Wednesday, September 26, 2012

Whining about weaning

Breastfeeding has required a great deal of effort on my part.  A few months ago, I discovered the root of my troubles is "insufficient glandular tissue."  Despite my greatest efforts, hundreds of dollars on food, drugs, herbs, acupuncture and an SNS; I could not exclusively breastfeed my sweet daughter.  If you are not familar with the term insufficient glandular tissue, you should also know it goes by the (embarrsing) name of "hypoplastic breasts" or even worse "tubular breasts."  I prefer to use IGT because it defines the reason for the other two names, and sounds less deformed.  

Technically, these breasts are deformed--somewhere along the line of puberty and early menstruation, I lacked the hormonal stimulation to create mammary tissues.  Even though all my efforts to supplement made an impact, they could not make up for the fact that I didn't have enought milk-making cells in my b-cups.

Shortly after this discovery, we hit a sweet-spot in feedings.  I used the SNS a few times a day, offered bottles a few times a day, and I pumped two times a day.  Suddenly, baby girl did not want to breastfeed.  I was defeated, once again.  The embarassment, shame and stress were all back.  How could I ever maintain my supply?  Why did she not want to breastfeed? and of course What was I doing wrong?

Things got ugly in my head pretty quickly.  My mind was full of negativity and confusion, and I was at a loss.  I had no idea what to do.  Then I started spotting, eight days later I started bleeding, three days later it got heavier, a week later it was worse.  After 5 weeks, I made an appointment with a RN.  She was very respectful of my choices (acupuncture, herbs, home birth, etc) and she offered to me what she knew.  Two choices: birth control pills for three months or metformin.  Since we have no desire to prevent future pregnancies, metformin was my choice.

The goal with metformin is to help my body handle sugar better, this should allow me to lose weight easier, since I gained weight breastfeeding.  If I am able to lose weight, my hormonal balance should come under control, thus preventing excess estrogen and insanely long periods.  Hopefully, all of this will establish a normal menstrual cycle and allow me to get pregnant in the next year.

After 38 days of bleeding, changing the sheets, I started getting faint, weak and exhausted.  I hadn't yet filled my prescription yet, and had to miss a day of work.  On my day off of work, I pulled out Women's Bodies, Women's Wisdom by Christiane Northup.  I read, the book most of the morning while in bed.  I discovered some amazing things, and rediscovered what I knew to be true: I could take charge of my health.

What I knew deep down, but had ignored was painful and empowering.  My daughter stopped breastfeeding because I had nothing left to give.  Sure, I had milk, but my body lacked the strength and energy.  I have put dozens of tiny things ahead of my well-being, to the detriment of my health and my relationship with my husband and daugther.

I have discovered that I stuff my emotions. Today when I heard news that made me sad I thought "it's okay, get on with it."  I realized immediately, that it was not okay and I needed to cry.  I cried for 10 minutes, about a broken washing machine.  My daughter and husband, snuggled me, smiled and accepted that I needed to let it out.  I felt so much better.

Now begins the hard work, changing my life: body, mind and spirit so that I can be healthy, and whole.

I love my daughter, and I miss breastfeeding.  I am embarassed that she weaned at 9 months, I wish I could nurse her into toddlerhood.  I cannot have that dream.  I have to let it go and accept that my body has done all it could to nourish her for the past 19 months.  It may not offer her a full belly, but my body can offer her snuggles and with that strength, love, comfort and support.  

Weaning happened when she was ready, not when I was.  Weaning happened when I needed it, she listened to my body when I would not.  My little girl saved my life.  

Sunday, September 16, 2012

Birth Matters

Birth matters because people matter.

Laboring mothers deserve respect, this means informed consent and evidence based care.

Babies matter and deserve the same level of respect.  

Fathers (and birth partners) deserve the same treatment as well.

