Sunday, September 7, 2014

My Best Pieces of Breastfeeding Advice



I am not a doctor.  I am not a certified Lactation Consultant.

What I am is a mother.  A mother who has breastfed for almost 4 years total (and still going), across the span of 6 years.  The only time I haven't been breastfeeding in the past 6 1/2 years, I've been pregnant.  I kinda like to think I'm sorta an expert on this stuff.  I've done countless hours of research, suffered through 5 bouts of mastitis, a bazillion clogged ducts, a sealed off milk duct that required a biopsy, medical emergencies that required sudden weaning, failure to thrive in an infant, oversupply, and pretty much every other issue you could possibly imagine.

Well, I guess that depends on the craziness of your imagination...

I have had tons of people ask me for breastfeeding advice, so I'd like to offer it, unsolicited, on my blog.  And if it's one thing you will learn to love as a parent, it's unsolicited advice!  /sarcasm

Let's see how many different nicknames for breasts I can come up with!

My advice:

1.  Breastfeeding HURTS at first.
Everything I read before I had my first said "if you're doing it right, breastfeeding wont hurt!"

THEY'RE LYING.

Breastfeeding HURTS.  For a few weeks at least!  It's completely normal and doesn't mean you're doing anything wrong.  Of course, if you're doing something wrong, it will hurt worse, and possibly cause problems, but don't assume that just because breastfeeding is hurting, you're doing it wrong.  I'll explain how to tell the difference and how to make it feel better faster in a minute.  Also, it does get better, so the pain is totally worth it.

2.  Make sure your baby is latching correctly.




An improper latch can cause tons of problems!  It can be incredibly painful for you, cause your baby to feed poorly, and establish bad habits.  The baby should have almost the entire areola (dark circle around your nipple) in his mouth.  Try the "hamburger".  Hold your breast, pinched between your thumb on top of your breast, and all 4 fingers underneath it like you're holding the worlds most awkward hamburger.  it should make your areola a little flatter.  Wait until the baby opens his mouth wide.  If he doesn't do it out of instinct, gently pull on the bottom lip and they should open their mouth wide.  Once the nipple is in his mouth, make sure both lips are flared out.  They should look like that time you put pringles in your lips to make duck lips.  (Don't pretend like you haven't done that, we all know you have.)  If the top or bottom lip is curled in, gently pull it out.  If the baby is latched too shallow, unlatch by putting your pinky finger in the corner of their mouth to break the suction and start over.  (Don't just yank your nerp out of their mouth unless you're into insane amounts of pain.)

3.  Lanolin is your best friend!
I'm not being paid by anyone at all.  I promise.  But the very first thing you should buy for your breastfeeding journey is Lanolin.  It's hypoallergenic cream for your nipples that feels like a cross between vaseline and earwax, and is the closest thing to heaven your poor little breasticles will have for the next few weeks.  There are a few brands that make the cream, but Lansinoh is easiest to find, you can get it at any drugstore, Target, Walmart, etc.  Smear it on your nipples after EVERY feeding, and after you bathe.  Wait for your nipples to dry, then apply a generous amount.  It will help keep your nipples from cracking and bleeding (yes, I said bleeding) while they get used to being mauled several times a day.  You don't have to wash it off before feeding your baby.

4.  Feed on demand
Don't try to get your newborn on a schedule.  It won't work, and if you make your child wait for food in order to adhere to a schedule, you are going to make your life and theirs a living nightmare.  Babies 0-6 months old cry only when they need something.  If what they need is food, and you deny them that, they develop all sorts of emotional and psychological problems.  If you don't believe me, go read a few child development books.  How does this relate to breastfeeding?  In the first couple of months, your breasts are regulating their supply.  They need to figure out how much milk to make.  How do they do that?  By "calculating" output based on when and how much your baby feeds.  (please note, at this point I imagined boobs using a calculator and laughed.  I would be delighted if you did the same.) Your boobs are not a never ending well of breastmilk, so if your baby needs more volume than what you're making at one feeding, guess what?  The baby is going to nurse again soon.  Does this mean you're not making enough to keep your baby fed?  NO!!!  It means your baby is communicating with your breasts, saying "Hey!  I need more food!  Please make more!" So it's important to let your baby nurse as often as it wants, even if you begin to feel like a human pacifier!  Which brings me to my next point...

