Sunday, August 2, 2009

World Breastfeeding Week



I have discovered that today marks the beginning of World Breastfeeding Week. In honour of that I'd like to tell you a story. I have permission of my friend Anna to relate this all to you.

As I just mentioned I have a friend named Anna who lives in Slovakia. Thanks to the wonder that is Facebook we've been able to reconnect a bit over the past few years. Anna is the mother of 2 lovely little girls.

Shortly after her second child was born she posted a status about her daughter not gaining weight. I didn't want to intrude, but I had also been there with my second baby and wanted to offer help if I could (as well as help can go when you live on 2 different continents).

I kept our messages to each other. They went something like this (with a little bit of editing):

Hi Anna,

First, congratulations on the birth of your new little girl, I've been one of those silent lurkers on your blog site following along.

Your status caught my eye tonight, and I wanted to share what I hope will be some encouragement.

When my son was born last year, we went through a lot of worries about his weight, he kept dropping weight after we left the hospital and did not gain. It was a mystery to me because it seemed that I was always nursing him.

I worked with a lactation consultant nurse quite extensively and she really helped me out. She discovered that although it seemed that he was always nursing, he was really only nursing for short periods of time and then falling asleep (a vicious cycle really). As well there were a few issues with getting a good latch on and she taught me how to latch him and hold him properly so he would get a good feed. I did have to take some time to pump and supplement with extra breast milk when I fed from one side that was slower than the other as well with a feeding tube.

It was a lot of work and heartbreaking work because you think these things are supposed to be natural therefore easy...but he did start to gain weight and eat better, and here we are a year later ready to celebrate his first birthday.
Now I don't know if you are breastfeeding or not. I have no idea what resources there are in Slovakia for new babies and moms. But I hope that if you need help for your little girl you can find it. If you are nursing her and would like some tips, I know of some good websites that have good information to help.

I just felt compelled to share because I know how sad and scary it is when your baby isn't gaining weight. I hope that helps you some. I'll be praying for your daughter as well.

Take Care,
Kristen

She replied:

Hi Kristen,

such a timely message from you! I've cried soooo much in the last 2 weeks! With my first daughter, a similar thing happened... she dropped weight significantly and after 3 weeks, I started supplementing with formula and then only ended up being able to breastfeed for 4 months before there was no milk.

I was determined it'll work this time with this baby. Well, it appeared to be going so well but she did lose weight and since we've been home, 2 weeks now, she did not gain. My doc said we have to add formula to my breastfeeding... I saw her again yesterday and she is insisting we need to start doing something for her health.. of course I want my kids to be healthy and well but I am so worried that once I intro formula, there will be quick road down to my breastfeeding. I am so discouraged. I really thought it'll all go well.

As you said, my daughter too is very sleepy, I think still due to her jaundice, so she falls asleep, she is pretty weak and thus can't suck properly. I am also convinced she is not latching on right and that's part of the problem. Finally, I tried expressing yesterday to see how much there was in one side while I offered her the other - and I discovered I have pretty low supply - about 20 ml in one! I was so disappointed. I've been trying to tell the nurses and the doc that I think she has a problem with latching but no one is helping. The lactation consultants do exist here I've heard but it's very new and rare and I don't have an access to one... I am so desperate for help... I've been looking online and found some stuff but I mainly need actual physical help - teaching herhow to latch on, how to suck and walking with me through the process.

Sadly though, I think now she might actually be hungry as i guess not enough milk forms due to her non-proper latching and so as the doc insists, I might need to add formula. She wants us back on Thurs but said we need to test her with a formula bottle of 50ml to see if she'd drink that... she also took some blood and thought she might be iron-deficient...

It's very frustrating and so discouraging all for me... I feel so trapped and don't know what the right thing is to do.

If you do have some good websites, please pass them along.

Thanks again for contacting me, Kristen, it's good to be able to chat and even just to get it out of me, too.

Thanks for prayers, too! Boy, do we need them!! (I've not even gotten into telling you about how difficult life is right now with our first, she is dealing with jealousy issues and we've seen our sweet little wonderful girl turn into something she never was before... but that's another topic, it's just adding to my grief...)
Sorry I vented so much...
Blessings,
Anna

PS So are you still breastfeeding your son?



Wow! So much information to tackle. With a second child you have both the worries of getting the baby off to a good start, but also the sibling rivalry that develops from the first. Here's what I wrote back:

Don't worry about venting, I did a similar thing with my friend Jill when I was going through this (she has 2 boys the same ages as mine)...you need to share with someone who is going through the same thing. And as well, I had the jealously issues with my first, and guilt about that too, so I hear you there.

