After struggling with my first few days of breastfeeding, I realized that I needed help. Reading through my many pregnancy books, breastfeeding books, and copious websites just wasn't cutting it. I was in so much pain and I could not fix it by myself. I rifled through the many brochures from the hospital that we had delivered at, then called and made an appointment to see a Lactation Consultant. I was so happy that I would finally get some help, but because Little Deer was born around Christmas, most places had limited holiday hours. They were able to get me in as soon as they could, but it wouldn't be for a few days still. I knew I wouldn't be able to last that long, so Mr. Deer and I tried to think of some other solutions.
Since our insurance is through the military, they're very specific on what providers you can see. We knew that they would cover seeing a LC at our hospital, but that we would likely pay out-of-pocket if we saw somebody else. I think Mr. Deer and I both wanted to get help as quickly as possible, whether our insurance covered it or not (and hopefully we could send in a claim and possibly get reimbursed). We decided to call our doula and she quickly recommended a Lactation Consultant that lived close by to us. She had nothing but wonderful things to say about this LC, not to mention that she did home visits. The idea of not even needing to leave the house at that point sounded glorious.
After getting the LC's phone number, we quickly gave her a call. When I think back to talking with her on the phone that day, I remember just feeling such a sense of relief. Even though nothing had changed in that moment, just knowing I was talking to someone who knew what they were doing and wanted to help me was so wonderful. As I recounted what our last few days had been like, I broke down in tears. She was very encouraging, and told me it would be ok and that I could do this. She then asked me lots of questions to try and figure out what was going on. Through her detailed questioning, she quickly determined that:
- My breasts were swollen from the pregnancy and the three liters of fluid I received while in the hospital.
- On top of being swollen I was also engorged from my milk coming in.
- Little Deer was likely not latching correctly, and the above points only made it harder for her.
She had a few things she wanted me to try, and she was hopeful that the nursing would get better soon. She wanted me to eat lots of watermelon to help with my swelling, put cold cabbage leaves over my breasts after nursing, use lots of lanolin, and to try nursing while leaning back and allowing LD to find the breast and latch on herself. I talked with her early in the morning, so we had the entire day to try all of these things out. Though they were all great suggestions, by late afternoon I hit my breaking point. I called her back, on the brink of tears yet again, and explained that I needed her to come and see us. It just wasn't working. Her children were home from school for the holidays, so she quickly found somebody to watch them and headed over (bless her).
She arrived at our front door carrying a tote with her supplies as well as an infant scale. While Mr. Deer held a snoozing Little Deer, the Lactation Consultant sat down on the couch with me and we talked more about what was going on. She had a pad of paper out and took notes throughout her visit. After we talked, she examined both breasts. As she had suspected, I was still swollen and super engorged. I also had open and raw wounds on my nipples. She asked if we had a breast pump and I said that we did, but I didn't really know how to use it. She said pumping a little would help since my breasts were so full. She was pretty impressed by the amount of milk I had, and said that if I didn't already have so much on my plate I should consider donating my milk (maybe the next time around!). She first showed me how to hand express some milk, then she showed me how to use our breast pump. She noted that the flanges that came with our pump were too small for my breasts, and quickly pulled some larger ones out of her bag. Once I was hooked up, she showed me what the various buttons did, how I should clean it, and even the in's and out's of storing breast milk. That was all so helpful!
After talking about pumping, she wanted to address my wounds. I had been using some nipple butter before and after nursing, but I just wasn't having much luck with getting them to heal. Really it makes sense since LD was nursing every few hours, and she didn't have a good latch. The LC said she was worried about them possibly getting infected, so allowing my nipples to heal would be really important. She wrote out a detailed plan for me (so nice to have it in writing when you're that sleep-deprived!). To start, she wanted me to go on 3-4 days of "nipple rest." I was to exclusively pump and bottle feed LD so that I could allow myself to heal. I initially balked at this. LD was barely a week old yet. I was worried about nipple confusion and the like, but she assured me that it was ok and that I needed to make myself a priority. If I wanted to nurse for many months to come, I needed to heal up and be well. She also included in the plan some salt-water soaks, lanolin, and wearing breast shells. Though not the most attractive things, wearing the breast shells would allow my nipples to not be pressed upon by my bra or clothes, and to get some airflow that would help with the healing. She also had some of those in her bag which was perfect.
The swelling and engorgement alone was enough to make it difficult for Little Deer to latch on properly, but the LC wanted to examine Little Deer and watch her nurse too. Right around the time that she was done examining me, LD woke up and quickly let us know she was hungry. Before allowing her to nurse, the LC looked in LD's mouth, felt around, had her suck on her pinky, then moved her around to look at her head, neck, and back alignment. She said she thought LD might have a slight posterior tongue tie, but that it was subtle and often times hard to diagnose. Also, she seemed to have a preference for turning her head/neck to the right and her back was slightly curved that way. She let me know that sometimes this could lead to issues with nursing. She weighed LD on the scale (so we could see how much she was getting form nursing), then worked to get her to latch on.
Even with taking her on and off the breast several times, it was hard to get her to latch properly. Even if you waited until she opened really wide, she still somehow managed to slip down and get a very shallow latch. Besides the pain, the tell-tale sign that something was wrong was that whenever we were done nursing, my nipple always looked like a smashed tube of lipstick (lovely visual huh?). This was often indicative of a baby with a poster tongue tie. She had me pull out my nipple shields (I had several different kinds from the hospital) and showed me which one she thought were best as well as some tricks to getting them to stay on.
After it was all said and done (she had been there probably over an hour by this point) she weighed LD to make sure she had taken in enough milk. Fortunately throughout our breastfeeding challenges, her trouble with latching never prohibited her from getting the milk she needed. I am still very grateful for that. Once she was weighed, bundled up, happy and fed, the LC sat down with us to go over everything we had talked about:
- We reviewed the protocol for my nipple rest and pumping schedule, as well as how I would store my breast milk and feed LD with a bottle.
- She went over the steps I would take to facilitate wound healing including the salt water soaks, lanolin, and wearing the breast shells.
- She wanted us to make an appointment at the Seattle Breastfeeding Medicine clinic to get LD checked out by a physician who specialized in breastfeeding issues so we could address her possible tongue-tie and body alignment.
- She talked about our plan for after the nipple rest. She was hopeful I would be less swollen by then and that it might be easier for LD to latch, but if not she wanted us to go ahead and use the nipple shields.
It was such a great visit, and I honestly don't know that I could have made it through the breastfeeding experience if it weren't for meeting with this Lactation Consultant. Her ability to quickly come over to our house, thoroughly examine both LD and I, and then write up a detailed plan… It was beyond awesome. She also encouraged me to call or text her if I had any questions. The entire visit ended up being $150, but she deducted $25 for us being a military family which was very sweet, so the total came to $125. Though she emailed us an invoice that we were able to send in to our insurance company, I would happily pay it all again in a heartbeat. It was so worth it.
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In my next post I'll talk about how actually implementing our breastfeeding plan went, and where we went from there. This was by no means the end of the challenges we faced, but we were finally heading in the right direction.
Did you see a Lactation Consultant? What was your experience like?