Cloud and Pumpkin

This post was written by Cloud, who blogs at Wandering Scientist.

I never doubted that I would breastfeed my baby. I'm not really sure why this was. I didn't think formula was some awful thing, although I had seen the research on the benefits of breastfeeding. Maybe it was because my mother had breastfed me until I was about two years old, and spoke of it as a wonderful experience. Maybe it was because I am trained as a biochemist, and considered breastfeeding to be a pretty amazing thing for my body to be able to do.

Regardless of the reasons for the decision, I never regretted it. Breastfeeding was sometimes hard, sometimes easy, sometimes painful, sometimes glorious, but always something I was glad I chose to do. Breastfeeding was one of my favorite parts of mothering an infant. I breastfed my daughter until she was 23 months old. We weaned because I was pregnant with baby #2 (due in September!) and breastfeeding was exacerbating my all day morning sickness. I decided to start moving more actively towards weaning when Pumpkin was 21 months old and nursing 2 or 3 times a day and Hubby and I were pretty sure we'd try to get pregnant again. We weaned slowly and gently, with not too much fuss. She never asks for "Boppy" anymore (she always heard me talk about a Boppy around nursing time, and that was the word that stuck with her). I still sometimes miss it.

The early days of breastfeeding seemed very hard at the time, but looking back, I think I had a fairly average experience. We had trouble establishing a latch. Pumpkin was not a patient baby. She wanted milk immediately, and that's not how the human breast works. She would give up sucking before my milk letdown and scream in frustration. For the first week, Hubby and I used a syringe of expressed milk and a little tube that we threaded into her mouth along with the nipple to give her the instant gratification she needed to keep sucking. For the next week or two, we used a tiny dropper and a little medicine cup of milk to dribble some onto the nipple and into her mouth and keep her from getting too frustrated. We needed that less and less as time went on, but even when she was 3 or 4 weeks old, she still sometimes needed a dropper or two of milk to calm her down so that she could actually nurse. I had to use a nipple shield for awhile, although I can no longer remember what prompted me to start with that. We broke that habit when she was between 4 and 6 weeks old, I think, but my memory of that, like so many other details of early motherhood, is fuzzy.

My family was very supportive of breastfeeding. However, even with family support, I was struggling more than I cared to admit during the first couple of weeks. The second week, Hubby convinced me to go to the breastfeeding support group at the hospital where I'd given birth. I didn't want to go. I didn't want to leave the house- it was too hard and I felt like a milk-soaked mess. Hubby gently insisted, and drove me to the meeting. I went back almost every week after that, even continuing to go after I went back to work. I worked half time for a month and had every other Friday off for many months after that. I chose Fridays for my day off so that I could keep going to support group. Hubby is a very involved father and was always very supportive of breastfeeding. He has done many wonderful things since Pumpkin was born, but convincing me to start going to that support group may well be the most wonderful thing he did. That group of women helped keep me sane as I adjusted to motherhood, which now seems like such an integral part of who I am but didn't come easily to me at first.

I went back to work when Pumpkin was 3 months old. I worked 3 days a week for a month, and then 35 hours a week until she was about 10 months old. My support group was wonderful, but no one there could tell me much about pumping at work. After all, women who pump are generally at work at 10 a.m. on Friday morning. The group leader had some general advice. I had experience pumping, since I had been doing it since the very beginning. Once we got Pumpkin to latch and wait for the letdown, I continued pumping so that Hubby could give Pumpkin one bottle a night. This allowed me to get a little more uninterrupted sleep, and also ensured that Pumpkin was comfortable taking the bottle. The support group leader had suggested that we introduce the bottle when Pumpkin was about 3 weeks old. I remember worrying about "nipple confusion" and prepared that first bottle with a certain amount of trepidation. We never had any problems switching between breast and bottle, and I went back to work confident that she would at least eat while I was gone.

