is breast still best if it comes exclusively from a bottle?

i included a space on my to-do list to write a blog post about ramona’s third week of life, but she’s 25 days old now–halfway through her fourth week–& i want to write about something a little more immediate & relevant to my own life. guys, having a baby is difficult. not that i didn’t think it would be. it’s just difficult in a different way than i was prepared for. in a kind of a meta way, i was prepared to be unprepared for the difficulty, but it’s still tough.

the big news is that ramona really started getting the hang of mouth feedings last week. the main things she had to do to be released from the NICU were a) maintain her temperatures without help, 2) pass the car seat test, & 3) take all of her feedings by mouth. they delayed starting her on a bottle for a few days so that i could work on breastfeeding her. we did board one night so i could try her at the breast at every feed for 24 hours. sometimes she really took to it; more often she took a few sucks & then fell asleep or thrashed around until she got a bottle. but by saturday, she was taking entire feeds from the breast, no supplementation necessary, & she could suck down an entire bottle in like thirty seconds flat.

jared & i remembered different things about when her feeding tube could be removed. he thought they had said that a baby needs to take all feeds by mouth for 48 hours, but in the discharge binder (my source of info, considering how little i remembered of the discharge class, which i attended while still on two percocets every four hours), it said 24 hours. once ramona hit 24 hours with no tube feedings, i asked to speak with a nurse practitioner to clarify the issue. she looked at ramona’s chart & said she’d write an order for the tube to be removed that night. “& we might as well do the hearing test too. & the car seat test. & i’ll leave the paperwork for the hep B vaccine with you. &…do you guys want to room-in tomorrow? & then she can go home the next day?”

so, long story (well, maybe not so long) short, ramona was released from the NICU yesterday. she’s been home with us for a little more than 24 hours now.

& it is really hard.

rooming-in was hard too. i don’t know if all NICUs do this, but overland park regional medical center has some rooms actually in the NICU where parents can stay overnight with their babies in preparation for going home. the parents are responsible for all their baby’s care during the rooming-in period, just like they would be at home. they change all the diapers, take care of all the feedings, administer baths as necessary, dispense any medications or other tests. if all goes well & baby comes out the other side alive, having gotten all its medication, maintaining its temperature, & eating okay, it can leave.

the tough part is that we were still on the hospital schedule. in the NICU, ramona’s temperature was taken, her diaper was changed, & she was fed every three hours around the clock, since birth. if she pooped her diaper fifteen minutes after having it changed–tough luck, kiddo. unless the poop actually seeped through her outfit, she was left to sit in it until the next diaper change. (& the NICU nurses seemed surprised when she developed a diaper rash. go figure.) if she got hungry before feeding time–too bad. she’d have to wait. needless to say, this is NOT how i would have parented her at home. but we had to chart her temps, diapers, & feeds NICU-style during the rooming-in, so we had to more or less stick to their schedule. & it was hard because she didn’t eat that well at her first few feedings, so she kept us up half the night screaming for food. seriously, she screamed almost non-stop from 12:30am until 5:30am. when i did put her to the breast, she was too hysterical to take to it & we wound up giving her a bottle (of breast milk–i am still pumping around the clock & had milk in the fridge). she calmed right down for the bottle & slept like a log once she’d finished it.

anyway, now she’s home, so i can feed her at will & exclusively at the breast, right? my whole plan when i was pregnant was to exclusively breastfeed. when the NICU insisted we have a “bottle system” ready to go before they would discharge it, i kind of mentally dismissed the idea, thinking we’d buy some bottles to honor the request but just never use them (except for the occasional dad feeding).

but it’s just not working out. she cues for food, i offer her the breast, she latches on for about ten seconds, & then she whips her head away & screams. i try a different position & the same thing happens. lather, rinse, repeat until both of us are near tears & finally i break down & give her breast milk in a bottle. she polishes it off in no time & falls asleep like the happy, satisfied baby i wanted at the breast.

