Thursday, July 7, 2011

An exercise in patience and faith

Early in the morning

For months now I've been planning to write a post about breastfeeding. I have kept a running list in my head of tips for moms who are nursing or considering it. But we'll get to that in a hot minute. My friend Jag told me that all during her pregnancy she had this fantasy about breastfeeding her baby, how it would be this beautiful, tender, idyllic bonding experience full of sunshine and hugs and roses and tra-la-la-ing. She was surprised as hell--indignant even--when it proved challenging. I was the opposite. I knew that I should do it, but I remained on the fence about breastfeeding right up to the first time Mo latched on. And I tried not to think about it too much beforehand. My big pregnant fantasies were all about sleeping on my stomach. And jogging.

Jogging.

Seriously.

People used to ask if I planned to breastfeed, and I mumbled something about giving it a try. There was no good reason for my ambivalence. I guess nursing was a foreign concept to me, and I thought I wouldn't like it or it wouldn't work. Which is a strange attitude for the woman who didn't take a single Tylenol or sip of wine throughout her entire pregnancy. When I was that crazy serious about trying to make the best choices for my developing fetus, it should follow that I would continue down that path after the baby was born. Right?

Most people who go into breastfeeding as wishy-washy as I was probably don't stick with it. Not all moms are able or willing to breastfeed successfully. But I would venture that a much higher percentage of women could breastfeed their babies than those who actually do it. Check out these stats: 75% of new moms in the U.S. start off exclusively nursing when baby is first born; by 3 months 33% of moms are exclusively breastfeeding; and by 6 months 13% of us are still on board. Only 13%.

That's dismal, ladies.

Mo and I just made it to 6 months together. Yay, us! I did not expect to make it this far. And I never thought I would enjoy nursing my baby, but I really do. If you are considering nursing, planning on nursing, planning adoptive nursing, thinking about relactation, or in the process of nursing, here are my thoughts on how and why we were successful in spite of my initial doubts. I hope you find it helpful. Please feel free to add any tips you might have or ask me questions. Also, Genevieve at Mama Natural has a list of nursing tips that are really good. I'll try not to repeat too many of hers. Next stop, 1 year!

1. Get schooled. Robb groaned when he found out that I signed him up for boob class with me. But thank goodness I did. Taking the breastfeeding class offered by our hospital made us both more confident that breastfeeding was the right choice for us and our little one. I say "us" because it is very important to get your spouse/partner/mom/sister/bff (or whoever will be your primary support person) on board. You need a cheerleader. You need a second set of eyes when you're not sure if you're doing it right. And you really need somebody to bring you a sandwich. My cousin Amy asked, "What do you learn in a breastfeeding class?" We learned the anatomy of lactating boobies, how an infant's stomach grows and develops, the composition of breast milk, what a breastfeeding baby's poop should look like at different stages, various positions for nursing, what a good latch looks like, the health benefits of nursing for both baby and mommy, etc. Added bonus: the class was taught by a board certified lactation consultant who is on staff at my hospital. Betty is fully awesome. If your hospital does not offer classes, contact other hospitals in your area or your local La Leche League to see what is available.

2. Ask and ye shall receive. Take a tour of your hospital's birth center and ask them what kind of breastfeeding support to expect. There is a lot your hospital can do for you. For example, you should ask if there is there a lactation consultant on staff. Will she be available on weekends too? Will she stop by your room to make sure baby is latching on properly? Will she visit you more than once? Are the nurses knowledgeable about breastfeeding? Is there a nursing supply shop located at your hospital or nearby? Will you receive a discount on purchases (nursing bras, pumps, milk storage bags, etc.) because you are delivering there? Are there hospital grade pumps available to rent? When you are discharged from the hospital by your OB and baby's pediatrician, will the lactation consultant also conduct a breastfeeding discharge? Do they send you home with an info packet to make sure baby is getting adequate nutrition? Will they give you any free supplies (for example, my hospital sent me home with a full Ameda pump accessory kit)? Once you get home can you call the birth center nurses with questions? Can you schedule a private (paid) one on one session with the lactation consultant if you are struggling? Is there a (free) breastfeeding support group? (If you are delivering at CMH, the answer to all of these questions is YES!) While you are in the hospital, ask your nurse for several small tubes of lanolin for your sore nipples and start using it before you need it. Trust me on that one.

