My mom feeding Ellie at Granny’s house.

I have been planning this blog in my head for at least the past month. I know it will be painful to write—there will be tears—but I hope that it will also be therapeutic as well as, possibly, helpful to other moms who desire to breastfeed.

I would say that my breastfeeding journey began when I registered for the breastfeeding class at the hospital where we planned to have Ellie and where we also took childbirth education classes. I knew that I wanted to breastfeed, I really didn’t even have to think about it. My mom nursed us, my brother’s wife nursed her kids and my sister nursed her first child. I was aware that there could be difficulties—a close friend of mine in Georgia had mentioned on Facebook that she had challenges with her first baby and my sister had some issues at first too. At my first baby shower, which was in Georgia, my friend showed me the latching technique that worked with her babies. I was slightly embarrassed about the demonstration (she stayed clothed and used a doll) but appreciative for the information. Between that and the breastfeeding class (2.5 hours on a Saturday in April), I felt prepared. I also planned to work with a lactation consultant in the hospital right away. My reasons for wanting to breastfeed were simple: costs less, health benefits for baby, health benefits for me.

When we got to the hospital for Ellie’s arrival, I handed out the copies of my birth plan which stated that I planned to breastfeed and did not want my baby to be given formula or fed with a bottle. I thought I would get to try to feed her right away because the hospital made a big deal about immediate “skin to skin” contact. However, apparently there was some sort of trouble with Ellie when she was born. I think a nurse halfway explained it to Chris but I just remember that someone held her near me while they wiped her off, but I did not get to hold her or try to feed her. She had a team of nurses around her, a few feet away from me in the room, for about 20 minutes maybe, and then they took her to the nursery for about 30 minutes. I remember I asked for a lactation consultant and was told that they arrive around 9am (Ellie was born at 7:23am).

I finally got to hold my baby about 55 minutes after she was born. A pediatric nurse helped me breastfeed her, for maybe 5 minutes. I remember she said to make sure her nose was clear so she could breathe, and she also said something encouraging about it going well or Ellie taking right to it or something like that. Then they took her away again for some more testing (I think) and I started the process to get my catheter and tubes removed. I was in the bathroom, trying to pee, when I heard my mom say that I needed to come out and feed Ellie or they were going to give her formula. Shortly after that, I heard a nurse saying that they really needed to give her formula. I remember yelling from the bathroom “do NOT give my baby formula!” I finally finished in the bathroom and came out to a very stressful situation. Chris was out in the hall trying to explain that we needed a lactation consultant and we did not want to feed Ellie formula. Unfortunately, he heard a nurse talking on the phone saying “these people don’t want to feed their baby.” So frustrating!! I very much DID want to feed my baby! I wanted to feed her! A nurse tried to explain to me that her blood sugar was low and why that was dangerous. I said to her “I don’t need a lecture, I need a lactation consultant.” I just wanted one more chance to give her breast milk (colostrum) and if that didn’t get her blood sugar to where it needed to be, I would let them give her formula. Finally, a lactation consultant came and she was wonderful. I remember her name was Robin since that’s my middle name. She worked with us for 45 minutes, doing breast compressions and imparting wisdom. The only worrisome thing she said was that my breasts looked slightly different in size and spaced far apart which could be signs of “hypoplasia” – where there isn’t enough milk ducts basically and you don’t make enough milk. I said “Well I’ll just be praying hard that that isn’t the case.” The next time they tested Ellie’s blood sugar, it had risen to a safe place. They continued to test her throughout the day and night, and she was in the clear.

I worked with one other lactation consultant while at the hospital, who happened to be the same nurse who taught our childbirth education class. She watched me feed Ellie and said we were both doing great. She also said that the advice to keep her nose clear was basically crap … “I’ve never seen a baby suffocate while nursing.” Actually I think Robin said that but my point is that the pediatric nurse who helped me the first time really didn’t know what she was talking about. I found out later that she thought we did fine breastfeeding so she made the decision NOT to get a lactation consultant to come see me, even though I had asked for one. ARGH.

Meanwhile, the pediatrician told us we needed to make an appointment to bring Ellie in the following week, on Monday or Tuesday. We left the hospital on Thursday evening, and I called to make her appointment on Friday. We were able to get an afternoon appointment on Monday. As it approached, I was concerned because her diaper production was not where the book said it should be. She was peeing very infrequently and very little and sometimes there was some pinkish red discharge in her diapers.

Monday’s appointment came and it was devastating. Ellie weighed 8 pounds 13 ounces when we left the hospital. Four days later she had lost a whole pound. Babies can lose a maximum of 10% of their birth weight and still be healthy. But between the weight loss and the low diaper production, the doctor was worried. He said that the pinkish red discharge were (a word I can’t remember) crystals and often are a sign of dehydration. He said Ellie seemed to be fine but we needed to get her some nutrition as soon as possible, which meant supplementing, which meant formula. I absolutely did not want to do that. He had me try to breastfeed her for 20 minutes, then weighed her again. No change. I was heartbroken. He said to get a breast pump and see how much I could pump. If I pumped 2 ounces, I could give her that instead of the formula. Otherwise, supplementation was necessary, even though I was scheduled to go the lactation clinic the next day (I had called that morning and at first they didn’t have an appointment until the end of the month. I dissolved into tears, scheduled the first available, but then she called me back 20 minutes later to say someone had cancelled for the next day and did I want to come in. I was ecstatic! It felt like a huge answer to prayer). We left the doctor’s office with formula samples and headed to Target to buy a pump. We also went by Whole Foods to get fenugreek, an herbal supplement that has been known to increase milk supply. I called a friend of mine who is a pediatrician and asked for her advice about supplementing. She confirmed that I should do it to be safe and to use a slow-flow bottle. I also found out that she knew the lactation consultant who helped me in the hospital (Robin) and was able to reach her on her cell phone. Robin called me later that night to talk through the situation and offer advice. She said not to take the fenugreek yet because if I was engorged it would only worsen the situation.

I was not able to pump 2 ounces, so we had to give Ellie formula. I was so upset – Chris had to do it and I couldn’t even watch. I was still doubtful that it was necessary, honestly, but Chris felt very strongly about it and I was in agreement after getting a second opinion from someone I trusted (my pediatrician friend).  [Side note: I would have chosen her to be Ellie’s doctor but she doesn’t work full-time because she has four kids of her own.]

The next day we drove downtown to Centennial Women and Children’s hospital where they have a lactation clinic called A Mother’s Place. It is awesome. They have really nice consultation rooms and a little “boutique” where they sell everything you need for breastfeeding (pumping supplies, supplements, pillows etc.). We met with a woman named Martha who was very comforting. We were there for over two hours. She hooked me up to a hospital-grade Medela pump and showed me how to do breast compressions while pumping. I was engorged because my milk had come in (I didn’t even realize it) but Ellie had not been able to get much of it out. And once you’re engorged, it becomes more difficult for it to come out. While I pumped, she examined Ellie and showed us how to use a “special needs feeder” that Medela makes. She said that the problem was twofold – Ellie was very sleepy and she had a weak suck. She gave us tongue training exercises, recommended that we buy the feeder and use it (we did) and that we rent the hospital-grade pump (we did). I remember she said something very encouraging, like we would just work through things and then we’d be able to have a normal breastfeeding relationship. I was so relieved to hear it, I asked her to repeat it. We made a follow-up appointment for ten days later and returned home determined to do whatever we needed to do so that Ellie could breastfeed and we could stop supplementing.

