Pain to Pleasure, Challenges to Enjoyments - my breastfeeding journey

One thing I knew for certain when I got pregnant was that I wanted to be able to breastfeed my baby. I had already heard so many stories of moms giving up on breastfeeding attempts early on. After all my prep work leading up to Jude's birth (see post on Confidence - the essential ingredient to successful breasfeeding) , I envisioned a pretty smooth journey. We had even practiced different holds in my pre-natal class so I was all set, I knew exactly how to hold my baby in a cross-over hold  and what a correct latch should look like, sounds easy enough, right? Wrong... 

      

Although I was mostly hung up on not having enough of a milk supply to continue breastfeeding that ended up being the least of my concerns. 

The journey started right in the delivery room. Lucky for me, the only intervention I ended having was the nitrous oxide/laughing gas which I really enjoyed. I'll have to save my birth story for another post. Nitrous oxide does not pass through the placenta as would the epidural or pethidine. With the help of midwives at Corniche Hospital we managed to latch on and get breastfeeding started in the delivery room. I was a happy camper!

Well the following few days were not easy. From having people pinch my boob to get her to latch, from having a lactation consultant yell at me that crying was a late sign of hunger - even though my baby was on the boob just a few minutes before she walked in - , from having my mother and other relatives try to convince me to put my baby on a supplement when Jude would be crying at night. It was definitely not easy starting things off.

However, I'm glad that I stuck with my instincts and kept what I had read in mind. I knew that supplementing would not encourage my milk to come in and that I just needed to keep my baby on the breast and nurse her as much as she wanted.

It took a bit of practice to get the correct latch. Even when we were latched correctly, the first few seconds were quite painful. I initially thought the pain was due to wrong latch, but it turns out that some women get latch-on pains that last for a few seconds at the beginning of every feed session until they get accustomed to nursing. It was quite painful,  I would just close my eyes in anticipation of the pain at each feed. That continued for at least a week. 

By the second week I was so engorged and could feel lumps forming, all the way up my underarms. That's right, my UNDERARMS ...  I know! Shocking - apparently the way I was sleeping with my arms crossed over my head would get the milk to flow in that direction. How odd!

By the third week I started getting a fever and chills and ended up being re-admitted to the hospital. I was so chocked up when they told me that I would be admitted all I could muster up to say was "What about my baby? She's breastfed". At that point in time I could not bare to be separated from my baby. I'm sure she would have been fine if I had left her with my mom to take care of. 

I insisted that I would be able to cope with taking care of my newborn whilst being hooked up to an IV the whole time. Of course my mom knew that it would be difficult and she insisted on staying with me for the whole three nights that I was in hospital sleeping on an uncomfortable semi-reclinable chair since there was no spare bed in my room. While she cared for her daughter I cared for mine. 

They put me on antibiotic drips and I had to continue on antibiotics for another 2 weeks. After running all kinds of tests they could not fine anything wrong with me and attributed my high fever to possibly mastitis and told me that I had an oversupply issue! Who would have thought. The lactation consultant asked me if I was taking any galactagogues .. and I was like galacta - WHAT? Sounded like something from a galaxy in outer space. I now know that a galactagogue is any substance taken to increase milk supply. Well, yes of course, I was on hilba and both my mom and mom-in-law insisted that I drink 3 cups of this heavy fenugreek porridge to ensure that my milk supply came in (recipe below). I was so sick of being forced to drink this porridge, it would make me feel so full that I had no appetite to eat anything else. I was so glad that I could go back home and finally stop drinking it on ... ahem.. "medical grounds". That's what it took to convince my overeager family !

During my time at the hospital I met with different lactation consultants all with different opinions on how to address  the oversupply issue. Some insisted that I should pump to relieve the engorgement, whereas others discouraged me from pumping as that would not resolve the oversupply issue. It was so confusing, but I ultimately ended up going with what I felt most comfortable doing. I took a break from pumping for a few days but then went back to pumping once a day at least because I wanted Jude to be able to alternate between bottle and breast.

Unfortunately, being on antibiotics probably lowered our good bacteria and ended up leading to thrush which was something we ended up struggling to get rid of for another 6 - 8 weeks. I even gave up sugar in the hopes of expediting the recovery.

Its been pretty smooth sailing since then, although I do think that I tended to be a bit susceptible to blocked ducts and had them on at least 4 different occasions. After trying a few different things, I found that the quickest solution for me was to take lecithin supplements whenever I started feeling a block and pumping directly after feeds to make sure to drain the block.

Today nursing is so easy and enjoyable I look forward to connecting with Jude when I get home from work in the one way that I know no one else can. I love our bond and although I initially planned on nursing for 6 months, my new aim is 1 year and will see from there.

Hilba Recipe (if you dare!) 

Ingredients
2 tbsp hilba (fenugreek)
3 tbsp rice soaked in water
pinch of cardamon powder
Saffron strands
Sugar to taste
1.5 litre milk

Directions
Soak hilba overnight in water
Grind the rice in a blender with a bit of water
Heat the milk, then add ground rice
Stir continuously to keep lumps from forming
Add sugar, cardamon and saffron
Continue to stir and cook on low flame until milk is reduced to half
Add drained hilba and continue to cook for a few more minutes
Cook less or more according to the thickness you prefer

Confidence - The essential ingredient to successful breastfeeding

Its unbelievable the amount of people who can make you feel that you don't have enough milk, or aren't successful at breastfeeding. This is probably the major reason that a lot of women give up breastfeeding or introduce formula early on.

There are a lot of variables to successful breastfeeding but in my opinion one of the most important things that you can do is build up your confidence that you actually are capable of breastfeeding. There are some women who truly are unable to but some women are simply misguided.

Its unfortunate that in the short time that formula has been introduced, our women's breastfeeding support system has completely sunken into the forgotten past. Formula is definitely easier, but why not provide your child with the most natural, most healthy nutrition for the first few months of their life if you can.

These are a few things that I did that gave me the confidence I needed to begin and establish breastfeeding.

1. Pre-natal classes
2. Attending local LLL meeting
3. Reading
4. Understanding cluster feeding

 Pre-natal classes

I attended a pre-natal class by Karen Wilmot of  Pregnant in Oman.  This class not only gave me the confidence that breastfeeding is possible , but also gave me the confidence to go for a natural delivery. Understanding the different stages of labor and delivery, and the different types of medical interventions got me well prepared to know what to expect and how to deal with different circumstances that arise. Going for a natural delivery helped me ensure that both me and my baby were alert in the first few hours after birth (not drugged through pethidine or an epidural), thus we were able to get her latched on and begin the breastfeeding journey right at the delivery room within minutes of being born. I'm thankful that my circumstances allowed for a natural delivery although I did come very close to having an emergency c-section.

La Leche League Meeting

La Leche League (LLL) is an international women's support organization that encourages women to breastfeed and provides support to those who may have difficulties or questions. The group was established in the 1950's by a group of American mothers who wanted to go the ulterior path away from the mainstream formula feeding that was current at the time. This group of 7 housewives began having meetings to support other women who wanted to establish breastfeeding and were available to answer questions at all hours of the day or night. This small group has now turned into the most influential breastfeeding advocacy organization with chapters all over the world.

I attended my first LLL meeting in Abu Dhabi a few weeks right before delivery and dragged my other pregnant friend along with me. It happened to be a toddler meeting (mothers and their toddlers).
The mothers we met were very open to discussing any of our questions or concerns regarding getting things off to a good start. They handed out leaflets on breastfeeding and even had a library of breastfeeding books that we could borrow. More importantly, having met the group leaders and exchanging phone numbers with them, ended up being very helpful for the needed support in the early days. I remember feeling like I was failing miserably in the first week and was scared to go into my appointment at the lactation clinic for fear that they would tell me that my baby was loosing weight and that I would have to go on formula, the women at LLL really gave me the advice and support that I needed at that time and to my surprise my baby had re-gained her birth weight and more within the first week (its normal for babies to loose some of their birth weight before gaining it back again).

I remember my friend and I walking out of that first meeting thinking that we had never been exposed to so much boob ever before. Whilst we knew that we wanted to breastfeed our newborn babies, we were quite surprised to see that moms were still nursing their toddlers who were walking around the room playing, hopping onto their moms laps to nurse and then hoping back off to join their play group. We could not remember the last time we had seen a woman nurse a newborn baby, let alone toddlers old enough to be walking around. Little did we know that within a few weeks when our babies arrived we would also be bearing it all and not ashamed to nurse. I guess with older babies, although nursing does tend to continue its less common to see it done in public.


Reading

The only way to understand more about how to get things off to a good start is to be armed with the knowledge. Given that more women around us today are used to grabbing formula if a baby seems to be crying too much or waking too often, I found that reading helped me understand the cycle of breastfeeding and persevere without caving in when older women around me tried to challenge me by saying that my baby was not getting enough milk from me. Two sources that I found really helpful were the LLL book Womanly Art of Breastfeeding and the online web source www.kellymom.com

Understanding Growth Spurts and Cluster Feeding

When your baby starts cluster feeding, that can be the time that you really think that you must not have enough milk. In fact many women around you will probably tell you that you don't, and that's why your baby is still hungry. I'm sure this is the point when women will grab that formula and begin supplementing.

Cluster feeding takes place when the baby demands to be fed frequently, even hourly. For us this tended to happen usually late evenings and early mornings.

Our first incidence of cluster feeding took place right around the 1 week mark which also coincides with a growth spurt period and my baby pretty much nursed from 6pm all the way through to past midnight, with very short breaks in between. I was fine with doing it because I understood what was happening. Because my husband had attended the pre-natal class with me he also understood what was going on and was very supportive. Breastfeeding is based on supply and demand, by following the baby's cues to feed whenever they want you can ensure that your milk will come in to meet their demands.


Overall, these are the things that I really believe helped me out, although I did struggle with nursing in the first month, starting off with soreness from the wrong latch followed by mastitis and a course of antibiotics which then also led to thrush which took over 6 weeks to get over. Despite the initial hurdles the experience has been very rewarding and I am amazed at the power of our bodies to nurture and I enjoy the special bonding experience that comes with nursing.