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Breastfeeding After Gastroschisis – Member Story

Renée Barendregt and her baby Harry, who was born with gastroschisis

Our closed breastfeeding support group is full of amazing parents who use their own personal experiences to support and inspire others.  Some of these parents are facing challenges that seem impossibly difficult.  Renée Barendregt is one mum with a story to share about breastfeeding her baby Harry, who was born with a birth defect called Gastroschisis.

Renée‘s Story

Harry was diagnosed with Gastroschisis when he was in the womb at only 12 weeks. Gastroschisis is when the bowel is protruding out of a hole on the stomach that is meant to close over around 10 weeks. Depending on the size of the hole, more than just the bowel can be growing on the outside.

As you can imagine this was a huge and heart breaking shock for my partner and I.  We learned that our baby boy would be taken into surgery as soon as he was born.Before I even conceived, breastfeeding was extremely important to me. I believe it is a true blessing to nourish our children in such a natural, beautiful way. But I knew it wasn’t going to be easy to begin with. I knew it would be challenging, especially after learning that he would not feed for possibly the first 2 weeks.

Harry was born by emergency Cesarean at 34 weeks and 5 days weighing 2kgs. Although we were nervous, we had the whole pregnancy to somewhat ‘prepare’ ourselves. Harry was taken from us straight away. All I was able to do before he left was touch him with my finger. There were doctors surrounding him, helping him breathe. At this point I was sad. I didn’t get skin to skin contact and couldn’t breastfeed him straight away.

He Couldn’t Have Any Milk At All

For the first 3 weeks of Harry’s life, he was not able to have any milk. He did not have one single drop of milk for the first few weeks of his life, because his bowel was not working properly yet. Yes, you’re right, he would have been starving. And for me as a mother this was heart breaking. I had my alarm set 24 hours a day and pumped every 3 hours. It was hard and confusing because I couldn’t be with him over night. Every part of me was yearning for him.

I would take my breast milk into hospital each morning and by the time he could actually have any, there was bucket loads.

Feeding Harry

I couldn’t directly breastfeed him straight away, he was fed through a tube in his nose. The doctors had to monitor exactly how much was going in to determine that his bowel was working properly. He started with a tiny 2ml every 3 hours until his bowel “woke up” and was able to tolerate more.

Renée Barendregt and her baby Harry, who was born with gastroschisis
Renée Barendregt and her baby Harry, who was born with gastroschisis

It got to about 3 and a half weeks and they said I could try and breast feed. Although I had to drain my boobs first they explained he still would get a small amount! I was so excited the moment finally came. He fed wonderfully.

As a mother, I cant help but feel guilt over those weeks. I wasn’t able to respond to my baby when he was hungry or scared or be there next to him 24/7. But I gave him as much comfort as I could in the situation that faced us. The nurses fell in love with Harry, they always said he was so good and never complained, even when he was hungry those first few weeks.

Our breastfeeding journey was a little up and down when Harry got home from hospital, but we have stuck at it and are still going. Harry is now nearly 10 months old, and is as healthy as any other ‘normal’ 10 month old. At this stage there will be no further issues with Harry’s tummy.

I would love to meet more mums and hear more stories. Follow our journey on Instagram www.instagram.com/hello.harry_

Renée x”

Thanks so much Renee, for sharing your story with us.  Renee would love to meet more mums and hear more stories.  She would love for you to follow her on Instagram here.

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LaVie Lactation Massager (AKA Boob Vibrator)

A few weeks back, my Facebook newsfeed exploded with posts about the Lactation Massager from LaVie – a new kind of vibrator especially designed for clearing milk blockages.  I was tagged in a lot of these posts by friends and followers who remembered a post I put up back in January about using a vibrator on my own blockages.  My friend Diana at Milkbar Breastpumps got in touch with me around that time and offered to send me a LaVie Lactation Massager for my feedback.

I felt a little skeptical about this product, mainly because I have been using a cheap vibrating wand from eBay which works really well – would the extra expense for a dedicated boob vibrator be worth it?  And would it actually work better?  Not only that, but the LaVie did seem to resemble a sex toy, which again, caused me to wonder what advantages there would be to using a LaVie instead of my cheap vibrating wand.

Why Use Vibration?

Basically breastmilk is thick and can coagulate to form a blockage.  Vibration might help your milk drain more effectively.  If your milk flow is restricted, either by engorgement caused by oversupply or infrequent draining, or by something pressing on breast tissue (eg a bra or shirt that’s too tight) blockages can form, that further stops your milk from flowing properly.  Vibration can help dislodge blockages and liquify them enough to get them out of your breasts.  It also feels really satisfying for  your breast to be drained so effectively, and I also find the vibrations relaxing, like a supercharged massage on my skin and across my chest muscles that are often too tight from spending too much time sitting with a poor posture.

What features does the LaVie come with?

