Weaning

Weaning (the process of transitioning from breastmilk or formula to adult/table food) is, like many other things in parenting, something that each diad or triad has to figure out for themselves.  There's no "right" answer or way to do it.  So if you're reading this looking for advice, please don't feel like this is a prescription for what to do.  Just a description of how we did it, in case that's helpful for you and your family.

Miss O was fully breast fed or nursed until I went back to work at 3 months.  We did occasional bottles during that time, to get her used to someone else feeding her (see this post for an explanation).  But MOST of the food was with me.  At 3 months, I started pumping full time at work, which meant hiding out in my office 2-3 times per day with the double pump, so that O could have enough breast milk to last her during the day while she was at day care.  We continued on that pattern until 4ish months.

Between 4-5 months, we started giving O "tastes" of foods.  she'd lick a carrot (yes, raw) or we'd put a spoon full of something in her mouth for the flavor, knowing she'd push it back out with her tongue.  We did this just as she was beginning to sit up supported, such as in a bumbo chair or well supported in one of our laps.

At 5 months, the daycare provider told us "Olivia cries when other babies eat food and she doesn't have any!"  I know that her crying was about wanting to be part of the experience, not about hunger.  But it made me feel guilty anyway. :-)  Thus, even though we never really planned on doing purees at home (which reminds me I need to write a post about baby led weaning), I started sending 1-2 little containers of pureed veggies, fruits, or meats into day care for them to play with.  During this process, she still was getting all her required nutrition from breast milk.

Between 6 and 9 months, we started offering solid table foods.  This phase of the game took a LOT longer than I expected.  I thought my curious daughter would start eating food and really pull back on the breast milk... but no, she didn't.  I got more efficient with my pumping, so that I only needed to pump twice daily.  But I still was S.O.L. if I couldn't pump the 10-12 ounces she needed during the day.  That's why all of you who know me in real life started noticing how much weight I lost around 9 months!  I couldn't keep the girl satisfied with enough breast milk!

All of that leads me to the decision process on weaning.  By 12-13 months, several things had happened.  A, I was SO SICK of pumping at work. B, I'd increased from 20-32 hours, meaning that I'd have to pump even MORE than I used to.  C, Olivia had transitioned from day care 3 days a week to being home with our awesome summer nanny 4 days a week.  D, she was REALLY doing well with eating solid foods.  I could tell that she was doing more than playing with the food, actually eating it.  Our grocery bill was going up.  Table food was successful.  Thus, I decided the time was right to slow down on the breast milk and really increase the solid food intake to meet O's needs.  I felt like I needed to do one thing at a time-- night weaning or pump weaning.  And since I hated the pump so much... it was what I got rid of first.

The process of weaning from the pump was stressful to me.  I didn't know how much to pump, how frequently to pump.  I was worried about engorgement.  But it all worked out.  At 13 months, I started pumping less, but still twice a day.  A couple weeks later, I transitioned to pumping once a day but still on both sides.  And finally, I started pumping once a day, but only one side (alternating days).  At 14 months, I had a couple of really busy days at work, forgot to pump all together, and realized I survived!  Thus, I brought the pump home, sterilized it, and sold the darn thing!

Simultaneously, I weaned Olivia off bottles.  She went from 3 a day to 2 a day at around 12 months.  Then from 2 a day to 2 smaller ones per day around 13 months.  Then down to 1 a day at 13.5 months. By 14 months, she was getting a little 2 ounce bottle of breast milk, mostly just because she liked it and not for the calories.  Then, of course, I'd stopped pumping.  But I had this frozen stash of breastmilk that I'd been managing all along since storing up during my maternity leave.  So I decided we should continue with the little "snack bottles" until it was all gone.  I started defrosting 2 ounces at a time, and MOST days, O would drink one.  Though some times either the nanny or daddy would forget.  At this point (we're nearing 16 months), we have one week left with summer time nanny and then O goes back to daycare.  The timing is going to work out perfectly, because I have about 8 ounces of breast milk left in the freezer!  I can't believe how many transitions are happening this fall.  But at the end of next week, no more bottles, no more breast milk in the freezer will be one of them!  Crazy, right?

At 15 months, I also started getting tired of night nursing.  We were still waking twice per night (midnight and 4ish) to nurse.  And though we have a "family bed" and a montessori bed next to it, O can come and go as she pleases, the lack of consecutive sleep had begun to wear on me big time.  So, Ben and I flip flopped places in bed and we started night weaning.  It's taken about a month to get it down consistently, but O is going from 7pm to 6 am more often than not without nursing.  She frequently wakes and cries at which point daddy will soothe her back to sleep with a pacifier, back rub, and some water from the straw cup if needed.  But night nursing is essentially done.  Even on nights when daddy isn't home, we can get the same pattern with me (though I am more likely to just nurse her if she wakes... I'm lazy when I'm woken out of REM sleep).

All in all, it's been successful and by 16 months, I think we'll be consistently only nursing about twice daily-- morning before day care and evening before bed.  I hope we'll continue that pattern and relationship through the rest of this year (up until O's 2nd birthday in April), but I think she'll tell me when she's ready to be done.

How did you and your family decide to wean?  Cold turkey? Night wean first then bottle wean? Other?  

Breastfeeding while Sick? 5 things...

In February I had the inevitable happen... I got sick.  Really sick.  I spent 24 hours pukin' my brains out followed by a week or so of what my family would call "lower GI symptoms."  Ya know what I mean?    Lower G I ???  Anyway, not only did I feel like I wanted to die, and thus didn't really want to put baby's needs first, but I had a sudden drop in my breast milk supply.  I was panicked (once I finally had the energy to be) that this might be a sudden end to my nursing relationship with O, months before I'd hoped.  But in the end, we pulled through.  Here we are, several weeks later, no worse for the wear and with some advice for those of you who might go through something similar...

First, don't stop nursing!  Very few illnesses in the first world require you to stop nursing.  If you get advice from your doc to stop nursing, double check with your lactation consultant and/or midwife.  If what you have is viral, your infant has probably been exposed to the virus through your breast milk before you even have symptoms.  Besides, as you are fighting your illness, your body is creating antibodies to combat the virus... and baby gets those through the breastmilk too!  So it's a good thing to keep giving it to them.  But on a more 'systems' side-- even if your body doesn't feel like it's creating a lot of breastmilk, if you stop stimulating your breasts, you will reduce the supply.  So please please keep nursing, even if it seems futile, if baby doesn't seem satisfied afterwards, etc.

Secondly, hydrate, hydrate, hydrate!  It's important for you to be drinking LOTS of water and/or gatorade (with electrolytes).  You lose more water than you think when you have... lower GI symptoms... AND you lose lots of water when you nurse.  Ergo, you need to be replacing a TON of water when you're sick AND nursing.

Third, hydrate your baby.  While we're on the topic of hydrating... if you feel like you can't hydrate your little one enough because of your temporarily low milk supply, it's not a bad idea to think about giving her some extra fluids too-- pick up a little pedialyte from the store (preferably the non-flavored kind... they don't need random flavorings...) and give baby a bottle of it per day.  When I was sick, little O didn't love the pedialyte at first.  But by the end of my week of illness, she sucked the pedialyte down by bottle.  And it made Ben and I feel really good when she had nice, full wet diapers.  (I know.  Sad when life progresses to the point that a full diaper is what makes you feel good.)

Fourth, consider what medications you take.  Most of the over the counter drugs we tend to take in the US while sick (e.g., tylenol, antacids, cough meds) are either 'safe' or have a 'safe formula' that you can theoretically take while nursing.  However... most of these meds simply mask or reduce symptoms, but they don't actually make you well any faster.  If what you've got is a virus, it's gonna have to run it's course.  So please look up meds online -- I'm not going to go through which ones are safe here and which aren't.  But maybe consider NOT taking something that's just supposed to make you feel better.  'Cause if you know modern science at all, you know that we can't really do randomized controlled trials on mothers and babies, so we don't REALLY know what all the effects are.  So maybe a warm washcloth to soothe your headache is better than tylenol.  Or some natural gingerale could ease your stomach pains, or a neti pot could clear your sinuses without the dayquil.  You made it through labor and delivery... you'll probably survive a couple days of feeling like crap too.

Fifth, stay calm.  Stress will only make the whole thing worse.  I know that's so hard to hear and believe when you're in the midst of it.  But the mind-body connection is something that none of us understand as well as we should.  So if you can breathe and believe that you, too, will survive this drama... it will probably come true. :-)

Nursing Mother, Working Mother by Gale Pryor

I recently finished reading this book, Nursing Mother, Working Mother by Gale Pryor and Kathleen Huggins.  I'd picked it up at my local branch library, because I thought the title and topic were particularly relevant for me.

I'm not going back to work full time, but I am returning 20 hours a week after the end of my maternity leave.  And because of the length of my work days, I will certainly have to pump while I'm there.  I thought, based on a brief scan while standing in the stacks, that this book might offer me a bit of support, advice, and encouragement, specifically about the pumping part.

After having finished it, I'd say that it certainly is well written, but possibly a bit repetitive if you plan on reading it word for word.  In addition, the early chapters were very basic/familiar to me from previous reading I'd done on Attachment Parenting. However, for anyone who isn't obsessed with reading parenting books but is just looking for 1 or 2 basic ones to get started, those early chapters are a nice summary.

The 2nd half of the book was more relevant to me... providing advice about the different factors involved in being a nursing mom who works, pumps, etc.  And overall, the book gives a nice background history on women's rights with regard to being a mother in the workforce and also some interesting cultural information about breastfeeding and different parts of the world.  For instance, in one of the early chapters, the author sites a study from Tanka in South China.  According to this book, women who nurse typically do so with their right breast only.  And 80% of the breast cancer that develops in older women occurs in the left breast.  Pretty decent argument for breastfeeding, eh?

Engorgement

Holy Cow!  Engorgement is a nightmare!  Stop reading now if you know me personally and don't want to know intimate details of my breasts... seriously....

So when I was about mid-way through my pregnancy, a friend with a 3-4 month old child at the time gave me some great advice.  She told me that she'd focused so much on reading up about pregnancy, labor, and delivery that she sorta forgot to read about what happens afterwards -- child rearing and all of the pieces that entails like breastfeeding, sleeping, etc.  She recommended I not follow her footsteps and do a little reading about what was to come.

Did I follow that advice?  NAH.  Why?  I was so engrossed in my pre-motherhood life and my green principles and my goals for a natural pregnancy, labor, and delivery, I really just didn't recognize how important her advice was.

And while in the hospital on days 0, 1, and 2, the early parenting thing was so straight forward, I thought I had time before things would get hard.  I mean, nursing went well from the first moment (the lactation consultant called us "the best pair for nursing in the unit right now!"), Ben was a rock star diaper changer, we were getting a fair amount of sleep, eating well ourselves, fought off the crazy pediatrician... what could possibly go wrong in the first 24 hours home?

Oh... you mean day 3 and 4?  THOSE first 24 hours at home? The days where engorgement is likely to bite every mother in the *ss???  And who had done no reading about it and didn't know what to do?  ME!

So.  For those of you who aren't yet mothers or maybe didn't have to deal with engorgement during your first child's life or something, engorgement is when you're finished producing colostrum and your milk comes in.  For me, it happened on Friday night, 12 hours after getting home from the hospital (aka, the land where nursing was easy), and coincidentally, while Ben was at work.  His mom had come to stay with me for the first 24 hours so that he could work and I'd be taken care of.

So we were nursing right along and everything was fine... and then all of a sudden, my breasts were literally the size of watermelons.  I thought they might explode.  And I knew that there was something I was supposed to be able to do about it, but I couldn't figure out what.  So my post-partum emotions just made me cry... not necessarily helpful.  My right side (while huge) was not as bad as the left, so Olivia still latched on fine and could feed.  But she and I could not make the left side happen for the world.  It was too engorged, to firm, and she couldn't get latched.  And my crying didn't help because it just made her cry.

I'd read and listened to a lot of sources that said one should not pump early on, because you don't want to teach your body to make more milk than your child needs, or it can make things worse.  But I couldn't figure out what else to do.  And Ben's mom was really interested in me pumping.  Unfortunately, the pump wasn't cleaned/sanitized, so I couldn't do it until Ben got home... hours later... after much crying... and yelling at my poor mother-in-law (who took it in stride, I might say!).

I did end up pumping on the left and feeding on the right through the next 12-18 hours while I figured things out.  I knew it wasn't the "ideal" situation, but it was how I could survive through the night and I didn't know what else to do.

The next day, once calm enough to actually do a functional google search, I learned about Reverse Pressure Softening, which was really my saving grace through the rest of the weekend.  I made a call on Saturday to the lactation consultants at Mt Auburn who also supported my choice to use RPS and to stop pumping.  And by Monday, we didn't even need the RPS!  We'd made it through!  Later, my midwife asked me if I'd tried cabbage, which I hadn't.  But I guess it would be the next solution on my 'to-try' list if this ever happens again...