Getting a good start breastfeeding... What do I need? (Long)

[bekahjean]

I've done lots of searches, checked Kellymom and bfar, and still don't know exactly what my plan is. Please tell me your option!

Here is my story so far:
I had a breast reduction at 19. It was fantastic and I would do it again. It has made the last 10 years so much more comfortable for me, but I don't know exactly how much impact it has had on my ability to BF.

Bubba was born 9/08. He was induced at 40w3d and born at 6lbs 14oz. I wasn't able to nurse him for about 3 hours (there wasn't a medical reason for this, it's simply that the nursery took FOREVER to bathe him and get him back to me), so I don't know how much of an impact the delay in nursing had. I wouldn't be surprised if they had given him formula or sugar water while they had him, since I know they have done this to friends of mine who said they would be exclusively BFing. He did OK nursing at the hospital, and weighed 6lbs 12oz (I think) when we left. After he got home, he became a little more difficult, not eating well and sleeping for long periods of time.
In retrospect, I let him sleep for too long and I'm pretty sure he needed treatment for jaundice.
At 2 weeks, he was 6lbs 8oz, but the ped said not to worry, bring him back in a week. He dismissed all my concerns (low weight, jaundice, almost zero milk from pumping, spitting up/reflux) as being a nervous, 1st time mom. 1 week later, he brought up all those issues as things he was concerned about and I should have mentioned. I did, you idiot. We switched peds and continued weekly weigh ins. At 6 weeks, he was 7lbs 4 oz, only 6oz above his birth weight. I still wasn't producing much while pumping (about 4 oz over the course of the day with the Ameda) and we had to supplement with formula. He was diagnosed with GERD and failure to thrive. I took fenugreek and grew to hate maple syrup, ate oatmeal, and drank the (horrible) mother's milk tea. I did give up on pumping since I wasn't getting much from it (SO frustrating!) and we were supplementing anyway.

Eventually, he started gaining and I BF (with formula supplement) until 7 months. I just couldn't go any longer, even though I had planned to BF for a year. It was making me crazy and I don't feel any guilt about stopping when I did. He's still a small kid (15th percentile for weight), but he's growing OK and the doc has no concerns.

SO... Here's where I need advice.
DS2 is due at the end of the week, and I want to feel more prepared this time around. As I've mentioned, I have done much more research but still want feedback on my "plan".
The things I plan on doing differently this time:
1) I WILL be nursing right after he's born. They can cool their heels while he nurses and I don't care what anyone says about it.
2) I'm considering bring my pump to the hospital. I looked into renting a pump from the hospital, but they "don't do that, and don't know of anyone who offers pumps for rent." There is no LC on staff ("Can't you just ask your ped?") and it is not a supportive BFing environment.
3) He will be fed on demand for the 1st month, at least, before I try to establish a schedule. I think that with Bubba, I was too concerned about trying to schedule feedings and it hurt my supply.
4) I plan to pump after every feeding (although I might skip pumping in the middle of the night), and not worry (ha! easy to say!) about how little I get from these pumping sessions. It's all about increasing demand, right?

So, what do you think?
Do I really need to bring the pump to the hospital? My milk didn't come in last time until after we had gotten home.
Does pumping before my milk comes in help increase the demand so that there will be more milk from the beginning?
Should I start the fenugreek right away without waiting to see if I have a low supply this time?
What else can I do to help lay the groundwork for a more successful BFing experience?

I know that it will be OK if I can't do it all on my own. I'm trying to take the pressure off of myself ahead of time, but there is a good possibility I might be lying to myself. ;)

[boogiemomz]

The thought that I kept having reading your post was not to let that baby out of your sight in the hospital if you can help it. If the hospital staff is not going to be any more supportive actually offering BFing help post partum, you will have to advocate for yourself and your baby, making it very clear that he will be rooming in with you. You should even be able to request that they bathe him in the room with you. Nurses might give you a hard time or act put off. Their problem. In those first hours/days, get as much snuggle time and skin-to-skin time with your baby as possible, and don't let them take him away so you can just worry if they're not respecting your wishes for feeding him.

If it were me, I wouldn't worry with the pump at the hospital. It's likely to just be frustrating before your milk fully comes in (and I don't care what anybody says... pumping and not getting anything IS FRUSTRATING!!), and it will certainly be exhausting. I would just keep that baby close to the breast as much as you can and try to rest together. Is there an LC that you could hire privately, or a local LLL representative you could talk to about resources? I can't believe they tried to just refer you to a pediatrician when an LC was requested. LAME-O. Many ped's IME do not work to promote or support BFing at all... if things aren't going perfectly, just FF. You need someone who will advocate for you and your choice to BF.

ETA: Maybe either bring the pump OR have someone who can bring it to you if you wind up having to stay a few days for whatever reason. Your local LLL would also know if there are pharmacies around that rent hospital grade pumps, which IMO would be worth it in your situation, trying to establish supply, etc. I can't imagine that NOWHERE in your area is a hospital grade pump available for rent.

