Torn between 'AP' beliefs & breastfeeding

[MarcyC]

Yes...you read the title right. Here is my situation.

Right now, we are nursing with an SNS, but he's got a horrible latch (due to a late-diagnosed tongue tie diagnosed by an LC and medical professionals who disagree with the diagnosis and won't do a darn thing about it). I also have low prolactin levels so I don't produce a lot of milk and end up supplementing with formula, hence, the SNS.

So, our routine has been to use the SNS on one side while I pump the other. Picture this in your head. One of the older kids or DH hold him while I get "set up". I tape the SNS tubing on one side, then get the pump ready to pump the other side and then get handed the baby. Get him latched on to the one side, then get the pump started. That pretty picture usually will last all of 2-3 minutes.

He pulls his tongue back, clamps down and pops off. I've got him cradled, say in my right arm, nursing him on the right side. With my left arm I use my elbow to hold the pump horn in place and use my left hand to get him re-adjusted/latched at the breasts. He fidgets and cries and finally get's re-latched and we resume our nursing/pumping. That lasts 2-3 minutes before he's popped off, yet again.

All in all he's on an off 15-20 times per session, if not more. He cries, I cry, we've got pump tubing all over the place, SNS tubing all over the place, milk leaking from the SNS and the pump (but never from my breasts).

All I can say is that it is !

Nursing sessions end with his red, swollen, teary eyes and my red, swollen, teary eyes. Both of us frustrated to no end. When he is actually nursing, he doesn't look at me lovingly. He looks stressed. He looks sad.

Plus, I get to feeling resentful of the whole thing and I've found myself actually wanted to pull away from him when it's time to nurse him. Instead of wanted to cuddle him, I feel like a robot...like this is something I'm "programmed" to do, but yet, I feel very disconnected from him.

My problem is that I do believe in every baby's right to nurse and receive breastmilk. I really believe that in my heart. And I absolutely know that breastmilk is best and formula is not the best thing. BUT BUT BUT...in my mind being AP = following your baby's cues. He's definitely giving me cues the breastfeeding is not his thing, nor is it mine right now.

And EP'ing isn't for me either. I've got two older kids that I homeschool and a two-year old terrible tornado who seems hell-bent on destroying anything and everything in her path. As much as I'd love to EP, I don't see it being feasible right now.

So...what do to what to do what to do? Mamas, help me here...I'm open...truly open...to any advice. Thank you!!!

[PatioGardener]

I'm so sorry that you are going through this. Each time I read your posts I think about how strong you are!

Is there any way you could look into donated milk? That way you could nurse with the SNS but not have to worry about pumping. Your baby would be getting breastmilk - yours and the donated milk. As he grows hopefully his latch will change and he'll be able to nurse without the SNS and your milk supply will respond (or at that point you may want to look into domperidone etc, or add pumping sessions etc.)

This may not be a realistic scenario (getting supply back later), you'd want to run it by an LC first.

Good luck with your decisions. You are so thoughtful, I know whatever you decide will be right for you.

[jessjgh1]

Marcy,
Hugs to you. I dont' know exactly what to say, but a few things popped into mind.

Your baby has gotten several months of breastmilk in a very difficult situation, you have truly given him a gift, but you also have to strike a balance. You've been maintaining a very hard and stressful routine to try to solve the problem. There's solving the problem (which would be great) but also reducing the stress and cumbersomeness of the routine which may do wonders for you, him, even may positively effect your supply.

Right now you don't have to tackle everything at once, or make a final decision.
It might not feel like you have options (or perhaps it feels like you have too many??)
-Try giving him a bottle and not using the sns-- does this give you a little more energy to think about continueing to pump?
-You don't have to expressively pump, set a schedule that seems reasonable and supplement when you have to.
-Continue using the sns, but stop pumping.
-Go soley to botte feeding (w/ or w/o breastmilk)
-Given your situation is it worthwhile to try just the breast (no sns) every now and then? He may have grown a bit and be able to handle nursing better now.
T-ry something if it feels wrong, try something else or go back...

I realize that some of those things risks your supply, so hard decisions have to be made with what you are comfortable with, but from your question it seemed you want the process to be peaceful. I rember feeling the same way too. ( I think I posted before about finally just lying down with him and offering him the breastI - which was a leap of faith-- or extremely crazy, given the circumstances). Just being able to have some times where your hands are freee to cuddle (and not pumping or taping) etc, might help you figure out your decision.

I remember feeling so horrible, sad, frustrated, and angry. And, I think I know what you were saying because thinking back when I thought and wondered and questions about how upsetting and hard it is on the little one is the worst feeling of all.
You are a very awesome mother to be so thoughtful about all of this.

We are thinking of you!

Jessica

[kristen1978]

Couldn't read and not post. No practical advice. I do remember, however, how frustrating and heartbreaking it can be!

So, just lots of good vibes : and , mama! You are stronger than you know, and you know what is best for you and your baby!

[MaryJaneLouise]

Marcy, if it helps I have BTDT also. Since I could only feed one at a time, sometimes the other DS had to wait his turn. Not fun with a hungry babe. No advice, just another .

[earthmommy2]

Marcy,
I don't have magical answers...and I so wish I did!! But hugs I have tons to spare and you get a bunch!!

:

Firstly, how old is your baby? Because I think I missed that?? Have you tried to contact other health care professionals that might be willing to clip the tounge tie? I know sometimes MD opinions are different, and another might see the problem it causes. Have you tried adjusting your hold? I know when DS was really little we had to do a football hold to work around his tounge tie, and I am so glad that I learned that b/c my Ped wouldn't clip it either. Also, I can understand why you pump while he's nursing but maybe if you take that out of the equation it will make the event less stressful, and being stressed only tightens up your whole body and thus you can't have an effect let down either. Have you tried the various methods I'm sure you know of to try to boost your supply? I know that some people it just doesn't work, but thought I would put that out there.

Remember if you just can't make it over the hurdle and you have to go to bottle feeding based on the fact that your LO's cues are telling you this just isn't going to pan out...That is ok too, whatever you have done so far, is awesome no matter how you look at it.

[p1gg1e]

So sorry your struggling so much

Could your LO have an allergy...I know another issue but just a thought.

[boheime]

I would stop the pumping while you nurse. I know theoretically it saves time, but dealing with a baby, the tube, etc. is enough at once. When you can, pump after you nurse. If you can't pump as often as you like, don't beta yourself up.

I'm a low supply mom. I am nursing my third child. After my first I was preapred to deal with low supply with my second. However, she had a lot of issues of her own and it took almost 6 months to get her on the breast full time with the LA and off of finger feeding. There were times I wondered if she would ever get it; she is now over three years old and still nursing.

Nursing my third has been the best because I have accepted that he gets what milk I can give him and we are enjoying our nursing relationship (okay...I still obsess a little. Bad habits are hard to break but I'm trying to just enjoy him and not worry about how many ounces of supplement he took today). He is 6 months and started signing "milk" today for nursing which just brings tears of joy to my eyes.

If you need someone to talk to, PM me. I'm always happy to talk with mothers who are having problems. If you just need someone to listen or hear from someone who has been there.

[stacyann21]

I would stop the pumping while you nurse.

I agree. It sounds chaotic. Pump after nursing with the SNS or when baby is asleep. It's more important to put baby to the breast than pump anyhow. My son was also tongue-tied, luckily it resolved itself without surgery. Lots of good, milky vibes your way mama.

[MeepyCat]

ITA with ceasing to pump while nursing - or, if you must, get one of those hands-free pump-holder bras so that you don't have to do the juggling routine.

[guestmama9904]

Originally Posted by MarcyC

....


My problem is that I do believe in every baby's right to nurse and receive breastmilk. I really believe that in my heart. And I absolutely know that breastmilk is best and formula is not the best thing. BUT BUT BUT...in my mind being AP = following your baby's cues. He's definitely giving me cues the breastfeeding is not his thing, nor is it mine right now.....


So...what do to what to do what to do? Mamas, help me here...I'm open...truly open...to any advice. Thank you!!!

i am truly sorry to hear that breastfeeding is just not working out in a natural way. it sounds really hard.

so please take this in a positive way when i say this- all babies are born to be breastfed. i dont think its fair to assume because he is having a hard time, or may have an impediment such as tounge tie, that this therefore means his "cues" are to bottle feed. from my understanding if a baby has the sucking strength and ability to use a bottle he should be able to use a breast. it sounds like you are doing everything you can with you and your family. what sort of resources are you taping outside of the family? have you met with a LC or two? how about a la leche league meeting? i found these to be helpful in the beginning. and i know this might sound silly but what about just nursing, no sns?

[MarcyC]

Hi everyone and thanks!!!

Let me try and address everything. Let me also say, that I am not trying to come up with excuses not to breastfeed. I'm just being honest and telling it like it is...

Resources outside the home - I've seen two LC's, and had a phone consult with a 3rd LC. I see my LLL (who is also a friend) each week at our homeschool group. I've seen our regular ped. I've had a second opinion visit with another ped who was recommended by LLL Leader and an LC. I've seen two ENT's and a pediatric dentist. The only person who correctly diagnosed his tongue tie was the second LC I saw (and she was paid for by a lactivist mama here on MDC who I've never actually met in real life). I'm also using a hospital-grade rental pump that I have through Feb. 2nd. At this point, our financial resources are tapped out. And, yes, I know the expense of formula. It's like this. If I could pay one more doctor who would absolutely assure me that he could take care of this problem, I'd do it in a heartbeat. But right now we're paying all these health professionals, the problem isn't getting fixed, and we still have to buy formula. Financially, we're strapped.

