Or this post could be called C v. My Boobs. Whatever the title the point is PCOS has reared it's ugly head again. It wasn't enough that it took RCW and I almost 2 years to conceive while suffering 2 miscarriages, but now PCOS has come back to laugh in my face.
Almost as if to say, "Ha, just because you had an fairly easy 9 months, don't think I forgot about you!"
I knew from the beginning I wanted to breastfeed C, if at all possible, but I also realized that PCOS may make that wish hard to achieve. So I also went into this knowing I may not be able to, and I needed to be ok with that outcome as well. Some things you just can't help and controlling your body is one of them, in this instance.
In the hospital on Day 1, our L&D nurse, Lori, had him on my boob in recovery. We nursed for about 10 minutes and I thought we both did great. It didn't hurt! That was success, right? When we got settled in our Postpartum room, we tried to nurse again. And again, he latched on (or so I thought) and it didn't hurt and away we went. We danced this dance for his first 24 hours - we put him on my boobs when he started rooting and acting hungry or if it had been 3 hours since he last ate.
Then on Day 2 in the afternoon, we had a visit from our hospital's lactation consultant. Imagine our surprise when we learned that C was not latching on correctly. She showed us some techniques and told me I would be better to hold him in a cross cradle hold in these early weeks. I told her I had PCOS and I was worried so she brought me a hospital pump and told me to start pumping after feeding him or at least 5 times a day. Even if nothing came out, she called this 'insurance pumping'. An effort to stimulate my milk supply even more than C could do alone.
Everyday we did this in the hospital - nursing C as best we could and me pumping away with nothing coming out. And every night when the nurses took C away to check his stats they would come back and tell us he had lost more and more weight. His weight went like this:
Birth on 2/15 - 8 pounds, 9 ounces - he was such a big baby they checked him for diabetes! Luckily, he passed with great blood sugar levels and was cleared.
Day 1 on 2/16 - 8 pounds, 6.6 ounces
Day 2 on 2/17 - 8 pounds ,1 ounce
Day 3 on 2/18 - 7 pounds, 12.2 ounces
Night 3 on 2/18 - 7 pounds, 8.2 ounces
Day 4 on 2/19 - 7 pounds, 7 ounces
We had been warned all along that so long as he didn't lose 10% of his body weight we were ok. We could continue the breast milk without any supplements. It was on the morning of Day 4 - our discharge day, that he had officially lost 10% of his body weight. He was down a pound since his birth and the nurse that morning said we should supplement him. She told us she would have the on call pediatrician look him over, checking his weight and his jaundice (since he wasn't eating enough, he wasn't pooping enough and wasn't getting rid of his bilirubins). The on call pediatrician was an older gentleman with white hair (when I saw him finally). He agreed that C needed supplement so they gave him 20ccs of formula, just under an ounce.
I cried. And cried and cried. And felt like a giant failure to my son and to my husband for not being able to meet C's most basic need - nourishment.
RCW left me alone to go get breakfast and I cried some more alone in the hospital room while preparing to come home. That's when the on call pediatrician knocked on the door to tell me his thoughts. I tried to wipe away my tears and he proceeded to give me a lecture about how formula is fine and he didn't understand why people had such strong convictions against it. He said C would be fine and to continue giving him a supplement of 20ccs with every feeding until we saw our pediatrician the next day. His old school demeanor didn't help the matter, but what can you do. I knew it was in C's best interest to give him formula so he could gain some weight back and start to thrive...and stop being yellow!
*****
We came home on Sunday, February 19 and on Monday, February 20 we went to his pediatrician. He had gained half an ounce and was up to 7 pounds, 7.5 ounces and his bilirubin levels had gone down too! His pediatrician agreed that we should keep him on a supplement, but also knew we would be working with a lactation consultant (LC) at my OB's office and we should follow her game plan. Our ped, Dr .R. said since he was a big guy to start with, he wasn't in any real danger with his weight loss and otherwise he was perfectly healthy so we wouldn't see her again until his 1 month check up!
*****
On Tuesday, February 21, we headed out bright and early at 8:30am to the LC. She took C's weight and he was up to 7 pounds, 8 ounces - another half an ounce gained! Then I nursed him on both sides with her taking his weight with her ultra sensitive scale in between. From the right side, he only got 2ccs, and on the left he got 6ccs for a grand total of 8ccs. While RCW feed him his supplement from a bottle, I pumped. When we measured how much I pumped we got an additional 6ccs. My grand total Tuesday morning was just 14ccs. That is about half an ounce of breast milk from 1 sitting.
Our LC agreed that he needed to gain some weight back, but because he was so chubby at birth we weren't in any dangerous situation. We talked about our desire to give him breast milk and then we talked about our game plan.
For starters, I'm taking a medication called dom.peri.done - 20 mg four times a day. Its an expensive little pill costing us about $70 for 2 weeks worth, but it should help my milk supply come in quicker than waiting and we figured if we could breastfeed we'd avoid the cost of formula so we're giving it a shot. Also, once my milk comes in, I won't need to take it anymore so we're just looking at possibly using for for 4-6 weeks total. We're feeding C 8 times a day on a 3 hour schedule or as he requests it (which he doesn't, we typically have to wake him up to feed him at the 3 hour mark!) and I'm pumping after each feeding. Yes, feel bad for my poor boobs!
*****
We did that for a week - waking him up every 3 hours, nursing him on each side, giving him a bottle of formula supplement and a bottle of pumped breast milk (if we had it) to get him 1-1.5 ounces at each feeding and then I would pump for 15 minutes. By the time we got him feed, me pumped and him changed and settled to play or sleep, there was about an hour and a half until the next feeding.
