Wednesday, February 4, 2015

To feed a child: round two times two

If you recall my experience with Maxson, breastfeeding him at the beginning was an emotional journey. I'm so lucky I had that experience to lean back on because I was more prepared emotionally this time around for similar events.

For those interested, here's kind of a log of my journey from the past few months. It's not exactly what I was hoping for but we're making it all work and everyone is happy and fed and growing.

The first couple days the boys exclusively breastfed, mostly just getting the colosterum. I knew I didn't have any milk but I also know that was normal, milk doesn't come in until somewhere between that 48-72 hour mark. We were barely at 24.

On the morning of day 3 during our meeting with the NICU doctors, they asked if I was ok with supplementing with formula. Without a second's hesitation Casey and I both said yes, do as needed and what's best. It was an easy decision with a lot less emotional guilt attached than the first go around with Maxson. Gaining weight would be pivotal in helping the boys progress sooner and come home. So after each time I nursed them, they would then receive a supplemented amount of formula. This first day was just 15 ml or so and over the next few days they would increase the amount to 20 and 30, some feedings they would even take in 45 ml! I was definitely supportive of giving them additional formula to grow, it's what they needed. It was hard for me sometimes because I felt like at times the nurses would just keep trying and trying to get the boys to drink more formula than they actually needed or wanted. I wanted the boys to be satisfied but not stuffed to the brim because I wanted them to breastfeed really well at the next eating time. There came a point where I began resenting the nurses and formula just a little bit for this reason, I felt like they didn't have my wants in focus. What I realized a couple days later was that I was the one who was wrong. After a few days they finally gained some weight, this was at the same time my feelings from above were happening. I can remember not forcing Quinn to drink much on a couple feedings. That night he lost another ounce or so and may have even had an alarm go off that night. I realized that feeding them formula, and quite a bit of it, was a means to an end here in the NICU. The doctors and nurses DID have the best needs of my babies in mind, I was the one being prideful in not wanting to give them too much formula. From then on I was more than happy to feed the boys as much formula as they would like, even coaxing them to drink more than they're initial fall asleep period. I was also worried they'd be used to drinking x amount of ounces at each feeding and I wouldn't be able to make that.

I believe it was at some point during day 4 or 5 I heard the first few swallows while nursing from one of the boys as they nursed. It was the first hints of milk coming in! I was beyond thrilled. During my whole stay at the NICU I tried pumping as much as I possibly could knowing that it would help my milk come in sooner plus increase the amount that was coming in. I'd try to pump within an hour of them nursing. Most days I would pump about 4-5 times during the day to let my body know "Hey. See this action? That means you need to be making more milk!" I'd put my timer on for 15 minutes and usually turn on Friends (**side note if you're pumping a ton: a nurse said that instead of buying one of those pumping bras that are super convenient but kind of pricey, just cut some holes in an old sports bra. Works like a charm for a no hands pumping bra plus it's way less expensive!**) I also began taking fenugreek on day 4, 4 tablets 4 times a day. I drank A TON of water. One time I logged how much water I drank during only the daytime hours and it was 200 ounces. I was amazed, that didn't include all the night time drinking.

Over the course of the next week they would begin drinking less and less formula after each feeding until about day 9 they really didn't take in any formula. That was a triumphant motherly feeling for sure.

Both boys did experience nipple confusion I felt like at times. There was no way around them not having bottles and I liked giving them a pacifier for comfort so we just had to push through it. There would be times where I'd have them both breastfeeding and one would just be fighting to latch on. I had no idea why he wouldn't, he'd be mad and crying and frustrated and I was doing the best I knew. After a few minutes he'd finally latch on and be happy but it did cause the tiniest bit of anxiety at times. I felt like if I treated it like I do bad behaviors with a toddler (sometimes you just ignore it) that it would go away and they'd overcome it. Luckily for me that was the case and they continued to breastfeed like champs.

At their 2 week appt (just a couple days after we got home from the NICU) I was exclusively breastfeeding, they were choking on milk constantly and happy with what I had supply wise. I was told to pump after just the morning feeing. I was happy with where we were at.

