Breastfeeding

Breastfeeding Diaries: "I watched so many videos, and none of it helped me when the real thing came”

Follow new mother Audrey Good as she learns to breastfeed baby Harvey during the first 48 hours in the hospital.

 

Monday May 11, 2020

9:18 p.m.: After 65 hours of excruciating labour, Harvey is born! For the last 30 hours, I was stalled at seven centimetres dilation with a failure to progress. We moved from a home birth to the hospital in order to augment the labour with pitocin. Finally, after a few hours on the pitocin, Harvey shot out with only 18 minutes of pushing!

All the pain of the past few days starts to move into the background as my husband, who caught Harvey, places him on my chest. The din of the midwives working and all the hospital equipment fades away and I can only feel Harvey’s slippery skin against my chest. One of the midwives assists me with my first latch in their recommended position for brand-new babies—cross-cradle hold.

9:40 p.m.: After a whirlwind of documents, papers, and information, the midwives inform me that Harvey in the bottom tenth percentile for fetal weight by gestational age (SGA), and that they will need to monitor his blood sugar every three hours for the next 36 hours to ensure he can sustain his own feeding and development. We begin with a prick of his heel to draw blood for the glucometer. 2.8mM—a pass! We are looking for 2.6 or higher.

I feel delirious. There is so much information to absorb and so many decisions to make, and the information rushes by at top speed.

10:30 p.m.: The nurse comes to check on my vitals and baby’s vitals, everything is OK. I ask for a quick lesson on feeding—one of the benefits to a hospital birth is access to all the expertise of the nurses. There has been so much information, and I’ve had to take it in on a modicum of sleep.

11:30 p.m.: I’ve been lying in bed in that semi-conscious state between wake and sleep. The excitement and trauma of the birth are still racing through my head, the same way you still feel like you are in a moving car after a long road trip. The nurse comes into check on Harvey—2.1 blood sugar, a fail—and his body temperature is very low. I feel like a failure. My son is cold and hungry, and I don’t have a clue how to help him.

The nurse shows my husband how to administer a tube of dextrose and puts Harvey in the baby warmer until his body temperature reaches an acceptable level. She also shows me how to hand express colostrum into a cup and suck it into a syringe. I will have to supplement Harvey’s feeding with an additional tube of colostrum every hour from now on.

SGA babies are so small and tired, it’s a vicious cycle—low birth weight means low energy and fatigue, which makes it hard for them to nurse, which means low blood sugar, and then poor temperature regulation, which then leads to even more fatigue. The worry is enough to kill me.

Tuesday May 12th, 2020

2:30 a.m.: Harvey gets his third test. The dextrose, supplementation via syringe, breast feeding, and warmer all worked together to get a better reading. Sugar is up to 3.9! It is so sad to hear his screams when the nurse lances his heel. I feel like someone is ripping my heart out.

5:30 a.m.: Over the next 24 hours, Harvey has six more tests. The feeding and testing schedules happen in tandem every three hours. It takes about an hour to feed, an hour to express, and then if I’m lucky I can catch about 30 to 45 minutes of light rest—you can’t even really call it sleep!

My heart still cries out for Harvey every time they prick him. His blood sugar spiked after the dextrose, but he’s still been on the breast with supplementation from tube feeding. I’ve asked each nurse who has come in for advice on breastfeeding and gotten a few pieces of the puzzle from each of them. I’m a klutz, and can barely catch a ball, let alone do this. It’s tough to apply all this advice in real time—“rotate the baby, get an asymmetrical latch, roll the nipple first, massage the breast tissue too, brace the head but not too rigidly, bring the baby to you and whatever you do, don’t lean to the baby. Now drop your shoulders and relax! This is supposed to be enjoyable!”

Seriously? I wish I could have practiced, but it’s impossible until you have your baby there. I watched so many videos on latch, positioning before the birth…and I feel like not a moment of it helped me when the real thing came.

Wednesday May 13th, 2020

5:30 a.m.: The constant interruptions is pushing me close to my breaking point. (The test for blood glucose and baby and maternal health mean there is a nearly never ending flow of people into the room. Add my husband trying to get supplies and deliver meals, and it’s total chaos) I haven’t slept more than an hour at once since my labour began on May 9th. If my husband wasn’t here to help with the tube collection, diapers, and calming Harvey, I don’t know what I’d do. I know some people had to give birth alone during the pandemic, and I can’t imagine their pain. I am grateful for the combined experience and help of everyone involved. It may be exhausting, but it’s also a relief to have help and support. I’m determined to pass the tests.

8:30 a.m., 11:30 a.m., and 2:30 p.m.: Harvey is only on the breast and syringe supplementations now—no more dextrose gel. I’m worried because his sugar is going down, but he’s still passing his tests: 3.1, 2.8, and 2.6. The last two are borderline—he had cold feet on one which initially caused a fail, and 2.6 is right on the cusp of failing. The worry I’m feeling is gnawing at me. My son is depending on me to feed him yet I wonder, Will my breasts produce? Am I doing this latch correctly? Will worrying affect my production? Will the complete lack of sleep prevent me from producing for him?

5:30 p.m.: We are discharged from the hospital. Its eerie being home, having left as two and now returning as three. When we finally cross the threshold, I can’t do anything but stand in the doorway and cry. I’m excited that Harvey’s blood sugar has stabilized, and while I’m so grateful for the help and testing at the hospital, I’m relieved that we can begin to feed on Harvey’s schedule rather than the hospital’s.

I’m starting to get better at certain holds that allow for dominant hand manipulation of the breast. Not so great at left handed control still. Despite a few setbacks of baby pulling off or fussing, I think I am just beginning to get the hang of this.

8:30 p.m.: Our midwife comes for a home visit, and Harvey’s weight is normal. She checks my latch one last time and teaches me side-lying feeding, so that I might be able to increase my restful times each day. I feel like the three of us have passed the first of many challenges we’ll face as a family over the years!