Friday, June 25, 2010

My Journey into the World that is Extended and Tandem Breastfeeding

Back to the Beginning:
    In February of 2002, I gave birth to my first beautiful baby boy- Adam. I was just about 16 when I had him and I didn't know anyone who breastfed so I formula fed him.  It wasn't a matter of it being gross or choosing to formula feed, it was just that it didn't even cross my mind.  Sure, I knew what breasts were for and sure I leaked like crazy during my pregnancy so I knew I had milk, I was just so used to the "Babies drink milk from a bottle" mentality that it seriously never even crossed my milk to breastfeed him.  Interestingly enough, I can't for the life of me remember anyone at my OB/GYN's office or at the hospital asking me if I was going to breastfeed or bottle feed.  I really don't remember being given an option- but they brought my baby to me (after a long fight but that's another story altogether) and showed me where the little glass jars of formula where.  I guess it was just assumed that I would be formula feeding.

    6 weeks later though and I held my crying baby and I wasn't able to console him.  I got this overwhelming urge to put him to the breast.  Did I? No, sadly I did not.  There are a few reasons why- 1.) I thought it was too late, 2.) I didn't think I'd be "allowed" to -which is nonsense because my parents have no problems with me breastfeeding my younger two.  I think teenagers are just overly worried about their parents not being accepting of certain things., and 3.) I didn't know the first thing about breastfeeding so I didn't know what to do.  Instead I suppressed this maternal instinct and have kicked myself since.  I felt incredibly guilty even at that moment when I didn't put him to the breast but I really thought it was too late.  To be 16 years old and really wish that you had chosen to breastfeed instead is pretty rare I think.  It's really one of the very few things that I'd change if I could go back in time.  Sure, I have a perfectly healthy 8 year old boy now but if I could redo things, I'd breastfeed him instead.

The Middle:
    When Adam was about 3 years old, my partner (Ed) and I decided we wanted to try for a baby.  Sure we were only 19 at that point but we were in love and we wanted to expand our family.  We tried for 3 months and decided to take a break until we bought a house.  We were still living with my parents but had tried to conceive because there was plenty of room and we had decent jobs.  The plan was to try to buy the house a few streets over from my parents.  We found out soon after that we had succeeded in creating a baby the month we gave up.  It's funny how things work out like that.
    During my pregnancy, I joined a birth board on, a place that had become my home while teaching Adam to use the potty and trying to conceive.  On my new prospective birth board, the question was asked "Are you planning on breastfeeding or formula feeding?".  Well- then it all clicked.  Breasts were for feeding babies.  The milk that I leaked during my pregnancy with Adam was my body gearing up to nourish him.  The intense urge I had to put him at the breast when he was 6 weeks old wasn't crazy.  I was meant to breastfeed!  I became slightly crazed at this point and made it my mission to learn anything and everything I could about breastfeeding- how do I go about it? Why do people still do it if formula is available? What do I need?

    I found the Everything Breastfeeding board on, Kelly Mom, Le Leche League, Dr. Jack Newman, and Ask Dr. Sears and read everything I could.  I learned about latching, hold positions, the "C" cup hold for compression, overactive letdown, oversupply, adoptive nursing, induced lactation (sometimes called re-lactation, and much more.  You name it, I read it-even if it didn't seem to be relevant at the time.  At first, I told those around me that I'd only breastfeed for 6 months.  Then I read more and decided that I'd nurse him until he got teeth.  I held onto this thought process until I learned that when a little one is properly latched, they can't bite you.  It's a good thing I changed my mind about the teeth because he got his first teeth before he was 6 months.  As I read more, I decided that I would nurse him for at least his first year.  Then of course, I read even more and found that the current recommendation was to breastfeed for at least 2 years and then for as long as mutually desired. 

    The American Academy of Pediatrics (AAP) and the World Health Organization (WHO) have policy statements advocating extended breastfeeding. The AAP states:

"Pediatricians and parents should be aware that exclusive breastfeeding is sufficient to support optimal growth and development for approximately the first 6 months of life{ddagger} and provides continuing protection against diarrhea and respiratory tract infection.  Breastfeeding should be continued for at least the first year of life and beyond for as long as mutually desired by mother and child."
"There is no upper limit to the duration of breastfeeding and no evidence of psychologic or developmental harm from breastfeeding into the third year of life or longer."
  While the WHO states:
"On a population basis, exclusive breastfeeding for the first six months of life is the recommended way of feeding infants, followed by continued breastfeeding with appropriate complementary foods for up to two years or beyond."

    Well that definitely sold me on the idea of extended nursing.  I was one of those people who thought "breastfeeding is for babies", "if they're old enough to ask for it, they're too old", and "nursing a toddler is just WRONG".  Suddenly I found myself realizing how ignorant I was.  I decided at that point that my long term goal was to breastfeed for 2 years.  I'd be sad and disappointed if I couldn't make it that long.  2 years is a long time though so I set mini-goals for myself.  1 year was the first mini-goal because i wasn't willing to accept anything less. 

    In August of 2006, I gave birth to yet another baby boy (though Ed had been convinced that he would be a girl.  Our first ultrasound had proved differently)- Logan.

He was born via repeat cesarean section (a long story for another time) and the IV fluids had caused my nipples to be rather flat.  The hospital staff assured me that once the IV was removed that my nipples would return to their normal state but for the time being, I couldn't get Logan to latch properly. I kept trying but he'd just get frustrated because he was hungry and he couldn't get a good latch at all.  Several nurses tried to help (although one nurse squirted formula on my nipple insisting that he'd smell the formula and it would help him latch...which makes little to no sense to me.) and the hospital lactation consultant finally brought me a shield.

    I hadn't ever read about the use of nipple shields so this was new.  Funny little things, shields are.  They did the trick though! He nursed like a champ once he had something to latch onto!  The trouble was, when they removed the IV and my nipples returned to normal, I couldn't get him to latch without the shield!  As I quickly learned, nursing outside of my house with a shield made things very awkward.  I mean, I was awkward nursing in public anyway because I was so new at this.  I had Ed position the stroller in front of us to cover us up while I got him latched.  I had to get rid of this shield! It was making everything more difficult!  It took us about 4 weeks of picking up the instant he rooted, trying to latch him onto my nipple and switching to the shield if he fussed.  If I couldn't get him on the first nipple without the shield, sometimes after his belly had gotten the warmth of some milk, he'd be willing to try to latch onto the second breast.  Finally we ditched the shield.  It was lifesaver but we no longer needed it.

    We decided to wait until 6 months before starting solids as per the current recommendations so he was exclusively breastfed for the first 6 months of his life.  This boy would not even take a pacifier for me so he had nothing but a breast that whole time.  At 6 months, he made it quite clear that he had no interest in solids whatsoever so we backed off and he continued to be exclusively breastfed.   Around 9 months or so, he expressed an interest in food but not purees.  He wanted nothing to do with them so I did more researching and learned about baby-led weaning.  We adopted that approach and just gave him appropriate sized pieces of whatever we were eating with a cup of diluted juice but he didn't want to eat often so he remained mostly breastfed.  This continued until he was a year old- my mini-goal!

     On his birthday he was given his own little cake to make a mess of- though truth be told, he ate very little of it.  We had reached our mini-goal so our next mini-goal was 18 months.  We were doing it!  As he started eating more and more solids, he started nursing less and less.  He was still nursing first thing in the morning, at naptime, and at bedtime with a few more times thrown in during the day by the time we reached 18 months.  At this point, I readjusted my goal and set course for the 2 year mark.  2 years came and went and by this time we had learned about child-lead weaning and decided to let him self wean.  Neither Ed nor I could find a reason to force him to stop. 

    We had plenty of reasons however to allow him to continue.  Sometime in January of 2009, I was nursing Logan to sleep and he started to seize.  I had never before in my life seen anything like what I was witnessing.  Before his seizure, he had been completely fine.  No fever, no symptoms of any kind of illness- just seizing.  My mother had been here for a visit and was standing behind me when I started screaming.  She looked at him and yelled "That's what you did!".  See I had had convulsions when I was 11 months old after having my DTP vaccine so she knew what she was looking at whereas I was just terrified because something was wrong with my precious baby!  Ed had been outside in the garage doing laundry so my mom went and yelled out the door for him to come quick while I was dialing 911.  No parent should ever have to experience something this frightening by the way.  It's AWFUL. Long story short- he had a massive ear infection that had presented no symptoms whatsoever until his temperature suddenly spiked up to 104 and he started to seize.  He had to have tubes placed in his ears because this wasn't his first ear infection- it was just the worst and had no symptoms.  Over the course of the next few months he had 2 more febrile seizures- oddly enough there were no ear infections present.  This whole incident meant it was even more important that he continue to receive breast milk.

   * We also discovered that he has a bit of a digestive issue and while the doctor is working to correct that, breastfeeding is helping him through the tummy pain that he's experiencing.*

    At this point he was only nursing in the morning, at nap time, and at bedtime.  Occasionally he'd hop up on my lap to nurse because he just needed the extra comfort.  I wasn't sure if he was actually getting much milk.  I knew he was getting some because I could hear him swallowing but I didn't know how much he could possibly be getting 2 years later but he needed the comfort so I let him continue.

The Here and the Now:
    In May of last year, I discovered that I was pregnant again.  Logan was still nursing but in most cases breastfeeding during pregnancy is fine (though one should always consult their midwife or doctor if they are concerned) so we proceeded with him nursing approximately 3-4 times a day.  At one point in my pregnancy, I lost my milk supply.  I thought we were done but he kept crying and crying because he wanted to nurse.  I cried with him because I felt so terrible for him.  I let him keep trying though and about 3 days later, things were back to normal!
    In October we all got hit with the H1N1 virus so obviously his breastfeeding was important.  He was less sick than the rest of the house.  I however felt like I had been hit by a bus.  He nursed more (almost constantly) during our bout with the virus.  We were all bed ridden.  I've never been so sick in my life!  I couldn't understand what was going on though as I watched those around me getting better and I was just getting worse.  I had a horrible fever and chills and still felt like garbage.  It wasn't until the red streaks appeared on my breast and I felt like it was on fire that I realized that I had mastitis.   I was no longer sick with the "Swine Flu" but felt just as ill.  After a nice round of antibiotics, I got through my first ever case of mastitis.  I consider myself fairly lucky that I went through 3 years of nursing before ever having to deal with that!
        Logan continued to nurse up until the day that I went into the have his baby brother- Xander.  Much to my chagrin, I had yet another c-section but this time I didn't have

any problems getting the baby to latch.  The hospital staff actually seemed quite impressed with the fact that I knew exactly what I was doing.  I was in the hospital for 3 days and my older children were not allowed to see me because the hospital would not allow any children under the age of 12 in the unit for fear of spreading the flu.  I tried to fight it because of Logan nursing but they were persistent and simply would not allow it.
    Adam and Logan spent those 3 days with at my brothers house.  Logan cried every morning when Ed went to pick Adam up for school.  Logan cried a lot in those 3 days.  The first thing he did when I came to pick him up was nurse.  Boy did he nurse! For the next few weeks, he nursed like a newborn again.  I'd be lying if I said I wasn't overwhelmed.  It was then that I realized just how difficult it is for mothers of twins.  I mean I knew it was harder than a singleton but I could really empathize now.  When my milk first came in-well...I had milk before but my body was making colostrum along with the milk and then all the baby's milk came in so I just had more milk-Logan got mad.  The day he got that sudden gush of milk into his mouth he pulled off the breast, yelled "BABY DID IT! YUCKY!" and started crying.  He didn't like that there was milk.  A few days later he got used to it and resumed the crazy newborn nursing.  As I said, this went on for a few weeks.  He'd cry if I tried to nurse Xander without him.  He was beyond jealous.

    He adjusted though and has gone back to nursing only a handful of times a day.  During the day, what usually happens is I breastfeed Xander on demand and if Logan wants to nurse, I ask him if he can wait his turn.  He'll say "Kape" (which means "Okay") and then go off and do his own thing until Xander is done.  At night, I nurse them both together and a lot of times, they hold hands while they nurse. If you've never tandem nursed, then I'm sure it's hard to imagine how one goes about doing so.  We cosleep so I put Xander in the bed first- so that he's between me and the wall and can't fall off the bed, then me, then Logan, then Ed on the nights he's not working.  Xander gets the left breast while I lay on half on my side/half on my back and Logan hops up and leans over top of me and gets the right breast.  When Logan is done nursing, he lays down and goes to sleep.  It's not the most comfortable thing in the world but it happens once a night on most nights so I just kind of deal with it for now.  They're not going to breastfeed forever so in the big scheme of things, I don't have to deal with the weird laying position for long.

    This time around, I've also set mini-goals for myself but I feel confident that we'll meet them all.  Xander is 5 months old today and at this point he is exclusively breastfed. 
     I plan on introducing solids next month but because we do baby-led weaning, he'll get very few purees and will start will table food.  If he's not interested in food then he'll continue to be exclusively breastfed until he is ready for solids.  He'll be allowed the same freedom of nursing until he's ready to quit just like Logan.  Some days I wonder if Logan will ever wean but he seems to be nursing less and less every time he nurses now so I'm sure it will happen on it's own in the near future.

    I love breastfeeding.  I love looking into my nursling's eyes while they stare up at me in a milky daze.  I love not having to get up in the middle of the night to fix a bottle or having to cram all that stuff in my diaper bag, or washing bottle parts.  I love all the benefits that breastfeeding gives me and my children.  It's easily one of the most amazing things in the world.

    The most important tool that a breastfeeding mom can have is her support system.  Without out that, everything would feel impossible.  My mother didn't feel comfortable breastfeeding me or my brother because she feared that she'd be ridiculed by her family and my father's family.  I think this can easily happen to anyone. She formula fed us because she lacked a good, solid, support system.  That's not to say that you can't breastfeed without support however it is a very valuable asset.  I was lucky enough to have a wonderful support system.  Ed supports just about any decision I make because he knows that I've thoroughly researched it first.  My parents are supportive as well.  I have some friends that are supportive of my choices even if they wouldn't make the same choices themselves and that's a good compromise.

    I'm glad I get to enjoy this time with my little ones!


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