Looking for The Lactivist? She's retired. But you CAN still find Jen blogging. These days, she's runs A Flexible Life. Join her for life, recipes, projects and the occasional rant.

Sunday, January 20, 2008

An Amazing Pumping Mom

I'm honestly not sure I can do justice do this article if I try to add my commentary, so I'm simply going to link you up to an article about one of the most amazing pumping moms I've ever heard of.

(Thanks to Lactivist reader Krista for sending it my way.)

Labels: Pumping Milk

Author: Jennifer Laycock » Comments:

Looking for The Lactivist? She's retired. But you CAN still find Jen blogging. These days, she's runs A Flexible Life. Join her for life, recipes, projects and the occasional rant.

Monday, January 14, 2008

Article on Exclusively Pumping

There's an article over at Babble today about mothers who choose to exclusively pump. I was interviewed for the article and you'll find several quotes from me.

It's an interesting article. It addresses some of the challenges faced by moms who lead them to EP and some of the problems with EPing in terms of what the baby misses out on. (Proper jaw development is a major one, higher risks for obesity as well.)

Overall, I was pretty pleased with the article. I'm not so thrilled that I came out sounding like I thought pumping was better than direct nursing, but I certainly can't blame that on the reporter who accurately quoted me. Just sort of shows how single sentences can have different tones when taken on their own.

Anyway, I'll be making a post here in the next week or two about my thoughts on EPing verses EBFing, so stay tuned.

Labels: Pumping Milk

Author: Jennifer Laycock » Comments:

Looking for The Lactivist? She's retired. But you CAN still find Jen blogging. These days, she's runs A Flexible Life. Join her for life, recipes, projects and the occasional rant.

Friday, September 28, 2007

Weighing in on the Sophie Currier Case

I have no doubt that many of you have been wondering why I haven't mentioned Sophie Currier or her fight to gain time to pump during her medical boards.

The reality is, I simply haven't felt prepared enough to write fairly about it. By that, I mean I didn't feel I had enough information to argue for or against her. Even now, I've heard a million different arguments on both sides and have a hard time keeping everything straight. As you guys know, I try not to jump on issues with my gut, so in a case like this one, it can be difficult for me to form an opinion I'm willing to share publicly.

Now it may seem like a clear cut case. A mom needs an accommodation to allow her to pump. She should get it, right?

Well, perhaps. I'm cautious enough in my long term lactivist thinking to know there can be more to the story. So questions popped into my head...

1.) Is she the first pumping mom to take the test? Have there been others? Have they found the existing breaks to offer enough time? Why is she the first to petition for more time?

2.) How long is the test? How many breaks are allowed?

3.) What is her flexibility in terms of when she can/must take the test? Can she schedule it at a later date? Could she have taken it in the past? Did she take it in the past?

4.) How would her being given extra time affect the people around her. Would it give her an unfair advantage?

The list went on and on.

As you know, it's been a busy summer. One that has left me with far less time than I'd like to research such things. So for the most part, I've watched and listened and waited to form an opinion. I've had a little more time in the last week to read about the issues surrounding the case, and while I still have some mixed feelings, I'm a little more confident in my opinion.

I bet, based on the thread earlier this week, that many of you think I'm going to say she shouldn't have been given more time.

Many of you would be wrong.

My first reaction, when I heard about this incident (a while before it hit the press actually...Ms. Currier did seek to work things out before going public) was outrage. How idiotic to not allow a mother time to pump during this test. Quickly though, my critical thinking side kicked in and I found myself wondering why Ms. Currier was the first person ever to ask for or need this accommodation. After all, surely she's not the first lactating mother to sit for the medical boards, right?

That last one was answered pretty easily. It doesn't really matter if she's the first person to speak up about it. We all know that plenty of folks "suck it up" even when they shouldn't have to because they're afraid of rocking the boat. (haven't we spent the last two days discussing this very thing? While I support sucking it up in regards to "wants", I don't think a job always qualifies as an automatic "want.") I've heard from more than one women in the medical field that there are many unspoken rules and expectations and that women who "expect" anything perceived as "special" are labled as troublemakers. That leaves me not quite ready to dismiss the need for more time simply based on the idea that other women said they had enough time to pump.

I've also learned that not everyone pumps like I did. Some women genuinely need more time than others.

My second reaction was to laugh at the irony. The medical board...the people who are supposed to value and promote breastfeeding...were telling a mom she should just wean her daughter so she could pass the boards and become a doctor.

Labels: Lactivism, Pumping Milk

Author: Jennifer Laycock » Comments:

Looking for The Lactivist? She's retired. But you CAN still find Jen blogging. These days, she's runs A Flexible Life. Join her for life, recipes, projects and the occasional rant.

Sunday, March 25, 2007

The TSA Breast Milk Debacle

It's tough...trying to figure out how to fly as a nursing mom, especially if you're flying without your infant. While the TSA has pretty clear-cut rules about this issue, they seem to have a lot of problem making sure their own agents know the exact policies.

Now the official TSA policy is NOT difficult to understand.

If traveling with your child, you may bring breast milk on board with you. If you are not traveling with your child, you can either store it in three 3 oz containers in a one quart zip lock bag OR you can check it. Obviously, if you have any quantity of breast milk, it needs to be checked.

Doesn't sound all that complicated, does it?

Apparently, TSA officials can't get it straight. There have been several instances in the last few months of moms being forced to miss flights or to dump their expressed milk. In some cases, that's because the mom hadn't taken the time to familiarize herself with the new TSA rules and is trying to carry breast milk on without properly packaging it. In other cases, the mom was following the rules to a tee and the TSA officers simply didn't understand them or enforced them improperly.

Well, there's another story about this in the news and I'm getting frustrated.

Heidi Souverville of Sacramento is upset because she was told that she could not bring 27 ounces of expressed milk on board with her. (She WAS given the option to check the luggage.)

I can't find any details on how Souverville had her milk packed. I don't know if she had it in three ounce containers and had few enough of them that she could fit them into a one quart bag, or if she simply read the guidelines stating that you could carry breast milk on board and missed the part about needing to have your baby with you. (Yes, I KNOW that rule is idiotic...)

A quote from an article on News10.net:

On the TSA website it said if you were carrying more than three ounces, if it was breast milk or formula, that was OK," Souverville pointed out in an interview at her Curtis Park home.

TSA officers insisted the exemption only applies to mothers traveling with their children, and the rule was stated clearly on one section of the TSA Web site.

CBS13 claims that the TSA updated the site to clarify the policy just last month after the issue happened. Here's what I found on the TSA site today under their general guidelines for what is allowed on board...

Allowed as Carry-On
Baby formula and food, breast milk and other baby items - These are allowed in your carry-on baggage or personal items. You can take these through the security checkpoints and aboard your plane. However, you must be traveling with a baby or toddler. [emphasis mine]

That snippet also linked to the full guidelines on traveling with children (or breast milk.)

The first paragraph on that page has the following line:

If you're not traveling with a baby or toddler, any formula or breast milk you're carrying must meet the requirements for carrying liquids, gels and aerosols (3-1-1).

On the 3-1-1 page:

3-1-1 for carry-ons = 3 ounce bottle or less; 1 quart-sized, clear, plastic, zip-top bag; 1 bag per passenger placed in screening bin. One-quart bag per person limits the total liquid volume each traveler can bring. 3 oz. container size is a security measure.

and also...

Declare larger liquids. Prescription medications, baby formula and milk (when traveling with an infant or toddler) are allowed in quantities exceeding three ounces and are not required to be in the zip-top bag. Declare these items for inspection at the checkpoint. [emphasis mine]

Now, I can't go back in time and see exactly what the policy USED to say, but I do know that when I flew to Chicago back in December the TSA site was VERY clear on the fact that you either had to have a baby with you or you had to check your milk. (the option of carrying it on via the 3-1-1 rule did not exist when I took my Chicago trip.) It took me less than five minutes on the site (in December) to find out that if I wasn't traveling with my child, I'd need to check any expressed milk.

