Sunday, July 15, 2012

Lactation Consultants

This post is in response to some comments I received on Facebook regarding my post on nursing.

I am afraid in my attempt to be brief and not whiny, I broke a cardinal rule by using a sweeping generality. I do not believe all lactation consultants to be awful people. Really, I don't think any of them are bad. I just had a particularly bad experience and have had a really hard time overcoming the problems generated. I did, actually, go to one on the recommendation of a friend who finally helped tremendously. If it weren't for her, I would probably not still be nursing. No one has said I offended them, but I hope I did not. In an effort to be more thorough in my explanation, here's the specifics of my experience with lactation consultants.

I went in to nursing very positive and encouraged by the LCs I had met. I read books, took classes, and thought I was as prepared as possible. They told me nursing was natural; anyone could do it. They said everything that led me to believe it would be easy.

Somewhere just after giving birth, a nurse or LC gave me a nipple shield. I still don't know why. (I had a c-section and was VERY groggy afterwards.) These are usually given to women who have inverted nipples or who's babies have problems latching. As far a I know, I didn't have either issue, but was given one none the less. They then told me that as long as I was using the shield, I needed I pump for 20 minutes following each feeding session.

Newborn babies eat a lot and often. Pumping after every feeding was time intensive, because by the time Lucas ate and I pumped, it was time for him to eat again. So I was anxious to stop using the shield as soon as possible. But by the time I got my head together enough to wean him from that, he was attached to it. I experienced many nights with both of us in tears because he would not latch on without it. I really felt like I was started off at a disadvantage, and no one could even tell me why I had even been given it in the first place. It took a good 3 weeks to be completely rid of the thing, which, in my hormonal, sleep-deprived state, was forever.

Issue two was my entire experience with LC #3.

I saw two LCs the day Lucas was born. They told me to feed him when he was hungry. They gave me no other instructions. They were nice, happy, encouraging, but said nothing specific other than feed him when he's hungry. So that's what I did.

My second day in the hospital, I saw LC #3. Probably the main issue was that our personalities did not mesh, which is strange because I'm generally able to get along with everyone. She came into the room just as I was getting ready to feed him. I had decided to try a different position, just because. I had been feeding him in the crossover position, where he lays straight in front of me, like you'd hold a baby. I was going to try the football hold, where you hold him kind of under your arm. Well, she came in and said, "I see you're using the football hold," and I said, "well, this is the first time I've tried it, usually I've been using the crossover hold," and she said, "but you're doing the football hold now," like, if I'm doing the football hold, that must be the only way I've ever done it and what an idiot I am for thinking I'd done it differently. She then proceeded to tell me how I was doing everything completely wrong.

One of the (many) things I was doing wrong in her opinion was only feeding him when he was hungry (which was every hour or so). She said I wasn't nursing him enough. When I told her that the previous LC had said nurse him when he's hungry, she said that was fine for the first 24 hours, but after that I needed to wake him up and make him nurse for half an hour every 2-3 hours. She made it seem like I was an idiot for not knowing that, and what a bad mother I was for not doing it.

So, feeling like a failure, I regrouped and refocused on being more diligent. Mark and I worked our butts off that day and night to be sure he was nursing as often as she said. Mark would rub his back and tweak his ears and mess with his hands and feet while I nursed him to keep him awake. We thought we were doing really well. He still nursed every hour to hour and a half. It was really hard to keep him awake, so he didn't nurse for 30 minutes at one time, but did at least 30 minutes within a 2-3 hour period. We thought we were doing well.

The next day, LC lady came back, and without even asking how we thought things were going, said he wasn't nursing enough and we would need to supplement with formula.

Now, here's this woman who's colleagues have all but outright said formula is bad, bringing formula in and showing me how to feed it to my baby. I was still so out of it and confused and overwhelmed that I didn't have the mind to ask questions or even be upset at her brashness and the fact that she didn't at all take into consideration how I thought things were going. The formula in no way hurt Lucas, of course. It was just very disenfranchising to be treated like an idiot.