Going back to work was an overall positive thing for me- I believe firmly that I am a better mother because I work (this is very much a statement about me, and not a general statement about whether other women should work or not). However, returning to work was definitely an adjustment. For the first week or two, I kept getting terrible headaches. I finally realized that I wasn't drinking enough water, and was getting dehydrated. I wasn't sure how to schedule my pumping sessions and how many times to pump during the day. I have an office job, and I was lucky enough to return to a private office, so I was able to just close my door, strap on the pump (I used a hands free bustier), and keep working. I eventually decided that since Pumpkin was eating roughly three times while I was gone, I would pump three times during the day. I kept this schedule until she was about 10 months old, and then dropped down to pumping twice during the day. Around this time, I also switched jobs and lost the private office. I continued pumping, though- my new employer had a lactation room. (I live in California. Lactation rooms are required by law.) When Pumpkin was about 15 months old, I dropped down to pumping once a day. I stopped pumping altogether when she was 17 months old. I certainly never thought I'd pump so long, but Pumpkin was not a good eater, and I worried less about her nutrition when I knew she was getting breastmilk during the day.

I had occasional problems with supply after I went back to work. There were many months when I had to pump before I went to bed in order to have enough milk to send with Pumpkin the next day. Sometimes, I had to take fenugreek to help increase my supply, and sometimes I found that just increasing my protein intake was sufficient. Anyway, it was an excellent excuse to go out and have a hamburger for lunch. I always had to watch my water intake and make sure I wasn't getting dehydrated.

I slowly figured out how to make the pumping routine easier. After a couple unexpected midmorning trips home to retrieve forgotten pump parts, I bought extra bottles and extra pump parts, so that I could repack my pumping bag at the same time as I unpacked it. I bought some bags that could be attached directly to the pump horns, so that I would always have something to pump into, even if I forgot the cooler bag with the bottles. I got a bit blase about pumping. I would pump while listening in on teleconferences, with my phone on mute. If I needed to talk, I would turn off my pump and unmute my phone. I even pumped on an airplane. I had to take a business trip when Pumpkin was 6 months old. On the way out, I tried pumping in the airplane bathroom- it was too cramped and I felt guilty for tying up such a precious resource for so long. I tried pumping in the airport bathroom, and discovered that I could not actually sit still enough to keep the automatic flushing toilet from flushing. So on the way back, I wrapped my big shawl around me, turned towards the window and pumped at my seat. This worked better that anything else I tried, and the man sitting next to me didn't notice anything was going on until he saw the little bottle of milk appearing from under my shawl.

I didn't love pumping, but I didn't mind it. I was glad to have the choice to continue breastfeeding while also returning to work. I also used the pump to have a couple nights away with my husband without Pumpkin. My parents came over and stayed with Pumpkin, and Hubby and I drove to a hotel about an hour and a half away. The first time we did this, when Pumpkin was about 9 months old, I mostly wanted to sleep. Pumpkin was not an easy sleeper, and Hubby and I were chronically sleep deprived. However, as she got older and started sleeping a little bit better, our nights away became less about sleep and more about a chance to reconnect as a couple. I'm incredibly glad I didn't have to wean to make this possible.

I have learned from the stories of others that there is a lot of luck in having the sort of breastfeeding relationship I had with Pumpkin, and there is certainly a lot of work. I am very grateful for the luck I had, and glad I stuck with it through the times when it was really hard work. Now, as I look ahead to the next baby, the logistics of managing two kids is a little intimidating. But if I look back at all of the logistics we've already figured out, I know we'll be OK. And I'm sure that as long as my luck holds, I'll be breastfeeding this baby, too.

Meg and Elias

Things had been a little rocky right before Elias arrived. I'd been in and out of the hospital and on bedrest because of impending pre-eclampsia the loss of vision it was causing. Ultimately we went from a doctor's appointment at 39 weeks to the hospital, do not pass go, do not collect $200, hopefully your brain won't explode and your liver won't shut down on your way.

Except for the medieval torture that is an emergency induction, everything went fine and 26! hours later Elias was born and he was on the small side. And he was on the yellow side. And we were on the Over-the-moon-happy (and thank-god-I-don't-have-to-lie-on-my-left-side-anymore) side.

All that time I had spent trying to get pregnant and lying on my left side while pregnant was spent visiting Kellymom and reading The Breastfeeding Companion and visiting message boards and blogs and I felt like I knew what the deal was. I didn't actually KNOW anyone who had nursed a baby, but most of the things I have learned in life I learned from books. I went in thinking it would be REALLY HARD. I knew I would give it my best and if things went badly I'd give it a month and if they went well I'd give it a few years. I was going to be pretty hard core about not supplementing with formula because I knew how important it was to establish a supply in the beginning.

