To Pump or Not To Pump

July 26, 2017

This is a question many new parents are faced with. People do not realize the amount of information thrown at new and expecting parents until they are expecting and new parents themselves.

One of the big decisions parents have to make is how they are going to feed their baby. It seems like most Americans consider breastfeeding. There are many obstacles that interfere with breastfeeding – that is a post for another day but let’s talk pumping milk.

I recall when I was pregnant with my first baby I took a breastfeeding class. I knew I wanted to breastfeed but did not have many role models so I listened intently on how to breastfeed. I remember the instructor talked about pumping and how it is best to rent a pump – I am not sure I remember much more. When Phoebe was born I struggled with how to get her latched and how often to feed her and I had a striped scab across one of my nipples and a hickey on the other from her latching onto the areola. I remember in a fit of frustration telling Rob WE NEED TO RENT A PUMP! NOW!

 

It took a few days for us to figure out how and where to rent a pump – this was 1995! Phoebe and I found our rhythm – she found my nipple I found how to listen to her cues. The pump arrived and I stared at it.

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For three and a half weeks. We rented it for four weeks. I knew I needed to use it before returning it and having spent over $80 renting and buying parts. I put the shields on my breasts and was impressed that milk came out of my breasts.

Later that night Rob came home from work. This was summer and there had been a storm. The electricity was out. Phoebe started to root around. “You have to give her this bottle! Now! My milk is going to go bad and we do not have a refrigerator and it is 99 degrees!”

Rob grabbed the bottle and tried to feed our screaming baby. I walked out of the room. My breasts began to tingle and leak.  Rob was sweating, Phoebe screamed louder and louder. Her head spinning like Linda Blair in the Exorcist. I started to cry. I think Rob was crying, too.

“Give me the baby.” I latched her on and we both chilled out.

“What do I do with this?’ asked Rob.

“Pour it down the drain,” I told him.

It turns out I did not need to pump. The company I was working for went out of business so I became a full time mom.

I asked Rob if he felt he needed to feed Phoebe to bond. He laughed and told me he felt bonded with here.

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And eventually I became a La Leche League Leader and then a Lactation Consultant (IBCLC).

 

As someone who has been in the breastfeeding business for two decades I have seen different trends. With the Affordable Care Act offering up pumps to expecting parents and with social media there is a big pumping culture. And there is so much information shared that it can all be confusing.

If your baby latches on, you feel comfortable and your baby is gaining weight there is no need to pump.

Conversely, I have seen women who were told not to pump for two weeks or for one month or whatever someone told them was a rule. Or no one told them to pump while their baby is being supplemented with formula. In some of these cases this compromises their milk supply. The bottom line is that the baby must be fed. But if your baby is being supplemented and you want your body to make milk then it is important to pump. Milk is made by removing milk form the breasts – this can be with a baby who has a good latch, by hand expressing or by using a good breast pump.

 

Let’s now talk pumps. Pumps are not all created equally and not everyone responds to pumps the same. I have worked with people who pump using their hands – hand expressing – here is a cool video:

hand expressing

 

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There are hospital grade pumps, electric single user pumps , and hand pumps.

 

When should you pump?

  • If your baby is separated from you
  • If your baby is not gaining enough weight
  • If your baby causing you so much pain you cannot tolerate nursing
  • If your baby takes a bottle
  • If you are donating milk
  • If you are working away from your baby

There is no need to fill your freezer! Pumping is not an Olympic sport!

How many people compare their milk stash to those they see on Instagram?!

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You really only need enough milk to feed your baby.

If you want to pump that is cool but if you do not want to pump and do not need to then don’t pump.

People can bond with a baby without a bottle. If you want your baby to have a bottle of breastmilk, then pump.

Each situation is unique and blanket statements do not help new parents. For help call an IBCLC (International Board Certified Lactation Consultant) Find a Lactation Consultant or a La Leche League Leader.La Leche League International

 

 

 

 

Uniforms and Fairy Dust

January 30, 2015

Why do new parents seem so guarded or opinionated or defensive? Well, much of it is that they are protecting their new family.

Another thing I have noticed is that parents feel they have to subscribe to a specific style. In the years since I first became a new mom – over nineteen years ago, I have noticed that so much around parenting is trademarked. I believe that is all about marketing. I have written about how poor parents are the biggest target of marketing these days.

