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Posts Tagged ‘breastfeeding’

After a post went up from a Babble blogger that shamed mothers who breastfeed without a nursing cover, and piece over at Slate that indicated the simplest way for us to move forward as women in society would be for lactivists to care less and the market to over better nursing covers, I was invited to write a guest post for Annie at PhD in Parenting. I hope you will visit me over there and join our conversation about misogyny, the female body, judgments and the mommy wars.

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Every day I think about Paula, the midwife who helped me birth my younger children. She wore a white lab coat with a big purple button that said Listen To Women. I think of her as I continued to be troubled about the rigidity within some corners of  the birth community. Today I was reading on the ICEA blog (International Childbirth Education Association).  The author was responding to a doula’s question that had through Facebook: How do you guide a clients who are not interested in breastfeeding?

Here are the non-answers that stood out the most to me:

I was very proud to respond that I have never had a client that was not interested in breastfeeding.

If I ever move from Santa Fe and start working as a doula elsewhere I am afraid I will be in for a rude awakening.

I use social media outlets like Facebook and Twitter to post articles about the benefits of breastfeeding.

I downloaded and printed “Thank you for breastfeeding in public” cards to hand out to women that I see breastfeeding in public.

As far as I can see, the author not only did not answer the question, but lacks the professional experience to even field it.  I have had this experience a few times. If the doula who wrote asking is anywhere out there, please allow me to respond. From time to time as a doula, you may encounter clients who are not interested in breastfeeding. The first thing I try to remember is that my primary role is birth support. Although I am a strong proponent of breastfeeding, the job I have been hired to do is help this mama labor and birth her baby. If I am able to ask my client some open-ended questions about her lack of interest, sometimes I can better understand her needs. I do believe that breastfeeding is a healthy choice for mother and child. However, I also acknowledge that while I might have stats at my fingertips about research and benefits, I have only known my client a short time. I don’t know how she came to her decision. I don’t know how strongly she feels about her choice. Keeping in mind that it is not my job to change her mind, I might say something like,

Can you tell me about your decision-making process?

How did you come to decide that breastfeeding was not for you?

Do you know any other moms who breastfeed? If so, what was it like for them?

If not, do you have questions you want to ask me mom-to-mom that you don’t feel comfortable asking anyone else?

Are you uninterested in feeding at the breast? Might you consider pumping colostrum and breastmilk for a few weeks?

When I ask these exploratory questions I might find out that she is on a medication that is contra-indicated for breastfeeding, or that she thinks is contra-indicated for breastfeeding, that no one in her family breastfeeds and she is not willing to try something that seems so foreign, that she is expecting to go back to work at 6 weeks postpartum when her paid time is up and has heard pumping is miserable and she may not have time for it anyway. I might learn that she tried breastfeeding before, did everything “right” and never made the milk she thought she should. She is still wounded over that and doesn’t want to go down that road again. I might learn that she is a sexual abuse survivor and cannot imagine sharing her body in this way. There are so many things I can learn when I ask open ended questions of my clients. Some of the obstacles face are ones that can be conquered with support. Others are conquerable in the best of circumstances but that may not be what my client is experiencing right now.

Many women who do not breastfeed or who breastfeed for a few months do know the benefits. They often feel quite guilty that they are not breastfeeding. The question for birth professionals must be how are you going to support women? If you take rigid stance on an issue and don’t open up for exploration and conversation, you may miss a beautiful opportunity to help a woman birth her baby.  You may or may not be able to help her decide to breastfeed. Can you be at peace, knowing your respect and openness are more valuable to her at this time?

 

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Long story, no? Where were we? Oh, yeah, juice filled bottles.
All those empty calories.

That phrase, empty calories, both haunted me and became completely meaningless. When a mother is stacking stage 1 and 2 baby food jars to see how many of them add up to 550 calories – and wondering if she really devotes her whole day to feeding the baby by spoon, maybe he’ll grow – well, let’s just say she doesn’t need any help worrying about calories. By the way that’d be about 7 jars , provided you don’t waste your time on low calorie food likes carrots and green beans and just go straight for the good stuff:

100 calories per jar! 80 calories per jar!
(more calories in fewer jars = more time I could sleep)

And apparently your about to be 5 month old can too have meat.
Can too.
Calories in carrots were not worth my time. A few bottles of juice didn’t take up any of my time. He drank it himself in the carseat on the way out to buy more baby food and baby Pepcid.
Three formula bottles a day was not enough calories. He was still not an any growth chart a month later. We adjusted his dose and then maxed out what we could give him according to his weight. That’s when our pediatric gastroenterologist nurse practitioner gave me a present:

Apparently, my baby could have Cherry Mylanta – the grown up kind – up to a teaspoon, whenever I wanted. Anytime he had a reflux episode, I could give it to him to stop the pain. I could stop it. The baby Pepcid was there in his system to prevent the episodes. But his little baby body was way out of wack and we couldn’t prevent it all the time – yet.

reflux episode + pink chalky liquid = baby feeling better = mommy getting her game back.

Within a week, he knew the blue bottle meant. I carried it in the diaper bag next to our bottle of juice – and our new favorite kind of calories, a ziploc of arrowroot cookies. How that child loved anything that had a fair chance of staying down!

We had been cleared for breastfeeding and had been playing around with it really. It wasn’t his favorite. It wasn’t a cookie, for example. It was a lot of work for him – probably not a lot of calorie pay off for him, maybe not worth his time – like carrots. He’d fuss a bit, nurse a bit, like our earliest days together. I thought maybe we could go back to breastfeeding on a part-time basis. We never quite worked our way back. For a little while he nursed before naps and bed if we were on my bed together and the room was dark and quiet. I made a cursory effort at pumping. We lived in the dorm at that time and I was taking care of a sick baby – and had a 5 year old. There wasn’t lots of time for pumping. I wasn’t all there for it. I was disappointed in myself, felt I could make a greater commitment to it. I did see some small progress for a few weeks, but then a huge hormonal shift sealed my fate. In February – when he was 8 months old – an unplanned pregnancy and very early miscarriage just flattened me emotionally and I’m pretty sure there was just no milk after that. The turn around time hormonally was just too extreme.

There was, naturally, the accompanying mini-depression in which several rather large issues got tied together into a gigantic knot inside me, inside a cold, hard winter in a job I was struggling with deeply. It was a mix of processing this loss, reflecting on a previous and more traumatic loss, the loss of the breastfeeding – which really represented the loss of mothering the way I planned, or of having mothering this baby be pleasant or easy – and the loss of the sudden windfall of an unplanned (as in I don’ t have to take responsibility for the decision!) third baby (who would be perfect in every way and would nurse for close to two years).

A gift came our way, a trip to England, in perhaps less than ideal circumstances. Matt’s grandfather’s home needed some loving attention. He had passed away in December and the family needed some time together in his space. It turns out that sometimes ocean hopping is just what you need. We found our way there and let the Thinker meander on English countryside, let my husband walk us all down memory lane in Dorset and Weymouth, go out for cream tea with grandparents. LP was quite a charming little 9 month old riding in the back pack here and there in lanes, on beached, in castles and garedens, all the while drinking up his bottles, chomping down arrowroot cookies and drinking juice from a cup (more socially acceptable activity for babies and toddlers.)

We reached equilibrium. It was there in that spot that I sad goodbye to nursing. I watched by baby make his first moves towards toddlerhood, as so many 9 month olds do – practicing on big person food, practicing standing, giving a whirl at jumping. I began to look more ahead than back and the months that followed were an uncovered treasure store of pleasure in him, in our attached connection (that went way beyond the breast, which in fact had never really had much to do with the breast or the milk it produced), in his delightful little personhood. His first words, first jumps – which preceded his first steps, his charm, his laugh, his smile.

I’d gotten kicked around and I was the last woman standing. I’d found a patch of motherhood that I could ride like a wave and it was glorious. I’d put the torn up, battered down pieces of me back together. The absolute perfection of that baby boy at that time was something I never could have foreseen. Aside from the too frequent ear infections (common GERD side effect), it felt very close to perfect. I know it can’t have been, but it was perfect in its completeness; my heart got filled at that time for the months that would follow. For that breathing space lasted all of 8 months.

* * * * *
This is the first segment of Henry’s story.
It’s the story that brought me back to writing. It’s the story whose second chapter brought me to blogging. It’s the story it’s taken me more than a year to get the courage up to write it down. I needed enough space to pass that I could look back at who I was then and keep on loving.
The next chapter will appear here in the coming months.

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Apparently, a baby can have GERD that is silent. Not silent as in quiet or absence of noise, but silent as in no vomit or spit up. I think at this point LP had spit up maybe 5 times in 4 months. So, spitty he was not. However, if a baby throws up inside his own throat and then swallows what he regurgitated, you hear the sound.
The sound of
episodic,
high pitched
(high pitch = baby in pain)
crying.
And it doesn’t go away by 4 months. It doesn’t go away at all, unless you treat it. He will just cry more and more, because of the pain and because of the hunger. Only, he won’t know it’s hunger because in his very small, still developing brain:
eating=pain.

I imagine now he might have spat up a bit more, you know, if he’d been eating at all. Truthfully, I don’t think he had been eating well all along – remember poor latch, upcoming growth spurt, building milks supply, that had been around 10 weeks – and probably he had not eaten anything close to well for 2 months and most likely he had been surviving on sips of milk from my breast and water from my cup in the preceding two weeks. He was growing taller, being stretched out. There was not an ounce of baby fat on that child. He had a pointy chin, pointy elbows. It was easily masked in the fall weather with fleeces and hats. Even I did not see him naked all that much in our old drafty apartment.

I called my pediatric office on that day to say he had skipped three feedings in a row. That was a gross underestimation. 2lbs can’t be lost in three feedings. His diapers had been light for weeks. I had just been too sleep deprived to really absorb what that meant. It’s all so foggy now. The doctor asked the nurse practitioner to try a bottle. They eyed me suspiciously. Like many well meaning souls they respected my right to breastfeed and supported it as the healthiest choice. But, like all breastfeeding mothers I was suspect – was I going to insist on it event to the potential detriment of my baby? – No, I wasn’t. At all. Even so, he refused the bottle. The back arching, screaming, shrieking baby appeared. When not having an episode, LP was the sweetest, mildest tempered baby on the planet earth. I was completely in love with him and he with me. When presented with food, he was absolutely unrecognizable. The whole office came to the door. It was horrid. I was crying. Administrators were crying, the nurse was crying. In any case, the pediatrician called the hospital, the gastroenterologist at the pediatric hospital. It sounded like silent reflux. It had to be. If the Pepcid helped, it was GERD. If it didn’t help, it wouldn’t hurt him. No, they didn’t need to see him. Just weigh him, get the right dose and call it in.
Getting the dose right seemed like higher math. Still, I was assured it would be called in. Also, formula. Please put the baby on hypoallergenic formula. Just to be sure it wasn’t a milk protein allergy. Here is some to take home. We can revisit after we’ve seen him eat for a few days. After he sees the specialist.
Suddenly all the rules had changed. Now willingness to put baby on meds without a real diagnosis and willingness to wean suddenly = good mother. Okay

Let me be very honest here. I want to say this kindly, but I was broken-hearted. For me and for him. I wanted to nurse. I wanted nursing to be okay again. I hoped it might be one day. And I mixed up bottles of formula. For the first time ever. I had to read up on it, seriously. I was using tap water at first, unfiltered and unboiled. I also want to say that I am deeply aware that I had a hungry, sick baby, as well access to medicine and food to make him well. So, yes, I screwed my head on straight and did the next right thing. And I did need some talking down by my nearest and dearest. But, I was basically at peace.
Speaking of peace, after we managed to acquire our very own bottle of baby Pepcid and the teeniest dropper ever – And after we gave it to him and waited the requisite 30 minutes before feeding, oh the peace. He drank, burped, drank burped. For the next several weeks, our biggest problem became helping him through the 30 minute wait time, because he finally could eat. He could eat exactly three times a day happily. That’s how many times a day he had baby Pepcid. And 30 minutes was meaninglessly long to him. A totally different type of crying began and it was lovely to hear.

Yes, you are right, 4 1/2 month old babies do in general need to eat more than three times a day. Ours could not. Nor could he poop. Our very special hypoallergenic formula was causing bit of a back-up and baby oatmeal and pears were not powerful enough to help, nor pureed prunes.

Take a look though:

Our brand new pediatric gastroenterolgist was great – only she wasn’t actually a doctor. She was the nurse practitioner in pediatric gastroenterology at the Connecticut Children’s Medical Center. The doctor had an opening in January if we wanted to wait. It was October. We’d like to see the nurse practitioner, please. And she really was great. Baby Pepcid was working. He was poked, prodded, meausured and weighed with super accurate equipment, again and again.

He was gaining. His blood work was great. He still couldn’t poop. Before I knew it, I had to swallow my pride and pour pear juice into bottles for him to drink. He drank the specialized formula three times a day, 30 minutes after baby Pepcid. He ate as much baby food as he wanted (doctors orders!) and in between he was to drink juice. Out of a bottle. Yep. So, when I was out and about – you know not waiting around at home for 30 minutes to pass, or sitting up in his bouncy for and endless parade of puree, he’d drink a bottle of juice. in his stroller – to tied him over to baby Pepcid/meal time. And to help him poop.

