Tuesday, August 31, 2010

My Story: Nursing Through Pregnancy, Triandem Nursing, Child-Led Weaning & Milk Donation

Breastfeeding has been an AMAZING journey for me and my babies. It has offered me so much, and I feel so blessed to have had this time with my children and look forward to it with future ones. Even though I've been blessed with a massive milk supply (though I share!) and have continued nursing my babies well past toddlerhood, we've still had our share of struggles...but it's been worth every second, even in the difficult times. And while I feel like my experience has been quite easy compared to what some mothers and babies have to go through, my story is also one of the more uncommon, which often translates to less support. I don't know anyone (personally) who nurses through pregnancy. I only know one person who nurses a child over 3 years old. I don't know many people nursing 3 children. I don't know many people who pump for donation. And many of the people that I DO know seem to think that what I do is odd...sometimes they even imply that it's wrong. So the internet has been a HUGE support and encouragement to me, because this is the one place I've been able to find common ground with other breastfeeding mothers. And that is the reason I want to put my story out there as well.

My husband and I got married when I was 18 and he was 21. We wanted a baby whenever God would give us one, but it took 18 months and we had several miscarriages along the way. But during that journey I had a lot of time to "plan out" my parenting. I never gave much thought to feeding though. I remember asking my husband what he thought we should do, and he said, "You'll breastfeed, of course." LOL (He comes from a family of 6 kids where each was breastfed for at least a couple years) So that made my decision for me, no qualms about it. Clearly I wasn't very concerned either way at the time.

So when my first daughter, Miss I, was born in February 2006, we began our breastfeeding journey. I was very blessed to have it come easily and naturally for both her and I. There was that normal, toe-curling discomfort for the first week or so, but we got the hang of it. I never really had any issues while breastfeeding my daughter alone. We had a short bout of thrush at about 4 months but it cleared up only days later, and around 7 months I started to get really sore when she'd nurse for some reason (still not sure why that was), but that was about it. Pretty uneventful!

When Miss I was almost a year old, my sister-in-law had a baby girl. 2 weeks after she was born, my sister-in-law got an infection and was hospitalized for another week. God was able to use me and I went and nursed my niece since her mommy couldn't, and she wouldn't take formula. I am very grateful to have been able to provide that for her.

I got pregnant again when Miss I was 18 months old. I continued to nurse her during my pregnancy, even despite my fear of miscarrying again, though I knew God had it all under control. I chose to nightwean her during the early weeks, primarily because I was SO uncomfortable laying on my side in bed that it made for a miserable experience all night long when she wanted to nurse. It took us about 2-3 weeks but worked out well in the end. My milk turned to colostrum at 16 weeks, but there was still enough to satisfy my daughter for the rest of the pregnancy. It went pretty well until the last 6 weeks or so, at which point nursing became VERY painful. We toughed it out though, and it was a blessing in disguise because when my new baby, Miss B, was born at home, we didn't experience ANY of that "new nursling discomfort". So we just sailed smoothly into our tandem nursing experience.

Nursing my two girls went very well. They were both nursing champs, very efficient (neither one of them ever, even from birth, nursed for more than 5-10 minutes per session and emptied the breast(s) each time). Miss B, however, slept through the night (we're talking 6-8 hours at a time) a LOT during her first 5 months of life and even though most mama's would consider that awesome, I didn't feel that way! I had read so much about deep sleep and increased SIDS risk and it worried me! I wasn't quite as worried about my milk supply though, since I still had Miss I nursing, but I would still try to wake her at times in the night to see if she'd nurse, and she just had no interest. So I learned to accept it, and lo and behold she started waking again to nurse throughout the night before she hit 6 months of age.

When Miss B hit 6 months I started to pump milk for donation. I feel like that if God has given me so much milk, even more than what I "need" for my own babies, it's only right that I should make it available to other moms and babies who haven't had as much success with breastfeeding. Most people are still getting used to the idea of donated breastmilk, but to me, it's only natural that we offer up human milk first! I hadn't done much in the way of pumping before, but with a simple Avent Isis manual pump I was getting 6-7 ounces per session and after a few weeks I had quite the stash built up. It took me a while to find someone to offer it to, but eventually I found a couple local mom's who needed milk and was thrilled to be able to share it with them.

