Breastfeeding for Professionals
Potensmidler Apoteket danmark uden recept. Finally, the day came when I could get the retention stitches removed. Michigan State Spartans Store Pingback: I am so glad you found the article helpful. My delivery progressed very normally - Baby A arrived after not much more pushing, and Baby B, who had been breech until then, flipped his little self around to be delivered head first. Peter Schatzberg Miami Pingback: The main reason is such extensive damage on each side was causing too much pain to breastfeed.
Breastfeeding for Parents
The circumstances of the labor suggests that this baby might have been posterior and gotten 'stuck'. Shawn confirms that her baby was indeed 'sunny side up' but that this was not noted in her medical records. This is not unusual; many doctors don't see posterior position as relevant and fail to note it in records or mention it to parents, yet many other providers feel that it is the cause of many c-sections.
Positioning often helps facilitate rotation, but Shawn was not able to try these. Also, although the midwife felt that rupturing the bag of waters more fully would help dilation by bringing baby farther down, doing this tends to fix baby in its poor position and make a normal vaginal birth difficult to impossible.
Breaking the bag of waters is the last thing that should be done if baby is in a poor position for birth. When I went to see my OB about fertility treatments, I remember one of her first comments being, "You really should try to lose some weight prior to beginning treatment MY OB was skeptical, however, and ran at least 3 progesterone tests and two ultrasounds before she was convinced.
My physician had not been derogatory in our visits, but I was concerned about her pessimistic approach to my care.
What a sigh of relief! After a great 'start OB care' appointment the doctor commented, "Things look really good, but because of your low progesterone I don't want you to get your hopes up until after the first trimester. Although the pregnancy had been progressing fine and all signs were good, she was treating me as though the pregnancy was a risky one. Her attitude when I visited her was usually apathetic.
I remember feeling that she just couldn't believe that someone my size was having such a healthy pregnancy. False labor pains begin at 2: Contractions begin at minutes apart. I figured it was more false labor pains since I had not had a bloody show but ultimately learned that these were in fact the real thing. I called my midwife when the office opened at 9: She thought I may be right in assessing the pain as false labor.
I had not slept all night from the pain and she prescribed a sleeping pill. She said, "If it's false labor, the pills will stop them and you'll sleep, but if it's the real thing, you won't be able to sleep through the contractions. I didn't want to be in pain AND groggy! Once there, she confirmed that it in fact my water had broken and then informed me that the fluid was stained with meconium.
She also stated that I was only 1 cm dilated and at this point I had been in labor for over 13 hours. She recommended pitocin to get things going. I'd learned that those moms induced with pitocin had very hard labor pains and my midwife confirmed that this may be the case. We then left for the hospital. I am confined to bed with external fetal monitor. I am told that I may be able to walk the length of the bed if the baby responds okay to the contractions.
So far so good. I admit defeat and request the epidural. I breath a sigh of relief that I can't feel anything but pressure. Midwife checks and I'm still only dilated 3 cm. She waits for a contraction and stretches the cervix another 3 cm to 6! Midwife tells me there have been a few drops in the baby's heartbeat and asks to insert an internal monitor for more accurate readings.
Realizing this would confine me to the bed but wanting to do what was best for the baby, I reluctantly agreed. Midwife discovers that my bag of waters had not completely ruptured and may have been delaying the baby's drop into the pelvis. She breaks the sack and the baby moves to -1 station. I am exhausted and disappointed, but ask to be given more time before considering a C-section.
The baby had several heartbeat decelerations after contractions and she was concerned. I am dilated 8 cm and he tells me to push although I have not yet felt the urge. It is unproductive and a C-section is recommended.
I begin to cry from the exhaustion and disappointment, but after We had chosen not to learn the sex of the baby and although we both wanted a girl, we felt very strongly it was a boy. She was suctioned well and the meconium had minimal effects on her. Apgars 8 and 9. My husband left to go video the baby for me and I was whisked off to recovery. I invested a lot of time developing my birth plan and although this is the farthest from my dream birth, my daughter far surpasses any hopes I had for my baby.
I wish all of you the best in your pregnancies and pray that each of you have an uneventful labor and delivery. Things were bad; fortunately they didn't turn out even worse. In , my husband and I were told that I had almost zero chance of becoming pregnant we had been trying for over a year and that if we did get pregnant, that I had almost zero chance of carrying to term.
The reasoning given for my inability to get pregnant were: I realize now how ridiculous most of these reasons are, but I had doctor worship issues at the time. So, we decided to start saving to adopt. In , I found myself pregnant.
At the first visit 7 weeks , the doctor sent me straight to a perinatologist because I was too high risk. I was heartbroken, but I believed him. However, I didn't schedule because I needed to hold onto hope for this blessing in our lives.
At 8 weeks, I went to the ER with major abdominal cramping--thinking I probably was miscarrying. They did an ultrasound and again, couldn't get a good heart beat, but said everything looked normal and that there wasn't any bleeding. So, they looked around and found a large cyst forming on one of my ovaries.
Hubby and I just could not wrap our heads around why we would be given such a blessing, only to have it taken away. So, we decided to wait and see.
At 10 weeks, we saw the Peri again - he did another ultrasound and finally found a good heart beat. Of course, he also saw the cyst and a fibroid on top of the uterus. The cyst had grown since the ER visit, but the fibroid was small. At 11 weeks, my cyst burst and caused excruciating pain. I was afraid to go to the doctor at this point as I didn't want to hear abortion again. At the 12 week visit, I had a fever and major abdominal pain.
The peri did an ultrasound and saw the fluid around the ovary assumption that the cyst burst as it was no longer there. I clearly had an infection, so he put me on antibiotics. I can't remember which one, but it was a class C I believe. I also had a UTI, so it would take care of both said the peri. Anyway, he said again that I should abort as he couldn't say whether the antibiotic would hurt the baby or not "better safe than sorry-right.
At 16 weeks, the peri did an ultrasound that showed everything seemed to be going okay. Baby looked "normal" and my infection was gone. I was reminded that it didn't mean everything was fine and that I should be getting the AFP and so on very soon to see. I also was sent to do a glucose test since I was overweight.
I had lost weight so far, but since I was fat, obviously I had to have GD--grrrrr. At 18 weeks, I decided I had had enough of the abortion talk and can't carry to term stuff, so I switched to a regular OB with a different practice. We hadn't talked about it much with the old practice since they didn't believe I would "produce" a baby anyway. I was happy to have an earlier due date though--I wanted to get this pregnancy over with so sad I thought this way and see if she would be healthy.
At the 24 week visit, I was told that everything looked good including no fibroid growth , but after examination, my pelvis would not do well with a large baby.
Yep, even being a very large woman, I clearly couldn't birth a baby of normal size. And the cesarean talk started I was a good patient and went straight to the ER where the contractions measured just enough to call it pre-term labor. Fortunately, I had a great nurse who sheltered me from all the interventionists I had told her about my experience so far and she helped tremendously.
She put me in a quiet, dark room. Soothing music and lots of water. Had me lay down for two hours and then re-checked. Contractions had reduced to what they considered safe and she got me sent home.
By 36 weeks, the OB had me do another ultrasound for size. More cesarean talk and my relief at having "what appears to be a normal baby" was replaced with the destruction of my wish to have a vaginal birth. For so many of the wrong reasons, at 38 weeks we scheduled my "induction" for the due date. To the OBs credit, she did say that I was not a good candidate for induction--she told me I would end up with a cesarean.
I believed all of it. Induction, however, was my last ditch effort at a vaginal birth as I was having this monstrous 10 lb baby and was just high risk I thought. I'm so sad for my lack of knowledge and for what I put my poor baby through as I let the hospital manage my birth. I was contracting when I arrived, so they waited two hours before starting with the cervical softener and pit doh, I wish someone had told me that I could go home at this point.
I wish I had thought of it. I was hooked up to machines, given a blanket to put between my legs and told to not move, but try to go to sleep. There was no way I could sleep. The OB on call came in and told me that she could break my water, but it would hurt.
Gushing, gushing fluid and way more pain. At this point, the pit had been going strong for over half a day, being turned up every couple hours and I was in a lot of pain.
