Friday, October 30, 2015

Our Breastfeeding Journey

I feel like I should start this post by explaining that I am sharing about our breastfeeding journey because it was extremely difficult, but our struggles led to a very happy ending. And I want other mamas out there to know that they are not alone, there is hope, and that perseverance along with amazing help may just lead you and your little one to an amazing breastfeeding relationship.

I realize this is a super long post, but I want to be as detailed as possible to share each issue we encountered and how we got over each one.

I learned a bit about breastfeeding in our For Love of Baby childbirth classes, plus the girls and I took an additional class just on breastfeeding at a local hospital. When Raleigh was first born we attempted breastfeeding right away. Even with the help of our nurse and midwife, Raleigh just wouldn't latch. We left the birthing center that same morning, but continued to try and nurse as much as possible while at home--still no luck.

The day after Raleigh was born we headed back to the birthing center for a check-up. I showed the nurse how I was attempting to get Raleigh to latch. I had used every skill I had learned from classes--proper positioning, hand expressing milk out into his mouth to get him interested, brushing my nipple against his cheek to get him to open his mouth, creating a nipple sandwich and essentially shoving it into his mouth, keeping him awake by stripping him down to his diaper, blowing on his face, and rubbing him with a warm washcloth. At the appointment, the nurse noticed a cough that Raleigh had. It seemed that he had swallowed some amniotic fluid on the way out, and was working on coughing it up. We thought maybe his tummy was full and that's why he wasn't interested in nursing.

That evening, with the help of a bulb syringe, Ryan was able to help Raleigh get the last of the fluid out. But he still wouldn't latch. I was so afraid that Raleigh was going to miss out on my colostrum, so my friend brought me a hand pump to use. Maybe my nipples weren't long enough. Maybe they needed some extra stimulation and stretching with the pump. Still no latch. Then the crying started. He had been so sleepy up until then that he hadn't cried much at all. He must have just realized that he was hungry.

Raleigh was in tears. And I was in tears. I had prayed even before I got pregnant for The Lord to bless me with milk. He did bless me with milk, but I couldn't transfer it to Raleigh. I wanted so badly to provide for my baby naturally, to give him the best nutrition possible, and to create a bond that only a mother and child could have through breastfeeding.

On Tuesday we had our first appointment with the pediatrician. When we first met with the doctor while I was pregnant I enjoyed his laid-back demeanor and gentle approach. Raleigh had lost 12 oz. in just two days (weighing in at 6 lb 2 oz), but our doctor assured us that in the new few days Raleigh would surely get the hang of nursing. And that his brown fat would keep him nourished until then. After doing some online research, I am not convinced that brown fat is meant to nourish in the absence of milk. We no longer see this doctor.

By Wednesday morning, Raleigh still hadn't been able to successfully nurse. He had only received the milk that I was able to hand express into his mouth or what poured out into his mouth from being so engorged, and his soiled diapers became less frequent. With the recommendation from one of our nurse friends, we frantically called Nursing Mother's Place at Novant Hospital as soon as they opened, and made an appointment for the first available lactation consultation. We needed a second opinion, and we desperately needed to feed our baby.

Within the first few minutes of our appointment with Linda I knew we were in good hands. She confirmed that Raleigh was not able to successfully latch, that my positioning and everything I had been trying was the best that I could do, and that we needed to feed him somehow..and quick! Raleigh was down to 6 lb 1.4 oz--a 12.6 oz loss from his birth weight in just three days. While there is an average amount of weight lost in babies' first week (3-10% of birthweight in 24-72 hours), this had surpassed that average. Because Raleigh couldn't even latch onto a bottle, Linda helped us create a plan. I was to pump every two to three hours, ten minutes on each side, offer him the breast for ten to twenty minutes at least, with and without a breast shield, have as much skin-to-skin as possible, give facial massages six times a day to his jaw, cheeks, lips, gums, and tongue to stimulate movement, schedule an evaluation with an ear, nose, and throat doctor to look at a possible tongue tie, feed him with a tube, and come back the next day.