However, the articles that I've read state that Souverville was given the option to check her bags. I guess I'm not clear on how the option to dump your milk OR check your bags suddenly becomes "being forced to dump breast milk." (According to Souverville, she didn't want to check her breast pump bag because the bag isn't designed to be checked.)

Let me be clear that I have the utmost sympathy for ANY mom that is forced to throw away hard-earned expressed milk, but this issue has been in the news so much, I guess I just don't see how moms can claim ignorance. I had no problem finding the rules back in December (which were stricter than they are now). In fact, any time that I've checked the TSA guidelines in the last five months (and I've checked at least half a dozen times) it has clearly stated that moms traveling with breast milk but without baby must check the breast milk.

So just to be clear, let's summarize...

Traveling with baby = breast milk allowed
Traveling without baby = up to 9 ounces of properly packaged breast milk allowed... check the rest.

For the time being, these are the rules folks. You don't have to like them, but you DO have to follow them. Otherwise, you're going to run into trouble.

Now, what DOES strike me as odd is a line from KCRA 3 that says it wasn't just about the breast milk.

Souverville said she had never had trouble bringing her breast pump on board a plane, until a February flight from Phoenix to Sacramento.

She said TSA agents refused to let her bring on board her pump and 27 ounces of breast milk.

So wait...she couldn't take her PUMP on board? None of the other articles mention the trouble taking the pump on board, so it could be a mistake in this story, but if that's the case, it's something that I can TOTALLY get up in arms about. There's absolutely NOTHING on the TSA site that says there would be any problem with taking a breast pump on board and I'm flabbergasted that a TSA agent would have an issue with it.

Labels: In the News, Pumping Milk

Author: Jennifer Laycock » Comments:

Looking for The Lactivist? She's retired. But you CAN still find Jen blogging. These days, she's runs A Flexible Life. Join her for life, recipes, projects and the occasional rant.

Monday, March 19, 2007

Good for The Limited

I'm generally not a fan of the Limited. After all, this is the company that thought it was a good idea to sell thong underwear emblazoned with slogans like "wink, wink" and "eye candy" in little girl sizes.

That said, my cousin's boyfriend has started working at the corporate offices of their "tween" division and he reports back that they have lactation rooms with corporate pumps, storage space, comfy chairs and locked doors. ;) (Don't ask me how he knows this, I'd imagine it was mentioned on his tour and he paid attention since he knows I'm such a lactivist.)

So, to the folks at "The Limited"...you suck for trying to sex up our kids, but at least you get a little credit for knowing that they need breast milk in the years before you turn them into tramps.

Labels: Lactivism, Pumping Milk

Author: Jennifer Laycock » Comments:

Looking for The Lactivist? She's retired. But you CAN still find Jen blogging. These days, she's runs A Flexible Life. Join her for life, recipes, projects and the occasional rant.

Sunday, March 11, 2007

Exclusively Pumping: Good Advice is Hard to Find

This month's breastfeeding carnival revolves around the idea of good and bad breastfeeding advice and boy, do we have a LOT of great posts for you to check out. I'll be talking about the good and bad advice that I ran across in regards to pumping exclusively and will include the links to all of our other entries at the end of the post.

Before my first daughter was born, I'd only ever heard of exclusively pumping once. Shortly after I got married I was visiting with a friend that I only see once a year. She had her six week old daughter with her and headed off once to pump. I said something to the effect of "Oh, I don't mind if you nurse" and she explained that she pumped her milk and fed her daughter with a bottle.

I never gave it a second thought until three years later.

I was sitting in my hospital room facing down the on-call pediatrician telling me that she would not release my three day old daughter unless I agreed to supplement. Nursing had been a nightmare since the second night when the nurses took her to the nursery and I ended up having to fight to get her back. There had been 26 babies born while I was in labor and despite my repeated requests we had still not seen an LC an hour before we were due to be released.

Elnora had lost 10% of her weight and was fighting fairly bad jaundice. I was putting her to the breast once an hour or more, but all we ever managed was a big scream-a-thon. Now I had this pediatrician telling me that if I wouldn't agree to give Nora a bottle, she wouldn't release her.

"Get me a pump!"

It just kind of got blurted out. A vision of my friend passed through my head and I remembered her pumping and bottle feeding.

"What?" said the Pediatrician.

"Get me a breast pump and the LC right now. I am not leaving without my baby. I'll pump and supplement with my own milk."

"Whatever," and she left.

It took about four hours, but an LC finally walked into the room carrying a Lactina Select. We talked and then she worked with me on nursing positions and offered encouragement while Nora continued to scream. She showed Greg how he could help me get her latched and gave us her number so that we could call if we needed more help. Then she showed me how to use the pump.

She then went to talk to the LC and got us cleared for release by agreeing that I would pump and then add enough formula to supplement half an ounce after each feeding. The pediatrician came to see us to let us know we were discharged. She offered her "support" by sending us home with a literal garbage bag full of RTF Enfamil.

Gee. Thanks.

Elnora got a 1/4 ounce of formula that night mixed with the breast milk I'd pumped. It was the last formula she ever had. I won't go into the nightmare that was the next day or two of trying to nurse, but let's just say that by the end of our third night home, I had abandoned nursing and had decided to exclusively pump.

I had no idea what I was getting myself into.

I think that was a good thing.

I spent the next few weeks double pumping for twenty minutes at a time every two hours. My milk came in like Niagara falls and by week two I had literally filled my freezer with the excess milk. In fact, I was pouring a good 8-10 ounces a day down the drain. (I know! Can you even imagine??)

I went to the web to start looking for information about how I might back off all the extra pumping and what I needed to do to make this work long-term. I was amazed at the lack of information available. All of the pumping information that I could find was aimed at working mothers who pumped while they were at work and that breastfed while they were home.

Finally, at a Baby Center discussion board, I learned that what I was doing was called exclusively pumping. I immediately began searching Google trying to find information about it. I was amazed at the vast void that stared back at me. There was a little bit of information at KellyMom and there was a site called Exclusively Pumping that had a few links to some articles. (Both of these sites now have far more information on the topic.)

In other words, I was mostly on my own. Unfortunately, I was the first person to breastfeed (because exclusively pumping is STILL breastfeeding, it just isn't nursing) in several generations on both sides of my family and I didn't know ANYONE except that long-distance friend that had ever exclusively pumped.

The LC that I'd worked with was absolutely useless beyond showing me how the pump worked. In fact, when I called in to talk to her about switching to exclusive pumping, she called me back and pretty much said "oh. good luck with that." The local LLL chapters didn't seem to know much about pumping since most of the moms there were full time at home moms that rarely even used bottles. When they talked about expressing milk, they did it by hand or with a hand pump.

Thus, my learning was mostly trial and error with a lot of luck (or as I like to call it, blessings) thrown in. I discovered the milk bank and started sending 100+ ounces a week their way while kicking myself for all the milk I'd poured down the drain. They were full of advice about pumping and I finally started to connect with some other exclusive pumpers online.

The sad thing is that 90% of my interactions with people about exclusively pumping were negative. Not because they didn't think it was a great thing for me to do, but because they were convinced that I'd never keep my supply and that I'd never make it to a year. I heard warning after warning about how many times I'd get mastitis (I got it twice in fourteen months), about how hard it would be to keep up my schedule (it was) and about how much extra work it was to pump and bottle feed (it was.) I also had moms tell me that I was shortchanging my daughter by denying her the comfort of nursing at the breast.

This is why you'll never hear me speak poorly of moms who end up formula feeding. Believe me, I GET why people give up breastfeeding.