5.  Just because your baby nurses constantly doesn't mean you're "not making enough".
All babies are different.  Some babies sleep through the night at 2 months old (and if you're lucky enough to have one of those babies, please know that I hate you).  Some babies nurse every 3 hours, some nurse every 6.  Don't compare your baby to another, just go by some basic guidelines: if your baby is wetting 6-8 diapers a day, and pooping at least once every 10 days (this pooping tidbit applies only to exclusively bfed babies), you're making enough milk.  As long as your pedi says your baby is following a growth curve in a positive direction, you're making enough milk.

During the newborn phase your baby should be nursing every 3 hours or so, but if they're nursing every 30 mins during a period of time, that's not bad.  It's called cluster feeding, and it's completely normal.  Remember, babies don't only nurse out of hunger.  They also nurse as a comfort tool, and it's VERY IMPORTANT to let them.  It establishes necessary emotional bonds and feelings of safety essential to their wellbeing.  Also, if your baby is in a growth spurt and needs more milk today than they did yesterday, they're going to have to communicate with your breasts to tell them that.  This "cluster feeding" can be downright inconvenient, but it does NOT mean you aren't making enough milk.  It does NOT mean you need to supplement with formula.  All babies, even all related babies, are different.  My 1st fed on a strict schedule since the day he was born (a schedule he set, not me!).  He would follow it almost down to the minute, so it was very easy for me to schedule appointments or go run errands.  My 2nd, who was born 16 months apart from my first, literally nursed every 30 minutes until she was almost 2.
And when I say every 30 minutes, I mean
EVERY.
FREAKING.
30.
MINUTES.
During the night she was constantly nursing.  During the day she was constantly nursing.  I had to nurse her in so many embarrassing places (during a dental cleaning... during an OB visit... while bringing groceries in from my car... I could go on...).  It was emotionally and physically taxing for me, especially when I had people glaring at me or ridiculing me for putting my child's emotional wellbeing before my own social acceptance and comfort.  If I didn't nurse her she would scream violently which would annoy people EVEN MORE than having to watch me nurse.  Sooo I was really doing them a favor, even if they were condemning me for it.

But anyways... I digress.

6.  Breastfeeding doodads and stuff
Repeat after me:  Any shirt I can lift up or pull down is a nursing shirt.  Any shirt.  Don't spend $40 on a dedicated nursing shirt.  Get a $5 camisole and a $5 t shirt and bam, you have a nursing shirt.  And if you're even cheaper frugal (like me!), just get yourself a cheap scoop neck shirt and there you go.

Breastfeeding pillows are comfortable and make it a lot easier to breastfeed, but when you don't have a dedicated time block to breastfeed, and you're forced to do it on the run, they're just a waste.  So if you're lucky enough to have peace and quiet during breastfeeding, and you don't have to get up and fetch things, get one, they're comfy!  But if you already have a bunch of kids that require your constant attention, don't bother.  Unless you use that one Michelle Duggar uses that clips around you and allows you to nurse while walking around?  That thing looked awesome.  I never owned that one.

Breast pumps can come in handy.  I definitely recommend pumping a storage of breastmilk for your freezer.  In case of an emergency (like say... an appendectomy...) you will not have to go through the extremely unpleasant process of suddenly weaning your baby.  Also, you can pump a bottle just to get some free time.  If your husband is interested in being a parent, too willing to give you time to go out sans baby, pumped milk is a great way to buy a few extra hours out.

Nipple shields are awesome if you have latching difficulty or inverted nipples.  I haven't used them, but I hear they're miracle workers!

Breast pads are a lifesaver if, like me, you over produce and leak constantly.  I leak like a runny faucet for months, and I have to wear bras and breast pads even to bed!  I prefer the Lansinoh disposable ones, they're comfy and thin and I have yet to leak through one, even when they weigh a ton, but there are a ton of different brands out there.  When my supply settles down and I'm only leaking drops, I switch to washable ones, they're much cheaper, but they don't hold a lot, and it's easy to leak right on through to your shirt.

Nursing bras can be expensive.  Rarely do they look cute, unless they're REALLY REALLY expensive.  And for some strange reason, nursing bras usually come padded.  (Because if it's one thing women want, when their tatas are already 4x their natural size, it's to make them appear EVEN LARGER!!)
*sigh*
Anyways... like I said, I have to sleep in bras because of the whole leaking thing.  Because of that, I buy 4 or 5 cheap, cotton, underwire-free nursing bras at Walmart, and tell my husband to just deal with it.  They look like training bras, but they get the job done, they're inexpensive and they're comfy.  And barely anything about breastfeeding is ever comfy.  You can get one or two of the pretty kind for fun times, but I warn you, trying to fold down the padding and yank your boob out is really, really uncomfortable, and extremely difficult to do gracefully.  For me, it's just not worth it.  Plus, remember, as your supply settles down, your boobs can change in size.  That means you could go through 4 different bra sizes over the course of a year.  $$$$

I can't think of any other nifty nursing doodads, so if you can, leave 'em in the comments!

7.  Your baby is going to hurt you.
Nursing hurts all over.  First, you deal with the pain of engorgement.  Your boobs have just increased in size DRAMATICALLY overnight, so sometimes you're left with itchy, ugly stretch marks, a feeling like you have two heavy, painful boulders strapped to your chest, and the pain only increases every time your milk lets down.  Then, you have a little teeny baby who is going to suck on one of the most delicate parts of your body.  Don't worry, it DOES get better!  Your nipples WILL stop being sore.  Your boobs WILL stop feeling like rocks.  The stretch marks WILL fade!  Switching to formula WILL NOT make these things go away!  (in fact it will make engorgement worse)  You will feel so much better in a month, I promise!

As your baby grows, they start to play with your boobs as they nurse.  They claw at them, mash them, try to move their heads around with your nipple still in their mouth, chomp on it, pinch it and a million other things.  You have to remember, the baby doesn't see this as a piece of you, they see it as a toy, a learning tool, a fascinating thing that gives them delicious food!  Especially when they develop teeth, things can get painful.  But I promise, they don't keep chomping.  I find the chomping phase usually lasts a week or two, then they get bored of it and move on to something else.  So stick it out, mama!  You can do it!

This icon is 100% accurate

Other parts of nursing that can hurt are clogged ducts and mastitis.  They're not super common, but they're definitely common enough to talk about.  Clogged ducts are pretty self explanatory.  Your gland isn't draining properly, it backs up, and you feel a tender lump in your breast.  You can massage it under hot water (shower) and open it back up.  Feeding more on that side can encourage it to open back up, too.  Both of these things can hurt!  But stick it out!  Mastitis is an infection of a duct, often caused by a clogged duct.  It makes you feel like you have the flu, you get a fever, your boob is sensitive, and has a pink rash on it.  Go to the doc and get some antibiotics, but you can stick this out, too!  I've heard of SO many people quitting nursing because of these things.  If I can deal with it, so can you!  It's really not that bad!  You went through 9 months of uncomfortable pregnancy and hours of painful labor!  A week of feeling like crap and having a sore boob is nothing!

People often ask me how I deal with babies that bite during nursing.  First, I cry a little bit.  Then, when they bite, I gently push their face into my breast.  It instinctively, immediately releases their jaw so they can open their mouth to breathe.

Also accurate

8.  Breastfeeding is still, for some stupid reason, frowned upon by a lot of closed minded, selfish, immature people
Its unfortunate, but ever since the formula push of the 50s, breastfeeding has taken a back seat to formula.  In the 50s, scientific "breakthroughs" were the most fascinating thing, and anything man could create synthetically was automatically better than nature.  I actually interviewed my grandmothers extensively about this subject!  Breastfeeding was for the poor or the immigrants back then.  It was a status symbol to formula feed your child, because that meant you had money enough to afford it.  It was not, as most people believe, just about modesty.  It was very common in the 20s and 30s for women to openly breastfeed everywhere, including church.  Once the formula boom coincided with the baby boom, breastfeeding was all but lost.

Nowadays, it's all about profit.  Formula is EXTREMELY expensive.  Formula is nearly forced down your throat as soon as your baby is outside your body.  You're sent home with a new diaper bag full of the stuff, your name is added to a mailing list (where they get your info I have no idea) and you're sent samples and coupons nearly every day.  When your body is hurting, you get no sleep, people are openly shunning you for breastfeeding, and you just want to feel good again, it's easy to give in and give up.  VERY easy.

Don't do it!

Like I said, it DOES get better.  You learn to ignore glares from the stupid people, because the amazing, loving stares from your baby as you nurse them are all you can see.  You will looooove not having to lug bottles and formula and water and crap all over creation.  And laws are catching up to the times, and are allowing mothers to breastfeed where and whenever they please.  (To check your state's breastfeeding laws, go here: http://breastfeedinglaw.com/ ).  It's just easier to nurse!  And free!

9.  Co-sleeping
Let me start out by saying this:  Because of our culture, it is currently recommended that Americans DON'T co-sleep.  The reasons for it being considered unsafe here is because in our culture it is common to...
have lots of blankets and pillows on our bed
have pillow top mattresses to sink into
drink wine/other alcohol before bed
take prescription sleep aids or other drowsiness inducing meds
be overweight

All of these things pose a significant danger to a co-sleeping child.  If any of these things apply to you but you're still interested in the benefits of co-sleeping, they have awesome new products that attach to your bed called co-sleeper bassinets.  Get one of those!

I am lucky enough to have a California king size bed with a firm mattress, I'm tiny, I don't take any medication, I don't drink and I only have blankets and pillows on half my bed, so I co-sleep.

Co sleeping makes breastfeeding INFINITELY easier.  Actually, it makes the whole newborn phase infinitely easier.  My babies don't sleep through the night until they're about 6.  My 5 year old still wakes up once a night.  Seriously.  So, during the year(s) in which baby nurses at night, I LOVE being able to roll over, whip out the boob, nurse, and roll back over.  I don't have to get out of bed.  With the co-sleeper bassinet, it's the same idea.  You sit up, take baby out, nurse, put baby back and go back to sleep.  Less work = less time = more sleep for you.  I HIGHLY recommend it when done safely.  There are tons of other physical, emotional and psychological benefits to it, too!  For both mom and baby!

10.  Figure out what works for you.
I can tell you what to do until the cows come home.  (Fun fact relating cows to breastfeeding: my husband often moos at me when I nurse or pump.  Great guy.)  But you need to listen to your baby and find what works for YOU.  There are a million great reasons to nurse.  Your baby's physical, emotional, and psychological health.  Your physical, emotional, and psychological health.  Your wallet.  Your connection to your baby.  If nursing one way or another isn't helping all of these things, find a new way to do it.  There's a million great ways to nurse.  If you want to use a cover for modesty, use it.  If you want to pump so you don't have to nurse in public, do it.  If you want to whip out your lady lumps any old place while people stare wide eyed, do it.  Do what works for you and your baby, not what works for anyone else (sorry, but that includes your husband!).  Breastfeeding is hard.  It is a hard thing to do at a hard point in your life (adjusting to a new baby).  So as long as what you're doing is safe for your baby and you, do it, mama!
And try to consider that sometimes the safest, best, most relationship-saving thing you can do for your baby is give up.  Nursing can be extremely stressful, and if it's coming between the building up of a nurturing, loving and safe relationship between you and your baby, it's time to move on.

11.  Let the baby wean when it wants to wean
Around 6-9 months, baby will go through a phase of wanting to look at anything and everything.  He will nurse for exactly 14 seconds, then get distracted, then remember it wants to eat, then get distracted again.  We're told to find a dark, quiet, calm place to nurse during this phase.

All you moms of multiple children can stop laughing now.

When you don't have a calm, quiet place to nurse, it can be incredibly difficult to nurse an easily distracted baby.  Moms often think this is a signal that the baby is "no longer interested" in nursing.  It's not.  It's a normal phase of babydom.  So what can you do?  Just keep trying.  Baby will not starve himself.  It may make for frustrating nursing sessions (a lot of them, actually...) but you just gotta keep going.  Luckily it's around this time you get to start introducing solid foods, which can top off baby's tummy after a particularly annoying nursing session, and also introduce him to something new and exciting and sure to hold his focus.

It will be more obvious that baby wants to wean because he will make absolutely no attempt to keep going.  A distracted baby will come back and look for the boob.  A ready to wean baby wont.  What if your no-longer-a-baby doesn't want to wean and you're ready?  Ask yourself why.  Is it for convenience?  Nothing about motherhood is convenient, mama.  If it's because the baby is about to start preschool/kindergarten/college, well, you may have a better argument.  Drop one nursing session every few weeks and replace them with table food (assuming your baby is over 1 year old), or formula, if you're forced to wean before then.

A sudden need to wean is a horrible thing to endure.  I've done it.  Twice.  This is when having breastmilk storage is important.  If the weaning is temporary, you'll have your bases covered.  If it's permanent, you can use the storage to gradually wean the baby, lessening the shock and emotional impact sudden weaning has.

Be sure your medically necessary weaning is actually necessary!!  I cannot stress this enough.  Breastfeeding is not a profitable industry, but lawsuits and pharmaceuticals are.  Therefore there are not a whole lot of tests done on lactation risk when it comes to medical issues.  99.9% of medications say "do not breastfeed" on them purely for CYA purposes of the manufacturer.  Don't believe me?  Go read your bottle of Tylenol, the safest medication to take while breastfeeding.  Yeah.  Then, there's this giant book your pediatrician consults that compiles testing done 5-30 years ago on certain medications, which can be really handy but often outdated.  The leading medical testing is done by Dr. Thomas Hale who operates his own website that is up to the minute with their lactation risk reporting.  You can find the most current information about what you can and can't breastfeed on.  Don't worry, he's a legitimate Dr. that leads world renowned studies on both pregnancy and breastfeeding medication interaction.  If you'd like to learn more, or check your meds, go here:  http://www.infantrisk.com/forum/forum.php


I love breastfeeding.  It's hard.  It's come between me and people I love.  It's embarrassing.  But it's also the best thing I can do for my child.  It's amazing.  It's empowering.  It's healthy.  It's one of the things I'm going to miss the most when my last baby, weans.  I hope my experiences can help any of you guys out there.  Do you have any helpful questions?  Please don't hesitate to ask!  Also, if you have any other funny nicknames for boobs, I'd love to hear 'em!

Monday, June 30, 2014

Life and loss

I'm on day 4 in the hospital.  I was lucky enough to have a scheduled, prepared procedure.  A lot of people here weren't so lucky.  There are mostly elderly people, some who look ready to die at any given moment, and some who have lapped me in the hallways on my daily walks.  There are people guarded by security because they tried to harm themselves.  People who are guarded by nurses because they're severely mentally disturbed.  People who scream all day and all night.

Then there are the nurses that cater to everyones needs no matter how dire, no matter how they're treated, no matter how many hours it's been since they've had a break, a meal or a moment to use the bathroom.

Then there are the doctors who are mostly robots that smile, but don't really care much about you, they just keep an eye on their "project" to make sure it works well enough.

I don't feel like I have the capacity to take in the delicacy of human life.  How strong our bodies are, to be able to repair itself after major injury, but how weak they are to completely shut down from even the smallest wound in a certain place!  Everything is "normal" on one hand and "life threatening" on the other.

It makes me want to do everything and nothing at the same time.  I'm too fragile to leave my bubble.  I'm too short for this life to not.  My children are too delicate to expose to life's dangers.  My children need to experience as much as possible for they could leave this world at any moment.

My head is spinning and my heart is hurting thinking about all this.  It's terrifying and freeing all at the same time.

This is when people snap.  Either it's too much to take in or they comprehend it all and use their time to really live.

After losing my hopes and dreams, my gram, having a complicated birth, and getting appendix cancer, I seem to be listing a bit to the left.

Wednesday, June 25, 2014

The 'C' Word | The scariest post I've ever written

2 weeks after my appendectomy, I was feeling back to myself again.  I remember thinking how grateful I was to be feeling good.  To have energy to think, keep my kids entertained and even go out shopping!  It was in stark contrast to when I came home from the operation tired, groggy, dizzy and devoid of all energy at all.  It was only two weeks, I was so fortunate!

