She’s been crying for … 24 hours? Sure, not non-stop; she has to eat sometime, and she’s had a couple of little 20 minute naps. But otherwise crying, calming down for a minute when I do something, then crying again. Bouncing her on an exercise ball was the only thing that worked, and it’s hard to do that for hours on end. Swaddling didn’t help for very long and only when combined with the swing (but I took what I could get), and I had no luck with the pacifier. I tried various holds, and so on. Her hunger cues were not terribly clear, but I made my best guesses, and she never seemed too hungry, but would cry as soon as she was done and moved an inch.

I’m definitely feeling at my wits end, and fortunately Jason worked a short day and came home and took her. He’s had more luck with the pacifier than I have, but I don’t know that it’s going to last. Yes, half an hour of quiet is good, but I want to find out what’s wrong. I hate to rely on a pacifier, and worry that it’s going to make the breastfeeding issues worse, but we have to use what we have to use.

I can’t begin to describe the soul-deadening despair that sets in when NOTHING you do can get you more than enough time to eat a piece of chicken. The OT exercises are out the window, the dietary changes are being implemented, the gripe water didn’t do anything, trying having her go naked didn’t do much (10 minutes of quiet once). She’s got a pediatrician appointment tomorrow, which, at 15 hours away, seems like an eternity, and I’ve got a call in to the midwives since Friday. I don’t feel like I’m going to go insane, but I do feel like the only way to get through the day is to just go numb and automaton my way through it. It gets the job done but I feel bad at what I’m not giving her.

“Colic” gets better by four months or so. Three months of this is some kind of inhumane punishment, and I’m hoping and praying that there is something that someone can do to help us.

After the meeting with the occupational therapist, we now have a bunch of stuff to do to work on Daphne’s feeding. I’m starting to get the hang of giving resistance on her chin when she’s opening and closing her mouth, and she’s getting used to the lip exercises. But neither of us is doing great with the tongue exercises yet. She hates it with the pacifier (as in turning red, looks like she’s choking, and screaming hates it) and I’m not a whole heck of a lot better with my finger yet. I can feel what she’s doing with her tongue (no wonder my nipples hurt!), but she has a strong tongue and it’s hard to press against it without REALLY pissing her off. But we’re working on it.

It’s probably just the resistance on the chin getting a better suck, but feedings have definitely changed since we started this. They are MUCH shorter – 10 minutes on a side is a long feeding – and they’ve been almost all spaced out farther, to at least two hours between feedings. She is still, however, crying like mad for hours in the evening, and we don’t know if it’s too much food in her stomach, too fast of a fill of the stomach, or some other digestive issue. It’s fairly clearly digestive, and gripe water is somewhat helpful (though sometimes she need two doses, and it seems to also be helpful if I drink tea with the same fennel, chamomile, ginger ingredients) and she seems to have some degree of reflux (based on the spitting up and pain she’s displaying), but we’re not sure the best way of dealing with it. At the moment, though, those “now 20 minute” feedings are still close to an hour, as I try to keep her upright and not slumping on her stomach for half an hour after she eats.

I’m keeping my fingers crossed that we can get the tongue exercises worked out, and she’ll stop trying to squish my nipple to get milk.

well, I’ve got hope for there being light at the end of the tunnel. I don’t see the light yet, but I now have hope it is there, and after the past couple days, that’s saying something.

we met with the OT, Judy Simmons, this morning. Daphne cooperated well, just barely making it to 9:30a after her last feeding ending at 6:30a (we got kinda lucky, and I made Jason take her when she started thinking about waking up so I could remove the smell of milk). The OT liked her suck/swallow pattern, but first had to correct my handling of her. since my nipples point to the side, rather than straight forward, the traditional advice of wrapping the baby around my body and lining up her nose to my nipple doesn’t quite apply. I do want the nipple pointing up into her palate, but I also want her body lined up with my breasts, and her head in a closer to neutral position (mostly due to the nipple pointing issue). my tendancy is to turn my body into her, in order to get ahold of her head, but it leads me to, as Judy described it, chase the baby around.

after watching and listening to Daphne and I nurse, she checked out some anatomy and physiology. one of the first things she noted was that, particularly after the initial feed, which goes relatively well, she would start over opening her mouth which led her to close too forcefully, much like babies start flailing their arms, rather than move then with control. so, she put a finger on the bony part under the chin to offer a little resistance when Daphne opens her mouth – not enough to move her head, just to stabilize her jaw muscles. this makes her not ram her jaw open, but pause to get a good draw that’s not possible with a flailing jaw, and not over close her mouth as well. of course, timing the resistance on her chin to when she’s opening her mouth isn’t the easiest thing in the world, but it does seem to be helping. over time, as her jaw strengthens, I shouldn’t need to do this for her.

