Ups and Downs of Breastfeeding

**Too Much Information Warning** 

This post is about the trials and struggles of breastfeeding, mastitis and breast abscess. 

I want to share some things that I wish I had known a month ago. You see, I read several books on breastfeeding but they were only partially helpful. There is nothing like first hand experience to teach you the ropes of breastfeeding. I am writing this as a way to share with readers my experience with the hope that it may save someone else the issues I have had. 

My husband and I were determined to breastfeed. I went to a breastfeeding class before I had her and got a Medela Pump in Style Advanced. We really wanted to do this and not just because of how much money it would save us. It is so much better for our baby. I'm not going to go on about the benefits, there are plenty of sources for that. 

I went into labor on a Saturday. I didn't know that their Lactation Consultant doesn't work on the weekends at our hospital. She told us later that they put a stop to all of her overtime she used to get by working weekends too. Once I finally got Jorja back from NICU (they were worried about her breathing but it was a very common thing that turned out to be nothing) it had been 4 1/2 hours since I had her. I was a little worried about not having fed her but I knew it would be ok. Here is when the first set of problems began. When the NICU nurse brought her in to be able to eat I told her I was a first time mom and would need help with getting her to latch on/eat. She helped me for like 2 minutes. Jorja latched on but only to my nipple. I didn't know the difference at this point. Jorja sucked for 15 min and we called the nurse who said to let her go 25 if she would, and she did. I didn't know that she was just sucking, not swallowing and only on my nipple. We did this all night as the NICU nurse would bring her back to eat every 3 hours. Then when the next nurse came on I had her help us again because I knew it wasn't right. By Sunday night, I was in tears because of how much pain I was in. By this point, my nipples were cracked and I had smiley cuts. The nurse that came on Sunday night was very helpful (or so I thought). She brought in Medela nipple shells. 

These are used to keep your clothes off of your tender nipples and also draw out the nipple (if you have flat or inverted nipples) to help the child latch on. I would put these on 30 minutes before feeding her. Then she had me use a nipple shield. This helped Jorja actually get colostrum. I also started doing the football hold. This is one of the best positions if you are having problems getting them to latch. I felt so much better. Little did I know that it wasn't what I should have been doing...

Monday morning the lactation consultant (LC) came in. I told her how excited I was that Jorja was getting something with the nipple shield. She about had a cow because the shields, while useful at times, creates a bad habit and is hard to get rid of. Something about where it directs the milk in her mouth. So, she helped me get Jorja to latch on correctly but Jorja liked to keep her tongue up in the roof of her mouth in front of the nipple. At times she would flick it down over the nipple. PAINFUL! The LC had me pushing down on her chin to get her tongue to go down. This is so hard to do. My later research said that this is only done when the child had developmental problems....um Oh my Gosh... and it can be harmful. Needless to say, we didn't do that anymore. When we came home Monday I was exhausted, in pain and scared I wouldn't be able to breastfeed. 

After going two days with reading EVERY Le Leche League (LLL), Jack Newman, Kellymom.com and random website in the world, I knew I still didn't have it figured out. I cried and cried (partly hormones) because of the pain and stress of feeling like Jorja wasn't getting any food. So, I called a local LLL leader and she came over Thursday morning. She helped me get her latched on correctly....um it totally didn't hurt when she was on correctly after the initial latch....See, I knew something was off. She was very encouraging. 

Sadly, after she left I was still having problems getting the correct latch. With practice, we kept persevering. I was religiously using Lanolin (sidenote-lanolin is oily and will leave nice oil stains on your clothes, bras, etc.) to help give my nipples some relief. It is worth the stains! 

At some point that second week I placed a call to our pediatrician and spoke with a great nurse who kept telling me I was doing an amazing job to have made it as far as I had with the pain. She talked me through each step and asked questions about what I was doing and everything. I was doing what I could to ensure a good latch. I just needed to be patient and let them heal. 

Around 3 weeks I realized I had a lump in my right breast. I failed to catch that I had a blocked duct which turned into mastitis. So, Tuesday I called for antibiotics after trying massage, different feeding positions, showers, and heat without any luck. Now, before I start on the mastitis, I'll tell you several things that probably led to the blocked duct.

1. Continually sleeping on the right side = pressure
2. Not having a good latch to start with= not draining the breast
3. Going from only feeding on one side each time to both= not draining 
4. Sleeping on my stomach ONE night.

So, by Friday after taking Jorja to her appointment, I was going to my gynecologist to have them check it because it was bigger, hot, and red. They gave me a shot of antibiotics and sent me for an ultrasound to check for an abscess. There were two different abscesses. The radiologist came in and tells me he wants to stick needles in to drain them. Oh had I been fearing this! It hurt!! They used 18 gauge needles without any numbing. He got 10 cc out of the first one. Then tried to get the second, used numbing gel (much better) but wouldn't draw any so they stuck a third time and got a few cc. They sent the "liquid" off to the lab to test to see what kind of infection and to see what antibiotic would work best if the shot doesn't work. The radiologist did say that if he has to do that again he will use Linocane  since it hurt so bad...gee thanks.

I have been resting and pumping to make sure I drain that breast. I haven't pumped every time I feed her, but I have been a couple times a day. It is amazing. When I started pumping, I already had the lump and never got much out of that side. After having it drained, I was able to get 2oz from that side the first time I pumped! I don't have the fever or chills today which makes me have hope. I do still have a mass but I would think it is left over inflammation. I go back Monday to have it checked again.

The ups of breastfeeding make everything worth it. She is doing great growth wise- gained a whole pound in two weeks. She sleeps around 4-5 hours at night. Having the bonding time with her is amazing. Knowing that I am providing her with the best possible nutrition is great. I will continue to breastfeed her. I am so glad I didn't quit in the beginning. 

So, why am I telling you all of this? For several reasons actually.

1. Make sure you have someone planning to help you with breastfeeding. Either know that the LC will be available, or contact a LLL leader to be on call to help when they are first born. 
2. Even though it seems horrible, it is so worth it. 
3. Make yourself try for at least the first month before even considering quitting. I had to take it one feeding at a time, then one day, then one week. And even after dealing with an abscess, I am still feeding her! You CAN do this!
4. I didn't think I would get a clogged duct. Don't think that you won't. Be proactive and read about every aspect. 
5. Don't do the things that could lead to a clogged duct thinking you won't get one. 
6. Call the doctor at the first sign of a clogged duct that won't go away. They should go away at 24-48 hours. 

*Update* I ended up having to have them drain the mastitis which turned into an abscess (whole different post). I went on to breastfeed for 9 months after practicing and getting a correct latch. 
I don't think the shield or shells are the completely bad. I don't think they are the best answer... You must work to get a correct latch. I do believe that using the shells to help "pop out" the nipples so they can latch is very useful!! I will be using them again if I need to.