Wednesday, February 26, 2014

What Do You Do with Baby Clothes When You No Longer Need Them?

As my youngest, who just turned four months, begins to outgrow his clothing, I'm finding in myself an unexpected sentimentality. Many of the baby clothes we have were originally my oldest's (now seven years old!) and have been handed down to each of the boys in turn. There are several outfits that all four have worn, and every time I bring out a box of the next size up, I am heard to squeal, "Oh, this was my favorite! No, this was my favorite!" I look forward to putting certain outfits on the new baby as he grows into them.

I do buy the occasional new bodysuit or sleeper, or sometimes I see a little outfit I love and can't resist purchasing, but this handing-down from one kid to the next means I don't ever have to buy anyone a whole new wardrobe...except the oldest. In fact, I'm so used to being able to just go into the garage and pull out the box of next-size-up clothing that I'm actually resentful at having to buy new clothes for my oldest as he outgrows or wears out his clothes.

Since we've basically decided that four kids is our limit, I no longer need to keep clothes to hand down once the youngest goes up a size. My baby is quickly growing into the 6-9 month size clothing, and I have retired the newborn and 0-3 month stuff. As I put the box away, I realized, I don't need to keep any of these. I have no one to save them for. I can throw them away, or give them away, but I don't need them in my house anymore.

It's a bittersweet feeling. On the one hand, it'll be nice to finally free up some storage space by getting rid of these giant tubs of clothes. On the other hand, it's an odd thought that, after seven years, I don't have to save things.

And I'm finding that I want to preserve the memories attached to some of the outfits. I pulled this yellow duck outfit from Baby Y's drawer and realized it's the outfit my oldest came home from the hospital in.

Baby N, four days old

Baby G, six weeks old

It was too big for the 9-pound Baby N when he first wore it, over seven years ago. We had forgotten to bring a "going-home" outfit with us to the hospital, and someone had brought us this outfit as a gift, so we dressed him it in for the occasion.

But when I put it on the 18-pound, four-month-old Baby Y, it was a smidge too small. The top snap is missing - torn off in some washing in a previous lifetime. I put it in the "too small" tub and brought in the next size up, 6-9 month. I rummaged around to find a "new" outfit, which fits Baby Y perfectly. This, too, was originally N's. I remember S wearing it. I'm not certain if G wore it.

Baby N, three months old

Baby Y, four months old

But this tub, again, is full of seven-year-old outfits, well loved and well worn, but still usable and adorable.

Baby N, five months old.
Baby S, four months old

I just spent quite a while combing through old pictures, hoping to find that I had a picture of each kid in the same outfit, but so far I've come up empty. I have N and S in the same outfit, or even N and G in the same outfit, or S and G in the same outfit, but not all three or, better yet, all four.
Baby S, six months old (with Grandma)

Baby G, five months old

I've read of people craftier than I who have made quilts out of old baby clothes or found other ways to create lasting or useful mementos from them, but I am not that crafty or creative. Still, I like the idea of keeping some of the outfits, somehow, in some form. I don't want to keep tubs and tubs worth of clothes I don't need, of course, but I think I'd like to save a couple of outfits. Part of me likes the idea of giving an outfit to one of my sons, fully grown and a father himself, and saying, "You and your brothers wore this as a baby."

It's as if the clothes in some way carry the memories of the babies who wore them. Most of the clothes, I remember who gave them to us, or when I bought them, or where they came from. I remember a specific instance or photo when one of the babies was wearing a particular sleeper or overalls. Clothes that weren't bought for my kids but were handed down or over from friends whose babies outgrew them somehow feel less "mine." They have other babies' memories attached instead, other parents' styles.

Some outfits have been thrown away over the years because they were irrevocably stained, or torn, or lost too many snaps or buttons. Some can't be passed along anymore because they're almost unusable or simply worn out. But a few of them have held on, going from baby to baby and staying in relatively good condition. In a way, I'd hate to cut those up to make a quilt or something anyway, since they're still wearable. I'm still thinking about what I'd like to do.

