Wednesday, January 23, 2013

My Breastfeeding Post

This post might be somewhat premature. Silas is four and a half months old and I have been exclusively breastfeeding him, and intend to continue to at least one year. Based on what I've read, I expect to continue to two years. So even though I haven't had a ton of experience, I've had enough that I'd like to take the time to share my information and experiences.

That being said, class is dismissed for anyone who doesn't want to talk about breastfeeding! But I do ask, if you know anyone who is thinking about breastfeeding or having troubles, please suggest they read this or check out the resources I'll link at the end.

I'm sure I'll post something less soapbox-y tomorrow or later this week.

First things first - I do not believe that feeding your child formula makes you a bad mother or that it means you are feeding your baby something bad. I do believe there are a just more benefits to breastfeeding.

As long as you feed and love your baby, your baby will grow to be a healthy, loved child. But I've heard far too many stories of people who wanted to breastfeed and couldn't to just sit here and not say anything. I think there's a lot of misinformation out there. Here's what I've researched and learned from personal experience.

The Benefits (both for you and your baby!):

Breastfeeding burns calories like you won't believe. It can take up to 500 calories (in addition to your normal pre-pregnancy diet) a day to produce milk. This translates to losing your baby weight faster while still getting to eat more. The hormones involved in breastfeeding also help shrink your uterus to its pre-pregnancy size faster.

Breastfeeding protects your infant against disease. When your baby is born, his immune system is brand new. Breastmilk transmits protective antibodies to your baby, helping to prevent illness. If you get sick while breastfeeding, you transmit the new antibodies that your body is making to your baby. Various studies have shown that breastfed babies have fewer infections.

Breastmilk is designed for your baby's needs. I mean, it makes sense, right? Human milk is uniquely designed for our human babies. Unlike formula, human milk composition changes from feeding to feeding, as well as during a feeding, to match up to a baby's needs as best as possible. A feeding session starts out with watery foremilk, which helps satisfy a baby's thirst and ends with rich hindmilk, which helps satisfy a baby's appetite. And if the baby wants to comfort suck (babies have a strong need to suck; it helps them reduce the stress of learning about the whole darn world), your body will respond to the light sucking and let the baby suck without getting as much milk. It's hard for a breastfed baby to overeat because of this.

Related to the above, breastfed babies can also end up having one or few bowel movements a day (after the first few months. For the beginning months, you can expect a bowel movement every two to three hours or so). I believe this is related to the nutritional composition of breastmilk matching your baby's nutritional needs so well that there is just not much waste to come out! Which means less dirty diapers for you to change. My personal experience has been one-two dirty diapers a day for the last month and about three-four for the two months before that. The first month was easily one diaper every two to three hours.

And related to that, breastmilk-fed babies tend to have nicer smelling poop. I'm not saying it's roses; I'm just saying that, again, due to their bodies being able to use more of the nutrients, there's not much left to come out stinking! For the first month or so, we didn't even need a diaper pail. We do now, but I guess it could be worse!

Breastfeeding prevents periods. Now, it is not a fool-proof method, so if you don't want to get pregnant again, use additional birth control. But the hormones involved in breastfeeding help suppress your period and therefore help prevent another pregnancy from occurring too quickly. I personally think it's amazing how our bodies are designed to recover from childbirth before allowing another pregnancy to happen. But, it doesn't work for everyone, so again - back up birth control if you don't want to get pregnant again.

All in all, I do believe that it is worth it to attempt to breastfeed your infant for as long as possible. Even if as long as possible is a week or two, you will still reap the benefits of hormones to contract your uterus back down and to jumpstart your weight loss. Your baby will reap the benefits of two weeks worth of antibodies to help protect him.

The Potential Downsides:

There are some tough parts to breastfeeding. I don't want to sugar coat it and say it's always a perfect, memorable experience. I'm not out here to lie. And breastfeeding is harder on some than others. That's why I always say I'm lucky that I've had such an easy time of it. Here are the downsides I've come across:

It can be time-consuming. At first, it is time consuming as can be. Due to the easily digestible contents of breastmilk, a breastfed baby is an often hungry baby. This is true of all newborns and babies; they have tiny stomachs and can only have so much milk at first. The oft-heard "wisdom" that a baby needs to eat every four hours is said with formula in mind. A breastfed baby will need to eat every hour and a half to three hours for the first few weeks of life, and often beyond. Typically these feedings will space to two to three hours after the first few months. You might have a baby that goes longer, especially if your milk production is very abundant.

