A Follow-Up to the Story on FFF

My breastfeeding/formula feeding story is over at Fearless Formula Feeder today. Suzanne Barston's book, Bottled Up, was something I stumbled across during early pregnancy and read. The resources she offers on formula feeding were invaluable as we made the transition from breastmilk to formula, and I was much less distraught about the choice because I'd read a more thorough discussion of some of the studies on breastfeeding vs. formula feeding. My submission to FFF ends shortly after we made the switch to formula and saw the drastic difference 2-3 bottles a day had made in our child. Here's where we are now:

E. is nine months old. Several days ago, she took her first, unaided, unsupported steps. She still definitely prefers help when walking, but she's not far from taking off running on her own. She's still a tiny child, but she was less than six pounds when she popped out, so that's not suprising. She's about fifteen pounds now, and on track to triple her birthweight over the next few months, just like the books say she should.

She loves food. Yesterday she tried eggplant for the first time and was pretty interested in it. The list of solid foods she can eat is growing, and so far, she has no food allergies. We've tried her on a number of the major potential allergens and nothing's been a problem yet.

We're down to one breastfeed a day. Back in February, I learned that I had gallstones and would require surgery to have my gallbladder removed. I started slowly dropping our daytime breastfeeds because I knew it would be easier afterwards if she wasn't as dependent on the breast by then. The "morning snack" feed went easily, but the afternoon one, the one she relied on to propel her into her afternoon nap, took more convincing. In the process, she discovered soothers (Canadian word for pacifiers, for any Americans reading), and now uses those to get to sleep, rather than nursing or a bottle. Once we were down to breastfeeding only in the evenings, night, and early morning, I called it good for the moment. Then she dropped her middle-of-the-night breastfeed, followed by the early morning one. The evening breastfeed is the only one left. She seems to want to make sure the breasts are still there, but isn't as into it as she used to be. The feeds don't last long, and she keeps getting distracted. She isn't quite ready to stop, but I don't yet know how much longer it will be.

My surgery was just over a week ago. The first three evenings after, I didn't nurse E. Between the incisions on my abdomen and the codeine in my pain medication, it just didn't seem like a good idea. Once I'd switched over to normal Tylenol, I put her back on the breast. I'm still making milk, which sort of surprised me. We'll see how much longer she keeps going with it. I don't want to nurse past a year, but I'm willing to keep going until then.

She's pretty happy about formula. She can hold a bottle on her own now, and often, after she finishes it, she lies back on her pillow (handy use for a breastfeeding pillow, by the way), and sings to the empty bottle. She gets grouchy when she sees me mixing it up and she's not getting it fast enough, or when it's too cold for her taste.

We've ended up with the Costco brand of formula. If you just need regular formula, or even sensitive formula, this is definitely a great way to go, pricewise. The stuff they sell at the Costcos here in Canada appears to be fairly similar to Similac, which was the one E. responded to best. Our go with the Nestle samples was not encouraging--she didn't like it and the formula made her extremely gassy. The one time we tried the Costco formula from the States, we discovered it was weirdly frothy and came in smaller canisters than the kind here in Canada (other than that, it was fine).

Formula's been a good fit for us. E. rarely gets sick, and is gaining weight normally. She often ends up being a little skinny around the middle because she'll have a growth spurt and get taller, but her arms and legs have an appropriate amount of baby chubbiness. She's finally willing to sleep most of the night on her own in the crib, though we're still convincing her it's safe to fall asleep on her own. My worries now mostly revolve around whether or not she'll find something on the floor I've missed and eat it or whether she's going to start climbing soon, not about whether or not she's starving.

Our Milk Saga? Not really so much of a saga anymore. Drama gone. Baby happy. Parents sane. Life is good. 

Milk: Letting Go

"You should try this," the clerk at the health store says, unprompted, holding up a box of mother's milk tea.

"No thanks," I reply, arms tightening slightly around my daughter. "None of those supplements really worked for me."

"Maybe you didn't try the right one," she pushes.

"We tried a lot of things," I say, then change the subject. "Do you sell honey?"