Shortly after that time, when Miss B was about 9 months, I had to have my wisdom teeth out. I wasn't concerned about how it would affect nursing, because it was a short procedure and I was able to nurse immediately prior to it and as soon as I got home from it. However, the one thing I wish I never would have done was accept the antibiotics. I am not a fan of them (at least not used as often as they are), because of how they truly do so much damage to the gut and it's colonization (and therefor having a domino effect on the rest of the body), but for some reason I opted to take them after my procedure. And that's when my first big breastfeeding struggle began. We ended up with thrush (despite me taking quality probiotics regularly even prior to the procedure). Badly. After 2 weeks I was just starting to get on top of it, but then I got an infection in one of the tooth sockets and ended up going BACK on antibiotics, despite knowing there were many natural alternatives I could have tried (I guess the desperation got to me?). Of course the thrush came back with a vengeance. It took me 3 months to get rid of it, and even though it was gone for the time being, the damage the antibiotics did has stuck with me...I've struggled with candida issues ever since. (If anyone is interested I do have loads of information and natural treatment regimens and dietary changes for candida/thrush) It was an extremely discouraging and painful time.

I got pregnant with my third child when Miss B was 13 months old. At this time she was still nursing regularly throughout the day and night, and Miss I, who was 3, was only nursing maybe once or twice a day, and sometimes she'd even skip a few days in between. Just by chance, Miss B ended up sleeping through the night (completely) one night early on, and so I just went with that and choose to use that as the beginning of our nightweaning experience. Normally I wouldn't nightwean a baby under 18 months but since she sort of started on her own (and did well continuing with it), we chose to go ahead with the process.

I ended up dealing with thrush several more times during the pregnancy. My natural treatment regimen usually cleared it up. The girls nursed well and normally the rest of the time (again my milk turned to colostrum at about 16 weeks), but once again, about 6 weeks prior to delivery, I started to get VERY sore during nursing sessions. Just like last time, I sucked it up and just dealt with the pain, hoping it would lead to another comfortable transition with a new nursling.

I ended up with a yeast infection in the last 3 days of my pregnancy. Honestly, I was terrified. Not because of the infection itself, but because I knew that, because the baby's gut is colonized during delivery through the vaginal canal, it could very likely cause my baby to have candida problems from the start, which in turn would probably mean dealing with thrush. Again. And the thought really depressed me. I treated it and just prayed that everything would be okay. My new baby BOY, Mr. C, was born in March and it was another beautiful home birth. Mr. C was a big boy...born at 9lb 10oz, 22 inches, and a 15.5" head! SO glad I was at home for his birth, as I have no doubt I would have been told I "had" to have a c-section if I was in the hospital because of how things went (and then who knows how breastfeeding would have gone for us!?!). He nursed well from the start, quick and efficient just like my girls (though I did have some longer nursing sessions with him, which were new to me!). Nursing 3 kids wasn't any more difficult than just nursing two of them, and I'm VERY glad I was still nursing Miss B as she was still fairly young when Mr. C was born and it was important that she still have that consistency. Miss I still just nursed once every 2-3 days, sometimes every day, and I was ever so thankful for my older nurslings when my milk came in and I was dealing with painful engorgement.

As I had suspected, we did end up getting thrush. I was able to treat it naturally, but it kept coming back, and eventually seemed to be cyclical. We dealt with it for about 5 months, and even more so than the last time we had it for months, it was an extremely painful, trying and discouraging time. Mr. C is now 6 months and we've only been "thrush free" for about 4 weeks, and unfortunately I have a feeling it's coming back (cyclical, remember?). I am confident that this all began with the antibiotics throwing my natural got flora out of whack, because never in my life had I dealt with these kinds of candida issues until that point. So we're on the road to healing...slowly, but surely. The most difficult thing has been knowing that if we ARE passing it back and forth (though I treat all of us, we all take probiotics regularly (thrush or no thrush), etc), it's so much harder than when just nursing ONE baby since it's harder to pinpoint and more difficult to get under control. I struggled with the decision of whether or not to wean Miss I, and possibly even Miss B, just to lessen that, but I'm SO glad I haven't. I admit I even had thoughts run through my head about weaning all three of them, even my baby Mr. C, and THAT is one of the things that scared me the most, because obviously breastfeeding is extremely important and special to me, and it had to take a LOT or discouragement to get me to that point.

