Giving a Bottle in Hospital

The last week has been rough. Both of my boys and I are all very sick, my littlest boy the sickest, and we have been to the children's hospital both last night and tonight to monitor his oxygen saturation and his breathing, after things became a little dodgy. I just returned home and need to do some writing to calm myself a little before I take my own sick self to bed for hopefully more than 45 minutes of sleep.
This is me. Tired. Sick. Worried. Coping. 
With regards to breastfeeding, this has been a whirlwind week too. Many things to write about, but this is what happened just now.

At the hospital this evening, he had lost some weight. They asked how often he is feeding, how long for, what is his usual, how much does he normally take, how much supplement how many times a day, etc etc etc. I was surprised at how much I couldn't answer accurately, due to my goal of not being obsessed about numbers and timings this time around, which was probably incredibly unhelpful... 

Then the lovely nurse suggested that she bring in a pump for me and that I try to give him a bottle, as he is really struggling to feed effectively right now.

My beautiful boy! Lucky we grow them
so chubby when they are so little!
Now. This exact situation shows me how far I have come. I didn't stress about it. Ok, I said, let's try it. I just figured that my bubba is sick and needs the least amount of stress possible to get healthy again. I showed her my SNS, which she hadn't seen before (!), and she was happy to do whatever I liked, but I decided to try the bottle. Of course, if giving him a bottle will make him drink more this one time, and might allow him to get over the hump, then let's try it. I don't know if that is actually the case, but we needed to try something different. And I would try the pump. Eek. She originally suggested it as a way to ease the pressure in my boobs. As if.
There it is. The Pump.
I held him in a similar way that I would if breastfeeding, and she gently put the bottle teat in his mouth. He was not interested. No way in hell was his mouth ever going to close around that thing. It was squirting milk into his mouth and that made him gag and cough. The nurse went next door to get a smaller size teat and when she came back he was on my boob like a champ, drinking better than he has in days. WOOT! So she said there was no need, he was doing great.

AND my other side was leaking! 

So. How do I feel about all this. I am overjoyed that he prefers my breast to a bottle, and that he managed to have a good feed. That shows me that I am doing things that make him want to be there, which makes me feel all warm inside. The moment we tried a bottle with my older boy, after so much struggle, he jumped at the chance. I'm also glad I didn't need to get within a metre of that hospital-grade pump on wheels, though I am getting curious about what it would produce.

Meanwhile, my littlest boy is still in struggle town, but I am keeping a close mama eye on him and he is going to be a-ok.
Checking Oxygen levels while we snuggle.
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Out of the house with breast milk - How we did it.

I have been so amped to write about how I completely managed a full day out of the house yesterday with only the expressed breast milk, and all the decisions I made regarding safe transport, keeping it cooled, warming it, not wasting a drop, etc. It was so complicated to figure it out, and then it all just happened!


Feeding on the tram! Is it crazy that I
always dreamt of being able to do that? :)
Here is how I did it:
Formula, SNS bottle, Thermos,
container with a bottle of breast milk.
I brought my typical Thermos and formula as back up in case I either chickened out or something went wrong with the expressed breast milk. I then brought the empty SNS bottle and the full bottle of defrosted but refrigerated breast milk. I put the bottle of breast milk in a ziploc bag with some ice cubes (my gel ice pack was oh so conveniently stored in the drawer under the oven instead of the freezer...). I then put that in another ziploc bag as leakage backup, and the whole thing inside a Tupperware container. The plan was that he would get hungry, I'd pour some of the cold milk into the SNS bottle, pour some hot water from the Thermos into the Tupperware container and warm it in there, while keeping the rest cold until next time.

The cold milk inside two bags with ice
What I actually did was get some cold milk into the SNS and then sit on the SNS bottle. Truly. Like a mama hen, I slowly warmed that milk. By the time he actually wanted it, it was lovely body temperature. Ingenious, right?! Not exactly speedy, but I was in anticipation-mode all day, so it worked perfectly. No need for anything fancy, haha! 
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The Steep Learning Curve of using EBM

So now I have this huge freezer stash of breast milk. Woot!

