Even more than I had wished for a natural birth, my main hope was that I would be able to exclusively breastfeed my baby. This was both because of the many benefits of breastfeeding (for her and me), and because it really just seemed like the easiest way to go. Nothing against those who choose to formula feed - this was just what I really wanted. When I determined I was going to have a C-section, rather than a vaginal birth using forceps, I became concerned that it would cause my milk to come in later, and would have a negative impact on breastfeeding. I asked the doctor if it could impact my ability to breastfeed, and she said it shouldn't.
After my C-section, I unfortunately wasn't able to try breastfeeding as soon as I would've been able to try with a vaginal birth, because most of my body was still behind the curtain, until we went to recovery. That was when I first got to try it, and I was still all shaky from my surgery/epidural, but my baby knew exactly what to do, right away.
She has always been so eager, and wanted to be breastfed just as much as I wanted to breastfeed her. I was very lucky in that respect, because if she hadn't wanted it as much as I had, it would've made it much more challenging.
Breastfeeding initially seemed to be going very well. She seemed to just want to feed pretty much all the time, which was what I had expected because newborns have tiny stomachs, and breastmilk digests more quickly than formula. Cluster feeding also helps the milk come in. Regular breastmilk can take about three to five days to come in, and I know from my research during pregnancy that it tends to take a bit longer after a C-section. I was making colostrum, but my regular milk was taking some time to come in. The second night in the hospital was so difficult, because she seemed to be crying constantly no matter what we did, and she wouldn't sleep. I also remember that she would often cry while I was feeding her, which seemed to be frustration because she wasn't getting enough milk. It was on the second or third day in the hospital that the nurse started pushing us to supplement with formula.
When the nurse got us to start supplementing with formula after breastfeeding, she had us doing triple feeding, which is where you breastfeed, then pump, then feed the baby what you pumped, and supplement with formula afterward. It is very unsustainable in the long run, but it is used short-term to encourage milk to come in, or to increase milk supply. The nurse wheeled in this big Medela hospital pump, and brought a bunch of parts in, then she set me up with the pump, without actually showing me anything, turned it on, and left the room. She literally didn't even show me how to turn it off, let alone how to change the settings. There was never any mention of flange sizes or suction levels.
Now that I know more about pumping, I know that the flanges she gave me to use were way too big, and the pump must've been set to the highest suction setting (higher suction doesn't necessarily mean more milk, as pain can impact the let-down).
The first time, I just started pressing random buttons on the machine when the time was up, because she hadn't shown me how to turn it off, and she hadn't come back in the room (there were no labels on the buttons). Also, it was a double electric pump, but she only had me pumping one side at a time until I asked for another set so I could do both at once. Pumping was immediately excruciating for me, because of the factors mentioned above. It hurt so much, every time. I would coat my nipples in Lanolin after every pumping session, even though it didn't seem to help me at all. I couldn't even let the water touch them when I showered, and it made breastfeeding so much worse, because they were so raw.
I would cringe and almost cry every time she latched on, not because she was hurting me, but because they were so damaged from pumping.
The nurse never seemed to notice or care about any of this, and just kept having me do the triple feeding every few hours.
When it came time to leave the hospital, the nurse told us we should rent a pump and keep triple feeding (she didn't seem to know that it isn't sustainable, as I don't think she even mentioned an end date or plan for when to stop). We had called a pharmacy and put one on hold to get on our way home from the hospital, but then my doctor came in and spoke to us before we left. She said we didn't need to keep triple feeding, and that my milk would come in if I just kept breastfeeding on demand (also, it was already starting to come in before we left the hospital - I was getting engorged, leaking, and getting clogged ducts).
I was crying when she told me I didn't need to pump anymore - I was so happy and relieved!
We called and canceled the one we were going to pick up. We did need to get some formula though, as we didn't have any at home, and we were still supplementing with a bit of formula after each breastfeeding session, to ensure that she was getting enough.
We were still hopeful at this point that we'd be able to get back to exclusively breastfeeding, and not having to supplement with formula anymore. Then the doctors appointments started. I cried at many of the first doctors appointments, either because I was talking about my birth story, or how much I wanted to exclusively breastfeed, and they kept telling me she wasn't gaining enough weight, and to supplement more.
It got to the point where I would dread doctors appointments, because they made me feel like I was failing.
At one of the first doctors appointments, they recommended we see a lactation consultant, which was the best advice they ever gave us. The soonest we were able to get an appointment with the one they recommended was a few weeks away, so in the meantime, we just kept supplementing. When we went to the lactation consultant the first time, I was worried that it would be like another doctors appointment, where we don't learn much, but leave feeling like we failed. Thankfully, it was such a different and better experience. She immediately made me feel at ease. The first appointment was mostly focused on ensuring that my baby was able to latch well and remove milk efficiently. We realized that she had tension in her back and neck (from being so bunched up in my uterus, and from the challenging labor), so the lactation consultant recommended bringing her to an Osteopath or Chiropractor to loosen her up and help with latching and positioning. (We did end up taking her to Osteopathy three times, after which she was nice and loose.) She also helped put an end to multiple-hour-long feeding sessions. My baby was a very sleepy feeder in the early days. She showed us some techniques for getting a good latch, as well as some positions to feed in, and which bottle and pacifier shapes were best for breastfed babies. Another thing she showed us was paced bottle feeding, since we were still doing top-ups with formula after each feeding session. She also recommended a probiotic and a bunch of herbal supplements known to help with milk supply. The probiotic was because of the antibiotics I took to fight off the infection - I had to bring back the good bacteria. She also alerted me that I needed to apply nipple butter, as they were very red and sore. I hadn't even realized, because of how sore they had been in the hospital. I told her the water in the shower hurt, and that apparently shouldn't be the case. They are much better now - I still put nipple butter on everyday before I shower.
There was one point, I think it was after the first lactation consultant appointment, where we tried just breastfeeding for a while without supplementing with formula, while taking herbal supplements and everything, to see if her increased demand would increase the supply. At our next doctors appointment, I really felt like I had failed, because she gained less weight again, and her growth wasn't going quickly enough. The doctor told us to go back to supplementing after each feeding session, which was very tricky at night.
I had to wake up, breastfed her on both sides, give her a bottle, change her diaper, and go back to sleep, approximately every 1-3 hours.
We booked another appointment with our lactation consultant, which ended up being closer to when our baby was around two to three months old. Again, she made us feel so at ease, gave us lots of good information and help, and we left feeling better. This time, she showed us a supplemental feeding system, where you set up a bottle with a feeding tube coming out of it, and insert the end in the corner of the baby's mouth while they're breastfeeding, so it works like a straw. These systems are great for babies like mine who hate bottle feeding, and love breastfeeding. It allows the baby to have a formula top up, while also helping to increase milk supply. Unfortunately, we were only able to do this for another month or so, as she soon got too big. She would pull the tube away, or it would just take too long to drink the larger amounts of formula. I really wish we had discovered it earlier, because bottles were always quite a struggle.
The lactation consultant also told us about a way to buy used breast pumps, and helped me get the correct flange size measurement so I could buy the right size. I didn't end up pumping very often (my body doesn't respond well to pumping - my baby is much better at getting the milk out), but it was nice to have the option. When I told her that I hadn't noticed a difference in supply with the herbal supplements (so I stopped taking them because they are very expensive), she recommended that I get the doctor to prescribe Domperidone. I got the prescription and started it shortly after that, on a low dosage, and moved up to a high dosage. I feel like it makes a bit of a difference, but we still need to supplement. My hope now is that as we add more solid foods to her diet, we can phase out the formula top ups.
My baby and I co-sleep (which I love, and will certainly have a blog post about soon), so eventually, we were able to cut out the top ups at night, since that is when milk supply is highest. This has made our nights so much easier and better. Also, over time, we switched from doing a top up after every feed, to now (at six months old) only doing two formula bottles during the day (still as a supplement, right after breastfeeding - not replacing a breastfeeding session). I am also still taking the high dose of Domperidone, and I eat oats everyday, as those are known to help with milk supply as well.
My Reflections:
Overall, I'm very proud of how far we've come with breastfeeding, and the fact that we're still going strong six months in, and we both still love it.
When my husband and I took all the courses and read all the books before having a baby, everything made it seem like you either breastfeed or formula feed, but combo-feeding is actually another very common way to go.
We didn't even know that low milk supply was a common issue, until it happened to us.
To each their own (no judgement!), and I know many Moms stop breastfeeding for their mental health, or for many other reasons, but for me, breastfeeding has been so good for my mental health, and I'm really dreading stopping. I hope to do it until my baby is at least two years old.
It has been an amazing bonding experience, and it's like a superpower - it always calms her down, and it puts her to sleep when she's tired. It's also so easy for us, and it's free, compared to the very pricey formula.
I'm so lucky that I have all this time off with her to be able to breastfeed on demand 24/7. I'm loving it so much!
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