Monday, September 30, 2013

Breast feeding

No one ever really talks about how difficult breast feeding is. The only inkling I had from reading other infertility blogs of people who had "crossed over". I read many accounts of people who struggled and never found a blogger who successfully breast fed twins. 

This article recently explained exactly how much help and support most people need in order to be successful with breast feeding. As much as having the girls in the NICU was incredibly difficult, I'm so grateful it brought me into contact with the lactation consultation Char. I'm a firm believer in the fact that things happen for a reason. I'm positive that without Char I would not still be breast feeding. 

As part of our discharge from the NICU the doctor offered to send a home health nurse to the house to weigh the girls for the first two weeks. We gladly accepted and waited to hear from someone once we got home. 

Last Tuesday a nurse named Sue called me. We spoke briefly over the phone and she informed me that she was also a lactation consultation in addition to a nurse. I'm not going to lie, over the phone I didn't like her at all. She seemed a bit critical of how we were doing things; using a shield to nurse the girls, keeping them on a schedule, etc. We made an appointment for her to come over on Friday morning to weigh the girls and we scheduled it around a feeding time so we could get her input. 

On Thursday evening I noticed that Clara's tongue was a little white. I didn't think much of it but took note. That night while nursing I noticed that my nipples were super sensitive, almost itchy while the girls were feeding, and I had some weird sensations while pumping that were like super quick little shooting pains in my breasts. I didn't think much of that either to be honest. 

The nurse Sue came Friday morning and really redeemed herself. As soon as she saw how little the girls were and when I demonstrated my attempts to get Clara to latch without the shield I think she understood. She saw that their mouths are really small and that she really struggled without it. She was very positive about how the girls were gaining weight so well and how great they did nursing.

I had been doing a lot of reading about breast feeding and came across information on thrush. When the nurse came on Friday I mentioned Clara's tongue to her and she took a look. We got some wet gauze and tried to remove the residue on her tongue to no avail. She then asked if I had any symptoms. When she told me what they were I knew something was up. She told me she would call the pediatrician's office with the weights but also tell them about the thrush. She was hoping they would go ahead and treat it without making us go to the office. She also told me that Lucy and I would also need to be treated or else we could all pass it back and forth. 

I called the pediatricians office around 1:00. They wanted to see the girls and scheduled us an appointment for 2:50. I then asked if they would be able to treat me and they told me no so I called my primary and scheduled an appointment for 2:00. We quickly fed the girls, I pumped, and we dashed out the door to my appointment. 

My primary looked at my nipples and said they would be happy to treat it and call in the prescription cream to my pharmacy. I brought one girl into the exam room and W waited in the waiting room with the other. 

From there we headed to the pediatrician. We had been earlier in the week and were pleased with the Dr. Rather than seeing the Dr. they had us see a PA. She examined Clara and didn't seem convinced. She was really looking for lesions on her cheeks, lips, or gums and found nothing. She then said she wanted to call the Dr. in to get his opinion. When he came in he also looked and then concluded that he didn't think Clara had it. He said he would bet that she didn't but was willing to treat the girls if we really wanted. They asked us what we wanted to do and I was suddenly completely unsure. They said they would give us a few minutes to think about it and stepped out. 

W was more inclined to not treat it, especially if they didn't have it. I was super confused and faced one of my first tough mommy decisions. We decided since we would be back on Monday that we didn't necessarily have to treat it immediately. We could wait and see. When the PA came back in I asked her if she would look at me to see the whole picture and she said she couldn't since I wasn't a patient there. We left without the prescription for the girls and with me confused and overwhelmed and practically in tears. 

When we got home I saw I had missed a call from the nurse Sue. She wanted to know how we made out at the pediatrician and I called her back and told her. She was super frustrated and said she was  quite sure Clara and I both had it. She urged me to treat all of us and we talked for a bit. When we hung up I was even more confused. I had the home health nurse/LC and my primary telling me I had thrush and needed to treat it and the pediatrician betting we didn't have it. Since it was close to 4:30 at that point I asked W to call the pediatrician and get the script called in for the girls. That way we had it and could decide from there. 

At that point I pulled out Char's card and gave her a call. She was so happy to hear from me and wanted to know how we were all doing. She also told me that it was her first day back in over a week and that morning she had gotten my card. She said she was so touched by my card that it made her cry. We chatted for a few minutes and then I asked her about the thrush. When she asked about symptoms and I described what was going on she was quick to confirm what my gut was telling me; Clara and I definitely had thrush and we needed to treat it ASAP. 

She gave me a lot of instructions on sterilizing the shields and pumping equipment, using a vinegar and water solution to wash my nipples before and after every feeding, how long to take the medications for, what to do with my frozen breast milk during this time, etc. She was, as always, incredibly helpful. 