Have you saved your babies clothes as they're outgrown, or do you prefer to pass things along as soon as you don't need them? What creative ways have you seen to preserve the memories attached to baby clothes?

Thursday, February 20, 2014

Why I Vaccinate My Children

My youngest, Baby Y, had his four-month well-baby checkup today. He weighed in at a healthy 18 pounds even and was a robust 26.75 inches long. At four months, he is rivaling his three brothers for size and chunkiness. Four months also meant a second round of vaccinations for my little one. He needed rotavirus, which is administered orally, as well as shots for hepatitis B, Hib, pneumococcal, diphtheria, pertussis, tetanus, and polio (some were combined, so it was three shots total). He didn't even react when the first shot was given, and cried briefly after the third. He slept for a few hours and is now playing happily, like nothing happened.

Of course, something did happen. Something extraordinary, really, if you think about it. A hundred years ago, diseases like polio ravaged young children, killing or paralyzing many. Diphtheria was a real threat, as was pertussis (whooping cough). While whooping cough isn't terribly dangerous today to those with developed immune systems, it can be, and often is, fatal for young babies. Vaccinations are one of the greatest medical advances of our time, along with antibiotics, improving length and quality of life and preventing much childhood suffering.

My husband and I choose to vaccinate our children according to the CDC schedule. We believe that it is not only our responsibility to our own children but to society at large to aid in limiting the spread of preventable diseases. My children are growing up in a world where they don't have to worry about losing a sibling to polio or a friend to pneumococcal disease or meningitis, and they are growing up in such a world because of the miracle of vaccinations. We can and will do our part to protect our own children and those they come in contact with.

We are not sheep blindly following our doctors' recommendations and the "guv'mint's" instructions. We are aware of the arguments against vaccinations and for delaying them. We are also aware of the science behind vaccinations, how they work, and that there are risks that come with giving vaccinations. We believe that the benefits of vaccination far outweigh the risks and that the risks posed by the diseases prevented by vaccines far outweigh the risks posed by the vaccines themselves.

Because my children have shown no adverse reaction to being vaccinated, I am very comfortable continuing to have them receive immunizations on schedule at their regular physicals. The only shot I refuse is the hepatitis B shot at birth. Its purpose is to prevent vertical transmission of hep B from mother to baby, and since I do not have hepatitis B (and, indeed, was vaccinated for it and received a booster series as a teenager), I feel it is unnecessary to add anything to a newborn's already busy first few weeks of life. The hep B schedule, then, starts at two months for my kids instead of birth. I also will put off a vaccination for a few weeks if my child is sick, because I want to be sure of the source of any symptoms. This is all per the recommendations of my doctor and the CDC.

Some children do have adverse reactions to vaccines, and in some cases these reactions are life-changing or even fatal. I know that. Any time we add something that nature didn't put there, we assume risk. Any medical procedure we undertake, any medication we take, any surgery we opt for puts us at risk that doesn't exist without that action. But we also assume risk when we do not avail ourselves of the advantages afforded us by modern medicine. Many of these diseases we vaccinate against carry a risk of suffering and even death. These are not trivial diseases. Polio is not like a minor cold. Pertussis is not a little cough. It is unacceptable, to me, to expose my children to these greater risks of disease, suffering, and possibly life-altering complications when the alternative is a little shot a few times as a baby, and possibly a booster when they're older, even given the possible risks and side effects of the vaccines themselves.

Vaccines generally work for the individual, but they work better when everyone gets them. If there is a measles outbreak in my town, for example, brought in by someone not vaccinated against measles, it puts my children at risk because the vaccine may not be 100% effective for them. However, their chances of being exposed to measles are considerably lower because the majority of people they come in contact with are also vaccinated. If one of my children were to be exposed to measles, it puts my young baby at risk because he is not old enough yet to receive the vaccine and could be infected with measles. The more people who are vaccinated against measles, the smaller the chance that anyone in my family will be exposed to it. And, vice versa, if my family members are vaccinated against measles, it reduces the chances that the people they come in contact with could be exposed to measles through them.

We protect each other by protecting ourselves.

