Thursday, June 26, 2008

When Fertility Makes a Comeback

I've read lots of questions from moms on Internet boards about when their periods will return after having a baby. I believe that the average length of time for a "true" breastfeeding mother is 14 months. In Ecological Breastfeeding: Natural Child Spacing, the author outlines what she defines as ecological breastfeeding. It involves breastfeeding on demand, no bottles, no pacifiers (though I would argue about that), co-sleeping, and night nursing. I did all of that with the exception that two of my three had pacifiers for a few months in the beginning. Strangely, my fertility returned most quickly with my first, who didn't get a pacifier at all. With Kathleen, my period started up again when she was 16 months old. I didn't get my period after Alexander's birth for 22 months. It took 21 months with Grace.

The little secret about having periods while still breastfeeding that I never read about happens to me the week before each one. My nipples become very sore; early pregnancy sore. I haven't really looked into the detailed reason; I know it is hormone related. Since it happens when I'm not pregnant, and therefore my body doesn't need to worry about sustaining a new life, I don't really understand the point. What is my body trying to tell me? Is it just a byproduct of hormones that serves no purpose? The pain totally goes away a couple of days before my period and doesn't come back for a month. I don't know anyone who has experienced this because the people I could ask didn't nurse this long, and the people I know who have nursed this long aren't ones I want to ask.

It's strange how moms won't talk about some things. I wish someone had told me how much it would hurt to breastfeed in the beginning, but all of the things I read said that if it hurts, then something is wrong. I had pain with my first two children that was intense, but only lasted two days. I had none with my third. I tell friends that it may hurt a lot, but if things are going well, it won't last long. I think telling them that it won't hurt is wrong. Pretending everything is always rosy never helped anyone.

Tuesday, June 24, 2008

The NICU: How It Hurts to be Helped

My firstborn spent her first five days in an NICU. I am still surprised that I managed to begin and continue breastfeeding under those circumstances, even though it was almost eight years ago. It bothers me to know even after all that time, breastfeeding in NICU's still isn't what it should be. I have read journal articles in periodicals directed at NICU professionals detailing the benefits of breastmilk and the act of breastfeeding itself to premature and sick newborns. I have read instructions to these professionals on how to better facilitate and accommodate breastfeeding mothers. Unfortunately, I have not seen much change in the
behaviours of these professionals.

I understand that it is easier to measure the input of formula when you are trying to get an preemie to gain weight. I understand that things flow more smoothly for the NICU when babies are on fixed feeding schedules. I understand that mothers constantly being underfoot can be a nuisance in the unit. I also understand that breastmilk is highly superior for all infants, including premature ones. I know that skin to skin contact is very important for babies to gain weight, regulate their temperatures, steady their breathing, and bond with their mothers. Did you know that premature babies are at a much higher risk for child abuse later on? The thinking is that their mothers aren't as bonded to them as they would be had the child not been kept away from them by medical necessity.

If breastfeeding was truly believed to be important by NICU professionals across the country, then there would be changes made in the way it is approached. I have a niece in the NICU right now. Her mom is dedicated and nursing and pumping so that she can breastfeed her daughter. She is being undermined by the staff, whether she recognizes it or not:

  • She is allowed to nurse her baby every three hours. Breastfed babies should be allowed to nurse as frequently as they want. Breastmilk is much more easily and quickly digested than formula, yet this baby is being fed on a formula schedule. What a shock; she isn't gaining enough weight, in fact she's losing more than they would like. What is an NICU to do then? They give her bottles of pumped milk, which they have now decided to fortify with formula.
  • She was told to pump before coming in to nurse the baby. That means that the premature infant who everyone is so concerned about losing weight and using too much energy has to work harder to stimulate the let-down because any of the milk left over from the last feeding has already been pumped out.

It is very hard as the mother of an NICU patient to recognize the fraud when a nurse tells you why they want you to do this or that. You know that they want to heal your child and send her home with you, and you want to do everything they say will help the baby reach that goal. You don't want to cause trouble, and you don't want to say things that they might dispute. The thing that every pregnant woman should understand before she has her baby is that the NICU isn't trying to deceive you. They aren't sneaking around to make breastfeeding difficult or impossible for you. They honestly don't recognize breastfeeding as having the value that it truly does, so they aren't working hard to preserve it. In a society that assumes that all babies will eventually be on bottles of formula anyway, they don't see a reason to fight that eventuality.

Saturday, June 21, 2008

Natural Becomes Artificially Important

The other day, my mom reminded me that "they" now say that newborns should sleep with pacifiers to prevent SIDS. She is a healthcare professional who works with preemies and other sick babies. I didn't bother pointing out the reason that "they" recommend pacifiers at night because it has fallen on deaf ears before. Babies who sleep beside their mothers (as is natural) do not sleep as deeply as babies alone. They breathe in rhythm with their moms, they share sleep cycles with each other, and they nurse more often than if they were in another bed. All of this helps to prevent them from stopping breathing in their sleep (sleep apnea), which is something that lots of newborns do, especially premature ones. Since we aren't supposed to sleep with our babies, they sleep more deeply, and more die of SIDS because they don't wake up and start breathing again (one suspected cause of the horrible syndrome). If a newborn has a pacifier in his mouth, then he will suckle in his sleep and keep from falling so deeply that he might stop breathing. So now, your baby should sleep with an artificial nipple, even though it is taking the place of your own nipple and warmth and breathing that are supposed to keep him alert enough to live through the night.

It drives me insane that it is being promoted as a new way of saving babies, just like the "Back to Sleep" campaign. It definitely saved babies' lives, but it wouldn't have been necessary if people still slept beside their infants to begin with. A breastfeeding, co-sleeping newborn does not ever sleep on her stomach; she couldn't nurse if she did. Babies sleeping alone on their stomachs sleep much more deeply than their backsleeping counterparts. I feel like some day there will be a breaking scientific discovery that co-sleeping helps prevent SIDS. The news channels will be full of "experts" debating why this is true and why no one knew about it.

Living in a society where scientific studies show a reduction in SIDS when the mother breastfeeds and sleeps with the baby at least in her room, yet has a majority of mothers using formula and putting their babies to sleep in another room, can be so frustrating.

Saturday, June 14, 2008

Advertising Genius

This ad showed up at the top of a bulletin board for mothers that I frequent. What it should say is: Breastfeeding + Supplementing = Weaning. The same companies who come up with this advertising are the ones that send Formula Reps (think Drug Company Reps, only slimier) to wine and dine doctors. If you are a doc who wasn't given any training or facts about breastfeeding in medical school, and then you get perks and meals from an attractive man or woman in a suit who tells you all about the benefits of their formula, what's going to happen? You end up on a "health" channel telling new moms that sometimes you "need to supplement".
Do new moms really need FREE tips, FREE advice, and FREE product samples from a FORMULA company? What are the tips and advice? Switch as soon as possible from your healthy, free source of infant milk to our less-healthy, expensive stuff?

Friday, June 13, 2008

Adoption Entry 1

As it turns out, my husband and I are not just talk. We are nearly finished with our pre-application paperwork with the Volunteers of America adoption program! In fact, the only hold up is a current family picture, which we plan on taking tonight. My goal is to mail out the info on Monday. We had to fill in all sorts of information about us, our children, our house, our parents, and our siblings. We also had to go through a checklist they call the "Comfort Level Assessment" on which they listed everything from drug use to letting the birthmother know our whole names. It really makes you think when you are presented with a checklist for your ideal child. Part of me thinks that you take what you get because that's what happened when we had our three children naturally. On the other hand, I would have given a lot when I was pregnant for a guarantee that my unborn baby was healthy. It has taken us almost a month to fill that form out, but I think we're finally ready to commit to our choices.

The next step involves the VOA deciding that we meet their criteria for adoptive parents. If we do, then I believe we will schedule an interview with the adoption coordinator to discuss our Comfort Levels in more detail. After that, we go through a homestudy with a social worker. Once we are approved by the SW, then we wait. We will probably have to submit a "Dear Birthmother" letter for pregnant women to pursue while searching for the best family to entrust their babies to. How in the world do you write that letter?

We aren't limiting our search to babies of any specific race, and from previous inquiries into this area, I have deduced that the wait might not be that long once we are approved. They warn you that it could take two years, though. As I am still nursing Grace and hope to nurse the new baby too, I hope things move fairly quickly once we start the ball rolling.

Wednesday, June 11, 2008

Insufficient Training Syndrome

I've never watched the Discovery Health Channel's Deliver Me before yesterday, but I see it advertised all of the time. I swear that I don't watch TV only to catch people sharing misinformation, but there is just so much of it out there that I can't escape it.

