Nursing Your Kids

Canada is expected to classify BPA (the chemical found in some hard, clear plastics and some cans) as a dangerous substance. Recent studies have linked BPA to breast cancer, obesity, and infertility.

And a Yahoo article reports that the The National Toxicology Program found that

“experiments on rats found precancerous tumors, urinary tract problems and early puberty when the animals were fed or injected with low doses of the plastics chemical bisphenol A.

While such animal studies only provide “limited evidence” of bisphenol’s developmental risks, the group’s draft report stresses the possible effects on humans “cannot be dismissed.” The group is made up of scientists from the Centers for Disease Control, the Food and Drug Administration and the Institutes of Health.”

This is a controversial topic for mothers these days. Most women, whether they breastfeed or formula feed, use baby bottles. Many of the most popular bottles are made from plastics containing BPA. Mothers who formula feed are also exposing their children to BPA through the formula containers- many brands of powdered and liquid baby formulas contain BPA.

Some mothers, especially those with older children, feel that the risks of BPA are just hype, and that their kids turned out just fine so why panic now. Plenty of women on my pregnancy board used X brand of bottle or X brand of formula with their last child and have no interest in switching. Other mothers understand that toxins are everywhere but would rather limit their children’s exposure to those they can control. These mothers are actively researching bottles that don’t contain BPA and the brands of formula that either don’t contain traces of BPA or have the lowest levels.

I fall into the latter category. I know that my children will be exposed to many chemicals throughout their lifetimes. I know my children will eat unhealthy foods and play with toys I don’t approve of. I know there will be lead, phthalates, and BPA in my kids’ environment no matter what I do. Even so, I plan on controlling their environment to the best of my ability for as long as I can. I sold my Avent breast pump and bottles and plan on buying glass or BPA-free bottles for the new baby. Sam’s sippy cups are aluminum or safe plastics. Whether it’s hype or not, if a chemical might be dangerous I want to keep it away from my kid for as long as I can. I can’t control things forever, but I sure would like to try to keep my babies safe while I still have the ability.

It’s tough to know what to do, especially when such a huge portion of the population has a, “I grew up on chemicals and I turned out fine approach,” but taking small steps and making minor changes is a good way to start. Safe Mama has a great post on how to avoid panic and confusion.

During an appearance on Oprah, Salma Hayek’s comments about her weight loss and her breastfeeding experience caused some controversy. Hayek said:

I thought, ‘As soon as this baby’s out, I’m just going to lose all the weight superfast because I’m going to breastfeed, and everybody tells you if you breastfeed, [the weight] is going to come off.’

I’m proud of what I’ve lost. And the rest is going to go when it’s time to go.

The main objection to the statement is that it sounds like she’s accusing women who did lose weight easily of lying and being unhealthy. I can see why her comments could be taken the wrong way, but since I’m one of the women who did not lose weight easily I know exactly where she’s coming from.

When I was pregnant with Sam I had an easy, healthy pregnancy where I worked out several times a week and ate well. The weight piled on anyway. My doctor didn’t believe that I’d gained as much as I had and questioned the accuracy of my pre-pregnancy weight. I carried small, with a big basketball belly right up until 37 weeks when I puffed up like the Goodyear blimp.

I thought for sure that breastfeeding would help me drop the weight. It didn’t. The water weight dropped off right way, but the rest went slowly. Even before I got the okay to exercise I walked miles every day up and down unfairly steep hills pushing a 30 lb stroller. Once I got the okay I went to yoga classes, did cardio several times a week and lifted weights two or three times a week. I ate well and drank a ton of water. It still took me nine months to fit into my pre-pregnancy jeans and close to a year and two stomach viruses to get back to my pre-pregnancy weight.

I think it’s great that Hayek was honest about her experience, despite her generalizations. Her generalizations are probably based in experience- I’m sure plenty of Hollywood mamas work out too much and don’t eat enough in order to lose the baby weight, just as some of the mothers I’ve known have done the same thing.

For me, weight loss because of breastfeeding was a lie. I worked my ass off to lose the weight and it still felt like it took forever. If breastfeeding helped you drop the weight, that’s great. I’m envious. But it doesn’t work for everyone.

