My Babies Voice

When Aya was littler, I remember being jealous of the moms whose babies slept peacefully and often.  It seemed I often thought of these calm babies as "good" babies, and mine as "difficult" or maybe even "bad."  My friend used to call her babies cry his "voice."  This helped me rethink what I thought about Aya's cries in the night, and in the day.  It was her only way to express herself.  She wasn't trying to be loud or tiring or difficult. 

As Aya grew, she learned to suck on her arm for comfort like a thumb.  I noticed that each time she'd cry she would eventually take her arm to calm herself.  She too didn't want to be crying.  It wasn't fun for her either.  This gave me more compassion.

I found this article earlier this week.  With the arrivial of our next baby this Fall, I may need to remind myself of these cries for help or love or peace.  http://www.breastfeeding.com/reading_room/good_baby.html

Nursing in Public

As I sat in public places trying to nurse little bean I dreaded the outcome of each feeding. Would she cry out? Would she be content? Would she be more unhappy than she was before I fed her? I had an image of breastfeeding in my mind that didn't match my reality. The image was of a perfectly calm, content, peaceful mother who held her equally calm, content and peaceful baby. But there was a problem. My Aya squirmed and fidgeted her way through feedings. She sometimes even stopped and let out a cry. She certainly didn't fall asleep at the end. My face wasn't peaceful either. I was tense and anxious. I wish I had pictures of the early days I fed Aya. Maybe moms would be encouraged to see that not all breastfeeding relationships start out looking like the peaceful images we see on the front of breastfeeding books or pamphlets.

I believe that I dreaded nursing in public mostly because my breastfeeding reality didn't fit the pictures. I thought that if Aya didn't feed well in front of others they would judge me and think to themselves, "Well she certainly doesn't have this figured out." I felt embarrassed, even a little ashamed, silly and like a very young, inexperienced mom. I felt very vulnerable.

Can you be good at breastfeeding?

During our early struggle to work out breastfeeding, I was very sensitive when people made suggestions about how to make it better, especially if it was a suggestion to use alternatives to breastfeeding. Looking back, I realize I was defensive because I thought I could be good or bad at breastfeeding. I wanted to be good at it, not struggling.

Now, I don't believe you can be good or bad at breastfeeding. You can be knowledgeable, flexible and sensitive to your babies needs, but I don't think it is something that can be graded. I looked at my breastfeeding as something that could be evaluated and assessed--and if I was good at it I felt I could be proud. This kind of thinking wasn't helpful for me. I needed to know breastfeeding isn't about being good or bad at it. It is about lovingly caring for your baby. It is about a relationship that nourishes, nurtures, protects, calms and embraces your child. You can't be good or bad at it, and one breastfeeding relationship can't be compared to the next. At its core it is good, no matter how difficult it can be. There isn't a plaque for nursing mothers that says, World's Best, or a certificate to win at an award ceremony. If only I had realized this lie I believed sooner.

Feeling Sensitive

During our struggle to work out breastfeeding Aya, I became increasingly protective of our nursing relationship. In the process, I also became increasingly defensive when someone suggested I try some different alternatives to simply feeding my baby from the breasts. We heard lots of things.

How about you pump all of your milk and then give her it in a bottle?
Try this bottle--it says it ends colic!
It sounds like she is swallowing a lot of air while she feeds and I bet that is causing her gas.
We could try formula and see how she does on it.
Maybe your milk isn't good quality.

Oh, it was so hard to listen. Anytime someone tried to offer a gentle suggestion to help I felt my body tighten and grow hot and frustrated. I didn't want to believe that anything but my own body could feed my baby best, but at the same time I knew that breastfeeding at this time was not making Aya (or me) happy. It felt very personal and I felt very violated when a suggestion crossed over from an onlooker and into the arms of my breastfeeding baby. The space between my chest and baby felt like a sacred, vulnerable space that shouldn't be touched no matter how well meaning the person was. Yet, I know everyone was only trying to lovingly help because they knew how upset I was.

I hadn't expected to feel this way, but I did. I think all mothers who want to exclusively breastfeed their baby have felt like this in some way or another. Or, they have felt this way about other decisions they have made as a mother. It takes a person who is secure in their own decisions to hear suggestions in the way they were intended. I just wasn't there yet.

Cabbage Leaves?

Yes, cabbage leaves. When Mary Kay started talking to me about ways to decrease my milk supply, she said a little tentatively, "You can try cabbage leaves too." Cabbage leaves have been used throughout the generations as a way to decrease a woman's milk supply, help with engorgement, or during weaning to keep the mother comfortable. Let me tell you, they work, and they work quickly!

I was open to trying anything of course, and so I took Mary Kay's advice and applied a freshly washed cabbage leaf to each breast, 20 minutes at a time, twice a day. We were careful not to overuse it because cabbage works quickly and effectively and we didn't want to diminish my supply too aggressively.

I liked to "wear" the cabbage after I fed Aya and took her for a walk. Since I wanted to walk for longer than 20 minutes, I watched my clock closely and when the time was up, I reached into my shirt, pulled out the cabbage, and tossed it on the ground for some natural composting. I had a good laugh about this thinking that if anyone had seen me they would have been very confused to see a young lady pulling a cabbage leaf out from under her shirt. However, I needed a good laugh during this time and so I did it without a worry in the world.

Reducing My Milk Supply

My oh my, where do I begin! Well, for starters, reducing my milk supply took quite a lot of experimenting and adjusting to meet Aya's needs. One of the best ways to reduce an abundant milk supply is to keep the breasts full as long as possible. Full breasts send a message to the brain that they overdid it and don't need to continue producing so much. This may seem simple, but when you have a baby that needs to eat frequently, keeping breasts full is difficult.

The way to get around this problem is to try what they call block feeding. Basically, you only feed on one side for a given period of time and block out the other; by keeping the one breast full longer you decrease your supply while still feeding your baby. It is a bit of a guessing game as to how long to block out a side, but we started by switching every two feedings. Since I was feeding Aya every 2 1/2 to 3 hours, this meant I blocked out one breast for about 5-6 hours at a time. Now as you can imagine, when this time had elapsed and it was time to let Aya feed from the other breast, it was VERY full, TOO full. If I had let Aya simply feed from that side she would have been overwhelmed by the milk and received far too much foremilk--the whole reason for her discomfort to begin with. To get around this, I had to pump off the first 1-2 ounces of milk before I fed Aya a more balanced milk with the hindmilk she had been missing out on for too long. At first, it was a bit of an experiment as to how much milk I needed to pump off. Too much, and my body would continue to make far too much milk. However, too little, and Aya was a very unhappy little lady.

So, our goal was twofold--keep Aya calm and peaceful by pumping off some milk while still decreasing my milk supply. Slowly but surely my supply did decrease, and I got good at knowing when I had pumped just enough milk so that Aya would be comfortable. Like learning to make bread or ride a bicycle, I began to get the feel of a breast that was just right for feeding Aya in comfort. In time, I knew my supply was decreasing because I didn't have to pump off as much milk in the beginning. Sometimes I didn't have to pump at all, especially late in the day when milk supply naturally decreases.

The hardest thing about pumping for me was that I had to do it for night feedings. It was really difficult for me to listen to little hungry Aya scream while I sat next to a nightlight and pumped. It was exhausting and felt like too much work. Several times, I thought about quitting all together. The pump made my breasts sore at first too; I had to use lanolin again, and felt like I was starting over in some ways. Nursing was not relaxing for me at all. It was the opposite. It made me nervous as I waited to see Aya's reaction to a feeding. Would she be content and peaceful? Would she arch her back and scream? Would she gulp and choke? I had seen pictures of women feeding their babies and not one of them looked like the battle it was for me. It was hard to continue when I felt like I was the reason Aya was so upset and challenging.

Through the entire process, we watched Aya's stools closely as an indicator of whether or not she was receiving hindmilk. During this time, I was eager to change her diaper to see if her stools had changed from green to yellow. Finally, after nearly a week, they did, and we knew Aya was finally getting a more balanced meal at each feeding.

The most miraculous change during this experience was Aya's demeanor. She wasn't colicky, her milk just wasn't quite right. She went from being fidgety and irritable, always on the brink of a meltdown, to a happy, calm little lady. Her fists unclenched, her arms relaxed. And so did we.

A new diagnosis; not colic

After we learned from the pediatrician that Aya had colic, I decided I should also call our lactation consultant to get her advice. I didn't think that screaming after feeding was normal or okay. Mary Kay agreed, and after listening to Aya's symptoms, suggested I was probably producing too much milk and overwhelming Aya's little developing system. I loved the questions she asked to help address our situation. They felt important and comprehensive. They felt like they were pinpointing a problem and not just addressing symptoms. She wanted to know Aya's birth weight, discharge weight, current weight, and all the details of what her feedings were like. After listening thoughtfully, she said it seemed as though Aya might be gaining weight too quickly. She also said that because Aya was gulping and choking her way through feedings, my letdown was probably very fast and forceful which is common with oversupply. Additionally, Mary Kay wanted to know what Aya's stools were like. I told her they were green and had wondered why I never saw the mustard yellow ones I thought breastfeed babies were supposed to have. These green stools also turned out to be a sign of oversupply. And so, the education on oversupply began.