***

E. is nearly seven months old now. She's still small, but she's gaining weight at a normal rate and is busy crawling, sitting, and working on walking. She has yet to get sick with anything more than a slightly runny nose. We've introduced solid foods and moved her into her own bedroom. I'm still breastfeeding, but I've recently reduced our daytime feeds so that I'm only breastfeeding at night. I have to have surgery sometime in the next couple months and won't be able to lift E. very easily for a couple weeks afterwards. I'm cutting down on breastfeeding a bit sooner than planned so my recovery won't be as much of a hassle. It was easier than I thought it would be. It only took a day or two for my body to adjust with each one, and while E. was not happy about switching her afternoon breastfeed for formula, since she usually uses the breastfeed to get herself to sleep (which is why we're also in the process of teaching her to fall asleep on her own), it only took a day or two for her to be okay with it.

My feelings about breastfeeding are so mixed up that I didn't expect to be sad about reducing feeds. I hadn't realized how much the bonding part of it had affected me. In those first weeks, it didn't feel like bonding. It just felt miserable. I started counting down to when we could introduce solids. I don't know when it became something more emotionally positive, but it did, to an extent. 

My original goal was to breastfeed exclusively for six months. When that was derailed, I decided I would continue breastfeeding, along with the formula, for the six months, and see where it went from there. By the time we hit six months, I felt ready to quit most days, but E. didn't seem ready for it. Once I knew having surgery was a certainty, rather than a possibility, I decided it was time to cut down. And it felt stranger than expected.

Breastfeeding less has made me enjoy feeding her in the evenings more. It's easier to deal with her biting me with her brand-new teeth occasionally because it's not a constant battle. I don't get irritated from wearing uncomfortable nursing bras during the day (one gave me a bruise at one point because of the fit), my complexion is finally starting to clear up, and oddly, I feel more comfortable in my body. More like myself again. But once in a while, something reminds me of the hell of those first weeks of parenthood, and those emotions come rushing back.

I hate that incidents like the one above still make me feel bad. I know the clerk was just trying to sell me something and she took a look at me and decided that since I look like a crunchy mom, I'd obviously be exclusively breastfeeding. She didn't know my story. She just assumed. And it hurt. Enough that, while she and someone else in the store were chatting about natural vs. refined sugars, I pointed out that agave is pretty dang refined. I wasn't very catty about it, and it's true, but I said it out of my irritation more than anything else, and that wasn't right. 

I still want to slap the people who come up with the really sappy sayings about parenthood. I enjoy being a mum, and my daughter is very important to me, but this is not the be-all and end-all (I remember saying something similar about sex once). Parenthood does not always bring out the best in me. Sometimes it brings out the worst. Sometimes I am frustrated and unhappy about it, and sometimes I am extremely content. Some days letting go of the grief that I have about parts of is harder. Today is a more difficult day, solely due to that conversation at the store, but as always, I'll find an equilibrium again and be okay.

Breastfeeding and Feelings

I have a love-hate relationship with breastfeeding. That's no secret. It still surprises me sometimes, how difficult I've found it, in so many little ways. And yet there are the moments when I love it, love being able to do this.

We're firmly set in the combo-feeding camp now. E.'s been good with all three of the formulas we've tried her on, and she's happy with a couple different bottle and nipple types. And I'm still breastfeeding her. She loves it. She gets a lot of breastfeeding in during the late evening and in the mornings, and then lunchtime, dinnertime, and one nighttime feed are usually formula. There's also a late-afternoon breastfeeding period. I tend to get a chunk of time in the early afternoon when she isn't eating and isn't sleeping, in which we can go for walks and run errands without it being a hassle.

The times when I struggle with breastfeeding are when my nipples are sore, again. Even when she's properly latched, there can be some discomfort, though it's not the pain I experienced when we had thrush, so it's easier to deal with.

There are days when I long for the times when my breasts were not used for feeding a tiny wiggly child who wants to look around while eating.

