Friday, August 31, 2012

Breastfeeding your child Part 3: 3-12 months

If you've made it to three months breastfeeding, congratulations!!!

Setting small goals (get to the end of the day, get to the end of the week, get to 1 month, then 3 months, then 6 months) can be extremely helpful in making breastfeeding work, and is exactly what kept me going until the three month mark.  I promised myself that I would trust in my body and give myself small, attainable goals.
Once you make it through the first few months of breastfeeding though, things can be just as tricky as they were in the start.  Let's talk about a few problems that can trip up a nursing mama and cause her to stop breastfeeding.

(If you are a working mama, a lot of this will pertain to you!)

Many women return to work around three months after their baby is born.  To be able to continue to breastfeed while working requires a significant amount of work to coordinate/plan pumping your breastmilk in your workplace.  I would HIGHLY recommend having a discussion with your boss or manager prior to returning to work about your needs regarding pumping space and time.  This can be tricky, but you are covered by law to have a place to pump your milk and time to do so.  

I had the luxury and the curse of wonderful and terrible pumping accommodations in my various (current) jobs.  Two out of the three jobs at which I currently work have amazing pumping facilities.  Private (or semi-private) rooms with comfortable chairs, hospital grade (multi-user) pumps supplied, and even a television in one of the pumping rooms!  My third job?  Not so great.  To be able to work at my third job, I'm a little embarrassed to say that I've pumped in offices (locking and non-locking, one office actually that the door didn't even fully shut all the way, and I had to push the back of my chair against the door), empty patient rooms, staff break rooms, and yes, even bathrooms.  These were not ideal and definitely not optimal situations, but I need/needed that job and tried to make it work for me.  When I return to work after my next maternity leave, I will be requesting better pumping conditions fromemployer #3, and I highly recommend for you to do so if you are a first or second time mama that anticipates less than optimal situations.

Once you are actually at work, many women find it difficult to tear themselves away from their work to actually have time to pump.  Before I went back to work, I promised myself that time wouldn't be a reason why I quit breastfeeding.  I promised myself that even if there were 10 patients waiting to be seen after, that I wouldn't let those people become more important than what my son needed from me.  Because I viewed it like this, I had an easier time sticking to it.  And, to be totally honest, it became a time in my day that I enjoyed.  In the beginning, I would get three breaks a day (I work extended hour shifts) where I pumped, but I also spent time doing catch up charting, talked with our daycare provider, and (gasp!) just relaxed sometimes!  Seriously though, if breastfeeding is important to you and your family, just allow yourself the freedom to have that time without worrying about work.  It will still be there waiting for you when you're done pumping, ready for you to pick right back up where you left off!

The next problem I had was clogged ducts, which eventually led to mastitis.  A key part about breastfeeding is that demand helps to determine supply.  If you and your baby are lucky enough to stay at home together, your body is only producing just as much as your baby needs.  However, any time you add in the pump, to either replace a feeding your child misses while you are away or for other reasons (increase your supply, decrease the firmness of the breast before baby nurses, build a freezer stash, etc.), you run the risk of changing the message you're giving to your body. 

The message I gave my body was produce, produce, PRODUCE more milk!

By a few months in to pumping, I had pumped my way into a significant oversupply.  Since I left for work much earlier than little man had to wake in the morning for DH to take him to daycare, I pumped first thing in the morning every day.  Some days, I was able to pump up to 16 ounces total, in one pump session.  I would also pump three more times additionally at work, and then come home and nurse my son 1-2 times before bed.  I could pump 30-40+ ounces per day, when he would only be taking 20-30 some days at daycare.  Our freezer was always full of bags of milk (in my favorite Lansinoh bags!), however, so were my breasts, especially on days when I didn't work. I began to have clogged ducts- hard, uncomfortable sore spots on my breasts- at least every week or two.  Between months 3-7ish I don't think I made it through a month without having at least two clogged ducts per month.  

The problem is, though, that #1- almost no mother can ever ALWAYS be at home with their child.  #2- There are multiple other things that can lead to clogged ducts as well, such as growth spurts, initiation of solid foods, incorrect or inadequate massage to the breasts, wearing too tight of clothing or bras, nursing strikes, and many other reasons as well.  My main cause was overpumping, but again, clogged ducts can come from many different starting points- and are equally frustrating and painful no matter the cause.

I tried everything I could scour on the internet, hot packs before nursing, cold packs after, nursing in different positions and holds, pumping to release the clog, hand expressing (typically hanging upside down like a contortionist in a hot shower), vitamins/supplements, etc.  You name it, I tried it.  Looking back, instead of trying to fix the problem, I really should have just pumped less, and eliminated the oversupply by decreasing the demand, but at the time I really didn't get it.

Then came the clogs that I had a really difficult time clearing, one of which led to mastitis.  I was caring for my son, at home from work on one of my days off, when all of a sudden I had a significant fever (at the first feeling of discomfort, I took my temperature and am pretty sure it was at least 102 degrees) and just felt so unbelievably horrible all at once.  It was so difficult taking care of my son during that time, as he and I were the only two at home that day, but we made it through, and thankfully my Ob called in prescription medications for me to get me through it.  It took a few days of significant medications, but we kept nursing through it (per their recommendations) and when I felt better, we were right back on track.

If you are dealing with an oversupply, clogged ducts, or mastitis, I highly recommend to you to take a look at your pumping routine.  Look at how often/how long your baby is nursing and try to use that as a guide.  I know it is really tempting to take all the extra you make and stash it in the freezer for later, but if you are making more each day than your baby is taking, you may want to either decrease pumping session length or number.  Or, if you really want that freezer stash, make sure you pump once a day or so on the weekends (based on how much extra you are making) to maintain that consistent amount your body is producing every day, instead of only a few days a week pumping SO much more out.  Again, it is all a demand vs. supply issue here!

During the time I had mastitis, I am pretty sure I said to DH several times, "This is it!  I'm done!!!"  But then the fact that I'm really, really cheap came to mind, and I said, okay, just until the end of this week.  When I got through the mastitis and the end of that week, I said to myself, okay, just another week more.  And so on.  Those really small goals got me through so many hard times during the middle of our breastfeeding journey, and I am so thankful for it.  My supply eventually evened out, I stopped having clogged ducts, discomfort, and pain, and things became normal, and dare I say, easy!  

Once you're able to get through the first 3-6 months of breastfeeding, a lot of women have told me that it gets to be simple, easy, and good.  I experienced just that.  We were able to stick it out that long, and at that point, it became very comforting to both of us, very sweet, and a routine thing.

Well, until my son became a toddler.  :)  But that is for the next post on Sunday! :)

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  1. Any thoughts on how you'll handle BFing this time with a toddler? I'm in the same position as you and thinking about trying one of the Koalakins but open to any other thoughts.

  2. This time frame is when I faced my biggest challenge: my son started refusing the bottle at 6 months. From that point on until today, I had to be with him for every single feeding. Of course, now that he is a toddler, he can go the whole day without a nursing session, but that was a strenuous six months there.

  3. I hadn't seen the Koalakin previously, that looks interesting! I didn't have my ring sling last time when little man was a newborn, we didn't buy that until a few months down the line, but I nursed in the beginning in the Moby wrap. I'll try nursing in the moby wrap and in the ring sling this time and see how both work out and which I like better. Thankfully, little man is pretty safe and contained in the main area in which I'll be nursing new baby girl, so I'm hoping there will be times where I can just sit with her and nurse, and the mobile nursing will be the infrequent part... fat chance, right? :)


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