After my last update, where I waxed poetic on the awesomeness of life with a newborn, things took a serious downturn. Arlo is doing great, not to worry about him. He is a sweet, healthy, growing boy who I love so much it hurts. The problems that I have been having are my own. Around two weeks post-partum Arlo hit his first growth spurt, and wanted to nurse for hours on end. It seemed like he was never full and since I was prepared for a growth spurt around this time, I did what I thought was best and nursed him whenever he showed signs of hunger. After a full day of this, I started developing some pretty serious nipple pain from the constant feedings. It wasn't bad enough to stop nursing though so we pressed on for the two or three days that he had his constant hunger. Later that week at my two week visit with the midwife I mentioned that I was still having sore nipples and even briefly saw one of the lactation consultants at the birthing center. She helped me with his latch and said things should get better.
By the following weekend I was in tears from nursing him, even though he was back to feeding on a normal schedule for his age (still around 10 or so feedings a day). Desperate to get a break from breastfeeding, we went out one evening and picked up an electric pump after I realized the crappy manual one I had bought during the pregnancy just wasn't going to cut it. Pumping a few times and giving Arlo breastmilk in a bottle brought some relief to my pain, but it wasn't my ideal situation and the pain wasn't going away completely. As it turns out, my neighbor, Mary, is a lactation consultant (and possibly one of the nicest people I have ever met) and we ended up seeing her for a two hour visit at the hospital that weekend. She provided me with a nipple shield and recommended that I use it during every feeding to help give my breasts a chance to heal. She also mentioned during the visit that he had a tongue tie and pretty think upper lip tie, but she wasn't sure that his condition was the source of my pain.
A few days after we saw the Mary, Arlo got sick for the first time. He was only three weeks old and even though it started as just a cough and mild congestion, we brought him into the pediatrician within 24 hours of his symptoms starting. The doctor didn't seem too concerned, and gave us a list of symptoms to look out for at home. Should they develop we were to bring him back in or take him to the ER, depending on the severity. Unfortunately, his symptoms grew worse before they got better. There were several sleepless nights where I woke up at 4am and just laid there for hours watching him breathe, counting his respirations to make sure they were not above 60. Even as a nurse, in my severely sleep deprived state, I felt like I couldn't make an accurate assessment of the poor little guy. I woke Erik up a couple of times, and asked him to count his breaths with me. Fortunately it never got to a point where we needed to seek additional medical treatment. Still, I was so exhausted, and so worried, and still in such pain all the time that it was starting to really affect me emotionally.
Eventually Arlo started to show signs of improvement, but he was sick for a good week or so. Along with everything else I already mentioned, during this time we were also battling a nasty diaper rash that just wouldn't go away. That might not sound like a big deal, but it was just another source of frustration and worry that we didn't need to be dealing with. We finally got a prescription at his one month visit that helped clear it up quickly, but it still comes and goes. During his one month check-up, we also learned that he wasn't really weight as he should, and was only in the 2nd percentile. He started off small so we didn't expect him to be off the charts weight-wise, but the pediatrician was slightly concerned and said we would need to keep an eye on it and recommended a weight check in two weeks...
Fast forward another week, and I was still having the terrible nipple pain (going on around two weeks now). I was using the nipple shield and pumping occasionally to give myself a break from feedings, but it wasn't showing any signs of improvement. Desperate to seek relief, I started researching the tongue and lip tie that Mary had mentioned. After reading this article, it was all I needed to explore getting Arlo's condition fixed. As a child, Erik had to have his tongue tie corrected for speech issues, and since the condition is genetic in nature, it makes sense that Arlo might require the procedure eventually. Since there was a good chance that my pain was caused by an improper latch related to the ties, we decided to go ahead and have them taken care of right away.
We took him into an ENT who performed the procedure right in the clinic, in around 30 seconds time. I tried to nurse him immediately afterwards as instructed by the ENT and nurse who was helping us, but I was still so sore I couldn't tell if there was any improvement or not. She said it would take a few days for him to learn how to use his "new mouth" and I should start feeling better soon since he would likely have a better latch. A few days later, sitting on my bed crying from the severe pain I was still feeling, I sent Mary a text saying that I would rather go through labor again than be dealing with the pain any longer. And I meant every word.
Since it was Saturday, she called her friend at the birthing center, and got us an "emergency appointment" with Rebecca, the LC who is on call during the weekends for urgent breastfeeding issues. Rebecca spent a good two hours with us, watching Arlo feed with and without the nipple shield, watching me use the breast pump, and examining us both thoroughly. In the end, there was still no clear answer as to the source of my pain. She recommended continuing to pump exclusively as I had been doing the past few days, bottle feeding him the pumped breast milk. It came up during the visit that I have a history of Raynauds phenomenon, and she thought there might be a correlation with my pain, as there sometimes is in breast feeding mothers with this condition. I wasn't too eager to take the medication used to treat this just yet, I was hopeful that a few days of pumping to give my nipples a break would get me back on a healing path.