My surgeon had called the day prior, and I missed it, but he left a message saying he was calling to see how I was feeling, how the incisions were looking, etc.  He said he'd call back the next day, but he didn't, so I didn't hear from him until Monday.  My phone rang and he asked how I was feeling, and I was overjoyed to tell him how great I was doing.  I had suffered with appendicitis for the weeks prior to my surgery, so I really was excited to feel normal again.  He kept trying to interrupt me, but I was so excited I was babbling.  Finally when I stopped chattering, he said "I need to tell you something, but I know you have high anxiety, so I don't want you to freak out"

My chest froze.  I couldn't breathe.  I squeaked out a little "okay..." and he continued.  He apologized for having to tell me over the phone, but I told him that I was going to come to the check up appointment in a few days alone with my kids, and he said it was very important that my husband came with me to that appointment.  There was no way for him to tell me to bring my husband to the appointment without arousing suspicion, so he had to tell me everything over the phone at that very moment.

"The pathology came back from your appendectomy..."

I didn't even know they sent appendices for pathology...

"We found a carcinoid tumor on your appendix."

Carcinoid.  I knew that word.  It means cancer.

"It's small, but we also found carcinoid cells in the outer layer of the appendix."

It spread.

"So we need to meet and discuss your future care."

Chemotherapy.  More surgery?  Am I going to die?  I have cancer?  I have cancer.

After I burst into tears and tried to extract every bit of information from him, I focused on the necessary bit of information that made my already-cheaply-renovated world come crashing back down: I had appendix cancer.  A type of cancer I didn't even know existed.  But it did, and google wasn't kind during my frenzied searches.

I panicked and asked if I could go that evening to see the surgeon instead of waiting a few days for the already scheduled follow up appointment.  He was so kind, and said he'd wait at the hospital for me, I could come as soon or as late as I wanted to, and he gave me his personal cell phone number in case he was away from his office, or I arrived after hours and the secretary had gone home.

I'm proud to say I only cried once during that meeting.

Here's what I know:
Appendix cancer is very slow moving.

It's almost never found unless by accident during an appendectomy from appendicitis, or a different close-by surgery.

It rarely spreads, but the two indicators that it has spread is a tumor greater than 2 cms (mine was 0.8 cms) or carcinoid cells in the outer layer of the appendix (which I had)

In order to rule out cancer spreading past the appendix, if you have either of the two above indicators, you have to have a right hemicolectomy.  You get 1-2ft of your large intestine removed and a few inches of your small intestine, then they sew the two tube ends together.  They also take your lymph nodes and vascular system that supported the removed portion of your intestines.

I should feel like myself again in a few months to a year

My first thoughts was what any normal person would think when told they have cancer: am I going to die?  I thought of my babies living the rest of their lives without me.  Missing Luke's first steps and first words.  Missing Liam's first day of preschool.  Missing Erin's progression into womanhood and motherhood.  Missing Aiden going on a mission or getting married.  All of these amazing life events without me there to see, to help, to counsel.  It ripped my heart out in ways I could never possibly explain.  You think you know how bad it could hurt until you have to actually consider it because it's a real possibility.  Would they forget how many times I told them I loved them?  Would they forget the times I took them to ice cream?  Would they forget how we would giggle over silly cartoons on TV?  Would they forget my laugh, my smile, my hugs and kisses?  The special notes in their lunch?  Every little thing I cherished about watching them grow up suddenly became more precious than oxygen.  I clung to every memory, every hug, every kiss, every tear, every time I was needed or wanted.  My heart felt like it was slowly, painfully being suffocated.

And here we are today.  1 day prior to surgery.  "Surgery prep" day.  It also happens to be my 29th birthday.  Tomorrow at 7:30am I will be in surgery, at the mercy of a handful of doctors and nurses.

Please, if you pray, pray for me to be okay.  Pray for me to recover easily and without much pain.  Pray for me to get the "all-clear", to be told "the cancer didn't spread".  Pray for me to be able to be a mother to my babies here on earth for many more years.  Please, pray.

And if something does happen to me, please make sure my kids know every single day how much I love them.