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
The reflux worsened as she grew and began to feed more, and it started to affect our breastfeeding. She couldn’t be fed in a cradle position or lying down as she would vomit her entire feed. I had to adopt the kangaroo position (where the baby is feeding vertically) and feed her in my baby carrier! Her sleep was sporadic with the pain from the acid allowing for 30 minutes of sleep at a time. She was exhausted. We were exhausted. Her latch began to suffer, as she associated my breasts with the pain of the reflux – I would bring her to my breast and she would scream and turn away. Public feeding was impossible and it felt we were in a bad place. Through desperate attempts to get some relief whatsoever, my midwife suggested my partner feed her with some of my pumped milk. With that, she seemed relaxed and as a result vomited less. Gulp. I felt relieved but also a bit sad.
The first time she was given a bottle by Papi
I pumped again and agreed to another bottle-feed. Pumping revealed that I also had a fast let down and oversupply (in one sitting I was able to pump 400ml or more), which would have exacerbated Amelia’s reflux. . Somehow we got into a routine of my husband bottle-feeding her every night. Perhaps due to my desperate attempts to avoid the breastfeeding battle, I kept pumping the ‘missed’ feeds. Unfortunately, the more bottles she received, the more she favoured this relaxed and constant flow of milk, and she refused me more in the day. I refused to stop breastfeeding, though, as I had so much milk. Maybe this was a bit selfish – I wanted her to still have my milk. From five months old I was exclusively day feeding her with my pumped milk.

Every feeding routine consisted of bottle prep and pump prep, whilst simultaneously feeding. It turns out I was a good pumper! A good pump (hospital grade), a good pumping bra, a Bjorn bouncer chair (mainly used to prevent spit up) and lots of patience got me through it. I pumped as I fed her. Not the usual breastfeeding route, but in my mind I was still breastfeeding her. Even in the middle of the night, I pumped. I took that pump everywhere! I had my routine – five times a day – and I stuck to it. I was pumping 1500ml a day and this was my drive, as she was getting one hundred percent my milk only. As she got older I was able to miss a pumping session here and there and occasionally we had special moments when she would sleepily latch on at night. I know some people thought I was crazy, and maybe I was a little, but I was determined for her to get my milk. By ten months, I was pumping three times a day, and I was also three months pregnant, so I decided it was time to stop. I had enough milk reserves to last until she was one. I was happy with that.

Daily life -- a bottle of breastmilk, the pump on the couch ready to go.
Did you go into motherhood with a firm idea of how you wanted to feed your baby? Where do you think these ideas came from?

I had zero pre-conceived ideas. I just knew scientifically it was better. Perhaps this is why I kept the pumping routine. I knew that my milk was full of only good things. Having an oversupply of milk in this situation was maybe a good thing. Having so much milk helped me deal with the loss of the 'normal' breastfeeding journey. I wasn’t able to hold Amelia close to me due to the reflux and feed her in normal positions. My lack of pre-conceived ideas for feeding came from my lack of education. Perhaps I could have done more myself. I have no memory of anyone asking me how I planned to feed my baby or what my views were on breastfeeding. I knew mother’s milk was better but I only knew about the practical advantages. My sister had a baby five months before me and I saw her struggle with zero help, in the UK. I accepted this as normal and expected the same.

Did your experiences follow your expectations?

I had a very matter of fact expectation of breastfeeding. I thought that if it didn’t work then so be it. Move on and don’t let it get to you. This was the complete opposite to the reality. I was neurotic and almost competitive with myself. I logged every feed and pumping session.

What is the biggest challenge that you have had to attempt to overcome?

Feeling very alone and helpless in a foreign country without a lot of support with breastfeeding. To a certain degree, reflux in babies is normal – but Amelia’s was extreme to the point of needing medication. I had to fight to get the doctors to take it seriously. Their response was always the same: Give formula specially designed for reflux babies. When I would tell them about my pumping/feeding routines, they would tell me I was crazy and it was unnecessary.

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How did you feel when bottle-feeding your baby in public?

Honestly, I felt sad and triumphant at the same time. Sad that I wasn’t breastfeeding her but triumphant that the feed in the bottles were from me. Sometimes I felt that I needed to keep explaining to people as to why I was feeding her a bottle of my own milk. My friends knew and often joked about the ‘liquid gold’. Also, it was a logistical hassle if I was not at home. I would have to plan my outings around pumping times and feeding times. Often the last thing I would do before leaving the house was have a good twenty-minute pump! Then I could get out for a few hours. Day trips were not practical until she was much older.

