Tuesday, 30 April 2013

Triumphant Tuesday: Breastfeeding a Baby with a Gut Disorder

Severe projectile vomiting in young babies can be the sign of a gut disorder called Pyloric Stenosis. This is where the tube connecting the baby’s stomach to their gut grows rapidly thicker until it becomes so thick that the stomach can no longer empty properly. The condition is often accompanied by constant hunger, belching, and colic. If left untreated it can lead to severe dehydration.

It is not known exactly what causes Pyloric Stenosis, and distinguishing it from reflux or gastroenteritis is hard for the novice parent. So when Rebecca, a first time mother, discovered her breastfed baby was suddenly vomiting, she was confused. When does spitting up move from a laundry problem to a medical one? When does spitting up mean something serious?


“I guess I always knew that I would breastfeed to the point where I didn't go to any antenatal classes, I just thought 'well how hard can it be'? After a long and difficult labour that ended up in a theatre-forceps delivery I embarked upon one of the most challenging but rewarding periods of my life.

Shy on support

In the recovery room there I was: I couldn't feel my legs, my baby daughter Lizzie was neatly wrapped up in my arms and I was flooded with the feeling of relief that I finally had her safe. I tried latch her on but she wasn't interested and soon fell asleep. Nobody seemed to have the time to sit with me. Nobody went through expressing or suggested spoon or finger feeding to try and get her interested. 

It was many hours later when Lizzie suckled for the first time, I had to try all sorts of tactics to get her feeding such as bathing to wake her up, feeding lying down, football hold, cross cradle hold... finally she and did it.

Once my milk came in it was hard for me to tell at first if Lizzie was getting enough milk. I was so engorged that I didn't think my breasts were being drained at all. They were constantly full to the point where my nipples were flat and Lizzie couldn't latch. Thankfully on the first weigh-in she had gained weight - not lost - gained. I was relieved. Everything seemed to be going well.

The vomiting begins

Lizzie piled on the weight until week 3 when she suddenly started vomiting. At first it was tame and could have been passed off as wind but then it quickly got progressively worse until she was regurgitating  whole feeds. I don't mean a 'happy spitter', I mean projectile vomit and loads of it. We had a major laundry issue to say the least. I kept asking family members if it was normal for a baby to be sick this much and the replies that came back were, "yes babes are sick don't worry". But I did worry. I thought breastfed babies were not this sick surely? 


One evening I phoned my mother and begged her to tell me not to worry and sought her reassurance that this was all normal. She said she couldn't give me this reassurance and suggested I take Lizzie to get weighed. So I took Lizzie to the clinic where they weighed her - she had lost weight! Half a pound! The health visitor arranged an immediate appointment at the local hospital.

At the hospital, the first doctor we saw tried to fob us off, saying that Lizzie was not being winded correctly. I knew this was not the case. Fortunately the infant feeding specialist saw us next. She agreed that it did not seem like a feeding/winding issue and put the doctor's theory to bed. 


Lizzie was then put on a drip and was not allowed anymore food. I co-slept with her in hospital that night and kept her close to me as much as I could. The next day Lizzie was sent for an ultrasound scan. As part of the scan, the doctors wanted to give Lizzie a bottle of dioralite. I refused the bottle so we cup fed instead. She vomited it all back up as predicted. The doctors then told me they had found the reason for her vomiting: she had Pyloric Stenosis.

Pyloric stenosis is when the passage between the stomach and small bowel (pylorus) becomes narrower. The passage is made up of muscle, which seems to become thicker than usual, closing up the inside of the passage. This stops milk or food passing into the bowel to be digested. The milk sloshes in the stomach often curdling before the baby is sick.



The thickened pyloric muscle can be felt, especially during feeding, as a small, hard lump on the right side of the baby’s stomach. The muscles around the stomach can sometimes be seen straining, moving from left to right as they try to push milk through the pylorus.

Lizzie was retained in hospital for a week whilst she had to undergo an operation under general anaesthetic to correct her stomach. There were no alternatives to the operation. Left untreated, Lizzie would soon become seriously dehydrated. 

The day of the op came and we pushed her down with a nurse to the theatre. Lizzie was asleep so we gave her a kiss and then we went for a walk. Although it was vile to see my babe being taken away like that, we were both relieved that it would finally be over.


I expressed my milk around the clock to keep up my supply. I had never done this before. It was daunting. No one offered support. 

Luckily I managed to keep my milk supply up (with a ruddy huge stash of expressed milk to show for my efforts!) 
Lizzie was able to get straight back to breastfeeding while she recovered from her operation. Within a few weeks she got back up to the weight centile that she was on previously. Phew.


