Wednesday, December 7, 2011

Breastfeeding: where we've been, where we are, where we're going (plus some nitty gritty)

Since I need something to do to feel productive while I sit here and eat salt & vinegar chips on our brand new couch avoid the stack of Christmas cards in the dining room relax for a few minutes in front of the tv, I figured I'd write the breastfeeding post I keep writing in my head lately.

Where we've been:

I exclusively breastfed Julia until we introduced solids about a week shy of six months. She had about two ounces of formula the first night home from the hospital when she was starving and my milk hadn't come in yet, but otherwise, it was all me. She did not nurse exclusively, though. Around week two or three, we introduced a bottle, which she took just fine. We ended up doing about a bottle a day and she never had any trouble switching back and forth.

We had two trips away from the baby during those six months, so I pumped like a crazy person and went to these extreme measures to make sure she still had breastmilk while we were apart. In retrospect, it would have been better to have just given her formula, but I was hell-bent on exclusively breastfeeding, and didn't really understand how to incorporate an alternative, so that's what I did.

Everything went smoothly, for the most part. I got mastitis once, which ended up drastically reducing my supply on one side, but I was still able to produce enough for the babe. After awhile, we got into the habit of giving Julia a bottle before bedtime, then I would pump later in the evening for the next night's bottle. That ever so slowly decreased my evening supply to the point where I wasn't pumping enough for the next night's bottle. After my freezer stash was used up - built up for and during those trips - we ended up adding in formula around eight months. I agonized over this, but despite being attached to the pump for hours in the evenings I was coming up shy, and the sanest choice was clearly to supplement with formula.

Then, we went on vacation and I decided to stop pumping in the evenings altogether. This was AWESOME for my personal life but bad for my supply. I was going from about 3:00 in the afternoon to the next morning without feeding or pumping, and my body couldn't seem to balance that with the rigorous feeding Julia was doing from morning to afternoon. In retrospect, it would have been better to have spaced out the nursing sessions more evenly throughout the day - maybe give a formula bottle in the afternoon and nurse again at night.

Right about this time, my supply started to really tank. I remember worrying to Robert the week I stopped pumping about whether I was making the right choice, since it looked like it was a slippery slope for me - a little drop in demand seemed to be rapidly snowballing.

Turns out, I was also newly pregnant...

Breastfeeding while pregnant (nitty gritty):

My supply started to decline right away. Some women don't seem to notice a change until much later, but I definitely noticed - even before I knew I was pregnant. In all the reading I've done on breastfeeding while pregnant, the one conclusion I can draw is that it's totally different for everyone. Some people are affected more than others, but the range of normal is huge and varied.

For me, I noticed the initial supply dip, then another much stronger dip around 14 weeks. After the initial dip, Julia mostly lost interest in all the nursing sessions except the morning one. She would usually just get up and leave after only a minute or two. I'd give her a cracker or something and she'd happily munch on that instead. So, we weaned down to just the morning session painlessly and fairly quickly (over two weeks or so). I did supplement with formula (she was only 10 months at this point) in bottles. I know some women choose to power through it but for the life of me I don't know how - I was so exhausted with first-trimester fatigue that I felt all my life force draining out of me when she nursed. I just couldn't imagine keeping my body running and sustaining three people. Plus, it's not like formula is evil - she's done just fine and she's doing just fine and it's so much nicer to have a well-nourished baby.

I also called the lactation consultants at the hospital at which I gave birth. Their opinion was that there wasn't much I could do to increase supply while pregnant because the pregnancy hormones supersede pretty much anything you can try. The usual galactagogues aren't safe to take during pregnancy so my only potential option was to pump more to increase the demand on my body, which may or may not work for a little while. Um, no.

