Bottle Bootcamp: Third Time's a Charm

Before I had Val people would always ask me "are you going to breastfeed?" and not like it is any of their business (receptionist at the nail salon) but yes, I had planned to breastfeed. It didn't work with Marlo, because she was so early, and ultimately I ended up just pumping for 14 weeks with her. Val ended up being full cooked, so this time I was determine to get that "perfect latch" and breastfeed my little lady. I was warned early on that if I wanted to exclusively breastfeed, I shouldn't introduce a bottle until 4-6 weeks so as not to cause "nipple confusion."

To my surprise she latched like a champ on her first try (and we have had zero problems every since.) So we followed orders (from doctors and lactation consultants) and didn't introduce the bottle until 5 weeks. And damn were we confused when Val just stuck out her tongue and refused to latch onto that silicone nipple. What is happening here? Why isn't she taking this into her mouth? Parental confusion is more like it.

We bought every kind of bottle out there, and tried again for days on end...and not once did she take the nipple into her mouth and actually drink. I was baffled. I had a few friends that said their kid never took a bottle, but there was no way my kid was going to be one of those! If she didn't take a bottle that would mean I would be her sole source of food for God knows how long and that scared the crap out of me.

At 11 weeks old we were told about "bottle bootcamp." The idea is that mom pumps first thing in the morning and the dad stays at home with bottle-refusing-babe all day long consistently trying to get the baby to take the bottle. Mom leaves the house so that baby does not "smell" milk in mom's boobs. Mom comes back just to pump, but while at the house she does not go in the same room as baby. Mom is not allowed to be within 20 feet of baby for 36 hours (or so I was told). Do not make eye contact with your baby, or else! Dad must persist through screams and sobs and force bottle into babies mouth. Baby might not take bottle for hours, but will ultimately because baby is so hungry they have no choice. As long as they have a wet diaper every 6-8 hours they are fine, says the doctors office, but if it comes to 8 hours with no wet diaper, you need to breastfeed the baby. After 36 hours of torture, be sure to give baby at least one bottle a day to remind them of the silicone goodness.

We did this twice. The first time she didn't eat from 5 AM until 2 PM. My poor husband toughed it out those 36 hours but was able to get her eating from the bottle for 2 days straight...until I started to breastfeed her right at that 36 hour mark. She was back on that sweet boob train and wouldn't look twice at a bottle. We tried every trick in the book, and every position in the book and she refused it. All that work for nothing!

Another month went by and we tried it again when she was 3 months old. This time she didn't go quite so long starving herself at the start, and we had her on the bottle for a full 48 hours. But then I introduced the boob again, and once again, she refused the bottle flat out. She was all boob, all the time.

Around 16 weeks I started to lose my mind a little. Val became a grazer - she was eating every hour practically, but only for about 3-5 minutes each time. This continued at night and the longest stretch of sleep I was getting was 2 hours. I was irritable, I was exhausted and I was attached to my baby for 24 hours a day for the most part. She was either sleeping in my arms (as she would only sleep for 30-45 minutes during the day, but I could get at least an hour if she was sleeping on me) or at the boob fountain. I needed a break, but there was nothing I could do because she couldn't take a bottle. I needed to be able to be away from her for more than an hour at a time, but I couldn't and it was driving me a little insane.

Don't get me wrong, I am head over heels about being a mom for a second time and Val is the bees knees. She is such a pleasant baby and an absolute joy, but every Mama needs a break now and then! Every Mama needs a little Dada time now and then too!

My husband was the one that brought up doing the bootcamp again, and I wasn't for it in the beginning, but I was convinced and gave him the green light: we started round three this past Saturday.

And apparently the stars were aligned because Val gave me the best birthday present I could ask for...she took the bottle like a champ! There was no crying, there was no screaming of any sort - she just opened up and threw it back. I have even been able to breastfeed her in the mornings and she happily goes back to the bottle!! And at night....4-5 hour stretches!!!! I am a new woman.

Now I should mention that I made the decision to start phasing out the boob all together. I breastfed her for four months, which is a huge accomplishment in my eyes, and longer than I was able to give Marlo breast milk. So we actually started introducing some formula in the bottles (with pumped milk for now) and I don't know if that did the trick or what, but I am not analyzing it as I don't want to jinx what we have going.

I feel like I have my life back. I didn't love breastfeeding, but I didn't hate it. I was never sore or had any supply issues, so I have nothing like that to complain about. But now I can enjoy multiple cocktails guilt free, I can go out to dinner with my girlfriends, I can go away for the weekend with my husband (take note husband!!) I know this decision is totally a selfish one, but I was not in a good place emotionally or physically last week and needed to make a change.

Thankfully Val was picking up what I was dropping and took the bottle without a fight.

 Val I promise to get you a pony when you grow up!! (it will be mine and little if you catch my drift :)

Bittersweet goodbye

This past Saturday morning, I did the usual pre-nap routine with little miss—I closed the shades to her room, zipped her up in the sleep sack, sang her a lullaby, and sat down with her in the rocking glider.  I cradled little miss in my lap, and offered to nurse.  She hesitated and shook her head no.  I knew that was it: she had decided nursing was no longer for her.  As I put her down in her crib for naptime, she cried a little, and I shed a few tears myself.

