Friday, April 13, 2007

Il Latte League: Arabella on Breastfeeding

PLEASE NOTE: I am not a lactation consultant or medical professional of any kind. I am simply, to paraphrase Grover Monster, "a mother who is trying." Here is a bit of what I've learned in the past six weeks, while nursing my twins.

1. One thing that nobody tells you about breastfeeding is the tremendous time commitment involved. After giving birth, I was taught in the hospital that, to help milk come in and to keep it up, one initially needs to nurse or pump (or do a combination of the two) 8-12 times per 24 hour period (therefore, every two to three hours), for 15-20 minutes on each breast at each time. For example, if your baby nurses on each side for five minutes, then pump for 10-15 minutes on each side right afterwards. Yes, this means that... will have to excuse yourself in the midst of a family gathering to go and pump. When your 80-year-old uncle asks why you're leaving the room, you will have to announce that you are going to "pump." He won't understand, and will ask you to clarify. You will need to explain that you are pumping milk--as in, from your breasts. Probably loudly, because it is always the relative who is hardest of hearing that asks such things. This explanation will not be nearly as embarrassing as it sounds, because 1) 531 different strangers will have seen you in several unsavory variations on naked during your delivery and subsequent recovery, 2) every man you have ever known will suddenly ask you about your breasts, and 3) at least one well-meaning relative, while attempting to cook you dinner or bake you something sweet, will spy your freshly-cleaned breast pump parts on the drainboard and mistake them for a funnel, and you will already have had to launch into an embarrassing explanation about what they really were for. will not be able to be away from your baby and/or your pump for any length of time. This is okay; it is just one of many, many reasons why you need to clear your schedule and not plan on doing anything after you give birth. will have to get up in the middle of the night even if you have someone helping you feed your baby/babies at night. It is still worth it to have help at night, though, if you are lucky enough to have someone offer. Pumping for 15 minutes twice during the night is way, way better than being up ALL night, and changing diapers, to boot. may have to type a blog entry about breastfeeding with one hand while you clutch a baby at your breast with the other, not that I would know anything about that. Particularly not as I write this.

2. In spite of the time commitment, breastfeeding is still very, very much worthwhile. Aside from being so good for your baby, it really does help your uterus shrink back to its regular size, and it really does help you lose weight. Before very long, you will be able to go a little bit longer between pumping sessions, if you are pumping, and you will probably be able to empty your breasts in less than 15 minutes. Plus, you'll have huge knockers. Of course, if you can't, won't, or don't breastfeed, don't feel badly about it, and don't let anybody else make you feel badly about it, either! It's not easy.

3. Don't worry too much if you get off-schedule. Just pump or nurse as soon as you can, and then get right back on schedule. I went five hours on the day I was discharged from the hospital, and came home terrified and panicked about engorgement. I assembled my breast pump in a hurry and pumped as soon as I could; everything was fine.

4. Don't panic if you can't put your baby to your breast within 60 minutes of delivery, as is suggested by every lactation consultant (LC) in the universe.

5. Similarly, don't panic if you learn that the NICU or nursery staff has fed your baby formula, or has used bottles or pacifiers, also contrary to the advice suggested by every LC in the universe. In my very humble, completely biased, and totally inexperienced opinion, the threat of nipple confusion is greatly exaggerated. (Yes, bottles are easy, but breasts are warm and soft.) BUT...that said, make your wishes known, early and often, regarding whether you want the staff to avoid formula, bottles, and pacifiers. Remember, YOU are the parent. flexible and realistic enough to listen to the advice of qualified professionals, if there is a real reason why your baby needs to be fed formula in order to thrive.

6. Breastfed babies eat more often than formula-fed babies (for example, it could be every two hours versus every three). If you make the decision both to breastfeed AND use formula, you may want to breastfeed during the day (for maximum fun and bonding) and use the formula at night (for maximum sleep).

7. When you first try putting your baby to the breast, hold your baby's head with the hand opposite the breast you're working with. Hold your breast with the other hand, behind the areola. Using your index and ring fingers (on the bottom) and thumb (on top), gently press your breast until it gets a bit more horizontal, like a sandwich. Hold the mayo and all other disgusting condiments. Touch your breast to your baby's nose, wait until he or she opens his or her mouth wide, and then guide the baby's head to the breast, not vice-versa. Put as much of the nipple AND areola into the baby's mouth as you can.

