Tuesday, April 5, 2011

Let's Talk About Breastfeeding - Part II

I got a little clinical in the last post, and one of my goals for this blog is to keep it on a personal level. I do intend to bring in educational information when I find some that I think is interesting or important, and I will certainly include sources and quotes and useful knowledge when it directly relates to something I'm writing about, as with the Pitocin information a few posts back. However, I felt it was important to do a general post about breastfeeding before bringing it back over to my own experience.

Why did I want to breastfeed?

When I was pregnant with my first, I wanted to breastfeed, but I only had a vague notion of why. "It's better for the baby." (Better than what?) "Breast is best." (Breast, as opposed to what?) My mom and aunt breastfed, so of course I should too. It's just what you're supposed to do. Breastfeeding itself was a very abstract activity to me. I think maybe twice or three times in my whole life had I actually seen someone breastfeed, always when I was a small child, and the process and act had never really been directly explained to me. I didn't have a concept of how it worked, or what it should look like, or what the reality of it was. I had only heard how "I loved nursing," and "I nursed for 9 months," and "It's a really wonderful experience," without the accompanying truths, that it takes work in the beginning, that nursing a newborn is not like nursing a nine-month-old, that some people nurse into toddlerhood and beyond. I just didn't really know anything about it.

So when my first son was born and I expressed my desire to breastfeed, somehow I had this idea that I'd bring him to my chest, he'd start sucking, and we'd do that every few hours. I didn't know that milk supply is governed by baby's demand. I didn't know about proper "latch," and that what you eat can get into the breastmilk, and that there are specific ways to hold the baby. I didn't know about not giving pacifiers in the early days so as not to mess with the latch and sucking reflexes, or not to give bottles for similar reasons. I didn't, to be honest, really have a concept of what one might put into a bottle!

And yet, I wanted to breastfeed. Even after trying it, and not liking it, and not understanding it, and feeding formula for weeks, I still wanted to breastfeed. I still regretted "screwing it up" (as I thought of it). I regretted not having the information I needed in advance. I regretted not asking the right people for help. I wanted to breastfeed.

But WHY?

Honestly, I'm not even sure, now. I think part of it was that I felt like I had failed at something that should have been simple, and I'm not the sort of person who fails. I think part of it was that I felt like something was wrong with me, and I wanted to "fix" it. I also think that once I started learning about all the benefits of breastfeeding and breastmilk, once I talked to people in person and online about what breastfeeding is really all about, I really felt that I had missed out on something. Something big. Something important. And maybe, subconsciously, I realized that I had missed out on an important opportunity to bond with my son by not having to care for him in those vital early weeks.

By the time my son was several months old, I had tried and failed to relactate, although I did manage to give him a few weeks more of suckling (nursing is, after all, more than just for food), a few more drops of breastmilk. We moved across country and changed jobs, and I became a work-from-home mother, which meant I was with him a lot more often. I thought maybe at that point I could have been comfortable nursing him, except the one attempt I made to get him to latch, he looked at my breast like it was a UFO and had no idea what I wanted him to do. And that was that.

But, by then, too, we had learned that we had been blessed with a very picky bottle-feeding baby, who would only drink a full meal if it started out piping hot. He hadn't always been that way, but by the time he was about four months old, he literally would refuse a bottle unless it was hot. By then, we had learned the trick of warming the water before mixing the formula, which saved several minutes in the bottle-making process, but that wasn't always possible when we were out and about. We got pretty adept about asking for hot water in restaurants, but we were at a total loss if we were, say, at the zoo, or a gas station, or Walmart when he needed a feeding. Once I was near a Starbucks, so I went in and got a cup of hot water from them. For some reason, I remember that time very fondly. Anyway, my point is that my baby made formula feeding difficult. It also took us until he was 11 months old to figure out that we could carry hot water with us in a Thermos (duh). How nice it would have been to work that one out sooner.  (I realize that not all babies are so picky about bottle temperature, and many people can simply carry pre-measured bottles of water and a can of formula and quickly mix the formula and water and feed it. It wasn't this way for us, and he never grew out of it. He just eventually stopped needing a bottle, and our lives got so much easier.) Oh, also, he didn't digest the regular formula well, and it took us several weeks of trying in the beginning to find a formula that didn't make him terribly unhappy and gassy. It turned out that the kind of formula where the proteins are broken down more worked very well for him, and we were quite pleased to find a generic version of that particular formula, which saved us probably hundreds of dollars. But it was still about $14 per can, and by the age of four or five months, he was going through about two cans a week.

All of this added up to a lot of money and aggravation for feeding this baby. I now look back on that as somewhat of a blessing, because it made me very determined to breastfeed our next child. I had watched several mothers feed hungry babies by just opening up their bra and hooking them up, and I so wished it were that easy for me. Not to mention the number of times we got caught out longer than expected and didn't have a bottle or formula on hand. I once actually went to Walmart and bought a bottle and a can of formula so I could feed him while I was out. Very frustrating, and another problem I would not have had if I had been breastfeeding.

Combine this difficult bottle-feeding experience with everything I was learning about breastfeeding and breastmilk. I found myself spouting off all kinds of random information as I came across it, as if I were some kind of breastfeeding expert. I became a breastfeeding advocate even before I became a "breastfeeder."

It was no mystery, then, why I was so determined to breastfeed our second baby. I was obsessed with the idea. By the time he was born, I had read "The Womanly Art of Breastfeeding" cover to cover, had devoured articles about breastfeeding and breastmilk, had watched videos about how to obtain a proper latch, had learned all about milk supply and demand, how to know if your baby was reacting to something you were eating, growth spurts, night nursing, and why you shouldn't give a pacifier or bottle in the first four to six weeks. I had learned about how supplementing with formula often resulted in eventually terminating the breastfeeding relationship entirely, how feeding a bottle of formula before bed did not, in fact, make the baby sleep better, how formula actually messed with all the benefits breastfeeding had on the baby's gut, and even about things like oversupply and overactive letdown, which I may or may not have needed to know. In other words, I had all the book learning in the world, but I still hadn't actually nursed a baby for any appreciable length of time.

Well, book learning is great, but it's not the same as the hands-on (breasts-on?) experience, let me tell you right now. Having the knowledge is important - if you don't know the rules to basketball, you can't play it, but knowing the rules doesn't mean you can go out on the court and shoot a three-pointer. That takes practice.

So does breastfeeding. As much as I knew intellectually, when they first handed me my second son and put him to my chest, I had no clue how to actually do that breastfeeding thing. I was so determined to make it work, though, that I just nursed him. And nursed him. And nursed him. For the first six months of his life, that baby nursed every hour. (You measure the time between feedings from the start of one feeding to the start of the next, regardless of how long they are at the breast in between.) If I started nursing him at 9:15, he would need to nurse again at 10:15. In the early days, he was sometimes at the breast for 45 minutes. This meant I had 15 minutes between feedings to, say, pee, or eat, or type two-handed. This meant I couldn't so much as run an errand without having to plan to stop and nurse him while I was out. I learned to nurse in public very quickly, because I had no choice. I was going to nurse that baby. At about six or seven months of age, he finally stretched out to going two hours between feedings, and it only took about five to 10 minutes for him to complete a feeding, so things got considerably easier. But to this day, even though I'm not nursing at all, I am envious of those women whose babies start out going two or three hours between feedings.

I think if I had been less determined, the idea of letting someone give him some formula once in a while would have been very seductive. I can see how, despite having no big problems, like mastitis or thrush, bleeding and torn up nipples, low supply, or severe food intolerances, my son's nursing habits might have driven me, or someone like me, to give up. I did go a little crazy after a while, but I couldn't fathom any other option. And because I was with him almost all the time, he didn't even get very many bottles of expressed breastmilk (which I was more than willing for someone to give him if I couldn't be with him when he was hungry.) After a point, he wouldn't even take a bottle.

During the first several months, though, I did spend time every day expressing milk. Usually I did it once a day, obtaining between 2 and 4 ounces of milk between hourly feedings. I quickly learned to hand-express, mainly because setting up the pump, using it, and then breaking it down and washing it was really too much trouble when I didn't really have to do it. I also found hand expression to be more productive for me. I had a terrible, though not completely irrational, fear in those early weeks that something would happen to me like it had the first time around, and I would have to spend several days unable to nurse him. If that were to happen, I wanted to make sure I had a supply of breastmilk stored up in my freezer so that he would have something to eat.

As it turned out, not only was I healthy (thank G-d), but he rarely needed a bottle anyway, since, as I mentioned, I was almost always with him. I managed to store up a few hundred ounces of milk over time, much of which ended up getting thrown away. I gave a few ounces here and there to my older son when he was sick, figuring it certainly couldn't hurt, but he didn't really seem to like it. I did give 50 ounces or so per month to my housekeeper, who had had a baby a few months before me and couldn't pump enough for him when she was off cleaning houses or when her son was with his father. So her son got some of my milk, which makes me a little proud. I also shipped 75 ounces of milk from California to Florida to help out a woman whose baby, at four months of age, simply decided he didn't want to latch on the breast anymore. She was determined that he would not get formula if she could help it, but she was only able to pump about half of what he required and solicited milk donations to help make up the difference. I added my small contribution to her effort as well.

I can't say that I always "loved" nursing. I loved that I nursed, certainly. I love that I was able to provide that extraordinary benefit to my child.

So, why do I want to breastfeed my next baby?

I don't have to answer that one, do I?

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