I have been lucky: for both my kids, I was able to breastfeed them through their first year of life.  Believe me, it wasn’t always easy. You name it, I weathered it: sore and cracked nipples, breast engorgement, mastitis, plugged ducts, leaky breasts.  I am an old pro when it comes to the associated gear. I have a wardrobe of nursing tanks that provide easy access to the boob while discretely covering that awkward, inevitable postpartum midsection jelly-belly; glamourmom is my personal favorite brand (both for the design and the cool name).   Over the years, I have stocked up other nursing paraphernalia: boppy, breast pads, lanolin (my BFF), softjels and soothies.

For when I was away from my kids and couldn't breasfeed, I bought the Cadillac of breastpumps: the Medela “freestyle”—named such because it is powered by a battery pack rather than an outlet plug.  Admittedly it does allow you to walk around, rather than sit captive in one place...though I don't think it feels so “free”—after all, you are pumping milk from your breasts. (Did I hear, “Moo”?)  With my pump and “hands-free bustier” to hold those pump horns in place, I have pumped everywhere: at home (walking around doing chores), work (sitting at my computer desk between meetings), and even in airport bathrooms (icky). Once a conference, I was so relieved to find a proper (ie, clean, private, and comfortable) mother’s pumping room,  I emailed the organization sponsoring the pump room, thanking them profusely.  

Physical discomforts and logistical challenges aside, breastfeeding has been a joy.  After the initial “how does this process work anyway?” (and to my surprise, I had to re-learn it each time—after all, each child is different), it’s been a mutual admiration club.  My two kids have loved nursing—almost too much—the dude initially refused taking a bottle, and little miss never did.  Eventually, after we got through the discomfort of the early days of nursing and the sleepless newborn nights, I loved it too.  I cherished the physical closeness, the chance to slow down during the day to cradle them, to caress their baby thighs, admire their baby toes, and hold their baby hands. 

And as they grew, I cherished holding them in my arms and marveling about how big they had gotten.  But soon, it felt like time for each to wean.  With the dude, around that one-year mark I started weaning little by little, dropping one feed at a time.  At first it was hard.  But soon he was dropping feeds on his own.  For a few weeks, he held on to that last feed...until one day before nursing, he sat up, gave me a kiss on the cheek, and that was it. A bit anti-climactic, but very sweet.  I still remember that moment vividly.

With little miss, I was very conscious that the end of nursing also meant the end of infant-hood in our household.  This summer, even as I suffered a few cuts on my nipples, I hung on.  With each feed, I experienced excruciating discomfort--I never thought a tiny, 1/2 centimeter cut could be so painful! I slathered on lanolin, used a breast shield between nursing sessions to help the healing process, and took ibuprofen around the clock to mitigate the pain.  Many times, I contemplated quitting cold turkey.  But I gritted my teeth and soldiered on, committed to the slow wean, as I had done with the dude.  In retrospect, I was a little crazy. But I couldn't quite let go—I knew that when it was over, it would really be over.

Little miss never looked back after that day.  She's never asked to nurse again.  So this week, I’ve given away all my nursing gear.  I’ve noticed I’ve also felt a little blue.  I know that will pass—I’m mourning a big change in my baby’s life, and in mine.  In life, every goodbye is also a hello—in this case, to a new exciting phase: toddlerhood.  Many joys await, but for now, I'm still reminiscing about nursing my baby. It is a bittersweet goodbye indeed.

Attached at the boob

Sweet baby Val with a belly full of
boob juice

It has been four weeks since Val, my second daughter, came into this world. Four weeks of very little sleep, learning to do everything with one hand while Val sleeps on my shoulder and four weeks of lots of caffeine. Val is much different than her sister M - she was fully cooked when born, not five weeks early like M, which of course meant she was larger and more developed. Val has better neck control at four weeks than M did at four months! Also, they facially don't look a damn thing alike...which I love as it makes them their own little individual selves.

But the biggest difference, for me at least, is that for the last four weeks I have been exclusively breast feeding Val. I had severe anxiety about attempting to breast feed her before she was born, but just minutes after she was born she was latched and ready to roll. And she has been eating like a champ ever since. She is packing on the pounds, I haven't had any pain and my milk supply could feed a small village.

So what is there to complain about you might ask...

Well it is a strange thing being the sole food source for another human being, and because I am only pumping once every other day (at most) it is all boobs all the time. If Val was my first born it would be different, but on top of her I have a toddler to take care of as well, making life even more exhausting. And in the last ten days she has been cluster feeding like it is her job. Schedule? What is a schedule? Sometimes she eats every three hours, sometimes it is every 45 minutes. Sometimes it is nonstop for an hour.

Don't get me wrong, I am enjoying the bonding time with her when I feed her. That is, when it is quiet, and I am not in a rush to go anywhere, and I am not stressed about what I have to do next. I love looking down at her little tiny self and rubbing her back and knowing how much she relies on me right now to survive.

But try breast feeding a newborn while trying to make dinner for a whiney toddler with one hand, and having your dog bark at you incessantly because you forgot to put her food out for dinner. Or breast feeding standing up, holding your baby in one arm, while trying to fix your daughters curly mess of a head of hair before school with one hand.