The LaVie Lactation Massager comes with some pretty cool features:

  • It has a rechargeable battery, so you can use it without being anchored to a power point
  • The battery also charges up super fast.   The brochure said it would take up to 30 minutes.  I didn’t check exactly how long, but I plugged it in the first time, and when I looked at it about 15 minutes later, it was fully charged (and it wasn’t charged when it arrived because it wouldn’t turn on)
  • It’s a medical grade silicone and BPA free.  It feels lovely and velvety soft
  • It’s completely waterproof, so you can take it in the shower and submerse it in the pool or kitchen sink.  This also means that you can use something oily to aid the massage effect (which I recommend, because although the medical grade silicone is soft, it doesn’t glide across your skin as well as a smooth plastic would)
  • I would describe the LaVie is broadly shaped and is capable of sending vibrations across a fairly large area, which is handy when you’re dealing with a large blockage
  • It has varying levels of vibration and vibration modes, so you can find what really works for you

Is it just a rebadged sex toy?

This question may not be running through your mind, but it was definitely running through mine.

Being a vibration tool, the comparison was always going to be there.  I have seen sex toys that look exactly like the LaVie, right down to the silicone covering, the bright girly colours and the shape.  The variety of vibration modes also add to this comparison (eg buzz pause buzz buzz pause buzzzzzzzz pause – I am still a bit confused about how these types of modes are useful in lactation).

But the vibrations are too broad.  They are clearly designed to stimulate a large area.  If this was a sex toy, the vibrations would either be concentrated at the tip for clitoral stimulation, or the actual massager would be shaped either as a phallus or with a curved tip for g-spot stimulation.  Also, after some experimenting, I can see that the shape of the LaVie is excellent for reaching blockages that are deep within breast tissue.  If you want an orgasm, you’re not looking for something that’s going to stimulate your deep tissues.

In conclusion on this point, if the LaVie actually is a rebadged sex toy, it wouldn’t have been a very good sex toy.  If you want to wear it in your underwear or have a play with it downstairs then I won’t judge you for it, but I feel pretty confident in saying that it’s been designed for breasts.

Should you buy a LaVie?

If you:

  • Are comfortable with the $39,95 price tag;
  • Not comfortable with the idea of buying a sex toy to use on your breast;
  • Looking for something wireless; and
  • Looking for something waterproof:

then the LaVie could be a great choice for you!  I can especially see it being popular as a gift you might buy for a new or expecting parent.

If you also like supporting local retailers, then you should consider shopping at Milkbar Breastpumps.  The LaVie was gifted to me in exchange for my review.

 

 

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My Extended Family – Sometimes Support Looks Different

I’ve talked lots of times about how thankful I am for growing up in a family where breastfeeding is completely normal.  My husband’s family isn’t like that.  They aren’t “against” breastfeeding, like some families are, and they have never tried to convince me to stop, for any reason.  I think they are probably like a lot of families in Australia – they know breastfeeding to be the normal way to feed babies, and they have seen the campaigns telling everyone why it’s important, but they are still wrapping their heads around because they didn’t grow up around it.

They sometimes don’t know which way to look when I’m breastfeeding, especially as my kids have grown out of babyhood and into toddlers, but they don’t say anything – they know their feelings are their issue and don’t expect me to stop on their account.  They sometimes ask questions about how it all works.  Sometimes they make inappropriate jokes, which can be a bit squirmish for me, but I don’t take it as a sign of disrespect, it’s just their way of getting used to the idea.  Sometimes they tag me in every single breastfeeding thing they see on Facebook too.  Sometimes I’ll be tagged in the same thing twenty times after I’ve already seen it in every single group I’m in, but ultimately I appreciate the effort everyone goes to, to find common ground with me.

Soon after my son turned 3, breastfeeds became something that we don’t do out of our home, and soon after that they were something that only happened in bed, either before or after sleeping.  So while I have never lied to anyone, it would be understandable for any family members who don’t read my blog (most don’t), to assume Mr 5 finished breastfeeding a year or two ago.

A few weeks ago at a family barbecue, everyone was feeling pretty merry after a big dinner and a few drinks.  A family friend told a story of the horror and disgust he felt when he found out a bartender at a nightclub was still breastfeeding her 6 year old.  I looked for my kids, preparing to swoop them out of earshot if these comments turned into a boisterous conversation.  Mr 5 is extremely perceptive, and he would have felt great shame to hear someone talking about term breastfeeding that way.  I’m a pretty assertive person and don’t usually shy away from expressing my opinion, but I never considered engaging in a conversation or argument in this situation, purely for the protection of my kids.  My husband must feel the same because he didn’t say anything either.  I almost held my breath and shut my eyes, waiting to see the reaction from my inlaws.

A few of them suddenly found the grain of our wooden table very interesting.  Someone found a spiderweb in the corner of the ceiling to stare at.  I actually saw one or two rolled eyes.  After an awkward silence, one of my husband’s brothers very obviously changed the subject.

And that was that!

Some people might have felt the silence was a lack of support, but I feel the opposite.

What we say matters, but sometimes what we don’t say matters more.  I don’t know if my inlaws support the idea of term breastfeeding or not, but their unwillingness to get involved in a discussion shaming a mother and child for it while my kids and I were present means the world to me.  Sometimes support is loud and vocal, with lots of praise heaped on top.  And sometimes it’s a quiet nod in your direction, acceptance that you (you with the awesome kids, who are probably awesome because of the way you raise them) deserve space to do what you do when it’s working for you.

Sometimes the biggest hurdle to finding support from your extended family is understanding that although they don’t support you the way you expect or even the way you want, they probably still care about you in their own way.

I love and appreciate my extended family very much, and I’m blessed to feel like they love me too.

 

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My Stance On Tongue Ties

People often ask me what my thoughts are on tongue ties – specifically whether or not I think they are over-diagnosed, whether I think they are a fad, and what I think of professionals who deny their existence.

Well here it is.

Some people are tied and some people are not.  We should have professionals we can trust to assess and correct ties, and assist and support families through the recovery process so they can feed (and live) normally.

In an ideal world, this would be all I would have to say.  Sadly, there is a lot about the way tie issues are handled that are not ideal.

I’m tired of feeling like tie issues are political. I’m tired of feeling like I need to say which team I’m on. When it comes to breastfeeding support, I think we should all be on the same team.

I’m tired of the issue of ties being so contentious that I have had to alter my language when I’m troubleshooting breastfeeding problems with other families.  I feel like if I say “have you considered ties?” I might start a huge drama, basically where a bunch of people with loud opinions and an inability to listen to others join in the conversation to essentially embarrass themselves.   Instead I find myself saying “Have you considered having your baby’s oral function assessed by a health care professional who is experienced in the way oral structure can affect breastfeeding?  Some babies have physical deformities in their mouth that prevents them from breastfeeding effectively.  Sometimes these deformities require surgical correction”.  It’s convoluted and nonsensical, but I find myself feeling like I need to skirt the issue to avoid world war 3.

If ties are being overdiagnosed, then that’s a huge problem.  And if they are being underdiagnosed, then that is also a huge problem.  But the language people are using around these discussions, and the suggestion that families are irresponsibly seeking surgical treatment that’s unnecessary, is perhaps an even huger problem.

When I read posts about about ties being a fad, or that they are being overdiagnosed, and that online support groups are contributing to the problem, I feel like I am being blamed because my kids had ties, and having them surgically corrected had a positive impact on both of my breastfeeding journeys.  I feel like I am being accused of making this perceived issue worse because I tell other people about my situation, and encourage them to investigate whether they are facing the same problems I faced.  I have felt scorned for talking about my experience, and that is wrong.

Whether a family is being affected by ties, or whether they only think they are being affected by ties, the bottom line is that they have a problem that warrants investigation.

I’ve seen a lot of posts and articles published by medical professionals about ties that really concern me.  The language used ranges from dismissive and patronising (as if accounts from individual families are irrelevant, as if their successes and failures are meaningless and as if they’re so stupid that they don’t even know what did or did not help their breastfeeding journey) to alarmist (implying negligence or abuse for either seeking or failing to seek surgical correction).

If you’ve promoted a strong opinion on whether tongue and lip ties are a fad, whether they are over or under diagnosed or whether mum-to-mum social media interactions are creating mass hysteria, then perhaps you need to think about the consequences of that, and what your ultimate goals are.  Do you want to make parents afraid to talk about their experiences because they don’t match your own?  Do you want to make political statements and criticise your peers?  Or do you want to help families breastfeed.  Every family is unique, and we would do better to focus on the individuals in front of us, instead of making sweeping statements about what is a very broad and diverse group of people.

Our community of breastfeeding advocates is too small to be divided over this issue.

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3 Things To Say To Someone Who Is Worried About Their Milk Supply

It can be hard to know how to support someone who is having concerns about their milk supply. You may be aware that a lack of milk supply is actually very rare, but hearing that when you’re worried you’re not making enough can feel dismissive too.

On the flipside, going on a long-winded explanation about the process of supply and demand can feel overwhelming to the parent who is probably already feeling confused enough, as well as tired and stressed out.

And suggesting an introduction of formula, a full-time switch over, or early solids bring their own set of problems along. Additionally, lots of breastfeeding support groups (like Breastfeeders in Australia) have rules about not suggesting formula use to a parent who is committed to breastfeeding. You can read more about why we have this rule here and here.

Here are 3 things that I like to say:

  • How is nappy output?  When my son was a newborn, I remember ringing my IBCLC/Midwife, distraught that my son hadn’t had enough milk that day because he was crying and looking for more milk.  She asked me to think about how many times I’d changed his nappy that day.  Um, OK, well I wasn’t keeping track, but it felt like about a million, because he was a peeing, pooping machine.  And the penny dropped.  All of those wees and poos weren’t being created out of thin air.  The Australian Breastfeeding Association suggest that if your baby is having “at least 6 very wet cloth nappies or at least 5 very wet disposable nappies in 24 hours” then that is a good sign they are getting enough milk.
  • Have you thought about seeing an IBCLC?  An International Board Certified Lactation Consultant (IBCLC) is a health care professional with a specific focus on breastfeeding.  If you are having supply concerns, an IBCLC is the best person to talk to about whether supplementation is necessary, what the best way to offer it will be, and how to balance offering supplementation without unnecessarily risking your longterm breastfeeding goals.  Just as you would talk to a dietician about planning a healthy diet, or a personal trainer about the best way to improve your fitness and strength, an IBCLC can help you with any aspect of your breastfeeding journey.  The Lactation Consultants of Australia And New Zealand (LCANZ) can help you find someone close to you.
  • Have you thought about ringing the National Breastfeeding Helpline on 1800 686 268?  Here in Australia, we have a a free helpline with trained breastfeeding counsellors available 24 hours a day, 7 days a week to talk to families about feeding issues.  These counsellors have a minimum Certificate IV qualification and have the right skills to not only talk about the technical side of breastfeeding, but to also communicate in a supportive manner.  While their training is not to the same standard as an IBCLC, they are accessible to everyone and they have more breastfeeding experience than the average fellow parent you’d come across in an informal breastfeeding support group.  If you need help, but aren’t sure if your problem warrants a booking with an IBCLC, calling the National Breastfeeding Helpline is a great option.

