Lactivism or Bullying?

Okay, that's it: I try to stay neutral on the issue of breastfeeing. I've pointed out, on many occasions, that yes, "breast is best" for baby, but that there are many times when it may not be best for Mom, or for the family as a whole. As of righ tnow, though, I've just about had it.

In recent years, breastfeeding's benefits have been much touted, and hospitals - at least in my experience - are now pushing breastfeeding as hard as they once pushed formula. Formula samples are banned from some hospitals. "Nurse-ins" are being organized anywhere a breastfeeding mom may have felt slighted. Sometimes these are legitimate concerns of unfair treatment, but sometimes it is - quite frankly - a case where Mom got herself into a snit over a look that she didn't like. Before anyone takes me to task for not supporting breastfeeding mothers, let me state: I wholeheartedly support a breastfeeding mom's right to feed a baby anywhere he/she needs to be fed. If you choose to continue breastfeeding into toddlerhood, good for you, but at that point, the child doesn't NEED to be breastfed immediately anymore than they NEED to have a sandwich at the exact moment they demand it. You do not need to nurse a two or three-year-old in the middle of a department store, or IN a public pool. But that's another rant.

I've been a very outspoken opponent of the Mommy Wars. Most of us do the very best that we can for our children, and our families, and we work damned hard to do it. Working out of the home, working AT home, stay at home... none of it is easy, but we do it because THAT IS WHAT WORKS FOR OUR FAMILY, and it is no one else's business why we "choose" the path that we do.

But with all of the emphasis now placed on breastfeeding, baby feeding has become one of the hottest issues in the Mommy Wars. Breastfeeding moms often feel that they don't get enough support, and "lactivists" claim that with the right support, almost any mom can and should be breastfeeding. They will usually use the caveat of "if there's no medical reason why she can't" but the inference is that true medical excuses are few and far between. Anything else is just irresponsible parenting.

Why have I gotten my knickers in a knot over this now, you may ask? My youngest is nearly 28 months old, and the bottles have long since been kicked to the curb. I will never again feel the frustration that comes with wanting to breastfeed, but simply not being able to, for reasons I have already explained on this blog - you can read about it here, if you haven't already.

It was this article and the follow-up here that got me into an uproar. It wasn't the articles, though: those are just musings on the economics of baby feeding by a soon-to-be first-time mom, for a FINANCIAL website. It's the comments that got me. The first ones encouraged the woman to breastfeed, because it's the better option for baby. Fine. Nothing new there. Then comments like these began to appear:

• There is no debate about it: breast-feeding is best for babies. It is also best for mothers. The better deal, by a longshot, is breast-feeding. Anyone who can do this for their child absolutely should. Period. The benefits to the child are absolutely tremendous, and they last for years. It would be foolish to choose differently, if the choice is yours. Irresponsible article!
• Generally, formula is for the "too posh to push brigade."
• Why even write an article confusing expecting mothers when breastmilk is 99% better for the child. Why not do what is best for the child instead of most convenient for the mother. Maybe this woman shouldn't be having a child.
• If you're able to breastfeed but think it's just too inconvenient for you, you're not a real mother. You're just a robot with a bottle. Why not just hand your kid over to the commune and pick him up when he's 4, after all the baby-raising inconvenience is over?

So much for supporting other moms. By the way, all of the spelling and grammar mistakes in those quotes belong to the nutjobs who wrote them, not to me.

I will say this ONE LAST TIME (yeah, right...): what is important is that a baby is loved, cared for, and fed, NOT how they are fed. I will not stand for new mothers being bullied and ridiculed into ANY feeding choice (or diapering choice, or work-situation choice, or sleeping choice, and on and on, ad NAUSEUM.) You made your choice with your children, now SHUT UP about it. People who try to make themselves feel better about their choices by belittling others are just showing how low their self-esteem really is.

Thrush - It Ain't Just a Songbird

It's one of those fun things that no one mentions when they talk about the importance of breastfeeding: THRUSH. Sore, bleeding, cracked nipples? Sure, they mention that. Milk leaking through your clothes? Check. Supply issues? The football hold? You know all about that! But does anyone ever mention the possibility of a yeast infection on your boobs? Or in your baby's mouth???

A friend from university, and a fellow mom-blogger, Jenn, tweeted today about her youngest developing thrush, and it brought it ALL back for me.

