Saturday, July 9, 2011

The big old breastfeeding extravaganza

This post is a somewhat rambling reflection on my 15 month breastfeeding experience.  I included some headings to break it up a bit, so feel free to scroll.  There are also links at the bottom to a few other posts on more specific breastfeeding related topics.

The End

Breastfeeding Michael and Sophie came to an end last week.  We were down to the one feeding before bed for about a month, and after our recent road trip during which Mike and I wanted bedtimes to go smoothly, I dropped that last feeding with bittersweetness.

Surprisingly Sophie was the one who was not at all happy to be put in her crib without that bedtime feeding.  Michael laid right down looking up at the ceiling, waiting calmly for sleep.  Sophie cried furiously, and I took her back out of the crib.  I couldn't bear the idea of the end of the breastfeeding experience being painfull for any of us.  Mike grabbed  Michael, we all read some books together, and Sophie and Michael drank some milk from sippies. When we laid them back down, Sophie cried again, but not as intensely.  I was a little bummed out by that and left Mike inside while I went outside to clean up some yard projects.  When I came back in about ten minutes later, she was out.  We had survived.

The next night was better.  Sophie still cried, but it was the moaning kind of cry they both do occasionally when they're just very tired.  She was out within a few minutes.  Night after night, the new normal has sunk in for all of us.

This was the end of quite a journey.

The Beginning

Aside from hearing them both cry out loud for the first time and seeing their little Michael and Sophie faces, my proudest moment of their first day of life was when we attempted the first feeding.  With pillows propped around me and sitting up in bed, Michael and Sophie were brought to my sides.  We stripped them down to their teensy newborn diapers to keep them awake and alert and to get that beneficial skin-to-skin contact.

With all I'd read about latching difficulties and the challenges of breastfeeding newborn twins, these two little champs surprised me by knowing just what to do.  The nurses helped me get started, and soon, after Sophie and Michael had been out of my body for about an hour, there we were, connected again.

The lactation consultant visited later on and urged us to get pictures when she witnessed a tandem feeding the next day in near amazement.  We didn't follow her suggestion, but the pride I feel now, having breastfed twins for nearly 15 months, makes a boob shot seem less nuts than it did at that time.  As I find myself saying a lot these days when a camera isn't handy for a milestone moment, committing some things to memory is just better.

Tandem Feeding

At home I started using my Ez-2-Nurse twins breastfeeding pillow. These days when people say, "I don't know how you do it," I say "We just do." In the beginning, even if they did't mean it literally, I told people about the pillow. It deserves a good amount of credit for the success of this breastfeeding experience as well as our general sanity while juggling the needs of two newborns. 

Tandem feeding became trickier as the babies got bigger.  I had to move to the floor with pillows propped under the ends to prevent the pillow from bending under their weight at around the eight-month mark.  By the time they were 10-months-old, I was feeding Michael and Sophie one at a time.  I didn't love the time this change added to the process, especially in the morning before work.  It also made it complicated to breastfeed without another adult around to keep the unfed one busy.  However, it was fantastic to have that time one on one with Michael and Sophie.

The Supply

In the hospital we were told to start supplementing each feeding with two ounces of formula to bring their weights back up (they tend to drop in the first day or so). Supplementing was a huge pain, especially multiple times in the middle of the night.  Luckily it didn't negatively impact my supply.  This only went on for the first week or two (details from that time are fuzzy) until the pediatrician said Michael and Sophie had gained enough weight to nix the supplementing.  Thank goodness!

Day and night I breasfed every two hours for the first month, twelve times every day, never getting more than an hour or so of sleep at a time.  In the second month we gradually stretched the time bewteen feedings to three hours, and by the time they were four months old, Michael and Sophie nursed every four to five hours.  Every additional hour was a huge relief!

At that point the new school year started, and I went back to work. The babies ate at 6:00 a.m., 10:30 a.m., 2:30 p.m., 6:30 p.m. before bed, and 3:00 a.m (until they started sleeping through the night at around 5-6 months).  I breastfed first thing in the morning and last thing at night and pumped at work midmorning and as soon as we got home in the afternoon to make up for the two 6 oz. bottles (24 oz. total) while we were apart.  Eventually I asked the child care center and my mom to push that 2:30 p.m. feeding to 3:30 so I could breastfeed instead of pump, and that worked fine.  Again, this was a great relief to only have to pump 12 oz. a day.

My supply was adequate before I returned to work, but pumping is just not as effective as breastfeeding, so I didn't always produce the full 8-16 oz. with the pump that the babies needed in their bottles.  Sometimes I pumped before I went to bed and added that milk to the next day's bottles.  Sometimes I dipped into the freezer stash I built up over the summer to make up the difference.  Eventually an occasional bottle of formula here and there, about one feeding a week, was needed to get us through. 