Now. The logistics. There seems to be a steep learning curve when it comes to using expressed breast milk (EBM) as opposed to formula. I am a total whizz when it comes to efficient preparation of formula, but I have no idea how to efficiently prepare a bottle of expressed breastmilk from frozen. And what about when I am out of the house? I can't very well carry around milk at 2 degrees and feed it to my boy, but I can't exactly warm it on the go when I'm at a playground, right? And I can't carry it around all day... so should I just bring formula and keep doing that when I'm out? (I figured this out! Check out how I did it here.)

A photo of my gorgeous boy, just because he's gorgeous
Turns out that you have to leave the breastmilk in the fridge overnight to defrost slowly, not run it under very hot water so it defrosts quickly and is ready to use. Hence... I have already stuffed it up and had to tip one whole bag down the drain. (edit: This was totally unnecessary :( I have also since learnt that unless breastmilk smells distinctly off, it is fine! Soapy and metallic are signs of high lipase, though, and different to smelling 'off'.) Goodness I can't tell you how terrible I felt. I remember when my husband once was warming around the 10ml of milk I had pumped for my first boy, and the bottle tipped over and spilt into the warm water around it. Almost grounds for divorce. And I just tipped 150ml down the drain. Sigh. I'm so sorry, my wonderful milk lady.

But now I have done it for a full day. I have put another woman's milk into my little boy, and it is there inside him being digested. I was pretty darned nervous about it the first time, actually...
This is it! First feed with the other breast milk! 
I'm having to pay more attention to feeds now. I didn't used to care so much if I made too much formula and tipped a bit out, but I don't want to tip out a single drop of this golden substance, especially after the debacle with the first bag. So I am learning that although he makes it through the night with no supplement, he always needs around 40ml about an hour after he wakes up in the morning. I'm also learning that he needs me to be very quiet during feedings right now in order to feed properly, and I am very lucky that my toddler thinks that whispering is an hilarious trick. Haha.

Things I have learnt in just one day:

1. It takes longer than overnight for breastmilk to defrost in the fridge. Hence my boy's first feed with the expressed breast milk wasn't until around 4pm on the day after I collected it, despite leaving it overnight in the fridge! Since then, I've learnt a trick that was originally written about with regard to defrosting turkeys (ha!): Put the bag of frozen milk into a container of cold water, and then put it in the fridge overnight. The difference is remarkable! Fully defrosted by morning!

2. Don't shake breast milk vigourously. I did this once out of habit, to about 40ml of milk, though I still fed it to my boy. I figure it can't be THAT bad.

Defrosted, with a lot of fat at the top.
3. Breastmilk can hang around at room temperature for around 4-6 hours. That means that I can be more prepared that I could with formula, which is only good for an hour, and which you need to make up immediately before feeding. So now, when I have time between feeds, I can gently swirl the big bottle of milk in the fridge so that all the goodies evenly disperse and then pour some into the SNS bottle, and stand that in a bowl of warm (not hot! I'm learning!) water to gently come to temperature.

4. Breastmilk looks so cool! It has so much fat in it! Or hers does, anyway. No wonder breastfeeding mamas are so hungry!

5. Breastmilk is sticky. When the SNS tube occasionally comes loose from its valve and a few drops spill out onto my belly, it dries very sticky.

6. I'm not quite as cool with getting another mamas breastmilk on my body as I am with being covered in formula, which is weird, considering.

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A freezer full of somebody else's milk

I woke up today to find this message on my phone from my beautiful midwife:

Good morning dear Jo. It might be x-mas and easter all together for you today! I have a mamma with a baby -- same age as (my little boy) -- who has pumped and frozen litres of milk for a family. Now the family doesn't take the milk. I can say with all my heart - it is the very best quality!!! Interested? She would probably also continue if the flow is right! :) 

So... after a lot of talking and organising and checking, this is now my freezer:


After my last post about potentially asking my friend for her excess milk, I did an enormous amount of research and spoke to many many people about the pros and cons of using another woman's breastmilk, particularly in an informal fashion, and not from an organised milk bank. It lacks the diligent screening that occurs with such milk sharing, lacks the pasteurisation and the guarantees.