I was desperately trying to breastfeed my second daughter, despite my breast reduction surgery. We had finally gotten a rhythm of some nursing, some bottle-feeding when she suddenly stopped wanting to nurse altogether. I was certain that she had just develped a preference for the bottle, and I was sunk, and I was absolutely inconsolable over it. It was only when I took her to the walk-in clinic for something else that the doctor saw the tell-tale white mouth.

Because I was breastfeeding AND bottle feeding it was much more complicated. When there are bottles and/or pacifiers involved you have to boil them after every use until the thrush treatment is over, and then THROW OUT every single one, because if the yeast gets back into the baby's mouth, the thrush comes back. At the time we had Avent bottles, and a set of two nipples was nearly ten dollars, so to replace ten of them was just... horrific.

But there's more! The treatment is for baby AND mom, so anything that touches mom's nipples, clothing-wise, has to be washed in hot water and bleach. So much for the new mom "it's sort of clean" idea. Every time you wear something, it has to go through the laundry. Just what you need when the house looks like a cyclone hit it.

So what does thrush look like? Have you ever seen those white spots of mold on cheese? Yeah, like that, in your baby's mouth. At first it's very hard to tell the difference between thrush and milk residue on the inside of the mouth, but as it gets worse, it's pretty gross. Plus, milk residue will scrape off, thrush won't. In terms of what you might see on your nipples, well, I've never been all that sure, but apparently doctors can tell. All I know is that they ITCHED!

There are generally two treatments for thrush: one involves yeast-fighting ointments for you, and yeast-fighting drops for baby. You have to put the ointment on your nipples a few times a day, and be careful to wash it off before you feed the baby again. The baby gets these icky yellow drops that they will invariably spit out all over everywhere, and they stain, just so you know. The medication is called "Nystatin", although personally I'd suggest that you also ask for an oral medication for yourself called "Diflucan".

The other treatment possibility is called "Gentian Violet." It was the most commonly used treatment until recent years. It's a purple liquid that you dab on your nipples and inside baby's mouth (although Dr. Newman says that you can just put it on your nipples, then let the baby feed and it will transfer to baby's mouth that way). The great thing about this treatment is that it only takes about 3-4 days to work, and in my experience, it actually worked better. I've heard people say that it stains clothing, but in my case it washed out fairly easily, much more easily than the spit-out Nystatin drops.

The only problem is that these days it is NOT easy to find. I ended up having to find a pharmacy that did compounding, since apparently it's used for compounding certain medications. So you can try pharmacies in or near medical centres. I suggested to Jenn that she contact her midwives, and they could tell her where to get it, and apparently that worked. I'm not sure that conventional doctors would know, to be honest, although I'm sure that some would.

Thrush isn't fun, but it doesn't have to spell the end of your breastfeeding relationship AT ALL, so don't let anyone tell you that! In fact, it's probably easier to deal with if you are exclusively breastfeeding, since you don't have the bottle nipple/pacifier issues to contend with. KellyMom has lots of information about thrush here.

Hives Aren't Just for Bees!

I have been very blessed in the kid lottery. Every pregnancy you pray that your child will be healthy, and for the most part I have four extremely healthy, smart, gorgeous kids (do I sound biased? Because I'm totally not biased...)

Having been an active participant on several "mommy boards", in the past five and a half years, and having mom friends IRL ("in real life" for those not up on their message board slang) though, I've experienced a lot of grief for my mommy friends who are going through health issues, sadly sometimes even death of a little one. I have one friend (whom I'm still trying to convince to write for this site) whose kids have such bad food allergies that she homeschools them, just to keep them safe from the allergens that could kill them.

Then here's me: not a care in the world - complacent even. Baby number four arrives, beautiful, healthy and big. He's what I refer to as "the world's easiest baby": he eats well, sleeps well and loves everyone to whom he's handed.

I notice, however, that he has some rather raunchy, LOUD gas after his nighttime bottles. He lies there and grunts and moans for about an hour after his middle of the night feeding. I decide to try Enfamil Gentlease, to see if it will help. Almost immediately the late night gruntfests stop. Although he had never been particularly fussy, he just seems to be happier.

By the time he's about six or seven months old he suddenly stops sleeping through the night. He starts waking up in the middle of his naps. His drool is so bad that he could fill a swimming pool. I assume that it's teething, except that no teeth are cutting through. Finally he starts vomiting a little bit, with a strong smell of stomach acid. I assume a stomach bug and try to wait it out for a few days, but he's waking up more and more often from sleep, so I take him in to check for an ear infection.

