Nursing Woes

First things first

The birth story is coming, I promise you that.  But right now, I'd like to talk about nursing RH.  Or rather, the hazards of nursing RH.

She's a good nurser.  She gobbles down milk like no babe I've ever seen.  She chugalugs mightily.  You can hear her little glug glug glugging from across the room.  It's incredibly adorable.

Her latch?  Horrific.

Nursing in the hospital

Utterly terrible.

She has a few problems when it comes to latching.  For one, she holds her tongue to the back of her mouth when she opens up her mouth.  Even when she screams.  No, she has no tongue tie.

That means that, once she latches, she does one of two things.

A) She pushes the nipple out between her gums while she sucks it back and forth.  This is excruciating.  She also sometimes manages to catch a bit of areola in between her gums and lip while she's doing this.
B) She scrapes the front of the nipple incredibly hard with her tongue while she sucks.

Sometimes she does both.

This results in purple and blue, scraped and bleeding, achy nipples of constant misery.  Sometimes with blistered areolas.  Yes, that it every bit as painful as it sounds.

Of course, once she's had a few gulps and starts to get sleepy, I can disengage her and re-latch.  A couple of tries in and she's latched fine- happily chugging away and not causing anybody any pain.  At that point, nursing becomes positively lovely.

Before that can happen though, there is the first part.  The part where I am terrified of putting my nipple into her mouth, lest she mutilate me some more.  The part where I scream and cry and thrash, trying not to cause any more damage before I can get her the hell off of me.

Four nurses in the hospital evaluated our feedings.
My doulas watched this procedure.
RH's pediatrician has chimed in.
They all agree.

There's basically nothing I can do.

The girls know that this is how babies eat

She's getting better, but as she gets better, she also gets stronger.  And as she gets stronger, she gets more aggressive.  She has over the last thirty six hours (or approximately twenty nursings) discovered that she is a speed demon.  She is now capable of snapping her jaws just and beginning to suck so fast you can't even see it happen.  So fast, the my nipple ends up caught perpendicular in between her gums while she begins to suck hard enough to move a golf ball through a garden hose.

There is nothing I can do to fix this, but to wait.  To try to be patient and keep correcting her latch.  While my nipples swell and ache and bleed and maintain a vivid purple color.

The thing is, this isn't exactly unusual.

This is the third baby I've nursed, and the second who seemed determined to inflict pain in the early days.

SI?  She was vicious.  Entirely different, though.  She would get her latch, she would nurse perfectly for a few moments, and then she would clamp her jaw shut like a vice.  There was no opening it.  And I would scream and cry and beg and plead, and do my best to pry her tiny jaw open, all to no avail.

DD was a perfect nurser, almost from the word go.  She never did anything to cause me pain until the day she weaned.

So I know how this goes.  I went through six weeks of agony with SI before she just nursed like you always assume a baby is "supposed to."

And now here I am with RH.  Who keeps fixing one problem, only to invent a new method of torture.

Only this time, DD and SI are around to watch.

DD is terrified whenever I start to nurse the baby.  She wants to know if RH is going to hurt me, if she's biting me, if I'm going to cry, if I'm okay.

She's making cute little noises!

I feel so guilty.

And Grandma and M... they don't like it either.  I wouldn't if I were them.  But frankly, their repeated suggestions that I pump and let somebody else take a turn feeding her for a day just make me mad.  I don't WANT to take a break.  I worry that taking a break is just going to set her back instead of moving her forward.  But it's tempting.  Because my nipples?  They're usually in agony.

Yes, I want to pump.  That's because I have such ridiculous over supply.  Because frequently, RH will torment my nipples and then have nothing to eat.  But I *like* nursing.  You know, once the ungodly awful part has passed.

I'll snap at M about it.  But I won't snap at my MIL.  I'm too grateful that she's here, taking care of my home and my toddlers while I'm recovering.  (The three of them baked delicious sweet potato muffins today.  Who could complain?)  But I'm just going to keep up putting my nipples directly in harm's way and trying to stifle the screams.  And trying anything I can think of to make them hurt a little less.

Gel nursing pads keep them raw, but help with the bruising.  They make my nipples ache each time I take them off.

Cloth nursing pads stick tot the drying blood and then peel away the scabs when I try to take them off.

No nipple shields mean that I'm constantly leaking milk on myself.

Every time a cool breeze goes by, my nipples scream.  Every time I step into the shower, each drop of water makes me wince.  When DD or SI or even M try to give me a hug, a flinch away from the pressure against my chest.

Nursing?  Not so glamorous.

I know it's going to get better.  I know it is.

I know how to get us a good latch.

Me and my girls- you'll be seeing a lot more of this picture

I know what a good latch feels and looks like.  I know how nursing works- I was an awesome cow for almost ten months with my twins.

