Tuesday, November 10, 2009

Breastfeeding: One Year

I’ve been nursing Henry for 10 + months, and I plan to wean him after the 1 year mark.  For me, nursing has been relatively drama free, which has entailed having self-diagnosed mastitis twice, clogged milk ducts countless times, and cracked and bloody nipples.  Since Henry’s top teeth came in, a bit of soreness returned, but it passed in a few days.  He’s nibbled while nursing a few times, each time followed by a grin, but I’ve learned that he only nibbles when he’s full.  I’m not a breastfeeding crusader, but Henry and I have a great routine going and I love the quiet time we have together nursing.  I’ve considered weaning before the 1 year mark, but the expense of formula, and Henry’s dairy allergy requiring soy formula have deterred me from seriously considering it.

Half of the moms I know breastfed their babies, and half of those moms weaned around 5 or 6 months.  For many moms nursing is extremely painful and frustrating.  A wonderful mother I know had two children who were allergic to her breast milk anytime SHE ate dairy.  She nursed both kids for as long as she could, but finally gave in to formula.  Her kids are healthy and happy.  Another baby I know never figured out how to latch on, and her mother gave in to formula after a few days.  Again, the baby is happy and healthy.  Each mother and baby makes the decision for themselves on whether or not they will breastfeed or use formula.

Breastfeeding at the Hospital

I attempted nursing soon after the birth.  A lactation consultant met us before we left the delivery room, but she was unhelpful.  Henry took to the breast quickly and furtively from the beginning.  He nursed so well.  He once choked and spit up what looked like 3 tablespoons of collostrum.  We were worried at first as we didn’t know what it was.  Other than the spit up incident, I was upbeat and encouraged.  Unfortunately, lactation consultant #2 made me feel inadequate.  Her discouraging tone made me nervous and uneasy, and Henry stopped nursing.  He must have sensed that something was off.  We had trouble nursing for a couple feedings.  Thankfully the morning we checked out of the hospital, lactation consultant #3 came by to check on us.  She suggested SNS to encourage Henry’s latch.  It worked like a charm.  I taped the plastic tube to my nipple.  The tube was connected to a milk reservoir that I pinned to my hospital gown.  My milk hadn’t yet come in, and taping the tube to the nipple encouraged Henry to latch.  The formula also supplemented Henry’s feedings to ensure he got enough milk.

To help my milk come in I used the hospital pump regularly.

Breastfeeding at Home

Once my milk came in (day 4), we no longer needed formula.  In fact, we still have the unused and unopened hospital formula in Henry’s closet.  Henry nursed 8-10 times a day for 45 minutes to an hour each time.  I basically nursed him all day long.  My nipples were extremely sore, cracked and bloody.  Henry’s pediatrician recommended I limit Henry’s nursing to 45 minutes.  Apparently, he was comfort nursing.  Once I capped his nursing at 45 minutes, the bloody cracks started to heal.  Using Lansinoh lanolin was also helpful.  

I was so thrilled when the milk came in.  I pumped after each feeding to encourage the milk to come in.  Of course, that backfired, because I started producing too much milk and got clogged milk ducts.  I soon learned to time each pumping session to ensure I didn’t over-pump.

Clogged milk ducts are literally plugged up ducts.  The milk gets backed up, and it feels like hard inside out pimples scattered all over your breasts.  The only way to cure them is to encourage feeding and massaging the hard spots in a hot shower.  It’s a vicious cycle as baby will have trouble nursing if there are hard spots, and the milk won’t flow consistently.  It is extremely painful, and if they persist it can develop into mastitis, which entails horrible flu like symptoms such as chills, sweats, fever, fatigue etc.  That was the first time I learned the concept: mommies don’t get sick days.  Henry quietly sat in his swing and seat most of the day as I suffered through the symptoms.  Luckily when I woke the next morning the symptoms were gone.  My OB/GYN told me that I probably didn’t have mastitis since the symptoms went away without antibiotics, but I’m convinced my diagnosis was correct.

To prevent getting clogged milk ducts/mastitis:
1.    Don’t skip feedings.  If baby sleeps too long, try pumping a little bit to relieve the engorgement.
2.    Don’t over pump.  If you’re going to create a stock in your freezer of milk, choose an extra time each day (a non-feeding time) to pump.  When baby is eating 8-10 times a day, this isn’t really feasible, but it can be easily done when baby eats 4-5 times a day.
a.    Over-pumping causes engorgement, and when that happens baby will have trouble latching on.


