Nursing a Toddler

At 19 months old, there is no question that my little Monkey has left infancy behind and is now a full fledged toddler.  And really, toddlerhood is a lot of fun!  I love watching him as he learns new things every minute, and I swear, his vocabulary is increasing exponentially. His play has evolved into more pretend play and sensory exploration, leaving pretty terrific messes in his wake.  He has also become much more independent.  I was amazed last weekend at a St. Patrick's day party when he took off with his Granny and Papa for at least a half an hour before he came looking for me.  But all of this learning, growing, and newfound independence is exhausting, and he still loves to snuggle up with his mama and nurse.

So, how is nursing a toddler different than nursing a baby?

For starters, he's bigger and he won't sit still, but that's not so bad.  Because he's bigger, he's able to latch on all by himself and I can multitask while he snacks.  In fact, he's nursing down for a nap as I type this.  The gym-nurse-tics I could do without most of the time, but if nothing else, it's quite entertaining (it certainly provides my husband with a source amusement as Monkey assumes the downward dog yoga position without unlatching).

The part I hate the most about nursing a toddler? The dreaded nursing in public.  I feel very self conscious when we nurse in public (which is not helped by his distracted Karate Kid inspired nursing style: latch-on, latch-off).  Sometimes I find myself hoping that Monkey won't ask for milk (or, muk, as he calls it) until we get home.  But, to be honest, most of the time no one even bats an eye, and if they have an opinion they keep it to themselves.

When he was younger, I proudly nursed in public everywhere we went. By openly breastfeeding in public, I felt like was helping other mothers (who might be nervous about doing so themselves) by normalizing it.  I have to periodically remind myself that the same is true for nursing a toddler in public.  There are a lot of "closet-nursing" mamas out there who, just like me, feel squeamish about others knowing that their toddler is still breastfeeding.

Now, I'm not going to lie.  I am not as open about it as I used to be.  Most of the time, Monkey nurses in our ErgoBaby carrier, and, while I don't cover him up (as if he'd allow that!), most people don't realize that he's nursing and think he's just sleeping.  But, some people do notice and they often give me a look or even say something to let me know that they've noticed.  Sometimes it's a look of disapproval or disbelief, but more often than not, it's a knowing smile from a mama who's been there, and that just makes my day.

I have no intention of weaning him before his second birthday (as recommended by the World Health Organization, among others), and I have no idea how long we'll continue with our nursing relationship after that.  Perhaps I'll let him self-wean, I'm just not sure yet.  For now, I'm enjoying the snuggles and milky smiles while I still can.

Unsolicited advice for my pregnant friends

If you are already visibly pregnant, you may have already noticed that social boundaries are beginning to change as friends, family, and even complete strangers put their hands on your belly - sometimes without even asking!  Over the course of the next few months, you’re going to hear from just about everyone that your life is about to change in ways you can’t even begin to imagine. The barista at Starbucks will warn you about the sleep deprivation and tell you to get lots of sleep now (as if that’s going to make you feel better when you’ve been up for days with only a few hours of sleep – “Oh, I’m so glad I got all that sleep last month!”).  The lady behind you in line at the supermarket will tell you all about her own (or her sister’s, cousin’s, best friend’s or neighbor’s) pregnancies.  Some coworker will recount every gory detail of her first pregnancy, from morning sickness to crowning.  

The good news is that you won’t be pregnant forever, and the belly groping will eventually stop.  The bad news?  Once your baby is born, the unsolicited advice will overflow as you will become fair game for every well-meaning man, woman, and child to tell you everything you’re doing wrong and why their way is better.   

