Breastfeeding, pregnancy and a miscarriage

Here's the story of the beginning and the end.

On the night of December 6, 2014, I took a home pregnancy test because I felt I might be pregnant. My period wasn't really late yet, but I didn't feel any PMS and was curious. It didn't help that I also had plenty of unused tests lying around begging to be peed on. I got a faint positive line! After a few days I retested and got the same very, very faint line. Almost unnoticeable, but it did get darker out of the time frame specified on the package. So there definitely WAS some hCG (human chorionic gonadotropin, the hormone released during pregnancy) going on there.

I finally went and got a blood test December 10th just to confirm. HCG measured at 68, which is kind of low, but doesn't necessarily mean something is wrong. It was still early on. Progesterone was nice and high. The midwife who ordered the blood test and gave me the results was convincing me that I have to wean if I want a health pregnancy, but since I knew I had no problematic history and my progesterone was fine, there was really no reason to stop just yet. And it's a good thing I didn't. At that time I didn't know it, but breastfeeding would become my healing and coping mechanism.

I never experienced any pregnancy symptoms, just a missed period! No nausea, no cramping, no weird pains, no tiredness and fatigue, nothing! I kept thinking something was off because last time around I was feeling lots of symptoms at this point in the pregnancy. I got some pimples (which I never got last pregnancy). I wasn't curious for too long because on December 28th I started to bleed. First like a period, but then like Niagara Falls.

The next day I went to the ob/gyn office and the midwife who examined me said my cervix is closed so that's a good sign, but she ordered a vaginal ultrasound and blood test to see what's happening. Blood test on December 29th showed an hCG count of only 2300 which is way too low. The numbers have to double every 48-72 hours, and this was way, way behind. December 30th was the day for my ultrasound appointment and the results: no heartbeat, gestational sac inside the cervix, something else on one of the ovaries. So clear, I know. The doctor was also confused.

January 2nd I retake the blood test and the level is now at 568. That's a very good sign. Still bleeding. January 5th I pass what seems to be the embryo or whatever because it's just one big blob of something indiscernible. Finally. After that bleeding tapers off, my levels continue to drop, I breastfeed Sam.

It was so, so good that I was still able to nurse. Imagine I'd have weaned and then after this experience I'd lose that delicious, pleasurable, nurturing mothering bond. Devastating thought! Each time I nursed Sam throughout this ordeal, it gave me renewed strength. I delighted in nursing, more than I ever did.

I did not ignore the midwife's advice completely, though. I did drop two feedings in the span of those few weeks. I felt they weren't really necessary anyway, plus I needed more sleep (less waking up at night). It wasn't difficult at all because Sam ate much better and his sleeping development progressed to allow him to sleep much longer stretches at night.

Some points:

• My supply was not affected by this at all. In fact I didn't have any hormonal drops in supply that I normally got with ovulation. So that's a good thing. People think the day they become pregnant is the day their milk supply vanishes into thin air and they've got to wean ASAP. It doesn't work like that. Most of the time the supply changes occur during the second trimester.
• The myth about breastfeeding during pregnancy causing miscarriages? Well, here's an explanation: For a pregnancy to be able to continue and the fetus to grow and be supported, you need adequate levels of progesterone. That's what thickens the uterine lining every month. Breastfeeding is associated with lower levels of progesterone. In most cases, if a woman doesn't have any history of low progesterone, breastfeeding will totally not cause a loss of pregnancy.

New menstrual changes during breastfeeding

I just got my second period after having a miscarriage. More on that soon. It's weird. Remember I wrote about how ovulation found me experiencing sudden letdown issues, resulting in less output but normal everything during periods? Well, now things have become the exact opposite! They do say that your menstrual cycle can change with each pregnancy you go through, so it makes sense. When I ovulated this cycle, I really wasn't sure if it was actually happening or not. I did not feel any nipple soreness during breastfeeding, no letdown delay, no supply drops, no stomach cramps... nothing! I just saw some extra discharge but that could have been anything. I still marked that day down in my calendar.

Two weeks later to the day I get my period. So I guess something did happen then. I just felt no breastfeeding-related symptoms. However, I got them now with my period! Guess I can't escape it. I feel the soreness, the stunted letdowns, less swallowing on Sam's part, and all that. However, the period itself didn't come with its own symptoms (yay!) like cramping, vaginal itching etc.