With the exhaustion and anxiety building, I was hardly able to provide enough milk using the hand pump for each feeding. I would pump and pump and pump, and suck it into an oral syringe that was connected to a tiny tube taped to Ryan's finger. For every feeding, Ryan had to stick his finger with the tube taped to it into Raleigh's mouth so that he could get some milk.

Our arsenal of feeding supplies

The next day we headed back to see Linda. Raleigh was up to 6 lb 5.8 oz. We were elated! Our new plan consisted of pumping eight to ten times a day for fifteen minutes, try power pumping once per day (ten minutes of pumping, ten minutes off, three cycles), take three fenugreek capsules three times daily with food to encourage supply (I was very close to contacting a friend of mine to use some of her pumped milk because I just could not keep up and was trying to avoid formula, if possible--this is a wonderful option, by the way!), offer the breast as much as I could with and without the nipple shield, lots of nuzzling and skin-to-skin, attempt to bottle feed 1-2 oz every two to three hours, and come back the next day.

We met with an ear, nose, and throat doctor that day who told us that he felt like Raleigh's tongue tie probably wasn't the issue and that his underdeveloped lower jaw was likely the culprit of his poor latch. We would have to give it time and his jaw might fix itself in time (could be months or years) or he could be looking at surgery (and definitely braces later on). I was utterly disappointed. I was counting on this to be the answer. This was all I had left. The only thing I could hang on to. I had been praying so hard that with a tongue-tie fix things would just fall into place. Raleigh would latch and life would be amazing. It had been less than a week since we brought our baby boy home and I was already so mentally and emotionally drained.

We left the appointment and I was in tears again. This was normal. I cried constantly. But not because I was having general feelings of post-partum depression. It was breastfeeding-specific. I had so much anxiety, disappointment in myself, and frustration that I could hardly cope. How in the world could I be a good mother if I couldn't provide him with such a basic need? I had done everything "right"--a healthy, uncomplicated pregnancy followed by a completely natural and unmedicated birth. I encapsulated my placenta, for goodness' sake (more on that later..)!

Late that night I had my mother-in-law purchase some formula for us. It was incredibly hard for me to request, but I just wasn't sure I could pump enough milk to sustain Raleigh. All I could think about was trying to pump for the next feeding and nothing coming out, a screaming, hungry baby, and having to run out to get formula to supplement with a starving baby at home. I needed this formula to just sit in my pantry to give me peace of mind knowing that I had a back-up plan if my milk failed me.

But God provided. I was able to produce just enough milk all night. And success--Raleigh took the bottle, although we had to practically shove the nipple of the bottle so far back in his mouth to create some sort of suction. But we had moved on from tube feeding!

The next day we met with Karen, another lactation consultant at Nursing Mother's Place because Linda was out of town. Raleigh had gained a few more ounces and was thriving! He latched at the appointment and had a full feeding at the breast! And the next two times at home were a success. And was gone. He no longer latched.What was I doing wrong? It was obviously me. Babies don't just nurse perfectly and stop. I obsessed over positioning him just so, with the pillow just right, my arm in a certain spot, but nothing. No more latching and no more successful nursing. It was back to the bottle for the weekend. And my milk production had increased exponentially!

We went back to see Linda on Monday. Raleigh weighed 6 lb 12.4 oz! With a few successful nursing sessions and a nice supply of milk, our new plan was to lower my fenugreek intake, offer the breast with and without the breast shield, only bottlefeed at first if he is frantically hungry, try out different breastfeeding positions, get rid of the Boppy pillow (looking back I much prefer the My Brest Friend pillow that was used at our consultant appointments--the only use our Boppy gets these days is when my dog lies down on it), lots of skin-to-skin, and maybe try rebirth.