See, even after she is fed Val does not like to be put down. She likes to be held in your arms, preferably over your shoulder. She has a bit of reflux (apparently I breed children with reflux - I am waiting for a study to show that eating a excessive amount of American cheese sandwiches while pregnant causes reflux in babies) so we have to do the holding her upright for twenty minutes after feeding thing now, but even after that 20 she is irritable when I put her down. 90% of her life she has spent in my or someone else's arms, the Ergo or Moby Wrap.

Because of this, things have definitely fallen by the wayside. I shower every other day if I am lucky...and forget shaving my legs. M has been watching a lot more television than she used to, and I am fine with it. I hardly ever cook dinner anymore. I have a laundry basket full of clean clothes in my bedroom that has been there for two weeks and I now use it as a remote closet.

A few nights ago I was ready to throw in the towel. It is hard to go from sleeping 8-9 hours at night to sleeping 45 minutes here, an hour there, and most times with a baby on my shoulder. And then to look over and see my husband sleeping so soundly next to me, while my blurry eyes are trying to focus on the latest round of Scramble With Friends on my iPhone so that I stay awake instead of smothering my tiny baby with my giant breast...after having done the same routine just an hour before. I was driven to tears. I longed for the days when M was a baby and my husband and I took turns feeding her at night, instead of me taking sole responsibility for the 3-4 a night feedings. Mama does not function well on no sleep!

During the next feeding that early morning I got out my iPad and did some research on cluster feedings and it turned out that what Val was doing was fairly common in babies at her young age. Everything I read said that there will be some life come the three month mark...though I don't know if I can handle two more months of this insanity.

But then I came across the most touching article, that brought more tears to my eyes. It is a letter "written" from a newborn to her breast feeding mommy that was featured on theleakyboob.com website last year. It is heartfelt and touching, and kind of gave me a slap in the face. What I am doing is so important for her health and well-being right now, that I just need to put my needs to the side and tough it out for a few more months, maybe more.

My husband asked me the other day "so how long are you planning to keep solely breast feeding Val?" and I didn't really have an answer. I had never set a goal for myself (and Val) but I couldn't be happier that I made it to four weeks already. Hopefully the nights will get easier in the next few weeks as she gets bigger and bigger, and hopefully some day in the near future we will actually be able to go more than 45 minutes without being attached, as Mama's back needs a break peanut!!

I would love to hear from other nursing mothers out there about cluster feeding in the first few weeks, as well as if there is any hope for feedings to get shorter and more spread apart any time in the future!!


- Posted using BlogPress from my iPad

Do Not Fear La Leche League!

submitted by Mama M

Breastfeeding has been a challenging road for us, and still is to this day, 6 months later. At first it seemed like it would be easy, baby C latched on the first try in the hospital and I thought I had just the normal amount of discomfort. A few weeks later, when the discomfort just continued to get worse I went to see the first lactation consultant (at Isis), she told me that baby C had a high palate and I needed to basically shove as much of my boob in there as I could. This meeting was very stressful and I left feeling rushed and not very supported.

Another few weeks pass and the pain was only getting worse, I went to see the second lactation consultant (at Lactation Care in Newton). I liked this experience much better, and would highly recommend them (even though it didn’t quite solve my problems). This consultant said that we had thrush and recommended treatment, she helped by calling the pediatrician who called in prescriptions for baby C for Nystation oral and for me for APNO. Unfortunately I had a terrible reaction to the APNO (burning sensation), but I persisted with this treatment- twice!

Thrush is a yeast infection, and its symptoms can present in either or both mom and baby. Online I read it described as ‘deep breast pain’, personally I would describe it as feeling like someone wearing a metal glove was periodically throughout the day grabbing my boob and squeezing it- ouch!

Fast forward another month, still having pain, and I had moved halfway across the country due to my husband’s job.  I am currently living far from family and friends, in a small town in southern Illinois (after previously having lived in New York City and Boston), where the closest Starbucks is 80 miles away in another state and the nearest Whole Foods is 3 hours away. Yup, we got Walmart and that’s about it. Actually it is a cute college town, just not the big city I am used to. So, with not much around, I reach out to La Leche League leader and she suggested trying a holistic treatment of Gentian Violet and Vinegar rinses. Within days the pain that I had endured for 3 ½ months subsided. It was like a whole new world.

Now, even though the LLL leader had helped me by email/phone, I was still hesitant to attend a meeting. I expected it would be all hippie-women wearing scarves and talking about how beautiful and natural and easy breastfeeding is. Boy, was I wrong. The women at the meeting are incredibly supportive about breastfeeding and all kinds of parenting issues, many of the leaders had issues with breastfeeding themselves which is why they want to help other mothers. Shame on me for judging them before I even met them.

Being out here in the middle of America, it can be hard to meet other moms and make friends. Well, going to the LLL meetings is one way that I have been able to meet some fabulous women who are very open-minded and supportive, and had some fun playdates.

Pregnant and planning to breastfeed? Get yourself to a La Leche League meeting before the baby comes. Have a newborn baby and having issues? Stop by your local chapter meeting for support or call your local leader, they really do just want to help.

Weaning

This is probably the least interesting topic on this board, but I swear it has promise! Part of your life is about to be returned to you! I was a happy breast-feeder for 13+ months, but I was very happy to be done. I was working full-time and I was more than happy to say good-bye to my pump. Here are some quick steps to an easy weaning experience.

• Take it slow. It took me about 2 1/2 months to go from breastfeeding/pumping six or so times to a day to being completely done. I was petrified about getting mastitis, so I gave my body plenty of time to adjust. I dropped one nursing session a week. If my body still felt full during the time of my dropped session, I'd wait an extra day or two (e.g., the nursing session I dropped was at 3 pm and my next session was at 6 pm, if I couldn't make it to 6 pm comfortably, I'd wait a few more days before dropping the next session).
• Shorten sessions before dropping. This is harder to do if you're actually nursing vs. pumping, but it still can work (consider feeding your child before you nurse and make sure there is a cup of milk ready when you pull them off). If you normally nurse or pump for 10 minutes, start by shortening the time nursing/pumping to 8 minutes. Drop 2 minutes each day until the session is only a minute or two. Depending on how long you typically nurse, it might take a week for you to get down to a minute or two. You can go ahead and start dropping a new session at the end of the week or stay as is for another week, giving your body extra time to adjust. I found I didn't need to shorten the sessions when I was still nursing/pumping 4 times a day, but once I was down to just 3 sessions, it felt more comfortable to shorten before I fully dropped it.
• Provide your baby with other entertainment. It's easiest to drop the mid-day sessions first, because typically you can distract your baby during that time - a fun activity, a special food, or even just a bottle of regular milk or formula. Just keep things moving and don't give them any indication that nursing is nearby - that is, keep your shirts on ladies.
  
• Feel free to keep nursing just one or two sessions for a while. If it's easy to nurse your child to sleep or you like the comfort of early morning nursing...do it. You can easily do those two sessions for months and wait until your child loses interest. When you're ready to drop these particularly snuggly sessions, be sure to be extra patient and provide lots of extra soothing. Even if your child is taking a sippy cup during the day, you may want to provide a bedtime bottle for a few extra weeks just to make the weaning process easier. I was able to transition without the use of a bottle...two days in a row we had late dinners out (shocking, I know) and my son fell asleep for the night on the way home. After that, we just gave him a sippy of milk at dinner and called it a day.
  
• Cabbage leaves and ice work. So do tight bras. Cabbage leaves in the freezer are even better. When you get to the point that you're ready to drop the final session, go as long as you can. When you feel really uncomfortable try to hand express some milk in the shower or pump for just a minute or two to relieve pressure. You may need to do this occasionally over the next few days to fully finish the process.
• Enjoy your energy. I felt a HUGE surge of energy in the days after I fully weaned. And I never gained any weight. I think if you take the process slow, your body adjust. I'm convinced that when I nurse, I store fat for the winter...at least that is what I tell myself.
  

Here is a sample schedule:

Week 1: Nurse/pump 6x a day
Week 2: Drop one day session cold turkey to get down to 5x a day.
Week 3: Drop one day session cold turkey to get down to 4x a day.
Week 4: Drop one day session cold turkey to get down to 3x a day.
Week 5: Shorten mid-day session by two minutes each day. At the end of the week you should be only nursing/pumping 2x a day.
Week 6: Continue nursing/pumping 2x a day. Begin using cabbage leaves and ice.
Week 7: Shorten one session by two minutes each day. At the end of the week you should be only nursing/pumping 1x a day. Continue with cabbage leaves.
Week 8: Continue nursing/pumping 1x a day.
Week 9: Shorten last session by a few minutes each day.
Week 10 and on: Pump ONLY when you feel uncomfortable.
When you're done: Celebrate. With a BIG drink. Burn nursing bras, pumps, etc. Cry at state of your boobs, but celebrate the fact that at least they are yours again.

More information here: http://www.kellymom.com/bf/weaning/

Breastfeeding Diaries: To Pump, or Formula feed - that is the question! (UPDATED)

8 weeks ago I shared with you all my breastfeeding story, and told you I would check back in with you in two months for an update...The long and the short of it? It never worked.

For 5 weeks we followed the directions of the lactation consultants, but Marlo and I just never clicked, which in turn got me frustrated and led me to the decision to give up trying and strictly pump milk and bottle feed. I will be the first to admit that I didn't give it 100 percent effort. Since I had to use a nipple shield to get her to latch at all it took me too long to get the shield in place, and try over and over to get a good latch. She would get frustrated that she wasn't fed quickly enough and paw at the shield until it came off. Even if I had her little arms pinned down she would put the shield in her mouth and pull it off. So I began trying less and less frequently until I threw in the towel.

I continue to pump 6-7 times a day, so she is still getting breast milk, but mama is starting to feel like a cow. I call it "going to work" when I pump, because right now my job is to feed this little baby. With all this pumping has come 3 yeast infections (thrush) which thankfully I haven't passed to her as she isn't officially breastfeeding. The APNO I originally claimed to be a lifesaver stopped working for me, and I was put on Nystasin, which is also a topical ointment, but one typically given to the infant with thrush. It seems to clear up in the redness and burning, but I am sure it is just a matter of time before it comes back. And on top of that I now am getting these tiny blisters on my left nipple - righty has been in the clear thus far. Apparently it is skin that is growing over the milk ducts and clogging them. I discovered them after lefty produced about half of what righty did one night. I now have the lovely task of popping them by forcefully squeezing my boob between my hands...I do get some sick satisfaction out of it - like popping a zit.