My OB came in as she was starting her shift and told me that I was not progressing and should expect a cesarean. If I wanted to keep trying, she'd "let me go longer. I got the epidural around 22 hours after pit started. I needed the constant negativity to end. The monitors showed slight dips in baby's heart rate with some contractions and I signed the paperwork to get my cesarean.
I thought I probably had a baby with major problems and I was in pain with constant fluid running all over the place from AROM. I was wheeled into the OR. I weighed too much, so I had to help the nurses move me from bed to operating table just the beginning of the too fat punishment. My arms were strapped down and the anesthesiologist started the numbing process.
My BP dropped drastically and I tried to throw up, so they started administering several medications not sure which ones to help with that. I was "re-stabilized" and forced to breath through an oxygen mask as I was so numb, I was having trouble breathing. I know my BP dropped several times as the nurse kept telling the doctor that my BP was too low again and medications were administered.
More anti-puking meds were given each time as I kept feeling like throwing up. They held her up over the screen for like 2 seconds and then brought her over to the warmer table where the pediatricians worked on her.
She didn't make a sound for what felt like an eternity, probably 2 full minutes, but then we heard her and felt relief. At least she was okay for the moment. Elizabeth's apgar scores were 6 and 9. All of the constant interventions had caused some distress, but she was okay.
A healthy 9lb, 12 oz baby girl. I began swelling immediately afterwards, even though I had almost no swelling in pregnancy. I was also in a lot of pain.
I kept asking for more pain medication and received a lot of percocet. Nothing seemed to help with the pain though. It was searing, burning pain. And Elizabeth wouldn't nurse. She had been heavily medicated via my induction and then was given formula while I recovered--the staff had told hubby that Elizabeth was hungry and since I was in recovery with no visitors, he would have to feed Elizabeth formula grrr again. About 4 hours after the surgery, my mother and husband came to see me.
She's with my sister and brother-in-law, bonding with everyone but me. So, my sister finally brought her in and I got to see my baby.
I was still too numb to lift my arms, so everyone had to pass her around and hold her so I could look at her. Finally, about 45 minutes later, I could move my arms enough to hold her.
She wasn't interested in nursing and began her extended sleeping regimen. Nursing never worked out well. Why didn't she get help? Finally, I decided I couldn't take it any more and asked to go home. I was released with a prescription for vicodin and went home. At my 8 week checkup, I still complained of being in pain and was told that I was too overweight and out of shape.
If I'd work on exercising more, then I'd heal faster. Of course, the OB did find a strange bulge in my abdomen and ordered an ultrasound. Ultrasound showed nothing, so I never heard from the OBs office again. At 17 months post partum, I went to my PCP because I was getting uncomfortable and the cyst was too big to be an ovarian cyst.
He felt it and told me I probably had cancer. Basically, he said that 17 months out from having a clear abdomen, it didn't look good and that I should start making plans for my death. He sent me to get panels of tests for cancer and another ultrasound. Everything came back negative no cancer and no baby. By 18 months Post partum, the cyst had grown to the size of a 20 week fetus.
All the tests kept coming back negative, so I was sent for a cat scan. The cat scan showed that there was a lap sponge and surgical tape with something that looked like metal strings. For months after my cesarean, I was told that I was just fat and had no tolerance for pain because, of course, there couldn't actually be something wrong with what the OB or staff did during the cesarean.
For almost two months, I thought I was going to die and leave my 1 year old with no mother. All of that because I believed the doctors from before I even got pregnant that I was broken. Everyone was still thinking it was no big deal, so a laparoscopy was performed. There was too much damage and the "foreign objects" were too big. So, I then had open abdominal surgery. There was a ton of scar tissue, of course.
I was told that it would be highly unlikely that I could get pregnant, but if I did to at least wait a year or more to ensure my abdomen could handle such a high-risk thing. There was no additional scarring to my uterus, but I'm "just so high-risk now. Most OBs had heard of my case and didn't want to see me as a patient. I interviewed 3 and found one that I thought was going to be VBAC friendly and sympathetic to my history.
Stacy's extreme problems with ketones in gd are unusual. So was the level of calories she needed to have normal levels. Most gd moms are given around calories; some docs restrict obese gd moms to calories but this raises the danger of ketones and brings up whether the mother is adequately nourished at that level. However, Stacy ended up with the highest caloric totals I've ever seen for a gd mom calories! She also had to stop exercising to stop the ketones; this is very unusual.
However, her ketones had probably become so out of whack previously in the pregnancy that such drastic measures were needed to stop them.
Fortunately, her providers did measure them regularly not all do and experimented till they found what worked best for her. They didn't simply apply a uniform protocol, which helped a great deal. I was diagnosed with GD at 28 weeks. With my other two pregnancies I had failed the 1 hour glucose test, but passed the 3 hour one. My fear for the health of the baby and being absolutely terrified of blood tests, wreaked havoc on my emotions. I was determined to do everything possible to avoid insulin injections, even though I knew that it may be inevitable.
First, a little history. This was my 3rd pregnancy. My first baby was born when I was 29 years old. I was a dress size 20 when I became pregnant with him and gained less than 5 lbs during the pregnancy. Not because I was trying to not gain weight, I ate very normally. My body simply didn't gain weight. At 32 weeks gestation I noticed that he had become suddenly a lot less active.
Thank God for the doctor recommending counting kicks early on. I went in to see my OB and was put on a fetal monitor immediately non-stress test. The baby was having dips in his heart rate.
They rushed me to a local hospital that had a more advanced neonatal ICU. As soon as we arrived there, his heart rate took a drastic plunge and he was born by emergency C-Sec.
He is now a perfect, simply amazing, brilliant little 6 yr. Baby number 2 was born 14 months later. My dress size was still a 20 but I had gained about 10 lbs since the first pregnancy. Again, with this pregnancy I gained little weight. On his due date, after 14 hours of labor, the baby went into fetal distress and was also born by an emergency C-Sec.
His situation was totally unrelated to his brother's. He was born with a rare skull bone abnormality, that was corrected by surgery when he was 2 months old. But because of that problem, his head was simply unable to pass through the birth canal.
He is now a perfect, hilarious, brilliant little 5 yr. Ok, now back to baby number 3. With this pregnancy I was 35 years old and had again gained about 10 lbs since the last pregnancy I was now a size At the beginning of the pregnancy, after much discussion with my OB, I decided to have a planned C-Sec.
Once I made that decision, I was completely relaxed about the rest of the pregnancy. We also decided at that time, that this third child would be our last, so I planned to have a tubal ligation at the same time. The decision was made long before the GD diagnosis. After being diagnosed at 28 weeks, I began the diet and exercise program given to me by the doctor and registered dietitian.
I stuck to it to the letter, but something wasn't working right. My ketone levels were registering "high" everyday. I had been very inactive due to an accident I had been in for a few months prior to and throughout my pregnancy. So, not only was I a plus size person to begin with, but my metabolism was certainly not normal either.
Although, like many large women, I had gained almost no weight up to this point in my pregnancy. At first the dietitian and doctor told me to not worry about it since many people lose weight when they begin the program. My blood sugars were all fine. But then when they saw my ketone levels they decided to take action. I figured that my body was just in so much shock from actually exercising, that it just couldn't help losing weight.
I cut the exercising down to 5 minutes after meals Finally my ketone levels went down to "small" and "trace" readings, but I was still losing weight. With the agreement of the dietitian, I stopped exercising altogether. In my case, that worked. I stopped losing weight, had no ketones, and by just lowering my calories back down to , my blood sugars stayed within normal range.
I was able to control everything without insulin injections. A planned cesarean is a LOT more relaxing than an emergency one. Everything went as planned to the letter. It was almost comical, shaking the doc's hand and saying "OK, now go get my baby. I was given a spinal block and had no ill side effects from it. For some unknown reason, the baby's blood sugar was low at birth.
It registered 29 which was well below the hoped for reading of 40 or higher. My husband was handed a bottle of formula and he fed her about an ounce of it right away. Her blood sugars came up to normal and have remained that way ever since.