I planned on writing a outraged piece about J Lo and her decision not to breastfeed because it would interfere with her ability to train for a marathon. The article I read had her quoted as saying things to the effect of, ‘I wasn’t breastfed and I turned out fine,’ as though that’s a good excuse for not bothering to even try to breastfeed when there’s no question that it’s the best possible for nutrition for an infant, and things like, ‘I want my children to be proud of me,’ like being an international sensation isn’t enough of a source of pride.

But since I’ve sat on it for a few days I’m not so outraged anymore. Instead I’m just sad that instead of spending time with her newborn twins she’s spending time with a personal trainer. Rather than make her kids proud by being a good mother she wants to make them proud by being in good shape.

I can’t really compare her life to mine. She is, after all, famous and her looks are worth far more than mine. But I still know what it’s like to want your body back. I was in great shape before I got pregnant with Sam and I’m sure I’ll never be in that kind of shape again. But before Sam was born I had ten or more hours a week to spend at the gym, lifting weights and practicing yoga. Perhaps when he’s older and the baby is older I’ll find that time again, but right now it’s not a priority. I still make time to exercise, and when the new baby is born in May I’ll make time to exercise again as soon as I get the okay, but for those first few months when the baby is nursing non-stop I’ll probably keep my gym membership on hold so I’m available for my baby. Those first months go by so quickly and with a spring baby I imagine I’ll get my exercise by walking to the playground every day or chasing Sam around the beach while wearing the baby in a sling or wrap.

It’s hard to struggle with body image when pregnancy so drastically changes the way you look and feel. I’m sure it’s worse when you’re paid to look fabulous. But so many other celebrities have been so public about breastfeeding that it just makes me sad that J Lo, who is such a role model, such an influence on women, seems to be telling the world that her body comes before her children.

This afternoon on our way to a favorite restaurant we stopped at the playground to find a missing sneaker. Sneaker found, we let Sam loose to play for a few minutes and I chatted with a friend, another pregnant woman with a daughter Sam’s age.

The restaurant we were heading to happens to be our favorite happy hour spot. When Sam was an infant we’d stop there every Friday afternoon for margaritas. I lamented the fact that I am currently unable to enjoy a margarita. Bob asked how long it would be until my friend could drink again- essentially asking her due date. My friend mentioned that even after delivery you can’t drink while you’re nursing. I told her that that’s not totally true. You can drink, you just can’t get wasted.

She looked guilty for a minute then told me that after abstaining for a while she went out with a group of moms who were medical professionals. They asked why she wasn’t drinking. She told them it was because she was nursing and they laughed and explained that it was fine. A glass of wine or a single cocktail enjoyed at the right time isn’t going to affect your baby. Moderation is key and Kellymom has a list of guidelines for responsible drinking while nursing.

The conversation was timely since I just saw this article:

Breastfeeding moms can drink moderately

Stockholm - Breastfeeding women can drink moderate amounts of alcohol without endangering their baby, Sweden’s National Food Administration said on Tuesday, changing its previous recommendation to abstain entirely.

The agency, which aims to monitor food quality sold and produced in Sweden, stressed its intention was not to encourage women to drink while breastfeeding and strongly advised women to continue to abstain from alcohol while pregnant.

When I got pregnant with Sam I was in great shape. I’d been working out 4 or 5 times a week for years, I did yoga a few times a week, and walked all over the city. I was tight, toned, and slightly underweight. By the time I had my first doctor’s visit when I was 8 or 9 weeks pregnant I’d already gained 8 pounds. It never stopped. I kept gaining and gaining despite the fact that I was still working out 4 or 5 times a 50 week and doing yoga. I stopped looking at the scale when I hit 50 pounds gained a month or two before my due date.

Everyone told me I’d have no trouble losing the weight, especially because I was breastfeeding. I heard all sorts of rumors that breastfeeding helps with weight loss. I heard about women who dropped weight without trying and kept losing weight until they were below their pre-pregnancy weight. I heard about women who kept the weight on and lost it all at once when they stopped nursing. I struggled and struggled to lose the weight after Sam was born. When he was six months old I still couldn’t fit into all of my pre-baby pants. By 9 months postpartum I was able to wear most of my old clothes. With the help of two nasty stomach bugs I was back to pre-pregnancy weight by Sam’s first birthday. By the time he was 18 months old I’d gained 8 of those pounds back.

Maybe I would have lost the weight again when he stopped nursing, but I got pregnant again before I had the chance to find out.