Kudos to you for working so hard to prepare for this. You are already doing a beautiful thing for your baby. Good luck and keep us posted! And congrats on the new LO on the way! :yay:

[MoJo]

I agree with Boogiemomz. My number 1 rule was baby stays with Mom or Dad AT ALL TIMES.

I didn't have breast reduction, but I do have scar tissue on one side.

I thought you might be encouraged to know my newborn (who was allowed to nurse right away) was immediately a better nurser than her older sister (who was taken for bath & routine tests before her first feeding).

With Jelly Bean, I'd pump after every feeding, struggling to get enough for one small bottle to leave while I worked for a few hours in the evening. Now, I can pump that bottle in 1-2 sessions and even have a little milk in the freezer, which never happened with Jelly Bean.

So, there is hope! Kudos to you for doing all you can for your babies!

[lowrioh]

No personal BTDT but I have 3 good friends who had very negative experiences BFing their first DC but had a great experience with their second.
Good Luck!

[Dream]

I really don't have any advice as I'll be facing something similar. I didn't have colostrum or milk till the 4th day, when I asked a nurse whether there's a LC in the hospital she said no and gave me a hospital grade pump saying it'll make the milk come. This time I'm hoping to consult a private LC.

[Kaylee31]

I can't give any advice, but I can sympathize, as I never was able to BF all. I had a emergency c-section and didn't get to try to nurse DS for hours after he was born also. The hospital did have 2 excellent LCs on staff, and gave me a pump, but nothing helped. I continued to pump at home, and produced some colostrum 9 days later. But my milk never came in. I'm trying for another DC, so I'm also curious as to ways to increase my supply next time around.

[stillplayswithbarbies]

Start going to La Leche League meetings now and tell them everything you have said here.

Find the Breastfeeding After Reduction yahoo group and start reading and posting there.

If you have to suplement with formula, use a Lact-aid or SNS to supplement at the breast to stimulate your supply while the baby gets the formula.

[bekahjean]

Thanks for the replies!

I do plan to keep him with me in the room while at the hospital. The only times Bubba was gone from the room was when they first took him for his bath, his circ, and to be weighed. Twice he came back with a pacifier, so I think that this time either DH or I will go with him on all occasions. I already told DH that if there are any unforeseen complications, he is to stay with the baby at all times. It shouldn't be difficult for one of us to stay with him, and if they have a problem with that, they shove it. (I have a bit of an attitude about the hospital, since they were SO rude when I called about the LC and the pump. I remember asking one of the nurses for help BF when Bubba was born and she told me they didn't like to give too much advice since their advice might interfere with my natural instincts. Um, 1st time mom here! I didn't have any instincts! I might be gearing up for a fight that doesn't happen, but if it does... I'm ready! :ROTFLMAO:)

I asked DH if he thought I should bring the pump to the hospital, and he said why not? It's not that big and we only live 5 minutes away. I think I'll bring it, plan on using it while I'm there, and not worry about it if I don't.
As far as a hospital grade pump, I might call the local pharmacies near the hospital. They might have a better suggestion than the hospital did. It's a decent sized town, but it is very remote in terms of what is around us. For reference, the nearest BRU is over 90 miles away and the nearest Target is 60 miles.

As far as a local LC, I've looked and can't find one. I think there is one at the university 30 miles away (according to the LC finder that I used online). There is a local LLL, but I feel like it might be too late to contact them before the baby is born. He's due on Friday. I should really pack my hospital bag! :tongue5:

Thanks again for all the advice and keep it coming!

[boogiemomz]

Thanks for the replies!

I do plan to keep him with me in the room while at the hospital. The only times Bubba was gone from the room was when they first took him for his bath, his circ, and to be weighed. Twice he came back with a pacifier, so I think that this time either DH or I will go with him on all occasions. I already told DH that if there are any unforeseen complications, he is to stay with the baby at all times. It shouldn't be difficult for one of us to stay with him, and if they have a problem with that, they shove it. (I have a bit of an attitude about the hospital, since they were SO rude when I called about the LC and the pump. I remember asking one of the nurses for help BF when Bubba was born and she told me they didn't like to give too much advice since their advice might interfere with my natural instincts. Um, 1st time mom here! I didn't have any instincts! I might be gearing up for a fight that doesn't happen, but if it does... I'm ready! :ROTFLMAO:)



Atta girl! Let 'em have it. :11:

The LLL thing would probably just be a phone call, and it might actually save you a lot of time because they could just tell you exactly who rents pumps and if there are any LCs in the surrounding area, and you wouldn't have to waste your time calling around asking and doing your own search. I would definitely call, it's not too late! No need to make an appointment, just ask them where to find a pump and/or an LC. If you are up against these wackos in the hospital who don't want to interfere with your "natural instincts," I'm sure LLL would be happy to help. If BFing is a struggle at first, your "natural instincts" might not be helpful... if they tell you to run screaming from the room, for instance!

