When I got closer to the end of my pregnancy with Cruz I knew without a doubt I was going to breastfeed him. I thought it was odd that so many people were curious about if I was going to or not. More than just close friends and family, acquaintances and random strangers even asked. It wasn't an option for me. Of course I would breastfeed him, why wouldn't I?

Growing up I had been told a few times my mom breastfed us. It was natural, normal. She told us how she'd have to feed us TWINS at the same time and when I was younger I never fully appreciated how difficult and draining that must have been. I didn't hear my mom tell me how hard it was. She mentioned how she was in contact with La Leche League (LLL) members and how her milk was so rich she was told she should consider donating her milk to milk banks. Even though I knew she did this for us, with us, I didn't blink an eye when all my dolls were fed through a bottle. I remember their puckered lips and fake bottles whose nipple fit perfectly in those lips.   Thankfully, pop culture didn't steer me away from breastfeeding. My natural instincts knew it was the only way to go.

When my nephew was born, I had the profound privilege of being a part of his first few weeks. Every moment I had I drove to my twin sister's house and helped in any way I knew how. Not having been around a lot of newborns in the past, and never having seen the difficulties of breastfeeding, it was surprising how much work it was! We'd get up in the middle of the night, he'd latch on, and either her husband or I (sometimes both at the same time) would help with the SNS (or Supplemental Nursing System, typically given to moms who have had given birth through Cesarean, or to moms whose milk wasn't coming in fast enough).

It was tough, he was hungry, we were tired. My sister tried as best she could for as long as she could in those first few weeks and even contacted help through her hospital. In the end, she decided the best thing for him was to give him formula. Although she felt as though she couldn't breastfeed him, she didn't give up without a fight. I'm thankful for spending those weeks with her, watching and helping her with that fight because I knew it would help me when I had my own children. 

Before Cruz was born, I was ready. I knew it was going to be hard. I knew that as natural as breastfeeding is, it's a skill that takes a while to hone. A skill that many women all over the world hone on their own, but for me, I'm grateful for the people in my life that were there to support me and for the ones who let me be a part of their struggles so I may be more knowledgeable.

I attended a LLL meeting in my weeks before his birth and I was adamant that a lactation consultant come to my room within 24 hours of Cruz's birth. I wanted to get support immediately so I didn't have to make the choice to give him bottles unless I knew I had tried everything and it was totally necessary, just as my sister had done. 

In the first few days home, I suffered painful engorgement and was on the phone with the lactation consultant almost daily. At his first well visit only a few days after his birth, I went to see the lactation consultant *again* to make sure his latch was good and I was “doing it right”. She reassured me everything was great.

By the time Cruz was three weeks old, I was still in a lot of pain every time he latched. It was so severe I would cry out in pain or silently cry. At that point I made yet another appointment with the lactation consultant. She referred me to the Ear Neck Throat doctors to look at a possible tongue-tie. She warned me it was considered a controversial procedure to correct it because many ENTs don’t consider tongue-tie an issue since “structurally” or physically there’s nothing “wrong” with the tongue. We went anyway.  A $5 copay later and he had told us he saw nothing wrong with Cruz’s tongue. 

Still in pain, I went to my local LLL meeting that week and described what I was going through. Although the leader prefaced the meeting that she was not an expert, but had two children with tongue-ties, she referred me to the head ENT at Oakland Children’s Hospital. It turned out Cruz didn’t have a classic tongue-tie in the front…he had an anterior tongue tie, in the back, on the sides. A simple swab of local anesthetic, a quick incision, not even a cry, and his latch immediately improved. Not only did it not hurt at all but he seemed happier too.

Fast forward to Cruz’s well check at 7 months…the pediatrician told us he had not gained one ounce since his last visit at 4 months, and although he had grown in length, his head did not grow at all either. We had three different nurses measure, including the one who usually does all of his measurements at these checks. I was told to get him to gain weight yesterday and hope that with the weight gain comes head/brain growth. I even questioned the growth charts they used at that office, asking to not compare him to formula fed babies, or babies who had started solids at four months old. It didn’t matter. At 7 months, he was deemed failure to thrive. I asked the pediatrician what to do. He was an exclusively breastfed baby who had just started solids but that was just for practice. She recommended less solids and to follow each nursing session with as much formula as he wanted. In the meantime, she recommended blood tests to rule out any diseases.