Birth has been taken away from us, much in the same way as death has.  Birth has become so distant from us in this culture, that we fear it in the same way we fear death.  One hundred years ago, our great-grandmothers did not have an ultrasound or hear their growing child's heartbeat.  Yet, I believe they carried a valuable knowledge that is being lost.  In that day, home-birth was not something "crunchy mamas" did, it was what mothers did.  As time has passed birth has been handed over to professionals.  Professionals who have many things to manage that include time, cost and risk.  A tragic result of this dynamic has been that mothers lack the intuitive knowledge women of previous generations experiences.  Just as sadly, women have been taught not to trust their intuition when it comes to caring for their pregnant and laboring bodies.
Interventions can be life-saving, decrease trauma, allow rest for long labors and even prevent unnecessary cesearan sections.  Interventions are so routine that those desiring normal, unmedicated births have to negotiate with medical staff to acheive this goal.  The problem is that inteventions have now become standard care, some familes do not even know why the intervention or monitor is being used.

Good medical practice includes informing you of the reason for the intervention, the benefits and risks associated with the procedure then allowing you to consent to the procedure.  In a true emergency, informed consent does not apply and the medical staff will step in and keep you alive.  If they are offering a procedure, you have time to ask the questions and decide.

Do you know what this is? Do you know how it works?
Internal Fetal Monitor

Throughout the years we have discovered that medications given in the 1940's resulted in damage to the fetus' appendages, that x-rays are associated with cancer, and that large amounts of alcohol may damage a growing fetus.

As medical knowledge grows it is important to know that we learn through trial and error.  That is not an insult to the medical community, it is a fact.  The only way we learn is through practicing medicine and later finding out the results of that practice.

We now know that breastfeeding is best, for mother and baby in most instances. Learn more about the benefits of breastfeeding.  I think most of us would agree that our culture is poorer for sexualizing breasts to the point that a baby with a bottle is socially acceptable, while a breastfeeding mother has to cite the law (if it exists in her state) in order to feed their child in public.

We know that skin-to-skin  contact is better for mother and baby, than separation after birth.  I think most of us wanted to hold our baby immediately after birth.

We also know that it is best to wait at least two-minutes before clamping the cord.  Is that the practice you have experienced?

There are dozens of other examples  The point is we must demand evidence-based-care for ourselves, our sisters and in the years to come, our daughters.  

Modern maternity care is affected by much more than that doctor-patient relationship.  Insurance companies, hopsital policies and pharmaceutical companies all have their say in labor and delivery.  In many countries, including the United States the government has a say as well.

Freedom for Birth releases in 1,000 locations around the globe on Thursday, September 20, 2012.  This film follows stories in which medical boards and courts are deciding where, when and how some women give birth.  This is not evidence-based care.  This is not informed concent. This is not respectful. This is wrong.  This is a human-rights issue.

We must take a stand for ourselves, our sisters and our daughters.

If not now, then when?  If not us, then who?

Birth matters.

Tuesday, July 3, 2012

BabyWise or Attachment Parenting?

Kangaroo Care Day 3 as a mom

While pregnant we took the "Baby Wise" class.  I even read the book - twice, like a good mom-to-be.

The theory made sense to me, proactively meet the babies needs: a meal, a diaper change, sleep. If I could not meet those needs and baby was still upset, there was nothing else I could do.  Our baby would be a "welcome member of the family" and would not become a "selfish child."  

When she came, this proactive approach to meeting her needs really helped us to learn her signals: she scratches her face when she is wet, she wiggles and then goes silent when she has a bowel movement, she cries when she is hungry and she will lose it if your put her down while she is hungry.  

I followed my instincts and my body while I birthed her. I was unmedicated, we had the Christmas-tree lit, the birth pool was warm and comforting.  My husband even made me laugh in the heat of battle, as he assured me that we couldn't switch places because no man would ever be strong enough to give birth.  I delivered our daughter after 20 hours of labor, standing up because that is what my body told me to do.

Three days later, my daughter had lost 8 ounces.  Seven ounces would have been fine, but eight was too much.  I hadn't experienced engorgement and didn't think my milk had come in yet.  After only 48 hours in this world my daughter had her first bottle, six months later she still needs them.  I imagined offering my baby the first bottle a week before maternity leave ended, I imagined a struggle.  In reality she gulped down that half an ounce of donated breast milk, and I began pumping eight times a day.  I struggled with her acceptance of the bottle and my body's inability to meet this need for her.

I drank Mother's Milk Tea, I mad my own with Fenugreek and despised the scent of my own home.  I drank water, I avoided caffeine, I ate well.  I took Goat's Rue, More Milk Plus, Fennel Oil, Lactate Support, Chinese Herbs, Weekly Acupuncture, Nipple Stimulation, the works! My daughter still needs 3-4 bottles a day, and I can barely pump four ounces in 24 hours.

How did this happen?  How did the mom who trusted that she could birth normally and follow her body's cues decide that a book was the authority on her child? 

In my zeal to be a good mom, I fell for a plan that fit my society better than it fit my family.  I rejected my instincts to feed her because "it wasn't quite two hours yet".  I wanted a happy, convenient, well-adjusted child.  Babywise tells you flat-out that they don't support scheduled feeding, but somehow many parents walk away with that message.  Even with that disclaimer repeated, I felt like I was failing when I offered her the breast before two hours had passed.

So my story, is simply that.  My story.  It is not your story, it is not a judgement of your choice or any one else's.  It is mine and I believe MY choice to be "baby wise" set me up for breastfeeding failure.  

You may have heard bad things about babywise. Maybe you practice it.  One message etched in my mind from the book was that demand feeding will not increase your milk supply. Out of fear of mother failure, I tried not to feed her too soon.  

I resented my midwife's direction to feed her on demand, but I followed her advice anyhow. I fed her when she acted hungry, I changed her when she acted wet, I snuggled her when she seemed to need it and I soothed her when she had trouble falling asleep.  I loved it, yet I felt guility for it.

Everything I have read about producing more milk has the bottom line, breastmilk follows the rules of supply and demand.  The more baby demands, the greater your supply will be.  Babywise lied.

My assessment is that when you are babywise you mold a baby for western culture: stuffed with formula, falls asleep on it's own, learns to soothe itself and becomes independent.  Indeed, my experience as a babysitter agrees that babywise is great.  Feed them, get them ready for bed, turn off the light, close the door and watch a movie until mom and dad get back. Easiest twenty dollars I ever made.

I have concluded that a mom's instincts trump the experts, as most good pediatricians would agree.  Mom knows when something is off with baby and no textbook answer will suffice.  As a mother who values breastfeeding, baby snuggles and the privilege of caring for an infant, I must reject babywise.

As a responsible adult, I must admit that I chose that path and that it hindered my goals.  After six months of guilt and confusion, I decided I needed to commit the "sin" of reading "The Attachment Parenting Book"  

The AP book offered me peace and confidence.  It told me that I should follow my instincts.  My husband has beens saying that all along.  It took me far too long to get here.

I am not an AP mom, I am not a BW mom.  I am a mom.    I choose not to be defined by a style of parenting.  I am the expert on my daughter, if I am blessed with another child he or she will not be the same.  One-size does not fit all for parenting.  We parent people you see, and I haven't yet met two people who were exactly alike.

My daughter has needs: safety, nourishment, cleanliness, love, respect, compassion and touch.  I will offer them to her as I can.  I can never be there for her at every moment, just as my mom cannot always be there for me.  I will take care of myself, my husband and my daughter to the best of my ability.  I will trust that as a family, we can figure out solutions to all of the problems we encounter.

I choose to do what works for my family, not the nursery or the babysitter or the random old lady on the street who thinks I spoil her.  I choose to let go of my need to get things done and the self-esteem boost that my checklist offers.  When I am eighty, I won't care about the dirty dishes, the extra feeding that made me sleepy at work the next day.  I will make happy memories now, so that I can cherish them later.  I will enjoy my daughter, not win a mom-contest with her behavior.

Call me what you will, I don't care.  Well, perhaps I still do.  I just won't let myself be preoccupied by it.

What parenting style works for your family?  Was it the style you thought you would use?