Docking the space shuttle

The key to early breastfeeding success is the latch.  What is "the latch?"  It is the way the baby connects with your breast to feed, and it is way more than just putting his mouth on your nipple.

In  our case, it felt a lot like docking the shuttle at the international space station, except you only have control over the station.  The shuttle has a brain of its own, and it is a person named Elliott. 

Components of my good latch:

• intense, driving motivation to breastfeed
• four adult hands
• three human brains
• plan of action written out prior to birth by lactation consultant (LC)
• great support team and medical providers at birth
• no medications during labor
• smooth, problem-free delivery
• healthy, hungry baby with a big open mouth
• hospital that supports skin to skin, feeding within first 20 minutes, and rooming in
• LC available the first night
• another written prescription for action by LC before leaving hospital
• baby's dad who would  not let me settle for an imperfect latch

Elliott, Day 1

That the nurses and LC could see on my chart the breastfeeding prescription--which included strategies to avoid soreness--meant that everyone around me was prepared to help.  The first day and a half I let the baby nurse and nurse and tried a few times to latch him myself.  It felt OK.  His mouth was huge.  Edema wasn't a problem since I had received no IV fluids and no medications. The nurses said, "That latch looks perfect.  Textbook."

It wasn't until I got to meet with the LC who prescribed my breastfeeding strategy, Suzanne, on Day 2 just before we were discharged that I realized I was on a course to repeat my mistakes.  She said,  "On a scale of 1-10, what is your pain level?"

I said, "Maybe two or three."

She said, "It needs to be zero.  Take him off and try again."

When breastfeeding hurts, the latch is not good enough, and breakdown of nipples begins, leading to more pain and more breakdown.  This is the cycle I got trapped in with Sam.  Suzanne was taking no prisoners this time.  She wrote another plan for us before sending us home.  We took pictures and videos of the right way to do it.  At home, Max emulated her helping hands and rigorous standards.  He insisted on zero-pain latch.

Our life was a jumble of nipple shields, pillows, tylenol, breast pump parts, ice packs, cabbage leaves, waterproof pads, and used tissues.  But we made it.  We nursed.

My breastfeeding support survival guide

I've already chosen a hospital and a doula who have great track records for breastfeeding success.  But I need to have a reference guide in case things don't go smoothly: my breastfeeding support survival guide.  I have some research to do to fill in the blanks, but this will be filled in and in my overnight bag when we leave for the hospital.  Am I missing anything?

In-hospital lactation consultations:

• List of all hospital LC's and their availability (Cost: covered by insurance)
• Who can help if they aren't available (are nurses trained to assist?)
• Outline of routine postpartum care I can expect at my hospital ("magical hour" skin-to-skin contact, minimal intervention, etc.)
• Training and qualifications of other staff to help, such as nurses

After-hospital lactation consultations:

• List of 1-3 providers and phone numbers who travel for in-home visits (cost: covered by insurance if affiliated with a hospital--be sure to get prior insurance approval)
• List of local hospitals and phone numbers that offer lactation appointments (cost: covered)
• List of 1-3 Skype services (cost: $45-$75/session, not covered by insurance)

 Pediatrician:

• Postpartum pediatrician's office, phone number and hours of operation, and services (traveling nurses? Same-day appointments?)
• Local pediatrician's office, phone number and hours of operation

References:

• List of feeding cues and signs of a well-fed baby
• List of favorite information sites (kellymom.com)
• List of recommended YouTube videos on latching
• List of books and DVD's on hand  
• Printouts of medical protocols for most common breastfeeding problems (http://www.bfmed.org/Resources/Protocols.aspx)

Support groups:

• List of 1-3 local breastfeeding support groups, their phone numbers, and schedules
• List of online forums

Other lifelines:

• Doula phone number
• List of friends and family who are breastfeeding supporters

Battle Babyfood: Round 2

The bell is about to ring on Round 2 of Battle Babyfood: I am expecting baby #2 in just over 2 months.  I've spent the last 3 years training and conditioning, and I am now a mommy of steel: nothing is going to stand in my way this time.

