Re: I think I've lost my battle :(
Hey mama. You're not failing. You're succeeding at giving your baby as much of your milk as possible, despite some very trying circumstances.
It sounds like there is a lot going on, and all of it is difficult stuff, but it all sounds fixable if you have the time, dedication, and energy to persist and make it happen. Most of all, you have to want to make it happen, and that desire can only come from within. That's not me telling you to "hang in there". I'm just saying that there is hope. If letting go of nursing will leave you feeling guilty and give you a broken heart, don't feel like you have to let it go. But if letting go will release you from severe distress and shame and allow you to move forward as a better mommy, no one will criticize you for that!
Okay, so here's what I think is going on: first, a rough start. Your baby spent time in the NICU and ended up with jaundice, and because of that formula and bottles were introduced very early. That delayed your milk production, but it sounds like it was unavoidable since baby was unable to latch and you were unable to produce enough milk in the early days. Because baby was difficult to latch and used to the bottles, you started using the shield, which enabled baby to latch but also may have hindered his ability to transfer milk and caused him to feed constantly (it's common for babies who are having trouble getting enough milk to make up for poor milk transfer by nursing non-stop). And because milk transfer was impeded by the use of the shield, you ended up with low supply.
Low supply is typically very fixable, even if baby is have trouble nursing. What you need is:
1. A good pump. Hospital-grade rental is best, an excellent double electric pump is second-best. Don't try to squeak by with a cheap electric or manual pump- they won't do the job and will only frustrate you.
2. Correctly sized shields. The pump should not be causing cracking, and if it and not the baby is responsible for cracking, that suggests that the shields are improperly sized.
3. A rigorous pumping schedule. When I needed to increase supply, I pumped every 2 hours during the day and every 3 at night.
4. Olive oil. If lanolin is not lubing your nipples enough, olive oil might allow them to slide more freely in the collection tube.
5. Hands-on help from a good LC, preferably one who is an IBCLC.
6. Herbs: fenugreek, blessed thistle, and ordinary oatmeal are all said to be good for supply.
7. Drugs: as a last resort, there are Rx drugs (Reglan and Domperidone) which can increase supply. They have side-effects in addition to increased supply, and are not for all women, so speak to your health care provider before taking either one.
You also need to deals with the cracks, and the pain from cracking, and here are some suggestions which may help:
1. Moist healing. Use lanolin, hydrogel pads (like Soothies), and keep the humidity in your house high.
2. Immerse your nipples in a shot glass of warm water before nursing/pumping. If the scabs are moist, they will not tear open as painfully.
3. Try a combination of 1% hydrocortisone cream and Bacitracin antibiotic ointment on the cracks to fight infection and inflammation. Use a ea-sized amount, mixed and applied using a clean finger.
I know this is that hardest thing to believe, but even though you're in a really tough spot right now, things can improve. I had terrible cracks, was using a shield, needed to pump and supplement, and thought I would never enjoy nursing. But I ultimately did- the baby grew and her latch improved as she got older, and with time and effort I was able to ditch the pump and bottles and just nurse.
Coolest thing my big girl said recently: "How can you tell the world is moving when you are standing on it?"
Coolest thing my little girl sang recently: "I love dat one-two pupples!"