There are lots of other things that MIGHT help – expressing, offering top-ups via a cup or syringe, breastfeeding more, skin contact, special cookies and other recipes and medication – but they also MIGHT NOT help either.

We’ve all heard at least one horror story of a baby who’s health was placed at extreme risk due to malnutrition because supplementation was not given when it should have been.  But if you join any community of families, you will also find many who’s breastfeeding journey had an untimely end because of unnecessary or inappropriate supplementation.  We can avoid both of these situations by making sure families have access to factual information and qualified people to support them.

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There Are Actual People Who Actually Behave Like That

Last weekend I had the pleasure of attending a beautiful wedding.  It was also child-friendly, which meant both Miss 2 and Mr 5 were there too.  Miss 2 is still an avid breastfeeder, so having her there with us was actually a bit of a relief.  It can be hard work running around after her, but I would prefer that over worrying about her being distressed in someone else’s care.

The thing about weddings is that sometimes they put you in a room with people you wouldn’t normally hang out with.  I think over the last 5 years, I’ve slowly conditioned all of the people around me to celebrate breastfeeding, or at the very least accept that I do it, and find a way to be OK with it.  Maybe it’s my social circle, hopefully it’s just society in general – I rarely come across someone who isn’t OK with me breastfeeding.

I was wearing my Colette dress from Mama Clothing. I didn’t get a pic at the wedding, but here’s a snap from my sister’s 21st.

Miss 2 breastfed frequently that night – she was a bit tired and out of her element with all of these new people, so she needed quite a bit of comforting.  I was happy to be wearing my beautiful “Collette” breastfeeding dress from Mama Clothing.  Towards the end of the night when I was rounding up hubby to come home with us, a man in his late 20’s said hello to Miss 2, who was up in my arms.  She must have felt a little confronted, and she immediately stuck her hand into my dress and put it between my breasts.  Breasts are comforting for her, and even when she’s not suckling, they can still give her comfort – a reminder that I’m there and she’s safe.  This guy looked shocked and said “What’s she doing?”.  I ignored him and let the conversation take it’s course.

He spoke to her again and asked her if she was having a fun night.  Again, she stuck her hand straight into my top and he said “What the f*ck is she doing that for?”.  I just stared at his face, expecting a joking smile on his face or something, but no.  His mouth was twisted into an expression somewhere between shock and disgust.

He then actually addressed my little girl.  “Get your hand out of there, that’s disgusting”.  “Hey mate, she’s breastfed.  Leave her alone, it’s fine.  They’re my breasts and if her behaviour bothers me I’ll let her know myself”.

He actually just stared at me with an open mouth.  As I turned and walked away, I heard him say to my husband in horror “She’s breastfed?  OMG that’s gross!”.  I heard my husband say, with a laugh, “Didn’t you know that’s what they’re made for?  You clearly don’t have kids yet!”.

This is no reflection on anyone else at the wedding.  At one point, I noticed someone snapping a photo of me while I was breastfeeding, and he smiled at me afterwards. One lady came and sat with me when she noticed I was alone, and she kept me company for a while.  Most of the guests ignored me, which is also fine.

But that’s life!  While some people will go out of their way to make you feel comfortable, most people will ignore you and leave you to do what you’ve got to do.  And every now and then you’ll come across some fool who’s had too much to drink and will open his mouth without thinking about it first.  I could be mistaken into thinking people like this don’t exist – like I said, most people in my life are awesome about breastfeeding.  But the wedding was a reminder that there are actual people who will actually behave like breasts are only for sex or porn and that breastfeeding is disgusting.

If you come across someone like that, I hope you’re comfortable enough with yourself to not let them get you down, and instead that you and those around you will treat this person like the rare and bizarre specimen they actually are.

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Milk Production – What All Breastfeeders Need To Know by Maureen Minchin

Maureen Minchin BA(Hons), MA (Melb), TSTC is a medical historian and health educator, and author of Milk Matters.  She is all that, AND she is an active contributor in our Breastfeeders in Australia community on Facebook.  Maureen recently sent me this post and asked me to share it far and wide, so I’m uploading it onto our website to facilitate that. 

