Tuesday, September 15, 2015

Bilirubin and Breastfeeding Woes

Since I last wrote 5 days post partum, there has been a lot of stress. Not even referring to the "normal" newborn stress of sleeplessness and juggling two babies. Stuff beyond that.

Beginning at five days post partum, A started refusing the breast. And by refusing, I mean writhing away, crying uncontrollably for hours, etc. Horrible as a mother seeing and hearing this. We had gone to the pedi earlier and she thought his tongue was tight but since he had gained weight and was eating let it be. We had agreed but he went over 10 hours without eating and by dawn we were scared and fed up. We made a pedi appointment Wednesday as soon as they opened. When we got there they agreed it was concerning that he was not eating, obviously he had lost weight, and he was looking more yellow. They suggested formula, bottles, things that freaked me out and angered me. 

Even though they had gotten A to breastfeed at the pedi, once we returned home it was the same struggle as the day before. We contacted a periodontist to see about a frenotomy but they could not see us til the next day. I texted someone from La Leche League and she said feed him by dropper. That was a pain in the ass. A did not take the milk in steadily so I spilled milk all over the place and baby started smelling like sour milk. It honestly added to my odiousness of him at the time. I was so frustrated that I yelled at him, at my husband, cried uncontrollably, everything. I even said I hated the baby with such vitriol it makes me feel guilty and sad it happened. 

Later Wednesdsy, pedi called and said A would have to come back on Thurs to get bilirubin checked as it was high still. No surprise since he was not eating. 

We continued Wed to offer the breast to A (refused every time) and feed with the dropper. So every feeding was long, tiring and filled with tears from A and me. 

Thurs we hauled ass to the periodontist for a 7 am appointment. They confirmed diagnosis of tongue and lip ties and used a laser to burn and seal skin. Unfortunately, we were not able to breastfeed after the procedure - a huge disappointment. I was crushed. More tears and anger flowed. 

From there we headed to the pedi. A had neither lost nor gained weight. His bilirubin was even a bit higher, but basically the same. So we were asked to come back Friday (yes, for fourth day in a row!) and expose him to indirect light at home. Sitting on the deck as a family overlooking the canal was very much needed but it was still a long night ahead trying to feed A. 

From pedi we went to my OB to get me Checked out and P got circumcised. We could not circumcise A due to the high bilirubin. More sunlight exposure later and more feeding struggles. Contacted two lactation consultants and got one to come out to our house on Saturday.

Friday, pedi appointment again and bilirubin declined, but they wanted to see A again on Monday. Getting so sick of these trips to the doctor!! Messes up the whole day and makes me sad that my precious time with C home is spent making these trips.

Saturday consultant came and spent  three hours at my house. She even observed P eating, which was helpful. I learned a lot, one important thing like do not force baby's head into position (sonething everyone else did when "helping" us) use their tush instead to position them. Also, how to set up a good breastfeeding from skin to skin contact. She did say, however, that the twins are not even "born" yet, and therefore they do not fully know how to eat yet. She felt I would see immense improvement around 40 weeks, and in the meantime, use a bottle with expressed breastmilk to start sessions if needed, offer breast periodically during feedings and at every feeding, and do tons of skin to skin.  Also she was very impressed with my supply, already enough to freeze 7-8 bags! But she reminded me to keep pumping if A did not feed from the breast. She also stressed the importance of the post-frenotomy exercises that we have been doing with A to promote healing of the procedure and to retrain his sucking muscles. Yes, 6 times daily we must massage the sites of the surgery, manipulate his tongue, push the frenulum back, all of which hurts and infuriates poor A. 

Of course, the first time I tried to feed A after she left he would not nurse. I broke down again. It seemed when people were helping us he would eat but once we were left alone I was unsuccessful. C was taking pics, videos, reading articles with me, yet we were both helpless. 

In a frenzy, I texted the consultant and La Leche League leader what should I do? Should I give up? I feel less connected to this twin, help!

The consultant was particularly encouraging. She said Things will improve soon and to stick with it. Also to keep sending her picd and she will critique them. La Leche person invited me to a meeting tomorrow to get tips from her coleader. 

Sooooo luckily in the past two days things have improved. I started noticing A would root a lot more for the breast and make an attempt to suckle it. He started opening his eyes more while eating, seeming more calm. He even started nursing a bit after the bottle (about 1/2-1 ounce) and three times even refused the bottle and nursed right away! 

Hopefully this trend continues. 

Of course, despite all this shit, I am thoroughly enjoying the boys. I love cuddling with them. I admit I sleep with at  least one at least once during the night and seeing their REM, hearing their coos, feeling their twitches, smelling their hair, is just so special. 

1 comment:

  1. How's it going?! Need an update! I'm still preggers. Hope you and the boys are still doing good.