Shortly after Mr. C was born, and before we started dealing with thrush, I started pumping for donation again. This time I was able to use a Medela PIS double electric pump from my cousin, and I was SHOCKED at how well that thing worked. The first time I used it I got 10 (yes TEN) ounces on ONE side (and six on the other that Mr. C had just recently nursed from)- granted, it was shortly after birth so I had loads of milk as my supply hadn't regulated, but wow. I was flabbergasted! Previously I wasn't aware that an electric pump would make that much of a difference. I was wrong. LOL I wasn't able to get more than just over 100 ounces total before the thrush took over, at which point I stopped pumping. I was so excited to have found a young mom to donate to. She was actually located at our vacation destination so we traveled with the frozen milk and dropped it off with her. It was a neat, blessed experience for me. Again, I thank God that I'm able to share what he has so abundantly blessed me with.

And here we are today. Mr. C is still nursing strong, every 2-3 hours (sometimes longer) during the day, and every 1-4 hours (depending) during the night. Miss B, at 2 years old, still nurses 2-3 times a day, sometimes less. Miss I, at 4.5 years old, is still nursing anywhere from once a day to once a week. I have to say, it's been VERY neat to watch the natural progression of child-led weaning. The circumstances that have led to where she's at today have been natural life events, not anything forceful on my part, and I can testify to the fact that they DO slow down on their own, and I know that soon I will also be able to say "they do STOP on their own." I admit it makes me sad to think about. I know we will be ready, but one of the hardest aspects of child-led weaning, for me, is knowing that we won't know that her last nursing session IS her last until hindsight, and I don't want to miss it! It's going to be a milestone for us both when that day comes, as my first baby, my first nursling, will have moved on. I'm SO grateful for the time I've had with her though. It's been absolutely precious.

A few other notes...

All of my babies have dropped over a pound of their birthweight and it takes them about 2.5-3 weeks to regain it. While according to some that might have indicated a need for supplementation, my mommy instincts knew better. It was normal for my babies (especially considering they all have my husbands lightening fast metabolism...wish I could say the same!). I'm so glad I never interfered with that. They had adequate diapers, were alert, still gaining (just slowly at first), very healthy...no reason to add anything artificial into the mix for the sake of numbers.

Cycles..oh cycles... Oddly enough, for me, it seems like more nursing equals less time away from my favorite (sarcasm intended) monthly visitor. Though that's not entirely accurate, as I don't get "normal" cycles back immediately, but with Miss I, I was nursing constantly around the clock, naturally following the "rules" of LAM (co-sleeping with baby, no pacifiers, feeding on demand, etc) and got my first period (albeit anovulatory) at 4.5 months postpartum. I was not thrilled. It wasn't until about 10 months postpartum that I actually started ovulating again, though. Then after Miss B, who nursed LESS during those first 5 months (since she slept through the night so often), but still following LAM "rules," I made it to 7 months postpartum before my first cycle. I hoped for a longer break after Mr. C (considering I'm nursing 3 kids and was pumping for a while too!) but it didn't happen...at only 3 months postpartum I had my first anovulatory period, and it's happened twice since. Despite keeping track of my temperatures and all that fun stuff (think NFP), I am at a loss as to what my body is doing this time around!

One of the hardest things (for me) that I encountered along the way over these last 4.5 years was just the negativity from some people around me. I don't live in an area where a ton of people breastfeed- at least not where it's KNOWN that people do. As I mentioned before, I definitely have never personally encountered anyone locally who tandem- or more, triandem- nurses. Or even nurses through pregnancy. I have, thankfully, met one person who nursed her children until they weaned on their own, both around 5 years old, and she has been such a blessing to me. But it seems like most people are just anxious for me to wean my babies, and are bothered that I'm nursing them past a certain age. I've never figured that one out- my babies are healthy, social, advanced, independent (as much as they need to be), and breastfeeding is doing them absolutely no harm. In fact, they BENEFIT from it. But even as confident as I am in our decision, it's still hard to hear the negativity. I just wish more people were educated on the benefits of breastfeeding (including tandem nursing and extended breastfeeding).

And so that (a novel later) is my story. I realize it's not a typical one, nor is there anything super exciting about it, but it's been my experience nonetheless, and I hope that somehow it might encourage someone else out there.

