Continued from Part One – breastfeeding hurts, and maybe I have Reynaud’s.
I didn’t have maternity leave – I only had about two weeks fully off from work, at which point I returned part time, and ramped up to full time by five weeks (mid november). So Eliza and I only got to try nursing in the evenings, between 5:00pm and 9:00pm – which was also the time of day when she was crankiest. At the time, I thought it was possible she had some nipple confusion, but in retrospect, I think it was more the time of day and her mood. We were both pretty clumsy with the positioning – I had a boppy pillow but didn’t find it very helpful. I’d usually get Kevin’s help getting her into position, stuffing pillows and blankets everywhere, holding her arms down. She would inevitably get angry and start to holler, and then I’d get upset and have to hand her off to Kevin. Milk would get everywhere. This would all take at least half an hour, longer if we were remotely successful, and by the end, I’d need a shower and a change of clothes (and a hard drink). And then I’d need to pump.
I went back to the LC several times to work on positioning and latching, the latter of which is still impeded by Eliza’s tiny tiny mouth. The pain is very intense still, radiating back from the nipple, and it didn’t go away completely when I wasn’t nursing or pumping. It didn’t get better over time, despite the medicine (nifedipine for Reynaud’s, and an anti-fungal for thrush). The LC is more and more convinced the problem is Reynaud’s, because my nipples never stop being purple even when I don’t nurse for days. She was totally geeking out over my boobs – calling in her LC friends to look at them, and even taking a picture to show some folks in Seattle (with my consent, of course).
After a few weeks with no improvement, when Eliza was about six weeks old, my doctor upped my dosage of nifedipine, the vasodilator. The pharmacy screwed up the prescription, so that instead of doubling the dose, I was suddenly taking SIX TIMES the dose. For two days until I figured that out, I could barely stand up without passing out, and had a raging headache, but I could nurse 90% pain free. So I was finally convinced the main problem is Reynaud’s.
I was relieved to know what is wrong, but still not sure what to do – I couldn’t keep taking that dosage of medicine, and even when I did, I had to nurse Eliza literally every hour because she couldn’t get enough milk to stay full longer than that. Also, to even try nursing exclusively while I was at home, I had to break my regular pumping schedule. This was a huge mental leap, as I was so terrified of what would happen to my already inadequate supply. So basically, I was ready to throw in the towel, and that was what made me able to nurse her even somewhat effectively – so that she was hungry at the same time my breasts were full. In order to let myself try, I did a lot of data analysis… we have this phone app, baby connect, where we had been keeping track of everything – diaper changes, bottles and amounts, and I had been using it to time my pumping sessions (and record the volumes). So I analyzed my pumping. The effects of duration of and interval between sessions on the volume. And I found that they had little effect – I basically always produced half a mL per minute of breastmilk, about 700 mL per day, whether I pumped ten times or six, it was about the same.
Once I cut back to the correct dose of medicine, the pain came back – varying between a 2 and a 6 on the pain scale during nursing or pumping, which was a huge improvement …. but still pretty bad, considering what percentage of my day I spent feeling like that (two to three hours a day actually pumping, and another hour or so washing pump parts, getting set up, etc.). I’d also get clogged ducts every few days, which would ramp the pain back up. I spent every day vacillating wildly between wanting to stop, hating it, and thinking I could manage to keep doing it for a long time, another week, another month, maybe this is going to work out just fine.
Around this time, when Eliza was six to seven weeks old, a number of things happened. First, Eliza starting sleeping in longer chunks – first four hours, then five, then one night – nine. I still woke up every three hours, whether by an alarm or from engorgement. Resentment was building towards my husband, who was getting to sleep as long as the baby, and towards the baby, for… sleeping? for having a tiny mouth? I don’t know. But it reached some boiling point and I decided I didn’t care – I wasn’t setting an alarm any more, and I would cut back to pumping less. So I started getting more sleep, and was pumping four to six times a day, with only maybe a 10% decrease in my supply. Also in this time period, I realized the baby was far better at unclogging my ducts than the pump was, even though the pump was better at fully draining my breasts. Then, the headaches I’d had as a side effect of the nifedipine started getting less severe. Finally, I had been downloading books to read on my kindle app on my iPhone, and found that I could ignore the pain much better, and actually almost looked forward to pumping, if I were in the middle of a good book. So that’s: sleeping baby, sleeping Susie, hoover baby, improved headaches, and good books.
That winning combination, along with Eliza’s increasingly large mouth, has seen me through a slow decrease in pain over the last two months. At some point I stopped taking the nifedipine – I kept forgetting doses, and then didn’t take it on a trip. That basically brings us to now, which I’ll write about in a final installment.