Wednesday, February 11, 2009

Ali's Annals 7.0: My milkshake brings all the boys to the yard...

And by yard, I mean boobs.

Let me interrupt myself and provide you with a "deep thought" of the day: did you ever notice that babies don't get bad breath? As adults, when we sleep with our lips cracked, seeping our most private dreams with each exhale, it always seems that upon waking everyone is met with your unmistakable death breath. Miles not only sleeps with his mouth agape, but his little tongue pulsates as though he is suckling, which I am sure helps distribute all sorts of mouth muck around his oral cavity. And yet, he wakes up with nothing but sweet winds blowing from his tiny lips. Perhaps it is an evolutionary design meant to make Mums happy after a sleepless night. 5am smiles and sweet milk breath are enough to make the whole night worth it.

Let me interrupt myself for a second time and say: Happy Valentine's Day! Gold stars for anyone who can name the show this is from...We had a rather low key V-day. I have picked up 3 extra projects with the CDC and am working nights and weekends to get it done, so I had a romantic date with 500 abstracts Friday night. Eric and I did order in Indian and shared in a beer and a late night on demand viewing of Tropic Thunder. We are a class act I tell you... We went as a family to music class on Saturday, confronted the jungle that is the Dekalb Farmer's Market, and spent the afternoon making baby food and organic Barley Apple Stew (yum!). Here Miles is gnawing on his spork and feeding himself his new banana puffs from Happy Baby. At this point, he just likes to manipulate the puffs until his soggy hands break down the puffs into a sticky paste.

After dinner, we took an evening stroll. Miles is sporting his usual poker face for the camera. (The end of the post I have included a silly little "ditty" from our walk. I am having trouble uploading videos, now, so this was all I could do!)




Back to the post topic. Before we jump into the reviews and recommendations, it is essential to mention that breastfeeding (BF) is not for everyone. Either by choice or circumstance, some babies are not fed with 100% breast milk (or any at all). As mothers, I believe we should respect and have compassion for families' decisions and situations surrounding how we feed our infants in the first months. And for those who face obstacles, learn to give yourself a break! (I write that for myself as much as for the readers.)

Breastfeeding can be hard. Well, it was hard for me. I thought it would be a matter of mouth to nipple, but it wasn't. Despite the struggles, I can say at 9 months, we are still going strong!

Complicating things for us is that I work full time outside of the house, and went back to work at 6 weeks. Additionally, Miles was tube fed and fed breast milk in bottles for the beginning of his life. Pumping and nursing is the best of both worlds, but it is also the WORST of both worlds. I'll focus on situations in which one pumps and nurses, but for this particular annal, will focus solely on breastfeeding. Pumping will come next post.

Obviously, as the dairy cow, mom's diet is part of the process. I believe that nursing moms should extend the adage "dieting and pregnancy do not mix" to breastfeeding. (It is universally suggested not to diet for at least 2 months postpartum.) Nurture yourself--in mind, body and spirit, and your milk will benefit in both quality and in part, quantity. I hesitate to talk too much about weight because I do acknowledge that I am fortunate in not being confronted with the struggles of losing weight after having a baby, but in my heart I feel that for those who breastfeed, restricting foods and consuming "diet foods" is not in your best interest. Kellymom (my fav boobie site) has some telling information regarding diet and breastfeeding. I think a well balanced diet is correlated with more than just the composition and volume of milk, but eating well will provide you with the energy for midnight feedings. I also think that if you take the time to eat a well balanced diet, you are more likely to pass on the healthy habits to your children.

So I begin with my nursing mom's food staples:
  • Mother's Milk Tea. I have grown to love this tea. I add milk to increase my calcium and protein. I have the Yogi brand at work, and the Traditional Medicinals at home. I drink anywhere from 2-4 cups a day. One warning: if you drink a LOT of the tea, you may start to smell like you are perspiring syrup. This is just from personal experience...
  • Prenatal vitamin. Keep that folic acid coming! Although this is old news for many, the FDA has published a list of prenatal vitamins (along with children's vitamins) and their lead content. It may be a good idea to check out your vitamin against their standards.

  • Natural peanut butter sandwiches. The lactation consultants at the hospital suggested these as a great snack. I know there is the whole PB scare, but at this point, this kind of PB is not indicted. Additionally, there is some research to suggest that high levels of PB consumption in a mother may contribute to later allergies in the kids. Well, I am taking that risk!

  • Avocados. I could eat this at every meal. I have been known to split an avocado and eat it in less than 5 minutes. I put chunks in salads, soups, and even eat Miles's leftover avo mash. Great source of "healthy" fat.

  • Flax. There isn't enough room to here to sing the praises of flax. I have both meal and oil. I actually use the oil in Miles's food if he is constipated, but the flax meal I hide in lots of my food--oatmeal, baked goods, yogurt, nursing balls.

  • And some other staples that give you a big bang for your buck: Trader Joe's steal cut oatmeal, quinoa, barley, nursing balls (go on a hunt through my other posts for the recipe) Greek yogurt and eggs.

Some mums find that their diet dramatically affects their children's milk and have to adjust what they eat, but I cannot say that has been the case with me. Some swear that eliminating dairy or wheat from their diet reduces colic and gassiness, but I defer to the professionals and suggest you talk to a lactation consultant. My bff Kelly does have some thoughts.

I won't offer advice on latching on or the mechanics of BF, as you'll receive those from lactation consultants and can read about it in about every resource designed to provide BF information. What I will outline is my biased opinions and thoughts.

  • Not all babies latch on for 45 minutes during which time you can catch up on reading or file your taxes. Miles will rip on and off. In the beginning, it was just his style of feeding. Now, he will pull off at any change in our environment (e.g. Dad walking into the room, our solar powered crystal beginning to cast rainbows around the room when the sun emerges from a cloud, a car passing by...), and he is accustomed to rolling over onto his belly. He also has no concept of modesty for his mother. I'll sit there with the "faucet dripping" if you will, until he decides to roll back over and find his lifeline.

  • Speaking of dripping, breast milk doesn't actually come out like a faucet. Although I wasn't too shocked by this, I think Eric had some idea that milk would come out of some central vein in the form of a big stream. Think of it more like a lime crusted shower head, or a sprinkler with last year's mud stuck in half of its holes. Sometimes, you'll even have a sprinkle that shoots out at a crazy angle.

  • You can spend hundreds of dollars on nursing bras, nursing tanks, etc., but you don't have to. I have one $40+ nursing bra that I wore only a handful of times, and 2 nighttime nursing bras that are just a glorified sports bra with easy access to the goods. I quickly found that just wearing a tight tank top under every piece of clothing sufficed. Or, you can just do it jungle style like I did for a few weeks, and go topless. For work, I add a bra without underwire, but it is your run of the mill, cheap Target number. Yes, I am not well endowed, so my perspective may only be relevant for the other under C club members.

  • Another potentially less useful than you first think BF accessories of note: the Boppy. I found it more comfortable to NOT have a Boppy to nurse. While in the NICU, I also tried another type of BF pillow aide (not sure of the brand), but found it to be more of a distraction. I did end up using a worn down feather pillow that I have kept between my knees for 20+ years at night as a wedge while nursing. The Boppy actually came to use more when we were working on sitting up, so I am glad I had it. So, if you don't find use in the Boppy, don't feel like a failure--it doesn't mean you are doing it wrong.

  • There are a number of different holds while BF. Find one that is comfortable, and don't let people convince you that one is "better" than another. I was a total football holder in the beginning, but now have some sort of contortionist hold that is not recorded in any book. The truth is, if you are uncomfortable, BF will get old really fast. I will suggest letting your back be supported by a chair/couch. This is related to the idea of bringing the baby to you instead of bring your boob to the baby. In the beginning, I would lean over and dangle the food in front of Miles's mouth. More than one NICU nurse told me, "save your back. If you get in the habit of doing that, you'll be crippled in a matter of weeks." Okay, so they didn't say I would be crippled, but they did tell me that leaning forward would result in long term back trouble. It was a habit that was hard to break, but I am glad I did. Finding those positions in the beginning are challenging. Take deep breaths, and do what works for you.

  • You don't need to rent a hospital grade scale to determine if your baby is drinking enough. I was convinced that Miles could not come home if we didn't bring a pulse ox lead, heart rate monitor and scale to weigh him after feeds. Sometimes you can tell by the "weight" of your breasts if your baby has drank a considerable amount, but that was not a reliable subjective measure for me. And after months, you will most likely not feel that ridiculous fullness you felt in the beginning, but somehow you produce just as much milk. Wet diapers are a much more reliable measure of hydration in your baby. You WILL have moments of thinking, "How do I know how much s/he is eating? Is it enough? how do I know it is enough?" Luckily, you'll be going to the pediatrician frequently, and s/he can help you determine if your baby is gaining enough weight.

  • Some may subscribe to the "document every feed and diaper" routine. You would think that a type A, OCD survivor, mother who still color codes her closet would be the type to keep a binder in the nursery of all of the feeds and diaper changes--especially because it was done at the hospital! Well, you're wrong. For me, it was too overwhelming, and I just wanted to "be" with Miles. I am an "on demand" kind of parent and if he was hungry, he ate. If he needed a diaper change, I changed it. I trusted that I would remember, even in my new mommy haze, if he hadn't had a good 6-8 wet diapers in a day. The extra chore of writing it all down on paper, or even documenting it through one of those electronic devices seemed like extra effort that I a) didn't have and b) didn't want to be bothered with. If it works for you, though, more power to you...but again, don't feel like a bad breastfeeder if you don't!

