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Sunday, September 11, 2016

Your friend has low supply?

As someone who has struggled with low supply for both of my babies, who had over forty appointments with lactation consultants throughout Switzerland and also in Australia, who used formula and donor milk through a Supplemental Nursing System for almost six months, who tried seemingly every milk-building remedy from every culture on earth, it's time I write this post.

I had some truly wonderful friends during this time, but I also lost friends during this time, which still breaks my heart.

I struggled a lot during my second pregnancy. Instead of a baby-shower, my Mum organised for friends and family from around the world sent me a bead for strength and love during the birth and postnatal period. This was about a quarter the length of the final string, and is probably my most valuable possession. So much love.
If you find yourself sitting next to your friend who is struggling with low supply, whether you consider it true low supply or merely 'perceived low supply', here's a few tips.

Disclaimer: I am a very sensitive person. During the first six months of each of my baby's lives, I was the most vulnerable and emotionally pained that I have ever been. All I can do is share my own personal experience.



WHAT TO AVOID SAYING

1. 'Do you really have low supply?' This is hard. There is a lot of information out there about how to ensure you truly do have low supply, and that your fussing baby, empty-feeling breasts and bottle-guzzler don't necessarily mean you aren't producing enough milk. But you are her friend, not her lactation consultant. Don't question her, don't expect her to explain to you in detail about all the ways she is (or feels she is) unable to provide for her baby. Don't get her to justify her pain to you.

2. 'Have you tried fennel tea?' or any number of remedies... lactation cookies, beer, more skin to skin, checking for tongue tie, staying in bed for a weekend with baby, meditation, domperidone, etc. Again, unless she specifically asks you for advice, don't offer it. Chances are you are the ten-thousandth person that has mentioned this to her, and you might just be the straw that breaks the camel's back and have a box of breastfeeding tea thrown in your face.

Literally thousands of dollars and francs spent on milk-boosting remedies
from all over the world. These lactation cookies, though, were the tastiest that I tried! :) 
3. 'You just have to stop trying so hard. Relax and your milk will come.' This, to me, is always the real doozy. Have you ever tried really really hard to relax? You know, every book and pamphlet I read before having my first baby said that if you really work at it, and there's no medical reason for being unable to breastfeed (insufficient glandular tissue, hormonal imbalance, retained placenta, etc), you can. Just keep trying. There are always new things to try, and you can trust that your body and your baby know what to do. So... when it isn't working... we should stop trying so hard? How can you stop thinking about it when your baby reminds you continuously that they are hungry? It is seems to be the people who've had problem-free breastfeeding journeys that love giving this advice.



4. 'It's because you are giving supplements. If you stopped supplementing, your supply would go up.' Ummm no. Yes, true, breastfeeding works as supply and demand, and every time you supplement you are signalling to your breasts that they don't need to make that milk... but hey, I'm keeping my baby alive. Your friend is choosing to feed her baby, which has to be the priority. This idea that every drop of supplemental milk you give is damaging you own milk supply and reducing your chances of being able to exclusively breastfeeding is something that was always at the forefront of my mind when feeding, and resulted in every feed being one that made me feel insufficient, and dramatically contributed to my depression. Truth does not trump sensitivity. You are not being a good friend by telling her this.

Us using a Supplemental Nursing System
5. 'Let me guess. You weren't breastfed as a child, so you were lacking in self-belief to begin with. That's where this has all stemmed from.' This. This totally undermines your friend's autonomy and intelligence. There is research into this area, which acknowledges that women whose family members struggled with breastfeeding were more likely to expect difficulties, therefore more likely to supplement too early and readily accept the potentially-premature end of their breastfeeding journey. But what about those who were adamant that they would breastfeed, who didn't know of their family-member's breastfeeding problems until after they had theirs, and who furiously tried everything to be able to establish this relationship with their baby? Saying this to these mothers is hurtful, dismissive and unnecessary, and also exceptionally rude to their own mothers.

6. 'You are so stressed... maybe it would be better if you just stopped.' She knows that this is an option. She knows. She wants your support. She wants to feel like you are there with her, not that you are judging her decisions, and think she is doing the wrong thing.

7. 'At least you don't have oversupply. That's a real nightmare.' Sigh. At least your body can keep your baby alive. (And yes, I acknowledge that oversupply has it's own problems, of course. But don't expect someone with low supply to sympathise with those at the time of her own struggles!)
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SO WHAT CAN YOU DO?

