I was hesitant to blog about this (it’s a bit of an emotional/personal topic), but after watching two moms in my post-partum class dissolve into tears recounting their breastfeeding troubles, I realize that such problems are a lot more common than we are lead to believe, and that sharing my experiences might save someone else from weeks of needless agony — both emotional and physical.
Breastfeeding has been extremely challenging. The first five weeks of it were, in a word, hell. The subsequent few weeks were very difficult, and only in the last two to three weeks can I finally say that breastfeeding has been going smoothly and relatively painlessly.
We learned about breastfeeding in our prenatal class, and my biggest take-away was that most babies will latch properly on their own if given the opportunity via early skin-to-skin contact. Baby-led breastfeeding, as it is known, entails placing the baby on the mother’s chest and allowing the baby to find the breast by smell and sight. Apparently, this will usually result in successful latching within a couple of hours.
Although Oliver was placed skin-to-skin with me immediately after birth, I was in the unfortunate position of having my upper body reclined and my legs up in stirrups for two hours, while the midwives and obstetricians figured out how to stitch my extensive tearing — not exactly ideal nor comfortable positioning for a successful first latch. I was also very uncomfortable and upset during the process, which resulted in Oliver being fussy and anxious at a time when we should have been relaxing and bonding. It was three hours later by the time all of the stitching and other postpartum procedures were finished and I finally had a proper opportunity to breastfeed. But by this time, Oliver seemed ravenous, so we forewent the time consuming baby-led latching process in favour of just getting him on the breast as quickly as possible.
I believe that our failure to achieve a good latch in the early postpartum hours definitely set the tone for our subsequent difficulties.
The next complicating factor was the shape and size of my nipples. As my nipples are somewhat flat/inverted, Oliver was not getting the necessary cue of my nipple touching his soft palate, and was thus outright refusing to latch on — turning and shaking his head, closing his mouth, and crying. By the next night after birth, I was extremely upset and Oliver was obviously starving. The one thing I was supposed to be able to give my son to nourish and calm him was instead serving to frustrate him and make him cry even more. I was heartbroken.
The next morning we had a visit from our doula, who offers breastfeeding support as part of her services. She showed me how to shape my breast with my hand in order to provide more firmness and protrusion so that my nipple could reach Oliver’s soft palate. With considerable difficulty, we got him to latch, and I was finally able to feed him. The latch was painful and it would regularly take 10-15 tries before he would actually start suckling, but I was focused on just getting Oliver to be able to eat. Quite honestly, I figured that the pain was an adjustment to a new sensation and a normal part of the early days of breastfeeding.
By the next day (day three), my nipples were excruciatingly sore, blistered and cracked. The midwife took a look at my latch, deemed it to be okay, and gave me lanolin ointment and a nipple shield to help prevent further trauma while my body healed. By the evening of day four, Oliver began vomiting blood. We took him to Children’s Hospital to get checked out (because we had declined the Vitamin K shot, there was a chance that this was an early sign of Vitamin K Deficiency Bleeding), and as it turned out, the blood he was vomiting was my blood, and it was coming from my damaged nipples.
Over the course of the next few weeks, I tried every breastfeeding aid I could find: nipple shields, breast shells, nipple formers, gel packs, ointments. I began pumping in the evenings just to give my nipples an opportunity to rest. Some days, I would have to feed exclusively on one side because the pain on the other side was unbearable. I dreaded every single feeding session and began to experience tension headaches that lasted for days. I was also really sad that something that was supposed to be so natural and beautiful was so difficult for us.
Four weeks after Oliver’s birth we had our prenatal class reunion and the topic of breastfeeding difficulties came up in conversation. I mentioned that I was experiencing a lot of pain, and our prenatal instructor graciously offered to look at my latch. She immediately identified the problem and gave me some assistance in trying to fix it, but by this point, the bad habits were ingrained and Oliver was resistant to change. She referred me to a certified lactation consultant, who was able to visit me at home less than a week later.
The lactation consultant was wonderful and very, very thorough. First, she ruled out any physiological issues, such as tongue tie (interesting note: there was no mention of my nipples, so apparently flat/inverted nipples are not considered by the pros to be a “problem”). Then she showed me, using doll and breast props, how the latch was incorrect and what we would need to do to fix it. Then finally, after five weeks of suffering, I experienced my first painless latch! It was such a huge relief to know that pain-free breastfeeding was possible, but I felt like an idiot for not having sought assistance sooner. At the end of the session, she wrote a series of instructions and cues for me to help me remember everything I needed to be doing and/or looking for when initiating a latch.
One other thing the lactation consultant pointed out is that flattened “orthodontic” pacifiers can exacerbate certain breastfeeding problems — as they did in my case — because they encourage babies to compress the nipple between their tongue and the roof of their mouth. We had to discard all of our existing pacifiers and re-train Oliver to use a more rounded nipple. He never really took to the popular GumDrop pacifier, but we have had moderate success with the Playtex Binky “Most Like Mom” nipple.
It takes a lot of time and effort to undo five weeks’ worth of bad habits, so the following few weeks were a mixture of good latches and bad latches, good days and bad days. I was told to be ruthless in not accepting bad latches, but sometimes Oliver was so ravenously hungry and riled up that I just had to let him latch (poorly) so he could calm down.
Now that we have the latch more or less mastered, I no longer dread feedings. I’ve also noticed that Oliver feeds much more efficiently (this is also probably a function of age and size), and that he’s coming off the breast satisfied. In the early weeks, I would often end up removing him from the breast prematurely because the pain would become unbearable. This lead to even more fussing and anxiety surrounding breastfeeding.
The reason I have shared this story is that I think there are a lot of women who ultimately end up giving up on breastfeeding because it is painful and/or the baby has difficulty latching. If I hadn’t been so well apprised of the benefits (to both Oliver and myself), and hadn’t thus been so determined to make it work, it really wouldn’t have taken much to convince me to switch to bottle feeding. We are told that breastfeeding is easy and natural, so when it turns out to be difficult (difficult being a huge understatement in my case!), it’s easy to believe that we must have some sort of insurmountable flaw that will prevent us from doing so; that we must be one of the very small percentage of women for whom breastfeeding simply doesn’t work.
When we have baby number two, J and I have already decided that we will hire the lactation consultant in advance, and have her visit us as soon as possible after the baby’s birth so that we can start off properly, right from the beginning. Her expertise made a world of difference, and was probably the best money we have spent since Oliver’s birth.