14 October 2013

Why Noah Won't Be Breastfed

For any who didn't know, I induced lactation earlier this year for an adoption that didn't work out. I started in February or March and made it about a month until I HAD to pump because my milk kept letting down. Then I took a break in May and picked back up until we learned that adoption wasn't going to happen.

The day Noah's birth mom chose us I started back up with the lactation induction :) I wanted to at least try. If it didn't work I would be fine with that but I wanted to give it my best shot. This time my milk started letting down after about a week. I think it worked more quickly this time because A) I had done it before, very recently, and B) I had an actual, real-life adorable baby in front of me that I was producing for.

All my induction stuff. A prenatal, Fenugreek, Blessed Thistle, Mother's Milk, Progesterone and Domperidone. Also Mother's Milk tea isn't in the picture. I took Fenugreek to help my supply while nursing Aurelia.
We waited until papers were signed and we were officially his parents before bringing in my frozen milk from earlier in the year. I wish I could've seen me walking into the NICU with my frozen milk :) I was SO happy and SO proud of everything I had done. I. MADE. MILK! For my baby! A baby I didn't give birth to! I proudly handed over the milk and explained that it wasn't a ton but it came from MY boobs, it started off with colostrum AND it was going to be great for him :) Hooray! It really felt so good that the milk I had worked so hard to produce earlier in the year was not only going to a good use, but that that good use was my own son :) I wanted to get pumping so Noah could continue having milk after my frozen supply ran out.

My frozen milk lasted little Noah almost two weeks. I felt bad that I didn't have more and couldn't do more but nurses kept reassuring me that I was already willingly doing something really hard and really awesome for Noah. One nurse reassured me that even though it didn't last terribly long, Noah got my milk during the most crucial time, the recovery from his malrotation and g-tube surgery.

Originally the plan was to try breastfeeding Noah as soon as I felt I had something there for him to eat. We hit a hitch though in that he has something called Micrognathia. Basically it's an abnormally small lower jaw which also means his tongue is further back in his mouth. He also has a higher pallet. This makes any kind of oral feeding really difficult, but especially breastfeeding. 

In the NICU Noah was rarely taking a bottle and when he did he wasn't taking much. We were told he had done better at first but for some reason had gone downhill. Sucking is extremely difficult for him with his tiny, tricky shaped mouth. I spoke with lactation, nurses and the neonatologists, and while all of them were incredibly supportive of my efforts, they all gently let me know the chances of him being able to breastfeed were next to zero. Still I carried on with the lactation induction, planning to provide him milk through whatever way we would have to get it into his tiny body.

A few days before Noah was discharged I nervously collected my pump kit and made my way to the pumping room. During my 30 minutes of pumping I sat there thinking. Noah had his g-tube put in a little over a week ago. All of his feedings were going through that tube and he couldn't tolerate them going very quickly. Each feeding took about 90 minutes. If I were to pump each time I would pump for at least 30 minutes, then put the milk in his g-tube for 90 minutes. That's already at least 2 hours. Then there is time to burp or vent him, take a short break and start right back up again. Where was the time for all that? I couldn't do that. Maybe if he were our only child then it would be only a little more realistic but especially with a toddler I just couldn't dedicate 2+ hours out of every 3 to providing my breast milk for him. The cost wasn't worth the benefit.

I finished pumping and disappointedly poured what little milk I had from the bottles into the tiny little container. I had only produced about 2mL. All the nursing staff and lactation staff had been so encouraging! They were so excited although I'm sure many of them were skeptical, maybe thinking I was exaggerating my previous success. Here I was having to walk back into the nursery with hardly anything to show. I was embarrassed. I had wanted to walk in there with a full ounce and say "SEE?! IT TOTALLY WORKS! ADOPTIVE MOMS CAN DO IT TOO!" I had hoped huge quantities would come quickly and easily, as unrealistic as I knew that was.

My first pumping for Noah after about a week of inducing lactation.

So I walked in the nursery and sheepishly handed my paltry pumping to the nurse. I told her I was disappointed and she said, "Why?! This is great! This is a normal amount for a first pumping by someone who had given birth. We'll go put this into his next feeding right now!" I was so relieved I almost cried. I really had done it. At least one time I had been able to give him fresh milk. I had proven to myself that it could be done and I was glad I had tried.

I had done everything I could for him, talked to the available experts, gave it my best and came to the best conclusion for us -- I would stop inducing lactation. 

I stopped all of the medications that day but my milk STILL keeps letting down :) It's weird but still pretty cool. I think it's amusingly ironic that my body is able to do this incredible thing and it can't be put to use this time :) It's funny :)

I'm really really proud of what I did and really glad I tried :) It's incredible that we had any success at all, and all that horribly difficult work I put in earlier this year really paid off when I was able to give that milk to our son :)

Right now we try a bottle at each daytime feeding and then feed the rest through his g-tube. At night he has a continuous feed through his g-tube that lets him sleep almost the entire night, or at least not wake up from hunger.

We've worked a lot with occupational therapy and are getting Noah set up with some other therapists to help with his bottle feeding. A few days ago he took an ENTIRE feeding (a little over an ounce) from a bottle! :) He makes this clicking sound with every suck and he's still working on coordinating sucking, breathing and swallowing but he's making progress :) We're being careful not to push him too hard, too fast and we're so excited and thankful for every bit of progress we see :) 

I am SO thankful for the support we received at the hospital. I fully expected to be met with weird looks, "you're doing what??"s and plenty of "just give him formula, it's just as good" but we weren't :) At most I expected people to let us do whatever and just stay out of the way, but instead we were encouraged and praised for my efforts and supported in whatever route we wanted to go :) Everyone at the NICU was so respectful of our choices and our efforts :)

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