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Top Ten Things I Learned from Breastfeed Chicago (except that there are 22 things…)

23 Mar

Thank you to the ladies on the Breastfeed Chicago Facebook group for their contributions! In no particular order:

  1. Coconut oil apparently can cure ANYTHING.
  2. Find a supportive mama tribe – toxic relationships aren’t worth your time.
  3. Breastfeeding in public is not only possible; it’s normal!
  4. Preemies CAN learn to breastfeed!
  5. Twins can too!
  6. If your boobs look like they are covered in blood, check to make sure it isn’t just ketchup from lunch.
  7. Never quit on a bad day.
  8. Trust your baby and trust yourself.
  9. You’re not alone.
  10. That there are tons of mamas just like me who want to challenge society’s norms of breastfeeding.
  11. Toddlers can breastfeed, too!
  12. Don’t put limits on your expectations for nursing…do it until it no longer works.
  13. When you think you’re the only one with an issue, one of two things will happen: you will find that you are not alone, and you may learn something new in the process.
  14. Breastmilk has amazing antibacterial properties!
  15. What you pump isn’t an indication of your supply.
  16. Read up on “normal” baby sleep – it’s probably not what your grandma or girlfriend is telling you!
  17. Your breasts are never empty – you are always making milk.
  18. Pumping straight into storage bags will save a ton of time!
  19. Keep on keepin’ on and get help if you need it. Perseverance in those early weeks is key!
  20. “Put a little breastmilk on it.” Breast milk is to me as Windex is to “My Big Fat Greek Wedding”
  21. Side-lying nursing can save your sanity.
  22. AND… the number one thing that I’ve learned from Breastfeed Chicago is to never doubt the power of well-informed and supported moms to change the world, because we’re doing it every day.

What I Learned About My Own Gut Health Through Breastfeeding Allergic Babies

17 Jul

My firstborn was always a fussy baby, and for most of her first year of life we had no idea why.  She was gassy, never slept for longer than 45 minute intervals, and regularly exploded out of her diapers.  Her stools were frequently greenish and stringy with occasional streaks of blood.  She was sometimes wheezy.  But, aside from these persistent annoyances, was overall a very happy baby who thrived on my breastmilk once we got over our initial challenges.

We got a clue as to one underlying cause of her fussiness when she was about 9 months old.   She had been showing readiness for solids since about 7 months of age, and ate with gusto.  She loved steamed sweet potatoes and mango.  She loved banana.  She loved oatmeal (made with warmed breastmilk, of course!).  But when I tried her with yogurt one day her face blew up in a huge rash!  It was an immediate reaction – everywhere the yogurt had touched her face or hands were red with angry welts.  My daughter was allergic to dairy!  I should have known – her daddy was too when he was a baby.   Thus began my personal journey through learning about allergies and gut health (both mine and my babies), and how they both relate to overall health … and by extension, breastfeeding.

Luckily, my doctor never suggested a trial of partially-hydrolyzed whey or soy-based infant formula, but I know some pediatricians do – despite the fact that the FDA disputes the claim hydrolyzed whey formulas are “hypoallergenic” or should be given to infants with allergy symptoms and that there are several dietetic associations that have raised concerns about the safety of soy-based formulas due to the phytoestrogen content.   I think my doctor knew better than to suggest formula to me – he knew my answer would have been “no.”  Plus, have you seen how much that stuff costs?  It was much cheaper for me to just work towards indentifying and eliminating allergens.  I didn’t have to spend any money to NOT eat something.  And, just because there were 1 or 2 small components in my breastmilk that were irritating my baby, I knew, overall, that my breastmilk had many, many other things that formula just couldn’t provide to her.   Elimination of the allergens from my breastmilk, I knew, would be what would give her the opportunity to truly heal.

This was six years ago, and frankly, there are a lot more resources available now than there were then for understanding that there is a relationship between a mother’s gut health and the behavior and symptoms of her breastfed babies.   Heck, there is a lot more research available now that looks at the links between gut health and our health and behavior in general and how amazing it is!!  I’m not going to pretend to be an expert… I’m not!  And we had a LOT of trial and error along the way.  But, both my daughter and my son turned out to have various allergies and intolerances, and I CAN say for sure that these are the things that helped us the most:

Changing my diet to eliminate the things my babies were allergic to.  Through an elimination diet and then with confirming blood tests for both IgE (immediate reactions) and IgG (delayed response reactions), we eventually figured out my daughter is/was allergic to dairy/soy/eggs and my son had some sensitivities to gluten.   When I eliminated the known allergens from my diet, I saw wonderful changes in their behavior and symptoms.

I won’t lie – living without some of my favorite types of foods sucked.  Birthday parties where there’s nothing on the menu but pizza and buttercreame-frosted cakes were the worst!   I’m really glad we confirmed things with testing through our doctors, though, because giving up those foods and food groups is not easy and I really needed to see in black and white that I was putting myself through the crazy diets for a good reason.   During all of this, I was very careful about continuing to take my prenatal vitamins to ensure I wasn’t depriving myself of necessary nutrients I needed as a nursing mother.  But, the improvement we saw after eliminating was enough to keep me going, and eating a diet rich in healthy foods that are as close to the source as possible (mainly fresh fruits and vegetables, high-quality meats, and low-processed foods like nuts and healthy fats) was and is better for our health anyways.

I learned a lot from both the KellyMom website and La Leche League’s information pages on elimination diets and breastfeeding allergic babies, and our holistically-minded doctor was open to running both IgE and IgG tests for us.*

The second thing I did was I took some time to focus strengthening my own gut health.  I did this both by eliminating allergens for my children and by cleaning up my own diet… but also by the addition of a few things:

  • Omega 3 fatty acids – I started taking a daily dose of fish oil supplements since we really don’t eat fish more often than maybe once or twice per week.  We take omega 3 fatty acid supplements because I believe they are good for my heart, my baby’s brain development, settling inflammation in both our bodies, and even keeping postpartum depression at bay.
  • Probiotics – There’s a lot of benefit that comes from having a baby and momma with fortified intestinal flora.   Probiotics work by keeping other microorganisms in your system in-check so yeast (read: thrush) and other bacteria (like staph bacteria, which have been linked with mastitis) don’t overgrow in your system and cause issues.   I’m not saying they are a cure, but I am saying there’s a lot of research pointing in the direction of them being a preventative.  Additionally, probiotics boost the immune system, and are good for helping with symptoms of colic too.  When a mom has high levels of helpful flora in her gut, her breastmilk is rich with them, too, so her baby benefits.   We get our probiotics both through cultured milks (like non-dairy keifer) but also through over the counter supplements found at our local health food store’s refrigerator case.
  • Fiber – Fiber not only helps keep us regular, it acts like a little sponge in our systems, cleaning up our digestive tracts and helping us flush toxins, waste, and other nasties out of our bodies.  Adults are supposed to be getting 20-35 grams of fiber a day – preferably from raw sources like fruits and veggies.  I started incorporating a bowl of steel-cut oats into my breakfast routine as a way to get some good fiber and protein, and for its reputed benefits in helping milk supply.  We also use chia seeds as another source of dietary fiber.
  • Digestive Enzymes– I was probably the most skeptical about these.  I actually didn’t take them with my daughter because I was so wierded-out by them… I mean enzymes??  They put those in my laundry detergent, don’t they?  Why would I want to supplement myself with enzymes?  (Turns out the enzymes in detergent and the enzymes produced by our pancreases are similar in function – they both help “digest” things – but different in type).  And, by the time my son was born and showing similar patterns as my daughter had in terms of symptoms and stooling, I was getting desperate.Also, by that time, I had found the Academy of Breastfeeding Medicine’s Protocol for Allergic Proctocollitis, and also had read Dr. Jack Newman’s Protocol for Colic.  Both sources mention pancreatic enzyme supplementation for moms who are nursing allergic babies.  Knowing that those are very trusted and evidence-based sources of information on breastfeeding, I decided to just try the enzymes and see what happened.Guess what?  They helped the most of any of the changes I made (except, of course, elimination)!   They were most helpful, I think, because they made any accidental exposure to allergens I had – like when we were eating out – less of an issue.  I found an inexpensive plant-derived enzyme blend at my local health-food store.  I chose a broad-spectrum blend that is labeled for helping to digest proteins from dairy/soy/gluten.  It did not contain any HCL or pepsin – only plant-derived enzymes such as proteases (aids protein digestion), amylases (aids starch digestion), and lipases (aids fat digestion).  The brand I found was labeled as formulated for children, so I decided I would be OK with trying them for myself.  I also began eating lots of high-enzyme foods like lacto-fermented veggies – hourray for pickles and sauerkraut! – and fresh (not canned!) pineapple.    Now, I gotta say, I love my enzymes, and now that my kids are older, they love them too.

