So months ago when I first started thinking about trying to blog again writing THIS was the first thing that came to my mind. This post is especially dedicated to all of the exhausted new mothers who are doing exactly as everyone told them not to do, Googling in the middle of the night. I am so so hoping that by the powers of SEO and Dr. Google, maybe just one person who really needs to read this, will.
This is a topic that is extremely close to my heart…literally…this post is about boobs. If you have a problem with boobs and breastfeeding babies then please look away now.
I always knew I would exclusively breastfeed my child. Like before he was even conceived I knew. My mother breastfed my sister and myself for over a year each; my sister breastfed my nephew for just over 15 months; and my friends have all breastfed their children beyond their first birthdays. In my community it’s just sort of understood that’s what you do and everyone I know did it without problems.
When I found out I was pregnant with my son I immediately started researching everything there was to know about pregnancy and birth. I bought What To Expect When You’re Expecting for myself and Dude, You’re Going to be a Dad for my husband (sidebar, he did NOT like the Dude book and felt like it really talked down to him like he was too stupid to understand basic human biology or too grossed out to know what was actually going to be happening during labor and birth. My mom bought him a copy of The Birth Partner and he liked that one a little better.). I downloaded multiple apps that tracked my pregnancy progress and provided fun little daily tidbits on my baby’s growth compared to various fruits. I obsessed over every twinge, tickle and pain and spent hours searching Google to see whether other women had ever felt what I did, spoiler alert: they have. I first felt my son move around 18 weeks and spent the rest of my pregnancy compulsively poking my belly every hour to make sure he was ok in there. When our 20 week ultrasound showed very conclusively that “it” was a “he,” I began researching how to raise a boy because I felt woefully unprepared for the chaos that was sure to accompany him. Later on in my pregnancy I even bought a copy of What to Expect the First Year and started reading about child development and milestones beyond the womb.
But in all of my research I never took the time to learn about breastfeeding or more specifically, the challenges that might come along with it. I remember very distinctly when late in my pregnancy my best friend, who was also pregnant with her first child but about 8 weeks behind me, mentioned something about a breastfeeding problem that she and her husband had discussed in their birthing class. She asked if I had knew anything about it and what my thoughts were. I remember very confidently, “ahem” cockily, replying that I wasn’t going to research any potential problems because it seemed pointless to worry. Secretly I was thinking that of course I wouldn’t experience any issues with breastfeeding. HAHAHA.
So imagine my shock and disappointment when my son was born, a ravenously hungry little piranha child who latched perfectly, and I experienced HORRIBLE, toe-curling, scream inducing, knife-like pain in my freaking nipples. I sobbed while trying to nurse him in the hospital immediately after he was born. I screamed in pain when the lactation consultants and nurses helped me latch him on in the recovery room. I balled my eyes out and gripped the bed as literal shards of glass stabbed me in the nipples every time he nursed for the whole 24 hours we were in the hospital after his birth. (Note to self and reader – there WILL be another post about our hospital experience – it sucked and I will eventually talk about it) About 8 hours after his birth, at the urging of our nighttime nurse we ended up giving Owen formula because my milk hadn’t come in yet (which I later found out is COMPLETELY normal) and the nurse felt like I wasn’t nursing him enough because of the pain. She also brought a pump for me to use and I ended up getting about ¼ ounce of colostrum. During our 24 hours in the hospital we saw 3 different lactation consultants who all said the same thing, he’s latching great, he doesn’t have a tongue or lip tie, you shouldn’t have any pain, it’ll get better soon. The one small bit of helpful information we got during that time actually came from the labor & delivery nurse who was there for Owen’s birth, she had casually informed me that I had slightly inverted nipples as she was helping me with my bra immediately after he was born. I remember looking at her in confusion because no one had ever noticed or said that to me before. She said not to worry, it was fine and normal. Oh how wrong she was.
Anyway so fast forward to our first week at home. I’m attempting to nurse every 2 hours but the pain is completely unbearable. On day 2 my milk came in so I basically switched to exclusively pumping and feeding Owen bottles of expressed milk. This made me feel slightly better because at least I wasn’t a complete and total failure as a mother and was producing milk. (To be clear, this was my personal thought process in a muddled haze of new mom guilt. I FIRMLY believe no mother is a failure if they can’t/don’t want to breastfeed, however you choose to feed your baby is 100% your family’s decision and fed is best all the way.) So at this point I’m totally resigned to being an exclusive pumper and I’m Googling the shit out of tricks to pumping enough. Which, if you don’t already know, there is a woefully small amount of helpful literature out there for exclusive pumping moms. I’m not the one to write about it but someone else definitely should!