i have no idea what to do. she is capable of maybe two or three decent meals at the breast in a day (though none yet today), but no way would she be taking enough calories that way. & i have to admit, being able to give her a bottle & know she’s eating is a huge sanity-saver. she’ll nurse fitfully at the breast for an hour or more & take about the same as she’ll take from a bottle in three minutes. in the middle of the night, desperate for sleep, the bottle looks like my best friend. & i justify it by telling myself that she’s still very small & doesn’t have a lot of stamina, & my supply might just be too much for her to handle direct from the breast, & we have plenty of time to make the transition as she gets bigger & stronger & my supply evens out to adjust to her actual needs, & in the meantime, she’s still getting breast milk from the bottle. & it also means that jared & i can split feeds evenly, which gives me more time to myself (to think about what a failure i am as a mother, that i can’t even breastfeed my own baby despite having enough milk to fill the grand canyon).

i’m going to consult with my doula once the holiday is over, & i’m going to attend a la leche league meeting & see if anyone there can help me out. maybe it’s ramona’s size. maybe i’m not positioning her properly. maybe she needs some extra time to adjust to the sudden change in environments & caretakers. maybe this is normal for premature babies. maybe it’s okay to just keep pumping & giving her bottles of breast milk until she’s weaned. maybe this just isn’t a big deal. but it makes me feel really sad & crappy.

Advertisements

14 responses to “is breast still best if it comes exclusively from a bottle?

  1. I’ve been reading your blog excitedly for about a year or two now, but have been lurking. Sorry. I think it’s really awesome, as I’ve always thought you are.

    I’m sorry things are so difficult right now. I’m not a mom (yet–I’m trying), but I think all the things you’re telling yourself about why Ramona is having a hard time transitioning and that you both have time are absolutely correct, but they probably don’t feel that way, and that sucks. I’m hoping the best for your first days together at home (with her on the Outside, anyway) and amazed you’re still posting with a newborn! I’ll read just about anything you write.

    Much respect,
    Ami

    • thanks! i found out later that part of the reason she was suddenly struggling with breastfeeding is because she had a tooth rubbing on her tongue. this crazy baby! it’s always something with her.

  2. Please be gentle with yourself. I think it’s amazing that you are pumping – however she is getting your milk is great! Keep in mind that you are also recovering from a major surgery, a stressful birth situation, time in the NICU and becoming a parent – no easy feat. I understand that preemies often struggle at first with breastfeeding simply because they lack the stamina that breastfeeding requires – a doula once told me that “babies are lazy” in that if it’s easier for them to get the same milk with less work from a bottle, they will often default to that – which makes sense especially when they are extra-little and extra-tired. It’s a really great thing that you aren’t having supply issues – and that you are pumping for her….Again, be kind to yourself – you’re doing what you can to nourish your little baby the way she needs nourishing. Maybe it doesn’t look the way you imagined it should, but don’t get tangled up in too many expectations right now….You’re doing a great job and lots of us out here in cyber-lurker-land are cheering you on!! Keep at it, mama!!

    • thanks! i have pretty much decided to exclusively pump. that way i can share the feeding workload with my partner. obviously i still have to do the work of pumping (& storing, which is its own conundrum, with my complete lack of supply issues), but i find that far less stressful than trying to coax a screaming baby to latch on to the breast.

      i am trying to be more patient with myself & with ramona. i think when she first came home, i had this idea that i should have things figured out more already because she was almost a month old. but i still had so much adjusting to do because it was really like bringing home a newborn for the first time. i had to learn her cues & cries & figure out what noises to ignore & adjust to attending to her needs around the clock, & of course, the first week was doubly hectic because it was xmas & all kinds of people were visiting from out of town & she had to go to the pediatrician & the dentist & have a weigh-in & the cat had to go to the vet, etc etc etc. things have since slowed down a little, which makes it easier to deal.

  3. Hi Ciara, I’m one of Jared’s friends (we met about a year ago when you guys were in Boston). I found your blog when I was checking FB for updates on Ramona. I hope that I am not over-stepping by putting my two cents in.

    First of all, the fact that you are meeting all of Ramona’s feeding needs with breastmilk is pretty awesome. You have a lot going against you in terms of it being hard to breastfeed. Preeclampsia? Check. C-Section? Check. Premature baby? Check. I know a lot of moms who had preemies and/or c-sections and a lot of them weren’t able to provide their little guys with *any* breastmilk. So please, please, please don’t beat yourself up about having to use bottles. You’re doing an awesome thing for your daughter and you should be proud of the effort that you’re putting into it.