I am also getting severe pain in my boobs when my milk comes back in after pumping. I was told by my doctor and lactation consultant that this is because I produce such a large quantity of milk (I actually pumped 6 ounces out of each boob the other night). Good times.

Lately though, everyone keeps asking me how long I plan to pump and bottle feed Marlo, which has gotten me thinking about what my options are. Really there is only one - start her on formula. For some reason, with that choice comes a whole slew of guilt. Why should I sacrifice my babies well being for my selfish reasons? I have had to cut broccoli and citrus out of my diet because it was making her uncomfortable when I gave her my milk after eating it myself...is that such a big loss? What are a few hours a day of being uncomfortable if I am doing what is best for my baby?

But then I get selfish and think about the freedom that comes with giving her formula. No more changing tops and bras due to leaky boobs, no more nipple pain, no more of being a slave to the pump and having to wake up in the middle of the night to get relief. I wouldn't have to worry about drinking too much wine or what I was eating...sounds glorious!

But then I think about the cost of formula, and how we have saved so much money the past 8 weeks by feeding her breast milk. Her spit up doesn't smell, and neither do her diapers - and that would all go to shit (ha). And the 5 additional Weight Watchers points for breastfeeding are an added bonus...BLERG!!

How does one make this decision? How did you make the decision as to when to switch your baby to formula? Was anyone else pumping and bottle feeding? I would love to hear your stories/comments below...I need help Mamas!!!

I was given this link to a great article about weaning from pumping, and wanted to share: http://www.exclusivelypumping.com/2010/01/02/weaning-from-the-pump/

Breastfeeding Diaries: Pre-term babies = an uphill battle

While I was pregnant people would always ask me if I planned to breastfeed my baby. I have friends that were big advocates, and others that formula fed their babies, so I was getting opinions from all sides. I figured I would give it the old college try - I knew it was supposed to be the best thing for both the baby and myself, and heard that it came naturally, so why the hell wouldn't I give it a try! I read as many books as possible about breastfeeding, talked to friends about it, took a class on it, watched videos, researched online - for some reason I was more nervous about breastfeeding than I was about giving birth, so I wanted to be as prepared as possible.

Cut to the hospital after giving birth to my baby 4 weeks and 2 days before her due date. When the nurse asked "do you plan to breast of bottle feed," I of course said "breast." After a quick trip to the NICU, our baby girl was whisked down to our recovery room to being her rooming in, and when she arrived she was a hungry hippo. The new nurse that was tending to us brought her to me and said "here you go, she is ready to feed." And then stage fright set in.

As I held my tiny 5.5 pound baby in my arms I started to freak out...OK, what hold do I do? The football? The cross-cradle? Remember what the photos in the book looked like. Deep breaths...they said to relax...deep breaths. Do I put a pillow behind my back? Right boob or left boob? Shit, how do I get her to open her mouth? Is her body aligned correctly? Oh my god my boobs are huge! And her mouth is so teeny - this will never work! She is starting to cry, crap - I am going to cry...

So I looked up at the nurse and said "I have no idea what I am doing!" To which she responded (now she was not the nicest person, and thank god we only had her for an hour before the shift change) , "You just have to get her to open your mouth and shove your boob in there." THANKS!! I knew that much you dumb bi-atch.

After what seemed like an hour of failed attempts to get my little girl to latch on to my Dolly Parton-esque boobs, the nurse said we needed to feed her right away and was it ok to just give her formula...Shit...Yes? I don't want her to starve?!?

Thus began my uphill battle with breastfeeding my little girl.

The nurses explained to me that with pre-term babies (35-37 weeks) they have yet to develop the correct sucking technique needed to breastfeed, hence the use of the very fast flow nipples on the bottles they were giving her. They also do not have the ability to open their mouths as wide as need be in order to get and maintain the correct latch needed to successfully breastfeed. So basically I was not going to be able to breastfeed as planned for a while...

While at the hospital I met with two lactation consultants who put me on a plan:

- bring the baby to breast every time she is hungry

- attempt to get her to latch on

- if no successful latch after 10 minutes, bottle feed (with formula while I was not yet producing milk)

- then pump for 10-15 minutes

This plan lasted about 10 days - and in those 10 days I developed the most painful red ring around my nipples. I am talking on a scale of 1 to 10, my pain was a 9 every time I pumped, so I had to take 3 advil about 30 minutes before pumping, and still I was in tears and doing my Ugai breathing...I was about to throw in the towel, but my husband kept telling me that we should contact a lactation consultant to get some help. I couldn't handle the pain anymore, so I put a call into a woman that came highly recommended by a friend - Dot Norcross (of Newton, MA).

Now when I think of Lactation Consultants, I tend to picture them like I picture Doulas and Midwives - kind of crunchy hippies, older, gray hair, soft spoken, shop at Chicos and wear patchouli - and they might be practicing witches. Don't ask me why, but this is what I thought (no offense to anyone - totally my own opinion of course!).

Dot runs her small business out of her lovely Newton victorian house, and employs a group of the kindest elderly women on her staff. I felt like I was going to see my beloved grandma and her friends...we were greeted at our car and whisked into the "pink room" where we sat in chairs that were straight out of Grandma's Home & Garden. After a quick discussion about the birth, pregnancy and time at home so far, it was time for the "whip out your boobs" portion of the program.

