25 January 2010

To wean or not to wean

There is a lesson here, if you have time to read though this...

I have breastfed all four of my boys.  I feel passionate that it is the best thing to do for my children, but I also know that it is not always possible for everyone and do not judge others for their choices.  That said, I do think a mother owes it to her kids to at least give it a try before making a decision not to do it.

My four experiences have all been different from start to finish.  When I was expecting my first son, I was sure I would breastfeed him and did not expect any problems.  After he was born, via c-section, he latched on and nursed well during his first day.

Being a new mom, I had no idea what I was doing.  I had been told two things... that babies basically set their own schedules and that I should never wake a sleeping baby.  These two issues set me up for failure.  Zack slept 6 hours and when he awoke, he would not nurse.  He screamed and arched his back and refused to latch on.  In hind-sight, I assume he was starving and was impatient for the immediate satisfaction that came from a bottle that the nurses quickly gave him, after chastising me for letting him sleep too long.  He also turned out to be colicky and extremely sensitive to sensory stimulation, so it could have been anything and that is another issue entirely.

This was not the best start to motherhood.  I quickly insisted on leaving the hospital 48 hours after my c-section, hoping that once we were home, I could quietly nurse my baby without the pressure of the nurses.  Zack continued to refuse the breast, though.  Every time I tried to feed him, we both ended up frustrated and in tears.  I persisted, though.  I could not give up, so I continued to pump and bottle feed Zack.  Each feeding lasted twice as long as it should have because I would pump each time I bottle fed him, even through the night, to keep up with the need.  After 3 weeks, I was ready to call it quits.  I was exhausted and emotionally drained.

One day, though, we were sitting on the sofa, Zack drifting in and out of a nap in my arms.  I decided to see if I could get him to nurse while he was in that drowsy state, not so hungry.  Sure enough, he latched on and continued to happily do so for the next 14 months.

When he was 14 months, I decided he was old enough to do without the breastmilk and wanted to have some time before we started trying for number two.  The weaning process was a challenge, he was pretty attached to the experience, but I thought it was best for him to move on, so I persisted and after a few weeks, he was weaned.

When Dwight was born, he latched on and nursed very well, despite starting out with two days in the NICU and taking a bottle.  I was elated to have such an easy nursing experience and I learned that nipple confusion is a myth.  I was ready to nurse as long as he wanted.  When he was about 15 months, he weaned himself gradually.   I was not quite ready for it to happen, but he did it on his own and I followed his lead.

I always wanted four children, but I assumed that number three would be our last, so before Bob was even born, I was bound and determined to let him nurse until he was at least two.  We were moving overseas just after he turned two and I figured that the nursing would be great for transitioning him to the new surroundings (and 12 hour time difference.)  When he was born the first thing the nurse said to me when she brought him to me in recovery, after my third c-section, was "he is not going to be able to nurse.  He is very tongue tied."  I was shocked.  However, he did nurse pretty well.  I could tell he had to work hard at it, though, so we consulted an ENT and at six weeks of age, Bob had a frenulectomy.  (They clipped his frenulum, releasing the "tongue tie.")  He immediately nursed more easily and I thought my plan was full speed ahead...

Ah, but he had other plans.  When he turned one, he tossed the pacifier out of the crib, on his own, and two weeks later, he refused to nurse.  He weaned himself, cold turkey, and I was devastated.  I pumped and kept up my supply and continued to try to return him to the breast for 6 weeks, to no avail.  He had moved on.  I could not believe it.

Finally, while living overseas, we decided that our family needed a fourth child.  Harold was born while we were living in Beijing.  I could see, immediately, that he was tongue tied just like Bob had been.  I informed the OB and pediatrician that we would not leave the hospital until they had fixed the problem.  On day two of life, Harold had his frenulectomy and he nursed well.

We knew we would be moving again when he was 18 months so I was hoping to be able to breastfeed him through the move. By this time, though, I had wised up enough to know better than to count on it, but he worked with me and was still going strong when we moved.  Two separations did not even sway him.  I pumped during the absences and he took a bottle until I returned and he latched on without incident.

Harold turned two in December and showed no sign of weaning.  I began to wonder if this was the time to guide him through the weaning process but did not feel great about it.  He was so happy and I really hated to take that away from him.  I figured, though, that two was old enough and much past that might be too old.  So, we went from three feedings per day (wake-up, nap and bedtime) down to zero in about a month.  Last Tuesday was his last morning feeding.  He even gave it up on his own, much to my relief.  I wondered how I would ever give it up since it gave us an extra bit of time resting in the morning, but he woke up on Wednesday and said "Hi Mommy, we go downstairs now."  So, that was it!  Of course I had mixed feelings but I knew it was a good thing for both of us.

He asked to breastfeed once in a while over the next several days, but it was a quiet, half-hearted, request that he quickly moved on from each time.  Today, however, he awoke with a fever and stuffy nose and cough.  When he asked to nurse, I decided to let him.  The comfort and the nourishment it provides is like none other and withholding it seemed unnecessary.  So, here we are, back to the drawing board. 

The lesson I am hoping to provide in this very long, stream of consciousness, post is that it is great to have goals and a plan but try to keep them loose.  If you have a firm parenting plan, you could be setting yourself up for disappointment and frustration.  Children come with their own plans and it is up to us to figure them out and work with them.  We can learn lessons from our children, but each child is different so we have to be flexible.  This lesson is true for most aspects of parenting- sleep schedules, feeding, discipline and more.

When it comes to breastfeeding, I am a big advocate, but I always reassure my clients, friends and anyone who asks... Give it a try.  If it is a struggle at first, try hard to get through the first six weeks and most likely it will get considerably easier.  If not, evaluate the situation, give it a lot of thought and then make a choice.  It is your choice.  You have to decide what is the best path for both you and your baby.

So, we will see what tomorrow brings us...
Good luck!

19 January 2010

What I am Reading Now

Don't Swear With Your Mouth Full.  By Cary S. Chugh, PhD.  It is a great book for parents of children who don't respond to traditional discipline methods.  Stay tuned for highlights...

07 January 2010

Miscarriage


Miscarriage... It is not often discussed but it is so common that once the topic is breached, I find most women I meet have a personal story.

At least 30% of pregnancies end in miscarriage but many losses are so early that women may just think their period is late and not even know they have lost a pregnancy. Today, though, with the easy availability of home pregnancy tests that can detect a pregnancy even before a missed period, more and more women are aware of the loss.

When I was pregnant with my first son, I was ultra conservative and careful about every aspect of my life. I ate carefully, did not take any medication whatsoever, exercised moderately- not too little and not too much, etc. My baby was born healthy. The next time I was pregnant, I decided that I should relax a little and not be so paranoid. I really did not do anything differently but at 7 weeks, I miscarried. So, I reverted back to my old thinking and was uber-cautious.

I knew that the miscarriage was not caused by anything I did but making sure I followed all the "rules" made me feel like I had more control over the situation. I knew that by eating well, avoiding medications and alcohol, avoiding any chemical known to be harmful- including caffeine, I was doing the best I could for my baby. I conceived the second month after my miscarriage and delivered a healthy baby 9 months later.

As it turns out, for some reason, I lost a baby before each of my four healthy pregnancies. In hindsight, I now know that I had a miscarriage before my first baby as well. Like many other women, I thought I was just late, but I'm never late. My OB told me that, while there is no way to know for sure, it is most likely that I had a miscarriage the month before I conceived my first son, making the total 4 losses. After a moderate level of testing, no cause was found for the miscarriages. My theory is that the babies I lost were girls and for some reason my body cannot carry girl babies. It is only a theory, though, my doctor did not dismiss the idea, nor did she confirm it.

I know there was nothing I could do to prevent the miscarriages. I did everything I could to make sure my body was healthy before I conceived and continued to do so until my babies were born. Each pregnancy was different. Each one brought different complications but in the end, all the boys are healthy.

Having been there and done that, I would advise every woman who wants to get pregnant to prepare her body by living like she is already pregnant when she starts trying to conceive and continue the clean living throughout the pregnancy. Doing this will help you know that, no matter what happens, you have done absolutely everything you can for your baby. If, G-d forbid, you have a miscarriage, you will know that nothing you did caused it.

If you have 2 consecutive losses, ask your doctor to do some simple blood tests. One simple and often overlooked test is: Factor V Leiden Mutation. Progesterone levels could be low. It could have been a random chromosomal abnormality. Your doctor can help you, so don't be shy. Be your own advocate. If you have more than one loss, and you have to have a D&C, ask the doctor to test the material for abnormalities. If you have a feeling about a problem, don't be shy, you know your body and should ask the doctor any and all questions you have.

If you have any questions or concerns, contact me at Erin@EveryBabyBook.com