Opinion seems very divided, and people are very passionate about their views either pro or con. Those who work in the medical field berated the consideration of such a thing, as it is a bodily fluid and should be (and often is) treated in the same way as blood. Others were so passionately for the sharing of breast milk, as it is the best nutrition for my child, it is mothers helping mothers, it is community, it is a 'why not' situation. And a lot of people had opinions that they couldn't properly articulate, where it would just 'feel strange' or makes them 'uncomfortable'.

I had to figure out where I stood. As usual, I was pretty divided. I have always been very interested in mainstream medicine, very much having wanted to study medicine and become a doctor myself for a long long time. I also, though, consider myself reasonably alternative and humanistic, wanting to believe in and trust people, and yet often struggling to let go of full control. So I researched. I researched everything. Every possible medical risk -- I made sure I knew about it. Everything that I could do to decrease this risk -- I made sure I knew about it. Home pasteurisation? I knew about it, knew the process, the pros and cons, and was equipped to make the right decision for me.

Requisite feeding photo:
I forgot my necklace for this little grabber to cling to!
It turns out that this lovely woman was pumping 150ml from one breast, once a day in the morning while she fed her boy from the other side. She was pumping with the expectation that her milk would go to somebody that I know second-hand -- a reasonably renowned person in the medical community, and that made me trust it all the more. All her tests had been done, she was the perfect person for the job, and she was very excited about being able, so easily, to help another mother in need.

It was all organised, and then three months later, her freezer was full and still nobody was collecting it. It turns out that the husband did not agree with the situation and felt very uncomfortable with their child growing up on another mother's milk. As my big boy says, 'What a bummer!' And so, my midwife contacted me. She knows the story of my first breastfeeding journey and she has been through it all with us. She understands my wants as much as anyone. I received the message this morning, spent all day speaking to both my midwife and my lovely milk mama, and then -- after collecting a few cooler bags from my friend down the road (what kind of Aussie doesn't own an esky?!) --  I went to collect it.

What do you bring for the woman who is about to give you masses of her milk, that she so lovingly pumped for somebody else's little baby? I had no time, so I brought a huge bunch of tulips, a beautiful potted plant (in case she isn't into cut flowers -- her man is a gardener, after all) and the biggest fanciest box of chocolates I could find. When I was there, I found out how much a box of the freezer bags cost (so expensive! Crazy!) and gave her the money for the bags, which I'm happy that she took. Giving me her milk should not be costing her money, after all.

We had tea -- breastfeeding tea -- I spoke only in my interesting German the whole time, and it was just lovely! I feel so warm and fuzzy about it all. The only reservations she had were that she was very worried that the curry she eats may cause my boy some problems, but I assured her we are a curry house too, and goodness this little boy seems to have a wonderful digestive system! Ha. And now we have plans to take our little babies for a coffee and wool-clothing shopping trip.

So two milestones for me today. I have a freezer full of breastmilk and I made a new friend by speaking in only German.

Phew. A big day for this mama.

(Read about my milk-sharing experience here also at Breastfeeding Today, La Leche League's online magazine.)
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How feeding looks at three months

So we have reached three months! And one day. I have been breastfeeding for over three months! Those first three months were the months that scared me shitless, and we have made it through. I even managed to suck up those little froggy feet moments and the times when he would curl up onto me in a ball, exactly the way he was in my tummy but with his head up. I enjoyed my new little boy's first months of life, which is pretty huge considering how absolutely petrified I was about it while I was still pregnant.
Three months of those squishy cheeks that just get squishier!


Being able to feed a three month old baby is something entirely new to me. I have changed! I remember being so scared of using the SNS in public, and now if I see a pregnant woman, I wish I could give her a pamphlet and ensure that she knows this is an option! I don't purposefully hide it anymore, though it is often hidden out of habit. So I'm feeding in public with pride, not fear, hoping that somebody sees and questions either myself, the internet or their midwife / lactation consultant about this. Maybe I will change just one woman's life. 
Feeding at a cafe with the SNS (though no-one would know it)
and my new beads for him to cling on to/
We are having some issues that I now know are typical three month old feeding issues (thanks to my wonderful Zurich mothers facebook group for educating me on the normalcy of this!). He latched on, takes a few sucks, and immediately pulls away. Again and again and again, for the entire duration of the feed. If I had heard someone say this earlier, I would have assumed they had an overactive letdown, where milk was shooting out too fast and their bubba was pulling away from it, but that's definitely not the case with me. He is rarely distressed when he is pulling off, and often he just looks up at me and smiles, then goes back on again. It seems like he has gained an awareness of everything around him, though it doesn't even seem that distractability is to blame, as he isn't scanning the room at the time, or showing obvious signs of this.