Not wanting to have to draw blood unless we needed to, I asked what the worst-case scenario was. She told me she wished I didn’t ask…she said worst cases were leukemia, or some rare childhood disease (I can’t remember what it was called) where he would not see his first birthday.

I immediately contacted my LLL leader for advice. He was a happy baby who not only made every age appropriate milestone, but he had made them earlier than his peers. He was even sleeping through the night for the entire month before we found out something was wrong! I had been nursing Cruz mostly on demand for months now. He would sometimes go even 4-5 hours and still didn’t show signs of hunger. Not even crying. Usually by the fourth hour, I would be painfully engorged so I would nurse him anyway, even if he didn’t show the signs. He happily nursed at any time, whether it was four minutes after nursing or four hours. 

I thought maybe my milk wasn’t fatty enough for him. I started taking twelve fenugreek (the amount at which I finally smelled like maple syrup) combined with four mothers milk plus a day. I started nursing him every two hours, both sides, for at least ten minutes each side. He was a distracted nurser and wouldn’t nurse very long if there were something else in the room that seemed fun to play with or look at and the only thing that I could do to keep him at the breast was to play some stupid fisher price app. I offered him up to eight ounces of formula after each nursing session. Sometimes he finished all eight ounces, sometimes he only wanted two ounces. I was also instructed to nurse him then offer a bottle every time he woke up in the middle of the night, assuming that if he did wake up, he woke out of hunger. 

We had to go in to the doctor’s office every other day for the first two weeks for weight and measurement checks (head and length). Within the first 48 hours he gained almost two pounds. By the end of the second week he had “caught up” to his own weight curve and his head had shown small growth (but any growth was a success).

Within thirty days all of the blood tests came back and they found nothing “wrong” with any of it. They chalked it up to not enough calories. I was able to slowly wean him off the formula when he was ten months old, starting with the bottles in the middle of the night. The last one I cut out was the bottle after nursing before bed. By the time he turned eleven months he was back to being only breastfed every three hours and any time he woke in the night (which at this point he had begun to wake three + times a night!).

By the time he turned one, we were able to increase his solid intake and I got the “all clear” to return to on demand nursing. Two weeks after his one-year birthday he contracted hand foot mouth and went on a nursing strike. Combined with no nursing and all of the supplements I was taking to maintain my increased supply for him (the fenugreek and mothers milk plus), I came down with mastitis. I took antibiotics, pumped, anf massaged it away.

To get Cruz to nurse again, we took a few baths together and I didn’t offer nursing to him. I just cuddled him and by the third bath, he had felt good enough to nurse again.

Cruz is now almost nineteen months old and I am no longer taking the mothers milk plus pills but am still taking four fenugreek pills a day. I’m thankful I was able to get down to only four gradually without hurting my supply or risking a plugged duct or worse. Other than nursing to nap and at bedtime, he still nurses on demand which some days feels like it’s all day, and others it feels like it’s only to nap and to bed. Cruz still wakes between two or three (sometimes four to five) times a night to nurse when he’s not teething. When he’s teething, he will either stay latched on all night or wake at least once every twenty to forty-five minutes!

Because of everything we went through, especially after he was four months old, I felt like a failure. I felt like I was starving my child and didn’t even know it. I was inhibiting his growth and sabotaged my own supply by not catching on to his cues (if he even showed any). How did I miss the fact that he wasn’t getting enough? I looked for all the tell tale signs of hunger. To this day I harbor a lot of guilt and sadness. Although he’s thriving now, I can’t bring myself to trust when he says he’s not hungry or walks away from the table like most toddlers do. I’m supposed to trust that he will eat when he’s hungry. I’m supposed to trust that he will graze and barely eat some days like toddlers do, then sometimes eat like there’s no tomorrow like toddlers do. Everyday I battle with trusting Cruz and trusting my instincts. I keep a mental list of everything he consumes within each three-day period, just so I don’t miss anything. To make sure weird patterns don’t emerge. 

For this I am grateful I am still able to nurse him. On days he barely wants to eat or is too busy to eat, I know I can count on calories and nourishment from my milk. I will continue to battle this until I forgive myself and know that I was, and still am, doing the best thing I can for Cruz.

It hasn't been a walk in the park. The challenges I've had to face in the breast-feeding world: engorgement, plugged duct, blebs, tongue tie, supply drop, mastitis, Cruz batting at me while nursing, and kneading and scratching, Cruz wanting to sit up while nursing and tear off or down right refuse the cover while in public, distracted baby nursing, being so exhausted that my arm falls when nursing him at night and the slippage results in painful, accidental biting! 

I'm not going to lie, there are time I absolutely hate it. It can be isolating, especially in this culture. I'm stared at in public even if I use a nursing cover (which I hardly do anymore). Often times I have to go to another room to nurse, or I'm the only one in the room who still nurses, or the only one in the room who's ever nursed. Ridiculous as it sounds, sometimes breastfeeding is blamed for Cruz's sleeplessness, attachment to me, lack of weight and even sometimes the opposite - his "thunder thighs", and also sometimes his inability (or what I think is unwillingness) to "selfsoothe".

Breastfeeding is not supposed to be painful, but sometimes it is. Cruz likes to do acrobatics while nursing sometimes. And as much as I try to get him to stay still, he's strong. And active. And willful. And I'm exhausted. So I let him "get away" with it because I know it will last only 3 more minutes and then he'll be almost asleep. Or distracted and full and want to go play.

But as much as I hate it, 
I love it so much more.
I know he's getting the best possible nourishment there is. He’s only had one ear infection (and that was after he was one year old). He's only been sick twice and thank God I was able to nurse him through both of those times. The benefits for him are numerous but I'm not a martyr; I can't deny the benefits for me! And now that he’s a toddler, any time he is having a bad day, tantrums, falls and gets hurt, or needs comforting, nursing is the best answer! But even more so than all of the physical benefits for both of us, the greatest benefit is I've been able to continue to naturally connect with him deeper than anyone else in the world can. Only a nursing mother feels the gentle eyelashes flutter and slowly close for the last time as her child falls asleep peacefully at her breast. Only a nursing child can find and latch onto his mother’s breast in the pitch-blackness of the night and be nourished and know comfort the way nature intended.

These are the things that keep me going. They far outweigh any negativity society puts on breastfeeding. Even when I'm asked for the millionth time, "when are you planning on stopping?" It's a funny thing this breastfeeding relationship...people are always so curious when women decide to breastfeed and for how long.

When Beyonce nursed her baby, it made headlines. Perhaps because it came on the heels of Time Magazine's controversial issue depicting an extended breastfeeding relationship between a mother and her son. Perhaps because Beyonce is a pop star and very much in the public eye. Perhaps because she wasn't ashamed or made to think she had to hide when it was time to nourish her newborn. It makes me sad that our society as a whole doesn't view breastfeeding as the norm, and that it's even a topic to discuss at all. 

Shouldn't something so natural to mothers and babies be something that is naturally overlooked as a "hot topic" since it's something that can and should be happening enough to be the norm? Instead of "Oh, look, that mom's nursing her baby/toddler in public <gasp>", shouldn't it be "Oh, I didn't even notice her nursing her baby because I see it often enough it's not shocking."

Blessed be the day mothers can nurse their babies without making headlines. Blessed be the day no one asks a mother IF she'll breastfeed. Blessed be the day appropriate extended breastfeeding relationships between mother and child aren't questioned...more on that topic another day :) 

For now, I leave you with this…

My breastfeeding goal when I first had Cruz: definitely 6 months and shoot for 1 year as ultimate goal.