Looking back, probably the biggest issue was that I had to keep dealing with issues with LCs, and was never able to deal with developing good techniques. The best way I can describe it is to think of it as a number line. If I started at a zero, LCs were supposed to guide me to a 10 to be successful. But the ones I dealt with in the hospital put me in the negative: the nipple shield and bad communication just pushed me back and back. So by the time I got to a good LC, she helped tremendously, but I was so far into the negatives, she did amazing just getting me back to zero. This was the LC I saw on recommendation of a friend. She was associated with a completely different hospital, and was so kind, encouraging, and helpful that I left her office thinking if I ever have another baby I might go to that hospital just so I can have her as a LC. I saw her in the height of dealing with the shield, so that's what we focused on in that session. She helped me understand that the shield wasn't a bad thing, and if we had to use it the entire time we nursed, it would be okay. She helped me see that he was getting enough to eat. The biggest thing: she told me that nursing hurts. Every other LC had told me that it wouldn't/shouldn't hurt and if it did I was doing something wrong. She singlehandedly got me back to zero, and enabled me to move forward.

I probably could have returned to her, and probably should have, but I was really struggling with asking for help. I had been told it was natural, every woman could do it, and that implied that it should be easy. What should have been emphasized is that it's hard and it's okay to ask for help. I spent all of my time online trying to find ways to improve things, but was hesitant to actually see someone. We were doing okay at this point; no longer using the shield, but it was still extremely painful. Instead of seeking more help, I decided to wait for my 6 week check up with my doctor and ask her for help.

The last bad experience was with the nurse at my doctor's office. My doctor referred me to her nurse, who was supposedly a LC. She had me nurse on an exam table with no arm or back support, which was really painful because I was holding him up all on my own, and when he slipped his latch got shallower. After nursing like that for 15 or 20 minutes, all she could say was, "it looks like his latch is a little shallow." When I asked her for some ways to improve his latch and get it deeper, she literally told me, "you just have to shove it in there." Helpful.

I was so beyond frustrated at this point, that's when I stopped looking for improvement. I had spent so much time reading online, and I just kind of shut it all out. It was at this point that I stopped nursing and went to exclusive pumping. That, I was able to make work.

I pumped exclusively for probably 5-6 weeks. It was cumbersome. I had to deal with pumping and bottles and all of the supplies that went with it. I had lots of support from my husband and other family members who would wash dishes, a task that literally never ended. It felt like Christmas when we would have all of the bottles clean at one time. I'm sure they all thought I was crazy to keep breastfeeding through it all. But at 3 months, I decided to try to return to nursing full time. This time around was so much better. For the first time since he was born, I actually think I'll make it a year.

So, that's my LC story. What matters most is that I've made it, with great support from family and friends. I had that instinct - I knew that we could make it work, despite all the odds. I am appreciative of the help I received, even through my frustrated refusal to seek it out. There are good LCs out there. I hope if you're beginning this journey, you will be blessed with a good one. Just don't be afraid to ask for help. Nursing is the hardest thing I've ever done, but as a result, it's the most rewarding. It certainly isn't the right choice for everyone, but it was for me, and I'm glad I've made it this far!

1 comment:

  1. Yikes. Sounds like you had a whole heap of crap at just the wrong time. Like you I was very committed before my first baby was born and I believe that this paved the way for success - in the end. My son was born by forceps and was partially paralysed down one side of his face. Add that to the epidural and the fact that my normally very perky nipples had run for the hills and it was a recipe for disaster. Within hours they were telling me to give up, use formula, he's hungry, you're starving him, etc. We only have midwives and doctors here and none of them have enough specialist training to help when things are not straight forward. I fought back, researched, went to see a BF charity, pumped a bit, cried a LOT but I ended up feeding him until he was 2 and a half when he went off the taste as I was pregnant again. I vowed that I would never go back into hospital again and I lad my little girl in water at home. She latched on perfectly within 5 minutes of being born and I never had so much as a sore nipple. It was so much easier the second time around because one of us knew what we were doing and we were starting from just about zero (as you said). I just wanted to say that you are fantastic to have kept going through that and although he will probably never thank you for it, you are doing an amazing thing and you should be rally proud of yourself. xx