In the meantime, we’re continuing to go to the lactation clinic and every time we see a different lactation nurse, which is super awesome, who has us change our positioning or switch sides more often or sing the alphabet while we try to latch. Of course it all sort of works without too much pain in the clinic but the minute we get home and I try to nurse Owen on my own, it all falls apart and we’re a sobbing, screaming mess of agony again.
I’m still Googling every chance I get and around week 2 I became completely convinced that I was experiencing nipple vasospasms. If you’re not familiar with these you’re in good company. Basically when the baby compresses the nipple to nurse the compression cuts off the blood flow through the nipple causing deep shooting pain, color changes (nipple goes from white to blue to purple to red to pink), tingling, and burning. The pain usually happens a few seconds to a few minutes after nursing.
I also stumbled across one tiny little article describing something called nipple adhesions. Apparently when nipples are inverted they can actually form tiny strings of tissue (adhesions) that hold the tip of the nipple into the inverted position. When a new baby begins nursing on that nipple they pull the tip of the nipple out of its little hidey hole and stretch those skin strings – which hurts like a BITCH until the adhesions actually break and the nipple is no longer as inverted. I tried to talk to my Dr. about my findings but she was pretty dismissive and just referred me back to the lactation nurses at the clinic who again kept telling me that “breastfeeding shouldn’t hurt, if it does then something is wrong with your positioning.”
Well fast forward to week 4 and I’ve had enough of the stupid hospital lactation clinic with their completely unhelpful songs. Since we lived in the amazing boob-friendly city that is Portland, Oregon at the time, I found a private certified lactation consultant a few blocks away that could see us the following week. What a huge difference it was. We spent 90 peaceful minutes with her and she listened as we talked through all of our issues and concerns. She watched as Owen and I attempted to nurse and she provided a few helpful positioning suggestions. Then she actually examined my nipples post-nursing. Low and behold she CONFIRMED that yes she could see evidence of adhesions as well as very clear vasospasms. And then she uttered the words that completely changed my thought process about the entire experience, “breastfeeding is not always pain free, especially in the beginning and especially with these issues.” OMG. Every single lactation nurse we had seen up to that point kept saying that his latch is good, our positioning is good, so it shouldn’t hurt. I had felt like there was something wrong with me, that I was somehow deficient, because these professionals kept telling me that everything was good and I shouldn’t feel pain, but I did. Finally, here was someone telling me that my situation was different and that my pain was to be expected because my anatomy was slightly different. Immediately I felt 1000% better.
By this time I had already been starting to experience slightly less pain and had found myself actually wanting to attempt to nurse before simply pumping. But now this woman had validated my pain AND she even had some solutions. In terms of the vasospasms, the biggest issue was temperature change. When my nipples got cold, it triggered the spasm. Of course when you’re half clothed nursing a baby, you’re bound to get cold. Her advice was to buy air activated hand warmers and keep them in my bra. After nursing or pumping I would slather on some nipple balm, then my breast pad, then a hand warmer and it was heaven! Even now, 11 months later, I found myself buying a few hand warmers when we had insanely cold temperatures a few weeks ago.
As for the adhesions, unfortunately there’s no easy solution. For me, the act of nursing/pumping for about 7 weeks seemed to finally break them all. From everything I’ve read/been told, I shouldn’t have to go through this again with any subsequent babies because 11 months of nursing has changed my anatomy enough that my nipples aren’t as inverted – but we’ll see. In cases where there is serious inversion and the issue is known prior to delivery, there are other options such as a hard nipple shield that actually pulls the inverted nipple out or the Hoffman Technique where you essentially just stretch the nipple out using your thumb and finger. Breast pumps should never be used prior to delivery because the nipple stimulation can cause contractions and premature labor.
All in all, my biggest takeaway from this entire experience is that I just needed someone to acknowledge my pain and think outside the box with me to figure out what was causing it. Once that happened I actually felt like I understood what was going on, the pain was to be expected and I could either choose to deal with it or not. And I chose to keep going, even though there were SO many times where I just wanted to stop. But this isn’t one of those “I’m so glad I kept going” kind of things, because it really would have been completely ok if I had decided that I wanted to stop. I still would have bonded with my child and he still would have gotten the nutrition that he needed. Now I am happy that I stuck with it because I do enjoy nursing now. But I am also really excited that we’re coming up on a year and are slowing down. Caring for a baby is exhausting emotionally and physically and I tip my hat to every mother out there as she makes the best choices for her and her baby.