Needing To Build Up My Milk Supply Again

Originally, I wasn't going to re-post anymore blogs until January (so this post was wishing everyone a Merry Christmas, thus the comments below) so that I could instead use the time to "remodel" my blog, but it ended up only taking me 24 hrs--so I will now continue posting where I left off when my son was four months old. This was written on Saturday, August 16, 2008:

I'm depressed. In my last post I mentioned that my milk supply had gone down this past week, despite still taking fenugreek. So, I've been pumping all day, every day--only to have it get worse! If you've been following my blogs, then you know that this tends to happen every couple of weeks, but usually pumping all day (in addition to still putting Logan to the breast) has always gotten the flow up again, so that once I'd start pumping more than Logan drank, I could exclusively breastfeed again.

This time, however, it hasn't been enough. (I know this because he's been crying his "hungry cry" at both the breast and after he finishes the bottle.) It's no surprise to me because I'm pumping half as much as I did a month ago. Therefore, I am down to just six storage containers left in my freezer! I will cry if I use them all up. I still have leftover formula that we got free when he had jaundice, but I refuse to give it to him when I worked so hard those first seven weeks to be able to breastfeed 100% of the time. (To read about my earlier breastfeeding rollercoaster, click here.)

I had no idea we could have a relapse at four months old. I don't know if he's going through another growth spurt or what. But my breasts have definitely changed--they are no longer full and I get NO natural reminders now to feed. Up until recently if I was just a few minutes late they would hurt like crazy and start leaking. I don't even need to wear my bra pads anymore (I recommend the organic washable kind). Now I'm convinced I could go all day without pumping/nursing and hardly notice. It's like my breasts think I'm done--but I'm not! I'd still like to continue for another 8 months! Maybe I've gotten too busy and need to focus more on breastfeeding again.

I do feel that I've been more stressed lately, and my lactation consultant told me in the beginning that stress is the #1 reason for low milk supply (and I had that in the beginning, too, with Logan's jaundice). Recently I've been feeling run down. . .this summer has been jam-packed (there's been one weekend since Logan's been born that we didn't have plans). . .I definitely need a break. But, we have plans the next three weekends as well as stuff during the weeks. I guess something might have to be canceled or else it's just going to continue the cycle of me feeling stressed & tired which then makes Logan the same way. :-(

At this point all I can do is try again tomorrow. I also found some good tips on the web by Sally Wendkos Olds, author of THE COMPLETE BOOK OF BREASTFEEDING, which I will end with.

Ways to Build Up Your Milk Production

• Nurse your baby more frequently for several days, using both breasts at each feeding. This is the single best way to enhance your flow of milk.
• Wake your baby, if necessary, to feed him more often.
* Pump or express milk between feedings. But don’t get discouraged if your pumping yields as little as half an ounce of breast milk. Your baby is almost certainly getting more than this. Even the best pump is less effective than a vigorously nursing baby.
• See a lactation specialist if your baby is not suckling well or nurses only a few minutes at a time.
• Cut back on your schedule. Do less. Rest more. Nap at least once a day, more often if you can manage it. Ask someone else to help with marketing, cooking simple meals (or getting take-out food), and doing basic laundry. Most people like to help a new mother, so take advantage of this willingness now. You can always reciprocate later on.
* Even though everyone wants to see the new baby, ask visitors not to come for several days -- or even weeks -- unless they’re people who will wait on you, not expect you to entertain them. Let your answering machine take phone calls – which you can return later when you’re not so tired. Well-meaning family and friends can wear out the new mom.
• If you can, take an occasional day or two off from work or from other obligations (by, for example, having someone come in to care for your other children) so that you can focus only on nursing your baby.
• Check your diet. Are you eating enough? Are you eating the right foods? Are you drinking enough fluids? Some women find that eating or drinking more seems to produce more milk. Keeping a glass of water or juice near the spot where you nurse is a good idea. You don’t need to drink any more than you need to meet your thirst, but some nursing moms find that they are thirstier than usual.
• Make a special effort to relax. Of course, this is hard when you’re concerned that your baby isn’t getting enough milk—but the more you can relax, the more milk your baby is likely to receive.
• Develop a few affirmations that you can repeat to yourself, such as: “I am a bounteous supplier of milk for my baby”; “I am doing the best thing I can as a mother”; “My baby is growing fit and healthy from my milk”; “My milk is my baby’s perfect food.”
* Visualize your baby at a little older age, looking well fed and happy.
* Vitamin B complex, brewer’s yeast, and the herbs fenugreek (also called fenugeek) and blessed thistle are sometimes recommended, as is the controversial prescription drug domperidone, which has not been approved for any use by the U.S. Food and Drug Administration.
• Believe in yourself and trust your body.

Note: Do not offer your baby formula while you’re building up your milk supply. A few ounces soon turn into a full bottle, which soon turns into several bottles, until you find that you’re producing even less milk. If your baby is drinking from a bottle, he is not stimulating your breasts and thus not doing the most effective thing that will increase your supply of milk.
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P.S. I also have a relaxation CD by Earth Mama, the same company that made one for my preparation for childbirth (it was a HUGE factor towards my positive HypnoBirthing experience--I think ALL pregnant women should get it, whether you strive for natural labor or not). I listened to the "more mama's milk" CD once, but I plan to take a bubble bath tomorrow night and listen to it again!

Breastfeeding Rollercoaster

This was originally written on Monday, June 9, 2008:

If you have found this blog due to the issue of jaundice, you can read my two posts about my experience here. If you are here for the issue of breastfeeding, you might be interested in my other posts on this subject, found here.

In the Preparing to Breastfeed blog, I wrote, "I am planning to breastfeed. There really doesn't seem like any other option. From every book I've read, every doctor and lay person I've talked to, etc. there's no reason NOT to."

