A Retrospective of Two Weeks Breastfeeding

This writing is to compare two breastfeeding experiences: Noe's first two weeks and Kei's.

Preparation

Noe:
I decided to fully breastfeed my baby because of what international health organization and experts recommends for baby's first six months. But I thought that breastfeeding should be natural and should not be learned. So I made no effort in looking for any information about breastfeeding at all. Despite that, I was really confident that I wouldn't face any difficulty breastfeeding. Later, it turned out that I was too cocky.

Kei:
Having volunteered with Breastfeeding Mother Support group and received counseling training from them, plus, having purchased the Breastfeeding Answer Book, and having engaged a lactation consultant to counsel me during the first few days after birth, I am (hopefully) better equipped to breastfeed my baby. I roughly know the basics of breastfeeding and I know where to look for help if anything goes wrong. I am more confident but hopefully not as cocky as during Noe's time.

Birth and The First Few Hours

Noe:

Noe was delivered vaginally with only two pushes and I had very few stitches. It was relatively easy labor but with severe complications post-partum. After clamping the umbilical cord, Noe was given to me for cuddling, but I didn't know that I could breastfeed him at the very moment. I thought I had to finish all the childbirth procedures; stitching and all; before beginning to breastfeed for the first time. Hence I handed him back to the nurse to be taken to the nursery, because Noe was crying (stupid decision by me). A few minutes later I had severe post-partum hemorrhage which was caused by lack of contraction in my uterus. The bleeding could've been reduced if I had been breastfeeding when Noe was given to me for cuddling, but I didn't know that. The bleeding was so bad and I ended up feeling cold, shivering, and very tired. After the critical condition ended, the nurse asked me whether I wanted to breastfeed, and I declined saying that I was too tired. The nurse asked again, "But you asked for total breastfeeding.." and I insisted, "Yes.. but I am really tired now, please just give him formula if he's hungry. I will try to breastfeed him when I feel stronger". I regret this decision even until now, and this decision caused Noe to have nipple confusion which later caused a series of breastfeeding problems. I was then brought into Intensive Care Unit, and stayed there for 18 hours, before seeing Noe again for the first breastfeeding.

Kei:

I decided to prepare for ideal condition to begin breastfeeding. First, I intend to have drug-free birth, because anasthesia is known to cause drowsiness in newborn and inability to breastfeed right after birth. Secondly, I engaged a lactation consultant during labor to assist breastfeeding during the first hour. I was glad that my birth plan was mostly followed. Kei was put on my breast for skin-to-skin contact within 10 minutes after birth, but he was not really interested in breastfeeding at the moment. So we quickly weigh him and measure him, and put him back into breast at the second 10 minutes after birth, and this time Kei is more interested in breastfeeding. The first time he nipple-feed me, which is wrong, so we had to break the suction and attempt for a more correct latch-on. Kei managed to latch-on beautifully during his second attempt, and despite his "weak" suck (compared to Noe's suck, which is a toddler) I could feel the effect instantly. I felt a bit of pain in my uterus which means that it is contracting, hence reducing the bleeding. I think Kei breastfed nicely for about half an hour before dosing off to sleep. When Kei was bathed for the first time, he expelled meconium instantly since he had drunk the colostrum. The expulsion of meconium is very important as it will help to reduce the risk of jaundice.

The Second Day

Noe:

Noe breastfed for the first time 18 hours after childbirth. Since he had been given formula while I was in ICU, he latched-on incorrectly to my breast just like he was sucking bottle. Noe was basically nipple-feed, and I did nothing to correct it because I didn't know it was wrong. Ami Prasetyo, a friend who was visiting, pointed out my mistake, but I ignored it because I haven't yet felt any pain. Meanwhile, no lactation consultant or nurse helped me with my latch-on, hence the mistake was not corrected. By early evening, I began to have sore nipple, but the massive dose of painkiller given to me masked out the pain. At night, Noe did cluster feeding. This means Noe feeds non-stop from 2am to 4am. I didn't know that such condition is normal during the first few days. But I was too tired due to my bleeding and low hemoglobin rate, and I didn't understand why Noe wasn't satiated at all. At the end, I was overly tired and I asked the nurse to take Noe away to nursery and feed him with a bottle of formula.

Kei:

Three hours after birth, Kei was brought in to breastfeed, but he wasn't interested. I attempted to feed him for one hour but he stayed asleep. I thought that this might be a normal situation, whereas in the beginning the baby was a bit sleepy, and this might be nature's way to help the mother rest after childbirth. I sent Kei back to nursery so I could sleep: making the most out of baby's sleepy time. Kei breastfed for the second time approximately six hours after birth, and during the first day he fed every five to six hours. I tried to sleep as much as possible, because I expected that Kei would do cluster feeding sooner or later. During Kei's third feeding, at around 10am, Doris (lactation consultant) came for a visit and helped me with a "refresher course" on breastfeeding. I learned that I had to catch Kei's big mouth opening (say AAH!) in order to produce a good latch-on. This is a bit challenging because Kei's behaviour was random (like most babies) and I was the one who has to be observant of his behaviour. Basically both mother and child are learning about each other's ability and limitation. Kei's was a quick learner, he learned that he would be rewarded with milk if he opened his mouth really big. As a result, Kei has always done good latch-on and I didn't have any soreness. Later on, at night, true to my prediction, Kei began to cluster feed. This time, I was physically fit and prepared, so I said to Kei, "Let's have a battle, who is stronger and who will survive the night with cluster feeding". I fed Kei non stop from 1am to 4am, going from left to right breast and repeat the cycle, nonstop. At the end, at 4am, Kei fell asleep by himself, being too tired of cluster feeding. I was glad I won the battle. I then sent him back to nursery and I slept comfortably for four hours straight. After that cluster feeding session, Kei feeding hours began to become more regular and predictable.

The Third Day

Noe:
During the second day I received blood transfusion in order to boost my hemoglobin rate. Noe roomed in with me during the day, and sent to me from the nursery every 3-4 hours during the night. My sore nipple was getting worse with the nipple skin peeling off. The painkiller started to lose out to the pain of sore nipple. I asked the nurse for a help to cure the sore nipple, and she was aghast to see such a bad nipple condition. She gave me medela ointment to apply to the nipple before and after nursing. The problem is, the nurse was not fixing the latch-on problem, which was the source of the problem, and I didn't know it. In the mean time, no lactation consultant paid me a visit (and I didn't know that there is such thing as a lactation consultant). Meanwhile, most people told me that sore nipple is normal for the first week and it will subside by itself. So I took it for granted that sore nipple is the normal pathway towards breastfeeding. Little did I know that sore nipple is not a normal condition and that it could all be resolved by a quick visit to IBCLC (certified lactation consultant).

Kei:
Since I had a vaginal delivery without complication I was able to come home the second day. So far Kei has been breastfeeding well, as indicated by his pee and poo cycle. I saw that Kei has been having more than four poos, which was very good for a two-day old baby. Kei also didn't show any sign of jaundice, so doctor let him out of hospital without prick test. We were discharged in the afternoon. Kei's weight upon discharge was 2630 grams. Losing weight during the first days was normal because the baby shed meconium and excess water in the body. Back home, Kei feed every 1-1.5 hours. At night, he was again having cluster feeding, this time it was for six hours straight. I fed him in cradle hold position and fell asleep sitting down cradling Kei. Lucky that I managed to maintain the cradle position while I was asleep, and Kei was latched on all the way. That was the last cluster feeding session for the first two weeks.

The Fourth Day

Noe:
Since my blood transfusion result was good, I was discharged at the third day. It turned out that going home was a struggle for me. I was considerably weak due to the blood loss, this means I was easily tired. Compounded with difficulty breastfeeding with sore nipple and baby blues, I became sad easily. Noe was feeding quite frequently and it tired me, and he was given formula. When my husband gave Noe the first formula bottle at home, it dawned to me that I did not want to bottle-feed him, because it seemed to be really cumbersome: preparing the formula, ensuring the right temperature, feeding the milk, and washing/sterilizing the bottle afterwards. Knowing me, I would be too sloppy and too careless to bottle feed Noe. Besides, my weak condition didn't spare me enough energy to do the extra chore of making formula milk and cleaning it afterwards. From that moment I decided to go back to total breastfeeding, despite the pain of sore nipple.