And so, when it came time to wean from the pump I decided that I needed to give back. I'd made it two months past my goal of a year and I'd done it despite the complete and utter lack of good advice and support. When I launched the Lactivist, I wanted it to be a place where I could share some pumping advice so that other moms that found themselves in the same situation as me could get some good information. I'd learned a lot, finally found some resources and had had contact with quality LCs that really knew their stuff when it came to pumping. That information needs to be shared.

You can read some of the posts that I've put together on this subject in the Lactivist archives. Some of my favorites...

Exclusively Pumping - Why Does it Get Such a Bad Wrap?
Building a Supply Through Pumping
Differences in Nursing Verses Pumping
A Year of Exclusive Pumping Comes to a Close

Some other great resources for moms that plan (or need) to exclusively pump...

Establishing and maintaining a supply through pumping (Kellymom)
A comprehensive look at exclusively pumping (iVillage)
Exclusively Pumping Support Board (iVillage)
Exclusively Pumping Email List (Yahoo!)

My hope would be that over time, more LCs, more LLL leaders and more people in general would learn about the hows and whys of exclusively pumping. I'd hope that people in a position to help breastfeeding mothers would take the time to learn about an alternative that may well save a child's ability to receive breast milk when nursing attempts fail. I'd hope that moms that are successful breastfeeding would support pumping moms with words of encouragement without making the task out to be so difficult that the mom will end up discouraged.

And of course I'd encourage EVERYONE that works with pumping moms to learn about milk banking and to share that option with moms that have excess supply.

You can read the rest of this month's carnival entries for even more posts about breastfeeding advice and how it can make, or break, the nursing relationship.

Tanya over at the Motherwear Blog includes her list of good breastfeeding advice and bad breastfeeding advice that she's heard over her years as a lactation counselor.

Breastfeeding 1-2-3's Angela shares some tips on how to get good medical advice about breastfeeding (and especially weaning) based on her own experience with a handful of doctors that tried to get her to stop nursing.

Sinead at Breastfeeding Mums encourages mothers that have found good resources for breastfeeding advice to share them with other nursing moms.

Andi at Mama Knows Breast talks about how important frequent feedings are in those early days to help establish a good supply.

We're also joined by several guest bloggers this month. You'll find guest entries at the Black Breastfeeding Blog, Mocha Milk, Cairo Mama, The Twinkies, The Baby Gravy Train and Random Wonderings.

Labels: Breastfeeding Advice, Pumping Milk

Author: Jennifer Laycock » Comments:

Looking for The Lactivist? She's retired. But you CAN still find Jen blogging. These days, she's runs A Flexible Life. Join her for life, recipes, projects and the occasional rant.

Tuesday, March 06, 2007

Getting Breast Milk Through Customs

I've been trying to dig up some information for a friend on getting breast milk through customs and thought I'd open it up to my Lactivist reader to see if any of you have any experience in the matter.

The mom is planning a trip to Mexico with her husband, but without her children. (You know, the GOOD kind of Mexico trip...) She plans on pumping while she's there and would like to bring the milk home with her. However, neither one of us have been able to find any information on the Mexico requirements for flying with breast milk or on potential customs issues. (Because when she flies home, she'll have to pack according to Mexican air guidelines, not according to the TSA and of course she may also have to deal with customs agents if they search her luggage.)

I spoke with the TSA this morning about the situation and she said to stick with the TSA guidelines of checking any expressed milk (you can't carry milk on the plane if you are not traveling with a child) and suggested that the mother carefully label both the package containing the milk and any individual containers of milk. They also gave me the phone number for the Mexican consulate and for Border Patrol, which I've forwarded on to the mom so that she can call to see if they have any additional input.

So, any Lactivist readers travel INTO the United States from another country with expressed breast milk? Did you have to deal with customs? Did you have any problems? How did you figure out what the packing requirements were in the country you were traveling from?

I (and my friend) would really appreciate any input from moms that have made similar trips.

Labels: Breastfeeding Advice, Pumping Milk

Author: Jennifer Laycock » Comments:

Looking for The Lactivist? She's retired. But you CAN still find Jen blogging. These days, she's runs A Flexible Life. Join her for life, recipes, projects and the occasional rant.

Sunday, February 18, 2007

Just a Quick Post

As I sit here on the full size bed in my old room hooked up to the milking machine (a.k.a. my PISA)

Anyone ever notice how hard it is to find dress clothes that are easily accessible to nurslings? I know that Motherwear and other online companies have some great options, but I mean like...you are packing to leave in a few hours, you've lost enough weight that you weigh less than when you were pregnant, but when you try to wear your pre-pregnancy dress clothes the effect of your post-partum stomach makes you look like you belong on Jerry Springer...and yet...you need clothes for calling hours and a funeral?

Got in to town at 4:00pm. Headed out at 5pm with my cousin to try and find clothes. Great success at our first stop until I realized that I'd picked out a button up shirt and a suit vest. Yeah...I'm sure my very conservative family will just love it if I unbutton both my vest and my shirt to give Emmitt access. LOL

Next challenge...finding a pullover top that's both dressy enough and LONG enough (I'm tall through the torso.)

I finally found two shirts, both very nice, very dressy and actually long enough. (And hey! One of them came off the clearance rack for $12!) So poor little Emmitt gets to eat after all. ;)

The tough part now is deciding whether to try and take him to the funeral or to leave him with the babysitters that have been arranged for at the church. (Oddly enough, my midwive's three nieces...) Greg and my grandmother (the one that's still alive of course) will take shifts watching them during the two sets of calling hours today. Thankfully the funeral home is literally at the end of my parent's street so I can nurse him, head down for the first two hour set, come home and nurse him and go back for the next two hour stint. It's just deciding what to do about the funeral tomorrow.

(No, I didn't forget Elnora. She's staying home and going to the baby sitters, she's watched them before and all her cousins will be there as well, so I don't mind leaving her...but Emmitt's the only one small enough to not be walking, so I'm hesitant on leaving him...)

Ok, full milk bottles, off I go. (And a sincere thanks to everyone for their kind words, prayers and thoughts!)

Labels: Life as a Mom, Pumping Milk

Author: Jennifer Laycock » Comments:

Looking for The Lactivist? She's retired. But you CAN still find Jen blogging. These days, she's runs A Flexible Life. Join her for life, recipes, projects and the occasional rant.

Saturday, February 10, 2007

An Update on Tandem Feeding

Elnora's been back off breast milk this week. As I wrote last month, I'd decided to start giving her a sippy cup of expressed milk each day. It seemed to make a huge difference in her appetite.

It's been about a month. She's now at around 23 pounds. That's about a 2 pound gain!

I've cut back on the breastmilk now because I don't want to put a lot of weight on her really quickly and I also want to have some to give to the milk bank. (I pump about 10 ounces a day.) I'll probably switch to giving her two sippies of it a week and freezing the rest for the bank.

She's continuing to do better at eating though. Still having some trouble with veggies (she loves corn and green beans, but not much else) though she's now up to several fruits (any berry, bananas, apples, oranges, and fresh pineapple.) She's even had some meat! (She might have had a total of 16 ounces of meat in the first two years of her life.)

She at the chicken n dumplings that I made last night and a week or so ago she ate a few pieces of pork tenderloin.

The other interesting thing is that she's really cut her fluids down by a lot. She might have one sippy of milk (mine or cow's) and one sippy of half juice, half water now. For juice, we're using V8 fusion which is a combination of fruit and vegetable juices. It's a little lower in sugar than OJ and Apple juice and not as sweet.

We'll see how it goes...if I notice her appetite dropping off again, I think we'll go back to the "glass of breast milk a day" scenario.

I'm with others, I'd LOVE to see a study on this. I really like the theory that breast milk gets digested so much more quickly that it leaves her hungry sooner than the cow's milk did...it makes good sense.

