Wednesday, August 31, 2011

Breastfeeding Issues - One Mom's Experiences

My friend Jennifer has spent some considerable time blogging about her breastfeeding struggles with her firstborn, now 7 months old, and I thought that you all might enjoy reading her writings! Take a good look especially at the second entry, as it is full of awesome advice for struggling mamas:

Adventures in Nursing

Adventures in Nursing II (Addressing Improving Low Milk Supply Issues with Breastfeeding))


Monday, August 29, 2011

Finally, Someone Saying What I Want to Hear: Kegels

Have I ever mentioned how thoroughly and deeply I dislike kegels?

If not, here you have it: I loathe kegels. Utterly loathe-dislike-despise them. To me, the feeling of doing kegels is something akin to the sound of nails on a chalkboard. Except it's much worse.

The only time I manage to force myself to do kegels is when I am pregnant and working toward a deadling (childbirth!), and then I usually do them with my legs crossed as hard as I can so that I can't feel them. And then I add in a loudly sung Austrian drinking song to further distract my mind from them.

So much for "the exercise that you can do and no one will know you're doing them!" (I think the Austrian drinking song is what gives it away.)

Well, I am happy to report - kegeling is no more for me! Thank you to the author of this article!

Why You Should Stop Doing Kegels

And now I'm off to squat - infinitely preferable in any amount to those awful kegels!

Is anyone else out there with me, or am I the only wimp who can't stand those things?

Later note: I realized, after writing this post, that while I was overjoyed to see this article, most birth professionals still do recommend kegels. If you like kegels, believe them to be beneficial, or have received benefit from doing them, I certainly do not want to discourage you from doing them! Kegel away. This post really just was a reflection of my personal joy at finding a reason not to do something that I thoroughly dislike, not a lecture to the world to stop doing kegels. Please, do your research and make the decision that you are comfortable with.

Lovely Homebirth Story!

A wonderful homebirth story from a blog that I frequent (read it! it's awesome!):

Eden's Homebirth Story

Just loved the part about finding out baby's gender.... and two hours later discovering that the gender had been misidentified! Love it! 

Congratulations to this family and their new sweet little one!

Saturday, August 27, 2011

Expectations - My Version!

Birth Faith posted a wonderful article earlier this week on "Expectations" - what components of birth, breastfeeding and parenting were easier or harder than she expected. I thought I'd write my own version! You will notice that some of her "easier than I expected" are going to be in my "harder than expected" and vice versa - so much for consensus!

Harder than I ever expected:

- Establishing breastfeeding - YIKES! With both of my babies, this was incredibly difficult and required much time, tears, effort, and a supportive midwife and pediatrician. I now know why breastfeeding rates are so abysmally low in the U.S. - not only can breastfeeding easily be sabotaged, but it really needs the help of a small community to get started and be successful.

- Afterpains - They say these don't occur with your first baby. NOT SO. Ouch, ouch, ouch, ouch. Enough said.

- Night feedings - Night feedings are pure torture. As a friend of mine said, "I hate it when late afternoon comes because I know that another horrible night is now before me." Try being utterly exhausted and then spending almost all of the night being up nursing a baby and then trying to put said baby back to bed. I thank God for our wonderful late pediatrician, who said "Take the baby to bed with you!" so that I only had to go through two months of those hideous nights before we discovered the joys of co-sleeping.

- Marriage - Much harder than I expected! Negative behaviors (nagging, negativity) are my default even when I recognize them as wrong - so incredibly frustrating, and a constant challenge for me.

- Parenting - If one thing has rocked my world, it has been parenting. I had no idea how difficult it would be (once they hit the toddler stage - infant stage was pretty easy), how it would challenge me to the core of my very being. I am still learning - and I think always will be - and am so grateful for godly parents who have tread the path before me (and whose advice I covet and treasure) and for the great books out there which have helped so much.

- Pregnancy - Hello, hyperemesis gravidarum!! So much for floating through a glowing pregnancy. :)

- Birth - This was really a lot harder than I expected, but it was also an amazing experience that transformed me from the inside out. Completely worth it (though I don't usually think that while I'm doing it).

- Adjusting to life with a first baby - Getting used to not having a true schedule, not having any true alone time - very difficult. Second baby was a breeze comparatively (also helped that he is an easy baby!). It will be interesting to see how #3 hits!

Easier than I ever expected:

- Healing after birth - Aside from those blasted afterpains (ouch! ouch! ouch!), it wasn't bad at all, most likely thanks to the wonderful treatment of our midwives (lots of olive oil, gentle pushing phase, no episiotomy, etc.).

