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I heart RVA Nursers

July 18, 2011
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As a full time-working mom who nursed exclusively past a year, I know how hard it is to keep it up. I went back to work 6 weeks after my baby was born and had to trek across the VCU campus twice a day to their lactation room, hoping I wouldn’t have to wait for anyone and rushing to get back to my work (read: it sucked!). Soon after, I started a new job and was lucky to be working for and with two other mamas with babies about my daughter’s age. Our office became the  “dairy farm” . Our company, although an extremely large company on the whole, did not have a lactation room specifically. At one point they took an empty office, gave us a chair and a desk and called it the lactation room. It was sad, with bare walls and a pile of abandoned telephones on the floor. Since then, we’ve had a flux of new working pumping mamas and they created a specific “mom room” which is much nicer, with a  radio and soft lighting.

But even with a nice room, pumping is hard. Taking time out of your day, at least twice a day – it takes a lot of scheduling. And when you’re juggling experiments (like I am – I don’t expect most people have this problem) or client meetings or deadlines, the amount of time it takes for the set up, the let down (har har), and the take down of your pump, storage of your milk, washing and possibly sterilizing your pump (if you have the facilities to even do so) it just makes it not seem worth it to a lot of people. Not to mention people who work hourly jobs, or work in places that do not have convenient places to express milk. A lot of mamas just do not have the “luxury” of pumping at work. And it’s not right. Pumping isn’t a luxury – its’ a necessity. Pumps are now covered by insurance. The Affordable Care Act has made it a requirement that hourly workers have a respectable place to pump (NOT a bathroom, car or closet), and are allowed to take multiple breaks to express their milk without fear of being fired or having their pay docked.

Low income, young, uneducated mothers make up a large part of my city’s popultaion. And now, our mayor has started a Breastfeeding Commission to promote and support exclusive breastfeeding up to 6 months for all mamas in our city. He has amazing goals for this initiative including increased funding for education and support programs, and an ultimate goal of getting 75% of Richmond exclusively breastfeeding up to 6 months by 2020.  The ethnic and socio-economic make up of our city contribute largely to the low numbers of moms nursing even up to 3 months. The need to go back to work early, cultural views, age, all make it hard for a lot of Richmonders to breastfeed exclusively. And when even the hospitals and peds aren’t on board with helping to establish breastfeeding (apart from MCV – doing awesome things for breastfeeding!), where else are these women going to get that education? Luckily, the mayor recognizes not only the health benefits of breastfeeding but the economic benefits as well. Mamas who nurse their babies are less likely to miss work b/c they have healthier babies. So maybe he’s looking at it from a business standpoint, but either way – it can only benefit the new moms of our city. Thank you, Mayor Jones!

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Breastfeeding Blues

May 23, 2011
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When I first started breastfeeding I was so anxious and stressed that I wouldn’t be able to do it, that we would have latch issues, that she wouldn’t gain enough weight – the normal things a new mama worries about. So the first week or so, I attributed the dreadful, anxious butterfly feeling in the pit of my stomach  with a  normal response to being new to nursing. Plus, I was so sore I would brace myself for her initial latch – holding my breath and curling my toes. I thought the pain might  have something to do with the fact that I felt so awful right before my milk let down and as she started to nurse. But as weeks went by and we adjusted to life nursing, and nursing was no longer physically painful I still felt the pit of my stomach stressed feeling you get when you realize you’ve just written the bitchiest email about your boss and how stupid they are and then sent it to the entire company (your boss included). Yea that kind of awful feeling. Or when you’re so worried about an exam you can’t sleep.  I would also feel irritable – angry almost. And I felt like maybe I hated breastfeeding. Because I definitely hated that first few minutes. I was worried that something was wrong, I shouldn’t feel this way when I was so lovingly caring for, feeding and bonding with my baby. I knew it wasn’t PPD because I felt fine  at all other times.

This feelingI’ve only just now come to realize is a very  normal response to milk let down: D-MER or Dysphoric Milk Ejection Reflex, which is ” characterized by an abrupt dysphoria, or negative emotions, that occur just before milk release and continuing not more than a few minutes.” (D-MER.org) This is caused by a drop in dopamine that occurs due to the rise in prolactin/oxytocin that is needed for let down and milk production. Once the milk is made, the dopamine levels rise again,  the hormones rebalance and the feeling goes away.

I assume (b/c I was never actually diagnosed) that I had a very mild form of it. I could assure myself that the feeling wasn’t due to anything I really truly thought about breastfeeding or my baby and I would just breathe through it. I talked with other mothers and my midwife and found that the feeling of nervousness was a common occurrence for some breastfeeding moms. Once I knew that it wasn’t so abnormal I felt much better able to deal with it. To be able to name it made it a much easier thing to handle and talk about.