3. Set small goals.It is daunting to think of breastfeeding for the entire first year, especially in the early days when you are exhausted and your nips are burning. Instead focus on small stuff. I knew I could make it through the first few days, at least long enough for Mo to get colostrum. Once we got home I moved my goal to 3 weeks. And once accomplished, I focused on 6 weeks. I have done this with baby steps. (That makes me think of What About Bob.) Honestly, though, the first 6 weeks were the most difficult for me. Once I cleared that goalpost things became a lot easier. Nursing was finally less painful, and Mo started sleeping longer at night. If you are able to nurse through the first 2 months of your child's life, you can definitely join me in the 13% club. Just keep in mind that the winning contestants on Survivor only have to make it for 30 days.

Pussies.

That's right, this blog is edgy.

4. Remember economics class. When the stock market takes a dive, my emotional reaction is to immediately pull my money out to try to save what I still have. But investment professionals will tell you that is the wrong response. I should buy when the market is low and sell when it's high. Breastfeeding is the same. It is a system of supply and demand. When baby demands more milk, your emotional reaction is to mix up some formula to make up the deficit. But that is the wrong response. Breastfeeding begets breastfeeding. When Mo demands more milk, I nurse her more frequently, and my milk production rises to the occasion. You should expect your baby to go on a feeding frenzy during growth spurts at about 3 weeks, 6 weeks, 3 months, and 6 months. Some growth spurts are more pronounced than others, lasting anywhere from a day to several days. Remember the game Hungry Hungry Hippos? It's like that but on your boobs. Ride it out. This is how your body adjusts to baby's changing nutritional needs.

This is where breastfeeding becomes a metaphor for faith. If your newborn is nursing 10-12 times a day, if he has the requisite number of wet and poopy diapers each day, if she hasn't lost more than 7% of her birth weight in the first few days, then you are doing it right. Check his weight. Count her soiled diapers. Consult with his pediatrician. Take it one day at a time. Resist the urge to supplement her diet with formula. When you supplement you send your breasts a clear message that they are already making enough milk. (***See my note at the end of the post.)

Disclaimer: Obviously I am not a medical professional. And I would never advocate breastfeeding for the sake of breastfeeding to the detriment of your child's growth and development. But I would advocate trying to troubleshoot nursing problems with your pediatrician and/or lactation consultant before you throw in the towel. If you and your baby's doctor agree that nursing alone isn't doing the job, then it's probably time to supplement.

5. Become a joiner. This is Robb's tip for successful breastfeeding and remaining sane as a new mom. I go to a free breastfeeding support group every Wednesday at the hospital. It's hosted by a board certified lactation consultant. It's a great place to talk about nursing issues, commiserate, and laugh. And babies love to look at other babies. If there's nothing like this at your hospital, contact the nearest La Leche League chapter for a support group. Oh, and unrelated to nursing I found a terrific group of local moms on Meetup.com. They plan activities for little ones and families, mama's nights out, clothing swaps, playdates, and volunteer activities. If you are absolutely not a joiner, do yourself a favor and have at least one person you can talk to about breastfeeding, whether it's your partner or sister or friend. You are going to need a sounding board.

6. Go surfing. When you have questions in the middle of the night, the internet has answers. My favorite resource is Kellymom. If you are not sure how to use your breast pump or how to manually express breast milk or how to discretely feed your baby in public, search YouTube. There are how-to videos on just about everything you can imagine.

7. Weigh & feed. It's something we do at the support group. Here's how you do it. Strip down baby and put her in a clean diaper. Weigh her in just the diaper. Feed her. Weigh her again in just the diaper, but don't change her diaper until after you weigh her. Tada! You just figured out your baby's milk intake. If you are curious about how many ounces your baby is drinking in an average sitting, talk to your pediatrician's office about doing this periodically. If they are supportive of your decision to breastfeed your little one, they will probably help you out with this. Or try your general practitioner.

8. Strap on the feed bag. In the early days you will be so whacked out and sleepy that you will forget to eat and drink. Put your helpers to work keeping you in food and drink while you are pinned down under a hungry infant. You have a better chance of keeping your milk supply up if you keep yourself properly hydrated. A trick that helps is to drink a glass of water every time you feed the baby. Also, there's something about oatmeal that boosts supply. If you can't stomach hot cereal, get your helpers to bake oatmeal cookies, and then eat as many as you want. You have my permission.