Lizzie was now 3 months old, yet still feeding relentlessly every 2 hours around the clock! She would not let me put her down and was very unsettled. At the time I assumed she must simply be a high-need baby and spent the days rocking and singing to her to settle her in between feeds and naps. 

Tongue Tie


Then I started to get a blanched nipple on the one side, which was not something I had experienced before. I went to the local breastfeeding support group where the support worker looked at Lizzie's tongue and immediately confirmed she had a tongue tie. They asked if I would like it dividing. This was the first I had heard of such thing so I declined. (Big mistake). I thought I would just carry on, after all it seemed that it wasn't really her problem it was mine, and this was only a blanched nipple (little did I know!) 

Blood in her poop

I continued to feed and rock and sing until about month 5 when Lizzie started having blood in her poop. For some time she had been having a lot of poops (10 each day!) I assumed this was normal but on investigation and another trip to the hospital they confirmed it was a dairy intolerance. In order to continue breastfeeding for the next few months I had to cut out all dairy from my diet. It was horrible. I loved Tea, cake, cheese, butter, yogurts... this was going to be hard.

When Lizzie reached 6 months old we started solids and Baby Led Weaning. I was told that babies run out of iron at this stage so they need to eat a wide variety of food - and fast. But Lizzie did not like food, she gagged and wasn’t interested. I didn't force the issue and went at her pace but in the back of my mind I was always worried. She was still breastfeeding every 2 hours, all day, every day!

During this time I had family and friends suggest that milk wasn't rich enough and also to keep putting Lizzie down because she was never going to get used to being on her own if I didn't. I never acted upon this information but it does knock your confidence as a mother. I remember saying to them, please just tell me to keep going!

Even though Lizzie was only 6 months old, my husband and I decided we were ready to start trying for baby #2. However as I was still breastfeeding, would I be able to conceive easily or would it be a struggle?” 
Find out in Part Two next week!

Tuesday, 23 April 2013

Triumphant Tuesday: Breastfeeding a Baby with Multiple Allergies

Human milk is the most natural and physiologic substance that a baby can ingest. If a baby shows allergic sensitivities related to breastfeeding, it is usually a foreign protein that has piggybacked into mother's milk, and not the milk itself.

Yet many mothers (and more worryingly, health professionals) believe that if a baby has an allergy the only remedy is to switch to hypoallergenic formula. This is grossly untrue. In such circumstances, mothers do not need to reach for the bottle - they just need to take a break from eating or drinking things containing the offending protein for a while. Allergy is certainly no reason to wean - it simply requires an investment of effort from the mother. And every baby is worth that, right?

This mother thinks so. When her baby became seriously ill it was discovered that he had multiple allergies, requiring a complete overhaul of his mom's diet! Could she deal with this whilst also battling recurring mastitis, aggressive oversupply, and a return to employment?

“I will say that my biggest regret from my whole birth experience was allowing visitors so soon. I had originally planned on waiting at least until we got to the recovery room to see visitors, but my fiance's parents came strolling in about an hour after I gave birth when I wasn't even dressed yet. They were so excited to see the baby that they didn't even notice me, but my fiance eventually saw how uncomfortable I was and shooed them away. They visited a few more times during our short stay at the hospital and my parents came to see us as well. This was really hard on me, as I was trying desperately to get my baby to nurse and people kept coming to visit, wanting to hold the baby.

My son's name is Theodore aka Teddy. We call him by the nickname 'Bear'. My little Bear and I had trouble breastfeeding from the start. He wouldn't latch in the hospital despite my receiving help from three different nurses and two lactation consultants.

Nipple Shield


After 24 hours he still hadn't fed and when they came in to weigh him I broke down and cried. My inlaws of course, were around to witness my distress, which made me feel even more uncomfortable. The lactation consultant asked if I wanted to try a nipple shield, but warned me that they often lead to low supply and could be difficult to wean babies off of. I was desperate at that point so I agreed to try one.

Although he did much better with the shield, I had a love/hate relationship with it. I loved it because it allowed me to breastfeed my son, but I hated what a pain in the ass that thing was. It constantly leaked milk out of it (mostly thanks to my oversupply) and I felt like all I did all day was wash them. Eventually I bought about ten and just kept them in a bowl next to me so that I could easily grab them during the night.

The lactation consultant was still worried that he wasn't getting enough, so during each feeding we used a syringe/tube system to give him a little extra expressed breast milk while he was latched on. They were also worried about the shield leading to supply issues, so they had me pumping after every feeding round the clock.