So when I hear about people who credit breastfeeding with rapid weight loss I get a little bit bitter. Screw you, Naomi Watts. I’m sure your personal trainer had more to do with your fabulous shape than breastfeeding.

Actress Naomi Watts has said the pressures of motherhood are the reason for her slim post-pregnancy figure.

She said: “Breastfeeding - that’s how you drop weight. Even though you are just eating all the time, he is eating too”.

At least she’s honest about the sleep thing.

She adds: “My son is a true joy, but motherhood is harder than I thought. The biggest surprise was the lack of sleep. He is still struggling to sleep through the night”.

I saw a question on a message board where a mother with the flu asked if it was still safe to nurse her child, fearing that she’d pass on whatever illness she had to him.

Last winter, when Sam was still nursing regularly, I became ill with a stomach virus on two separate occasions. The first time I got it first and he didn’t get sick at all. At the time I attributed it to him receiving my anti-bodies through my breastmilk. I figured he was better able to fight the virus because he was nursing full time. The second time I got a virus he got it first and passed it to me. I definitely got the worst of it. He woke up in the middle of the night vomiting. He vomited three or four times then he was done. I wasn’t so lucky. I was ill for days starting the morning after he was sick, but he stayed well hydrated and calm because he was able to nurse. Again, I felt that he benefited from the breastmilk. If he’d been on formula he may not have fared so well.

Here’s what Kellymom has to say:

The best thing you can do for your baby when you’re sick is to continue to breastfeed. When you have a contagious illness such as a cold, flu, or other mild virus, your baby was exposed to the illness before you even knew you were sick. Your milk will not transmit your illness to baby, but it does have antibodies in it that are specific to your illness (plus anything else you or baby have been exposed to) - they’ll help prevent baby from getting sick, or if he does get sick, he’ll probably not be as sick as you.

You can also take measures to prevent baby from getting sick by doing the usual things to prevent the spread of illness: washing hands often, avoid sneezing/coughing on baby, limiting face-to-face contact, etc .

Because motherhood has turned me into a hippie (see my first post about BPA) I’ve moved on to yet another cloth product- nursing pads. Instead of the crinkly, crunchy papery pads I used those first six months with Sam I decided to go for a softer, more environmentally friendly alternative. It’s not that the disposable pads didn’t work- they worked just fine. But now that we’re using cloth diapers it just doesn’t make sense to use a product that creates trash instead of something I can wash and reuse.

Not really knowing what to expect from washable nursing pads I read a bunch of reviews of the more popular brands and couldn’t really come up with any consensus. I imagine, that like the disposables, it’s a matter of personal preference. I know I don’t want anything plasticky, like Lily Padz- for some reason the idea of walking around with silicone stuck to my skin kind of creeps me out. I may want gel pads like Soothies for the first few weeks, but not so much afterwards. Since I had some overproduction issues I don’t want to run the risk of embarrassing leaks just using a simple cotton pad, so most of the washable pads available in drugstores are out.

So I turned to the cloth diaper message boards. Again, there was no consensus on which brands work the best, but people overwhelmingly recommended using pads that are backed in wool. Wool is used as a diaper cover because it’s absorbent, breathable, and doesn’t leak. The same principle applies to nursing pads. Everyone who uses them likes them. The only complaint is that they don’t always look right under shirts, but that applies to the disposable pads as well- I used a ton of different brands and never found one that didn’t show through a shirt.

I ended up buying a several pairs of organic bamboo velour pads with wool backing and a few pairs of thinner pads made from bamboo which is really soft. I’ve only leaked once so far this pregnancy, but I’m sort of looking forward to leaking again so I can see how well they work. The worst that can happen is that I won’t like them and I’ll have to sell them. Believe it or not, nursing pads, like cloth diapers have a pretty high resale value.

One of the things that made life with a newborn much easier for me was the purchase of a ring sling. When I was pregnant I registered for a Baby Bjorn, since I’d seen them everywhere. But Sam was too small to use it for weeks so I returned it and found myself desperately in need of a carrier. I’d read about Hotslings and Peanut Shell slings, so when Sam was about two weeks old I loaded him in the car and went on a mission to buy a carrier. We tried a Hotsling first. I plopped him in the pouch and bounced a bit to get him comfortable. He cried and fussed, but I decided to buy it anyway just in case he needed time to get used it.

We headed to the next place, The Breastfeeding Resource Center, to try out some other carrier options. Sam screamed the entire way there. When we got into the store I put on a Peanut Shell and stuck him in. He screamed even louder, seemingly outraged by the suggestion that he might actually enjoy being carried in it. Next I tried on an Over the Shoulder Baby Holder, the biggest, bulkiest, ugliest ring sling ever. I slipped him in and he immediately quieted. I asked if there was a place where I could sit down and feed him. One of the women offered me her office. I lifted my shirt and found with the sling I could nurse him discreetly and still have a free hand. He nursed for close to an hour and fell soundly asleep.

Clearly the choice of carriers had been made for me. I hated the Over the Shoulder Baby Holder. It was comfortable for a while, but I felt completely overwhelmed by the bulky padding. Even so, I wasn’t taking any chances with other carriers. I returned the Hotsling (which was too big anyway) and I stuck with the OTSBH which we used daily for the first year of Sam’s life. Using the sling I was able to nurse him without drawing attention to myself in a variety of places. We nursed at Sam’s Club, on the Yeungling Brewery Tour, Target, the beach, restaurants, and the dinner table. Sam nursed while I vacuumed, took long walks, did yoga and used the bathroom.

Buying a sling was one of the best moves I made. There are a ton of other slings and carriers available. I’ve already purchased a new, non-padded ring sling made by Sleeping Baby Productions and a Gypsy Mama water wrap for the new baby. When the baby is a little bigger I will probably buy some sort of Mei Tai or carrier with straps for back carries. You can buy some of the more popular brands online at Amazon or Target and there are countless smaller online and brick and mortar stores to buy and try as well. The Baby Wearer is an excellent place to read reviews of different types of carriers and get advice from seasoned baby wearing moms and dads.

A Utah couple recently lost their second child. Their first child died in 2003 after accidental asphyxiation while sleeping in her parent’s bed. The second child, whose cause of death was undetermined, died in the night sleeping between his parents. The couple is being charged with child-abuse homicide. According to court documents, the couple was warned against co-sleeping by their pediatrician the day before their child’s death. From the Salt Lake Tribune:

Prosecutors and health officials say the case should serve as a reminder to parents to put their kids to bed in a crib, in part because studies have found connections between bedsharing and SIDS, sudden infant death syndrome.

“If you do it safely, the risks are so low. The fear is really taken out of it,” said Melissa Knighton, a Salt Lake City mother who sleeps with her 19-month-old daughter, Abigail, and uses a crib to store toys. “By just saying, ‘The child died of co-sleeping,’ that doesn’t tell us anything at all. There’s dangerous ways to crib sleep, too.”

I don’t know what to make of this. First of all, I can’t imagine the grief this family must be feeling. But I’m not sure about whether it’s right to prosecute them for parenting. I don’t know the circumstances of how they slept. I don’t know if the parents are drug or alcohol users/abusers, if they sleep in a fluffy bed full of pillows, down comforters and feather beds, if they’re obese or if they’ve just been the victims of misfortune. Without knowing more details about the sleeping arrangements it’s difficult to determine whether this was a form of child-abuse homicide.

Salt Lake County District Attorney Lohra Miller - who said she nursed her children and occasionally fell asleep, only to startle awake - said her office is not out to prosecute co-sleeping parents when deaths occur.

The couple were reportedly heavy sleepers, and advocates advise against co-sleeping in such cases.

We co-slept off and on for the first year of Sam’s life. I didn’t want to at first because I was terrified of SIDS, but nighttime nursing sessions inevitably ended up with both of us falling asleep. I’d startle awake and transfer him to the pack n play beside our bed six or seven times a night. But then I found myself startling awake to check to make sure he was breathing. If I couldn’t hear him or couldn’t feel his little chest rise and fall I’d panic and hover above him looking for signs of movement. As sleep deprivation took its toll it became easier to just adjust his swaddle and put him on his back beside me. Then I read some arguments in favor of co-sleeping.

Here are the preliminary findings based on mother-infant pairs studied in the sleep-sharing arrangement versus the solitary-sleeping arrangement (Elias 1986, McKenna 1993, Fleming 1994; Mosko 1994):

Even though these studies are being conducted in sleep laboratories instead of the natural home environment, it’s likely that within a few years enough mother-infant pairs will be studied to scientifically validate what insightful mothers have long known: something good and healthful occurs when mothers and babies share sleep. (read the full article at Dr. Sears’ website)

Dr. Sears and other co-sleeping advocates made me feel better about my choice to keep Sam in bed beside me. We took all precautions, making sure that no pillows or blankets were close to Sam and always placed him on his back. Nighttime wakings were frequent, but rolling over to nurse became second nature and I no longer had to fully awaken. When he started sleeping for longer, six-hour stretches when he was about four or five months old we moved him to a crib in his own room, next door to ours. Each night when he’d wake up to nurse I’d bring him into bed with me where he’d stay until morning. We kept this arrangement up until he was close to a year old and no longer slept well in bed beside me.

I truly believe that co-sleeping is beneficial for mothers and babies when done safely.

The research on bedsharing and infant death is mixed. A 2005 study of SIDS deaths in Scotland found the largest risk occurred when parents slept with infants on a couch and when the baby was less than 11 weeks old. Other studies have found a higher risk of SIDS with infants of low birth weights, among mothers who smoked, among parents have consumed alcohol or are overtired.

Supporters of co-sleeping often cite James McKenna, director of the Mother-Baby Behavioral Sleep Laboratory at the University of Notre Dame. He says a blanket admonishment is simplistic and confuses “normal, healthy human behavior” with pathology.

I’m sure that co-sleeping is dangerous if you’re drunk or stoned or on a soft, fluffy couch. But for the parents who aren’t reckless, for parents who sleep together with their child mindfully and safely, co-sleeping allows for a good night’s sleep and provides bonding time for working parents who don’t always have the luxury of spending time with their baby during the day.

To sleep safely with your child:

For more information on co-sleeping safely, the benefits of co-sleeping and the risks, Sleeping with Your Baby is an excellent resource.

Nursing an infant has a learning curve. Obviously I’ve only ever nursed one so far, but I’m assuming that I’ll still have several (or more) weeks where nursing #2 has it’s challenged. There are struggles with latch, the questions of where to put the oh-so-necessary nursing pads, the trouble to find a comfortable position, and of course the struggle of how to nurse a floppy infant discreetly. Once you and your baby get used to each other it’s easy to nurse in a variety of places and a variety of positions and have most people assume you’re just holding your sleeping baby. (Unless your baby is a noisy, active eater. I can’t help you with that one.) But until then it’s tough, especially for a first time mom who’s nervous to begin with.

Do you really need shirts specially made for breastfeeding? No, like nursing bras you don’t need them, but they certainly do make things easier when they’re well made. When Sam was first born I had a small selection of nursing bras and a few ill-fitting nursing camisoles. The bras made nursing in public- and public is relative when you’re swamped with visitors those first few weeks- much easier, but it still left the question of exposing the floppy, post partum skin around my waist when I lifted my shirt. The ill-fitting nursing camisoles solved the problem of the exposed skin around my waist, but they were uncomfortable because they didn’t fit well and exposed a whole lot of flesh up top when they were unsnapped.

The moment when I knew it was necessary to buy something well-made was when I realized I had to bring my 6-week-old to a wedding. I was in the height of overproduction and Sam was nursing every two hours or less. The dress I was planning on wearing to the wedding (which I was in!) didn’t fit very well and would have required me to take it off to feed Sam. I knew there was no way I’d ever be able to relax unless I got something appropriate to wear. I went to my local upscale maternity store and bought a simple black skirt and matching top. Since all of the bridesmaids were wearing black dresses that didn’t match anyway, I blended right in with the bridal party and got to enjoy myself at my best friend’s wedding.

Eventually I decided to bite the bullet and just buy a few nice, nursing tops for the other occasions when we’d be out and I wanted a combination of subtlety and fashion. They really made all of the difference in my comfort level. I got a few tops from Japanese Weekend and a Glamourmom tank which solved all of the exposure problems of the ill-fitting camisoles. The JW tops were pricy, but they made nursing out and about so, so easy. I think that this time I’ll try to buy one more Glamourmom tank and another nursing top. I may even treat myself to a bathing suit with easy breastfeeding access. (need any info on sunscreen?)

It’s such a relief that there are so many places to buy stylish clothes that make breastfeeding easy. Some of my favorites are the two I linked to above, Motherwear, and the new line by Gap.