I was a little concerned that she might not want to latch on to me after trying a bottle nipple first, but she latched on like a pro on the first try, a couple of hours later. The baby did not have any shoulder dystocia any other troubles associated with GD or anything else, for that matter.
It was a lot of work, but very much worth it, and I have a whole new understanding of my body and my metabolism. My emotions went through typical upheaval after her birth, but I think that was probably due to lack of sleep as much as due to hormonal fluctuations. I am now slowly adding exercise back into my daily routine and am amazed at the difference it is making in me both physically and emotionally. My boys like Richard Simmons better than Big Bird. Basically a regular pregnancy Also because of my age there were concerns that the baby would have problems down's syndrome, spina bifida, etc so the clinic did test for AFP The results came back high, which led to more concerns and we were scheduled for an ultrasound.
At the ultrasound, we found out that the reason the AFP was high was because there were 2 babies, not one, which was a great relief. The pregnancy was generally uneventful, other than the fact that I was miserable through most of it because of my size and it being a twin pregnancy.
I had horrible heartburn most of the time, sciatica which I have still The doctors initially suggested to me that if we made it through to 7 months that would be great and then we'd see how it was going, since twin pregnancies generally wind up being pre-term. However 7 months came and went and I remained pregnant and miserable.
Then they suggested 8 months and they would consider induction since I was so uncomfortable They tell me, "Well, lets just let nature take its course Finally since I was going in to be seen about twice a week by then I had been experiencing some liquid leaking for a couple of days and mentioned it, thinking it was a new kind of incontinence problem another side-effect of the twin pregnancy , and they checked it, found out it was amniotic fluid and decided to let me go and have my babies.
We think every once in a while about having another baby, but since the fact that we HAD twins was entirely my fault the older you get the more predisposed to having multiples and now I'm 38, I don't think we'll be having any more Two is plenty and we have a boy and a girl and they keep us pretty busy.
Jessica's doctor felt that because the baby was large at 34 weeks and had low blood sugar, she must have had some undiagnosed GD. There is no way to know this for sure.
However, between being premature, having been exposed to brethine and steroids before birth which raises maternal blood sugar levels, which then can make baby's blood sugar drop after birth , low blood sugar in the baby would not be an unusual finding.
On the other hand, it IS possible that she could have developed some late GD between the usual 28 week test and the 34 week delivery. Progesterone levels don't peak till week 32 so it is possible, if unusual, that if she was borderline before, that progesterone peak at 32 weeks could have pushed her over into GD. Still, it is not a foregone conclusion.
This is one possible risk of both spinals and epidurals. Spinals are placed into the innermost space by the spinal cord, with the drugs going directly into the Cerebral Spinal Fluid. Because they are making a hole in the membrane that surrounds this fluid, sometimes that fluid will "leak" out the hole and the brain will not have as much fluid cushion as it is used to having, causing a temporary but very unpleasant headache.
Although an epidural is placed in the space just outside this membrane and in theory should not cause a "spinal headache," sometimes that inner membrane is pierced anyhow and the headache occurs despite a different "space" being used for the anesthesia. The usual treatment for a spinal headache is to give the person lots of caffeine as they did Jessica and to give them a blood patch.
In a blood patch, a little bit of the woman's blood is injected into that space so that the blood can clot and hopefully block the "hole" and the fluid leakage.
It's unknown why they did not go ahead and give Jessica a blood patch; that might have significantly eased and shortened her discomfort. Saturday the 8th, following our birthing class! I hollered for DH, and ended up leaking even more fluid.
I eventually soaked through a beach towel and the mattress by the time the doctor called back. So I was put on bed rest, brethine asthma medication to stop contractions! The brethine didn't work, so I was put on Magnesium Sulfate. The steroid celestone was given too to help develop the baby's lungs.
Since he was also [footling] breech feet first , I was to be sectioned. No luck with an external version with no fluid! So I was on bed rest, and bed pans yich until Monday evening when both steroid injections were on board, and I was taken off the Mag Sulfate.
The side effects from the Mag constipation, numbness and fluid retention were pretty severe by this time, and it was good to at least get some circulation in my legs.
Tuesday, my contractions picked up, and I was on the external monitor still, listening to Rascal and watching the Tocometer measure contraction strength. I did pretty well until 5 that night, and called the nurses insane for not believing I was in pain.
The doctor checked me on a fluke don't want to check someone with ruptured waters often and I was at cm fully effaced with Rascal's feet descending down through the cervix. I was sectioned within a half hour, and had a rough 3 sticks, 2 for a spinal and then 1 for an epidural. Rascal was lodged in my cervix, so they took careful time to dislodge him and his head was pushing up into my diaphragm as they did so. It was hard to breathe for a few minutes until they unstuck his legs and delivered him feet first.
I didn't hear any announcement of sex or anything, they were worried about his lungs etc Now, he's a preemie, 34 weeks, and he weighed in at grams, or 8 pounds! He didn't require any suctioning, but his first glucose check was 12, so there was some late developed and un-caught GD with me.
I saw him for a quick few seconds, and my husband went off to be with him during all newborn procedures pre-planned. While they were stitching me up, the Duramorph in the epidural was fading, and I felt the last layers of tissue and the staples being put in-- ouch! I did get a narcotic to last me through that part, and was wheeled into my post partum room, right across from the nursery. I did get very itchy from the Duramorph, but wet washcloths to my face, and a drug in the IV took care of that.
I had eaten dinner they fed me! I felt tired and drugged from the narcotic, but it helped with my resting that night, and I was on Oxygen until morning since I wasn't breathing deep enough.
DH came in to tell me all the news, and update me before we went to sleep. I developed a spinal headache and am on high-caffeine intake until it fades. So it looks like all the complications were: Poor Gideon is still in the hospital on a monitor rooming in with me now for Premature infant apnea, and his colon is under developed since he's a preemie, and we're fighting his high bilirubin levels.
On a side note: The C-section was the most relieving thing that happened to me all weekend. My recovery is perfect, wound is clean and dry and healing well, and I'm walking as well as I was when I was waddling when pregnant.
Never feel a section isn't a real birth! To me, it was a breeze, and I wouldn't mind having to have them every time provided I can get a good epidural! My story starts with the fact that I was trying to get pregnant for about 3.
I was able to get pregnant a few times, but miscarried. We never got a definitive answer, but worked on the premise that I have weak ovulation leading to a luteal phase defect the time after ovulation and before next menses was too short.
With the use of mgs of Clomid on days , IU of Fertinex on days , hCG injection on day 14, intrauterine insemination and sex on days 15 and 16, another hCG injection for progesterone support on day 21, and finally 50 mg of progesterone twice a day through the end of 14 weeks LMP.
I had some early scares because of bleeding, but was allowed frequent ultrasounds to check the baby. I was watched carefully throughout the first trimester, having many more appointments than the average patient, because of my recurrent miscarriages.
At 16 weeks I was told I was officially an average patient and no longer considered high risk. I chose to do the triple screen at 16 weeks which came back fine and a level II ultrasound at 20 weeks revealed all was well. I was diagnosed with gestational diabetes at 27 weeks.
It wasn't a big shock since I was 33 and have a family history of diabetes, but what did surprise me is that my one hour glucose test came back at I opted against taking the 3-hour GTT since my one-hour test was high enough to prove glucose intolerance, but my doctor did insist on a fasting level for confirmation. I was given the choice of trying to control my GD by diet or with insulin.
My doctor felt that insulin was the best control, and I did some research and found studies indicating a lower incidence of macrosomial infants when GD was treated with insulin. I had already been pretty much following a diabetic diet, so I didn't feel there was much adjustment that would help. I saw a nutritionist who only increased my calorie intake to about and frequency of meals, not the balance of what I was eating.
A diabetic counselor taught me to monitor glucose levels at home, give myself insulin injections, and discussed walking and arm exercises to help reduce blood glucose levels. Between all of these things, I had the GD in good control within a week, and perfect control levels under for the rest of my pregnancy.