My breastfeeding goal now that Cruz is a year and a half...that's between Cruz and I. We'll stop when we're ready :) 

 

I like to dedicate the last Friday of the month to a breastfeeding-related topic.  Today’s post is a shout-out to all the mamas who are managing to feed their babies breastmilk against the odds.  I am not going to call them out by name; I will leave that to them if they want to share more of their story in the comments section.  I do want to share their situations so that if you know of someone or you are the someone in their situation, you can take heart in their stories and maybe breastfeed just one more day…

 

I also want to put my Bradley Method® teacher hat on and state each family needs to evaluate their situation and decide which path is right for them.  This is not a judgment on parents who choose to formula-feed – they have their reasons and that decision is right for them.  My goal with this post is to encourage the families who want to breastfeed because that is the choice for their family, and let them know that other people have been in a tough place and made the choice work for them.

 

These are examples taken from our last two classes in Fall 2011 and Winter 2011-12.  I also have examples of working moms for you to take inspiration from – you can read their stories here and here.

 

Mom 1:  Mom showed signs of pre-eclampsia and was having gall bladder issues.  At their doctor’s advice, they decided to head in for an induction at 38 weeks since mom’s blood pressure kept climbing higher and higher.  They had an emergency cesarean section when the induction sent both mom and baby into distress.  Baby was born at 5 pounds, 3 ounces – not bad for a pre-term baby, yet still pretty small.  Mom started nursing in the hospital, and the staff insisted they supplement with formula since they felt he was loosing too much weight. It soon became apparent that Baby wasn’t getting enough either way since he lost too much of his birth weight and didn’t gain it back within the first ten days of his life.  They finally got baby’s weight back to an acceptable level so they could cut out the formula.  It seems like maybe the issue is a tongue-tie – they’ve been to four lactation consultants and one pediatrician so far with no definitive answer…yet another appointment is on their schedule to see if they can get the information/help they need to get baby latching properly.

 

Guess what?  At the time of writing this post, Baby is seven weeks old…mom knows he isn’t getting enough at the breast, yet she has committed to giving him breastmilk.  She is pumping and bottle-feeding and this kiddo is thriving.  He is weighs over eight pounds now and is just as chunky as can be.  I think the secret to her success is her attitude.  She calls her pump her best friend. 

 

Mom 2:  This Mom went into pre-term labor at 35 weeks and five hours later she was holding a 3 pound, 12-ounce bundle of joy.  Being so little and so early, he did not have a strong sucking reflex.  Because he was small, he was in NICU for observation and parents were very limited on the time Mom could hold him and attempt breastfeeding. The staff mentioned it was highly likely supplementing with formula would be insisted on, depending on breastfeeding/pumping results.  Despite the “no pressure, but” attitude, mom nursed, and then she pumped and was able to produce enough colostrum and then breastmilk for baby during their extended hospital stay.  No formula necessary!

The parents found out Baby was tongue tied when he was 3 weeks old (after a lactation consultation) and had it fixed at 4 weeks.  In order to ensure baby was getting enough calories until the procedure, Mom continued to supplement breastfeeding sessions with bottle-feedings of pumped milk. At four weeks old, Mom reported Baby was up to 5 pounds, 11 ounces.  Since then, he has had his tongue-tie procedure and Mom reports his latch is already much improved.  Today’s update: he is now 5 weeks old and weighs 6 pounds 1/2 ounce!  There are some residual latch issues as baby re-learns to nurse…yet mom is keeping up a positive attitude and is working on getting Baby exclusively breastfed.

 

 Mom 3:  This Mom attended our classes while pregnant with Baby 2.  With her first child, she visited 5 different lactation consultants for help.  The fifth one was the charm – and she and her daughter ended up having the breastfeeding relationship they wanted; even what some people would consider an “extended” nursing – daughter was nursed until she was two years old. 

 

Fast forward to this birth:  Baby seemed to be nursing vigorously in the hospital, but the scale told a different story.  Mom was incredulous that she was going to have to do this the hard way again.  With this baby, it has been a nipple fit issue – and I learned something new.  We teach in class that it is possible for women with different sized breasts and/or nipples to feed their babies.  I didn’t know it meant sometimes that means feeding with a bottle until the baby’s mouth is big enough to take the breast into the mouth and be able to nurse efficiently. 

