Supplementing *warning boobs discussed*

When I was pregnant with Walter, I had planned to exclusively breast feed him.  "Breast is Best" right?  Especially when we found out about his Cystic Fibrosis, I was more committed to the idea of breast feeding because of it's immunity boosting benefits. Well up until two days ago little Wally had never had anything but my breast milk to eat.  Before I explain his new supplemented eating plan, I want to share a little of what I've been doing to achieve my goal of breast feeding...

***Disclaimer 1*** I do not judge mothers who choose not to breast feed, or who want to and can't for various reasons;  believe me-I know how hard it is!  I am simply sharing my experience of pursuing breast feeding.

***Disclaimer 2*** This is a long-detailed post.  Feel free to skim :)

Right after he was born we had Wally placed on my chest to do the "breast crawl."  For those of you who are unfamiliar, a newborn baby can smell his mother's milk and has enough head strength and instinct to bob his head around towards the smell of milk until he finds the breast and can latch on for that first meal.  Breast feeding advocates say this is the best way to kick off a breast-feeding relationship and that baby often has a better latch when he's allowed to initiate.  I was really excited about trying this approach, but I didn't know if I'd be patient enough to wait for him to find food, or if I would feel compelled to help him. Well, score one for Team Bohall, Wally was a champ and found the breast very easily.  After that, nursing was a learning process for both of us during those first two days at Provena.  We tried frequently, but often he seemed uninterested, or got tired quickly as soon as I would hold him, or else it just plain hurt!  But we did get in two really good sessions within that first 48 hours where he fed for 15 minutes on each side.
After we were transferred to the Carle NICU, Walter was made NPO which means he ate nothing by mouth.  But I was still committed to breast feeding and so I was pumping every three hours even through the night.  People tell me that sounds horrible, but I thought it wasn't too bad.  I knew exactly how long it would take and my body kind of got into a rhythm.  Pretty soon I was waking up before the 3 hour alarm.  It's a lot more work when there's a real kid that needs feedind, and may or may not go back to sleep when he's done ;)  Although the implementation was easy, I wasn't producing much milk even after it came in.  In the NICU they had a "pumping lounge" because most of the babies couldn't actively breast feed, so lots of moms made use of it.  In said pumping lounge there were all kinds of "helpful" charts and posters telling you how to pump and how much you should be getting.  "Pumping Goal: 16-24oz per day or about 1oz per hour."  Well I was never anywhere near that, it was more like 1oz every three hours, but I was still optimistic as many people told me that babies are much better at expressing milk than any pump, and he would likely kick it up to high gear once he could nurse.  Meanwhile I was banking a lot of milk for when he was cleared to take some food by mouth.
Walter was cleared to start eating on Friday May, 18th, 11 days after he was born.  At first it was just by bottle but then after a day or two we were doing some nursing, which seemed to go okay, but then we'd still offer him some breast milk by bottle afterwards which he greedily took down :)
On Monday, we got the news that we'd likely be going home the following wednesday, provided his last x-ray was clear...and it was!  We were so excited, until the Nurse Practitioner on rounds Tuesday told us she was concerned that he wasn't taking enough by mouth yet to be dismissed.  I was so mad; I actually said to her "Well, he's only been eating for 4 days!"  But undeterred, she said, well we will watch him overnight and see how he does.  Our nurse that was assigned to Walter took us aside after that and said, "I know you want to breastfeed, and I think that's great, but because they can't tell how much he gets at a feeding, I would just give him bottles for the rest of the day and overnight in order to show he's eating enough...so we did.  I pumped and we woke him every three hours through the night to give him 60-70mL of breastmilk by bottle.  When morning came, the staff was satisfied and we were outta there by 2pm Wednesday May, 23; 16 days after he was born.  I felt like we had just completed a jail brake.
After we were home, nursing kind of plugged along but was becoming more painful and I felt he wasn't getting enough.  I had an appointment Friday May25th with Theresa Hardy, a wonderful lactation consultant at Christie Clinic.  She helped me correct his latch so it wasn't so painful for me, and was more effective for him, and got me started on Fenugreek, an herbal supplement to promote lactation and prescribed extra pumping after he nursed.  I had a recheck the following week, and his weight had dipped some from his NICU release, but was still above birth weight, but we decided not to chance it, and I got started on Reglan, a prescription medicine which causes increased milk production.  I was optimistic that this would be the magic bullet and things would improve, he would start gaining weight....which brings us to today's (June 7th) appointment...
When they weighed him he was back down to birth weight 7lbs 9oz at 1 month old.  I was sad, but I knew we could help him if we supplemented and I was ready to do it, but I just didn't know how.  Would I nurse and then give a bottle after...and then pump?  I wasn't sure I could do all that.  Then Theresa brought up Supplemental Nursing Systems, which I forgot about as an option.  Basically you run a tube from a reservoir of formula, and tape it to the breast.  Then baby nurses as usual but he is getting the breast milk and the formula.  Genius!!  This way he gets extra nutrition, but you don't have to sacrifice nursing or endanger your milk supply.
So far Walter thinks this is a fine plan and is nursing and gaining weight well.  But there's still the extra step of pumping when he's done nursing.  I'm optimistic about his weight gain and our nursing future, but time will tell.  There are moments when I'm like; Really?  We're doing this?  Giving him a bottle would be so easy!  But I've decided not to consider changing the plan until at least Monday.  Sometimes you just have to go one day at a time, and the next time you think about it, it's not so hard.  It was hard for me to feel like the old marketing ploy of "Science can feed your baby better than you can." may be true in our case.  But for now, I guess some breast milk is better than none, and we'll see how the supply holds out/increases; and what his calorie needs end up to be.