8. If at all possible, arrange to meet one-on-one with a lactation consultant. Do this as soon as you can.

9. Ask your friends for help and advice about breastfeeding. Or e-mail strangers on the Internet; whatever you prefer.

10. I have heard that, if you have the option, it is better to put your baby directly to the breast than to feed the baby pumped breast milk, the reason being that there is evidence that your body senses germs in the baby's mouth and manufactures antibodies to them. I do not know whether this is true, but if it is, it sure is cool. Pumped milk is quite rich in antibodies, too, though, so don't worry if you can't put your baby directly to your breast.

11. If possible, let the baby come off the breast himself/herself. If not, use your clean pinky finger to break the suction at the baby's mouth before pulling away.

12. If you have a C-section, talk to your doctor about taking your pain medication before a breastfeeding session to give it time to kick in. The reason for doing this is that breastfeeding makes your uterus contract, which can hurt a bit after a C-section. Make sure your doctor knows you are breastfeeding and prescribes a pain medication that is safe for breastfeeding. If it is like pulling teeth to try to get your pain medication out of the nursing staff, talk to your doctor and have him or her make it clear to the staff that you are to get your pain medication on time and without a hassle. If they make you "describe the pain" before they give you your medication, instead of saying "burning" or "numbness" or "stinging" or "4 on a scale of 1 to 10," one particularly descriptive way of doing so might be to say, "It's the kind of pain you feel when someone cuts your stomach open and then the same area is made to contract, so give me my ____ doctor-prescribed-and-authorized pills (insert expletive of choice)."

13. Breastfeeding may initially make you wince a little, but the pain shouldn't be overwhelming, by any stretch of the imagination. Pain is often caused by a poor latch. If you feel pain while breastfeeding, have a lactation consultant check the position of the baby's latch. For what it's worth, I found the so-called "pain" at the breast to be no big deal, and I'm a huge baby about stuff like that.

14. For further reading, I recommend So That's What They're For! by Janet Tamaro. Like most experts, she advocates exclusive breastfeeding, which made me feel a bit guilty, because I'm supplementing, but she does cut slack to mothers of twins and other special situations. Plus, the book is really funny.

15. Enjoy this special time with your baby!


Anonymous wordgirl said...

Yeah...breaking the suction before pulling the baby off the breast is KEY because if you don't....OUCH! Glad to hear things are going so well. And from recent announcements, I gather that Mignon and I totally put the Boy Mojo on you guys.

10:30 AM  
Blogger Mignon said...

Arabella, this is an EXCELLENT tutorial. I'm going to remember and print this when my next friend gets pregnant.

If I can add a couple things...

1) Breast milk is much sweeter/tastier than formula (according to several pediatricians I've spoken with) which is why a baby will not abandon boobies easily.

2) Nursing is much more difficult than bottle-feeding for a baby, and they actually burn calories while doing it. If a baby is trying to extend a nursing session to more than 30 minutes (on a single boob), they may be losing more calories than they are gaining.

3) Nursing can be more painful than childbirth. It was for me. I sobbed and bit the thick palm of my hand hard enough to draw blood more times than I can count for both my kids. My solution? A Teflon nipple shield. Arabella's right - they babies weren't latching correctly, and no amount of coaching and training could make them change, but in order for me to carry on without having permanently bloody nipples was to wear a shield. Without it the babies were getting more blood than milk.

Arabella - you're a natural. What lucky little boys you have!

7:28 PM  
Anonymous TB said...

Mignon's right. You are doing a great job and this is the most practical and useful info. I've read on the subject to date. Thanks so much for sharing... I know you don't have a lot of time right now.

I hope I'm able to take to it as calmly and naturally as you have!

11:40 AM  
Anonymous Elizabeth said...

This should be reprinted and copied and pasted on every website and message board for new mothers! One thing I wish I had known is that the first few times you pump, you're only going to get anywhere from a few drops to a teaspoon or two. I was honestly expecting a fountain of milk to come out right away!

Smooches to you and the boys!

10:27 PM  
Blogger Tits McGee said...

What a fabulous post, Arabella. My two cents: ice bags when your breasts first become engorged with milk and ache like hell. Worked like a charm for me.

Congratulations, and thanks!

12:15 AM  
Anonymous Medela symphony said...

I could relate with you on this one, I am pumping mom by the way and have been pumping from last three months, I think pumping has made things bit simpler for me!

1:50 PM  

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