Healing: Some Breastfeeding Discussion

While catching up on my blogrolls after my ten-day holiday, I was surprised and moved to find that not one, but TWO of my favourite writers had tackled the subject of breastfeeding in the past week.

First, Linda at All and Sundry tells us that "It's all normal" when it comes to feeding your child. Having been contacted by a doula, Linda ponders what this pro-breastfeeding advocate might have said to her when she was [formula-] feeding her own kids. Apparently, this unnamed doula feels that there are a lot of negative things said to breastfeeding mothers, and so she takes it upon herself to counteract this by offering an encouraging comment to breastfeeders whenever she sees them. Linda muses on what she herself might say to a formula-feeder, and concludes that the appropriate response would likely be to "Smile and tell her what a beautiful baby she had. Because anything else is really none of my damn business."

To which, of course, I offer a hearty AMEN.

Heather at The Spohrs Are Multiplying opens her post by saying that "Breastfeeding is really, really hard in the best of circumstances." (Now there's a sentence we don't see or hear often enough!) She discusses her own struggles in feeding her daughters. Madeline, born premature, spent her first weeks and months in the NICU, being fed pumped milk. Annabel is healthy and at home, and has been since the start, but Heather's mental health deteriorated so significantly following Annabel's birth that her doctors, caregivers, and family were all pleading with her to increase her medication to a level that would genuinely assist her. Heather, with the stubborn single-mindedness that seems so familiar to me, didn't want to up her meds, as it would then be passed to Annabel through breast milk. It became a choice between her own mental health and her daughter's physical health, and we all know who wins loses in that scenario. After struggling with guilt and panic attacks, Heather made a choice ensuring that she would be the best mother she could be to her daughter. It was months later before she could actually write about this choice, however, as she still felt ashamed of her decision.

These are powerful stories that need to be shared. I've witnessed horrible prejudice and mistreatment of bottle-feeding moms, and I've treated myself badly for my own sense of failure. My mental health was precarious at the time that I tried to make rational decisions around how to feed my daughter, but of course I couldn't realize that at the time. Looking back, I wonder how I got through it. But even knowing what I know now doesn't change the fact that I still struggle with feelings of guilt and inadequacy. I've tortured myself on dark lonely nights when I can't sleep, wondering if Gwen's disinclination for affection was caused by an unrewarding breastfeeding relationship. I've wished thousands of times that one choice or another could be revisited: the choice to have a hospital birth led to us getting the Norovirus, making Gwen too ill to nurse and jeopardizing my milk supply. Or the choice to believe the public health nurses when they said I didn't really need to see a lactation consultant, they were just as knowledgeable.

The breastfeeding bomb pops up in unexpected places, and whenever it does it's like a punch to the gut. Gwen is now two years old and yet when she goes to the doctor, I still have to answer whether she was breastfed or not (and I never know what to say, because it's not really a yes-or-no question in my world; yes she was, but not exclusively). Reading magazines or checking out websites about parenting and kids' health will still poke me in my sore spot by reminding me that one of the Top Five Ways to Avoid Everything You Want to Avoid and Make Your Kid Brilliant is to breastfeed.

I am taking steps, now, to let go of this. It's still difficult. But I think there are a few key things that are helping me. One is to realize, like Heather says, that breastfeeding is difficult at the best of times. Having difficulty with something that is difficult is not a mark of failure. And ours, like Heather's, were not the best of times. A favourite statement I like to remind new moms about - one that I wish I had known, back at the time when breastfeeding felt like the only way to be a good mom - is that "Lactation is natural. Breastfeeding is an art." Yeah, that's right, world. It doesn't just happen magically, and it isn't all innate. IT'S A HELL OF A LOT OF WORK. Sure, some women take to it more easily than others, and if you're one of them, thank your lucky stars. But for the rest of you? You need to know - you're not alone. You are not the only one struggling with this. And it pisses me off that we as a society would rather let new moms feel like failures, feel isolated and scared and that they are doing it wrong, than to tell the truth: it's hard, and feeling like it's hard is NORMAL, and it doesn't make you a bad mom.

Another thing that helps is to look at Gwen - who now gives affection eagerly and unabashedly - and know that neither her health, nor her intellect, nor her emotional development, are any the poorer for having breastfed for a shorter time than I imagined, and having never achieved the brass ring of "exclusive breastfeeding".

Finally, and this is the hardest and yet most important key to my letting go: I did not fail at breastfeeding. (I have never said or typed those words before, and it's challenging to do.) I need to change my thinking. I did breastfeed. I breastfed my daughter to the absolute extent of my ability for nine full months. That was not what I'd planned, not what I'd hoped, but that is what happened. And I should - I CAN - accept that. I did not succeed to the extent that I'd dreamed, but that is not the same as failure. And I am starting to work on redefining that experience not in terms of what I did not do, but in terms of what I did do. Maybe I can even define myself (in my own mind - the only place it really matters) as a breastfeeding mother, not a breastfeeding failure. And when I see those little breastfeeding bombs, I can remember those moments with contentment, not resentment.

Go read Amber

Amber recently posted an entry called "The End of The Breastfeeding Relationship" with some thoughts on breastfeeding, weaning, and the judgement that we as mothers are subject to. All topics near and dear to my heart.


First of all - isn't it a tad overdramatic that we call it (cue ominously thundering organ music) The Ennnnnnd of the Breaaaaaaaastfeeding Relaaaaaaationship"? When we toilet-train our kids, is it the End of the Diapering Relationship? When we teach them how to walk, is it the End of the Carrying Relationship? When we teach them how to talk, is it the End of the Grunting and Guessing Relationship? Get serious. Why do we overemphasize breastfeeding so much, to the point where we tack on the word "relationship" and, more terrifyingly, "end"? I can honestly say, a few months post-wean, that my relationship with Gwen has not changed one bit. Not. One. Bit.


Amber points out that "the entire breastfeeding debate or discussion, whatever you’d like to call it, does a pretty good job of making women feel either superior or inadequate but does little to provide a supportive and understanding cushion for most new mothers." Truer words were never blogged.

I wanted to write a well-thought-out post on the subject myself, but it turns out that most of what I want to say is either (a) already being said by Amber, (b) repeating stuff I've said on this blog before, or (c) just more frustrated ranting/whining. So just go read Amber's post and join the discussion there (or here).

In Which I Ramble On For a Few Hundred Words About Only Vaguely Connected Subjects

We have a gate at the bottom of our stairs, but every once in a while I totally gap and forget to close it, and sure enough I find Gwen halfway up the first flight. It's always a forehead-smacking moment (for me, not her). Speaking of head-smacking, though, I've seen her take some fantastic headers while cruising the couch, even landing face-first so dramatically that I was *sure* there would be blood when I picked her up. (There wasn't, though.) And sometimes this makes her scream like a banshee and other times she just shakes it off as if she barely noticed the sudden transition from vertical to horizontal. My point is, I don't know why I bother trying to protect her from the stairs when she does such a terrific job of destroying herself on solid ground.

Things are going well these days. In fact, I would say the past few weeks have been the best since this whole motherhood adventure began. Gwen is sleeping well, which, let's face it, is the key factor in any assessment of life satisfaction. We have found a real groove with our days, heading out to one baby-related activity every weekday, which instead of making me feel rushed makes me feel appropriately non-bored (and Gwen the same, methinks). If I don't get out of the house and have a face-to-face conversation with someone I'm *not* related to at least every second day, I get a little irritable.

As such, we've been going to Strong Start a couple of days a week, and man, I really don't know why I waited so long to check this program out. It's made of everything wonderful: it's free, it's any age from birth to 5 years, it's fairly unstructured, it's every weekday, and best of all it's drop in. Come when you're ready, leave when you're done. Absolutely beautiful, and Gwen loves it. A gigantic classroom full of appropriate and stimulating toys, as well as a group of older kids to follow around and adore? PERFECT.

We also go to our Mother Goose classes on Wednesdays, and on Tuesdays Gwen hangs out with her Gramma and I get out on my own. Last week I took my laptop to an Internet cafe and did a few hours' worth of work for the volunteer organization I am a part of. It was bliss (not the work itself, but the aspect of it being uninterrupted).

Other than that, I've got a solid group of friends that I can call and/or contact on Facebook to arrange walks, playdates, and so on. It's a very good groove, and I am loving it.

That said, Gwen has had a cold the past week or so, and fear of spreading the germs around to our friends has kept me home from many activities, which I'm not enjoying. On the plus side, Gwen has been - for the most part - the most cheerful sick baby I've ever seen, not getting any more cranky for the nasty cough or the streams of mucous hastily exiting her nose. Woe betide you if you try to wipe it, though, for she will scream and weep as if being beaten.