1. Hold her. When she has a moment without a baby or pump attached to her breasts, hug her (gently, if her nipples are going through a tough time!) and hold her hand as she talks to you.

2. Let her know that you've done a bit of research into this area, or have some experience (which I expect is true if you are reading this!), or know of some good lactation consultants (if this is true), and if she ever wants any advice or tips, you're happy to help.

3. Be practical -- Hold the baby while she finishes her tea, takes a shower or nap; bring lasagne and salad; take her dirty laundry and bring it back the next day clean and folded; do the washing up.

4. Tell her that she is an amazing mother. She is the best person in the entire world to be the mother to this little baby. Tell her how you can see her baby feels such comfort and love with their mother.



Lastly, I want to say an enormous thank you to my gorgeous friends who held my hand with me throughout my journeys and managed to keep their mouths shut and their arms and hearts open -- you know who you are. I love you.

Wednesday, August 31, 2016

Five Tips for Pumping

Andrea, my go-to exclusive pumper, has shared her top five tips for successful pumping! Check out my interview with her over here.
* * * 
Tip #1:
Get yourself a good hospital-grade double pump. I tried two brands and found Medela Symphony to be the best. (Check if your insurance covers a pump! Often it will!)

Tip #2:
Get a pumping bra... Yes I know they are not sexy but they hold the cups well against your skin, create a good suction and you can carry on with emails, calls and even being with your baby.

There it is -- the big Medela Symphony over there.
Tip #3:
I was told so many times to think of my baby when pumping... that didn't work for me. I found I couldn't pump properly. I distracted myself with a book or facebook or something so I wouldn't stress about how much milk I would be able to pump.

Tip #4:
Store your milk in small volumes to avoid waste. Babies don't follow rule-books on how much they should drink. My midwife suggested 80mls in each bag so that I wouldn't create too much waste when defrosting or warming the milk.

Tip #5:
Try not to over-pump....it hurts!!! The best way I found was less suction and more tempo....

(Edit: "This would be my Tip #6! I totally forgot about this one! To pump more, use hands-on pumping.)

My stash of donor milk
* * * 

Thanks Andrea! It's great to be able to share some tips from an experienced pumper. But because I'm me, I can't post pumping info without just a little extra important info! Nobody is surprised, I'm sure. Brevity has never been my strong suit. 

The most important thing to know about pumping is that your milk output 
in no way represents the amount of milk that you are producing. Some women can pump over 200ml in one sitting, others will sit there with incredibly full breasts and a thriving, exclusively breastfed baby, and not be able to get one single drop out of their breasts during a pumping session. If you have tried pumping and it isn't working, or you are getting very little, don't think that this means you have low supply!

I had such bad pumping experiences with my first, that I didn't touch a pump whatsoever until I went away for a night when my little one was 18 months! In the words of Jack Newman, “Do what you can. A mother exhausted from pumping is probably no further ahead with milk production. And yes, it is not necessary to express your milk if this is a burden and makes you want to stop altogether.”


So, to all the new mamas out there pumping away, take a read of Andrea's tips, take a deep breath, and give that little bubba of yours a kiss. <3 We are all amazing mamas, doing all that we can. 

Saturday, August 13, 2016

Interview with Andrea - Exclusive Pumping

Andrea is the mother of two beautiful girls and has added to the general craziness of life with two littlies by started her own sewing business, Spirited Child.

I asked Andrea to be an interviewee for Milk and Motherhood because I knew that her journey took a bit of a different turn than the 'usual' (upon reflection, though, is there a 'normal' breastfeeding journey?!). After struggling with a variety of problems, she became an exclusive pumper for her daughter and is now the woman I turn to when mothers ask me for advice and tips about pumping! She is an inspiration, and gave so much of herself to be able to give her beautiful little baby what she could. Here is Andrea, talking about her love/hate relationship with breastfeeding, and reminding me once again why I hold exclusive pumpers on the highest of pedestals in this world of baby-feeding. 

Andrea and Amelia
Tell me about your breastfeeding journey and how you found yourself exclusively pumping for your baby.

Breastfeeding…I have a love/hate relationship with it. Before I had my first, Amelia, I never knew how much I would love it. Actually, I didn’t think I would care – my attitude was very matter of fact about it. But I also hated breastfeeding because it didn’t fully work for us in a ‘normal’ way.

Amelia, my wonderfully spirited child, latched on immediately after birth and fed well. She gained weight and everything seemed great – it was painful, but it was working. I logged her feeds using an app and tried to keep a level head. At week three, I began to struggle and started to become neurotic over her feeds. She began to spit up a lot. Despite being reassured this was normal, to me it didn’t seem so; she would vomit after every feed and writhe in pain... saturating her clothes,her burp cloths and me. That did not feel normal. After a lot of discussions with my midwife and debates with our paediatrician, it was finally confirmed that Amelia had a severe case of reflux and colic. We had to medicate her due to the constant pain she experienced.

The first time I gave her a bottle of my milk

Friday, August 5, 2016

It is World Breastfeeding Week, and I have dreams

It is World Breastfeeding Week, and I still don't know how I feel about it...


As someone who has been on both sides of the breastfeeding 'debate' (and yes, there still is one!), as a mother who was scarred by her inability to breastfeed, and now as a mother who celebrates the joy that is breastfeeding and is even pursuing a career based around it, I remain unsure of how I feel about a week dedicated to breastfeeding awareness.

It is vital that those mothers who feed their babies through other means do not feel shame when this week is promoted. It is vital that they do not see it as another wound to their heart. To me, this week shouldn't only be about celebrating breastfeeding -- it needs to be about education. I'm not even necessarily talking about the education of mothers and mums-to-be here: I have heard too many stories -- hundreds, perhaps -- of women who desperately wanted to breastfeed, but who received ill-informed advice from medical professionals that resulted in the sabotage of their breastfeeding relationship. This week should be about raising awareness in society and within the social and medical systems around these women to allow them to achieve their goals and dreams, whatever they may be. I don't want to talk about the medical benefits of breastfeeding – it has never been about that to me. It is about my instincts; about that burning primal urge in me to be the body that nourishes my child, both inside and outside of my belly; about my dream of motherhood. People need to talk less about the milk and more about what women want.
Feeding my first with love
Feeding my second with love
 I want to live in a world where the word 'choice' isn't used to make mothers feel less guilty about a medical system that failed them.


I want to live in a world where nobody feels uncomfortable when they see a woman feeding her child, in whichever way is working for them.

 I want to live in a world where no mother feels uncomfortable feeding their child -- not feeling the need to cover herself and her baby, and not feeling that she wants to hand out pamphlets to everyone that watches her prepare formula, so that they truly can understand what she has been through. 

I want to live in a world where no mother feels shame with regard to how are feeding their babies, and sadly that is currently so far from the truth -- both with breastfeeding mothers and with non-breastfeeding mothers. All mamas need to feel proud of having gone through what they have in order to keep their babies fed and healthy.  
2012, with my first bubba.
2015, with my second bubba. Not an easy day.

Busting my gut and pushing myself to the brink in order to achieve a breastfeeding relationship with my baby is a choice of mine; it is personal, it is deeply emotional in ways that are impossible to articulate, and I thank every person who has supported me throughout, whether that be through actively offering hugs and high fives, or through choosing to omit criticism.

Next time you see a bottle feeding mama, know that there is a chance that she is just like I was -- that a system failed her, that she is sad and stressed beyond belief, that she is not being able to fulfill her dreams, that she feels judged for not being able to do what is deemed as 'best'. Send her love, send her support.

Next time you see a breastfeeding mama, know that there is a chance that she is just like me -- that she is filled with doubts and never knows if she is doing the right thing, that it is so very far from easy, that she has been through so much to even be able to bring that baby to her breast, and that she hopes that one day she won't regret how hard she has worked to get to this point. Send her love, send her support.

Monday, July 25, 2016

Hurricanes, War and Dystopia

One of the reasons that I cried early in the life of my first boy, when met with the reality of being unable to exclusively breastfeed him, was that I was unable to keep him alive with nothing but myself. I imagined that if he has been born a century ago, he would not survive. It was months before I acknowledged this thought and voiced it to my husband, who immediately reminded me that there were wet-nurses for such a situation, and of course he wouldn't have died.

That made me feel a lot better, until I realised that we were considering only a world where there exists such resources, where women would be available and willing to provide such support; a world free of extreme crises. If we suddenly were to find ourselves thrown into a wartime situation, running for our lives, I would not have enough milk to be able to sustain my baby. Yes, these are the things I thought about. And these are still the things I think about! Perhaps this is my bizarre way of feeling gratitude for the situation that we are in, for the resources that are so freely available to us to ensure the health of our children and ourselves.


Us, comfortable, warm, safe.
A friend recently asked if anybody else is feeling the need to start honing skills and hoarding supplies in preparation for the world to become "a bad (but very real and less glitzy) version of Mad Max". I was reminded of a novel I read in preparation for the Zurich Writer's Workshop a few years ago, where a Polish woman was breastfeeding her nine-year-old son while living in the forest during the Second World War. Having a milk supply is handy.  

I am then, though, curious about the effects of stress on milk supply (but there's a whole other post there...). There exists many stories among mothers where stress has 'dried up' their milk, or at least significantly reduced their supply, like Sharon's weaning story after the loss of her sister-in-law,  or my own mother's description of her milk drying up when I was a few weeks old, after my dad's stepfather died.  And there does exist a real study (!) that demonstrate that "various types of stressful stimuli can depress lactation". Surely being thrown into a life-or-death wartime situation is as stressful as it can get, right?

When I was in Berlin for a breastfeeding study day recently, there was the mention of Hurricane Katrina and some of the horrific stories that emerged. There was a discussion of the importance of breastfeeding for survival in emergency situations, and how the risks to a not-exclusively-breastfed baby in such situations is incredibly high -- lack of a reliably constant source of formula, lack of a reliably constant source of clean water, and lack of guaranteed sterility of bottles and teats. Breastfeeding in emergency situations ensures a baby's nutritional security, so long as the mother has enough food and water to ensure her own survival. I mentioned that I had heard that formula samples were being handed out to Syrian refugee mothers. As such, a flurry of lactation support headed to landing sites to assist mothers by providing education, support, ensuring good nutrition and hydration, and a safe place for them to breastfeed, and potentially even the education and support necessary to allow relactation.

Image from here
'The culture of bottle feeding in Syria and Jordan was perpetuated through the untargeted distribution of breastmilk substitutes (BMS) in the early days of the response and the concept that poor diet among lactating women negatively impacted on their ability to breastfeed. Especially during the first phase of the influx of refugees into Jordan (end of 2012 and through the first half of 2013), many non-governmental organisations (NGOs), community-based organisations and well-meaning donors from Gulf countries distributed huge amounts of BMS to refugees in camps and host communities. BMS products were not distributed according to assessed needs, for example to mothers who were unable to breastfeed. BMS were usually included as a general item in food baskets distributed to refugee families. Those distributions were in general ‘once-off’ distributions with no provision for sustained supply to infants established on these products.' (Reference)

Am I the only person that thinks of these things? 

(Edit: I found an interesting post here, on the page The Fearless Formula Feeder, about feeding in emergency situations. It's an interesting read, and worth mentioning.)

Sunday, July 17, 2016

Interview with Sharon

Meet Sharon. Sharon wears an invisible cape every single day that signifies her strength in this world of babies and motherhood. She has been through the ringer. We are incredibly lucky that Sharon is also an 'oversharer' (the best people are, right? ;) and revealed the often gut-wrenching pain of five years of unexplained infertility and resultant invasive fertility treatments on her blog.

She and her husband now have two beautiful girls, Lillian and Matilda. Among all the joy and tumult that new babies bring, they have also had to navigate their way through Matilda's diagnosis of CysticFibrosis, and the incredibly tragic loss of a very close family member.


Read about Sharon's breastfeeding journey here, and how she “didn't realize it would also be kind of a delight!”:






Tell me about your breastfeeding experience

My twin girls were born a day before 37 weeks and were just over 4 pounds each, so we supplemented breast milk with formula from day one to ensure they didn't lose the ounces that newborn babies often lose. We were in a hospital that really understood and encouraged breastfeeding and they had me feed them formula via a Supplemental Nursing System and had me pumping immediately to get my milk flowing. My girls took to the breast right away, even though they were so tiny, and before we left the hospital I was comfortable tandem feeding them. They never were exclusively breast fed and we went through phases where they got more milk and phases where they got more formula, but I loved our breastfeeding relationship. We breastfed until they were 8 months old, moving slowly from exclusively tandem feeding to exclusively individual feeding by the end (as their size and development changed).


Wednesday, July 13, 2016

Look at this photo! What are we missing?

This is a photo of my friend Vanessa's great-grandmother, publicly breastfeeding her son,Vanessa's grandfather, ninety years ago. How amazing is it that she is in possession of such a photo?! What a snippet of social history right there!
When I looked at this photo, there were a few things that jumped out at me immediately, so I decided to take a look at a few historical images of breastfeeding.

Look what I found: