September 8, 2008

Feeding Woes

It all started about three weeks ago. We'd just gone for our second pediatrician's appointment. The purpose of the appointment was just to make sure that PK had gotten back to her birth weight of 3.278kg. When we'd seen the doctor a few days after PK's birth, there had been a 100g drop in PK's weight since her discharge - 3.210kg - from the hospital. The doctor didn't seem to be concerned, since it appeared that PK was feeding well and was having regular bowel movements and pee. Then at our second doctor's appointment, we found out that PK hadn't gained any weight since that first appointment. The good news is that PK hadn't lost any weight since our first pediatrician's appointment, but of course, not gaining weight is never a good thing.

Usually, lack of weight gain seems to point to a problem with breast-feeding, so the doctor suggested a few things that we could do, such as increasing frequency of feedings and ensuring that PK was awake during feedings. She also suggested that we contact either a lactation consultant or go to a breast-feeding clinic to correct any breast-feeding issues, and told us to return to her office the following Friday (we saw her on a Monday).

The doctor was nice enough to refer us to a lactation consultant who made house calls, so we chose to go with that option over the breast-feeding clinic. We made arrangements to meet with the lactation consultant at our house on the Wednesday. She wanted to time her arrival with the beginning of one of PK's feedings so that she could see what I was doing wrong. Well, it turns out that I was doing plenty wrong, namely around getting a good latch. This was extremely surprising to me, given that the nurses at the hospital where PK was born made a point of checking the latch on both breasts before I was discharged.

At any rate, because my latch was bad, my breasts weren't producing as much milk as they should have been, which of course contributed to PK's lack of weight gain. In order to solve the problem, she suggested that I supplement my beast milk with formula. In order to avoid nipple confusion, she provided me with a little contraption which had a little tube that I could tape to my nipple during a feeding. This ensured that PK was getting both breast milk and formula, and that the extra sucking action on the tube would help stimulate milk production. She also suggested that I start taking Domperidone immediately. Domperidone is a drug used to treat stomach ailments, but one of its (unintended) side-effects is to increase milk production (in both men and women). We paid $200 for that consult, but it seemed to be well worth the money. The nice thing is that the $200 included free phone consultations for as long as I was breast-feeding.

When we went to the doctor's appointment on the Friday, we were pleased to find out that PK had gained 100g and was finally making her way back up to her birth weight. The doctor suggested that we book another weigh-in for the week following, to ensure that she was still gaining a good amount of weight.

I brought PK into the office for a weigh-in on the following Thursday, and the news was not so good. She had gained only 70g in 6 days - very dismal, considering that she'd gained 100g in 4 days the week prior. Naturally, I was extremely distressed. What was I doing wrong? Why was this breast-feeding thing turning out to be so hard when it had appeared to be so easy and so natural to me in the beginning? I felt like a horrible mother because I just didn't get it. It didn't make me feel any better when I contacted the lactation consultant for phone advice, only to find out from her for a second time that I was still goofing up. Sigh...

So now, a bit over one month after PK was born, I sit here a distressed parent. PK's weight gain has been dismal. She looks so teeny and dainty - it's just absolutely devastating to see that your child isn't gaining a significant amount of weight, especially compared to other babies of the same age around her. Since last Thursday, we've been taking more aggressive measures to ensure that PK gains the proper amount of weight, including upping her formula intake from the feeding tube. We've had some good days and some bad days with PK's feeding since last Thursday. The most distressing thing we experienced was when PK vomited all of her food after a feeding. Naturally I was upset because she vomited, but I was also concerned about getting food to her, since I was pretty tapped out.

Fast-forward to Labor Day weekend. After spending all of Labor Day morning trying to get PK to eat something, I made an important decision - I would introduce PK to the bottle. I've actually been quite stubborn about introducing the bottle to PK. They say that you're not supposed to introduce the bottle to a baby until 4-6 weeks after birth so as to not cause nipple confusion. We hadn't quite hit the 4-week mark when we introduced the bottle, but it was close enough, and fortunately she takes quite well to both the breast and the bottle.

That being said, making the decision to introduce the bottle this early into the game was extremely difficult and stressful. Throughout my pre-natal classes, I can't tell you how often I was told about the benefits of breast-feeding. Besides, how can you go wrong with nature? So when I found out that I didn't have enough milk and that my baby wasn't gaining any weight, you can imagine how inadequate I felt as a mother. I was unable to provide for my child. My child was not gaining weight because of ME! What a horrible feeling to have! Of course, I realized that it's even worse to hold on to the idea of breast-feeding exclusively when your child is not getting enough to eat. I had to put my pride aside and just suck it up.

In the end, I'm happy with my decision. PK's weight gain is finally on track. As of our doctor's appointment last Wednesday, we found out that she gained 210 g in 6 days. That alone made my decision worthwhile. Not only that, but our pediatrician was completely supportive. This was a huge sigh of relief, since I was afraid that she would turn out to be a member of the Breast-Feeding Police. Goodness knows that that's the last thing I needed. I've heard enough stories of couples being lectured by their pediatricians for deciding to formula-feed. PK's health is our top priority, and if it means that we have to supplement her feedings with formula, then so be it. As I said before, she does seem to take both to the breast and to the bottle, so she's still getting all of the benefits of breast-feeding.

1 comment:

Fawn said...

I honestly think that there is much too big a deal made out of babies' weight gain. I've seen other moms go through the same distress and anxiety and guilt... I"m not convinced that it's necessary.

Having said that, I'm glad that you were able to make some decisions that have brought all of you some relief! We tried introducing a bottle to Jade at 5 weeks and by then it was too late for her... she absolutely wouldn't take more than an ounce of milk out of one of those weird contraptions. She finally did start taking them at 7 months.

I don't regret that I exclusively breast-fed, but man, there were times when I was dying for a break where I would really have welcomed Michael being able to feed her.

It's quite a roller coaster - hang in there!