There are days when I wish I wasn't so casual about pulling my shirt up or down and unsnapping my bra. I'm not an exhibitionist, and yet I've become extremely comfortable with breastfeeding in front of other people (though when in public, I do use the cover--it's just easier). I have to wear layers that allow me to stay warm while feeding her, so sometimes I look a little unfortunate. And when I do get a break that will keep me from feeding her for more than a couple hours, I have to plan for my breasts to get a little uncomfortably full. I don't get terribly engorged, but it's another source of discomfort. We're going to a Christmas party tomorrow night and leaving E. with some friends for the evening, and I have to make sure that what I'm wearing will withstand a little growth, and that I can fit breast pads in there, in case of leaks.

I'm tired of sharing my body with my child--it's like an extension of pregnancy, though it feels totally different, and for an introvert like me, it becomes very wearing.

And yet there are times when I appreciate it. It's convenient. It makes E. happy. When she's upset, it's often a great way to soothe her. Breastfeeding was very helpful during her first round of immunizations the other week.

I suppose there's something to this bonding and breastfeeding thing. I still don't get the rush of promised happy hormones when I feed her, though.

And I'm glad that my body works well enough that I can breastfeed her, even if she still needs the formula in order to gain weight.

But that doesn't stop me from feeling ambivalent. Is this the way it is for everyone?

Milk: The Saga Continues

The trying-to-feed-my-child saga has come to another turn. Last Monday, my doctor gave me a prescription for Domperidone, to help boost my milk supply, but told me that I might need to supplement. J. and I decided we'd give it a few days to see if the medication would make a difference, and then if it didn't, we would start supplementing. I'd weighed E. on Monday, so I went back to the public health unit on Friday to weigh her again. She was pretty furious about the whole scale thing as usual, and when the numbers settled, I knew what we'd be doing that evening. Over five days, she had gained one ounce.

That is not normal weight gain for a baby at all. The most she's gained in a week so far has been three ounces, and that's with spending most of the day attached to my chest. No wonder she's been so fussy. This week, she decided that me setting her down constituted horrible torture that required much screaming. I couldn't even get a glass of water without her screaming at me.

Fortunately, we had bottles on hand (since I'd had ambitions of expressing enough milk for a whole bottle), and we have half a dozen cans of formula that our doctor offered me (I think he was tired of them cluttering up his counter and he doesn't have a lot of really young patients in his practice right now), so I didn't have to go to the store and stare helplessly at all the choices. When J. got home from work, we mixed up a bottle and he gave it to her. She was pretty happy about it. She was also pretty happy about breastfeeding again at her next feed, and has remained happy about either option (unless she's grumpy, in which case, breastfeeding makes her happier. Actually, she's just happier in general. She's not always too excited about diaper changes, or about the part of baths where we wash her hair, but she's not screaming about being hungry anymore, and she's sleeping more because she doesn't have to eat quite as constantly.

I'm still breastfeeding her as much as I can, but there are times when she's getting next to nothing out of there, is really hungry, and starts getting extremely upset. Those are the times when she's been breastfeeding for something like an hour, and then downs 4 ounces of formula in less than ten minutes when we offer her a bottle, and drops off to the sleep.

And the difference, other than her moods and her sleep schedule?

I weighed her this afternoon. She'd gained about seven ounces since the last time I'd weighed her. She's finally over the six pound mark. Finally.

the complexities of milk

This breast-feeding thing has gotten more complicated in the last few weeks. I have to admit that I'm getting tired of my relationship with my daughter centering around food. Admittedly, her needs right now involve being fed, changed, and kept warm, so that's inescapable to a certain extent, but this is getting frustrating.

It started with my milk taking a little longer to come in than normal, or at least, coming in but there not being that much of it at first. Then my supply went up a bit, then went down, and we got to experience a screaming child who was being fed every two hours at a minimum but was still hungry and was gaining weight at a rate of at least 2 ounces less per week than the low range of normal. Then I got thrush, which is now improving, but the visit to the doctor to find out what I needed to do for the thrush resulted in him saying that I might have a low milk supply.

