Wednesday, February 23, 2011

Ten Reasons

This is not the first time I've had to send an awkward email of the following sort:

[Regarding a professional event, addressed to random_info@professionaleventURL] "This is an unusual question. I am a nursing mother with a young baby at home, and I will need to pump once while I am gone. Is there a (private) location that I might use for about 15 minutes? A bathroom is my last resort. I am hoping there might be an empty room somewhere."

Jack has been nearly exclusively breastfed for 7 months. I'm going to give myself a little credit here: this is no small feat. Milk leaves my boobs about every 3 hours, healthy or sick, night or day, at home or at work. More than 95% of what Jack eats is my breast milk. Not only have I made it to 7 months, I have no intention of slowing down any time soon.

The biology of nursing is fascinating. Lactation is all about supply and demand. The more the baby asks for -- frequent nursing, complete emptying of the breast -- the more milk is produced. Some the regulation is local (stretch receptors inhibit milk production as the breast fills) and some of it is systemic (prolactin is involved, among other hormones). Nursing is a lot of work, but I don't mind.

A friend of mine asked me what nursing is like. She wondered why women enjoy it. The sensation of nursing is difficult to describe. I wouldn't say it is a physically pleasant sensation (at least not consistently), but it is nice on an emotional level. Right before the milk lets down, I feel a wave of contentment, as if I suddenly let out a deep breath and relaxed. From that moment on, I am focused on Jack: his sandy blond hair, his lovely baby smell, the happy noises he makes while nursing, the angle of his eyes and nose, his contented pace, his shoulders cuddled under my shoulder, his tiny hand holding mine... the little fingernails I probably need to cut. Yes, my mind wanders. Of course, Jack is a squirmy, fidgety guy, and much of the time he's kicking and thashing and trying to get comfortable... but at night, when we're both sleepy and relaxed? It's exactly as I described... and it's time of bonding that's really, really nice.

So, nursing's great.

It's pumping that's the problem. It's the hard, mechanical, uncomfortable and inconvenient pump that's the problem. I dislike -- no, I hate -- pumping.

But pump I must, 3-4 times a day. I pump to send Jack to daycare while I attempt to work.

Here are ten reasons why we've made it this far.

1. I am lucky.

True supply problems are rare, but they do occur. I was exceptionally lucky to start the nursing journey with a slight oversupply of milk. I made a bit more than Jack needed, and I've put in a lot of effort to maintain this oversupply. I feel very fortunate to have had a decent starting point.

2. I nursed on demand when Jack is born.

The early weeks are absolutely critical in establishing a good milk supply. The more frequently you nurse, the more *sensitive* your body becomes to changes in baby's milk needs in the future. I did what women around the world do (everywhere except America, that is): every time my baby cried, whether I thought he was hungry or not, I offered him milk. If I had supplemented Jack in the early days, or if I had attempted to regulate his feeding schedule, things might have been more challenging.

3. I was determined.

Nursing hurts. It hurts very, very badly. Imagine a tiny, ravenous, uncoordinated piranha biting down onto a highly sensitive region of your body in two hour intervals. He's hungry, he's angry, and he doesn't understand how to get the milk out... but he knows, if he keeps trying, something will happen. You love the piranha, but the sight of his hungry mouth makes you recoil in fear Then imagine that you have an undiagnosed thrush infection for the first six weeks, which leads to burning, shooting pain throughout your breasts every time your milk lets down. I spent the first four weeks crying while he nursed. Sometime around 6 weeks, nursing was a neutral experience. By 8 weeks, I often looked forward to it.

I remember desperately asking everyone around me: when did you enjoy nursing? When did you look forward to it? For me, I'd say that things got better for good at around 10 weeks.

Before things got nice, I continued nursing because I was determined. In the beginning, nothing would have swayed me from breastfeeding Jack. Formula was simply not an option. I was committed and we worked through the various obstacles. Now, I love to nurse Jack. I love our special time together. I love knowing that I can supply what he needs. It was worth every moment of pain to get to this place of nursing equilibrium, and I'd do it again in a heartbeat.