We took Ellie back to the pediatrician to be weighed two days later and she was up 3 ounces to 8 lbs. 2 oz. I continued trying to breastfeed, and we also supplemented using the special needs feeder. We did tongue training exercises with the pacifier and with our fingers. It was a huge challenge waking her and keeping her awake to eat. We stripped her down to just her diaper, we tickled her, we blew on her… and I pumped. I started taking fenugreek again but it gave me really bad diarrhea so I stopped. The following Thursday I went back to the lactation clinic with my mom. I remember Martha saying that Ellie hadn’t make as much progress as her tongue as she had hoped for. I told her it was hard to pump both breasts at the same time and do compressions, so she had me try using a pumping shirt which helped a lot (I wish I had gotten it at the first visit).

That Saturday, Chris and I along with my mom took Ellie to see Granny in Kentucky. We were having a nice visit until we went to feed her and she kept falling asleep. It took over an hour for her to drink 2.5 ounces from the special needs feeder. I kept saying something was wrong … my mom and Granny kept trying to reassure me that she was fine but Chris and I just felt like it should not take her that long to drink so little. She was 15 days old and it had been a challenge to feed her from day one. I remember one day when Chris was at work and we didn’t have any family members around to help (we had lots of help the first month so I’m not sure when this was) and I couldn’t get Ellie to nurse or eat from the bottle and I was sobbing and saying over and over “I just want to feed my baby.”

In the meantime, I was emailing with my friend in Georgia and both she and my mom suggested I attend a La Leche meeting. I planned to do that but it was a week or so away so in the meantime I did some research on the web and ended up joining a breastfeeding support group on Facebook. I posted a question asking for advice about feeding a sleepy baby. Somebody commented asking if she had been checked for tongue tie. I said I was seeing a lactation consultant so surely she would have mentioned it if she thought that was the problem (I remembered seeing a folder labeled “tongue tie” in the clinic but we didn’t talk about it). At the La Leche meeting, I was also asked about tongue tie. [Side note: while I don’t agree with everything La Leche promotes, I met some really sweet ladies and it was a helpful experience. I think they are a wonderful organization for mothers who prioritize breastfeeding.] So, at the next lactation appointment (June 6), I resolved to ask about tongue tie. Martha said that while she did not have an obvious tongue tie, there was a chance that she had one of the “posterior submucosal” variety. I would need to take her to see a pediatric ENT – they are hard to get an appointment with but she referred me to the nurse practitioner at Vanderbilt who could examine Ellie. I was able to get an appointment for June 13. The next day, we had another really lengthy frustrating feed. That weekend, we started using the slow-flow bottle instead of the special needs feeder. It just seemed that sleepiness wasn’t really the problem … it seemed like Ellie was getting tired out from the sucking. She was able to eat better from the easier bottle although she dribbled a lot. I was counting down the days until the June 13 appointment – I was hoping so hard that a tongue tie would be the problem because that was a problem that could be fixed. In fact, while researching tongue ties online, I found this blog which was very encouraging.

The nurse practitioner at Vanderbilt’s pediatric ENT office was uh-maz-ing. So nice, so professional. We talked for a bit and then she examined Ellie. She confirmed a submucosal posterior tongue tie and explained the “surgery” to fix it – local anesthetic and just one simple cut done by the surgeon. It only took a few minutes and they could do it right then and there. It could take up to 2 weeks to heal, during which time we’d need to massage the area to make sure it didn’t reattach, but it would probably make a huge difference in her ability to breastfeed. We opted to get the surgery done and I felt so relieved. I would be able to breastfeed now!

I have to say I did notice a difference in her ability to breastfeed after the surgery. We continued to supplement using the special needs feeder and the slow-flow bottle. On June 26, I took her back to the ENT office where the wonderful NP examined her again and said that her tongue had healed beautifully. I was thrilled. I went from there to the lactation clinic for visit number four, this time with a different consultant (I think she was the manager … Martha made my appointment to see her saying that she wanted me to get another opinion). I thought we would be discussing how to wean her from the formula, but unfortunately that was not the case.

