Tuesday, December 30, 2014

My Nursing Story (So Far)

A few years ago, I read and reviewed a book called Breastfeeding: Stories to Inspire and Inform. Ever since then, I've wanted to record my own breastfeeding story someday. My son isn't fully weaned just yet, but here's the story of our journey so far.

Two days old.

I don't think I've ever had anyone ask me outright for the reasons why I choose to breastfeed my baby. Probably a good thing, because the response I would have likely given would have been a flippant "Why wouldn't I breastfeed my baby?"

The main reason is this: my milk is my baby's normal food. Sure, formula milks can be used as an acceptable substitution, but no formula will ever be as perfectly matched to my baby as my own milk. It's not that breastfeeding is superior to formula; breastfeeding is what's biologically normal, so any alternative is simply inferior. (I honestly don't say that to be insulting to moms who formula fed for any reason; it's the simple truth.) Babies who are not breastfed are at higher risk for all kinds of health problems (ear infections, allergies, SIDS, diabetes, and heart disease, to name a few), both as a child and in adulthood. Babies who are not breastfed may not have as high of an IQ. Babies who are breastfed have jaws and palates that are shaped differently than babies who are not breastfed. Babies who are breastfed get extra immune support from mom while their own immune systems develop. And the consistency and exact ingredients of breast milk changes from day to day, hour to hour.

If you ask me, breast milk is pretty magical stuff.

And breastfeeding has benefits for me, too. Thanks to breastfeeding, my menstrual cycle did not return until more than a year after my son was born (it's called lactational amenorrhea). Thanks in part to breastfeeding, I was slowly able to return to my pre-pregnancy weight. Thanks to breastfeeding, I am at lower risk for various types of cancers, diabetes, and heart disease.

Aside from all that, formula is crazy expensive (according to some sources, it can cost an average of $170/month). I can't think of any good reason to pay that much for something that I can make myself.

***

Most of my memories surrounding the birth of my Little Bug are a bit fuzzy by now. Blame all of those fantastic post-birth hormones; I remember feeling bliss and empowerment and awe and a million other wonderful feelings, but not many specific details about the hours immediately following the birth.

I do have a vague recollection, however, of the midwife's apprentice helping me to get Bug latched on for the first time. I remember asking, as every brand new first-time mama surely does, how I would know when he was latched on. I don't remember her exact response, but it was something to the effect of "You'll just know."

And you know what? That's completely true. Or it was in my case, anyway. There's the feeling of a baby nuzzling and licking and snuggling with your nipple, and then there's the definite feeling of a baby latching onto your nipple. It's impossible to miss. I had no idea what it would feel like, but I knew the instant Bug latched on for the first time and started nursing for real. That's one of my favorite memories from Bug's first day.

Before they left, the midwives advised me to let Bug sleep a lot (since birth is hard work for the baby, too!), if he wanted to, but also to try nursing at every opportunity. I followed this advice to the letter. Every time he woke up, I tried to get him to nurse. Every time he merely stirred, even if he didn't fully wake up, I offered my breast. (For the record, if you just snuggle baby up to your breast, there's a good chance he'll start rooting and trying to latch on in his sleep!)

The basic mechanics of breastfeeding are this: supply and demand. Letting your baby nurse on demand, especially in the early days, is essential to developing a solid milk supply and building a good breastfeeding relationship with your baby. If you let your baby nurse every time he asks to, you are telling your body that you have a hungry baby to feed, and it will produce milk accordingly! That's why my midwife advised to feed as often as possible.

Despite good advice, the first few weeks of breastfeeding were difficult for me. I struggled with the fears of inadequate supply that all new moms likely have, and I lived life in a haze from lack of sleep. Looking back, I know I should have gone to bed earlier every night, stayed in bed later when possible, and tried to take more naps when my son was sleeping during the day.

But honestly, that was hard. I wanted to hold my baby all the time, even when he was sleeping. (I secretly suspected that he slept better in my arms anyway!) When I wasn't holding him, I still wanted to just be with him: to watch him sleep, to examine his fingers and toes, to sniff his head (babies are like drugs, I swear!), to listen to the little newborn sounds he was always making. Who wants to sleep when they have a brand new baby? I didn't want to miss anything!

I had plenty of colostrum; my body had been noticeably producing it for weeks. My mature milk came in three days after Little Bug was born. Specifically, when I was in the hospital waiting for my RhoGAM shot. It was pretty sudden. We had been nursing normally all day, and then suddenly I was leaking everywhere! Probably the only time I will ever be thankful for being in a hospital gown, since at least I didn't get my own clothes soggy.

After a few days, breastfeeding began to get painful. Really, really painful. Toe-curlingly painful. I-want-to-breastfeed-but-am-dreading-the-sensation-of-baby-latching-on painful. My nipples cracked, although they did not bleed very much. I used several different kinds of nipple creams and butters, and eventually settled on using lanolin because it was the only thing that seemed to help. I used breast shells to keep my shirt away from my nipples, and to give them plenty of space to dry and heal between nursing sessions. (I also spent a good deal of time completely topless! Thank goodness for family and friends who were comfortable with breastfeeding.)

That pain lasted about six weeks or so; after that, the discomfort began to gradually lessen, and Bug and I began to get the hang of this new skill. While I believe he had a perfectly okay latch (a bad latch is one of the most common causes for breastfeeding pain), I also believe he just had a small mouth and was unable to take in as much breast as he needed to during those early days. I also think that my reliance on using a breastfeeding pillow contributed to the pain, and I know that I didn't practice particularly good posture while nursing (which can also contribute to pain).

A little over 4 months old, and obviously getting plenty to eat.


I bet you probably know at least one person who has "failed" at breastfeeding. Probably more than one. Or maybe you know some people who, for whatever reason, never even tried. It's a sad fact in our society today that all too many women do not succeed in exclusively breastfeeding their baby. Most everyone gets pushed to try and is given lots of information about why breastfeeding is "best" for baby, but there are many cultural and institutional roadblocks along the way.

I encountered my fair share of booby traps, like every new mom probably does.

Support, or Lack Thereof.  In my opinion, being surrounded by people who support your decision to breastfeed is probably one of the best things you can do to ensure success. Arming yourself with all the knowledge you can find about the hows and whys of breastfeeding may not be enough if you encounter serious disapproval from others.

Think about it. You want to breastfeed, but your partner is against it: it's "disgusting," it's unsanitary, your breasts "belong" to them. Or they want to feed baby too. Or they believe breastfeeding should be private, and get uncomfortable whenever you nurse in front of anyone else. (In this last case, they generally mean well, but this perspective can still be damaging. More about that later.)

Or your own parents/grandparents/siblings/friends used formula, and they know nothing else, so they're constantly pressuring you to go that route too. Plus, they can't help you when you have questions, and every time you say anything about problems or discomfort, they respond with "Well, maybe breastfeeding isn't for you. You tried it, but it's not working, so why not just switch to formula?"

Or maybe you're the first of your friends to have a baby. Maybe they have never even thought about the idea of breastfeeding, so they're not necessarily against it, but they don't really understand it either. At the very least, none of them can offer support when you face rough patches.

Or your baby's doctor doesn't know anything about breastfeeding. This is not uncommon, since most pediatricians have had little or no education about breastfeeding. At best, they're ambivalent about it; at worst, they tell you formula is superior, or say you're doing a disservice to others by not letting them feed baby. Or they give you bad advice, like recommending supplementation or using formula at night to "help baby sleep better," or telling you you're "spoiling" baby by feeding on demand rather than trying to schedule meals. Or they tell you baby is not gaining enough weight, because they're using growth charts for formula-fed babies (breastfed babies tend to grow differently). Maybe they offer you formula samples at every well-baby checkup, despite the fact that you have no interest in using it.

I was lucky. I never had anything but support. My husband knew from the beginning that I wanted to breastfeed, and he supported my decision 100%. He got a little squeamish when it came to nursing in public (he's more modest than I am, clearly), but he was always willing to plan outings about nursing sessions. My mama supported me, and she helped me as much as she could during the first few weeks after birth. My in-laws never batted an eye when I nursed in their presence. One of my best friends was exclusively nursing her baby, and she was a great source of information and support about breastfeeding and anything baby-related.

Nursing in Public.  This is a doozy to many people. Some are uncomfortable with the idea of others seeing your breast. Some feel breastfeeding is a private act and should be done in a private space. Some are fine with it so long as you cover up. Some people are disgusted by the entire concept of it and don't hesitate to tell you so should you have the audacity to nurse where they can see you.

The truth, of course, is that nursing a baby in public has nothing to do with what others think and everything to do with meeting baby's needs. Baby needs milk. Or baby needs comfort. Or baby is sleepy, and can't settle down enough without nursing.

It's not a political statement, it's not an act of exhibitionism, and there's certainly nothing sexual about it. Breastfeeding, in public or at home or anywhere, is simply about meeting baby's needs. That's it.