Kei:
So far the breastfeeding experience has been really painless (but still a bit tiring with its high frequency). And my mature milk has begun to come in: I experienced breast fullness and I could see white milk when they're squeezed. Meanwhile, Kei's poo has turned yellow and grainy like curry. His breastfeeding frequency has also begun to space out to 2-2.5 hours.

The Fifth Day

Noe:
Away from the hospital and away from the painkiller, I just realized that sore nipple pain was worse than labor pain. I literally broke down to tears every time I breastfed because it was really really painful. My mother was really puzzled to see me crying and screaming out of pain of the sore nipple. People reassured me that the pain will subside after one week, so I decided to stay put despite the pain. Of course, with crying and screaming. The nipple skin peeled off leaving a really painful gaping wound. I decided to do away without bra, because the friction of the nipple with the bra aggravated the pain. Meanwhile, my mature milk began to come in and I began to leak all over the house. I also began to have slight engorgement. All the changes in my body had never happened before, and I was really stressed out because of it. Meanwhile, my husband went off to buy breastpump and nipple shield because he couldn't stand to see me in great pain.

Kei:
I began to have breast engorgement but no leak yet. There's also lump in armpit. I gave cabbage compress for 2 hours and it was soothing. Noe helped empty the breast but didn't help alleviating the engorgement. I also had a low grade fever, and I took panadol to cure it. This time I know that all those changes in my body were normal and it was my body's attempt to calibrate the right milk supply. I was more prepared, especially with the breastfeeding book, and had known the first-aid measure to overcome engorgement. And by the way, I don't have sore nipple at all, and this makes breastfeeding really enjoyable.

The Sixth Day

Noe:
This time I tried to pump the milk so that I didn't have to go through the pain of breastfeeding directly. To my horror, while pumping, the sore nipple wound opened up and blood was expressed alongside milk. I was totally freaked out seeing the bloody breastmilk. Not knowing what to do with it, I threw away the bloody milk and quit pumping at the very moment. I decided, again, to bear with the sore nipple pain, instead of having to bear seeing my nipple exploding with blood.

Kei:
The low-grade fever subsided, but the slight engorgement stayed on. Due to the engorgement, latching on became more challenging. Luckily the "sandwich" technique as taught by Doris helped to ease the latch-on process. Kei adapted really well to the changes in my body. Despite all those changes, I managed to catch all Kei's big mouth openings, and latching-on was easy. Kei had learned that his reward of milk comes with the big AAH that he made.

The Beginning of the Second Week

Noe:
Breastfeeding and baby caring becomes a dreaded task for me. I felt really miserable. Compounded with baby blues, I really didn't enjoy having a baby. At this stage, a baby is not yet responsive to eye contact, and this made me feel unappreciated. I felt really incompetent because my mom always criticized the way I care the baby. Moreover, breastfeeding was really painful with sore nipple. Breastfeeding was also a hassle. I had to change clothes very frequently because of bad leaking. I had to ensure that I install the breast shield to protect the sore nipple, and milk drips inside the shield, onto the tshirt, onto the floor, creating a big milky mess all over the house. The whole house smells like stale milk. In short, I was feeling really miserable. But somehow I didn't stop to change to formula feeding. Most probably because I didn't have the energy to make formula milk, clean the bottle, sterilize it, etc. My hemorrhage made me fall tired really easily, and I just wanted to avoid extra work related with house chores, including cleaning the bottle. This is mainly why I stuck with breastfeeding. It wasn't at all any noble goal to give my baby the best nutrition. It was mainly out of my weak physical condition and my own laziness.

Kei:
At the beginning of the second week the engorgement had subsided and the milk supply seemed to have stabilized. The leak was not as bad as in 2005, surprisingly. Nevertheless, both Kei and Noe seemed well satiated. BTW, I am doing tandem nursing, which means I breastfeed both Kei and Noe. But I only do tandem at night. It is a bit tiring, but it seemed to lessen the sibling rivalry between the two. Despite having to feed to kids, so far I don't have nipple soreness. Baby care and breastfeeding are now enjoyable for me, mainly because it is not a painful experience. Oh this time I also experienced baby blues during the first week, but by the end of second week it has subsided.