I was beyond frustrated. Why was breastfeeding so hard? Isn't this supposed to be natural and instinctive? Didn't God create us to breastfeed and provide the perfect food for our babies? I wanted to give up every single day. But Ryan encouraged me to continue. He knew how badly I wanted to nurse and often had to remind me of how far we had come. Little by little, the situation was improving. I cried often and absolutely dreaded nursing. I tried to put each feeding off as much as possible. I am sure that Raleigh could sense my tension, frustration, and even misery. I hated nursing, I hated the stress, and I began to have feelings of resentment creep in--resentment towards being a mother and even towards Raleigh.

Because the electric pump I had ordered through insurance still hadn't come in, I had to rent one for a week. Praise God for the electric pump--so much easier and more efficient than the single hand pump. I began pumping like crazy. I was obsessed with getting as much milk as I could. I was scared that it would dry up or I wouldn't be able to keep up like before. Little did I know I was causing another hurdle for us to jump over--oversupply!

Somewhere along the way Raleigh began to latch. But something couldn't be right. It was excruciating. Each time he latched I gasped in unbearable pain. I gripped pillows and the arm of the chair while he nursed. I clenched my fists so hard that my fingernails left impressions in my hand. Was this normal? Was I just sensitive and my nipples had to get used to it? Did they have to toughen up that much?

On top of breastfeeding that hurt worse than while I was in labor, my milk supply had surpassed what was necessary, and I had an overabundance. I was practically drowning Raleigh each time he was at the breast. Each time my milk let down Raleigh pulled off while milk sprayed everywhere. I completely stopped taking fenugreek, block fed, tried various positions, and had to nurse with a huge bath towel to soak up the excess milk. This is not what I imagined. I was hoping for the kind of breastfeeding relationship you see in photos. I would be home-bound as long as I was nursing him. How could I ever do this anywhere besides the comfort of my own home with a bath towel by my side?

I called the ear, nose, and throat doctor again. We had to be seen. I needed to know for sure that his posterior tongue tie wasn't the issue. If they wouldn't get us in, then we planned to see another specialty doctor in Charlotte. But they agreed to see us that week to get his frenulum clipped. It couldn't make matters worse, so we wanted to give it a try.

They clipped Raleigh's frenulum quickly and easily. He hardly cried, and we immediately tried nursing. Still painful. Apparently, that wasn't the answer. The dark cloud of disappointment engulfed me again.

And we were back to see Linda that afternoon. Raleigh was 6 lbs 15.4 oz--he had finally surpassed his birth weight of 6 lb 14 oz! We mostly addressed my oversupply at that visit. I had become obsessed with pumping to build up a supply, which wasn't helping with my oversupply, so she advised me to reduce the amount of times I was pumping, had me nurse on-demand at least eight to twelve times a day, and practice helpful nursing positions where I was leaning back (that I could never recreate once I got home).

Linda was so encouraging, and was available after hours via phone calls and text messages. I felt that she was genuinely invested in our success, and that we were a priority. She was able to tell that even though Raleigh's tongue did have a bit more freedom of movement, he had learned bad habits while nursing up to that point. He was thrusting his tongue back and forth instead of "troughing" over his bottom gum. This is what was causing me so much pain, and we needed to stick it out.

So we kept trying. In addition to the pain, I started to notice milk blisters (blebs) on my nipples, red and raw skin tissue, and even some cracks that started to bleed just a little. Everything I read online told me this wasn't right, but I couldn't be sure. I nursed for as long as I could each time before having to give in and finish with a bottle. I felt like no one understood. We were so close--he was latching. This is what I wanted all along! But would it always hurt? Would Raleigh ever learn to suckle correctly?

At our lactation appointment, Raleigh weighed 7 lbs. Linda gave me the recipe for an herbal compress to help with the blebs and pain, encouraged me to offer both breasts at each feeding, showed me how to support my overly full breasts while he nursed, and taught me how to exercise Raleigh's face and create friction where his frenulum was clipped to prevent scar tissue from building up.