My insulin levels were adjusted periodically, including adding a second smaller injection when my dinner levels were a bit higher than I wanted. I think my main issue with GD is that I felt that I was on a very rigid schedule since I was supposed to test my fasting level and 2-hour postprandials four pin-pricks per day and eat every 3- 4 hours.
I even had to wake up at 2 a. I exercised after breakfast and after lunch everyday, and tried to do after dinner but was often too tired by then. I figured at least I would be in good shape for labor. While my previous OB might not have induced me for another week, the new one didn't want me going past 40 weeks with GD.
We knew my exact dates and I felt more comfortable not going past my due date myself; I actually would have pushed the other OB to induce me at 40 weeks! My son didn't show signs of distress, but my insulin need was dropping, something that can indicate the placenta is beginning to fail. It was hard to find good information on insulin-dependant GD. My original OB didn't feel that it should be, and I agree. At 39 weeks I had a vaginal exam with the intent of stripping my membranes.
At 39w5d I was admitted to the hospital for prostaglandin gel applications to the cervix. I had some gel in the morning, did a lot of walking trying to get things going, and then had more gel in the afternoon.
I also started to lose my mucus plug, but had few contractions. I was sent home at 7 p. I'm not sure why I was being optimistic about the pitocin since I know it doesn't tend to work well before someone is dilated to 3 cm, but I guess I just figured I needed to labor, needed to get the baby out soon, and somehow it would work. Even the pitocin didn't do that much for me immediately, and it was restricting my movement since I was on a monitor and it wasn't cooperating; if I moved, we would lose the heartbeat.
I really didn't want to be stuck in bed and it was very uncomfortable. It was pretty clear mid-morning that my perfectly positioned baby decided to move and give me back labor. Every time I had a contraction, I would get a sharp pain in my butt and down my leg. In the early afternoon I was thinking I would be unhooked and sent home, but all of a sudden I felt something akin to a balloon expanding and then popping followed by a gush of fluid; my water broke, and there was meconium in it.
I was on the clock. I was at 3 cm and the OB put an internal monitor on me, something I hadn't intended, but appreciated since it allowed me some more mobility. For the next three hours I experienced strong but irregular contractions. I varied my positions and walked a lot to accelerate labor but by 4: By now, I'd been up for 24 hours so I decided to get some rest. After sleeping for two hours, my OB returned and checked me.
Since I had discussed these fears with my doula and OB during the pregnancy we had worked out how I would handle such a similar scenario and thus when my OB said he had to use pitocin to get labor going I knew I would get an epidural to help me with the pain. It was 9am by the time the pitocin was started and my epidural was already in place.
The labor went very quickly from then on and although despite two attempts with the epidural, it was not working as it should. For 25 minutes my doula worked with me to help me concentrate on not pushing and at exactly 1: Exactly 6 minutes and three contractions later my beautiful daughter was born. She was delivered straight onto my stomach and my husband cut the cord. A few minutes later the placenta was delivered and I had one stitch to repair a very minor tear.
My daughter nursed immediately and we were left alone to bond and rest. A short while after the birth I hopped of the bed, freshened up and walked to the maternity ward full of energy albeit tired. My doula had been a wonderful source of emotional support and physical help. She knew what my concerns were and was able to help me through the fear as well as rub my back between contractions and give a lot of encouragement.
My OB was wonderful also in that he gave me the space to try for the type of birth I wanted. My OB treated me, throughout, like any other pregnant woman and made no comment about my weight. At no time during the pregnancy or labor did he make me feel handicapped by my weight but rather was tremendously encouraging and positive. My husband was there the whole time and I cannot imagine going through birth without his continued presence and support.
Throughout, I felt surrounded by people who were caring and considerate of my feelings and what I was going through and they all helped me make this birth experience the best it could be. Basically a regular pregnancy Also because of my age there were concerns that the baby would have problems down's syndrome, spina bifida, etc so the clinic did test for AFP The results came back high, which led to more concerns and we were scheduled for an ultrasound.
At the ultrasound, we found out that the reason the AFP was high was because there were 2 babies, not one, which was a great relief. The pregnancy was generally uneventful, other than the fact that I was miserable through most of it because of my size and it being a twin pregnancy.
I had horrible heartburn most of the time, sciatica which I have still The doctors initially suggested to me that if we made it through to 7 months that would be great and then we'd see how it was going, since twin pregnancies generally wind up being pre-term. However 7 months came and went and I remained pregnant and miserable. Then they suggested 8 months and they would consider induction since I was so uncomfortable They tell me, "Well, lets just let nature take its course Finally since I was going in to be seen about twice a week by then I had been experiencing some liquid leaking for a couple of days and mentioned it, thinking it was a new kind of incontinence problem another side-effect of the twin pregnancy , and they checked it, found out it was amniotic fluid and decided to let me go and have my babies.
We think every once in a while about having another baby, but since the fact that we HAD twins was entirely my fault the older you get the more predisposed to having multiples and now I'm 38, I don't think we'll be having any more Two is plenty and we have a boy and a girl and they keep us pretty busy. Paula's Story gd, severe pre-eclampsia, induced premature vaginal birth. Paula's first pregnancy was complicated by primary hypertension, which she was on medication for. Primary hypertension can often become worse in pregnancy, becoming pre-eclampsia despite medications.
This is what happened to Paula. In addition, she developed gestational diabetes diet-controlled at about weeks. Had her pre-eclampsia not worsened, she would have been induced at 38 weeks because of the gd and blood pressure concerns combined.
As it was, when her pre-eclampsia worsened, they elected to induce at 36 weeks instead. Induction probably succeeded so early because she was already partially effaced and dilated before they began, although they did nothing to ripen the cervix ahead of time. Between pregnancies she developed overt diabetes. Because her PCO is very significant, she and her doctor elected to have her take Metformin Glucophage, mg per day throughout her second pregnancy but not for nursing.
Although her blood pressure remained a concern and she was "maxed out" on 3 blood pressure medications through the pregnancy to keep it under control , she did not redevelop pre-eclampsia in the second pregnancy, which she credits to the Metformin. They did add insulin during the pregnancy later on. She felt she had a terrific doctor for her pregnancies, very size-friendly. I was induced 4 weeks early due to severe pre-eclampsia. I was given magnesium sulfate and pitocin at 6pm on Thursday.
The broke my water and I began having contractions with in an hour. I dilated quickly to 10cm by 9: Labor in all was about 6 hours. I only required one internal stitch for a small internal tear. I did learn through this whole process to listen to my body.
The labor nurse was trying to get me to push differently then what my body was telling me. She wanted 3 shorter pushes when my body wanted 2 long ones. When I finally listened to my body I delivered very quickly.
After discussing this with my OB I did what my body told me and had much better pushes then what I had been having. I did have some problems breastfeeding at first due to the fact that she was 4 weeks early and didn't want to latch on very well. She had been tube fed, finger fed, and cup fed and like the 'instant gratification' that provided, versus having to 'work' for her food. Our second child was conceived through an injectable cycle.
I was when I conceived this child. There are so many benefits to taking Metformin during pregnancy, and I really wanted to avoid the pre-eclampsia that I had with my first pregnancy.
I also did not want to risk going off of Metformin because of the dramatic decrease in miscarriage rate while on it. The fact that there are no known deformities or problems while taking Metformin in pregnancy made me feel comfortable enough to take it. I know some doctors will not give Met in pregnancy because they are uncomfortable with the fact that no US studies have been done, but all of the information coming from other countries seems to indicate that it is safe.
The IV was started around 3 p. The Pitocin was started; they increased it every 30 minutes. I began having contractions about every 2. They were tolerable and I could breathe through them easily enough.
We were waiting for the doctor who was supposed to show up around 5 p. The intern came rushing in to do 'fetal scalp stimulation' which brought her heart rate back up. I then was told I had to lay on my side and that seemed to keep her heart rate up. The contractions while on my side were getting pretty uncomfortable and combined with the drop in heart rate I decided to get the epidural.
The funny thing is that while sitting for almost an hour to get the epidural I couldn't feel the contractions at all, and even had to look at the paper to see if I was still having them. Talk about positioning making all the difference. Once back on my side I could feel the contractions again until the epidural took full effect. I felt like I had to urinate with every contraction, but that was all I was feeling.
I figured it was just the pressure form the contraction. Finally at 1 a. I asked the doctor to check me. My bladder was so full he couldn't feel the baby. I was straight cathed catheter and checked and was 7 cm. About 10 minutes later I felt like I had to push. A full bladder can impede labor progress! It's important to pee every hour or so in labor. I waited more contractions and decided it was time to call the nurse. My nurse was gone to lunch and another nurse who waited another contractions before coming to the room told me I was only 7 cm 20 minutes ago, and I really didn't have to push; that the epidural should be working fine and I should be able to get through the contractions without any problem.
I told her my last one went from 5 cm to 10 cm in 45 minutes and I felt like I had to push. The stupid woman still wasn't going to check me. I insisted and she reluctantly checked me. I was at 10 cm and it was time to push. The doctor got to the room and got the stirrups up.
I began pushing and he was going to check to see where the baby was. He asked how long it took last time; I said 1. He commented it wasn't going to take as long this time.
I could feel her head almost crowning at this point, then with the next push she was crowning and out. I pushed for a total of maybe 5 minutes, and out she came. So much for not having to push. It was such a different experience from my first. Apparently I am 'wired' a little differently than most and with an epidural I am mostly numb except for the vaginal canal and perineal area my epidural last time did not work completely properly either.
I didn't realize this was any different from 'normal' until they went to put in a stitch I needed 2. So with one stitch left, they just put it in without any numbing agent with my permission. I figured I would get stuck once with a stitch or once that I would feel with the Novocain and either way I was going to feel it. Not only did they fit, but the contraction monitor actually worked! I know they used an internal monitor last time as soon as possible because they did have a hard time finding a heartbeat without my laying in a very uncomfortable position and then holding the monitor there.
I just figured that if they didn't get the heart rate all the time it was really no big deal, that the fading in and out which includes the rate dropping sometimes because of the monitor was just because I was moving or the baby was moving. With my second I just assumed the same thing until they got the internal monitor on. I had one who complained every time that she saw me because they told her to measure me.
She didn't understand why they even bothered to measure me because I was so "off the charts". I may have been off the charts, but I did grow according to the curve they use, so it was useful in following the growth of the baby. I can't think of anything differently my doctor did with me that he doesn't do with every other woman. I did see him more frequently, but that was due to the type II diabetes and insulin monitoring than anything.
I am nursing; it's the only way to go for me!! I always tell everyone I am too lazy to bottle-feed; there is too much work involved.
I know there is the same issue in pregnancy, but I can actually find information on Met in pregnancy but I can't find any on Met and nursing. I did realize the other day that I was on Met while I was breastfeeding 1, but she was almost 2 years old and I was in the process of weaning her.
I think once this one is eating more solid foods, I will start the Metformin again even though I will still be breastfeeding. Ann experienced some size-phobia and hassle from a previous provider, and decided to switch mid-way through her pregnancy. Ann's story can be read on her website at www. Ann also had to have an unusual vertical incision due to the baby's presentation.
Recovery at first was tough but all is well now. Breastfeeding got off to a rough start, but they persevered and are now breastfeeding exclusively. Lisa Z's Story twins, diet-only gd, vaginal birth. My story, despite the fact that I gave birth to twin boys, is actually rather boring thank God! I did develop gestational diabetes very early on in my pregnancy, and I was expecting that to happen for many reasons family history, my weight, the fact that I was carrying twins - all increase risk.
However, I was able to control my GD through diet and it proved to be not much more than a minor inconvenience during my pregnancy. I suffer from PCOS, and do not ovulate without pharmacological assistance.
I did conceive once before with the help of fertility drugs, but it was an ectopic pregnancy, which we were able to abort with drugs and managed to avoid any kind of surgery. At the beginning of my pregnancy I weighed pounds. At the end, I weighed After delivery, I was down somewhere in the 's, but alas, that was short-lived, and I am now back up to somewhere around my late pregnancy weight.
As for my labor - my water broke 2 days shy of 36 weeks. I went to the hospital and basically sat around a lot waiting for labor to start. About 12 hours after I checked into the hospital, the contractions started. A couple of hours later I had an epidural, which came out and had to be redone. Because of this, they gave me MEGA-doses of meds, which caused me to be completely paralyzed and numb from the waist down.
My dh and I fell asleep until the doctor came in early in the morning to check me which required both my OB and my dh hoisting my deadweight legs into the air so that he could examine me and promptly announce that it was "showtime. My delivery progressed very normally - Baby A arrived after not much more pushing, and Baby B, who had been breech until then, flipped his little self around to be delivered head first.
It took 23 minutes and the help of forceps, but both boys were delivered vaginally and in perfect health - 5 lbs. I took them home with me 2 days later. Just being large should not qualify you for a 'high-risk' label. It's smart to be aware of the possibility and be proactive about it, but be careful about doctors creating self-fulfilling prophecies.
My story is pretty simple. After one year of trying, my husband and I conceived our daughter. I weighed lbs. My doctor was great and really never mentioned my weight. She did list me as high-risk and was sure that I would have blood pressure and gd problems. Everything went smoothly until the last week when my blood pressure was elevated a little and she sent me home from work to rest. One week later my water broke in the morning and 14 hours later my daughter was born.
The staff at the hospital treated me well and I never heard anyone mention my weight. The only thing at the hospital that didn't fit well was the gown and the "one size fits all" panties they give you after birth.
I had an epidural after 8 hours of labor and that went pretty smoothly. The doctor had some trouble getting the needle positioned correctly, but it didn't have anything to do with my size. I had to push for almost two hours but that is not unusual for a first-time mother.
It probably would have gone faster if the nurse had asked about my flexibility earlier. Even at my size my knees can go back to my ears! Once I changed positions she came out in under 30 minutes. She was born perfectly healthy and scored 9s on her apgars. We did have to admit her back to the hospital two days after she was released for jaundice and dehydration because my milk took some time to come in.
Gina Marie was induced at 37 weeks because they suspected a 'big baby'; between 8. In most cases, ultrasounds are very inaccurate for measuring 'large' babies near term, although in this case it was accurate.
However, Gina Marie's case is complicated by her blood pressure and edema at the end of pregnancy, and the size of her baby at 37 weeks made the decision more complicated. In most cases, inducing early for 'big baby' is clearly shown to worsen outcomes, but occasionally in selected cases can be helpful.
However, her midwives did little to prepare her cervix for induction, making an induction less likely to succeed, and the induction at 37 weeks resulted in fetal distress for her baby after it was born.
Also, her baby was malpositioned, which is probably why labor did not progress. It is a difficult question whether the decision to induce helped or hurt her chances at a normal birth experience.
Waiting even one more week might have helped her body and her baby to be more ready, yet the concern over blood pressure and edema was a real one. Regardless, insult was added to injury when she encountered a very fat-phobic surgeon who was very unkind and discriminatory, and did a 'classical' up-down incision unnecessarily on her.
Most very large women can still have a low-transverse side-to-side or 'bikini' incision with careful management, or they can have an up-down or slightly higher side-to-side skin incision and a low side-to-side uterine incision. The reason given for a classical incision on very large women is to prevent infection in the moisture-prone area underneath the fat fold "apron" , yet it should be noted that this classical incision infected badlyusing a different incision didn't help!
It is Kmom's anecdotal observation that the large women she has seen with classical "up-down" incisions have tended to have more problems than those with the "bikini" incisions. Regardless, nursing techniques using a cool blowdryer on the incision, plus extremely strong antibiotics for very large women can often help avoid many cases of infection in transverse incisions, making these practical even for large women.
The decision to do a classical incision on Gina Marie was dubious at best. This is unethical and unprofessional, and much of her poor treatment after that may have been from the OBs attempting to punish her when she refused to have her tubes tied. She was later told that the classical incision would make it too dangerous to attempt to have another pregnancy at all, so one wonders if the doctor tried to prevent her from having more children by using this incision and accompanying scare tactics.
Many women including some large women--see other stories have had subsequent kids after a classical incision. This was pure scare tactics to frighten her out of having more kids. Gina Marie wanted to share her difficult story so that other large women can be aware of some common pitfalls to watch out for. She says, "I didn't have a good, normal birth story.
In fact, my son's birth was absolutely horrible. However, there are some important things that I learned afterwards that I think large women need to know and need to be on the lookout for, and they will be evident by the end of my story.
Before I went to the hospital, I had this idea of what childbirth would be like, and it definitely did not include the experiences that I have had. There is a happy endingI am alive, in possession of all of my faculties, and I have a gorgeous healthy baby boy. But I went through hell to bring him into this world. I started out with the local midwifery practice five midwives for a lot of reasons.
Number one, they seemed to be the most size-accepting. Number two, they were the least expensive. Number three, they were the only all-female practice, although I learned during the birth that female doctor does not necessarily mean understanding, sympathetic doctor. During labor, I was transferred to their backup OB practice. This practice consisted of eight doctors, only two of whom have a decent bedside manner.
I had an easy pregnancy for 8 months, except for the heartburn and the initial nausea. I had no real problems until the last month or so. I gained about 6 lbs. I ate right and exercised and really made an effort to take care of myself. Then, in my last month, I got really bad edema in my feet and legs, so severe that I was put on bedrest for two weeks.
My blood pressure started spiking occasionallynot to the dangerous imminent stroke level, but enough to be worrisome. I felt like a sausage. I could wear one pair of shoesmy cross trainersand only if I put them on first thing in the morning. At 37 weeks I had an ultrasound to determine the baby's size and position, because it was difficult for the midwife to tell through my big belly. The ultrasound technician determined that my baby was between 8. They were concerned that the baby would grow too large if I was pregnant for another three weeks.
I went into the hospital on a Wednesday morning, and the midwives induced labor with Cervidil [ Kmom note: They applied Cervidil to my closed, hard cervix around 1 p. My water broke around 11 p. Sometime the next morning, they gave me a pitocin drip. I asked for and got narcotic painkillers.
Finding veins has always been an ordeal for me, and it took three different phlebotomists about 10 sticks to get an IV started. I had 3 possibles, and the veins blew. I eventually dilated to 7 cm and stopped. Because of the problems with the IVs, the put in a central line on Thursday night when I was having heavy active labor.
A central line is an IV in the jugular vein. It was really traumatic. I had to have a plastic sheet over my face while they were inserting it so that the area around my jugular would be sterile, and I had to lie flat on my back, which is terribly uncomfortable for a woman in labor.
So, I was on my back, I felt like I was suffocating, and I was having contractions every minute or so. I could feel myself slipping out of reality.
This was the worst physical sensation of all of it. They decided at this time that the pitocin had done all it was going to do, so they took me off of the drip. They thought it would be best if I could be sectioned with only an epidural, but after inserting the damn thing right after putting in the central line, they determined I could not breathe adequately while laying flat on my back for the epidural to be effective during surgery. Still I had the epidural and the accompanying fluids all night Thursday night.
Friday morning, I still had not dilated past 7 cm, even though I had been contracting every minute or so for 24 hours. I think that the epidural slowed the labor further, and it didn't really do much for the pain.
The fluids that accompany the epidural to keep the blood pressure from dropping inflated my feet and legs like the Michelin tire man. By morning, I could not lift my legs. One of the known risks of pitocin is to increase swelling and retention of fluids. The fluids necessary with an epidural often tend to cause significant swelling in a woman who has undergone a long induction with pitocin.
This in addition to her previous swelling made for a severe problem. His heartbeat had not wavered on the fetal monitor, but he had also not moved beyond a -2 station.
I think what happened is that instead of facing forward or facing the rear, he was facing my left, and his shoulders were hung up on my pelvis. I could feel his little behind right below my ribcage all the way through labor. He never dropped down. A malpositioned baby could certainly have caused many of the problems she encounteredstuck at 7 cm, a high and unengaged baby that would not move down, little progress despite painful and strong contractions, etc.
And being stuck in bed due to the induction meant that she could not employ other methods of turning the baby, such as position changes, etc. This is one of the potential problems with induction. This OB was the meanest, most evil bitch I have ever met.
Even though I had shopped around and shopped around for pregnancy care that was not fat-phobic and would take into account only the facts of my health and not assumptions, the OBs backing up the midwives were not nearly as enlightened as the midwives were. So when she came in to discuss my surgery, the OB sat down and asked me if I wanted my tubes tied while she was in there.
I was shocked and told her no, that this was my first child, and I didn't want to make decisions like that at the moment. And she countered with a speech that boiled down to "you are too fat to have any more children, you shouldn't even be having this one, and if I had anything to do with it, you wouldn't be. Granted, fat people do sometimes have problems with general anesthesia.
However, it was a little heavy-handed for her to instruct me to discuss funeral arrangements with my husband before I went into surgery. She asked me if I was an organ donor, and then said it didn't really matter. I don't know what the hell this was supposed to mean.
I guess she was implying that my organs were probably not acceptable or something. It is unethical to pressure a woman to have her tubes tied while in labor. In fact, in many places it is forbidden, deemed a decision made under duress. However, OBs have had a history of doing this to women they don't approve of having children, from welfare mothers to minority women, etc.
This is supposed to be totally unacceptable now, but it is still done to some women including fat ones at times. The other remarks and treatment she received were extremely unprofessional. This may have been a case of the doctors 'punishing' her for not going along with them. I was given the prognosis of 'guarded'. It was my impression that she had never dealt with a patient my size before and that she didn't like fat people to begin with.
This kind of incision precludes a VBAC. Later I learned that a bikini incision could have been done if I'd had a more experienced doctor [ i. Part of me still feels like she did this kind of incision to punish me for being such a fat pig. Even very large women can usually have a bikini cut or a modified version thereof.
Only rarely is a classical incision necessary, but some doctors persist in using a classical incision on fat women anyhow. The concern is for infection, but with proper nursing techniques and special attention to prevention, infection can usually be avoided even in very large women, as noted.
My legs were so swollen from the epidural fluid and the previous edema that they were worried about blood clots in my legs. They wrapped up my feet and legs in ace bandages up to my thighs. They wheeled me down to the prep area for the Operating Room and the team of anesthetists gave me an arterial line yet another big traumatic stick.
My husband was there while they were prepping me for surgery, but the poor guy was as overwhelmed by the fatigue of being awake so long and the shock of the guarded prognosis and the business about funeral plans. He was sobbing loudly and disturbing the doctors. A nurse led him away. I could hear my baby's heartbeat on the fetal monitor until they took it out a couple of minutes before they wheeled me into the operating room.
He was strong and steady and never wavered, and I was grateful for that. I was halfway convinced that I was going to die. I remember thinking that it would be all right as long as my baby was OK.
While they were strapping me down for the surgery, the 15 or so people in the room introduced themselves to me. The pediatrician and her staff came over and I told them to be sure and take care of my baby, no matter what happened to me. The nurses swabbed my belly with betadine and put the anesthesia mask over my face and I went out.
When I woke up there was a greenish light over my head and people were calling my name and telling me not to cough while they removed my ventilator tube. I don't even know how long I was in surgery. I found out later that I lost 2 liters of blood during the surgery. The first time I saw the stitches, I thought they had sewn my navel shut.
They told me later that they were prepared to keep me on the ventilator for 12 hours after the surgery, but I was up in the operating room on the first attempt at waking me. Basically, I handled the anesthesia like a normal person would, despite their dire predictions.
As soon as they took me to the recovery room, they told me that my beautiful son was born at We named him Jacob Baruch after two of his great-grandfathers. Baruch means Blessing in Hebrew, and he is a blessing in my life. They took me to the ICU. He was born in respiratory distress because of the narcotics, and he was also getting antibiotics because my water had been broken for so long. Late on Saturday afternoon, the neonatal nursing staff bent rules and rolled my boy up to see me in an isolette and let me hold him for a few minutes.
I cried and cried. He had been screaming until I held him, and he immediately soothed and looked up at me. I swear he knew me. It was hard to hold him because I had wires and tubes everywhere, and so did he.
