Monday, May 05, 2008

Breast Intentions

Well if the title of this post doesn't tip you off, here is the big, bold TMI warning:

I am now going to talk lots and lots about breastfeeding. If this makes you uncomfortable than feel free to leave and come back another day. Consider yourself warned!!!

The breastfeeding talk will begin after these photos of Michael. . .

When Harper was young we were really lucky in that I had very little trouble breastfeeding her. I think I even managed to realize this at the time. She took to it right away, I produced plenty of milk, and I never had one single complication. The biggest problem we had was keeping her awake to eat enough and that was just at the very beginning. Harper never would take a bottle, so the most difficult part of breastfeeding her was that no one else could ever feed her for the first six months of her life.

Michael has been eating fortified breast milk since birth, which means I have spent lots and lots of time with the breast pump. When he finally got the go ahead to try directly breastfeeding he didn't take to it at all, but he was so little I didn't fret about it too much. Now here we are, he's nearly two months old, and the child has still not taken to breastfeeding.

With the exception of middle of the night feedings, I have offered Michael my breast every time I've fed him, but he was still not getting it at all. Last week we had an appointment with a lactation consultant at the hospital where he was born (totally free, by the way, for babies delivered at that hospital). The lactation consultant helped me work with a nipple shield and at least made a good show of being convinced that Micheal would get the hang of it. Incidentally the pediatrician said that Michael was gaining enough weight that if I wanted to battle him over breastfeeding a bit she wouldn't be worried about him burning too many calories in the process.

So now Michael's feeding time looks a bit like this:

Part One -- Struggle with Michael and the nipple shield. About 40% of the time he just snuggles up to me and falls asleep. About 40% of the time he gets really, really angry and screams. About 20% of the time he seems to actually get some milk from my breast before resorting to one of the other two options.

Part Two -- Feed Michael from a bottle until he seems full. There has yet to be a breastfeeding session where he doesn't take at least another ounce from the bottle, and he usually takes two or more.

Part Three -- More quality time with the breast pump, to make sure the girls were emptied and keep producing milk.

The whole process, when you add in diaper changes, bottle preparation, and cleaning of all the bottles/equipment, can take from an hour and a half to two hours. Michael eats every three to four hours, from the start of the previous feeding. You go right ahead and do the math to figure out how much time that leaves when I am not engaged in feeding or producing milk. Not much!

This is not a sustainable way to live/function for us as a family. Especially on nights when Matt has practice and isn't really home until after Harper is in bed. If it weren't for continued help from our parents we wouldn't even be having this discussion because I would have had to ditch the pump long ago.

Here are my options:

1. Continue things as they are, which is not really much of an option.

2. Forget trying to get Michael to breast feed directly, but continue pumping several times a day so that he can continue to drink breast milk from a bottle.

3. Continue giving Micheal breast milk until our supply of frozen milk is exhausted and then switch to formula.

4. (The Best Possible Scenario) Continue to struggle with the direct breastfeeding until Michael gets it and we are able to ditch the pump and the bottles, at least most of the time.

Here are the reasons to continue feeding Michael breast milk/encouraging him to breastfeed:

1. I had a wonderful experience breastfeeding Harper and I want that bonding/closeness with Michael.

2. There are health benefits for both of us if I breastfeed him.

3. If Michael gets the hang of it we will be able to leave the house and I will have everything I need to feed him without any extra equipment. I loved that I could feed Harper almost anywhere with nothing to prepare or clean up after (diapers not included!).

4. Formula is ridiculously expensive.

5. I have spent so much time pumping to make this possible that I hate to quit now.

6. I really want to do it!

Here are the reasons to say we've tried this long enough and just switch to formula when our supply of milk is exhausted:

1. Unless Michael learns to directly breastfeed soon this just does not seem like a sustainable situation.

2. I spend so much time pumping and feeding him, I am hard pressed to find time to interact with Michael outside of feeding times. I don't feel like I have any time to enjoy my baby because the window of time when I'm not engaged in pumping or feeding I'm frantically trying to do everything else.

