Thursday, April 23, 2009

Kids and Introspection

Here is a very truthful and affirming article, which was sent to me today by my good friend, Phil. I want to share it with all mothers out there, regardless of religious inclinations, due to the very accurate nature of the article's viewpoint. I find it sincerely empathetic and validating.

Religion or no, children certainly challenge their parents to be introspective! Having kids is not merely about bearing and rearing offspring until they are old enough to take care of themselves! In my opinion, regardless how "flawless" the instruction offered to his child, any parent who excuses-away the vast expanse of humbling and learning opportunities available to him throughout the years, has really missed his true "parenting" opportunity and the calling of why he, and not someone else, was fated to be the parent of this particular child. Having kids is an opportunity for the parent as much as the child!

As dearly as I love James, in my whole life of various challenges, I have never felt more incompetent or more unable to be patient and loving than now that I have a kid. Somehow, this loving little bundle always seems to bring out my shortest temper.

Yesterday was horrible, and by the time my husband came home, both James and I were having temper tantrums. To top it off, James decided last night to be wide awake from 2:00 until 5:30 a.m.! Ehhhhh..... Needless to say, I was grumpy this morning. I am so lucky to have a loving husband who is understanding and patient with us both.

Although I may be floundering hopelessly about, I can say that I have also never felt more called to try and put the virtues of my faith than into action with James. Although volunteering with homeless, hungry, and other people in need is very edifying - at the end of the day, I always get to leave the soup kitchen and its problems and go home to my cozy place! James, however, never leaves me alone! He is constantly lending me inescapable "spiritual direction," in that I feel the very immediate call to mercy, patience, kindness, understanding, charity, and love more than I ever have before. I don't know how any family with a baby could survive without those things!

And finally, in a very humbling way (whereas before I may have thought, "I'm a pretty patient person"), I am also able to discern my shortcomings and sins more easily. I no longer think I'm "pretty good at being patient" that's for sure! In an indirect way James helps me to be more humble in seeing and trying to correct all my flaws. He certainly helps me to "remove the beam from my own eye before pecking at the splinter in my mother-in-law's eye!"

The above article was exactly the affirmation I needed this morning. I think I'm going to print it out and carry it in my pocket.

Wednesday, March 11, 2009

Breastfeeding 454 - Oversupply Management II

If, after trying the pre-pumping and block feeding techniques mentioned in the previous post, your milk supply remains overly excessive, you can try various chemical means to interrupt your body's lactation. I must CAUTION you about these treatments: BE CONSERVATIVE! While they may be effective at bringing down your milk supply, taking these various treatments can also deplete and/or dry up your milk supply completely. You never know how your body will react to a treatment - so always, always try these remedies in very small, conservative increments - in order to properly ascertain your body's response!

Again, I will repeat, it is always better to try non-chemical means of managing overproduction before chemical interventions. These non-chemical techniques include:
  1. Pump off some foremilk to make it easier for baby to latch-on an engorged breast; also useful at decreasing the forcefulness of an initial letdown.
  2. Try unilaterally block-feeding your baby on only one breast for a set period of time. After this time period, switch breasts to feed on only the other breast for a set period of time. This style of feeding should help to down-regulate your body's production, with the intervals becoming shorter and shorter until you are eventually able to nurse your baby on both breasts during a feeding.
If these methods have not been effective for you, first talk to your lactation consultant about the following chemical means for reducing lactation. If the LC feels it is appropriate and safe to try these treatments, be sure to start in low doses so that you are able to understand your body's response to the treatments and proceed cautiously.
  1. Drink sage tea. Sage has a natural estrogen in it that competes with lactation-promoting hormones, and therefore has a tendency to decrease your production. Women who have lost their babies shortly after birth are advised to drink sage in order to dry themselves up - so be careful and don't drink too much! To make sage tea, put 1 tsp. of dried sage from the spice rack at the grocery into a tea infuser ball, then let it steep in a cup of hot water for about 5 minutes. You will probably want to also use another kind of tea mixed with lots of milk and sugar, because sage is very bitter. Try drinking one cup, wait 12-24 hours, and if your body hasn't responded, try drinking two cups, etc.

  2. Eat soy. Soy also contains natural estrogens that compete with lactation hormones in your body. I actually came across this remedy accidentally: I bought a number of soy-based energy bars at the grocery and snacked on them for a quick and nutritious meal during busy days with James. At the end of 3 days snacking on the soy bars, I noticed that I was producing almost no milk!! I immediately realized it had been the soy bars and stopped eating them, but it took 10 agonizing days of a hungry baby for my supply to return to normal. Again: be cautious! To obtain soy in your diet, you might try eating just ONE soy energy bar, drinking just ONE glass of soy milk, etc.
Finally, on a somewhat related note:
100-200 mg of vitamin B-6 per day will help with the swelling and pain of engorgement. I don't believe it brings down milk production, although you may feel that way since it will cause your breasts to become smaller and lose the ultra-full-swollen feeling. As with any treatment, be sure to double-check with your lactation consultant before trying it.

