Tandem Nursing

August 10, 2016

classic tandem

 

Tandem Nursing means nursing two babies at once. This can be twins or it can be siblings born at different times i.e. an toddler and an newborn.

Many people believe that you cannot get pregnant while nursing or that if you are nursing when you are pregnant you need to wean.

You can get pregnant while nursing.

Breastfeeding can be birth control under specific conditions. There is the Lactational Amenorrhea Method (LAM).

LAM works like this:

  • No return of menses since birth
  • breastfeeding on demand, night, and day
  • baby does not take any food or other liquids regularly
  • baby’s sucking needs met primarily at the breast (no pacifier or bottles) baby is less than 6 months old.
  • baby does not go longer than four hours during the day and longer than six hours during the night between nursing

 

With LAM there is about a 1-2% chance of getting pregnant – similar to taking birth control pills.

birth-control

Many people get pregnant while nursing. Often moms are advised to wean their older baby if they become pregnant. There is no need to wean unless you are at risk for premature labor and you are advised by your health care provider to refrain from intercourse.

What can you expect while nursing while pregnant?

About halfway through pregnancy your milk changes from mature milk to colostrum. Colostrum is thicker and does not flow as easily as mature milk. Some toddlers get frustrated and wean. Others hold on for dear life!

One telltale sign of pregnancy can be sore nipples. Some moms find nursing painful or they become averse to nursing and they choose to wean their older baby.

Others will put limitations on nursing – one mom used counting as her strategy – “you can nurse for ten seconds – 10, 9, 8 . . .“ Another mom had a nursing chair where they could only nurse sitting in the chair in a quiet room.

Some advantages of tandem nursing can be:

  • nursing toddler can help relieve engorgement
  • older baby not feeling left out
  • mom doesn’t feel she is abandoning the older child
  • she still has her magic toddler wand
  • sibling bonding
  • stronger immune system of the toddler

 

Disadvantages:

  • mom may feel touched out
  • judgement from family, friends and health care team

 

When nursing twins it can be a good idea to alternate breasts for the twins. This can be every feeding or everyday – Twin A gets the left breast while Twin B gets the right breast for one feeding and then alternate the next feeding or on Monday Twin A gets left breast and Twin B gets right breast and on Tuesday Twin A gets right breast and Twin B gets left breast and so on. Many moms of twins will choose to nurse one at a time once they get older to have one on one time. In the early days it can be a time saver to nurse both at once.

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How does one manage tandem nursing babies of different ages?

Elizabeth Tandem nursing Read the rest of this entry »

Change and Magic

June 26, 2014

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Yesterday was my birthday. Today was the last day of school for NYC Public School children. This weekend all three of my children will begin their summer at camp in the Berkshires and Rob and I will be alone for four weeks.

My oldest child has one year of college under her belt. My second child will be researching high schools in the fall. My youngest will begin fourth grade.

This summer many friends are leaving New York. They are going to Portugal, Massachusetts, Portland (both East and West) Israel, and Phoenix. The list goes on.

Change is hard. I have trouble with change. I have a hard time packing. I am challenged to move things around like furniture and art on my walls. I am a creature of habit.

But I also have change envy. I am envious of all those friends starting out on new adventures. I feel a little left behind.

Working with breastfeeding moms and babies I get to relive those early challenges of motherhood, the dramatic changes in the body and the heart. As someone who advises about weaning I get to relive the emotions of that milestone.

I was talking to Finn on the way to school this morning and he told me he wishes he could perform magic. The first thing I imagined I would do if I was magic would be to bring back my mother. This year in October it will be ten years since she died.

If I was magic . . .

Oh, the possibilities.

For now, I will remain in New York. I will continue to mother my children through all of the changes they experience. I will nurture my relationship with Rob. And I shall seek change that is positive. I will embrace each day, each challenge, each wrinkle and gray hair.

You see, this is about getting older. Yesterday was my 49th birthday and I am thinking deeply about 50. It is such a milestone. When I was a kid I used to imagine a grownup being 35 years old. I am past that quite a bit. I have to consider what this means.

I walk down the street and I look at other women. I try to figure out how old they are. I try to analyze their state of mind. I try to figure out if they are happy and healthy.

I will take in this final year of my forties. I am happy and I am healthy. And I know deep down I do possess some magic!

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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?

 

 

Love Lines and Body Love

February 9, 2014

My body is the only body I have, the only body I will ever have. It is where I live. My body is where I grew my babies, first inside then outside. I grew them with my breasts, my hugs. I lugged them around on my hips. I am happy to have these soft hips to balance a baby and my soft bosom to catch hugs. If you look closely at my hips and my breasts, if you catch the light just right you will see a light pattern, a texture, almost silvery, once purple but softly faded lines. Some people call them stretch marks I prefer love lines.

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Love created my babies. Rob’s loving hands caress my body. I love the feeling of skin on skin.

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I once held fantasies of having a perfectly toned body, a model size body but I don’t naturally have that body type and life is too much fun to work that hard for an elusive dream.

I had warts as a kid. Mama used to have me take an old silver spoon, rub it on the warts in a circular motion and toss the spoon behind me into the woods. This was supposed to disappear the warts. I was warned to never search for the spoon because if I ever found it the warts would grow back. The spoon trick never worked. Mama said I didn’t believe hard enough.

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When I was fifteen I had thirteen warts on my left knee. The doctor numbed up the middle of my leg and I lay back. I saw a miniature melon-baller in his hand and moments later I felt warm syrup dripping down my ankle. He scooped out those warts and red streaks of blood lined my leg and speckled the tile floor.

To this day I can see the silvery amoeba shape on my knee, particularly in summer when I catch a bit of color.

Speaking of tanning I have been cursed with a skin cancer gene. If you look closely at my chest and face you will see that they are marked up like old pair of jeans that have been reworked, stitches here and there, threadbare in some spots. I am a dermatologist’s dream. I don’t have bad cancer, just basel and squamous cells, moles, things that need to be removed here and there but are nothing lethal. I am a steady customer.

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I have plenty of moles. There is one on my left side, the part that curves in at the waist, just handy for a nursling’s little hand to migrate to and pull and pinch and finger. I had another one that he loved on my upper chest near my arm that was easy access when nursing. I complained to the dermatologist and he froze it off. The boy knew the one on my waist was bigger and softer anyway so he didn’t complain.

My daughters love my curves. They love to cuddle into me. My husband and son love hand-holding and spooning.

The chorus of love I hear is: “Let’s cuddle.” “Spoon me.” “I need a hug.”

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Legs tangle together on the sofa. We are a network of limbs, touching, embracing, kicking. My family is connected physically and emotionally. I feel like we sprang from my marked and curvy body.

For many women being pregnant with her second child is a wonderful occasion while for others it is a time of inner conflict. Yes, she wants this new baby but how could she possibly love anyone as much as she loves the little person here. Will the first child be abandoned? How will she stretch herself anymore than she already is? How can she create equality within her family?

It is important to realize that the learning curve with the first child is incredibly steep. When you are already in the role of parent bringing a new baby home is not as frightening.

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Remember this baby is born into a family unit. We do not mother each child separately. Yes, we have different relationships with each child but we can never divide ourselves equally. There are times when one child requires more time and focus. Yes, they will fight for attention. The mothers I have spoken with who feel that they do not abandon one child for the sake of another seemed to have similar attitudes: “We are a family, a unit.” One mom who refers to her family as “The 12th Street Gang.” I love this.

You know the Sister Sledge song “We are Family?” “I got all my sisters and me”

My mother loved The Prophet by Khalil Gibran. I picked it up recently and it made me realize how much his words spoke to her.

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On children he wrote:

Your children are not your children.

They are sons and daughters of Life’s

longing for itself.

They come through you but not from

You,

And though they are with you yet they

Belong not to you.

 

Children are individuals but they do not exist alone. We are here to guide and love them. They will model what they see. Let them play well with others and work through natural conflicts?

My freshman year of college I had an acting teacher who asked me which of my siblings I loved best. Without missing a beat my reply was, “I love them equally but differently.” That was my Mama’s work! She created that.

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(My siblings and me)

It is helpful to have strategies to be able to mother more than one child at a time.

Here are some ideas that can help:

~ wear the baby – get a sling, wrap or other carrier to keep the baby close and keep your hands free

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~ include the older child in caring for his sibling, do not force it, rather give him the opportunity to help, keep diapers and baby’s clothes within reach of him so he can get these things

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~ do not overindulge either of the children

~ ask open ended questions and really listen to him

~ acknowledge his feelings 

~ let go of things – dust, material objects

~ ask for help with the house and food – when people ask what you need tell them you need food and a clean house

 

You can never create true equality! Ask anyone with siblings – they will tell you stories. Go easy on yourself.

By keeping your family together the older child sees how he was cared for. By separating the two you teach them that you cannot love them together – that each child is just one unit, creating more competition. By including the new baby you are modeling love, acceptance and patience.

 

There are many things that can make or break the transition into breastfeeding. Breastfeeding in the beginning is time consuming and that is good. It is good because it creates the opportunity for mom to rest and heal from birth. It is also a time to study your baby.  It is time to get to know each other.

With this in mind there are a few things you can plan.

Create nursing stations in your home.

While still pregnant, notice where you like to spend time in your home. Many new parents build a beautiful nursery but you do not have to stay there for every feeding.

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Your baby does not care what the room looks like. Your baby expects to be close to mom and to have her milk available.

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Your nursing station can include:

~water for you to drink

~snacks for you

~a cloth diaper for spit ups

~diapers and wipes

~phone

~book

~TV remote control

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Nursing stations can be in:

~living room

~bedroom

~nursery

~den

Accept help!

For some of us it is hard to give direction. People want to help. They appreciate the guidance. They cannot read your mind as you sit there thinking “I sure am thirsty, I wish someone would bring me a glass of water” or “I cannot stand to look at that dust bunny another minute, I wish someone would clean it up.” Tell the people what you need and what you want.

When people ask what you need for your new baby tell them you need his food source fed – that is you! Have them make a meal.

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Limit your visitors to those who will help you. This is a special time and you want to be able to be yourself and be comfortable. You have a new member of the family and this little pod needs to bond and sort out their new roles as moms, dads, siblings.

 

 Take a breastfeeding class. A good class will give you the basics on what it looks like to nurse, on how to know that your baby is or is not getting enough and when and where to look for help.

Avoid early supplementing, unless medically indicated. If you need to supplement the best food for your baby is your milk. In the first couple of days you have a thick, nutritiously dense milk called colostrum.

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This is the perfect food for your baby. You can literally express some onto a spoon in these first days and spoon feed your baby. If it is medically indicated to supplement then you need to use a rental grade pump. Many moms buy pumps but they are not all created equal.

 

Find your community.

These days there are so many resources for new parents. Be sure and find one where you can meet other parents face-to-face.

~You can attend a La Leche League Meeting

~Find your local community center with parenting groups

~Find your local on-line community

Know where to find help.

A few good resources:

http://www.llli.org/

http://kellymom.com/

http://www.breastfeedingmadesimple.com/

http://www.isisonline.org.uk/

 

 

 

 

 

How Finn Saved Me

July 25, 2013

I had a dream last night where it I was holding onto a colorful umbrella and it was incredibly windy. I was about to be lifted into the sky and taken a way. Just as my feet were leaving the ground my eight-year-old son, Finn, grabbed my hand and said, “kiss me.” I saw his little pursed lips and that kiss saved me. His kiss kept me from being lost forever.

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This is not the first time Finn has saved me.

I believe he saved me nearly nine years ago. Finn was conceived the week my mother died. Mama and I were very close. Her death was a tragedy. She died of lung cancer less than five months after her diagnosis. The last time I saw her I should have known it would be the last but Mama was never good at good-byes. It was October and she said she would see me for Thanksgiving and Christmas. I should have known when she had me return a sweater to J. Jill that was just her style. I should have known when she gave me a floppy disc with her writing on it – she never shared her writing until she was ready. I should have known when her face looked gray and ashen as she slept on Daddy’s recliner. But we both pretended we would see each other again soon.

When Daddy called to tell me Mama had died I screamed and fell to the floor. I felt a huge hole in my chest. It was a physical pain as much as it was an emotional pain. That pain lingered for months and sometimes echoes through my body at trigger moments.

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A few weeks after her death I discovered I was pregnant. It was bittersweet. How could I have another baby without my Mama and after two miscarriages? How could I take another loss so soon?

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Not everyone loves being pregnant but I sure do. I am not one to get morning sickness. I love growing a little human inside of me. I always dream about my babies. Growing Finn gave me a focus away from my grief. Sometimes my joy and grief intertwined and I did not know I how I felt.

When Finn was born I noticed his blue eyes right away. Mama had blue eyes. Neither Rob, nor our daughters nor I have blue eyes. I wondered if they would stay blue. They have.

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Along the way Finn has guided me in many ways. He was terrible at nursing in the beginning so I learned the reasons why so many women want to stop nursing. I learned how to latch better. I learned about pumping and hand expressing. I learned to be a better Lactation Consultant.

He has informed my mothering. One morning when he was about two and I tried against all odds to get the children out the door to school on time I lost my temper and yelled at he kids. Finn stopped and with big alligator tears he told me, “You have to be patient.”

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I don’t know what happens when we die but Finn used to talk about where he was before he came into my belly. I like to pretend that Finn is Mama all over again. Finn loves me unconditionally the way Mama did. He tells me the truth and keeps me in line the way Mama did. Finn does not replace Mama but he fills a gap and has eased that pain in my chest.

Life and death are full of mysteries. These days many mysteries can be proven or disproven by science. There are some aspects of life I like to keep mysterious: love, dreams, the afterlife.

I will keep trying to listen, be patient and not fly away to soon.