At 3-4 weeks old I found they didn't seem quite as satisfied and content after some of the feedings, especially as it got later in the day (totally normal). I called my lactation consultant who suggested I go back on fenugreek for 3-4 days and pump after every other feeding. They eat every 2-3 hours pretty much all day long. Often they are super ready to eat around the 1.5-2 hours mark. After some feedings when they weren't quite satisfied I'd give them milk I had pumped and sometimes in the evening we'd give them formula too because I didn't feel like battling their in take and it seemed like it would take too long. I was a little unhappy about the situation but reminded myself all that matters is that they're bellies are happy and getting enough to grow.

Between 4-6 weeks I transitioned into pretty much almost always offering them 2 oz of formula after every feeding. I super hated it at first (actually I still kind of resent it) but doing so has just made all our lives happier and there's kinda less crying because their bellies are full and happy. I say kinda because there's always lots of crying in between breastfeeding and actually getting them their bottles. Sometimes they won't take any of it, sometimes some of it, and sometimes all of it. We just kinda go with the flow. It takes a way stinking long time it feels like with first breastfeeding then burping then bottle prepping then bottle feeding then more burping then bottle washing, ugh, and all of this is TIMES TWO! It would be just so much easier to purely breastfeed but alas I don't think I can produce enough milk. I think I'm producing enough for 1 1/2 babies at this point. I think the worst part of formula is how smelly their poop is, I seriously hate it. BUT the formula is keeping them alive and all of happy and them growing so alas I am still grateful for it.

between 8-12 weeks we've fallen into a pretty consistent routine of 2 oz bottles after every feeding and they always drink it all. The problem I'm dealing with now is that since they're not drinking as much during the night they need that extra amount during the day. So whatever I pump during the night I don't really count in my mind as their "extra feeding" amount after I nurse them (I pump in the night because I don't want to lose that amount I'm making and let it slow down). So sometimes it has been up to 5 additional oz after a morning nursing session which makes a total of nearly 8-9 ounces I'm guessing: 3-4 oz while breastfeeding, 3 oz pumped milk from the middle of the night, 2 oz formula. They're seriously like hungry little hippos over here. It's usually still 2 oz formula during the rest of the day unless they seem extra hungry and we offer them another 2.

I have found myself leaning on the formula a little more like a crutch than I'd like in that if they're super irritable before naps or won't go down for a nap I just give them 2 more ounces of a bottle; sometimes they drink all of it and sometimes just a tiny bit. I could nurse them but I don't like the idea of not fully empty one side of the milk but also not having a full side for whichever baby nurses on that side again shortly after and it just gets confusing. So bottles it is.

They're still getting decent amounts of breastmilk which is great. Nursing is a breeze, I love it and think it's one of the easiest and best parts of being a mother of little babies. Seriously, easy breezy over here, I lucked out in the nursing department. At home I'm fully ok with feeding the babies formula, it's part of our lives, they need it. Sadly, when out in public (the few times I've gone) or even just with friends, I'm embarrassed to say that I feel a little ashamed when I give my babies their bottles and friends ask "is that breastmilk?" "is that formula?" I don't know why it bothers me but it does. And I just feel that twinge of I'm-an-inadequate-mother feeling come on strong because I can't exclusively breastfeeding two babies at the same time because this mom did and this mom is always engorged because she produces so much milk and and and. I try to shake off that feeling immediately because I know it's not what they mean when they ask that question, it's just my own insecurities.

So as you can tell I'm still growing into this. During all these past months I go on and off fenugreek still as I feel necessary.

Power to the nursing mommas, it's a lot of sacrifice and giving of your body and constantly being there and available for them. I can identify with you

Power to the pumping mommas because holy cow pumping is not fun and relaxing and you're working super hard to get out that milk for the babies. I can identify with you.

Power to the formula feeding mommas because it is a labor of love preparing and washing bottles and sitting there feeding babies bottles because it's not hands free and easy. Don't feel judged by others, you're providing the best you can for your baby. I can identify with yu


Megan said...

Kimber! You are simply amazing! I absolutely love reading your blog. I'm incredibly impressed that you're able to record all these exciting and mundane memories that you are having with your cute kiddos. You've inspired me to do a better job of journaling :) Big hugs to those sweet boys of yours. And congrats are surviving and thriving as a mother of 3!

Andy Ballstaedt said...

Love your thoughts Kimber. You're doing amazing! in the grand scheme, those boys will be loved and taught and that's what it's all about. that's good parenting, the rest is bonus material. forget the ounces. and definitely forget what anyone else thinks ever. you're the best!