So, what makes me think you want to hear my advice now?  Well, maybe you don’t, but these are the things that I wish people HAD told me when I was pregnant, rather than telling me about their sister-in-law’s failed induction that led to a c-section or why I must get the epidural.  The following is my unsolicited advice:

1. You're reading the wrong books

When I was pregnant, I read lots of books: What to Expect When You're Expecting, Your Pregnancy Week by Week, and even Belly Laughs, by Jenny McCarthy.  It was fun reading about my baby's weekly development, and I felt reassured that all of my wacky pregnancy "symptoms" were normal.  It never occurred to me to read some baby books as well.  Seriously.  There I was, thrilled to be pregnant (despite the water retention, swollen hippo feet, acne, and frequent trips to the bathroom), just giddy with excitement about having a baby, but I was so caught up in the pregnancy part that I forgot to read ahead to find out what was coming next.  Well girls, all that free time you have to read while you're pregnant is going to be a distant memory once your bundle of joy arrives, so take advantage of it and read up a little bit on burping, spit-up, colostrum, umbilical cord care, sleep, and poop (it's amazing how interested in poop you will become in your first few weeks as a new mom).  I highly recommend The Baby Book (along with just about everything from the Sears Library), Sleeping With Your Baby, by Dr. James McKenna (even if you don't plan on co-sleeping), and The No-Cry Sleep Solution, by Elizabeth Pantley.

2. Do your own research

In addition to reading the baby books, I encourage you to once again take advantage of the free time you have now and do some research.  Think your doctor has told you all you need to know?  Think again.  I believe that most doctors really do have good intentions, but too many of them are not up to date on current recommendations or may not have taken the time to fully educate themselves and then their patients.  The burden is on you, so do your homework.  Find out what you need to know about medicated birth, vaccines, circumcision, and breastfeeding.  You will need to make decisions about all of these things and you will likely feel more comfortable if those decisions are informed.

3. Keep the receipts

Nesting during pregnancy inspires many trips to the local baby store.  I remember marching (well, actually, I was waddling) up and down the aisles with my husband, armed with our barcode scanner registry gun, convinced that we needed everything in that store.  We spent months agonizing over choosing the right crib, stroller, bottles, and the rest of the obligatory baby gear.  Well, I can tell you that our beautiful (and expensive) crib has yet be slept in, Monkey spends more time in a sling, wrap, or carrier than in a stroller, and once we had established breastfeeding, he refused bottles.

4. Attend a La Leche League meeting

It’s no secret that I’m a lactivist and want every baby to be breastfed, so I’m going to skip the part where I tell you all about the wonderful benefits to both baby and mom (I’ll save that for another post).  You probably already know most of that stuff anyway, right?  What you may not know is that breastfeeding, much like most aspects of parenting, is not without its challenges, and may not come “naturally” to all mothers and babies.  This is especially true for mothers who have endured highly medicalized births such as inductions or cesarean sections.  The best way to combat these breastfeeding challenges, should you encounter them, is to arm yourself with knowledge before they occur.  Yup, I’m telling you to do more homework.  Go to a La Leche League meeting near you and talk to other moms.  Moms-to-be attend all the time, so there’s no need to feel weird about possibly attending without a babe in arms.  Listen to the moms and meeting leaders and ask them any questions that you may have.  You may find that some of them delivered in the same hospital or birthing center as you and they may have specific advice.  LLL meetings are great for growing your circle of mom friends and for getting the support that many breasteeding moms seek.

So, there you have it.  I hope that this helps you along as you fumble towards motherhood.  Just one more thing:

5.  Enjoy every minute

I know, I know, the hippo feet, the nausea, the aching back, the hot flashes, and the exhaustion… I haven’t forgotten.  But I promise you that you will have moments when you miss being pregnant.  That amazing feeling of your baby moving around in your belly is unlike anything else in the world.  It’s the beginning of the unique bonding that takes place between mother and baby, and it really is amazing.  Remember, it only lasts for about nine months – a blip in your lifetime – so take the time to enjoy it.

Circumcision: whose choice should it really be?

Lately I've been feeling a lot of guilt over having had my son circumcised.  The truth is, I did absolutely no research on the subject (which is not like me at all).  My husband thought it should be done, and other people suggested that there were medical benefits (such as being cleaner, resulting in fewer infections, and a correlation with lower rates of STDs) so I said, "okay."  I barely even gave it a second thought until it came time to do it.  When the doctor came to take Monkey away for the circumcision, I felt sick about it.  When they brought him back and I saw his raw little penis, I cried.

So, why did I do it?

If only I had taken the time to learn more about it before he was born, I probably wouldn't have consented.  I know now that there was no legitimate medical reason to have it done.  I know now that it was painful for him.  I know now that the American Academy of Pediatrics (AAP) does not recommend it.  I know now that I made a decision that cannot be undone, and my son will have to live with it for the rest of his life.