As I was undressing in "grandma's" living room, I explained to Dot about the severe pain I was feeling around my nipples. As soon as the girls were out for her to see she looked at me and said something of the likes of "wow - you must be in terrible pain!" Turns out that I had a build up of yeast around my nipples that was causing the pain and swelling. It was due to a combination of not having the correct size flange for my pump, and the fact that I was taking medication for the cold I was battling. Who knew that there were different size flanges for breast pumps?? I did not of course! So she fit me for larger parts and called in a prescription for APNO (all purpose nipple ointment) to my OB...already I was feeling a little relived about the whole sitch.

Once we got into the latching and feeding portion of the consultation, Dot told me bluntly "with the size of your nipples, and the tiny mouth on your daughter, you are in for an uphill battle." Not exactly what I wanted to hear, but kind of what I expected to hear. She then introduced me to the trusty nipple shield - a tiny thin piece of silicone that fits over your nipple and resembles a nipple on a bottle. Well with the nipple shield in place, and a wave of her wand, Dot was able to get my little-mouthed girl to latch on and go to town. My eyes immediately welled up because I was so excited that it was actually happening (and I was in the second worst pain of my life - first being giving birth with an epidural that didn't work, of course). There was a light at the end of the tunnel!!

I don't want to give away all of Dot's secrets but we learned so much from her; what type of bottles we should be using, the correct way to hold them, the right way to burp our little baby, etc. All things we were doing wrong! And how were we supposed to know?! We came out of the 2 hour long consultation with a plan, and feeling so much better about the whole situation. With the combination of the nipple shield, the correct breast pump parts and the APNO, I was so much more positive about our breastfeeding plan.

Dot estimates it will take us about 2 months to get to where I can breastfeed my baby girl without the shield and stop pumping as much, so I have that date marked on my calendar. So come February 9, 2010 we will if Dot was able to work her magic for real, but for now I need to stay positive and think happy boob thoughts!! Stay tuned...

Pumping in the Parking Lot

By Mama S

This past Saturday night, I found myself sitting alone in the front passenger seat of my car in a dark, creepy hotel parking lot, dressed in a formal gown, methodically pumping away with my hand pump as I tried to relieve some of the discomfort in my engorged “bubbies.” Meanwhile, my husband and friends were inside the hotel dancing away at a friend’s wedding. Needless to say, it wasn’t my first choice activity for the night ( or my second choice, or third. . . ) and as I tried to wipe the spilled droplets of breast milk off my new BCBG dress, I cursed all the people who never told me about how annoying/horrible/uncomfortable pumping is.

So I am here to tell all of you – officially - it SUCKS. We all read so much about the benefits of breastfeeding. By way of incentive, we are often told about the many conveniences of breastfeeding: “the milk is always ready and always at the right temperature!” “you don’t have to carry bottles and formula everywhere you go!” and my least favorite: “it comes in such cute packages!”

Anyway, what no one ever mentions is that you are going to have to strap on plastic cups and have your nipples sucked off by a scary machine if you want to be able to leave your breastfed baby for any extended period of time.

Here is what I wish someone had told me about pumping before I had my baby:

If you want to breastfeed and are planning to go back to work, you will need a double pump. Either a hospital grade rental or the Medela double pump are your best bets. If, instead, you will be primarily a stay-at-home and will not need to pump with any regularity, you can get away with a single pump. Medela also sells a good battery powered single pump that is easy to travel with. The Medela pumps are expensive, but they are worth it.

If, like me, you already own a Medela double pump and a Medela single pump and you happen to forget BOTH while spending a night away from your baby, you can also get a $20 hand pump at Target made by Evenflo that will do the trick in a pinch (see sad, pathetic pumping story above).

Once you have chosen your pump, you will also have to choose supplies for storing your milk. Again, there are many options. Medela makes good pump and save bags that can be attached right to the pump and Playtex sells a kit that allows you to pump right into the Playtex drop-in bags and then just drop those bags into the bottles – very convenient.

Finally, a few miscellaneous items: When you begin pumping you should know that EVERYONE PUMPS DIFFERENT AMOUNTS so don’t be discouraged if you get less than some of your other mommy friends. And if you start pumping early before your milk has regulated you will probably get TONS of milk to start with but less as time goes on – this is normal. If you are interested in how much your baby is getting when he/she feeds, as a rule of thumb I have heard that we pump about one once less than what our baby would get from breastfeeding. Lastly, you should know that the pump can be used to encourage more milk supply by pumping about one hour after each breastfeed - but let’s be honest, who really wants to do that?

Happy Pumping Ladies!

Breastfeeding Diaries: "Born to Breastfeed"

It wasn't hard for me. I called the nurse in every time I tried to do it the first two days - I didn't want to get into any bad habits. Then the day I left the hospital, I tried to do it myself (and did), so I figured I could leave! I didn't give myself any option - I didn't have formula in the house. I figured, women have been doing this for a long time, so I was bound and determined to try. I never felt any pressure, but I know friends that been pressured both ways - either really pro-bfing or those hospitals that pushed a bottle or formula at night.

My doctors and pediatricians said nothing about it either way. The problem is your milk doesn't typically come in until you leave the hospital, and if you have issues, it hits you at the same point that you're exhausted and at wits end - it's easy to quit.