It was 6 pm on Friday when Eli was born. Lactation consultant gone for the weekend. We would be gone before she returned. I was at the mercy of the nurses. They were all over-joyed that I was nursing but less then helpful. As soon as he was born (after we were both pronounced healthy again) we were left alone in the delivery room and I began to nurse him. He seemed to know what he was supposed to do, but couldn't latch too well. And later downstairs with nurses help he also... couldn't latch. And one nurse suggested side lying, and one nurse suggested football, and another suggested cross-cradle. The pediatrician said he was small, we needed to keep him warm so he didn't expend calories keeping himself warm. He needed to eat because he was jaundiced. He was sleepy because he was jaundiced and all the warmth kept him asleep. It was all we could do to keep the child awake long enough to nurse for 3 minutes. Me managing placement, and my husband tickling his feet and Eli... Eli mostly slept or screamed. And occasionally he'd eat.

In the middle of the night, he screamed and screamed and we gave him a little frmula (half an ounce here and there) dripped from our fingers into his little open bird mouth, and I cried and wondered why I was torturing him thusly.

Eventually we went home and my milk came in (and boy did it pour out) and Eli gained weight and nursing hurt, but it was okay, no blood... we were doing well. I was slathering myself with lanolin every time he nursed. In those first weeks, my breasts and nipples and aeriolae were swollen and shiny and red and they ITCHED. And my nipples blanched and hurt all the time. I thought I had thrush. I emailed the lactation consultant. She said maybe you are ALLERGIC TO LANOLIN. I put that in caps because I didn't know that was possible. It's hypoallergenic, right, read the package. Hopefully if you stopped reading before and are skimming you'll see that. I stopped using the lanolin and in one day, I was CURED.

So then came our stumbling blocks. That beautiful skinny boy had serious, serious reflux. Starting when he was just a few weeks old, he would nurse for about 1 minute before he would start screaming hysterically. He would scream and scream for several minutes calm down, and I would nurse him some more and then he would scream and scream. This was how he ate. Constantly screaming. Of all the things that happened in the next year, having the one thing that most mothers can use to calm their crying child actually MAKE my child cry was hard to handle. He was also severely colicky and cried a lot (read "all day and night") for the first 4 months. We couldn't nurse discretely in public because he screamed and unlatched every couple of minutes, leaving me exposed. We finally got him medicine and he started nursing like a champ. Cutting his formerly 1.5 hour long feeding/screaming fests down to 15 minutes. Life was good.

Then that summer when he was about 7 months old, I got mastitis. First one side, then the next. Then twice on the same side. 8 times. My supply suffered, but we were starting solids (VERY slowly) and it was fine. It sucked and it hurt and boy I threw up a lot, but it was fine.

Then I got meningitis (not related to the mastitis). I went to the hospital and during this experience discovered how little doctors know about what medicines can be given to nursing mothers. I got a lumbar puncture without any medicine to make it more comfortable for me because the doctors didn't know that it was okay to give it to me and just assumed it wasn't safe. I got better from the meningitis but then had a spinal fluid leak. To fix the fluid leak, I underwent a procedure that I didn't need to have because I was told that they 8 day course of medicine that was the alternative would require that I stop nursing. I cried all the way home. I wasn't ready to stop nursing my 9 month old son. It was too soon, I wasn't prepared and MAN did my head hurt too badly to think about it. That doctor was also wrong.

Later I looked all these medicines up on a website called Lactmed and discovered that they are generally safe. My husband is a physician and in the odd instance he has a patient who is nursing he looks up medicines on lactmed and tries to find nursing compatible alternatives before telling his patient falsely that they have to stop nursing.

Eventually, I developed a rare sequela of meningitis and the wide spread pain disorder that it caused required a medicine that was TRULY not compatible with nursing. I was concerned for how an abrupt stoppage of nursing would go with my emotionally sensitive son. But I needed to start the medicine right away or I wasn't going to be able to be any one's mommy anymore. He was fifteen months old, and he asked to nurse twice one day and once the next. He didn't cry about it, was easily distracted from his goal and things ended peacefully.

I mostly wish that women who need medical interventions and are nursing, get proper care and that their doctors take that nursing relationship seriously, rather than assume you will either happily give up the right treatment or happily stop nursing. I know more than anyone how busy doctors are but asking them to take a minute to evaluate their course of treatment for the special needs of a nursing mother is worth it and not too much to ask.