    Second of all, you’re not missing out on much in terms of the benefits of breastfeeding directly from the source. There’s exactly *one* advantage to feeding directly from the boob, and that’s that babies learn how to stop eating when they’re full. But, at this point, Ramona needs every calorie that she can get. You can teach her self-control when she’s older. If you’re smart about how you store and heat your breastmilk, you’re not losing enough in the way of nutrients that you should be concerned.

    Breastfeeding is a nice little bonding moment, but there are a million other ways that you can bond with your baby. Billions of fathers and moms who use bottles are able to bond with their babies without the use of boobs.

    Lots of babies get expressed breastmilk. And lots of babies get formula. And they all turn out just fine. Breast is best, but it’s not the only acceptable way to feed your baby. I’ve struggled with this myself, because I’m really tempted to start supplementing with formula now that I’m back at work. So far, I’ve been mostly managing by pumping, but I know what it’s like to put all sorts of unnecessary pressure on yourself about how you feed your baby.

    *This is not your fault.* It’s just an unfortunate circumstance, and it was out of your control. Ramona needed bottles, and she got used to them. There’s a reason that they say not to use bottles (and pacifiers) until breastfeeding is firmly established. Once a baby gets used to eating out of a bottle, they have a hard time going back to eating the old-fashioned way. Bottle feeding is just so much easier for a baby. Bottles and breasts also require two different kinds of techniques. When breastfeeding, the baby is actively sucking to draw the milk out. When bottle feeding, the baby is mostly working to keep the milk from flowing out too quickly. You didn’t have any choice about when to introduce Ramona to bottles, because she needed all of those precious calories when she was brand new. Please don’t beat yourself up about this.

    And you still might be able to get her to breastfeed! When she’s bigger and stronger, it will be easier for her to breastfeed. A good lactation consultant very well might be able to help you out. I’m guessing that they’ll have you switch the nipples on your bottles to the slowest flow possible so that bottle feeding take a little extra work. But, even if you can’t switch back to the old-fashioned method, you still won’t have failed.

    I know that the grass is always greener on the other side of the fence, but I have the opposite problem from you. My daughter hates bottles, and it can be very limiting. Don’t get me wrong, I love and appreciate breastfeeding her. But she’s four and a half months old and a terrible sleeper. Because she doesn’t eat enough at daycare and I have to feed her all night long. It also means that I get to do every single one of the nighttime feedings. And I can’t go to bed early, because I have to be the one who feeds her before bed. I’m so ridiculously sleep-deprived, it’s a little bit scary. It also means that I can count on one hand the number of times that I’ve left her alone with my husband. I hope that this paragraph didn’t come out the wrong way, because I hate it when people complain about things that I can’t have/do. I just thought that it might make things easier for you if you could think about the advantages to the fact that Ramona will drink from a bottle.

    Anyways, I hope that some of this might be a little bit helpful. If not, feel free to tell me to STFU. At any rate, I got your address from Jared and I’m going to be sending you a little care package with some of our smaller hand-me-downs and a few other things. Let me know if there’s anything in particular that you either need or have too much of. We have a lot of extra blankets and sleepers, because a lot of people gave us blankets and sleepers. But maybe you have too many of them as well. :p There’s also going to be a lot of pink, because that’s also what people gave us. I registered for things that were mostly gender neutral, but lots of people bought us other stuff and they mostly picked out pink.

