Tag Archives: feeding

How to overcome obstacles: Breastfeeding Narrative #5

There’s so much that can go wrong when you’re breastfeeding.  You start out with those idealistic fantasies.  You know the ones that you have in your head:  you and the baby, nursing together, snuggled in a chair, stylish Boppy pillow, gazing lovingly into each other’s eyes, ethereal glow around you, birds tying ribbons in your hair.

Trouble is, for a lot of people, it doesn’t quite go like that.  First of all, I ordered those ribbon-tying birds in advance and they couldn’t even do a simple square knot, let alone a pretty bow.  All they did was crap all over the place.  Total ripoff.

I personally have dealt with a lot of obstacles — blistered, bleeding nipples, milk imbalance and an overactive letdown, a couple biting phases — and somehow managed to nurse Lane ’til she was about 3 1/2, and Jake’s still nursing strong at 15 months.  These things can be overcome!  Not ALWAYS, but usually.  Your best bet is to be prepared with some information in advance.  Read about some of the common problems at Kellymom.com.  Find yourself a La Leche League meeting BEFORE the baby’s born, and attend a meeting while you’re still pregnant.  Get the leader’s phone number.  Read a couple good books before the baby arrives.  Read this article at CNN.com and bookmark it.

So, I’ve had my share of issues; let me tell you what I personally did to overcome them.

1)  Blistered, bleeding, sore nipples.

Lane came out of the womb READY.  TO.  BREASTFEED.  She got latched on an hour after being born, and nursed like a crazy little sucking machine for a half hour straight… while I was completely prone on my back, legs in stirrups, getting a mystery tear in my vagina located and stitched up.  It was not a position conducive to getting a well-positioned latch, and despite assurances from the OB nurse that she was latched well… she wasn’t.  It didn’t hurt that much, but that first nursing session she sucked a pencil eraser sized blister on my right nipple.  Yeeeow.

Then it popped and scabbed over.  Double yeeeow.  But having done my homework, and very personally vested in making breastfeeding work for us, I knew it was important to let her nurse on that breast, despite the discomfort.  (Did I say discomfort?  Ahh, how time dulls the memory.  It was like a hot poker being jabbed into my nipple.)

So how did I manage?  Ibuprofin to cope with the pain, and Lansinoh brand lanolin cream.  (Lansinoh is AMAZING.  I cannot say enough good things about this stuff.  It is dreamy on sore nipples… not only does it help heal them, it also serves as a lubricant to prevent irritation in the first place.  And it is great for so much more than nipples.  It kicks diaper rash to the curb.  It softens hard, dry skin on your feet.  It is the only thing I’ve found that doesn’t sting to put on a chapped nose when you have a bad cold.  Spend the $10 and get a tube; it will last forever and you’ll keep finding new uses for it.)  Anyway… despite Lane’s near-constant nursing during our first few days, the nipple was all healed up in about three or four days.

2)  Milk imbalance & overactive letdown.

Let me take a minute to explain what this is first.  I’m going to be brief and if I’m any way unclear, you can always read a longer explanation.  Basically, when the milk starts flowing, it’s like skim milk.  It’s got more protein, not as much fat.  This is called “foremilk”.  As baby nurses, the milk gradually becomes thicker, more opaque, more fatty.  Like whole milk, really, and maybe even more rich than that.  It gets downright creamy.  This is called “hindmilk”.

So, you know how if you eat a meal that’s a lot of meat and little else (basically a lot of protein) it sort of messes with your digestion?  You get gassy (and STINKY) and get gas pains and let’s not even talk about the resultant ugly bowel movements.  Well, if a baby gets all foremilk and no hindmilk, he’s getting almost all protein in his diet… not too much sugar and like no fat at all… and boy do you know it by the diapers.  Breastmilk bowel movements are yellow and almost pleasant-smelling.  When you’ve got a milk imbalance going on, the poop looks green and frothy and loses that pleasant smell.  And baby gets gassier, and grumpier as a result.