It can be really easy though. You never have to carry bottles, you don't have wash bottles, and you don't have to prep bottles in the middle of the night. Heck, it's also free and makes you skinny – what else can you say that about it! And you don't have to worry about finding the one formula out of hundreds that your child can tolerate.

Pumping is a pain, but you only have to do it if you're at work. It makes you feel like a cow.

It didn't affect me emotionally. Physically it was hard. Engorgement was more painful than birth! But it was very rewarding and the fact that I did it for over a year is one of my greatest accomplishments. Also, being done was the best ever! Hooray energy. Of course, don't ask me about my boobies. They are sad little deflated balloons. And there is nothing less sexy than leaking milk all over the place, but after delivery your husband has probably seen more of you than he ever wanted to see anyway so it's kind of wash in the "will I ever be sexy again" department.

I liked the fact that most of the feeding responsibility (except the occasional bottle) was mine. It allowed me guilt my husband in doing all the crappy stuff I didn't want to do (like laundry). I still hold it over dad for just about everything. I say at least once a day, "I pushed this baby out of my (now ruined) ladyland and then he sucked the life out of my boobies...you can at least {enter chore}."

I'm a firm believer that it is one of the best things that you can do for your baby, however a happy mom is the MOST important thing for the baby and if staying sane means no bfing, then so be it!

And when I weaned, I definitely wore the cabbage in my bras. It was the best ever. I'm sure I smelled like sauerkraut.

Breastfeeding Diaries: "Advice from a Pro!"

Before the baby is born:

*Take a breastfeeding class or read a book – just so you know the basics of how your body works – it really is amazing how the body makes exactly what the baby needs at the time. I think one really important point is that at the beginning the baby will constantly nurse but this is to stimulate your supply. If you start to supplement with formula early, then your body won’t produce enough and it will be harder down the road. Also a book will show you some basic positions to try out. (As an additional note, it is probably helpful for your partner to take the class or read the book with you just so he knows the basics too – that way he’ll be able to support you in the best way he can.)

*Buy 1-2 nursing bras or tanks – buy probably 1 cup size up from where you are near the end of your pregnancy. Don’t get too many as you won’t know how big the ladies will get once your milk comes in. Tanks are nice because they allow you to expose your boob while still hiding your belly rolls J

*Buy some breastfeeding cream – Lansinoh makes one as I’m sure other companies do. You want to have this stuff from the start before the damage can be done.

*Check with your health insurance. Some companies will pay for a breast pump or reimburse you for visits from a lactation consultant once the baby is born (see more info below).

*Pack your Boppy or My Breast Friend pillow for the hospital, if you plan to use one.

*Pack a nursing cover if you are going to care if your visitors (like your dad) see your boobs (surprisingly, I ended up not caring – I think I had bigger worries at that point!)

*Talk to your partner about your desire to breastfeed and the kind of support you’ll need from him. My husband, while trying to be helpful, kept suggesting that we get some formula. He had good intentions, as he saw how frustrated and upset and tired I was getting from breastfeeding. However, I didn’t want formula in the house because I didn’t want to be tempted to use it. If I had made this clear to him before I was in the middle of it, he wouldn’t have suggested it multiple times.

*Breast pump. If you plan to nurse for the long haul and plan to be away from your baby at all (work, pleasure, etc) you’ll need a quality pump. If you are unsure if you plan to continue breastfeeding you may want to rent one to see how it pans out before buying one. We bought one at the hospital and it was nice because the lactation person showed us exactly how to use it. They’re scary looking but once you get the hang of it, not bad at all!

*Get in the mind set that it might be hard! For some people it isn’t but I think for many people it is really tough, particularly at the beginning when you are recovering from delivery. I think knowing that it is hard, but it does get much better fairly quickly, helps when you feel like quitting!

At the hospital:

*When you are getting checked into labor and delivery, they will likely ask you if you plan to breastfeed. We made sure that they wouldn’t give the baby a pacifier in the nursery because we had read that it can interfere with latching.

*Most things I read said that it is important for the baby to begin nursing as soon after birth as possible (even if they really aren’t eating anything). I think I nursed probably within an hour of him being born. If this is something you want to do, mention it to the nurses so they can make sure it happens.

*Ask for help and take advantage of any services offered. Many hospitals have daily breastfeeding classes for new moms on the postpartum floors. I had the lactation consultant come in and help too. The nurses can also be quite helpful.

*However…Try not to get frustrated from all the advice. While it was nice to have so many people want to help, I was given so many different (and sometimes contradictory) pieces of advice that I was left really confused.

*Try many different nursing positions to see which one works for you and your baby. You should have seen the pillow towers I built in the hospital to position him correctly. It would take me so long to pile up the pillows and then place him just so – know that this too will not go on forever – after a few weeks I didn’t need pillows any more….

At home:

*Know that your boobs will get huge, rock hard, and hot when your milk comes in!

*Accept that your one and only job in life will now be to feed this baby – at least for the first few weeks. You really will feel like you are nursing constantly (because you are!) The baby will likely need to eat every 2-3 hours (from the start of a session) – and it might take 45 minutes per session. So you really aren’t getting much of a break. Just remember, it won’t go on like that forever…

*Therefore, accept any and all help (and demand it from your husband). Your job is to feed the baby and recover from childbirth and sleep when you can. Therefore it is not your job to clean, cook, do laundry, entertain visitors (unless you want to), etc.