I'd like to encourage overproducing women that with patience, your supply will eventually regulate and hopefully you will be able to breastfeed your baby successfully. Take advantage of the ease of pumping for those of us with oversupply, and if your baby will absolutely not take to the breast, PUMP and bottlefeed! This way, you will be able to keep your supply for whenever that time arrives when your baby is ready to breastfeed. Be patient, however! For James and me, it took almost 3 months before he was able to breastfeed successfully. I believe that our eventual success in breastfeeding was a combination of factors: (1) James was more mature and able to handle my forceful letdown, (2) my milk had finally decreased to a reasonable amount, (3) the amount of foremilk had also appropriately adjusted downward so that James received more than just "sugar water" from nursing. At 11 weeks, when James finally latched-on and nursed successfully, I was ecstatic. I was so glad that I still had my supply and had not switched to formula. Ladies, don't be shy to keep pumping and offering your babies the breast. Eventually they will be able to accomplish this "overabundant" feat!

Tuesday, March 10, 2009

Breastfeeding 453 - Oversupply Management I

In continuation from yesterday's post, if you are dealing with issues of oversupply and over-letdown, you may experience difficulty in finding a lactation consultant or breastfeeding group that takes your concerns to heart. Oversupply is not as common a problem, versus women who believe they don't make enough milk -- and therefore, there is little advice "in circulation" regarding how to manage excess milk production.

After struggling with this issue with our son James, I think the first step to take when attempting to manage excess supply is to try and see things from your infant's perspective. Your baby is probably fussy and reluctant at the breast, and you are probably overcome with consternation as well. It was easy for me to feel upset with James. I thought to myself, "Why can't you just stay latched-on?!" James would often latch onto the breast and then about 10 seconds later, pull away, screaming and upset. This would, of course, make me frustrated and upset, but perhaps a bit of perspective is in order:

A woman who overproduces milk may have an overactive letdown reflex as well. When your baby attempts to nurse, he may receive an extreme and forcefully delivered volume of milk, versus the normal, manageable volume that is emptied into the infant's mouth at a slower dribble. Your infant may have trouble sucking, swallowing, and breathing in the midst of such an overwhelming letdown. Often, he may become choked at the breast - a feeling that is not only annoying, but painful!

Furthermore, in response to an overactive letdown, your infant may suck less vigorously, so as not to draw too large a volume of milk from the breast at one time. This only works, however, until the initial forceful letdown is relieved, and then the infant must suck to receive further letdowns and/or the hindmilk. With James, this proved to be quite confusing to him. He would begin a feeding with light suckling so as to avoid being overwhelmed by the milk, but he did not seem to understand that in order to finish the feeding, he needed to continue sucking strongly. Often, after an initial letdown had finished, James would become angry and hit my breast as if to say, "Hey! Where's the rest?!" Yet nothing was delivered to him because he did not continue sucking. Your infant may struggle with this same confusing learning-curve.

Secondly, if you overproduce milk, you are likely to have a great amount of foremilk. While foremilk is important, it is mostly composed of sugars and water, versus the hindmilk that comes later during a feeding and is composed of fats and proteins. Babies need both foremilk and hindmilk, but in an overproducing woman the baby may become completely full with foremilk before any hindmilk is delivered at all! This leaves the infant with a full feeling in his stomach, yet "still hungry" signals are being sent throughout his body because he has not received the proper amount of fats and proteins to complement his meal. This can cause the infant to instinctively nurse once more, but he may experience frustration at the uncomfortable, overly-full sensation he is receiving from his tummy, yet while also receiving "hungry" signals from his brain.

Finally, because an infant who recieves only foremilk during feedings has consumed only sugars and water, it can disturb the osmotic balance of the GI tract. Infants receiving only foremilk may experience quite a bit of gas and have uncomfortable, runny bowel movements.

There are a few very practical and easy solutions to these problems, which I will introduce here. If these solutions do not work, you may have to try more involved therapies (see tomorrow's post). However, these simple fixes may work well for many women dealing with initial engorgement, oversupply, or prolonged engorgement.
  1. If you are engorged, one way to make it easier for the baby to latch-on is to take your hands around the nipple/areola, and basically push back on your breast. You are attempting to push the milk BACK into the ducts, and make the areola area softer and smaller for the baby to latch on to (although you may also accidentally cause some milk to squirt out, this is not your primary goal). The milk with not clog your ducts, it will merely come back down the ducts and be released when your baby starts nursing.

  2. If you are experiencing an overactive letdown or overproduction of foremilk, PUMP OFF SOME FOREMILK before nursing your baby. Your production will slowly go down; don't worry about causing yourself to be perpetually engorged by pumping your breasts and nursing. I promise that your production will slowly decline. Pumping the foremilk may help your letdown to be less forceful, and it will give your baby the opportunity to learn that suckling is required to obtain the hindmilk.

  3. If you experience prolonged engorgement or a truly excess production of milk, try unilaterally block feeding your baby. You can read a research article explaining this method here. First, pump all your excess milk from both breasts. Then, feed your baby on only one breast for any time period of 2-12 hours before you switch breasts, depending on your level of overproduction. After the specified time period, you will switch breasts and then nurse your baby on ONLY the second breast for the same time period. As explained in the article, this technique helps to down-regulate milk production, so that your time intervals should become shorter and shorter as your milk production decreases until you are finally able to nurse your baby on both breasts at one feeding.
Tomorrow, I will cover a few more medicinally-leaning techniques for managing oversupply, but you should ALWAYS try the above suggestions first. Chemically challenging your body's lactation is necessary in extreme cases, but it can also lead to severly decreased and/or cessation of milk production! Therefore, the above suggestions which rely on physical cues only, should always be tried for at least a week before resorting to secondary techniques.