

She taught me how to prime the nipples.  First she had me push in on my areola with all 8 finger tips.  This is to soften the areola and release the milk from the area.  Then she had me grab my nipple between my thumb and index finger and pull it out, rotate half a turn and pull again.  She called this cherry picking.  This erects the nipple.  Priming helps the baby to latch on properly as they need to be able to suck in the nipple and areola and that's not easy for them to do if the areola is engorged and hard.

With me reclined at a 30 degree angle, she held Tyler over me face down until he relaxed and his head fell forward and his back rounded.  She then laid him on my chest and let him root around.  She had me push in on my areola with my index finger right where his nose would go.  This caused my nipple to point towards the roof of his mouth.  Once his mouth was open wide, she guided him on and then I let go of the areola.  We practiced this several times.  She rotated back and forth between breasts and weighed him in between each to see how much he was taking in. 20 mins later he was done and had taken in what he needed.  I was amazed, and there was no pain!!!  She was a miracle worker!!!

She then had me pump to see what was left.  She put olive oil on my areola prior to pumping and oh wow, the pumping was so much smoother and didn't leave me so sore.  We only got a small amount, so he took in most of the milk.  She then ran the breast milk through a machine that gave how many calories my milk is per ounce.  My milk has 50% more calories than formula.  I asked her if it's related to what I eat and she said, nope, the body just knows what the baby needs.

We asked her about pacifiers and she said absolutely, use them, it helps with his suck, but to only use Soothies.  Great, that's what we were using.

She sent me home and asked me to come back 3 days later and wanted to see a 2 oz gain.  I attempted this entire new process when I got home and it was much harder without her help.  This was going to take some practice.  No problem, there would be around the clock opportunities to get this down.

At the next appt, she weighed him and he had gained exactly 2 oz.  Yeah!!!!  We basically repeated the process and she helped me fine tune my technique.  I asked how long each session should last and she said to do 5 mins on each boob 2x for a total of 20 mins, or 40 mins max and then pump right afterwards.  She thought it was great that I was already taking Fenugreek and Blessed Thistle and asked me to bump up my vitamin D.  I asked her if I needed to come back and she said nope, I think you got it down.

Now on my own, the rest of the week had it's ups and downs.  Some sessions went beautifully where he latched on perfectly and I could hear him gulping away.  Other sessions, he fought it, gnawed on me, got frustrated, screamed and punched.  But we were making good progress.  I borrowed my mom's postal scale to make sure he continues to gain weight and so far he is.

Sorry for so much detail, but my hope is that this can help someone in my shoes.  My advice is to seek help right away and to not give up.  I went through 5 lactation consultants before we found the help we needed.

Tyler Update:

Tyler has cradle cap.  It really shows up after a bath.  His entire scalp is one big flake.

We're starting to see faint dimples!!!  Looks like Tyler's inheriting daddy's dimples, yeah!!!

Tyler has acquired the nickname Little Toot as he's a very rootin' tootin' gassy boy.

Show and Tell:

Great G-momma feeding Tyler

G-momma holding Tyler

Tyler sleeping in Daddy's spot.

Disclaimer:  No child was put at risk with pillows and blankets, I was sitting next to him the entire time he was sleeping.  ;-)

Tyler zonked out on Mommy's lap

Mommy trying to wake up Tyler

Mama Update:

I haven't weighed myself this week but I know I've come to a standstill.  Looks like I'm going to have to work at getting the remaining baby weight off.

I started experiencing what they call "let down" this week.  When it came time to feed and Tyler would start crying, my boobs would out of the blue start leaking and I would have milk pouring down me and dripping all over.  It was the weirdest thing!