Our Family

Our Family

Tuesday, March 6, 2012

Adventures in Breastfeeding Part 2 (6-12 months)

Around the time Evie was about to turn 6 months old - a developmental time of change in itself - a few other changes were about to take place. I was going to start graduate school that fall and be away from her for about 25-30 hours a week, a big change from being home with her all the time. This time I couldn't just "work from home" if I needed to; I really had to be okay with leaving and make it work. Also, we had her sleeping in our room this whole time in the pack-n-play, and we decided it was okay to transition her to her crib at this point - she was getting more and more active and I felt like I needed to have some space back that I could claim as my own (or at least mine and Gabe's) without having to tip toe around in the evenings to not wake her up. And finally, since we had been exclusively breastfeeding her for the first 6 months, it was now time to start to introduce solids. All of these things gave me great anxiety - not only for the fact that they were all happening at once. But there was also something about each of them that I was excited about as well.

As our summer vacations came and went, the anticipation of starting graduate school again left me excited and nervous at the same time. I felt a bit isolated as a stay at home mom, even though I had the freedom to visit people during the weeks (like Lee, Mom, Dad, Catie and Ellie, work friends), I often chose to stay home or do quick, controllable trips to stores to run errands or to parks or the mall to walk around (since it was so hot). I worked hard to pay attention to Evie's sometimes obscure tired signs to help her get on a regular napping routine. She normally took a late morning and early afternoon nap, and nursed before and after each one. I loved the predictability of everything, even though there were certainly still challenges. At any rate, I was looking forward to engaging with a new group of people who had interests similar to mine in Anthropology. I thought I may even make a new friend or two since I didn't see many of mine anymore.

For a couple of reasons, we had Evie's nanny, Debbie, come over for a few hours a couple times a week before I started school. We wanted to make the transition easy and make sure Evie wasn't startled into a new routine, and we also needed to get her to take breast milk from a bottle or sippy cup. We had tried in vain several months prior, but I thought it best to take a break over the summer since it didn't seem to be helping anyone. I bought a few different kinds of "learner" cups that were cups with softer spouts. I would leave the house and run errands (or even treat myself to a milkshake or two for the difficult emotional work I was doing) while Debbie would work with her on the bottle. Fortunately, this time around was much better than the last time. Evie took a couple ounces on a couple days, and that was enough for me. I knew she may not take as much as she needed (about 2 4-ounce servings), but she would take enough to sustain herself and stay relatively happy (and keep me from worrying!).

Transitioning Evie to her own room pretty much went off without a hitch. I don't remember her waking up any more frequently overnight than she would when she was in our room. The only downside for us was that we had to go across the house to her room when she woke up to feed and change her. And I do mean 'we.' Gabe has always been great about co-parenting overnight, even though he hasn't really needed to get up because I'm already up feeding her, but he values that time with her, too, and still gets up to change her when I call him through the monitor (she doesn't always need to be changed, though, so sometimes it's just me). I've always cherished our overnight nursings because they're so easy and relaxed. Even though I would have always loved more sleep throughout this whole process, I wouldn't have wanted to sacrifice it for nursing her. This is partly because I think she sometimes uses overnight feedings to make up for what she doesn't take during the day, but also because it's more easy, lovable time I get to spend with her when the weight of all my problems that I stress about daily seems worlds away. Some people (including one of her stupid doctors) suggest that babies be night weaned after a certain point since they don't really need the nutrition at that point. I completely disagree, and I always knew that Evie was actively nursing when she woke up (as opposed to comfort sucking), and I could bear the thought of denying her that when she was asking for it.