And if I bring the new baby to either of the weddings we attend this summer I may just have to buy this dress.

In the comments of my post about pumping exclusively Katharine wrote, Exclusive pumping because you don’t want to sit still and breastfeed sounds mechanical and icky to me.

Caro followed up by writing, Katharine, I bet that one woman’s relaxing is another woman’s icky.

These are both excellent points. When I first read about exclusive pumping (note: for some reason I can’t help but write pumpkin instead of pumping-and yes I just corrected that- every single freaking time I write it) I assumed women did it because they had to. It never occurred to me that someone who didn’t want to physically nurse their baby would actually go to all of the trouble of pumping. And pumpking (see!!!) is trouble. There’s equipment to wash, there’s milk to store, parts to assemble and disassemble, and then there’s the actual part where you have to hope the letdown reflex will kick in and hope you’re pumping enough. When you’re pumpking (ugh, I can’t make it stop- I may have to switch to the verb expressing) exclusively every ounce counts much more than if you’re just expressing occasionally.

It seems strange to me that someone (once all latch problems are under control) would rather hook up to a machine than hook up to a baby, especially for those middle of the night feedings. But strange to me isn’t necessarily strange to someone else. Like caro said, one woman’s relaxing is another woman’s icky.

A recent article in Babble about expressing exclusively brought some interesting points.

“I don’t think there’s any question” breast milk is superior to formula, said Dr. Ruth Lawrence, a professor of pediatrics and expert on breastfeeding at the University of Rochester. “I would opt for breast milk in a bottle rather than no breast milk at all.”

Still, she said, drinking pumped breast milk from a bottle differs considerably from nursing. “Babies who suckle at the breast — that’s the physiological way to feed. The baby doesn’t get the same kind of activity — tongue, mouth, swallow — when it is feeding from the bottle.” And, she added, “it’s been shown that the die is cast for obesity in the first year of life, and we tend to overfeed babies when we bottle feed them.”

For the two months I was expressing for Sam I remember that everyone who tried to bottle feed him, especially his grandmothers, tried to insist that he finish what was in the bottle whether he wanted it or not. I’m sure that this would have been the case whether it was formula or breastmilk, but that desire to see a baby finish a bottle is completely different than letting a baby nurse until he or she is finished. I’m sure that bottle fed babies are over fed, which is why they created a growth chart for breastfed babies. Even so, I don’t know that this is the best point for a breastfeeding advocate to make. So many women are turned off by experiences with pushy and rude lactation consultants that this point, that you’re basically setting your kid up for obesity by bottle feeding them isn’t going to make them feel any better about their decision to breastfeed, no matter what form the breastfeeding takes.

The balance of foremilk and hindmilk that helps nursing babies first satisfy their hunger, then feel full is missing when pumped milk mixes in a bottle. And psychologically there can be more pressure to finish a bottle when expressed breast milk represents so much work for the mother.

Yes! They call it liquid gold. It’s painful to see it go to waste.

Dr. Lawrence worries that most women aren’t getting the proper support when they set out to nurse their babies, and that some women find the idea so distasteful they don’t try. “Some women do it because they can’t envision the baby suckling at their breast. I suspect it has to do with our whole modern attitude about the breast. It’s become such a sex object.”

Wanting to physically separate yourself from your baby because you view your breasts as sex objects, not a temporary source of nourishment, is something that I find icky. Yes, breasts are sexual, but the inability to put that aside for the brief time period that a child needs them for food just seems cold to me.

All the women I spoke with would agree on one thing: mothers who wish to breastfeed would benefit from better support and information. Inconsistent, inconsiderate nurses and lactation consultants, doctors who either push formula or ignore mothers’ requests for help with nursing, and rigid hospital policies regarding babies’ weight need to change. As Dr. Lawrence points out, babies have been losing weight in the days after birth since the beginning of the human race: it’s a feature, not a bug. By fetishing weights and measures, the modern healthcare establishment borrows from the formula industry while paying lip service to breastfeeding — a recipe of mixed messages that sets mothers up to fail.