Linda noticed that Raleigh had a green, frothy poop while we were there--a sign that he was getting too much foremilk and not enough of the rich hindmilk that he needed. She advised I take lecithin three to four times a day to help the hindmilk dislodge and flow out easier.

Things had to get better. She assured me that they would. Ryan assured me that they would.

And they did. Nursing got better. It was a gradual process, and I'm not sure of the exact day that it clicked, but it did. Slowly, but surely, one feeding after the next, it got less and less painful. He learned to trough correctly with his tongue. And my milk supply regulated itself with me only pumping one extra time per day to build a stash.

Even for a couple weeks after nursing clicked I would still get slightly engorged, and every now and then Raleigh would pull off due to a forceful let-down. I do have to help Raleigh get an initial latch. And man, it is almost a full-time job. But we are nursing! And we both love it. I am able to provide Raleigh with a happy place of comfort and nourishment at the breast.

My Lucy Nest from Native Wilds (a great cover is a must-have!)

I am so thankful that I stuck it out. I am so thankful for a supportive husband who was beside me for nearly every nursing session, who encouraged me every single day, who loved me when I felt like I had nothing to give, and who is already an amazing father to our little boy. I am so thankful for Linda, the wonderful lactation consultant who spotted Raleigh's tongue tie, who worked with us from start to finish, and guided us in the right direction with love and understanding. I am so thankful for my family and friends who listened to me pour my heart out, cry, vent frustration, and even whine during this process. And I am so thankful for all the prayers that were sent up to The Lord and for Him providing us a way--He is good, He is faithful, and He is present.

Mamas, I want you to know that breastfeeding isn't always easy, and it hardly ever looks like you thought it would look, or goes just as you planned it. And I know there are times when breastfeeding really doesn't work out at all. But if you want to breastfeed your little one, I encourage you to seek professional aid, find a support group, and don't lose faith! Learning to breastfeed was a tough journey that I feel like only those who have gone through similar trials can truly appreciate. I am far from an expert, but I am more than happy to help in any way that I can, especially through prayer. Please feel free to reach out to me if you have questions or just want to chat!


Tuesday, October 6, 2015

Raleigh Parker Kearns: Birth Story

I told myself so many times to write down the details so I would remember it all! I never got around to it (until now), so I'll do the best I can at sharing how wonderful (and dare I say beautiful?) the birth of our Raleigh Parker was!

The Mr. and I were spending our Friday night like most of my Friday nights at nine months pregnant (and only three days away from my due date)--lounging on the couch with Netflix. That night I felt, without any other way to really describe it, "uncomfortable". I had been experiencing braxton hicks contractions for weeks at that point, but, for some reason, I felt a little more uncomfortable that night. I told Ryan, but we didn't think much of it, since it wasn't that intense. The rest of the night was normal, and we went to bed without any expectations.

I woke up a little after 2:00 am with a contraction that was just a bit more intense than I had previously experienced. I woke Ryan up and we waited. Nothing happened, so we both ended up falling back to sleep.

Then shortly after 4:00 am I woke up to a contraction that was "so" intense (I say that jokingly now) that it surprised me and I started crying. Ryan woke up and comforted me and we waited some more. I downloaded the app Full Term on my phone and began timing. BIG MISTAKE. The contractions weren't that intense, weren't close together, and didn't last very long. We should have just gone back to sleep, but, instead, we timed every single contraction for the next sixteen hours.

After a while, we decided to get out of bed and get ready for the day. I was able to walk and talk through contractions and they weren't consistent at this point. Around 9:00 am we went to the farmer's market like we normally do on Saturday mornings. We had fun at the farmer's market--we basically told everyone we talked to that "it could happen any minute". It didn't, of course. I called the midwife on-call just to let her know. I then called my mom to give her an update. And I had to insist she didn't cancel her plans for the entire day--so glad she didn't, since it was a long day!