I included the facts about how much better breastmilk is than formula and how to overcome common breastfeeding problems. I even took a breastfeeding class because I'd heard that despite it being something that women have been doing since the beginning of time, it isn't necessarily easy.

But, I figured that by me being a stay at home mom free & able to nurse whenever, and truly wanting it to be a priority, it was in my favor to do it. Surely something so natural wouldn't be THAT difficult. I had pictured breastfeeding my children my entire life, as I knew my mom had nursed me (as well as my husband's mom with him).

So, when my son was born, one of the first things that came to my mind was the tip at the top of my breastfeeding class notes: Nurse within the first hour of birth. (In the PTB blog I also included the rest of the tips I’d learned during class.)

Unfortunately, Logan was in intensive care during his first hour of birth. Even though we'd been told at 30 min. post-birth that he could be released, it took two hours before he was in the regular nursery. During those hours I asked several nurses, "When can I breastfeed? I want to breastfeed!"

Finally, four hours after his birth, a nurse brought him into my room and put him to my left breast in the football-hold position. I was relieved when Logan latched on, as that is the first--and often hardest--step. Not only that, but he began sucking strongly right away. The nurse cheered--and I thought that was the end of any concern. I'd had the wrong assumption that breastfeeding was either easy or hard, and so since it'd started off well for us, my experience would be easy. I didn't realize that many women have an issue that develops and THAT'S part of what makes it hard--that the whole experience can be a rollercoaster.

But, even when after only a few minutes Logan stopped nursing and fell asleep, I wasn't worried. The lactation consultants came to check on me and explained that newborns really only need a few teaspoons of colostrum, as nature has given them the ability to actually survive with nothing for a couple of days after birth! So, although Logan always fell asleep before the full twenty minutes that is recommended, I continued to be optimistic. Especially, since he'd had a rough birth--of course he was going to be tired. The main thing was that he was latching on, sucking properly, and having the correct number of wet & dirty diapers per day.

Still, by his third day (Monday, April 21st) he'd lost nearly a pound (from 7 lbs, 13.7 oz, to 6 lbs, 15 oz). While this is normal for newborns, for babies with jaundice weight loss is incredibly dangerous as it makes the jaundice worse. My pediatrician said I had one week to bring his weight back up through breastfeeding but then otherwise he'd need to be on formula. (Which my ped. didn’t want as he is very pro-breastfeeding.) I was crushed--and determined to nurse 24/7 if need be.

However, later that day we had to admit Logan to the hospital because his jaundice level was 21 (in the emergency range). This meant he had to be in an incubator and hooked up to IV fluids. Therefore, I was only able to take him out every now & then to nurse. :-(

Meanwhile, my breasts entered the engorgement phase. The nurses had all been asking me, "Has your milk come in?" (Changing from colostrum to real milk) I suddenly knew what they meant--not only were my breasts incredibly sensitive and SORE, but HUGE!!!! I hadn't thought it was possible for them to get as big as they did (it was rather creepy).

I didn't realize how important that day was. While I was preoccupied with Logan in his incubator, my breasts were basically asking me, "Do you want this milk? If not, we're going to dry up." If I had it to do over again, I would have pumped like crazy that day and asked the hospital staff if I could nurse Logan even more frequently. It wasn't until that night that they finally let me borrow their electric pump to relieve my milk for the pain (and then my milk was discarded!). I was surprised at how little came out, but the nurses said not to worry, that Logan was only 3-4 days old and that was all he needed at this point.

Until then I had only nursed Logan on my left breast--but that one was so engorged that it nearly made me cry to have him on there that night, so I decided to try my right breast (in a cross-cradle position). It turned out that Logan did a better job over there. . .and after that he would no longer take my left side at all! When I pumped on Tuesday (April 22, day 4) there was barely any milk on the left (not even 1/4 of an oz)--but my right picked up, as if it was over-compensating.

The lactation consultants at that hospital checked on me, and noticed that my left breast had become so engorged that the nipple wasn't as easy for Logan to latch on to anymore, so that's why my milk was drying up on that side. They gave me a nipple shield which was a miracle worker; Logan began to take that side again. They also checked to make sure that he was swallowing (which he was)--which meant that he was indeed getting milk from me. The only complaint as we left the hospital was that he still wasn't nursing for the full twenty minutes because he was still very sleepy. They said that was to be expected for a jaundice baby and just to nurse as often as possible and he would improve.

When I went home, I made sure to put him to my breast every two hours no matter if he woke up or not. My breasts had passed the engorgement phase so they didn’t hurt anymore, but to my shock they were actually smaller than before I was pregnant! (Since I'd only pumped a few times at the hospital and Logan wasn't sucking enough, my milk was drying up.)

Unfortunately, Logan stopped taking my left side again even with the shield and would still not stay awake on the right. Even though his weight got slightly better, his jaundice (bilirubin levels) did not. Therefore, as those know who read my blog about his first week, he was required to stop breastfeeding on Friday, April 25 and be on formula for four days.

The internet explains: ". . .enzymes in mom's milk allow bilirubin to be reabsorbed into the blood from the intestines, the baby processes fatty acids in mom's milk as a priority over processing the bilirubin. If the mother stops nursing, substituting formula, the bilirubin levels will drop rapidly. They will not rise again when the nursing is resumed."

This was true--in just 24 hours (by Saturday, April 26) Logan's bilirubin level went from 17.5 to 14.4 to 11.9. By Monday, April 28 he was considered recovered and the pediatrician said he could go back to breastfeeding.

During his four days on formula I had become concerned again about our future with nursing. The last tip on my breasfeeding notes had read: Wait four weeks before introducing the bottle. (As many babies will never take the breast again once learning how much easier the bottle is.) Logan was introduced to the bottle at exactly ONE week old.

