More secrets revealed: Breastfeeding isn't always easy.

That's right, people. The natural, beautiful process of breastfeeding is not always easy. Actually, for us, it hasn't been easy at all - even for a minute - since Evelyn arrived.

There are a few factors interacting to make things difficult:

1. Evelyn was "late pre-term" so, even though she is not considered a preemie, it's pretty typical of babies her age to have some issues with feeding. The main issue being that she is super tired and falls asleep before getting what she needs.

2. Since pretty early on, Evelyn has been borderline for jaundice. While we were at the hospital, they had us stay as long as we could to get her time under a blue light in our room to help her process the bili. Jaundice impacts breastfeeding because it only increases her lethargy.

3. My milk seemed to take forever to come in. It finally arrived yesterday. But before that, Evelyn was having to work extra extra hard to get just a teeny bit of milk.

Even while we were in the hospital, all of the nurses and midwives and doctors and lactation consultants were there offering their tips and tricks and suggestions for breastfeeding. I appreciated the support and ideas, but by the end I was just overwhelmed with all of it. They had me hand-pumping after every feeding attempt to get milk to supplement her with. They had us squirting that milk into her mouth with a curved syringe, they tried finger-feeding, and they had us squirt it into a nipple in her mouth that she could eat it from. They had me try nipple shields. They had me using an electric pump after every feeding attempt. They had me try all the different positions. We learned how to do "baby sit-ups" with Evelyn and all sorts of other tricks to get her to wake up and stay awake while eating.

We left the hospital on Friday with all of these bits of advice floating around and we did our best with little Evelyn. She was at 5 lb. 10 oz. when we left the hospital, down from her birth weight of 6 lb. 2 oz. On Saturday when the nurse did the home-visit, Evelyn weighed 5 lb. 8 oz., which is right near the cut-off of 10% of body weight lost which is when they start to get extra concerned.

The nurse showed me some more things and got us to finger-feed successfully so we could avoid the nipple feeding for now. Evelyn will use bottles of pumped milk eventually, but right now we're trying not to make it too easy for her so that she will become successful with the breastfeeding. For the finger-feeding, I hold Evelyn and have my pinky in her mouth, tickling the roof of her mouth to encourage her to suck. Jonathan uses a syringe and slowly squirts milk into her mouth while she sucks on my finger. It requires two people and lots of patience. But it gets her to drink about 1/2 to 1 oz. at a time. This is after she attempts feeding for at least 15 minutes on each side.

So, our current routine is:

1. Wake up Evelyn every 2.5 hours. Give her 30 minutes of stimulation to make sure she's really up for the feeding. (Jonathan does this part so I can sleep a little more).

2. I breastfeed. She has to try for at least 15 minutes on each side. Sometimes she'll do great and just go and go for 25 minutes on one side, and sometimes she'll have none of it and be mad, and sometimes she'll latch on great and immediately pass out. During all of this, I just try really hard to relax my muscles and my brain. Jonathan rests.

3. We finger-feed. It's a two-person job that takes about 15 minutes total.

4. I pump for 15 minutes to build up the milk supply for the next finger-feeding. Jonathan burps Evelyn and puts her back to sleep.

5. We both try to return to sleep, because we'll be getting up again when the alarm goes off far too soon.

Of course right now I'm breaking the sleep rule, which I'll regret later. I just couldn't get myself back to sleep.

So far, we have seen a medical professional of some sort every single day since Evelyn was born. It's tiring. Tomorrow, which is today now, Monday, we go back to the Birth Center in the afternoon for another blood draw for Evelyn's Bili and to meet with (yet another) lactation consultant. The goal is to get to the point where Evelyn can just breastfeed and get what she needs without the finger-feedings, so that I can pump and build reserves for things like sleeping a little longer at night (Jonathan could give her a late-night bottle of my milk) and returning to school. These things sound like far-off dreams to me right now.

Yesterday, Sunday, we went to the Birth Center around 1 PM to have Evelyn's blood drawn again because the draw from the day before with the home visit showed that her bili count had gone up again. There was a chance we'd have to take her back to the hospital if it continued to rise too high, so I was nervous. When we got to the Birth Center, we went upstairs with Kate and she and a student midwife watched me try to feed Evelyn. It was so frustrating. She wasn't latching on, she was getting angry, I was stressed. They had me do various things like eventually hand-expressing onto a spoon which the student midwife then fed to Evelyn. I tolerated it for a bit but finally said this is ridiculous because I thought the finger-feeding we'd been doing (and pumping rather than hand-expressing) was a whole lot more efficient and better for Evelyn anyway. So they drew her blood and we went down to the birthing suite to hang out and await the results (in case we needed to head to UNC). Of course the lab at UNC takes their sweeeeeet time.

But we were lucky that Maureen was there in the birthing suite with us. She had us try feeding again and she made me super comfortable and Evelyn did better. She noted that my milk still had not come in, and she talked to us about using some donor milk to get Evelyn the milk she needs while allowing me some time to let my milk come in and pump it to build my own supply for supplementing. We agreed to donor milk. That stuff is liquid gold - $4 per ounce! I wonder if there's a breast milk black market. So with the donor milk, Maureen had us try a few things. One of them was a syringe full of milk with a long thin tube attached which Jonathan would feed into her mouth as she was at the breast trying to eat. Evelyn was not a fan of this setup. We tried a couple of other things and finally just told Maureen that finger-feeding had been working, so that's what we did with the curved syringe and my pinky and the donor milk. Before all this, Maureen weighed Evelyn and told us that she had gone up to 5 lb. 10 oz. (up 2 oz. in one day), which was her hospital discharge weight and was promising to hear.

Then Maureen noticed that Jonathan was starting to doze off and she ordered him to take a nap on one of the couches. She told me that I should try to rest too, to help my milk come in, and she set me up on another couch with some magazines and a juice box and a blanket and swaddled little Evelyn to cuddle. Pretty soon we were all sound asleep. And Marueen and the staff decided to let us sleep. Isn't that awesome? I kept thinking this would not have happened at a normal OB/GYN office. They let us sleep until we all woke up on our own, and then they told us the lab results that had been in for a while. Evelyn's bili count went up but still was not high enough to make her head to the hospital for light treatments. We were free to go home, try to get her to eat as much as possible, rest as much as possible, and come back tomorrow. We got home around 8:30 or so. Long day at the Birth Center.

And that was basically our day. And that is basically our life. Trying to get this little mouse to wake up enough and grow strong enough to be successful with breastfeeding, and trying to function on very very very little sleep.