3. Under the current circumstances I have very little time to give Harper my full attention or any attention at all.

4. I have found I must pump at least once during the night to keep up my supply which leaves me with even less precious time to sleep.

5. Other people will continue to be able to feed Michael. Matt always takes one of the overnight feedings and that makes a huge difference in my ability to get some sleep.

6. There is at least one moment in every day when I want to collapse in tears because I just can't do this for one more minute.

So what do I do? The lactation consultant would have me give Michael at least another six to seven weeks to transition completely to the breast. The pediatrician says I have to weigh the benefit of breastfeeding against the stress of our current situation and will be totally understanding if I never use the breast pump again.

I am actually asking for advice here. I know that breast milk is the best for babies, but I also know that formula is not poison and may end up being the most realistic option for us. Please chime in here! I am calling on your collective wisdom for some guidance.

(Seriously, if you actually read all the way through this post, you must have formed some opinion. . . spill it!!!)


Anonymous said...
This comment has been removed by a blog administrator.
Anonymous said...

It is your decision, but I will support you in whichever one you choose. I love you.


Maggie said...

Oh that sucks! What a rough spot to be in - when there isn't an easy answer.

The RN in me says that there are some kids who really just don't take to breastfeeding, despite overwhelming desire for it on the part of the parents. If I were in your situation, I would set a time (maybe 2 weeks, I would never make it 6 or 7. Gah!) and after that, if Michael hadn't decided that he LOVED breastfeeding, I would switch to formula. I don't know that I would continue to pump quite as frequently, as one of the major desires I would have is to stop spending so much quality time with the pump.

Good luck!

Jana said...

Hi....I found you through Mommy Daisy when Michael was born. I've thoroughly enjoyed reading your blog!

My first child never got the hang of breastfeeding so I did the whole pump and bottle feed thing, too (also with a pumping session in the middle of the night). I lasted four months. I felt guilty about stopping, but like you, I was stressed out, exhausted and so tired of the pump I was about to throw it out the window. In the end, I came to the conclusion that it was better for her to have a happy mama than to have breastmilk. Besides, I comforted myself with the thought that she got the colostrum (spelling?) at the beginning and that was the most important part anyway.

Like Maggie suggested, I would set a time limit for him to "get it" and then move on. You can honestly say you tried and then move on (and get some sleep).

Anonymous said...

I'm still nursing Sophia and can honestly say that it has been a mental battle every day. My only trick was setting a date in my head of when I could stop. Once I got to that date, I weigh my options (money, convenience, my sanity) then choose another date. I agree with everyone else, choose a date then move on. Kelsey, he'll know you love him no matter what.

Jen said...

My sister pumped for 1 year because my niece had a hole in her heart and couldn't take the stress of breastfeeding directly. Sis took the pump with her everywhere (including to work where she is a police officer and works 60 hrs./week). I only say this to encourage you that pumping can be done long-term if it's what you decide. Personally, I'd stick with trying to breastfeed because it really helped me bond with our 3 kids (especially our last who surprised us by being born with Down syndrome and a hole in her heart). Overall though, choose what's best for you and Michael and don't worry what others think. He'll know he's loved whatever you decide.

Shannen said...

I have 3 girls and bottle/formula fed all three of them because I simply didn't want to breast feed. They are healthy, happy and the love of my life! Don't stress over it if you end up bottle feeding, the first year goes so fast and you don't want to remember it as having just been one big stressor, ya know? Many of my friends bottle fed too and they all have happy, healthy kids as well :)

Good luck!

Erin said...

Oh my goodness. I had a comment formed in my head, but then I saw Matt's comment and I got all teary.

What was I going to say?

OH. It sounds to me like you are not ready to give up trying. I say keep trying FOR NOW. Or, an alternate option: give up trying FOR NOW, and take another two weeks before trying again. Or, until Michael is a solid 9 pounds, and then try. But it sounds to me like you really want it to work still.

My other 2 cents is that I wouldn't worry too much about Michael deciding he won't like the bottle (like Harper) if/when he starts to breastfeed. I'd bet $100 that he'll continue to take a bottle just fine, no matter what direction you go.

I feel for you, Kels. That is exhausting.

