If you've read this blog much, you know that I was committed to three things for our new baby: 1) unmedicated childbirth 2) cloth diapers and 3) breastfeeding.  So it's with a mix of shame and an odd freedom that I have to tell you that our beloved C-section baby is receiving supplemental formula and wearing disposable diapers. 

Sigh.  This is where we are just past one week in.

The C-section is the easiest to accept.  When pediatricians or whoever asks about the C-section it's easy to say "He was breech and my water broke."  The diapers, well, our Daniel is too small at 5 lbs. 5 ounces for even the extra small cloth diapers that we have.  That one's an easy fix too; he needs to grow and he will.

But the breastfeeding, ai yi yi.  I knew it might be hard, but I didn't know why.  I still don't know why a loving God would make something so important so … difficult.  Maybe it's supposed to be easy and intuitive and we just messed it up the way we have made so much else about birthing a baby so complicated.

Anyway, I put the baby to my breast at first opportunity in the hospital and he didn't latch on as far as I could tell.  I propped myself up and employed the "football hold" and tried to remember everything else that had made so much sense in pregnancy class, just a week earlier.   A few nurses helped me but it was hard, the baby didn't seem to like it, and it hurt.  A lot. 

Uggh.  Finally, on the second night or so, a nurse came in in the middle of the night and said "Oh.  You have flat nipples."

I thought, grrreat.  Something else that is wrong with my body.

But !! that's the neurotic part, isn't it?  My body has performed pretty damn well through this pregnancy and yet that's always my weak spot.  I'm just waiting for the other shoe to drop, (ahem), waiting for the "It's Me, Isn't It, Doctor" moment whether one is coming or not.

Anyway.  The helpful nurse gave me a nipple shield, which is like soft plastic armor, and creates a taller nipple than the one I have, with holes in the end for my milk to get into the baby's mouth.  I tried it, the baby latched!  nursed!  The earth moved, the angels wept. 

Over the next few days my midwives and a lactation consultant visited me and all told me either not to use the shield at all, or not to use it for long.  Instead I was supposed to use various things to torture my nipples into getting taller, like a wide plastic syringe that pulled the poor thing up with suction.  Sounds like it would hurt, doesn't it?   Why yes, it hurt like hell.

So I kept the shield, nursed the baby, and it just got harder and harder.  He would willingly nurse for longer and longer times, 30 minutes, 60 minutes.  On Monday night I started feeding him at 11, trying to keep to the every-three-hours schedule I was instructed, and he would stop, fidget, act hungry, and never ever go to sleep.  I fed him from 11 until 2 am on Monday before collapsing in a heap of sobs and handing him to my husband to somehow soothe.

He was hungry.

On Tuesday I ended up in the office of the lactation consultant at my birthing center, where I found out that the shield prevents the baby from gumming the necessary parts of the nipple that tell my body to make more milk.  Was my milk coming in?  Who the hell knows.  Didn't seem like it.  We rented a breast pump and I was supposed to nurse and then pump, to stimulate my milk to come in.  The baby nursing wasn't going to do that because of the *%$$# shield.  At this point the baby wouldn't go near my nipple without the shield. 

I followed all instructions and things seemed better. We went back on Thursday, confident that a weight check would confirm that the baby was finally feeding well, only to find that his weight had dropped from 5 lbs. 6 oz. to 5 lbs. 1 oz.  I sobbed into a Winnie the Pooh receiving blanket.  Our baby was already so small that one of the pediatricians had looked at me and said "Did you smoke, while you were pregnant? At all?" and now he was almost under 5 pounds.  It was so sad and scary.

That's how I ended up saying yes to the Supplemental Nursing System.  I wear a little bottle on a string around my neck, from which a fine tube is taped to my nipple.  In the bottle is breastmilk, if I can pump any, or formula, which my pediatrician was all too eager to give us.  The baby nurses, and gets whatever comes out of the nipple and also what's in the bottle.  When nursing is over, I'm to pump for 20 minutes. 

We rushed home, and by the time we got there I was through feeling like a failure and just desperate to get some nutrition into our little guy.  I hooked up the SNS and after 22 minutes, Daniel was in full-on "milk drunk" – drooling, sleepy, and happy.  Finally not hungry.  Yeah, it's formula but who cares?  I'm no longer starving my child.  Hence the odd feeling of freedom.

So that's how I got to here.  I am supposed to feed him every two hours, three hours maximum.  This means I get up, get the breastpump bottles and parts washed, wash the SNS bottle and tiny tubes, and get something for me to eat because I'm starved.  It takes me about 10 minutes to get set up with the taping of the tube to the nipple etcetera.  Then the baby has to be waked up half the time.  I nurse him for 20-35 minutes, then pump for 20.  The good news is that whatever I can pump goes into the bottle for the next feeding and D. is probably getting 30-45% breastmilk through the supplementer.  If all is well and he isn't fussy, I can get it all done in an hour and 15 minutes.  If the baby goes to sleep immediately I might get to sleep 45 minutes before doing it all again.  Sometimes it all goes to hell and one feeding blurs into the next with no sleep.  I am resolute about not adding up how much sleep I am getting.  I truly do not want to know.

Like I said.. ai yi yi.  I try my best to stick to this shedule, and usually I'm getting it done every 3, sometimes 3 1/2 hours.  When he's sleeping peacefully it is so hard to wake him up to feed.  But we went to the pediatrician yesterday and I held my breath as they put D. on the scale.  I was ready for more bad news, but our little piglet gained 4 ounces in two days, and is well on his way to re-gaining his birth weight of 6.0.  More importantly, the whole rigamarole with the tube and the formula is working.  What a relief.

So I'm ashamed that I screwed up breastfeeding so badly.  There is more to the situation, his small size means he'd have trouble no matter what, and he may have some oddities in the shape of his mouth that aren't helping.  Most importantly we believe all can be gradually restored to a more normal, formula-free feeding setup.  In time.  And if not, eh.  I'd feed him Scotch if it would help him thrive.

There is so much to be learned about the way things go, compared to the way that we want them to.  I don't want to decide that there is no point in choosing the unmedicated birth, the cloth diapers, the breast over the bottle, because those things still matter to me. 

But oh, the shit that can go wrong.  You just never know.