Labels: All About the Kids, Healthy Eating, Pumping Milk

Author: Jennifer Laycock » Comments:

Looking for The Lactivist? She's retired. But you CAN still find Jen blogging. These days, she's runs A Flexible Life. Join her for life, recipes, projects and the occasional rant.

Monday, January 22, 2007

Breastfeeding Legislation Proposed in Indiana

Indiana State Senator Vi Simpson has introduced new legislation (Senate Bill 225) aimed at protecting breastfeeding mothers that need to return to work. The legislation would require companies to allow their employees to use break time to express milk and would also require them to provide a refrigerated storage area for that milk.

"The benefits of breastfeeding to infants and moms are widely known," said Simpson. "Allowing working mothers who nurse their babies to use breaks to express milk and to properly store that milk for later consumption is a way we can demonstrate our commitment to the health of Hoosier children."

Only eleven states currently have laws on the books related to breastfeeding and the workplace, so this would push Indiana ahead of most of the country in terms of lactivist progress.

Simpson also sponsored legislation back in 2003 that provided breastfeeding moms with protection from indecency laws. (That bill passed the Senate unanimously.)

If you are an Indiana mom, please consider contacting your local representatives to make sure they know you expect them to back the bill.

Labels: Lactivism, Pumping Milk

Author: Jennifer Laycock » Comments:

Looking for The Lactivist? She's retired. But you CAN still find Jen blogging. These days, she's runs A Flexible Life. Join her for life, recipes, projects and the occasional rant.

Saturday, January 20, 2007

Tandem Feeding

At least some of you just read that title and thought to yourself "no, it's tandem NURSING." Ha! Yourself would be wrong. It's tandem FEEDING.

At least it is in my house.

I've mentioned a few times in past posts that Elnora is on breast milk again, though I haven't really given an explanation. I wanted to experiment a bit before I wrote about it here, but today seems as good a day as any.

As you know, I have enough milk to feed a daycare center. Granted, I'm too lazy...err...busy these days to pump it all out, but I've got the supply. Back when I was pumping for a friend's baby I got in the habit of pumping every morning. (I usually get up before Emmitt, so the timing is good.) I can get about 10-13 ounces in about 15 minutes. Once my friend didn't need milk anymore, I had started freezing it for the milk bank.

Then I got to thinking. As you know, Elnora is VERY thin. She's in about the 2nd percentile and only climbed back onto the charts within the past few months. She's perfectly healthy, but I always worry about what might happen if she'd catch a bad stomach bug. It happened once before and we had to take her to the children's ER and put her on IV hydration. Her little body just has no reserves to pull her through a bad bug.

I know that the milk bank sometimes sends milk out to toddlers, older children and even adults that have severe weight issues. For some reason, breast milk seems to stimulate weight gain. I mentioned that to Greg and he pointed out that while she's always been small, she never got "skinny" until after I stopped pumping.

So I wondered...how weird would it be to put her back on breast milk? After all, lots of two year olds are still nursing. It certainly couldn't HURT her and there was a good chance that it would help her. There was a momentary "yuck" factor in my brain (after all, she's been on cow's milk for a year) before I snapped to my senses and got over it.

The next morning, that 10 ounces went into her Nuby cup. I put it in the fridge for a few hours so that it was cold, then swished it around and gave it to her.

She took a drink. Paused, looked at me with a quizzical look on her face ("Mom, this tastes different") and then proceeded to CHUG all 10 ounces. I could just hear Cousin Eddie's voice in her head going "it is gooooooooooood."

So for the past three weeks, Elnora has gotten 8-10 ounces of milk about 5 days a week and the milk bank has gotten about 5 ounces of milk each day.

Now here's where it gets interesting. On the days that she starts off with breast milk...she eats like a HORSE. It's uncanny. The first few times I thought it was coincidence, but it's the absolute truth. On a cow's milk day, she eats hardly anything, just like she did before, on a breast milk day, she eats everything in site. For example...

On a cow's milk day, she might eat this...
10 ounces of cow's milk
6 ounces of juice
6 ounces of water
a quarter of a waffle or an 1/8 cup of organic honey nut o's
half a banana or one clementine
a half a slice of bread with butter
5 or 6 green beans
a handful of goldfish crackers

On a breast milk day, she might eat this...
10 ounces of breast milk
6 ounces of juice
6 ounces of water
1.5 waffles
a whole banana
1/4 cup fresh pineapple
2 clementines
1/2 cup organic honey nut o's
1/2 cup green beans
1/2 CAN of canned pasta (or on one day, 3/4 of a personal pan pizza)
whole slice buttered bread
1/3 cup corn or broccoli
1/2 cup goldfish crackers

No joke, I'd estimate she takes in two to three times the amount of calories on the days that she has breast milk. I don't know if it triggers something in her digestive system or what the deal is, but it sure seems to be working. I told Greg that we'd weigh her in a month or so and see if she's gained some weight. In reality, as long as I'm nursing Emmitt, it's not a problem to pump and give her some expressed milk. I suppose she can have it for the next year or so if she wants. We'll just see how it goes.

So my question is...am I nuts? Has anyone else tried this? Again, I know lots of people tandem nurse, but does anyone know of a child who was weaned and then put back on breast milk a year later? Do you let your older children have expressed milk if they've weaned? Just curious to hear your thoughts on the subject.

Labels: All About the Kids, Life as a Mom, Pumping Milk

Author: Jennifer Laycock » Comments:

Looking for The Lactivist? She's retired. But you CAN still find Jen blogging. These days, she's runs A Flexible Life. Join her for life, recipes, projects and the occasional rant.

Tuesday, January 16, 2007

Casual Sharing of Breastmilk

While the idea of wet nursing has been in the news recently, there's also been a lot of talk about "casual sharing." What's casual sharing? Basically, it's when one mom provides breast milk for another mom without having gone through official screening and processing like you'd have with a milk bank. Sometimes it's between two moms that know each other, sometimes it's between complete strangers.

It's happening every day. People just don't talk about it.

So I'm going to.

I confess, I'm a "casual sharer." Yeah, I'm also an actual screened and processed milk donor for my local HMBANA bank, but this go round, I've also dabbled in the arena of casual sharing.

The idea first entered my mind shortly after I weaned myself from the pump with Elnora. I'd stopped pumping in early December and got to talking with a friend of mine in January. She'd had a c-section that previous October and ended up exclusively pumping after some nursing difficulties. She was putting forth a valiant effort, but it just wasn't working out. She, like many moms, simply couldn't get enough milk from the pump.

So I offered to re lactate to help her out. (I have no idea what I was thinking at the time...I'd just given the pump up, I didn't REALLY want to pump again, but I did want to help.) To be honest, I think I freaked her out. (Ok, to be honest, I kinda freaked myself out.) We never mentioned it again and she switched to formula a few weeks later.

Fast forward to early December of this past year. A dear friend ended up with an emergency c-section at 34 weeks due to a previa. She'd gone from a planned home birth to a difficult surgery in which she lost a lot of blood. It was a difficult recovery for her, not to mention the baby spending a few days in the NICU. She was bound and determined to breastfeed, but the baby just wasn't strong enough yet to fully nurse. So she found herself trapped in the nurse/pump/supplement cycle.

Her milk took awhile to come in...not uncommon with a c-section, tons of IV fluids and the severe blood loss.

Supplementing was a must.

We'd briefly discussed the situation before her surgery. She'd been hospitalized at 31 weeks for a previa bleed and we went over the options as far as donor milk if the baby required an extensive NICU stay. As it turns out, the hospital she was having the baby in does not allow donor milk. (They're not very pumping friendly either, but that's another rant.) We talked about sneaking in my milk if she ended up coming home before the baby but didn't yet have enough of a supply. Basically, she was going to get breast milk in this kid one way or another and I was happy to do what I could to help.

As it turns out, the baby came home the same day she did, but it seemed like the baby would constantly increase her intake faster than my friend could increase her output. So I offered to pump. They accepted. Out came my Medela PISA.