This consultant was very different from Martha – not nearly as nurturing and with a very matter-of-fact personality that I was not fond of. She said that Ellie was not latching correctly (hearing this after almost a month and a half of breastfeeding was very disheartening) and thus was expending a lot of effort for little payoff. At that point, Ellie was eating 3 ounces at each feeding. She was able to get her to breastfeed about an ounce (they weigh the baby naked, have her eat for 5-10 minutes, then weigh her again on a very sensitive scale to ascertain how much breast milk she is getting) and I pumped about an ounce. Then she had one ounce of formula from a bottle. There were two problems to fix – getting Ellie to eat from me everything I had to offer, and getting my supply up. She said I would need to take fenugreek and blessed thistle supplements faithfully for 2 weeks, 18 pills a day (6 pills 3x a day). I hate taking pills. So, while I did get some helpful information from that appointment, mostly I left feeling sad and defeated (and crying).

I continued to pump and breastfeed and supplement. Through this whole process, I cried a LOT. I am sure most of it was hormone-induced but I was so very frustrated. I felt very strongly that God’s plan was for mothers to breastfeed their babies. So why was it seeming so impossible for me?? [God’s plan design is also for women to be able to conceive naturally but that often doesn’t happen. We live in a fallen world…] I wanted so badly to be a success story. When I was pregnant, I had a few different people offer this advice: “Don’t feel bad if you can’t/choose not to breastfeed.” I tried to nod politely but in my head I was just thinking “I’m going to breastfeed. But thanks.” Actually knowing me I probably said that outloud, ha! I just thought that determination and expert help would get me the results I wanted. Failure was not an option.

Ellie had her 2-month pediatric visit on July 12. The doctor said she was doing great. She weighed 10 lbs. 8 oz. She was right at 50% for weight and like 97% for length. I asked if developmentally there was something that would change that would help her to get better at breastfeeding. He said “Usually by 2 months old, babies are set in a feeding routine that is unlikely to change.” I was not happy to hear that … but I didn’t cry! I called an independent lactation consultant who does home visits and set up an appointment with her. I wanted one more opinion. She came the next day. She was great although did not offer a whole lot of hope that Ellie would ever be able to breastfeed exclusively. We didn’t really get to do much of a follow-up after that since she was very busy – she went on a trip to Africa and she works as a nurse at a hospital – but we did chat briefly over email. She recommend some cookies and essential oils for increasing milk supply. I tried both and yet the amount I was pumping continued to decrease.

I nursed Ellie for the last time on Tuesday August 6. It had gotten to the point where she would get impatient and frustrated when I tried. We were leaving the next morning to see my sister in Pennsylvania and I was planning to pump when I was there – I didn’t want to have to deal with trying to nurse her, pump and bottlefeed her while we were away from home and away from Chris (meaning I had to do it all myself… he was indispensable in all of this… supporting me emotionally as well as feeding Ellie while I pumped, rinsing pumping parts, making formula and of course changing diapers). My main goal was to give Ellie as much breast milk as I could until at least her 3-month birthday. It worked out that I had help during the week from a babysitter (former neighbor/college student) until August 16, one day after Ellie turned 3 months old. I consider this to be a total God-thing. It is time consuming to pump! And I was also working, only part-time, but still. It was a big deal to have that help for the first three months (one month from family, two months from the babysitter) so I’m very thankful for that. We returned the rental pump on Monday August 19 (I cried). Of course, had I known that I would not need a pump for a whole year as previously planned, I would have only rented instead of also buying the top-of-the-line Medela pump at $300. Hopefully I’ll be able to sell it and get some of that money back. But I digress…

At the end, I was only pumping about half an ounce from each side, three times a day. Ellie was eating 4-5oz at each feeding so she was mostly eating formula and she began to refuse the breast milk. I gave her the last 2.5 oz. of pumped breast milk on Friday August 30 aaaaand… (you’ll never guess) I cried.