Bear nursed every 2 hours for about 45 minutes at a time, so pumping alongside was exhausting. I hated pumping (and still do). I dreaded every night because I knew I wasn't going to be able to get more than 30 minutes of sleep at a time and even that was pushing it. I also felt very trapped. It's one thing to be nursing a newborn all day, but to then spend the tiny amount of free time that you do have attached to a pump can be incredibly frustrating.

After I left the hospital the lactation consultant continued to check in with me. I kept saying that I thought I was making plenty of milk despite using the shield, but she assured me that I needed to keep pumping after nursing sessions if I wanted to sustain my supply.

Recurring Mastitis


When Bear was 4 days old I started to feel like I was coming down with the flu. I had a fever, chills, and was completely miserable. My mom, who had been staying with us, asked me if I had any red marks on my boobs. I went to the bathroom to check and, sure enough, both breasts were streaked with red. I had mastitis on both sides. After that I went down to only pumping twice a day after feedings. I was also determined to wean Bear off using the nipple shield.

Weaning off the shield was no walk in the park. I tried every day for 8 weeks with no luck. I was beginning to fear we would never get rid of that stupid thing. I think part of it was because my breasts were so big at the time and Bear just couldn't stay latched without it. He would always end up frustrated and start crying, which then made me cry too.

Finally on Thanksgiving I decided to try nursing without the shield before Bear got too hungry. It took a few tries, but I was finally able to get him to latch and he went a whole feeding without the shield! That was kind if the turning point for us. I knew he could do it without the shield, so I was determined to continue without it. From that point on we never looked back. My breasts became slightly more manageable, but I was already dealing with a huge oversupply. Every time I nursed Bear he would pull of screaming the second I had a letdown. I ended up having to unlatch him during every let down, catch my milk in a towel, and re-latch him. I also turned to block feeding.


Having an oversupply was so insanely frustrating for me. When Bear was a couple months old I kept reading about women who were saying that they were finally enjoying and even loving breastfeeding, which was not even close to what I was experiencing. I felt horrible that something that was so soothing for most babies was so frustrating and clearly unenjoyable for him.

That went on for 4 months and during that time I got mastitis three more times. Luckily by that point I could tell fairly easily when it was coming on and I would put in a call to my doctor for a refill on antibiotics.

At this point I just knew that pumping so often wasn't necessary (and that it was actually doing more harm than good), so I cut out all night time pumping and gradually reduced my sessions to twice a day.

Sick Baby


At around 2 months Bear was becoming increasingly fussy and gassy. He also had very loose, dark green, mucousy stools, eczema, and seemed to be permanently congested and wheezy. After speaking with the pediatrician about milk intolerances and all of its symptoms I cut all dairy out of my diet. Bear became so much better within just a day. About a month later though he still seemed to be having tummy issues. I did some research and found that half of all babies who are sensitive to dairy are also sensitive to soy. I cut soy out and once again, Bear improved tremendously. This was another big adjustment for me. If you've ever read a label you know that soy and soy derivatives are in everything!

When Bear was 4 months old, we were still struggling. He was a very fussy baby and never slept well. Getting 2 straight hours of sleep at night was a miracle. We would walk/rock/bounce him back to sleep and the second we laid him down he would wake up again. He was also still having a hard time nursing without pulling off and crying. I explained this to his doctor at one of his appointments and he said it sounded like it might be reflux. He prescribed us Zantac, which made absolutely no difference. The next medicine we were told to try was Prevacid. It seemed to help slightly, but after about a month on it I stopped giving it to him and saw no change, so we discarded it.

During this time, I was a mess. Despite huge efforts and help on my fiance's part, I felt very exhausted, alone, and anxious. Looking back I think I definitely suffered from a little postpartum anxiety. Every evening I was overcome with intense feelings of anxiety about the night ahead of me. At the time I didn't know how to put my emotions into words, so I never told anyone.

Allergy Tests


At 6 months Bear was still having eczema flair-ups and tummy troubles now and then, so my pediatrician wanted him to be allergy tested since he was already having issues with dairy and soy that I ate. During our appointment with the allergist I felt like we were completely undermined. The doctor performed a skin prick test on him and determined he was only allergic to egg. He told us that I should just reintroduce dairy and soy and that his eczema wasn't bad enough to be a big deal. I left feeling very unsure. My gut instinct was that the doctor was wrong, so I continued to experiment with different foods and documented how they affected Bear.

After a while I think a lot of my friends and family started to think I was being overly cautious and exaggerating his symptoms. There was even a time when I began to second guess myself and thought that it might just be all in my head. By this point I pretty much survived on almond milk, pasta, and different nuts/trail mixes.