Speaking of Facebook - and my awesome friends - one of them has started an Adequate Moms Group. It turns out there was a study done on the quality of parenting and the effect on the child's development. There is a significant difference in development between children who have negligent parents and those who have adequate parents - which is what you'd expect. However, the surprise is that there is NOT a big difference in development between those who have adequate parents and those who have excellent parents (whatever that means). So, with a sigh of relief, we can all embrace our adequacy. I'm writing a creed for the group: "I am an adequate mom. I have fed my child a Cheerio that she threw on the floor. I have fed my child a Cheerio that she threw on the floor the day before. When my child is playing in the next room and I hear a thump, sometimes I wait to see if there are tears before I go investigate." You get the idea. How freeing to be adequate!

Gwen's nap schedule has been weird lately. It almost seems like she's shifting from two naps to one - on Monday I put her down shortly after 10, and she didn't get up until 1:20 - nearly 3 hours!! Which left no time at all for an afternoon nap, because I wasn't about to have her nap from 4:30 - 6:30 and then be up until 10, thank you very much. So we got her to bed at 6:30 and she was SO ready. It's hard to predict from one day to the next where she will be at, and her being sick makes me want to just stay flexible and resist trying to squish her into a routine right now, because I know when I'm sick I need a little more downtime. So, once she gets better we'll work on the structure again. On the other hand, while the timing is unpredictable, the naps themselves are happening beautifully. At both naptime and bedtime she is putting herself to sleep in her crib after a diaper change, a bottle, a story, and a lullaby. It's absolutely heavenly to know that "getting Gwen to sleep" only requires 5-10 minutes of parental involvement.

I'm heading out on an ambitious trip next month. I owe my sister a visit (said visit was cancelled due to snow conditions in December) and I thought I'd make a week of it, visiting some folks in Vancouver and Powell River in a circle tour (since I missed out on seeing those folks due to the same damn snow). I plan to leave Nanaimo on the afternoon of Wednesday March 4th; spend two days/nights on the Lower Mainland; travel to the Sunshine Coast and spend the weekend with my sister and her family; then travel to Powell River and spend 3 days/2 nights there before heading back to the Island. One last hurrah before heading back to work. It will be so fun to show Gwen off to all the folks who haven't seen her in a while. Dude, she'll be walking by then! (maybe.)

Oh, and another thing. I think the combination of weaning Gwen + making some progress on her sleep (meaning *I* am getting more sleep) + losing nearly 20 pounds has just made me feel like my body is becoming mine again. I dug out some of my work clothes and even bought myself a gorgeous non-nursing bra, and I've been doing my hair and just taking a bit more care with my appearance. This has had a real effect on my self-esteem. Those women's magazines know what they are talking about. Also, certain activities that we thought would never happen again have actually begun to happen. And they are far more pleasant than I remember them being. Isn't that awesome?

Gwen is developing at a mad pace these days. She spends nearly all her time standing or cruising. She can cruise really quickly, and I kind of think that once she learns to walk she will progress to running and never look back. On Saturday, her grandpa saw her standing on her own for a couple of seconds: she pulled up using their sliding glass door, then pulled her hands away and just stood there for a moment. I haven't seen her do that on her own, but since I missed the original incident and was intensely curious to see if she could do it, I have stood her up myself a couple of times and then taken my hands away. She can, in fact, balance for 2-3 seconds. It's not much, but it's a start. Oh, and she has also mastered the pincer grasp (using her thumb and finger to grab something, instead of palming it) which should make self-feeding immeasurably easier. I'll try to get some video of her doing these things soon, because they are both awesome to watch.

I could easily write more, but wow, this post got really long. They call me wordygirl for a reason.

Second Chance

I am quite emotionally attached to my blogroll. I keep it small, because I actually read every single entry on every single one of those blogs (and for most of them, I've read years' worth of their archives, back when I had a government job and tons of time on my hands). I don't have time to check them every day, but once or twice a week I'll find myself with baby asleep, dishes and laundry done, and I'll grab an hour or so to catch up with all the other mommy- and daddy-bloggers on my list.

Two of my favourites, Amy and Emily, recently posted about issues close to my heart. What else? Breastfeeding.

Amy and Emily both had a lot of difficulty with breastfeeding their firstborn sons. Amy just had her second son, and Emily is expecting her daughter in December. So they are both facing the same issues again.

Emily writes: "I always wondered if the reason Asher and I had such a frustratingly terrible nursing relationship was because he was born so small and weak (one of the effects of preeclampsia is compromised blood flow to the placenta, which results in retardation of fetal growth and nutrition).

"No one ever speculated on why we were so crappy at it, but in the 12-ish weeks that I breastfed, we never once had a nursing session that lasted less than 50 minutes, unless it was because I ended it myself. I heard from eighteen million different people—friends, doctors, the Internet, CERTIFIED LACTATION CONSULTANTS—that when he was full, he would pop himself right off. As GOD AS MY WITNESS, PEOPLE, this never happened to us. Never. As in, not even once."

(I can so relate.)

After a pledge to stop breastfeeding without (too much) guilt if the same thing happens again, Emily reaches the crux of the matter:

"But I’m also terrified that it will go well, especially if this baby is born a little bigger and stronger than Asher was. I’m terrified that it will go well and I’ll still hate it. I’m terrified that it will go well and I’ll still feel resentful. I’m terrified that I won’t know how to do it right, especially since one of the things I’m looking forward to MOST about having a second baby is knowing exactly what to do with it. I know how to formula feed; been there, done that, and did it SUCCESSFULLY. Breastfeeding? Still kind of a big, fat mystery, since my entire experience with it is clouded by feelings of sadness and confusion and anger and also a lot of hysterical crying."

My emotional response to this is a great deal of empathy. Emily is one of the biggest reasons why I blog, specifically her entries on breastfeeding which - long before I even became a mother - I recognized as groundbreaking for the simple reason that she was being honest about her experience of motherhood, putting her guilt and pain and vulnerability out there for the world to see, speaking with such raw emotion and honesty about how damned hard it really is. While she likely made that post just as a way to work through her conflicting emotions, it has come to mean so much more to me (and, I'm guessing, to others): because women out there having the same difficulties now knew they weren't alone. There's a lot of propaganda out there about mothering in general and breastfeeding in particular, and it all depends on us not copping to the fact that this is really hard, instead pasting smiles on our faces and chirping mindlessly it's all worth it!

The fact that Emily is still facing the birth of her upcoming child with fear and doubt in her heart really resonates with me. Her post perfectly sums up the "damned if you do, damned if you don't" nature of much of motherhood.

Meanwhile, Amy writes:

"During the five months that I nursed Noah, I can probably count the number of times I could have described it as "blissful" or "wonderful" or even "pleasant." It was...mildly tolerable, most of the time.

"This time has been completely different. Unbelievably different. When the nurse first plopped Ezra rather unceremoniously across my chest in the recovery room post-surgery, leaving me to struggle with positioning him while mostly numb and immobile ... I was able to get him on and nursing vigorously almost immediately -- you'd never know that his birth had been such a rude surprise for him, and so heavily medicated. He was awesome. I'm using words like awesome and wonderful and blissful a lot these days. We're good at this. It works. It insert-Keanu-Reeves-style-WHOA works.

"He'll take the bottle grudgingly, suck it all down, and then demand one more go at the breast to fall asleep. Because he loves to nurse. And, amazingly, so do I.

"I had one recurring dream during pregnancy: I gave birth to a baby boy, and I breastfed him. And everything was fine, and then I woke up. So while I will resist the urge to end this post with a trite and corny saying about dreams coming true, you should know that I'm totally thinking it."

Oh, this one breaks my heart. Amy has gotten the nursing relationship she always wanted, and while I'm so very happy for her, it also hurts me deeply to know that there is one less mom out there in the "breastfeeding FAIL" boat. Though obviously drastically different in terms of scale, I compare it (very humbly) to the way it must feel when someone on an infertility message board announces their pregnancy: yes, you're happy for her, but you're painfully aware that that leaves one less person in your situation, and doesn't that just mean that she figured out something you didn't, and doesn't that really mean that you just suck somehow?

The books and the lactation consultants and the health care professionals and the Internets all use these words, "bliss", "wonderful", "beautiful", "bonding", "natural", "peaceful", when describing breastfeeding. It's so much more comforting for those of us who don't feel that way to cynically believe that no one does, that it's all a sham perpetrated by the patriarchy, that all moms dislike it but some are just better at tolerating it (and lying about it) than others. It's a bit of a blow when it turns out that one of the cynics changes her mind and says (in effect) "Oh, NOW I get it! THAT'S how it's supposed to work!"

The part that's hardest for me to swallow is that I will never get that second chance. Gwen is going to be an only child, a choice that I am perfectly happy with and have no conflicting emotions about. Still, when I read about Amy's experience with Ezra and her newfound love of breastfeeding, it does make me sad that I'll never have that. Not sad enough to reconsider having another child, because dude, what a crappy reason to reproduce - but just wistful. Then again, when I'm in my more rational mind I think, "If I hadn't already decided to only have one child, the disaster of breastfeeding definitely would have convinced me."