I did notice that I produced more on days:
  • after a weekend or longer vacation from pumping
  • when I drank lots and lots and lots of water
  • after I had gotten a good night's rest
  • when I used my hands-free pumping bustier
  • when I'd had a dinner with red meat as the main course the night before (this is just one I noticed but never read about in breastfeeding literature)
While I can't say I never stressed over maintaining my supply and keeping up with the babies once I returned to work, I never tried any galactagogues (fenugreek, blessed thistle, alfalfa, etc.) and kept extra pumpings to a minimum.  I don't mind pumping itself, but the cord, the hoses, the pump and bottle parts, the freezer bags, the cleaning and restocking of all supplies really annoyed me.  Avoiding that was worth some bottles of formula and an asterisk in my mind when I claimed to exclusively breastfeed.


When Michael and Sophie turned four-months-old, again around the time I returned to work, we introduced solids into their diet at the pediatrician's recommendation.  We started with good ol' brown rice cereal about one hour after I breastfed them in the morning. 

At around six months, we gave them a jar of first foods (or a homemade version) about an hour after their 3:30 feeding (like a dinner).  Eventually we added the first foods to the rice cereal meal in the morning and then another solid feeding about and hour after their mid-morning breastmilk (like a lunch).  When they turned one, we began considering these three solid feedings their breakfast, lunch, and dinner and dropped the breasmilk one feeding at a time by replacing it with a sippy of organic whole cow's milk.  I dropped one feeding every couple of weeks or so.  There was no method to that, just what felt right.

Speaking of supply, solid foods did make it tougher to produce enough milk.  Luckily around this time it was appropriate to drop their bottles down to four ounces each instead of six, so I only had to pump 8 oz. a day.

A helpful resource during this time was the book Super Baby Food, a thoughtful gift from a healthy-eating, good friend.  Mike took the lead on making homemade baby food such as organic sweet potatoes, peas, carrots, squash, avacado, bananas, and apples.  He'd have to give you the specific details, but this entailed steaming or baking the harder foods (fruits were typically raw) and pureeing the food in the food processor.  He froze the mashed-up produce in ice trays, popped the cubes out into freezer bags to free up the trays, and took out what we needed a day in advance.  He thawed the cubes in individual baby food cups (ones from store-bought food) sometimes with water to thin it down.  I rarely refill the diaper drawer or empty the diaper pail, and I hardly had to put any thought into where the babies' next homemade organic meal would come from.  My husband is just cool like that.

These days Michael and Sophie eat what we eat (in bite-sized pieces) for the most part.  Tonight we all had whole grain pasta with sauteed zucchini and tomato, olives, artichoke hearts, prociutto, feta cheese, rice wine vinegar, and olive oil.  I usually think they're pretty lucky little toddlers.

Weight Loss

Thanks to breastfeeding I lost all of my pregnancy weight and then some.  My clothes fit horribly all school year and I pinned the waists of my pants knowing this isn't likely to last. Now that I'm responsible for burning my own calories again, I'm glad I didn't go out and buy too many size 2's.  I'm still about 10 lbs. below my pre-pregnancy weight.  I'll do my best to keep it that wway.

Blockages and Candida

If you've read this far thinking, "Ok, she's talking all about her boobs, but it's not so bad," you might want to stop here.  This is stuff only breastfeeding moms and those in the medical community would really care about.  The purple nipple part is sort of funny, though.

With each dropped feeding came a blockage in my left breast.  My advice to anyone who develops a blockage is to address it as immediately as you can.  I found that taking a hot shower, massaging the lump, applying a heating pad for roughly 45 minutes just before a feeding, and putting my most aggressive eater (Michael) to work did the trick.  I didn't act as quickly the first time as I did for subsequent blockages, and it took a few tries to get the works flowing smoothly again.

A week or so after starting Michael on antibiotics for an ear infection and just after a blockage came clear, I experienced a seering pain in my left breast.  If it hadn't always been my better producer, Lefty would really have been on thin ice with me.  I did some research online and self-diagnosed myself with a bacterial (candida) infection.  I endured the pain for about a month while trying every over-the-counter remedy I could find--vinegar, grapefruit seed extract, Lotrimin, gentian violet.  Each of these remedies helped a tad but never cleared up the issue.  The gentian violet also stained my nipple a dark purple and scared Sophie into a screaming mess when she saw it!  I fed Michael with that breast in the dark until the color went away.

Because there were no visible symptoms, just that pain after feeding, and because some online comments said nothing prescribled solved the problem either, I was hesitant to bother with a trip to the doctor.  However, I was taking Tylenol and going to bed early to escape the pain every night.  And like I said, I didn't want breastfeeding to end painfully for any of us, even physically.

Ultimately my doctor concurred with my self-diagnosis and gave me a prescription for Diflucan.  I wish she could have just prescribed it over the phone, but she wanted to do an exam to be sure I didn't have mastitis.  I could hardly believe it, but I took my first dose less than an hour before a feeding, and the seering pain never returned.  Long story short, go to the doctor.

Thinking Back

This ending brings me pride, relief, and a whole lot of sentimentality.  I always thought it was pretty goofy when breastfeeding mothers talked about how much they enjoyed the experience.  I am now one of those goofy moms, remembering the challenges and the tender moments, and cherishing the complex dimension of my motherhood they both created.

Other posts you might find useful...

Those Notorious First Few Weeks
From Mommy to Moo Juice
How did Grandma do it?

You can also click the "breasfeeding" label in the left panel to see all of my posts that relate to the topic.

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