This happened with Lane, starting around the time she was about 3 weeks old.  I had an overabundance of milk, and she was satiated on mostly foremilk, without getting to the creamy, fatty hindmilk.  The solution I found, and what worked, was ‘block feeding’ – basically, nursing on only one side for a few hours at a time.  I think I did four hour blocks, where Lane only nursed on one boob.  After four hours I would switch to the other boob.

Related to this issue, I also had an overactive letdown.  When my milk starts flowing, it REALLY starts flowing.  My letdown could shoot milk 4-5 feet and soak an entire burp cloth.  Eventually I started catching it in a bowl, and it would often equal 1.5-2 oz. in 20-30 seconds’ time, which is a crazy amount if you think about a little tiny one-month-old baby trying to keep up with this onslaught.  Lane simply couldn’t nurse that fast and would gag… so we learned that as soon as I felt that letdown coming (it is a distinct tingling sensation) I would unlatch her and let that initial letdown pass.  She didn’t get that I was doing it to help her and she’d get all pissed off for those 20 seconds I wouldn’t let her nurse, but it was worth it to not have her gag.  (Either my letdown eased up with Jake, or he was just more capable of keeping up, because I don’t recall having to go through that rigmarole with him.  Each baby is so different!)

3) Biting.

Both my kids have experimented with chomping down on me… and funny, both went through the phase at about six months old.  When Lane was six months old, she didn’t have a single tooth.  Jake, however, already had four.  OUCH!  Don’t think for a second that Lane didn’t hurt me though… that little baby could gum you to death!

The solution that worked best for both babies was simply creating a negative consequence to the biting.  With both, if they bit, that was the end of nursing for a minute or two.  I said, “Ouch, that hurts!  No biting!” and immediately stopped nursing.  Also what helped was simple attentiveness.  I always got bit when I wasn’t paying attention… trying to do other stuff while we nursed, daydreaming, talking to someone else.  I reverted to making breastfeeding that intimate, bird-ribbon-tying affair for a while.  Once my baby didn’t feel like he or she didn’t have to vie for my attention, biting became much less of an issue.

So you want to breastfeed? Breastfeeding Narrative #1

This will be one in a series of breastfeeding posts. I’m getting a bunch of search results of people looking for breastfeeding information. Really, I’m no expert – I’m not a doctor, I’m not a doula, I’m not a lactation consultant. I am simply a breastfeeding mom who has nursed one child to three years old, and am currently nursing another who is nearly a year old.
If you’re looking for specific answers, I recommend giving a visit to http://www.kellymom.com, a breastfeeding site written by a lactation consultant. These will simply be me blabbering about my experiences and is not medical advice.
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So, you’re thinking about breastfeeding. If it’s still a big maybe right now, then chances are you’re pregnant or thinking about becoming pregnant. Good for you. Being a parent is probably the most rewarding thing I’ve ever done, but that isn’t to say it isn’t without its challenges. I can also say without a doubt, it is the hardest thing I’ve ever done. Nothing in my life has ever required more commitment, education, patience, and dedication.
Breastfeeding is definitely one of those parenting things that takes all that and rolls it into one. You need a lot of commitment, education, patience, and dedication to be successful at the breastfeeding relationship with your baby.
First, let’s talk about the commitment. There’s no hard and fast rule about how long you should breastfeed. There are lots of schools of thought here. Just about anyone will tell you that some breastfeeding is better than no breastfeeding, in terms of the benefits the baby receives. I’m not going to take it upon myself to spout on about those benefits; kellymom.com is a good place to start, but I’ll give a couple book recommendations too. (That comes in the education part of it.) The American Academy of Pediatrics recommends that it is ideal to nurse for at least a year, and then for as long as is desired by both parties. They set no upper limit on breastfeeding, much to the chagrin of all those internet tough guys who say that if the kid can ask for it, they’re too old to breastfeed. The World Health Organization says that it’s ideal for a child to breastfeed for a minimum of two years. Former Surgeon General Antonia Novello has said that “it’s the lucky baby, I feel, who continues to nurse until he’s two.” Quite an endorsement of extended breastfeeding.
Anyway, my point is, by choosing to breastfeed, you are making a commitment to your baby, and to yourself. You may choose to wean whenever you want, but I highly endorse trying to extend the relationship until at least two years old. There are a zillion reasons I can name from my personal experience, but the big one is that once you get into the second year of life, breastfeeding is a tool in your toolbox that I cannot imagine having to go without. Nothing calms an upset toddler like the breast. When a toddler’s not feeling well, he will often refuse to eat or drink, but he will very rarely refuse to nurse. (This phenomenon, according to her pediatrician, kept my daughter out of the hospital during a nasty tummy bug when she was 18 months old.) Toddlers can’t be reasoned with, and they don’t even always understand what you’re saying. They’re unsure of themselves but becoming more independent, they want to explore and be individuals, but they crave a safe, reliable home base. Nursing is a great (and granted, not the only way, but great nonetheless) way to provide that home base.
Oh I know, breastfeeding is so inconvenient. How will you ever get away? How will you ever get any sleep? How will you go back to work? The answer is, you’ll find ways. Breastfeeding parents have to be creative, and patient, and dedicated, and they have to be willing to put themselves out there a little more for their kids. I know, how inconvenient. But that’s parenting.