Kate said...

I came over from Erin's blog a while back and have also enjoyed reading your posts. Your children are so lovely!

I feel so much for you, your post sounds so familiar - that feeling of doing nothing but either breastfeeding or pumping and never getting a break or a glimpse back into your life outside feeding the baby. I can't imagine what it's like with a toddler on top of that. I agree with the others that it might help to set a short term deadline (and yeah, 7 weeks is NOT SHORT TERM ENOUGH!) and decide after that. I'm new at this mom thing but I do seem to recall that my guy turned a corner around 2 and a half months in terms of getting the whole breastfeeding thing.

There isn't a wrong decision here. Keep your own sanity and happiness in mind - they are important for both you and your kids! Good luck and I will keep you in my thoughts!

Swistle said...

I even exclusively breastfed TWINS, so you would think I'd be all strident and bossy and opinionated on this topic, and yet NO. My brief experience with a breast pump and a non-nursing baby has made me feel as if ALL BETS ARE OFF when a pump and a struggle are involved. TONS of babies do BEAUTIFULLY on formula, and I don't think anyone can tell one whit of difference later on: it's not like we say, "Oh, THAT third-grader was DEFINITELY a Formula Baby!"

I think if I had to pump and struggle as you describe, my plan would be to take it one feeding at a time. Each time, I would think, "If I want to, I can totally ditch it after this feeding and never look back." And when I got to the session that made me think, "Good. I WILL," then I would.

rccalyn said...

Wow. Good job for hanging in there so far. I breastfed my daughter (now 2) for 19 months. For the entire first 4 months, I was in tears every time because of pain that no one could help me fix. Once we FINALLY figured that out (just thrush), it was heaven. It really is just so easy and convenient! But there were many times where I sobbed to my husband that I was done, we were switching to formula, and that was that! With that in mind, here is my (not so) expert advice :-P Try really really REALLY hard to get him breastfeeding withOUT any shields. What a pain! I would say give him a full day of laying in bed, skin to skin, no shields, no bottles, no formula, ONLY breastfeeding! Or even two days. And if that really doesn't work, then I'd say you have the right to quit! I've heard that advice given by many La Leche Leaders to many moms in different situations. I hope you at least give that a shot!

Pam said...

This may not sound very helpful but it's your decision. Do whatever you need to do to keep you & Michael & your family happy.
I breastfed for 1 month and my son is healthy and happy - it was my decision and one I don't regret.

Weed said...

Hi, I'm a friend of Emily's and started reading your blog while you were on bedrest before Michael was born. I've enjoyed following things.
Okay, so I'm a stranger and what I have to say won't matter much, but I'll say it anyway. I had every intention of breastfeeding my daughter. I did everything they told me to, visited several lactation consultants, and endured pain and pumps and shields and such, but my milk wouldn't come in, so she was losing weight and we were both miserable. It was the hardest decision I've ever made, but with my husband's total support we switched to formula. It ended up being a great decision for us, as the stress and pain and dread of feeding time went away and feeding became much more joyful and we bonded just wonderfully. (Not to mention the benefits of having my husband get up for one of the nighttime feedings!)
That being said, like everyone else has pointed out, it's your decision and don't let what anyone else thinks make it for you--you have to do what's best for you and Michael and the rest of your family.

Anonymous said...

i had the exact same situation. after 4 months of bedrest i had a preemie. she refused the breast. refused!!! i tried and tried. met w/many lactation consultants. at first the nipple shield helped (but i always had to supplement w/bottle) but then she stopped that as well. it was SO frustarating. i had a toddler as well (20 months apart) and was soo difficult to do this and care for him. and i got no sleep. i ended up pumping only and giving her bottle. at least she got my milk, and it was quicker than doing the breast and pumping. i pumped for 7 months and supplemented w/formula. i was very sad about it because (like you) i had a great experience w/my first child and felt like i really missed out on the bonding. but there are so many other ways of bonding and you need some rest for a piece of mind! i thought i was literally going to lose my mind (from lack of sleep and stress of of preemie after bedrest and 2 under 2). take care of yourself. you need to be healthy for your kids. i heard the first 6 wks are the most important for breastmilk, and you already did that. if you have any questions, you can email me at good luck!

Kate said...

There is NOTHING worse than pumping and then bottle feeding. YUCK. I did it for two weeks (until the lactation consultant informed me that I wasn't making enough milk and sent me home with formula). I hear your pain. It took me 30 minutes of pumping to get 2 ounces... and then Colin took 40 minutes trying to nurse and then another 30 minutes on the bottle. By the time he fell asleep it was time to pump and repeat. Ugh. If it's any consolation at all... he seems no worse for the wear having been formula fed. The best part was that Greg could help with the feedings. The worst part was the expense and the feeling of "loss." Best wishes. And Michael looks GREAT!!! What a sweetie! I can't get over how much he's grown!

Emily said...

Ugh, Kelsey. Honestly I am totally impressed that you have kept it up this long. I can only imagine how exhausting it must be on a daily basis. And the nipple shield - UGH. I had to use that with Katy (she had a really hard time learning to nurse) for 5 weeks until she learned to latch on directly and that was 5 weeks too long. If you keep going with pumping, good for you, but you have given it a GOOD college try, and maybe formula would be the best option for your family as a whole. I think if I were in your situation, that's what I would do. I told myself this time I wouldn't put as much pressure on myself to nurse for a year like last time, and only because David has done so well with it am I not waivering on it right now.

And I agree with Erin, Matt's comment is perfect.

Lil Mouse said...

i havent had to do this stuff yet, but is there a point where he WILL be hungry enough to give it a go? I'm not advocating starving him, but it sounds like you're really committed to getting him to 'feed, so I wonder if him missing a session and then being rewarding by 'feeding might not do the trick?

is that wrong? sorry if it is. just kinda seems like he hasn't gotten the hang of it, and if you can get the guilt off of your mind and just let him cry himself to sleep a few times and then voila get some yummy food by doing what you're 'suggesting' then maybe it will click, oh THAT's what those are for... etc..

again, sorry if that's wrong?

Christina said...

Hi Kelsey...What a situation. First and foremost, you have already bonded with Michael, so I wouldn't worry about that. And while I also hauled around my breast pump for the twins, when it came to the little guy, it was harder to deal with both his needs and theirs. In the end, I was exhausted, mentally and physically, from doing a routine similar to yours (he did take from the breast, but it just wasn't enough so we nursed, pumped, and bottlefed in one session).

I know you know this, but you have to do what is best for you and your family. He is thriving right now, and will even if you end up switching all the way to formula.

If that isn't a solution you can live with, you could switch entirely to bottle feeding, and pump only say 3 times a day. That way, at least what you are giving him is part breast milk, part formula.

I think having a child once you already have another in the house means we sometimes have to put our ideal situations to the test.

Either way, I support you. Just thought I'd give you my two cents.

Giselle said...

Ugh. Kelsey. I admire you for doing what you are doing. Anytime you question what a good mother you are, you need to remember these sacrifices you have made for the good of your children.

Breastfeeding is great. Bottle feeding is great. Doing both? I would think not so great. So here's my opinion (and Jeff's best way for figuring out how you REALLY feel about a decision). Wake up one morning and say to yourself that you are not pumping another minute. That you are giving him what breastmilk is left and then formula. And tell yourself that an entire generation of babies grew up on formula (our parents) and they are running our country and inventing things and living long and healthy lives. Go a day without pumping and feeding him (your milk supply will survive a day, right?) And then see how you feel. Do you feel relieved and excited to be away from the pump and a little sad that breastfeeding is over? Or do you feel devestated and disappointed and guilty and miserable? And I would let your feelings help you decide. In my experience, deciding one way or the other...even if it's just for pretend...reveals your true feelings about tough things like this.

You are such a good mommy. I just wish I could be there to give you a big hug. And to use Harper as a playmate for my own bored, neglected 4 year old ;)

And, seriously...I've only met Matt once, but I want to give him a big old hug now too.

CARRIE said...

I found you from Giselle's blog and have been keeping up with little Michael.