When Bear turned 9 months I gave him a tiny bit of hummus to taste. He ate it and immediately became red and blotchy and began coughing and gagging. I called my pediatrician who referred us to a different allergist. During his appointment they did another skin prick test followed by a blood test. The results came back to show that Bear was highly allergic to milk, egg, wheat, nuts, and sesame. I was upset but also felt relieved - we finally had some answers to all of the issues we were experiencing!

However having to cut the remaining foods was pretty overwhelming. I had to stop eating so many of the things that were main staples of my diet. I switched to coconut milk and hemp milk and the rest of my diet is now mostly meat/fish, fruit, veggies, and rice, corn, and potato-based foods. When I cook I used lots of olive and coconut oil.


His first allergy bracelet!
Cooking can be somewhat of a challenge. The hardest part is just coming up with a variety of tasty dishes that will keep me full. Now that I'm back at work full-time I have to admit that lots of nights are just canned soup or a salad. I'm trying to get better about it because I want to continue breastfeeding for a while, so I need the calories if I'm going to keep my supply up. I have started drinking a rice-based protein drink every morning, which helps keep me pretty full.

If you had told me a year ago that I would be eating a dairy/wheat/egg/nut/sesame/soy-free diet I never would have believed you. I'm a total food person. I used to live for dining out, food festivals, and cheese tasting. My favorite foods ranged from home-made macaroni and cheese to panna cotta. Dairy was always my weakness- goat cheese, fresh mozzarella - I loved it all. Cutting it out of my diet was definitely an adjustment, but seeing the almost immediate change it made in Bear was so worth it.

Donating Milk


I will say that the one good thing about having an oversupply was that I always had a freezer full of milk. Unfortunately after finding out about Bear's egg allergy all of that milk became useless to me. So not only did I spend all of those months dealing with an oversupply - now I didn't even have anything to show for it and all that time I spent pumping! I had no clue what to do with the milk and it felt so wrong to just dump it all out.

Then I came across a donation site on Facebook and was shocked to see how many women were actually searching for breast milk for their little ones. Some just wanted it for the nutritional factor, while others needed it for medical reasons. I ended up finding a mom in my area who was searching for breast milk for her baby girl that was dairy-free. Being able to supply her with something that her baby needed and seeing how grateful she was was an incredible feeling. While dealing with an oversupply wasn't easy, I was able to see that it can be just as frustrating (if not more) to be on the other end of it and not have enough milk for your child. Donating milk helped me deal with my oversupply emotionally, though it was still very frustrating most of the time.


I considered quitting breastfeeding and using a hypoallergenic formula many times, but could never bring myself to do it. A lot of people are surprised to hear that I continued breastfeeding after finding out about Bear's allergies, but to me it actually became more important. Studies have shown that breastfeeding can actually help kids with allergies in the long run and I want to give him every shot I can at growing out of them.

"Never quit on a bad day" was a saying that went through my head often. After surviving reflux, an oversupply, and mastitis multiple times I was still determined to get to that point everyone talks about when breastfeeding becomes easy and enjoyable.

Bear is now 11 months old and I am breastfeeding him on a dairy, egg, wheat, nut, and sesame-free diet. It's not easy, but I have become fairly used to it. I had originally planned on quitting at 1 year, but since he would need either whole milk or formula until he turns 2, I have decided to keep breastfeeding as long as we are both enjoying it and my supply cooperates despite my being back at work full-time.

I'm pumping a lot less these days, but I do have a small stash saved up that I plan to donate again in the next couple of weeks.

Everyone Should Try Breastfeeding


I think everyone (aside from those who can't for medical reasons) should give breastfeeding a try. With all of the info out there about all of the benefits I just don't see why you wouldn't. I'm not going to judge someone who tries it and decides that it's not for them, but to flat out refuse to even give it a shot just seems silly. Perhaps it's my science background, but I've always felt like my body was equipped to feed my baby for a reason.

If any other breastfeeding moms out there are struggling, I just want to say that I understand how you feel and you are amazing. Breastfeeding may be "natural", but for me it was anything but easy. I'm so happy I was able to stick with it and I hope you are able to do the same. It's such a selfless thing to do and I don't think there is enough support out there for us. I still believe that every mom should be sent home from the hospital with an assistant and personal cheerleader. And a trophy. Of course a trophy."


