Saturday, September 10, 2011

lactation aid how to

Here are details of how I do the improvised lactation aid system.  I got the nasogastric tube from the lactation consultant, and have ordered a more commercial version of the system from Medela, they sell it.  In Canada I got it from weefeeds in Calgary (weefeeds.com or something like that), they order from Medela for me.  But for now all I have is the nasogastric tube (5 French, 25 cm) and a syringe to clean it with.

So let's walk through a night feeding.  I wake up when Emma starts fussing and looking for food, she is usually awake at 3 or 4 am for the first night feed (the last one is at 11 pm or midnight).  I grab her, I latch her on the LEFT boob, and I go pee while breastfeeding.  (Sorry, I can't hold it, and if I don't give her the boob, she starts screaming and wakes up MrH, who is working in the morning).  I wash my right hand, and hope that the other one is clean enough, but I only use one hand for the materials anyway.  I walk downstairs, open the fridge with the right hand, take out the milk or the formula, depending on what I have on hand (it is not my milk, it comes from a friend of mine who is a SAINT), and I grab also a clean bottle (for pumping afterwards) and the nasogastric tube and the syringe (I put some stuff in my armpit, and some in my mouth if I have to).  Then I walk upstairs where I usually feed and pump, I sit down on my glider, I put everything to my right hand side on a little coffee table, and continue feeding from the left breast until Emma lets me know that the flow has slowed down (she gets angry and starts making funny sounds, while biting and pulling on my nipple).  I then do breast compressions, to try to milk more, but I don't have much left usually.  I switch her to the right breast, and feed from there using breast compressions as well.  When there is no more milk coming, I put her back on the left breast, and let her latch well, then I take out the cap from the bottle with one hand (this is tricky, don't screw the cap on too tightly or it is almost impossible), put the nasogastric tube in the bottle (or bag, like here in the picture), and hold the bottle or bag between my legs as I am sitting.  I put the other end of the tube in Emma's mouth trying to enter at the corner and aiming upwards so as to not go under her tongue.  Sometimes it takes three tries, sometimes I get it right away, sometimes she gets annoyed with me poking her and pulls away, in which case I put the tube along the areola and nipple and let her latch onto both when she does.  Then she starts sucking, and I use my legs to hold the bottle, my left hand to hold her head, my left armpit to hold her body, my right hand to hold her hands that sometimes fly all over the place, and if her arms are pretty quiet and she is calm, then I use my right hand to surf the internet on the iphone while she is eating, because once she starts sucking the high flow of milk, she goes pretty quickly and in relaxed fashion, and the whole thing is on autopilot.

I hope this makes sense, email me with more questions if you need to, I will post pictures of the commercial system which you hang around your neck so it should be easier (sometimes holding things between my legs means I need to bend forward for the entire feed, and my back hurts).

This is by far the hardest way to do it, with finger feeding being way easier.  For finger feeding I just lay her over my legs, with her head on my knees and her legs on my abdomen, I put my right index finger in her mouth with the nail side on her tongue and let her latch, and the tube goes in the same way (corner of the mouth).  You have the whole left hand to use to hold the bottle and it makes it easier.  You can also hold the NG tube between the thumb and middle finger, paralel to the index, and insert both the index and the tube in her mouth at the very beginning, it is even easier this way.

Once the feeding is done, I burp her if I gave her formula, otherwise no burping is necessary for breast milk, I pump a bit with her on my knees, then I put her down on the changing table, I wash the bottles with tap water and rinse the tube with the syringe, then I change her diaper, then we go back to sleep with the boob used as soother.  In the morning I take the bottles downstairs to the dishwasher and I rinse the NG tube again with filtered water.

The only trouble is that my daughter has figured out that the milk is coming out of the tube, and she sometimes spits out the nipple and sucks just from the NG tube.  It is very funny to see.  She does not do it often though, only when she is pretty full and has enough energy to play and explore.  When she is hungry she just does the latching and feeding with no questions asked.

I rarely do give her a bottle, if someone else has to feed her or if I am out of the house in a place where I cannot set up my lactation aid.  But I try to avoid it, although she clearly still prefers the boob, despite receiving several bottles so far.

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