 

From Mom:

“My actual nipple is too big for his mouth to latch on properly to - lovely.  The even more ironic part is that my nipples are flat and inverted so outside of nursing I never even really have nipples and then when I need them for what God created them for and they have to exvert - they are too big!!  Aaagghhh, we are hanging in there though and little guy has gained over 3 pounds of all breastmilk so I am truly thankful I have been able to feed him still. Although, it's not the perfect experience I was hoping for, I am still hopeful and each day he is doing a little better!” 

 

There is also a suspected tongue-tie with Baby; so Mom is investigating that possibility as well.  To bring it back to the topic, Baby is almost five weeks old, and mom has found success nursing in the side-lying position and supplemented with breastmilk bottle-feeding to keep Baby growing and thriving.

 

Mom 4:  This is mom with two kiddos at home (4 yrs. old and 2 yrs. old) plus a newborn.  Baby is one week, five days old at the time of this post. 

 

From Mom:

“Breastfeeding started out strong, with a few clicks during a feed but no problems.  By day two, the problems with her latch and suck started to show themselves in the form of stripping my nipples.  By day three, Thursday, it was apparent she was not getting enough, a fact that was confirmed by a scale during a visit with the lactation consultant.  I started finger feeds Thursday night because she wasn't getting enough at the breast and I was in excruciating pain.  If either factor had not existed, I would have persevered.  Saturday night, it was after 9pm and I still hadn't had dinner, so I gave [Coach] a bottle to feed [Baby].  She took pretty well to it.  

 

It took her another day before she'd take a bottle from me.  She had problems with it flowing too fast, despite the preemie nipple, but there was less waste, so I switched entirely to bottles.  By Monday or Tuesday the clicking was a regular occurrence on the bottle.  Each day has shown a steady decline in her ability to eat from the bottle.  Some sessions result in only a tiny fraction of an ounce of milk consumed.  Today, Friday, day 10, we took her to get her tongue tie clipped.  We did not know that the doctor changed his policy and no longer does the clips on the same day as the consult.  

 

We are happy to note she is back at her birth weight (she never lost much, really, even less than many properly-fed babies), but given her difficulties on the bottle, I feel I need to switch back to finger feeding.  Every day that passes increases the risk that she won't breastfeed.  Not only is the stress of this risking my milk supply, but the whole pumping-feeding process is taking away from her and my other children.”

 

Going through this experience plus mothering her two other children – it has opened my eyes to what a mom is really capable of doing if she sets her mind to it.

 

Thank you Mamas, for helping me to write this post.  I am grateful that you are willing to share your stories with other families who are seeking encouragement out on the Internet.

 

All of these mamas are my heroines.  They have committed to pumping their breasts, and then washing and sterilizing their equipment and their feeding systems.  It is a major undertaking to do this several times a day.

 

Coaches, do not underestimate your contribution in this situation.  A mom will succeed in this effort because you are helping and encouraging her, and thanking her for going above and beyond to provide the nutrition you both want for your child.

 

If you are having challenges breastfeeding, take heart that it can be done.  I definitely encourage you to read the IBCLC blog post on what to do when breastfeeding isn’t working out.  You can also take heart in these stories – you are not alone.  There are other families out there making the choice to provide their babies with Mom’s breastmilk the hard way.  It is my fervent prayer that all mothers who want to feed their babies breastmilk will be able to find a path to do so joyfully, and from their breast if at all possible. 

 

No matter how you deliver the breastmilk, your growing baby is the best reward for the time and the effort.  In the time period when our children were exclusively breastfed, it was awesome and humbling to see them growing and thriving on my milk.  If that is what you want to do, I wish the best breastfeeding relationship possible for you, too.

 

 

Programming note:

Debbie Gillespie, IBCLC, RLC, will be back next month for another installment in her Breastfeeding 101 series.  To see her other blog posts, click the Breastfeeding 101 blog topic link.