Also, after leaving the hospital I did not have access to an electric pump. I had a manual, as I had only planned on pumping to relieve engorgement or on a rare day that I was away from Logan--which would have been fine if I hadn't had to cease nursing those four days. Just because I couldn't nurse, didn't mean that milk didn’t still need to be released. As I mentioned before, the combination of Logan not getting enough breastmilk when he did nurse (due to his sleepiness) with me not pumping enough inbetween his feedings, decreased my milk supply.

The good news was that he remembered how to breastfeed when he took to it again after formula, but the bad news was that I definitely didn’t have enough milk for him. Sure enough, he was never satisfied. So, I bought an electric pump (when he was almost two weeks old) and began pumping (in addition to nursing) and putting my breastmilk in a bottle because I could get more to Logan that way since he was still falling asleep every time and had never made it to the recommended twenty minutes. My pediatrician also recommended I buy More Milk Plus, an herb to help with lactation, which I did on the day of his two week check-up, Friday, May 2nd.

Both the pump and the herb worked. Within two weeks (when Logan was 4 weeks old) I'd finished the More Milk Plus and my milk supply had gone from 1-2 ounces (both breasts combined) after 20 min. of pumping to 7 ounces these days. (FYI: Newborns generally need 2-3 oz. every 2-4 hours, by one month old they should be eating 4 oz every 4 hrs, and by six months usually 6-8 oz. 4-5 times a day. Logan is 7.5 weeks old and still eating every two hours, but wanting 4 oz each feeding.)

I really thought during "week three" I was going to get burnt out. The lactation consultants were calling me daily to check in and give me advice, which was wonderful. . .but one day I broke down in tears on the phone because I didn't think I had anymore energy, as I was both pumping and feeding EACH twelve times a day, which meant I wasn't getting any breaks in 24 hours!!!!

I was glad that from Logan's perspective everything was great (we hadn't had to formula-feed him since his second week of life, so he was at least getting breastmilk each time), but I had always planned on nursing for 9 months to a year--now that thought seemed way too exhausting and draining!

It was nice that Joe and others could help out with Logan's feedings (especially in the middle of the night), but I couldn't help but feel like a failure since bottle-feeding hadn't been my ideal. I remembered how when I wrote the Preparing to Breastfeed blog I had felt so strongly about wanting to work as hard as I could to breastfeed. I'd written: "It is important for me to not give up if the going gets tough."

So, I started talking to women I know who had breastfed successfully to find out if they had any suggestions before I threw in the towel. Kendra said it often takes six weeks even for women without problems--so not to make any decisions until then. Lisa P had recommended undressing Logan when he fell asleep in the middle of his feedings to wake him up. Kim talked to me for an hour on the phone. I began to have new motivation. After hearing and reading so many success stories, I realized that the majority had dealt with at least one difficulty and had still ended up breastfeeding easily in the end. It was not too late for Logan & me, we weren't a lost cause, there was still hope. Despite the setbacks, there were also a lot of great signs that we were still on the right track. I hadn’t been aware that breastfeeding is just often something that takes a couple of months to get going. (No wonder it is the first topic written about in the popular What to Expect The First Year, which I'm currently reading.)

In fact, my mom even pointed out that she & I had gotten off to a similar start. As a premie, I'd had to be in the hospital for a month which meant I could only have breastmilk in a bottle (since premies generally are unable to nurse). When she brought me home, she had to wean me off the bottle and so I was fed both formula and put at the breast (because she didn't have a pump at home), and pretty soon I was just breastfeeding for six months. That helped me take the pressure off myself. I realized that being on both the breast AND the bottle hadn't been negative for either myself or my mom--and if that was my worst case scenerio with Logan, it would be alright. He would still get all of the antibodies and immunities and extra nutrients found in breastmilk, whether I gave it to him straight or pumped. And, if for some reason I couldn’t pump, I shouldn’t feel guilty for supplementing with formula as there is nothing "bad" about it.

Once I relaxed, there was more improvement: the pumps and bottles were cut in half--to six each a day! At a month old (May 18), half of the time Logan nursed flawlessly but the other half of the time he was still lazy. His sleepy time was also mine, as in the middle of the night I’d no sooner lay him down after he fell asleep while nursing, when he’d cry & indicate that he wanted more, but then fall asleep again, only to repeat the cycle every ten minutes--and so those were the times I'd end up giving him the bottle.

As he got farther away from when he had jaundice, I started noticing that he was getting more vigorous with both the breast AND bottle (despite the bottle being easier for babies, Logan had never acted like he loved it. In the beginning he didn't take it very well, and even after a month old he was sometimes slower on the bottle than on the breast--sometimes taking 40 min!)

So, after Sarah visited from Seattle, I had the energy again to try and cut down his bottles/pumps in half again—to 3 each a day! I finally understood what people meant when they'd asked, “Do you feel the let down?” I could tell the difference from when Logan was getting good milk and when he was just using me as a pacifier.

The downside was that he started getting more rough. He’d always been active while he ate, but now sometimes he pulls/yanks, bites with his gums, and digs his fingernails into my breasts!

Still, I knew it was worth it. As the six week mark approached (Friday, May 30th), my goal was to stop the bottles & pumps completely. The lactation consultants had stopped calling me, but their last advice had been that he might be relying on the bottle during his lazy hours and so the only way for him to rely on my breast instead was to not give him the bottle at all anymore. This meant I was probably going to have a rough week (because he’d get frustrated), but just as babies aren't going to overeat, they're not going to starve. (My cousin-in-law, Kim, said the same thing.) It was also going to require ME to not be lazy (so I’d need to continue to put him back to the breast even if he’d just been there ten minutes ago).