Normally this would not be an issue at all, but I need to reposition the SNS tube correctly every time he latches on again. Both hands, therefore, are absolutely occupied full time, so I am unable to build Lego aeroplanes while I sit on the couch, unable to turn pages of a book, unable to stroke my big boy's hair, etc. So things are getting tough.

Here is how our feeds are going at the moment. Not every time, but a lot.
  • Little boy cries with hunger. His cries are usually very quiet and squeaky, unless he has just awoken from a huge sleep.
  • Big boy cries because little boy is crying, little boy cries harder because of the noise.
  • I say, "Don't worry, he is just crying to tell us something, remember?" and while getting the SNS bottle ready to go, with two screaming kids in the background, I calmly go through all the potential reasons that the baby is crying. "Why do you think he is crying? What is he trying to tell us?" Cue older child burying his head into a pillow and sobbing. "Maybe he is tired? Or hungry? or needs a new nappy? What do you think?"
  • SNS bottle is ready -- those ten seconds felt like ten minutes -- along with my big boy's dummy and his back-up bottle in case he decides he needs those during that feed and I don't have the energy to argue. I make sure those are hidden, though, as I don't want to give them to him unless he desperately wants them.
  • I sit with my little baby on the couch and latch him on. Hopefully he will feed for ten seconds straight without pulling off, enough for my older boy to calm down. I have started to latch him on with the SNS tube right from the start now, trying to reduce the probabilitythat he will pull away crying again, which sets my big boy off again. 
  • Little bubba latches on and off every 5-10 seconds, aggravating the new big milk blister I have.
  • Big boy is calm but wants me. I get him to pick a book and 'Skooch in' next to us so we can read it together. He almost whacks his brother on the head as he opens the first page. He wants me to turn the pages, and normally I can but with all this relatching lately I have no free hands, so he gets upset again that he has to do it himself. 
  • Little baby is pulling at the tubes, pulling them out of his mouth, and milk is running down my shirt and all over his face. I try to get his fingers to cling onto the new breastfeeding necklace I have instead, which gives him something to play with, and try to ensure that the tubes don't get tangled up in it. I put my hand repeatedly in the way of his hand and we battle each other for each relatch, though sometimes we just end up holding hands. Relatching is sometimes working, but sometimes the tube is under his tongue or not in far enough or in too far, and he ends up not being able to suck any milk out of the tube and gets grumpy again, which gets my big bubba grumpy again too.
  • I suck in those little moments where little bubba looks at me and smiles so perfectly. 
  • When pull-offs are happening every two seconds, I swap sides, but always warn my big boy. "You know that he always cries when we turn over. He is still hungry and he thinks that all the food is gone! But there is more coming." 
  • Switch sides. Sometimes big boy cries when little baby cries, but mostly he is now calm enough to say, "It's okay, darling, there is more coming", which is just a little bit of magic. More hand battling, tube pulling, milk not flowing, etc. 
  • Little baby shows he is finished by either getting annoyed at me relatching him, or falling asleep. Then it is burp, clean up spit-up, and play.
Phew!

So yes, things would be easier if I bottle fed. But hey, despite all that, I still love it.

Blurry shot for obvious reasons... It's a team affair in this house!



 
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Finding the Joy

I read a great article recently on finding the joy in motherhood. She suggests at the conclusion of the post to spend one or two minutes at the end of each day writing in a journal, starting with 'Happiness is...' to focus on the positives in what can be a seriously stressful time. I really need to start doing this. Today. 


I am feeling like a resident of Struggle Town again, feeling like I am not giving enough, that I don't have enough to give, that I am not being a good mother and wife and friend and daughter and sister and and and...