Breastfeeding "issues" helped launch me into postpartum depression/anxiety, so take care of yourself above all else.

But, since Michael is a preemie, my gut tells me he really benefits from your breastmilk, and some breastmilk is better than no breastmilk. It doesn't have to be all or nothing. Give him what you have stored and pump enough so that he gets some (you determine how much some is) and then give him formula.

Think of this situation as him continuing to forge his own unique path in the world, different from his sister. (This thought helped me get a grip when my son had to be delivered c-section even though I wanted a natural, vaginal birth like what I had with my daughter).

Good luck with whatever you decide.

Anonymous said...

I want to take a nap for you! I had a horrible time breastfeeding my daughter the first few weeks--seeing the lactation consultant numerous times, pumping to keep up my supply (they even wanted to put me on some kind of herb), etc. And you are right, because when you add in diaper changes, feeding, and pumping, you have NO time to do anything. I wanted to scream and cry and would have done anything for a decent night's sleep, so I totally understand how you feel. And I didn't have a 3 year old to watch as well. Eventually, we got in a rhythm and were good, even though she nursed every 2-3 hours even at 4 or 5months old. I'm glad we did it, for many of the reasons that you mentioned, but you have to take care of yourself as well. An exhausted, stressed out mommy is no good to Michael, Harper or Matt. So, I agree with the others--give him a few weeks (but not 7!!!) and see what happens. You have definitely given it more than a fair try. He seems to be thriving so well, that I think he will do great no matter which way you go.


Anonymous said...

Please feel free to email me and I can give you my phone #, too. I can relate to all you're saying - it happened like this with my little 2 #, 13 oz., 7 week early preemie son. I vividly remember every single thought that crossed my mind during this process, even though it was 6 years ago. I can empathize with you 100%. I emotionally agonized over the "to breastfeed or not" decision. I'll gladly share how my outcome went.
Beth Anne (Jill's sister)

Liz said...

Luke never got the hang of breast feeding. I pumped like a crazy person for 4 months and started freezing a lot of the milk. When he was 4 months old we started a breast milk/formula combo and then when he was 6 months the breast milk was gone and he was then a formula baby for the next 5 months.
Hang in there as long as you can and keep doing what you are doing. You can always pump like crazy to bring in even more milk and just start loading up your freezer! :) If you have a deep freeze freezer milk can last up to 6 months!
You will be fine and Michael will be fine. You are a wonderful mom and he will love you regardless. :)

Astarte said...

When I was a teenager, I had a botched lumpectomy in my left breast by a doctor that turned out to be in the beginning stages of altzheimer's disease. He severed the nerve that triggered my letdown reflex in that breast, and along with all feeling in that nipple went went my ability to feed on that side. The milk came in, but couldn't come out. I tried for weeks to bf the kids, but doing it with only one side working was nearly impossible. With Josie, our oldest, I sobbed and sobbed, because I SOOOO wanted the experience, but after a few weeks my DH put his foot down in the middle of one night and got a bottle from downstairs. That signaled the end of the booby. With Patrick, I managed to hold on for a month or so, doing a few feedings a day and gradually supplementing as he got larger until he was all-bottle. While I wish I could have done it, nine years later I have to say that I've gotten over it. Josie is in Talented and Gifted pull-out classes, and Patrick could read fluently at four. Obviously, it didn't harm them.

I think what's best for you both is what fosters a happy family. You being overtired, overwrought, and constantly fretting isn't helping him or you, or the rest of your family. You're already past the six-week point, so anything else is gravy. I would say, use what you have left in storage, and give yourself permission to let go of this particular desire.

samantha jo campen said...

Oh honey. I kinda know what you are going through because I had to do the whole pump and bottle feed thing in the beginning, then met with a lactation consultant three times when we tried to go All Breast. It sucks. All the pumping and washing and blah blah blah.

Where we are now: nurse him whenever I'm around. But! He's never full! So we suppliment with formula to 'top him off' and give him a full belly (2-4 oz after every feeding). I have formula guilt. But it works for us. Plus we both haven't gotten the hang of nursing in public (positioning, etc.) so I bottle feed him when we're out too. He's happy. I'm happier. More people can feed him. I get more sleep.

Sadly, the main thing that pushes me to keep nursing? The cost of formula. We go through a $25 can every 8-10 days.

Michael is getting big and he is benifitting from breastmilk. But I know what it's like to want to rip your skin off your face because you can't do it anymore. Like you said, not another single second.

I like the goal idea. It has worked for me. Tell yourself "I'll nurse until 'X' date" Then when you reach that date reevaluate your situation. At two weeks when I was crying I said I'd do it until 4 weeks. Then I hit 4 weeks and I said I'd do it until 6 weeks. We're at 10 weeks now and I'm hoping to go to four months, then six, then eight. Whew. But if I stop, or you stop? Our boys will still be loved and healthy.

Take care of yourself. You've already given him so much, he needs a happy mommy too.


Mommy Daisy said...

I've been wanting to comment on this post. I see you got lots of great support and stories to read, and I'm glad for that. I am really late to the party, because I took a brief break from blog reading. But I definitely wanted you to hear my breastfeeding story.

Zachariah was taken to the special care nursery several hours after he was born. He was born with an infection that had to be treated. Right away we didn't know if something was wrong or he just had extra fluid on his lungs. So he was with us for a few hours, and we tried to nurse right away. He wouldn't take to the breast. I tried several times right away. (My husband later told me he was surprised I kept trying right and didn't give up right then. He knew I wanted to breastfeed, but I guess I seemed like a trooper to him at the time.) Anyway once he was taken to special care, the nurses brought me a pump. Yeah. I'm sure you did all that.

So, I'm trying to make a long story short. It was several days before I was able to try breastfeeding Zachariah. But he seemed to take to it right away. The problem ended up being that I didn't produce enough milk. At 6 weeks old that became very obvious since he started losing weight. So we were forced to suplement with formula. Trying as hard as I might, my milk supply would not increase. We tried many MANY things with lactation consultants and other recommendations. Every feeding session I would nurse then follow up with a small bottle of formula. It got to the point where he knew he'd get milk quicker and easier from the bottle, so he didn't want to nurse. The only way he would latch on well was to use a shield and he became dependant on that. At about 4 months it was a fight to get him to breastfeed at all. After a week of fighting him each feeding to take the breast, I decided it wasn't worth the battle. I didn't have enough milk for him anyway and he was already on formula, so why push it. It was making life hard for us all. (When he was losing weight we went through a period where I was pumping only, then feeding him expressed breast milk, then following up with a bottle of formula. Tiring!) In the end it was the right decision for the situation, and my husband supported me. I have a fantastic little boy. I'm glad we had some breastfeeding memories. But when I stopped it was for my sanity.

For a long time I felt inadequate and disappointed that our breast feeding experience wasn't what I wanted it to be. But I realized that I did what I could and it wasn't my fault that things happened this way. I have a happy healthy boy and I'm OK with the decisions we made now.

I wish you best of luck in your decision. And I'm so happy that your husband is supportive. That's the most important thing.

Jane V. said...

Hi! I just read your blog for the first time tonight and happened upon the breastfeeding dilemma. If you haven't already decided on your gameplan, here is my 2 cents: Take it one day at a time. If one day your brain just says "ENOUGH" then make your peace with it, give yourself TONS of credit for making wonderful choices for your children and take as much time with the transition as you need! Just to give you my "background"- I have 2 boys. My first son- also Michael!- I only fed formula via bottle. He is a thriving, healthy almost two-year-old. My second son, Liam, I struggled to breastfeed and ended up pumping for as long as I could. When I decided to stop pumping, I did it slowly so I didn't have to deal with too much discomfort (and I also got to transition the baby to formula gradually). Liam is a happy, healthy almost one-year-old. As much as I agree that breastfeeding is a wonderful thing, I still share a beautiful bond with both my boys. Lack of breastfeeding didn't prevent us from bonding. You sound like a caring, loving, amazing mom and this will not change if you decide to switch to formula. It IS terribly expensive and you do need more equipment but much like everything else, you adjust! Good Luck with everything :)