I remember when it was time to start feeding Phoebe solid food a mom at a La Leche League meeting suggested baby led weaning. This made sense to me – let her take food off the table – I would bite off a tiny piece of apple and let her chew it, I would continue to nurse her. Eventually I became a La Leche League Leader. A couple of years back at a meeting I was leading for toddlers a mom mentioned baby led weaning and I was thrilled to hear this concept being embraced until I heard about all the “rules around it. Rules? There is a book! Wow. I thought it was about being instinctive with a few guidelines about what foods to give and which foods to avoid so that they would not choke.

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I also noticed how people would comment on how attached Phoebe and I were. Of course, I am her mom, we are together (the company I worked for closed while I was on maternity leave and I was a full time mom then.) Then I learned there is an organization called Attachment Parenting – which I love! But I hear moms asking, “Is it is AP to . . . “ Or “does it go against AP if I . . .”

Then there are the breast feeders and the bottle feeders and the co-sleepers and the baby never comes into my bed, and there are “Never let the baby cry” and the Cry It Outs.

I belong to way too many groups on Facebook and I hear so many new moms asking permission to go outside of the rules of whichever category they have chosen to join. I hear arguments about how you cannot do this or you should do that.

Titles: Tiger Mom, Hippie Mom, Crunchy Mom, Stay At Home Mom, Working Mom

Does one need only belong to one “club?” Does anyone only do things exactly as planned out in a book? Do breastfeeding moms never give their babies a bottle? Do most parents have their kids in their bed at least some of the time? Do the families that make their own baby food sometimes use a jar or sometimes eat convenient food? Do the touchy feely moms yell? Does the Tiger mom cuddle? Does the home-schooling mom want to send her kid away to boarding school? Does the mom with the most awesome and fulfilling career want to quit her job and stay home?

If you asked these questions to these parents you would get a resounding YES from time to time.

It seems like a new mom has to wear armor to defend herself and her choices. She has to seek permission to care for her baby. Whatever happened to instincts? Have we cultured intuition away by writing books and coining phrases and categorizing everything and everyone?

Maybe the extended family has done things differently so a new mom feels she needs to defend her choices. Perhaps she is faced with criticism and needs to wear a uniform.

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Whatever it is I wish I could hug all new moms and blow some instinct like fairy dust at them and let them take it in, take in their babies. I want them to clear out the noise so they can hear. So they can hear that voice inside them that tells them: this is your baby, your child, do not strive to fit in, strive to find love, strive to find the wonder in your little person, strive to grow along with them.

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In the meantime I will interject my thoughts in those groups when I have it in me to do so. I imagine fairy dust with each click of the keyboard.IMG_7271

The Power of Tears

January 10, 2015

You never know what may come out of your mouth and how it may impact another person

In my early years as a La Leche Leauge Leader I used to hold meetings in my apartment. One steamy summer afternoon I sat on the floor of my living room folding laundry as Phoebe napped. The buzzer jolted me as I wasn’t expecting anyone. It was the day after the Series Meeting. A voice over the intercom said “I am here for the Meeting.” I buzzed her in.

At my door was a petite new mom with auburn curls and a five-month-old baby asleep in a dark red Baby Bjorn carrier. Beads of sweat speckled her stiff body. Tension permeated her.

“I am sorry but the Meeting was yesterday. Come on in and have a glass of water,” I said.

Her face fell but her body remained at attention.

“Come on in, I‘m just folding laundry. Have a seat.”

“No, I don’t want the baby to wake,” she replied.

She stood in my living room as I sat back down on the floor and went back to the task of folding a load of pinks, greens, oranges and yellows.

“It’s hard being a new mom isn’t it?” I asked.

“Yes.” There was a pause.

Then, “and my own mother wants me to stop breastfeeding. She doesn’t understand me. I just want to cry,” she blurted out.

“Well, then, cry,” I offered.

“I don’t want to cry in front of my baby. I don’t want her to think I am weak,” she was incredulous.

“You know, there is strength in tears,” I said as I folded one of Phoebe’s flowery sundresses.