[daisymommy]

I can empathize with you. I had a similar experience with my first DS, but for different reasons. I had inverted nipples, and my OB had told me not to worry, that when the baby breastfed the suction would pull them out. Yeah well, guess what my baby had nothing to latch on to! ARGH! It still makes me mad to this day.

With DD, I did some things to help with my issues before birth, but they aren't relevant to your story.

Once she was born, the things I did were:
-Breastfed within 20 minutes after birth. I didn't allow her to be taken to the nursery until I had gotten in one good nursing session. This also helps with stopping your bleeding, and getting the uterus to clamp down. I had this written into my birth plan, and had my midwife sign off on it.

-Had a LC all lined up to come to the hospital the week I was due. She was on call basically. She came and brought me a hospital grade pump. She said to pump after every feeding for 15 minutes. It wasn't to build up a milk stash, it was to give my breasts extra stimulation, so my milk would come in sooner (it too 7 days the first time, and even then it was hardly there). This time it only took 3 days, and it came in good and strong!

-I read all about what the cues were for a hungry baby (rooting, hands in mouth, the sound of the cry, etc.) and every single time I saw those cues, I nursed her. Didn't matter if it was every 45 minutes. I became a human pacifier. And I didn't remove her until she wanted to be done. I was on HER schedule, not the clock. No more of that 15 minutes per side, every 2-3 hrs. bunch of hooey.

-I watched the number of wet and dirty diapers as my clue to whether she was getting enough milk. Not the pump. Because to this day, my body does not respond to the pump. I can only get out 2-3 oz. per side. But I produce a ton of milk. I actually have had over supply issues. My babies would nurse round the clock, until they were stuffed like turkeys, and my breasts would still feel full. Just goes to show that it's true what they say, what you pump is no indication of how much your baby is getting. I liked this to keep track:
http://www.kellymom.com/store/freehandouts/breastfeeding-log-2wk.pdf

-I would have used a Lactaid or SNS if I had needed any supplementing, but I didn't.

The results of all this? DD was EBF till she started solids at 6 months, and I nursed her till she was 2 yrs. Now DS#2 was EBF as well...he was 25 lbs. at 10 months old!

Good Luck! Crossing my fingers for you that all goes better this time around!

Here's something fun for you:
http://www.food.com/recipe/oatmeal-chocolate-chip-lactation-cookies-by-noel-trujillo-192346

[citymama]

I think you are off to a great start with what you listed, and with your 20:20 hindsight about what to do differently this time. I agree with the others about baby staying with mom or dad at all times. Make sure he can sleep in the bassinet in your room, or in your hospital bed if need be. Nurse in the first 30 minutes after birth. Take your pump - I would take an inexpensive hand pump as well; I didn't need or use an electric in the hospital, but was glad to have a hand pump when the engorgement was painful. No pacifiers if you can help it.

Try PMing DebbieJ on these boards - she has a BFing after reduction signature (I think) and should be a good resource.

All the best with the birth and breastfeeding! :cheerleader1:

[tabegle]

If you don't have an LC available, can you hire a doula that might help you?

[bekahjean]

You guys rock. :) Thanks for all the advice; it really helped to validate the plans I have already made.

So now my plan is for one of us to be with DS at all times. He will be sleeping in the room with us ("something new" they're trying a the hospital) and I will pretty much be a human pacifier. I've packed my pump and I am bringing the hand pump piece as well. I'm not crazy about the Ameda hand pump, but it will do in a pinch. I don't have another OB appointment until Friday, but I'll ask about the fenugreek when I go. (On a side note, I didn't take the fenugreek and the tea together. I hated the tea. HATED IT! I'm going to have to try those cookies though!) I'm going to call LLL today to see if they have any other recommendations for a pump or a LC.

If there is anything else I should do, let me know! And thanks again. This board is one big :grouphug:. I love it.

[egoldber]

FWIW I had a great deal of difficulty breastfeeding my older DD and was able to exclusively breastfeed my youngest with relatively little trouble. Our main problem was she had reflux and managing that was a little challenging. :)

Many people are afraid of LLL, but their stated goal is to help you be successful breastfeeding, however it is that *you* define success. It's a volunteer group, so like any volunteer organization each group has it's own flavor and is only as good as the people who choose to volunteer in that area. We have many in our area. I visited one that turned me off and one that was wonderful. I started going in my third trimester with youngest DD and they were amazingly helpful.

[BayGirl2]

I think you've gotten great advice here and you seem to have a strong plan. Just wanted to add that contacting LLL is a good idea. They can give you some advice before hand and may be a great resource for you if you face any obstacles after the birth.

Good luck, and good for you for standing up for yourself and your baby in what seems to be an antiquated hospital situation.