And when watching other women breastfeed? I felt such warmth and frustrations simultaneously. When Amelia was still breastfeeding at night, I could relate to those special moments. I felt a little frustrated that we couldn’t have those quiet breastfeeding moments elsewhere.

Our last ‘normal’ breast feeding moment.
I always took a photo as I knew it would end…circa 5 months old

* * *

Andrea, thank you so much for your incredibly honest retelling of the breastfeeding journey you went through with Amelia. I know that there are so many women who are also pumping for their little ones who will gain so much from your story. Wanting your little baby to have your milk is, to me, the furthest thing in the world from 'selfish' -- particularly as an exclusive pumper! I take my hat off to you and your absolutely selfless pursuit to give your baby your all. 

Stay tuned for a future post, where Andrea will share her top five tips for pumping mama! 

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:

Saturday, July 9, 2016

Supplementation – It's all about the HOW

So. Your baby needs some extra milk (Not sure if this is the case? Check here.). I know that sometimes this realisation is hard, sometimes very very hard. First things first: know that you are an amazing mama! You are now taking steps to ensure that your baby grows and is healthy, and have made that your priority. You are doing the absolute best thing for your baby.
Now let's presume that you still hope to breastfeed, and just need to give a top-ups. There's not many catch-phrases that I use when discussing the feeding of a baby; I'm certainly not one to throw out a 'breast-is-best' anywhere whatsoever. But there is one that I do use, and I think it's one of the most important ones. It has to do with supplementing.

It's not the what, it's the how.

Friday, June 24, 2016

Interview with Danica

This is Danica.

Danica, a member of my breastfeeding support group, found a lump in her breast when her little boy, Ellington, was only eleven weeks old, and was diagnosed with breast cancer three weeks later. Get your tissues ready and read about this incredible woman's strength and determination, and embrace her positivity, despite being thrown one of the greatest curve balls.

Can you tell me a bit about your breastfeeding experience? I knew that breastfeeding would be challenging for myself because when I was in my early 20’s my OBGYN told me that breastfeeding would be challenging because I have one inverted nipple. At the time, I laughed and didn't think much about it. When I got pregnant, I immediately remembered what my OBGYN told me many years ago and unfortunately I was scared and nervous about my ability to breastfeed. As a first time mom, I had done my reading and I was looking forward to this beautiful, natural crawl that all babies “know” to do when placed on their mother’s stomach. Ellington and I did not have that beautiful, natural crawl. He wasn’t interested in eating. I wasn't producing a lot of milk. A lactation consultant visited me and recommended that I pump every two hours, 20 minutes on each side and to eat dates to help my milk come in. Ellington was fed my breastmilk with a small drinking cup or spoon for the first day or so. I used nipple shields for the first month of breastfeeding and had to continue to use a nipple shield on my inverted nipple for another month. At this point, I thought I was in the clear and I would meet my breastfeeding goals. I wanted to breastfeed Ellington for the first six months of his life and up to one year. When Ellington was about 2.5 months old, I discovered a small knot, what I thought was a clogged milk duct. I went online and searched for ways to unclog a milk duct. Trust me when I tell you that I tried all of them and had no success at unclogging the milk duct. I scheduled an appointment with my doctor. My doctor referred me to another doctor for an ultrasound of the knot. The doctor informed me that the knot looked mostly ok, but there was an area which concerned him. He wanted to do a biopsy of the knot and informed me that I would receive the results in a few days. On Friday afternoon, my doctor called me and told me she need to schedule an appointment with me and my husband first thing on Monday morning. I knew it was not good and asked for her to share what information she knew. She informed me that I had breast cancer and she would meet with me on Monday to discuss next steps. I did research over the weekend regarding mothers who continued to pump and dump through chemotherapy and radiation and was hoping that would be something I could do. My doctor informed me that pumping and dumping wasn't an option because my surgery and treatment would basically take up the next year of my life. I was and still am more upset that I had to stop breastfeeding my son, than I am about having cancer. Within one week, I had to stop breastfeeding my son and prepare myself for surgery and my upcoming treatment plan.
The last time Danica breastfed Ellington