she also noted that Daphne was doing a pretty good job curling her tongue (which they need to do in order to wrap around the nipple and get a good long suck), but only the first third of her tongue, and only at that initial suck where the milk was flowing fast. she was adapting to using a weaker tongue to pull milk out by rounding the middle of her tongue and compressing my nipple! (this is what’s been leaving the big tell-tale crease across my nipple, and rubbing one half of it raw.) so, we have exercises to do to help press down and draw forward on her mid-tongue as she sucks, either using a finger or a pacifier like a soothie. I’m happy and all that she’s adaptable and figured out a way around the slower flow and weak suck issues, but not when she causes another problem! besides the tongue exercises, though, we’re going to try occasional use of a nipple shield, not only to let my nipples heal, but to encourage her to use her tongue properly, since it changes things just slightly. (nipple shields, however, are a pain in the butt to use. I’m sure we’ll get the hang of it, but I look forward to not having to use it for the next year!)

additionally, she saw the lip curl that Daphne often likes to do, and thinks that she’s got tight muscles around the lips at the moment. it’s particularly hard to try to suck properly with your bottom lip is curled under (go ahead, try it), so we have a couple of lip exercises to work on that as well. the top lip curls under a bit too, and Judy is hopeful that it will only be a couple of days before I notice her not curling them under so often with these exercises.

she talked to us a bit about bottles, and finding the slowest possible flow rate we can for when we have Jason give her a bottle in the evening to help me keep my sanity. she also gave us a reference guide that gives us estimations on how much she should be getting in each feeding if she’s eating breastmilk alone. (she gave us that along with the caveat that the numbers on it are rough approximations, she’ll vary from feeding to feeding and from day to day. as best we can tell from weighings and her growth rate, she’s doing just fine.) she was fully supportive of not only taking her off the breast if she’s just hanging out there flutter-sucking (as it doesn’t encourage proper sucking action), but mentioned that babies this young don’t yet have the ability to unlatch themselves (without falling asleep and having their muscles relax involuntarily) so the pulling and flailing at the end of a feeding is her trying to get off the boob, but not knowing how. oh, it’s wonderful to know that it’s a sign I should unlatch her, because that is an uncomfortable experience.

in the end, we hope to get to feedings that are 20 to 30 minutes, as the 60 minute feedings are hard on her (tiring from all that work) and me (tiring from all that work!). and she was supportive of encouraging Daphne to try to get two or even two and a half hours between most feedings, not only because Daphne feeds better that way. she clearly didn’t suggest putting her on a schedule, but reinforced our current plan of trying to distract her for a little while if she starts indicating hunger an hour or hour and a half after she’s eaten.

finally, Judy mentioned that she saw a number of minor signs of reflux – the wet burping, the distinctive swallow, spitting up a bit after eating (fairly regularly), the fussiness in the evenings, and even the short time between feedings. so, keeping up the burping, keeping her upright after feeding, looking into an elevated surface for sleeping, not trying to get her to go too long between feedings, and possibly more regular use of the gripe water. I’ll also keep an eye out to see if anything I’m eating is making it worse (I’ve already eliminated onions, though I’m not certain I had to; chocolate may be next, which would be sad).

so, we had a lovely combination of (at least) three or four small issues that came together to make breastfeeding quite less than ideal.

all in all, I see hope in the tunnel of breastfeeding problems we’ve had. not quite light yet, though her first feeding after that appointment went better than they had in a little while. this may have been essentially a placebo effect – there were things I could do, so I felt better about it – since I still had some creases on the nipples. but we don’t expect this to be an overnight fix; it may take three or four days to notice a difference, and may take longer than that to provide a bigger change. still, in times like these, hope is almost as important as a fix. and I’ll take whatever hope I can get.

Four weeks (well, four and a half), and we’re still dealing with breastfeeding issues. “It’s learned, by both mom and baby,” is an understatement at best. The real trouble is that there isn’t a whole heck of a lot of support in that learning, and let’s just say that self-teaching breastfeeding is a recipe for disasters of the “oh, I didn’t know that wasn’t normal” kind. Really, there should be like a daily “meeting” with someone who knows about good/bad latching/feeding every other day for the first two weeks of breastfeeding. Because the line drawings in books and that movies on the internet (which is still a big step up for my generation) just aren’t good enough – this is the sort of thing, much like yoga, where it’s really quite useful and important to have someone give you feedback from an external viewpoint.