But I am a sore and tired cow this time around.

One week down.  One week of improved nursing, one week of improved attacks.

Hopefully this time next week things will be better.

Hopefully.

And if not, I suppose at least I have one recourse when it comes to bolstering my spirits that was denied to me for most of the last year.

At least now I can pour myself a drink.




FYI- My MIL is awesome.  As I type this, I am eating pigs in blanket (with fake pigs) and a spinach/strawberry/raisin/almond salad with black currant vinegar, she has put my children down for a nap, and she is snuggling my infant.  She is awesome, and I mean no disrespect whatsoever.




...also, I have spoken with a lactation consultant, who is perplexed enough that she's making a house call this week.  Here's hoping I'm doing something wrong and she can fix it.

Makin' with the Milks

Breasts are pretty awesome.  They're warm and snuggly, they're pleasantly roundish, and they make food.  Past that, they're pretty fun in other ways.  I'm very pro-breast.  As a sort of thick Jewish girl, I've had breasts for a long time.  Big ones.  Before my pregnancy, I'd been holding steady for about eight years at a 34G.  I would wander through lingerie sections snorting- those measly C cups!  Those adorably petite DDs!  Then of course, I had to go and procreate, and now?  Boobs of doom.  Yes, doom.  Did you know bras only seem to go up to a double O?

Of course, they're more useful now.  Never mind that it took me six months of constant searching to find a supportive nursing bra that I didn't have to get custom made, or otherwise altered.  Never mind that my breasts enter the room four or five minutes before the rest of me, never mind all of that.  They're doing an important job.  And I am beginning to wonder about when that important job will end.

You see, my children are growing teeth.  Those adorable toothless grins haven't changed much- YET- but those teeth are visible.  Pretty soon those teeth are going to be more than adorable little pearly spots, they're going to be vicious tools of destruction.

I'm not considering weaning as a purely pain related issue.  Frankly, I'm not sure SI (who used to be a FIERCE biter) even registers that she could nibble me anymore.  DD might figure out that she can get a funny reaction out of it, but they know what boobs are for and it isn't biting.  No, I'm not too terrified of the teeth.  Only terrified enough.

What seems almost pre-arranged is that the girls are essentially weaning themselves as they cut their teeth.  They only nurse two or three times a day now, mostly if they're sleepy and want to wind down for a nap.  They get three solid meals, as many as two of what we call "booby snacks," before a snooze, and then their bedtime eating routine.  They don't want bottles before bed, nursing until they're all sleepy is all it's about, not another real meal.  They decided they were ready to move on from their previous diet, and their mouths corresponded.

I love nursing.  I never expected to say that.  It was hard to get started, really freakin' hard.  There are a lot of women out there who were born to nurse, but I am not one of them.  For one thing, my mother had a hormonal imbalance that made her let-down EXTREMELY painful.  For another, (and I can't believe I'm actually putting this out there,) I have one semi-inverted nipple.  I fully expected an nearly impossible latching situation.  Amazingly, the thing stayed popped out the right way from the get go, but not nearly as much so as its counterpart.  And preemies aren't so good at latching or sucking so that breast was a bit of an issue.  Even if they have the skills they tire very easily, and if they tire before they get to eat they fail to thrive.  I fully accepted the idea of supplementing with bottles early, it was unavoidable.

Getting started breast feeding was hard.  It involved a lot of crying, a lot of disappointment, and a lot of anger.  Nothing has ever made me angrier than being post-partum.  But we finally got the hang of it a few months in.  And it's wonderful.  Not just because the girls are big and I credit their diet, not only because I know they're getting the best food they possibly can, and it's not because we're saving a fortune on baby formula.  A few times a day, I get the opportunity to just sit and hold my babies, to play with them a little, to soothe them, and to generally feel like we're the only people on earth.

It's a little like falling in love, a couple times a day.

Sometimes, it's just a pain in the ass.  Sometimes, it's another thing I have to do that keeps me from doing the things I need to do.  Sometimes, the girls don't cooperate and there's screaming and there's tears and I am helpless furniture.

I'm also getting very good at repeating the motherly phrases, "Don't hit your sister," and "Eyes are not for grabbing."

I'm pretty sure I'm going to miss nursing when it's all over.  I'm just as sure I'll be relieved- freed to return to tight and complicated clothing and nights out.  But I understand the women who keep up nursing into the second year and beyond.  The girls and I are both so calmed, so comforted by just getting that warm, snuggly skin-on-skin time together.  It's a beautiful thing, nursing your babies.  It's not exactly an essential thing, it's not something that works for everyone, but it is an awfully nice thing.

