The Breastfeeding Diaries: Lexy from Crazy Cass Life

August 13, 2014

Hey y’all!  I’m Lexy and I blog over at Crazy Cass Life. I’m a stay at home mom to 18 month old twin boys and a 1 month old little dude! Three boys in 18 months – you are all allowed to comment of the chaos of my house.  I agree!

I had a long breastfeeding journey with my preemie twins (luckily, at least so far, nursing this new little guy is a bit smoother!). That said, the twins received only breast milk (and solids) until 11.5 months and continued nursing until one year one day. They received frozen breast milk until 14 months. Even with our rocky start, we did it! Despite all of the difficulties and challenges, I look forward to the opportunity to try again with this next little man.

The NICU
The twins, Tripp and Davis, were born at 33w3d on January 13, 2013 and were immediately taken to the NICU. I got to spend my time after delivery in recovery instead of with them. (For more on my labor story look here. All of my plans to build a great supply through immediate skin to skin were ruined by my preterm labor. They needed the NICU more than they needed skin to skin.
Luckily, I had an amazing L&D nurse who came into my room with a pump (A hospital rental of a Medela Symphony. This pump and I became BFF over the next months. I cried the day I returned it.) and completely overwhelmed me by strapping me to this contraption and turning it on. Talk about a seriously weird sensation! 

I may have been overwhelmed, but I know I owe that night nurse so many thanks. Pumping early and pumping often is probably a huge factor in why I had adequate supply for two babies. 
The next three weeks the boys were in the NICU and I felt very sidelined as a mother. I didn't know where I fit. They needed their doctors and nurses more than they needed me. There was just one thing I could do for them that no one else could: pump. And so I did. I pumped every three hours. Without fail. Without exception.

The beginning of our home freezer supply. Each NICU storage bottle holds 4.5oz. 
 The 150oz pictured was joined by nearly 500oz that was stored at the NICU.

Through all of my pumping I established my supply and FILLED the freezer in the NICU. In fact, by the end of the boys NICU stay they told me to stop bringing milk to the NICU!
A few days after their birth, we were able to start practicing nursing. And so we practiced multiple times a day, but the boys were too small to latch well and would fall asleep before finishing a feed. They weren't strong enough for that level of work. I loved the skin to skin snuggles though!

While they were in the NICU, I would nurse one baby. He wouldn't eat enough. We'd wake him up and try a bottle. He wouldn't finish so he would take the rest of the feed by gavage. I would nurse the next baby. He wouldn't finish. He would take a bottle and not finish. He would take the rest of the feed by gavage. I was fortunate to work with a lactation consultant (LC) nearly every day during that time and so while things weren't working, I knew all the right things to do and try. And, because of her support and encouragement, I wasn't discouraged.

Before they could be discharged from the NICU, both boys had to go 48 hours without a gavage tube. This was the biggest (only) hold up to their release. Since nursing is harder work for a baby than a bottle, for 48 hours I stopped nursing and let them complete all their feeds by bottles and they were successful. This was the first time I felt discouraged. It felt like a "condition of their release" was me giving up my plans to nurse. I was told this wasn't the case and in fact, the LC at the hospital wanted me to return to the nurse, then bottle feed, then pump model when we got home. It didn't make me feel better.

The Early Days at Home
After our first week at home, I was exhausted and frustrated. The boys went three hours from the start of one feed to the start of the next and the feeding plus pumping process was taking close to ninety minutes. I couldn't keep going. I was truly suffering. I wasn't bonding with the boys. I was crying. A lot. Things weren't good.

I made an appointment to go see the LC at the boys' pediatrician office. She told me to stop nursing. Not because we would never nurse, but to give the boys time to grow and mature and try again in a few weeks when they were past their due date. At that point I was so frustrated and so tired of the ordeal that permission to "give up" was exactly what I needed. I was ready to throw in the breastfeeding towel and exclusive pumping seemed like a welcome change.

I stopped nursing and determined that if I was going to exclusively pump I'd be great at it. So I pumped. A lot. And by the end of March our freezer was overflowing. In fact, I was able to donate on multiple occasions to multiple moms because my supply was abundant. Moooo. For full stats on my milk production read this by the numbers post (It also contains really helpful information about tracking pumping and nursing.).

Milk cubes. I froze in ice cube trays and stored in freezer bags. Much more space efficient than any other system I tried.

A few tips for pumping:
• You should be eating as much while nursing as you did while pregnant. My LC explained that it takes MORE calories to nurse than to grow a baby!
• You should be drinking MORE than you did while pregnant. If you aren't floating you aren't drinking enough. Every mL you pump has to come from liquid you take in. Your body needs its normal liquid intake PLUS the amount you are pumping.
• Pay attention to your body. I was originally told to pump for 15min but I learned I got a second letdown at 18min and a third around 25. I did the best when I pumped approximately 30min. This is different for very woman so pay attention to how your body responds.
• Relax. Easy to say right? But when I was comfortably situated and distracting myself I pumped better than when I tried to stare at the bottles and will them full. I found my favorite place to pump was propped up in bed with the TV on and scrolling through my twitter feed. I obviously couldn't pump like this when the boys were awake, but I tried to pump during naptime. And I always pumped in my comfy position in the evenings while Casey fed them.
• Know that ANY breast milk your baby gets is good. Formula isn't the enemy and if you have to use it, either exclusively or to supplement remember that fed is best.
• Get a good pump. I rented from the hospital for the first 9 months and so had an amazing Medela Symphony. Then I changed to a Pump In Style Advance. It took a lot of fighting with my insurance company, but I really wanted a pump with dual phase expression since I was exclusively pumping.
• Invest in a good hands free pumping bra. I started with a Medela Hands Free that I was given and it was a godsend in the NICU but didn't work great. I then switched to the often praised Simple Wishes and it was only okay. I found I preferred pumping tanks and pumping bras. (Favorite brands: Milkalicious Tanks and Dairy Fairy Bras. Since I stopped pumping for the boys, Dairy Fairy has released a tank I'm excited to try when this next little guy comes along. I might have already bought two in anticipation.)
• Buy Pumpin Pals. Don't question this advice. Just do it. These flanges are FAR more comfortable AND better mimic the angle of a nursing baby to stimulate greater supply.
• Figure out your best way to entertain the babies while you pump. I frequently kept both boys in my lap where we could sing songs and chat together. Hello hands free bra!

Excuse the awkward photo blurring. Attempting to leave some things to the imagination. Wearing a milkalicious nursing and pumping tank.  It’s a pretty genius camisole because it does both!

 Nursing
On April 2, I tried to nurse for the first time since before the boys due date. And it was fairly successful! As in, no one cried. Yeah. I call that successful. We had low standards.
 I have no idea why I decided to try that day. I wasn’t frustrated exclusively pumping. I didn’t want to go back to the nurse, bottle, and pump days. I’m honestly not sure what I was thinking at the time. (And silly me never blogged about it!)

I continued to attempt nursing once a day until end of April when both boys really "got it." At 3.5 months old, I was nursing both boys nutritively. They were still getting one bottle at night before bed from their daddy so I could have some alone time (which I spent pumping, but hey at least I was alone!). 

I also want to acknowledge that nursing was really rough. We were doing it. But not well. It involved a lot of pain for me and reflux and spit up for them.  In June, the boys both had frenectomies to repair their tongue and lip ties. This SAVED our relationship. I was ready to give up nursing because it just hurt so much. But, immediately after this procedure I noticed a huge difference and things got better.

Davy all swaddled and goggled ready to have his tongue and lip ties repaired.

I can't even explain the amount of joy I got from being able to nurse. And nursing without pain? I was elated. Was it this amazing bonding experience I had heard about? No. Not at all. Was it convenient? Yes! Was it great that they still took a bottle? Yes! At this point I think I had the best of both worlds. Things were amazing.

I am not one of those moms who push breastfeeding. It was right for us for this time. I heard a great piece of advice at my twin club meeting while I was still pregnant. I clearly am too stubborn to have followed this good advice, but I thought on it often.
• For 6 days... Try nursing/pumping. If you don't have a groove or your milk hasn't come in, then stop. Fed is best. A happy mommy is best.
• For 6 weeks... Try to establish your breastfeeding/pumping routine. If it still isn't working for you after six weeks, then stop. Fed is best. A happy mommy is best.
• For 6 months...Attempt to give your baby exclusively breast milk. Then they start solid foods and many things change and if you need to stop, then stop. Fed is best. A happy mommy is best.

Tandem Nursing
We began working on tandem nursing as soon as they had nursing down. It freed up so much of our day to do other things. With tandem nursing my life no longer needed to focus on the boys eating schedule. I honestly don't feel qualified to give advice on tandem nursing. It worked for us. I had to always use a pillow (I liked the My Brest Friend). I have no clue how I got them both latched at the same time. I picked them up, put them on the pillow, raised my shirt, and held their heads and they did the rest. I almost always did it sitting on the floor so I could easily pick up/put down a baby and so I didn't have to worry about dropping anyone while burping. Once I realized I liked to sit on the floor to tandem nurse I bought a floor chair off of Amazon (they call it a stadium chair for sitting on bleachers. I call it the perfect floor chair!) and it changed my life. No more back ache! I was comfy! I've had moms ask how I got both boys to latch. How I picked them up. How I did... And honestly? I don't know! While nursing was difficult and took a lot of work, a lot of practice, and a lot of trial and error, tandem nursing just happened.

Breastfeeding and The Dairy Allergy
No tale of my breastfeeding journey would be complete without talking about Davy's milk protein allergy. It was initially diagnosed as MPSI (milk protein soy intolerance) and later changed to a milk protein allergy (a more severe diagnosis). Due to this, I was completely milk and soy free beginning in April when he was diagnosed. At this point I had the added pressure of knowing if I gave up nursing, he would get a formula designed for allergy babies and the first ingredient is high fructose corn syrup. That made me so very uncomfortable. I believe fed is best and am so glad a hypoallergenic formula is available, but I struggled with the idea of feeding my child corn syrup because nursing was hard or inconvenient. We were seeing a GI at the time who was also very pro-breastfeeding, particularly for babies having problems, due to the numerous health and GI benefits from breast milk. At every appointment he extolled the virtues of breast milk and inspired me to continue. I became even more committed to making breastfeeding work and sticking to a dairy free and soy free diet. Thankfully, Casey was on board and was so very supportive through all of this and even went dairy free with me (or at least dairy free at home. He was eating his cheeseburgers at work!). I was able to reintroduce soy to my diet when Davy was around 7 months (6 maybe?) but I had to remain dairy free until he weaned.

Weaning
Beginning mid-December I started losing weight at a decently rapid clip. I was pregnant (surprise!) and exclusively breastfeeding the twins and couldn't eat enough. It was clear weaning needed to happen for both my health and the little babies, but in my head I needed to make it to the magical one year mark before I introduced milk (or in our case coconut/almond milk). We saw the pediatric GI at the end of December just two short weeks shy of the boys first birthday. At the appointment the GI said it was time to start introducing milk. Whoa! I thought the goal was exclusive breast milk until one? Not according to the GI. The difference between 11.5 months and 12 months is just not important and so supplementation with some milk product is absolutely fine. He also told me that during pregnancy your milk gets less fatty (though no less nutritious) and with my underweight boys some milk product supplementation would be better for them.

The boys had been drinking water from a straw cup since they were 6 months old so I naively thought I would do the milk transition and bottle transition together. It didn't work. They did great with milk product but not so great with cups.

I started by offering a mix of milk product (we began with coconut milk) and breast milk in a bottle. They did great. I slowly increased the amount of milk product and they still did great. Eventually I was giving pure coconut milk or pure almond milk. On days they seemed under the weather at all I could defrost breast milk from the freezer and they did great with it. They easily went back and forth and drank whatever I offered them from a bottle. Weaning from breast milk to coconut milk was painless, seamless, and easy. (Some part of this journey had to be right?)

Many women talk about the pain of weaning and speak of cabbage leaves and taking sudafed and many other tricks to dry up supply. I didn't have to worry about any of those. My supply was drying up due to pregnancy. I think this was also why the boys transitioned so well. They weren't getting what they wanted/needed nursing so a cup of milk product was exciting and welcome.
I nursed for the last time on the morning of January 14, one day after the boys first birthday. From then on it was all bottles and cups.

What wasn't easy was transitioning from the bottle to a straw cup. But, I have already written about how we finally succeeded in that here. (spoiler: the right method made it painless but it took a while for me to find the right method) so won't retell the tale.

The Second Act
I have been back at nursing for a month with our youngest, James.  It is a completely different experience, proof that every child is different and every journey is different.  I expected nursing one baby to be easy. I thought all of my experience would help me this time. But, being a mom, we all know that kids like to throw curve balls.

On the one hand, James was a full-term baby who latched right away. (Well, sort of.  He refused to nurse the first three times we tried. But he latched within a few hours of his birth.) I never had to pump. I never had to tandem nurse. But, it’s still painful some days. Unlike the twins, he likes to clamp down on my nipple midway through a feed. Ouch!  I do not look forward to this guy getting teeth! I am also still dealing with oversupply issues so I have pain from that between feeds.  The engorgement from oversupply makes it difficult for him to latch sometimes so I am getting really good at hand expressing into a bottle.  Luckily, he will take a bottle so I can get a little breather now and then.

I fully intend to nurse this little guy until 6 weeks. And once we hit that goal, I intend to go for 6 months.  And once we make it 6 months, I’ll shoot for a year. 

I know that nursing is a journey.  I know that motherhood can be so lonely.  I would love to connect with you to offer support and acknowledge the awesome job you are doing as a mom.  I am @lexyjill on twitter and instagram. Please introduce yourself!

Be sure to catch up with the rest of the Breastfeeding Diaries at the top of my navigation bar. 


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1 Comment »

One Response to “The Breastfeeding Diaries: Lexy from Crazy Cass Life”

  1. Lexy, you are a bfing rockstar! The beginning of your story with the twins sounds SO similar to mine, and I'm impressed that eventually they took to nursing and you made it to a year.

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