So, on Thurs, May 29th, I rented a movie, sat down on the couch, and decided I would just keep Logan to my breast for as long as he wanted—no matter how slow he was or how long it took—so as to get him used to not having the bottle during his sleepy hours.

Two-and-a-half hours later the movie was over, but he was not finished nursing!!! I was so bummed. My nipples were obviously sore and I felt like I had no more milk left. Worst of all, since I hadn't pumped all that day there was no breastmilk in a bottle to feed him when I finally broke his latch, and he began screaming for more. So, we had to resort to the formula sample we had left over from his jaundice. (Now I have a couple of bottles of breastmilk in the freezer for if there’s ever an emergency again.)

I felt better the next day when he weighed in at twelve pounds already (I didn't need to be worried anymore that he wasn't getting enough by just breastfeeding; it's hard to be confident when you've pumped and are able to see how much there is verses nursing—especially since my breasts often still felt full after breastfeeding but always felt empty after pumping). So I planned to go cold turkey on him again. . .except that for the next week he went through a growth spurt (as is common at this age). Going from three bottles to none last week was not going to work, since he suddenly wanted to eat every hour and was sometimes having up to 5 ounces at a time! Once again I began pumping and nursing continuously all day.

On the bright side, I've noticed the following from nursing more:

1) My breasts have finally gotten big. Not as huge as they were when they were engorged, but bigger than normal—so at least I can finally have that perk, lol.

2) Somehow Logan nursing on my right side has begun stimulating my left side so that it's producing more milk when I pump. (Still not the same as my right, but about half as much--which is an improvement.) Best of all, for the past week Logan has been taking the left side now for as long as five minutes (without the nipple shield)!

3) The more he nurses, I’ve had more spotting since my last post, which means I don't think pumping has the same benefits to contracting the uterus (i.e. making it smaller)

4) Finally, nursing more often has made my milk come out like a sprinkler system! On day twelve, my breasts started hurting and leaking if I was late for a feeding (for the first time), but by leaking I mean just a tiny drip. Now I can hardly get my bra unfastened before it's shooting straight out and I have to clamp Logan's mouth around it to prevent milk from getting everywhere! And, whichever breast I'm on, the other one is literally pumping out milk. So this has benefited Logan when he is sleepy and not nursing as well (it comes out easier for him). When he does nurse well, it tends to run out of his mouth because it’s flowing so fast and he can’t even always swallow it.

Breastfeeding is a lot messier than pumping, so I have to keep burp cloths nearby (plus, opposite of what some say, Logan spits up a lot more nursing than with the bottle. . .one night he actually threw up all over me three times in a row--spraying me--so I had to take off my drenched night gown & underwear, as well as his outfit). I think it’s because he prefers to take the bottle in a sitting up position but that’s harder to do while nursing.

This week he seems to be slowing back down as far as his frequency of eating/his growth spurt—and so tonight I'm going to try to go cold turkey on him again! He's seven-and-a-half weeks old and we are so close to having this issue not be one anymore. Nine times out of ten Logan nurses excellent nowadays. He appears to prefer breastfeeding to the bottle, as he tries to do it anytime I'm holding him, wraps his hands (and even sometimes feet) around my breasts and cuddles close, makes noises, and smiles :-) I prefer breastfeeding as well, not only for the bonding experience, but because it's easier, more convenient, and takes less time. (Plus, I don't feel like a cow like I do when pumping, haha.) Also, I'm getting tired of washing bottles all of the time.

I'm glad that Logan can do both because the bottle is convenient when we're on a trip, for example, over the weekend we went to Iowa but with his growth spurt it would have been extra stressful to nurse without the time and environment on my side—so Logan did have mostly breastmilk-bottles. But I want to know that on a typical day at home I don't have to rely on pumping/a bottle AT ALL anymore—that he can nurse at anytime (and my milk supply won't dry up). I believe we're almost there. On Saturday night the electricity went out and so I couldn’t pump during those hours, and yet he nursed flawlessly during his usual sleepy time. (Another benefit to breastfeeding--it's always there, even in times of emergency.)

So, I'm keeping a video diary for the next 24 hours to hold me accountable (especially since this might mean I'll have to be up all night, so I've rented another movie). . .I’ve posted it at the end of this blog.

Otherwise, not a lot has happened in the week since my last post. My days are still zooming by. . . As I said earlier, Joe & I traveled with Logan for the very first time Friday thru Sunday (June 6-8) because my half brother came back to Iowa and I hadn't seen him since last year's Memorial Day weekend! Logan did really well on his first trip!

Joe golfed on Friday after work, so we didn't get to my dad & stepmom's house until almost 11 pm. My paternal grandma was also there, so everyone got to meet Logan for the first time (aside from my dad who had met him in the hospital).

On Sat. afternoon I was able to see my brother's DVDs that he's done while out in Hollywood the past year-and-eight months so that was very cool. Then, that evening/night Joe & I went to an old college friend's wedding reception.

My brother came back over on Sunday morning from his mom's house and we ate a yummy brunch. Finally, Joe & I went over to my mom & stepdad's house for a couple of hours before heading back to Omaha.

While at the wedding reception I talked with a girl who expressed interest in natural childbirth so I told her about HypnoBirthing because she wasn't familiar with it--but couldn't wait to now buy the book. I'm glad I can "pay it forward." :)

There had been a tornado in Omaha while we were gone which did damage to some homes, but fortunately ours is okay. We did pass a chemical explosion on the interstate, though. Apparently a semi blew up—and we came upon it right as the firetrucks were first arriving, so we were delayed a bit getting home. Thankfully, no one was injured.

Tonight Joe and I went out to eat. It was nice to dress up and go out on our first date since Logan was born!