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Tuesday, 16 April 2013

Triumphant Tuesday: Breastfeeding with Upper Labial Tie

Inside your mouth, there is a small fold of tissue which runs between your upper lip and gum (you can feel it with your tongue). This is called the maxillary labial frenum.  Most people have no significant frenum attachment, but sometimes this frenum attaches further down the gum, or runs between the front teeth and attaches behind them, causing restricted movement of the upper lip.  A baby with this condition may find it difficult to latch to the breast effectively. Once latched, his upper lip may be tucked inwards, resulting in a shallow latch causing pain for mom and insufficient milk intake for baby.

You are about to read the story of one such baby, Tom. He had an upper labial tie, and it was left undiagnosed until he was 20 months old! Yet he has never received a drop of formula. How did his mother assure this? Read on.


“Breastfeeding is definitely an emotive subject for me. I tried so hard to be successful.

Tough from Day 1

I couldn't get a good latch from the start. My son Tom was born 3 weeks early and weighed just under 6lb – he was tiny! He would never take enough breast into this mouth. We tried nipple shields yet I still ended up with huge cracks. I dreaded every feed and would be crying with the pain while he fed, which was never for less than 45 mins.


It’s hard to describe or compare the pain, it’s a bit like labour pain; like running a cheese grater over my breasts. It was a sharp, stabbing pain that didn’t stop. I dreaded feeding times. In between feedings my nipples would scab over a little and then it would start all over again! When the water hit my nipples in the shower it was really painful.

Patronising health professionals

I then saw numerous nurses, doctors, midwives, lactation consultants (travelling over 1500km one way! - 3 return trips). Everyone looked for tongue tie and high palate but not an upper labial tie. Many of the health professionals said that my nipple cracks were among the worst they had ever seen (I still have scars around the nipple 2 years later!)

The doctor I saw for my 6 week check up the hard work I’d been doing to breastfeed and said “you need a break too; it is ok to give him formula, even just one bottle a day – at night”. Undermining and not very helpful.

Mastitis

It wasn’t long before my badly cracked nipples led to mastitis. It started with a blocked duct which was a hard, aching lump. I massaged it for a few days and thought it had gone, but then my breast got a red warm area on it. Fortunately I promptly saw a Breast Surgeon who caught it early and prescribed Flucloxacillin.

We then started waking up near midnight to the sound of Tom (at 3 weeks old) vomiting and choking on the most vomit I’ve ever seen from such a tiny baby. It covered the entire inside of the bassinet and was a horrible yellowy colour. I figured out it was due to the just started Flucloxacillin.

But the fun and games were only just starting. I then got a staph infection in the nipple. Add to that vasospasm, 4 courses of antibiotics, topical antibiotic ointments and creams to be applied 3 times a day, then when that did not work to get rid of the staph - a long term course of antibiotics for 6 weeks. Thrush was always suspected but the lab results didn’t show it – we still treated my baby and myself for it anyway.

Pumping to the rescue!

To heal the cracks that had been there for weeks I was advised to pump to "rest my nipples" (Tom was 3 weeks old). Due to the staph the MASSIVE cracks never healed and I never could latch him on without extreme pain. So I only “breastfed” till he was 3 weeks old, and then pumped exclusively.

When I started pumping my nipples were still painful. It took a while sorting out the right size of breast shield/flange. The nurse gave me really large ones, as that is what they said my size was, but I was doing 40min long pumping sessions and it was taking forever to get the milk out. Plus the cracks were not healing and it may have even made them worse, since I had to have the pump on the highest setting! Here’s a photo of my "Strawberry milk". The cracks on my nipples would, every now and then, open up and bleed. Strawberry milk was the result. The milk in this photo had settled and separated. Of course I still fed it to Tom (even though my husband was hesitant) - I would never waste milk!



I later stitched to the standard size that comes with the pump and it was much better for getting the milk; I was able to use the pump at half the setting I was before which was better for the pain.

Pumping was relentless. I pumped 7/8 times a day whilst I persisted trying to latch Tom. I was glued to the pump for a total of 4 hours a day. I pumped in airport terminals, on planes, in moving vehicles, shopping centre breastfeeding rooms amongst other places. I definitely looked a sight, that’s for sure! I had a pumping bustier and a handsfree pump - the tiny Medela Freestyle. So I could walk around the house and get stuff done while pumping (although unfortunately, not eat - for some reason I always felt nauseated if I considered eating while pumping!) My family called me a cow.

I kept everything documented. Every ml that I pumped was recorded and the times, plus times and mls he ate. What I stored, when the stored milk was used I recorded it all!



This photo shows me finger feeding my breastmilk to Tom when he was 3 weeks old. We did this method of feeding for 2 months. It’s hard work, but the best method to use to avoid nipple confusion.





My routine looked like this: Tom would finger feed, taking 45 mins. Then I would settle him to sleep. Then I would have to be attached to the pump for 40 mins or so, then clean, pack and store the milk and parts – about at extra 10 to 15 mins. Plus all the recording milk amounts and working out his needs and what I needed to pump.


It was really stressful thinking about my supply in the early days! I was always worrying about Tom crying or needing me while I was hooked up to the pump. It was not too bad when he was little (he fit on my chest in between the shields or in my lap!) – but as he got older and bigger and could move around it got harder. Plus I couldn’t hold him as easily while attached to the pump. I used to get up in the morning (set my alarm) before I knew Tom would be awake, just so I could get in a peaceful/non stressful pumping session. The sessions that I had to do while he was awake were the worst/most stressful!

Unsupportive husband

My husband could see how hard it was on me and would say “You need a break – just put him on formula”. My parents and friends often said the same thing. It pissed me off! My husband already has 2 children from a previous relationship, who were both formula fed and his attitude/rationale was that they’re fine so formula is just another normal option to choose. It felt like he didn’t have the faith in me to feed Tom the way I was meant to. It actually strengthened my resolve to not turn to formula. I needed something to go my way (that I could succeed in) after Toms disappointing, traumatising birth.

However I admit, it was very tempting to take the easy route! Although I never bought a full can of formula – I bought a box of stick packs, about 6 feeds worth. Maybe I did that knowing that if I did have to resort to formula I didn’t want it to be permanent! Having formula in the house hindered me in that – I would think about how easy it would be to not be in any pain, not be feeding for 40mins/1hr per feed. I even got it out and sat it on the bench. I came SO close to making up a bottle!

But it also helped having it there because once I’d resisted using it once, it got easier and easier to keep resisting.

Nursing my sister's baby

When Tom was 10 months old I had tried breastfeeding my sister’s 4 month old daughter. It was completely pain free!! It felt different to ANY time I had ever breastfed Tom. It felt really nice and I could feel the milk being drawn out by her. This sent alarm bells ringing in my head.


I had for a while suspected Tom had an upper labial tie as his frenulum is quite large. When he was around 20 months and his 2 front top teeth had come through – he had a gap between them. We took him to a paediatric dentist, I had recently learnt of, who uses laser surgery. He confirmed my suspicions of the tie. I finally felt vindicated! It wasn’t me! And it SHOULD have been picked up by all of these people who examined me and him!

Despite all this - my gorgeous boy has never had a drop of formula pass his lips. There were times I wanted to give up and I still have the unopened formula in my pantry to prove it. But my wish to provide only the best for him has outweighed everything else.

Breastfeeding has cost me a lot more money than formula feeding ever would. But I'm so proud to say he's only ever had my breastmilk. I've even been able donate some of my freezer stash to a friend who could not pump the amounts I could.



This journey has been the Hardest experience I've ever had, but definitely the most rewarding! I wish more women would see pumping as an option if they “cannot” breastfeed. It was not easy and did come with its own set of challenges, problems and worries. Such as; the pump sometimes causing pain, bleeding cracks leading to “strawberry milk”, constantly worrying about supply (as we know pumps are not as effective as a baby for long term feeding), packing and storing milk, freezer space, using the milk before it went past use by date, planning days, outings and travel around pumping and keeping breastmilk cold, creating and maintaining a daily record of times pumped and amounts at each pump session and amount ingested my Tom at each feed (a LOT of paperwork!), and amounts wasted (warmed up for a feed but not drunk :(


I am extremely proud of myself and the effort I put into providing only the best for my son; that even in my darkest times I never “gave in” and went for the easy option of giving him formula. It still amazes me that he has NEVER had any formula.

Breastfeeding is the normal and best thing for babies. There are so many health and emotional benefits – I think many of which are yet to be discovered. Why would you want to put a man made, nutritionally inferior replacement into your baby, when the real thing is so readily available?

Mothers who don't try


Mothers who don’t even try: I think they are majorly uneducated and uninformed. It disgusts me! They obviously think that formula is as good as breastmilk! It annoys me that people wouldn’t educate themselves about something this important! Then of course bub doesn’t tolerate this or that formula or gets terribly constipated or sick from the formula. Not to mention that the bub gets sick a lot more often!

Then there are the women who say “I tried to breastfeed, but it didn’t work, etc, etc”. They piss me off just as much! It devalues my entire journey when they say that. I’ve NEVER personally met someone who had as many breastfeeding obstacles (blood in breastmilk – cause not detected, undiagnosed upper labial tie in baby, vasospasm/Reynaud’s phenomenon with tricolour nipple colour change, extremely deep nipple cracks, persistent long term staph infection in cracks, possible nipple thrush, blocked ducts, mastitis, 2 regular courses of antibiotics then 1 long term 6 week course, exclusively pumping, supply worries) as me, but I made it work! Surely most other people can too!”


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Tuesday, 9 April 2013

Triumphant Tuesday: Working and Pumping

Employment shouldn't spell curtains for nursing mothers. Not only is breastfeeding best for mother and baby, it is also in the employer's best interest. Employers who accommodate breastfeeding retain experienced employees; have a reduction in sick time taken by both moms and dads for children's illnesses; and enjoy lower health care and insurance costs. Win-Win!

Yet despite these incentives, the marriage of work and lactation is a rocky road for many. In 2009, the Society for Human Resource Management reported that only 25 percent of companies had lactation programs or made special accommodations for breastfeeding (SHRM 2009). Furthermore, these employers do not specify whether this means there is a private room in which to pump on-site, professional lactation support, subsidies for breast-pump purchases, or whether the “lactation program” consists of no more than allowing employees to pump in their own offices.

To make matters worse, many mothers encounter pressure from coworkers and supervisors not to take breaks to express breast milk, and existing breaks often do not allow sufficient time for expression (Rojjanasrirat 2004). What’s more, small businesses (fewer than 100 employees) are the least likely to have lactation programs, and whether the workplace is large or small, infants are generally not allowed to be there.

So how does this pan out for working moms? Meet Chantie. Forced to return to employment, having to navigate erratic pumping facilities and a bullying boss, then being stopped by customs officials for travelling with a breast milk ‘bomb’ – it’s all in a day’s work...


One of my first pregnancy memories was sheer confusion at the information and disinformation. I expected the birth experience would be the hard part, but the "feeding" portion was much more stressful. I received so much unsolicited advice.

Not-so-subtle formula-pushing

At the hospital, they did a nursing consult for me to see if I was doing something wrong. I was told that my technique was fine, but that sometimes it takes time for the milk to come in. The shift nurse told me that I wasn't getting any sleep since my baby was hungry. She was telling me that if I would give her a bottle that I would get more than an hour of sleep.


After we went home, we were back and forth to the pediatrician as my daughter just was not regaining her birth weight. I was sent home with a directive to start supplementing with formula.  I was very disappointed with this turn. It came with a lot of unsolicited advice on how I should just stop breast feeding and switch to formula, how it was easier, etc. I did the research on a lot of the homeopathic treatments that were aimed at increasing my supply with minimal success.

Back to work

I was able to stay at home with my daughter until she was three months old. Then, being back at the office translated to pumping for me. Work had a mother's room with a refrigerator for the pumping moms, so that made it easier.  The room had 7 stations, and only pumping moms had the code for the door.  5 of the stations had a commercial pump, and each mom could buy the piston attachment kit to use them. I worked hard at pumping and feeding to give my daughter the best start possible. 


Over the course of the year, I travelled to other office campuses on day trips, and made use of their pumping rooms. For one campus, there were no pumps in the room, so I brought along my own. On one trip home, the TSA (Transportation Security Administration) officer could not understand WHY I had breast milk with me but no baby. I tried to explain that my baby was at home, and that I was travelling for business. I was simply bringing home the milk for her later usage that I had pumped on the trip. After more than 20 minutes of questions and the bomb test for each bottle of milk, I finally asked for a female supervisor. I did make it thru security eventually, but it was just beyond me why he had such a hard time understand why I had milk with me along with a breast pump.

Troublesome boss

However my boss, who had her daughter a day after me, was the one that caused the most stress. I had returned to work and was there for about a month before she came back. I know that she was breastfeeding, but she would still book meetings over my scheduled pumping times.

Also, despite us negotiating no travel for a year, at around 9-10 months, my boss tried to bully me into a 3 week business trip to Europe. I turned it down and made it the year point.

My daughter is incredibly healthy and happy, and I think her good start has a lot to do with that. To me, my body makes milk and it includes everything that she needs. It's kind of like you can buy fast food and it's food, but it's a lower quality than if you made the same items yourself. While I acknowledge that formula has a place, I just do not think that it is as good as what my body made for her. I try to limit our diet to limited processed food, organic, etc. That just really isn't the case with formula, at least it sure doesn't look like it when you look at the ingredients.

My best advise...do your research, listen to your heart, and do what you think is right. Breast feeding was a lot of work, but it was totally worth it as it was an unrepeatable bonding experience for my daughter and I.”


