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.

Mothers Milk

A friend sent this article today, Swiss Restaurant to Serve Meal Cooked with Human Breast Milk. Market price--women will receive just over 3 pounds per 14 ounces of breast milk. With current exchange rates, that $5.45 per 14 ounces of milk. Finally a solution for all those lactating mothers out there who are worried about the cost of a daily Starbucks latte. Texas Mommy, you are in the money ;-)

Pretty strange.

h/t Lauren

Breastfeeding 101

As we have joyfully welcomed boy #3 into our home and hearts, I have begun the breastfeeding journey once again...  It is a well-worn road in our home and one that I cherish traveling with each of my children.  Baby J is no exception and has been taking to feeding famously!  Hallelujah!

Though with each child I'm learning that everything is different and in some ways, it's like I'm a new mother all over again.  Thank goodness for the lactation nurse who I met the other day at our pediatrician's office.  She was a gem of a woman and made me feel on top of the world for choosing to nurse my child.  Along with her encouragement came two precious nuggets of wisdom that I wanted to pass to all of our readers...  If you're nursing now or know someone who's going to breastfeed, keep these pieces of info handy!!  They were such a blessing to me.

*Baby falling asleep while you nurse? 

Try clavicle massage!  The clavicle or collarbone extends from the middle of baby's neck to his/her shoulder.  If you're noticing a slowing in nursing or if the baby is beginning to fall asleep, give the clavicle a circular massage which should initiate the suck reflex.  The nurse said that this should work to initiate sucking even while the baby is asleep.  And so far, it's worked like a charm!!  No more having to antagonize my poor babies to keep them awake--all it takes is a little massage!

*Sore and cracked nipples?

Try caffeinated regular tea bags.  Stick the tea bag in a mug of hot water (as if you were preparing tea) and wring out the water.  Then place the tea bag on the nipple and allow it to cool.  You can heat it up once more and apply before discarding and starting over.  While I haven't tried this one, the nurse promised it would work wonders.  Anything to prevent sore nipples while nursing--nothing is worse!!

Blessings to all of our nursing mother readers out there...

Ecological Breastfeeding--A Crunchy Catholic's Dissent

For those unfamiliar with this blog, here's a few of my crunchy credentials: I cloth diaper, I make my own granola, I've had a non-hospital birth, I shop at a farmer's market, a good deal of my food is organic, I own the Ergo baby carrier, I exclusively nurse my babies for six months and I continue nursing well-beyond, I frequent Rod Dreher's Crunchy Con blog, and, as revealed in a previous post, I'm considering growing a moss backyard :-)

But despite my general tendency to embrace a "natural" approach to life, I must dissent from the advocates of Ecological Breastfeeding (EBF).

Before I begin, I would like to thank all of our wonderful readers for a lively and thought provoking discussion regarding the recent changes at CCL. A special thank you to Sheila Kippley for her comment on my post.

I posted the end of Ms. Kippley's comment below, but to view her thoughts in full, please see the comments on my What’s going on at CCL? post.

One respondent considered that a 40% return by 12 months was insufficient for many. There is no contradiction between practicing EBF [ecological breastfeeding] and practicing fertility awareness. According to the two studies we have posted on our website (Remfry and Prem), only 6% of breastfeeding mothers become pregnant before their first period no matter how they breastfeed. Experience shows that many, many mothers have ample signs of fertility when they ovulate prior to their first menses.

The statistics still stand. On the average, mothers who practice EBF will experience 14 to 15 months of breastfeeding amenorrhea. The 70% who experience 9 to 20 months of amenorrhea provide an almost exact mirror of the 68% of events within the first standard deviation of a normal distribution. EBF remains a wonderful form of natural family planning, and it is the preferred form for many. The normal distribution found in our studies will be found in other real life distributions, but only if the mothers follow the Seven Standards of Ecological Breastfeeding. Not following them is not “bad” or doing something “wrong,” but the biological reality is that the consequent reduction in suckling will most likely lead to a shorter duration of amenorrhea. People deserve to know all such facts so that they can make an informed decision.

As one of our other commenters noted, Sheila Kippley was a real pioneer in studying the effects of LAM in breastfeeding mothers. Many women, including myself, are grateful for her hard work and dedication to NFP research and instruction. As Ms. Kippley noted, it is a form of NFP that works really well for many women.

