3 Doulas

When Should I Stop Nursing My Baby?

By: Mandy Schutt

 

My daughter is eighteen months old and is still an avid breast feeder.

I’ve lost track of how many times I’ve been asked,

“Are you still nursing her?” ("Yep!")

“How long do you plan on doing that?” (“Until it stops working for either one of us.”)

“Aren’t you afraid she will nurse until she’s in school?” ("Nope.")

I'm all about parental soul searching, and that almost always means-especially for us western mamas- attempting to slough off cultural opinions and expectations and deciding what is best for us as an individual.

While most of us are aware that breast is best, the question often still remains, “But for how long?”

 The American Academy of Pediatrics (AAP) recommends that breastfeeding continue for at least 12 months, and thereafter for as long as mother and baby desire. The World Health Organization recommends continued breastfeeding up to 2 years of age or beyond. What us Americans consider “extended nursing” is, in truth, just the norm in many other countries.

My personal take as a someone who is pretty well educated on birth, breastfeeding, babies, and- possibly even more importantly- been exposed to breastfeeding relationships in many, many other countries is: "What's the rush?"

…BUT then again, I'm one of those crazy nuts who believes that there is really nothing we need to "train" our children (aka baby mammals) to do. I believe by the default factor of being animals, we instinctively know a heck of a lot more than we, as intellectual beings, give ourselves credit for. Do we need to socialize our children so that they learn things like manners, language appropriate for various settings, sharing, and all that jazz? Of course we do, but in my mind “training” and “socializing” are two very different things.

I also think that, for some reason when it comes to nursing, we polarize our children. We find it acceptable for a child to learn to walk anywhere between 10 and 16 months. One 1yr old might have a very extensive vocabulary, while another child says nothing at the same age. In the same way, some children show clear signs that they are done with the breast at around a year while others don’t show those signs until they are toddlers.

Whenever I work with a client who consults me on a parenting issue they are struggling with, one of my first questions to them is, “Why do you believe that is or is not the right thing to do?”

Their response to that usually answers their own question…and the trick is that there is no right or wrong answer! For example, to the question of how long a mother should wait to wean, one mother might answer,

“I believe it’s the right thing to do now because I’m exhausted all the time and am beginning to really dislike the chore of breastfeeding my baby.”

While another might answer:

“Because my mother used to make fun of women who breastfed their toddlers, so I've always thought it was the wrong thing to do.”

While yet another might answer:

“We both still enjoy nursing so much but I’m I'm worried my baby will want to do it forever!”

You can imagine that there may be a very different “correct” path the above answers would lead a mother to take! Is one mother “more right” than the other? I don’t think so. My choice has been to allow my daughter to self-wean. I reserve the right to change my mind at anytime should something in my life change and create a need for us to close out breastfeeding relationship.

 Here is what Dr. Sears says on the subject of self-lead weaning:

Weaning is not a negative term, nor is it something that you do to a child. Weaning is a journey from one relationship to another. The Hebrew word for wean is gamal, meaning "to ripen." In ancient times, when children were breastfed until two or three years of age, it was a joyous occasion when a child weaned. It meant the child was filled with the basic tools of the earlier stages of development and secure and ready to enter the next stage of development. A child who is weaned before his time may show anger, aggression, habitual tantrum-like behavior, anxious attachment to caregivers, and an inability to form deep and intimate relationships. We call these traits diseases of premature weaning…

Former Surgeon General, Dr. Antonia Novello, proclaimed: "It's the lucky baby, I feel, who continues to nurse until he's two." A baby's sucking need lessens sometime between nine months and three years. The age at which this need lessens is individual, yet very few babies are emotionally filled and ready to wean before a year. Have confidence in your intuition.

 Full article here.

For my daughter, nursing is still a very important comfort measure. She is an inquisitive, happy toddler and loves to explore! Often this exploration leads to tumbles, scrapes, and tears. Other times it’s just plain old exhaustion that sets in and causes her emotions to fluctuate. During these tough times, she wanders back to mama for the comfort she finds through nursing. Additionally, breastfeeding has provided me with an unequivocal tool for solving my baby’s problems. Does she need a distraction? Hungry? Bored? Feeling overwhelmed? Sleepy and cranky? My breasts continue to be a solution for all of these sorts of scenarios.

I’m thankful that my body still provides my child a safe place to center herself and “reset”. I am okay with using my breasts as “instruments of peace” so to speak! Until my child is verbal and cognitively developed enough for my words and touch to do the same thing that my breasts do now, (and maybe even beyond, though I will need to assess that when the time comes) I feel that the choice to continue nursing is the perfect one for me. My milk provided her with essential nutrients in the first year and now they provide her with essential emotional comforts. Is this not just as important?

I admire any mother who will take the time to question the societal pressures of parenting and standardized expectations to do some real soul-searching on issues such as extended breastfeeding. There really isn’t a wrong or right answer; there is just a personal answer. You know your child and yourself better than anyone! When you allow yourself that truth, decisions like the one about when to wean, become a whole lot easier!

Nursing after breast Reduction

By Aimee Oswald, CD (DONA), HCHI

www.sweetpeabirth.com

 
Breasts are now one of my new obsessions! I've had them since I was about 12 years old and to be honest for a large portion of my life they were in my way, more of a hindrance than an asset. They were great for attracting men and once in a while I was able to get something at a discount, but beyond that they were not of much use to me...then I got pregnant.  For the first time in my life my tummy stuck out farther than the girls! I need to back track a little now. When I was 18 years old the doctor discovered a substantial lump in my left breast. It was determined to be benign but only after two surgeries which required that my left nipple be practically removed and then re-attached.  After the birth of my first daughter no milk flowed from this breast, not even a tiny drop.  The right one was not much better at producing and after many hours, countless sleepless nights, and pumping only bloody "milk" into bottles I labeled my breasts failures and picked up a bottle. 

About 8 years after the birth of my second daughter my girls had gotten totally out of control; I was now wearing a 36 I Bra, I as in after H!! The weight, headaches and constant strain of trying to find tops was enough and I decided to have a breast reduction.  I had no idea how very common this surgery was.  I knew lots of ladies that went up in size but since my surgery I've met many more who have chosen to down-size. Several of these woman are now venturing into mommyhood and have questions about how to be a successful nurser.  Here is what I've found out: 

Breast reduction surgery almost always compromises lactation potential to some extent, the good news is a woman can still breastfeed her baby. The question becomes not whether she can or can't breastfeed, but rather how much milk she will make.

Almost all post-breast reduction moms will produce some amount of milk, though some types of surgeries are less damaging to the mammary system than others. Some mothers will still have a full supply of milk after surgery, especially if their surgeon took care to preserve their mammary tissue, vital nerves, and ducts. Some women will find that even though they do produce milk they may need to add some supplemental milk supply.  There are options for this as well, one option is to use an at-breast supplementer such as the Medela SNS or the Lact-aid Nursing Trainer. These apparatus are basically a pouch or container filled with supplement that hangs around the mother's neck with a thin tube that is positioned alongside the nipple. When the baby takes the nipple and areola into his mouth, the tube goes in too, and the supplement flows along with any mother's milk that is being extracted from the breast at the same time. You can use expressed milk in the system. There are also several places to purchase donated breast milk that you can use in the supplementer. 

Whether you have or have not had a reduction surgery I strongly recommend that you attend a breastfeeding class prior to your birth. Not only will you learn about nursing but you will learn about the anatomy of the breast and this is very beneficial when trying to work your way to nursing your baby.  I also urge you to meet with the hospital or birth center provided lactation consultant, even if you are off to a wonderful start this highly trained professional can save you hours of crying (both you and the baby!) and sore nipples by just making simple adjustments to holds. If you get home and then discover you have run into a snag your doula, doctor,nurse, or childbirth educator can refer you to a home lactation consultant who will visit you or you can go to your local nursing support center and the amazing volunteers from La Leche League are always eager to assist.

Okay say you've done all of the above, took a class, pumped worked with a professional but for one reason or another you choose not to nurse. Are you a terrible parent? Will you have no bond with your baby?  Absolutely not!  You can still have wonderful bonding time with your baby during feedings and here are some hints to help with that:

First explore the possibility of either using your own pumped breast milk or donated milk in the bottle. Breast milk really is the perfect food for baby and should be used whenever possible.

Second when you bottle feed your baby go ahead and take off your shirt, hold baby skin to skin  and right next to your breast. This is the perfect distance for baby to see you and the closeness you both feel will be pleasing to both of you.

Lastly do not blame or become angry with yourself. Your baby loves you and just wants to spend loving quite time with you.

Slings Are Getting a "Bad Wrap"- Are They Really Dangerous?

By Mandy Schutt

My husband and I were walking through IKEA yesterday when a stranger came up to us with a frantic look on his face, pointed to the sling I was carrying my daughter in, then stopped dead in his tracks and said, “Did you guys hear about the safety warning for those things!?”

My husband and I eeked out a smile and thanked him for his concern but assured him that making a baby safe in a sling simply involved engaging the ol’ cerebellum- something we do on a daily basis- and thus, do not fear for our baby’s life.

Later that day…

We got home from IKEA and my husband got a phone call from a family member who let him know that she was sending us a newspaper article on the dangers of slings. She was deeply concerned, knowing that we often carry our baby in a sling.

 

Here’s the scoop on slings:

In Canada, there have been nine “incidents” involving soft infant carriers since 1995- two of these incidents were deaths. That’s soft carriers- not just slings. A soft carrier can be anything from a Baby Bjorn to an Ergo Baby to a piece of fabric wrapped around a child and any other back or front baby carrier- NOT just slings. 

There have been 14 suffocation deaths in the U.S. in the past two decades that have been related to soft carriers- again that’s ALL soft carriers.

 

Here's the scoop on cars:

According to the US Department of Transportation, during 2005, 1,335 children ages 14 years and younger died as occupants in motor vehicle crashes, and approximately 184,000 were injured. That’s an average of 4 deaths and 504 injuries each day.

I find it funny that no one has ever stopped me in a parking lot as I was putting my baby in the car, and said, “Did you hear about the safety warning for those things?” Additionally, not a single family member has shown the slightest tinge of concern that I drive with my child on LA freeways on a daily basis.

 

My point:

Babies have been worn by billions of mothers for millions of years. Let’s put all the figures into perspective here instead of sounding off an alarm that makes new moms nervous and paranoid about carrying their babies. Yes, babies could suffocate while being carried in a sling so when we wear slings, we need to be aware of how we are using them- in the same way we would be cautious laying our babies on a bed by moving fluffy blankets and pillows away from their faces.

 

The slings that have caused most of the problems have been the less popular, “bag slings”. Bag slings are the westernized version of a standard cloth sling. They are typically made from thick, synthetic material and have a bungee-like draw sting along the rim. These slings are deep and the wearer is not able to easily tighten or loosen the material to create a shallower “cradle area” for the baby to lie in. Additionally, the infants that have died in slings have primarily been a low-birth weight twin, premature, or had a cold. While babywearing can greatly benefit premature and lower weight babies, these little people require special needs while being worn. Kangaroo Mother Care includes  a special method of babywearing that is appropriate for these situations.

There are dangers lurking around every corner for our babies and it is really, really sad when babies die. I’m not lessoning the devastating deaths of the infants involved but I am hoping that we don’t all rise up against the ancient and ever-useful art of baby wearing. The media is having a hay day with this topic and is doing a poor job at informing the public. How so? By: a) not giving all the facts and statistics in their reports b) clumping all “soft carriers” into the same category c) over exaggerating the danger and not taking into account any of the benefits slings provide.

In my opinion, there are far more important issues for the government and media to cause a frenzy over; issues that take the lives of significantly more children on a daily basis. For example, the use of fire retardants (chemicals) in baby mattresses and clothing has the government’s stamp of approval despite its links to SIDS and poor brain development. How about addressing the drastic increase of premature births in this country due to labor induction?  These premature babies have a high chance of death in the first few months of life and if they live, can suffer brain damage yet there is no 5 o’clock media coverage on this issue.

While carrying a baby in a sling is truly not a difficult task, the internet is loaded with instructional videos, step by step instructions, and a plethora of information on proper babywearing techniques . If parents need a little guidance, postpartum doulas are also trained in how to use slings properly and can easily model and guide moms and dads in safe baby-wearing practices. Here in LA, there are baby-wearing workshops all over the city and you can drop into the Pump Station at any time and ask for a soft-carrier consult for free. The information on sling safety is abundant.

For many, including me, the benefits of proper babywearing far outweighs any danger posed by improper sling usage. It’s been statistically proven that worn babies cry less (one study found babies to cry 43% less when they were worn!) and because of this heightened alert, non-crying state they actually learn more throughout the day than their crying counterparts- literally making them smarter. Parents with infants who cry less are in turn less stressed and happier people. Dr. Sears outlines some of the benefits to baby wearing as well as how to safely do so, in his article entitled, “Babywearing”. Additional benefits of babywearing include: colic cure, assisting with breastfeeding issues, contributing to faster weight gain of underweight infants, regulating baby’s body temperature, increasing baby’s sense of security, allowing for vital skin to skin contact, making public breastfeeding easier as well as more discrete, and much, much more.

So- before you trade in your $40 sling for that $140 infant stroller- do your homework! Go to a baby-wearing workshop, check out what Dr. Sears- a babywearing expert (in fact, his wife and he coined the phrase) has to say on the matter, hire a postpartum doula for a consult, research the statistics, or contact one of the 3 Doulas for more information. Babywearing is not only extremely convenient; if done properly, it has proven physiological benefits to both baby and mom.

I found these beautiful photos of babywearing across the globe at this wonderful blog site.