If anyone ever wants to chat about breastfeeding, or if you need any support or help dealing with thrush (which obviously, unfortunately, I have plenty of experience with), feel free to contact me on my blog (Joy Filled Frugality). I'd love to offer up anything I can!

-Brynna, 25
Mom to Miss I (4), Miss B (2), and Mr. C (6 months)

Thursday, August 12, 2010

A Tale of Two Babies: My Breastfeeding Journey

When I was late in my pregnancy with the Boodge, I remember standing in the shower, looking at my breasts and wondering when I would see the development of a hole to let the milk come through. I guess I envisioned my nipple taking the shape of a bottle. When I shared that with my dear mommy-mentor friend, she laughed and assured me that little holes would open up all over my nipple to let the milk through.
There was so much I didn't know about breastfeeding, but I was lucky enough to know some of the things that would get me off to a good start. I was familiar with the research that outlined the many benefits to mother and babyof extended breastfeeding. I knew that the World Health Organization, Canadian Pediatric Society, and UNICEF all recommend breastfeeding for 2 years and as long as the mother and child want to thereafter, and I wanted to do that. I knew that it may be difficult at first, so I was prepared for some struggle to get started, and was determined to persevere. And I didn't have any inhibitions about nursing in public, which helped me feel free to go anywhere and enjoy social situations with my baby.
But I had no idea how much it would mean to me and my son, and the bond we share. Nursing him as an infant, I gazed at him for hours, falling more and more in love. My ability to nourish him from my body somehow helped me feel that mothering was natural, and gave me confidence in my new role. As he grew, we reconnected at the breast several times a day and we each restored our energy and peace of mind. It was a place where we could both be still in the tremendous changes we were experiencing, and just feel our bond. I was grateful for the way it soothed him when he was upset and gave him vital nutrients, liquids, and comfort when he was sick.
I also didn't know the ways in which it would be challenging, but I expected that as with any commitment in life, it would have ups and downs. Teething and illness brought a constant need to nurse, causing me to boil inside with the frustration of having to choose whether to comfort my child even if it hurt me, or refuse and deal with a wakeful, miserable baby. Nighttime nursing eventually exhausted me, and when I became pregnant again I found I could no longer cope with waking every few hours to nurse. And the first trimester also brought shooting pains that felt like hot pokers inside my breasts, causing me to seriously question whether I could keep nursing.
I didn't know how some people would react to my nursing a toddler, especially while pregnant. Although I realized I was nursing beyond what most women do, I wasn't prepared to face questioning and judgment about a choice that seems to me to be solely between a mother and her child. I didn't know I would have to strengthen myself inside so that the judgment of others wouldn't influence what I felt was right. I'm grateful to have one good mommy-mentor and the many voices on the internet that assure me that there's nothing wrong with extended breastfeeding, and much that is right with it.
As with any commitment in life, the more I have put into maintaining it, the more important it has become to me. Now, it is one of the most precious things I have given to Boodge, and he to me, so far. When I began I wasn't sure I would go as far as "natural weaning", which is when a mother lets the child nurse until he or she is ready to stop, often at around 4 years old. Before I nursed a child, I thought when to stop was going to be something I decided, and I didn't realize that my child would have strong feelings about it that I would want to consider.
Now, I know that to stop nursing Boodge would be to take away something that means comfort, security, pleasure, emotional restabalization, connection to his Mama. Just as it has come to mean a lot to me, it has come to mean a lot to him, and I don't want to take that away from him until he's ready to give it up. Before I nursed a child, I didn't realize that nursing was about so much more than nourishment.
Before I nursed a child, the idea that I may want to nurse two children, born over 2 years apart, never even crossed my mind. If it had, I probably would have thought that was a bit too "out there" for me. Now, I'm committed to the idea, even looking forward to it in some ways. Boodge is still happily nursing a few times a day, and I'm still enjoying sitting my big pregnant body down to rest for half an hour, connecting lovingly with my little boy who will soon not be my one and only baby.
I just don't see any reason to give up something that is so special between us, especially when our connection is about to change in so many other ways. I'm hopeful that tandem nursing will help Boodge adjust to having a sibling, and even, as many mothers who tandem nurse report, facilitate a strong bond between the two children.
Just as with learning to nurse the first time, I'm prepared for it to be hard in the beginning. I'm ready for tears and meltdowns and questioning whether I can do it. Maybe I'll even find I can't. But I'm also prepared for beautiful moments with my two nurslings, and feelings of pride and triumph just as I experienced the first time. Once again, I'm heading into unknown territory. I'm excited to see what it brings. To follow my tandem nursing journey or just enjoy some good reading about my life as a Mommy, check out my blog.

Katy, Mom to Boodge, and one on the way

Tuesday, August 10, 2010

A Cautionary Tale about Breastfeeding…

Has breastfeeding become the latest status symbol in our culture?

If you’ve read Hanna Rosin’s 2009 article “A Case Against Breastfeeding,” you might think so. After all, she likens breastfeeding – and the length of time a mother nurses – to the same status one might earn by rockin’ a pair of skinny jeans, owning Tom Ford oversized sunglasses, or possessing the sleekest stroller on the playground. Because being a mom is one thing…but being a cool mom is totally different, right? And breastfeeding seems to have become the ultimate badge of motherhood.

A friend alerted me to Ms. Rosin’s article when I was about eight months pregnant with our first child. I was horrified, to say the least. What a terrible example for new mothers, I thought when I read the article. She should be supportive and encouraging, not pointed and judgmental. She sounded bitter, jaded, and a touch hormonal. I threw it aside without another thought.

But this was all before I gave birth to our bouncing baby boy only weeks later. And then I realized, she was right.

About just about everything.

Our little guy Scotty came into this world two and half weeks early, weighing 8lbs, 6ozs. I endured three months of bedrest due to premature labor prior to his arrival, but I spent my time on the couch well – I read book after book I could find about babies, childcare, and pregnancy. I attended two classes with certified lactation consultants (wheeled there by my loving and patient husband) at my local hospital. It was there I was told to my face that formula was “poison” and there was nothing more beautiful or more natural than a woman nursing her child. Good mothers nurse; bad mothers use formula.

In fact, in one of the classes, we watched a video that showed an interview with a pediatrician who stated (and I quote, since I wrote it down), “Women ask me what the dangers are to breastfeeding. I tell them, ‘there are none. There are only dangers to using formula.’”

Famous last words.

We were released from the hospital after 36 hours. But by the time Scotty was four days old, I knew something was wrong. While it felt like he was latching appropriately, he cried…all the time. I began thinking the “sleepy newborn” was nothing more than a myth. At our first ped’s visit on day 4, he had dropped down to 7lbs, 6ozs. Totally normal, I was told by multiple people, including medical professionals. Still, I pressed for a lactation consultantation that afternoon since there were orange and red crystals in his diaper. This is usually a sign of dehydration, per my books. The ped reassured me it “wasn’t blood,” and encouraged me to continue breastfeeding. She even used several personal examples about her own children, all of whom were terrible nursers at first. She wrote on my chart “dehydrated,” “jaundiced,” made a note of Scotty’s weight, and set us up for a five to seven day follow-up.

The LC recommended I open a “breast-araunt” for the weekend (it was a Friday) and come back on Monday. Nurse constantly, she told me. When he cries, nurse him. Keep him at the boob for hours. Let him use you as a pacifier. I agreed, although this sounded like a prison sentence. There was no mention of formula.

For the next two days, I did nothing but nurse. I used my nipple shield. I warmed wet towel to drape over my engorged breasts with the hope of getting the milk out more easily. I didn’t sleep. I didn’t eat. I didn’t shower. I didn’t do anything other than sit in our new glider with the baby in my lap, with his face up to the boob. And he did nothing but cry when he wasn’t using me as a pacifier. And I did nothing but cry as I felt trapped in the nursery. But I could do this, right? I mean, everyone I know has had a bad nursing experience at first. And they tried, and tried, and eventually, it worked. I considered myself a hard worker, never one to shy away from a challenge, and did it. I bit my lip, swallowed my pride, and chained myself to the glider.

By Monday, we all held our breath when Scotty was put on the scale. It read 7lbs, 8ozs. The LC, a different one from Friday, shook her head with worry. This wasn’t good, and it wasn’t right. She gave us a new plan of action: pump breast milk and then feed it to Scotty via a hand dropper. During the entire consultation, there was no mention of formula.

We stopped at Babies’r’Us on our way home and bought a dropper.

And by Wednesday, things were looking better. Scotty was sleeping more. He was quieter and much more relaxed. I had several doctor appointments that day and each professional commented on what a good baby he was. In fact, it wasn’t until the LC from Monday called Wednesday afternoon to check in did I realize something was terribly wrong.

“What does his poop look like?” she asked over the phone.

“It’s still brown…not the meconium from birth, but it’s really dark and seedy looking,” I told her, exhausted from the day’s appointments, sitting in that damn glider again. My prison cell.

“It’s what?” She sounded startled. I told her again, and it was her tone of voice that sent chills through me. “He’s eight days old…it needs to look like Dijon mustard by now. If it hasn’t transitioned…you need to get him into the pediatrician’s office as quickly as possible.”

Fear hit me like a ton of bricks. I felt blindsided that I missed this. After all, I was just relieved to have a quiet baby. Within minutes, we were on the road back to the doctor’s office. The doctor, too, was stumped and sent us off for blood work. She reassured us that she put a STAT order on the blood so we would receive a call later that night with instructions regarding what to do.

When the call came in at 8pm that night, it brought me to my knees. The doctor on the other line told me that Scotty’s bilirubin levels were at 28. That we needed to take him to an emergency room right now. When I suggested a local hospital, he told me no, go to *** one. It was on the complete opposite side of town, but I agreed immediately. Confused but acting quickly, I raced upstairs to pack an overnight bag when the phone rang again.

It was the doctor. “What is the baby’s mental status?” he asked me.

As a former marriage and family therapist, this question was ridiculously common to me. In fact, it felt laughable that he was asking me in such a manner. I was used to talking about clients’ mental status once upon a time, back when I still had a private practice. Before the bed rest, before the birth, and before this hellish day that just wouldn’t end.

“His mental status?”I repeated. “He’s quiet, lethargic. Extremely sleepy. I can’t wake him to feed him. He won’t wake up.” I was just about to tell him that I think Scotty is exhausted, too, from the day’s activities, when he interrupted me with the most chilling statement I had ever heard:

“You need to call 911 right now. RIGHT NOW.”

I think, at that point, my brain just left. Because I don’t remember feeling anything after that. It was like my heart turned off and my head turned on. I became a robot. I hung up with the doctor. I dialed 911. I told the woman on the other end that I have an eight-day old newborn with a bili level of 28 (whatever that meant) that would not wake up. I had no idea what was wrong, but I knew it was bad.

An ambulance arrived an agonizing seven minutes later, and we arrived at the hospital (lights and siren) in less than 15 minutes.

It seemed like twenty people filled the room immediately, working on my child who was no bigger than a football as he lay on the giant hospital gurney. My husband and I just huddled in the corner, silent, watching the frenzy of action. We recited the events of the last eight days to two doctors who grilled us about our baby’s very short life. We watched as they put the largest blue light on the baby and covered his little eyes with what looked like baby sunglasses. Wires, tubes, and stickers covered his body, no longer than 20 inches. His little doggie onsie, the one my husband had bought just days earlier, sat crumpled and flecked with blood on the bed while Scotty laid naked in just his diaper.

The whole event seemed like an out-of-body-experience.

Eventually, Scotty was wheeled up to the NICU and the nurses told us to go home. It was now 2 in the morning; he was in good care and was stable. They would have more information for us tomorrow. Overwhelmed, both physically and emotionally, my husband and I began the long trek home, unable to speak since both had no idea what was happening.

Over the next few days, we learned a lot. We learned that a normal bili level for an eight day old baby is about 14. In fact, 14 is considered high. Twenty-eight – or 28.9, to be technical – was off the charts. And bilirubin, that substance that is present in the bloodstream of newborns, produced by the liver and excreted by urine and feces, is what causes jaundice, or the yellowing of the skin. I knew Scotty was jaundice – I read the books, attended the classes – but I didn’t understand what the big deal was. 60% of newborns develop jaundice. And none of the brochures, pamphlets, or books mentioned that it was a dangerous condition. All recommended sunlight as a treatment option.

But I understand now. If bilirubin isn’t excreted through urine or feces, it builds up in the blood. Once it hits a certain level (and it depends on the age and size of the newborn), it can cross the blood barrier in the brain. It is toxic to brain tissue.

Toxic. As in, it kills brain tissue…and the tissue doesn’t grow back.

It can cause, among other things, mental retardation. Cerebral palsy. Profound hearing loss. Blindness. And in some cases, death.

Death. As a result of jaundice.

During those few days, we were able to connect the dots. My milk didn’t come in until day 5; since I was told that formula was poison, I didn’t have any formula in the house. I had short-suited myself, intentionally giving away free cans to friends. My child was going to be exclusively breast-fed, remember? Because that’s what I was told. By lactation consultants, friends, the La Leche League, popular media, everyone. Only bad mothers give their children chemicals. Good mothers nurse.

Scotty essentially didn’t eat for the first five days. The colostrum my body produced was enough to sustain him, but not nourish him. When my milk finally did come in, he was already behind the eight ball and was too sleepy and tired to nurse properly. And it became a dangerous loop – too tired to eat, no food to push out the bili. So the bilirubin continues to climb, making him sleepier, making it harder and harder to eat. In fact, breast milk contains trace amounts of bilirubin from the mother, making it harder for the newborn to excrete their own. I later learned that formula is actually recommended when jaundice becomes an issue.

It was the perfect storm of variables. And despite all of my research prior to his birth, not one person or source mentioned this. Not one. And after reviewing six books about breastfeeding, only two even mention the word “kernicterus.” Kernicterus, latin for ‘yellow kernel,’ is the name of the disease given to kids who had hyperbilirubin at birth. Kernicterus kids, more often than not, have the list of conditions listed above: cerebral palsy, hearing loss, mental retardation, etc.

To find this information was astounding. Totally healthy, full-term babies, within days of their birth, develop permanent, chronic conditions that will forever affect their quality of life. All because of high bilirubin. Being “just a little yellow.” And in one study I found, researchers followed kernicterus kids and discovered a shocking 81% were “exclusively breastfed” prior to the spike in their bilirubin. Eighty-one percent.

Why are more people not talking about this? Why are LCs not required to disclose this information to their patients who want to exclusively breast feed? Why doesn’t breastfeeding come with a warning label? After all, we tote our children around in state-of-the-art car seats. We know not to let a newborn sleep on his tummy. Scotty had been given three hearing tests in the first eight days of his life – a non-life-threatening condition – but yet no one explained to us what happens when jaundice goes untreated.

And in the back of my head, during those eight hellish days of breastfeeding, I kept going because I heard a voice chanting, “Breast is best. Breast is best. Breast is best.”


Kernicterus can only be diagnosed when the child starts missing developmental milestones, such as head control, eye gaze, and hand coordination. I hadn’t anticipated seeing pediatric neurologists, pediatric gastroenterologist, and multiple visits with my pediatrician, but this was my new reality. I knew that in the event the bili had crossed the brain barrier and a kernicterus diagnosis was imminent, our next step (our only step, really) was early intervention.

I’m happy to report that Scotty managed, by the grace of God, to come out of this ordeal 100% unscathed. He’s a happy, thriving little boy about to turn one in mid-August. He coos, he laughs, he says “dog!” “Dada!” and “Mom!” with reckless abandon. But not all kids are as lucky; there is a Yahoo group dedicated to hyperbilirubin called “newborn jaundice” and the stories on this site are heart breaking. Absolutely devastating. I never deleted my membership, even after we realized Scotty was okay, to remind myself that this condition happens, and it happens all too frequently to be okay.

When Scotty was released from the NICU on day 12 of his young life, I made a vow to myself that if he was alright, I was going to do everything in my power to tell people about our experience. To warn them that sometimes, “breast ISN’T best.” Do what’s in the best interest of your child. Don’t be swayed by the La Leche’s media campaign or overzealous lactation consultants or well-meaning friends. Don’t buy into the playground hierarchy that whoever breast feeds longer is the better mother. I said I would march on Washington if that’s what it came to in order to tell new moms to supplement, use formula and stop the shame spiral that formula feeding has evolved into. It’s not a competition; it’s a life.

And do whatever is in the best interest of your child.

Kim, mom to Scotty (11 months)

Sunday, August 8, 2010

It’s Worth It

When I was pregnant with Sweet Thing, I read all the books about pregnancy and birth and even a little bit of parenting! One thing I didn't give a second look was breastfeeding. I knew I was going to breastfeed, I wasn't worried about getting my newborn to latch. I thought it would be a piece of cake.