That being said, I would like to explain my own thoughts on EBF a bit more, and why I think CCL made the right move in getting rid of the 7 standards of EBF and opting instead to advocate only exclusive and continued breastfeeding.

Since EBF alone does not work for all women, it must be used in conjunction with fertility awareness for real reliability and, as a result, I don’t think it belongs as part of regular instruction in NFP courses. I do agree that NFP books should explain the connection between frequent suckling and LAM (as CCL does), but to advocate the 7 standards of EBF is taking things too far.

In addition, and more importantly, I don’t think that EBF is the gold standard of “natural mothering.” While I realize that there are quite a few women who choose to practice EBF, and I don’t condemn them for doing so, I hardly think that it the “ideal” way or the most “natural” way to mother one’s baby. It is just one way, and for many of us, it is not so obviously “natural.”

There are certain ways of mothering that are superior and preferred parenting choices that are natural and obvious to just about everyone. For example, it seems pretty obvious that God created a woman’s breasts to feed her infant. Alternating from this norm should only be done for a good reason, as even Pius XII once noted. Likewise, it seems pretty obvious that God intended a woman to birth her baby naturally, thus a c-section should only be performed for a good reason.

I don’t see the 7 standards of EBF as quite so obvious, and some of the standards may be very unnatural for many women. For those unfamiliar, the 7 standards are below:

1. Do exclusive breastfeeding for the first six months of life; don’t use other liquids and solids.
2. Pacify your baby at your breasts.
3. Don’t use bottles or pacifiers.
4. Sleep with your baby for night feedings.
5. Sleep with your baby for a daily-nap feeding.
6. Nurse frequently day and night, and avoid schedules.
7. Avoid any practice that restricts nursing or separates you from your baby.

(Emphasis added). Specifically, #2, #4, #5, and #6, can seem a bit un-natural to many women.

First, there is nothing “natural” about regular, long term, sleep deprivation. There are many, many, women for whom frequent night waking to nurse, even while lying in bed with their baby, leaves them feeling exhausted and unable to function well. Sleeping in chunks of less than 4 hours leaves most people feeling exhausted, especially after several months of this. For many moms, a baby in your bed means less sleep, not more.

A daily nap leaves many women more drained than before they laid down, AND a daily nap may result in hours of insomnia later in the evening. Everyone’s body reacts differently to sleep, and so for some a nap will actually result in less overall rest. Personally, unless I am pregnant, napping always results in a significantly delayed bedtime with poorer quality sleep. So again, this standard is not rising to the level of obviousness as, say, breastfeeding or natural childbirth.

Again, avoiding schedules doesn’t seem so obvious. To me, human beings thrive when functioning on a daily schedule. Sure, unexpected alterations are necessary at times and an important part of life, but a schedule is a very “natural” part of a healthy lifestyle. It seems the goal should be to get baby onto a loose schedule—like all well-functioning human beings—not to avoid schedules altogether.

All this being said, I’m not offering you my own 7 standards of breastfeeding. I’m not saying that you need to get your baby on a schedule, or that your baby should be in a separate bed, or that you should avoid taking a nap. If EBF’s parenting techniques are working for you, enjoy it. I am simply saying that the 7 standards of EBF are hardly magisterial or even obviously “natural,” though the old CCL regime seemed to think so, as evidenced by the prior CCL manual:

• Ecological breastfeeding is the type of nursing that respects the natural order.

• Because this pattern of baby care is so much more than just feeding, we also call it natural mothering.

While Ms. Kippley’s comment did not go so far as to say mothers are morally required to follow the 7 standards, it is hard to read the old CCL manual without coming to the conclusion that any alternative to EBF is less than ideal—that is, inferior.

No poor mother, especially a young mom having her first baby, should go into motherhood thinking that she has some sort of moral obligation to uphold the 7 commandments of ecological breastfeeding. I think this is the reason that CCL ditched advocating EBF and started advocating the more obvious elements of breastfeeding—namely, breastfeeding that is exclusive (for the first 6 months) and continued (until child-led weaning). And for that I give them 2 thumbs up!