(Dad, if you're still reading this, skip this paragraph:) It sounds like many women (i.e. those that post on online message boards) experience nipple soreness in the first trimester that gets better around week 14. I had the opposite - almost none the first trimester, then weeks 14-16 it really peaked. It was toe-curling when Julia latched on. No worse than the toe-curling of the initial week or two of breastfeeding, but kind of a shock nonetheless. It's eased off a bit by now but it still makes me flinch for a second or two when she latches.

Where we are:

So, now I'm at 19 weeks pregnant and she's still nursing once in the morning. I think she's getting very little actual nutrition, though: if we give her a bottle or a cup of milk right after the session, she pounds it away, so I think it's mainly for comfort and just-waking-up cuddles. I can still hand-express a very little amount so I know I'm still making something, but I just can't believe it's very much. (And I'm not digging out the pump to see how much is in there.) I feel no let-down at all and even right before nursing, I don't feel full at all like I used to either. They say colostrum production starts anytime between now and the end of pregnancy, so I'm curious whether either Julia or I will be able to tell when that happens.

It feels like uncharted territory now. Like I said, there's not a whole lot of information out there on what's normal in similar situations. I'm so used to researching the heck out of every single parenting step I take (can I blame law school for this?), so it feels really weird to be truly winging it. It's also kind of nice and freeing - whatever happens, it'll be the right choice for our family and that's really all that's important.

It IS clear, however, that breastfeeding while pregnant is perfectly fine as long as the pregnancy is normal and healthy, and there are no indicators of premature labor. So far so good. My OB knew I was breastfeeding at the beginning of the pregnancy and didn't seem incredibly supportive, but she's apparently forgotten by now and I haven't seen any reason to bring it up again so far. My body will make milk tailored primarily for the new baby - hence the imminent colostrum production - so New Baby won't be missing out on anything, and anything Julia gets is just bonus good nutrition for her.

Where we're going:

I don't know.

I certainly never imagined I'd be in this position. It feels like such a hippie thing to do - be pregnant and breastfeed, but it's truly been a very natural progression for us. I've cut back here and there for my sanity but we both overall enjoy breastfeeding and there just hasn't been a compelling reason to stop. Julia is 13 months and she is still such a baby to me. That morning session clearly brings her comfort (and I die every morning for the chance to just lay in bed with my eyes shut for another 20 minutes) so it's really working for us now.

Maybe she'll lose interest down the line as it becomes clear there's a cup full of chocolate milk available immediately afterwards. Maybe she'll dislike the taste of colostrum when that change happens, and decide to stop then.

Maybe she'll keep at it for the whole pregnancy and I'll end up nursing both my newborn and my toddler. I have no desire to nurse my toddler the same amount as my newborn, but if Julia wants to pick up an extra session or two during the day, I can understand. I have no idea how she's going to react when she sees another baby partaking of "her" buffet, so if tandem nursing minimizes conflict during the tough transition, I'm okay with it.

Basically, I'm going to wing it. And not be afraid to set boundaries with Julia if I start to feel completely overwhelmed or too much like a milk factory for sanity. My goal is to nurse the newborn for six months, and then re-evaluate and see what I feel like doing. But if I don't hit that, I'm okay with it. (Well, not 100% okay, but mostly okay. It is my goal, after all, and I prefer to achieve them.)

And I kind of like that we're doing something unique. Not in a "I'm a better hippie momma than you" or "GOGOGOGOBREASTFEEDING!" way (you moms know exactly what I mean), but I've enjoyed navigating these (fairly) uncharted waters - and the uncharacteristic chilling I've been doing exactly because they're uncharted. And I like knowing I'm doing what works best for my family right now even if it's a little unconventional.

Which is why I'm blogging about it in such detail. I'll update as it becomes relevant but for now, we're going to just keep on keeping on. The human body can be such an amazing thing.

1 comment:

  1. Love this post - thanks for sharing! So many people are judgmental about breastfeeding, when the truth is that every mother/child/family is different, and nitpicking about every little why, how, when, and where is really unhelpful. You're doing the right thing for your little ones (only you can figure that out)!