So if you're feeling despondent about how your body is running through its menstrual cycles in a way that's much more annoying than it ever used to be, don't despair. It can change yet again, and hopefully for the better.

What does breastfeeding feel like?

I saw this amazing quote in a thread on La Leche League's forum, written by MaddieB:

"ONLY mom has the goods. No one else can provide your child with what you can when it comes to nursing. Nursing is not really like anything else. Imagine the most delicious drink, the most satisfying meal, the most loving hug and the sweetest kiss all wrapped up in one package. Throw in a magical balm that instantly relieves both physical pain and emotional anguish, and you will begin to have some idea about what nursing feels like to a child."

Hungry? Or not?

I met a cousin of mine over the weekend. She is a new mother to a 6-week-old baby. When I casually inquired how breastfeeding was going, she smirkingly answered, "Oh, my baby gave up on me after a few weeks!" Then she explained that her baby was always "hungry" after nursing and "she always wanted a bottle afterwards" so "I wasn't going to starve her."

After hearing that I really felt bad that this happened. Of course every mother knows what's best for her child but sometimes a bit of myth-y information can really lead her to make uneducated guesses and then decisions that probably aren't best for her baby. Let's see if we can figure out what went on with my cousin's baby.

My cousin was able to pump normal amounts of milk so she did not have a milk supply issue. Her baby was able to suck ok and transferred milk fine. Her latch wasn't a problem either. So then what happened? Babies love to suck. If a baby is given a pacifier, he'll probably enjoy it! A bottle is like a pacifier in that sense so many babies will gladly take a bottle at any time if offered (although Sam was NOT that kind of kid) even if they aren't hungry. Think of yourself after having eaten a delicious dinner of rib steak, fries and vegetables. You're probably feeling well-sated and going "ahhhh". But if I then served you a gorgeous dish of gooey chocolate brownie and mocha ice cream with fudge sauce, would you honestly turn me down? Babies love a good dessert too (and formula tastes great).

My cousin nursed her baby. Her baby was probably satisfied with the feeding, but probably not overly full (like bottle-fed babies tend to become after a feeding). Her baby cried for any of the following reasons: gas, general fussiness, the need to burp, dirty diaper, wanting to nurse for dessert, wanting to be held, or one of the other thousand inexplicable reasons why baby cry. She assumed her baby was hungry and offered her a bottle, which she slurped down (think of yourself attacking your dessert plate with gusto). Was her baby truly hungry before the bottle? No.

There's actually a condition called "Perceived Insufficient Milk" (which I believe I've experienced at some point!) where a mother honestly thinks she doesn't have enough milk for her baby. This happens when a mother misinterprets her baby's cues for hunger and she therefore thinks her baby is always hungry even though she isn't. This often causes premature weaning because the mother will just end up supplementing, assuming there are no solutions anyway.

Nursing more often than "the schedule" stipulates

Yes, I know the title is confusing but here's what I mean: Do you ever go back to breastfeeding more times a day once you already established less feedings per day? Say, you're nursing 5 times a day. Does it make sense to ever suddenly nurse 9 times a day? I think this would be ok even though it sounds "off schedule".

First of all, nursing doesn't have to be on a schedule like a high school curriculum. It's ok to nurse 8 times one day and then 20 times the next day. I do understand that it's nice to have a routine to rely on for stability. I enjoy a relaxed schedule because I work full time and we do need some sense of order. But sometimes I have to break out of that model. Like I've said numerous times, relaxed schedules are way better than fixed, rigid ones.

Like this week. Sam is nearly 15 months old. At this point he nurses once in the morning, once after work (sometimes not) and once before bed. Then he'll nurse once more during the early AM hours. This has been going on for about a month or two now. But last week he got pneumonia on top of an ear infection. And just when he was about to finish his 10-day course of antibiotics, he developed a stomach virus of some sort (we don't know yet if it's shigella - we'll get the results back one of these days). For the past two days he refused to touch any solid meals and would very reluctantly drink from a cup (only a few sips at a time).

I was scared he'd get dehydrated without the fluids and nutrition. So I turned to breastfeeding to help me out here. I just nursed him a bunch of times a day and I felt so good doing it. I was so happy I had this backup ammo to ease me out of this frightening situation. Sam would nurse almost always, even though he wouldn't want to drink other fluids. And he needed the liquids!