I found that goals helped keep me going.  When I started, my goal was to nurse for six months.  When that turned up, I decided to aim for a full year.  I'm halfway there, and I think at this point I'm going to let them wean themselves.  There are days that they don't nurse at all before bed, that pre-nap nursing session is purely a sedative.  I don't know that I'll ever have to really work on weaning, they're so cooperative most of the time, but it's coming.  Three teeth between two babies, two to three booby snacks a day...

They're not little babies anymore.  They're big babies.  And soon they'll be children, and I'll find another lovely thing to do with them that makes us all happy and calm before bed.  We'll read bedtime stories together, sing our lullabies together, get tucked in and kissed goodnight...  But for now?  Nursing is still awfully nice.  Because breasts are amazing.

"Breast is Best" v. Hysterics

I went into parenthood DETERMINED to nurse my children. I didn't know how long I would do it, and I still have no real concept of when that will end. We're going strong at 6+ months, and the pediatric recommendation is a full year, but my understanding is that children generally self wean between 8 and 18 months old. Yeah, big window.

The global average for length of nursing is actually four years, but that's the GLOBAL average. By most accounts, a majority those children would have been long weaned if there was anything else to feed them. Or any other available method of birth control. Breast milk is amazing, and has health properties that we're only just beginning to uncover. Did you know that you can use breast milk to treat throat cancer? I digress...

I had set myself a six month goal for nursing my babies. I figure, six months is pretty damn good, and nursing twins is HARD, right?

Good lord... I had no idea.

You see a little cat with a litter of six kittens just serenely laying there while the babies nurse away and you think, "That's the simplest, most natural thing in the world!" No. Absolutely not. Nursing is HARD, nursing is COMPLICATED, and human babies- unable to hold up their heads, roll over, or smile at you in thanks, can hurt your poor breasts more than you can possibly imagine.

One word. Suction. Suction is amazing. Using suction, you can life massive weights. You can clean your carpets. You can cause hematomas.

Babies develop the sucking instinct around 35 weeks gestational age. That means that if your baby is born full term, they shouldn't have too much trouble sucking that milk out.

The thing is, new babies are not patient. And they don't empathize (yet). And they have no concept of their mother as a human being. No, to a newborn baby, mommy exists for baby's warmth, comfort, and food. And baby will take what's theirs.

A newborn will latch hard, badly, and start sucking. If they're not getting enough, they might BITE you. HARD. And the fact that there are no teeth in that little jaw is irrelevant. That's the strongest muscle group in their bodies.

So imagine for a minute that you have a vice, attached by suction, clamping on your VERY tender nipple. Because you get all sore just for this very special moment. Now imagine that they're PUSHING YOUR NIPPLE AWAY as hard as they can, while maintaining that amazing suction. Oh yes, you'll survive. But never forgetting this ominous phrase- "Permanent nipple damage." Because pulling out your nipple without breaking suction? Oh yeah. Bad.

And there's always insult to the injury. When your nipples are black and blue, swollen and sore, that's when you're most likely to get an infected or clogged milk duct. And the best way to fix that? Yeah, more nursing.

From most of the moms I talk to, my assertion that it takes 4 months to "establish nursing" is just about right. You got that, four months of this. And they'll lull you into a false sense of security. You'll think that two weeks of perfect nursing means that you're finally through it all, that now you can lie back like the little kitty and let nature do it's beautiful thing. And that's when the growth spurt kicks in and the little bugger starts mutilating you again.

Then you have your loved ones weighing in. They hear you scream with pain, or see your breasts swollen with mastitis, and they tell you that it's okay to stop. This is what formula is for, and you've done your best but it's okay to just go ahead and give the baby a bottle. But you don't. Because you're going to be the best effing mother ever, and god damn if you're going to let something like half an hour of agony eight times a day stop you. And all that tension makes it impossible for you let let down, and you just get hurt more and more and more, and then you start to cry.

And crying will save you. Because those hormones that make you cry also make the milk come. And starting one kick starts the other. So you sob, weep, wail, and curse, and then the baby eats. Oh, it still hurts, but at least you're fulfilling your biological duty.

You will freak out your co-parent. You will freak out your baby. But hell, what do your tears matter? The tears of a mother are irrelevant- you cry so that baby doesn't have to. You brought that baby into the world in pain, and with pain you'll keep it here so help you.

...I understand Jewish grandmothers more every day.

But it ends. Nursing becomes established. And the clogged ducts and the purple nurples cease. And you're left with the weaning question.

I had decided that "at least six months" was a good goal. But if it takes four or five months to get good at it, why stop right away? I mean, a four month investment for a two month return? Screw that. I'm nursing until either they self wean, or they can walk up to me and ask me to nurse them. Because that's when things will start getting awkward.

And now, when they're teenagers and I won't let them borrow the car, I can tell them it's because I nursed them through all the pain and mastitis and that they can go ahead and give that a shot if they want to go to Julie's cabin in the woods.