Finally, there are definitely some individuals who cannot be vaccinated. Perhaps their immune systems are compromised. Perhaps they are allergic to an ingredient in the vaccine. Perhaps they have had a severe reaction in the past to an injection and cannot risk repeating that scenario. The rest of us being vaccinated also protects those individuals who cannot be vaccinated.

We've all seen how easily a cold or cough or stomach virus races through an office or classroom. Imagine if instead of fighting off cold-weather stuffy noses and the occasional 24-hour stomach bug, we were also constantly in fear of catching diphtheria or whooping cough.

Scary to contemplate, isn't it?

Protect your children. Protect my children. Protect the children who can't protect themselves. I vaccinate. Will you?

Friday, February 14, 2014

Why I Didn't Breastfeed My First Baby

My oldest son is 7. He was mostly formula-fed from birth, and completely formula-fed from about 7 weeks of age.

Given the person I am now, the breastfeeding advocate and educator, who has successfully breastfed three subsequent children, sometimes I look back and can't quite believe he wasn't breastfed. But his birth and my experience with him is what made me so passionate about birth and breastfeeding in the first place.

But why wasn't he breastfed?

Was it awareness, or lack thereof?
I don't think so. I was aware of the benefits of breastfeeding. I intended to breastfeed him. In fact, here's an excerpt from a LiveJournal entry I wrote when I was about eight months pregnant: 
The doctor asked if we'd taken any classes, which we have. She said, "Oh good, so you're prepared." Haha! Yes! I feel so prepared! Ok, I know the basics, and sort of what to expect. But prepared? I don't think you can ever really be prepared for your first childbirth. I mean, ok, the nursery is almost ready, he'll have clothes to wear and a place to sleep and something to eat (boobies!), but seriously. Prepared? I keep trying to remember the signs of labor and thinking how this class we took has a doozy of a final exam!
Then, about a week before the baby was born:
I went ahead and ordered a dual electric breast pump...Still cheaper than formula in the long run, and I hope that I will be able to give him breastmilk for as long as possible. 
So I was definitely "aware" of breastfeeding, of the benefits, that I wanted to breastfeed. I had made that decision and was planning ahead.

Was it education, or lack thereof?
This was part of it. And I think one of the big problems was, I didn't know I needed to be educated. I bought a couple of breastfeeding books, but I didn't read them. I didn't take a class, didn't attend any LLL meetings, didn't talk to other breastfeeding mothers about their experiences. Indeed, as the birth story I wrote just a couple of weeks after he was born shows, I didn't know what I didn't know:
They brought the baby to me and helped me latch him. He knew what to do, but I was still pretty out of it. I also have the timeline here a bit befuddled, because of what ensued. I know they needed to check his blood sugars because of his size, and asked us if it would be ok to give him some formula if he needed it, and if so, what kind. We said it was ok, but we didn't know anything about formulas, so just go ahead and give him whatever they thought was good. They suggested Enfamil with Lipil. Sure, why not.

If I had done any reading or taken a class, I would probably have known that he likely didn't need to be given formula, or we would have at least known to ask more questions. As it turned out, his blood sugars were fine, but I soon went into shock due to blood loss from the delivery. The nurses told me that because I'd lost so much blood, I wouldn't be able to make milk:
I didn't get a chance to try nursing again. I needed to rebuild my blood supply before I could even think about making milk.
I was stuck in bed for all of Sunday and Monday. They came and checked my bleeding periodically, gave me IV pain meds, brought me food. They brought the baby in on Monday for me to try nursing again, but I was pretty weak and sore. They were giving him formula, which was fine. With his size, he needed to eat, and I didn't have food for him. 
What no one told me, apparently, was that in order to make milk, I needed to nurse the baby. Even if my milk supply increase was delayed, I still needed to be nursing him and/or pumping to set up prolactin receptors and to encourage milk production. Even if he had to be supplemented with formula, that didn't mean I shouldn't nurse him. The colostrum would benefit him, too. I do recall that they fed him whatever colostrum I pumped, but it wasn't much.

Was it willpower?
Yes. I'm sure a big part of the problem was willpower. Now, I went through a traumatic birth, and I got off to a bit of a rocky start, but that alone didn't make breastfeeding impossible. The bigger problem in this story is that I didn't know how much hard work it takes in the beginning, especially when there's a rocky start, to breastfeed. I didn't know that if I stuck with it, it would get better and easier and really feel worthwhile, and so I didn't try.

Was it support, or lack thereof?
Yes and no. The support in the hospital was variable, as evidenced by some of the quotes above. Then there was this:
[On Tuesday, the lactation consultant] showed me how to use the pump and said I'd need to pump for 15-20 minutes every 2-3 hours to stimulate milk flow and establish a supply. She also suggested I rent a hospital-grade pump, because the one I'd bought would burn out if I used it that often. I think I pumped twice that day. With all the people in and out and all the activity, and my general weakness, pumping seemed like just that much more hassle, that much more of an energy drain.

Wednesday was better, and I did pretty well with pumping. A different lactation consultant came to see me and helped me breastfeed the baby. I tried the football hold, because of my sore abdomen, and the cross-cradle, which I found more comfortable. They told me I should breastfeed for 10 minutes per side and then pump for 10 more minutes.
This information is only sort of correct, and she didn't say the most basic thing, which is, "You have to nurse the baby to make milk, and here's why." She didn't say, "The best thing you can do to bring in your milk is to nurse the baby." She didn't say, "Spend time skin-to-skin with your baby and nurse on demand." She didn't say, "Watch the baby, not the clock." Etc. And no one, again, told me that it was hard work and perseverance that would matter the most. Everyone said it was fine to supplement with formula, and no one, not even me, fought for me to breastfeed.

On the other hand, my mom wanted me to breastfeed. She wanted me to so badly. But she didn't know how to support me, and I didn't know I needed support or how that support should look. A friend tried to help; she even offered to nurse the baby for me to show me how it works! She offered me the contact information for a local La Leche League leader. She knew I needed support, and she knew how to give it, but I didn't know how to take it, or that I should, and I was convinced that I should do what I was told by the hospital, not knowing, as many women don't, that the nurses at the hospital maybe weren't the be-all and end-all of breastfeeding information.

How did I feel about "failing" to breastfeed?
Well, there's this, from about 3 weeks postpartum:
I know these are questions best put to a lactation consultant, but I really want a more unbiased analysis. I want a totally practically-minded opinion, and I feel like an LC would push me to try breastfeeding, when I find it so discouraging. It's the lactation consultants who first told me to pump 8 times a day, and I didn't manage to do that and it just made me feel bad. I know that's what I'd need to do to boost my supply, but it's really hard. I don't know whom to turn to or whom to ask, and it's very upsetting. Breastfeeding is the one thing only I can do for my son, and I'm not even sure I want to do it. I know I'm not alone. I know there are other mothers out there who tried to breastfeed and just didn't want to. But I never thought I'd be one of them. I never thought I'd find it so difficult or, frankly, unpleasant.

I mean, anyone can mix some formula in a bottle and put it in his mouth. Many people have over the last 3 weeks, although it's his father who does it most often. But only I can produce breastmilk for him.
"I don't know whom to turn to or whom to ask...Breastfeeding is the one thing only I can do for my son..." I was so torn, and confused, and I didn't have the information I needed. I didn't want someone who would "push" me to breastfeed, and I thought all lactation consultants would be like the ones I saw in the hospital, who I didn't find to be helpful and I did find to be pushy. But that was exactly what I needed, someone who would "push" me to breastfeed. I didn't realize, you either breastfeed or you don't, and I certainly could have. (In that same post, I lamented that I "only" pumped 2 to 3 ounces in a sitting, having no idea that's actually quite good!)

And there's this, from one month postpartum:
I've been crying a lot. I think one reason is that I feel bad about having to give up on breastfeeding. I know I had so many extenuating circumstances that it would have taken a rather heroic effort to really get in there and exclusively breastfeed, but knowing the reasons doesn't make me less frustrated that things aren't working out the way I'd hoped they would.
And this:
A couple of women I know have recommended an LC in the neighborhood. Maybe I should talk to her. I don't know. I just want to feel better. I want to feel like I've resolved this for myself, and right now I obviously don't. If I try and fail, will I feel worse, or will I at least be able to say I tried? If I try and succeed, will I find the joy in it that I am hoping to find, or will I just get discouraged again? 
And then at six weeks, I thought I might try to relactate:
[I tried putting him to breast...] And even more exciting, milk came out! I thought my milk was dried up, but he got some out. Not very much, but enough that he was willing to keep sucking. So I let him. (Ow) 10 minutes on each side, he sucked. And milk came out on both sides. I let him keep going until it got too painful and he got too squirmy. I think he got a little frustrated when he wasn't the least bit satisfied after 20 minutes of sucking. I would be too, hehe.

Then we gave him a bottle of formula and he gobbled down 6 ounces, so I know he hardly got anything from me. But I wasn't so much interested in volume as ability. That was pretty exciting. My nipples are still sore this morning from it, but it felt really good emotionally.

I was not successful, but it's clear that I wanted to try, and I gave it a go. I even finally contacted the La Leche League leader that I should have spoken to in that first week! If my birth had gone more smoothly, I probably would have breastfed. I can't change the craziness that was my oldest son's first six weeks of life, but I think the lessons of what I went through can give us all some perspective on what other women might actually need, and how we can provide that.

What can we learn from my experiences?
I think we need to give most women, especially middle class, educated women, enough credit to assume they know about breastfeeding. It's not a lack of awareness that causes women not to meet their breastfeeding goals. After all, something like 90% of women state an intention to breastfeed upon giving birth, yet less than a third of them are still breastfeeding at six months postpartum, and not even half are still exclusively breastfeeding at six weeks. Something goes wrong in those first few days postpartum and in the early weeks.

I think the biggest factor in improving breastfeeding rates and success is education, followed closely by support. Education and support work hand-in-hand. First, we educate women not about why they should breastfeed (or not just about why), but about how breastfeeding works and what they can expect. Second, we educate women about finding and/or building a support network, to have phone numbers on hand they can call, websites to visit, books to read, to let them know that they can and should ask for help, that they don't have to - and shouldn't have to - go it alone, and that there's no shame in having a little trouble at the beginning. Third, we provide that support network, with continuity prenatally, at birth, and in the weeks following the birth. Whether they join a La Leche League meeting, are friends with an experienced breastfeeding mother, or get all their help online from blogs and Facebook, women and their partners need to know (a) they probably will need help; (b) it's okay to ask for help; and (c) where that help can be found.

It's amazing that I documented my experiences with such detail in the moment. It's hard to look back seven years through the lens of who I've become and remember what I was feeling at the time. Because I wrote it all down at the time, it's all out there, raw and visceral, and I can see right there what I knew, what I had, and what was missing. Filling in those missing pieces for other women can make a huge difference in their lives and the lives of their children.


To read the full account of my oldest's birth, see the four-part story starting here

For a quick-start guide to breastfeeding that answers many of the most common questions new mothers have, check out my e-book, The Jessica on Babies Breastfeeding FAQ, available for Kindle from Amazon.

Monday, February 10, 2014

Should We "Dread" Our Children's Growing Up?

The other day, I wrote a post delving into my feelings about having only boys. It was very popular and got a very positive response, but talking about it with some friends got me thinking a bit more.

In that previous post, I wrote that I sometimes joke about my relief that I won't have to experience the girl tween years, or puberty, or uniquely feminine drama. A few days later, I met up with a friend who has a toddler daughter, and we talked about how she is dreading those years. We laughed about how with boys, they get angry, they punch each other, and it's done with, whereas girls let things simmer and hold grudges. The day after having this conversation, I met a woman who said her grandmother had four boys but really wanted a daughter, tried one more time, and the fifth was a girl. I have encounters like that a lot. Somehow, when I had just two boys, it wasn't cause for comment, since having two kids is pretty average, and you just got lucky to have two of the same gender. If you have three, you start getting the question, "Were you trying for a girl?" as if somehow your family isn't complete unless you have at least one of each. But once you hit four, people are certain that you've "kept going" because you're "trying for the girl" and that you will keep going because you desire that daughter so strongly. Is it the same for parents with four girls? Do they get strangers asking if they're "trying for the boy?" I don't know. I imagine so. (Any parents of three-plus girls want to weigh in?) I usually just say that my husband and I wanted four kids, and this was just the luck of the draw in terms of sex. We weren't "trying" for anything, except "trying" to have four kids.