  • To switch or not to switch. Related to BF gadgets that you may or may not find useful (you know where I stand), they have these tags you attach to your bra to remind you what breast you last fed with. I never used these. For the first few weeks I was pretty much topless; unless I wanted to use temporary tattoos, the little gadgets would serve no purpose. Some say switch after every 5 minutes for every feeding to be an equal opportunity employer. Well, here's my take: your milk has different layers/flavors or courses if you will. (I am not talking about the colostrum elixir you will have in the beginning). Appetizers are composed of a light fare or foremilk--low in calories and fat. For the main course, you get the hindmilk with lots of fat and protein. (Appetizer on the left, main course on the right. I know, crazy, huh?) If the baby doesn't get enough of the main meal, it can actually lead to slow weight gain, fussiness, and frothy stools. I found it easier to just favor one side for each feeding. I tried to mentally note which side I started with for the previous feed, but I really tried to let go the control I could demand in tracking this information.

  • You will probably have one side that is a poor performer. My left side is just an over achiever and has been since day one. It's normal. Don't freak.

  • Here is a list of things that I was sure would happen or I was confident I would experience, but didn't.
Extreme let-down. For the first few weeks, I would get a tingly pins and needles sensation...like my chest fell asleep. It went away rather quickly, but I still managed to produce milk just fine.

Leaking. No matter what the circumstance, I never leaked. Maybe I am an insensitive mother, but no amount of any baby crying had me leak through a shirt. I would and still do "feel" my milk sort of "churn" when Miles cries, but nothing extreme. Again, it doesn't mean you are a bad mother or a bad breastfeeder.

Breast infections. I did not (thank you sweet Jebus) get mastitis. If you think you are heading down that path, seek medical advice swiftly.

Nipple injury. Your nipples will not always crack, bleed or chafe. Breastfeeding has been a logistical and technical challenge for me, but I can say that it has never hurt. Even with 2 little pearly teeth, I have remained relatively unscathed. I wholeheartedly believe this may be luck of the draw. DO NOT take it personally if this happens to you. It does not always indicate an incorrect latch or a failure on your part. There are a host of creams to slather on injured nipples that are safe for both mom and baby.
  • Here is a list of things I didn't expect.
Multiple bouts of clogged ducts. This is truly uncomfortable, and feels SO strange. A section of your breast will get all knotted and ropey. Somewhere in the duct system, a little clog lodges itself. My suggestion: heat, massage and nurse. Eventually it will dislodge with persistence. It can actually be kind of funny if you witness its release. It's like a garden hose that has sprung a leak.

Babies will play with your face, tank top strap or anything he can get his paws on while nursing. It's so darn cute.

I am not good at BF in public. I have done it in the car, on a plane, at a friend's house...but I thought I would be one of those moms who could whip it out and feed like it was as normal as taking out a tube of chapstick to apply. In part, this is because Miles is the ADD nurser, but also I have an intense fear that others will be offended. There, I admitted it.

There have been moments that I wished, prayed and made bargains with God that if he developed a way for fathers to nurse, I would do anything in return. Except become a nun (as Eric reminded me).

You most likely will fall asleep while nursing. The first time you do it, you freak out and think "negligent mother! how could I?" And after a few times, you almost look forward to midnight nursings when you can find a cozy position so the two of you can fall asleep.

Eric's additions:

It is difficult to run in the beginning. I forgot about this! It was more a matter of learning to run with a full cup size bigger.

Steer clear of low cut dresses/shirts. There were a number of occassions that I walked out of the room, looked in the mirror and said "nope, that is obscene," while Eric would comment, "looks great!"

I will address a lot more with the pump portion of the breastfeeding annal, but that's all for now.

I don't love BF, but I certainly don't hate it. There are moments I wish that time and space would hold still so I can sit with Miles nursing forever. And there are other times that I just don't want to do it.

In conclusion, treat BF like pregnancy: you can have expectations, but be willing to accept that it may not go as planned. And learn to really appreciate your efforts, or if you don't journey down the road of BR, appreciate and honor your situation as well.


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2 comments:

  1. Eric skipping down the street, made me howl with laughter. Great post Ali! Miles is getting so BIG!!

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  2. I agree with Tracey, and don't ever lose the ability to be silly and laugh! It will make parenthood much more enjoyable for all.
    Some comments:
    I had the cracked nipples, blocked ducts and Mastitis as a first time nursing mother. It stunk! I was proud of myself for enduring and continuing nursing. I do think that the more relaxed you can be the less these problems chance to plague you. I never had those problems with subsequent babies. Your advice for treating the blocked ducts is sound and should help avoid mastitis.
    Another impediment to public nursing is when the baby is a noisy nurser! You kids used to slurp, gulp, and smack loudly enough to be heard across a crowded room (I surmise - I never had the guts to put that into practice).
    In regards to mommy's diet while nursing, I tried all kinds of diet restrictions while nursing colicky boys to not much avail, although restricting dairy products ultimately seemed to be helpful long term as both boys were lactose intolerant. That being said, there is new research indicating that eliminating all possible allergens (like peanut butter) may actually contribute to future allergic reactions, because children are not able to develop any natural defenses to potential allergens. Similarly, being super, super clean can actually prevent babies' immune systems from developing effectively. Moderation seems to be the key with lots of parenting issues.
    Stepping down off my high horse now...

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