- Waiting through the last weeks of pregnancy - Most women seem to be impatient to have pregnancy be over. I have never felt this way! I love being pregnant, and since the nausea is usually gone or manageable by this time, I'm usually loving being pregnant and am sorry when labor starts.

- Sleep sharing - It rocks. Love it and couldn't live without it.

- Adjusting to a second baby - After the shock to my system from #1, getting used to a #2 just wasn't that hard. Some moms have this reversed, though! A friend of mine had a super-easy baby for #1 and a challenging baby for #2, and it was that #2 who rocked her world.


Have I missed anything in there that I should have listed? Let me know and I'll add it in! What would you put on your lists?

Friday, August 26, 2011

The Perfect Transport

I picked this birth story up from the Hypnobabies Facebook page, and I just loved it. Here are both parts:

The Birth of Brynn, Part I

The Birth of Brynn, Part II

I read a lot of great birth stories, but I loved this one especially - because this is what a homebirth transport should look like. Cheerful reception by hospital staff, wonderful treatment from doctor and nurses, seamless transport of care from home/birth center to hospital - it was wonderful from start to finish.

So often, homebirth transport stories are horror stories. Sullen or hostile reception at the hospital, doctors and nurses who scold, threaten, or actively punish mothers for daring to try to birth at home, midwives who are ignored or ridiculed by staff. So sad, and so unnecessary.

The midwife model of care is meant to fit seamlessly into a maternity system which has open doors of communication (and friendly working relationships) between OBs and midwives, between hospital and home. It doesn't need to be "us vs. them" - doctors and midwives working together in a collaborative model of care is so much more preferable.

So often in the birth community, we become polarized warring camps. Each side tells horror stories about the other, each side rallies the forces against the other side - it's really too bad. The end goal (and the goal which I try to promote on this blog) is friendly and professional collaboration between OBs and midwives, not a fight to the death with winner take all. That's why I sometimes have doubts about websites like "My OB said WHAT?!?!" which seem purposely to promote strife and hatred rather than working constructively toward any positive end-goal.

And so, after all of that, I loved this birth story. This is what transport can and should be, this is how doctors and midwives can and should work as a seamless team to transport mothers between birthing locations, and I would love to see more stories out there like this one.

Thoughts, anyone?

Saturday, August 6, 2011

Adding Two More....

To my list of Goals & Wishes for Pregnancy & Birth! I'll copy these into the original doc, too.

Short Second Stage

Most women love the pushing phase during a birth. They feel that they can get involved and be an active participant rather than a bystander (of sorts). I'm the opposite! I really don't like pushing. First time it was an hour or two, second time was..... oh, 20-30 minutes, not sure. But I would LOVE to have one of those one-or-two push births - that would be lovely!

Again, any ladies out there who have not experienced a birth yet, take heart - as I've said - most women really enjoy the pushing phase.

A Butter Birth!

A butter birth is a phrase used by midwives to describe a birth that is quick, easy, and where the baby slips out easily "like butter." I would love one of these! Can I put my order in now, please?

I'm sure I'll have more to add later!

Breastfeeding Story #2 - Tongue-Tie, Bottle Addiction & Other Fun Stuff!

In honor of World Breastfeeding Week, here is the story of our battle-to-breastfeeding with our youngest (or rather, now middle!) child. I started writing this story when he was eight months old and am finishing it when he is now 23 months old (procrastination, anyone?), so you will understand any discrepancies in times mentioned.


Here goes! The trials and triumphs of breastfeeding with our youngest, now age 8 months (and who is sitting on my lap making succulent slurping noises sucking on his fingers). And thankfully, I wrote all my dates down, so it will at least be somewhat accurate!

September 1st - Baby arrived! My labor time from water breaking (with immediate onset of labor contractions) to birth was 7 hours 11 minutes, a classic and short second-baby labor.

We started out with a few issues. Firstly, baby was a slow starter. His heart rate plummeted during second stage, necessitating a hurried pushing phase, and he needed quite a bit of stimulation and suctioning to get him going. He had a rough couple of first days, and scared us to death his second night, when he started having coughing/choking fits that made us afraid he was going to asphyxiate. Somewhere around midnight or two in the morning, we were alarmed enough to call both our midwife and our pediatrician, and at one point (when he turned himself black before starting to breathe again), DH nearly packed us into the car to drive to emergency. Thankfully, soon after this my milk came in, which for some reason cleared up most of baby's problems - his choking episodes stopped, his skin cleared up, and he was a lot happier. So were we!

