Sunday, 1 February 2015

Down the rabbit hole

So, after two years of trying to get pregnant, then finally hitting the jackpot and carrying our little squish to term, our newest daughter was born on New Year's Eve via c-section.  It was a wonderful birth (compared to her big sister's arrival in the emergency version) and she was perfect - everything present and accounted for, her dark grey-blue eyes blinking in shock and awe at me from my chest, weighing in at 3.860kg (8 pounds, 8 ounces).  I was taken up to the ward, with my new daughter tucked under my blankets, with a grin from ear to ear.  I was absolutely elated.  She was here.  She was safe.

But things started to go downhill for us the following day when she wouldn't attach to breastfeed.  After trying to attach, my baby would get worked up and then fall asleep from the battle of trying to feed.  This went on for days with no help from the ward midwives because A) public hospital, B) public holiday period so skeleton staff numbers meant nobody had time, and C) being my second child, they figured I was fine.  But I wasn't fine.  My baby developed jaundice so was sleepy, lethargic and almost impossible to wake, which made our feeding/attachment challenges even harder, which in turn exacerbated her jaundice because she wasn't getting milk to help flush it out of her system - the only thing more difficult than trying to feed a newborn who can't/won't attach, is trying to feed one who keeps falling asleep!  I would keep trying, but was torn about whether or not to let her keep sleeping... because all newborns sleep a lot, right?  Right?  I would get upset and frustrated when she wouldn't attach despite her showing interest.  And she would get upset at not being able to get to what she wanted and would turn beetroot red, arch her back and stamp her little feet into my very tender tummy.  And we'd both be in tears.  And then we'd both give up and fall asleep. And around and around we'd go.

But on the afternoon of the fourth day, one midwife took charge of the situation and an anxious and engorged me, and told me to express and feed my daughter with a bottle of my expressed milk "because she's hungry, she's lost more than her 10%, you've got the milk so let's just get it into her".

"But she can't be that hungry because she isn't crying," I said, to try and reassure myself that we were really fine.

"Well, to a point," she replied.  "But newborns get to a stage where they just give up and will sleep."
Queue anxiety point #1 - my baby has given up trying to feed and is now sleeping until she dies!

Despite that 'throw-away' line, I am thankful that that midwife made a call that I was incapable of making at that stage - express every two hours and feed her that way - and we were able to go home from hospital the following day with that plan.  But in the wee hours of our first night at home, I remembered I had nipple shields from my first daughter that I never ended up using with her (and let me just say, I appreciate my oldest daughter's breastfeeding success so much more and on a whole other level now!), and she attached and was swallowing!  Cue choirs of angels!  No more bottles and pumps!

But a new battle was beginning.  She was still sleeping around the clock (11am to 7am the following day, I kid you not!), so we'd have to wake her every two hours to feed, but most times she wouldn't stir enough or long enough to either attach or feed for longer than a few minutes at best.  We would strip her off, wet her face with a washer, blow in her face, bath her and even putting ice cubes on her feet in an attempt to feed her!  She'd even do the same with a bottle, so it wasn't just my boobs!  One night we took her to the emergency room because we hadn't been able to wake her at all!
Queue anxiety point #2 - something is wrong with my baby because she won't wake up, and it's because she's not feeding enough to get better/stronger!

So despite her somewhat success at feeding from me with the shields, my anxiety started to grow around her feeds.  She was so sleepy all the time that she wasn't feeding often enough to be getting enough milk to flush out the jaundice, or to play catch-up on her weight gains. So she didn't have the energy to feed enough.  So she was sleepy all the time.  So she didn't have the energy to feed enough. And around and around and around.

Every feed that wasn't what I considered "successful" would have me in tears.  Every feed that she'd try to attach (even with shields) but couldn't/wouldn't because she was too tired, would send my anxiety skyrocketing, and I'd get angry at her and frustrated with both of us for not getting it right!  In the first two weeks, I had to put her in her bassinet twice after failed feeds because I was just too mad at her and myself.  Then I would collapse in tears and hysterics and rant and rave about how much I hated it all.  My poor husband tried to pick up the pieces - a wife sobbing on the floor, shaking, in the small hours of the morning.

"I don't understand!  Why won't she feed!?  I hate her!  I wish I'd never had her!  I want to quit!"

It hurts to write those words.  I should be basking in her newborn glow.  I should be thanking God for giving her to me.  I should be relishing these newborn weeks because they'll be over soon.  But my brain doesn't work that way right now, and quite frankly I can't think of anything I want more than to fast-forward six months to when this phase is over.

I've sought advice from two GPs (my usual GP seemed to be more stressful than helpful, labeling my daughter a "lazy sucker" and saying things like, "she'll probably never feed very well."  Great. Thanks). Queue anxiety point #3 - it will always be this hard.
A paedetrician told me she has a short tongue and nothing can be done but to keep trying and waking her every two hours to feed (yeah, how?!?).

