Moo

Phoebe is now 10 days old!  I can't believe it!  There are lots of little things that I will try to catch you up on over the next few days.  However, our current most pressing issue is Phoebe's weight gain and feeding.  She was 6lbs 14oz at birth and weighed 6lbs 5oz when we left the hospital.  It is normal for newborns to lose some of their birth weight- I'm pretty sure they can lose up to 10% before doctor's really start to worry and intervene.  Phoebe had lost 7%.  On Friday the 5th when we were discharged, the hospital pediatrician said I must nurse her AT LEAST every 3 hours and also recommended supplementing with formula.  I really did not want to supplement with formula because I know that breast milk is best for the baby and I also didn't really want to give her a bottle so early.  I had wanted to wait until breastfeeding had been well established.

So we came home over the weekend and were pretty diligent about feeding every 3 hours.  Now, this was A LOT of work for us.  Phoebe had a lot of trouble with nursing at first.  I have flat nipples that she has trouble latching onto.  The lactation department at Northside hospital was a HUGE help!  I cannot praise them enough.  They spent a lot of time working with her and I to come up with a plan to help her nurse.  People had told me that breastfeeding is hard and a lot of work, but I don't think I comprehended at all what that really meant.  It was still much more of a challenge than I had anticipated.  I had to use all sorts of tools and gadgets I had never even heard of, as well as the pump, to try to help her latch.

Soft shells

Hospital Grade Breast Pump

Nipple Shield

So at first nursing took a little over an hour and at least 4 hands.  (So by the time you clean all the parts you have an hour and a half before its time to start the process all over.)  I don't understand how single moms do it.  (Now granted, not everyone has these types of problems.)  By the weekend when we were home from the hospital she seemed to be doing a lot better.  She slowly began to be able to nurse without all the extra tools and I assumed she was getting enough.  I would feed her and then pump after each feeding to help increase my milk supply; this took a little over an hour by the time I woke her up from a deep newborn sleep, I fought to get her latched on, she nursed, and I pumped.  On Monday the 8th we went to the pediatrician and she had lost more weight.  I cried.  We went back on Wednesday the 10th and she had maintained.  That was encouraging and the doctor seemed to think she was headed in the right direction.  She keeps reminding me to eat really well (which I have been.  No one told me how ravenously hungry you are when you are nursing!) and drink LOTS of water (which I also have been.)  She said "the milk's only as good as the cow it comes from".  I'm trying to be a good cow.  Moo.  We will go back to get weighed again on Monday the 15th.  At this point she should be close to her birth weight.  Babies should re-gain all their birth weight by 2 weeks of age, which for Phoebe would be this Wednesday.

Well yesterday plans changed.  I called the lactation department because I was having trouble with sore nipples and also had several questions about pumping, milk supply, latching etc.  We talked through Phoebe's history with nursing and her weight issues.  Again, the lactation specialist was bundles of help.  I'm not sure how she came up with this number (I will ask her today) but she said that in order for Phoebe to re-gain her birth weight by Wednesday she needs to be taking 2oz or 60mls of milk every feeding (every 3 hours). She was very concerned that Phoebe was not getting enough breast milk because she was only having 1 dirty diaper per day.  The rule of thumb is that newborns should have 6-8 wet diapers/day (Phoebe is doing this) and 3-4 dirty diapers/day. (Phoebe is not even close to achieving this.)  So the question is how much milk is Phoebe getting when she is nursing?  Well we don't really know, but on Tuesday there was one feeding where I had pumped enough over the course of the day to have enough for Chris to give her a bottle, so at her midnight feeding I only pumped.  I did not nurse her beforehand.  And do you know how much I got?  ...8mls.  Not even close to 60.  So the lactation specialist explained that she was there to help me breastfeed because that is best, but really recommended that I supplement with formula at least for the next 24 hours because the health of my baby is the most important thing.  I cried again.  A lot.

I was upset because I did not want to supplement with formula, and I really can't explain why.  There is certainly nothing wrong with formula.  It can serve a great purpose.  In fact, right now I am very thankful for it.  I had just really wanted the experience of breastfeeding and did not want her to have so many bottles.  And the more than anything I was upset because I felt like I had failed my baby.  I could not give her what she needed.  The poor baby has been hungry and I have not been a very good cow.  I keep questioning why am I not producing enough milk?  I thought your body was supposed to produce just the right amount for your baby?  Where is the disconnect for me?  Who knows for sure, but I'm wondering if its because she has had so much trouble latching and is therefore not stimulating my body to produce more milk.  If the milk supply is based on baby's demand and baby's demand is weak due to a ineffective latch, then that would explain why the supply is low.

I am feeling much better about it all now.  Certainly not the ideal situation, but of course I will do what is best for my baby.  I realize too, its probably not the last time I will fail my child in some way.  I am sure there is a redemptive lesson in this somewhere, but I haven't fully gotten there yet.

So we came up with a plan.  For the next 24 hours, every 3 hours when I would normally nurse her I will double pump for 15 minutes and feed her whatever I can pump out.  Then I will supplement with formula so that she receives 60mls at each feeding.  So for example if I pump out 20mls, she will get 40mls of formula.  This way we are giving my nipples a rest so that I will have a better chance of successful breastfeeding without the pain, Phoebe is still getting all the health benefits of the breast milk that I do have, and she is also getting the volume she needs with the help of the formula.  So this 24 hours will be up around 1pm today.  I will check back with the lactation specialist and we will re-evaluate the plan from there.  I will probably need to continue to supplement with formula for a little while because I am only pumping out 15-20ml of breast milk.  But hopefully we can work to increase my supply and get her back to nursing in order to make the formula obsolete.

One quick note on the formula.  One of the guys who helps stock the supply rooms at Kennestone hospital started giving me some leftover (unopened) packages of formula several months ago.  Said he saw that I was pregnant and thought I could use some.  Of course I was thankful, even though I had no intention of using it.  I figured I'd donate it eventually.  Well now of course I'm thankful to have it!  I read somewhere that breastfeeding saves $2,000/year in the cost of formula.  (Finances was another large motivator in the decision to breastfeed.)  Chris told Phoebe yesterday that if she gained weight and took to the breast again we'd put $2,000 in a savings account for her...

And now for fun pictures that have nothing to do with cows or feeding!

Leaving the hospital

My first night at home.  Getting ready to go to sleep in my crib

Mamo and Cece

Captivated by Grandpa

I love you Daddy

Sorry this was a bit of a long one...