Thursday, May 26, 2011

The New Plan

So it's clear now that my supply is nearly gone and before I go into details about the new plan, I'll go into details about all the medical professionals who screwed up and the instinct I didn't listen to.

When Matthew was born (at 1:20 am), he was a "big" boy. 9 lbs 1 oz didn't seem that big to me, but he still had to have 3 good sugar tests after birth. He passed all of them with flying colours. Nursing was a hard thing to learn and R and I went to the hospital breastfeeding clinic for some help. I was cracked and bleeding by the time Matthew was 12 hours old. The lactation consultant said I should probably pump on the bleeding side until it healed and sent us on our way. R left at 10 pm that night and I was alone with a newborn baby who wouldn't settle no matter what. I also hadn't slept since I woke up at 7 am the previous day. When the nurses offered to take him to the nursing station so I could sleep, it sounded like a godsend. They promised to bring him back for his next feed at 1 am. And so I got about 2 hours of sleep before I woke up waiting for the return of my son. I waited until 1:15 to start worrying, but I gave them the benefit of the doubt. I kept giving them 15 mins to see if they would bring him back, and when they didn't, I kinda started to freak out. "I didn't check their ID, what if they just stole my baby?" "He must be hungry by now, I need to feed him!" At 2 am I called them to bring him back. When they returned him they simply said "He was hungry so we finger fed him formula". Um, what? Who gave you permission to do that? And why wouldn't you bring him back for ME to feed? I was upset and confused, but I figured "they're the experts, I guess they know what they're doing".

His weigh in was around 3 am at 26 hours old and he had lost ... 3%! I thought this was a GOOD thing since they only worry at around 10%. I don't remember how it came about, but some time that morning, the nurses came in with a bottle of formula saying "he's a big boy, he needs to eat". I immediately thought it was odd to feed a baby 60 ml of formula when he'd only naturally be getting a teaspoon or so of colostrum. But again I trusted "the experts". The lactation consultant was sent in to teach me how to use the supplemental nursing system: tube feeding. It was hard and confusing and I was overwhelmed. Around 10 am I was anxious to get out. Since we had both gone to the bathroom, and passed all our tests I was told we could leave as soon as the shift changed. But they kept me and kept me in the dark. Turns out, they were concerned because I was weepy and crying all the time. Um... I JUST gave birth to a baby, I'm in PAIN, and you STOLE MY BABY IN THE MIDDLE OF THE NIGHT!!! I managed to convince them I DIDN'T have Post Partum Depression and they let me go, with a referral to a breastfeeding clinic attached to the hospital.

Tube feeding at home did NOT go well. It was hard enough just to try and get Matthew to latch without having to shove a tube in his mouth. I was in incredible pain from all the bad latches and overwhelmed and upset by the struggle. When Matthew was 3 days old, we went to the breastfeeding clinic. She promptly scolded me for tube feeding when there was no medical necessity to do so and told me I had jeopardized my supply. We did a weighed feed and Matthew took in 2 oz in 15 mins on one side. CLEARLY I had enough milk! She sent me home with instructions to pump for 10 mins on each side after every feed with a hospital grade rental pump. After 2 days of this, Matthew was choking at the breast and not latched very well. I was exploding with milk! Another trip to a different breastfeeding clinic identified the problem. I now had oversupply and not only could Matthew not latch properly to my boulders, but he was choking by the forceful letdown. I was sent home from that appointment with instructions to hand express before each feed and block feed to reduce supply. It took 6 weeks of weekly breastfeeding clinic appointments before it finally got under control. And at 6 weeks, my "typical" baby became suddenly colicky and inconsolable without gripe water and baby squats. Hmmmm.....

The 6 week mark also signifies my first post-partum appointment where my doctor promptly prescribed me the low dose birth control pill as my ONLY option other than condoms. It took me about 2 months to realize that my supply didn't seem as good as it once was and I went in for an appointment with my doctor. "I think the pill has decreased my supply". His response? "Oh yeah, it'll do that. Just supplement with formula or stop taking it and use condoms". Um... WHAT? "Isn't there a progesterone only mini pill I can take?" "Oh, um, I suppose, let me look it up". So I switched pills and things seemed to be going along nicely.