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Tuesday, 2 April 2013

Triumphant Tuesday: Exclusive Pumping

Exclusive pumping provides the worst of both breast and formula feeding. Like breastfeeding, it is hard work, the mother’s breasts are constantly ‘in demand’ and the weight of responsibility is squarely on mom’s shoulders; And like formula feeding, bottles still need to be steralized. Yet paradoxically, exclusive pumping also offers the best of both worlds – baby is getting mother’s milk, yet mother does not need to be on location.

One thing is certain, the extra time and commitment involved in exclusive pumping raises a host of unique issues. When her newborn had trouble latching, this mother turned to exclusive pumping. However, trouble was lurking around the corner. Was this a decision she would live to regret?


It all started after a hard 42-hour induction for pre-eclampsia at 38 weeks.  Our daughter and first born Zoë came into this world screaming and the nurses demanded that I put her to the breast immediately.  Baby and I were both exhausted and we couldn't get her to latch, so we decided to take a nap and start fresh.  After a couple hours, we were awake and ready to go.  The nurse came in to ‘help’, took one look at my small breasts, grabbed them, shoved my nipple into Zoë's mouth, and proceeded to tell me how difficult it was going to be for me being small breasted.  I started to wonder, "Can I really do this?"

Time-restraints


After 24 hours, we moved over to the post-partum wing of the hospital.  A nurse came in to tell me our daughter was severely jaundiced and needed to be under the bili-lights.  She made sure to stress that I was not to take her from under the lights for more than 10 minutes at a time.  I was devastated. It was taking at least 10 minutes to get our daughter to latch at this point.  The nurse seemed indifferent to my distress.  The next day another nurse came in to check on our progress, said we were doing great, and after 5 days in the hospital we were sent home.


The WIC were very supportive of my want to breastfeed by pumping and provided a hospital grade pump, but wouldn’t provide suggestions as to why I was in so much pain while breastfeeding.  Everyone kept telling me, “get through the first 6 weeks and it gets easier”.  Week 1, it'll get easier.  Week 2, it'll get easier... and so on.  We got to week 6, it was not getting easier.  My nipples were cracked and bleeding.  Every latch resulted in stabbing, toe curling, tear triggering pain.  I resented every cry my new baby made.  I didn't want to hold her or be near her for fear that she would be hungry.  I was engorged, swollen, and sore.  I wanted to give up.  I saw all the doctors available to me and cried about my experience; they said, "keep at it."  I wanted my baby to have breastmilk, but just couldn't breastfeed any longer.  I made the decision to start pumping.

Exclusive-pumping

Pumping was easy and painless, but time consuming.  Every 2-3 hours, day and night.  The routine was endless.  Pump, fridge, reheat, feed, washing parts.  I was exhausted and my supply was dwindling.  Every single day was a struggle to provide what our big eater was needing between 35-45oz depending on the day.  I bought some fenugreek and prayed it would help us and sure enough it did! My supply doubled and I was finally able to put some away in the freezer for a rainy day.

We then battled clogged ducts and 2 cases of mastitis, but carried on.  I wanted my daughter have every ounce of liquid gold I could provide. The mastitis was horrible!  The first time I did not even know I had it until it was too late.  I felt like I had the flu with the chills, shivers, headache, and fever.  Along with that I had a strong, throbbing, and stabbing pain in one of my breasts.  I couldn't just rest and sleep like an ordinary sick person, but had to pump frequently; the very thing that was causing me the most agonizing pain.  I stayed in bed for days only sitting up to pump or care for baby.

Drop in supply

We made it to 7 months and the fenugreek stopped working.  I tried power pumping, increasing my fluid intake, upping the frequency and length of my pumps per day, oatmeal, you name it.  To make matters worse, the WIC emailed me saying that they needed me to return the pump. I thought that this was the end and was beside myself.  I decided to give latching once last try.  It worked!  Zoë's latch was pure perfection.  She ate greedily at my breasts and coo'ed noises of delight. I thought this was a fluke but she latched again to her tummy's content, and again, and again...  I was able to stop pumping that day and we never turned back.


I feel defeated when a mother decides not to breastfeed without having tried.  Breastfeeding has provided me with this bond that I could never explain to someone who hasn't experienced it.  My daughter still enjoys being near my breasts and even still makes the suckle face as she falls asleep.  I’m a very strong advocate that any new mom should just try.  I feel the idea that breastfeeding provides comfort and joy for both baby and mother has been lost.  You can talk to someone all day about the benefits of breastfeeding, but it comes down to them.”


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