W ran to the pharmacy and picked up all of the medications. I will need to use a cream on my nipples four times a day for two weeks and the girls needs to have the same medicine in oral form also four times a day. 

I'm so glad we are being proactive about things. I don't want to wait until the girls mouths are covered in lesions before we take action. I was in enough discomfort already. 

I'm feeling a bit better. I'm less sensitive and nursing hurts a little less. I also noticed on Saturday that Lucy's tongue has the smallest little bits of whiteness on it. 

I didn't think breast feeding was going to come with so many challenges, but I'm so grateful for both lactation consultations who I've met. They really know what they are talking about. We are now 27 days into exclusively breast feeding and I couldn't be prouder. It hasn't been easy, but I will persevere, especially with support. 

15 comments:

  1. Congrats on sticking with the breastfeeding! That is amazing! I also had a frustrating time with diagnosing thrush and had a similar experience of one lactation consultant saying I definitely had it, and then a doctor saying I didn't have it. It is apparently a hard thing to diagnose, but all I knew was I was in terrible pain, so I thought, why not treat it and see if it goes away with the treatment. Doing nothing did not seem to make sense. I hope it gets better for you. I'm glad you are getting some good help, even if the advice is conflicting at times. Keep up the great work, Mama!

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  2. You are doing awesome!!! I never had enough milk to just nurse the boys, but I'm so thankful they were able to nurse some for seven months. It is a hard and super time consuming commitment for twin mamas, I commend you for keeping it up! There are a lot more mama 'gut' decisions on the horizon, but the first one is the hardest :)

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  3. KUDOS to you for getting second opinions and following your gut!! My friend Jules successfully breastfed twins (and still is - they're nearly 2). http://twopinktulips.wordpress.com/ Feel free to shoot her an email if you have questions - she would have no problem helping!

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  4. Wow good for you for following your Mother's Intuition! I have a friend who just pushed through the really tough period of nursing and said she is so proud of herself for making it to the other side.

    Good for you Mama!

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  5. Aw you are an inspiring mama! Thanks for sharing both the struggles and the successes.

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  6. Congratulations on nursing them! I have a friend who exclusively nursed twins for a year and a half! They never had a drop of formula or milk until she got pregnant and ended up with Hypermesis and just couldnt nurse them anymore. So, it can be done!!!

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  7. Good for you on both the nursing front and for pushing the thrush issue. I hope everything continues to get better from now on!

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  8. You are doing a great job! it will just keep getting easier and easier as they get bigger and you will be able to lose those shields. I have successfully bfed my twins for 14months and we are still going strong. Around 2 months it was so very simple, like changing a diaper. Mine were born at 33 weeks.

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  9. Ya know, I am really hoping to exclusively breast feed my twins when they come, too. But I'm also trying not to assume that it will be all easy and roses and lovely. And to not get too terribly attached to the idea in case there is something completely outside of my control that prevents me from going this route. (Except, I'm failing, because I am incredibly attached to the idea.) But thank you for talking about it, because you are right, there are not many twin blogs out there to provide encouragement (or there are, but I haven't found them). You give me hope!

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  10. I'm so glad that you had the LC/Nurse and Clara supporting you on Friday! Hope everything clears up with little drama.

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  11. I'm glad the first parental problem was solved successfully. Also, thank you for addressing this issue for others. You and W (double u-you were meant to have twins;) are already great parents. All the best!
    Sara-ff

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  12. I'm sorry you have thrush, Liz. I hope it stays away and I'm glad you got quick treatment. Breastfeeding is very hard in the beginning. I can't imagine twins. Does you hospital have a nursing support group? Aside from the wonderful LCs, my weekly support group helped me so much. It was a great way to get out of the house and still be able to nurse. I'm proud of you, mama. The girls are gorgeous.

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  13. That sounds incredibly confusing and frustrating to get different diagnosis. I'm so glad you have such wonderful Lactation specialists that have been able to help you. I hope I can be as fortunate in that regard. I'd like to breast feed my twins as well. Sounds like you are doing a great job!!

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  14. Breastfeeding twins is not easy! I am hoping it gets easier with more time. Good for you for being able to exclusively breastfeed at this point. I am still not quite there as far as supply but I am doing everything I can to increase it.
    Hope the thrush gets better soon!

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  15. I remember getting thrush while breastfeeding my daughter...it was horrible! Luckily, it goes away pretty quickly. Oh, and sunlight will help kill the excess yeast, so you can expose your breasts to the sun and it will help (if you get the opportunity). The girls are sooooo cute! I haven't been on in a long time...had a surprise of our own...and am just now seeing them!! Congrats!!!

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