There are two different kinds of milk mother's produce, foremilk and hindmilk. Foremilk comes first; it is a thirst quencher, high in lactose, and looks like skim milk. Later in the feeding, the fat content in the milk increases with each letdown. This later, more calorie dense milk, is called the hindmilk. It is creamy and thicker, and higher in calories. That is why it is important babies learn to empty one breast before going to the next, so they get a balance of both kinds of milk. When a mother produces too much milk (or more than the baby needs), an imbalance of foremilk and hindmilk is the result. Babies' tummies fill up on the early foremilk and don't have enough room for the hindmilk that comes later in a feeding. This imbalance will cause gas, fussiness, colicky symptoms and possibly reflux. The fact I switched Aya to the other breast each time she came off of the first breast crying only made the problem worse. As I switched her to the other side she was once again overwhelmed by additional foremilk, making her tummy hurt more .

I was so happy to hear there may be help for our little Aya, and relief for us too. The process of decreasing my milk supply was about to begin.

6 weeks and colic

Both Dan and I have decided that at 6 weeks we hit rock bottom. Dan's best friend was visiting us from California, which was something I had planned for Dan to thank him for all of his support during our pregnancy. It also happened to be the week we had not planned for. I knew something wasn't right, but I couldn't put my finger on it. What we did know however was that our little Aya couldn't seem to sleep, she cried when she was awake, and she wasn't eating well. When I would try to nurse her she would come off the breast after a minute or two and scream. I would assume I must not have enough milk on that side and switch her to the other, only to watch Aya repeat the same actions. She would nurse frantically for a minute or two, come of the breast, and scream. I would try to burp her but nothing would happen and she would continue to cry and cry some more, before we would eventually be able to bounce her to sleep. I felt like I was always waiting for the next feeding in hopes everything would be better. I had counted on feeding being a relaxing time for me and Aya, but it ended up being the opposite. Feeding Aya wasn't relaxing at all; rather it was stressful. It made me anxious and it definitely didn't seem to calm our daughter.

So, we called our pediatrician. Our pediatrician was very kind. She listened to our story with gentle sighs and watched me feed Aya. She said she seemed to be latched on well, and she was encouraged that Aya had gained a lot of weight. She guessed Aya was showing signs of colic and gave us a long list of things we could try to soothe her. She told us to get help. I looked over at Dan and I saw tears streaming down his face. Dan never shows emotions in public and rarely with me. When I saw him, I started to cry too. As we left the doctor's office I used the bathroom and caught a glimpse of myself in the mirror. I looked so bad, and I really didn't even care. When we left the clinic, Aya finally fell asleep in her car seat. Dan and I looked at each other and almost without saying anything at all, both decided to just drive until she woke again. We called my mom and told her we needed help.

Crying Spells

By 5 weeks, both my mom and mother-in-law were able to recognize that Aya's crying seemed more like distress than just fussiness. We couldn't tell. We always heard babies would cry so we didn't know what was normal. Both my mom and mother-in-law were a lot calmer during Aya's crying spells. I would sit and watch them gently rock her, bounce her or walk her from one side of the room to the next. Their faces were happy and full of delight, really. No, they weren't happy their grandbaby wasn't content, but they were happy because they loved her and wanted to spend time with her regardless of her disposition. My husband and I on the other hand were drained, our tanks were on empty, and we just wanted our little girl to sleep because after all, the only time she wasn't crying was while she slept. I remember my brother saying once, "Why do you want Aya to sleep all day?" I didn't like the question then, but looking back I have an answer, "Because it is the only time she is happy!"

My mom and mother-in-law also showed us different ways of holding Aya and tried to help reduce her gas by holding her on one side and then switching her to the other side. She seemed to be more comfortable face out, her head nestled against the inside of their elbows, her feet dangling on either side of the palm of their hands. They knew she had pain because one minute she would be peacefully asleep and the next her eye brows would furrow, her body would grow rigid and she would let out a loud screech. What we still didn't know was that we could help her by addressing the cause of the gas, not just treating its symptoms.

4 Weeks Old

There they were, more signs that something wasn't going right for Aya when she ate. Yet again, I didn't know. Feeding was becoming more and more of what felt like a battle. She would come on and off of the breast sputtering or choking. I would keep putting her back on the beast because it hadn't been very long, and she'd suck some more before once again coming off sputtering and fussing. Often, she cried after feedings and never really seemed peaceful. Aya was already getting far too much milk, far too quickly, but I didn't know. Later, I learned that the force of my letdown was like laying on your back and drinking from a hose that is on full blast. At this time, I simply switched Aya to the other side every time she came off of the first breast. I didn't know what else to do.