Wednesday, September 24, 2008

The Milk Maid

We have had a lot of questions in the comments and via email about why I pump instead of nurse my children. I've tried to respond to them all, but it is probably easiest just to explain it all here. So, after this, if you were to see the current state of the floor of my car, there will be no secrets between us!

After Dash was born, I found nursing to be excruciatingly painful from the very first moment. I was sobbing every time I tried to nurse, and still in pain even when not nursing. When I say painful, I mean pain that makes you look fondly on natural childbirth, because at least it is finite. My husband, who has encouraged me through several natural childbirths, begged me to stop nursing because he could not stand to see me in such pain all the time. To be sure, a lot of mothers experience some pain when they start nursing and there are usually treatable reasons for such pain. Seeing a lactation consultant as quickly as possible is my best advice. Nursing around the clock for years seemed like a form of torture, rather than the snugly, loving bond I had imagined.

I was (mis)diagnosed with thrush after my first 2 babies, trying all the typical thrush remedies. Nystatin, gentian violet, a crazy diet that makes Atkins look like a feast, vinegar, air, antibiotics for the kids, etc. Thrush is a very common infection for nursing mothers and is correctly diagnosed the vast majority of the time. It is also quite painful, so taking steps to thwart it as quickly as possible is so important.

However, nothing worked for me. I saw no fewer than 5 lactation consultants. I was advised to try pumping to let the thrush infection clear up. Pumping was still very painful, but just bearable to do 5 times a day. The pain never went away in over a year of pumping.

Before our newest Incredibaby was born, I decided to take further action. I met with a lactation consultant when I was 8 months pregnant, went on a crazy elimination diet that left me eating almost nothing other than nuts and plain yougart. She also gave me some things to read over.

I read about something I didn't know was possible...that Raynaud's Disease can have serious repercussions for breastfeeding mothers. Raynaud's is a circulation disorder in which your body overreacts to temperature changes and contracts the blood vessels, which constricts the flow of blood to your extremities. I have been diagnosed with severe Raynaud's for years. I loathe getting even a carton of milk out of the fridge, because I usually have an attack and my hands turn white.

Raynaud's can also cause the flow of blood in the breast to be cut off because of a constriction in the blood vessels called a vasospasm. It is often misdiagnosed as thrush, because the symptoms are similar...extreme, searing pain all the time. So now I know why breastfeeding causes me unbearable pain and why the months of treatments for thrush did not help. There is no "cure" for Raynaud's. In my skiing days, I had taken a blood thinning medication to help keep the blood flowing to my extremities, but it doesn't really help. Pumping is just bearable for me. I still grit my teeth and my eyes water almost everytime. I have a list of intentions to offer my pumping pain for taped right to the pump.

So, given that I can't nurse, why do I pump instead of use formula?

For me, it is very important to me to feed my babies breastmilk. I firmly believe in its superior health benefits for my baby and myself. It is the baby food that God designed. My husband is very supportive. I intended to pump for a year with my boys, but lost my milk supply literally overnight when I became pregnant again. When that happened, I switched to formula. Other mothers in their individual situations might make a different choice for their baby and their family, which I completely respect and would not pass judgement on!
Many moms do choose to pump for their babies for a variety of reasons. There are moms who work or have to be away from their babies for other reasons, and babies who need hospitalization.

There are some unique benefits to pumping.

Milk Banking. I have to pump 5 times a day to keep my milk supply (I know this from my personal experience). I pump about 50 ounces. Incredibaby eats about 32. So I am able to freeze and donate my extra milk to a milk bank. Several blog readers have asked questions about this. There are strict protocols to ensure the milk is safe for the most fragile infants. The milk is pasteurized. You must submit to bloodwork. If you and your baby are healthy and take no medication, then you are probably eligible eligible. Pump parts must be sterilized daily. The milk bank provides sterile containers for milk that must be labeled and dated. There are limits on caffeine and waiting periods after alcohol, tylenol and other OTC medicines. For a healthy woman, it is really not that hard! You would probably only need to make a few changes in your daily routine. I strongly encourage anyone with a freezer full of milk to contact a milk bank. They probably won't be able to use the milk you already have, but, by doing a few simple things, your milk will help the tiniest babies who need it. Make sure that your milk bank follows the guidelines of the Human Milk Banking Association of North America and is non-profit. If there is not a milk bank in your area for you to drop-off, you can arrange shipment of milk to a bank.

Others can feed the baby. Even though I feed him at least 95% of the time for bonding, others love to do it, too. And when I had an emergency appendectomy a few weeks ago, I had comfort in knowing that my baby would take a bottle and I had enough frozen breastmilk to get him through the 2 days during which I was totally incapacitated and on drugs not compatible with breastfeeding.

Special Situations. When a friend adopted a baby born at 26-weeks gestation addicted to crack to a mother who didn't know she was pregnant, they were desperate for breastmilk. Even though their doctor wrote them a prescription for breastmilk, their insurance wouldn't cover it and they could not afford it. (There is a charge for breastmilk, because it is very expensive to store, transport and pasteurize it and monetary donations to a milk bank don't cover all the costs..sometimes insurance will cover it. It is not distributed without a prescription). I was able to give their sweet baby boy milk, which was a blessing to their family and to me. There are so many stories like this.

There are some unique challenges to pumping.

Sleep. After feeding the baby in the middle of the night, I have to pump, clean the pump, fill bottles, store milk, which means less sleep for mom.

Travelling. Don't get me started here, but have you ever tried to explain to a 21 year old male TSA officer how much breastmilk a newborn consumes and that you have to bring enough in case the plane is delayed and you are not going to feed your baby milk expressed in a public airport restroom stall?

Chaos. Pumping while a 3 year old and 20 month old try to see how high they can swing the 2 month old baby in the baby swing. Signing Time anyone?

Guilt. We've discussed mommy guilt and mommy pride on this blog before. I felt very judged and guilty as a first time, insecure mom who desperately wanted to nurse my baby, but could not and didn't know why. We may joke about my method of lactation on this blog now, but these ladies helped me through some rough times when I was adjusting to the fact that I couldn't nurse and made me realize that my guilt was very unfounded and wrong. And they continue to encourage me all the time.

While I still desperately wish I was able to nurse my little ones, I have come to terms with the fact that I cannot. Expressing milk has been the solution for our family. I still enjoy plenty of snuggle and bonding time with my babies who sleep 6 inches away from me and I wear all the time. I am also thankful for the opportunities I have to share milk with others.

If there are any questions about milk banking or pumping, fire away in the comments.


Aubrey said...

Wow--you are doing an amazing thing. This makes me look at nursing in a new way; I completely took the simplicity of it (my experience was fairly easy) for granted. God bless you for your hard work!

clara said...

I had terrible pain nursing my first baby for the first three weeks and I thought THAT was hard. You should not feel guilty, it is really admirable that you have stuck with it for so long. I bet even your spouse probably wanted you to quit because he hated to see you in pain, but you carried on anyway!? What a tremendous story.

lauren said...

Hi TM-- I did a quick internet search on the topic and found that most resources say it's treatable with a drug called nifedipine. Have you ever checked that out? See this article

God bless!

texas mommy said...

Thanks, Lauren. I've been on nifedipine ever since I can remember. Unfortunately, it doesn't help me. I've tired all the tricks for nursing with Raynaud's....Nifedipine, warm compresses, vitamin B6, grapefruitseed extract, etc.

Right Said Red said...

Loved this post. Thank you for being so open and sharing this with all of us! I KNOW you will help so many mothers struggling with this. Texas Mommy, you are the best!!!!!

Erin said...

Great post! Thanks for all the info. I am one of those working and pumping moms (i love a quote i recently found from Sarah Palin about putting down the blackberry and picking up the breastpump...that is my life.).

What have you found is the best bottle for little babes to take their bmilk out of? I have been having a hard time getting SB to cooperate with a bottle lately, but it might just be that he won't take it from me. Dad seems to have better luck, but it can still be a struggle if I'm around (i nurse him when i'm there, but if we are on the go around town I usually bring a bottle).

Pumping and continuing to breastfeed is certainly a sacrifice when one's circumstances don't make it easy-- but it is just one of the many sacrifices we can offer up for our wee little ones.

I also experience mommy guilt, albeit in different ways-- leaving the baby with the nanny 4x a week, etc etc. But, God calls each of us to live the unique plan he created for us as individuals, and living with that knowledge helps asuage some guilt-- and envy!

Anyway, any suggestions on bottles!?


sophie said...

texas mommy, thank you so much for this post. I was almost in tears by the end of it! I love that you talk about using prayer to get through this. I have 3 boys, ages 5,3, and 7 mos. I've breast fed all (still the 7mo) and have truly taken forgranted how relatively easy it has been each time. Ever since I read your post, at each feeding I find myself thinking about you and other Moms who go through similar pain and suffering just to feed their babies. I plan to offer up prayers for you and other women in your situation during my nursing sessions, also for the babies who will benefit from your donated milk. I sure hope you can rid yourself of any mommy guilt! Know that God is surely blessing you for all of your efforts to grow closer to Him in all you experience.
Your children are truly blessed to have you as their mother.

texas mommy said...

Erin, We are currently using Born Free bottles, which I am happy with. We have used Avent and Playtex VentAire in the past, but the BPA scare left me searching for another option.

I like the Born Free bottles and we have had hardly any issues with spitting up with our youngest boy. We had a lot more problems with the Avent bottles and found out that the Playtex ones that I liked had BPA. I would assume a lot of it depends on the baby, but I definitely recommend the Born Free bottles.

I should add that, although I love my Medela pump and parts, I don't like their bottles, even though we have those laying around, too.

I definitely know babies that won't take a bottle from mom even if they will take one from dad or another care giver, so I don't know that a different bottle will solve the problem?

Mary Alice said...

Thanks for sharing this. I am so glad that you got to the truth of what is causing your pain, even if you can't solve it, at least you are no longer deprived of sugar or taking unneccessary meds.

I had to stop nursing when my baby was about 6 months and I have been using the born free bottles and really liking them, too.

Rachel said...

After posting my own issues with pumping this past Saturday on my blog, a friend of my sent me a link to this post. It feels good to know I'm not alone.

My daughter was born 10 weeks early with a birth defect. Her esophagus does not lead to her stomach, so she can't nurse until they fix it with surgery, which they can't do till she gets bigger. So I've been pumping for the past 4 weeks (they feed her milk through a G-Tube) and it's been a nightmare. I started off doing pretty well, but after I went back to work (until she comes home) my production dramatically fell. The lactation consultants pretty much gave me a guilt trip about pumping 8 times a day to keep it up, no matter what. This past weekend, I finally decided I couldn't take it anymore, as my mental health depended on it.

It got to where my entire day revolved around my pumping schedule, including taking time out of seeing my sick baby in the NICU. And when I couldn't even get half an ounce during most of my sessions, it really wasn't worth it.

I still pump, just to keep up some production until she can come home and hopefully nurse, but I'm not killing myself to do so anymore. I've decided that her getting formula isn't the end of the world.