I keep going back in my mind to the idea of "dreading" a certain stage, though. I looked up the word "dread." It means: "anticipate with great apprehension or fear." And I don't like that wording. We should "dread" getting a diagnosis of a terrible disease (G-d forbid!). We should "dread" a terrible earthquake (or another winter like those of you on the East Coast of the US are having) - G-d forbid! We "dread" inevitable sadnesses or tragedies, like the death of close loved ones.

But "dreading" our children growing up and entering new phases? That doesn't seem right. Our children growing and maturing and attaining new facets of their personalities, new skills, new expectations, a new outlook on life - these are not things to be afraid of. These are causes for joy! This means we're doing something right! Our children are alive, thriving, opening up to new experiences and ideas.

Sure, there are phases that are more stressful than others. I imagine nine-year-old girls give their parents plenty of stressful moments. There are questions we're concerned we won't be able to answer, problems we hope they won't have to face (but probably will), traumas and difficult times we don't want them to have to go through (but they probably will). And we can anticipate how we'll address their worries when they come up, how we'll respond to their misbehavior, how we'll guide and direct them as they grow. But to "dread" the inevitable growing-up of our beloved children? I'm not sure that's the right word to use.

Some parents "dread" the day their child asks where babies come from, or they "dread" the day their elementary schooler asks about the events of 9/11/01, or Columbine, or Sandy Hook. Some parents "dread" having to explain why people have skin of a different color, or why someone at school made fun of them for their weight or religion or hair cut or interests, or why Chris has two Mommies, or where Grandma is, or what happened to the dog. And we do worry about these things, but is it intense fear? Is it great apprehension? I hope not!

What I'm finding as my kids get older and start asking questions like those is that, even if I "dreaded" getting the question or having the topic come up, once it did, it wasn't as bad as I expected. I know my kids pretty well, and I have a pretty good idea of what will upset them and what won't, what will interest them and what won't, what they'll understand and what they won't. I enjoy explaining things to them. I enjoy anticipating the next question they'll ask or the next idea they'll present. And so when something does come up, I find I do have the tools to handle it.

So if I had a girl, would I "dread" her getting her period, or having to explain about safe sex, or issues about her appearance, or things like that? No. Sure, I'd worry about them. I'd play out scripts and scenarios in my head in anticipation. Her behavior probably would stress me out, and I'd jokingly complain about having a girl and having these problems with her. But I also think I would be grateful to have a daughter. Just as I'm grateful now for having my sons.

And there are more serious things that might happen to our children, or that our children might do, as they grow up. And I think it's fair to dread some of those things. But the normal course of maturing is not something to dread. Having a tween girl or boy in itself is not a cause for terror. Knowing your sweet toddler daughter will one day be a hormonal mess isn't cause for "great apprehension or fear." I think, quite the opposite, that we should dread our children not becoming hormonal pimple machines! We would dread the idea of our children not experiencing the fullness of life, taking risks, and simply growing up. There are plenty of parents out there dreading the day they don't have their daughters giving them sass or their sons watching porn in their rooms.

Now, I realize that when we talk this way, we're exaggerating, using sarcasm as a defense mechanism. I know that saying we dread various stages isn't a literal paralyzing fear. It doesn't mean we aren't grateful for our children or that we don't love them. It doesn't mean we regret having them. But I think it's important to have perspective, too. Often the things we're most concerned about, once they come up, aren't as horrible as we anticipated. And knowing that we can anticipate those moments can help us manage those fears in advance, so we don't have to dread them.