9. OSHA approves this message. When you're furnishing the nursery, a rocking chair or fru-fru glider is nice if all you're doing is rocking your sweet baby to sleep. But. You will be feeding your newborn. And if he takes his time with eating (mine did), you could be sitting in that chair for 8 to 10 hours a day. Feeding your child in the beginning is a full time job. This is where patience comes in. The chair you select must be at least as comfortable and ergonomically correct as something you would want to work in all day at a desk job. Choose wisely, my friend. You would do well to position said chair near a small table or dresser or toy box, so you have a place to set your water, snacks, magazines, what-have-you. And I waited to purchase a nursing stool until after Mo was born. It's one of those things--you'll either love it or hate it. Give it a test drive at the hospital before investing.

10. Relax. Don't you hate when people tell you to relax? Nursing and pumping is way more psychological than I ever imagined. It's a total head trip. So you must learn how to relax. When you're frustrated with your husband or mourning the demise of your bikini body or worried about returning to work or stressed because your baby won't stop crying, you need to carve out a little breathing room in your head. Not only will it keep the milk flowing; it's good for mama to have her own slice of zen now and then.

(*** In the interest of full disclosure, let me tell you this. Mo was born on a Monday. By Friday she had lost 15% of her birth weight. Because of my c-section and my thyroid issues, my milk was slow to come in. Early on Friday morning I wept onto my soundly sleeping child while pleading with her to eat. "Baby, please eat. Please, please." Robb and I were worried and sleep-deprived, but we are fortunate to have a very calm pediatrician. When we met with him that day Dr. N examined Mo, answered our questions, and told us to go home. We held our course but bought a jug of formula just in case. And my milk came in that night. By her week 2 checkup Mo's weight had jumped back up, and by week 3 she had surpassed her birth weight. We never used the formula. And the rest is history.)

4 comments:

old dog said...

That is a beautiful love story. Thank you for giving of yourself so fully for Mo. She is a doll. I didn't have all the helpful professionals in my life, but had the ear of fellow nursing moms. We made it through somehow. I just love the pictures. Now that's art.

Tmomma said...

Bug and I made it 9 months, which was great since I had been back to work since 11 weeks and had to pump during the day at work and once we figured out his food allergies had to throw away a couple months worth of frozen supply (that was painful!). But he was a champ from the start and it was our thing. Roo on the other hand, it just never happened and one of the lc's at the hospital gave me a terrible time about it. I did my best to pump for him but the guilt was massive. I felt lonely pumping in the middle of the night while everyone including the newborn Roo were sleeping. So, my family helped me get past this and said as long as he's fed and growing you're doing a great job as a mom. So when it was time for Bug to be born, I said I would like to work with a lc again but if there's any pressure, they're out. And it was amazingily easy, Bug latched properly the very first time, and aside from the normal challenges of the first 6 weeks, it was a good experience. Glad to hear you and Mo are still going strong, rock on!

bbmowery said...

Tmomma - I'm sorry that your lc gave you such a guilt trip about Roo. That's not cool. If I had only been able to pump and not nurse, I would have given up. I felt like I needed a remedial pumping class, and it took me a long time to get the hang of it. I think that's awesome you were so dedicated with Roo. That had to be so much work. Sad lonely work. Because pumping sucks--pun intended--even when everything is going smoothly.

Laura Gill said...

Awesome story!!! I'm a little embarrassed to say that I practically had to beat my kids off the boob just under 2 years old. Jesse was born when Jake was just 18 months old and there was NO WAY I was going to be nursing two babies at the same time so Jake went from boob to cup. I would have definitely failed at breastfeeding had it not been for Becky Nicodemus, the wonderful lactation consultant at Howard County General. She visited all the new moms individually and noticed immediately that my son wasn't latching on properly. She also noticed that he was tongue tied which essentially means that the little membrane under the tongue was too short and he couldn't stick his tongue out all the way. She arranged for an oral surgeon to come in that very night and do a tiny little snip under the tongue, and voila, like magic he was able to latch on. I loved nursing...it was such a peaceful, bonding time with me and my babies. I hated pumping despite having a very expensive electric double pump. I kinda feel sorry for all the moms that immediately start with a bottle and formula and miss the whole experience. I think that if they had the proper instruction and support at the hospital they would have more confidence and be more successful. So happy that things worked out well for you and Mo!