Off we went to the public health unit to weigh her before and after a feed and to talk with one of the nurses. Naturally, we hit the fussy point of the afternoon, so the visit consisted of the nurse and me trying to calm E. down enough to eat so we could see how much she got in. After she ingested a staggering 5 grams of milk, she calmed down and fell asleep. The nurse and I talked through what we could do to up my milk supply. I'd already started downing more water, and now I'm doing breast compressions while feeding and trying to make the time to do some hand-expressing in-between feedings. The look on her face when we started syringe-feeding her some expressed milk was priceless. Milk had never come out of a finger before and we definitely messed with her paradigm for how the world works. Cup feeding elicited similar expressions.

This got us to the point where E. is sleeping better, screaming less, and seems much happier when she's awake, but not to the point where she's gaining weight faster. My tiny child and I went back to the doctor yesterday and I'm now on medication to help boost my milk supply, and we've got a couple tins of formula in reserve in case that isn't enough.

Every medical professional I've talked with so far has been very encouraging and fairly helpful (the doctor from our practice that I spoke to yesterday was more in favour of supplementing than the one I spoke with last week, but they all still want me to keep breastfeeding as much as possible and want to make that happen). It's frustrating that everything else is fine with her except for her weight gain. She's growing bigger, she's alert, she's wetting the requisite number of diapers, she's getting better at holding her head up, and she can even roll over sometimes and she's not quite six weeks old. If the medication and possible supplementing don't do the trick within the next month, we get to visit a paediatrician to see if there's something else going on that's affecting her weight gain.

I'm not as stressed about all of this as I would expect to be, but I think I'm too tired to worry much. Whatever happens, we'll do what we need to in order to get her fed. I'm giving the medication a week or so after it kicks in to see if it's making a difference with her weight gain, and if not, then we'll add in a bottle or two of formula per day to round things out. I really wanted to get to the six months of exclusive breast-feeding, but making sure my child is getting enough food is more important. Now if you'll excuse me, she's dozed off so it's time to try expressing some extra milk. Sigh.

8 Things They Don't Tell You About Breastfeeding

While I was pregnant, I read a lot of books about breastfeeding, and we went to the breastfeeding class offered by the public health unit. Although I'd been a little leery of breastfeeding prior to getting pregnant, I came around to the idea pretty quickly once I knew a baby was on the way. It would mean that we wouldn't have to buy formula, and there are all those health benefits to it. I read a lot of women's stories about the difficulties they experienced while breastfeeding, and mentally prepared accordingly. I told myself that if we needed to supplement, I wouldn't feel guilty about it, since the important thing is to make sure your child has food.

So far, the whole breastfeeding thing hasn't been too difficult, which is the opposite of what I'd anticipated. E.'s not gaining weight as quickly as I would like, but she is gaining, and she's going through what the books and handouts tell me is the appropriate amount of diapers, so I know she's getting enough. My milk supply is still sorting itself out, so if she sleeps for a few hours, my breasts get a bit engorged, but that hasn't been too bad. My milk took a few days to come in properly, and my nipples are still sore, but for the most part, it's going a lot more smoothly than I'd expected, given all the stories I'd heard about potential problems. At the same time, there are also feelings and experiences I hadn't expected.

1. They'll tell you in the books and in the classes that if the baby's latched on properly, breastfeeding shouldn't hurt. What they don't tell you is that, even with a proper latch, breastfeeding will hurt for the first minute or so and then that pain just turns into discomfort. I had this confirmed as normal when I went to talk to one of the nurses at the public health unit and she told me that E.'s latch was great, and the discomfort was expected. Notice that I was only told this after I'd started breastfeeding.

2. Posture's really important. I finished feeding E. a few nights ago and handed her over to J. so he could convince her to sleep and, instead of going to sleep myself, I found myself experiencing very painful spasms in my upper back. I had to take Tylenol and then hop in the shower for a while before curling up with a hot water bottle. It's harder to achieve good posture while breastfeeding when you're out and about--chairs without arms and the lack of available pillows mean that there is less support for holding the baby up, so it's easier to hunch over and not think about the consequences until later.

3. Lanolin cream is your friend. Really. They'll mention it in the classes, but it's a very good idea to use it frequently. It's soothing and it helps toughen the nipples up. Those first few days are especially painful, so it helps to have anything that makes your skin feel better. Wet tea bags are also helpful, because of the tannins, although E. didn't quite like the taste they left behind.