For about a week, I took over 10 ounces a day. By the second week, it was about 10-12 ounces every other day. By the third week, they were hardly touching the extra stash I'd provided. By the end of the third week, it was all gold and they didn't need my milk anymore.

I cooked a few meals for them those first few weeks. It seemed funny to drop off a meal for them and to know that I was actually helping to feed the WHOLE family. ;) I was happy to do it though and I know she would have done the same for me.

Now, I want to make two very, VERY important point here.

First...I would NOT suggest this as a good course of action in all circumstances. I'm a screened milk donor for a HMBANA bank. The screening process is stringent. I've had blood work done, my milk has been tested, we KNOW that my milk is 100% safe. In this instance, it went beyond my friend simply taking milk from someone she trusted. We could look at this and know that the only difference between me dropping off the milk and her getting it from a milk bank was that it wouldn't be pasteurized. Otherwise, it was the exact same milk.

Second...our midwife (we used the same one) learned that we were sharing milk (she already knew that I was a donor and a milk banking activist) and thought the idea was wonderful. She actually ended up calling me twice about other client she'd had that had problems getting the milk in. In one case, the mother was 12 days out and still had no milk. She wondered if I'd mind donating some for the mom to use with an SNS. The other time it was a mom that had had twins and that simply wasn't keeping up with their supply needs quite yet.

Both times I said yes, but both times the parents decided to go with formula instead.

I think they made a good choice.

Formula is NOT the devil. It's not evil, it won't kill your child. Yes, in the cases of premature babies in the NICU, donor milk can mean the difference between life or death, but in these instances, the HMBANA milk banks are the place to turn. For healthy full term infants, formula is an acceptable (not equal, but acceptable) alternative. There ARE real risks associated with formula, but none of them are so severe that I'd advocate taking milk from strangers without some major precautions in place.

What do I mean by precautions?

Well, IF you were to insist on taking milk from someone that wasn't a family member or close friend that you had the absolute utmost trust in, I'd recommend doing the following.

1.) Begin your screening by asking the questions used in pre-screening by the HMBANA banks. (I'll try to dig this up and post it in the next week or two)

2.) Pay to have blood screening done. I believe the lab fees on this are around $150 or so.

3.) Consider buying a home pasteurizer. They run $200-$400 and will process small batches of milk.

To be honest, as much of a Lactivist as I am, I'd use formula before I'd take milk from a stranger. But if I was going to take stranger's milk, I wouldn't do so without following those three steps.

How about you? Anyone out there want to own up to casual sharing? Would you share with a friend or family member? Would you take milk from a friend or family member? How about sharing with or taking from a stranger?

Labels: Milk Banking and Sharing, Pumping Milk

Author: Jennifer Laycock » Comments:

Looking for The Lactivist? She's retired. But you CAN still find Jen blogging. These days, she's runs A Flexible Life. Join her for life, recipes, projects and the occasional rant.

Will Ferrell and Wife Viveca Paulin Plug Medela

I missed this, but now I wish I'd seen it...

Apparently, last night during the red carpet preview of the Golden Globes, Will Ferrell and his wife Viveca Paulin arrived sans their two week old baby but WITH Ferrell toting a Medela Classic breast pump. They ended up having a conversation with the interviewer about it and about Paulin's pumping schedule.

Cool.

Labels: Nursing in Public, Pumping Milk

Author: Jennifer Laycock » Comments:

Looking for The Lactivist? She's retired. But you CAN still find Jen blogging. These days, she's runs A Flexible Life. Join her for life, recipes, projects and the occasional rant.

Thursday, January 04, 2007

24 Hours in the Life of the Lactivist

Now, first let me be clear that this is not a mommy-martyr post. I am far from the busiest mom in the world and I’m the first one to admit it. This post was more just an interesting way for me to get a glimpse of how timing works out in the day. It’s also a post to put things in perspective for me after I have conversations with my mother.

Now to note, I have the world’s best mom. She is absolutely amazing and I couldn’t adore her more. Seriously, I am incredibly blessed. The ONLY issue I ever have with my mom is her constant refrain that if I’d only “schedule my time better” that I could manage to have a clean house. ;) So…with that in mind, I decided to keep a log of what I did today. (I guess instead of the 2 minutes at a time that I spent updating my list I could have spent those 2 minute bursts cleaning…lol)

So here we go…from midnight to midnight, this was my day. (Estimating what will happen in the last hour or so, since it is 10:30 pm as I post this)

Midnight Nurse Emmitt
4:30 am Nurse Emmitt
7:00 am Nurse Emmitt
8:00 am Wake up, go get Elnora and get her changed and dressed
8:30 am Pump milk for milk bank freeze milk, clean pump parts (read emails while pumping)
9:00 am Get Emmitt up, change and dress him
9:15 am Get breakfast for Nora and I (waffles! Mmm)
9:30 am Finish catching up on email while Nora eats, scan forums (work ones and the BabyCenter forum I host)
10:00 am Nurse Emmitt
10:15 am: Work on Search Engine Guide while Nora watches cartoons
Noon: Nurse Emmitt
12:15 pm Go to basement, check food stock for lunch and pull meat out of freezer for dinner
12:30 pm Feed Nora lunch, unload and reload dishwasher while she eats
1:00 pm Play the “let’s pick up the living room” game
1:15 pm Put Elnora down for a nap
1:30 pm Take a shower
1:45 pm Work on Search Engine Guide
2:15 pm Nurse Emmitt
2:30 pm Visit with a work friend that showed up for a surprise visit
4:00 pm Nurse Emmitt
4:15 pm Talk to a reporter from the Washington Post
4:45 pm Get Nora up from her nap and get her a snack and something to drink
5:00 pm Start thawing out chicken for dinner while working on Search Engine Guide
5:30 pm Take a break from work to go make salad, get chicken ready to fry and get pasta ready to cook
6:00 pm Nurse Emmitt
6:20 pm Start cooking dinner
7:15 pm Pack dinner, delivery to friend who just had a baby while Greg feeds Elnora dinner
8:10 pm Get home, eat dinner
8:30 pm Nurse Emmitt while Greg puts Elnora to bed
8:45 pm Finish up Search Engine Guide work
9:30 pm Nurse Emmitt
10:00 pm Here I sit working on The Lactivist

Add in about 15 total diaper changes between the two kids, a few snacks here and there for the kids or I, random phone calls, letting the dog out, feeding the dog, potty breaks, you know all that random fun stuff. Nora was supposed to get a bath today, so was Emmitt. I was supposed to grocery shop today, but Greg’s truck is broke and he had the car. Didn’t get any laundry done either.

What’s between now and midnight? I’ll likely watch an hour of TV while I visit a few forums, read through the last of my emails and unwind for a bit. At 11ish, I’ll pump again, then get Emmitt settled into bed clean up the toys in the living room and go to sleep myself around 11:30 or midnight.

Now, when exactly is it that I’m supposed to clean?

Labels: Life as a Mom, Pumping Milk

Author: Jennifer Laycock » Comments:

Looking for The Lactivist? She's retired. But you CAN still find Jen blogging. These days, she's runs A Flexible Life. Join her for life, recipes, projects and the occasional rant.

Sunday, December 31, 2006

Three Things I'll Do Differently This Year...

Yep, it's that time of year. When we all sit down and make up a huge list of unachievable goals that leaves us feeling bad about ourselves and ready to wipe those resolutions from our memories come the first of February. That's one reason that I don't typically make "New Year's Resolutions." That said, this month's Blog Carnival with the "booby brigade" is all about New Year's Resolutions, so I've got to find a way to work it in. ;)

So instead of hard and fast "resolutions" I've decided to write about three things that I've already started working on to do differently this year.