Getting Better

I got an email from my Dad yesterday that read, in part, "it's obvious that you and Chris are so enjoying being a Mom and Dad, and that you just love your little girl to bits." What a lovely little pat on the back!

It's true, things are looking up around here (except for the sleep, which I'll talk more about in another post). Gwen is a much more relaxed and comfortable baby, which makes her by default happier and more fun to be around. I attribute this entirely to the chiropractic treatments. She is no longer in constant pain, so she doesn't have long spells of inconsolable crying. Funny how that works!

The other thing that's made a difference is me finally letting go of all the stress and guilt and anxiety about breastfeeding. This is huge. What surprises me is that once I made up my mind to let it go, it happened almost instantly. I thought it would be a more difficult process - what a nice surprise.

In fact, now that I'm more relaxed about the particular method in which Gwen gets fed, I wonder if we might end up weaning sooner than later. No firm decisions made on this yet, but I can see the end in sight, and I feel quite peaceful about that. But again, more on that in another post.

I don't think I mentioned here that last week, I took Gwen to see another pediatrician, one who is emphatically *not* an ass. He suspects that she may have some reflux, so we are giving her an antacid on a trial basis for a month to see if that makes a difference. On the whole, though, he thinks Gwen is fine and healthy and that her fussy/gassy spells will resolve in the next few months as her digestive tract matures.

Speaking of digestion - it's less than 4 weeks until Gwen is officially old enough for solid foods. We have started putting her in her Bumbo seat at dinnertime, with a little spoon and plate, so she can grow to associate those things with mealtime. She also gets a good view of us eating, so that will become a normal activity for her, and one that she will be ready to participate in soon. I am very excited about that!

And All The Sane People Said, "It's About Bloody Time"

Gwen will be five months old tomorrow. We've been weighing her about twice a week since she was two months old, based on the recommendation of healthcare professionals. We have quite a bit of data on her weight.

And whether you take a big-picture or closely detailed view of it all, one thing is becoming increasingly obvious: the only times that Gwen gains weight appropriately are when we aggressively supplement her with formula. On the flip side of that coin, we can see that every time we have cut back on her formula in hopes that my supply would increase, Gwen's weight has stalled or even dropped.

So, we're done with trying to fight the inevitable. When my current bottle of Domperidone is empty, I'm not getting a refill. When my ucky herbal tincture runs out, I'm not ordering more. And when Gwen finishes nursing, she's damn well getting a bottle.

This is incredibly liberating. I feel really good about the decisions we've made, up to and including this one. Calling in a lactation consultant allowed me to feel that I really had done everything possible to maximize my nursing potential. And deciding not to follow her advice, but to go back to the one thing we know works for Gwen - a bottle after every feed - feels healthy and sane as well.

This doesn't feel like an end, but a new beginning. And it does kind of feel like it's about bloody time.

News from the House of Gwen

Gwen did the coolest thing yesterday. She was on her blanket and had rolled over onto her tummy, as is her wont. I placed her tummy time mirror in front of her and sat back down on the coffee table behind her.

She caught sight of me in the mirror, made eye contact, and grinned. It was the coolest thing! That's the first time she has shown any sign of understanding or appreciating mirror reflections.

Also yesterday, we took her to a doctor. The good news is, I am completely in love with this doctor as he gave her the most thorough examination she's had since birth, and spent 45 minutes with us talking about what exactly is going on with her. The bad news is, this guy is not accepting patients. Anyway, his theory is that Gwen's continued unhappiness is due to being fed formula, which regrettably she still needs to have as my milk supply is not adequate (more on that in a minute). He says that in his experience breastfed babies don't get colic. In any case, he assured us that she will grow out of it, that we are doing all the right things, and that we should continue to monitor her weight and bring her in once a month for a checkup. What a breath of fresh air.

So, in the past couple weeks as I tried to get Gwen off the formula, she started to lose weight. In a week and a half she lost over three ounces. Which didn't exactly fill me with optimism. But at the same time, I started to feel way more confident about continuing to give her formula. I guess when I began this quest what I really wanted was to assure myself that I had done everything I could. I've now reached that point. When KG asked me to set up a daily schedule with 12 feedings per day, and I realized this would mean feeding Gwen every 45 minutes, I put my foot down. Maybe this makes me a selfish woman, but I don't think so. I think I will be a better mother to Gwen if I am not crazy. I might try again to get Gwen off formula once we are starting solids, but at this point I'm just working on improving breastfeeding (positions, latch, seal, etc).

I also just received my Motherlove herbal tincture which is supposed to help increase my supply. Man, this stuff is nasty. It tastes like Satan's old underwear. It's like someone took every stinky herb in existence and mixed them together. To make matters even more fun, I have to avoid other liquids for 20 minutes before and after, lest the herbs get too diluted and become ineffective. So I can't even wash it down. Actually, last night I washed it down with pudding. Today I discovered that two pieces of gum work just as well, which is a slightly more healthy option! Anyway it will be worth it if it works. I am curious to see how long it will take before we can judge that.

Hopes and Fears

It's been a trying week. We are now on Plan C with the lactation consultant. I made a mistake with Gwen's weight, thinking she had gained 4 ounces, when in fact she was losing, so that was scary. And I didn't write about that, so I kept having people come up to me and say "Wow, good for you, so glad to hear that things are going well with Gwen's nursing!" which made me feel even worse.

Aside from the sheer physical work of managing Gwen's latch and doing whatever I can to make sure as much breast milk goes into her as possible, this is bringing up all kinds of emotional issues for me.


When I first met with KG and learned about Gwen's latch issues, gag reflex and seal failure, I was elated. It explained so much. Her failure to seal means she is swallowing air constantly, which explains why she is such a gassy baby. Her latch issues explain why she can't take in enough milk to pile the weight on, and why my supply is poor, since she's not stimulating the nipple enough to signal my body to make more milk. Her gag reflex explains why she latches so shallowly, causing her to fall off constantly and feedings to take for-freaking-ever.


And yes, I knew it would be a hell of a lot of work to fix these things. But I dared to hope. I dared to dream.


I allowed myself just one evening of imagining that all the work was behind us, that Gwen became an efficient, contented eater. I imagined the gassiness gone. I imagined what it would be like to be able to nurse the baby and carry on a conversation at the same time. I imagined what it would be like to be able to tell, concretely, when a feeding was "done". I even imagined, for just the briefest moment, that I would get the breastfeeder's high, that incredible rush of blissful bonding that people talk about.

But before I can get there, there is work to do. I know that. I understand that, and I respect it. Slogging through a difficult time to reach a cherishable goal is something I'm familiar with and even good at. But there's another person on this journey with me, and she didn't have a choice in the matter.

Before I started on this mad scheme, a feeding might go like this: Feed Gwen on one side for awhile, till she starts to fuss. Try burping her. Repeat until she fusses as soon as she is put to the breast. If she is still unhappy and crying, get her a bottle.

Post-mad scheme, it was more like this: Feed Gwen on one side for awhile, till she starts to fuss. Try burping her. Feed her on the other side for awhile, until she starts to fuss. Try burping her. Repeat on first side, then second side, and so on back and forth until she fusses as soon as she is put to the breast. If she is still unhappy and crying, get her a bottle.

If you read between the lines, you might notice that the second scheme requires Gwen to cry nearly hysterically before she gets a bottle. It also ensures my nipples are getting as much stimulation as possible, the better to produce milk, but at what cost to Gwen's peace of mind? I told myself that feeding from a bottle is less work for her, so maybe she is not starving so much as simply lazy. Still, listening to her scream like that at every feeding really made me question my motivations. In a year, or five, or ten, will she care that she was fed formula instead of breastmilk some of the time?

It's times like these that I question whether I am doing this for the right reasons. Is it really that important to me to eliminate formula from Gwen's diet, and put her through all the crying and frustration to do so? Is it because I want what's best for her, or because I want some shred of bragging rights that I managed to overcome one more obstacle and finally get her off the formula?

The nurse who facilitates our Healthy Beginnings group said something a few weeks ago that just really resonates with me. She was speaking to another mom who was feeling pressure from her husband to pump milk so that he could feed the baby. The nurse advised her that if she wanted to pump and have a break, that was great, but if she wanted to turn down her husband's request, that was fine too. "Whatever you decide to do, just don't feel pressured, because no matter what, you will never get back that first year with your baby."

It's so true. Gwen is growing and changing right before my eyes. What will I regret in years to come? Will I wonder if I could have gotten her off formula if I just tried harder? Will I wish I'd spent less time stressing about it and just enjoyed her babyhood, no matter what she was eating? Or perhaps both?

I don't have all the answers yet. I know I want to keep breastfeeding, though I don't enjoy it for its own sake. I have ordered some fancy herbals online that will hopefully increase my supply. And continuing to work on Gwen's sucking skills and latch issues will certainly benefit her. But I don't think I'm going to sign on for any schemes that will cause her to scream through our feedings, either.

We have another meeting with KG next week. For the past few days, I have been taking an approach somewhat between the two above, and tracking Gwen's formula intake, which seems steady at about 4 ounces per day. If she continues to need a supplemental 4 ounces, good grief, that's hardly anything, and she probably won't even notice it disappearing once solids are established. If my supply responds to the herbals and we can get her off altogether, that's great too.

And okay. Maybe I'll never get the breastfeeder's high, and maybe I'll never have an easy, contented eater. But I can sure as heck keep her from being a starving hysterical one.

Lactation Consultation

Gwen and I had an important visitor yesterday - a lactation consultant. She hung out with us for two hours, and we learned a LOT.

• Gwen's latch is too shallow. This causes bruising and pain on my nipples. Did you know that it's not actually normal for nipples to turn purple after every feed? I didn't.
• Gwen's gag reflex is very strong. Even when I manage to get a good latch, she pulls back a bit so that it's shallow again. This explains why she can't keep a soother in her mouth.
• Gwen's muscles at the sides of her mouth are not toned, so she doesn't create a good seal. This is why she drools, why she has milk pouring down her face when she drinks a bottle, and probably why she swallows so much air during a feeding.

So. Bad habits there. Will be a lot of work to correct.

The lactation consultant (Karyn-Grace, but she prefers to be called KG) is very optimistic about getting Gwen off formula, in fact long before we hit the six-month mark, but it will take a lot of effort. We wrote out a plan, and here are the main points:

• Feed Gwen 1 ounce from a bottle before daytime feedings, so she is not ravenous and is more likely to co-operate with latch correction
• Nurse as long as Gwen will do so, switching as often as necessary to ensure breast is not empty
• When both breasts are empty, let her be, unless she cries for more - then feed her another ounce (or however much she requests); this amount should go down over time, as the constant stimulation should push my body to make more milk
• Certain feedings will be breast only

I was quite skeptical that I'd be able to get Gwen to go to sleep last night with only my breasts and 1 ounce from a bottle, but she did ... and she slept for nearly eight hours, so I can't complain there.

Here's the part that's hard, though.

No one else can feed the baby (except for that 1 ounce at the beginning of the feed, and what's the point?). No one else can put Gwen to bed. Every night feeding is back on me. And no more Gramma time.

I can't leave her for more than an hour, because in order to increase my milk supply, I have to take advantage of every single opportunity to nurse.

Tall order. But it's not permanent. In fact, the only way I can accept this right now is to adopt the mindset that we are trying this out for a few days. In a few days, KG and I (and hopefully Chris) will talk again, and we'll see what's working and what's not. Then we'll decide what to do for the next few days. And then the next. And so on. If I picture the next two months of my life as a time when I will NEVER be able to say, "I need some baby-free time" I will lose my mind. But if I just take it a couple days at a time, I think I can handle it. And hopefully I will see results before the wallpaper starts talking to me.

I made a promise to my daughter the night she was born. I swore I would do anything. I didn't plan these words, they just erupted out of me in the pure emotion of the moment when I saw her face. I don't know exactly what that statement means, yet, but part of it means that I'm willing to try this for a few days, just to see.

So do me a favour, friends and readers. I know some of you - one in particular, for sure - think this is asking too much of me, and is a recipe for post-partum depression. It may well be. But for the meantime, as we try this out, please be supportive. That may mean saying something nice, it may mean saying nothing at all. I feel very strongly about this and want to try it. I promised Gwen.

Gwen's visit with the Pediatrician

Yesterday, we took Gwen to the pediatrician. We went armed with a list of questions, all basically relating back to her weight gain or lack thereof. The other issues - spitting up, fussiness during feeds, painful gas - were only a concern as they related to the weight issue. As in, I wouldn't take Gwen to the doctor to complain that she cries and spits up a lot. But the fact that she cries and spits up a lot and has never gained weight adequately? That seemed like a problem. I wasn't concerned that there was something serious wrong, I just wanted to make sure we weren't missing anything.


Our appointment was for 11:30. Unfortunately, I had to interrupt Gwen's nap in order to arrive on time. Further unfortunately, we then spent 45 minutes in the doctor's waiting room. Thinking that we would be called in any minute, I didn't feed Gwen the entire time, whereas she is used to being fed as soon as she wakes from a nap. Bizarrely, she was fine; not fussing or crying, just being sweet and making eyes at her dad.


At long last we were brought in. Dr. Graybeard (not his real name) told us to have a seat, and started asking questions that I thought were very pertinent - confirming that I'd had a healthy pregnancy, that Gwen was born at term, that both Chris and I were in good health. "Is she being nursed?" he asked, and of course that is the Can of Worms. I explained about the norovirus, and the disinterest in nursing, and the subsequent dip in supply and the failure to come back from that despite the full dose of Domperidone. "We've been supplementing with formula pretty much her whole life," I said. "But even with that, she doesn't seem to gain weight properly. I think it's because she spits up a LOT."


"Put her up on the table and take her clothes off," he instructed, and I did so. As I took off her pants, Gwen started to cry. "Oh, the table's cold, isn't it?" I sympathized. Well, not much to be done about it. Dr. Graybeard took off her diaper, plopped her on the scale, took her head and length measurements, poked her here and tapped her there, then indicated he was finished with her. Throughout, Gwen screamed at the top of her lungs. I put a new diaper on, got her dressed again, and sat down to nurse and listen to what the doctor had to say.


"Well!" he began. "You've got yourself a grumpy baby. I hope you know, this is going to be her temperament for the rest of her life. Some babies are sweet and charming and easy, and everyone wants to hold them, and some babies just aren't. That's the kind of baby you got. She's just a grouchy, difficult baby. You just have to accept that, she's always going to be that way. Any little thing - change in temperature, being exposed, seeing a strange person, whatever - she's going to scream about it.


"Her weight is fine. She's right here on the 25th percentile, no problem there."


I piped up as this was something I really wanted clarification on. "She was born at the 90th percentile. Doesn't she need to stay on that line?"


"No, not at all. As you can see, she's stayed consistently on the 25th percentile since she was one month old, and that's absolutely fine. There's no problem with her weight."


"Alright," I said. "Now, I was told that I should keep an eye on her weight, which I've obviously done, and that I could start to wean her off the formula as long as she was continuing to gain properly."


He shook his head. "No, I wouldn't do that. I wouldn't bother. I'm looking at you right now, and as she pulls off the breast, I should see that she is satisfied and full. I don't see that. I should see milk spraying on her, and I don't see that. I should see milk leaking from your other breast while she nurses, and I don't see that." I nodded, as I am not a leaky mom and never have been - I haven't worn breast pads since Gwen was about a week old. But I never knew that that was an indication of, well, anything.


"You just don't look like a good nurser, and you just have to accept that. You can't do it. You're a big woman, but I just don't think you have it in you."


"So you think I should just ... just keep supplementing her with formula."


"Yes."


"Alright." I sighed. "Well, I guess she's still getting some benefit from the breastmilk I am giving her, then."


"Well, at this point, it's arguable. Up to two months of age, you are giving her all the antibodies from everything you have ever been exposed to. After that? It's arguable. Breastmilk isn't really any better for her than formula, at her age."


Rattled, I turned to Chris and asked what other questions we had on the list. Chris started asking about Gwen's spitting up. "Well, she's just got a lot of gas, that's all. She's just a grumpy, gassy, difficult baby. Some babies are like that." We asked about a formula I'd recently heard of that billed itself as being more easily digested. He had nothing to say. Chris mentioned Ovol, and Dr. Graybeard went off on a rant about how Ovol is about as effective as waving a magic wand. "If you want to spend the money and believe the dream, go ahead," he smirked. "I've been in the pediatrics business for 35 years, you know, I've got a gray beard here. And during that time, I see things come and go. They don't really have any effect, they don't really have any place in the world of respectable medicine."


And that was pretty much it.


It took me nearly a day to process all of this, and here's what I think about Dr. Graybeard and his proclamations:


I think he is an ass. An abrasive, offensive, ignorant ass.


But the whole story just wouldn't end right without a little mocking, so let's dig a little deeper.


Dr. Graybeard says: "Your baby is grumpy."
Well, yes. We woke her early from her nap and then didn't feed her for over an hour, then took her into a cold, unfamliar place and took off her clothes. Wouldn't you be a bit grumpy? There's a vast difference between grumpy as a mood and grumpy as a personality trait, don't you think?


Dr. Graybeard says: "Her weight is fine."
I'm inclined to believe this one. He may have a bad habit of disgusing his opinions as medical fact, but it's hard to be subjective about numbers on a scale and on a growth chart. If he says it's fine, then I think it's fine, and if we're all wrong and she slips for a couple of weeks it's not going to be a matter of life and death the way it was when she was a wee little thing.


Dr. Graybeard says: "You're a bad nurser, and you can't get her off formula. Oh, and by the way you're fat."
A bad nurser? Thanks. I love the way you phrased that. If I'd been here two months ago, I would still be in tears 24 hours later. As it is I'm very unimpressed with your desire to summarize my entire nursing experience with just a few words, and after an observation period of about 90 seconds. I have a lactation consultant visiting on Friday who seems to think my goal of getting Gwen off formula when we introduce solids is a very viable one - and she's going to be spending 2-3 hours with me, to start, so that we can figure out how to reach it. On this topic, I am willing to go the extra mile (and pay the $75) to get a second opinion.


But okay, you're right about the fat part.


Dr. Graybeard says: "Breastmilk isn't any better than formula anyway."
Hmm. Then why do I spend most of my life as a new mom being beaten over the head with the Exclusive Breastfeeding for Six Months stick, then? Why not Exclusive Breastfeeding for Two Months? Did the World Health Organization not clear their latest recommendations with you before releasing them to the world? Or is the WHO one of those snake-oil organizations who just sells stuff we shouldn't believe anyway?


Dr. Graybeard says: "Ovol is a placebo."
Chris later asked me, "How the hell can a placebo have any effect when the person you're giving it to doesn't even know what you're doing?" Good point. One day last week I accidentally missed one of Gwen's Ovol doses, and we decided to just let it be for a while, to see if she still needed it. 36 hours later, in a storm of fussiness and flatulence the likes of which I hope you never witness, we were rushing for the Ovol. Yes, she needs it. Most effective placebo I've ever seen.


Needless to say, we won't be keeping this guy on our speed-dial.


Some pictures of our grumpy baby:

Breastfeeding Awareness Month

Finally got around to catching up on my blogroll today, and found out that August is Breastfeeding Awareness Month (at least in the States) and that August 1-7 was World Breastfeeding Week. That led me to Storknet's monthly newsletter, with an article titled "Going for the Gold: World Breastfeeding Week 2008".

Within the article are some statistics, such as the fact that "in the United States, the percentage of infants ever breastfed increased from 60% of those born in 1993-94 to 74% of those born in 2005." Good news, right? But the article continues, "despite this increase in the number of women who initiate breastfeeding, only about 12% of infants continue to be breastfed exclusively for a full six months."

Now, to me, this is really poorly worded. The message is phrased as if it's motivational: we've achieved major improvement in this area, but we still need to work on this other area. Come on, everyone! Let's pull up our socks and get 'er done! ("USBC Chair Joan Younger Meek ... urges us to rise to the challenge and meet the goal of six months of exclusive breastfeeding.")

But this isn't something we as individuals can control. "You've lost ten pounds and are nearly at your goal. Five more to go - rise to the challenge!" = appropriate. "You're nearly finished cleaning the house, and you've done a great job on the bathrooms and kitchen. Now you just need to vacuum the livingroom - rise to the challenge!" = appropriate. "You are feeding your baby as much breast milk as you produce. Now you just need to start producing more, so she doesn't starve to death! Rise to the challenge!" = not appropriate. It's a physical attribute that we have no control over, and is analogous to asking us to change our eye colour via will power. Rise to the challenge!

With all the hubbub about Breastfeeding Week/Month, I'm seeing the phrase "exclusive breastfeeding" a lot, and it's irking me the way this is put on a pedestal. When I am in my most calm and rational mind, I understand that breastfeeding is a spectrum, and that the fact I am giving my daughter 70% breastmilk is fantastic, so much better than 0%. Sure, it's not 100%, but it's pretty great, nothing to feel ashamed of. I just wish this message were given to new moms, myself included; the image of a spectrum, rather than a binary state: Exclusively Breastfed vs. Not Exclusively Breastfed. Success vs. Failure. Good Provider vs. Inadequate Mother. Devoted Parent vs. Not Trying Hard Enough.

There are a lot of circumstances that lead to Not Exclusively Breastfed, and they are not all the same. One woman may decide not to breastfeed because she doesn't want to be tied to the baby all the time, and would prefer to spend her time at the gym working to get her pre-baby body back while the nanny gives the baby formula.* Another woman may pick up a nasty infection at the hospital during birth that interferes with her baby's ability to nurse, causing permanent damage to her supply. Yet another may return to work at three months post-partum, whether by her own choice or her employer's, and be unable to pump enough milk to sustain her child through the day at daycare. And another may have given birth prematurely, a situation that will lead to baby being formula-fed until s/he is strong enough to nurse.

(*She may then write a book about it, which Mom #2 stares at in disbelief for two chapters before returning it to the library.)

Vastly different situations, and I'm sure you could think of dozens more. But all are lumped under the same FAIL category when we embrace the mindset that Exclusive Breastfeeding is the only goal worthy of praise.

Becoming a mother has hammered into me the truth of the statement, "The Personal is Political". I am suddenly no longer simply an individual, I am a Woman, a Mother, standing in for millions of my compatriots in whatever choices I make, whatever images I portray, whatever messages I accept. When I see an article like this one, and the incredible comments that follow, I don't just dismiss it as something distant and unrelated to me. I look at that mother's experience and realize it could be mine. I look at the vitriol contained in some of the comments and know that, by proxy, it is directed at me. I prepare myself for an "encounter" any time I nurse in public, and although I am more than prepared to quote the Canadian Charter of Rights and Freedoms if anyone asks me to sequester myself while nursing, it has not escaped me that in this, as in so many battles, there is no such thing as a win for the mothers. We are told to breastfeed, and subtly berated if we fall short of the exclusivity "gold standard". Yet there is little to no societal support for us doing so. And any mention or image of breastfeeding is so controversial, so uproarious, that we become entangled in protests, nurse-ins, flame wars, and litigation. Can't we all just get along?

What a quagmire. What a quandary. Is it any wonder that I sometimes look forward to the time when I will no longer be a nursing mother, and need no longer open myself up to such criticism and anger?

Doctor's Appointment

Tues July 22: 11 lb 3.3 oz
Thurs July 24: 11 lb 2.4 oz (down 0.9 oz)
Fri July 25: 11 lb 4.4 oz (up 2 oz)
Tuesday July 29: 11 lb 10.5 oz (up 6.1 oz)
Thursday July 31: 11 lb 7 oz (down 3.5 oz)
Tuesday August 5: 11 lb 12.3 oz (up 5.3 oz)

The advice I was given last time I saw a public health nurse at the breastfeeding clinic was to continue supplementing Gwen and to weigh her twice a week. For the past two weeks, the Thursday weigh-in has indicated a loss from the Tuesday weigh-in. Now, I understand that "some babies just gain weight slowly" but nothing I've ever heard or read has indicated that an actual loss was anything but abnormal. And for this to happen twice in a row is really weird.

Now, you might be wondering, so let me assure you:
- same scale used every time
- same person weighing her every time (me)
- same circumstances (naked, no diaper) every time

The only thing I've not paid attention to is whether I'm weighing her before or after a feed, or before or after a poop, etcetera.

After this happened for the second Thursday in a row, I made another appointment at the breastfeeding clinic. Seriously, what else can I do? I'm already supplementing, or as I call it, "stuffing as much food down her throat as I can". What more is there?

The nurse I saw was incredibly positive and helpful, and we talked about a lot of things. We talked about reflux. We did a pre- and post-feed weigh-in (she got less than an ounce during the feeding, which is appalling. Fortunately, I am not taking that as 100% accurate or typical). We talked about what a great job I'm doing breastfeeding (yes, she told me I am doing a great job, and told me to keep up the good work. Did I need to hear that? Oh hell yes).

The main message I got was that the breastfeeding clinic could not really do too much more for me, as my breastfeeding was fine. What I need to do, she told me, is take Gwen to a doctor to eliminate any medical cause for her weird weight patterns. So that's what we're doing today.

The nurse also gave me a growth chart and showed me how to plot Gwen's weight from birth. I did so, and learned that while she started out on the 90th percentile, she is now on the 25th. This is not at ALL normal, and while I am not terrified of something being seriously wrong, I do feel it would be foolish to blithely ignore these symptoms. Reflux and milk allergy are our main suspects at this point, as Gwen does spit up a LOT (often it seems she spits up everything we just fed her, which would explain the inability to gain weight steadily!).

I'm nervous about this appointment, mainly because I fear not being taken seriously by the doctor. Doctors, unlike midwives, are not going to take a full hour to examine the tiny patient, take a full history from her parents who are ultimately just making wild-ass guesses about what is going on, and come up with a treatment plan. I fear that the doctor will just brush us off as nervous parents, or declare instantly that "she has colic" (which is a meaningless term if I've ever heard one). The nurse I saw last week assured me that if I didn't like what the doctor had to say, though, I could ask for a referral to a pediatrician for a second opinion.

Twelve Weeks =/= Suddenly Easy

Sorry for the lack of posts. I've had some discouraging days (and nights) and wanted to wait until I felt a little bit more positive before posting. However, in the interest of honesty for my daughter to read someday (or perhaps for me to look back and laugh?), here's what's been going on.

Breastfeeding/Pumping

After Sunday's power-pumping day, I'm sad to say I haven't found the time to pump even once. On Tuesday, a nutritionist was the guest speaker at Healthy Beginnings, and she told us about a hundred times how important it was to exclusively breastfeed for the first six months. She emphasized how this would drastically improve baby's immune system and greatly reduce the chance of allergies. This all-or-nothing attitude really pisses me off because guess what, I blew the "exclusive" breastfeeding when Gwen was 10 days old and we started with the SNS. Maybe that was because I was a lazy mom who didn't care about my daughter's immune system? No wait, I remember, it was because she'd gotten the stupid Norovirus and was too tired to eat and had thus lost 9 ounces after birth and she needed formula to survive. Yeah, that was it.

Anyway, I came home from that feeling like crap because really, all any mother wants is to be able to provide for her child, and when you can't do that you already feel inadequate, and the last thing you need is someone putting Exclusive Breastfeeding on a pedestal like anyone who supplements is doing less than their best.

Weight Gain

Still not where it should be. I am now vigilant about weighing her twice a week, and she gained only half an ounce in five days (should have been between 3 and 8 ounces). That second weigh-in was on the same day as the nutritionist's talk at Healthy Beginnings so I really felt awful. I was totally being pulled in two directions: Gwen needs to eat (because she's not gaining weight) but she needs to eat breastmilk (because it's better than formula). So if she nursed and seemed satisfied I wouldn't offer a bottle, instead patting myself on the back and thinking I had managed to feed her adequately without compromising the Exclusive Breastfeeding mantra. Meanwhile she clearly wasn't getting enough because she was not gaining weight.

Sleep

I will be the first to say: we are very, very lucky with Gwen's sleep. She has on occasion slept as long as 10 or 11 hours (very rarely!), and even when the nights are shorter she usually only wakes up once (Knock on ever-lovin' wood). The problem is getting her to sleep, which seems to be getting more difficult lately. She used to go down fairly easily, between 6 and 7pm, but nowadays we start putting her to bed at 7 and sometimes we are still rocking and shushing her by 10pm. She will drift off in our laps, we put her in the crib, and she sleeps for 20 minutes or so before waking up and crying, at which point we start all over. It's incredibly frustrating. I have been starting to really dread her bedtime. As soon as she wakes up from her afternoon nap, my stomach knots up and my body tenses in anticipation of the horrible evening ahead.

Chris noticed that when we kept her up later, say 9 or 10pm, she actually slept 7 or 8 hours, so for a couple of nights we kept her up late. But that makes my day as a mom horrifically long. I really look forward to the time when she goes to bed and I can be a wife or just an individual: having time with Chris, having time to myself, getting a few things done or just killing time on the web. (And let's not forget the damn pumping session.)

Fussiness
This may or may not tie in to the sleep issue. Gwen has been a lot fussier lately than she had been in her first 2.5 months of life (she is 12 weeks today). I had thought things were supposed to get easier at 3 months, so to have things getting harder instead seems doubly unfair. Anyway, she yowls like a cat being mutilated, with tears rolling down her face, her legs stiff as boards and her little tummy rock-hard. Here is a brief summary of advice I have received on this topic:

"It's gas. You should eliminate dairy from your diet/eliminate vegetables from your diet/track your diet and her screaming for a few days and figure out what's bugging her/give her Ovol/give her colic tablets/give her gripe water/stop giving her formula/change her formula/stop giving her Vitamin D/put up with it because it's a sign of an immature digestive system."

"It's colic. You should make her comfortable by massaging her tummy/trying reflexology/putting her on a vibrating mat/putting her in the swing/doing the flying angel hold/swaddling her/bouncing her/bending and bicycling her legs."

"It's just a stage. You can't solve it, so you should just put her somewhere safe and go somewhere that you can't hear the crying for at least 10 minutes every day."

(Bolded things, by the way, are the ones we have tried so far.)

So what are we doing about all these frustrating issues? I won't call these 'solutions', but they are perhaps 'survival mechanisms'. Gwen's survival, that is.

Weight Gain
Obviously I have to offer a bottle at every feeding, even if Gwen only takes a few sips. Formula is not so expensive that we can't afford to waste a bit of it, and she desperately needs to chunk out. I have people guessing her age at 6-8 weeks old, then when I say she's nearly 3 months they ask if she was a preemie. Bring on the formula.

Breastfeeding/Pumping

After a lot of thought, I finally figured out what I want to do about this. I was getting exhausted trying to keep up with breastfeeding, pumping, and bottle feeding, and if I have to be more on top of offering her a bottle every time, something's got to go. For a while, it looked like the solution was to give up breastfeeding, but I'm not ready to do that. Finally, the solution revealed itself to me. A few months ago when I bought the pump, it was to ensure myself some freedom: so that I could go out for a couple of hours while Chris or his mom looked after Gwen. But as soon as the supply issue worsened, the pump instead became a cruel taskmaster, and I felt chained to it; trying to pump 3 or 4 times a day in order to increase supply, which completely took over my day and made me feel incredibly stressed about our daily routine. I need to go back to that feeling of freedom. From now on, I pump a few evenings a week and/or during Gwen's morning nap, just enough to ensure a couple feedings for me to get out of the house a bit. Much more sane.

Sleep

Chris and I have made a deal as of a few nights ago and continuing until further notice. I will do everything else for Gwen - feeding, diapering, administering Ovol, pumping and preparing bottles, laundry and so on - as long as he will put her to sleep at night. I already have the chore of getting her to sleep during the day, I am just out of resources when it comes to getting her to sleep at night. We also agreed that he would put her to bed earlyish, like 7 or 8. Strange as it sounds, I'd rather have the 4am wakeup than a sleep from 10-6 if it means I can have a couple hours off in the evening. So far this is working well (for me, at least!).

Fussiness

This is the one we don't have any idea on, yet - or rather, we have so many ideas we are not sure which one to pursue. We are so scattered that it's hard to follow any one course of action long enough to see if it's having an effect, and Gwen's screams don't exactly have a positive effect on our reasoning abilities. Starting tomorrow I am going to change her formula, and if by next week nothing has changed I think I'm going to take her to the doctor (so I can get ten more ideas about what to try).

So, that's about the state of things. We are puzzling our way through the post-partum phase with a lot of trial and error. We still have our senses of humour, fortunately, and we are still working together - we make a good team. It's also amazing to have the support and encouragement from our families and friends who give us advice, commisserate, and above all remind us that this will all pass.

Photos & Power-Pumping

Yesterday was exhausting. We had our photo session in the morning - yes! it actually happened! no one went into labour! - which took nearly three hours. Gwen was SOOOO good, I was amazed; there were no major meltdowns, though there were a lot of insecure and unhappy requests for comfort, which was absolutely fine. In all, I'm pretty sure we spent an hour of the three nursing.

We shot five rolls of film. Sixty pictures of the divine Miss Gwen. It's going to break my bank account to buy the prints.

Anyway, when we got home I started the major portion of my day's plan: a power-pumping day. This is recommended for increasing supply. I pumped every hour for 15 minutes, from 1pm to 10pm. (I missed one session at 6pm when Gwen nursed instead; other than that, Chris gave her a bottle.) I hadn't really predicted how tiring and somehow stressful this work would be, but it was. I tried to convince myself that I was doing this not to produce a lot of milk right now, but to scare my body into producing more in the future, but it was hard not to get hung up on the numbers. There were some sessions when I didn't get a single drop in 15 minutes. And my nipples were just killing me by the end of the day, too.

But if it works, and my supply becomes adequate ... well, isn't that the whole point?

To be honest, we are not supplementing Gwen all that much. For the most part, she isn't interested in the bottle. She maybe takes one or two a day; if she's been nursing for more than 15 or 20 minutes per side and seems fussy and frustrated, pulling off often, I judge that I'm empty and I give her a bottle. But this is the exception, not the rule, and she's acting much more pleasant in between feedings, so I'm optimistic that we don't have a serious problem. At last weigh-in she was 10 pounds 12 ounces - that's up 2 pounds since birth, which is still low, but she's gaining more rapidly now for sure. I'm going to keep weighing her twice a week when I go to Healthy Beginnings.

And when I get really frustrated and depressed about this myself, I remember that it's only three more months until she's on solids and the bulk of her nutrients will be coming from something outside my body, so the pressure will really be off and nursing will become less of a survival thing and more of a comfort and bonding thing.

Still gaining!

I weighed Gwen at the health unit today and she was 10 pounds, 5.4 ounces. Since their scale and Lillian's differ, to compare apples to apples you have to look at her last weight from that facility, which was last Thursday at 9 pounds, 6.5 ounces. So very nearly a pound in 6 days. Clearly the formula is working.

The nurse I saw today confirmed that there is nothing magical about formula over breastmilk, and heartily agreed that I could "top-up" with breastmilk if that was what I chose to do. So for now it's breastmilk top-up when we're home, formula when we're out (because you can mix formula on the fly and not have to worry about keeping it cool). Soon I'll be lying to old drive-by noseypokes just like Amber.

There is a whole thing going on with the stoopid mystery bacteria but it annoys me and bores me so much that I can't imagine you would want to read about it. Just know that I am frazzled and frustrated and mostly not thinking about it, and I'll let you know what's up as soon as I do.

The Vulnerability of Motherhood

There is this unwritten rule in our society, and it is: if a woman of any age is out in public with a child of any age, anyone who comes into contact with her is welcome to comment or offer criticism on subjects ranging from the child's manner of dress to the behaviour of the child and everything in between.

I call this drive-by parenting, and the best thing about it is that you don't have to actually be a parent to participate! No, single people are just as welcome to criticize as anyone else.

I was vaguely aware that this sort of thing happened, but the first time I heard a tale of it firsthand was from a friend who had troubles with her milk supply and so had to supplement with formula. She told me that she'd been approached in a local mall and asked point-blank "What's in that bottle?". I was horrified. What business was it of anyone's? That child could be adopted. That mother could have cancer and be taking drugs that could pass through the breastmilk. There could be (as there was) a supply issue. The woman could be babysitting and feeding a bottle of breastmilk. There are probably dozens of other legitimate reasons for giving a kid a bottle, whether breastmilk or formula, and having recently found myself in a similar situation I think that most mothers think long and hard, perhaps even agonize a great deal, over the feeding of their babies. The fact that strangers feel entitled to comment on it, knowing absolutely nothing about that family's situation, makes me jaw-clenchingly angry.

I had the opportunity to witness my very first drive-by last Wednesday afternoon. My car was at the dealership for an oil change, so I took Gwen for a walk in the stroller to kill time. We ended up at a nearby mall, where I sat in the kids' play area to nurse Gwen. Another woman came by with two tween-aged kids, a boy and a girl, who commenced playing with the crayons and blocks and so on while the woman sat on the bench beside me, idly paging through a kids' book. Not long after, a fifty-ish woman came walking by. Without pausing in her stride, nor meeting anyone's eyes, she commented briskly to no one in particular, "They're missing school already!?" with a look of disapproval shot towards the tweens. Aware, as apparently she was not, that it was the 25th of June, I turned to the other woman and asked, "Isn't school out for the summer?" She confirmed that it had been the last day. But Granny Drive-By was already long gone. She didn't want a conversation, she didn't want an answer, she didn't want to give anyone a chance to defend themselves by giving valuable information. She just wanted to drop her ill-informed opinion, giving someone the opportunity to feel like crap, and continue on her merry way.

I don't know how the other woman was affected, but I was in a blind rage.

Ever since I heard about the "What's in that bottle?" comment, I've been working on coming up with snappy retorts that make it clear I don't think it's anybody's business how I feed, dress, talk to, or treat my child. But with this event, I suddenly understood that when the Drive-By happens to me, and it will, I won't get a chance to respond, whether in defense of my actions or of my right to make my own parenting decisions.

The very next day, we were told that we had to start supplementing Gwen a lot more rigourously than we had been. One week and 10.5 ounces later, it seems this was the right choice. Bottle feeding, for us, is the new black. Bring on the drive-by.

Things have changed in the past generation. When Chris and I were infants, breastfeeding was not nearly as common as it is today. Breastfeeding was what animals did, and maybe third world women who couldn't afford formula. But here in North America, we knew better! We could have Scientifically Developed Formula, specially created to give your baby all the nutritional value he or she needed. I was breastfed, and my mom tells me it was a bit of a rarity at the time. Chris was formula-fed, and his mom has been subtly pushing me to give up breastfeeding since the first week of Gwen's life. But today, we know that breastmilk is absolutely the best food you can give your child. The American Association of Pediatrics recommends babies be breastfed exclusively for six months, and continue receiving breastmilk for their first two years and even beyond. There are hundreds of reasons why Breast is Best.

It's wonderful to have all this support and knowledge about breastfeeding, encouraging new moms to do what's best for their babies.

But.

As mentioned above, there are a lot of reasons why any given baby at any given time might be drinking from a bottle. And I think we've swung too far into Breastfeeding Fanatacism. I've seen moms at the drop-in who are supplementing with formula and feel they need to defend this choice by explaining their baby's whole life story before they can say anything else about any concerns or questions they have that week. I've heard other moms talk about how all they can find on the 'net is info on how great breastfeeding is, and no useful info on how to formula feed. And I've mentioned here before about how breastfeeding is touted as a Beautiful, Natural, Bonding Opportunity, a myth that annoys me no end because if you, as a new mom, don't find it Beautiful and Natural, there must be something wrong with you!*

So, society wants you to breastfeed. And you know it is best for your baby. So, assuming you are willing and able to do so, off you merrily go, nursing your baby whenever and wherever she happens to request it. But there is another facet to this issue: the pure unseemliness of public nursing. My friend Tricia was recently in another local mall (apparently, that's all we new moms do; go to the drop-ins, and then hang out at the mall) and was looking for a place to nurse her son. She was kindly but firmly directed towards the 'family room', which is of course nothing more than a washroom with a couple of stalls, a change table, and one chair right next to the garbage can. Yes, any new mother would love to spend an hour or so sitting in such a room! Ever so much more pleasant than sitting in the mall proper, watching the world go by! So you're subject to criticism no matter what you do; society expects you to breastfeed, but they sure as hell don't want to see it.**

*I also think that breastfeeding is so hard and painful in the beginning that once it stops hurting and starts working, women are so flooded with relief that they think it is a Beautiful and Natural Bonding Opportunity, when in fact it is just Mind-Numbingly Dull. But that's just my opinion.

**I am completely over my fear of nursing in public. I have even considered doing a summer tour of Important Nanaimo Landmarks and nursing at every one of them, just to stir the pot and give myself something to do. In certain situations I do use the Hooter Hider, but if I don't feel like it then I don't.

By the way: Your right to breastfeed anytime, anywhere is protected by the Canadian Charter of Rights and Freedoms.

Weight Gain, Heat, Daycare, Thrush

Have you all been dying of suspense, wondering what happened after my last post? Did Gwen gain any weight? Did I get over my fear of formula? Did Gwen in fact have a urinary tract infection?

Nah, you've probably all been enjoying your Canada Day weekends. At least I hope that's the case. And like us, you've probably been sweating to death.

So, the answers to the questions above can now be revealed thanks to a surprise visit from Lillian. I do very much wish she had called first, as she showed up with her scale and the results of the urine test about 20 minutes after I put Gwen down for the night. But such is life. The urine test turned up a bizarre bacteria that would not be expected to be found in urine. Neither Lillian nor the pediatrician she talked to had ever heard of it. They both suspected it was actually a contamination from Gwen's skin. They agreed that the course of action was to (wake Gwen up and) weigh her right away. If her weight was good, then fine, the bizarre bacteria could be ignored. If it wasn't, then she would have to go to the ER to get a catheter put in for a clean urine sample.

But her weigh in was good. Ten pounds, three-point-five ounces of good. (Hallelujah, we finally broke ten pounds!) That is a gain of 10.5 ounces in eleven days, well within the four-ounces-or-more-per-week rule. Yay.

Of course, the bad news is that this indicates we need to keep supplementing. I think a major part of my frustration with that is that if Gwen is getting a bottle, it should be from someone other than me, and I should be getting a break. Up till now, this has not often been the case. Of course, this weekend it has not been the case because Chris has been really busy doing a dozen other house- and baby-related jobs, like putting Gwen's crib together, installing a blackout blind in her room, stain-treating all her clothes, and so on.

The heat is making all of us a little cranky, too. I keep thinking of all those people who'd comment, upon hearing my due date of May 5th, how great it would be for me to *not* go through the summer pregnant. No one told me that the little heater-baby would still be glued to my body ten hours a day. Literally glued, nowadays, as our sweat gloms our skin together. Terribly uncomfortable. Last night I was sure Gwen was going to fry in her swaddle blanket, so we tried letting her sleep unswaddled. She didn't sleep, so neither did I. We worked hard all day at keeping her room cool enough so that she could sleep swaddled tonight - and there is a fan just outside her door keeping the air circulating. An air conditioner is looking awfully tempting, but it's such an environmentally unfriendly option that I'm just not ready to bite the bullet.

On another subject, we went out and toured a daycare today: Little Ferns. I thought it was a good place, lovely open layout and kind staff, with lots of nice wooden equipment and so on. We want to see some other places as well so we have a basis of comparison; the next one I'd like to see is Jolly Giant. I've been told that there is often no point on really "choosing" a daycare as really, only one of them will end up having a space for us, which is an awfully depressing concept and makes me think that I should be on every single waitlist in town. So, I'm working on that.

At long, long last, Gwen's thrush is nearly gone. I can still see spots on her behind, but really, only because I already know they are there. I'm going to keep using the cream I have until it's gone - which will probably be another week or so at the most - and then call it good. I will be immensely grateful to see that particular chapter of our lives end.

Immunizations, plus more

I just got back from getting Gwen's 2-month immunizations. Aside from the obvious fun of watching Gwen scream while the nurses stuck her with four big needles, there is other news as well. I'm not even sure how to process this all so this entry will be more about helping me do that, than sharing coherent conclusions.

While we were waiting for our shots, Norma, the nurse who helped us at the breastfeeding clinic last month, saw us and came to ask how we were doing. I told her I'd been wanting to come see her again to do a pre- and post-feed weigh-in, because we were now supplementing Gwen with a bit of formula, but she'd only gained 7 ounces in 4 weeks. She was stunned, and started asking questions. Here are the facts:
- Gwen feeds all day long, except when she is sleeping or having her diaper changed. She is rarely content to be on her own or entertain herself for more than a minute or two at a time.
- Gwen's latch is good and I can often hear her swallowing (actively feeding).
- I can pump 2-3 ounces of milk in a 15-minute session of double pumping, so I don't think supply is the issue.
- I am on the full dosage of Domperidone *and* Blessed Thistle supplements, and have been since the beginning of May.
- Gwen often repeatedly pulls off the breast after she's been feeding for a while, acting frustrated as if she is not getting any milk, at which point I switch her to the other side.

The nurse who was to give us our shots, Twyla, came in and joined the conversation. She too was stunned by the low weight gain. We weighed Gwen right then and there: she was 4266 grams.

There was a great deal more talk about breastfeeding and supplementing while we went over the "milestone" sheets, during which time, naturally, I was nursing Gwen. Twyla was surprised to see how quickly Gwen demonstated the frustrated "out of milk" behaviour - apparently she should be able to feed actively for 20 minutes before running out. I've never actually timed how long that phase is, though I will be paying attention now.

After the shots, which were horrible - Gwen caught on right away, and as soon as Twyla started wiping the site for the second shot she realized she was going to get stuck again, and boy she was not happy about it - we talked more about her weight and feeding and supplementing and so on. It seems puzzling that I can get a good yield from my pump, yet Gwen is not gaining. It was heavily recommended that we see a doctor to eliminate the possibility of a urinary tract infection or any other reason why Gwen's nutritional intake is being used for purposes other than gaining weight.

The ultimate recommendation from both Norma and Twyla was that we give Gwen a bottle of formula after every feed. That is, I should let her feed for 20 minutes on each side, then if she is still hungry, give her at least 2 ounces of formula, watching her cues to see if she still wants more. I question whether she should instead be put back to the breast at that point, but I guess if the breast is empty that will do her no good. It does seem like she is frustrated or impatient with a slow letdown, whereas the bottle can feed her quickly and leave both of us time to do other things. In the back of my mind I'm thinking of offering breastmilk in the bottle as well, because that's better for her anyway, and if it's an issue of impatience the bottle will eliminate that.

We took the crying Gwen back to the scale, stripped her down again, and weighed her. She was 4278 grams. I'd been feeding her nonstop for almost an hour, and she'd gained only 12 grams (less than half an ounce). Now admittedly, she did dirty a diaper in the meantime, but one would surely hope the gain would be more than that ... right?

So as of today we plunge headlong into the world of supplementing with formula, not to mention seeking medical attention to lay out these facts and see if there are any underlying issues.

I just feel thrown by all of this. I think the problem is that this would normally be the time, in any case, where we switch from midwifery care to The Medical Establishment, and so I knew I would feel a little bit disoriented during that switch. But this issue has me feeling like my barometer is completely askew.

I'm really grateful that Chris was able to be there with me today, not only for the fun of Gwen-wrangling, but to help me take in all this information. Sometimes I just get really emotional and can't process things very well, so it's super helpful to have someone else there to keep hearing what the nurse is saying.

Look at me, I'm growing as a person

I can't believe that I'm actually in charge of a baby. Who let this happen?

Things sort of came to a head yesterday afternoon when I got home from a very nice lunch engagement to find Chris not at work, and not in his office, but in bed, either having a bad reaction to an allergy pill or sick with some kind of nasty bug. I was exhausted from walking to and from the lunch, Gwen was screaming because she hadn't had a nap yet, and to top things off I was supposed to be heading out to see a friend. I called the friend to cancel, got Gwen down for a nap, and then lay down myself with my invalid husband.

To talk about - what else? - baby poop.

Seriously, I never understood what a constant topic this would be. But ultimately, when you are in charge of a creature whose only methods of feedback on health are weight and poop, you spend a lot of time thinking and talking about these two things.

I won't bore you with the actual conversation, but it led to the revelation that when I decided to have a child, I somehow hadn't thought about being the guardian of someone's physical health. I thought a lot about the socialization aspects, about how to teach a child the things I thought were important in life. I daydreamed about sharing special times together, about enjoying each other and building common interests. I never thought about the fact that I would have to take my own habits and beliefs about health care, add in a person who can't talk to tell me how they feel, and somehow produce not only a wonderful person but a healthy one. How'd I miss that?

The other thing about having a kid is - there's no way out. I know you're all nodding along like, Well, duh, but hear me out. I'm a quitter. I have a lot of things that I'm really good at, all of which I have a natural aptitude for. Never in my life have I worked and practiced to acquire a skill. The things I have to work for, I just don't do, because I hate spending time on something I'm bad at when I could just stick to the things I'm good at. And sometimes, I question whether I'm any good at this parenting thing - when she's had a case of thrush that's been going on for nearly a month, and her poops look weird, and she's not gaining weight*, and I'm just not totally sure what is the right thing to do. I don't like that feeling - I like being confident.

A couple of weeks ago when my mom was here she got sick with what looked like the Norovirus, and Chris and I got pretty worried that we were going to get it again too. Breastfeeding at that time was just starting to not hurt, and at one point I threw my hands in the air and said, "If I get the Norovirus again, that's it, I just quit." But short of abandoning my baby in a subway station, I kind of can't quit. I have to keep doing this, every day, making these decisions blindly, hoping for the best and trying to learn bit by bit. The kind of shit I usually despise.

The weird thing is, I somehow find it kind of liberating.

PS: While I may be growing as a person, I am also shrinking. My wedding ring fits again today, for the first time since November. Hooray, I'm married!

*I called the Nurse Line on a whim to see if they had any brilliant advice. I really shouldn't have bothered. All they do is type your statements into a computer and bring up some matches on their database - the guy didn't tell me anything I couldn't get from Google. With one exception.

He told me I should feed Gwen more often. When asked how many times a day I fed her, I kind of balked as this is a fairly meaningless question. She sleeps for about 15 hours a day, and I maybe spend 1 hour a day changing her diaper and making googly faces at her. Other than that, I'm feeding her. That's about 8 hours a day. Let's see - morning feed, post-morning-nap feed, post-afternoon-nap feed, pre-bedtime feed, and two middle-of-the-night feeds ... that's five times a day. He suggested I bump that up. "You're only feeding her every four hours," he told me. "Well, yes, but I feed her for three hours out of those four hours," I replied. He responded that I really ought to try and feed her ten or twelve times a day, or every two hours. Unless I start pulling her off the boob to walk around for five minutes while she screams, then come back, start again, and call that "two" feedings, I don't really see how such a thing is possible.

Formula again?

This morning's appointment with Lillian revealed that Gwen has gained a total of 3.5 ounces in three weeks. When Chris asked her what an average gain was at this age, she replied that it was about 4 ounces per week.

So yeah, it seems she's definitely inherited her dad's metabolism.

We are not panicking, because Gwen is showing all other signs of health: she is reaching her milestones (smiling, reaching for objects, interacting with us) and not screaming for food. Nor does she look gaunt or wasted. She is just a skinny girl. I joked with Chris that maybe she would grow up to be a supermodel, a thin and willowy creature that I utterly cannot relate to.

We are going to try giving her a feeding of formula once a day to see how she responds. It's interesting to see how my reaction to this has changed. In the beginning when formula was recommended, I wept and wailed and felt inadequate. Now I'm like, "hey, whatever she needs, and did you know that someone else could give her formula while I go take a nap?" Heh.

Also, since thrush updates are boring, a haiku:
Gwen's poor little bum.
Three weeks and no improvement.
Yes, I've quit sugar.