*****
On Wednesday, February 29, we went back to the LC for our weekly appointment. We got C naked and he weighed in at 8 pounds, 2.5 ounces. Yay!! He had gained 10 ounces in 8 days, we were looking for 6 - 8 ounces and he exceeded our expectations! Something was working!
Then we did the routine - nurse and weigh in between sides, RCW would feed him a bottle of supplement formula and supplement pumped breast milk and I would pump.
On this day, he took 8ccs from my right side and 6ccs from my left for a total of 14ccs. I then went on to pump 15ccs for grand total of 29ccs or just about 1 whole ounce! My numbers doubled from the week before. Hallelujah!
*****
We have changed our pattern a bit as some of the feedings are just taking way too long for me to do alone now that RCW is back to work. Our LC said we could do Plan A or Plan B - Plan A, what we had been doing: nurse, supplement by bottle, pump or Plan B, give bottle with either all pumped breast milk, all formula or half and half and pump. It cuts down on nursing time since C likes to 'hang out at the bar' as our LC put it - typical man! Due to his lingering and all the pumping, my nipples are sore so I am tending to do about 4 feedings on Plan A and 4 feedings on Plan B a day. Although, to be honest, I just want him to have breast milk and the more I think about it the more I'd be fine with going to Plan B full time. We shall see...
*****
From here on, we're still going to the LC once a week. I'll continue the finish up week 2 of my dom.peri.done and I'll be pumping every 3 hours, 8 times a day. RCW and I are playing it by ear at this point. The LC has told us that anyone's full milk supply doesn't come in for 4-5 weeks and we're just at week 2 so we have time and with my numbers doubling from week 1 to week 2, we're looking good. We're just hoping they continue to increase over the next couple of weeks!
But again, we'll do what's best for C. However, I know giving him as much breast milk as I can for as long as possible would be best for him in the long run and make RCW and I the happiest.
Anyone else out there have milk supply issues due to PCOS? Any tips or tricks or suggestions?
7 comments:
I have PCOS and have had 4 kids (problems conceiving the first, but my PCOS got somewhat regulated after I gave birth to my first). The first 2 I had no problems with but they were both voracious eaters and comfort nursers, so they were on the breast all.the.time. Neither of them were huge babies, but always gained enough. My second 2, were not voracious eaters and were not comfort nursers and both of them had weight gain issues and in turn I have had supply issues. I suspect I have always supply issues, but they were never really a huge issue since they first 2 nursed all the time so I think that made up for it. I pumped when I went back to work and was never able to pump as much as she ate.
At any rate, with my most recent baby I did take the dom, but started it much later than you, and it didn't seem to help me. My LC said that it is most effective when you start it very early, so it seems like you are on the right track with that. I wish I had started it earlier. If I ever have another baby, the LC suggested doing it earlier regardless of whether I am having problems at the outset or not, just to increase my supply, since it has proven itself to be low.
I also pumped after every feeding, so I feel your pain with that too. It's a huge commitment and very time consuming (and can be painful!) You're doing a great job! Hang in there. If you have any specific questions about pumping, supplementing etc, I'd be glad to help you out. I've read your blog for awhile, but am not a great commenter. Good luck!
Oh I so feel your pain!!! Tobin screamed and screamed for 6 weeks straight..little did I know I was starving him! I tried to pump so I could build up supply for when I went back to work, and I could only get about half an ounce after 30 minutes. After much research and crying, I decided I had to feed him formula. My mom told me that as long as I fed my baby, loved him, and took care of him, it was okay. I felt such extreme guilt though, and still do sometimes, although he is a much happier and healthier baby!!!! GOD LUCK!!!
I don't have PCOS, but it did take 10 days for my milk to come in. After 5 days my Ginny was screaming and despite my constantly nursing her she just wasn't getting what she needed. That night, at 2 am, I called my Mom crying because I hadn't slept in days and my baby was screaming. She came over, fed her a bottle of formula, and she went right to sleep. We went to the pediatrician, who suggested we use a syringe, inserted while she nursed, to give her formula. It made her want to suck more (she was actually suckling the formula out of the syringe while she nursed, and didn't get her hooked on the bottle (which is what some people worry about). If that's something you want to try, you can usually get syringes for free from a pharmacy.
I had supply issues and it sucked! I totally cried hysterically over it, too. I think it's great that you've start on the dom so early. Hopefully that will help up your supply. I did everything I could think of to up my supply and in the end I just didn't make enough :(. I exclusively pumped and then supplemented with formula. I think you're doing awesome and hopefully your supply goes up once your milk is completely in!
I'm so sorry its been difficult but you're doing great!! We supplemented for the first 2 weeks due to my PCOS and I also started pumping only at 2 1/2 weeks due to exhaustion from bf, bottle and pumping. I agree that it doesn't matter how they get the breastmilk and any is better than none. I still only pump what she eats a day and worry that as she eats more I may have to go back to supplementing but I just remind myself I'm doing the best I can and so are you!
Are you using a hospital grade pump? I've heard that they really help with boosting up your milk supply - I think you can rent them for a month at a time. One other thing that has really helped me with breastfeeding is to attend a breastfeeding support group that is sponsored by a hospital in our area. It's been a great way for me to get information from other women who are also breastfeeding.
I had supply issues (and pain, it never stopped hurting) and I was a fanatic. I did not want anything but breastmilk to pass Q's lips. The best advice I can give you is don't put too much pressure on yourself. After I had quit breastfeeding completely at 6 months, I read an article that said there's actually not as much scientific proof about breast feeding being so superior to formula as some would like you to believe. If I get lucky enough to have baby #2, I won't put as much pressure on myself and will just try to relax and enjoy it more even if that means moving to formula sooner rather than later.
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