And in all this, there was always 'advice' and 'warnings' to stop using nipple shields as soon as I was possibly able.  "They disrupt your supply."  "You'll get blocked ducts and mastitis because the baby can't drain the breast with nipple shields on."  "The baby won't get enough milk because they disrupt the let-down and flow." Etc.  So on top of the anxiety about feeding enough/often enough, her sleepiness and jaundice and never getting better, I felt immense pressure to give up the one thing that was making her feeds possible.

I've seen four lactation consultants, who've all given me difference advice.  But when the third one at the hospital said, "Oh, she's just content to starve" (the single worst thing she could have said given my anxiety triggers!), it started the gush of water out of my sanity dam.  I'd tried to feed my daughter in her presence so she could help us, but my daughter once again fell asleep and wouldn't feed.  I started to cry.  I started to cry harder.  I started telling her how much I didn't like my daughter; how if someone wanted to take her away, I'd happily hand her over.  Between handing me handfuls of tissues, the lactation consultant asked if I would mind if she called the Perinatal Mental Health unit to see if someone was available to come and talk to me.  I was embarrassed, but relieved that she did.  The next day, I talked to a mental health nurse over the phone, who arranged to come and visit me at home a few days later.  In the meantime, I had another massive meltdown at home about being worried my baby wasn't getting enough milk.

When the mental health nurse arrived the following day, I spilled my guts!  I told her everything I'd been struggling with, thinking and feeling - and not feeling (love, attachment, protective of my baby).  She told me I had Post Natal Depression, and that medication would be a good first step of several to help me get better.  I started to relax.  I had a plan.  I had help.  I was going to get better.  But then she, the GP and the pharmacist told me about the side effects of the drug I'd been given (the safest for breastfeeding mums), and that scared a good chunk of the crazy out of me!

"Your mood will get worse initially before it gets better, and this can sometimes include suicidal thoughts or tendencies, so if you feel that way, put the baby somewhere safe and either call 000 or go to a neighbour's house for help.  It can also disrupt your sleep, so take it first thing in the morning so you can get some sleep at night.  It can make you feel sick - like morning sickness - so try to have it with food to ease the sickness.  And it can also pass through the breastmilk to the baby and make them sleepy (like we hadn't struggled enough with that!).  But don't stop taking it - we have to wean you onto it, and wean you off; suddenly stopping it can do more damage."


So after battling my thoughts, I decided not to take it.

  • I felt so low already, I didn't think I could cope with being made to feel any lower and still function on any level - even minimal.  
  • Suicidal?!  Suicidal?!  Taking a drug that came with a warning to call an ambulance?!?!  Why are they even making it then!?!  
  • I didn't want any drug in my new baby's system unless it was for her needs or benefit, but certainly not one that was going to make an existing problem even bigger!
  • I was exhausted already and didn't think I could cope with more sleep disruption.  
  • Not being able to stop taking it once I started, even if it made me crazier?
  • And feeling nauseated on top of insomnia and suicidal?  Hell no.  All kinds of no!

That was just over a week ago.

  • So now I'm seeing a psychologist, and I have my second appointment with her tomorrow, and she's going to give me tools to help challenge my anxious thoughts.
  • I'm going on walking dates with a beautiful neighbour at least one night a week after our kids are asleep, so I can get some fresh air, exercise and a change of scenery (and gas-bagging helps too).
  • I will be able to drive at the end of this week (albeit a few days earlier than the recommended 6 weeks), so I've planned to attend a breastfeeding mothers' group (oh Lord, I hope they don't judge me for using shields) to meet some new people and get out of the house for a hour or two, and meet up with my sister-in-law for coffee once a fortnight, and also just get out and feel alive and independent again.
  • And I've also found ONE, international board certified lactation consultant to talk to for advice, to cut out the crap-load of mixed-messages I've been given to date.  And you know what she said?  "So what if you need shields?!  They're working.  I've had clients who've used them for two years!"  And if nothing else, I am embracing that one sentence from her whole two-hour visit.  I don't have to ditch the nipple shields.  It doesn't matter if I keep using them - they are my security blanket because I know feeds work with them; bub is getting lots of milk; she's gaining weight back.  My anxiety is lower when I use them.  When I try to feed without them, my anxiety is up from the start, and bub doesn't feed as well or for as long, if she attaches at all.  Decision made!

I have Post Natal Depression, and it's going to take time and effort to get better.  There isn't a quick fix, like "Just eat better" or my favourite, "Fake til to you make it!  Get dressed, put make-up on and smile, even if you don't feel like it, and you'll feel better".  Bwaa haa haa!

I am a nipple shield mumma and I will not give them up.  My baby has issues with feeding and needs help.  I don't know why.  It doesn't matter.  I will do whatever I need to do to make sure she's okay, and if that includes washing a piece of silicone after every feed for six months, Lord knows I will wash that piece of silicone after every feed for six months!

Feeding issues is just part of our journey and my daughter's baby story.  I will tell her all about it when she's older - and ask for an extra big bunch of flowers for the next Mother's Day.

I am getting better.  I am getting stronger.  I am beating this.