The story so far: I have been concerned that Daphne’s frequent feedings (eat for 30-60 minutes, then eat again 60-90 minutes later; lather, rinse, repeat the whole day long) were a sign of something not being right. Add to that the crease across my nipple, and I was pretty sure *something* was up. Since she’s feeding regularly and gaining weight well (8lb 0.5oz at birth, 7lb 6oz at day 4, 7lb 10oz at day 9, 8lb 7oz at day 25), Jason hasn’t been convinced there’s a problem. Of course, he’s not the one with her mouth chained to his boob. (Seriously, I picture a pierced nipple with a link chain attached to it that ends at a studded bracelet on Daphne’s wrist. S&M for the mom/baby dyad. -Speaking of which, apparently, english is one of the few languages that does not have a unique word for the mother/baby pair as a single item! Who knew!) But I followed up with a rambling, no-actual-question-asked email to my doula, which Jason pointed out was kind of unfair since it didn’t really have a clear question/issue. While true, it was one of those “my brain can’t function but thinks something is wrong” sorts of things. Seems to be a specialty of motherhood.

Following up on her suggestion, though, I went to a La Leche League meeting that was the next available day. It was interesting, and seemed very open ended (“what do you think of when you think of breastfeeding”, “have there been issues with the family about it”, etc.) but then did have some help from the leaders for two of us with feeding issues. The woman who worked with me for a bit tried a number of holds (which I seem to be fairly terrible at – it seems like I have oddly short arms and small hands for the things they want me to do, but maybe I’m just not getting the hang of it yet) but overall seemed to think I had a latch problem related to her not opening her mouth enough. We thought we had worked through this problem earlier, and to some degree, we must have, since my nipples had been able to heal, but there is clearly some variety of issue going on preventing a deep enough latch since there is nipple evidence to show.

After everything we’ve tried, however, we’re on to stage 3 – the pros. After a referral from the midwives, we’ll be seeing an occupational therapist Friday morning. Let me say, I *KNOW* that this issue is not life or death, or even “emergency”, but it feels like waiting three days to fix a latching issue is horrid. I’m hoping that we’ll discover something more useful than “well, she has a small mouth compared to the size of your nipple”, because that problem will take a lot longer to fix, I expect, than many other options.

It’s certainly not comfortable to continue with the latch issue as it is now, but it’s manageable, from my end of things. I am hopeful, however, that fixing this issue will make breastfeeding less uncomfortable, and perhaps help make her more efficient, which would be nice so we don’t always have to spend 30-60 minutes feeding! In the hopes of preventing a supply issue due to bad latch, however, I’m taking fenugreek in the meantime, and continuing to pump once a day so we can have some spare around for supplementing on those nights she seems ravenous.

In other news, but baby related, she’s had a couple days where she’s had a couple smiles (not intentional yet, but she had enough stomach upset that she was doing mostly a lot of less than happy faces). Those make everything a little more bearable, because hours on end with a stink-face baby is tiring, and with a crying baby is exhausting. In an effort to address that digestive upset, however, I’m trying to be more consistent in her supplementation with probiotics (I just came off antibiotics myself) and will be making my own gripe water (fennel, ginger, and chamomile) and probably give her a bit more regular dosing. She definitely seems to NOT like the process of farting, and seems to get fussy a good fifteen minutes before she needs to. Pretty much the same for pooping.

She’s also getting stronger – if I have her in my lap, facing me, leaning forward, she’ll push herself off my chest and sit upright momentarily before falling to either side or backwards into my hands. Her head control is improving right along with it, able to keep her head up for a few seconds at a time, and seemingly able to often stop it from just rolling around. That doesn’t mean she’s really enjoying the non-chest-to-chest tummy time she gets, but she tolerates it for a while. (Which is ironic, because – bad parents that we are – we allow her to sleep on her belly when we’re in the room, and she much prefers sleeping on her belly, but if she’s awake, she wants to be upright!) Fortunately, I picked up a K’tan baby carrier yesterday, which is easier to use than the Moby and lets my hands be free while she’s snuggled against me.

The trip out to pick up the carrier and attend the meeting, however, was slightly more than I had brain space and energy for yesterday. (As you can see by the disjointed nature of this post, brain space and concentration are at a minimum these days.) The driving was taxing, even without significant traffic, and the frustration of trying to feed her without the pillow I usually use for support and dealing with the bad latch AND what was growing gas just made for a draining day. When followed, upon getting home, with two and a half hours of feeding back and forth trying to get a good latch, it was exhausting and emotionally draining, and I just had to have Jason sit with me while I fed her – eventually giving up on trying to improve the latch – because I was overwhelmed with it all by that time. I’m glad he got home soon after I did so he could just be there. And I’m very glad that she slept relatively well last night so that I could recover a bit.

Hmm… perhaps some day soon I can have things in a blog post that aren’t entirely baby. But right now, my life revolves around my boobs and her digestion. What a life!