But then our real problems started! Although I had committed to a two-week lying in (or babymoon) in order to rest and get breastfeeding established, nursing did not go well. Baby would not stay latched on or nurse well, and our nursing quickly stretched out into frustrating hour-long sessions. Furthermore, his weight at his pediatrician's visits was not looking well either. When we saw Dr. M on day nine, he was concerned about baby's weight and told us to focus on good breastfeeding. When we came in for a weight check two days later, baby's weight had not only not improved, but had dropped further.

And this is where good medical care steps in and saves the day. Most pediatricians would have said quite firmly, "It's time to head to the store and buy him some formula. Now." Our wonderful pediatrician, on the other hand, said "It's time to head to the breastfeeding store and rent a breast pump. Now." And with that, he single-handedly saved our breastfeeding relationship. Ladies, care providers are so important! They can make or break a situation - whether it's a birth or a breastfeeding relationship or anything else. Be so, so careful whom you choose to shepherd you through life transitions and medical issues.

When we left the pediatrician's office, though, I was in a state of shock. I had just recently concluded a 33-month breastfeeding relationship with our eldest, and I thought that I knew the ropes. This couldn't be happening to us!

By the time that we had driven halfway to the breastfeeding store, I had talked myself into thinking that I didn't really need the breast pump. Instead, I convinced my husband to rent a baby scale, by which method we could keep an eye on baby's milk intake, and thus ensure that he was getting enough.

That was Friday. Thereafter followed one of the most stressful weekends of my life.

By his weight, baby should have been taking in about 2 1/2 ounces of breast milk at each feeding. With the scale, I soon found that our little dude was falling horribly short of this - most of the time he was taking in an ounce at most - sometimes half an ounce, sometimes nothing. And that would be after more than an hour of trying, with multiple breaks for weighing. It was utterly exhausting, horribly frustrating, extremely frightening, and in the end, futile.

By Monday, when our midwife visited to check on us, I was near tears and ready to cave. When she left, we followed her out to the driveway and drove directly to the breastfeeding store, where we rented a breast pump and bought all the necessary paraphernalia (bottles, breastmilk bags, etc.). We headed home and I did my first ever pumping session. Immediately after pumping, we poured the milk into a bottle and fed baby - he took a large amount of milk and was extremely happy about it. The relief was exquisite. And from then on, he ate well from the bottle and began to fill out properly and gain weight again.

After that, my life revolved around pumping! Prepare to pump, pump for 20 minutes, process milk (store, freeze, etc.), attempt to breastfeed baby, feed bottle to baby - and repeat every two hours, all while trying to look after the house and an extremely active three-year-old. Oh, and I should mention that at this time my husband also sustained a serious back injury when slipping in our flooded kitchen - so I was doing single parent duty as well!

Not fun.

A couple of notes:

I was supposed to pump around the clock, but sheer exhaustion kicked in and I was unable to do so. My willpower at 2:00 a.m. was non-existent. I was told that my supply would drop as a result and would eventually dry up, which freaked me out, but as a matter of fact it didn't - I was in oversupply and was able to freeze a full 12 ounces of extra milk a day (plus that which had to be thrown out when it didn't get used).
Additionally, I did a big no-no - I co-slept and bottle-fed at the same time. Apparently this is hideously dangerous, because a bottle left propped in a baby's mouth while the mother sleeps can wick milk out into the baby's mouth and drown it. I didn't know this, and I didn't realize that until there was a bottle-prop drowning case a year or so later, and I read up on it. I felt very blessed! Of course, I had noticed that the bottle would slip out of baby's mouth and wick all over the sheets, leaving a huge mess, but I didn't make the connection. All you mamas out there - now you know.

Continuing on:

Breastfeeding continued to be an utterly frustrating flop. I tried, but it just was not working. I began to talk on the phone with the breastfeeding store's IBCLC lactation consultant, and she mentioned that it would not be catastrophic if I gave up breastfeeding for the time being. As long as baby was being fed and my supply was kept up through pumping, there was always the chance to reintroduce breastfeeding in the future.

And so, while it was hard to do, I gave up attempting to breastfeed, and it was truly a big relief. With pumping, bottle-feeding, trying to breastfeed, and processing milk, I was spending almost all of my daylight hours on feeding time - it was more than I could handle. So for the moment, we were just pumping and bottle feeding.

I made an appointment to see the breastfeeding store's lactation counselor, and when we went in, she immediately diagnosed tongue-tie and advised getting it clipped. Finally, a diagnosis!

So I headed back to our pediatrician - only to find out that he didn't do tongue-tie clipping. Being extremely non-interventionist (which normally was wonderful), he preferred to leave things to nature and give an older kid exercises to do if he still had a tight frenulum when older. But since we needed something to be done now, we got a recommendation for another pediatrician who did tongue tie clipping (Dr. A in Phoenix), and we went to see him.

We had baby's tongue-tie correction done when he was five or six weeks old. The pediatrician told us that it was rather late to have had it done, and afterwards we found this to be true. Breastfeeding attempts after the procedure quickly showed that while baby could nurse, he had no intention of doing so! He was good and bottle-addicted. We were again at an impasse.

At this point, we received advice from two different quarters that was directly conflicting:

Advisor #1, the lactation consultant - We went and saw the lactation consultant. Baby refused to nurse even with her help. The advice we received from her was to spend a lot of skin-to-skin time with baby, and never to let him get upset at the breast (to avoid negative breastfeeding associations) - coax him into breastfeeding.

Sounded nice, but (1) I had no success with it, (2) with the way life was going, I had almost NO time to sit around doing skin-to-skin time. It just wasn't possible.

(I should also mention that she gave me breast shields to try. No dice.)

Advisor #2, our pediatrician - Later the same week, we saw our pediatrician, and he told us that our only hope was to make baby get upset at the breast - i.e. to withhold the bottle and let hunger do the job.

Talk about conflicting opinions! 

Well, it sounded a bit nerve-wracking, but since method #1 had turned out to be a total dud, we decided to give method #2 a go. The following Saturday, November 7th (baby was about 9 weeks old), I cleared my calendar, prepared to stay in bed all day with baby, and gave him his last bottle at 8:00 a.m.

Then we waited.

Baby would wake up, fuss, I would offer the breast, he would refuse, and go back to sleep. Repeat and rinse.

This continued for seven hours, until 3:00 p.m., when he finally caved. Beautifully and magnificently. Not only did he breastfeed, but he had an enormous feeding and never refused the breast again.

And he has not had even one bottle since then (in almost two years). Score one for the pediatrician!

The only unpleasant side-effect was engorgement, the end-result of being in over-production and having to slow down to baby's needs. I had never experienced engorgement before (or nothing like this!), so that was a surprising and unpleasant experience. I pumped once or twice for relief, but thankfully it only lasted a few days. Good thing, because it's no fun having red-hot watermelons taped to one's chest.

I learned a lot of lessons through this experience. First of all, I learned - again! - how difficult breastfeeding initiation can be, and how necessary and essential it is to be surrounded by breastfeeding supportive caregivers. With almost any other caregivers, this story would have ended in a formula-fed baby. Please, please, please choose your caregivers wisely.

Before anyone shoots me an indignant email: Yes, I know there are some situations in which breastfeeding is indeed physically impossible or where mothers do indeed have to supplement (I have had several friends in this situation), and I'm not trying to deny that or to put down mothers who cannot breastfeed. But this was not one of those situations, and good care got us over the hurdles rather than sabotaging our best efforts unnecessarily.

Secondly, with as much as I had learned in 33 months of breastfeeding our eldest, there were still unplumbed depths to breastfeeding that remained completely unknown to me. And there are still many breastfeeding difficulties that I have not yet encountered! Never underestimate your opponent.

Lastly, touchy-feely methods aren't always best. Sure, it sounded great to be all mammal-ish and snuggly with baby, but it wasn't getting us one bit closer to breastfeeding. The cut-and-dried method of our ever-realistic pediatrician did in seven hours what the touchy-feely method probably would never have accomplished. (And he had accomplished similar success using a similarly cut-and-dried method with our eldest son, for different problems.) I have found this to be true in much of parenting. Good lesson.

Oh, and as a side note, I also learned personally the effectiveness of the "dead baby card." Traditionally, the dead baby card is when an OB (or nurse or midwife or whomever) says something along the lines of "No, you don't have to consent to [procedure X], but if you don't your baby will die!" It's used quite commonly, unfortunately and it's almost 100% effective in coercing compliance. Well, I experienced this! And not even in a bad way. When I was talking to the IBCLC, she mentioned offhand something along the lines of "well, you just need to make sure that the baby is being fed, because if you don't, there won't be any baby to feed." She wasn't even being malicious! But being under the immense amount of stress that I was (not to mention sleep deprivation and being newly postpartum), that almost put me into hysterics. It's no wonder that the technique is so effective.

So that's our story! Hopefully it can help someone out there. I am hoping beyond hope that our 3rd baby will be an easy nurser, because I have had quite enough of breastfeeding crises! I'll report back on that later.

Happy World Breastfeeding Week!