Does this relate to breastfeeding? I don't think so, specifically... Though feeding is a bit rough at the moment (I'll do a post about that a bit later) and perhaps it exacerbates it, I don't know. I think it just relates to having an almost three-month old and a 2.5 and a bit year old. It relates to having a family in a foreign country a whole world away from where I grew up, where I am still learning the language, where I will always be, to some degree, an outsider, and where every sign of integration is something I cherish. It relates to always being tired and always being in some degree of pain (pelvic, hip, sciatica, neck, ankle and shoulder are my current aggravators) which makes me grumpy and not the loveliest person to live with. It relates to not being able to work on my novel properly for over two years. It relates to having a toddler who is the most highly sensitive kid that I have ever come across, which is of course so beautiful but also so emotionally exhausting at times, and makes me sad that I can't do some of the things that I always dreamt of doing with my child – making snowmen and snow angels, going to a christmas market, singing carols, enjoying the beach, joining him on a carousel, etc.

So. Things that happened today. Happiness is:
  • Watching my eldest boy overcome his fear of the big slide and then go down with his friend over twenty times -- on his bottom, his tummy and even head first.
  • Watching my littlest bubba in the arms of one of my best friends, so happily watching the goings on in the world, and her remarking on how lovely he is.
  • Making muffins with my big boy and smiling at the fact that he is still too scared to crack the egg with me, but instead gives me very specific directions about how it has to be done.
  • Admiring the beauty that is a two year old's body as he races around the house in only his train undies, and knowing that we made that.
  • Feeling the overwhelming love as my two boys lie next to each other, smiling at each other.
  • Having two kids in bed early enough to have an actual full conversation with my husband.
I realise this is just a me post, and not a breastfeeding post. But having a three month old baby and dealing with feeding issues and the resultant life issues kind of go hand in hand it seems.
Edit! Forgot to add my requisite BF photo! Here it is.

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12.5 weeks and going strong

There is so much going on in my boob-brain right now (it's located just left of the overthinking cortex, in case you were wondering). I have wanted to write a post a day but just don't have the time.

A few snippets of my crazy brain:

- My stunner is now twelve and a half weeks old. My first boy was eleven and a half weeks when we stopped our arduous journey and he began to be solely fed from a bottle. We have now made it further along, and with only a slight fraction of the heartache, which continues to amaze me. He has yet to ever have a bottle, which I am secretly very proud of (hmm not so secret any more). I still feel like I keep having to convince people -- even the people that are really close to me -- that this is what I want to do. It isn't an obligation, it is what I like! Feeding him a bottle isn't going to magically reduce my stress levels (I'm a stressy person, y'know? Yes, you know), in fact I think it'd increase them. I love feeding my boy the way that we do. So I wish that I didn't have to keep saying that and keep defending it... I'm not 'amazing' for sticking with this, it is just that it is working, so I'm not going to change what is not broken and what gives us both such satisfaction. 

This is how we roll.
- I try to be 'natural'. I tried incredibly hard to have natural births, using hypnobirthing methods and ensuring I was in an environment where I felt safe and empowered, and I did this so well both times (I still have to write my second birth story! It is a doozy!). I always try to avoid medications for myself and my children if I could try something else first, though medications obviously have their place (vaccinations, for example, ibuprofen for severe teething pain, etc). I am trying to feed my child the most natural way possible while his system is at its most vulnerable. And yet, I am drugging myself quite significantly with Domperidone in order to do this. Isn't it a bit of an oxymoron to try to lead a natural life, to want to feed my child 'naturally' and then have to take drugs to do it? I don't have any answer to this, it's just something that is floating around in my brain.

Ah those cuddles, where he throws a leg over me too :)
- The stupid SNS bottle keeps breaking. These people need to sort this out! A broken bottle means that I potentially can't breastfeed, which just is not cool. The part where the tube connects keeps breaking off, meaning that right now I need to stuff my shirt with paper towels to collect the drips that are coming out of the half-broken side, while he feeds on the other. I've considered just breaking it off and stuffing the hole with blu-tac or something similar (though I can't think of any other thing), but not sure I want little blu-tac remnants to enter milk, and not sure how to clean it effectively if that is the case. At least Medela have apologised and two new bottles (which are stupidly expensive) are coming in the mail either today or tomorrow. This is the third time this has happened. But we are still choofing along great with make-shift fixes.

