Thomas
May 25/04: water breaks @ 8:00 p.m. First contractions @ 11 p.m. Head to hospital @ 3 a.m., when contractions are 3 minutes apart and 1 minute in duration. Land in triage where beds are full, so labour in antiquated wooden waiting-room chair with EFM strapped to me for 2 hours. Finally assessed @ 5 a.m. 5 cm dialated. Moved to labour, but by then, I'd been unable to move around & coping skills are low, so request epidural. Dialation slows down. Finally fully dialated and able to push @ 12 p.m. (noon).
Push for 2 hours, break, push for another hour. Diagnosis of CPD. Told that since head won't descend, there is a chance that shoulders will be stuck if forceps or vacuum used & we'd have to rush for emergency c-section, so opt for non-emergency but unplanned c-section.
Thomas born @ 6.30 p.m. Able to view birth through homemade periscope hospital has made. Nurse in recovery room. Off to semi-private. Jim not allowed to stay overnight, so opt to co-sleep for night one, despite nurse's disapproval. Thomas loses weight, but not too much, discharged on day 3.
Day 4 check-in with publich health nurse. Discuss possibly giving formula b/c of urate crystals and low wet diapers, as well as no poop. Nurse disagrees and says to continue breastfeeding. Nipples are very torn up by this point, but latch is now good.
Day 5 checkup with doctor. Quite jaundiced by this point, milk still not transitioned. Go for blood test at lab. Doctor prescribes domperidone, 3x3, & Kenacomb for healing nipples. Come home & receive call from doctor's office ordering to go back to hospital; jaundice levels are dangerously high.
Pack up and rush to hospital. Admitted to NICU, ordered to make sure he is taking at least 2 oz of formula/feeding. Told how to use lactation aid (much different than actually doing it!), given pump (but only one horn -- very impractical). Quite overwhelmed by this point. Alternate feedings with l/a & finger feedings. Milk transitions on day 7, but breasts never feel full.
Day 8 discharged from hospital, finally. Had wanted to go home earlier, but hospital said no, even though jaundice levels were down. Very frustrated with hospital staff by this point. Continue feeding with l/a and finger feeding. Rush out to buy Medela PIS. Nipples beginning to heal. Also pick up Fenugreek & Blessed Thistle.
Week 2 - Week 16. Pumping after every feed, using l/a with every feed. Occasional break with bottle when going out (hard to use l/a in public). Feeling housebound & blue. Madly searching for information on how to increase supply. Feel there's a big hole there at this time (2004). Majority of info blames low supply on mismanagement, bad starts, etc. Play around with various levels of medication: increase domperidone to 4x4, Fenugreek to 4x4. Notice that Blessed Thistle doesn't seem beneficial at this point. Work on lactogenic diet, including oatmeal and leafy greens.
Month 4 - Month 6. Stop using l/a, switch to mostly bottles + some comfort nursing. Still pump for every feed. Producing ~15 oz/day. Continue on 4x4 domperidone, Fenugreek and lactogenic diet.
Month 7. Stop drug usage but continue pumping. Dramatic drop in supply -- down to 6 oz/day. Begin use of goat's rue. Had read conflicting reports on it - some claimed beneficial, others claimed may lead to lower supply, so waited until near the end to try.
Month 8. Stop pumping. No engorgement or pain drying milk. Gone within 3 days.
Lex
Birth
Had begun taking alfalfa (2x2) month prior to birth, based on book's recommendation (Making More Milk). Did not take goat's rue prior to birth.
Nursed immediately after birth and every 2 hours/day after. Co-slept from birth on. Good pee volumes, but no poo. Here is what I posted on my online board about this period:
Poop story: Lex had 4 bm's in the first 2 days (passing meconium). He then went 7 days without a bm and had a big one (transitional & breastmilk colour). He then went for an even longer stretch and finally pooped the other night (Feb 3). Diaper was full & poop was bm colour & consistency.
Weight story: Born @ 7 lb 15 oz, he dropped on Day 3 to 7 lb 6 oz, hovered at around 7 lb 7 oz for a couple of days and then really began climbing. Jan 25 he weighed 7 lb 11 oz, Jan 29 he weighed 7 lb 14 oz.
Ped consult was Weds. Ped ruled out many of the medical problems that the no poop could indicate b/c Lex looks well, is hydrated (6+ wet diapers/day) and had no other indicators (tummy not distended, etc.). However, he was weighed (Feb 4) and was at 7 lb 15 oz. Not a lot higher than his last weigh-in. So ped is pointing to insufficient milk as a likely problem.
We saw the nurse at the bf'ing clinic, who slightly adjusted the latch, but heard my letdown and felt that everything else was good. Got a script for dom at a low dosage (2x3). We're also doing fenugreek (3x3), alfalfa (2x3) and flaxseed oil (1x3). I just started pumping tonight after feeding.
Lex is nursing minimum of 12 times/day. Basically, I put him on the breast any time that he'll have me. He will nurse from 20 minutes - 1 hour per session, the 1 hour sessions tend to be mostly him nursing strong for the first part and then hanging out for the second part. (The ped did not like the fact that some sessions were for 1 hour.)
I am also using compression & switch nursing a lot. I had noticed that he didn't seem as satisfied later on in the day for the last few days, but I figured that it was about time for a growth spurt & just continued nursing until he was asleep. He is in bed with us and nurses throughout the night, too. However, I wonder how much he is getting during night nursing, as his diapers are more wet during the day than at night. Not sure what to do about this. So now I'm just working on getting him to nurse as vigorously as possible for as long as possible on each breast, and am hoping the domp and pumping will help more supply kick in.
His weight gain continued to be slow. One of my friends, who has charting software plotted it for me:

2 months: He still hadn't hit 10 lb at his 2-month checkup. At this point, I was doing: domperidone 4x3, Fenugreek 3x3, Flaxseed Oil 1x3, Metamucil 2x3, Brewer's Yeast 3x3, Alfalfa 3x3, plus Lactastim tincture: "Increases milk flow and enriches the breast milk. Goat's Rue, Blessed Thistle, Fennel, Blue Vervain, Alfalfa, Nettle, Raspberry." Plus, still nursing frequently and co-sleeping. Doctor suggested beginning supplementation with formula. She suggested just 1 oz/session, but I decided to take more of an on-demand approach. He gained 1.5 lbs in a week! At this point, I wanted off as many pills as possible, so went slowly off of all except domperidone.
4 months: Am now nursing on demand and supplementing, as well as pumping at night when Lex is sleeping. He usually has 15-20 oz formula/day and 4 - 6 oz breastmilk by bottle, as well as nursing. He is getting to be quite a chubster! Have just decided to try going back on Fenugreek at 2x3 dosage. I usually get 4 - 6 oz from 2 pumping sessions @ 9 p.m. and 11 p.m. combined.
So that's it for now. Was a lot of work to get it down, but am happy to have documented.