So, now let’s talk about the education piece of it. Breastfeeding ain’t easy, and it’s not instinctual. Well, it’s instinctual for the baby, but the way we give birth these days kind of interferes with baby’s instinct for breastfeeding. We use medication during the labor (there are studies that claim, while common pain relief methods like epidurals, narcotics, and tranquilizers will not harm the baby, they can make the baby more groggy when he’s born and interfere with initial breastfeeding). We have many more c-sections, which mean medication, and often a longer time before initial breastfeeding can take place. Too many times, we just simply can’t or aren’t allowed the opportunity to just put our baby skin-to-skin on our chest right after the baby is born, allow our own body heat to warm the baby, and allow the baby to find the breast on his own. That’s what’s instinctual and ideal.

Of course, instinctual and ideal can’t always happen. Even though I had vaginal, drug free births with both my kids, both my babies passed meconium (aka poop) in utero, and had to be treated by the neonatal team to ensure that none had been aspirated into their lungs. I didn’t even touch my daughter for nearly an hour after she was born; with my son it wasn’t nearly quite as long but it was still far from my ideal of having him placed on my chest immediately.

All of this is just a really long-winded way to say we probably all have this ideal in our heads that the baby will come out, latch on, and birds will tie ribbons in our hair and all will be well in the world. But even in an ideal birth with the ideal start, problems crop up along the way. Problems with the latch. Problems with reflux. Problems with milk imbalance. Problems with sore or cracked nipples. (And you can read about all those lovely things at kellymom.com!) This is where the education piece comes in. You need to know what you’re doing, before the baby shows up. You can’t count on instinct, and you can’t count on other people helping you (some hospitals have great lactation consultants and some… don’t), and if you wait until the baby’s born to catch up it may be too late. So I would recommend a few things. You could do some or all of these.

1. Read! There are three books I can personally recommend. I found them indispensible.

  • So That’s What They’re For! by Janet Tamaro. Certainly short of being a ‘definitive’ resource, this book is an enjoyable, easy read, and is a great starting point to lots of breastfeeding knowledge and breastfeeding with confidence. If you don’t do anything else to prepare for breastfeeding, READ THIS BOOK.
  • The Breastfeeding Book by Martha and Dr. William Sears. The Searses are by far my favorite baby/child book authors. They also have a great web site, http://www.askdrsears.com. They espouse the ‘attachment parenting’ approach, and it’s really what I do naturally with my kids. I’ve read a few of their books and have enjoyed them all.
  • The Ultimate Breastfeeding Book of Answers by Dr. Jack Newman and Teresa Pitman. This is another really excellent resource, to help you deal with nearly any breastfeeding issue that may crop up. It’s always in my nightstand for easy reference.

