Friday, September 16, 2011

Belated Activism

Remember how (back in May) I wrote a post urging readers to write to Mercy Gilbert hospital, thanking them for installing their new labor pool? Well, I myself am just getting around to doing that very thing! Here is my letter, and here is where you can send your own note. The best activism is positive activism!

***

Re: New Labor & Delivery Pool

Dear Mercy Gilbert,

I wanted to drop your staff a note to tell you how excited I am that Mercy Gilbert has recently installed a new labor pool for the use of laboring mothers in your maternity ward. That is simply a splendid development which will be such an incredible blessing to the mamas who choose to birth at your location. Water is such an incredible resource for pain relief and mobility during labor, and I am so excited to be able to enthusiastically recommend Mercy Gilbert as a birth place for local mothers. Congratulations, and great work!

I have spent two labors entirely in water (with one ending in a waterbirth), and I don't know how I could have done it without that water. It helped so much! I will forever be a big proponent of laboring in water as an enormous aid to pregnant mothers.

Great work! Thanks again!

Sincerely Yours,
Diana Johnston

Saturday, September 3, 2011

Facebook Nightmares, the Sequel - Following Up

At the beginning of July, I posted on my frustration at the ongoing pregnancy story of a high school acquaintance of mine (now a Facebook friend) who was being put through the worst of what our maternity care system has to offer.

You can read the story at the above link, but a quick recap: This mama was in her third trimester, first pregnancy, healthy mother, no complications, and had been told by her OB that her baby at term would be a huge, enormous, over-ten-pound monster who could not possibly be birthed vaginally, and that she needed to schedule a cesarean at 38 weeks.

* Pause to let anger subside. Breathe. *

I thought you might like to know how this story ended up, so here is the final chapter.

The cesarean was scheduled, but due to delays with the doctor being away, the scheduled date was for 39+0 weeks. However, the mother went into labor naturally, three days before the scheduled cesarean, and the baby was born that day. I do not know if baby arrived via vaginal birth or via cesarean, as the mother did not post.

Oh, and that "huge, enormous, over-ten-pound monster who could not possibly be birthed vaginally"? He was less than an ounce over seven pounds. Going by average weight gain, he would not have even broken eight pounds at forty weeks.

Yay for late-term ultrasound weight estimates.

So that was the end of the story.

And now, I'd like to follow a few rabbit trails, if my readers will kindly indulge me. Some of these will take the form of a frustration-rant, and I am also in a big hurry, so please forgive me if I am repetitive or even completely nonsensical and occasionally hysterical.

Rabbit trail #1:

I was fascinated by the wide variety of responses that I received to my original post concerning this situation. It was all over the board! Go back and read the comments to see what I mean. It ran up and down a spectrum, everything from "It is your duty to write to her and tell her the true facts of what is happening to her," to "This decision is between her and her doctor and it's none of your stinking business, so keep out of it." Quite a difference of opinion there!

Well, I'll tell you. As a personal thing, I have a strict policy of non-interference in other people's births. Even when they make me as upset as this one. Why? Here are the reasons:

(1) Advice can be really annoying. And it's a bad habit to get into (giving unsolicited advice).
(2) Usually, when people are ready to receive advice, they're already actively looking for the information themselves and don't need it.
(3) If a person is not ready to receive information, she will shut down anything that comes in the form of criticism of her beloved doctor. This is just something that women (myself included) do naturally.

So I really do my best to keep my mouth SHUT. (Unless specifically asked for information, and then I try to give gentle and encouraging information, to the best of my ability.)

On this one, I almost succeeded. Not quite, though. During this saga, I kept my mouth shut (besides notes of congratulations) - except for once, when I left one comment - something to the effect of "please be aware that late-term ultrasound is notoriously unreliable and is often inaccurate by up to several pounds." Then I left it alone, hard as it was.

What do you ladies consider your own personal policies in terms of giving advice when mothers are being taken to the cleaner's with bad maternity care?

Rabbit Trail #2:

This is something I haven't written about yet, but I found it vaguely disturbing - the fact that the mother was actually thrilled to be told that she needed a cesarean. During the decision-making process, she was actively enthusiastic about the idea and was very excited when it was finally decided that way.

Why?

Well, I'm guessing that it was for a number of reasons. First of all, cesareans really are more convenient. They're scheduled! Maternity leave, visiting relatives, vacation plans, holidays, whatever - it's all right according to plan with a scheduled cesarean. There's no doubt about that.

I discovered the lure of the scheduled cesarean last year, when a friend (having her third cesarean) asked me to encapsulate her placenta for her. It was around Thanksgiving time and we were planning to go out of town, which might have been hard - except that I knew exactly when this baby was arriving! So no muss, no fuss! It's no wonder that doctors and patients nowadays are falling into this pattern - there's no doubt that it's super-convenient. Admitted!

Secondly, and more elusively. Women today, especially first-time moms, are dead scared of labor, for a couple of reasons. First of all, we all know how much people love to tell pregnant women horror stories of labor/delivery that are filled to the brim with pain/gore/screaming/etc. etc. I think it must be instinctual, because I have to fight the natural instinct to tell horror stories too! But it sure doesn't help a young mother to prepare confidently for birth.

Secondly, most of the young women I know (real life and acquaintances on Facebook) are coming home from the hospital with experiences that would give Jack the Ripper goosebumps. I can only put it in the words of a blogger I read recently - "violent birth." Unnecessary induction, pitocin-induced labors-from-hell, epidurals, things go wrong, baby is crashing, emergency cesarean, side-effects, you name it. The cascade of interventions in all of its worst forms - over and over and over again, told until new moms believe that this is the norm. That this is just how birth IS.

Is it any wonder that a mother would welcome the thought of a neat and tidy scheduled cesarean? No contractions, no labor, no pitocin, no waiting, no fear, no nothing. Just an epidural and then "Here's your baby!" I don't blame them. Or the women who, having been through this nightmare with their first, welcome the thought of scheduled cesareans for the rest of their babes. I probably would too!

Because this is not something new. I have now seen several women told (usually for the most trivial of reasons) that they "need" to have a scheduled cesarean with their first child. And most of them go in with utmost cheerfulness. Some of that may be ignorance, but I think a lot of it is joy that they are going to escape the obstetric violence that now seems to be the norm in hospital births. (Not across-the-board - there are always good caregivers and great hospital births, but they just don't seem to be the norm right now.)

I must say, however, that it is saddening that most young mamas nowadays are not prepared for their hospital births with any sort of proper childbirth classes. I have read repeatedly about the decline of attendance in birth classes - that parents are taking more of a "show up at the hospital and let the doctor make the decisions" approach, and it is very regrettable because it leaves parents utterly vulnerable to bad medicine. Do these mamas know - are they told - that there are real risks associated with cesarean birth, for the mother, the baby, and for future babes? That there are lifelong potential health consequences for cesarean-born babies? That the risks of maternal death and stillbirth rise with each cesarean? Nope, most of them simply think of cesareans as "going out the sun-roof" with a whole lot of convenience and no negative consequences. Childbirth classes help so much with that - they allow mothers to at least make informed decisions knowing both sides to an issue and without being taken advantage of.

(And of course, none of this negates the fact that the cesarean is a wonderful life-saving procedure when used correctly - just not when it becomes a matter of regular and over-used practice.)

Why do you think that mothers welcome the thought of primary cesarean birth? Have you seem the same trend? (Personally, I know that I'd be freaking out and running screaming down the street at the thought of voluntary major abdominal surgery!)

Rabbit Trail #3:

And please forgive the vulgarity of the following discussion: 

One thing that I saw during this story that was extremely, extremely frustrating and disheartening - and that was the number of women who wrote lovely comments on the mama's wall such as, "Hurray that you're having a cesarean! Now your vagina will stay all pretty!"

Um, EXCUSE ME? Are you JOKING?

I can't even begin to unpack how much is wrong with those comments (and they weren't few in number, either).

First of all, a practical note. I have had two unmedicated vaginal births, one with a slight tear. I will be quite honest - I don't notice any real difference in the before and after of my own lady parts. Seriously, things do go back to normal. They're meant to. Sure, there are slight differences between a nulliparous woman and one who has had babies, but our bodies were meant to do this. My own set of downstairs parts is just fine, thank you. It's not like one's genitals are hanging in shredded strips just because one has had a baby. Our bodies were made to open for a baby's passage and then return to normal state.

Note: I know that this is not the case for everyone, particularly for women whose births were horribly mismanaged (episiotomies, etc.) or operative (forceps, etc.). So please do not write telling me how much permanent damage birth can do - I know that it does happen. But normal birth that is managed well really has less effect (on a majority of women) than one would think. We were created to birth.

But more importantly - much more importantly - is that important? Does that give us a reason to say things like that? Let's say that what I said above is untrue - that a woman's genitalia forever look like they have been mauled by an automatic cheese grater after having a baby. (Or even that there are slight differences following normal births.)

Even in that case, why would women say that to each other? Why would we choose to hurt each other like that? How can women do that to each other?

"Well, you've had a baby. No matter that you've just been blessed to participate in the holy and eternal act of bringing a new and precious life into this world. What really matters is that your vagina is no longer pretty. Too bad for you."

Why? Because now her husband won't find her attractive any more and will leave? Because her self-worth is wrapped up in the appearance of her genitalia? Because all that matters in life is dying with a pretty body instead of one that was used for the glory of God to do great and amazing things?

And would people say that about other things in life?

"Thank goodness you didn't have children. Think of all the hours of television you would have had to miss while you took care of them! And think of the weight you might have gained! Now your tummy will stay all pretty."

"Thank goodness you didn't breastfeed and nourish a child at your breasts. Now your breasts will stay all pretty!" (Well, unfortunately, people do say this one.)

"Thank goodness you didn't take up mountain climbing! You might have gotten icky blisters! Now your toes will stay all pretty."

My point being, of course, that there is more to life than maintaining a picture-perfect body. How much more glorious to use one's body in the service of one's family and society (and in doing other great and amazing things!) than to come to the end of life and say, "I did nothing, but my body is pretty."

Most of all, it is the unkindness that strikes one, though I know it is unintentional. "You had a baby, and now your vagina will be ugly. Poor you."

We women can be kinder to ourselves.

Okay, that's all the rant for now! I'd love to have everyone chime in - kind and civil comments only, please! And again, please forgive me - I'm writing in a rush (time limits!), so this probably wasn't the most polished entry.

Friday, September 2, 2011

VBAC or Bust

A high school acquaintance of mine recently wrote to me for advice on achieving a VBAC birth after a primary cesarean (that's what happens when one posts a continuous stream of birth articles on Facebook!), so I thought I'd post what I wrote to her!

And.... it looks today is this mama's birthing day, so I'm praying for her and sending VBAC vibes her way!

Unfortunately, my friend hasn't taken any birth classes or hired a doula, so her chances aren't that high in today's hospital environment. But she does have at least a marginally supportive care provider, so we will hope for the best. Regardless of birth outcome, we are looking forward to meeting her new bub! From "Gone With the Wind" - "The happiest days are when the babies come!"

So here's what I wrote..... what would you have added?

***

Hi, M!!

Congrats on your VBAC plans! Have a wonderful time, and don't stress if it doesn't work out. You have done an awesome job in preparing and planning.

My universal recommendation for all mamas, especially hospital birthers, is to consider a doula. There are lots of things that a person can do during labor, but usually one isn't in the state of mind to think of them and husbands usually don't. A doula can think of those things and help your hubbie to support you as well. If you're interested, I know you could easily find one even at this point.

Other things that come to mind randomly:

- Stay home as long as possible. You will be more comfortable and less confined.

- Stay hydrated. Eat when you want to, and drink at least hourly. Since some hospitals (or nurses) are still stinkers about this, make sure to take your own food. Some friends of mine recommend those portable yogurt tubes and/or honey sticks. And whoever is taking care of you (hubbie or doula) needs to offer you a drink constantly - usually juice or Gatorade with a straw, just offered maybe every 20 minutes.

- Stay mobile and upright as long as possible.

- Laboring in water (shower or tub) is SO incredibly helpful, both for comfort and mobility. I have spent both of my active labors entirely in water.

- Birthing positions are optimally something that you could discuss with your doc pre-birth. Most docs automatically do lithotomy with the bed broken down, but there are lots of other positions (hands and knees, for example) - though that depends on whether or not you decide on an epidural. Oftentimes your body will tell you very clearly what position you need to be in. During my labors, my body made it EXTREMELY clear that I should kneel leaning forward with my head resting on my arms on the side of the tub. Whenever I moved away, I was unbelievably uncomfortable and returned immediately. So a lot of it isn't planning ahead, but just following your body's lead.

You are going to be awesome, regardless of if this birth is VBAC or CBAC!!! Congrats in advance, and we can't wait to see pictures!! :)

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))

Enjoy!

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!