"disorder of lactation"

First off, a huge thanks to everyone who expressed understanding and support after my last breastfeeding post! I feel much less alone knowing that I'm (unfortunately) not the only one to have had trouble in this area, and also knowing that I have a wonderful support network cheering us on! Thank you.

Progress has been really slow on this front - for the past week, we've still pretty much only been able to do two "old fashioned" feedings per day, with the rest being pumped. It's really been taking a toll not only on my sleep but also on my confidence as a mother. So yesterday (Tuesday) we went back to the lactation consultants again. The good news is that the B6 seems to really be helping the Raynaud's / vasospasms, and she also encouraged me to use warm compresses more often and to do whatever I need to do to stay warm (not a problem! I like being warm, and apparently so do my boobs!). The bad news is that this treatment to date hasn't fully fixed the pain problem.

So after much awkward poking, prodding, and analyzing, the new theory as to the cause of my "disorder of lactation" is that I also have an underlying bacterial infection of some sort (in addition to Rose's vigorous sucking and my very sensitive skin and the Raynaud's). Now I have a "prescription" for a homemade ointment (hydrocortisone cream plus polysporin cream) that I have to apply after every feeding, and as a result I'm feeling a little more optimistic again. In addition, since the pain continues to be the worst during the first minute or so of feeding, we're now back to using the nipple shields again. However, we discovered that if I have the nipple shield on during the entire feeding, she only gets a fraction of the milk she needs (she got 10 ml of milk with the shield vs. 2 oz of milk without -- one ounce is about 30 ml, and she needs at least 3 oz of milk per feeding). So we just use the nipple shields for the first minute or two, then we take it off.

Got all that? It's quite a routine, for something that's supposed to be as "simple" and "natural" as breastfeeding.

In other words, here's our new routine (when Mike is not home):
1. Determine that Rose is hungry (which is sometimes hard to figure out!)
2. Feed her the milk I pumped 1.5-3 hours ago, repeatedly telling her to "slow down!" and giving her lots of burp breaks.
3. Lull her to sleep in her bouncy chair.
4. Put on the MotherLove nipple balm (to prevent friction from the pump), then pump for 20+ minutes.
5. Gently rub off the MotherLove and replace it with the hydrocortisone/polysporin cream.
6. Wash all the pump parts.
7. Figure out when she's hungry again.
8. Repeat the above steps. OR, twice per day:
Gently rub off the hydro/poly cream.
9. Place the nipple shield.
10. Try to convince Rose to open a BIG MOUTH.
11. Let her eat for 2 minutes.
12. Remove the nipple shield.
13. Try to get her to latch on with a BIG MOUTH again.
14. Let her eat as long as possible. (She likes to fall asleep after about 2 minutes)
15. Wake her back up again.
16. Place the nipple shield on the other side.
17. Let her eat for 2 minutes.
18. Remove the nipple shield and remind her to use a BIG MOUTH.
19. Hope she eats for more than 2 seconds.
20. Cuddle her to sleep.
21. Put on the hydro/poly cream.
22. Try to rest for 30-120 minutes until she's ready to eat again.

So, as you can see it's still quite a process. BUT, we tried 2 "old-fashioned" feedings (can you even call it that when you're using a nipple shield?) in the last 24 hours, and both involved very, very, very minimal pain - maybe not even pain, but just slight discomfort! I'm super hopeful that this new solution will do the trick, but I'm not going to push it too fast. Please continue to keep your fingers crossed for us!