The Breastfeeding Battle

There was never any question in my mind whether I was going to breastfeed my child or not. I only knew that there was a good chance that my breastfeeding would be cut short when I needed to go back on my meds. So I had a plan in place - breastfeed as long as I could, and pump, pump, pump to build a stash so that my baby could have extended benefits. So I got my free breast pump through my insurance, got supplies, and was all ready for baby.

Ha.

Life never presents us with what we expect. After this saga, a woman I work with said something that stuck with me - something always goes wrong when we have a baby - either it's a hard pregnancy, or a tough labor, or feeding the baby is an adventure.

Well, I fell into category number 3.

Apparently, my little girl did not have a good suck, despite living on my breast for hours at a time and she constantly fell asleep while nursing.  After a few trips to the pediatrician, we had to start supplementing with formula. I made a bottle - and then immediately put it back in the fridge for my husband to give to her. I felt like a failure. It took her a little over 3 weeks to gain back the 12oz she lost at birth (most babies take 2).

I started regularly attending a breastfeeding support group at the hospital. It was there we figured out that she was only getting about an ounce and a half of breastmilk after nursing for an hour and a half. Her lack of suck had killed my supply. Breastmilk is produced on a supply and demand basis - she wasn't sucking enough, and so I wasn't producing enough. For the record, I am well-endowed (I had to go to a specialty shop to get my nursing bras), and I think that may have had a little to do with it as well. Big boobs do not equal lots of milk. If anything, I think milk likes to get trapped in mine easier than it does in someone with smaller boobs. Anyway.

The lactation consultant in the group suggest renting a hospital grade pump, and following the odious schedule of feed (15 min per side) supplement (with breastmilk/formula) and pump 15 min. Every. Time. She. Ate. Every 3 hours we'd start this cycle. I hated every second of triple feeding (as it's called). I did it for 4 weeks. 4 whole weeks. I'd have to listen to Kaley cry while pumping, otherwise, it wouldn't get done. And I was determined to get rid of the formula supplement.

After 4 weeks, I went to the support group and was down to about 2oz of formula a day (from about 8-10). However, she only gained about 2 oz that week (Babies should gain about 0.5 - 1 oz per day - I have since figure out that my little peanut gains on average .5 oz a day, at the very bottom of the curve). I was discouraged. However, when she ate, she was now eating over 3 oz in a half an hour nursing session, so we had made significant progress on that front. Then Life decided to throw a wrench in the system and my ankle gave out while I was walking down the stairs that afternoon, and I sprained my ankle.

I couldn't walk for 2 days. I had to take care of my 8 week old baby in my bedroom for two days. Pumping was not an option. So, for those two days, we spent the time in bed. And I realized that because I didn't have to pump, and I wasn't constantly looking at the clock, hoping I could get my pumping session in, we actually had fun together. She was just beginning to smile and play with toys (although at that point I was her favorite "toy"), and I was missing it because I had to ignore her while pumping.

I only pumped a few more times in the evenings, and then finally put my pump away and never looked back.

She still only gets about 10-12oz of formula a day, which is about 1/3 of her daily food intake. And we have a nice system now - and lots of smiles and laughs.

My biggest fear, though, during that 4 weeks of pumping hell, was that it was all going to be for nothing when I needed my Enbrel. I started taking prednisone at about 5 weeks postpartum. By 3 months, it was doing nothing. I was scared - I couldn't imagine not being able to breastfeed anymore. And I didn't have the stash I had so hoped to build up in the early weeks. But, my lactation consultant saved the day again, and pointed me to infantrisk.com. We looked up Enbrel and found out because it is such a large molecule, and is biologically unavailable via the digestive tract (the reason it has to be injected), it is a lactation category 2, and is safe for breastfeeding (although, there has been minimal research done and should be taken at the users risk). I took the info to my doc, he did a bit of research himself, and we both decided that it was fine! I've been back on it for 4 weeks, minus one where I caught a cold and had to wait a week to take it again, and it is amazing how good I feel compared to how bad I was feeling before it.

This may have been one the the hardest battles I've fought in my life. Breastfeeding is so very hard for some people, and there is so much pressure and judgement surrounding how your your baby (or parent in general...), but to have the added worry of what my RA would add to the mix, made it that much more difficult for me. However, my mom said to me a few weeks ago, that the one thing this whole thing had taught me was patience - because it requires a ton of patience to do what I did for those 4 weeks.

Reviving the dead blog...

Okay - this time I mean it. I want to revive this blog. There needs to be more stories of people my age (gonna be 30 next year!) who live with RA everyday!

So, what's happened since October of last year? I got pregnant and had a beautiful baby girl who is now 3 months old! I do wish that I had kept this blog going during my pregnancy - but looking back, my RA did go into semi-remission.

 After my last post, I pretty much 'gave up" on actively trying to conceive. I remember going to the store to buy the first pregnancy and ovulation tests after my miscarriage, and I just couldn't do it. So I figured the month of November was going to be a wash. My RA was acting up, I was taking prednisone tapers every 2.5 weeks. I literally had sex with my husband twice during the month of November - both times around ovulation, but not really on purpose.. The only thing I did do on purpose was to time a prednisone taper with ovulation - apparently RA can cause inflammation in the uterus, causing the embryo not to implant. People who use IVF are actually prescribed prednisone to reduce inflammation to increase their chances of implantation (inflammation occurs due to the procedure in their case). So I figured, what the hell? What could it hurt? A couple of weeks later, I was working from home and realized that I had been due for my period a few days before. This, however, was nothing new for me, considering that my cycle lasts anywhere from 26-39 days without being regulated with birth control. I decided to go out and buy a pregnancy test within minutes. I remember walking into my house with the bag in hand thinking to myself "I don't know if anyone out there is listening, but I could really use some good news right now." (Note: Neither I, nor my husband, are particularly religious). I took the test, and got my good news. I called my husband at work crying and laughing. I got to tell my parents that night because they were on their way for a visit - I couldn't have been more happy or more scared.

My doctor decided to get me in for an ultrasound early this time around (as we found out about the last mc at an ultrasound at 10 weeks). I remember sitting in the waiting room of the ultrasound office freaking out - it was early (like 6-7 weeks) and I knew I couldn't handle another let down. We go in - and there it was! We go to see the flickering heartbeat of our little baby.

My first trimester was a breeze  - other than the nausea (and the fact that I couldn't eat vegetables...). My RA came back in my second trimester, but I was teaching 5 classes, taking 3, and was 4-6 months pregnant. I was prescribed prednisone by my doc to take as needed (in 9 day tapers). We had our anatomy ultrasound at 18 weeks and saw my little Spawn (this was my pet name for the baby, as we decided to keep the sex a secret). My third trimester was spent at home, because it was summertime, and my RA went away again, although I had the worst sciatica ever.

On August 15th, my beautiful baby girl, Kaley, was born, after 7 days of early (prodromal) labor, 1 false alarm trip to the hospital, lots of walking, a trip to the ER for sudden onset carpal tunnel literally hours before she was born, 4 hours of active labor, and 25 minutes of pushing...I'll have to tell that story in the next post.

Heather

The Double Edged Sword of RA

Prednisone...How I love you for making me feel 99% better. And how I hate you for making me irritable, hungry and full of unnecessary energy at weird times.