May. 13th, 2005

rivka: (family)
I am holding a sleeping baby upright on my lap, letting her digest for 30 minutes befor I put her back to bed. She's been on the Zantac for about sixteen hours now. It hasn't kicked in yet, but fortunately she doesn't usually have as many symptoms at this hour of night. My pamphlet on "breastfeeding the baby with reflux" says that it's often less painful to them to eat while sleeping, which she more or less was for this bottle. No symptoms ten minutes in - I'm keeping my fingers crossed.

We spent today trying to reintroduce breastfeeding. Alex was delighted. She latched on and held my nipple in her mouth, snuggling up and curling one hand posessively around my breast. She patted me happily. Here's whta she didn't do: nurse. She took the occasional sip, but nothing you could really call nutritive. So I'd put her to the breast and cajole and harry her, and then afterward I'd need to give her a bottle to keep her nourished. With her weight gain problems being so serious, I can't afford to wait out a nursing strike.

So instead I spent the day getting progressively more hysterical about the possibility that nursing just isn't going to work fot us. All day I kept thinking about a link [livejournal.com profile] porcinea posted to an article explaining the vital importance of not ever letting formula-feeding mothers think what they're doing is okay. We shouldn't say formula is "second best," because it's much further down the list than that, after nursing, pumping and bottle feeding, using a milk bank or wet nurse, and possibly letting the baby roll around on the floor eating lint. We shouldn't say "breastfed babies are healthier," we should say "formula-fed babies are sickly." And on and on. People posted approving comments in [livejournal.com profile] porcinea's journal. I haven't been able to get that article, or the people I know who really do feel that way, out of my head.

It's so important to me to make it work. It's so much better for her health. I know that. But I also wonder how long I can realistically keep trying, if she doesn't start taking in large amounts of calories from the breast soon. I mean, this is what our current feeding system looks like:

1. Nurse. Prod the baby to keep her from sleeping on the breast, and attempt to cajole her into taking more than just a few dainty sips. This step takes about 30-40 minutes.
2. Give her a bottle, adjusted downward from 2.5oz depending on how much she seems to have taken from the breast. Today that mostly meant 1.5 to 2oz of expressed breast milk/formula.
3. Hold her upright for 30 minutes to reduce reflux symptoms. Usually in here somewhere the reflux kicks in and she starts yelling and arching in pain.
4. Attempt to comfort and soothe the hurting baby.
5. Try to find a way that the baby will tolerate being put down so that I can pump breastmilk.
6. Pump, if possible. This takes 20-25 minutes for pumping and washing up.

She eats every two to three hours.

So the anecdotes people are posting about "I know a woman who pumped and fed bottles for months and then successfully established nursing" are kind of inspirational, but kind of terrifying. I couldn't keep this up for months. I would quit trying first. That probably makes me a bad mother, or at least, so I told myself all day. I'm not ready to give up trying yet, but I'm already being hammered by anticipatory guilt.

This evening, at last, she nursed with a little more authority. Not enough to count as a whole feeding, but enough to count as actual food intake. We'll see if she continues to improve tomorrow, or if we'll find ourselves back at square one. Also I talked to my sister, who reminded me that breastfeeding is not an all-or-nothing thing. Every bit Alex gets will help her, even if it's never enough to be her sole source of nutrition. So we'll keep doing whatever we can.

Yes, I am keeping in mind that my guilt and frustration might be symptome of postpartum depression. We are all keeping a very close eye on that. I don't think I'm there yet - I think it's more about stress and sleep deprivation and physical illness at this point. I mean, look at that feeding routine up there. You don't have to be depressed to find that overwhelming, right?
rivka: (family)
Alex is asleep in her sling. She has had five feedings in a row without reflux symptoms.

Oh please. Please. Please.

(My post of last night had a math error in it. At the time she had been on Zantac for 28 hours and four doses, not 16 hours. She'll get her sixth dose when she wakes up from this nap. Maybe it really has had long enough to work. Oh please.)

It occurs to me now that she's been just as sleep-deprived as I have, from the reflux. Before it got bad she napped after most feedings, but when the reflux is in full swing she starts to drift off to sleep and then jerks awake, screaming. Poor kid, she wound up overtired as well as in pain. No wonder she was so fussy. Today she's been sleeping well. Of course, I haven't tried to put her down, or anything. I have no problem with having someone hold or touch her 24/7, at least until she's feeling better and stronger. It makes sense to me that she'd have a very high need for contact just now.

She nursed moderately well last night and this morning. This morning I felt like the feeding was satisfying enough that she didn't need a bottle added on immediately - although I did need to pump afterwards to drain the mastitis-y breast. It may actually be plausible to have her start getting every other feeding exclusively from nursing, as the lactation consultant suggested. (We'll try again when she wakes up.)

This morning, while I was reading all of the wonderfully encouraging responses to my last post, I heard a gurgle. I looked down and Alex was smiling up at me. We grinned at each other like crazy fools for a full five minutes.

I am feeling much less insane today.

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