Tuesday, February 26, 2013

Breastfeeding with P-Nut: Part 1

Every time I've mentioned breastfeeding so far with P-Nut I've said, "it's going great" or "she's a breastfeeding champ!" That was the case in the very beginning but things have most certainly changed and I've been experiencing some hardships.

First of all I will say that although I chose to breastfeed both Little C and P-Nut, I do not think that formula is evil. I breastfed C for one month before switching to exclusively pumping. That lasted for 2 1/2 months. So all-in-all C received breast milk for 3 1/2 months (along with supplementing when necessary) and straight formula the rest of his first year.  We are also currently supplementing with P-Nut as needed.

I'm not here to preach about how "breast is best" I just want to share my story in hopes to help someone in a similar situation. I hope everyone out there does what is best for them and their baby.

As for me, I really want to breastfeed for as long as I can but I will be the first to tell you that I'm seriously going day-to-day on that right now. It is not easy and even though I believe in the benefits of breastfeeding I also believe that a happy mom makes for a happy family. Right now, breastfeeding is not making me happy. I will touch more on that topic in another post because I want this to be focused on the logistics of what is going on.

From the beginning we've had a good latch and Little Miss P-Nut is doing her part as far as sucking goes. That is already leaps and bounds better than it was with Little C. But then all of a sudden she started becoming extremely fussy in the evenings and every time I offered her my breast she would pull off and shake her head from side to side very quickly as she cried. I assumed it was because I didn't have enough milk for her at the end of the day and she was angry about it.

I started to pump in the mornings to ensure we had a bottle (or more) for her in the evenings when she would start fussing and that seemed to make her happy. She did not experience any confusion switching back and forth between breast and the bottle. 

Since I wanted to have a bottle for her each night I started to feel pressure to make sure I was able to pump one for her. I wanted to avoid the stress her and I felt each evening while she was fussing terribly and having the bottle also allowed the Hubs to participate and give me a break. But the stress I put on myself to get that bottle would cause me to sit at my pump with nothing coming out! My milk would not let-down. That is a terrible feeling.

I would sit for 20-30 minutes with not so much as an ounce coming out. I would start to get tense which didn't help anything, plus I was in pain. I noticed after a long day of breastfeeding, and especially after I pumped, that the tips of my nipples turned white. They were so incredibly painful and uncomfortable. I'm talking pain radiating from the tip of my nipple, deep into my back. It goes away but while it's there I am miserable.

So between my fussy baby refusing my breast, the lack of let-down at the pump, and the pain radiating from my white nipples, I knew I needed some help. In addition to doing some research online I made an appointment with a lactation consultant (LC). I am so glad that I did!

She came to my house and spent two hours with me observing, offering advice and answering a plethora of questions. Here is what I learned:

1) I have a forceful let-down. Based on what the consultant saw, P-Nut was pulling off my breast because the milk was coming too fast for her to handle. And here I thought it was because I wasn't producing enough milk. The LC showed me some positions for breastfeeding to help ease the forcefulness of the let-down. I also learned more from the Kelly Mom website.

2) The white nipples are caused by something called a vasospasm. The blood vessels are constricted during nursing and when the baby releases and blood is able to flow back into the nipples which is when the pain is experienced. Also, since I have the forceful let-down P-Nut is clamping down on the nipple to try and slow the flow.

Another possible cause of the vasospasm is something called Raynaud's phenomenon which causes poor circulation to the nipples and sometimes other extremities. I don't think Raynaud's is the culprit at this point but I will be discussing it with my OB/GYN at my postpartum appointment.

  • The most important solution for this is to make absolutely sure that her latch is correct and to not let either of us get lazy with it. (So far this has been a huge help)
  • After pumping I immediately put a dry, warm heat up to the nipples. I could use a rice sock or a heating pad but so far it works if I just use my forearms or press a blanket against myself and wait for my nipples to get back to normal. I have to press very firmly to ensure I don't feel the pain. Before I knew what this was I didn't want to touch my nipples for fear it would make the pain worse. I'd wait to put my bra back on and I would just let those suckers air out. Turns out I was causing the pain to be worse by handling it that way because cold air leads to poor circulation. I'm so glad I know this now!
3) P-Nut has colic and a food allergy. I had mentioned in my 1 Month Mama/Baby update that my little bundle is super gassy. At first we were told it was normal but then it started to get worse. More constant and very stinky. It was also apparent that the gas was causing her pain and she would arch her back and cry... A LOT. She developed a rash on her neck and cheeks. Reddish little bumps that were found no where else on her body. The LC suspected a food allergy and urged me to call the Pediatrician.
  • Our Pediatrician agreed that the rash was from a food allergy and she recommended that I cut out dairy from my diet. The proteins found in cow's milk can be very hard for baby's system to digest and that is probably the culprit for the gas. Also, the forceful let-down can cause gas so everything we've been experiencing is all related.
  • The LC urged us to get different bottles. I've been using the Medela bottles that came with my pump. They are what we used for Little C so I didn't go out and buy any new ones. Apparently, Medela's bottles are the worst for letting air in and are not good to use with colicky babies. Who knew?!?! I purchased Dr. Brown's wide mouth bottles for colic and they have been working great.
  • We use gripe water when necessary and use all the soothing methods we know of when P-Nut has an episode. All of the combined efforts are really helping.
  • We should use a soy based formula when we supplement. Other formula's are milk based so we had to make the switch. The Pediatrician also said that since we are only using the formula to supplement an ounce here and there, we could go with the more cost effective Target brand which is a very good product. I love how she looks out for my baby and my wallet!
4) Relax at the pump. If I put pressure on myself to pump 10 oz. (5oz. on each side) every time I hook up to the machine, I will drive myself crazy. Now that I know why P-Nut was fussy in the evenings I don't feel as much pressure to have a bottle for her every night. I still try for that but I've taken the pressure away. Now, even if I get 2oz on each side I don't stress because we have techniques to soothe her when the colic flares up and we have the soy formula for when there isn't enough breast milk. Pumping has been much better since I've relaxed.

So there you have it. If you take anything away from this post it is that breastfeeding is not for the faint of heart. If you are committed to it I urge you to get as much help as possible, whenever possible. Don't suffer through it. Doing research online is a great start but getting help from a real person who knows what they are talking about is by far the way to go.

My experience with Little C could have been much different if I had done more research and was willing to get out of my comfort zone and ask for help. And I would still be letting my poor nipples "air dry" after pumping, causing me more pain and I'd still be eating dairy and have a very angry baby on my hands if I hadn't sought out help.

Like I said before, do what is best for you and your baby and please know that you are not alone. Breastfeeding is not a piece of cake for everyone and you will find that there are more moms who struggled or are struggling with it than those who have no problems. And be sure to never forget those five important words...

You are doing a great job.

Keep it up, mama!

For my Part 2 installment click here.


  1. Beautiful! Thank you for sharing this ... interesting how our first reaction is we're 'failing' as a mom when baby gets fussy. Warm wishes.

    1. I know! The first reaction of failing is unavoidable even when we know it is probably nothing we did. Very interesting, indeed. Thanks for the warm wishes. :)

  2. I so remember those days of being like "There's no milk coming out!" So hard to trust our bodies when we can't "see" the product as it goes straight into the baby! I hope you find your breast-feeding groove again. It's great that you're being flexible with yourself and giving it all you've got.

  3. Thanks for sharing! It seems like you've got so much figured out but I can imagine it was quite a challenge and a long road to get there. You're doing a great job! :)