It’s hard to feel confident in your decision to breastfeed when your baby just keeps losing weight. At his first appointment with his pro-breastfeeding pediatrician, when Sam had lost more than 10% of his birth weight and my milk had yet to come in, he was weighed both before and after I nursed him. He actually LOST weight in between. I felt like a failure. When his pediatrician recommended supplementing with formula with a dropper until my milk came in I felt like more of a failure. But I’d read enough to know that it was normal and I continued to nurse him every two hours whether he seemed interested or not. A meeting with a good lactation consultant, a kind lactation consultant who was patient and thorough and sweet to me and my baby helped ease my mind two days later. And by then my milk had come in, only I didn’t really know it because Sam was nursing so often I didn’t really become engorged. I could have been set up to fail just as easily as thousands of other women who give up nursing in the first few days. But I wasn’t. I was well-informed and had a good support system including a pediatrician who reminded me for the entire first year of his life that breastfed babies just don’t weigh as much as formula fed babies and that I shouldn’t put too much stock into the percentile charts as long as Sam was healthy and growing.

Whatever the reason for expressing milk instead of nursing, I still think it’s a worthwhile pursuit. And while I don’t necessarily understand the women who prefer expressing for sexual reasons, or just don’t feel like sitting down with a baby who nurses on and off all day long, I still think they’ve made a good choice. Breastmilk is best.

On my baby message board a number of women have written about exclusively pumping for their babies. The majority of these women had to pump instead of give milk “from the tap” because their babies were unable to latch correctly. Some of the babies couldn’t latch for medical reasons, either they were premature or they had cleft palate. Other mothers just had bad experiences with lactation consultants who were unwilling to listen and unable to help. A few women on the board who are first time mothers-to-be have expressed interest in pumping exclusively for their children because they don’t want to breastfeed, yet can’t deny the health benefits. One woman just said she doesn’t have the personality to breastfeed- her baby was a lazy eater who would consistently fall asleep at the breast. She couldn’t handle just sitting there and pumped to avoid the stress relaxing brought on.

I have mixed feelings about exclusively pumping. The idea of it makes me incredibly jealous. Women who pump can go out and leave their babies in the care of their husbands, family, friends, or other caretakers for more than an hour or two. They can have a break when they feel overwhelmed, and trust that their babies will eat. At the same time, these women have to get up in the middle of the night and attach themselves to a machine. They can’t just drag their babies along when they have a day’s worth of errands to run, they have to schedule time to pump or run the risk of their supply dropping.

When I weigh the advantages and disadvantages to both I can’t help but think that mothers who pump exclusively are making the bigger sacrifice. Pumping, which is something I admittedly did on a very limited basis, seems like so much more work to me. It’s time consuming, yes, but there’s something so luxuriously lazy about just sitting down to nurse for hours every day.

I don’t really have any answers or profound thoughts on the matter. It’s just something I’ve been mulling over.

I saw this article about an office that’s so breastfeeding friendly that nursing mothers are allowed to bring their child to work. Sure, it’s a WIC office, so employees are setting a good example for their clients at the same time, but even so, I’m impressed. Very impressed. I hope that more workplaces take notice and make their policies more flexible.

Blest be the sling that binds
Moms bond with their babies as they wear them, even to the job

She dreads the day when the sling will eventually have to be retired.

In the comments of Bryan’s post that described zinc deficiencies as something that the “breast is best” people are trying to hide, Sarah wrote:

Zinc isn’t the only thing; I saw on GMA that Vitamin D is also not included in breastmilk and supplementing is encouraged. That’s also why, if a child has jaundice at home, they recommend supplementing with formula and then returning to the breast.

This isn’t entirely accurate. From Kellymom:

The American Academy of Pediatrics and the Canadian Paediatric Society recommend vitamin D supplementation for all infants and children to ensure that the small percentage of infants/children who need additional vitamin D do not become deficient.

World Health Organization information [Butte 2002, p. 29 states,
"...although there is abundant evidence suggesting that breastfed infants often receive less vitamin D than is required, most studies fail to find rickets in breastfed infants less than 6 months of age... infants who are exclusively or predominantly breastfed for 6 months or longer can be at an increased risk of rickets if their mothers are at risk of vitamin D deficiency, and the infants receive limited sun exposure and no vitamin D supplements."

In addition, gastrointestinal supplements are not the most easily absorbed form of Vitamin D. Per "Infant feeding: the physiological basis" [WHO, 1991] by James Akre,
“…it is now understood that the optimal route for vitamin D ingestion in humans is not the gastrointestinal tract, which may permit toxic amounts to be absorbed. Rather, the skin is the human organ designed, in the presence of sunlight, both to manufacture vitamin D in potentially vast quantities and to prevent the absorption of more than the body can safely use and store.”

As for jaundice, it’s a condition that occurs in more than half of all newborns. It’s caused by elevated bilirubin levels and in most cases it’s nothing to worry about.

From the AAP:
Q: Does breastfeeding affect jaundice?
A: Jaundice is more common in babies who are breastfed than babies who are formula-fed, but this occurs mainly in infants who are not nursing well. If you are breastfeeding, you should nurse your baby at least 8 to 12 times a day for the first few days. This will help you produce enough milk and will help to keep the baby’s bilirubin level down. If you are having trouble breastfeeding, ask your baby’s doctor or nurse or a lactation specialist for help. Breast milk is the ideal food for your baby.

And from Kellymom: I won’t quote the whole thing since you can go to the site and read it yourself, but I will quote the parts that stress that breastfeeding does not usually need to be discontinued because of jaundice and that formula feeding is far from being the first approach if baby isn’t feeding well.

Breastmilk jaundice is normal. Rarely, if ever, does breastfeeding need to be discontinued even for a short time. Only very occasionally is any treatment, such as phototherapy, necessary. There is not one bit of evidence that this jaundice causes any problem at all for the baby. Breastfeeding should not be discontinued “in order to make a diagnosis”. If the baby is truly doing well on breast only, there is no reason, none, to stop breastfeeding or supplement with a lactation aid, for that matter.

…the first approach to not-enough-breastmilk jaundice is not to take the baby off the breast or to give bottles . If the baby is nursing well, more frequent feedings may be enough to bring the bilirubin down more quickly, though, in fact, nothing needs be done. If the baby is nursing poorly, helping the baby latch on better may allow him to nurse more effectively and thus receive more milk.

Again, there are cases when jaundice is a problem and can be serious. But these cases are out of the ordinary and most breastfeeding mothers just need to nurse often and regularly to treat it.

Breastfeeding is not harmful. I think it’s dangerous to suggest that breastfeeding somehow deprives babies of essential vitamins and minerals. It doesn’t. Breastmilk is the perfect food. Formula is a substitute that is chemically engineered to mimic breastmilk. Formula companies add things to their formulas so it will be more like breast milk. Don’t let headlines and partial information dissuade you from feeding your baby the best food possible.

Last week Bryan posted the following:

Also, I have read a few article [sic] that state some essential minerals can not be passed through the breast. They suggest supplements for both mom and baby. Zinc is the big one I have found. Now, why don’t the “Breast is best” sites ever mention the need to supplement?

I wonder what else they are hiding…

While the information in Bryan’s post is correct, what he’s taken from it doesn’t seem to be. Based on his statement that the “breast is best” people are hiding things, it seems he believes breastfed babies are often deprived of zinc. This just isn’t true. Though it’s true that maternal zinc deficiency can be a problem, zinc deficiencies are extremely rare. There’s usually no need for additional supplementation after solids are started.

Most breastfed babies begin eating solid foods after six to eight months of age. Some breastfed babies begin solid foods sooner. The website he quotes states that human milk doesn’t provide the recommended amounts of zinc for older infants between the ages of 7 months and 12 months so breast-fed infants of this age should also consume age-appropriate foods…

In other words, breast milk provides enough zinc for up to 7 months of age. Kellymom, the breastfeeding authority on the web states that

Healthy full-term breastfed babies do not need additional zinc past what they get from breastmilk and (after 6-8 months) from complementary foods. Good sources of zinc include meat (especially red meat) and yogurt. Signs of a mild zinc deficiency include: lessened appetite, lowered immune function, limited activity, growth faltering. Low birth weight, small for gestational age and premature infants are at risk for zinc deficiency.

It doesn’t appear from either source that the majority of infants are suffering from a lack of zinc so I’m not entirely sure what he thinks the breastfeeding community is hiding. Doctors recommend that nursing mothers continue to take a prenatal vitamin for additional supplementation. But according the research on Kellymom:

If you eat a reasonably-well balanced diet, vitamin supplements are not considered necessary for breastfeeding mothers.

* Mothers who smoke cigarettes may benefit from additional iodine.

So if your diet is reasonably healthy and you have no known vitamin or mineral deficiencies, rest easy. Your breastfed baby should be fine.