Allergies and sensitivities just aren’t the major concern around my house that they were several years ago since we’ve taken steps to fortify our gut health and taken the time to heal.  It was not a quick process; it took time to for the inflammation do settle down in all our systems.  And, luckily, none of my children’s reactions were ever severe ones – I never needed to worry about anaphylactic reactions or keeping an EpiPen around.  But, the annoying compounded symptoms (itchiness, tummy troubles, moodiness, diaper rashes, irregular stooling, etc…) that we used to see are things of the past and reactions are minimal and passing if they do occur.  So, what started with a horrible rash on my daughter’s face, ended up in me learning a lot about the importance of maintaining good digestive health for myself and my family.  Hopefully, we’ll all be the healthier for it!
*  Author’s note:  There are lots of different testing methods employed by various practioners to determine what allergens may be causing reactions.  If you ask 30 different moms of allergic children what worked for their family, you will probably get 30 different answers.  Additionally, there are medical studies questioning the accuracy of some blood testing methods– IgG testing in particular.  The IgE/IgG blood testing worked for us given the ages of our children at the time the tests were run, and the symptoms I was observing.  But, by all means, do your own research and determine what testing method might work best for you and your family.


Additional resources:

On Omegas for Nursing Moms: http://www.uppitysciencechick.com/why_bfand_omega_3s.pdf

On Omegas: http://nccam.nih.gov/health/omega3/introduction.htm

On Probiotics: http://nccam.nih.gov/health/probiotics/introduction.htm

On Probiotics and thrush: http://kellymom.com/bf/concerns/child/preventing-thrush/

On Probiotics and mastitis: http://cid.oxfordjournals.org/content/50/12/1551.full

On Probiotics and Baby Colic: http://www.nytimes.com/2011/02/15/health/15really.html?_r=1&ref=health

On Dietary Fiber: http://www.nlm.nih.gov/medlineplus/ency/article/002470.htm

 

Elise Fulara is a proud breastfeeding mom of two who lives in the Western suburbs of Chicago with her wonderfully supportive husband.  When she is not wasting time on Facebook, cleaning up after her children, or trying to keep up with her garden, she works part-time as a freelance museum consultant and is also the owner of Sling Savvy, a resource for parents and educators interested in learning about the benefits of simple, fabric baby carriers such as slings and wraps.  She underwent breastfeeding peer-counselor training in 2010 through LLL, and is passionate about mom-to-mom support.  She facilitates breastfeeding and babywearing classes for expectant mothers at Elmhurst Yoga Shala. She would like to thank her mom for breastfeeding her.

Two Breasts for Two Babies, Part One: Breastfeeding Newborn Twins

9 Apr

Can You Breastfeed Twins?:  YES!

So all of a sudden you have these two babies out of your womb and you are responsible for their nourishment.  Sure you tried to prepare, but you really can’t ever be ready for the craziness that now is your life.  Can you even breastfeed them? Will your body produce enough?  Will you be able to keep up physically and mentally?  Will you ever sleep again?  The feedings are constant, you are exhausted and you are feeling completely isolated.  But you aren’t alone. You can do it.  I know it can be done, because I did it too.

When my babies were tiny, I looked online for photos of moms holding their multiple babies in nursing positions.  It helped a lot to actually see how it could work and as my twin girls grew, I used many of those positions.  I also was encouraged by reading other stories of successes and challenges.  This is my story.

You Mean There’s More Than One Baby?: The Preparation

I always planned to breastfeed.  My mom did, even in the days when it wasn’t as common in the States.  When I learned we were actually having twins, that plan didn’t change. If anything, it made more sense to breastfeed because of the money we would save on formula for two and potentially on future medical expenses.   However, I was apprehensive since a lot of the twin moms I talked to, for one reason or another, weren’t able to breastfeed long—if at all—so I felt I was in new territory.

I feel really lucky that we made it through the challenges, because there WERE times when I was just so tired and frustrated and wanted to give up.  However, I was determined and knew if we could just push through, it would work out.  I did have support, which makes a big difference and lining that up is crucial.  My husband was on board from the beginning, our extended family helped with the process (my parents and in-laws all had turns washing the pump), friends were supportive and the Moms of Multiples group I joined was a great resource as well as other online groups.  Dr. Barbara Luke’s book When You’re Expecting Twins, Triplets or Quads was excellent during pregnancy, but the chapter on feeding the babies after they are born was much too short.

The multiples birthing class we took didn’t prepare us in the way I would have liked.  I think practicing positions with dolls would have been a useful exercise.  It covered breastfeeding, but no one REALLY gives you the scoop on how to manage two babies and the physicality of it all.  While it’s different for all women, no one really tells you that it feels like knives down your breasts during let-down for the first month or two and that your nipples will get stretched to the point that they would shock everyone in a wet t-shirt contest, or that you might get bitten, or that you will probably squirt milk everywhere as you fumble to feed your babies, or that you get stimulated by other babies crying, or that you might still leak for up to a year or more after weaning, or that sleep deprivation is a form of torture.

Still, our bodies are amazing that they do prepare for this natural and wonderful process of providing everything your baby, or babies, needs. I remember dried colostrum when I was only a few months pregnant as well as the tenderness in my breasts as they prepared for the adjustment to an experience that can be described as a piranha attack by my voracious eaters.

My body may have been getting ready, but mentally I could never have imagined how exhausting it would be. And I could have given up, but I didn’t.  For that, I am proud.

C-Section and Breastfeeding Twins: Football Hold

I wanted a vaginal birth.  However, at 37 weeks, we had to induce labor.  After 22 hours of labor, I had developed a fever and the doctor recommended taking them out the way many multiples are delivered, via C-section.

The nurses gave the babies to me for their first feeding in the combination hold (one cradle and one football hold).  One baby latched immediately and with force and the other, while she took a minute, figured it out pretty quickly.  I definitely was relieved that there were no immediate issues with nursing, as I know this isn’t always the case. 

In post-partum, we had the babies go to the nursery so we could rest but had them brought back for feedings because I did have colostrum.  After a few days, however, my colostrum wasn’t enough and the babies got really hungry so I ended up having to give them formula per the suggestion of a nurse. I was pretty upset about that as I didn’t want them to have a bottle yet, but it was either that or they starve, so I was told.  I wish I knew before that incident that I could request a nurse change.  While the formula did give the babies more energy, I felt incompetent that I couldn’t provide everything for my kids.  I kept pumping at the hospital, though, to give them what I could and to help encourage my milk to come in.  The babies transitioned pretty easily between the breast and the bottle and, in the end, we only needed to supplement with formula for about a week.

With a C-section, we were able to stay in the hospital longer and get help from the nurses, which we wouldn’t have had otherwise, and my milk did come in so we were able to get support from the lactation consultant there as well.  Once at home, I called a lactation consultant for a visit and was reassured that I was doing okay.  I highly recommend utilizing the resources available to you early on as there is a learning curve for mommy and baby/babies.

At home at the very beginning, I was simultaneously feeding most of the time as it is generally recommended to try to get both babies on the same schedule so you can get longer stretches of rest.  I favored the double football hold as there was no pressure on the incision as I healed, but later nursed in a variety of positions.  Using boppies and a bunch of pillows helped protect the incision and support the babies.  The first few months especially are about survival for all of you, so if feeding on a schedule doesn’t work for you, then do whatever makes you more sane.  Once you figure out how to nurse lying down, you can snooze and it might be easier to feed on demand at night this way and then feed at the same time during the day.   If your breast is too full and big to comfortably nurse lying down, you can try putting a small pillow under your infant’s head to raise it up to the same level.  This nursing position might save your life, so do what you can to make it work.

Some parents of twins do shifts where one parent responds to the kids for the first part of the night (or alternate nights) and if it’s the dad, gives a bottle of pumped milk.  Some wake the dad up to do burping or to bottle feed one, but then everyone is miserable.  Some hire a night nanny (if you can afford it, it totally is worth it).  The nights at the beginning are so hard and time blurs together in one long repetitive routine, but it will get easier. Just hang in there.