Maureen is a very educated person, and some of the language used in her post may feel overwhelming.  I can not stress this enough – if you have questions, please ask, as we are all learning, and we are all here to help each other.  You can comment with questions, you can email us at breastfeedersinaustralia@hotmail.com or you can join our Facebook group and post there.

“The basics: hormonal stimulation + emptying of milk from breast
Obviously you need to allow baby to feed as needed.
And feeding must be effective and no obstacles put in the way of milk drainage.

Stimulation creates and maintains a basal level of prolactin, essential to getting increases in supply from birth, and later if supply has dropped . (But by three months a happily breastfeeding mum’s basal prolactin levels are comparable to a non –lactating mum – it is the repeated bouts of sucking-stimulated prolactin level rises that does the job of enabling lactose and so milk production, with prolactin returning to baseline in between if intervals allow).

Initially breasts overproduce, and then supply drops down to the level of milk taken on a daily basis. Lactation is energetically expensive, and thoughout human history women have never been able to afford to waste energy. So volume is regulated by need, and responds rapidly to change in demand. How?

Regulatory controls are within the breast itself. If a feedback chemical (FIL) reaches a certain level in the breast, it signals that milk is not needed and secretion is inhibited, and eventually stops.

The second internal down-regulator is high pressure. If enough pressure flattens the rectangular-ish secreting cells, then they stop work; over time they regress and disappear. That can be a local or a whole breast pressure. So habitual finger pressure that prevents drainage from one area, or an underwire bra that sticks into a particular spot, or surgical scarring, or a tight crop top, can have an effect. As can over-distension because of too long a gap between feeds from a breast. Or from sleeping/lying on one’s stomach, OK for some mums, hopeless for others (check out massage, might be best not to be too long facedown, and much massage can be done seated). If pressure gets high enough, it not only squashes the secretory cells, it can cause milk from the ducts and cells to leak into surrounding tissues and trigger inflammation. (mastitis) (SO feed before massage, time appt for the afternoon preferably; be prepared for some leakage. Towels and large absorbent pads in bed can be useful, save bed changes..)

Milk is made continuously, and is mostly water based, with about 7% cream. (The most variable component of milk, and babies drink less by volume of a high fat milk.) The watery part of the milk flows out of cells rapidly, the fat has to be extruded, sort of squeezed out by the cell into that aqueous fluid. The oxytocin contracts tiny muscles around those cells and pushes milk out into the ducts (the let down). A vacuum in the baby’s mouth is created when the baby’s jaw drops, and baby sucks. The seal needed for vacuum is created by tongue, cheek pads, and upper gum ridge etc. The vacuum – lower pressure area – allows milk to flow out from the breast – higher pressure area with letdown pushing milk out.

The relative amount of cream in milk varies over a feed, between feeds, between breasts, over the day, over time, following the general rule that the emptier the breast and the more letdowns it has been exposed to, the higher the fat levels. So after an interfeed interval, milk from the start of the first breast is ‘waterier’ than the milk at the start of the second breast will be, because the second breast has had oxytocin squeezes while the first is being fed from. And swapping back to the first breast after the second can mean an even richer milk again. Babies can be trusted to know when they are satisfied, and it sometimes takes the extra cream of a ‘third’ breast to do so.

Once lactation is established, the interfeed intervals are heavily influenced by the interaction between breast storage volume, and infant stomach volume. Over a day a baby takes about 750mL. A breast with storage capacity of 800mL could theoretically mean one feed a day, except that a baby’s stomach capacity won’t allow that! SO: a breast with very small storage volume will mean more frequent feeds at shorter intervals. So too does a small tummy. A baby with a big tummy capacity means fewer feeds per day if the mum’s storage capacity allows that tummy to be filled up (it can even get down to 3-4 feeds in 24 hours in some thriving babies under 6 months old.) They say the size of the baby’s stomach is roughly the size of its fist, but it can be distended comfortably. (If over-distended the baby will blurt back the extra – sometimes too much comes up, so yet another feed is indicated to settle things.) Being creamy, sometimes only a few extra mouthfuls are needed to get bub to drop off drunk.

Rates of milk synthesis vary over the day, and are governed by the degree of breast fullness. When the breast is close to its residual baseline (it’s never truly empty), synthesis rates are faster. When breasts are fuller, synthesis rates are slower. The small breast that empties quickly also refills quickly.

During the night sleep, longer intervals and higher-at-night prolactin levels combine to produce a full breast by morning. Take out a single feed then, and refilling will be slow: the 600mL capacity breast might have dropped to 500mL, but there’s still plenty there, so no rush to refill. By the next feed volume might be back to 540mL, and drop down to 450 after that feed. Over the day, by evening you can come close to running on empty, with baby staying at breast and drinking pretty much as you produce it. That milk may move from the stomach on into the small intestine at much the same rate, so baby doesn’t get that satisfactory FULL STOMACH feedback signal and fall off looking drunk, or else will sleep for a short time but wake up and want more. [There’s stuff that could be said here about gastric hormones and signalling, but no need.]