The rest of the afternoon, Ryan and I just hung out at home and labored away! We timed every contraction, I drank my labor-aid, ate energy bites, bounced on my birthing ball, and took a couple warm baths with essential oils. I noticed that I lost my mucous plug during a couple bathroom trips (by the way, pregnant mamas out there, losing the plug is very anticlimactic in and of itself). Slowly, but surely, my contractions got longer, more intense (read: painful), and closer together.

The contractions seemed to stall out around six to eight minutes apart for several hours, so around 5:30 pm we decided to go on a walk through our neighborhood. I didn't make it out of our driveway before a contraction hit and I had to kneel down on the asphalt. We decided we wouldn't get very far through the neighborhood that way and headed towards the field and wooded area by our house to walk around in the fresh air without being a spectacle. One of our neighbors saw us and came over to chat (sorry you had to see me experience a few contractions, Shelia!) before we decided to head back inside.

Walking around definitely got things moving along a bit more. The contractions were bringing tears to my eyes, and I preferred to lie across the birthing ball instead of getting up to move around. Thankfully, my sweet husband paid attention in our birthing class and insisted that I get up to walk around the house and continue drinking my labor-aid. Changing positions is key to keep things going! I was vocalizing through contractions and had to be reminded to "breathe" through them, although I wasn't easily able to slow my breathing to a slow, calm pace.

Around 8:00 pm contractions reached one minute long, five minutes apart, consistently for one hour (the long-awaited 5-1-1). Ryan gave our midwife, Nicole, a call to let her know. She told us to get ready to head to the birthing center (more about that here!) and to call back when contractions got just a little closer together. She suggested another warm bath to see if things would progress a little bit more.

Shortly after I got into the bath my water burst. And I mean burst! I had a minor freak-out because I wasn't exactly expecting to feel (it didn't hurt, but I did feel it pop), hear, and see it like that. Ryan ushered me into a warm shower to relax a bit while he called the widwife again. Unfortunately, the shower wasn't exactly soothing at that point since the contractions immediately became pretty painful and closer together once my water broke.

He came back to get me and told me it was time to go! He worked on packing everything up in the car while I attempted putting my clothes back on..they quickly became drenched from my water still leaking out. Somehow I made it to the car, and we began the thirty minute drive to the birthing center. Ryan made a few calls to let friends and family know that it was time while I groaned (or screamed, whatever you want to call it) and yelled about how mad I was they made me wait so long to go in because SURELY I was going to give birth right there in the car.

Well, luckily, I didn't give birth in the car. And things became basically a blur once we arrived at the center. The midwife and nurse were outside waiting for us, and they helped us to one of the rooms that was all set up for us. She immediately checked to see how dilated I was--yikes. That was my first dilation check, and I never realized how uncomfortable that actually was. I was only 4 centimeters dilated. FOUR. Right away I pretty much had a meltdown. I was expecting to be ready to start pushing at any second--I felt ready!

They had me lie on the bed with a peanut ball between my legs to help open up my cervix naturally. Lavender essential oil was put in the diffuser to help create a relaxing environment while we tried to get labor moving along. Ryan and the nurse basically had to help me move around into different positions on the bed because I felt completely paralyzed. I felt pretty nauseated as well, so they had me sniff peppermint essential oil to help (with a barf bag nearby). Surprisingly, the peppermint oil made me feel a bit more anxious and I ended up flinging it away. An hour later, though, I was 6 centimeters dilated!

I labored through a couple contractions in the bathroom and then we decided that I should go ahead and get in the birthing tub for the water to help with the pain and discomfort. It made a huge difference!

Shortly thereafter I was 8 centimeters, then 10--ready to go! The progress was wonderfully quick! Ryan stayed in the room beside the tub with me while I clung to his neck--he really brought new meaning to being a support partner.

I was incredibly thirsty, especially after I got into the warm birthing tub. I could only manage the word "water" to let them know what I wanted. But it turned out that was quite confusing--was the water too hot? too cold? No! Just give me water!

