Holy crap. I entered motherhood in complete denial. Not only did I imagine this beautiful home water birth, which absolutely didn't happen (read my birth story here). I was delusional in thinking breastfeeding would be this easy natural process. Natural, yes. Easy, no. Because Adler was 8 weeks premature his suck, swallow, breathe reflex hadn't developed yet. There is a lot of neurological development in those last few weeks that aid in their feeding. Fortunately in Germany where Adler was born they believe in the positive effects of breastfeeding, so they had us start breastfeeding on day one. This was great bonding time for Adler and I. They've done studies that breastfeeding can help reduce chances of postpartum depression. I fully believe and experienced this. There were two weeks that I exclusively pumped and bottle fed Adler. During those weeks I quickly started feeling down and one night told my husband Mike, "Adler doesn't even need me. Anyone could be his mom." I know and knew how ridiculous it was when I said it, but I was feeling low. Really low. That time spent together so close is our bonding time. It's when I feel most useful as his mom. Looking back now I better understand how I got to this current moment. I am being treated for a breast abscess and have sadly been through a 10 day course of oral antibiotics then 9 days of IV antibiotic therapy and just started my (fingers crossed) last oral course of antibiotics to kick this infection to the curb once and for all.
If you are considering breastfeeding your baby I can't stress the importance of a good latch. There were a several factors that started us down the path to a breast infection. His mouth was so small, since he was born at 32 weeks and 3 days. This prevented him from getting my whole nipple in his mouth. In the German hospital I had a lactation specialist watch us feed and she said things looked good. Granted this doctor spoke almost no English, so maybe there was more she wishes she could have said to us. When we arrived back to Red Deer from Germany the NICU nurses watched us a few times and said all was good too. I knew from reading Jack Newman's "Guide to Breastfeeding" that something wasn't quite right though. Breastfeeding should not be painful. Feeding Adler was excruciating. Every time Adler latched, especially on my right breast, I winced in pain. I kept trying to fix his latch, but what really helped his latch was time and growth. Eventually we fed long enough with a bad latch that my right nipple cracked. It was a small crack and seemed not to be a big deal at first. I only knew there was a crack because after he fed the moisture made the skin swell and you could see the split. There was no additional pain besides the normal wincing pain I mentioned earlier. Next a small lump developed in my right breast. I noticed it, but it wasn't painful so I just monitored it. Over the course of the week it started to grow. After talking with my midwife I started a few natural remedies for a blocked duct. I'd use a warm compress on it, I started taking Lechithin, eating raw garlic for the possible infection and massaged it like crazy. Mike would massage my breast as Adler fed. I tried feeding him from all fours with his chin toward the lump. Nothing seemed to help and in fact the lump got bigger and harder. My midwife and I started to get concerned that it would turn into mastitis, so she put me on a ten day course of Keflex. Nothing changed.
No better or worse. Once the antibiotic course was finished I started noticing the lump getting redder. This time I went and saw my family doctor. He sent me to get it ultrasounded that same day. After getting it ultrasounded the radiologist concluded that it was a galactocele which is a benign milk cyst. That put my mind at ease. I would just continue to breastfeed and when I was done breastfeeding the cyst would go away. I decided to try a little therapeutic ultrasound on the lump to clear any blocked ducts. Over the next two days things kept getting worse. I went back to my family doctor. He sent me to get some blood work done to see if there were signs of infection. By this time it was getting really bad. The lump was excruciating to touch, it was hot, pain was referring into my armpit and it hurt to move my arm. Mike and I made a game time decision that I couldn't keep waiting for results and that I had to take action.
Wednesday night he dropped me off at the Emergency Room at around 11pm. We decided that the worst place for Adler (a premature baby) to be is the ER. In Canada we are in the peak of flu and cold season and didn't want to risk Adler getting sick. Instead I brought my hand pump and would pump while at the hospital and Mike would bottle feed him at home. They took blood and started me on IV antibiotics, which was the beginning of my treatment for a breast abscess (pus filled sack). I didn't get out of there until 4am. The nurses informed me that I would have to come back every morning between 8-10am for my dose of IV antibiotics. The next morning when I went in for my treatment a surgeon came to see me and analyze the abscess. Fortunately Mike was with me for this experience. It was not pretty. The doctor concluded she wanted to aspirate the abscess which means stick a needle in it and draw out the pus with a syringe. She said, "We can numb the area which would just be one more needle would you be ok if I just do it?" I hesitated but agreed. At that instant she jammed the needle into my breast and started sucking out pus. She dug around which was excruciating and made me feel faint. After getting 5mL she decided I was in too much discomfort to continue and that's all she could get out. I went home feeling drained and defeated. There is one thing I was pretty set on, and encouraged by the doctors, and that was to continue breastfeeding.
Every morning I would go into the hospital after Adler's morning feed. He'd wake me up crying since he's demand feeding, I'd feed him, and then get ready to head into the hospital. Each day I had to check in with triage for my treatment. Some days I was in and out in 1 hour others it took 2+. On the fourth day the fluid was filling the abscess again, so the doctor took a look at the abscess with the ultrasound to see how big it was and where it was located. He concluded it needed to be aspirated a second time. He offered me the numbing agent and I accepted after confirming it was okay to continue breastfeeding with it. The needle for the numbing agent stung but not nearly as bad as the pain I experienced with the first aspiration. Two full syringes (20 mLs) later we were finished. It felt so much better and seemed to make a big difference. They determined I should continue my IV therapy until it was almost completely healed.
On the sixth day the doctor on call looked at the abscess again through the ultrasound. It had gotten progressively smaller and was feeling much better. He called the surgeon on call to see if they should aspirate it again or lance it. I had read that I should avoid lancing at all costs, so I was hesitant when that was recommended to me. Especially since my abscess was extremely superficial and not that big anymore. The surgeon decided that no more aspiration or lancing would be needed. If I continued IV therapy the antibiotics would eventually get everything all cleared up. Yay!
I think that mother's of premature babies (really all babies) should spend extra time with lactation consultants from birth until a few months old depending on how early they arrived. There are great resources online for breastfeeding at La Leche League. They have meetings all over Canada. If you're experiencing pain don't try and be like me and "push through it." More chances than not something is wrong with your latch and the fix could be as easy as switching positions or your baby could be lip or tongue tied... Looking back Adler's latch certainly was not ideal for the first two months. No matter how many times I tried to flip his lips open they always turned back in. This caused and sometimes still does
cause lip blisters. Adler is three months old now and breastfeeding isn't painful at all. The abscess is slowly shrinking every day. Breastfeeding Adler was the right decision for me, but know breastfeeding isn't for everyone. As a mom you'll know the right decision for you and your baby. Trust your instinct. Almost all the moms I've talked to have had some sort of breastfeeding issue whether it be a blocked duct, mastitis or another issue. You aren't alone. Breastfeeding is beautiful and I am so happy, for now, it's going well. Every day the abscess gets smaller and this horror of an experience becomes more a memory than my reality. I hope that by sharing my experience it can spare someone the pain and misery I went through.
MacKenzie and Adler