2. Attend a breastfeeding seminar at the hospital you’ll birth at.

3. Find a La Leche League meeting to attend before you give birth and after you give birth.

4. Hire a doula. There are two types of doulas, birth doulas and postpartum doulas. A birth doula is sort of like an extra support person for you during birth. They do not offer medical advice; they will help you work through labor and birth and just be on your team and try to help you get the best birthing experience you can have, which can do a lot for getting breastfeeding started the right way. A postpartum doula is someone who comes to your house after you’ve given birth. They do stuff to give you more mom/baby time. They can also offer breastfeeding and general baby care advice, but again they are not medical professionals. A postpartum doula might watch the baby for a while so you can take a nap, they might play with your older kids to get your more uninterrupted baby time, they might cook dinner, clean for you, etc. But I would say mainly they are about education – breastfeeding and baby care, and showing the dad and the baby’s other siblings why it is so important to get you as much baby time as possible in the first few weeks. A postpartum doula is really a jack of all trades, baby-wise.

Now, let’s talk about patience; I mentioned earlier you need patience to breastfeed. It’s so true. A big difference I’ve observed between breastfeeding and bottle feeding is that breastfeeding takes more of the mom’s time. With bottle feeding, anyone can prepare and give the bottles. Also, the babies I have observed bottle feeding, they seem to be done with a bottle feeding faster and last longer between feedings. Breastfeeding can be a big hunk of time out of your day, especially in the early weeks. Babies can take 20-30 minutes or more to finish a feeding, and then they might want to nurse again an hour later. That’s OK and normal and not unexpected. What’s ‘normal’ for length of feeding and time between feedings for breastfed babies varies enormously from one baby to the next. If your baby’s hungry, then he’s hungry, so nurse him. Again, there’s that inconvenience factor popping up.  Babies are demanding and you can’t reason with them.

Then, you need patience for other things, too. You need patience to get your husband on board, maybe. You need patience when dealing with (hopefully) well-intentioned but meddling relatives and friends. You also need to teach patience to others. A big challenge for me when Jake was born was helping Lane understand that when Jake was nursing I couldn’t just get up and attend to her; she had to learn to be patient and wait until he was done nursing. Parenting in general is a giant exercise in patience. Breastfeeding just adds another facet to that.

So lastly, let me talk for a moment about dedication.

Miyagi: Now, ready?
Daniel: Yeah, I guess so.
Miyagi: Daniel-san, must talk. Walk on road, hm? Walk left side, safe. Walk right side, safe. Walk middle, sooner or later [makes squish gesture] get squish just like grape. Here, karate, same thing. Either you karate do “yes” or karate do “no.” You karate do “guess so,”[makes squish gesture] just like grape.

Breastfeeding is the same way. Either you will breastfeed, or you won’t. If you “think you’ll try”, or you’ll “give it a shot”, or you’ll “see how it goes”, you’re not going to end up breastfeeding. You might, for a few days, or maybe a couple weeks even, but if you don’t have the resolve to stick through the first six weeks, which is by and far the toughest part, then you’ll find soon you’re reaching for that free sample of formula you got in the mail.

So if you really, truly want to breastfeed, you need to dedicate yourself to it. You’re not going to “try” to breastfeed, you are GOING TO BREASTFEED.

Luke: All right, I’ll give it a try.
Yoda: No. Try not. Do… or do not. There is no try.

I say, make a promise to yourself that you’re going to breastfeed for six weeks. Six weeks is not a long time – it’s 42 days. If you can make it through those first six weeks, you can breastfeed forever. Because right after week 4 or 5, you’ll realize, hey, this isn’t bad at all. We have the hang of this! And from that point on, it will be smooth sailing.