I couldn't breastfeed baby #1, now I'm pregnant with baby #2

[Eva's Mom]

My story is a bit long but I'll try to keep it short! My first baby, Eva, was born on January 5, 2006 so she's just under 7 months old. I had planned on breastfeeding her exclusively for a year but it just wasn't in the cards for us.

Her birth was a little bit stressful (aren't they all?! ) I was in early labor for 28 hours, active labor for 20 hours, and pushed for 3 hours. She had passed a LOT of meconium in the womb, so much that it got into my system and my husband could smell it on me before she was born. When she was born, she went to the NICU where she stayed for the first 36 hours. I was unable to nurse her right away like I wanted to because of this, and on top of that it took the hospital staff 16 hours to get me a pump! Finally I got the pump and started pumping for 15 minutes every 2 hours. It wasn't too bad. I tried nursing Eva in the NICU but she was just too confused from the forceps and the hematoma and being in the NICU and couldn't latch on. She was diagnosed with meconium aspiration and pneumonia (although it was just a shadow of a spot on her lung.) When they finally brought her to my hospital room after 36 hours, I worked with the hospital LC's and we were able to get her latched on correctly. It was a little tricky because she broke her collarbone when she was born and couldn't be laid down on her right side because it hurt her. She also had to go to the nursery for antibiotic treatments 3 times a day for a week which was very stressful for all of us. We stayed in the hospital for the first week to facilitate this. Eventually we were all very happy and Eva worked very hard to get my milk to come in She only had very mild jaundice so I guess my colostrum is good stuff!

Here's where it gets weird. Finally on day 5, my milk started flowing but I developed mastitis in my right breast that same day. It felt like there was a marble under my right nipple and all the surrounding tissue was red and hot, yowch! I went on dicloxacillin to kill the infection.

But the weird part is that I never got engorged... According to the LC's at the hospital, I have "great breasts for breastfeeding!" so I'm pretty sure they are not hypoplastic. They're not widely spaced, they're very veiny during pregnancy and afterwards, and my areolas are a normal size. I thought nothing of it in the beginning, I just thought I was lucky for not getting engorged. Eva did great, she only lost 9 oz total and started gaining again. Her discharge weight at one week old was 8lbs 6oz, woohoo!

So we plugged along for the next week. She was hungry all the time. She fell asleep every time she nursed so every session lasted at least 40 minutes, usually more like an hour. I also pumped with a manual pump in between feedings to help out my supply. Talk about tiring!

We went to her 2 week checkup. Her weight... 8lbs 6oz. The LC at the pediatrician's office watched me pump with the hospital pump. I only pumped 1/2 oz in 10 minutes with the electric hospital pump. So she told me to take some herbs and said to start supplementing with formula. Eva didn't like the formula right away so I didn't force her to take it. We went back for a weight check 3 days later. Her weight this time was 8lbs 5.7oz. I broke down sobbing.

I switched her to a different brand of formula and continued to breastfeed and formula feed until she was 8 weeks old. In the meantime I tried fenugreek, blessed thistle, and alfalfa combined but they didn't help. I drank mother's milk tea, I pumped during every feeding... I can't remember all the suggestions that were given to me but I tried them all. The harder I tried, the less milk I made. I was curious about trying Reglan but was scared of the side effects so I didn't try it. At 8 weeks, my daughter started having serious nipple confusion and it broke my heart. She started shaking her head and screaming every time I offered the breast. I couldn't do it anymore. I was becoming stressed out and depressed and made the decision to switch completely to formula. It was the hardest thing I've ever done. I was depressed about it for weeks and felt like a failure. I tried everything but still felt like I hadn't tried hard enough. Now I don't regret what happened at all and I have nothing against formula (just my own personal feelings, I know many don't feel this way). But I want to know why it happened.

Now I am 10 weeks pregnant with our second baby and I am going to try my hardest to breastfeed again. No matter what happens, I have promised this baby that he/she will get at least 8 weeks of nursing like I did with Eva. I'm really hoping history doesn't repear itself here.