Evie continued to only take small amounts of milk while I was away, but she would usually make up for it by taking a lot in the afternoons and evenings when I got home. I was also getting used to pumping each day that I was away (4 days a week). I didn't exactly have a private space to do this, so I had to notify people and compromise. As a graduate assistant, I shared an office with 2 other students, and I let them know that I'd need to pump certain times while I was there. I was fortunately able to do it just once a day (and just pump a lot), even though I probably missed 2 feedings when I was gone. Although I had a nice electronic pump generously bestowed upon me for Evie's baby shower, I opted to use a small hand pump for a few reasons. It was much more easily transported so I could fit it in my backpack (the electronic one is like a big duffel bag), it was quieter, and it didn't require electricity. The timing of when I had to pump was more tricky. For the days on which I had 3-hour morning classes, I had to use the 10-15 minute break to pump. Luckily my office was right down the hall from my classes. But I had to hope that none of my office mates (or the professor I was working for - all of whom had keys) would walk in on me. This did happen a few times, but I was able to turn away and explain what I was doing, and they would hurriedly leave (even though I said they didn't have to, but really, what were they going to do?). For one of my classes, though, it was completely on the other side of campus in a building with few extra rooms. I told my professor about my situation to see if there was a private room I could use to pump in, and she offered her office to me. This was very nice and generous, but in the beginning she would go in at the same time as me and check her email. This was a maternal and child health class, though, so she was very supportive of me doing this, and I just tried to play it off like it was completely comfortable for me to pump in front of a stranger. Of course I always had to pack a small cooler with ice packs so that the milk would say cold the whole time I was at school. While I usually remembered to do that, I sometimes missed a piece or two in pre-assembling my hand pump (since it needed to be washed every day), and if a piece is missing, it doesn't work and I become very engorged (which is painful!!). Small annoyances aside, I was pretty successful with pumping, especially given some not-so-accomodating circumstances.

We were at the same time excited to try solid foods with Evie and also a little anxious. Nothing is easier than breastfeeding in terms of swallowing, digesting, and not having to prepare anything, so it took some work to get comfortable with foods. We started out using baby led weaning, which means you start with whole solid foods (as opposed to pureed foods) so that babies learn from the beginning how to handle food. It is also supposed to help them be in control of their eating (rather than the parent controlling everything), and explore different textures so that they will be healthy eaters later on. We weren't quite prepared for the anxiety we felt when she would gag or choke a little, even though these were normal reactions. We tried to let her work these things out as much as we could, but sometimes she would spit up whatever she ate (including some milk), so we started trying purees after a while to see how she'd do. She seemed to like both methods on and off until a few month into it she really just preferred solid foods that she could pick up and eat herself. So for the most part, we feel like we pretty successfully did the baby led weaning, although we relied on some pureed food a little bit. She never had any difficulties to the extent that we had to interfere, which was a great lesson for us to learn. I've seen other parents jump in to "help" their child out when they're trying to work something out on their own (which can look like choking), and it can make the process more dangerous. I was always prepared to do the baby heimlich or cpr if needed, but luckily I didn't have to.

The fact that she was taking little bits of food here and there helped me feel better about leaving her when she wouldn't take much milk. Eventually, more towards 8-10 months, we started routinely feeding her 3 meals a day (even though some would be quite small). When she was around 8 months, she got her first real cold. She spiked a fever of around 102 and got a runny nose. I'm not sure what else she felt, but I know she was very uncomfortable and probably had a sore throat, because we had a couple of very rough days and nights where she was feverish, wouldn't sleep, and wouldn't nurse (except little bits here and there). We were very worried because this was so abnormal for her. Also, the following week we were supposed to go on a big family vacation to Ohio, and we weren't sure if she'd be clear to go. We eventually took her to the doctor to rule out an ear infection (which would have made flying painful and could possibly injure her ear drums). The doctor said one ear was a tiny bit red, and if we wanted to go ahead and do antibiotics since we were flying she'd be okay with that. We wanted to be safe, and even though she was on the up swing of the cold or virus, we wanted to make sure it would stay that way and that she would possibly be protected from any other bacteria that might come her way on the trip. So Evie had her first round of antibiotics at 8 months old. Then I started getting what I think was a bad sinus infection, so I took the same antibiotics (amoxicillin), which I subsequently found out I was allergic to! At any rate, she got better after a few days of the onset of the cold and she did great on the Ohio trip.

After that trip, the end of the year quickly came closing in, and the stress came on just as fast, as I realized I had several final papers and exams due soon. Around Thanksgiving, Evie started refusing to nurse at certain points throughout the day. This was new to me, and I was very worried that she was trying to wean (even though most babies don't self-wean until after 1 year). At the same time, when she did nurse, my "let-down" would be very slow, and she sometimes wouldn't wait on it and would stop nursing before the milk came down (although she would get a little bit without the let-down). I was extremely stressed out about all of this, and I started recording all the times she would (and wouldn't) nurse. At the worst point, I think she only nursed about 3 times one day, but I was also gone during much of the day. Normal for her during this time would be around 7-9 times per day. I was completely devastated and spend a few nights crying to Gabe (and probably other people), and I was starting to feel like I was slipping into depression about it. It's hard to explain why it was quite so traumatizing, except that I felt wholly responsible for providing this nutrition to her (especially at a time when her weight was really slimming down, and one pediatrician expressed concern over that). More importantly, though, I felt like she was denying me a bond that I held so sacred, and there was nothing I could do about it. Yes, I actually felt a little mad at her, even though I know she wasn't doing anything intentionally. I felt frustrated that I had so much to give, and she just wouldn't take it (when many women have the opposite problem). I felt jealous and spiteful towards the mothers who complained that they couldn't keep their babies away from them because they wanted to nurse constantly. It sort of felt like being infatuated with someone and realizing that they only wanted a friendship back. I felt rejected and sad, and it was hard to put on a happy face around others, but I was not ready to give up.

I talked to a La Leche League leader who said "if I were you, I'd fight it." (Of course, meaning not to give up and try to stick it out - not to try to force her to nurse). So I did. I went to a wholistic pediatrician who advised me in a few ways. First, he told me to do whatever I could to relax, as much of this can be stress-induced. So I tried relaxing music, breathing exercises, and visualization every time I went to nurse Evie after that. He also suggested getting some supplements to help with supply and let-down (my supply started to drop since she wasn't nursing as much, even though I was trying to pump to keep up). There were times when I worked pretty hard to encourage her to nurse, doing things like trying different positions, laying down, stopping for a bit and trying shortly after, humming, and all of the relaxation exercises. I think some combination of these things ultimately worked, or the issue would have improved anyways over the same amount of time. After talking to several people about this, I've come to see these refusals a "nursing strikes," perhaps because I was so stressed and she sensed it, or for some other reason that I won't ever understand. I am grateful for the pediatrician that suggested the relaxation exercises, because they also helped me in my life in general. I took on a new perspective that the papers and exams I was so worried about were nothing compared to the relationship I wanted to have with Evie, and so I was able to block thoughts about those out when I nursed her.

Even though things got better from there for the most part (she had a couple of smaller refusal times after this, but not as severe), I sort of felt on edge every time I would nurse her, not knowing if she'd do it or not. When my winter break came, I felt so much more relaxed, and I got to stay home with her for almost a whole month - just the two of us! Nursing was probably even better during that time than it was before the strikes started. I just wanted to at least make it to one year, and after seeing how things went throughout those couple of months, I gained some confidence in feeling that things would be okay. Even though I started school again in early January and she got sick a couple more times, our nursing relationship remained strong and I learned to love every minute of it.

At the end of Evie's first year, she was nursing around 7 times per day and eating 3 meals per day. And I had finally found a better pediatrician that validated what I already knew was best for her, and said this is how much she was supposed to be nursing if I wanted to continue (and in order to provide the essential fatty acids and nutrients she needed for development through her first year). Normally she would nurse when she woke up in the morning, before her 2 naps, once before lunch, once before dinner, before bed, and then usually twice over night (sometimes more). I could tell that there were a couple of nursing sessions that were becoming optional to her, though, and I felt more at peace with letting those go if she wanted to let them go. Within the few weeks before and after her first birthday, we ended up dropping 2 sessions completely. For a while I kept offering, but when she consistently refused, I stopped offering. It is a little freeing to not be tied to all of those nursing sessions. Also, she ironically started drinking breast milk better from a cup during this time, so when I am gone, I know she'll take what she would if I were there. This is a wonderful feeling! I've had a pretty easy schedule this semester and have been able to do my graduate assistantship work from home. For the first month or so I would stay and work from home while Evie's nanny came, and I would nurse her before her first nap. This became a little confusing and awkward to pass her back and forth, so I finally felt comfortable just leaving for the whole 5-7 hours that I needed to work, and when I come home Evie is ready to nurse again and take a nap. I now nurse her 4-6 times per day, but would be okay with slightly less. (I don't need to supplement her diet with cow's milk or any other milk as long a I'm still nursing her 3 times per day). I also still love every time we get to nurse. She sometimes still falls asleep after she's done, and that is one of the sweetest moments of my day when that happens. Since she is also starting to talk more and more, she has started saying "sitch" (switch) after she finishes on one side. This started with her copying when I would say it, but now she says it on her own.

I finally feel like everything is happening exactly as it's supposed to, and I don't think much about nursing anymore - I just have an easier confidence in it. I don't know how long I'll nurse her or when we'll drop more nursings, but I'm so proud of myself for getting this far in this way, and I'm in no hurry to stop any time soon.

No comments: