Sunday, February 22, 2009

Breastfeeding 101

Expecting baby #1 was an interesting experience. Every woman I knew who'd had children suddenly had lots to talk about. I loved the advice and wisdom (usually, ha!), but I'd get a little uncomfortable when they'd start talking about breastfeeding. Yikes, is that something you really want to talk about in public?? (Yet here I am posting a blog for the world to see...). But then I had baby #1 and I understood. It's not about the breasts. It's not sexual like in a sexy way. It's about a baby getting his food (err, milk).

And man, it can be complicated.

Being pregnant the first time uncovered what became a great fear for me: Would I be able to successfully breastfeed? All of the women I'd talked to in my maternal side of the family said it didn't work for them. They were only able to go a short while, if at all. Some never had their milk come in. Some were told they had bad milk. Etc, etc. I felt a pressure already, that this might not work out, and I would be letting down not only my child, but even my husband, in my lack of maternal abilities.

So what to do?

I devoured information. I read lots of books on the subject. But what really did it for me was going to a breastfeeding class. Chuck was supposed to go with me but he had to work late, and I kinda think that was good, because the class was really meant just for me. It gave me confidence. Actually, even more than that, it gave me hope.

So here's what I learned: first of all, I learned some history about my family - most of the women in my family were having babies back when the medical community thought formula was an improvement over breast milk. Sometimes doctors gave women medication while in labor that dried up their milk...some did it without even telling their patients! So, there was a bit of explanation to dissolve my fears. I also learned that there are very few cases where women cannot breastfeed. Most of the time, obstacles can be overcome. And there's no such thing as "bad" milk.

I often felt like all of the 1.43 million reasons "why breastfeeding was the best choice" was kinda overkill (yeah, I'm exaggerating, it was probably more like...1.429, ha!) But then I started breastfeeding and I understood why I needed to be convinced that it was worth fighting for. Breastfeeding it harder, plain and simple. There are negatives like, since it's so easily digested, it doesn't last in the baby's tummy as long, thus he needs to eat more often. Which means less sleep. Breastfeeding also takes awhile to get established, and there are so many issues that can arise.

However, here were a few of the reasons for breastfeeding that I found helpful.

~There are over 100 elements of breast milk that man has yet to unravel and be able to reproduce. The latest discoveries of how to reproduce 2 of them, DHA and ARA, are why you see the big hype about them by formula makers. What you don't see are the components of breast milk that aren't in it yet. Maybe someday we'll have something equal to breast milk, but it's not there yet...

~Breast milk can even give you baby antibodies that medical science has yet to figure out. If you get sick while you're nursing, your body will create antibodies and prevent your baby from getting sick. How cool is that?!!

~Breastfeeding reduces the chances of breast cancer in the mother. Since I have breast cancer, among many other cancers, in my family, this was a big motivator for me.

~Breastfeeding is a marvel of God's creative abilities. As a babe nurses, it actually causes the uterus to contract (which helps you heal from delivery), and basically pulls everything back in that's been stretching out for the last 9 months. And of course, it helps you lose the baby weight and you get to eat food for two. That was fun! ;)

~Your baby actually gets exactly what he needs when he's nursing. If he (or she) is sucking weakly and slowly, like they're not really hungry - they get the more watery, thirst-quenching milk. If they're sucking strong and fast, they get the meat and potatoes of the milk, highly substantive, highly caloric (it's called "hind milk"). So compare that to formula or even pumping milk, and you know there's a bit of a difference.

~No bottle making thru the night, or while on the go. You've always got it with you, and it's always ready (and free, unless you count the extra food you're eating!). Hallelujah!

~Your child is more likely to stay off drugs and go to college if you breastfeed. JOKING!!!

It is necessary at this point to say this: new moms have enough opportunities to feel guilty or like they're failures - the last one you need to feel bad about is breastfeeding! If it doesn't work, and you've searched for solutions, but it's just not working out, don't sweat it. Many of our generation grew up on formula and we're ok, right?!

So... baby #1 starts to nurse for the first time. After getting over the initial awkwardness and modesty, I asked for a lactation consultant to check on us. BEST IDEA ever. Always ask for a lactation consultant, especially your first time!! So the lady came in and helped me see how, even though the baby knew how to suck, he didn't necessarily latch on right. He was sucking his bottom lip in, which caused blisters and pain for me. When he would cry and need to be nursed, I found myself in a major guilt trip. I did not want to endure the pain! I had told Chuck before we had him, that I needed him to cheer me on and be strong for me! But by about the end of the second day, seeing how much I was hurting, he was nearly throwing the towel in for me! But the lactation consultant helped us correct everything. And for those painful sores, she went over the the burn/wound unit and cut up these gel pads, that I could then cover the sores with. They made everything feel so much better, and actually heal faster!! There's now a similar version of them that you can find in most drugstores, they're called Soothies.

That tip alone, saved my attempt at breastfeeding.

So, I decided that I would have a goal of making it 6 weeks then reassess if I could go on. By 6 weeks it was an established routine, so my goal was a then to make it 12 months. By the time the babe was 12 months old, he was starting dairy (so no need for formula) and he was so big in stature, it just felt right to wean. Nothing against those who nurse longer, but that was just my preference. Also, the American Academy of Pediatrics stated that it was best to nurse at least 12 months, so I figured that was a good goal.

A few other tips about getting started:

1. While you can't take ibuprofen while pregnant, you can take it immediately after birth. So I took 3 ibuprofen every three hours (and you're up that often, nursing the babe), for about a week. Not only did this help relieve muscle soreness from delivery, it prevented engorgement from being too big of a problem (milk comes in during the first week, and with it "engorgement" where your breasts a heavy and uncomfortable to say the least.) My teacher described it as when you're "hard, hot (in temperature), heavy and you wanna run away from home." Once you know this is a possibility, it helps you not think you're crazy. You might want to warn your husband and those around you, so they know what to expect. ;) Overall, I didn't have much engorgement or hormone least not to the point of running away, ha!

2. Don't pump unless it is necessary for the first 6 weeks. Your body is trying to figure out how much milk to make, so the more you demand, the more you'll deal with engorgement. As tempting as it may be, don't worry about stockpiling it in the freezer for awhile...


Hopefully you'll never have to deal with thrush, but if you do, here's how to get thru it...

First of all, thrush is a yeast infection that can develop in the babies mouth, and/or in the mother. It's pretty easy to identify in your baby by the white spots in his mouth that don't wash away like leftover milk would. In the mother, it can be identified by sores on the outside, major pain while nursing, or by pain on the inside.

If you suspect any type of infection, always go to the doctor. The pediatrician will confirm if it's thrush, and probably give you nystatin lotion for your breasts, and a fluid nystation for the baby. However, I have found that if you have thrush yourself, call your OB/GYN. If you tell the OB that your baby has thrush and you suspect it, they may just call in a diflucan (one pill to take) that would help.

And chewing acidophilus supplements, and eating yogurt are always good at fighting yeast.

Also there's gentian violet, it's available over the counter at most drugstores. It kills yeast on contact (thus helps with sores, but I'm not sure how well it works if you have pain inside the breast). It costs about $2-3 and you can take a q tip, dip it in the gentian violet liquid, then paint it on you and the entire inside of the baby's mouth. And repeat after each feeding for a few days. It's more work, and it dyes everything it touches, but if money is tight, or you think the thrush is mild, it's a good option. It also leaves you baby with beautiful "joker lips," making small children come up to you in the grocery store and ask what's wrong with him... LOL

Big eyes
One last issue to discuss: nursing in front of others. Everyone has their own preference, but for me, I hated being secluded while nursing. It took me a few months to get the courage and skill, but I managed to learn how to cover up enough to nurse in front of others. And by baby #3, I discovered this nursing poncho which gave me much more peace of mind while nursing in public. I've even attempted to sew a couple of them myself, but I've gotta learn the sewing machine more before I can make these quickly... Anyhow, you can buy yourself one at I'd consider it indispensable, and wish I would've had it with the previous babies! It also makes for a blanket or burp cloth in a pinch. ;)

Ok, so I've officially emptied my brain of all the wisdom I can think of from my 3 years of breast feeding. Here's the rundown of how it went for me with all 3 boys...

Baby #1 - After the initial rough start, it was smooth sailing. I forgot to mention, as we were teaching Charlie to latch on correctly, we did give him formula thru a small tube, called an SNS treatment. We only did it once or twice, and it did the trick. He didn't get as frustrated since he would get a little formula, and was able to realize how to not suck that lip under. From then on, I breast fed "on demand," but I wasn't sure when he was demanding it, so he got milk nearly anytime he cried. He therefore had a hard time with weaning, because it was a great source of comfort for him, which I replaced with an even worse source of comfort: chocolate milk. If there's one thing I've learned, it's don't let your kids go to sleep drinking anything besides water. Their dentist will thank you someday (as will your own wallet!!).

Baby #2 - Because I knew better how to position the babe, I made sure he was latched on right every time. I never had any pain or engorgement for the entire 12 months, I kid you not. I did attempt to put him more on a 3 hour routine, which helped me to differentiate between when he was hungry or crying for something else. And I can count on one hand how many times I pumped, I think that might've had something to do with it, too. And he was so excited about solid foods, he hardly noticed when I weaned him at 12 months. I think it's also just Chance's laid back personality, too...

Baby #3 - Has been a challenge for all 12 months. First, he was in the NICU for a week, which meant getting up, dressed, and walking from my room to his every 3 hours. I enjoyed having the time to hold him and care for him, though. Many of the nurses were impressed that I didn't skip feedings at night & just let them give him formula, but really I knew that my milk supply was getting established, so I needed to nurse that often anyway. The first day I wasn't positioning him right (got a little sloppy sitting in the NICU), and could tell right away that I needed to correct the problem. But overall, it was a good start.

One quick story. The first 12 hours after birth, Chandler had no milk. He had a large air bubble in his chest, so they didn't even attempt to feed him, other than the sugar water he was getting thru the IV. They said it's perfectly fine for a baby to go up to 24 hours before eating at first. But at the 12 hour mark, as I peered over his crib to watch him sleep, I felt "the letdown." Your body actually reacts to being around you baby!! Another marvel. So, I pumped (since he couldn't nurse directly), and brought back was the doctor said was an "impressive" amount of colostrum (the fluid you produce until your milk comes in). As I stood there watching him again, he began to fuss, so the nurse asked the doctor if she could give him the colostrum thru a dropper. They had expected to put a feeding tube in, yuck. But the doctor chose to give it a try, and Chandler gobbled it up! The doctor then looked over at me and said, "Come back in 3 hours and we'll let him try to nurse." It was a miracle and such a relief, when he started nursing directly 3 hours later!

Anyhow, all three boys got thrush in their first few months. But it wasn't until Chandler that I got it too. Twice. He actually got it four different times! So gentian violet and I are good friends. But man, that really was a source of temptation to stop breastfeeding. Ugh. But we managed to make it through.

Then, there's the whole fact that he started skipping a feeding at night at 2 months, but then picked back up at four months, which carried on until he was 8 months and we realized he was tongue tied. So basically, since he couldn't stick his tongue out very far, as he grew, he wasn't able to suck hard enough to get the "meat and potatoes" hind milk. Thus, once we corrected that, he started sleeping 12 hours at night because he was able to get his belly good and full!

And finally, in our last month of breastfeeding, I got the mother of all breast infections, mastitis. It causes you to feel like you have the flu (and majorly drained of energy!), and then the pain starts, which feels like a blocked duct. You get to be on antibiotics for at least 10 days, taking them every 6 hours (set an alarm at night, wooohoo), and you have to fast 2-3 hours before, and 1 hour after...which means you have "windows" of time when you can eat. Like I said earlier, if you ever suspect infection, get to the doctor asap. The earlier you catch it the better!

So with the mastitis, you're to nurse as often as possible to get the infection out - which means that instead of decreasing the number of feedings a day, we actually increased. But now that that's over, I'm starting to decrease... To think, he'll be a year old a week from today! Wow!

This time around, beyond that first week, I haven't pumped much. I've also been lazy about it, and just given him formula bottles when he's been with babysitters. Like I said, formula's not the devil, ha! Thus is life with 3 kids...

I hope this has been helpful. Please feel free to leave more tips in the comments, or share your story... And may your breastfeeding be rewarding and without issue!!


Raena said...

Great post! I am a big fan of lactation consultants...used one with both of my babies. Great job at explaining the pros of breastfeeding.

Austin and Ashley Evans said...

Thanks for the tips! Im sure in the next few months, Ill be coming back and rereading this!

Kathy said...

This is so great Ang!!!!

Sam was preemie and was weak nurser. I pumped for the first 4 months until he began to latch properly. I had to fight for it! (Thankfully he was my first!)

Great things shared here. So great!


Leslie said...

I also have 3 boys so I am thrilled to have found your blog...from the Evans. Anyway great post on breastfeeding. I really struggled with my twins so I just pumped for 7 months. This last baby is still nursing and it's going well. I love that you totally support bf but also know that formula will not hurt them at all!!

suzannah | the smitten word said...

this is wonderfully thorough!

i also loved my nursing cover (and find it to be a great shower gift.) mine has wire in the neck so you can see your babe. love being able to nurse modestly without having to hide out anywhere.

my greatest breastfeeding find is wool nursing pads. they're breatheable, naturally anti-mircrobial, they never leak, they've aren't itchy, they stay dry, and you only need 2-3 pairs. i never had any nipple problems, plugged ducts, or infections, and i think it's partly because of the great wool pads--my skin was never wet.

Tabitha (From Single to Married) said...

what a great post! This is something that I need to learn more about so I appreciate all of the information!

The Tibbs' said...

Loved your post! It was very informational! You should send it to Mothering Magazine and Parenting! You are a good writer! I am hoping that you get this because, I am needing your email address to add you to our blog... HELP! Anyway, maybe you could friend me on FB. Have a good one!