Surviving Mastitis

Last month I had my second bout with mastitis. It is not pretty, let me tell you. But I got through it, again, without antibiotics or further complications. There seem to be some common conditions that bring it on, for me at least.

The first time I had it, Del had gotten his first round of newborn shots (at 8 weeks) and the pediatrician told me he’d probably be sleepy. That entire day, Del nursed only sporadically and yes, slept a lot. That night was the first time he slept “through the night” (a total of about 7 hours uninterrupted that night) which should have been marvelous. Except that my breasts got so full I was getting sore. Sometime in the night I thought it must have gotten very cold outside and our apartment was cooling down, because I had chills. By early morning I realized my chills were fever, and it was easy to tie the fever to the bright red, hot, hard and painful spot on my left breast, about the diameter of a Ritz cracker. My temperature was 101 and I was aching all over. Checking my breastfeeding books and the internet confirmed my suspicions: mastitis.

Breastfeeding feelings and D-MER

Many thanks to Mothering Touch for sharing this video about a condition I had not heard of till now – Dysphoric Milk Ejection Reflex (D-MER). The video is worth watching -knowing there is a physiological reason for negative feelings that come right before milk lets down can help many moms manage the condition.

The gist is that about 10% of breastfeeding mothers experience a wash of negative emotions preceding the milk let-down reflex. (For those to whom this is Greek: milk let-down occurs in response to the baby suckling – in the first few second/minutes of a breastfeeding session, the baby is not getting milk. The suckling stimulates the milk ducts to open and release the milk stored behind them. It often causes a physical tingling sensation, and is accompanied by a release of the hormone oxytocin – the bonding hormone – to the brain.) For 10% of nursing moms, the moments preceding milk let-down are accompanied by a brief sense of doom, failure, anger, panic and/or fear. Most moms who experience this don’t know it’s a physiological condition, and don’t find help.

Personally, in my early days of breastfeeding, I experienced a rush of sleepiness when my milk let down, and sometimes a feeling best described as peaceful sadness. The sad feeling has pretty much passed,  but I still often feel very sleepy in response to that dose of oxytocin. Not surprising – it’s the same hormone that makes us cuddle and sleep with our lovers. I always figured it was my body’s way of insuring that I get some rest, and that my baby and I snuggle and bond in a way I might overlook if not physically reminded to do it.

I want all moms who are willing to also be able to breastfeed – and to get help for any challenges they experience. I hope this post helps.

A few images of breastfeeding that I like

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Here’s what I think about the TIME magazine cover.

This week’s TIME magazine cover has sparked a media milkstorm you can’t avoid if you’re even remotely alive and connected to the outside world. From a dozen Facebook references to glimpses of the cover on the morning talk shows while I worked out this morning (yeah, bragging about working out this morning) to emails from friends asking what I thought.

I think several things, but you should skip it all and just read #6 because that’s the one that matters.

Can you accurately identify the problem here?

1) That mother is way hotter than most moms. (This is important later.)

2) It’s as much my business how long she nurses her child as it is my business who a gay man or woman can and can’t marry. That is: it’s my business to say this is something a responsible adult should be allowed to decide for themselves.

3) I might have been inclined to say that nursing that long is just too long, except that I recently saw this and it really touched me: http://mothering.com/all-things-mothering/baby-2/breastfeeding/extended-breastfeeding-from-the-mouth-of-the-not-so-babe  …so, probably longer than I will breastfeed Del but I am moved that this very little person in the video has a clear sense of how and why nursing is important to her.

4) This photo is completely staged for maximum reaction: a) the woman is young and hot and standing in a posture that is emphasizes her sexual attractiveness. Remove the child and cover the bare breast and she’s just a sexy woman making  eyes at the camera. Her sexuality is being highlighted – see #5 for more on that. b) Her child is standing on a chair. No one would ever nurse that way. Put this mom in her yoga pants and GAP nursing t-shirt on a couch holding a child the way she most likely nurses him and it’s a very different image. c) The child is dressed in big kid clothes including camo. The kid is what, three? Put him in his pull ups and t-shirt with big bird on it and several aspects of this image change. d) The child is a son. They heighten the viewers gut reaction by showing us a boy sucking a girl’s boob. My point is this: same mom, on the couch in her comfy clothes, holding a pig-tailed three year old girl in pull-ups and t-shirt, nursing — voila, far fewer people would look, care or react. It would hardly make a magazine cover, which is a shame because that would be a lovely image.

5) The image plays on the mental confusion of  most anti-breastfeeding-in-public types – their ingrained fear of the blend of sexuality and nurturing that public breastfeeding entails. It is just more than they can handle, because by golly boobs are for sex and I should not have to see them being used any other way (translation: because I don’t WANT to see them being used any other way). My point, if and how long to breastfeed is a decision for parents to make, but now all the uptight, don’t-show-me-that fogies are going to add their unnecessary voices to the kerfuffle.

6) I think it’s just plain shitty of TIME mag to put that kind of divisive title on an the issue preceding Mother’s Day. “Are you mother enough?” Let’s get mom’s to fight and judge each other. A Mother’s Day Cagematch. Ya know, we mothers already do a really good job judging each other. And most of us are doing an even better job judging ourselves. Way to go, TIME. This cover, with a few roses and breakfast in bed, would be just about enough to ruin any mom’s day. Nicely done.

Honesty, and four things I don’t love about breastfeeding

The TED talk video I posted yesterday has really impacted my thinking. The day before I wrote about four things I love about breastfeeding. In the interests, then, of honesty about parenting, here are four things I don’t love about breastfeeding.

See, no one likes it. image from manolaw.blogspot.com

1) Leaking. My boobs leak. Not all the time, thankfully, but sometimes a lot. I can’t really sleep topless anymore because when Del sleeps long stretches of the night, at least one breast will get very full and begin to leak – especially if I happen to be lying on that side or on my stomach. I awaken in the wee hours in a little puddle of breast milk. So I have to sleep in a top of some kind all the time. And even then, when my milk lets down as Del begins to nurse, the breast he’s not eating from leaks. If I don’t have breast pads around, that means a wet pajama top or a damp bra. *sigh*

2) Nursing bras. Don’t get me wrong, mine are great. They are comfortable and open and close easily with one hand. They are absorbent. They are good colors – nude, black, hot pink. But they’re not exactly miracle bras. Support does not equal lift. And sexy they ain’t either. I really look forward to putting the girls back into a nice, low-cut push-up bra that shows off their non-nutritive attributes.

Dollface here LOVES her nursing bra. She is very happy. image from bebybaby.com

3) Sensitive nipples. The better books will tell you that breastfeeding should never be painful and if it is, something is usually wrong that can be corrected. This is really true. But even though breastfeeding isn’t painful, I still end up with nipples that I am just aware of. They usually feel a little like chapped lips, and a little overly warm. Pretty much all the time. I look forward to one day just not feeling them.

4) Having to pump. I am pretty sure that every breastfeeding mom hates pumping. If not hate, at least a tolerant annoyance. I am somewhere nearer annoyance than hate, since I really don’t have to do it all the time. Pumping now and then to build up milk supply is not a big deal to me. It’s the pumping when I’m out away from Del for more than a couple of hours – like, oh, photographing a party or a wedding, or having more than one or two sessions scheduled back to back. Remember #1: full boobs leak. Yeah, also full boobs hurt. And having to take breaks during a long photo shoot to pump milk from your swollen breasts is just a thing I don’t love.

I have it easy, I know. I have had no major challenges breastfeeding Del, and many many women do have challenges that they persevere through to successfully breastfeed for whatever length of time they can. And some women just can’t make it past the challenges and choose to give it up. I am grateful that Del and I have had an easy and satisfying breastfeeding experience. I know I will miss it whenever it comes to an end… but I won’t miss the things on this list. And look out, Victoria’s Secret, I’ll be beating down the door for your hottest double-Ds.

Four reasons I love breastfeeding

A week or so ago I sat in a bright classroom in downtown DC with about twenty other mothers, all of us with our babies on our laps, in slings, or on the floor in front of us. All of the babies were between 4 and 9 months old, and most were first babies, a few were second babies. It was a class at the Breastfeeding Center on breastfeeding your 4-12 month old. The moms in this class were mostly calm, mostly at ease with their chubby, curious babies, and mostly in love with breastfeeding. By way of contrast, just a month or so prior I had attended the weekly meeting of moms whose babies were 0-3 months old – sleepy-eyed, stoic, with delicate infants clinging to them. In that class, moms gather like soldiers on day-leave, drinking each others’ support like liquor to steel themselves for the return to the front. By the 4-12 month class, these moms are confident and composed, battle-tested officers at ease in their field. It’s a rite-of-passage, getting from earnest new mother to comfortable mama. It shows in the faces of those who’ve made it. It feels good to be here.

A bottle for breastfeeders

I’ve delayed letting Del try a bottle until now, even though it meant missing seeing Girl With the Dragon Tattoo, in order to give us advantage in breastfeeding.

Not that we have had any problems – the kid is a natural. Before he was an hour old he was happily nursing at my breast – an accomplishment which I know went a long way to soothing my sadness over our lost homebirth. Del nursed happily on demand and still does. The only “complaint” we have is that he eats so fast he gives himself gas and gets overfull, leading to some  uncomfortable burping and spitting up that is his personal 9 on the 1-to-10 scale of how-bad-is-it.

As easy as breastfeeding has been for us, I’ve still guarded it pretty closely, waiting more than six weeks to pump and experiment with the bottle. And in order to prevent any risk of nipple confusion or preference for the ease of eating from a bottle, I researched nipples and was very happy to find Medela’s Calma nipple. (Doesn’t it sound like an like an IKEA name? Calma.) The ingenious work of Medela, makers of all things breastfeeding-supportive, the Calma nipple is designed to require that baby create suction before any milk will flow. Normal nipples will release milk with only a squeeze of baby’s lips, but the Calma actually has a valve that requires baby to suck before milk will flow, and if baby pauses, milk will stop (mimicking the behavior of baby and the natural action of the breast). It was on the pricy side – $26 for one nipple with bottle from Amazon, but to me, as an investment in a healthy year or more of nursing, it’s worth it.

So we tried it with Del. I pumped while he slept and when he woke, and was a little bit hungry but not wildly so, I gave him the bottle. He seemed curious about the new texture and shape in his mouth – not mom, and not his paci, but gave it a tentative suck. I encouraged him using the same tone and words I use to praise him at the breast and he kept up sucking it, and soon was getting milk out. When he seemed happy with the situation, I passed him to Zach, and Dad got to feed him the rest of the bottle. He drank up the whole 3 ounces.  I will admit I had really mixed emotions while he was using his bottle – happy that he took it with no resistance, pleased to see him getting some precious time with Zach, and also a little worried that he was somehow getting gypped out of the sweet, warm bonding that is nursing (and that I was too!). And maybe a little shock that he’s already big enough for this.

So, while I was overall glad that first bottle attempt was a success, I was also glad when he was hungry again a couple of hours later, and snuggled up to my boob and sucked away contentedly.

 

Tears

Del and Co. have had a hard few days.

It seems that Del hates burping. Definition of “hates”: grimaces, arches back, wriggles uncomfortably, cries in distress, coughs and occasionally manages to get spit up to come out his nose, along with producing burps that, once out, provide instant but short-lived relief. It isn’t pretty. Such traumatic burp sessions following a perfectly nice nursing interrupt the usual cycle of nursing to sleep – meaning once Del has managed to dislodge the offending gas, he’s wide awake and in need of comfort. These gassy sessions correspond with his evening cluster nursing anyway, so he’s eating more frequently. And he’s having a growth spurt, we think. A perfect storm of distress. A trifecta of tears.

And after about three cycles of this, mommy cries too. I nursed Del last night till my nipples were raw. I don’t know how he was still getting any food out of there – and maybe he wasn’t and that’s how he finally calmed down. But all in all we spent about four hours straight, Zach and I swapping who would burp him, who would change the diaper, and who held him while the other tried to eat some dinner. (Oh yeah, I also have lost all ability to cook a decent meal in which all parts are done at the same time and nothing is burned and/or undercooked.) Every nap attempt was thwarted by a poopy diaper or onset of gassiness. Every nursing interrupted by painful gas that often caused him to cry harder and louder than he ever has in his nearly 21 days of infant life. And yes, I cried too… around 11 pm when Zach had gone to take a quick bath and I had tried to make The Wonder Years play on Netflix and it got stalled at 99% buffered and I had a sad, sad, screaming baby on my shoulder and couldn’t manage to put my boob back into my bra or keep a burp cloth under Del’s mouth… somewhere about the time he coughed some spit up out of his nose and I got so sorry for him and his pain… I sobbed right along with him. With Fred Savage’s prepubescent face grinning down at me as my baby and I blubbered together in the rocking chair. It was a pitiful sight.

My sleepy husband must have wished he could get back in the tub when he came out and saw us. I imagine we looked terrible.

All’s well that ends well, though. Del finally calmed around midnight, nursing with me in bed, and slept beside me for an hour or so before I moved him to his cozy little Nap Nanny, and tucked his hand-knit blanket around him. He slept peacefully. Mom and Dad slept peacefully. And Del seems happier and more comfortable today – maybe he is just a morning person.

Winter Solstice

Yesterday, December 21st, was Winter Solstice – the shortest day of the year. It was Del’s due date, but instead, he had his two-week pediatrician visit! It has been an amazing two weeks.

Sleepy, well-fed baby

He is such a good baby. If there’s a definition of easy baby, it’s Del. He rarely cries and has a curious and contented disposition. When he is awake, he likes to be held so he’s in on the action. He is social and will put off napping to engage visitors. He likes to be read to and sung to, and enjoys lying on his wooly sheepskin stretching his long arms and legs and gnawing on his fingers. I take a million pictures because he is so beautiful and my eyes cannot get enough of seeing him. I am grateful that newborns need holding, because I have learned that mommies need to hold. It’s pure biology – I need to hold my son as much as he needs to be held. I have declined visitors’ polite requests to hold him, and taken him back from his grandmother, and on occasion felt reluctance to pass him to his father. I am jealous of his little body and it soothes me to have him close.

I love breastfeeding. Again, I know am lucky to have this easygoing baby and to have encountered no breastfeeding challenges so far. I credit good genes (thanks Mom!), good preparation (thanks, Breastfeeding Center) and good practice (go Me!). The night Del was born, after he was weighed and measured and brought back to me, I put him to my breast and he nursed like a champion, and has done so ever since. Feeding him is a pleasure, and he is growing like crazy. He only lost a few ounces in the hours after birth, and had regained them plus more by day four. At his two-week visit he weighed 8 lbs 5 oz – a 1 lb 5 oz gain since he was born, in just 13 days. As my friend Heather put it: Go boobies!!

Today is Zach’s first day back to work after two weeks off. Two intense weeks – 35 hours of labor, a day and half in the hospital, and another 10 days at home with a newborn, sleeping in three hour pops, driving to lactation consultants, pediatricians, and getting a little of his own work done on an important work project. He is a swaddling and diaper changing pro. And he’s pretty awesome company in the face of sleep deprivation, circumcisions, unexpected late night poop bombs and even the occasional crying jag. I love him.

The sun is setting. Tomorrow there will be a little more daylight. And a little more the next day. Happy Solstice!

Laughing to Lactate?

from contributing writer Letty Muse Tomlinson

I have fond memories of joining my mother in my little brother’s nursery as she breastfed him, after work.  It was time for his “papita,” as she called it – an affectionate Mexican-Spanish slang term for mealtime.  In my recollection, these were family-bonding times.  She held her baby close to her breast as he nursed, and her preschool daughter sat at her knee and kept her company.  Isn’t this what breastfeeding is all about?
Thirty years later, it was my turn to re-enact this beatific tableau (sans preschooler).  Only, it didn’t happen. My daughter, born 6 weeks premature, spent her first two weeks on Earth in the Neonatal Intensive Care Unit (NICU). While I would nurse her, some, on visits to the NICU, most of my early breast-milk extraction experience was with a machine rented from the hospital. While recovering at the hospital, I followed the nurses’ and lactation consultants’ advice to look at a picture of my daughter and keep a blanket she’d slept in near my face.  In lieu of having the actual child against my body and on my breast, these tokens would have to substitute to stimulate my milk production.  But then I went home.  And at some point, staring at a picture of a kid who was several miles away, in an incubator, feeding and growing and just waiting to join us at home, became as boring as it was bumming. If I was going to be plugged into a milking machine for 30 minutes to an hour, like some kind of bovine, I had to keep myself entertained.

This is not Tina Fey.

Enter Sports Night, the entire series on DVD.  I burned through the series in two weeks.  (To be fair, Sports Night only ran for two seasons.)  In those two weeks, I’d like to think Aaron Sorkin’s whip smart dialogue fortified my breast milk like some sort of mega-vitamin.  Then the baby came home.  And then all was bliss.  And then it was boredom again.  And then it was Buffy-time.  For the next few months, my nursing and feeding routine involved plopping myself in front of the TV to watch Buffy the Vampire Slayer, seasons 3 – 7.  When Buffy ran out, I turned to The Adventures of Young Indiana Jones, which I don’t really recommend, as it’s pretty corny.  However, you do get to see some of today’s stars in their unknown years:  Elizabeth Hurley with thicker eyebrows, Daniel Craig as a Nazi, Anne Heche as a bohemian, etc.  But I digress.  The point is I watched a lot of TV while I nursed. Though I initially felt guilty about it, I came to feel like I’d discovered something great:  using captivity as a means to catch up on television series I’d always meant to watch.