I'm lucky: in the middle of the doctor's visit, after the doctor had noticed the "excessive drool", Joshua threw up, right there. Not a lot, but enough that the doctor had an "aha" moment, and diagnosed him with reflux. I was shocked. He was happy, and he wasn't a spitter by any means. Projectile spit-up was something I had never, thankfully, had to deal with. However, within 48 hours of his first dose of Zantac he was sleeping again. It was miraculous.

And life went on.

A month or so later I was happily feeding him breakfast - apple raspberry baby food. As I went to get him dressed about 20 minutes later I was shocked to see dark red splotches all over him: hives. I was certain it was an allergic reaction, but to be certain we rushed over to urgent care. Since applesauce had been one of his first foods, we knew it had to be the raspberries.

So let's see: regular milk-based formula - no; raspberries - no. Okay.

Our next experience was an accidental exposure to egg whites (accidental since he was less than 12 months old and we knew he wasn't supposed to have them). At least, that's what we're still assuming it was. More hives. Then white chocolate. Hives.

Occasionally I tried going back to the regular milk-based formula. No go. He could handle cheese and yogurt, but not plain milk, apparently. I started wondering what on earth we were going to do when he hit 12 months old. With every baby it was this exciting moment: NO MORE FORMULA! Now I was terrified instead. What on earth was I going to give him? Was I going to have to give him formula until he grew out of whatever problem it was that the milk caused?

We decided to try and move him on to soy formula, to see if he could tolerate that, and then move him on to soy milk if it worked. It seemed all right, so soy milk it was.

Except that the soy milk, unlike the soy formula, didn't seem to agree with him, either. He started having liquidy stools almost immediately. Not diarrhea, but definitely not normal for a toddler, either. (Oh, the things a parent has to think about...)

Our family doctor, God love her, has never really known what to do with Joshua's milk issues. She didn't really know what the Gentlease formula was for (in her defense it's still new to the market in Canada), and she was suspicious of him possibly needing soy. This week I described the problems that we were having, and she wanted me to try whole milk. I was hesitant, but I agreed.

I haven't even been able to give him an entire bottle of whole milk yet and already I'm seeing problems. Back to the BAD gas, and his diapers are even worse. I'm honestly so frustrated right now that I don't know what to try next. I may try rice milk, as a friend suggested, but other than that I don't know what to try. Other than that all he drinks is extremely diluted apple juice. I'm so frustrated I feel like just giving him the gentle formula again for a few months, but the extra expense is such a pain.

I know that what I'm dealing with is so very minor compared to what many parents I know have gone through. As I said, I know that I'm very lucky. Still, after four kids you have a tendency to feel like you've seen it all. Other parents ask you for advice and you've almost always dealt with something similar. This is new territory for me.

I'll take any advice that my readers have to give! What kind of health issues surprised you as a parent?

Breastfeeding after Reduction Surgery

I remember it well, my consultation for breast reduction surgery. It was 11 years ago. I was 22 and in my last year of university. In the four years that I'd been at university my bra size had gone from a comfortable C-cup to a FFF (what I lovingly refer to as "Holy F--- that's big!") I was pretty miserable, although not as bad as some people I've heard about. I knew I wanted that surgery, though. The last bra I'd bought had cost $120. My back hurt and my shoulders slouched.

It was fairly quick, as we discussed how the surgery works, what a reasonable expectation was for post-surgery size and when the surgery could be done. Then there was about a thirty second discussion. "Is there any chance I'll be able to breastfeed?"

"Oh, about 50/50, I suppose," he said. "We don't remove the nipple anymore, so that helps."

"Okay," I said.

That was it. At the time I thought it was no big deal if I couldn't breastfeed, but I was sure that I would be one of the ones who could. Then almost exactly 2 years after my surger we had our first baby. During the pregnancy I talked about the surgery with my midwives and asked if I should be talking to a lactation consultant before the baby arrived so that I'd know how to handle things. No, I was told, just wait and see. Well all right, then.

Baby arrived, ended up as an unexpected c-section because she turned breech at the last minute. I was given a morphine pump afterwards for pain. I remember almost nothing of my baby's first 24 hours, until a nurse finally said to me "Are you ever going to try and feed that baby?" I don't think I even knew what day it was, truthfully. But she took baby in one hand, my boob in the other, and shoved them together, and there it was. Baby was breastfeeding. Except that didn't last long. The nurses started to freak out over my breast reduction. It was a small rural hospital. I don't know if that was the issue or not, but I don't think there was a lactation consultant on staff at all. They insisted that I needed to supplement with a tube at breast. This was less than 48 hours after birth. My milk, however much I was going to have, hadn't even come in yet and they decided that it was more important to supplement than it was to let me get the hang of latching on.

Trying to maneuver the tube while getting a baby to latch on, all while dealing with the pain of major surgery was just plain frustrating. The day came that we were to go home and the nurse tried to tell me I needed to stay another day so that they were confident I could feed her. I just wanted to go home by this point. I was hormonal and lonely and tired of being manhandled. I said "Just give me a bottle then." And that was it. When I got home and realized that my milk was coming in I immediately regretted my hasty decision, but at that point I couldn't get her to latch at all. I'd been so busy trying to keep that damned tube from falling off that I never really learned how to latch her on.

My husband heard about Dr. Jack Newman, who was then at Sick Kids with his famous breastfeeding clinic. He brought me the phone number and after working up my nerve I called. Dr. Newman called me back personally, as he's well-known for doing. He was very kind and tried to help, but I was so overwhelmed by everything I don't really even remember what he told me. I just couldn't deal with it. So our first was completely bottlefed.

And truthfully it was fine. She was happy, healthy and we loved every minute with her. Every once in a while I would get a rude comment from someone about why I wasn't breastfeeding. I know they meant well, because "breast is best", but despite my bravado about it, it cut deep.

By the time I was pregnant with my second I decided to look into the issue more. i found a book called Defining Your Own Success: Breastfeeding After Breast Reduction Surgery" by Diana West. I devoured it. I read about herbs, Domperidone, pumping to increase supply... all the things that no one told me about before. Plus, I learned that there was NO need to supplement immediately after birth since Baby is supposed to exist on minute amounts of collostrum until mom's milk comes in. No one (at least no one that I know) gives birth and has milk flooding out of their breasts a few minutes after birth.

So I went in to the hospital prepared for my VBAC, armed with my new knowledge (even with the book in my bag in case of any questions from the nurses). 24 hours later I'd had my second c-section (that's another story for another time). I'd asked to nurse her as soon as I was in the recovery room. She latched on beautifully (although the nurse had to do it for me) and everything was just find, until the anesthetic made me throw up and my husband had to take the baby while I hung my head over a basin.

I told them I didn't want to supplement immediately. Then she started losing weight, like all babies do after birth, and somehow this became an issue. I HAD to supplement. I was risking starving my baby if I didn't. She wasn't getting her tongue moving properly, and I needed to finger feed her until she figured it out. Then the lactation consultant (different hospital) came in and made me cry. It was horrible.

But I persevered. I ended up at the hospital's lactation clinic after we went home, eventually crying again, but this time with a much nicer LC. I had the Domperidone and I got Blessed Thistle and Fenugreek. I pumped as often as I could stand and my supply still just wasn't enough. She told me that there was no reason I had to stop breastfeeding. I could breastfeed, then give her a bottle. Just nursing because we both wanted to. So that's what we did. Except then we both ended up with thrush from antibiotics I had to take for an infection a few weeks later. But it lasted twelve weeks, and although it wasn't long, and I didn't exclusively breastfeed, it still felt like an accomplishment.

Baby #3 arrived. I was NOT going to be bullied again, and I wasn't. Apparently in the 13 months since Baby #2 the nurses had training on breastfeeding and they were told that there weren't to discourage a mom from breastfeeding, no matter what (or at least that's what the bitter nurse told me). So when it seemed like he wanted to nurse 24/7 and still wasn't happy, and I decided I needed to supplement, THEY were the ones trying to discourage me. We ended up "comfort nursing" again, but this time it went longer. Often when he was upset, nursing was the only thing that would calm him down. It lasted 14 weeks.

I wish I could say that things magically changed with Baby #4. Unfortunately with three other kids to look after I just didn't have the time or energy to commit to keeping my supply up properly. It only lasted 7 weeks.

It makes me sad that I was never able to do it, but at the same time I'm glad that I didn't completely give up, either. There are a lot of people who ARE able to do it, though, so the whole point of this post is that moms who have had breast surgery should NOT give up. Educate and make the decision for yourself! Decide what options will work for you and your family. I had a terrible experience with tube feeding, but so many people have great experience with Supplemental Nursing Systems like this.

A lot of people also are able to boost their milk supply with herbs such as Blessed Thistle and Fenugreek, or with a prescription for Domperidone (unfortunately not available in the US).

One of the best online resources for BFAR is at http://www.bfar.org/ It's where I originally found my book and information and I strongly recommend you check it out if BFAR is something you want to try.