Around 12:00 am I felt the tiniest impulse to push. It wasn't as strong as I imagined it would be, but my body knew what to do. While in the water I was able to freely switch positions, with squatting (still clinging to Ryan's neck) being the most comfortable and most fruitful. Throughout our time at the center, especially once I started pushing, they did intermittent fetal monitoring using an exterior doppler--it was exciting to hear his little heartbeat just minutes before we knew we were going to meet him for the first time!

When I first arrived at the center my hair was in a topknot. Somewhere along the way I realized that my hair was no longer in this topknot and I was absolutely drenched with sweat. I wanted to ask Ryan or the nurse to put my hair back up, but I couldn't even verbalize it! "Water" (labor makes you thirsty!) and, I'll admit it, "I can't do this" were the only things I really said for a while.

After maybe fifteen or twenty minutes of pushing our midwife announced that she could see Raleigh's head and he was so close! I could literally reach down and touch his head! It was amazing and frustrating all at once--he was right there, come on! After another, seemingly long fifteen minutes of pushing, Raleigh emerged..partially! Of course I knew that forceps, vacuums, and even "yanking" were far from ideal, but I figured once he was out that far that we could just lightly pull him out. Nope! I suggested that they just pull him out (ahem..I might have yelled this), and I was politely told "no" and that I needed to keep pushing. Defeated, I pushed some more.

I was very vocal towards the end of pushing (no matter that my parents and in-laws were waiting in the next room over and could absolutely 100% hear me..), but my midwife had to keep reminding me to put that energy towards pushing. She was so gentle, but firm--she knew what it would take to get our baby out quick and safe.

At12:37 am Raleigh Parker Kearns officially graced our lives with his sweet presence weighing in at 6 lb 14 oz and 20.5 inches long.

[From our newborn shoot with Joy Davis Photography when Raleigh was 12 days old]

Our midwife had me grab him out of the water, and I was immediately able to hold him close doing skin-to-skin. Raleigh didn't cry, and Ryan and I were in pure amazement. I was sort of out of it, but I remember saying that I couldn't see him--I had him snuggled so close, but I wanted to look at him! The nurse snapped a few photos on my iPhone (sorry, these are private and not exactly G-rated) while we waited for the umbilical cord to stop pulsing. The cord was then clamped, and Ryan had the honor of cutting it.

We made our way from the birthing pool to the bed where we could get cozied up to stare and snuggle skin-to-skin with our sweet baby. Our parents came in not longer after to meet their new grandbaby. The rest of the night went very quickly. We arrived around 9:30 pm, I delivered Raleigh at 12:37 am, and then we left around 3:30 am. Yep, you read that right! Birthing centers don't require you to stay very long after birth, and since all I had were very light abrasions (no rips here, praise The Lord!) in my nether region, there was no reason we couldn't head home and get absolutely comfortable.

So at 4:15 am on Sunday, August 9, 2015 we arrived home as a family of three!

While not necessarily easy, and certainly not without pain, our labor and delivery experience was unforgettable, and has me sure that we will choose a natural water birth for our next little babe. I could not have managed without an amazing support team, including my incredible husband, Ryan. He was by my side from the very first "uncomfortable" contraction, and was full of encouragement the entire time. I am so thankful for him (and his patience)!

We were prepared throughout pregnancy that things do happen and situations arise that are out of our control, and a trip to the hospital and even interventions were a real possibility. But with God's grace, everything went according "to plan". We were able to achieve a natural birth at our birthing center without any interventions whatsoever! I felt cared for, respected, and safe. I couldn't have dreamed or prayed for a more liberating and joyous experience. Read our Birth Goals here (more about our placenta encapsulation in a later post)!

About halfway through typing this post I questioned sharing so much. Will this gross my friends out? Am I embarrassing myself? Who really cares? No worries if you stopped reading after the first paragraph or two (which means you wouldn't be reading this now)--all I know is that when I was pregnant I was glued to just about every birth story I could find, natural or not. I was so interested in the details and the unique aspects of each journey. So I hope you enjoyed reading about our experience!