24 February 2014

Exclusive Pumping

This is not just one of those posts where I tell you how busy I've been to excuse a delayed absence on my blog, although it is that as well. This is a post where I tell the story of one of the hardest things I've ever done in my life. It's personal, it's intimate, but it's not embarrassing for me to talk about it.

Sleeping angel

On Cinco de Mayo, after a difficult and long labor, I delivered a healthy baby boy named Ivor. Wrinkled, blue and crying, he came into this world a complete mystery to me. Partially in shock, and mostly in love, I looked at his cone head and his puffy face and still couldn't believe this little creature was mine to care for. Within minutes, he peed on his dad. We laughed. Soon after he was cleaned up, I brought him to my breast and he nursed eagerly. It hurt.

While pregnant, I read about the benefits of breastfeeding everywhere. I knew I wanted it for my baby, but what I didn't know was how difficult it can be. I had dreams of breastfeeding while I was pregnant, and it was always easy. I requested help from the lactation consultants multiple times before leaving the hospital. We went over different latches, and we tried to address the pain that I was feeling. I left feeling a bit more confident about it, although it was still uncomfortable.

Larbear gets a turn to hold Ivor

Ten days passed before Ivor's "one week" appointment. He hadn't gained weight since we left the hospital, but the doctor didn't seem overly worried and I knew that breastfed babies sometimes take longer to regain their birth weight in the beginning. Four days later, I weighed him on the postal scale at home, putting his tiny body in a punch bowl. He had gained 4 ounces, which seemed right on track. Still, he was screaming almost nonstop except when he was sleeping. At this point we were completely sleep deprived and overwhelmed. I began a total elimination diet, thinking his screams were caused by gas. I ate only pears, lamb, rice, squash and sweet potatoes. It was a struggle to find time to feed myself, and Ivor was spending up to 10 hours a day at the breast.

A few more days passed, and Ivor didn't look like he had gained weight. If anything he looked skinnier. I put him on the scale again, and it said he had lost an ounce. It was the Friday afternoon before Memorial Day, and the pediatrician's office was closed until Tuesday. I pulled out my pump for the first time to see what I was producing. I pumped all weekend, bottle feeding him when he wasn't nursing. The results from the pump were minimal. On Tuesday I took him to see the doctor, who used the phrase "failure to thrive." My stomach sunk. He recommended formula, but I insisted on a referral to the lactation consultants to try to solve whatever problem we were having with breastfeeding. The next day, I found myself back at the hospital with Ivor to meet with Jinx, the head lactation specialist. She told me that for his weight, Ivor should be getting around 60ml per feeding. She weighed him before and after a feed and I cried when she told me he had only eaten 18ml. His latch looked right, but he had what she called an "ineffective suck." His short lip and tongue frenula were part of the problem, compounded by a high palate. Between the energy spent feeding and the energy spent crying, Ivor had no calories left to grow.

Scratchy kisses

The body only makes as much milk as the baby demands, and my supply had been withering since his birth. I was producing about 9 ounces a day, and he needed a bare minimum of 18. I would need to pump if I wanted to provide milk for my son, and I would need to pump extensively to get my supply back. We supplemented to get Ivor up to a healthy weight while I worked on my supply. Determined, I read as much as I could about "exclusive pumping," the glamorous moniker for what is the least glamorous thing I have ever done with my breasts.

A woman trying to increase her supply should pump between 8-10 times a day, between 2-3 hours apart. I kept this up for nearly 3 months, setting alarms to wake me up multiple times a night, sleeping whenever I could, and letting household chores, personal hygiene and all forms of entertainment take a back seat to this madness. When I wasn't feeding or holding Ivor, I was pumping or cleaning bottles. With the help of my moby wrap, sometimes I pumped and held him at the same time. I have a very supportive family, without whom this never would have worked. Even with help, I felt my sanity crumbling on more than one occasion. I wasn't trying to be a martyr— this was part stubbornness and part absolution of the guilt of letting my sweet baby starve for those first few weeks. It was also partly due to my distaste for the smell of formula.


The same weekend I started pumping, I saw Ivor smile at me for the first time. He still screamed a lot, but the more milk I made, the less he cried. I stopped the elimination diet, as it was now heartbreakingly clear that gas was not the cause of his screaming. My baby had just been hungry.