The floodgates opened. I didn’t know if it was five months of pent of tears or a lifetime.

Her body softened with each sob. Even her curls fell easier around her face. Her baby girl woke up and she sat on my couch and nursed her. At first she was stiff. I touched her shoulder and gently pressed her back into the back cushion. More tears fell.

This woman had traveled from the Upper West Side of Manhattan to the East Village. If you live in New York City you know that is quite a journey on public transportation, particularly for a new mom.

I never saw the woman again or heard from her but I learned the power of simple words that day.

I often cry with the moms with whom I work and I cry in front of my children. I always feel powerful after.

This morning I attended a panel discussion of the Children’s Health Council at Cornell Weill Medical College on New York City’s upper east side. The topic was Tots to Teens: Sleep and Your Child.

The panelists were Vikash K. Modi, M.D., FAAP, Haviva Veler, M.D. and Mary J. Ward, Ph.D.

The topics they addressed are the things I discuss with my clients: routine, rhythm and consistency for good sleep hygiene. The topic of co-sleeping was mentioned but was never actually addressed during the panel discussion. It was great to hear these panelists discuss normal sleep behavior and when medical conditions get in the way.

Then they talked about the importance of letting babies learn to sleep on their own. They even encouraged Cry It Out. What was especially compelling was the fact that the two moms on the panel confessed their own discomfort with letting their own babies Cry It Out. I was relieved to hear this because it confirmed I was listening to real people with real life experience. But I wonder why. Why they have expectations that others should “do as they say, not as they do?”

They discussed the problems of electronics and irregular schedules. They discussed how light disrupts the excretion of melatonin.

They never discussed diet. They touched on allergies, mostly airborne allergies causing inflamed adenoids and obstructing airways. But they did not discuss what and how babies are fed. I wonder if they considered this in their research.

They talked about sleep associations like music, blankets and parents. They insist these “objects” need to not be there when the baby falls asleep or they will need these associations when they wake in the middle of the night. They did not discuss breastmilk or the melatonin levels that change throughout the day to help babies to sleep more. They discussed circadian rhythms.

I learned the two factors that determine the need for sleep are 1)circadian rhythms and 2)how much time has elapsed between sleep sessions.

During the Question & Answer period there were many parents asking about their own children’s sleep issues. Luckily I got a chance to ask my question. Into the microphone, I spoke, “I am a Private Practice Lactation Consultant and one of my favorite things to show new families is how to SAFELY lay down and nurse their babies and to know how to SAFELY fall asleep if that were to happen. Why then when families pass into the borders of the United States do their bodies suddenly become dangerous?”

Dr. Ward admitted that she may be biased toward Western philosophy and mentioned a study that showed most parents do not like sleeping with their babies or children.

It made me wonder if the participants in that study answered that they don’t like it because they are conditioned to think it is bad? Are they conditioned culturally to think that babies are not supposed to cross the border of the marriage bed? Maybe I am reading too much into it. Maybe my personal bias towards wanting more sleep and wanting to breastfeed comfortably colors my thoughts on this controversy.

Gerald M. Laughlin, M.D. suggested that in this country the mattresses on adult beds as so soft as to cause suffocation as opposed to the hard mattresses in Asia where co-sleeping is the norm. I am not an anthropologist but I do sit on a lot of beds and very few I have examined are soft enough to cause a risk for babies.

Dr. Veler stated that there is research that states that there is an increase in SIDS when sleeping with parents. I told her I have research that negates that untruth.

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I brought along two copies of Sweet SleepNightime and Naptime Strategies for the Breastfeeding Family, the new book by Diane Wiessinger, Diana West, Linda J. Smith and Teresa Pitman published by La Leche League International. This book debunks many myths around sleep. The authors really went through many studies with a fine tooth comb and proved that in specific circumstances co-sleeping is the safest for babies.

They talk about the Safe Sleep Seven. For this to work a mom needs to be:

1) a non-smoker

2) sober

3) breastfeeding

the baby needs to be:

4) full-term and healthy

5) kept on his back when he is not nursing

6) unswaddled, in a onesie or light pajamas

and they both need to be

7) on a safe surface.

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This is nearly a five-hundred-page book so if you are really interested I recommend you check it out – many of those pages notes with citation of studies and research.

I gave one to Dr. Veler and the other to Dr. Loughlin.

It is my hope that these doctors will really look at them, take in the research and consider their words when they are asking parents to do what goes against their instincts.

I did take away some good information about my own older children. I learned how sleep works. My knowledge of the technology interfering with sleep is a real thing. I learned that it is absolutely normal for my thirteen year old to not want to wake up early in the morning.

I also learned that by trusting my instincts and paying attention to my children’s sleep I know what works against them getting good sleep and what helps. As babies we all slept better together. I did not mind being their sleep association “object.” It reminds me of the time when Phoebe was a toddler and she was holding onto her little red Elmo and another mom asked me, “Is Elmo her security object?” I was stunned then I realized what she was asking. “No.” I replied. “Well, what is,” she needed to know. “Um.” A beat, then “I am,” I beamed.

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I have seen the documentary Breastmilk twice.

The first time around I was happy to see the diversity of the subjects, the inclusion of gay families and the normalization of milk sharing.

 

I came away knowing that Dana Ben-Ari is a true documentarian in that the viewer is brought into the scenes unobtrusively. We observed real life situations and outcomes.

The second time around I was sitting next to woman who nursed her child a decade earlier. She squirmed in her seat and whispered to me, “If I had seen this before having my son I would’ve been afraid because it seems so hard to nurse.”

 

Certain elements were left out that I believe only a seasoned eye would catch. Missing from the film: physicians trained to support breastfeeding, pre-natal education, support for the mom and baby and extended work leave. Were with these elements missing from the film because they are missing in real life?

 

There were a handful of subjects followed from pregnancy through the first birthday of the baby. In the end only one of those babies was nursing.

 

The moms who experienced premature weaning talked extensively about how was “really okay”, that “the doctors were right”, they “had their baby’s health in their best interest” and “thanked goodness that their baby was healthy.” What I saw behind those words was grief, defeat and lots of justification for their unplanned weaning.

 

The producers, Ricki Lake and Abby Epstein, say the outcomes of the subjects of their film align statistically in the United States with breastfeeding rates.

I believe documentaries are made not only to show real life but to affect a change or to educate or to inform.

 

There were experts talking about the cultural anthropological aspects of breast-feeding in the Western world but there was no real information on how to make breast-feeding easier or even pointing out what got in the way. We did see a bit on how our culture gets in the way: the boyfriend who not wanting to be patient as his baby nursed, the nurse not wanting to be patient as the parents wanted to baby to self attach, the moms who had to go to work and could not keep up making milk. Once again women, these new mothers, are at the mercy of the system, a system that does not support women or children.

 

In my documentary I would show women all of the world breastfeeding. I would show statistics on breastfeeding rates in different countries. I would show how birth practices impact breastfeeding, how working outside of the home impacts breastfeeding, how education and lack of education affect breastfeeding.

 

But I am not a filmmaker. I am a lactation consultant, a La Leche League Leader, a mom, a friend. I am working in the field daily to support mothers and babies one by one.

 

The longer I work in this field the more obstacles I see. What do you think? How do you see breastfeeding? Do you see it as easy? Do you see it as a privilege? Do you see it as impossible? How does a baby see breastfeeding? What if we asked babies? Would that change our outcomes? Would that change our culture?

 

 

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I am a group person. Let me just put that out there right up front. You may find it hard to believe but I was a very shy child. Not until fourth grade when I cracked a joke and most of the class laughed did I feel any level of confidence. Until that moment I was a loner, hiding behind Mama’s legs then using my baby sister as a shield.

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 In sixth grade Mama took us to Ala-teen, a support group for teenagers with alcoholic loved ones. I joined the theatre. When I moved to New York I joined a Buddhist cult – for only a day and half but I still joined! When I became a mom I joined La Leche League. When I wanted to lose weight I joined Weight Watchers.  I lead various breastfeeding support groups. I belong to the B & N 5 – a writing group.  