Since there is no medical rationale, why are we still cutting our baby boys? For the sake of tradition, culture, or religion?  Just because something has gone on for a long time (e.g., slavery, female genital mutilation, hazing) or is done in the name of culture or religion (suicide bombings, honor killings, ritual human sacrifice) doesn't make it right, and male circumcision is no exception.

I don't know any men who would voluntarily be circumcised as consenting adults, so why on earth do we, as parents, subject our sons to it?

"He won't be able to remember it, so it's okay."

Really?  REALLY???  Most people can't remember anything before the age of two (and some before the age of 5), so does that mean that it doesn't matter how we treat our children for the first couple of years because they won't remember anyway?  Go ahead and slap your kid around - he won't remember when he grows up, so it doesn't matter.  This kind of "logic" helps parents feel better about the mistakes they've made along the way (and hey, nobody's perfect), but it shouldn't be used to justify abuse - or unnecessary cosmetic genital mutilation.  Besides, we wouldn't allow this to happen to our daughters, would we?

I can't undo what I have already allowed to be done to my son, but I can (and do) support the MGM Bill to end nonconsensual genital mutilation.

I'm a Little Bit Crunchy

The Definition of a "Crunchy Mama" (according to Urban Dictionary):  

"Mother who supports homebirth, breastfeeding, baby wearing, cloth diapering, co-sleeping, gentle discipline, etc. One who questions established medical authority; tends to be vegetarian and/or prepare all-organic foods. See crunchy and hippie.

'That crunchy mama is breastfeeding in public again!'"

While I remain undecided on having a homebirth myself (the four doctors who make up my child's grandparents would have a collective conniption), I fully support a mother's right to make that choice for herself.  I am a passionate breastfeeding lactivist (and IBCLC-in-training).  I wear my baby as often as possible and my collection of baby carriers is ever expanding.  I like the idea of cloth diapering, but Hubby thinks it's gross, and the truth is, the initial cost is so much more expensive than sticking with disposables.  I believe that co-sleeping is natural for babies and cribs are silly.  Gentle discipline has always been my way, even as a teacher.  I hate using anything with unnecessary dyes or fragrances, especially on my baby.  I am vegetarian and I plan on feeding my baby whole natural (preferably organic) foods rather than jarred processed foods through baby-led weaning when he is ready for solids.  I am a vegetarian, but that's not a choice I plan on making for Monkey.  And don't even get me started about extended breastfeeding!  That one's gonna open a big can of worms after Monkey's first birthday.

So it seems that, now that I'm a mom, I'm a little bit crunchy.  I don't think I'm super granola crunchy, but just a little crunchy (although urban dictionary may beg to differ).  Unfortunately, outside of my online circle of friends, I don't have many people in my life who would describe themselves as such, so I often find myself keeping my crunchy opinions quiet.  And, you know what?  That kind of sucks.

But, what to do?  I like my friends so I'm not looking to trade them in for crunchier alternatives, nor do I wish to "convert" them.  The truth is, I would guess that most of them would be surprised to learn that I'm a little bit crunchy.  Hubby is aware (although slightly in denial) and tolerant of my crunchy tendencies and is even somewhat supportive (as long as the ideas that I propose are not too much more expensive than their less-than-green alternatives as we are on a tight budget these days).

Are there any other closet-crunchies out there?

Bring back the Leaky B@@b!

Breastfeeding did not come easily to me but I was lucky to have the support of my husband, my mom and dad, a handful of fabulous lactation consultants, oh and about 5,000 "Leakies" on a facebook page called The Leaky B@@b.  I'm not sure how I found TLB, but boy am I glad that I did!

Nursing my little Monkey...
Tell me, is this hateful, threatening, or obscene?

When posting on TLB, I felt safe.  I could ask questions about nipple pain without embarrassment or proclaim "BREAST IS BEST!" without offending anyone.  It wasn't long before I felt like a part of the Leaky family.  We cared about and supported one another without judgement.
On new year's eve, I posted for a friend who was suffering from chronic clogged ducts and within a few minutes, a handful of Leakies had responded with encouragement and helpful suggestions for relief.  My friend was amazed, and I felt proud to introduce her to my virtual family.
Approximately 24 hours later, The Leaky B@@b was removed from facebook with the following explanation:
"Your Page "The Leaky B@@b" has been removed for violating our Terms of Use. A Facebook Page is a distinct presence used solely for business or promotional purposes. Among other things, Pages that are hateful, threatening, or obscene are not allowed. We also take down Pages that attack an individual or group, or that are set up by an unauthorized individual. If your Page was removed for any of the above reasons, it will not be reinstated. Continued misuse of Facebook's features could result in the permanent loss of your account."

Huh?  Apparently my caring, non-judgemental, supportive family was considered by some to be "hateful, threatening, or obscene."  It's so absurd, I can't even wrap my head around it. Too many breastfeeding mothers have encountered ignorance and discrimination or have been made to hide under blankets or in bathrooms to feed their babies (despite laws protecting their right to breastfeed in public).  That was out in the real world, and now it's happening on facebook as well.
Shame on you, facebook, for violating your own Terms of Use by "attacking an individual or group."
Please, do the right thing and Bring back the Leaky B@@b!

Breastfeeding Part III

Over the next four weeks, I continued to meet with three lactation consultants: Ann, Kathleen, and Patty.  We tried nursing in different positions to see what would work best.  We went back and forth with using the nipple shield - sometimes it worked well, other times it hurt like hell.  It always seemed like he latched well when a lactation consultant was watching but then when I was alone, we just couldn't get it together.

My mom and Hubby were both very supportive and did what they could to help, but I still felt really alone.  I felt like no one really understood why this was so important to me and I couldn't explain it if I tried.  Most people told me that I had tried hard enough and it was time to give up. After all, their kids had had formula and were "just fine."

Monkey's latch steadily improved, but he often got fussy at the breast, especially in the evenings.  Okay, he was more than fussy.  He would latch on for a couple of minutes and then clamp down and pull back while flailing his arms and legs and finally (after I unlatched him) screaming his lungs out.  The LCs couldn't decide if the milk flow was too fast or too slow and the pediatrician was sure it was reflux.

At six weeks, we finally turned a corner.  At the breastfeeding drop-in at the hospital, he had been transferring more and more milk each week and this time, Patty said she thought I was ready to drop the bottles.  She told me to try just nursing him for the next two days and to come back in for a weigh-in in 48 hours.  I was so happy!  I called Hubby on my way home and told him.  He seemed a little bit apprehensive about trying exclusive breastfeeding again after what had happened before.  For the rest of the day, we nursed as much as Monkey wanted.  That night we went to my first La Leche League meeting and I told my story.  I was so excited that I was able to finish the story by saying we were getting rid of the bottles.

But then something awful happened.  As I was nursing Monkey towards the end of the LLL meeting, my nipple began to hurt.  One of the leaders came over to help me, but when she looked she said his latch looked pretty good.  I figured that maybe it was just from nursing more that day than I was used to, but as the night went on the pain just got worse and worse.  Around 4am I was in tears as Monkey nursed happily.  Hubby finally told me to stop and gave him a bottle while I pumped, but even the pumping hurt.  I suffered through the pain as much as I could the next day, only giving Monkey one more bottle.

I was nervous about his weight and couldn't wait until Thursday, so on Wednesday I called Ann (one of the LCs who had been helping me) and she came over with her scale to weigh him.  He had not lost any weight, so I was relieved - but I was still in pain.  I continued to breastfeed through the excruciating pain for the next twenty four hours.  Finally, Thursday rolled around and Monkey and I went to see Patty.  I was elated to see that he had gained two ounces!  Patty was excited too, but she was concerned when I told her about the nipple pain.  I sat down to nurse him so that she could see his latch and she said it was perfect.  On the verge of tears, I told her that it felt like he had razorblades in his mouth.

"You just said the magic words!"  She explained that the pain I was describing was classic yeast/thrush and told me to get a prescription for "triple-nipple-cream" (also known as APNO).  I called my OB immediately and had the ointment about an hour later.  Within a few hours, I began to feel relief and by the next day I was breastfeeding pain-free.

Monkey is now 22 weeks old and has been exclusively breastfed since he was 7 weeks old.  We still go to the breastfeeding drop-in to see Patty and to help other nursing moms who are struggling.

Breastfeeding Part II

For the next couple of weeks, we worked hard to nurse every two hours, day and night.  It hurt a little bit, but it was not that bad so I wasn't worried.  I figured I just needed to get used to it.  

At the beginning of the third week, things started to get bad.  My nipples were bruised and so very sore.  Something had drastically changed, but I couldn't figure out what it was.  One desperate night, Hubby and I wound up supplementing with the milk that I had pumped in the hospital.  We used a tiny 5cc syringe because I was sure that using a bottle would forever doom our breastfeeding relationship.  I met with two lactation consultants that week, one at the hospital and one who came to my home.  They were both helpful, and a before and after weighing showed that Monkey transferred about an ounce, but the pain continued.  

That Saturday, my husband had to go to a party with his parents and my mom was having dinner with friends, leaving me alone with Monkey for the first time ever.  A few minutes after Hubby left, Monkey started crying and didn't stop.  I tried everything I could think of, but (other than one short 30 minute nap) the crying continued.  About four hours later, after several tearful phone calls, my mom came over to help me.  We determined that Monkey did not have a fever, but still I couldn't soothe him. 

I called the pediatrician on-call, and she went over a list of things for me to check to figure out why he was crying.  She finally told me to drive him around for twenty minutes and, if that didn't work, to take him to the emergency room.  We tried the driving and it didn't work, so we took him to the hospital.  They weighed him and ran a bunch of blood tests and then they told me that he was malnourished and dehydrated.  Needless to say, I was crushed (and then I was the one crying for hours).  At 5lbs 15oz, he was 3 ounces below his birth weight and his bilirubin levels were 13.5 (which I later found out was not as high as the doctor had suggested, but still not great).  

The ER doctor said that we had to supplement Monkey with formula, which I had never wanted to do.  As I watched Hubby feed him that bottle of formula, I thought about his "virgin gut" and how we were ruining it.  It broke my heart that we were no longer exclusively breastfeeding.  I had heard the stories and I knew that supplementing with formula could destroy our chances for successful breastfeeding.  They almost admitted Monkey into the hospital that night, but, after talking to our pediatrician, they finally decided to let us take him home.  They gave us strict instructions for feeding him: every two hours, breastfeed for no more than twenty minutes (so that he wouldn't "waste" too much energy on it) and then give him pumped breast-milk and then formula.    

Monkey sleeping with Hubby after returning from the hospital

That Monday, we took him to see his pediatrician.  He weighed 6lbs 5oz, so he was finally over his birth weight (by 3oz) at three weeks old.  The pediatrician agreed with what the ER doctor had said and wanted us to continue supplementing.  I asked him if I could just give pumped milk and eliminate the formula, but he said that we should continue with the formula in case my breast-milk "didn't have enough calories."  

The day after meeting with the pediatrician, I went back to the hospital to meet with Kathleen, one of the lactation consultants who had helped me after my delivery.  She did a before and after weighing and told me that Monkey was doing non-nutritive sucking and only transferred about a tablespoon of milk.  We discussed the possibility of a posterior tongue-tie and I made an appointment to meet with an oral surgeon.  Kathleen also watched him drinking from the bottle and was concerned with how much time it took him to finish it.  She recommended using different bottles to minimize nipple confusion since his latch had gotten worse and she gave me a new nipple shield to use.    

I left feeling so discouraged.  I couldn't tell when Monkey was getting milk and when he was doing non-nutritive sucking.  Feeding him had turned into a nightmare.  The entire process took at least an hour and between the nursing and the pumping, my nipples were in bad shape.  I was pumping as much as I could after every feeding to maintain my supply and I was beginning to feel like I was developing a closer relationship with my pump than with my baby.  This just wasn't the breastfeeding experience that I wanted.  I hated seeing him drinking from a bottle, but I hated even more to think that I had been starving him before!  I really wanted to go back to exclusive breastfeeding, but it seemed that I was unable to adequately nourish him that way.  

I felt broken.  

next:
Breastfeeding Part III