Here is where it keeps breaking. GRR!
Ah there is more more more -- about taking my friend's milk, about pumping, about periods, about body image, about infertility...  but that's enough for today.
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Nappies

I was going to call this post 'Poo', but decided against it. There will be a small mention of wee too. Haha. However, if poo talk isn't really up your alley, perhaps it is best to read elsewhere for the next few minutes. Oh, and I won't include photos, ha.

(Oh! A quick aside. I did share that last post with my friend who has an abundance of milk, and she is happy to share, and we are talking talking talking. I haven't totally made up my mind yet if it is the right decision for us, now that a lot of research and a lot of skeptical opinions are zooming around and around in my mind. And she doesn't exactly live down the road, so safe transportation is an issue I need to iron out. But we are talking, and deciding together. Yay!)

Back to poo.

Loving those wrist rolls! 
The internet it a wonderful thing. Anyone who has ever been a little dubious about the contents of their baby's nappy and done an internet search (oh how embarrassing my search history of the past three years must be) will have found an awesome slideshow from Babycenter -- my go-to quick info site -- that has real photos of baby poo, showing indicators of healthy and unhealthy, as well as formula and breast-fed poo. The internet is also a wonderful thing, as it has allowed me to share photos of my baby's poo with an incredibly helpful, supportive and interested mama who has a little boy just a little bit older than mine. Her boy is exclusively breastfed, and she sends me pics of her boy's poo variants too. We are surprised that Facebook hasn't removed our accounts yet. But really, isn't that amazingly cool (okay, and perhaps a little gross), that we can do that?

Now, you know those households where mums and dads do paper-scissors-rock to decide who will change the poo nappy? We aren't one of them (okay, we were just one time). I am always very eager to do it. My little boy's poo is the biggest indicator as to how much breastmilk he is ingesting as opposed to formula. I
won't go into specifics (the slideshow link is there, if you want those!), but needless to say, whenever I open a pooey nappy, I either jump for joy or let out a deflated sigh.

It isn't remotely predictable either. My boy is going through a growth spurt right now and is chowing through formula as well as feeding every 1.5-2 hours, day and night. This is kind of exciting for me, as I know that this kind of frequency will be continuing to build my supply, but goodness he is having a lot of formula. So I'll be waiting in anticipation for the next poo to see if my milk supply really has been increasing with his constant feedings, or if it has really just been all formula.

Now, a quick mention about wee. My boy's morning nappies are so exciting to me! He still spends the whole night with no formula, even last night when he was seemingly permanently attached to me, so the big morning nappy is, I know, a result of all my milk during the night. And it is always pretty full! That makes me very happy. 
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My Friend's Milk

I have a friend who has an abundance of breastmilk.

Here in Switzerland, there does not exist a breastmilk bank where I can gain access to another woman's milk to give to my boy. If there was, I'd do it.

Yet another obligatory breastfeeding photo :)
My friend has so much milk that she has to insert special cups into her bra to collect all her excess as it drips out throughout the day. If she absentmindedly bends over to get something off the ground throughout the day, it all tips out. She doesn't have the inclination to freeze it at the moment, as she thinks that by the time she uses it in a bottle, the frozen milk will be too old. And donating milk here is so ridiculously complex it is not really a possibility.

So I am considering asking my friend if I can have her excess milk.

This stirs up so many odd feelings for me. I have such an inexplicably strong desire to be the sole one that sustains my baby. It defies all logic and is so far from rational, in the same way that an arachnaphobe's fear can also be entirely irrational (for example, I have such a strong physical response to large hairy spiders, but small, fragile-looking and poisonous -- potentially deadly -- ones simply make my heart race a little). Would this friend then be a particularly special person in my little boy's life because she provided the milk that allowed him to grow? But I don't feel this way when it comes to the formula he gets... Why?!  Could I manage to do this without feeling like a failure in some way?

And I don't want her to feel obligated in any way, to feel bad if it is an odd situation for her in some way, or if it makes her new life as a mother any more complicated.

There are so many emotions connected to this, and it seems I can't articulate it very well.

I might just ask her, revealing all my irrational thoughts surrounding it too. I might just share this with her.

(Edit: Here is my later post where I managed to fill my freezer with another mother's breastmilk!)
Thriving at 11.5 weeks!
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