My Thoughts on Pumping: Do It

And start right away.  It encourages your milk to come in and helps establish a strong supply at the beginning. Plus, it lets other people help you out!  Once you are home, you can take a break and get out, though you still need to pump so you don’t really get a break.  And, if your twins are born early, pumping still provides them with the best nutrition, your breastmilk, and you can still work on establishing breastfeeding when possible.  It’s hard work to pump and keep up with it, but in the scheme of things, a year—while the first one feels like forever—is short in the life of your child.

Nursing At Home:  Boppies are your friend

I didn’t want to buy the twin breastfeeding pillow because, come on, what was I going to do with a U shaped pillow?  Two boppies, however, and other pillows around worked great!  At home, a big pillow supported my back and smaller pillows supported the boppies underneath and I would wear the boppies almost like a hula hoop with a baby on each. It took many weeks for me to be able to nurse without help and the girls had to be given to me one at a time for a while, but by about 6 weeks, I was able to get them on and off by myself, which I’ll describe in Part Two.

Nursing one at a time with a boppy allows you do have some time to feel like a person, which is really important to an overtired mama.  I could nurse one while at the computer using a boppy. I could nurse one while eating dinner on a boppy. I took my boppy on the airplane and that was so helpful (we traveled a lot, so I would nurse one and my husband would bottle feed pumped milk for the other and we would rotate who got a turn with the real deal).  The boppy was multipurpose for tummy time and games and bottle feedings and reading books to the kids.   Absolutely a great investment to get two boppies for your two babies.

Getting Out:  What’s That?!

Note that I don’t have a full section on getting help. Well, that’s my own issue, but it is important to get help and let others take care of the housework, or meals, or watch the babies so you can at least get a shower.   Even some alone time with one of the babies instead of both will change your perspective.

There is getting out with the family, getting out with the babies, getting out with just one baby, getting out alone, and getting out for date nights.  That’s a lot to juggle, so it’s no wonder the last three probably don’t happen very often.

If you are out in public with both babies, you can still breastfeed them.  It’s easier to feed one at a time.  I used a shawl with one baby at a time, while distracting the other baby with a book or toy or daddy.  Sometimes, though, I got to use a private room and could whip out both breasts at the same time to be more efficient.  There were times when I brought bottles of expressed milk too and I know some moms prefer to feed that way in public. There are many solutions, but the important thing is to get out of the house.

Somehow, we were able to go out for dinner for our anniversary one month after the girls were born since I left pumped milk for my amazing dad who managed to feed hungry, screaming babies propped on boppies.

I didn’t get out much by myself at first, but I recommend at least getting outside with the babies for a walk. It will do you all a lot of good.  It is important for mama to get alone time too for a haircut, a girls movie night, even grocery shopping by yourself will seem like a welcome break!  I was able to get away for a couple hours here and there (feed kids before I left and when I got back with milk in the fridge for emergencies), but it wasn’t until the girls were weaned that I could go away overnight and have that much needed and deserved break.

Don’t have any expectations of yourself for the first 3-6 months.  After that, you will start to see the light of day, unless, of course, you have to go back to work (or choose to) and you absolutely have to get on some kind of schedule sooner.  I hate to say 18 months is when it gets better, since that seems like such a long time away for a mom of newborn twins, but there are milestones along the way.  The first year really is a blur, but looking back, it goes by fast.  Now, it is so much easier since the kids have each other to play with and well, it’s just fun to have twins.  There are always new challenges and even still, there are struggles.

Going crazy happens.  And, when you are at the bottom, all you have to do is ask for help. Make a call to a help hotline or call a friend to give you a break or take a walk. We’ve all been there. Some of us just admit it more than others.  But, no matter what, be proud of yourself for doing what you are doing.  You are trying to do the best you can for your babies and that’s all you can do.  Congratulations on being a twin mama!

Amanda S. is a SAHM mom of twin girls in Chicago.

How I Ditched the Nipple Shield

22 Mar

As I sit here typing while nursing my son, I think back to just a few short weeks ago at how hard it once was for both me and him. On December 27 my son was born at 7 lbs 12 oz, and was just amazingly beautiful. I held my son to my chest shortly after birth and he suckled for a few short moments then fell asleep. After he returned to me, I kept trying to latch him and he just flat out refused. The nurse came in and tried to help, but she could not get him to latch either.

Before I left the hospital I had to do a New Mom class, in which they asked if you were going to breastfeed, bottlefeed, or both. Out of the seven new mommies, I was the only one who wanted to breastfeed. The nurse told me after I returned to my room that an LC would come in to make sure everything was going okay. That was such a relief to me, because he was not getting the hang of it. She came in a little later, took my son from me, undressed him and shoved him on my boob – which to a first time mom scared the crap out of me! She messed with his little mouth for a few minutes around my nipple and told me he was not a strong enough sucker. To my disbelief, the person who was supposed to help me just broke my heart. I looked at her and asked her what to do, and she said, “Well, you can just keep trying, but you probably should just give him formula to make sure he keeps eating.” FORMULA? Seriously – this coming from an LC. I said okay thank you, and promptly forgot everything she just told me.

As I was worrying about my son not eating, my MIL sat down next to me and reassured me everything was going to be okay. She asked if she could help and I agreed so she took my son in her arms, and was slowly able to latch him on. She did not force my boob in his mouth, or make him scream by undressing him, she simply put him on my chest and let him do it on his own. He was doing it- I was so relieved, yet he again stopped a few moments later. She reassured me everything would turn out okay, and that he probably was not yet hungry anyway.

During my hospital stay I continued to try to get him to latch without success, so when I returned home I was pumping what seemed like every waking moment, and fed him by bottle. We were both in tears almost every night. Then, I came across one of the best groups in the world – Breastfeed, Chicago. A friend of mine who has a little girl only a few weeks younger then my son was part of the group, so I figured it would just give me some added support. I posted what issues I was having and someone suggested a nipple shield. I was confused and a little scared on what that was, and had some awkward images in my head. Yet, I went to Target and found one. We went home, I completely undressed from the waist up, and I was determined for him to figure it out. I placed the nipple shield on and slowly tried to get him to latch, but he still refused.

I continued to pump about 8 times a day, if not more, and tried at least once daily to get him to latch. I would pump for a few minutes to get my milk flowing, so it was not much work for him, tried to latch him, and when that did not work, I would try with the shield. It seemed like he would never figure it out, and I started getting very depressed. I felt like I was not supplying my son with his nutritional needs. My husband came home from work many times to me and our son half naked in our bed, both crying – and me, desperately trying to get him to eat. My husband was such a trooper and would take our son from me, remind me that I was an amazing mother, and would walk away, letting me gather myself together. I started talking about switching to formula because I simply had had enough. I told my husband that if our son didn’t figure out breastfeeding by the time he was 3 months, I was done. I was reading parenting books, talking to other nursing moms that I knew, and would check Breastfeed, Chicago daily. Looking for tips and tricks to get him to latch.

After 11 weeks of trying, my son finally latched with the shield – yet I tried not to get too excited. After 24 hours passed and he still hadn’t needed a bottle, I was officially ecstatic – enough so to call my MIL and my own mom to tell them the amazing news. Yes, he was still using a shield, but he was latching! That meant the world to me. After 6 days of using the shield I was going nuts – trying to remember to take it with me, trying to place it on my nipple when I was half asleep – the thing that made breastfeeding possible for us was starting to wear on me. So, I placed him to my bare nipple, and to my surprise, he latched! I sent a picture to my husband at work, and of course posted on Breastfeed, Chicago almost immediately. Now, a week later, I sit here typing with my son lying across my chest, boob in his hand, eating away. I never though this day would come. I ended up in tears many nights, regretted having to give him a bottle, hating with a passion being confined to the house due to having to pump so often… yet now everything seemed so worth it. Just to simply say I breastfeed my child!

I joke that my son figured out breastfeeding just so he could avoid formula. He and I were determined to make him a boob boy!

I hope you have found this inspiring, and know that to be able to breastfeed your child may not be the easiest thing you will ever do, but is one of the most rewarding things you will ever do.

My name is Diane and I can proudly now say I am a breastfeeding, baby-wearing, cloth diapering mom. I am 21 years old and married to the love of my life, Tyler, and we have one son named James. I have my nursing degree, although that is on pause so I can be a SAHM. My husband is a video game programmer in the city of Chicago. My only goal for my son is to grow up happy and healthy and for us to be able to provide him whatever he wants/needs. However, if you ask his daddy, he would say he wants James to be able to program before he can read!

Editor’s Note: Before you resort to using a nipple shield for yourself, please make sure to talk to a knowledgeable and supportive lactation professional, and read up on all the pros and cons of nipple shields. Find out more here.

Breastfeeding My 10.5 Month Old

12 Mar
Editor’s Note: Special thanks to The Maiden Metallurgist for generously allowing us to repost this piece. Please see the end of the post for additional resources.*
I was talking to my grandma earlier today about our favorite subject- Henry- and breastfeeding came up. Again. My grandma is obsessed with the fact that I am still breastfeeding my boy.

She is a little senile, well, maybe more than a little, so we tend to have the same conversations over and over and over again, and breastfeeding is one of her favorite topics with me. I can understand why, it is something that we can relate completely to one and other about despite our generational differences.

My grandma talls me, every time we talk, that she breastfed my mother for 4 months and my uncle for 8. She always apologizes for only breastfeeding my mom for 4 months, as if I’m somehow judging her and goes on to tell me that my mom bit her so she had to quit. Bear in mind that my mother is 60 years old (sorry for outing you mom), some sort of guilt has lingered with my grandma for 60 years over quitting breastfeeding at 4 months. I always tell her that I think it is great that she breastfed at all, I now know from personal experience that it can be natural and difficult at the same time.

I don’t think my grandma has anything at all to feel guilty about. We know how how good breastfeeding is for babies, but I also think it needs to be a mutually beneficial relationship. Especially because it is such a time intensive undertaking. Breastfeeding is wonderful, probably my favorite thing I’ve ever done, but it also takes a degree of sacrifice and determination, if you are a working mom that is.

When I am home, nursing is so much easier than making a bottle. But work is another story; the time I sacrifice pumping, the worry I expend about my supply, the pain and soreness that a week of pumping leaves my nipples feeling. Despite all that Henry and I aren’t ready to give up.

I’ve talked about my struggle with low supply here, but to sum up, I was pretty desperate.  Breastfeeding is very important to me, and I was struggling to produce enough milk when pumping to feed Henry.  When I nursed him at home I never had a problem, but bodies respond differently to pumps than they do to babies, and I just couldn’t keep up pumping at work.  We are lucky to have a bit of a cushion, a freezer with a decent stash of frozen milk, but I knew that by using that milk my supply would only get worse as my body learned that it didn’t to produce that milk.

I begun supplementing my diet with the galactagogues fenugreek and blessed thistle, drinking extra water, eating extra calories, I did power hours, nursing vacations, breast compressions, I tried a new pump, hand expression, even double pumping to trick my body into thinking it was feeding twins.  Despite all of this I got to a point where I was lucky to pump 5 ounces all day (4 20 minute sessions).  There was only one option I hand’t explored and that was prescription medication.  I made an appointment with my OB and his LC, they agreed I was a good candidate for Domperidone.  My doctor was nervous about potential side effects; it is not FDA approved nor does it have a very high success rate.  But, like I said, I was desperate and willing to give it a try.  Armed with my prescription I ordered it from Canada and now, after 4 weeks I am seeing an amazing improvement.  I went from pumping 5 ounces a day to 15, still not enough to feed my boy when I’m gone, but a huge improvement, and I’ll take what I can get.

At this point I’m letting go of the worry.  We can get to one year.  Henry is still getting almost all of his nutrition from milk, and shows no signs of weaning, so although I planned to give up the pump at 1 year, we’ll keep going as long as we need to.  But I refuse to obsess about it anymore, and use like that, we are back to having that mutually satisfying breastfeeding relationship.

The Maiden Metallurgist is a full time shift working mom in Chicago’s south suburbs.

*We salute all moms with supply issues. As always, Breastfeed, Chicago! encourages moms to talk with their health care provider and their IBCLC about ways to increase milk supply; we do not endorse any particular medications or treatments. “The Breastfeeding Mother’s Guide to Making More Milk” is an excellent resource for moms struggling with supply. Kellymom has several good suggestions, in addition to lowmilksupply.org.

Enlightenment and Healing

12 Dec

Nine years ago my son was born. Nine weeks premature and weighing just over three pounds, I was thrown into the world of NICUs, breast pumps, and doctor visits. When my pregnancy came to an end, my grieving began. I didn’t realize it as grieving right away—I was far too numb from the whole experience to have any true concept of what I was going through—but as life began to balance out and I came up for air, I recognized a feeling of loss and began to examine it.

My first thought was that I was grieving over the loss of the last two months of my pregnancy and the “normal” birth experience I had so wanted to have—and that was perhaps part of it. But as the first year of my son’s life picked up speed and life began to fill in the gaps left by the gradual disappearance of hospital visits and baby gifts and concerned phone calls from family and friends, I began to recognize a loss that did not stem from the circumstances surrounding my son’s birth so much as the loss of the entire relationship I had hoped—expected—to have.

Because my son was born nine weeks premature, within a few hours of his birth I had started to use a breast pump to initiate and maintain my milk supply. It had never been a question of whether I wanted to breastfeed, but after the birth of my son it became a question of whether I would be able to. An endless cycle of breastfeeding, bottle feeding, and expressing quickly consumed my days, and two months into my son’s life, the stress of that exhausting routine, the experience of having a preemie, the preeclampsia that affected my own health, and a father who was dying from cancer, took their toll and I couldn’t continue on any further. Shortly after my son’s due date, recognizing I had to make a change, I committed myself to exclusively pumping for my son and tried to make peace with the fact that breastfeeding wasn’t going to be part of our lives.

The loss that I felt as a result of not breastfeeding took me by surprise. No one tells you that you will experience grief. No one tells you that it hurts. No one tells you the sense of regret you will experience when you think back to those early days of your child’s life and you question the “what ifs” that might have made things different.

But this is not a story of grief and sadness; instead it is a story about enlightenment and healing.

My experience with my son taught me the importance of relationship. He taught me that what we do matters and how we do it matters. He taught me that I have an inner maternal instinct that is to be trusted, nurtured, and valued. He taught me that life is a continuum and that mothering starts long before a baby is born and will continue long after our children leave our homes. He taught me that process matters and what happens before will affect what happens after. These lessons weren’t learned easily, and many of them weren’t learned in time to benefit my son and I. Our relationship has been built on struggle and common challenges, and we continue to conquer those challenges together, trying to repair the lost relationship we both so desperately desired when he was born.

Not being able to breastfeed my son was a loss: a loss for both of us. I have come to understand that our biology has expectations, just as we do, but those biological expectations are far more important than my own personal expectations. They are based on centuries, and maybe even millennia, of genetic heritage. To try to circumvent those biological expectations can only result in an imbalance and leave us feeling loss. I grieved the lost breastfeeding relationship with my son, just as I grieved the normal birth experience, not because it was what I had expected or wanted, but because it was what my biology expected.

Two and a half years later, I stared at a positive pregnancy test and was surprised that the first thought to pop into my head was: “I wonder if I’ll be able to breastfeed this baby?” Emotions that I thought I had examined and dealt with and discarded after my experience with my son came flooding back to me. And at that moment my journey of healing began, ushered in by my new baby, my daughter.

As is often the case, my second pregnancy was entirely different than my first and I was entirely different as well. Certainly I now had experience as a mother, but I also carried with me the hurt and fear resulting from my first breastfeeding experience. While I had infinitely more knowledge about “normal” birth and lactation, I also had insecurities and mistrust relating to my body and my body’s ability to do what it was supposed to do. It didn’t work the way it was supposed to the first time, so why should I think it would all work out the second time? As those nine months progressed, I devoured everything I could about the normal birth process and breastfeeding from a biological perspective and decided to commit myself to trusting my body. Faith can be both scary and freeing, and I gave myself to it entirely.

My re-education about breastfeeding challenged social attitudes about mothering and babies. I learned to question my knowledge and strove to focus on breastfeeding practices that were biologically sound. When my daughter was born I ensured that she was placed on my chest immediately and we enjoyed more than an hour of quiet time getting to know each other before she was weighed and cleaned. She latched for the first time within the first half hour and stayed with me, often in my bed, for our entire hospital stay. She nursed frequently and eagerly. Things seemed to be going well. And then upon our arrival home, those familiar worries and fears set in.

Nothing really was going wrong; my daughter was over her birth weight by five days of age, after a bit of initial soreness we seemed to get into a routine that was working well, but yet I clung to the past, worried that things weren’t as good as they seemed and that certainly my body was going to fail me yet. For the first month of my daughter’s life, I worried every time she cried that it was something I was doing, that my milk wasn’t sufficient, or that for some reason things were not as good as they seemed. All the usual newborn issues were, in my mind, somehow connected to my ability to breastfeed and mother. Her cries or fussiness would bring back the overwhelming memories of my experience with my son and my emotions continually churned. Eventually, I decided enough was enough and I returned to that place of faith I had been in before my daughter was born.

And neither my body nor my daughter disappointed.

Once I relaxed into the relationship with my daughter and put my trust in both my body’s ability to provide for her and her ability to know when and how much she needed to nurse, I entered a period of ease. I finally recognized the power my body holds and the empowerment that can come through the process of birth and breastfeeding. I recognized that my body is capable and strong and nurturing. And I recognized that in our society we often are given information, advice, and practices that are in direct competition with our biology.

In order to allow our biology to do what it needs to do, we often need to question the influence of our society and in some cases put it aside in favour of biology. In retrospect, I can see the influences of society greatly affected my breastfeeding relationship with my son. It saddens me that I was unable to breastfeed him as I had wanted, but I also recognize that I only did what I knew to do at the time. Ultimately, my experience with my son brought about the enlightenment I needed to breastfeed my daughter and that experience has influenced my life since he was born.

Breastfeeding my daughter was a relationship—is a relationship. She weaned just a couple months after her third birthday, but the closeness that we enjoyed from our nursing relationship is still very much part of our lives today two years later. Being able to participate in that relationship helped me to heal the lingering hurts from the experience with my son. It returned to me the ability to trust my body and the process and to ultimately have faith in something outside of myself.

While at times it does sadden me that my son and I did not enjoy the same relationship as my daughter and I did, I remind myself that the relationship between a nursing mother and baby benefits everyone surrounding them. My son was very much part of the nursing relationship with my daughter, witnessing the love and closeness of our relationship but also being a part of it as we would sit and chat while his sister nursed. The healing brought about by breastfeeding was not just my own; it also helped my son witness that important relationship that he was unable to experience for himself, and I have no doubt he will carry it with him into his adulthood and into the relationship with his own children.

Stephanie Casemore has experienced breastfeeding as a challenge, a gift, and a healing experience. She exclusively pumped for a year for her first child and nursed her second child for three years. Turning the challenges into a positive as an opportunity to support other mothers, Stephanie shares her experience through her books:  Breastfeeding, Take Two: Successful Breastfeeding the Second Time Around and Exclusively Pumping Breast Milk: A Guide to Providing Expressed Breast Milk for Your Baby.

Our Favorite Breastfeeding Advice

7 Dec

This week’s post is all about our members. Members of our Facebook group were asked how long they’ve been breastfeeding and their favorite words of wisdom. We want to emphasize that there is no “right” length of time to breastfeed your baby – everyone takes their own journey, but every journey is a lot more fun when you have supportive and encouraging people around you.

Thanks, everyone!

  • AN: Just say no!!!
    Your baby won’t starve while you are getting tended to after birth…even if you had a c section. Insist on NO bottles and baby will latch! I don’t think this is scientifically proven but many many moms who’s babies were given bottles in the first 4 weeks had bfing issues (including me with my first) 1st baby 10 months…fought til the very last drop
    2nd baby…10 months and going strong!!!
  • CC: 1 child; nursed for 32 months, and counting. Best advice: You are enough for your child – there isn’t always one way to get the job done, every mom and baby are as unique as individuals and use Lansinoh before and after feedings and pumping.
  • JPY: 2 children… #1 – severe supply issues nursed 8 months (supplementing the entire time)… LC didn’t think I’d ever make it that long. boy did I prove her wrong! #2 – going on 6 months EBF on the 17th! The most helpful advice was to feed baby where ever & whenever. Don’t postpone feedings when baby just comes home from hospital b/c you have company or b/c someone wants to hold the baby and try to calm them when you know they want to nurse. :)
  • EL: I’m nursing my second now.. 22 months old. When I first started, tho, I had a nursing epiphany when I learned (at LLL meetings) that cluster feeding in the evenings didn’t mean I was out of milk, and that nursing was something I could do in my sleep… When I was taught how to nurse side-lying. Both of these things helped me to just relax and have confidence in myself.
  • BB: “Never quit on a bad day” helped me.
  • WOS: 2 children, #1 was nursed 27 months (though she would’ve liked to nurse longer!), had a lot of issues in the beginning (baby was in the NICU her first four days, so she was given formula, I was encouraged to pump but my milk did not come in until she got home, so whenever I tried to nurse in the NICU she would scream and get frustrated). We had some rocky weeks (as I refused to use formula when we got home) and I used a nipple shield for the first six months (not recommended by LC but I did what I could to make it happen). Be patient and keep on chugging away at it (and with the help of professionals and determination) you can BF, even if you do get off to a rocky start! #2 has been nursing for 10 months and counting!!!
  • TL: I am on baby #2 and have been nursing for almost 4 years straight (dec 27th is my first 4 year bday) I never thought I’d make it past 3 months and I can’t believe I am tandem nursing an almost 4 year old and a 10 month old! The most helpful advice I received was to take it one day at a time and if baby is happy and having wet diapers baby is getting enough!
  • Kristin P: My little man is 27 mo, and we are going strong with nursing!! He was EBF his first 15 mo of life, and continues to nurse every 2 hours or so – definitely never goes longer that 3 hours without his ‘yummies’! The best advice I received was to follow my babe’s cues/lead for feeds, not the clock or schedule. I read that advice in the Dr. Sears Baby Book that my doula recommended. Other invaluable advice was that bedsharing is a wonderful way to establish breastfeeding – also from Dr. Sears. I was already following Aubrey’s lead, and bedsharing, but it was really empowering and validating to read his words.
  • JSS: #1 breastfed for 15 months, #2 is still breastfeeding at 13 months. They didn’t overlap. Best advice was that babies go through growth spurts every couple of weeks where they’ll want to nurse more – just stick with it and let them nurse as much a they want to. They’re not starving, and your milk supply will catch up.
  • MS: Daughter nurses still at 3.5 years and son is 9 months old and obviously still nursing. The best advice…trust you body and its ability to nourish your child, not only physically but emotionally.
    My daughter is a testament to that. When I ask her why she still wants to nurse (once a day) she tells me that “I nurse because I love you and I like nursing.” To me, weaning just because someone says to wean at a certain time doesn’t make sense.
  • Karaleigh: 10.5 months- drink LOTS of water, be patient and enjoy every moment of it.
  • BP: Six months for my six month old daughter. For us, the best advice was skin to skin contact and laid back nursing. And I’ve so appreciated having a good breastfeeding friend to laugh with for plugged ducts, and other challenges as they come up!
  • NLR: Between the three of them 6 years. (omg lol) Best I’ve got is don’t give up. Get help if you need it. It will get easier. #2 had a really rough start. Things did not level out for about 8 weeks. (So much pain, bleeding, screaming & crying; not just him haha) Once he and I got the hang of it, it was great. Went 25mos. If you have a c-section, you CAN most definitely nurse your baby minutes after birth. I had my younger two in my arms as soon as I was stitched up and in recovery. They were never more than a few feet away from me. Don’t let them tell you otherwise.
  • Renee: 38month old still nursing and tandeming with his almost 3 month old brother. Best advice I ever got was to just relax. Stop and take it easy. Take a deep breath and watch as it all works out :)
  • Mirjam: 29 months…stick with it. Breastfeeding can be hard in the first few weeks, but when the two of you figure it out, sharing those moments of peace and silent connection are going to be worth any amount of work that you had to put into it.
  • MMV: All four of mine were EBF…#1 was 16 months and self weaned (I was not ready for her to stop!), #2 was a little over 24 months, #3 was also a little over 24 months, and #4 is 26 months and counting. Best advice was nursing on demand and also that even though nursing is the most “natural” thing to do, you and baby still need to work a little to figure it out! My mom also gave me the book “The Womanly Art of Breastfeeding” which was helpful since I never went to any classes or groups. Also, I agree with the c-section comments…my four were born by c-section and it did not prevent me in any way from nursing :-)
  • Rowkeena: ‎19 months..Don’t give up when they start teething. You and your baby will form a communication where they understand that biting hurts. If you want the good stuff, no biting!
  • Brandy: 32 months combined, and still going. See a lactation consultant for breastfeeding advice, not a pediatrician!!! :)
  • Beth: 22 months and counting. The best advice I got came before my son was born. A friend told me that it’s okay for it not to feel natural at first and that it is hard at the start. She encouraged me to take a class before my son was born. My husband and I did just that, we took a class with a lactation consultant about 3 weeks before he was born. Looking back, I really wonder if I would have made it without that advice.
  • AR: Don’t quit on your hardest day.