So at long last, here's my question. What possible reasons are there that my milk never came in fully and I never got engorged?? :cue the Jeopardy music: I would absolutely love to have a full supply this time, but is there any hope of that happening? Could it be hormonal? Could it be due to the meconium that was circulating in my system for over 4 days (that's when my husband noticed the weird smell on my skin)? Was it stress? Was it leftover hormones from the pitocin and epidural? Could being overweight have an impact? I started that pregnancy at 220 lbs and gained 42 lbs during my pregnancy (that in itself is a long story full of excuses! ). I started this pregnancy 18 lbs heavier than last time. As soon as I started losing more weight, I wound up pregnant again! But if that's the culprit, is there any way to correct it? Obviously I can't lose more weight now since I'm pregnant again.

I plan on discussing this with my OB at my first appointment next week, but I'd love words of wisdom from some breastfeeding experts! I hope someone out there has an idea!

[@llli*andrea.wolford]

that must have been so stressfull on you!
Do you have a lll group in your area?
Start going to meetings that will help you! If you make some breastfeeding friends you'll have some support to call.
get a copy of the womany art of breastfeeding. Read and learn so that you know miss information when you see it.
Who knows this baby might not have any of the problems that your older child did.
man 16 hours to get a pump, that was a long time. ugggg......
1/2 an ounce pumping is realy good for somebody with a week old newborn!
Some moms just cann't pump very much.
Try and avoid any bottles, learn to count diapars this time around, and feed on demand. Sometimes babies want to eat up to 12 times in 24 hours, thats normal!

[@llli*mami.kathy]

Wow, I don't know what to do of this, except for the beginning which it wasn't your fault, I don't see any type of mismanagement that would cause your supply to go low. Did you fed the baby on demand? than mean no schedules or restriction, did you use a pacifier? did she had plenty wet and soiled diaper? when she lost the weight, was she sick or anything else that might cause her to loose weight and it got overlooked by her ped? Something that was wrong from the LC was to make you pump, First because the amount you pump is not a good indicator of your supply at all, and second because there's a better weight to see if your baby is getting enough like weighting the baby before and after you fed her. Also that LC didn't sound too knowledgeable, she was very, very quick to recommend formula.

To answer some of your questions, well I'll just give you my opinion it's isn't actually an answer. It could it be something hormonal, but true low supply it does happen but it's very rare, it's usually a mismanagement but from your story it doesn't look like it wasn't your case; stress can play a role; I don't think weight has anything to with it, actually I've read on this forum from someone that her supply start getting low if she started to loose too much weight; and last but not least, history doesn't have to repeat again.

You were smart to start looking for info this early, so start surrounding yourself with support and very knowledgeable people. First you should get in contact with a LLL leader and find a group, talk to your OB about it, hopefully she's pro-BF, have the number for different LC, preferably board certified ones, and look for a truly pro-bf ped. That other LC should it worked with you to try to find the reason for what happened in your situation.

Good luck and take care!!

[Eva's Mom]

Thanks for the responses! Sorry my posts are sooooo long, but I really want to get across all the background on the situation and how hard we tried (I say "we" because my husband was and is SO VERY supportive) and that I don't think it's something simple like not drinking enough water. LOL I heard that one from some other mothers who didn't seem to understand how I could be having problems You know how some people are like, "Well, I didn't have any problems so you must not have problems either!" No, I'm not bitter at all!

It was just such a hard and depressing situation. I had read all about breastfeeding while I was pregnant so it was supposed to work! I was not supposed to have problems, kwim? My mother had told me about how when she had me, her breasts were like 10 lb bowling balls when her milk came in and they were hard as rocks. She said she had so much milk it hurt, so that's what I was expecting.