ELLIE ROSE – HAPPY AND HEALTHY AT 3 1/2 MONTHS

I will probably always wonder if there is something else I could have tried, something integral that I could have done differently. Not because I’m beating myself up, but because I really really REALLY wanted to breastfeed. All that time and money, and even a SURGERY, and my daughter is formula-fed. It kills me! I am still tearing up as I type that. I am extremely disappointed that it didn’t work out. But at this point, I have to chose to focus on the positive. We did have a breastfeeding relationship. I was able to calm her down a few times when she was really upset by breastfeeding her. She got breast milk until she was 15 weeks old. Thankfully, she doesn’t need special formula – after using Enfamil Newborn for the first three months, she is now eating Costco brand (Kirkland) which has the same nutrients at half the price. After all the trouble with the special needs feeder and the slow-flow bottle, we were using the Medela Calma nipple which was a great solution. I highly recommend it for babies who sometimes breastfeed and sometimes bottlefeed. Now we are using Born Free bottles because a friend gave me all of hers after her son turned one. They seem to be working really well. I feel like being formula-fed has made it easier for her to adapt to a somewhat consistent sleeping routine and sleeping through the night (which she did at 13 weeks). And I have to admit I am relieved that I won’t have to deal with nursing in public with a cover or teaching her not to bite me when she gets teeth (although I would have been happy to put up with both). The hardest part is feeling like I have to explain why I don’t breastfeed when it comes up in conversation. I’m working to break myself of that. My husband and I and our immediate family members know that I tried everything to breastfeed and they don’t judge me so why should I worry if strangers do? I know that in the scheme of things this is one small part of a much bigger picture. Soon she will start eating “solid” foods and we will get another chance to give her the best nutrition (we plan to make our own baby food). If I do want to quickly explain to someone why Ellie is formula-fed, I say “she had a late-diagnosed tongue tie and by the time her suck was sufficient for breastfeeding, my letdown was very slow and my supply had sharply decreased.” Would it have worked out if she’d never had formula? If we’d found and fixed the tongue tie sooner? If we’d stuck to using just the special needs feeder? If I’d pumped more? If I’d taken the supplements more faithfully? If I’d taken prescription drugs? We’ll never know, and you know what, it doesn’t matter. It’s in the past, and that’s okay.

One statement that helped me the most in dealing with this – my sister who had been trying so hard to be positive and encouraging finally said “this is just the first in a long line of frustrating things that she will do that you cannot control.” I shouldn’t put quotes because I am paraphrasing 🙂 But it helped me realize that there are going to be so many things that don’t go the way I want them to in this whole parenting experience … better learn how to deal with it now!

Finally, I will end with what advice I would offer for expectant moms (especially first-time moms):

• Remember that breastfeeding is not easy EVEN IF you don’t have as many obstacles as we did. For something that is natural, it’s very unnatural at first. Be confident in your choice. Even if your choice is formula. I would urge any mom to try to breastfeed for at least the first month but that’s just my (very strong) opinion and I respect that it’s a very personal decision. Of course, I am much more understanding now about moms who formula-feed than I used to be (duh).
• Connect with a lactation consultant who does home visits before you give birth. Schedule an appointment with her within a week of bringing the baby home. This might be overkill, but it’s better to have help and not need it than to need it and not have it.
• Purchase and read at least one book on the subject while pregnant. I was given The Nursing Mother’s Companion — even though it was after I had Ellie it was still helpful.
• Connect with a La Leche group in your area (preferably before baby comes).  I also recommend kellymom.com as an online resource and this Facebook group.  If you choose not to go to a La Leche meeting or join the Facebook group, make sure you connect with other moms who breastfeed because their experience and encouragement will be invaluable.

If you have any questions about my experience, feel free to ask (unless you’re going to criticize me, in that case, keep it to yourself haha). Believe it or not, there are some details missing from this very long blog.

And now, I can close the book on this subject. If you’ve read this whole thing, thank you for caring enough to do so. And even if nobody does, I’m glad I did it for myself.