And let me tell you what you must already know to be true. All the places I went, I could just tell that people thought I was the most wonderful, responsible mother ever. No, not really. They told me about tooth decay, baby bottle mouth, empty calories, failure to thrive and sugar addiction. It was really dreadful. Truly. There was nothing gracious for me to say. Should I tell them I’d only just gotten out of a horrible scrape with this kid and had saved his life by letting all my good parenting paradigms call to pieces? Should I just run away crying? Should I tell them to mind their own damn sugar addiction? I have no recollection of how I handled this. Only hating it and surviving it. And also not giving a damn what they thought. Because my baby was starting to gain weight. So now suddenly, unrestricted solids at 5 months and bottles of juice = good mother. Weird how that works out, huh?

More tomorrow on how I kicked motherhood’s ass with my super powers of juice filled bottles, arrowroot cookies and playing with antacids. Also, how early weaning kicked me around the room a bit, but I was the last woman standing.

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Did I ever tell you about Little Puppy? I mean really, all of it?

He was born June 04. It was an easy labor – really easy. I started of 5cm dilated in prodromal labor, the kind that is non-patterned and not hurting. I arrived at the hospital in the wee hours of the morning with persistent non progressing contracts and begged my midwife to break my waters so I wouldn’t have to be pregnant any more. 10 hours later he was born. Labor stayed relatively mild, intense contractions that peeked high and heavy but didn’t really impeded my ability to walk or find comfort in knowing it would pass in a minute. The delivery itself was more troubling. His head was transverse and a bit oblique too, I think. Looking from his perspective, wandering “what now mama? what do I do?” Tuck that chin little man and spin out! He did, a little too fast, a little too spinny, a little too urgent – having sat there for an hour. There was some damage to my perineum. It was a hellish repair. My recovery was miraculously quick all things considered. It may be that I was given a miracle because I was gonna need it.

At birth weighed 8lb 6ounces. A few ounces shy of my first baby’s weight, but no concerns. All seemed well. I felt in the first few weeks that he was not as good a nurser as my first child – then I felt guilty and tried not to compare them – In the next few months he gained weight. Some weight. I felt he should have been gaining more quickly, maintaining his position on the chart – like his brother did. Then I felt guilty and swore I would not compare them.
Not Compare = Good Parenting.
Every Kid is Different = Good Parenting.

By three months, he was either completely angelic or impossible to console. I felt his latch was not good – he was on/off very frequently – was he getting any hindmilk? Worries about Latch = Good Mother. No worries, LaLeche says he is latching on and off to build up my milk supply for his upcoming growth spurt. Allowing baby to do this so your milk supply increases = Good Breastfeeding Mom. Hurray me.

Between 3 months and 4 months we were experiencing episodic crying episodes frequently throughout the day, clustering in the evening. Colic. It had to be colic. Nothing else was wrong I was resenting the hell out of my baby = bad mommy. Colic. Okay, great, it goes away. It goes away. Resenting the hell out of my baby will go away. I slept on the sofa away from my husband and at the far end of the apartment from my 5 year old. I slept on the sofa next to a battery operated infant swing on full tilt. I had two sets of rechargeable fast charging D batteries. The moment it started to slow down the crying would begin. I’d change the batteries. make some feeble attempt at feeding, be refused. His tiny fists punching my breasts. His back arching as he let out piercing howls. I’d bring my face close to his face and pat his cheek to get him to snap out of it…literally a 4 month old baby so stressed that I had to snap him out of it. I’d stick him in my sling – cries, shrieks and all – and start moving as quickly as possible. It helped. I think in my mind, I thought, if this helps, there can’t be anything really wrong.

At 4 months he had dropped on the growth chart, significantly. But was still on it. He weighed about 12 lbs. Haunted, by an older brother who weighed 19lbs at that age, I pictured him thinking – ease up mom! I’m me. He was normal developmentally, and I described the crying:
Some babies cry more than others, even when it is not colic. He can have some baby cereal.

I went home convinced, sort of. I thought, I need to me more patient with nursing. Not rush it, not make him do it the way his brother did. Let it go, just relax. I’d sit in the rocker trying to get him on, just to take a little. I’d avoid it, then try to do it more frequently, then it’d be so miserable I’d avoid it, then I’d try to time his actual nursing. He loved the cereal. Loved it. For a while I was so crazed and sleep deprived I thought he hated me.

The night the infant swing stopped working as a soothing technique ripped me apart. I thought about his delivery. I thought, how am I going to survive this? Thank God the next day he stopped eating altogether. Would not even try, not even close. I was on the phone with a friend. I was weeping and saying this isn’t right -She said, go with it, go with it then, your the mom. Thank God. He was 4 1/2 months old – he weighed just over 10 lbs. He’d lost 2 pounds in two weeks.

Within two weeks he had been diagnosed with severe and silent GERD. It was better than our first diagnosis, which was failure to thrive.

More news tomorrow on how Little Puppy and I are not failures.

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