As for online help, there are some breastfeeding support groups on Facebook.
I belong to Canadian Breastfeeding Mommies http://www.facebook.com/group.php?gid=2244768189

I got some good help there with pumping milk.
and attachment parenting http://www.facebook.com/group.php?gid=2224151641
which covers everything from breastfeeding to babywearing

There is some great information on the La Leche International site
http://www.llli.org/
It has country links...if there isn't anything for Slovakia, try Canada resources.

Here are some sites that help with latching (how to instructions and videos)
http://www.breastfeeding.com/helpme/helpme_images_latchon.html
http://www.breastfeeding.com/helpme/helpme_video.html
http://video.about.com/breastfeeding/Breast-Feeding-Latch-Position.htm

I found that I had to really take control of my son's head and that breast compressions were very important to get him to suck properly.
Here's what I did for success:
1: sit comfortably, get a pillow to help set up baby
2: tuck baby's lower arm under her (so that she isn't flailing about...swaddling both arms in works well too)
3: cradle her so that you end up holding her head so that you have control of where it goes
4: take hold of your breast with your other hand...express a few drops of milk, rub the nipple across her lips
5: when she opens her mouth wide, shove the breast in (repeat until she is latched on)
6: then take your hand to start compressing...a proper compression, you grasp your breast and squeeze down and forward (kinda forcing the milk out) and hold for a few counts, release, and compress again...you kinda start to get in a rhythm with your baby (don't do what I did at first which was compress, compress, compress all quickly, the holding down is an important part of it)
-make sure that she eats for a good 20-50 minutes

If she starts to fall asleep here are some wake up baby tips (your husband and older daughter can help with some of these):
1: start undressing her
2: blow on her head/neck
3: tickle her feet
4: get a cool cloth and gently rub it on her

A good breast pump is important right now too.
Pump often so that if you need to supplement, you can supplement with breast milk first. Remember that pumping is never as effective as a baby's suck so it will be less than you think.
I found the best times to pump were 1) on the opposite breast than he was eating while he was eating, 2) about an hour after he ate, 3) first thing in the morning

A piece of advice that helped reassure me was this: If you need to supplement, 90% breast milk and 10% formula is better than no breast milk at all...allow yourself that grace. Her's health is the most important thing. What my doctor was worried about (and why she sent me to the breastfeeding clinic) was that my son would just keep falling asleep and falling asleep and she wanted him to wake up...he needed to get his iron stores up.

Also, if you do introduce a bottle, try breastfeeding first and then finish with the bottle (that way you always get good nipple stimulation which is what helps keep up your supply)
If introducing a bottle replaces a feed...pump to replace that feed for the same reason.
I know one mom who purposely introduced a bottle when her baby was quite small so that she could get a break at night (take a bath, have some alone time)...it turned into a real nice time for her husband to spend with their daughter.

As for your older daughter...because that issue is important too!
Here's some tips that worked with my son.
Give yourself grace in these early days. I kept him in part-time daycare until my second was 2 months old, so I could get some sleep. Take people up on offers to help and get them to take her out for a bit, or, get your husband to take her on some daddy-daughter dates...for a muffin, or to the park, or the library or where ever.
When my second was newborn, my first's TV time went up a bit (I was always very strict about only an hour a day until then) This time isn't forever and sometimes a kids DVD is just what the doctor ordered.

Use the time you are feeding baby as a quiet special time for all 3 of you. Get out the puzzles, get out the storybooks. Have your oldest turn the pages as you read and all 3 of you camp out on the bed. Coloring, play-dough are great too.
Friends of mine with little girls found that their oldest having a baby doll to take care of helped with the transition. We didn't get our a baby doll but he did start carrying around his stuffed sheep like a baby. (including holding it under his shirt so it could eat :o))

My husband reminded me that it would benefit our second to see me doing something with our first, so I took time to put the baby in the baby swing and do something with our oldest each day (it's exhausting I know). We would make cookies (something he and I did every Wednesday anyway) or I'd put baby in the sling (baby carrier) and kick a soccer ball with our first...just so he knew that the baby was not taking his place. I'd also talk to him about who he was and how special he is to us. My mom got us a great book called I'm a Big Brother (there's an equvalent sister book)
http://www.amazon.com/Im-Big-Sister-Joanna-Cole/dp/B0012F9VSO/ref=pd_bbs_sr_1?ie=UTF8&s=books&qid=1204637272&sr=8-1
that we used that was great to help.

We had noticed that friends of ours really used dad to take over when mom was busy with the baby so we tried the same approach, not so easy when dad is at work I know.
We still battle with sibling rivalry now and then and we've learned that we can never leave the 2 of them alone together. Unintentionally, pre-schoolers can really hurt their baby siblings, because their brains are developed only to react, not think and act. Our oldest gets quite upset when baby cries...so will hit him to get him to stop crying...which of course makes him cry even more. So if my husband's not home and I want a shower, I put baby in his crib, and settle our oldest with something before going in.

Equally important, take care of yourself! Get sleep whenever you can! You are no good to either of them when you are exhausted...
I know, it sounds ridiculous: Get the baby eating for close to an hour every 3 hours, and breast pump, and see to the needs of a demanding , jealous pre-schooler and still take care of yourself...and not feel exhausted and stressed and guilty...supermom! The thing that kept me going was knowing that this time doesn't last forever and you will get through. With our first I didn't know that you get through it...with our second I had the benefit of having gone through the first 2 months with the oldest and knew there was a light at the end of the tunnel. 6 weeks seems to be the magic number.

I know this is a lot of information, but I hope it helps some. I also know that good breastfeeding support is hard to come by (and we're supposed to be so advanced...) We met up with one of my husband's cousins in England last summer who had a 3 month old. She was so upset that she was formula feeding her baby. The nurse there told her that she couldn't breastfeed properly so she had to start using bottles. When we talked more, it sounded like she had similar issues, but no support to get her through. Another friend of mine here in Canada was told to start using formula because her baby woke at night to eat when he was 4 months old (which is perfectly normal) and so her supply dropped and she wasn't able to follow through the way she wanted to either.

The best place to get breastfeeding support, if you don't have a proper breastfeeding nurse is usually from other breastfeeding mommies. We've been there, we know. (and don't listen to those who say, but it's so easy...because it isn't...it's easy once you get going and know how...it's not to get going properly...)

I just remember that Jill knows a lady who is an exclusive pumper...her babies bottle feed, but bottle feed breast milk (I can't imagine having that much supply, but God created us beautifully)

As for our boy, he did get the hang of it and did gain weight. I still do breastfeed him (he's turning one on Thursday), but not exclusively. I'm in process of weaning, but still in debate on when to cut him off...our first was already weaned by this time (11 and a half months is when he stopped). I actually had a difficult time introducing our second to a bottle when I went back to work last fall. (I waited to long to introduce it-I would have started when he was about 6 weeks old) The first week was terrible (my husband brought him to me at work a couple of times because our son refused the bottle) La Leche helped us out there too to get him to take it. He was bottle fed breast milk for the first few months and slowly introduced to formula. I don't pump anymore...I don't have the supply...in fact I only breastfeed on one side now, because my slow side slowed down more and more gradually that he stopped being able to get the milk as fast as he wanted it.

When I had first started to breastfeed him, we discovered that the right side was slow...what the nurse had me do was use my pumped milk and then take some into a syringe that was attached to a feeding tube and slip the feeding tube into his mouth when he was on that side (kind of like adding an extra duct to his feed) so that the would realize that he was getting milk from that side too. I only had to do that for a few days until he got the hang of it.

Oh I remember that so well, I was so tired and frustrated, I thought it this didn't work, to heck with it...I'm bringing in formula. I also remember the breastfeeding nurse suggested putting breast milk into a small cup (like a medicine cup, shot glass size) and teaching baby to drink from it...you need to put a receiving blanket around baby because it can get messy, tip the cup a little and apparently, they can lap it up like puppies...who knew?

You can also find out how much your daughter is taking in by getting a test weight. Get her weighed before she eats...feed her, then weigh her again...the difference is the amount of ounces that she is getting in.

Remember too that formula isn't a crime...it's to assist you in getting your daughter to be healthy. Use it if you need to and forgive yourself for it.

If anything I hope this helps you at least know you aren't alone!

-Kristen


We continued on with updates for a bit and the good news is that Anna and her daughter stuck with it. She did have to supplement with a little formula, but her daughter is now over a year old and just a beautiful little girl. I went on to nurse my son until he was about 17 months.

I think Jill said it best when she wrote about breastfeeding basics a few months back. Breastfeeding is a lot like sex, perfectly natural, but it can be awkward and a learning process at first.

A great online resource is www.breastfeeding.com
They have everything that you would ever want to know about breastfeeding your child (including online tutorials and podcasts with lactation consultants).

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