Afterwards, I gained the courage to try something my doctor had given me the “okay” for ten days ago. . .but it was only ¼ success. In other words, it looks like there’s going to be another post-pregnancy challenge. :/ I knew my luck would run out after 4 hrs of pushing and a quicker-than-average recovery (not feeling any soreness after three days, bleeding after a week, and looking exactly back to normal "down there" when I looked after one week). But last night made up for that. . .um, to warn you the first time after baby is worse than giving birth!

BUT ANYWAY--here is my cheesy breastfeeding video diary. (Notice how Logan smiles when I say that we’re just going to only breastfeed for the next 24 hours, haha!) I apologize for my appearance, this was not a hair & make-up day!!!!!!

History of Breastfeeding in America

Not long after I gave birth to my son and began nursing for the first time, I read the excellent novel by Kim Edwards, The Memory Keeper's Daughter. There was a line on page 42 that said: "in 1964 breast-feeding was radical."

It had already crossed my mind that none of my grandmothers had breastfed my father, mother, or stepdad--but I'd been too busy with my new baby to wonder why. By the time I read The Memory Keeper's Daughter four months later, life wasn't quite so crazy and I became very interested in researching this topic. Why would all three of my grandmothers buy formula when 1) None of them were rich (wouldn't they want to save money?) 2) They were all stay-at-home moms during the time their kids were babies (wouldn't it be convenient with more time to nurse?) and 3) They all complained of gaining a lot of weight, LOL! (wouldn't they want to lose it easier?)

I asked my grandmas three months ago and learned that it was the doctors during that time--yes, doctors, who told women to buy formula rather than breastfeed! Back then scientists hadn't tested breastmilk yet to discover how special it was, let alone the effects on metabolism. Formula companies and doctors (who worked together) were convinced man-made milk (which they could control and monitor) had to be better than something from a woman's body (since many women weren't in top health). They didn't realize until decades later that a woman didn't need to be in top health; nature still made her milk the healthiest source possible for her child!

Thankfully, these days breastfeeding is much more wide spread, and is gaining more acceptance by society--although there is still room for improvement. My favorite magazine, Mothering, had an article in their September-October 2008 issue titled "Reel Milk." It discussed how Hollywood tends to shy away from breastfeeding, and if specific messages are repeated often and strongly enough in society, they can begin to feel like "the norm"--and norms, as most sociologists argue, often dictate behavior.

The author (Sarah Rubenstein-Gillis) believes we are influenced from childhood. She found only three films with G ratings that come close to depicting breastfeeding. The first is a nursing Pegasus foal in Disney's animated classic Fantasia (1940); the others are the suckling pigs in Charlotte's Web (both the 1973 animated and 2006 live-action versions). She writes, "A typical media-exposed child might logically conclude, especially if he or she has not seen breastfeeding at home, that nursing is for animal babies and bottles are for humans."

For films with a PG, PG-13, or R rating, "Most seem to be shot from a heterosexual male perspective, emphasizing the sexual ojectification of breasts that permeates American cinema. In addition to sexually intriguing portrayals, breastfeeding is depicted variously in these films as funny, disgusting, fascinating, shocking, heart-wrenching, triumphant, and, very occasionally, mundane." Many may be left with impressions that reinforce confusing, discouraging, or negative attitudes about nursing.

In November 2006, real-life mom Emily Gillette was kicked off a Delta/Freedom Airlines flight for breastfeeding her 22-month-old daughter.

Rubenstein-Gillis found "only two American films that go against the grain by normalizing public breastfeeding. One was made more than 70 years ago, and the other is set more than 70 years in the future. James Cagney's The Mayor of Hell (1933) shows a working-class mother matter-of-factly feeding her baby under a blanket in a courtroom as an older child looks on. In the sci-fi thriller Imposter (2001, PG-13) set in the year 2079, a nursing mother gazes into her child's eyes while riding in a futuristic public transport vehicle. In both scenes, those who surround the nursing duos either ignore them or look on in a friendly way."

Even in most hospitals, staffers distribute free formula samples and promotional "goody bags"--something that has been demonstrated to negatively affect breastfeeding rates. Medical personnel receive minimal training in lactation initiation and support.

I can attest to this. I falsely assumed after giving birth to my son that my nurses were going to consider breastfeeding a priority and be on top of it for me since I'd never breastfed before (and now I realize how little I knew about it). Nope, I learned right away I was on my own. No one ever asked me how I was doing or offered to help me. I discoverd it is up to women to figure everything out before they have a baby. . .which can be pretty hard when you've never had the experience! I'd taken a breastfeeding class while pregnant so at least I was aware of a few "rules"--but I still didn't like having to initiate everything, whether it was at my original hospital just to nurse for the first time, or at Children's Hospital later that week--as, not long after my son was born he had to be admitted due to high levels of jaundice. He was hooked up to an incubator and on IV fluids. A million emotions and thoughts went through me that week--I am amazed I even asked for help! If I hadn't, I now know my milk supply would have dried up and that would have been the end to my breastfeeding. I remember my breasts getting severely engorged as I waited for the hospital's breast pump. A nurse quickly walked me through it and then left the room. . .I remember feeling so clueless and insecure. I hadn't even figured out breastfeeding yet, let alone the whole pumping thing (especially since before my son was born I hadn't planned on ever pupming--or at least so soon)!

One of the nurses got a bottle of my milk ready for Logan, even though he was only 3 or 4 days old and I'd remembered learning that you shouldn't give a bottle to a baby that soon (if you're wanting to exclusively breastfeed). Thankfully, the superb lactation consultants showed up at that moment and they turned out to be my saving grace. They got me off to a better start and are the reason I was able to breasfeed at all! They were angels on earth. (For my complete breastfeeding rollercoaster story, click here.)

I can only imagine how hard it was for women before lactation consultants worked in hospitals. I'm sure there were many women in the mid-twentieth century who used to have a gut instinct that they should breastfeed but instead trusted their doctor who gave them formula. It is another example of how we need to remember that our doctors are human and not necessarily what they say is true. We should never take what they say as gold--without doing our own research and looking inside ourselves first. If we come back with the same answer, then we will know in the future if we made a mistake that we did the best we could and there is no reason for regrets. Same with if you ever look back at a situation and wish you had listened to your doctor. But, at least with the example of breastfeeding you won't find a doctor nowadays who won't tell you that "breast is best!"

But in the baby boom era, aside from thinking that formula was healthier, it was also seen as a status symbol. Middle-class women were talked into splurging on formula so as to feel more like wealthy women rather than the poor. Even prior to when formula was offered, higher class women didn't breastfeed--instead, a lower-class lactating woman would nurse several upper-class babies from her community (wet nursing). According to the pregnancy.org article: A Look At Breastfeeding: Past, Present, and Future, the role of a woman was to be delicate and refined--not a "cow!":

[Breastfeeding may have been natural once], but we don't live in that time now, and we must adapt our doings to the age in which we were born.......Let no mother condemn herself to be a common or ordinary cow unless she has a real desire to nurse..... Women have not the stamina they once possessed.

Mrs. Panton, Circa 1860

According to Activity Village.com: "Wet nursing declined around about the same time as other, artificial means of feeding emerged. . .For women who did breastfeed their own children, during primitive and ancient times infants were breastfed until they were five, six or seven years of age in the Middle Ages."

During the 1800s, breastfeeding for longer than one year was actually considered harmful. (I wasn't able to find out why.) Activity Village.com went on to say: "The first artificial baby milk was produced way back in 1850. In 1867, Henri Nestlé was mass producing artificial infant food, and by 1873 half a million boxes of Nestlé’s Milk Food were being sold in America, Europe, Mexico and Argentina. Until this point, only those who had access to a cow could give their baby cow’s milk – and many did!

Links between the advertising of baby food and a decline in breastfeeding led to an enquiry by the American Medical Association (AMA) in 1924. Enquiries such as this would continue in many forms for the next five decades.

By 1948, the World Health Organization (WHO) had been formed to look into public health and nutrition all over the world. At about the same time, the American Academy of Pediatrics (AAP) came out and recommended breastfeeding as the best way to feed a baby.

In 1975, Nestlé sued Bern Third World Action Group (AgDW) for translating a report about the effects of artificial baby milk into a publication with the title “Nestlé Kills Babies”. AgDW were found guilty of libel, but Nestlé were also told to improve their marketing practices.

1991 saw the World Alliance for Breastfeeding Action (WABA) formed, along with the first ever World Breastfeeding Week. Today, we are advised by midwives and health professionals all over the world that breastfeeding is the best way to feed our babies."

As far as statistics go, in 1982 there was finally an increase in nursing--approximately 62% of women were breastfeeding in the hospital and 27% were still doing it at six months. In 2000, 67% of women were reported breastfeeding in the hospital, and at the last report in 2006, 77% were! (However, only 30% percent were still doing it at 6 months of age. If you want to see the statistics broken down, click here.)

It appears that in regards to "status," society is opposite compared to a hundred years ago; breastfeeding rates in 1999-2006 were significantly higher among those with higher income (74%) compared with those who had lower income (57%).

I posted a blog while I was pregnant titled "Preparing To Breastfeed" that said: "One of the outstanding benefits of human milk is that it is custom-made for each infant. Mothers with premature infants make milk that is specifically composed for their infant with extra antibodies and proteins. Breast milk contains not only carbohydrates, fats and proteins, but also has growth hormones and special substances that enhance visual and brain development, as well as antibodies to fight infection. Scientists are unable to put these valuable substances into formula. Studies have shown children who breastfeed have fewer instances of ear infections, diarrhea and upper respiratory infections. The advantages carry over into later periods in life. Adults who were breastfed have lower cholesterol and fewer occasions of heart disease. Studies have also shown that women who breastfeed have lower rates of breast cancer and cervical cancer. In addition to experiencing fewer common illnesses and diseases, breastfed children have higher IQ's."

So why doesn't everyone breastfeed? According to "A Look At Breastfeeding: Past, Present, and Future":

First, the promotion of breastfeeding without practical help and knowledge has led to many frustrated, unsuccessful breastfeeding attempts with subsequent backlash.

Second, a much shorter hospital stay does not provide adequate time for mother's milk to come in or for appropriate education and support. In Australia in 1993, a country which is known for its support of breastfeeding, the average hospital stay for vaginal delivery was still 5 to 7 days, and for C-section, 7 to 10 days. Australia also has the foresight to send home health visitors once the mother is discharged to offer further assistance and support.

Third, the continued increase of women in the workplace, many times by necessity and not by choice, has influenced the incidence and duration of breastfeeding. A nonsupportive work environment makes breastfeeding difficult at best.

In my "Preparing To Breastfeed" blog, I summarized several common problems women face (and gave tips for all women on how to breastfeed). Aside from sore nipples, infections or painful lumps, yeast infections/thrush, and engorged breasts (all which I wrote about in that post), I also briefly mentioned in another post that some babies are affected by a mother's diet through breastmilk.

As you already read, my biggest problem was having a baby with jaundice. There are many babies, who for a variety of reasons, are slow learners and this can be very frustrating--and scary. No mother wants to starve her baby. Some are born with a tied tongue that make it impossible for them to latch. Fortunately, a pediatrician can recognize this immediately and perform a very simple surgery before you even leave the hospital. Also, 20% of women have inverted nipples. Nipple shields and nipple shells (two different things) can work wonders, as well as icing nipples prior to feedings, or a breast pump can be used to at least give a baby breastmilk in a bottle.