How wrong was I?

Breastfeeding was a challenge for us from the beginning.

After giving birth, we tried to latch about an hour later, with not much luck, we didn't worry about it. She wasn't hungry anyway. Later on in the day we tried again, and it was painful, and the nurses were trying to help, telling me she's got it, she's doing well. But it was still painful, after unlatching and relatching, I was still in pain, finally I gave up and kept my mouth shut because the nurses weren't helping. Sweet Husband helped me hand express the colostrom to spoon feed our newborn.

We went home the next day.
That night was awful our beautiful newborn screamed for what seemed like an eternity, we tried everything, rocking, bouncing, singing. Anything but nursing. I didn't want to, I was hurt.

Finally we had a nurse come to our house, she then gave me a pump and told me to pump every two hours and 'finger feed' Sweet Thing so I could heal.

I healed and we tried nursing again. It was still painful, like someone pinching my nipple as hard as they could. We tried different positions. Nothing helped. We were told she had a tongue tie and may need to clip it.

A new nurse came a few days later and fitted me for a nipple shield.
Finally after 10 days of pumps and tiny cups and syringes full of mommy milk Sweet Thing was able to nurse, and I was pain free!!
I was ecstatic, I felt like a real mommy!

We nursed successfully from then on with the shield, and only recently have we both been completely weaned from it now at 8 months.

Although the beginning was tough and I had more than my fair share of doubts and not wanting to do it anymore. I stuck it out and I am so glad I did. I now love breastfeeding, it is a nice quiet time for me and Sweet Thing, I love that I am the only one who can do this for her. I love that she was a tiny 6lb 9oz baby girl and and now she is a healthy 18lb 8 month old, all thanks to mamas milk. I am sad that our breastfeeding is slowing down now that Sweet Thing is on more and more solid foods lately. I will not wean her, this is her decision.

I urge every mother to breastfeed, and though you may think you just can't do it anymore, you can! You really can!

Sarah, 21. Mom to 1 girl, Sophia 8.5 months

Friday, August 6, 2010

Helping Them Grow

There’s a certain feeling of awe and accomplishment that comes over a new mother with the first glimpses of her baby. After nine long months of watching your belly swell, of feeling kicks in your ribs and trying to guess whether this poky bit is an elbow or a knee or a heel, it’s still a shock to see the tiny person that was in there. Those perfect little fingers, soft baby skin, itty-bitty nose all grew ¬inside of you and because of you. You’ve shared your food, your air, and your energy with this child in the most intimate and complete way possible, and now you finally get to cuddle him or her in your arms.

The beauty of being a nursing mother for me is that I get to repeat this moment every day. For the first six months of my daughter’s life, I was able to nourish her as completely as I did in the womb. There was nothing I needed to buy, nothing that someone else made that I needed to rely on—just my breast (although I did go through a few boxes of breast pads in the beginning!)

I always had a special feeling of pride when the pediatrician plotted her increasing weight on the growth charts. I wanted to say to her “You know those two pounds she gained? That was all me!” It was incredible to watch my daughter first wiggle, then roll, then crawl, knowing that every ounce of energy she was using came through me. And as she nurses, I marvel at how the baby who used to curl up on the Boppy now can stretch her long legs almost across our nursing chair. I wonder if I can see her fingers and toes growing when she pauses to look up with her sweet milky face. We’ve definitely had our share of sore nipples (I told my husband that the first few weeks of latching HAD to be the same feeling as for him to get kicked in the crotch!), nursing-marathon nights, skipping out on events because the baby needs to eat, and awkward wet spots on my shirt, as well as my first plugged duct making its appearance this week, but overall nursing has been full of far more ups than downs for us.

We started solid foods about three weeks ago, and I had a moment of sadness the first time she tasted something other than my milk. But I also know that my job as a mother is to help her grow, not just physically but also developmentally. I did that for six months with breastmilk alone. Now we’re still nursing for most of her nutrition, but the avocado and the carrot and the sweet potato helps make her part of the family at mealtimes and sets the stage for weaning someday. And I still watch her with joy after she nurses off to sleep, knowing that over six months after she was born, I’m still helping to grow a person.

~Elizabeth, mom of Amelia, 6.5 months