Nursing without an SNS is not an option. He cannot transfer milk well because of the tongue tie. As it is, I have to use the largest size tubing of the SNS AND have the second tube open to equalize pressure (basically turning my boob into a flesh-bottle). He is mainly taking from the SNS and not necessarily stimulating my production at the same time. At the time we saw the *good* LC, she said he probably hadn't actually stimulated my supply since birth (he was 3 mos. at the time). She was surprised I had any milk left at all. If I try to nurse him without the SNS, he will starve.

I'm going to look into getting a hands free pumping bra on ebay. I can't afford one new right now so hopefully I can find one used. That might help.

Pumping after nursing is not really feasible right now. I need to multi-task. The older two are homeschooled and we've gone beyond the "3 R's" to include science, history, social studies, and religion. They are in 3rd grade so they need more than just the basics. That takes a lot of time as they are not self-learners. We purchased a homeschool computer program hoping that would help but it hasn't they need a lot of guidance. It's just their learning style.

I honestly don't think it's allergy related. He does have a physical problem. It's a Class III posterior tongue-tie. You can read more about it here: http://www.aap.org/breastfeeding/8-27%20Newsletter.pdf.

Jessica - you are right - the options are overwhelming.

Oh, and whoever said that if he can take a bottle, he can nurse. Not quite. Using a bottle is much easier for a baby because of the flow. The muscles used in bottle-feeding are very different than the muscles used in breastfeeding. Breastfeeding actually takes more work and coordination.

Now one more thing is added to the mix. Because of this...well because of everything....the homeschooling, the house being a disaster, the clutter, the terrible-two year old-tornado, and the breastfeeding difficulties, I'm spiraling downward. Way downward.

I'm already on zoloft for PPD, but last night on the way to church I had visions of slamming my car into a brick wall (and I had the baby with me). I've had thoughts, not just last night, but for a week now, that this whole darn family would be better off without me. The kids could go a public school with a real teacher who wasn't so pulled in many different directions. My toddler could go to a pre-school where she'd get the attention she needs and not a mom who is going back and forth between schooling and nursing. And the baby wouldn't have a mom who couldn't even nourish her own baby. Yes, I was thinking, they'd be better off without me.

I finally called my dr. this morning and he had me come right in. At first he seriously wanted to hospitalize me, but after a long talk just decided I should be on drugs for PPP (post partum psychosis, not just depression). Unfortunately, and he did a Hales check, the drugs for PPP are NOT compatible with breastfeeding. I went and got the script filled, but I'm not sure where I want to go from here.

[SKSsmommy]

I am so sorry. YOu NEED to take care of yourself first!! MY personal reccomendation would be to just use the formula and the SNS so that you can keep your "nursing" relationship , nourish your child, and keep your sanity. Since you don't think he is getting much from you anyway, I'd still take the med.Stop pumping since he can't have your milk with the med. that you NEED. Resign yourself to the fact that you did the best you could given YOUR circumstances. your baby WILL thrive. If you need to go to bottle go ahead, but I think for your sanity you will learn to love teh SNS nursing to keep the bond that you so desperately don't want to loose.

I had to give up pumping for my 3rd ds when he was 6months because of allergies and my sanity with 2 other small kids. He had a bilateral complete cleft adn I did the best I could. I was so upset to stop, but at that point he was 100% tube fed and I had to be a mommy to everyone. It broke my heart that I'd never get to nurse him. I am currently struggling to nurse my 4th with a bad latch and low supply. I know the toll. My biggest tie up is loosing the "bond".

DOes he nurse well wtih the SNS(even though its open) or do you have to still give bottles. Is that still too stressfull(and I can totally see why).

Unless someone has BTDT its really hard to understand the physical and emotional toll this stuff takes.

((HUGS))

[jessjgh1]

((hugs))

Take care of yourself momma... you have so much going on right now. Your kids need you and you need to be able to see that. Housecleaning and even schooling can all wait. You can lovingly nourish your children-- your love and presense is most important.


Jessica

[guestmama9904]

wow. way more comlicated than i assumed mama, im so sorry. your mental sanity does come first i think.

please note- there are safe anti-psychotics.

i too suffered from post partum depression with psychotic features. i was rx'd an anti-psychotic that also works as an anti-depressant xyprexa. as far as i and my clinical nurse practitioner who was rxing at that time researched xyrexa is safe for nursing. so its not true that no anti-psychotics can be used. i ultimately chose to take only zoloft but at a very high dose, 200 mg daily. it took 3 months for me to be able to titrate to this high dose and i experienced sever physical side effects. but after 3 months i was a different person, happy, motivated, no intrusive thoughts of suicide or harming my child, and best of all no thoughts that people were trying to harm me. it was a very very scary time in my life and i am telling you my story so you can know that its possible to get through. i was able to breastfeed normally but my child had no physical impairments. best of luck and healing to you.

[beru]

Originally Posted by MarcyC

Hi everyone and thanks!!!

I'm already on zoloft for PPD, but last night on the way to church I had visions of slamming my car into a brick wall (and I had the baby with me)...
I finally called my dr. this morning and he had me come right in. At first he seriously wanted to hospitalize me, but after a long talk just decided I should be on drugs for PPP (post partum psychosis, not just depression). Unfortunately, and he did a Hales check, the drugs for PPP are NOT compatible with breastfeeding. I went and got the script filled, but I'm not sure where I want to go from here.

I have bipolar disorder and have had psychotic episodes in the past. That puts me at increased risk for postpartum psychosis. I decided during my first pregnancy that I would do everything in my power to prevent that. Breastfeeding is clearly not the first priority for me-even though I feel very passionate about it. I have been able to succeed at breastfeeding because my current medication is compatible with breastfeeding and we have done some careful planning to safeguard my mental health. I and my family have been very lucky. If things had been just slightly different, then I would be on a different medication that is not compatible with breastfeeding. I wouldn't hesitate giving up breastfeeding if that is what it takes to safeguard my family's safety. And I am prepared to do so if it does become necessary. I support you in stopping nursing because that may be what you need to do to enable you to take the best care of your children.








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[PatioGardener]

MarcyC, First of all x 100 for you!

Would you consider donated milk? I don't know what the chances are of a donating mom in your area, but if there is one, would that be an option?

again!

[kathteach]

Marcy your baby needs a happy healthy mom more than he needs breastmilk. If I get busted for saying that here well then I do, but honestly, look at the research as far as depressed mothers and infant growth. You have done one h3ll of a job and you should be PROUD. Not many would, including those who are holding you to impossible standards in this very thread. It breaks my heart to see you go through this. I am going to be very bossy here and say I think you should take meds to get a more objective view of your situation. BF compatible meds, whatever. You don't have to stop. But you need mental health help to make a clear decision. I don't want to say more because I'm not sure about TOA or whatever it's called.

And as far as the posters who are saying you MUST give your baby breastmilk, well, they can go ahead and start pumping and then ship it to you.

[guestmama9904]

kathteach- i dont think anyone here is saying this struggling mama HAS to give her baby breastmilk. I personally just was trying to impress upon her that I suffered from severe ppd w/ psychotic features and was able to breastfeed normally and safely. It can be done, but the OP has extreme stuff going on including a baby with a physical impairment. im not suggesting every mom can do this. and i would love to "ship" my breastmilk to her except that i havent made any in over a year!

[MarcyC]

Thank you so much! I've called my doctor and we've decided (for now) just go with a higher dosage of zoloft. I'm only one 100 mgs., for now so we're going to 200 mgs.. If that doesn't work he's agreed to try me on a "breastfeeding-friendly" anti-psych med., but if that doesn't help he feels really strongly that I take a med. for myself and quit BF'ing. He's worried about me and told me flat out that it's better for the baby to have a mom who formula-feeds than to not have a mom at all. I also have to check in with him, either by phone or in-office, at least once a week. He's also referred me to a psychologist/counselor. Don't know when exactly I'd fit that into my schedule unless they have night/weekend appointments, but I'll try.

Now...getting back to my original reason for posting...I do believe that all babies were meant to be breastfed and deserve breastmilk, but I do think his cues are saying he doesn't want to breastfeed. Think of it in these terms: say all people were born to walk, yet you were born with a physical impairment that didn't allow you to walk. One doctor says there is a surgery that can be done, but even with it, there is no guarantee. Another doctor says you don't have a problem, even though you know you can't walk. Yet another doctor says he has a way to "make" you walk, yet every time you do, it just ends in tears and frustration. Now...do you REALLY WANT to walk and be totally in tears and frustrated every time, or will you just accept the fact that you can't?

Think about diabetics or people with allergies. My DH is lactose intolerant, yet he LOVES ice cream. He's willing to deal with the physical pain it causes him in order to eat his ice cream. Some people, however, will go without the ice cream to avoid the physical pain.

EACH AND EVERY nursing session ends up with either he or I or both in (severe) emotional distress. Do you think he's meant to breastfeed that much that the emotional distress is worth it? Or do you accept the fact that he has physical limitations that will (at this point) more than likely go untreated and let him have a bottle in peace and tranquility?