This was generally not a problem for me. I tried using a cover early on, as many new moms do, but Bug hated it, and I kind of did too. (And by cover, I mean a light blanket.) San Diego gets pretty hot, after all, and who wants to sit under a blanket on a hot day to eat? I did my share of nursing in the car (with the A/C on, of course), and I did nurse in a bathroom a few times (but never sitting on a toilet in a stall), but early on we mostly tried to plan for outings right after Bug had nursed so that we could hopefully get an hour or two out before he needed to breastfeed again. And honestly, I was a bit of a homebody for a long time after the birth; we were just more comfortable staying home most of the time, and Bug and I didn't have a car most days anyway. After my husband deployed, I started getting more stir-crazy, and I started slowly getting bolder about nursing my baby wherever we were, whenever he needed it. I got better at getting Bug latched quickly and efficiently, and most of the time there was no skin shown. I also learned to nurse with Bug in the Ergo carrier, which was fun; I wandered around Target or the mall on more than one occasion with a sleepy baby latched on, and no one was ever the wiser!

Eventually, nursing in public became a total non-issue. Bug needed to nurse. So we nursed. Simple as that. I have never once gotten a negative comment about it, and to my knowledge I've never even gotten dirty looks. That's probably a good thing; anyone who had tried to take up arms against me would have gotten quite a tongue-lashing!

I also eventually recognized that simply seeing more women nursing in public helped to normalize it for me, and helped me to become more comfortable with doing so myself. And that made me want to nurse in the open more often too, to help normalize it for others.

As a quick aside, did you know that almost every state in our country protects a woman's right to breastfeed in public? It's a good idea to know what the breastfeeding laws are in your state! Know your rights, and don't let anyone bully you.

"Let me give baby a bottle so that you can sleep/take a break."  Yes, sleep is definitely important to maintaining a solid milk supply. But, as stated earlier, breastfeeding is supply and demand. Every time you skip a feeding and let someone else feed baby, you are essentially telling your body that baby doesn't need milk right now, and eventually your body will start producing less milk to compensate. Ultimately, skipping nursing sessions will hurt your supply, no matter how good intentions are.

Note that I am certainly not advocating against letting others feed your baby, if that's what you want to do. While I firmly believe that there are plenty of other ways for your partner, other family members, and your friends to spend time with baby, if you choose to give your baby a bottle, that's your decision. But you need to pump or manually express your milk at the same time, so that your body knows that baby is still demanding milk.

This was also never really a problem for me. My wonderful husband only offered to get formula for our baby once, and that was early one morning after an exceptionally exhausting night during a growth spurt, a night of near-constant nursing that left me feeling inadequate and near tears from lack of sleep. It was said in the best of intentions, and when I reiterated my dedication to seeing this through, he never suggested it again.

When I was pregnant I had fully intended to buy a breast pump eventually, so that I could express milk and let others feed Bug on occasion. But between my understanding of supply and demand and the knowledge that just nursing was so much easier, I decided not to spend the money and just keep on with what I was doing.

Nine months old. This is the only picture I have of me breastfeeding Bug.


In all honesty, the pain in the early days was the biggest issue I had with nursing. I had dealt with engorgement in the days after my mature milk appeared, which was extremely uncomfortable, although I managed okay with frequent nursing and occasionally hand expressing a little in the bath. I had a few clogged ducts along the way, but thankfully never dealt with full-blown mastitis. Cluster nursing was hard, when he was going through growth spurts or sick or hitting his "wonder weeks," but also manageable. I did get one milk blister, sometime around Bug's second birthday, strangely, which almost inspired me to wean on the spot until I figured out what it was and took steps to make it go away.

Considering the things I know my friends have gone through, I realize I have gotten off very lightly. I am very grateful that breastfeeding has gone so smoothly for me overall.

***

The process of weaning starts as soon as you begin feeding your baby food other than mama milk (or formula). For us, that started somewhere around Bug's six-month mark. I honestly don't remember what his first solid food was, but I do know he wasn't particularly interested.

I have already written about how baby-led weaning worked for us, so here I'll just say that Bug honestly wasn't interested in solids until well after his first birthday, although I did valiantly offer them to him every day starting at around 7 months. Sure, he ate a few bites here and there, but breast milk was definitely still the primary source of nutrients for him.

After his first birthday, he started eating more solids, but he was still nursing every 2-4 hours around the clock. Shortly before his second birthday, he seemed to finally be eating more solids than breast milk.

But oh, the night nursing continued. Some people may accuse me of being crazy for "allowing" this, but Bug continued waking every 2-4 hours at night, every night, to nurse. Many people don't realize that this is actually well within the spectrum of normal nighttime behavior for babies and toddlers. I was committed to parenting on my own terms, based on intuition and what's actually evidence-based, and in this case, that meant nursing completely on demand, night as well as day. Some nights, I got lucky and got a 5 or 6 hour stretch of sleep, but those nights were rare. (And even when he slept longer, I still woke up out of habit. Oh, the joys of motherhood.)

These continued night wakings made life a little harder in some ways, but I just adapted my sleep schedule and went with it. I went to bed early, usually by 9:00 P.M., sometimes shortly after Bug went to sleep. I frequently took naps with him during the day. (You don't even want to know how little housework I got done for the first year of my son's life.) We bedshared for a long time, which made night nursing easier. While I never developed the skill of sleeping while Bug was actively nursing, there was something to be said for letting him drift off to sleep while nursing, and then to just have to unlatch him before I could drift back off myself.

Shortly after his second birthday, I made the decision to partially night-wean him. Originally, I had intended to fully night-wean him, but soon decided he wasn't ready for that. After a few very unhappy nights (during which I stayed next to him, rubbing his back and singing quietly and offering many kisses), Bug started consistently sleeping for a 7+ hour stretch at the beginning of every night, although he continued waking up around 3:00 or 4:00 A.M. for a quick nursing session. I am completely okay with this. Just having that one long stretch of sleep is doing wonders for me, and at this point I am content to let him give up that last night nurse whenever he is ready.

I know lots of people will think I'm nuts to be still nursing my son at night. To each her own, I guess. In all honesty, I'm pretty sure that night nursing is the reason why we are still breastfeeding at all right now. After we mostly night-weaned, my supply diminished dramatically. I am still making milk, but not nearly as much now that the demand has dropped so significantly.

And by this time, his daytime feedings had already been reduced to just before and after sleeping, with maybe the occasional mid-morning nursing session. After factoring in partial night weaning, we were nursing just a handful of times every day.

A month or so past his first birthday, milk drunk and passed out.


I remember reading once in a blog post or article or something about full term breastfeeding, that many mothers never plan to keep nursing as long as they have. They simply "fell into it."

For me, that is so true.

Here it is, plain and simple. My son is coming up on his third birthday, and he is still nursing. Not a lot, generally only a few times per day, but he is still nursing. And he doesn't seem likely to quit completely anytime soon.

And I'm okay with that.

For me, breastfeeding started out as a day-to-day thing. I wanted to breastfeed, but it was so painful that I just kept pushing to go for one more day, one more day. Then it got less painful, and I was determined to make it to six months of exclusive nursing, as is the recommendation by pretty much every organization that supports breastfeeding. At six months, I aimed for a year of breastfeeding (with the addition of other food on the side), which is the recommendation of the American Academy of Pediatrics (and one of the requirements for becoming certified as a natural childbirth instructor with Birth Boot Camp, which I was at one point in time). At Bug's first birthday, I set my sights on two years, which is what the World Health Organization recommends. And once we reached that mark, I just decided to let the process run its course.

So we're still nursing. Not sure for how much longer, but I'm not worried about putting a deadline on it. Bug will stop when he's ready to.

3 comments:

  1. Lots of great information! I'm sure many moms out there will be able to appreciate your first hand knowledge. What are your suggestions for adopted infants? Any ideas or information you have come across would be greatly appreciated.

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    1. Are you interested in trying to induce a milk supply in yourself so that you can nurse your baby when you adopt? That is a possibility, if you are interested! (And I think it's awesome if you are looking into it!) I am certainly not an expert, but the basic idea behind inducing lactation is to create a demand by nursing (if you already have your baby) or by pumping, many times a day. It will take awhile, but if you keep sending your body the message that it needs to make milk, hopefully it will start eventually. If you do already have your baby, you can try nursing with a supplemental nursing system, which is basically a tube attached to a bag of donor milk or formula, which is then right next to your nipple so that even if baby is not getting much or any actual milk from you, she is still getting sustenance from nursing. You can also use artificial hormones to help with inducing lactation. La Leche League's book "The Womanly Art of Breastfeeding" has a short section on induced lactation. They recommend the book "Breastfeeding an Adopted Baby and Relactation" by Elizabeth Hormann, IBCLC, if you are interested in learning more. (I haven't read it, but I trust that any book recommended by LLL is a good one!) You might also ask around with any lactation consultants in your area if they have any knowledge of or experience with induced lactation.

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    2. Also look for the book "Breastfeeding Without Birthing" by Alyssa Schnell. It's supposed to have a lot of good, accessible information about inducing lactation.

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