    • yeah, i remember you & no, you’re not over-stepping your bounds by commenting.

      since i wrote this post, i have pretty much decided to exclusively pump & give ramona breast milk in bottles. the pumping obviously creates a certain degree of work/sleep deprivation for me, but i find it far less stressful than trying to breastfeed, & with the added benefit that jared can contribute equally when it comes time for ramona to have a meal. when i think about being her sole source of food around the clock, i start to feel very panicky. maybe things would be a little different if she took to it really well, with no screaming or fighting, but i still really appreciate being able to keep sleeping at 3am when she is screaming for milk because jared can get up & satisfy that requirement as well as i could. i am kind of tethered to my pump, but i never left the house a whole lot even before i had a baby, so it’s not really a big deal.

      she is also more than capable of spitting out the bottle when she decides she’s done eating, so i wonder how much she is going to struggle with self-control down the road.

      i still don’t know if i totally believe in nipple confusion…in ramona’s case, she did great at breastfeeding when we were in the hospital. we never had any problems until the night before we took her home. & within a day or two of her being home, we realized she had a tooth! it was on the bottom in the middle, so it was rubbing on her tongue when she tried to latch on to the breast. the tooth has since been extracted…but i just don’t know that i WANT to breastfeed her. i spent some time feeling pretty guilty about that, but…it is what it is. it’s not how i expected to feel, but i don’t see that there’s anything to be gained in forcing myself to do or feel something i don’t really want.

      personally, i don’t mind pink stuff! pink is my favorite color. as long as it’s not all a bunch of “princess”/”dive-in-training” stuff, i am fine with it. & even if it is…free stuff is free stuff, right?

  4. Breastfeeding any new baby is bloody hard, let alone one as little as Ramona. It sounds like you are doing brilliantly. Oversupply has been an issue for me too (my second is 12 days old), but i heartily recommend getting some help: Australian breastfeeding assoc for me; LLL seems to be your equivalent. Or a private lactation consultant if you can manage it. Big boobs and small babies lend themselves to the underarm or football hold, I have found. I hope things get easier for you soon.

    • my doula does lactation consulting as well, & there’s a la leche league meeting in my town next week. i have since decided more or less to just exclusively pump rather than try to make the transition to full-time breastfeeding, & some friends that made the same decision were frustrated with LLL for the emphasis on breastfeeding directly from the breast & making some judgments on moms who pump. but we’ll see what my experience is like.

  5. I wish I had some really practical advice to give you, but the only thing I can really say is that you are not a failure as a mother! If it makes you feel any better (& I hope it does), some random internet person who reads your blog is absolutely sure that you’re not failing. I understand feeling sad & crappy because I absolutely felt sad & crappy after my son was born & we didn’t have even half the struggles you did; nevertheless, please try to be easy on yourself. It does get easier & it will. Also, your daughter is delectable. I’m really glad you put up a new post, but I wasn’t sad at all to check back & have the first thing I saw be that wee smile on her face.

    • thanks! yeah, i think i was going through some baby blues. things have already gotten a lot easier. she is gradually becoming more work as she has more periods of alertness, but i feel a lot more comfortable spending time with her & loving on her now. i think it was a mix of hormones, the stress of the birth/NICU experience, disappointment over not getting what i wanted as far as full-term baby/birth with few interventions/baby comes home right away/etc, & just the panic of having to care for a new baby. i’m kind of over it now.

      & her tiny smile is indeed the best.

  6. So many of my friends have struggled with the breastfeeding at the beginning. In my micro-circle of experience, I would say that an initial, exhausting struggle is definitely the norm. Nearly all my friends worked through it and ended up with a happy, workable breast-feeding routine. Given the difficulty many women have with full term babies, it’s not surprising that you would have a hard time with a early baby. Don’t beat yourself up, don’t get too discouraged. The obvious truth is that Ramona has a mom who will do her absolute best for her, and that matters more than anything. I think your efforts will pay off.

    • the upsetting thing is that we were breastfeeding pretty well in the hospital. ramona seemed to have a real instinct for it, apparently i have perfect boobs for breastfeeding, & i had no supply issues whatsoever. had she been a full-term baby, we probably would have looked like the blissed out cover models for some breastfeeding book–the kind that all the other moms hate.

      but then she grew a tooth & things went to shit. the tooth has since been extracted, but i’m in the zine with the pumping/bottlefeeding & don’t really want to stop. i like being able to split the workload down the middle with my partner (well, aside from the fact that i still have to do all the work of pumping).

  7. I’m sorry things are rough right now, but I’m glad she’s home and eating. I think you’re doing great, despite how crappy you feel, for whatever that’s worth.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s