Its something that doesn’t often come up in pregnancy books and if it is mentioned only in terms like, ” You may experience a feeling of anxiousness or sadness upon initial let down.” But it was never defined or elaborated on. Now it is coming out – Babble posted a great article about it last month (read it here) and why it hasn’t become a facet of breastfeeding education – yet.

As bad as it felt, I knew that nursing was so important to myself and my baby that I didn’t let it stop me. And I think that if more women knew that it was a normal physiological and not psychological reaction, they may not use it as an excuse or reason to wean early. It did get better.

we have…a weaner!

April 29, 2011
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It’s true! I wanted to wait a good week or two before I truly believed it (and actually said it out loud). But it has happened! At 21 months my baby is weaned! And it took a serious weekend of constant nursing to really make it stick.

About two weeks ago she came down with something. our ped said it was a fever/nausea flu thing. All I know is she slept for an entire day, wouldn’t eat and became extremely dehydrated. She was dehydrated despite the fact that I nursed her almost constantly when she was awake. she even co-slept the first night and nursed throughout the night. By monday she had only had three wet diapers over three days. Obviously, my body is no longer making nearly the amount of milk to keep her full (or hydrated). We got her to the doctor, got her some anti-nausea medicine, went home and had three bowls of soup, two cups of water and some pedialyte. And I decided it was finally time to quit nursing.

Obviously at this point she was nursing for the act of nursing itself. for the closeness. for the mommy and me time.  I was too. But also at this point I’d rather leave it than take it. I’d like my boobs back completely. I’d like to stop stretching out my bras and my shirts. I’d love to wear dresses for an entire day without worrying there will be a nursing melt down and I won’t be able to get to my breast.

I didn’t really make a conscious decision or tell myself ,”Today is the day.”  I just started saying no. “No nursing baby. How about some juice?” “Would you like some water?” Nine out of ten times she says yes. She might say no but she then continues about her day. We still cuddle in bed at night and first thing in the morning. I have Dora’s help. It may be a cop-out but it distracts her enough that I can still have snuggle time without my boobs being the only thing on her mind. So I’ll take it. We did it!

How do you know it’s working?

April 19, 2011
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I had a new mom frantically ask me, “how do I know she’s getting enough milk??” referring to her days old baby girl. And at first, its hard to answer. because you really can’t tell, can you? She’s having wet diapers – good sign. She’s having the breastmilk poops – better sign. But she’s screaming like she’s starving. Hmm.

I think every mom goes through this. You look at the pictures in the books and think back to the breastfeeding classes that tell you how a baby’s lips are supposed to look when they’re latched on properly. But you can’t see that! How can you turn your body, while keeping that baby on and see, why yes, her lips are correctly positioned. all is good.  Nope not going to happen. And you can’t feel that “good latch” b/c your nipples are so sore and not used to this whole breastfeeding thing that all you’re feeling is hurt.

The best thing to do to avoid that awful hungry baby cry is to preempt it. Be hyper aware of the rooting a baby does – nuzzling into your arm or chest. B/c by the time she starts crying it could be too late and she’s already worked herself into such a frenzy there’s no way she’s going to settle and eat well.

Watch out for engorgement. If your breasts are too full its hard for the baby to get a good latch. If the baby doesn’t tell you she’s hungry, your boobs definitely will. It’s a symbiotic relationship between baby and boob. They make their own schedule and know each other well.

Don’t stress. It affects mama, baby, and milk production. You’re new at this and so is she! Everyone will figure it out. And if not, ask your pediatrician for help. Find a lactation consultant. Find another mom to help you. And honestly, if it’s so stressful or worrisome, pump and give the baby a bottle. establishing good breastfeeding is so important, but a healthy happy baby is even more so.

Supply and demand

March 30, 2011
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Right after I had the baby, I, like many other mothers had serious concerns about my supply. Would I make enough? How long would it last? Well, it turns out I made plenty and it has lasted well into her 19th month and counting. As I’ve admitted before, I made so much I almost don’t like to talk about it b/c there are so many that don’t.  I would pump 12 ounces twice a day and know that she couldn’t eat it all, and I really wanted to help out other mamas who couldn’t produce that much or any.

So I started searching for a milk donation center or milk bank. There was only ONE  on the east coast near Richmond at WakeMed in NC. To donate, you must have a minimum of 200 oz. Okay, I was making and storing a lot, but not that much! And moms can’t combine shipments. Which, I understand, but if both mom passed the donor criteria and everything was well labeled, it should be fine to ship together. Especially considering the reason shipments are so huge is to keep shipping costs down. So unfortunately, I was unable to share. We did end up using all of the milk I made, mixing it with her cereal as she got older. But it was still so disappointing to not be able to help other mamas who needed it.

I suppose for some, there is an ick factor sharing milk. I don’t really see it. I would hope that mamas would look past the initial discomfort in using another mom’s milk when she realizes how much that mama cares about helping another child. Breast milk is full of so many vitamins, nutrients and antibodies that are impossible to recreate in a formula that I would much rather my daughter get someone’s milk than have formula. A brand new study conducted by doctors at Prolacta shows that babies fed an exclusively human-based milk diet as opposed to a human/cow’s milk diet had significantly lower rates of NEC. The company has conducted a significant amount of research in human milk benefits for  premature babies and uses donated milk to produce a number of milk supplements. What they do is intriguing, especially to the scientist in me. You can read more at Prolacta Bioscience.

The Human Milk Banking Association of North America is a wonderful resource for potential donors and recipients. And I’ve just read that Virginia is getting their own milk bank! The Mothers Milk Bank of Virginia is in the process  of finding a location and funding. There isn’t a lot of information on the website but I hope this happens soon, or at least by the time I have another baby!

The bias against breastfeeding

March 24, 2011
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I first saw this article posted on Facebook and I was immediately outraged.  I wanted to comment: ” I am and work with PhD educated women and WE ALL breastfeed, we all pump and we all went to graduate school for Genetics, Immunology, chemistry, etc. We are far from incompetent!”

But I didn’t. Instead I went and found the original research article and read it. I was actually amused (although still outraged) about what the conclusions actually were. I was not, however, surprised by it. Basically, the authors found that breast are seen as sexual and women who are considered “sexualized” (i.e. slutty?) are deemed less competent. So for many college-age men and women (who were interviewed for the study) having your boobs out whether you are feeding your baby or stripping equal out to the same stereotype.  Freaking ridiculous! It completely validates my opinion that breastfeeding is not only a mothering issue – it is a feminist issue. How much more can we do to say, “We are women, we are not sexual toys. We are mothers and daughters and sisters and we deserve to be respected as much.”

It brings me back to a recent trip I took with three other highly educated women (two of whom are pediatricians). One of the pediatricians actually said ,”I will not breastfeed. I just can’t. That’s not what breasts are for.” And it was all I could do to not scream at her. Really?! What are breasts for?! That is EXACTLY what they are for. Only now, especially in the western culture, have we made breasts into something else entirely.  How is it that other cultures are clearly able to separate the sex from the  nurturing and we are not? And how is it that a medical professional cannot separate her breasts from being biologically necessary for her baby and sexually necessary for her husband?

And to get back to the study, the fact that breastfeeding women are seen as less competent is surprising, considering that studies have shown that, particularly in America, it is the highly educated, higher earning women who exclusively breastfeed. As I said, I work with numerous women who have at least a master’s degree and we all breastfeed and pump well past 6 months.

Unfortunately, many people are not educated on the benefits to breastfeeding – not only to the baby but to the mother. It seems as though lately there is a strong push to bring breastfeeding to the mainstream and maybe we just need to “desensitize” everyone to it. As  silly as that sounds, this study only proves that most people cannot be mature about breastfeeding and the benefits it has. It will only help that people like Michelle Obama and MomsRising.org make it part of improving the health of our country.

 

 

I have sprung a leak

March 23, 2011
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I am an overachiever. In my education, in my career, in my milk supply. I’m almost ashamed to say it, when so many mamas have such problems making enough milk or keeping their supply up. But I make milk and I make a lot of it. Even now, when she is starting to wean herself and only sporadically nursing there is plenty in there. My husband is sure that there’s nothing left.  Ah but there is, see? And this abundant supply led me to rebel against the two biggest don’ts of lactating women: underwires and plastic nursing pads. dun dun dun…..

How do I stop the leaking? This is by far the most embarrassing part of nursing. The two big wet spots.  Part of the problem is how much the breastfeeding classes and experts tell you NOT to use plastic backed nursing pads. They will cause mastitis. And of course, I was scared to death of mastitis. But, plastic backed pads are really the only ones that are good at preventing the leaks from reaching your shirt.

I used a lot of organic cotton pads (some custom-made – b/c most nursing pads also don’t fit larger breasts and forget engorged large boobs! yet another issue). But the cotton pads always soaked through and they always showed through my shirt like enormous nipples. Not cute.The problem with wearing pads is you really don’t want to look like you’re wearing nursing pads. I mean really, do we need to advertise it more that I’m lactating and possibly leaking? It’s already hard enough trying to wear a nursing bra with no under wire (b/c that is also a no-no and will cause mastitis). Oh how I missed my IPEX during nursing.

So live and learn, after about a month back at work and dealing with having to carry a change of clothes and 10 sets of cotton nursing pads, I switched. I started using plastic backed pads (and wearing an underwire, nursing bra experts be damned!). And I was fine. No mastitis. I don’t know how I never ended up with a clogged duct with all the plastic and wires I had going on, but whatever I was doing worked.

And then come to find out they make these things called lilly pads which are basically pasties for nursing moms. I’m sure these are an even bigger no-no but I will definitely be trying them with the next baby. It would just be nice to not have to be checking your shirt every few minutes for wet spots.

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