OK, so that is me psyching myself up.  But it is true that the knowledge I gained from trying to breastfeed a baby, having major problems and not having nearly enough help, finally finding a stopgap solution on my own (exclusively pumping for 20 months), and then asking a lot of questions and doing a lot of research and writing afterward, has me much better positioned to beat the barriers this time around.

My thinking in July 2008 was: If I can get through labor and delivery, I can get through anything, and breastfeeding will come naturally.

My thinking now is: I will be supported in labor and delivery by a slew of dedicated helpers at my hospital.  I will be supported in breastfeeding--which could be even more difficult and painful than labor and delivery--by no one except the team I build for myself.  And by support  I mean people professionally trained, experienced, and ready to provide medical guidance and intervention if needed, as well as emotional supporters.

So I'm getting started building my network of pros to make this happen, including a breastfeeding-friendly midwifery/OB practice, a breastfeeding-friendly hospital (that has incidentally made strides in its lactation support practices since Sam was born there almost 3 years ago), a great childbirth educator and doula, at least one great lactation consultant willing to do home visits and/or work with me via Skype, and a breastfeeding-friendly pediatrician.

Let the battle begin!

The other side

All last week as my body was gently reminding me that it COULD still breastfeed, if I wanted to.  I resisted mightily, and now am officially on the other side!  I feel sad and excited at the same time.  Sam is such a big boy lately, eating and talking.  Just last week, he began to say "I like it" and "No like it," taking a new level of control over his own diet.


So what will  become of babyfood, the blog?  Looking back, there seems to have been a trajectory of shock, desperate search for answers, tons of research read, realization of the higher level of barriers (not just physical) I was caught in, and then finally, a sense of calm.   Last week, I went back and tagged my posts by baby's age so those mothering infants can find posts relevant to them.  I will continue to post about toddler feeding, especially as we enter the potentially picky-eating phase, and also reflect on my year and a half of baby feeding. 

I'm also thinking of two close friends who embarked on their own babyfeeding journey nearly the same day that I ended mine, sending them good luck and best wishes.

On to the next phase!  Thank you for sticking with me.

Letting go

I have just expressed the last breast milk for Samuel.  I feel the mix of pride and heartache that I now know is exclusive to mothers letting go of their children.  I felt it when he was born and his umbilical cord was cut, and I'm feeling it now for the second time, since once again he is no longer dependent on my body for survival.  I am sure I will feel it again and again throughout his life as he makes leaps toward independence, each one seeming to arrive too quickly and each one bigger than the last.  We're only just getting started.

Time to Retire

Samuel will be 20 months this Sunday, May 15.  It’s time to retire from pumping milk.

When he was two weeks old, I gave up nursing despite never having wanted anything more in my life, thinking formula would be it for us.  Then, I had some luck: the pump worked.  The first few months were difficult, seven or more sessions a day, literally hours stuck in a chair hooked up to a machine.  But it worked, and Sam got breast milk.

Then I got lucky again, in that I was able to donate extra milk to one adopted baby and again to a milk bank for premature and sick babies.

Even better, pumping got easier and I cut back to four, then three times a day, two.

Then, just last month, Sam stared eating some serious solid food.  I kept it to one pump for the past few weeks, getting a tiny bit of milk.  Sam kept eating, and he sprouted his eye teeth.  And last night, he ate a huge plate of food--fish, vegetables, cous cous--just ate like a champ.  This is the message I’ve been waiting for. 

 So, on May 15, I’ll call it quits.  My baby is a little boy now, healthy and smart, and I can only take a deep breath and appreciate how lucky I am. 

One ounce of milk; Happy Mothers' Day

A few weeks ago, I reduced to one milk pumping session a day and saw a big decrease in supply--down to less than two ounces total.  I was a little sad, since I'd hoped to continue at once a day for a little while, but it just didn't seem worth it for so little.  But then, of course, I found myself reading about the benefits of even a tiny bit of breast milk per day.

From Kellymom.com:  "Even 50 ml of breastmilk per day (or less - there is little research on this) will help to keep your baby healthier than if he received none at all."  So, an ounce a day it is, for a little while longer! 

A second topic: today is Mothers' day.  My guys made today very special for me, and I've been thinking about how each of the people who are "moms" in my life have given me something very special--and how lucky I am to have THREE of these.