So, yes, I joke that I'm glad not to have to deal with "girl" stuff, and I know I won't have the stress of my daughter coming home and asking for birth control, or having a fight with her best friend, or being made fun of because she doesn't have an American Girl doll, but I also won't have the joy that a daughter brings.

Maybe it's time to focus on the positive.

What are your favorite things about having a son? What are your favorite things about having a daughter? Did you have a preference before your baby was born? What are you most looking forward to sharing with your kids as they grow up?

Wednesday, February 5, 2014

Why Won't My Baby Nurse?

As your baby gets older (over three months old), some aspects of breastfeeding get easier: Your baby learns to latch properly and can do most of the work herself. You get more practiced at arranging yourself and your baby to nurse comfortably. Your nipple pain subsides and any damage heals. Your milk supply balances out so you're not constantly engorged or spraying your baby in the face. Your baby becomes more efficient at extracting milk and can finish a feeding much more quickly. She may be taking in more at a feeding and can go longer between nursing sessions. You've figured out what positions are comfortable for you and your baby. Your confidence improves, and with it your ability to relax while nursing.

And then, suddenly, you're hit with a new set of frustrations!

As babies reach three and four months of age, they start to "wake up" to the world. Their lives are no longer just about sleeping, eating, and pooping. Now they're smiling at faces, staring at interesting patterns and objects, trying to reach out and grab things. They want to sit up and roll over. Life is fascinating, and nursing, while still comforting and necessary, sometimes becomes an interruption to their exploration, rather than their priority. They've also decided what's comfortable for them, which may not always be your first choice.

At this point, you may find that your once-eager nurser has to be convinced to eat, won't eat in certain positions or places, or flat out screams at you when you offer the breast. This can be discouraging and make you feel like you're suddenly doing something wrong, just when you finally had it all figured out.

Take my baby, for instance. On our recent road trip, he decided he didn't want to nurse in the cradle hold sitting down. Oh, no. I had to stand and bounce, or lean over his car seat, or wait until we could curl up in bed at the hotel. The other day, we spent several hours at the Social Security office and he got hungry, but would he nurse happily? Of course not! I had to convince him he was hungry and tired, and he finally fell asleep after being walked and rocked for a while.

I find he nurses best when we're both relaxed and in a calm zone. At home, I usually take him to my bed and lie down with him to nurse. When we're out and about, I try to sit as comfortably as I can so that I can relax. The more rushed or tense I feel about having to nurse him, the less likely he is to simply latch and feed. Often, he will calm down without nursing. When he does, I usually just try to get him to wait until we're in a more convenient place for him to nurse. If he's really not willing to wait, I'll do anything and everything to get him latched and eating, no matter where we are.

I figure that if he gets three or four really good feedings in throughout the day, the snacking or fussy popping-on-and-off that he does the rest of the time is fine. He's still getting enough to eat, even if it's frustrating.

I think the number one rule is to relax. This applies to a lot of things when it comes to breastfeeding. Relax, follow the baby's lead, and don't stress about it. You can't force a baby to nurse, but you can remind him that he's hungry. If he really just doesn't want to latch right now, see if you can find another way to calm him. Sometimes once he's calm, he'll be more content to feed.

Some tricks that work for me when my baby is reluctant, for whatever reason, to nurse:
  • Try a different position. If I'm sitting down and using a cradle hold and he's resisting, I'll try standing up and using cross cradle to get him latched. Sometimes I even need to rock or bounce him while he nurses. Alternatively, if I have him in the carrier upright, I'll try taking him out (if possible!).
  • Try the other side. Sometimes my baby just doesn't like one side for some reason but will happily latch and nurse on the other side. 
  • Have him suck on something else, first. I'll give him a pacifier or a finger to suck for a few minutes. Sometimes this calms him down and reminds him that he's upset because he's hungry. Then he'll take the breast and eat well.
  • Let him pop on and off enough times to get letdown. When I'm nursing in public, I don't love it when he's popping on and off because I feel like I'm flashing everyone, but often once he gets letdown, he'll eat happily. If I'm in a place, position, or situation where I can let him do this, I'll go with it.
  • Try to calm him and wait until we're somewhere else. Sometimes he just doesn't like the location. I'll rock or bounce him for a bit, or roll him back and forth in the stroller, or drive around for a few minutes. This will calm him enough that he'll fall asleep, or he'll be willing to try again in a new place. For some reason, he seems to like when I dangle my boob into his mouth while he's in the car seat (when the car is PARKED, of course), so if that's an option, I'll do it, when all else fails.

