# 19: Beginning of Breastfeeding

While I wholeheartedly believe "fed is best," I knew personally I wanted to exclusively breast feed. Honestly, I didn't even want to pump. While I ordered a pump through my insurance to have on-hand, I expected to use it a few months in and only on a need-to-have basis. However, reality often doesn't go as planned. My first few weeks breastfeeding have been quite interesting, and I want to share not only my experience thus far, but also some items and knowledge that have aided me. 

My Experience
When I was in the hospital, my colostrum came in thick and quick. Genevieve's larger tongue made an initial latch a bit clumsy, so a nurse offered me a breast shield and we got an instant latch. When I saw the lactation consultant the following day she was impressed by my supply and techniques I was using to feed. She thought I was a nurse based on my knowledge and approach, but I expressed that I was simply attempting to be relaxed and flexible and had done some research about methods and practices during pregnancy. I scheduled a lactation appointment the following week to check in and focus on latching without a nipple shield. 

The nipple shield not only protected my nipples from chapping, but also made the pain of breast feeding go away almost entirely. I might feel a bit uncomfortable the first minute or two, but overall I was surprised by how easy it was to feed Genevieve. Early on after feeds, I would apply an organic nipple butter to prevent irritation. 

By day three my colostrum changed to milk. I was incredibly engorged with both breasts having excessive amounts of lumps (giving new meaning for me when Fergie sings "my lovely lady lumps..."). Literally it felt like I had swollen glands throughout both breasts. If I massaged or tried to rub them out, I was mostly ineffective. I was uncomfortable but not in pain. I assumed that this was normal and just a strong initial reaction to milk coming in. I assumed as the supply of milk settled from feedings, all would resolve itself; I was wrong. 

On Genevieve's one-week birthday, I had my appointment with the lactation consultant. We worked on latching without the shield. Due to my fast let down, abundant milk supply, and Genevieve's larger tongue: she was a lazy drinker. This meant she could get an abundance of milk without doing much work and therefore less stimulation to my breasts. This meant I wasn't being emptied appropriately. The lactation nurse recommended that I purchase a haakaa (a what?) and that I pump to empty the breast after each feed. 

Initially, I chose to ignore both of these pieces of advice. I ignored the haakaa advice because it was a silicon suction cup to catch the let down from the opposing breast (used for feeding or pumping). I assumed this would catch a small dribble and was simply unnecessary. I ignored the pumping advice because I read that pumping early on would result in an oversupply of milk--something I already had and didn't want to intensify. Two days later, I had a 103 degree fever, convulsive chills, and a red mark on my left breast: hello mastitis. 

At this point I went into mastitis management mode. The symptoms came on in the evening, and so we scrapped our plans to have neighbors visit and cook dinner. We ordered door dash, quickly sanitized and prepped the spectra breast pump, opened the glass baby bottles and bottle warmer we thought we wouldn't need for a couple of months, and I started taking Tylenol to combat the flu-like symptoms. I added lactation storage bags and a haakaa to my amazon cart.  I messaged my doctor about everything I was doing that night but expressed the likelihood that I would need antibiotics. Even with Tylenol my fever stayed above 100 degrees and peaked at 104. Fortunately we got the antibiotics the next day and I began (reluctantly) taking ibuprofen as well (RIP stomach, hello yogurt). 

Within 48 hours of antibiotics my fever stayed below 100 degrees without Tylenol. The ibuprofen helped with the swelling and clogs. The worst part about the antibiotics was that I had to fast two hours prior to taking the medicine and one hour after; I had to take the medicine every six hours. It was a constant challenge to not be too full or too hungry during this window. Thankfully the yogurt helped my stomach with the ibuprofen. But as someone who avoids medicine and likes to ride it out with sicknesses, I was so over the medication schedule. 

During all of this, I had to pump every two hours and continue to feed Genevieve. I was feeling pretty exhausted and fortunately Andrew could help by giving Genevieve a bottle. Initially she did not want the bottle when Andrew offered it; earlier that day she took a bottle from me no problem. I used a body hold and held the bottle similar to the way we had been breastfeeding. When I showed Andrew the method, G took the bottle with ease. I was slightly stressed the next day when I tried to breast feed and she was fussing and pulled away--she had been a good feeder and never given me any trouble previously. I worked through it and got a latch and while that one feeding was more challenging, I have since had no problem going back and forth from breastfeeding to bottle. 

My pumping process was  obnoxious. I could not simply sit and let the pump do its thing. No, I had to bend over parallel to the ground, massage and milk myself and even then more clogs would form (in both breasts) and I never felt like I could completely empty myself. I was only getting about 1-3 ounces from both breasts combined at the time and was feeling quite frustrated. I knew mastitis could temporarily reduce one's supply but wanted to make sure Genevieve was getting enough. Fortunately at her 2-week appointment she surpassed her birth weight of 7 lbs 1.8 oz and was a whopping 7 lbs 6 oz. 

After a couple days my supply resurged and I would get upwards of 16 oz of expressed milk from pumping and the haakaa at one time (the haakaa is now is my best friend because it is convenient and I get SO MUCH MILK. Not to mention I am no longer excessively leaking into my bras and shirts. I did not understand that when you stimulate one breast with baby or pump the other releases milk as well. For me this wasn't a simple dribble but consistently 4-5 oz. I use the haakaa at every feeding.