According to my baby's pediatrician, when a child is vomiting and or having diarrhea, the number one fluid of choice is breastmilk. Number two is Pedialyte, and number three is any other drink. I was surprised to hear him say that since it's known that many pediatricians aren't major proponents of breastfeeding. Sure they'll tell you to nurse your baby but they don't really encourage you or help you out with difficulties. Like this doctor had no problem telling me to just give formula bottles if I wanted him to drink more (as if that would work - he hardly enjoyed drinking EBM bottles!).

So we basically nursed a lot the past two days. In between, I gave him a sport popup water bottle with Pedialyte inside (that gets the fluids down a lot faster than a bottle or sippy cup would). He was able to keep some foods down, like corn flakes, baby cereal puffs, and potato sticks (the snack type that's similar to potato chips).

Now I've got one more reason for why I'm still breastfeeding Sam at 15 months :)

Sleeping through the night and breastfeeding correlation

I randomly thought about this the other day and I wonder if this idea is of any significance. I noticed that mothers of babies who sleep through the night early on (sleeping longer than 6-8 hour stretches, in this case) are less likely to nurse their babies past the half-year mark. It's just that whoever I talk to whose babies were such good sleepers as newborns and young infants said they didn't nurse beyond a few months.

Here's why I think that happens. It's widely known that milk production gets a real boost during the nighttime when prolactin, the milk-making hormone, is at its best. Nursing (or even pumping) at night really gives your milk supply an edge even beyond the nighttime. Now, if a mothers isn't breastfeeding her baby at night because the child sleeps through the night (and why wake a sleeping baby?) her prolactin doesn't really get chance to shine.

If milk supply isn't given that extra oomph from nighttime nursing, it might not function so well during the day. This is even more hampered if a mother works full time and has to rely on pumping during the day to keep up her milk supply. If a mother can stay at home with her child and nurse on demand then this probably isn't such an issue because a nursing baby can effectively extract enough milk (whereas a pump doesn't do that great of a job).

Now this is far from a scientific fact; it's just a speculation on my part. What do you think? Do you have evidence to support or disprove this claim? If yes, share it! I will try to conduct a poll about this on a breastfeeding website and share the results here.

Finger-feeding a baby who can't breastfeed

Sometimes a baby is born with some sort of difficulty which makes it hard for him to nurse properly and or obtain a good latch. Sam was like that. Due to his tongue tie he wasn't able to latch onto my nipples or even suck that well. Only the second day did he attempt a little sucking and by the third day he was able to actually nurse for an entire feeding. So what happened during this time? The hospital staff fed him bottles. I had no choice, really. They did not tell me anything about hand-expressing colostrum (idiots) and they just found it easier to feed him formula, so that was what happened. My sister did give me great advice about that, though. She said to have the nurses use a breastfeeding-friendly method when administering the bottles.

If you read what the internet has to say about that, you'll see all kinds of suggestions from using an SNS (supplemental nursing system), to cup-feeding, spoon-feeding, dropper-feeding, and finger-feeding. The SNS is a really helpful tool (based on what I've read online and heard from mothers who have used them) but I don't have much info since I've never tried it out. Cup-feeding and spoon-feeding sound very messy to me. I know that Sam couldn't easily drink from a cup until he was several months old so no way could I see that working when he was a few days old! Droppers don't sound bad, and I've resorted to using that at times when he was reluctant to eat (I have plastic pipettes).

Which leaves finger-feeding. How does this work? You (or whoever is feeding the baby) wash your hands (important!) and fills a bottle with milk or formula. Then you attach a lactation aid which is really a thin tube that can attach to the baby bottle. Tape the other end of the tube to your finger and let your baby suck your finger as if it's a nipple or pacifier. Release the milk into the tube and your baby is now being fed!

This was a great method to use in our case because Sam was able to build up his sucking muscles while eating, but without the nipple confusion a regular bottle would have caused. I wanted him to learn to suck on skin, not silicone. I actually never did this because the nurses in the hospital were doing it for me, but the technique did work to help Sam suck better, and it got him fed without a bottle!

So if you're in such a situation where your baby can't nurse for whatever reason, don't give up hope. You probably can sort out your breastfeeding issue, whether it's a physical issue like tongue tie, or a milk supply issue. But in the meantime, there is no reason your baby has to be given a bottle. Bottles don't help as well as other breastfeeding-friendly methods do. Plus you can give your baby your own milk most of the time!