But again, babies have baby sized stomachs. It is not unreasonable for them to be hungry every two to three hours. Also, consider how often you might eat or drink during the day. Is it unreasonable to say that at 7 am you might have breakfast and then two hours later have a cup of coffee or water and then lunch three hours later and so on?

Also, breastfeeding being time consuming is a natural way for our bodies to remind us that giving birth is an ordeal and we need time to relax and put our feet up. If you're like me, you might have anxiety over dishes in the sink, or over meals being made from the freezer instead of from scratch. I can now say that it does get better. As you recover and begin to adapt to your life as a mom, you will find the energy once again to do whatever it is you want to do - (whether it's housework-related or just getting out to exercise more or whatever).

Pumping sucks. I think that a major contributing factor to babies being weaned from breastmilk before six months is that pumping sucks. It's a hassle to bring pump parts to work, to find a place and time to pump and to store pumped milk. I hated the time involved and the stress over whether or not I would pump enough milk for Silas to have. (For some, the pump is less effective than your baby at extracting milk). Personally, I was able to supply enough for Silas and store an extra few ounces each week in the freezer for days when I wasn't able to get quite enough milk. But I will acknowledge that without the support of my supervisor, who did not fuss if I took an extra minute or two on my break, I would have been horribly stressed out about everything.

Also, many people have jobs that make pumping harder. For example, nurses cannot just say "oh, it has been two hours and I need to pump" when one of their patients is coding. Waitresses or other hourly employees might not find a supportive work environment for pumping. All in all, I think that the issues of pumping were a huge factor in my wishing that the US had better maternity leave laws. But that's a different issue for now.

Your wardrobe is somewhat limited. This is hardly an issue, but there have been times I've been sad about this, so it's worth mentioning. There are tons of cute nursing-friendly tops. This is great if you have a lot of money, not so great if you can only afford to buy a few tops. I have had to wear the same few outfits since Silas was born. It hasn't been a huge deal, but at times I have looked at the other 85% of my wardrobe and wondered when I'll ever wear those items again.

Breastfeeding Troubleshooting:

Here is the main portion of my soapbox. I think that there is way too much incorrect information given out to women who want to breastfeed.

What if I make too little milk? A common fear is that a woman won't be able to provide enough milk for her little one. I know that fear well. When I had nights where Silas would eat from one side for forty minutes and then fuss and cry and eat from the other side for forty minutes and then fuss and cry and eat from the first side for another half hour, I would have one hand on my baby and one hand on my phone, texting my mom with all my worries. How could I possibly have enough milk for him? He seemed so hungry! And, over and over I would text: is this normal?

Today, I have a 19 pound 4 and a half month old who has grown spectacularly on breastmilk alone. I just had to keep nursing and trust that my body would adapt to his needs. And it did, but only after hours (days) of worry on my part. Here's how to ensure you make enough milk:

Nurse often, whenever your baby seems to be hungry. Women are constantly told (in my experiences), babies need to eat every three to four hours. I cannot stress enough that this is not true when you are breastfeeding. Your breastfed baby will need to be fed every hour and a half to three hours, especially in the first few weeks. Sometimes, your baby will want to nurse for close to an hour during each session. These marathon breastfeeding weeks are designed to signal your body to make the right amount of milk for your baby.

The issue comes in when a mother, expecting to have to feed her baby every three hours, hears her baby cry an hour after he's eaten, and assumes that the issue is anything except hunger. Or, a sleepy baby will stay napping for three hours after eating and the mother (quite naturally) wants to take advantage of this time to rest as well. I can't blame you. I would want to do the same. But it is so important to establish your supply during the first few weeks. Definitely consider waking your baby every two to two and a half hours during the day, and every three to four hours at night until your supply is well established.

And, don't doubt yourself if sometimes your baby wants to eat constantly or every hour for awhile. This is perfectly normal for some babies (and for almost all babies during a growth spurt). Pick out a favorite TV show and make sure the remote is close by, and nurse the day (and night) away.

Eat (and drink) enough! Mothers, in their desire to drop pregnancy weight, might want to cut back calories right away. Or, they might not realize that breastmilk production takes as many as 500 extra calories a day. It is very important to know that sometimes, breastmilk supply can be increased simply with your eating enough calories a day. I've noticed that my appetite has increased, which helps me get extra calories. I also drink a lot of apple juice during the day because it provides liquids and calories without caffeine or carbonation (too much of either makes me feel icky, but choose whatever beverage works for you). It helps if whatever you eat is healthy. Oatmeal is a great choice.