Anyway, I nursed completely on demand, I charted all her wet and dirty diapers for about the first 4 weeks (she had plenty of both), and I charted how long she nursed from each side. I did everything I was supposed to do. She just didn't gain any weight after my milk came in and eventually started losing She wasn't sick except for the original meconium aspiration and by day 3 they said the spot on her lung was gone and she was perfectly healthy then. I'm also not on any drugs or medications and I take my PNV, vitamin B-12 (I'm a vegetarian), folic acid, and fish oil everyday. I've also had my thyroid tested before and that test came back normal.

We did make the mistake of using a Soothie pacifier from the beginning. The NICU nurses had given her one and at the time I thought it was fine because she was still able to latch really well (the LC's said she had a perfect latch). The other excuse I had was that it helped her get through the times when they had to redo her IV and I couldn't nurse her.

One thing I wish I had done differently was talk to other LC's about my supply issues. I had dealt with all the LC's at the hospital when I got mastitis but we didn't talk about my supply at all. She had enough wet diapers and wasn't losing weight at that point so everyone thought that everything was fine. When I realized that everything wasn't fine, I was no longer at the hospital so they couldn't help me

The LC at the pediatrician's office was very helpful. She's the one who got me started on the herbs and had me charting all the feedings and wet diapers. When we decided to start supplementing, I told her about how I always offered the breast first and made sure that Eva nursed for at least 10 minutes before offering her the bottle. We were so worried because she had started losing weight even though I was nursing her on demand. I was a little surprised that she didn't have me try an SNS, but honestly I was getting so worn down and stressed out at the time that I didn't even want to deal with it. I just wanted my baby to stop losing weight. I had briefly mentioned my problems to my midwife but she didn't really seem to understand why I had problems and didn't seem very concerned. I'm hoping my new OB is different!

Every feeding started off with her nursing 10-15 minutes, and usually she was falling asleep the whole time through the nursing session and doing that tongue fluttering thing, so then I'd offer however much formula she wanted. We couldn't keep her awake while nursing no matter what. We'd pump her arms and legs, strip her down, tickle her, splash cold water on her, that kid just couldn't stay awake. It was like she went into a deep trance every time she got my nipple in her mouth. I don't know, maybe she really wasn't latched on as great as everyone said she was.

I also talked to the WIC LC's every week and got the standard advice. One told me to make sure I was drinking tons of water, which I was - I was drinking about a gallon of water a day. The next time they told me to try the herbs fenugreek and blessed thistle. I told them I was and that they weren't doing anything so she said keep trying. Then the next time they said I could talk to my midwife about trying Reglan. I was unwilling to go that route because I thought I had depression issues.

Now I waver back and forth between being really positive about this next time and feeling completely despondent. On the one hand, I know history does not have to repeat itself. On the other hand, I am completely baffled as to why I never got engorged, not even a little bit. I've read and heard from other people that you are supposed to get engorged when your milk comes in, and if you don't then it's a sign that there's something wrong. That's the part that gets me down and leaves me feeling hopeless. I guess the only way to know is to try again so that's what I will do! But I am dying to know what in the world happened!

In the meantime, I go to a mom's group at the hospital every week that is headed by an LC. She said she'll work with me this time and hopefully we'll prevent the same thing from happening again. I'm also planning on attending some LLL meetings toward the end of my pregnancy. I can't wait to see what happens!

[@llli*mami.kathy]

Well, I'll come back to your post b/c my daughter is just screaming for me. Like I said before it doesn't sound like a case of mismanagement at all, it sound like you did everything right, I've a bit more to add. It will be so great to know what happened to you, I know how it feel when you can't find the answer for something.

Will be back!
P.S. try not to stress so much about it.

[Eva's Mom]

I can't wait to see what else you have to add! I'm trying so hard not to stress about it, but I'm one of those people who just has to know. It's a complete mystery. No one else has been able to give me any good ideas about what it could be yet.

I bet all this worry is for nothing and I'll be swimming in my own milk in February LOL!