I wanted so badly to breastfeed, but I couldn't because of all the stuff I was getting in my IV. A lactation consultant came and brought me a breast pump and I diligently tried to establish a milk supply, but the most I could manage was getting the inside of the breast shell wet.
I was told that I would have to pump and dump for 3 days because of all the drugs in my system. I was getting some very strong antibiotics through my IV, so they figured it wasn't an infection. The fever didn't go away within 24 hours. Monday morning they decided that I might have had a pulmonary embolism, and sent me to nuclear medicine for tests on that.
They injected some kind of radioactive dye so they could see an embolism, and this made my hypothetical milk unusable for another 2 days. Well, I didn't have a pulmonary embolism. The OB said that i was was possibly microscopic blood clots from the surgery causing the fever.
I was also having difficulty breathing when I wasn't sitting straight up. They determined my oxygen saturation level was low, and the bad OB who had been so mean to me said it was because of sleep apnea which I had never had a problem with before or since. The next OB to come on shift after her did a blood count and determined that my hemoglobin was low, and I had a transfusion of two units of blood.
I perked up immediately. This relief OB also prescribed some Lasix for me to help with the swelling, and I eliminated 6 liters of water in 24 hours. From the time I entered the hospital until I left, I lost 47 lbs. I got up and started walking around about 3 days after the surgery, and it was incredibly difficult because of the incision and because I was so swollen. My feet were so swollen that it hurt to stand on them.
I couldn't wear any shoes at all for a month after the surgery. I was released from the ICU into a regular room, and finally I was allowed to have my baby in my room with me so I could see him and feed him and care for him. I still had to sleep with oxygen and have my oxygenation level checked several times a day, but I felt like a regular patient, and I had more privacy, etc. I kept trying to pump breastmilk for my baby, but was unsuccessful. I was also feeling horrible, could barely move, etc.
So I made the choice to take the medicine and feel better, since I had been unable to produce anything anyway. My breasts produced the occasional drop or two for a few weeks afterwards, but once I was out of the hospital and could safely nurse my son, he didn't want to take my nipple. This was really hard for me, because I strongly wanted to be able to breastfeed. I had been so sure that I would that I bought no bottles or pacifiers, only a breast pump and pads and a nursing bra.
Because my baby and I were separated for so long, because I could not put him to my breast due to the drugs in my system, because I had undiagnosed thyroid disease at the time, and because I had traumatic bloodloss during the surgeryall of these things worked against me. My son was also born with a tongue-tie, which would have hindered his latching on if I had been able to offer it to him.
It seems that breastfeeding was just not in the cards for us. A tongue-tie can be fixed with a small procedure and doesn't have to preclude breastfeeding. However, significant blood loss and resulting anemia is known to affect milk supply negatively, as does low thyroid. The problems she had getting any milk were probably a combination of no nursing access from the baby a pump is not as efficient as a baby , her undiagnosed hypothyroidism, and the anemia affecting her milk supply.
In addition, any medicine she took to help with the swelling may have also affected her ability to make milk. I should mention that while I was in the hospital trying to get my blood oxygenation levels to an acceptable level and getting IV antibiotics and anti-inflammatories, every doctor in the whole evil practice came by my room to bitch at me for being fat and to talk about diets.
Some were less aggressive and insulting about it than others, but they all felt it was completely important to tell me that I am too fat. Like any fat person in America could possibly get to be 30 years old without dieting at some point.
Like I haven't been informed by family, friends, strangers, and doctors that I am fat fat fat fat fat and I need to diet for my entire life. As is this was a completely new discovery. I felt particularly betrayed when the lead midwife came in and gave me the speech. When I first became pregnant, I told her that I was worried about my eating habits and I wanted to take care of myself and give my baby good nutrition. I kept a food diary for two weeks and showed it to her on my next visit.
It was a faithful diary. She praised me for the variety and content, told me that I was doing a good job of eating healthy low-fat foods. She suggested that I eat more protein, but otherwise did not criticize my eating habits. So it was a shock and a betrayal when she came in and told me that the best plan for my life was a really strict diet. The bitchy cruel OB got in on the act, which is hardly a surprise, and laid it on with a trowel.
Not only did I need to diet, but if I did not do so, I would be dead before ten years, because women my size don't live past This is so hard to do, my 2 week old feeds every two hours and finding time to pump on top of that is impossible.
Right now I am only pumping and bottle feeding him either breast milk or formula when there is not enough breast milk being pumped. What are your thoughts on this? As long as you are using the correct size nipple shield I recommend the 24 mm and you are putting the shield on correctly, there is absolutely nothing wrong with using it.
I have seen a supply decrease using a 16mm or 20 mm nipple shield, but never with a 24mm. You do not need to pump every time you feed, especially not for 20 min.
I often recommend pumping 3 times a day, 10 min after a feed, for 10 min. If you are still having some trouble with getting milk increased you can always use some herbs.
Eventually your baby will not need to use the shield, and will most likely self wean off of it. Keep doing what you are doing, and monitor the pees and poops. If the baby is peeing at least 6 times and pooping at least 3 you are doing great. I was so happy to find this article. I have been worried and considering EPing because my baby will not latch with out a nipple shield. I have tried everything an the LCs make you feel like a terrible mom for using one! Just the reassurance I needed!
I am so glad that you found it helpful! There is absolutely nothing wrong with using a nipple shield as long as it is placed on correctly! Like I said in the article for some women this is the only way they are able to breastfeed. Good job doing what works best for you to make you the best mommy possible for your baby! I use a nipple shield to breastfeed my 3 week old premature baby girl and it works for us.
And so very glad to hear that using one will not affect the amount of milk I produce- despite what the lactation nurse told me! I was wondering how early can you use a shield? The lactation nurse said not until the milk comes in and the midwife said as soon as I can express about 5 mls. You can use a nipple shield from day 1 if you needed to.
It does not matter if your milk is in or not. All that matters is if it is placed on correctly. As long as you slightly invert it, and stretch it over to vacuum your nipple in, you should be fine. I recommend using a 24 mm shield as well. Sorry for the confusion. Good luck to you and your little one! I have a one month old and have been using a nipple shield pretty much the whole time breastfeeding. She gets frustrated and then so do I and the shield goes back on.
I now have really sensitive nipples. Hi there, first let me say that as long as the nipple shield is being used correctly, there is nothing wrong with using one.
One day he will come off your breast, swat the shield off, and go straight for your breast no questions asked. What I generally recommend doing is start a feed with the shield, then when you switch to the second breast take off the shield. If you are still having trouble I would schedule an appointment with a lactation consultant who can help you transition off.
As for the nipple tenderness, that is something that your breasts will get used to, but generally it is because of a good latch. You can take Prim Rose oil capsules mg times a day and this will cut back on some of the tenderness. I have been searching all over for articles that included pictures of correct usage of shields. My baby is 3 weeks old and we have tried latching with and without.
LC in hospital tried for hours with us as I have inverted nipples. I have mostly been pumping lately since its just too frustrating and time consuming to pump to draw out nipple, work with my darling to get a good latch and then to nurse.
This is baby 5 and pumped exclusively with others. Now, with soccer practice and ballet classes and other activities for older children, hauling around the pump is not always appropriate. Is it too late to try and work with the shield? Thank you for your response! Yes you can absolutely try to use a nipple shield as it will probably help you a great deal. It is all about positioning and inverting the shield first so that it can vacuum the nipple in. If you are having trouble, I would recommend scheduling an appointment with a lactation consultant to help you.
If you are local to southern California, I would be happy to meet with you personally. Just remember to lean back, bring the baby to you…and of course remember to rub your nipple or in this case nipple with the nipple shield on from his nose to his chin until you see a wide open mouth then shove him in.
If pumping is hurting, you can always put lanolin in the pump to help lubricate it so that it wont cause more nipple damage while pumping. As always if you have further questions please let me know. I have been using a nipple shield since day 2. I was given one by a great LC in the hospital. When I got home I started looking online and panicked due to all the poor information out there about the evils of shields. My LO would not latch well without it, likely due to not very prominent nipples.
With the nipple shield he was back to birth weight by day 5! He does take forever to nurse, but I think this is more due to his personality and feeding style than the shield. Now at one month he will latch without the shield, but keeps falling off and gets frustrated so we always end up putting it back on.
Again, thanks for the great article. Many of us new moms who stumble upon it find great comfort from it right when we need it most. I was given a 20mm by the LC and sometimes the outer rim of my nipple has some bleeding, it seems too small.
I never recommend a 20 mm shield unless it is a teen mom or a really preemie baby. If you use too small of a nipple shield it can decrease your supply and cause more discomfort. I recommend using a 24 mm from the start if possible. Just remember to stretch it on so that it suctions in. Let me know if you have any further questions. Thank you for sharing your expertise. My issue is that my baby doesnt open wide enough. I know he is able to but it is rare that he does. I was going to try the nipple shield to help with overactive let down if that is causing him to compress and I will begin to suck train.
Any way I can talk to you via phone?? I would try some suck training on him, and make sure you are leaning back and bringing him to you.
Gravity will help open up his mouth wider. You never want to go to your baby as this will cause him to be more on his back thus resulting on him clamping down more. I would be happy to talk to you on the phone, however you might benefit from seeing a lactation consultant in your area that could look and see what else is going on.
I could recommend some if you would like to message me privately. Love this, thank you for putting this out there! I had my son two weeks ago and while in the hospital, a nurse handed me a shield. No questions asked and never told me to meet with an consultant. I was so sleep deprived and medicated I agreed. I thought it was amazing until I got home and started researching specifically about shields and became so angry with the nurse…what if I lose my supply? What if he never learns to latch on the breast?
They are expensive and not user friendly in public situations etc. Point…there are not positive messages out there on shields and it terrifies me. So, thank you for giving me hope. I met with a lactation consultant last week and it was not very helpful. I feel like she gave me 0 information about how to use them, long term use, how to clean, do they need replaced, should I start pumping?
My son and I are hooked, although trying to wean from their need. That said, my questions are: Am I being used as a pacifier at that point? For the record, he is gaining weight like a champ! It sounds like you are well on your way to a successful breastfeeding start. Based on what you are describing, it sounds like you have the wrong size nipple shield. As long as you are using a 24mm medium size Medela brand nipple shield you should be fine.
I never recommend anything smaller then that. As long as a nipple shield is put on correctly it will not lower your milk supply. When you latch, make sure to lean back and bring him to you, never go to the baby.
He should be tummy to tummy and you should not see your areola. Watch his jaw glides, as long as there are big long glides he is latched correctly. When you see the flutter suck take him off. I am always available for facetime appointments as needed if you would like further instructions. We do use the 24m Medila shield — I am keeping your FaceTime option totally open!
I am having the exact same issue. My nipples were starting to heal but now are getting pulled through the holes in the shield which is so painful! I have the 24 mm size too and have been applying it like described above so I have no idea what to do to help it. Did you have any luck fixing the issue? Are you using the Medela brand Nipple Shield? That is the only brand I would recommend. The other brands have too many holes.
If your nipple is being stretched that far, then I would suggest trying to latch the baby without the nipple shield and see how you do. If you need help, I would recommend trying to find a local lactation consultant to observe a feed. If you need help locating one, I would be happy to help.
The shield is smaller, though, and so nursing with it is more painful in the long run. It also seems to mess up her latch after a few feedings. Some sort of weaning shield that has the tip cut off but still encourages a wide latch might be a good solution. If you have a hard time doing so, it may be a good idea to make an appointment with a local lactation consultant to hopefully help you through the transition.
I am not familiar with the NUK shield, so I can not provide information on that, but I would always recommend using a 24 mm shield.
Best of luck to you. I weigh him before and after nursing and he tends to only get about an oz in an hour long nursing session. Is this due to the shield? I really want him to be EBF before I go back to work on jan 3. We started using them on day 2 with my slightly premie baby who was unable to latch without them. The advice was to slowly begin to remove them at home. By week three and many painful and frustrating sessions of trying to get rid of them many tears from baby and mum!
I went to see a lactation consultant who diagnosed baby with a tongue and lip tie that were preventing proper latching and the reason for so much pain and nipple compression. So now we are at week 7 and the ties have been snipped three days ago.
Her suck is definitely stronger and seal better, not so much milk spilling out during feeds, and she seems to be more settled on the whole with less cluster feeds in the afternoons and evenings like before, but the pain is still there for me. I feel like she has a fixed pattern for tongue coordination now that might not change…? I liked your post on training tongue position for latching so will give that a try.
Fingers crossed, as I would love to experience pain free nipple shild free breastfeeding! Any advice though would be much appciated. So thrilled you find this information helpful. Let me assure you I have yet to meet a baby, in all my years of practice, that at some point in their breastfeeding journey did not sit up, swat the shield off, and go straight on the breast no problem.
For some babies it may be sooner then later, but like I said as long as you are using the shield correctly preferably a 24mm medela shield there is nothing wrong with using one. Research has shown how using a nipple shield with a preemie baby has improved latch and milk transfer which was very apparent with your little one. I would most definitely try the suck training that as mentioned in my previous article, it should help.
Then nose to chin, hug baby in. Flip that lower lip out. Make sure cheek is touching breast and that you do not see the areola. Make sure you are using good pillow support as well. I hope this helps. He had a tongue tie cut two days ago and has not been breast fed for four weeks.
He is now six weeks old and screams when I try breastfeeding. They are already damaged and seem to just rub against the shield. Am I doing something wrong? I always recommend using a 24 mm shield, never anything smaller. Anything smaller just adds to the discomfort your already experiencing.
Make sure when you use the shield that you invert it slightly, then push onto your nipple and stretch it on so that it vacuums the nipple in. It should be difficult for it to come off.
Then make sure you are leaning back, bringing baby in to you, and that you are using good pillow support. Make sure you are using good breast compressions or massaging the breast to allow more milk to flow. Hand express some milk into the shield so that there is milk pooled and waiting for him. Hi there, thanks for the post it seems everyone else thinks I need to come off the shield but I feel I will always use it at least until he knocks it off like you say.
I have friends that used a shield for the whole time they breastfeed. My baby was 6 weeks prem and we had am awful time trying to feed him. I have a 16mm medela shield as that is what my lc recommended. I am yet to compare his recently but he seems to be getting bigger. He has quite a small mouth and I feel a bigger shield would be to much for him to take.
Do you think this sounds ok… I am always concerned my milk will dry up not that it appears to be at this stage. Have been using for 2 weeks now after previously bottle feeding. As I mentioned in the post, there is nothing wrong with using a nipple shield as long as it is used correctly. At some point you and your baby will decide to get off the shield and when that time comes, then I would encourage you to do so.
However, I would recommend transitioning to a larger shield such as a medium 24mm. I know that seems quite a bit bigger compared to the 16 mm, however the small size you are using will attribute to a lower milk supply because as the baby grows so will his mouth and he needs to learn to suck effectively.
The 16mm only covers the nipple not allowing the baby to compress part of the areola sending the nerve messages to your brain to tell your body to make more milk. If you use the 24mm, invert it slightly first, then stretch it on, it will allow the breast to be compressed how it is supposed to, and not lower your supply.
This will also help your baby widen his mouth bigger thus resulting in a more effective latch as he grows. Maybe a good solution would be to transition to the bigger size before stopping the shield all together.
If my nipple is being pulled through sheild is this affecting transfer n supply? If your nipple is being pulled through the shield it is too small for you. I would recommend using a 24mm medela shield. Any other brand will not work. Also if you are able to fill the entire shield, you may no longer need to use it. Make sure you are monitoring the babies output. Is your little one peeing and pooping enough?
Let me know if you have any questions. Thanks a lot for your article — Like many of us — first time mom — we are never too sure we are doing the right things. Because I have flat nipples, my LS recommended to use nipple shields. I start at day 4 and my baby is now 14 days and we are doing great with breastfeeding. I am so glad you found this helpful.
I would recommend using a retainer box. If you have an orthodontist close by or even a dentist, usually they are pretty happy to give you one, or sell you one. That is the perfect carrying case.
If not Target usually has travel cases you can use, like you would use for bars of soap.