When I purchased a breast pump months earlier, I had no idea how vital it would become. Every day I saw results— not big ones, but a gradual increase. Two months after I started pumping, I had gone from 9 ounces in a day to over 30. Ivor was gaining weight, happy, and loving.

3 weeks / 23 weeks. What a difference! Ivor is 24 weeks today and so happy and healthy.
3 weeks and 23 weeks. What a difference!

I had become an exclusive pumper, or EPer. There are many women like me who for whatever reason are unable to breastfeed but are determined to provide milk. It's a hard place to be sometimes, with the constant question "breast or bottle" coming from every direction. Many people have never heard of EPers, much less considered their struggles. We even have our own facebook group, several hundred moms strong, where we commiserate and exchange advice. It's invaluable to mothers who don't fit conventional norms and for whom there is less literature available.

Yes, there's an app for that. It's called Milk Maid.

Gradually I took the plunge and "dropped a pump," as they say in EP speak. Going from 8-10 pumps a day to 7 felt amazing. I got to sleep for more than 2 hours in a row. Sometimes it still felt like I was finishing one pump and I only had an hour before I needed to start all over again, but it was a little bit easier. And every time I've dropped a pump since, it has felt incredibly freeing. Every time, I wonder how I did it as often as I did before.

I remember the fist day I had to freeze milk because I was making more than he was drinking in a day. Soon I had a little freezer stash going. It was nowhere near what some women have, but I looked upon it with pride. Finally I felt like all my hard work was paying off.


Warning: the next paragraph is graphic. Skip it if you are squeamish.

After a few months, I discovered a small tear on one nipple. It hurt like crazy, but I kept pumping. I tried applying coconut oil and even Neosporin, but it would not heal. Every time it started to close, it was ripped open again by the pump within hours. I was in agony. I should have rested it, but I was scared to stop and unsure what would happen to my supply, so I kept going. It was raw, and it grew bigger and bigger, but it was not infected. I pumped like that for nearly two months until one day it started bleeding into my milk. When I looked down and saw what looked like crushed raspberries in my bottle, I broke down. I dissolved into tears and vowed to give up once and for all. I was done.

Except I wasn't done. You can't just stop. I was incredibly engorged, and I knew I needed to get the milk out to prevent mastitis. I hand expressed the next day, while pumping the other side. The injured side was swollen and painful. I took the day off work.

After resting my injured breast until it healed, I lost a lot of my supply. Back at work and unable to return to pumping 8-10 times a day, I was never able to get back to my peak, and slowly I whittled away my entire freezer stash. Now I make about half of what Ivor eats. We supplement with formula again and he gets a fair amount of solids. It was disappointing at first to fall short of my goal to provide enough milk for a year, but I have made peace with it.

Ivor at the park

In the past 9 months, I have been attached to this pump for over 1300 hours, or 55 days. Sometimes I look back and wonder how different things might have been if I had not chosen to pump for Ivor. Maybe it would have been less stressful, and I could have had more time to enjoy him. It's a trade off, and every mother has to make that decision for herself. Mostly I'm glad I did what I did, because I gave him an important gift while at the same time I learned something about myself. I can finish things. I can be determined. I can be strong.

I decided to put this into writing to raise awareness for this issue. Everyone says "breast is best," but many women struggle with breastfeeding. Not everyone has the support system and time off work to do what I did. Whether the women in your life are breastfeeding, formula feeding, or feeding expressed milk, please encourage them and keep an open dialogue. There is no shame in feeding a baby, no matter how a mother does it.

Ivor in the bath


JudyD said...

I am so very proud of you, Kristen, for how you charged into motherhood, guns a - blazing and never taking 'no' for an answer. You have surely impressed this old great-auntie! I love your sweet little family!

Katherine said...

Oh Kristen! Your post made me cry. You worked so hard, and I am so impressed by your dedication! I'm glad you insisted on seeing a lactation specialist, even after hearing what I'm certain was incredibly difficult from the doctor. Ivor is incredibly lucky to have you and your family! And you are so right, there is no shame in feeding a baby no matter how you do it.

bird said...

I wouldn't expect anything less from someone as loving and dedicated as you, and I definitely applaud you for your perseverance! You're definitely an inspiration for me :) But you know all your hard work has paid off when you look at that adorable smiling face!