4. I bought a f&#$ing expensive breast pump.

I spent $360 on the double electric pump, $50 on all-glass bottles, and another $100 on nursing paraphernalia (bras, tanks, adapters).
Without a doubt, the expensive pump was worth every penny. In a pinch, with a good let down, I can pump both sides empty in 6-8 minutes... some of the less expensive pumps can take as long as 20 minutes per side (40 minutes total). I can pump without an outlet (in the car!). I can stash my pump in a bag that doesn't look like a pump bag (portability!). The pump is efficient: it empties me nearly as well as Jack does, and I have no doubt that helps keep my supply up. This f&#$ing expensive pump makes my life easier, and that means more good milk for Jack.

5. I don't have a freezer stash to rely on.

Most women build up a stash of frozen milk while they are on maternity leave. I pumped an extra 80 ounces before I returned to work... and then, several days before Jack started daycare, I found out that it was all rancid and unusable. I have excess lipase (an enzyme that degrades fat) in my milk, and it makes storage tricky. My milk keeps for about 2-3 days in the fridge. The only way I can freeze it is if I pasteurize it on the stove immediately after pumping, and I never seem to have enough milk left over to do this consistently.

The typical working-mother pumping-milk scenario would go like this. For whatever reason, a woman has low supply on a particular day, relative to the baby's needs. She supplements with a few ounces from her freezer stash. Because the baby gets some milk from the freezer stash, there's less demand on mom's boobs to make more milk. Over time, lots of freezer-stash supplementation (without compensatory pumping) can lead to a decrease in supply.

I have no freezer stash and no option. I *must* pump a minimum of 15 ounces of milk for Jack every single day. If I don't get that much during the day, I pump and pump and pump more at night. Sometimes Jack is hungry, and he nurses overtime to make up for it. This stimulates more milk production, and my supply compensates. I keep a daily record of how much milk I've pumped, and I can tell you that my supply has gone up since my return to work four months ago.

6. I co-sleep.

We both wake up every 2-3 hours so that Jack can nurse. This frequent nursing at night does wonders for my milk supply... I see a difference when I don't co-sleep.

7. I nurse Jack before he has solid food, and I don't fill him up with carbohydrates (ie, no rice cereal)

This ensures that breast milk stays his main source of nutrition, as it should be when he is still so young. Jack is very curious about food -- he wants tastes of everything, and we give him however much he'll take. I just make sure he's had the opportunity for milk first

8. I avoid medication

I took a decongestant a month ago. It was awful. It killed my milk supply. I thought we were done. Thankfully, I spoke with my local La Leche League Leader, and she encouraged me to keep trying... I pumped every hour for days on end, and my supply eventually recovered. I think I've taken a permanent hit, though.

There are a variety of medications that will decrease milk supply. Decongestants and menthol are two of them, and now I avoid both.

9. I continue to nurse on demand

Read any baby book, and they tell you all about how the baby should be stretching out their feedings and sleeping longer at night. I've ignored the conventional wisdom. Jack still nurses every two hours. Sometimes he only nurses for a minute or two at a time, but he nurses frequently. I don't mind. It keeps my supply up, and it means shorter nursing sessions in between.

10. I have the support of those around me.

I spend at least (at least) 2 hours a day getting Jack his milk: washing bottles, washing pump parts, walking to the pumping location, and actually pumping. My boss, my friends, Greg, everyone... everyone has been supportive. I had access to a lactation consultant while I was in the hospital, and I've spoken with my La Leche League leader several times. I could not have continued to pump without such a supportive community.

How much longer will I pump? Your guess is as good as mine. I began this adventure with the certain goal of nursing Jack, but no plan as to how long I would continue.

1 comment:

  1. that is so amazing you are still breastfeeding/pumping and especially with such a demanding schedule. I REALLY wish i had any supply. damn pcos.. of course i had to be one of the "rare" cases. we tried everything to increase it (except a medicine my dr said we could try). at a pump i could only get 1/2 oz. I was DEVASTATED! I give you a lot of credit! your an amazing mom!