Fast forward another few days, and I was reaching a breaking point. Arlo was around five weeks, and I had been having almost constant pain for the past three of them. I called Rebecca and asked her to see if one of the nurse practitioners at the birthing center would be willing to start me on the medication for Raynauds. Fortunately they were okay with this plan, and phoned me in a rx for Nefedipine, a medication often used for people with high blood pressure but also used in the treatment of Raynauds. I was so hopeful and almost completely convinced that this would resolve my pain, but after eight full days on the med (and all the awesome side effects that came with it) there was not a single bit of relief. I quit taking it as I saw no point in continuing.
In desperation, I asked Mary if it would be possible to stop breastfeeding/pumping altogether, let my milk dry up and nipples heal fully, and then take a milk stimulating medication to restart my supply. She said that there was a chance it wouldn't come back, and if it did it would likely only be a fraction of what it was before. She also recommended I try a gentler pump, which could be rented from the birthing center. As fast as I could get there, I went in and picked up a Medela Symphony pump, which is a hospital grade pump made for women who pump as much as I had been. I found it to be much more comfortable, and again thought that this pump was the answer to my problems. I was hopeful that in a few days I would start to feel better...
The week that followed brings us to last week real time. I went in for my six week postpartum check-up with the nurse practitioner, still having the same pain that I had been for so long. She was awesome, and so comforting to talk to. From reading my chart, she already knew everything I had been through and offered a lot of support during my visit. She understood how hard it was to be exclusively pumping as I had been. I never would have understood this cycle had I not had to go through it. Instead of just waking up in the night to nurse Arlo, I have to give him a bottle (sitting up), change him, pump, clean the pump parts, and measure out the next bottle, a process that takes a good hour every time. This cycle continues through the day, and is utterly exhausting. It's nearly impossible to leave the house unless I have just pumped and fed him, and then we have about two hours before we need to return to repeat the process. I can't see this as sustainable long term. On a happy note, while we were at the birthing center for the visit I had them check Arlo's weight and found that he had plumped up to a healthy 8 lbs, 12 oz! He had gained 2 oz per day since his last visit, which is a lot of weight gain in such a short time period. We were told that he had "caught up" weight wise and there was no need to worry.
During the visit, the NP picked up on something that I had also been thinking about, but hadn't yet been treated for... Since I was on antibiotics for my pneumonia at the time I gave birth, and Arlo had that stubborn diaper rash that was still coming and going, she thought my problem might be caused by thrush. She said she would be willing to put me on a two week course of difulcan to see it would make any difference in my pain level. As of today, I have been on the med for six days and still have no improvement. I remain hopeful though, as I have read it can often take 10-14 days of treatment for the pain to resolve after starting treatment. I am now taking this whole thrush issue very seriously, in the event that I actually have it, and have been following this candida protocol strictly. The grapefruit seed extract, probiotics, vinegar rinses, nystatin, diflucan, I am doing it all. I have been avoiding sugar and simple carbs. I am also sterilizing all of our bottles/pump parts/pacifiers every day. All our clothes and towels are washed on hot with vinegar added to the load. Its become an obsession and combined with our already busy pumping/feeding/taking care of baby schedule I have little time for anything else. (yes, I am sitting here writing an epically long blog post but with that in mind, I am doing so at nearly 4pm, still in my pajamas, with a baby taking an equally epically long nap) :)
So... I continue to try and find hope that there will come a day where I don't have to spend so much of it in pain. All through the pregnancy I had these visions of being this warrior breastfeeding mama, fearlessly whipping out a boob whenever and wherever my baby was hungry. Instead, the reality is that I am ashamed to get out his bottle and feed him in public. I feel like people are judging me, and wish they made a shirt that says "It's breast milk people"! I guess feeling this way is perhaps being a little judgmental myself. I know not everyone chooses to breastfeed, and in the end all that matters is a healthy, growing child. I just don't want anyone to think that I gave up on, or choose not to give my baby what I truly believe to be the best nutrition that exists for him. So perhaps if any lesson was learned through this, it would be to never jump to conclusions or make quick judgements on another mothers parenting. It's hard enough to have a newborn and adjust to the new life that they bring. You never know what struggles and difficulties they have faced or are currently fighting. That bottle they are holding might be breast milk, or it might be formula, and both are okay. Happy, healthy babies and children come from lots of different parenting styles, and who is to say who is right and who is wrong?
And with all of that, my break is officially over, as I hear the beginnings of a baby waking up... Hoping to come back soon with much better news. For now, I am taking it one day, sometimes one hour, at at time, and trying to enjoy all the happy moments I get to spend with this adorable face, who continues to melt my heart every time I look at him...
