What is Exclusive Breastfeeding (EB)?
Exclusive Breastfeeding (EB) is a method of infant feeding where a baby, typically from birth up to 6 months of age, receives only breast milk without any additional food or drink, not even water. This approach is recommended by health authorities like the World Health Organization and the American Academy of Pediatrics due to its significant health benefits.
Exclusive breastfeeding ensures that the baby gets all the essential nutrients, vitamins, and minerals necessary for optimal growth and development. It also provides antibodies that help protect infants from common childhood illnesses and strengthens their immune systems. This practice not only fosters a unique bond between mother and child but also offers long-term health benefits for both.
Our 3 month journey to get to only breastfeeding
Our son was born happy and healthy. So when he quickly went from thriving baby to struggling baby we felt shocked and confused.
He was born with both a lip and a tongue tie, but we didn’t know that at the time. Test care providers run so many tests when a child is born, but they don’t check the mouth for these kinds of issues.
I didn’t come to breastfeeding unprepared. I had read every article I came across on the topic. I also read The Womanly Art of Breastfeeding cover-to-cover. I was completely sold on the importance of exclusively breastfeeding– no bottles, pacifiers or other artificial nipples of any kind. None whatsoever.
I thought we had done everything right to give my son a good start. I had a natural birth – medication free! I pulled my baby onto my bare chest the moment he was born for instant skin-to-skin contact. We waited to cut the umbilical cord until it stopped pulsing so he would get as much blood and nutrients as he could.
First time breastfeeding
The first time I put my son to my breast, he didn’t take to it well. We stayed at the birth center for quite some time until the midwives were sure he would nurse. Finally, after numerous attempts at latching each time someone checked on us, a bloody nipple, the use of a nipple shield, and a lot of effort and focus on my part, he ate for a reasonable period of time.
We took my newborn son home about 2 o’clock in the morning. My husband and I were anxious to get home. In hindsight, it might have been good to rest at the birth center a little longer or to have asked for help once we were home. Mother and baby were both doing well though, so we were allowed to leave. That first half night was a blur. My husband and I were both excited, exhausted, and completely taken with this little person who had come into our lives. He slept on my husband’s chest for the first several nights of his life. We never wanted to put him down. He was so cuddly and precious.
The next couple feedings went well. At least, I don’t remember thinking anything was wrong. Then, when we woke up for the 6AM feeding, he wouldn’t take to the breast again. Finally, at 10AM, after a lot of struggling, I called the midwives. I was told to express colostrum onto my finger and let him suck and just keep doing that for a while.
They said babies don’t eat much during their first couple days. Their stomachs are tiny, so their meals are small but frequent. The key in the beginning is getting that nutrient-rich colostrum. My son suckled on my finger for a couple feedings and this effort sparked within him a new interest in nursing. He began to love to nurse, even though he wasn’t good at it. I was thrilled. I had no idea that he was struggling to get anything.
Lip and Tongue Ties
I had never heard of a lip tie or a tongue tie before. A Lactation Consultant (LC) came out to our home when my son was 3 days old. My milk had come in and my left breast was engorged. I just wanted to be sure everything was going as it should.
The Lactation Consultant was wonderful, kind, and knowledgeable. She gave me some breastfeeding tips and taught me how to use my breast pump correctly. (I thought, “Like I would ever use that thing.” Boy, did I!) The LC said we were doing great. She briefly mentioned he might have a lip tie, but he and I seemed to be doing well as a breastfeeding couple, so she gave us an A+ and went on her way.
Looking back, I was much more arrogant about breastfeeding than I had any right to be. I was so determined that “this was how it’s going to be”. I didn’t make allowances for mistakes or things beyond my control. This made dealing with all the issues that would arise even more emotionally challenging. It hindered my willingness to accept and admit that there were any problems, which made it difficult to ask for help.
Help and Support
When he was 5 days old, I almost had a meltdown. Ok, ok, I did have a meltdown. My mom had just left to go back home. I had just finished a much needed shower, and exited the bathroom, when my husband thrust our upset son into my arms for me to nurse him. He was screaming and crying! He was too upset to eat and it was clear this was exactly what he needed to do. All the books and articles and care providers said newborns needed to eat every two hours, but he didn’t keep to this at all. He was showing all the signs of hunger but wouldn’t nurse. He was frustrated, and I was frustrated. To put it bluntly, we were a hot mess!
I gave up and called my cousin who had texted me the day before, “If you’re having any trouble breastfeeding, give me a call anytime. No matter what time it is.” At this point, I just needed to talk to someone I didn’t have to pay, so I gave her a call.
So there I was, sobbing, face and chest red-streaked, still naked from my shower, holding my screaming newborn. My hair was wet, unbrushed, and tangled, and she said, “Let’s FaceTime.” There’s something about the progression of pregnancy and then the final act of labor that eventually sucks away all your modesty until you just don’t care anymore.
To be honest, she didn’t tell me anything I hadn’t either read or been told previously. However her kindness, loving encouragement, and support were exactly what I needed to get through the night.
It’s so important to have good support when it comes to breastfeeding! Breastfeeding may seem like the simplest, most intuitive thing in the world, but complications can arise and when they do, it can be one of the most difficult things in the world. Fatigue, fluctuating hormones, and fear of being a good parent can make it difficult to ask for help. So even if your only support is a Facebook group, or a single friend or care provider, reach out to them. It can, and does, get easier – even with complications.
Supplementing with Baby Formula
We went in for his one week appointment and he had lost weight. This is expected in all newborns, but typically their birth weight should be regained by two weeks of age. When we went in for his two week appointment, he had lost even more weight. This started the beginning of supplementing. Remember how I was very anti-artificial nipple? Well, I was (and still am) even more anti-baby-choking-coughing-and-aspirating-while-using-a-dropper. He just didn’t know how to take food from it and my husband and I sat there and wept struggling to feed him, while I pumped to keep him supplied with breast milk.
We went in for weight checks every few days. Eventually, we just borrowed a scale to take home. Each time the routine changed because he wasn’t gaining enough. My supply suffered and we went from 100% breast milk, to using a formula (yes, I was anti-formula too) called NeoSure, a Similac formula for premature babies. It has extra calories per ounce and helps babies put on weight faster. I have since learned that there is also the option of using donated milk. Look up an organization near you to learn more about this option.
By four weeks of age my baby regained his original birth weight.
We continued to work with the Lactation Consultant. She was a huge reason I continued to breastfeed as she was so very supportive and encouraging. She was constantly brainstorming on how to make breastfeeding easier and more efficient for us. One of the first things she taught us to help with our new supplementing routine was the paced-bottle technique. “>See technique here. It was also recommended that we use Dr. Brown’s bottles. They are special bottles that have a piece on the inside to help with the aeration and keep the baby from getting gassy.
We broke our rule on “no pacifiers” too. When you’re worried that your baby is crying away all the calories he needs to grow, you get over yourself and your rules pretty quickly.
My husband and I saw my son successfully gain weight on the formula we were given, but we desired for our son to go back to breastfeeding completely, if that was at all possible. We knew of all the benefits to breastfeeding, and we wanted our son to reap them. Our goal was that one day he would be exclusively breastfed.
Using a Supplemental Nursing System (SNS)
We started to decrease his supplements. I can’t remember exactly what that looked like. Our routine seemed to change every week and so sometimes what transpired was a blur. I do remember when he was about 6 weeks old we tried to exclusively breastfeed again. He stopped gaining weight. So we quickly went back to formula again.
The LC carefully recommended I try to use SNS or Supplemental Nursing System. (I say carefully because she did not want me recommending to others. She said that babies have to have a good ability to suck and swallow correctly or they can aspirate so please consult an LC if you are interested in using SNS.)
If you aren’t familiar with SNS, it is a bottle hooked up to small tubes you tape to your breast near the nipple. It’s very contraption-y. The flow to your baby can be controlled by pulling the tubes through notches. For some, giving supplements through SNS can be a great way to transition a baby back to the breast. For others it can be a nightmare.
Conceptionally, SNS is easy to use. In practice it can be tricky. There is an element of trying to hide it from the baby. These young little tykes are smarter than you might think, even at only weeks old! We didn’t want him to see the bottle hanging from my neck, and thus, a visual cue for him to eat. I personally struggled with getting his supplement the right temperature if it had been in the fridge. Most of the time I didn’t time the preparation correctly to get it warm enough before a feeding was required. So obviously there was a noticeable temperature difference when using cold pumped breast milk as a supplement. When using formula, the challenge wasn’t the temperature but the noticeable taste difference.
One comic relief throughout this whole process, was the look on my son’s face when we gave him formula. It was almost like giving a lemon to a baby, but not perhaps, as intense. I used his noticeable preference for the taste of breast milk to fuel my determination to continue to breastfeed.
Let’s face it, up to this point, breastfeeding had been a challenge – and one I didn’t expect. Feedings took twice as long because I would nurse him, then give a bottle, and then pump as well. I also realized that all the switching from side to side frustrated my son. He just wanted to eat. Many babies prefer bottle feeding because of the ease of the flow. I was thankful mine preferred breastfeeding, but this did not fill his tummy. So I’d remove him from my breast and switch to the bottle. SNS did help to streamline the supplementing process.
Another challenge was that the tubes can easily be pulled to “open the gate” if you will. So a squirming baby, or a move to switch from one side to another, often resulted in a mess. Once the gate is opened, liquid is coming through it until it’s closed again.
I remember one night I tried to use SNS during a feeding and I was so tired. My son was not hungry – he was HANGRY, which was typical for his mid-night feeding. I couldn’t find the cord that allowed the bottle to hang from my neck. I had taken it off to clean. So I carefully propped the bottle on my chest. The struggle was I couldn’t move fast enough. I would get him latched, then try to release the tube, and since he wasn’t getting anything, he’d unlatch himself. Of course, he did this about the same time I released the tube, which caused milk to go everywhere. As you can imagine this became a vicious cycle – one that resulted in my son screaming in frustration, me in tears, and my husband eventually bottle feeding him.
All things considered, for my son and me, the SNS was helpful. The flow was there which kept my son interested since he still wasn’t capable of transferring milk effectively. At the same time, the suckling of my little one helped maintain my supply. He wasn’t frustrated and we were on the right path towards exclusively breastfeeding.
I stopped using SNS once my son realized this whole feeding thing would go a lot faster if he just sucked on the tube and he stopped trying to latch. After this, we were on the right track to more breastfeeding. We were down to half the formula we had started with and supplemented with 4 bottle feedings (8-12 oz) a day, each one after time at the breast, after which, I would pump.
The plain and simple truth was my son wasn’t holding up his end of the deal. Successful breastfeeding takes two and he wasn’t extracting the milk he needed. He fell asleep on the breast after less than five minutes and never initiated a letdown. He lacked vigor and I had no clue how to teach him that.
The LC recommended a speech pathologist (SP), which upon her suggestion I thought sounded absolutely absurd for an infant. Well, eventually I broke down and scheduled our appointment with the SP. We saw the improvement the exercises she gave us made in our son, I felt guilty for not calling her earlier. He had weak cheeks; a quivering, tired jaw; and a thin tongue. Who knew “weak cheeks” were a thing?! Although his tongue had good range of motion after releasing the tie, he wasn’t using it correctly.
The exercises she assigned us were easy, fast, and worth every penny we didn’t have. My son actually enjoyed the exercises and we saw a little improvement by the following week, which continued thereafter.
Increasing Milk Supply
My milk supply was suffering. My LC said she thought it had reached the glass ceiling. I have to admit I was devastated by her saying this. I wasn’t willing to believe all this hard work was for nothing. After some research, I decided I wanted to help my supply with domperidone, a prescription medication that has a side effect of increased lactation, although this is not its original purpose. Before I got the medication, I realized throughout all the changes in routine and special systems we had used, I had forgotten some of the very basic things that aid breastfeeding efforts.
I cannot emphasize the importance of doing your due diligence and researching on your own. Heeding the advice of others is a good practice, however, in those early weeks especially, my husband and I felt lost. Finally, we agreed, it was time to take back our parenting. What this meant for us was taking all advice with a grain of salt, figuring out what options we truly had, looking at our end goal, and weighing that against the progress and health of our son. We still listened to all the advice given to us, but each piece had its proper place and our own critical thinking was crucial to make it work for our family.
In my research, I read an article on increasing supply. See article here. This was what helped me remember the breastfeeding basics.
Two of these things were increased time at the breast and lots of skin-to-skin contact. So when my son was 10 weeks old, I took a nursing staycation and did just that. I relaxed and stopped stressing about my supply (stress is a worst enemy when it comes to increasing milk supply). I didn’t worry about if he was getting enough and just kept him on the breast as much as possible. If he needed a supplement to top him off, so be it.
100% Breast Milk
My son had a growth spurt/frequency feeding during this time of our nursing staycation and my body responded well to it. I was thrilled! We kept reducing the frequency and volume of the supplements we were giving my son. One day, his dependency on them had decreased to the point where I was pumping enough that we were able to stop giving him formula.
By week 12, my son was getting 100% breast milk, with only a morning and an evening bottle. One day we realized he didn’t need them anymore. My son still took a bottle almost every morning for a couple more weeks. I have never been a morning person. After getting up all through the night with our little boy, my ability to be more human than zombie hangs by a thread. Lucky for me, my husband is as big of an early bird as they get. He got up with my son about 5 or 6 each morning to give him this feeding while Mommy took a nap. Somewhere between 3 and 4 1/2 months, his feedings timed just right to where he didn’t take a bottle at all.
Throughout this process I had to learn to surrender and let go. We wanted our baby to be breastfed, but we had to stop trying to control the outcome and just do the best we could. I believe “letting go and letting God” and going to back to the basics were the most helpful things we did. If we had done that in the first place we could have saved ourselves a lot of stress!
Starting at about 3 months, my son exclusively breastfeeds. Despite all the challenges we faced, it can be done!
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