*Get a husband pillow. This thing was awesome and enabled me to really easily nurse while still in bed.

*On a related note, try to learn how to nurse while lying down on your side. It really is wonderful to not have to sit up in the middle of the night to nurse. (though I didn’t learn/attempt this position until he was probably 5 months old – not sure why).

*Drink lots of water!

*Set up a comfy nursing station both upstairs and downstairs (or in the places you’ll be during the day and night). Stock this place with the tv remote, books, magazines, snacks, nipple cream, chapstick, water…

*Have a lactation consultant come for a visit. The hospital or your pediatrician should be able to give you a recommendation. I had one come when my baby was one week old. Nursing was going ok at that point. I was having some pain, my nipples were a little blistered, and I just didn’t think he was latching on correctly. I was also worried about whether or not he was getting enough to eat. I had a lactation consultant come and it was wonderful for my piece of mind. I showed her what I was doing and she basically affirmed that I was doing great – and gave me a few pointers for improvement. Most lactation consultants also have a scale they can bring so you can get the baby weighed to make sure he/she is gaining weight. An added bonus – my health insurance reimbursed me for the visit (and would have reimbursed me for several more visits from her if I needed them).

*Decide when/if you’d like to introduce a bottle. Based on my reading, we gave him his first bottle at 3 weeks. We decided on this time frame because my research indicated that before this might cause some nipple confusion, but if you wait too long, the baby may reject the bottle in favor of the boob. Every baby is different but for us this worked – he takes the bottle or boob, whichever is offered.

*That’s not to say we didn’t have hiccups with the bottle/boob. At times, it would seem like he didn’t want a bottle. Then he’d go on a boob strike. I think it’s somewhat normal and in most cases, passes!

*Once you’ve got the feeding and pumping thing down, try to build a little freezer stash of milk. It’s nice to have some

Breastfeeding Diaries: "Strap 'em Down!"

I did not breastfeed, so I had to wrap up the girls pretty tightly shortly after the birth. They suggest bringing a very tight sports bra to the hospital which you can put on afterwards, then the next 1-2 weeks basically living in it and also icing your boobs down to keep the milk from coming in. This is soooooo important. I didn't do it right away, to be honest I just "forgot" to ice them once I got home, and waited until my boobs really started to hurt before I started icing them. I think they must have weighed about 15 pounds each, seriously! So uncomfortable and painful. I looked like someone who had just gotten a boob job - they were huge, firm and up to my neck - and so painful! So make sure to pack your boobs with ice packs nonstop that first week (unless you are breastfeeding). I did not expect my boobs to be so sore. It got to the point where I sent the hubs out to the store late at night to buy me cabbage, because I read online in several places that putting cabbage leaves on your boobs is supposed to help (cabbage leaves have some vitamins or herbal something in them that is supposed to help) - it actually worked. I felt silly putting cabbage leaves down in my bra, and combined with the bag of frozen peas and carrots I was using to "ice" them - I had a freaking salad in my bra! Ha Ha!

Breastfeeding Diaries: "The Old College Try"

Bfeeding stunk for me...I hated being a mooo-tilda. I don't know if it was the extreme size of my boobs, but it was a battle between baby and I every feeding. She could never get the right latch....and that's all they stress - the right latch, the right latch - and you stress and stress until you've cried more about what a failure you are as a mom, because it's so natural and good for the baby.... If they want you to do it so bad, and it's so great and natural, then why are there millions of lactation consultants out there? At the hospital they're HORRIBLE - they sit above your boobs usually massaging them in front of your husband and then all of a sudden they'll go "there you got it, that's a latch - great....oh you lost it....try it again" and you have NO IDEA what happened that was right, and what changed, cause it all feels awful.

If you do try it - use that lactation crème lasinoe on your nipples...they will bleed and crack. You'll need some sort of pads too - after soaking through a shirt at the mall, I realized it's not for me. Pumping is great - it was easy for me and I had a super duper pump that cost like $600....it was more than hospital grade....the lactation consultant I went to asked me all sorts of questions about it because she had heard, but knew nothing about them. I think I'm the exception, I feel like most people don't like pumping. You just feel tied down like some sort of farm animal. I went everywhere once I stopped b-feeding baby, and I feel like other people around me had a lot less freedom.

Baby is growing just fine - she doesn't have a big belly, but she's a solid kid...and she's had her fair share of being sick, but that can be attributed to daycare.

Major support for bfeeding - because I think it's a good idea to try and see if you like it - I know I'll try it again in the hospital with baby #2, will come from that Isis Maternity class - the girls in my class (9 out of 10 breastfed) all did stuff out all the time....they went to movies, they went out to eat, they went shopping, they would go everywhere and breast feed everywhere. The class was the single greatest thing I did for me and baby, but for someone who needed support for bfeeding....you just learn so much about how acceptable it is, and you get to hear of the places in the greater boston area where people have gone and successfully had a feeding session (i.e. - one girl was furniture shopping and did it in a chair at the store, but it was perfectly acceptable by the people working there). Isis has a great place to bfeed if you're in the copley area, and you can get your parking validated!