Engorgement feels like your breasts are overfilled water balloons.  They get hard as rocks and leak.  The milk will even spurt.  Whether you pump or not, you will get engorged while nursing.  At the beginning your body is figuring out how much milk baby needs, and it will sometimes produce too much.  For example, when Henry slept a long stretch at night, I would wake up soaked.  Then I would be engorged and Henry would have trouble latching and get frustrated.  He even got sprayed in the eyes a few times.  I learned to manually squeeze or pump off the excess before feeding him.  Waking up before his regular feeding to pump was tricky, but I succeeded in doing that a few times.  

Breast Feeding in Public

I was extremely shy about nursing in public.  I didn’t think I’d be able to do it.  I made it 3 months without having to nurse Henry in public, but I definitely was feeling restricted.  My sister insisted I learn to nurse in public, knowing that I wouldn’t last long if I didn’t figure it out.  With heavy coaxing from my sister, and a busy day, I finally did it!  We were visiting Henry’s new cousin at the hospital, and then headed to a baby shower in the neighborhood.  I didn’t have a choice but to nurse him in the hospital lobby.  I set up a chair in the corner of the room, put on my Bebe Au Lait nursing apron and tucked Henry underneath.  We did it, although not without Henry’s protest.  It took many tries to get Henry comfortable nursing under the apron.  He still doesn’t enjoy it.  He kicks his legs and flails his arms, but if he’s hungry he will nurse.

43 states, the District of Columbia and the Virgin Islands, have laws that specifically allow women to breastfeed in public.  28 states, D.C. and the Virgin Islands exempt breastfeeding from public indecency laws.  24 states have laws relating to breastfeeding in the workplace.  There are even 12 states that exempt breastfeeding mothers from jury duty.  I recently received my first jury duty summons, and postponed it easily with a short phone call.


How Much Milk Should I Produce?

Each mother produces a different amount of milk.  Milk production depends on many factors, but mostly on how much the baby needs.  First, the more often you feed and the longer you feed the more milk you will produce.  From birth to 2 or 3 months Henry fed every 2-3 hours for 30-45 minutes.  The stronger he grew the quicker he fed.  Starting around 3 months he nursed for 10-15 minutes at a time.  At around 6 months, Henry could get all his milk in 5-10 minutes.  

In the first couple months I could pump 2-4 oz. max in one pumping session (5 minutes).  When Henry was around 3 months old, I was producing close to 8 oz of milk in one session.  He started solid foods at 4 months old, and at around 6 months started eating enough to supplement his breast milk.  The more solids he ate, the less milk he needed.  Solid Food post coming soon.

The amount I pumped roughly corresponded with the amount of milk Henry consumed.  Around 3 months I was having trouble producing milk late at night.  I had developed a habit of pumping at Henry’s 8 p.m. feeding so that Chris could give him a bottle.  What I didn’t know was that my body was decreasing milk production at the 8 pm feeding, because I was pumping at that time every day.  I started moving the pump session around each day, and my milk production went back up to 8 oz after a few days.

I also learned that my body produces more milk in the early part of the day.  And my milk production goes down when I’m exhausted or dehydrated.

At 6 months, Henry was nursing 5 times a day (7am, 11am, 2pm, 4pm, 7pm), and I would pump once in the mornings between his first and second feedings.  Generally, I would feed him every 3 hours, give or take an hour depending on when he was asleep.

At 9 months, we cut his nursing down to 4 times a day (630am, 11am, 4pm, 730pm), and I still pump once in the morning.  On days that I’m tired, I skip the pumping session knowing that my milk production might be down.  As convenient as pumping is, it’s also tedious.    

The Long Haul

Nursing for a year is a serious commitment.  It’s been more difficult than I anticipated, but I’ve enjoyed it.  I have a wonderful bond with my little baby boy.  I’m so proud of what Henry and I have accomplished.  I’ve watched him drink my milk and grow at an amazing rate.  It’s the same feeling I get when I water my plants and watch them bloom, but multiplied by a million.  I feel a part of every giggle and every smile.  Of course, there are days when I envy moms who have the freedom and convenience of formula, but I know I will miss nursing him when it is all over.  I will miss the quiet time we have together.  I will miss watching him pull at his hair and kick his legs.  I will miss the comfort my milk gives him.  But I will be free.

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