The End of the Second Week

Noe:
At the end of the second week I truly regret my negative feeling towards breastfeeding Noe. This is because suddenly Noe was unable to breastfeed anymore. At that point, I realized that I would take whatever pain caused by breastfeeding as long as Noe wants to breastfeed. Noe's inability to feed came very suddenly, and I felt really rejected. Although I'm not a religious person, at that time, I prayed to God that I was really sorry to Her, to be so negative about my breastfeeding pain, and I prayed that Noe would return to breastfeeding. The story went like this. Suddenly, one morning, on Tuesday 29 March, Noe lost his ability to latch on. We tried for many hours to put him into the breast but he was just unable to do it. Indi was so worried that he took sick leave from the office to help me. We gave up trying to breastfeed after six hours trying when we heard grueling sound from Noe's stomach, indicating bad hunger. We finally gave him formula, and Noe fell asleep, satiated. It was really weird because he couldn't latch on my breast, but he would take the bottle. We went to a lactation consultant in our hospital for two days straight, but she was unable to give us a satisfactory answer. At the end, on Thursday 31 March, I went to Doris and she did a thorough analysis of my condition. Doris gave a clear diagnosis: an overactive milk ejection reflex, which means I have too much milk and Noe was like trying to drink out of a fire hydrant. She also gave me three steps to overcome the problem: 1. Pump before breastfeeding so that Noe didn't have to cope with the let-down; 2. Breastfeed in lying-down position to defy gravity; or; 3. Pump and feed through bottle. At home, we tried the second way. Our good friend Karyn, who was active in La Leche League, also lent us her support by trying to get Noe back to the breast again. The situation was really bad that even my mom flew back from Jakarta (she thought Noe went on strike because Noe missed her). But amazingly, at night of 31st March, Noe went back to breastfeeding! It was the best birthday present for me ever, and I thank God that She answers my prayers. After two weeks, my breastfeeding problem didn't stop. I had three times mastitis attack within the first three months. My hemorrhage had left me with a physical condition that is vulnerable to infection. But I could cope better because I knew how to look for breastfeeding information and where to find help.

Kei:
Except for dripping and leaking all over the house, so far I didn't have significant problem. I hope that breastfeeding would stay to be a breeze like this until Kei is at least six months, and hopefully, two years.
Conclusions and Lesson Learned

My first month breastfeeding experience with Noe was really bad and painful, plus, it was further aggravated with baby blues. The only thing that kept me from shifting to bottle-feed was my laziness and my weak condition after hemorrhaging. Moreover we don't have permanent live-in helper (maid), and my husband couldn't afford to be sleep deprived. Hence I simply didn't have enough energy to do the extra effort of making formula milk and cleaning the bottle. Apparently my weak condition was the silver lining of my childbirth complication, that had forced me to breastfeed. Despite the rough beginning, eventually it became really easy. I am glad to be able to continue breastfeeding until now.

My experience with Noe taught me that breastfeeding is not easy and it is something to be learned by the mother and baby. If I have read breastfeeding references and prepare myself, I might have better and more pleasant beginning. But I was too cocky.

My second child birth taught me that good breastfeeding start is important to avoid the compounded problems that will arrive later. The first two days is good time to learn to achieve effective latch-on and learning about the baby's cues (like, how to catch the big AH for a perfect latch-on), because the early days is not yet troubled with engorgement or leaking. I would highly recommend close contact with lactation consultant or counselor during the early days.

It is very important to know where to find breastfeeding help. Breastfeeding difficulty often needs to be addressed fast, that's why, most breastfeeding support groups and hospitals provide breastfeeding support hotlines. First and foremost I would like to thank Google for helping me to find information really fast. And I'm very grateful of my lactation consultant and breastfeeding guru, Doris Fok (Thank Google from which I found her contact info). Too bad, many people didn't know that there is a profession called lactation consultant that gives help for breastfeeding difficulties. Moreover, it is too bad that the modern urban culture has put breastfeeding as something to be embarrassed about, hence women nowadays couldn't easily find reference about breastfeeding in public sphere.