1.) Drinking. No, I'm not going to give up alcohol...I don't drink it anyway. But as any nursing mom knows, breastfeeding a child on demand leaves you as dry as the City of Westerville. Having never been a big fan of water, that leaves me guzzling tea, juice, milk, and whatever other non-water beverage that I can get my hands on. I did the math a few weeks ago and realized that on average, I'm consuming about 400-600 calories a day in liquids. YIKES! (No wonder I stopped loosing weight) In fact, I was drinking about 1.5 gallons of milk a week. (at least it was skim!) So I've decided to limit myself to ONE calorie containing beverage per day. Everything else is tea (unsweet, decaf) or water (with lemon or lime). Thankfully I've found water with lemon or lime to be pretty palatable and we've recently switched to organic milk for the adults in the household (Nora has had organic milk since she weaned) so I really can't afford to buy myself a gallon and a half of milk each week. ;) I'm not going to do the whole "must drink x ounces of water a day" thing, but I find that I'm thirsty enough that I probably drink about 80 ounces of fluid anyway. Since I already eat fairly healthy, I'm hoping that this change in what I drink will help jump start a bit more weight loss. (The pounds just melted off when I was pumping for Nora, I was kinda hoping for the same this time around.)

2.) Volunteering. Before I had kids, I did a lot of volunteering. In fact, there was many a Sunday that I got to church at 7am and didn't leave to go home until nearly 3pm because there were so many ministries going on that I was involved in. I also found myself heading out at least one night a week to help out with something. Having two kids and not many babysitters makes that a lot more difficult. That's one area that the Internet is super handy for. Volunteering doesn't have to mean getting out and doing things physically...sometimes it simply requires time. To that end, I'm going to "volunteer" more actively as a home birth and breastfeeding activist. I'm going to get involved with my local LLL group to make some more contacts in the community and I'm going to devote more time to building out the content side of the Lactivist with articles, tips, resource guides and more on topics like breastfeeding, pumping, milk banking and childbirth issues. I'm also in talks to work on setting up an Ohio resource site that helps women connect with doulas, midwives and other childbirth and breastfeeding related professionals.

3.) Over-Extension. This may seem ironic in respect to number two above, but I'm going to work to try not to overextend myself so much this year. While my "real job" really only takes about 15-20 hours a day worth of work, I've added in The Lactivist, two kids, some discussion forum hosting and a slew of extra consulting work. Somehow I keep finding myself committed to a speaking gig or a teaching seminar or something else that only takes a few hours to do, but that requires many hours of prep work. My brain says "oh, that will just take an hour or two on X day" and my mouth then says "yes" before I really get a chance to think through what I'm committing to. I never realized this until 3 weeks post-partum when I realized I had two teleseminars scheduled that I hadn't prepared for. (Who agrees to do a training seminar 3 weeks post-partum??) So now I'm working to think things through a little more before committing myself to extra "work." After all, if I'm going to spend more time volunteering, that time has to get taken away from somewhere. I think "extra projects" are what's going to lose out.

Will I manage to pull them all off? Well, number three is kinda doubtful, but I'm feeling pretty confident about one and two, since they're more about gradual changes than massive, unattainable goals.

Wondering what other breastfeeding moms are determined to do this year? Check out the rest of the posts in this month's carnival of breastfeeding...

Sinead over at Breastfeeding Mums writes about wanting to better schedule her time so that she can spend more time enjoying her kids and less time hacking away at her computer.

Tanya at the Motherwear Blog offers up 10 great ways to promote breastfeeding in the coming year and asks everyone to pledge to fulfill at least three of them. (It's only January 1st, but I've already knocked out 4, 5, 7 and 8 and FULLY plan on doing 9 by the end of the week. ;) I'll get to the others soon. (Oh yeah, you can also sign up for a change at a $100 Motherwear shopping spree as well.)

Angela over at Breastfeeding 1-2-3 shares her decision to get serious about exercise once again and features some great information about starting up an exercise program after birth and how it might (or might not) impact your nursing relationship.

Andi at Mama Knows Breast says it's time to get organized! From clearing out the sock drawer to donating used toys, Andi has some great ideas for removing some of the disorder from your life.

We're also joined this month by two guests to the carnival. Carrie over at Natural Moms Talk Radio (hey Carrie!) and Momma's Little Angel.

Labels: Life as a Mom, Pumping Milk

Author: Jennifer Laycock » Comments:

Looking for The Lactivist? She's retired. But you CAN still find Jen blogging. These days, she's runs A Flexible Life. Join her for life, recipes, projects and the occasional rant.

Saturday, December 16, 2006

Attack of the Lactation Consultants

One of the complaints that I often hear from moms that had trouble breastfeeding is that they heard so much pressure from friends and family to "just quit and enjoy the baby." One of the things they often say is that in retrospect, they wish someone had simply said to them "you CAN do this, it will get better." To that end, we often push new moms to see lactation consultants "early and often" to make sure that breastfeeding gets well established.

But what happens when it's the lactation consultants that are the problem?

Picture this. You're the mother of a baby born six weeks premature. You're recovering from a difficult c-section with excessive blood loss. Your baby has spent several days in the NICU and you're swelled up like a Macy's balloon from the IV fluids that have been pumped into you since you were hospitalized several days before the birth. You desperately want to breastfeed and you're bound and determined to make it work. Unfortunately, since baby came early, you've not yet attended a breastfeeding class.

Starting within a few hours of the birth, you start to hear things like this...

"You MUST start pumping within six hours of the birth!"
"You need to pump, but you can wait until tomorrow..."
"You don't need to pump for a day or two, get some rest"
"If you don't start pumping within twelve hours, your milk might not come in"
"Pump early and often, as much as you can stand."
"Make sure you pump every two hours for the first few days"
"You can go up for four hours between pumping sessions if you're tired."

Now fast forward a day or two...

"Your baby was premature, she doesn't have the energy to nurse"
"Breastfeeding is the easiest way for a baby to eat, it takes less energy than a bottle"
"Your baby may not be able to nurse for a few weeks, until she's stronger"
"You've got to get that baby on the breast and do it now"
"You're supplementing? You need to stop so baby gets hungry enough to nurse"
"Don't worry about supplementing, we can wean baby off of it over time"
"Is baby latching? Is baby getting milk? You can't just nurse her if she's not getting enough milk"
"Try taking one bottle away at a time, see if she nurses better"
"Nurse her less so that she can focus on growing, then we'll work on the latch"

At this point, you're in an endless cycle of attempting to nurse, then bottle feeding, then pumping. You might get an hour of sleep here and there and oh yeah, you're still recovering from major surgery. Now it gets even more fun...

"If you don't get that baby on the breast soon, you may lose your milk supply"
"Don't worry, get some rest, you can build your supply up over time"
"You're still pumping? Baby should be nursing by now!"
"You're taking a four hour break at night from pumping? You can't do that, you must pump more often!"
"Get to a lactation consultant immediately!"
"You don't need to come in for a consultation until next week"
"Sounds like things are going fine, call me if you think you need a consultation"
"Why did you wait so long to call? You've got to get help pronto, as in yesterday"

You can sort of fill in the rest on your own...I'm sure it's happened to some of you. We tend to talk about how great lactation consultants are and how necessary they are to the process and I agree 100%. But how do you weed out the good LCs from the bad? How do you know who is giving you old information and who is giving you new information? How do you work around odd personalities that run the gamut from "squirrel on crack" shooting off rapid fire instructions in a dizzying daze to laid-back "things will be fiiiiiiine" lackadaisical attitudes? (And that's before you even add in the advice from well-meaning friends.)

It's enough to send any new mom running to a room with her baby and locking the door behind them so that they can just find a few minutes to enjoy each other's company.

And we wonder why breastfeeding rates are so low?

I think lactation consultants are amazing people. I know a few personally that I have an enormous amount of respect for. Unfortunately, LCs are like any profession...it's filled with good, qualified people and with people that have no business slapping those initials behind their names. It's further proof than an LC can, quite literally, make or break a mom's breastfeeding experience.