In my case, my son latched perfectly but wouldn't suck long enough. On the bright side, my son is now 6.5 months old and we're still hanging in there!

Breastfeeding has come along way since the beginning of time--we even have a Breastfeeding Awareness month in August now! Since 1956 we've had groups like La Leche to help women, and many places of business boast about being "breastfeeding-friendly." The Healthy People goal for 2010 is to have 25% of babies breastfed to a year old. Currently the statistic is around 16%. I hope I've encouraged you to get on board to help America reach that goal!

Preparing To Breastfeed

This was originally written on Monday, March 24, 2008:
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*Those who are interested in this post may also be interested in reading my other breastfeeding posts, HERE.
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Hope everyone had a happy Easter!

I forgot to mention last week that I experienced the baby's hiccups that I'd heard and read about. It's now occured three times and it reinforced that L.J. is head down--because they're coming from that direction! None of them have lasted more than 2-3 minutes, but they all had the same pattern and feeling. Each time was like a light tapping inside of me--without any movement. Almost like what your heartbeat would feel like if you could feel it from the inside.

However, I'm also confident he is facing front because his feet or knees keep pressing outward from me. When a baby is born it should be facing towards the back (so as not to suffocate), but sometimes the doctor can turn them if they're not, so hopefully that won't become a concern for me.

Lately I've been craving shakes A LOT (ice cream is a common craving during the third trimester) and in less than two weeks of eating it every day (sometimes more than once), it is noticeable: I should have only gained a half a pound since last week. . .but instead gained two! I'm up 30 lbs. now, which means I officially weigh more than Joe. (He already lost the few pounds he had gained during my pregnancy.) So, no more shakes for me--I still have six weeks to go--i.e. only 3 more pounds!

I also had to try a Runza last week. Ever since I moved to Nebraska almost five years ago, I've been hearing about their trademark sandwich: the Runza, found at the fast food restaurant with the same name. I've always thought it looked good from commercials, as well as sounded good from the description. . .but I have to say I was disappointed. Can you say FALSE ADVERTISING? The sandwich didn't look anything like it did on TV (rather than on fluffy, fresh-looking bread, it was flat and looked burnt), it was put together rather sloppily and the flavor wasn't anything special. Also, the color was bland rather than seasony-looking. Oh well, at least I can say I've had one now.

Over the weekend my mom and stepdad visited for Easter. Fortunately, the recliner fit in their Blazer so it is now in our nursery, making the room officially complete (along with my great-grandmother's dresser)! :-) (My mom also gave us a rug)We went out to supper on Saturday night and then to church on Sunday, followed by lunch.

At church there were a couple of songs that L.J. really danced along to :-) My parents enjoyed the service, and although my mom would prefer to see me carry on Catholicism with L.J., she said she accepts that we're going to raise him in a non-denominational church because it's more important that I've found a church to keep up my relationship with God. At least L.J. will be raised in a Christian home.

My parents were able to feel L.J. kicking, so that was fun for them. We also washed L.J.'s clothes & blankets, so everything's definitely ready now :-)

So, now for today's topic: breastfeeding.

As you know, I took a breastfeeding class last month because I am planning to breastfeed. There really doesn't seem like any other option. From every book I've read, every doctor and lay person I've talked to, etc. there's no reason NOT to. According to my HypnoBirthing book:

"In recent years, research has confirmed that breast milk is truly a unique food that cannot be duplicated. Formula is not equal to breast milk. The evidence of this fact became so overwhelming that in 1997 the American Academy of Pediatrics adopted a policy statement recommending that children receive breast milk for twelve months. The World Health Organization recommendations on the priority of infant nutrition are in the following order:

1) mother's own milk directly from the breast
2) expressed mother's milk fed to infant another way
3) other human milk (from a milk bank)
4) infant formula"

I can understand that for some there are valid reasons for not being able to breastfeed, but it doesn't seem like there are any not to pump. I, personally, would feel I was not starting my child off on the best "health" foot if I chose to give formula instead. Therefore, it is important for me to not give up if the going gets tough.

"One of the outstanding benefits of human milk is that it is custom-made for each infant. Mothers with premature infants make milk that is specifically composed for their infant with extra antibodies and proteins. Breast milk contains not only carbohydrates, fats and proteins, but also has growth hormones and special substances that enhance visual and brain development, as well as antibodies to fight infection. Scientists are unable to put these valuable substances into formula. Studies have shown children who breastfeed have fewer instances of ear infections, diarrhea and upper respiratory infections. The advantages carry over into later periods in life. Adults who were breastfed have lower cholesterol and fewer occasions of heart disease. Studies have also shown that women who breastfeed have lower rates of breast cancer and cervical cancer. In addition to experiencing fewer common illnesses and diseases, breastfed children have higher IQ's."

As I mentioned in a previous blog, my hospital has special lactation consultants who will not only work with me while in the hospital after giving birth--but will come to the house afterwards if I'm having trouble. They don't want any of their patients to have an excuse for not being able to breasfeed. According to them, all problems are fixable. And, good thing, because it'll also save you money: if you bottle-feed formula to your infant for a year, cost is $1200-$2700. . .but your body provides your baby the perfect diet for absolutely free.

I took several notes during my breastfeeding class. Here are some tips I found helpful:

*Nurse within the first hour after their birth.

*If your baby is making smacking noises, trying to eat its fist, or sticking out its tongue--they are hungry.

*Make sure they use their tongue when feeding--that is the first key. (You can entice it out with your finger.)

*Vary between three breastfeeding positions and use both breasts.

*Hold the baby's head behind their ears.

*To know if your baby is getting enough, they should have one dirty & one wet diaper on their first day, two on their second, three on their third, etc. up to the sixth or seventh day--then it stays the same.

*Eat oats if you need to stimulate milk prodcution (oatmeal, oatmeal cookies, etc.), as well as garlic. Have 20 g of protein in the morning and drink Mother's Milk Tea (by Nature Sunshin).

*Follow same diet plan that you did while pregnant (do's and don'ts)--be careful and slow when introducing caffeine back in. If you plan to drink more than one alcohol beverage, you must pump in advance or you will be feeding your baby alcohol.

*Feedings usually take 15-25 minutes.

*Feedings will be every 2 hours during the first month.

*Wear breast pads to absorb leaks when not nursing. Throw them away when they're wet--use cream (recommended: PureLan 100 Nipple Lotion) after every feeding to avoid dry or sore nipples.

*Expose your baby to light during the day, keep rooms dark at night.

*For engorgement (happens by day four):
HENRIC--Heat (take a shower before nursing), Expression (do a breast exam), Nurse, Rest, Ice & Ibuprofen (helps with swelling), Cabbage (wear leaves up to eight hours).

*Keep a feeding diary after you leave the hospital--this will help when you go to the pediatrician, as well as if you need to discuss nursing problems with a lacation consultant.

*Medela is the best brand for pumps. The hospital will give me a harmony (manual) pump to have. This is usually good enough for mothers who are at home. Mothers who work outside the home often use electric pumps--always use on minimum setting and always clean after each use.

*For pumping, it is easiest to do while nursing the baby (dad can help).

*Breastmilk can be stored up to 5 days in the fridge and 6 mos in the freezer. Can store flat in zip-lock bags.

*Wait four weeks before introducing the bottle.
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In addition, breastfeeding burns 300-500 extra calories a day (best way to get rid of the fat deposits which stored in the hips & thighs during pregnancy) and is a special bonding experience. Just like with labor, it should be looked at with a positive view. It can help to prepare yourself for common breastfeeding problems:

1) Sore Nipples
Many women find that their nipples not only feel sore after every feeding, they are red and pointy instead of round and smooth -- all indications that your baby is not 'latched on' properly.

The "latch" as experts call it, is the way your baby connects to your breast. When done correctly, your baby will open his or her mouth very wide and take in a good deal of breast tissue. This means that your nipple ends up way in the back of your baby's mouth where the hard and soft palates meet.

If, however, your nipple is sitting in front of your baby's mouth, you're going to feel the pinch every time baby's tongue comes up -- and baby is not going to have an easy time feeding.

The solution is to insert your finger into the corner of your baby's mouth to break the latch as soon as you feel pain -- and then try latching on again. Ideally, your baby should take at least one inch of your areola into the mouth.

Experts say you can further ease pain by avoiding the use of soap on your breasts, which can be drying and irritating. Instead, wash with plain water. You might also want to let some milk air dry on your breast after feeding, which can help reduce some inflammation and soreness.

2) Infections or Painful Lumps
Even when your baby is latched on correctly, you may develop a sore or tender spot in your breast, or even a painful lump. Says lactation expert Carol Huotari, this commonly results from a plugged milk duct, or the beginning of an infection known as mastitis.

"Either problem can be easily remedied, and you don't have to stop breastfeeding in the meantime. It's perfectly safe to continue, even when an infection is present," says Huotari, manager of the Breastfeeding Information Center at La Leche League International in Schaumberg, Ill.

If the pain is from a blocked milk duct, experts at La Leche say you should apply moist or dry heat compresses to your breast for 10 minutes, three times a day. Also, massage your breast in a warm shower. As the duct unplugs, you may express some milk, which helps relieve pain. Continuing to feed on that breast is important because breastfeeding helps further open the milk ducts, says Huotari.

3) Yeast Infections or Thrush
Yeast infection is a less troubling but still uncomfortable condition on the surface of the breast skin. This problem can develop even after weeks or months of successful nursing. The culprit is thrush, a form of yeast infection that thrives on milk. This infection will likely affect both you and your baby.

Signs of thrush include red or pink shiny skin that usually itches, and may flake or peel, says pediatrician Audrey Naylor, MD. To learn if your baby is infected, look for white spots on the inside of the cheeks, or sometimes a persistent diaper rash.

If you do have a breast yeast infection, Naylor says you don't have to stop breastfeeding. But you and your baby do need treatment.

4) Engorged Breasts
Engorgement is normal and can develop when your milk begins to flood your breasts, usually between the second and sixth day after you start nursing your baby.

"Once milk starts to come into the ducts, there is also a flooding of lymph fluid and blood, which causes the tissue in the breast to swell."

Because that swollen tissue pushes down on the milk ducts, the ducts can sometimes clamp shut. When milk can't be expressed, it builds up inside the breast and engorgement occurs.

Your best solution is to place cold packs on the breast for about 20 minutes.

"Right before you are ready to nurse, put a warm pack on your nipples for a few minutes -- this will also help with the 'let down' [milk flow] and can encourage feeding."

"Most important is to keep on nursing," Huotari tells WebMD. "The more milk that is expressed, the less chance you have of engorgement."

The following organizations can help you find a lactation counselor in your area:

Le Leche League International. The oldest name in the breastfeeding arena, this worldwide organization has counselors and group leaders nationally and internationally. To access its huge database of experts, visit the web site: www.laleche.org. Or call (800) LALECHE.You can also try your local telephone directory under La Leche League, where you might find a local chapter.

International Lactation Consultant Association. This group helps train lactation consultants worldwide and provides many of the guidelines and training materials used to teach breastfeeding counselors. Visit its web site, www.ILCA.org, to access a national database of experts. You can also email info@ilca.org or call (919) 861-5577.