    (nursing #2 nearly 8 months & going strong, #1 only 10 weeks. :( )
  • EN: In our 26th month of breastfeeding, the best advice I’ve received is not to worry about the future yet. Most of our concerns about the future will be resolved or become non-issues by the time they arrive, whether it’s nursing with teeth, supply after introducing solids, nursing during pregnancy, or weaning. Don’t waste your energy worrying about possible concerns; instead, focus on the present and enjoy today.
  • CS: #1 for 11mo and #2 8.5 mo and counting – best advice I can give is make breastfeeding the only option, we couldn’t afford formula and I wanted to breastfeed with our first anyway, but even though it hurt and she was tongue-tied (fixed at her 1week weigh in) I never even thought to give her anything other than my milk. If you know it’s your only option, it’s a lot easier to stick with it! (sometimes it still hurts, but I’d rather be in a little pain and give my kids the best start I can than the alternative!)
  • JM: 15 months. Most helpful advice (from my daughter herself): “boob!” surprisingly (or not) I received a lot of unhelpful advice
  • IKK: One boy, 27 months old, still nursing. Even when the kids around him are sick for a week or two with bad colds, he always got over them in about 48 hours, with a little increased nursing. Best advice? O my! Where do I start? First of all, most (almost all) hospitals are NOT baby/breastfeeding friendly. So keep your baby near you as much as possible, maybe even the whole time and do skin-to-skin and nurse non-stop to help your milk come in. Especially if you had any interventions during the birth, it might take a little longer for the little one to latch, etc. Don’t let anybody intimidate you. One nurse kept telling me that my son was going to get cold having him skin-to-skin (because I kept taking his onesie off – even though he was UNDER the blanket with me). But he did not. And he did nurse. Another big thing is: get support. Be around other nursing mommies. Whether it’s LLL or just some friends, it’s so important to have someone to share your questions, joys, and sometimes frustrations. It’s all part of the journey and the last thing you need is somebody suggesting that “stop nursing” would end all your issues. And lastly, always remember, this is the relationship between YOU and YOUR CHILD, nobody else. This is one thing you share, unique to you two, special, magical, amazing and FOREVER – nobody can take that away. And nursing is part of that relationship, so when you are having a hard day, follow your heart, look into your babies eyes and do what you feel is best. Trust yourself.
  • SSK: #1 bf for 12 months, #2 for 18 months, #3 for 27 months, and # 4 and am still bfeeding strong at 20+ months (while going to school full time). So that is a total of 77 months, so far… I unfortunately received no advice with my first, but had read every book out there (11+ years ago) and it happened to come naturally to both of us:) Recently many friends have had first babies and have called on me to help with breastfeeding (which I love and do). The best advice I give them is to relax and not get frustrated too soon, keep at it and call if they need anything anytime! It is not “easy” or “natural” for everyone and takes a lot of dedication in the first several weeks!
  • Mirjam: Do you know what is so interesting? Reading all of these posts makes it really clear how much of a learning curve is involved in breastfeeding! Nearly everyone who has posted, myself included, breastfed their second child longer than their first, and the third longer than that. Which again kind of echoes what many mamas have said – breastfeeding is a learned behavior, both for you and your baby, and it is important to see it as that so you don’t get frustrated if you falter at first.
  • MH: 20 month First Son, 22 month Second Son -  Get through the first month of breastfeeding and it gets easier, in general. I had no guidance about breastfeeding just thought it would be easier and cheaper than formula. Advice: “try not to listen to people’s opinion about how long to breastfeed – short or long, only a mom/child knows what is appropriate.”
  • Beth M.: 49 months and counting (14m with #1, 19m with #2 and 16m with #3). Best Advice?? Just relax…your body knows what to do. :)
  • HHL: 2 kids- I breastfed the first for 11 months(and pumped and bottle fed breastmilk until 12 months) and am currently still nursing my 16 month old. I’d say the best advice I received and not until the second was to ignore the clock and feed on demand. I spent so much time recording feedings and EVERYTHING else the first time around and the second time I wrote down NOTHING and life was so much easier. I truly think a huge part of breastfeeding success is surrounding yourself with like minded mamas. It can really feel like an uphill battle when you tell someone about a nursing issue and their response is why don’t you just stop, you’ve done it long enough vs. receiving a sympathetic ear and good ideas and options to give you the support needed to continue. Sometimes all you need to keep you going is for someone to tell you, “I’ve been there” and that’s hard to receive if you don’t know other moms who have nursed and are nursing.
  • DS: One little lady still breastfeeding (she’s 46 mos.) and one on the way; best advice — I definitely 2nd Brandy  — unless you have a dream pediatrician, go with the lactation consultant’s advice (or now, the advice you get here! :) Second best — trust yourself and your mothering instincts always!
  • ERM: Wasn’t able to nurse my 12 month old twins but have been PROUDLY nursing my 6 week old since she was less than an hour old. BEST advice I received (which I didn’t get until last week) was to NOT even think about a pump or pumping for at least the 1st 6 weeks. It just adds too much pressure and stress. Just nurse, nurse, nurse and get that relationship down. If baby is thriving then you know you have an adequate supply. I highly recommend a trip to Jill Rabin in Northbrook also. =)
  • KCS: Child number one, age 5, nursed two weeks past his 4th birthday. The twins are three and still nursing. I nursed all three for 2 years.
  • ECH: 16 months or so with my first, 5 weeks so far with this new baby. The best advice I received was if you were missing nursings because you were busy, spends the weekends in bed nursing. It helped me to work full time, pump, and continue the nursing relationship.
  • NW: I’ve been breastfeeding for 3 months, and plan to keep going onto 12. Determination and the bond kept me going. The day that we had an 8am dr appt, we were outside waiting for the doors to open and he was hungry, so I fed him in my car, and he looked up at me with milk all over his face and gave me one of the first smiles I’d seen. :) Best advice was skin-to-skin contact, it helped me within hours of some nipple confusion. But I’m lucky enough to have a generally easy breastfeeding relationship with my son.

No More Failure Stories: Karaleigh’s story

28 Nov

Editor’s Note: This post is the first in a series we’re calling “No More Failure Stories.” We know that mom-to-mom support is one of the most important ways we can ensure that other moms continue to breastfeed, despite setbacks and difficulties. We hope that Karaleigh’s story will help you to remember a time when someone helped you get over a hurdle. Whether or not we know it at the time, words of encouragement and support can make the difference between “breastfeeding didn’t work out for us” and “yup, we’re still breastfeeding.” Share your story with us! breastfeedchicago@yahoo.com.

I knew I wanted to breastfeed from the moment I got pregnant. After all it’s free, it’s an easy postpartum weight loss program, and the benefits for both me and baby are fantastic! But then I began to worry. Would it be easy? Would it hurt? Would I know how to do it? Could my baby really survive on “just” my milk?

These thoughts intensified when I gave birth to a premature baby who was too small and weak to latch on. So I did what I could; I tried and tried again to get her to latch and suck. In the meantime, I spent endless hours with my breast pump. I called lactation consultants, but they were all too busy to return my calls or too booked to see me. It took five weeks of trying before I was able to get my daughter to exclusively breastfeed, but I did it.

Through my experience of breastfeeding I felt that it was very important to encourage and support those who wanted to breastfeed. After my friends delivered their babies, I would always check in to see how they were doing and ask if they had any breastfeeding questions. I periodically sent encouraging emails and fun facts about breastfeeding like how breastfed babies have higher IQ’s!

The first friend I told that I would be her breastfeeding cheerleader was overjoyed. She was very much wanting to breastfeed for at least the first year. Within the first week her pediatrician was encouraging her to supplement with formula. She resisted. I got a frantic email a few days later. She emailed with a screaming baby in her lap saying, “I think I need to use formula, he is hungry and there is nothing left!” Together we problem-solved. First step, deep breath. A screaming baby can rock even the strongest woman’s confidence in her ability to be a mommy.

With formula advertising everywhere, and coupons, samples, doctors, nurses and friends suggesting formula. How do we gain confidence that we CAN feed our babies with breastmilk? We need to team together! We need to call our fellow sisters, aunts, cousins, sorority sisters and friends and make sure they have the support and encouragement that they need to breastfeed. We need to talk openly about our journeys with breastfeeding, our trials, our errors, our successes, and our sleepless nights so that other women know that they are not alone. No women should have to struggle in private to feed their child. No woman should have a breastfeeding question go unanswered. It is our duty as successful breastfeeding mommies to be cheerleaders for our tribe.

Karaleigh Salmi is mother to Ellie (10 months old) and 3 dogs. She has a wonderful, supportive husband who encouraged her through all the challenges of breastfeeding. Ellie and Karaleigh overcame the challenge of Ellie’s premature birth and stay in the NICU, and have been successful at breastfeeding. Karaleigh is a Ph.D. candidate in the field of clinical psychology and a stay at home mom.

The Pump Room

14 Nov

This post was originally posted on The Chicago New Moms Group blog. Thank you to Linda Szmulewitz for allowing us to re-post it! Share your pumping-at-work experiences in the “comments” section below!

Recently on the mother to mother Breastfeed, Chicago Facebook group, a mom vented a brief story of a negative interaction with a coworker that she had regarding her need to pump at work.  This story sparked a very strong memory for me of a time, now 6 years ago, when I too returned to work and was pumping so that I could continue to breastfeed my baby.  I wanted to share that story with all of you in hopes it might be helpful to others.

Whenever I think about new and veteran moms returning to work and pumping, I am immediately brought back to December 2005.  I was a new mom, returning to work after my 3 month maternity leave.  I was a social worker in an outpatient HIV clinic within a large hospital in New York City.  I was very fortunate in that my daughter was going to the day care that was part of the hospital across the street from my office.  This afforded me the opportunity to go over during my lunch and breastfeed her, thus eliminating one time a day when I had to pump and also one less bottle that someone would be giving her.  Like many new moms who have returned to work, I was no longer the same person I had been when I left to give birth just 3 months before.  I now had a new role in life, new priorities and my job no longer really ranked up there with the things that mattered most to me.  I knew that I was going to be moving in 6 months and had it set in my mind that I could handle pumping at work for that amount of time.  I knew it wouldn’t be easy, but with an end in sight, I thought, “how hard could it really be?”

At the time, I shared an office with two other coworkers, both female social workers.  One was, and continues to be a very close friend.  The other was a friend prior to me having a baby and even came to my home to visit me and my daughter while I was on maternity leave.  My actual cubicle was at the back of our office space, meaning that my coworkers did not have to walk past my office to get to their own.  On my first day back at work, both of my office mates were out.  It was great!  I did my job, saw my patients, put up my little curtain and pumped when I needed to.  In between I washed all my pump parts, and nursed my baby at lunch over at the daycare.  I felt empowered by my ability to work and also provide the most nutritious food for my baby. Sadly, when everyone returned, this all changed.

The coworker who I was very close with thought it was great that I was pumping at work.  She didn’t have children of her own but understood the purpose and the necessity of it.  The other one, we’ll call her Veronica (her name has been changed to protect the not so innocent), was another story entirely.  I told her that I would be pumping a couple of times a day in my office and that I would try to do it at a time that she wasn’t going to be seeing patients.  I asked that, if the actual door at the entrance to the office was closed, could she please knock before coming in?  She didn’t take this well at all.  She accused me of trying to control her and thus preventing her from doing her job.  She also told me she was not comfortable with hearing the pump from the other side of the cubicle wall.  I’m embarrassed to say that several screaming arguments took place between us which usually led to one of us storming off.  Suffice it to say, this did not make for a very relaxing environment to pump in.  In retrospect, I realize now that I was very hormonal, exhausted from being up at night with my newborn for the last three months, and in the midst of a major life change between having just become a mother and now transitioning into my role as a working mom.  I also naively assumed that all would be supportive of my choice to breastfeed.  Now when I think back on it, I realize that I did not have any other friends with babies, and I didn’t know anyone who had returned to work while pumping.  As time went on, I began to think about some of the things that had happened to Veronica that may have made her react how she did.  She was single and her slightly older sister had just had a baby a few months before I had.  Her sister had chosen not to breastfeed so the actual process of continuing a breastfeeding relationship while working was foreign to her.  That being said, she made no attempt to understand what it entailed or what I was going through.

The hostile climate in the office worsened, when a week or so after I returned to work, the New York City Transit Authority went on strike for 4 days, discontinuing bus and train service in all 5 boroughs.  Since I no longer had any sick time left (it was all used up during my maternity leave), I had no choice but to go to work, but that also meant figuring how how to get my infant daughter there as well.  Since many of the day care workers lived in the outer boroughs and it was taking them 2-3 hours to get home each night, one day they had to close the day care early.  Nothing was going on in our office (our patients couldn’t get to their appointments either) so I picked up my daughter early that day and brought her back to my office while I finished up for the day.  She quietly hung out in her car seat while I typed up some last few notes.  Next thing I knew, Veronica stormed into my cubicle screaming at me for once again assuming that the way I was choosing to use our shared space was okay with everyone else.  Suffice it to say, when I finally made it home that night, I cried for quite some time from all the stress this was causing.  I was totally baffled by her strong negative reaction to me and my baby.

My supervisor at the time tried to be as supportive as he could.  He was in a tough place because he was both mine and Veronica’s supervisor and although he knew that she was being unreasonable, he didn’t really know how to handle the situation.  As far as Veronica was concerned, I could use one of the exam rooms that were constantly in use for patient care and would never have provided any privacy.  The hospital knew that they were required to provide me a non bathroom space to pump in (although I did end up pumping in the bathroom at least once), but their solution was for me to make a 20 minute trek over to the NICU pumping room each time I needed to pump.  This would not have allowed me to do my job.  In the end, I was lucky enough to be able to move into a former supervisor’s private office where I could both work and pump for the remainder of my time at work.  Veronica and I never spoke again and the entire practice was divided among whose “side” they were on as a result of the entire situation.

In retrospect, I probably should have approached the situation differently.  Maybe I didn’t take into account how she would feel about it.  Honestly, at the time, I wasn’t really concerned with anyone else other than my baby and how I was going to provide food for her while being away from her for most of the day.  I certainly let my emotions get the best of me and probably seemed like this crazy breastfeeding woman to her, but I didn’t care.  I guess I still don’t.  I know that everyone has their own issues and some people, for whatever reason, are not entirely comfortable with breastfeeding.  As a nursing mom, pumping in order to feed my baby was a logical and natural choice for me.  However, for someone who had had very little exposure to breastfeeding, my decision must have made her feel awkward, uncomfortable, and imposed upon.

If you are returning to work and will be continuing to pump, my advice to you would be to seriously think about the environment you will be returning to and how you can make your very difficult job of pumping at work as easy as possible. In Illinois, your employer is required by law to provide you with a “non bathroom” space in which to pump.  Currently, 24 states have laws related to breastfeeding in the workplace.  Talk to your coworkers.  If they are a group of single 20 and 30 year olds who have not had any experience with breastfeeding moms, be prepared to educate them on all the hard work that moms do to provide the best food for their babies and share some of all the excellent benefits of breastfeeding (like how your baby will be healthier, resulting in you not taking days off to care for a sick child). You may even make a difference in their decision to someday choose to breastfeed their own baby.

For a long time after this experience, I had this fantasy of sending Veronica a letter detailing to her how she had made my life a living hell for that six months.  I would have told her that I hoped that someday she would be lucky enough to find someone that would make her happy and they would be lucky enough to have a baby together. I hoped that when she became a mother and experienced it as the total life change that it is, that she finally would understand why the way she treated me was so wrong, so hurtful, and so traumatizing.  I guess this blog post is that letter.

Linda Szmulewitz is a mom of two, a licensed clinical social worker, a postpartum doula, and the founder of The Chicago New Moms Group. She can be found blogging about all things related to being a parent at www.chicagonewmomsgroupblog.com.  For more information about The Chicago New Moms Group, please visit the website.

Bridging the Divide Between Breastfeeding Mothers and Their Doctors

10 Oct

I am on the phone with the pediatrician again.  Not my regular one – she is on maternity leave – but another doctor from her group.  It has been a long last couple of weeks for me and my 13-month-old son.  He’s had a persistent, reoccurring ear infection and has been prescribed a very powerful antibiotic, since the more mild antibiotics he was prescribed a few weeks ago weren’t helping and he continued screaming in pain every time he would lay down on his left side.  I am sleep deprived and frustrated.

These new antibiotics seem to have done their job.  The infection has cleared up – no more screaming – but we are left managing a side effect from the antibiotics: severe diarrhea.  I’ve called the doctor this time because my son has broken out in a screeching, fire-engine red diaper rash.  I was initially concerned about an allergic reaction to this new antibiotic, but I soon realize what is really going on when I begin to feel a persistent, needle-like, almost itchy sensation deep in my breast tissue.   Yeast.

But, the doctor disagrees with me.  “They’re completely unrelated, “she says flatly.  “If you have a yeast overgrowth in your breasts, you did not get it because your son is taking antibiotics.  He is just sore from all the diarrhea.  Continue giving him the medication until it is all gone, put some Desitin on the rash, and things will be fine in a few days.”  She says nothing about why I might be experiencing pain in my breasts. I roll my eyes, but thank the doctor for her time and hang up.  

The new mom I was five years ago probably would have believed what she was being told and followed the doctor’s advice.    After all, I’m not the one who went to medical school.  But the mom I have become after having breastfed two children over the last 5 years has learned the hard way to be a very skeptical creature when it comes to medical ‘advice’ as it pertains to breastfeeding, and I suspect this doctor of being either misinformed or ignorant.

My skepticism is confirmed when I flip to pages 480-484 of my copy of “The Breastfeeding Answer Book” – a nearly 700 page treatise of breastfeeding information that cites nearly 400 peer-reviewed medical publications.  Sure enough, right there in black and white I read what this doctor apparently never learned in medical school, or during her years of practice – that yeast overgrowth (a.k.a. thrush) is, in fact, associated with antibiotic use in either mother or baby , and that a mother and her nursling(s) can pass a yeast overgrowth back and forth to each other.  According to the book, successful treatment means that “…both mother and baby will need to be treated simultaneously…” because yeast can be difficult to get rid of.  A quick call to my local LLL Leader helps me narrow in on some treatment options to try (the book lists quite a number of them) and in a few days with the help of some probiotics and over the counter antifungal creams, both my son and I are feeling better. [Editor's correction: Recent research shows no correlation between antibiotic use by baby and yeast overgrowth in the mother. Breastfeeding Answers Made Simple contains up-to-date evidence on this issue.]

I wish I didn’t have to be so skeptical.  I wish I could just trust that the information pertaining to breastfeeding or my status as a nursing woman I hear from my and my children’s doctors is accurate and evidence-based.  I mean, we’re talking about the normal way to feed a baby here, right?  We’re talking about a way to feed a baby that has been demonstrated, among other things, to result in lower rates of childhood obesity, type 1 and 2 diabetes, leukemia, SIDS[i], higher IQ[ii] and even better emotional well-being[iii].  And, we’ve all seen the study that suggests it can reduce a mom’s risk of premenopausal breast cancer by 60%[iv].  60%! Why wouldn’t our doctors be all over that?

Unfortunately, however, between my two children who have been seen by various pediatricians from several practices and doctor’s groups and my experiences with my own personal physicians is that it is just not the case.  Instead, my experience has been that among the medical community in general – and, even among those that we would most expect to be knowledgeable such as pediatricians, nurses, midwives (yes, even midwives), and obstetricians –ignorance and misinformation regarding the fundamentals of lactation and the basic dynamics of a mother/baby breastfeeding relationship abound.  And, despite my best efforts, I have yet to find a local pediatrics practice that actually follows American Academy of Breastfeeding Medicine protocols for a breastfeeding-friendly office (although I do know there are a few in the greater Chicago area).  

What I have gotten, at best, is a lot of lip service about pediatrics practices being ‘breastfeeding friendly.’   Offices have claimed to be ‘breastfeeding friendly’ even though their patient handouts use the terms “breast milk” and “bottles” interchangeably, they have free formula samples and coupons littering the waiting room and stacked behind the front desk, they use infant growth charts with formula company names stamped on the bottom, they offer new parents no information about safe co-sleeping, and they often reinforce the idea that at a certain age, babies “should be sleeping through the night” while giving no consideration as to whether or not this is a good thing for a mom’s milk supply.  And, I have never found a local practice that has an IBCLC on staff holding regular hours for appointments (although I have observed that a few have given referrals to local lactation consultants in independent practice).

So, what’s a nursing mom to do in this environment of indifference, ignorance, and misinformation?  I’m no expert, but this is the way I’ve learned to handle it for myself and my children, sometimes learning the hard way:

Be a critical thinker and know where to go for trusted, evidence-based information regarding breastfeeding

Always, always, always, double-check with a trusted, up-to-date, and evidence-based source to make sure that you are getting accurate information from your health care provider.  This might be a person who can help you locate the information you need such as a breastfeeding counselor, group leader, a CLC or IBCLC, or it may be an online or print resource that you go to directly yourself.  Examples that I have found especially helpful are: LLLI handouts or books such as The Womanly Art of Breastfeeding or The Breastfeeding Answer Book, Breastfeeding Answers Made Simple, Breastfeeding USA information, The American Academy of Breastfeeding Medicine’s protocols, the InfantRisk Center, etc…

Be an advocate for your baby, yourself, and your nursing relationship

It has been my experience that health care providers seem to forget that even though the cord is cut after birth, moms and their nursing babies are still biologically and emotionally connected through the act of breastfeeding.  From time to time, you will need to remind care providers that you are involved in a nursing relationship with your baby (or babies) and that when a physician is treating one of you, they are really treating both (or all) of you.

This also means that in addition to locating breastfeeding-friendly care for your children, you need to keep in mind that you need to find breastfeeding-friendly care yourself, whether it be a gynecologist, primary care physician, or a mental health care provider.

Trust yourself and what you know to be true

According to the Surgeon General’s Call to Action to Support Breastfeeding (2011), “Inadequate education and training of clinicians has been identified as a major barrier to breastfeeding, and education on breastfeeding is not a core element of most medical school or residency programs or of programs in nursing education. Unfortunately, there are few opportunities for future physicians and nurses to obtain education and training on breastfeeding, and the information on breastfeeding in medical texts is often incomplete, inconsistent, and inaccurate. ” (p.46)

What this means is that it is entirely possible that even your average nursing mom does know more about breastfeeding than your average doctor.  Trust that if you are informing yourself from up-to-date, evidence-based sources you are doing the best for you and your baby.

Be respectful and choose your battles wisely

Let’s face it.  Until doctors undergo the education they lack, this situation presents a huge grey area with the potential to threaten the doctor/patient relationship, which is predicated on the notion that doctors are the trusted experts.   Plus, health care providers are people too, and no one likes to be told they are wrong.  Confrontation, accusations, and show-downs are likely to be met with hostility.  When you have concerns, bring them up, but do so in a firm, but respectful way.   I like to bring evidence-based print resources with me to appointments (like my copy of The Breastfeeding Answer Book), and just hand them over while simply asking, “But, what about this?”  This forces the doctor to argue with the data, and not with you.

Compromise

While I haven’t been able to locate a local pediatrics group that I would consider truly breastfeeding friendly, I have been able to find a physician within a group who treats me with respect, listens to my concerns and takes them seriously, respects my breastfeeding relationship, and is open to new information.   Needless to say, I do my best to make my appointments with only her.  It has been my experience (and economic privilege) that access to a doctor like this is a truly valuable resource worth its weight in gold.  I’m grateful to have found her for the care of my children.

But moms, change won’t come if we just grin and bear it.  We moms need to speak up and demand that it is not good enough for our medical care to just be breastfeeding-marginally-neutral.  In order to help moms meet their personal breastfeeding goals; we need health care providers who are truly supportive.  It is my plan to write the management of my children’s doctor’s group a letter telling them about my experiences.  I hope to demonstrate that there is demand among moms for doctors who practice in truly breastfeeding friendly environments, and we can and will vote with our feet.

Now, because I’d like to end this post on a positive note, and send the love out to local physicians who are helping to support breastfeeding moms, tell us Chicago moms, what experiences have you had with a truly breastfeeding-friendly healthcare provider?

Author Bio:

Elise Fulara is a proud breastfeeding mom of two who lives in the Western suburbs of Chicago with her wonderfully supportive husband.  When she is not wasting time on Facebook, cleaning up after her children, or trying to keep up with her garden, she works part-time as a freelance museum consultant and is also the owner of Sling Savvy, a resource for parents and educators interested in learning about the benefits of simple, fabric baby carriers such as slings and wraps.  She underwent breastfeeding peer-counselor training in 2010 through LLL, and is passionate about mom-to-mom support.  She facilitates breastfeeding and babywearing classes for expectant mothers at Elmhurst Yoga Shala. She would like to thank her mom for breastfeeding her. 

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