I saw my own breastfeeding relationship with Elnora tanked by an LC. I saw my breastfeeding relationship with Emmitt saved by one.

How do we fight this battle? How do we take women that are the first in generations to nurse and get them the guidance and the help that they need without making things so difficult that they call it quits simply to get a moment of peace with their child during those precious early days?

Labels: Pumping Milk

Author: Jennifer Laycock » Comments:

Looking for The Lactivist? She's retired. But you CAN still find Jen blogging. These days, she's runs A Flexible Life. Join her for life, recipes, projects and the occasional rant.

Tuesday, December 12, 2006

Did I ever tell you about the time...

...that my breasts got me on South Korean television?

No? Maybe that's because it just happened this morning.

Seriously... Last week I got a phone call from a woman with SBS Korean Television. Apparently SBS has a tv program similar to our 60 Minutes or Dateline type shows that occasionally does documentaries. They were filming one this week that focused on breastfeeding and breast milk banking. (Apparently, South Korea has an abysmally low breastfeeding rates...)

The documentary team had found The Lactivist blog and knew that I was both a milk donor and a lactivist. She said that the film crew was hoping to have the chance to do some filming at the Mother's Milk Bank here in central Ohio and they wanted to know if they could interview me as well.

Yep...that's right. South Korean documentary film crew wants to talk about, and film my milk jugs.

As if it's not breaking enough new ground to be the first breastfeeder in generations on both sides of my family...or to run a lactivist blog, or to have all of my friends and family think of me as that crazy, crunchy, home-birthing lactivist. As if it didn't give folks enough of a laugh to have that photo of me nursing Emmitt make the AP wire after our Delta Nurse-in a few weeks back.

Now my boobs are going to be on TV half-way around the world.

Of course I said yes. ;) It's all for a good cause right?

So this morning, I spent about half an hour chatting with the producer about how I got involved in milk banking, why I built this web site, what I hope to accomplish through my lactivism and so on. (I wonder if I'll be dubbed or have subtitles...I've never been dubbed before...do you think it hurts?) The kicker was that the producer wanted to know if he could have footage of me pumping.

Now I've nursed in public all over the place. From malls to restaurants to stores to planes...if I've been there, I've nursed there. I've even pumped in some strange locations (remember the whole rifle range story?). What I've never done is pump breast milk with a camera man about six inches away filming close ups of the entire process. Praise God that I wore a nursing top today and could at least pump without my still-lovely post-partum tummy making it into the shot.

They say they'll send me a tape once the documentary is put together. Unless they dub the whole thing, I don't suppose I'll understand much, but it will be something unique that I can put with Emmitt's baby stuff. That kid's certainly going to have some stories that his school-mates don't...

"Look Emmitt...here's a picture of your first smile...and here's the picture of you just after you were born on that futon that you happen to be sitting on right now. Oh, and here's the Columbus Dispatch article from when we went to the nurse-in...oh yes and don't forget that South Korean documentary that we did where mommy showed all of South Korea what her breasts look like when she's hooked up like a dairy cow."

Yep...this kid doesn't have a chance of being normal.

I kinda like that.

Labels: Life as a Mom, Milk Banking and Sharing, Nursing in Public, Pumping Milk

Author: Jennifer Laycock » Comments:

Looking for The Lactivist? She's retired. But you CAN still find Jen blogging. These days, she's runs A Flexible Life. Join her for life, recipes, projects and the occasional rant.

Epidurals and Breastfeeding...

There's a new study making the rounds of the blog world this week that talks about the possible effect of epidurals on breastfeeding. In fact, my friends Andi and Angela have already shared their take on the subject. The study, featured in an article over at BBC News titled "Epidurals 'Hamper Breastfeeding'" speculates that there may be several factors in play that cause moms who have epidurals to have lower breastfeeding rates.

From the article:

The researchers, led by Dr Siranda Torvaldsen, say: "There is a growing body of evidence that the fentanyl component of epidurals may be associated with sleepy infants and difficult establishing breastfeeding."

They add: "Whatever the underlying mechanism, it is important that women who are at higher risk of breastfeeding cessation are provided with adequate breastfeeding assistance and support, both in the initial postpartum period [just after birth] and the following few months."

Pat O'Brien, a spokesman for the Royal College of Obstetricians and Gynecologists, said it was possible that fentanyl had an effect on the baby.

But he added: "There are other factors which may explain this link, including that if a woman chooses not to have an epidural, she may also be more motivated to persevere with breastfeeding.

I've actually been having this same discussion with both my midwife and a friend that's a lactation consultant. While I fully believe that there's a tie-in here, I don't necessarily think that it's a direct result of the epidural medication that's causing the problem.

Personally, I think the issue is two-fold.

1.) There's an obvious "belief-system" that can vary between moms that choose to get epidural pain relief and moms that choose to have an unmedicated birth and there's a good chance that those personal beliefs influence the success and duration of breastfeeding. A reality of having a successful unmedicated birth is that moms must put a LOT of time and effort toward preparation. Natural childbirth classes like those offered by Hypnobabies and Bradley take a LOT of time and effort. Unmedicated childbirth is hard work, at least in terms of preparation. Thus, it can pretty easily be argued that women who are willing to consciously plan for and work toward an unmedicated birth may be more likely to "stick it out" when breastfeeding gets tough. (NOTE: I am NOT saying that epidural moms are bad, that unmedicated moms get medals, blah blah blah...I've HAD an epidural, believe me, I get it. LOL...My point is simply that there's a tie in between the "work" associated with preparing for an NCB and the work associated with nursing. There are plenty of epidural moms out there that breastfeed just fine.)

2.) The BIGGER factor, in my mind is IV fluids. See, the moms that I know that had epidurals and had an easy time breastfeeding where those that didn't have their epidurals for HOURS (or days) on end. Without the epidural, it's unlikely that they had bag after bag of IV fluids. See, there's a tie-in between massive fluid overloads and difficulty breastfeeding and I personally believe that it's the massive fluid overdose that causes the problems, not the medicine in the epidural. Here's why...

First, when mom has a MASSIVE amount of fluid in her system, things tend to swell...especially low-hanging areas. Think of how the feet, the hands and yes, the breasts, tend to collect fluid when mom is having edema problems. That swelling that takes place in the breasts mimics extreme engorgement and makes it very difficult for baby to get a good latch. Anyone that has tried to nurse knows that breastfeeding a baby with a bad latch is painful, VERY painful and frustrating for the baby. In fact, unresolved bad latch is what pushed me to switch to pumping with Elnora. (And yes, I did have an epidural and IV fluids with her.)

The second problem is that when mom is overflowing with excess fluids, the body works very hard to return to its natural state. That means that mom's body is working hard to flush that excess fluid out of the system. Obviously the process of making breast milk means adding MORE fluid to the equation. A new body of research is starting to look into the possibility that women's bodies actually fight the production of breast milk in moms that have massive fluid overloads. Basically, the body says "nope! you have too much fluid already...we're not letting you add any more!"

That's why I tell moms that it's just peachy to have an epidural if you want one. After all, despite having a wonderful experience with an unmedicated home birth for my second child, I get that some moms simply have no interest in the "full" experience of labor and birth. There's absolutely nothing wrong with that. The availability of pain relief to laboring mothers is a fantastic invention! However...it's a good idea to hold off as long as you can and to avoid that IV until it's time to get the epidural so that you can avoid that fluid problem that can come with the epi. In fact, I have two friends that had so much IV fluid during their labors that their feet literally squished when they walked for up to a week after the birth. One was unable to breastfeed and gave up after a few days of frustration, the other is still fighting her way through.