While you shouldn't generally try to delay feeds when your baby is a newborn, once breastfeeding is going well, your baby is growing, and your milk supply is healthy, delaying a feed by 20 or 30 minutes isn't really going to harm anybody. You may be uncomfortable, and your baby may be unhappy, but it's not going to cause any long-term damage, especially if it means that he gets in a good feeding once you have the opportunity. I don't advocate skipping or delaying much more than 30 to 45 minutes, but it's not always up to you! When the baby just won't eat, he just won't eat!

Some other reasons your baby may be refusing to nurse at certain times or in certain places or positions:
  • Teething. Yes, babies can start to teeth as early as 3 months, even if teeth don't show up for a couple of months. Sometimes the pressure of sucking can increase teething pain (while other times it offers relief!). Teething pain comes in spurts of a couple of hours, which is why he may refuse at some times and not others. Teething pain may also be felt in the ears, and laying on one side may be more painful than the other side. This is why switching sides may be helpful.
  • Ear infection. As with teething pain, the pressure of an ear infection is worse when lying down. If you can nurse with him more upright, that may help. Also, lying on the side that is affected will be more painful than lying on the other side, so, again, nursing on the less painful side may be more effective.
  • Stuffy nose. A stuffy nose can make nursing difficult-to-impossible. She can't breathe and eat at the same time if her nose is stuffy. Squirting saline or breastmilk up the nose to help loosen the mucus and then sucking the mucus out (I highly recommend the Nose Frida for this, rather than a bulb syringe) may help. You might also try nursing in a steamy bathroom or run a humidifier to moisten those nasal passages. Keeping baby more upright can make it easier for her to breathe, as well.
  • Reflux. The pain of stomach acid coming up into the esophagus may make a baby reluctant to nurse lying down, as well. With reflux, your best bet is to give small, frequent feeds and keep your baby upright or reclined as much as possible.
  • Gas. Maybe baby just needs to burp or pass gas, so his little tummy hurts. He feels hungry, but nursing isn't making him feel better. If you can help him move the gas bubbles out, he may settle down and nurse happily.
  • Unpleasant association. Did you have an especially strong letdown at some point that may have made your baby choke? Did you eat something unusual that might have bothered his stomach? Is the taste of your milk possibly different because of your period coming, something you ate or drank, or a breast infection? Maybe something upsetting happened while he was nursing that scared or hurt him, and now he associates nursing with that occurrence. Sometimes it takes a few days for your baby to get over a bad association with a particular nursing session. In this case, just keep offering, and especially offer when he's sleepy and/or relaxed. Once he has a good, comforting nursing session again, he should return to the breast more happily.
  • Your scent. Are you wearing a perfume you don't usually wear? Have you been around people wearing scents or smoking that your baby may not be used to? Did you change shower gels or laundry detergents? Babies have an excellent sense of smell and are used to your smelling a certain way. They seek out the scent of your milk to help them zero in on the breast. If you've done something to obscure the scent she's used to, she may be agitated or even bothered by the smell. See if changing clothes, washing hands, or changing locations helps.

Please remember, it is not normal for a baby under a year old to "self-wean." There is usually a reason they refuse the breast temporarily. If they're completely refusing to nurse, this is called a nursing strike, and these typically last just a couple of days. Nursing strikes are most common around 4 months and 10 months of age but may occur at any time. Keep offering the breast as often as you can, try some of the thoughts mentioned above, and spend time skin-to-skin in a quiet place with your baby. Babies won't let themselves starve! If you're really concerned, consult with a trained lactation consultant (IBCLC) to make sure there's not something else going on that can be corrected.