Last spring I was talking to my friend Amy, she and her husband own a fantastic café in the East Village , ciao for now. Amy and I often talk about parenting – we both have three children. I whined a bit about Phoebe graduating high school and starting her freshman year of college. We both welled up with tears lamenting the passing of time. I mentioned my changing body, peri-menopause, aging, all the changes we women experience. “We need a support group for that!” we nearly sang in unison. Amy immediately offered up her café  as a spot for our group. I let the idea simmer for a couple of days. I had also mentioned to the B & N 5 that I wanted to teach a writing class. An idea gelled. Writing Through Transitions! I search the web and found a woman on the west coast had written an e-book and was doing workshops by that name, so much for original ideas.

I bought and read her book. It was good but she is a therapist and her approach was different.

My background is more in peer-to-peer support.  My new group would be for women, we would talk and write about all of these changes, these transitions. I have creative strategies for managing the group and divining memories from the past while being able to express oneself and to be heard.  A few of us gathered last fall to workshop the idea at ciao for now. I saw what worked and what I needed to change. So now, beginning March 20 we launch the official Women Words & Transitions workshop at Lila Wellness.

If you are a woman of any age in or around New York City I hope you will consider joining me in this creative, self-exploration journey. You need not be a writer just a woman.  I can help you explore the many changes in your body, mind, relationships and more.

I plan to offer weekend long workshops for those who cannot commit to weekly meetings. Let me know if you are interested!

 

Mother Anger

July 1, 2013

We openly talk about being angry at our teenagers, our mothers and our partners but how many of us openly admit to being angry at our babies?

I recall late on night, or was it early one morning? This was in the summer of 1995.  New to parenthood, Rob and I were trying to figure out how to integrate a new baby into our lives. Phoebe kept waking and crying. We were still at that point of reading books and not our baby.

The newborn cries impaled my body and I understood the story that my mother repeated often about the eighteen-hour drive up I95 from North Carolina to Massachusetts when I was a six-weeks old. She described a constant bloodcurdling cry and openly said she wanted to throw me out the window. I now knew that feeling, that longing to dispose of ones precious newborn.

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Just as I was trying to figure out how to quit my job as Phoebe’s mom, Rob threw the sheets off himself and I thought he was going to hurdle her into the neighbor’s house. I immediately shifted gears into protective mama bear. I scooped Phoebe into my arms and put her to my breast for the millionth time that day and I wept.

How could I be so angry at my sweet baby girl? Didn’t I love her? Hadn’t I signed onto this job? Did I really want to give her back?

A few days later I attended at La Leche League Meeting. Lucta, the Leader, was a transplant from South Carolina. I loved listening to her deep drawl. I loved how everything that flowed from her mouth was like reading a Fannie Flagg novel. She was funny, self-deprecating, maudlin and full of wisdom.

A mother of five, Lucta spoke of how her vanity saved her first born child. When she wanted to hit him or throw him out of the window she would walk outside onto the sidewalk and hold him out for all to see.

“Ah was vain. I would never do somethin’ regretful in front of anyone,” she proclaimed. “Mah vanity saved that poor child.”

And then she said it, out loud. “Ah was angry.”

The guilt I had about my feelings of anger at Phoebe began to fade with her words. Then she said it was normal to mourn your old life. Normal. I was normal.

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I have learned to respect those words in my life.

Grief is real and it is a process. Once you have a baby, one chapter of your life is closed, forever. No matter how much you love motherhood you have lost the innocence of childlessness.

One brave mother brought it up at my support group the other day. She said out loud that she gets angry at her adorable baby.  Relief permeated the room. Acknowledgement that it is normal to have all different feelings as a new parent is priceless.

It is taboo to talk about anger towards a baby. New parents suppress these feelings because we romanticize babies and new parenthood.

Parenthood is wonderful – some of the time. Parenthood is challenging – some of the time. As long as you do not actually throw your baby out the window or into the neighbors yard you are pretty normal.

One game I have played with myself when I am either out with my three children or if I am feeling on the edge of losing my mother cool is, I pretend I am the subject of a documentary. I pretend that I am being filmed and I want to set a good example. Silly? Yes, but this little game has gotten me through hard moments in my mothering.

Love your baby. Remember, you have a relationship with this little person. Do you ever get angry at your best friend or your spouse? And so you ever just have the best time ever with these people? It is the same with your child.

And, if you ever feel like you want to act on your anger let your vanity step in. Go out and stand on the sidewalk with your baby.