That said, I'll be interested to see more research as this comes out. It's certainly possible that the medication itself is what's causing problems, but we all know that the narcotics in the epidural leave the system pretty quickly and many babies don't get the hang of nursing for a few days. Thus, I really do think it's something else (the fluid) that's contributing to the problems that many "medical mamas" have with getting breastfeeding established.

Labels: In the News, Pumping Milk, Stats and Studies

Author: Jennifer Laycock » Comments:

Looking for The Lactivist? She's retired. But you CAN still find Jen blogging. These days, she's runs A Flexible Life. Join her for life, recipes, projects and the occasional rant.

Monday, December 11, 2006

Offering Support...Knowing How Hard to Push

It's a hard line these days in being supportive of breastfeeding without going overboard. I never really realized that until this past week.

See, I have a friend that was planning a home birth early next year and that was determined to breastfeed. Quite honestly, of anyone I've known (other than myself) I'd have given her the best shot at making a go at it, because she isn't afraid of hard work and is a VERY strong individual.

Unfortunately, she ended up with a previa that wouldn't quit and had to have an emergency c-section early last week. Since she was only 34 weeks along, that meant that the baby spent a few days in the NICU. Since there was a previa, that also meant that during the c-section they had to cut through the placenta (which ups the risk of hemmorage) and she lost about 1.5 liters of blood. Put all those things together and you have a mom that is so far from exhausted and stressed that it's ridiculous.

Nonetheless, she was determined to breastfeed, so I wanted to try and help in terms of that so that she could focus on other things. But again, this is the question of how hard to you push. There's also the issue of how many times can you say "the hospital gave you bad information...you need to do X instead."

We all know that mom needs to nurse or start pumping ASAP after birth. In fact, within six hours is the ideal. Unfortunately, when her husband tried to get the nurses to bring her a pump, the nurses pitched a fit, saying that she had to rest and she didn't need to pump that day. (In fact, they said the ONLY reason for her to pump was to get her used to the "sensation" of pumping....arg...sure, let's wait a day or two and make sure the milk NEVER comes in.) Her husband went to bat for her though and pitched a fit until he found someone to bring a pump.

That said, they never showed her how to use it or hook it up. So I headed back into the hospital that night to show them what to do. We got the pump hooked up, I showed her husband how to work it and we got them setup with a schedule. (He'd brought an alarm clock so that he could wake up, run the pump for her, and clean the parts.) That said, we still had to call to request dish soap (to wash the parts) and Lansinoh (since pumping is VERY hard on the nipples) and ready-feed bottles (so that she could pump straight into them instead of losing milk during transfer). Quite honestly, it was like this hospital knew NOTHING about pumping.

That was the last I saw of them for a few days as I had to head to Chicago for a show. I checked in when I got back and things weren't too much better. She was still valiantly pumping away, though she was now down to about 8 times a day instead of the 10-12 I'd told her to aim for. (The hospital lactation consultant told her she could pump much less than I'd suggested.) Unfortunately, she said that she'd gone from getting a decent amount per session to getting almost nothing. She was also now nursing, them bottle feeding, then pumping.

Once again, it was an issue of I knew she wasn't pumping long enough OR often enough, but I also knew that she was about to pass out from exhaustion every other second of the day. So how hard do you push? She also hadn't seen a lactation consultant to work on the latch and getting baby moved to the breast, but again, how hard do you push? When I went to visit I saw that they were feeding the baby from those ready-feed bottles that the hospital has and were using one of those teeny tiny nipples that allows baby to feed with the lips almost closed. (As opposed to a wide bottom nipple where you can flange the lips to mimic a proper latch.) I asked about that, but they didn't have any other bottles. (I took them a set the next day that had the Playtex wide-bottom nipple)

The hospital had also put the baby on neocate, a soy-based formula. I asked why and they simply said that the were trying to get more calories in her. (Neocate has 22 calories an ounce while most regular formula has 20 calories an ounce.) But still, I'd always been under the impression that soy-based formulas were ONLY to be used if baby couldn't tolerate a milk based formula...otherwise your only option if baby can't tolerate the soy is to go straight to the prescription based formulas like Alimentum (sp).

So, I offered to pump. After all, I'd be pumping to donate to babies I didn't know, I might as well take a few days or a week and send that milk to a baby that I DID know. Plus, we know that my milk is really high calorie (25 calories an ounce on average) and if I pumped after Emmitt nursed, I could kick that up to 27-30 calories an ounce. That's way more nutrition per ounce than the Neocate and coming in a form that's more easily digested. So today is day three of pumping to help supplement what she's getting on her own. Thankfully, as of yesterday, she was starting to get some volume again.

That said, she's still not been to see a lactation consultant and as of last night was planning on waiting "a few days, or maybe until next week" which just doesn't seem soon enough to me. After all, the longer they avoid getting a good latch and the longer baby gets used to a bottle, the harder it's going to be. There's also the hard and fast reality that not everyone can bring in a milk supply with a pump. But again...how hard do you push?

Breastfeeding is the absolute best thing that you can do for your child, but there's also a point where it's not unreasonable to give up, get some rest and get to the point where you can care for your child without risking your own health. Knowing where that point lies can be tough though.

I guess the best thing I can liken it to is the person bound and determined to have an unmedicated childbirth, but knowing that they'll probably lose it in transition. Almost every woman I know who attempted unmedicated birth in the hospital broke down and asked for an epidural. Most of them made it clear ahead of time that they were to be stalled until it was too late if they did so. In fact, I made my husband promise to make me wait 20 minutes at least three times before "letting" me get one if I asked.

Now I realize just how hard it is on those support persons. People DO change their minds and it's not unreasonable to do so. I know that if I'd asked for an epidural and my husband had immediately gotten me one that I would have been furious with him after the fact. On the other hand, if I'd REALLY needed it and he'd tried to keep me from having it over and over again, I'd be mad at him for that too. Thus, the balancing act of a support person is a tough one. Part of me wants to tell my friend that it's ok and understandable if she wants to give up, but I also think there's a very high chance that if we gave her that "out" and she took it, that she'd be really mad at us down the road. On the other hand, I don't want to be the obnoxious person who makes someone feel guilty for giving up after what has amounted to an incredibly valiant effort.

So what's a friend to do? Stand by, offer support, offer suggestions and gently push...knowing that by ONLY gently pushing, things may fall to the point that breastfeeding become impossible? (which is what's happening now) Or risk long-term anger by either pushing HARD or by giving "permission" for someone to quit?

And do hospitals sit around all day planning out all the little things they can do to tank breastfeeding? I mean SERIOUSLY! It's like they read the book of how to make breastfeeding easier and then did everything the exact opposite. It's pretty infuriating.

Labels: Life as a Mom, Pumping Milk

Author: Jennifer Laycock » Comments:

Looking for The Lactivist? She's retired. But you CAN still find Jen blogging. These days, she's runs A Flexible Life. Join her for life, recipes, projects and the occasional rant.

My Little Helper...

It's funny how older siblings...even when still very young...ca learn how to help out with the whole "caring for baby" thing. While Nora just turned two last month and is one of those two year olds that doesn't talk...she's very observant and LOVES to help with Emmitt.

Usually that means bringing me a diaper, or throwing the dirty one away...but she seems to be getting the value of breastfeeding now too. :)

Yesterday afternoon two sets of aunts and uncles, my grandfather and my cousin were visiting, One aunt was holding Emmitt and he started his "I'm hungry" fuss. Nora immediately looked at me. I didn't get up right away, so she came over to me, looked at Emmitt and the tried to lift up my shirt. LOL

This morning, I got the pump out (since I've finally started pumping to donate milk) and while moving to turn it on, she grabbed the horns and held them up to my breasts. LOL

At least I'm making sure she grows up knowing how to pump and breastfeed. ;) I'm still waiting for the day that I catch her nursing a doll. I so very much want to be able to snap a picture of that.

Labels: All About the Kids, Pumping Milk

Author: Jennifer Laycock » Comments: