With my first baby, I was blithely determined to do pregnancy, delivery, and postpartum the 100% Natural and Organic Way. I was gung-ho into prenatal pilates, yoga and organic eating; I hired a doula and consulted the midwives; I took a Hypnobabies course; I bought the sling for Babywearing; I hired a lactation consultant, BEFORE delivery. I was the annoying patient who showed up to L+D with a 3-page Birth Plan.
And Mother Nature set me straight big time– you can’t mess with Mother Nature, after all. You can’t control how your pregnancy/ labor and delivery/ breastfeeding/ or ANYTHING will happen.
Loss of control is a very difficult concept for type A, mildly OCD, hypomanic overachievers like myself (and most physicians, I suspect).
So after our really bad, almost disastrous first L+D experience (see previous posts), I set my mind to at least getting breastfeeding right.
I was all set to breastfeed exclusively for 6 months, at least; I was going to pump extra, TONS, and I had bought breastmilk bags and containers for organizing all that White Gold in our freezer.
And Mother Nature, once again, had a good chuckle on me.
My milk took forever to come in- perhaps the emergency C-section had something to do with that. So I used a hospital-supplied hand pump, which caused major suction damage to my breasts, and they bled. The hospital’s lactation consultant stopped by before we left and was very brief and not too helpful, and suggested that things would take a few days to heal up. I figured, I could suck it up for a few more days…
But, at home, I was in agony. My nipples got cracked. And HURT, like – and this is a very exact sensation- like someone was stabbing me in my nipples with a sharp metal letter opener, every single time I fed my baby. And it was a holiday (4th of July). The lactation consultant I had signed a contract with was away. The doula was away. I cried every time I tried to breastfeed. The pediatrician was worried about Babyboy’s weight. I cried some more. My husband was worried about me.
I asked the on-call OB, friends, and relatives what to do. Soothies were briefly soothing. Lanolin was yucky and useless. Ice packs helped for a few minutes here and there. I seriously considered quitting.
It was a nurse practitioner with our Pediatrician who suggested APNO cream. APNO (All-Purpose Nipple Ointment) is a compounded, mild topical medicine made up of Mupirocin (an antibiotic), Clotrimazole (an antifungal), and Betamethasone ( a steroid). I called the on-call OB, who begrudgingly called in the prescription, and it took 24 hours to fill… But once I got it and started applying it, it made a world of difference.
I still feel that it took TOO long for someone to suggest this miracle ointment, APNO. I was annoyed that someone hadn’t just sent me home from the hospital with it. I mean, I almost quit breastfeeding—and many moms do, for the same reason.
The lactation consultant finally showed up, and confirmed my latch was OK. I think it was the damage from the original hand pump that caused the problem… She also thought that maybe Babyboy was slipping off during the feed, as newborns with no head control are wont to do, and that might have been contributing.
She wanted me to try all these different breastfeeding positions, like in a sling, and lying down. These never worked. Even with her there helping, Babyboy looked at me with a mixture of horror and annoyance, like, “What the Hell, Ma!” I never got comfortable with breastfeeding in any position other than cross-cradle, and I always had to be either sitting up in bed, or in the rocker, with the My Brest Friend Pillow arranged just so.
I never got the hang of breastfeeding on the fly, and I especially dreaded being caught out in public. Likewise with the sling- I never figured out how to use my Maya Wrap. I watched the video and experimented, but we always ended up all tangled up, with Babyboy flashing me that Look again: “What the Hell, Ma!”
I never was able to pump any extra milk, even 1 lousy bag. What I had seemed just enough, and I was loathe to pump more, and become any more engorged and uncomfortable than I already was. I returned the bags and plastic breastmilk organizers. I was really not sad at all when I returned to work at 3 months postpartum and my milk dried up almost overnight: I never needed to pump at work at all, even for one day, and I was SO thankful. Babyboy transitioned to formula, and he’s done just fine, thanks ever so much.
So anyways, THIS time around, with Babygirl, I am determined to breastfeed for at least 3 months. I was hell-bent not to even leave the hospital without some APNO. My milk came in really quick- by day 2, really. But once again, even without using a hand pump or anything, my nipples were blistered and bleeding. Three different lactation consultants confirmed that the latch was fine, again. Just, my nipples were ravaged.
I asked the NP who was rounding for the OBs for a prescription for APNO- and she hesitated. “That’s STEROIDS,” she stressed, “Like Prednisone. I hate to give you that if you don’t really need it.”
Now, never mind that Betamethasone is nothing like prednisone. Betamethasone is a mild topical steroid that we slap on all kinds of minor skin irritations, like eczema, and is also comobined with antifungals and slapped on minor fungal skin irritations, like intertrigo.
So, I was prepared to do battle with her to get me some APNO, but I didn’t have to. The very experienced nurse caring for me simply went to the hospital dispensary and retrieved a bottle of it for me to take home, just like that. “This stuff works miracles,” she explained. “I can see your nipples are blistered, and you need this. What’s important is that you breastfeed comfortably.” God bless her!
Now, Babygirl has been feeding like a little pink piranha for 2 weeks, with APNO ointment in hand, all is well. There is some pain initially- like a stinging/ tugging, for the first minute or so; and the nipples are sore, especially in the shower. But overall, nothing like the excruciating pain I endured the first time around.
So many women I know have experienced bad pain with breastfeeding- and many have quit. Of course latch issues may be part of the problem. But latch issues cause nipple breakdown, which lets in bacteria and fungus, which causes inflammation and pain—so APNO is part of the solution there as well. I say, if it is a harmless ointment that keeps women breastfeeding comfortably, then it should be more widely prescribed.
And, as a close supportive friend of mine soothed me when I stopped breastfeeding at 3 months: “Any amount of time you can breastfeed your baby, is what’s right for your baby.”