On the episode I was watching last night, a woman came in for her postpartum check up with one of the doctors. She said something about the baby wanting to nurse all of the time (I didn't catch the exact phrasing since my kids were playing a tickle game). Rather than explain that newborns need to eat at least every two hours (no one wants that to be true, but it is), the OB told her that some moms just don't make enough milk to satisfy their babies and NEED to supplement with formula. Then she said what I consider to be her real reason for the incorrect statement, "I had to supplement both of my boys with formula because sometimes I just didn't make enough." There you go: she can't admit that she did anything wrong, so she passes off her own inaccurate logic on her patients.

I believe I've blogged before about the purely western phenomenon of "Insufficient Milk Syndrome" which mysteriously only occurs in places where formula is widely available...Read the section in Our Babies, Ourselves about it to understand that it isn't really something that happens. To be sure, there are medical conditions and plenty of medications that can cause a woman's milk to dry up a bit. If the OB on the show had begun to investigate a true cause for this woman's low supply, which she never even established that the woman had to begin with, then I would have believed that she knew what she was talking about. A newborn nursing every couple of hours (or even every hour at some point) DOES NOT mean that the mother doesn't have enough milk. The baby could be going through a growth spurt or the mom could have gotten so out of sync with her baby's feeding needs that she was only giving him the low-fat early milk and never the high-fat hind milk. Did this doctor look into any of that? Supplementing leads to lower milk production! All she did was speed up the weaning process for this mother and possibly countless other mothers watching the show. The less the baby nurses because it's getting full of synthetic milk, the less milk the mom's breasts will make. It's SUPPLY AND DEMAND!!!

I found a good quote on Kellymom about doctor's education about breastfeeding:
However, very few physicians trained in North America or Western Europe learned anything at all about breastfeeding in medical school. Even fewer learned about the practical aspects of helping mothers start breastfeeding and helping them maintain breastfeeding. After medical school, most of the information physicians get regarding infant feeding comes from formula company representatives or advertisements.

It's truly awful that in this age of cancer, obesity, diabetes, and all sorts of other problems, doctors are not being educated about breastfeeding, when not breastfeeding has been linked to all of them. Don't listen to your doctor about anything connected to breastfeeding without first researching his/her advice first. The La Leche League is not out to trap you, they have lots of info that you need.

Tuesday, June 3, 2008

What's Up With Hospital Gowns?

I just emailed my sister-in-law a list of things I found necessary to pack for my trips to the hospital to have a baby, and one of the items I listed was a nightgown that allowed access to her breasts. It never occurred to me when I was expecting my first child that hospital gowns would restrict breastfeeding. I delivered at a facility with a reputation of being strongly pro-breastfeeding, yet their gowns made it a choice between bottles or sitting half naked in a room full of friends and relatives. Expecting a brand new mother to choose between her family's adoration of her new baby and sitting alone nursing said baby is too much; in her condition, she might be having trouble remembering where she is ;)

In case you haven't had the pleasure of ever wearing a hospital gown, they go all the way up to your neck and tie in the back. The only way to get to your breasts is to untie the back, which leaves the back flapping in the wind, and pull at least one arm out of the sleeve. That leaves nothing covering the top of your breast. If you thought to bring a robe with you, you can get more coverage by wearing it, but it still takes two people to get you set up to nurse.

I think that hospitals should either offer nursing-friendly gowns to new mothers. Since they currently don't, your doctor should suggest that you bring your own nightgowns. I've seen them listed in some pregnancy books as things to pack, but the majority of the ones I've read didn't mention a thing.

Not all nursing nightgowns are created equal, though. My mother-in-law bought me one when I had my first baby, and I was given a similar one when I had my second. They were the type that have two large openings in the front which are supposed to stay closed because of a pleat at the top of each. Maybe that works if you're a size 2 after you deliver, but real women still have a belly in the hospital after the baby is born. That pulls the holes open, and I spent the entire time with both having to check the openings to make sure my entire sad stomach wasn't exposed to my visitors. Forget walking around in them. A quick search of Motherhood Maternity's online selection of nursing nightgowns reveals that they no longer sell that type (at least on their website). There are plenty of attractive and modesty-protecting gowns out there. With my third baby, I brought along two regular nightgowns that buttoned up the front. Underneath, I wore a soft, sports-bra type nursing bra that was loose and comfortable.

Make sure to pack at least two because things can be messy after delivery, and you don't want to end up back in a hospital gown!