Thursday, November 11, 2010

Learning how to nurse

When M was born, we were immediately separated for two hours, while we were each 'under observation.' Our full term, 9 1/2 lb, healthy girl was carted off to the NICU because there was meconium in the amniotic fluid. This is common in an infant born after 40 weeks. When M was born, her breathing and heart rate were normal, and her apgar scores were high. She had no signs of Meconium Aspiration Syndrome, yet she was whisked away.

My parents got a good look at M before I did. I was vomiting when they tried to show her to me, an effect of the anesthesia. Mom said M looked like a giant baby compared to all the preemies in the NICU. When they finally brought our baby to me, I was relieved. But somehow, it was like being handed a stranger. I didn't feel her come out; I didn't hold her while she was gray and squishy; I didn't even have a chance to offer her milk. When she was finally in my arms, she was dressed in baby clothes from the hospital, wearing a diaper and swaddled in a blanket.

Months before her birth, I watched this great video illustrating how babies will crawl to the breast and latch. Nursing our children is the most natural part of life. It's instinctual.

According to the World Health Organization (WHO), it is recommended that breastfeeding is initiated within 60 minutes of birth. Infants also shouldn't be offered any artificial nipples or pacifiers. Because of our unnecessary separation, we didn't have that opportunity. When the time came to nurse M, the hospital lactation consultant (LC) told me my nipples were flat and handed me a plastic nipple shield. M latched a few times that day, but because of the plastic device, never got much colostrum. I was exhausted, and while B was on baby duty for 2 hours the first night, he found a pacifier gifted by a well-meaning relative. When I woke to see the device, I let B know we would not be using that. But it was too late. M wouldn't latch again. And to this day, M uses a pacifier at night.

Less than 24 hours after M's arrival, another LC insisted our healthy, 9 1/2 lb, full term baby needed to supplement since she hadn't latched again. So, I sat with a breast pump attached to my boobs, trying to get my milk to come in. Across the room, B gave M a bottle of formula. We were able to order donor mother's milk, but not 'in time' for M's feeding. The next three days in the hospital, M had donor milk from a bottle provided by dad while I cried and tried to get my milk to come in. I also continued to try to get M interested in getting milk from me instead of the bottle, but to no avail.

My milk came in on the fourth day, but it took M 3 1/2 weeks to latch. That may not seem like much time, but to a new mom, that is an eternity. And it took even longer for us to bond...but that's a topic for another post. We read books upon books about childbirth and breastfeeding before M arrived. We knew the WHO guidelines, and we hired a post-partum doula to come to our house. But being medicated and exhausted in an environment with 'experts' telling us what to do, we just didn't have the presence of mind or strength to fight it. As first time parents, who were we to argue with the pediatrician insisting M needed formula within her first 24 hours of life? And when the LC was attaching bizarre devices to my breast, like the SNS (a complicated feeding tube), I trusted that it was a necessary evil.

Thankfully, we have a secure, attached relationship, and our little one, now 8 months old, nurses like a champ. With the support of our post-partum doula, local La Leche League chapter, and midwife and family who believe in breastfeeding, we were able to jump those initial hurdles. We spent three and a half weeks enjoying skin-to-skin contact and frequently offering the breast. M rooted instinctually, but a nipple is so different from the plastic substitutes that it took time for her to figure out the real thing. A visit to a recommended LC in town finally ended in a successful latch. M was exclusively breastfed for 6 months, and she still only gets tastes of whole foods.

La Leche League has excellent resources for mothers planning to breastfeed:

Attending meetings before and after M was born ensured our success.

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