Recommendations
I finished my antibiotics and am now taking certain precautions and using specific tools to avoid reoccurring mastitis (fun note: a couple days ago it felt like I was developing mastitis again already in my other breast...). I will itemize these items below with links for reference:

Sunflower Lecithin (supplement): I have heard from several mamas I know and through many social media groups that this supplement is a must for preventing clogs and mastitis. I asked my doctor if I could add this to my routine and he agreed so long as I found a reputable brand since supplements aren't FDA regulated. Since taking this my clogs are easily massaged out and my milk flows more easily and freely when I am pumping. I feel like I am now able to actually express my breasts adequately and they feel SO much better. I take them with dinner because milk supply is most abundant in the morning plus I would feel most engorged during sleep and the early morning so I figured this time of day would be optimal, so far so good. 
https://www.amazon.com/Carlyle-Sunflower-Lecithin-1200mg-Softgels/dp/B07G7HSQK9/ref=sr_1_5?crid=3KJ8AEX87OKEH&dchild=1&keywords=sunflower+lecithin+capsules&qid=1623418911&sprefix=sunflower+lec%2Caps%2C198&sr=8-5

Haakaa: So good I bought two. These are super cheap and incredibly effective. I bought two because I use one during breast feeding and pumping to catch the other breast's let down. I purchased a second because I read that epsom salt and hot water in the haakaa can help soothe nipples and help work the clogs out. I have used my haakaa for this twice and will be doing so much more frequently. It offers so much relief and does help with the clogs. The reason I got two was because I want to make sure the epsom salt isn't in the milk I catch in the haakaa. If you are breastfeeding, you NEED a haakaa even if you don't have the issues I have dealt with. 
https://www.amazon.com/Haakaa-Breast-Manual-Silicone-Breastfeeding/dp/B07CWK4S5W/ref=sxts_sxwds-bia-wc-rsf-lq2a1_0?cv_ct_cx=haakaa&dchild=1&keywords=haakaa&pd_rd_i=B07CWK4S5W&pd_rd_r=cab0be7f-069d-45c0-8392-0f1f592debd7&pd_rd_w=JvEae&pd_rd_wg=pO6yn&pf_rd_p=6b8835ed-96d6-4089-a8ed-3370ca81c53d&pf_rd_r=QQFB3M8MB16333CGATH1&psc=1&qid=1623419260&sr=1-1-18e0f783-7b71-42f0-a291-5a15b3cb969e

Epsom Salt + Coconut Oil: Beyond smelling absolutely amazing, the coconut oil really does help soothe the nipples and the epsom salt in the haakaa helps to reduce inflammation that causes the clogged ducts. 
https://www.amazon.com/Dr-Teals-Coconut-Soaking-Solution/dp/B06XYGL2Z8/ref=sr_1_5?dchild=1&keywords=epsom+salt+coconut+oil&qid=1623419358&sr=8-5

Silver Nursing Cups: Expensive but 100% worth it! While I initially started with a nipple butter post feeds and a reusable pad, I was leaking through my shirts a lot and the pads would get soaked and that would irritate my nipples. These cups naturally function as an antimicrobial and can treat pained nipples but also PREVENT issues. I use these cups, with a couple drops of breast milk and then cover with a reusable pad and have zero issues and the pad, bra, and shirt stay dry. Plus I no longer need to use a cream or butter to soothe the nipples. I basically wear them all the time but once a day I rinse in warm water and leave to dry. 
https://www.amazon.com/Silverette-Original-Silver-Nursing-Cups/dp/B00D4MWKNQ/ref=sr_1_1_sspa?crid=3N52DB6M23C7E&dchild=1&keywords=silver+cups+breastfeeding&qid=1623066066&sprefix=silver+cups+%2Caps%2C277&sr=8-1-spons&psc=1&spLa=ZW5jcnlwdGVkUXVhbGlmaWVyPUFOVUdaWDlHVlVUU1QmZW5jcnlwdGVkSWQ9QTA5MjI3NTZISVZOSlBCVFhYOEgmZW5jcnlwdGVkQWRJZD1BMDcyOTQ5NzMwM0VLSElWQzE1STEmd2lkZ2V0TmFtZT1zcF9hdGYmYWN0aW9uPWNsaWNrUmVkaXJlY3QmZG9Ob3RMb2dDbGljaz10cnVl

Reusable Nipple Pad Covers: See the link for the ones I like most. I tried a different kind of reusable pad that had a soft fabric and it irritated my nipples. These have a better cupping shape so they don't rub the nipples as much and absorb leaks better. 
https://www.target.com/p/lansinoh-washable-nursing-pads-4ct/-/A-75568309#lnk=sametab

One of the book titles I read in pregnancy about breastfeeding definitely resonates with my experience with breastfeeding thus far: Breastfeeding is a Bitch But, We lovingly Do It Anyway by Cassi Clark. While there are definite pains and frustrations that are inevitable with breastfeeding, it definitely feels worthwhile. I really enjoy the quality bonding time with Genevieve during feedings. She tends to feed for 20-40 minutes and with bottles is sometimes fussy after feeds, but from the work and exertion of breastfeeding she's much sleepier, relaxed, and "milk drunk." Midway through the third trimester I developed carpal tunnel and trigger finger. Unfortunately they haven't subsided yet, and therefore expressing is more uncomfortable in the moment and bothers my hands more (fortunately soaking in epsom salt seems to help). 

Overall, I have had some hiccups and challenges with breastfeeding. Honestly, I think everyone does. I can say that breastfeeding hurts less than I thought it would. Though I think the breast shield (that I am still using) helps. I might be in mild pain for the first two minutes but then the pain subsides. It feels like a worthwhile endeavor and one I plan to "lovingly do anyway" at least until the time feels right to wean (which I believe for me will be sometime after 6 months and no longer than 12 months).