That is until I introduced solids at 6 months. At first he liked them, but over Christmas he got sick and outright refused solids. He was also cutting 4 teeth. He then went on a nursing strike that lasted about a week. It was difficult to even get 1 oz of fluid into him, but every 15 mins we would try and give him SOMETHING and I would offer him the breast whenever he cried. He always refused. Eventually he started nursing again and all was well. Until he had his first allergic reaction. It was peaches and a small "teething rash" turned into a full body rash. We were instructed to stop all solids until the rash cleared. When we started up again, I tried avocado thinking it would be readily available in Mexico when we went on vacation. Again, full body rash. Arg. So again, we stopped all solids. And so our feeding experience went. Up and down with Matthew refusing solids and developing allergies. And all along, the sleep issues just kept getting worse.

So now we're caught up to my first appointment with my doctor about his sleep issues, and the following appointments with the dietitian, naturopath, lactation consultant and pediatrician. And now the plan:
1. Stop taking the mini pill
2. Start taking Domperidone
3. Offer the breast whenever he wants it
4. Use breast compressions to convince him to drink and not just suck
5. Eat meals together and allow him to eat well spiced table foods
6. Offer many snacks throughout the day and push dinner later to eat with the family
7. Try not to offer the breast overnight unless he won't be settled any other way
8. Make an appointment with a pediatric allergist
9. Come back in 3 weeks to see how the breastfeeding is going and make a plan for back to work.

So that's the plan. The new plan. The breastfeeding friendly plan, and since we "think" he has a milk allergy, it's the best plan I can think of that avoids expensive hypo-allergenic formula. After 5 1/2 months I really hope I can say THIS is the solution I've been looking for.

Wednesday, May 25, 2011

Milk Supply Crashed

I went to a breastfeeding clinic today and after seeing about a bazillion different professionals, one thing is very clear: my supply has all but dried up. I was beginning to realize this was the case when I started to actually pay attention to the WAY Matthew was nursing. He's not really drinking any milk. This explains a LOT! So I now have a prescription for Domperidone and a follow up appointment.

The real question is WHY has my supply crapped out? After much discussion of my history, it becomes very clear: really really bad, conflicting breastfeeding advice. After being sent home from the hospital supplementing and tube feeding, overcorrecting with pumping, overcorrecting with block feeding, low dose birth control pill and cutting out night feeds, it's obvious why my milk has struggled to keep up. It appears that even my mini pill is affecting my supply so I will be dropping that ASAP. I now realize why Matthew seemed suddenly "colicky" at 6 weeks: he was reacting to a drop in my supply. It's probably the reason for all the nightly wake ups. It's probably the reason for Crabby McCrabberson showing up every afternoon and lately every morning.

So we have another piece to the puzzle. Now I just need to make an appointment to get a referral with a pediatric allergist and wait for my follow up appointment at the breastfeeding clinic. Hopefully at that point we can make a plan for how to proceed when I go back to work. Fingers crossed that we get some sleep REAL soon!

Tuesday, May 3, 2011

Mystery is Unravelling

Today was the day we saw the dietitian. It was very eye opening for me. She listened to all my concerns, asked tonnes of questions and really wanted to know all the details of Matthew's life and how the introduction of solids had gone. I went over his ups and downs with food, his allergies and his sleep issues. She came to one conclusion right away: he has a milk protein allergy. His full body rash reaction to regular formula really should have tipped us off. So now we both have to go dairy free. It's going to be very hard because there are a lot of products with hidden dairy in them. We're also going soy free. That's not a big deal since I'm already allergic to soy and avoid it, it shouldn't be too hard to keep Matthew away from it. So that was problem A solved, then we went on to problem B.

I told her that I was concerned that it looked like he didn't gain a lot of weigh from 6-9 months, aka since starting solids. So she weighed him. Matthew has lost at least an ounce in the last two months (the scale kept fluctuating). Not good. You want babies to GAIN, not LOSE! :( My poor baby. He's probably been starving all this time and that's why he hasn't been sleeping well. So in addition to going on a strict feeding schedule, we have to supplement with formula.

I feel so bad for my poor baby. All those fussy afternoons, all those long nights, were probably because of an upset tummy and hunger. I am so glad I finally listened to my instincts. I KNEW something wasn't right. I should have pushed the issue earlier, but I'm glad I finally got someone to listen to me. We are going to push on with all our new information and at Matthew's one year appointment, I'm going to ask for some blood tests to see if Matthew has a soy allergy like me in addition to a milk protein allergy.

Yes there is a moral to this story, one I should have learned long ago. Listen to your instincts. If you know something isn't right, even if you can't identify it, push to find the answer. If you don't like the answer you're getting, look elsewhere for help. But do not give up. I wish I had learned this lesson for myself long ago, but at least I have finally learned it when it counted most, when it affected my beautiful, wonderful baby boy.