Don't feel that you have to supplement right away. I know the fear. What if your baby isn't getting enough to eat and is hungry? What mother in her right mind would deny food to her baby? The desire to supplement can be intense, especially in those early days before your milk comes in, and the baby's weight is dropping, or if you see friends with babies who just seem to gain weight and grow so quickly. But babies are designed to lose a percentage of their birthweight and it is only cause for concern if they lose 10% of their birthweight or do not regain their birthweight within two weeks. And there are a variety of growth curves that babies can follow. Don't think that just because your baby wants to eat again so soon that you need to supplement. Just keep nursing, and, if you're very worried, keep in close contact with your (hopefully pro-breastfeeding) pediatrician. They can monitor the situation and offer advice as to when you truly should consider supplementing.

And if you do supplement, pump to replace that feeding. Again, a baby is often more adept at extracting breastmilk, so don't be surprised to get only an ounce or even less during a pumping session, especially in the early weeks. (And in the first few days, you might get a teaspoon or less. It's ok. The act of pumping helps signal your body to make more milk each time).

What if I want to be out and about and don't want to nurse in public?  I believe that nursing is an activity that does not need to be hidden. Babies drink milk and our bodies produce that milk. Why could we feed a baby from a bottle without a second look and then get dirty glances if we try to feed our babies from the source? The truth is, when done discreetly, many people won't even realize you're breastfeeding. All they'll know is that your baby isn't crying from hunger. And everyone loves a content baby!

But, I also know that not everyone feels comfortable with nursing in public, and it's not my place to suggest that you do something you're uncomfortable with. You can try a nursing cover - there are many ones that seem nice and keep everything covered. You can try nursing your baby in your car. Some malls and other stores offer nursing rooms.

Alternatively, you can express milk in advance and bring that in a bottle.

What if my baby hates my breastmilk? This wasn't something I was familiar with. But the forums I went to seemed to be full of women who were eliminating all sorts of things from their diets to sooth their babies stomachs. It seems that for some babies, some food items can end up irritating their stomachs or giving them gas. If this seems to be the case for you, I would suggest looking at your diet and potentially eliminating dairy for a bit. I admittedly don't have a ton of experience in this area as Silas hasn't seemed to have issues with what I eat. He did have some bad gas days. If your baby seems gassy, make sure you are moving their legs a lot. You can do bicycle legs, froggy legs or just stretches to help them pass gas. Also, burp them often when switching between breasts and keep your baby upright after eating for a bit. This may help more than eliminating foods. Again, check with your pediatrician as each individual baby may be different.

How do I survive when I have to wake up every two hours? I never thought I would be able to live on broken sleep. I have always had a fairly early bedtime and enjoyed getting my 7 to 8 hours of sleep. Surprisingly, however, I have not died yet from lack of sleep. The broken sleep has been worth it to breastfeed, so here are my tips.

Nap when your baby naps. Everyone says this, and I didn't do it at first. And you probably won't either. No matter what I say, you'll think that something needs to get done and that while your baby sleeps is the only time it can get done. But hopefully after a few days, you'll realize that it is more important to let your body rest for a few weeks. When your baby goes down for a nap, lie down. Even if you can't sleep, I've found it helpful to repeat the mantra "even closing my eyes and relaxing is better than nothing." I've also found it helpful to mentally make lists of what I wanted to get done. I would make a list in my mind, and then repeat my mantra until I fell asleep or my baby woke up.

Consider learning to nurse lying down and possibly bedsharing. This was very helpful. However, I do know there are risks to bedsharing (letting your infant sleep in bed with you). So be cautious and read up on that (this post is already much too long for me to go into that. Just be safe about it). For me, I found that nights became infinitely much better when I just let Silas sleep between Smiley and me. When he fussed for food, I barely woke up. Mornings came to find me much more rested than if I had to get out of bed, get him out of his crib, nurse him, put him back in his crib and then got back into bed.

I would say there is a wide variety of what can work for you. For instance, Silas now spends the first part of his night in the crib and when he wakes up, I get up to feed him and bring him into bed with us. This "part-time bedsharing" is currently what works best for us. Very occasionally, on nights I'm feeling well rested, I'll try to put him back in the crib for a second stint. Some days, I just let him fall asleep in bed with me from the get go. There's never a "correct" way.

Resources: For further research or if you don't trust my opinions and want to see some scientific studies, you can check out the following sites: This website has tons of articles on breastfeeding, along with scientific studies and facts. This website deals with all sorts of questions and concerns. It is truly a great resource and one that you can read while breastfeeding your infant in a comfy computer chair! The World Health Organization website also has information worth reading. More information, from UNICEF

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