4. Breastfeeding releases oxytocin, which is supposed to make you feel good. You know what else it does? It causes the uterus to contract. This is fantastic for recovery after birth, but especially in the first couple of days, it's painful--just like menstrual cramps or mild labour pains. So not only are you extremely sore from giving birth, with very sore nipples, you're also getting contractions every time you feed your baby. These lighten up, but I'm still getting occasional twinges at nearly every feeding. I'm not really noticing the alleged happy effects of the oxytocin, and am starting to wonder if that's actually true.

5. Breastfeeding can be exhausting. You're tethered to a tiny human being who doesn't care about your needs at all and wants to eat all the time. When a growth spurts hit, your child will want to eat even more frequently, so it will feel like your entire life is about feeding the baby. And right now, yes, it is. You don't get privacy or time just for you--the baby needs to eat. For an introvert like me, this can be really difficult.

6. Breastfeeding is also boring. You can only stare at your child for so long before you get tired of watching them eat and start counting the number of blotches on their skin from baby acne. Yes, you can do stuff around the baby, but it takes practice to learn that. I can now type and knit around E., but it took me a while, and I still have to be careful because if she gets dislodged slightly, she ends up yanking on my nipple. Let's just say that I'm very happy that we have Netflix (even if Canadian Netflix has a lot of inexplicable gaps--they have filmed Supernatural not three blocks from here and I can't get it on Netflix or at the library).

7. You will be told that you need to eat a healthy, balanced diet to keep up your milk supply and to provide proper nourishment for your child. You will not be told how to achieve this when your partner goes back to work and your baby starts cluster-feeding, thereby anchoring you to the couch with no one to cook for you. I doubt that coffee and Goldfish crackers constitute a balanced diet, so I'm hoping that the vitamins I'm taking will help mitigate things a bit. This may get better when I can put her down between feedings without her waking up or screaming her head off. Yesterday, I cooked breakfast at about 10:30 in the morning, even though I'd been up since 4, and she cried through most of it, while I tried to tell her that I really, really needed to eat and that I'd be feeding her again in just a few minutes.

8. You're also encouraged to breastfeed because it helps with bonding. I assume that this is true, since it's hard not to bond somehow with a person that's connected to you physically for so many hours in the day, but it doesn't feel as wonderful and magical as so many lactivist blogs say it is. It probably is for some people, but not for me. That may change once E. is doing more than eating, sleeping, and pooping, but at this stage, I don't feel an overwhelming rush of joy when she starts eating. I'm glad she's eating, and I'm glad this is working, but I'm sure I'd be just as paranoid about whether or not she's still breathing if we were bottle-feeding. I doubt that I'm alone in this. My mother says that it seems like some people turn breastfeeding into a religion, and I am apparently not one of them. Maybe I'll feel differently once E. starts smiling deliberately.

If I didn't think that it was important to breastfeed, and if we had the money for formula, I might very well not be breastfeeding, or be doing mixed feeding. I don't particularly enjoy having someone so dependent on me 24/7 and I'm very much looking forward to when we can introduce solid food in late February. It's not really easy right now. The first day of cluster-feeding made me feel really helpless and isolated, and I started sobbing the moment J. got home from work, because she hadn't slept for more than a hour at a time all day and had eaten constantly, so I didn't get anything done and hadn't gotten any sleep. It's a relief to hand her off to him and watch him play with her, because right now, her automatic response to me is, "Mommy=food." Even if I've just fed her, if I'm holding her and she's awake, she starts rooting.

However, my frustration and ambivalence do not mean I'm going to stop breastfeeding. I'm determined to hit the 6 months of exclusive breastfeeding mark if it's at all possible, though I'm less excited about the idea of breastfeeding her past a year. That part we'll play by ear. Somehow, the thought of breastfeeding someone who can walk and talk doesn't appeal to me that much right now, but we'll see how we all feel once we get there. In the meantime, five months and one week to go before we can add in solid foods. And one week before I can start pumping and introduce occasional bottle-feeding.