Breastfeeding issues

About the time I took Will for his two month check up, I was starting to get a feeling something wasn't quite right. He had gone from sleeping and settling really reliably, to being very restless throughout the day. By this stage we were down to one night feed, then waking about 5am for his first morning feed. Will had gone from really happy and settled to really... not. One of the things they tell you to look for is enough wet and dirty nappies. He was over the line, but not by a lot. I felt like he was looking a bit lean. He had been measuring up around the 85th percentile, so he had always been quite chubby. He was certainly growing, but he was a stretched out string bean. I had mentioned it at his last check up, but they weren't concerned, particularly as he was still sleeping through. 

Then he stopped settling at night. I'd give him his feed, put him to bed and half an hour later he'd be awake, hungry again. I'd give him a top up and he'd go to sleep and stay asleep until morning. I'd been hand expressing and storing the milk in the freezer. Over a week these top ups went from 60ml to 120ml and I was convinced I wasn't imagining things. 

We went off to see the lactation nurse I'd seen while we were in hospital still. She listened to me and my list of things that weren't quite right, yet weren't glaringly wrong either. Guess what? In the two weeks since our last check up, Will had gone from 85th percentile, to 15th! He had actually lost weight!

It took her about 2 minutes to work out the problem. When I was discharged, my medications had all been checked for safety during breastfeeding. What hadn't been checked, was the long term effects. It turns out ditropan (oxybutynin) suppresses breast milk supply when it's used for prolonged periods. My happy baby was grumpy because he was starving. 

Side note for those of you who don't have SCI- a para of my level has a reflex bladder. That means that when my bladder fills to about 200ml, instead of stretching like most peoples, it just empties right away. Ditropan allows my bladder to relax and stretch as normal. This means I don't have to spend my whole day racing to the toilet and I have far, far less bladder leakage issues!

Since I kind of need my ditropan, we had to find another solution. More drugs! I was prescribed domperidone, which is an anti-nausea medication with the happy side effect of stimulating the pituitary gland, responsible for milk production. I started on 30mg a day, and could increase (up to 60mg) or decrease to see how much I needed. It turns out 30mg is about right. It starts to kick in within a couple of days and settles after a week or so. So in the meantime, my starving baby got to have a go at some formula. Within days Will was settled and happy again. 

Skinny baby gets a top up!

When I went to get my script renewed, I had the doctor weigh Will to see if we were making any progress. He had put back on the weight he had lost, meaning, at 12 weeks old, he now weighed the same as he had at 6 weeks! But at least we were on the right track!

The other way to increase milk supply, is to increase demand. So, after every feed, I was also expressing. At first it was only 20 or 30ml, but that quickly increased as the domperidone began to work. Will was sleeping overnight, but I didn't want my body to know that, so for a good month or so, I was getting up overnight to express. I'd express before bed then get up about 2am and again about 5am. 

There are dozens of pumps on the market to help with this. I tried several, manual and electric before I gave up and just went back to hand expressing. I just found for me it was much more effective. I do really have to make sure I don't let my hands get dry though, because I will give myself sores. 

  

It is quite common for babies who bottle feed to reject the breast completely, but Will has managed to continue with a combination. I found as he got bigger that he got distracted feeding very quickly, so we switched to bottle feeding breast milk through the day, to make sure he was getting enough. We still have a breastfeed and cuddle in bed to start our day, but all his other feeds are now from the bottle. I think about quitting expressing every day, but I haven't yet. 

2 months

After two months, things are starting to settle down a bit. I'm feeling a bit more in control, I've worked out how to pick Will up without dropping him. I feel like I've sort of, maybe, a little bit, kind of, got this under control. 

We have changed things around a little bit in the bedroom. Furniture. We moved the furniture. We have moved out my bedside table and put the bassinet beside my head and I park (9 years in and I still don't know if that's the right word) my chair facing the bassinet. It means I have to turn around on the bed, but I'm closer to where I need to be. 

I learned pretty quickly to always bring a spare nappy or two and wipes to bed. I also bring some of my chair cover/waterproof mats, which are the perfect size for a small baby, so when he wees from a cold bum in the middle of the night, it doesn't go all over the doona! 

The original plan was that I'd feed, then Tim would do the nappy changes overnight. After a couple of weeks though, he was become harder and harder to wake, so I just do the changes too. 

Remember how I had had to borrow a truck-sized wheelchair to get me through my last few weeks? Well a couple of weeks post-birth we were able to return that and I was able to get into my farm chair. My farm chair is my original post-rehab chair and 5.5cm wider than my usual chair. Still wide, but only a small, short truck. I don't think I've been so happy to see that chair since I first got it! It was like a zippy little sports car! It also means that I can drive again (after my 6 weeks post Caesarean of course) because I can get that one in and out of the car myself. 

Driving means getting Will in and out of the car by myself too. We have a capsule, which weighs a couple of kilograms, plus the 4kg he weighs... Well it has taken a bit of practice, but I think I've worked it out. most of the time I can get him in and out without much trouble. It looks awful and I wouldn't try it without him strapped in properly, but I can do it! Freedom!!!! 

The first time I went into town by myself, it took me six minutes to get us both out of the car. Well, that gave us something to improve on, and we did. I played around to start with, to see if it was easier to get him out of the car in the capsule, or to get into the back seat, then get him out with me, then me into my chair, then pick him up. It was a long-winded as it sounds. Once I worked out the right technique for the capsule, it was heaps quicker and easier. The other great thing about the capsule is that he will stay asleep when I'm getting him in and out of the car. 

Most of the time I use the pram, but I do use the baby bjorn carrier sometimes, like if I'm doing a big shop at the supermarket. All those trips with my basketball chair has prepared me for pushing a pram though- I find it so easy! We zoom around! 

All rugged up, ready to go see the cows

One of the logistics I hadn't quite worked out in my head, was my morning bathroom routine. At this stage, it has been really easy, I just go while he sleeps. So while that lasts, I'll take it!