But take out a lot of milk in the am, by feeding on one side and pumping the other breast, then letting baby have the second side for as long as wanted, and milk synthesis rates speed up to replace milk in both breasts. SO this is the ideal time to express milk for storage or as a reserve. (Don’t be persuaded to think about expressing after every feed unless it’s for a medical reason: it creates too much work, keeps breasts cold, and is a pain.) And while you would freeze that extra expressed morning milk, it can be stored in the fridge during the day till it’s clear there’s enough been made to keep baby full that day; if not, you can pour off some and feed it to baby bu spoon, cup, syringe, whatever.

I developed this strategy to deal with what I called six o’colck starvation, when I just could not satisfy baby wioth a full feed. Before I tried this, I had to keep baby at breast for hours, contentedly getting small dribs of milk but refusing to leave or drop off to sleep. Topping baby up in the evening with some of the morning milk meant she went off to sleep, my empty breasts refilled before she woke again a few hours later, and in between I got my other two kids to bed and cleaned up. This was where the Kaneson pump came in handy, as it’s a simple silent no-strain one-handed pump: draw back the outer cylinder a tiny bit to create the slight suction needed to relax the ring of muscle around the nipple and milk pours out of the second breast when oxytocin hits both breasts and triggers letdown). But not until mums are comfortably feeding and can multi-task should they think about trying this. Getting position and attachement right and baby feeding well and breasts producing well is the first priority. When mums can feed and drink a cuppa they can do this no trouble. If they want to get milk to store. Or to give an older child a glass, or make breastmilk ice blocks. Or whatever it’s needed for.

Breasts being peripheries, they are colder than other parts of the body. They need to be warm for blood circulation to bring in nutrients for milk making. Simple things like hotpacks or having a small patch of wool, silk or fleece to tuck into the bra around the breast not in use can make a difference to refilling rates. So can an afternoon nap. I never ran dry on days when I snuggled down with a baby and had a full-body after-lunch rest. I always did if I worked through the day and only sat down for feeds. Some mums can cope with strenuous exercise and still lactate successfully; others can’t. (Babies don’t like the taste in milk of lactic acid created by exercise, but it disappears after about 30 minutes.)

So increasing milk production means increasing sucking stimulus, and frequency, increasing synthesis rates by breast emptying, and decreasing any competing activities. In short, go to bed with baby and sleep and feed feed feed, and (optional) express first thing in the am. After 2 days of more frequent feeding, basal prolactin levels rise – they may have fallen too far – and milk-making increases. A babymoon it’s sometimes called. Not possible for many mums with children and dogs and household tasks. Using drugs to increase prolactin has its risks and in any case will not work if the problem is insufficent breast emptying and natural feedback down-regulation of supply.

Decreasing milk production is equally simple. Increase intervals between feeds, for example by one-breast feeding with only short times on the second breast, back to the emptier first breast for a couple of hours, monitoring the unsuckled breast and expressing only to comfort and to avoid mastitis. Within 24-48 hours of one-breast feeding supply will drop, sometimes catastrophically. It’s disaster to suggest this to new mums with oversupply, as many hospital-based midwives have done. The mums go on for more than 24-48 hours and then wonder why their milk has gone. Lying face down compressing boobs, wearing a tight crop top or bra, creating pressure feedback, and you may achieve the same outcome via mastitis. (In a breast with no skin damage, most mastitis starts with milk leaking into breast tissue where it shouldn’t be, under pressure.)

Mums need to know what an efficient working breast feels like: soft and flexible even when heavy with milk, filling up, softening again after a feed; maybe tight and tense to touch if the interval is too long but immediately relieved by milk removal. Warm but not heated, not reddened skin. Not lumpy, even up in the armpits where there is some glandular tissue in many women. There’s always a reason for any change and thinking though exactly what’s happened can find it, and prevent recurrences.

There is a lot more in Breastfeeding Matters 1998 edition that would be of interest and relevance, in chapters on milk supply, nipple problems and mastitis. Breastfeeding is a skill that has to be learned, and without early practical support and understanding of how supply is regulated, women struggle.”

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My Body Failed Me

When I fell pregnant with my son, I had my sights set on a drug-free, vaginal birth.  A normal birth.  I was a woman, after all.  Billions of women did it before me, and billions would do it after.  Our bodies were made to do this, why should mine be any different?

Well things didn’t happen that way.  It all started to go wrong as I approached my estimated due date and showed no signs of readiness for labour.  After going through several “stretch and sweep” procedures, I was induced.  First with cervidil, then a cervical balloon, and then after both of those failed to put me into labour, my waters were broken and I was put on a syntocin drip.  I didn’t cope with the sudden onslaught of labour, and my son’s posterior position probably didn’t help.  I accepted gas fairly quickly.  The gas made me nauseous and vomit, but it also masked the fact that my body was involuntarily pushing.  I was only 3cm dilated, so I was given an epidural.  Sadly the uncontrollable pushing caused my cervix to swell shut, and 12 hours after my waters were broken, my son was pulled out of my via an emergency csection, 10 days after his due date.

I felt so good about my body during pregnancy that I never considered it might not do what it was supposed to during birth

When I was pregnant with my second baby 2.5 years later, I felt determined to do better.  I did special exercises to try to keep my baby out of a posterior position.  I walked and swam as much as I could to keep myself strong and make sure my stamina was good leading up to birth.  And I rested more.  I eliminated stress from my life.  I made a point of informing myself better, and this time around, when I showed no signs of labour I politely refused the stretch and sweeps.  I stonewalled conversations about induction because I was healthy and my baby was healthy and I didn’t want to submit my body to unnecessary procedures just so I could conform to the hospital’s preferred timeline of events.

Seven days after my due date I woke to contractions – I had gone into spontaneous labour and I could have been happier.  But despite my best intentions, my labour followed the same route as my first – I began pushing involuntarily when I reached around 3cm dilation, resulting in cervix literally closing the door on any chance of a VBAC.  I was eventually taken in for another emergency csection, except this time we had to deal with a torn cervix, bladder adhesions and serious damage to my uterus.  I was told very seriously that if I ever decide to have another baby I will need to have a csection scheduled before 37 weeks, because it would be very dangerous for me to have even one single contraction.  I will never have another chance to get the birth I wanted.

I was trying to look happy for the photo but I feel like my face gave away the other emotions I was feeling too

I am a successful breastfeeder and an advocate for it too.  I don’t pretend to know what it’s like to not be able to breastfeed.  To do so would feel disrespectful to those who have actually lived it and feel hurt over it.  But I do know what it’s like for your body to fail at something that it should have been able to do.  I know what it’s like to prepare for something and then find that it’s just not going to be possible.  I really wanted vaginal births, and I thought I did everything I could to make them happen, but my efforts weren’t good enough.  Is this what it’s like when someone wants to breastfeed but can’t?

When I think about my birth stories, I feel a lot of feelings.  I have grieved for the birth that I wanted but didn’t get.  Even though my daughter turned 2 last March, my grieving process doesn’t appear to be over yet (the tears in my eyes as I type this out are proof of that).  I accept that my kids face some increased health risks because of their delivery and although I strive to learn more about them, I still sometimes feel indignant and defensive when someone else brings them up.  I feel confused about what went wrong – did I do something wrong?  Is my body built wrong?  Did my care providers do something wrong?  I feel frustrated because when I ask questions to piece together exactly what happened it seems everyone is more concerned with reassuring me that everything is OK and that I did my best, and that method of delivery doesn’t even really matter.  They ignore the fact that I want factual, objective and honest information to help me move past this.

I am thankful that I don’t feel guilt or anger.  Guilt and anger are toxic feelings because they revolve around blame, and the idea that something could still be done about my situation, and they can’t.  Nothing can be done because it’s already happened and I can’t change the past.  I think some people use guilt and anger to hide away from their feelings of sadness, without realising that this stops them from moving on and finding their closure.  Talking about my story still makes me feel really sad, but each time I open up about it, I feel myself let it go a little bit more.

My c section births didn’t meet my expectations, but I love my kids more than I ever could have hoped

I guess the reason I’m talking about this today is because when talking to a pregnant friend about their breastfeeding goals, someone else chimed in that I shouldn’t get her hopes up so much because not everyone can breastfeed, and that I have no idea what it’s like to deal with the disappointment of being unable to do something I thought I could.

It may be true that not everyone can breastfeed and not everyone can have vaginal births.  But it doesn’t mean we shouldn’t hope we can.  It doesn’t mean we shouldn’t try.

If you are struggling with your feelings about birth or breastfeeding, please talk to a trusted health care professional, or get in touch with PANDA – Perinatal Anxiety & Depression Australia

Have you ever felt like your body failed you? 

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Not How I Thought We Would Finish Our Journey

Once you breastfeed past a certain age – past infancy, past toddlerhood and into childhood, you start to see weaning finishing in a certain way.  I’ve always had fairly low expectations about the end of our breastfeeding journey, and lately my goal has been to get through one day at a time.  I had no intentions of telling my 5 year old he isn’t allowed to breastfeed anymore – we’ve come this far for me to make a decision like that based on my own feelings.  I thought that one day he would either tell me he didn’t want it anymore, or that he would simply choose not to have it.  But last week he got sick.

He had an illness that involved sores in his mouth.  He wasn’t SICK sick, he didn’t have a fever, he wasn’t lethargic, he didn’t cough and he wasn’t snotty.  He still wanted to run around and play as usual – he was upset that he had to stay at home and didn’t really understand the risk of people catching his illness when he didn’t really feel sick.

He could barely eat anything because it hurt to swallow, and he couldn’t chew, because his tongue and the roof of his mouth had sores too.  He doesn’t take medicine and I don’t encourage it anyway, but we talked about it and he preferred to deal with the pain.  I did manage to get him to gargle salt water a few times.

And on the Tuesday when we first noticed he had a sore mouth, he couldn’t breastfeed.  He couldn’t even latch without pain, and there was no way he could get to suckling.  He said he couldn’t make his teeth move right without it hurting, and I knew the vacuum would have caused him pain.  The night we realised this, he was quite matter of fact when he told me he couldn’t have milks, so he was just going to cuddle me instead.  No tears, no great upset.  The next morning he awoke for his morning breastfeed (he normally breastfeeds twice a day) but again, couldn’t.  So he hopped out of bed to find his favourite Transformer toys instead.

The next night he didn’t ask or try.  He wasn’t upset.  I couldn’t bring myself to talk to him about it because I was worried bringing it up would upset him.  Another morning and another night passed with no breastfeeding.

On Friday night, he cautiously asked for some Easy Mac.  I felt like I held my breath when he sat down to it.  He devoured it.  I realise Easy Mac is a terrible choice, and it barely qualifies as food, but when your child hasn’t eaten in 3-4 days, anything will do.  We went to bed that night and I wondered what would happen, but again he didn’t ask, and I didn’t bring it up.

And that was that.  I was really surprised and taken aback, because I never expected sickness to be the end of our breastfeeding journey.  I felt sad, not that it was over but that it was over in a way that felt really unfair.  I felt like my son had been robbed of the luxury of being able to make a decision about no longer breastfeeding.  But as he wasn’t talking about it and wasn’t asking for it, I didn’t bring it up and I resolved that if this was it, then I would let it be.

The next morning, Saturday, we could see no trace of sores in his mouth.  Thank goodness, because he had to play soccer at 9am, and his cousin’s birthday party later that day.  We had an extremely busy day that day, and although he hadn’t shown any obvious signs of illness, Saturday was too much for him.  We had a very cranky and upset child at 8pm that night.  He was resisting bedtime with all he had, and my resolutions went out of the window.  I quietly said to him that his mouth wasn’t sore anymore, and he could have some milks if he wanted to.  And then he was happy, settled and peaceful.

Until this illness, he’d never gone more than a day without a breastfeed.  I am proud of the fact that he coped so well with his illness, and I know that when the time comes, he will handle it well.  But that time is not now.

 

 

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Member Story – The Boob Job Risk That People Forget About

Elective breast surgery is risky.  Actually, any surgery is risky.  But weighing up the risks versus benefits for an elective surgery is not as straightforward as when the surgery is essential for your survival.  Many women, particularly those who are planning to start or grow their family after the surgery, feel that they negate the risk of  breast surgery by seeking reassurance they will be able to breastfeed when their children are born – by having implants inserted under muscle, with the incision made at the crease of the base of each breast.

As elective breast surgery, including elective breast surgery performed overseas, becomes more common, many seem to have become completely accepting or even dismissive of the other risks involved.  It would appear that many women consider the risk of infection so low that it’s barely worth considering.  Courtney O’Keefe never thought her breast surgery could result in an infection that could prematurely end her breastfeeding journey, let alone her life.

Early in 2011 I lost 35kg after a lap band surgery.  The weight loss affected my breasts, so I decided to get implants and a lift.  The lowest quote I got in Perth was $22,500, but I could get it done for $7,500 in Thailand at Pattaya Hospital, Bangkok.

The plan was to get 350cc implants and I was expecting a small anchor scar (as I was having old breast tissue removed as a part of the lift).  Instead, I woke up with cuts straight across my breasts, plus the incisions under my armpits where the surgeon had inserted 550cc implants, not 350cc as we had agreed.  I felt like I’d been completely butchered.

But the biggest shock was yet to come.  I had been feeling unwell since the surgery, but 2 days later I felt extremely sick and I started hallucinating.  When the surgeon removed my bandages to remove my stitches, my wounds immediately split open.  Please click on this link if you would like to see Courtney’s infected wounds.

I came back to Australia and was admitted straight into a local hospital, fighting for my life.  Whatever was wrong with me was shutting down my liver, kidneys, brain and heart.  The hospital immediately began treating me for golden staph and methicillin-resistant staphylococcus aureus (MRSA), until swab results came back and we learned I had contracted some kind of super bug from Thailand.  The infection resisted treatment and my whole body went into some kind of meltdown.  I had repeated seizures and losses of consciousness.

I spent 4 months in the care of Infections Disease Control, then I was transferred to another hospital to be cared for by Plastics, to treat some of the damage inflicted on my body.  I thought I had recovered but the infection came back in November 2015.  I was rushed back into hospital.  My implants were removed this time, and I was given a partial mastectomy after the implants infected some surrounding tissue and muscle.

Again I recovered and gave birth to a beautiful baby girl early in 2017.  Miraculously I was able to breastfeed her, and I was so happy!

Sadly the infection struck me again when she was only 5 months old and I had to give up breastfeeding while I was being treated.  I was, and am completely devastated.

As Courtney’s treatment made it unsafe for her to breastfeed, or even use the undrinkable breastmilk in a bath, she was forced to pump and dump a huge amount.

Thanks so much Courtney, for bravely sharing your story with us.  It’s unfair that her breastfeeding journey ended prematurely, but I hope she takes comfort in the knowledge that every breastfeed that she was able to give her baby was a win and the benefits her daughter will reap from those feeds will last a lifetime.

If your breastfeeding journey has ended prematurely, the Australian Breastfeeding Association offer debriefing by their trained breastfeeding counsellors.  You can access this free service by calling the National Breastfeeding Helpline on 1800 MUM 2 Mum

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