Like Every Mom: A Bottle-Feeding Mom's Story

Today, we have a Guest Post from our friend Jessica. Unable to breastfeed due to the need to take some heavy-duty medications, she wants to share ways that breastfeeding moms can support mothers like her.

Like every mom, I have a mantra. It keeps me going when the toddler has thrown off his diaper in favor of peeing on the floor, the only food in the fridge is a stick of butter and some olives, and I’ve forgotten to move clothes to the dryer for the third time.

“I’m doing the best I can with what I have.”

Child, if you don’t want your diaper then sit on the toilet. While I order a pizza and wash the damn clothes again. Screw it, let’s just buy new clothes.

This mantra first came to me long ago, when I was freshly pregnant, excited and terrified. I sat in my doctors office as she listed off all the tests, appointments, and risks associated with this new adventure. In passing, before I left, she said “and you won’t be able to breastfeed.”

What? Well, I’ll do the best I can with what I have. That’s all I could say. Because what I have is Crohn's Disease, and by a stroke of faith and luck I found myself in my GI’s office that day discussing the pregnancy that should have been impossible. But I had asked God for this baby, and that changed everything for me.

Months before my pregnancy and after trying every medication on the market (and all of them failing to control my Crohn's), I was put on bi-weekly injections of Humira and daily high doses of Prednisone. For the first time in a long time I was able to eat, I was able to live a normal life, I gained back the 20 pounds I lost to illness, and I was thriving again. I was getting healthy enough for the bowel resection I would need to remove the damaged part of my colon. And then…. BABY! What an awesome surprise! I thought I was getting healthy enough for surgery, but I was actually getting healthy enough to be a mom.

I would be able to wean off the prednisone for my pregnancy, but would have to resume it again after delivery. I would take Humira throughout pregnancy and after delivery. While these two medications worked beautifully to control my illness, they are not nursing-mamma-friendly. From the FDA:

“It is not known whether adalimumab (HUMIRA) is excreted in human milk or absorbed systemically after ingestion. Because many drugs and immunoglobulins are excreted in human milk, 

and because of the potential for serious adverse reactions in nursing infants from HUMIRA, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.” 

“Systemically administered corticosteroids (PREDNISONE) appear in human milk and could suppress growth, interfere with endogenous corticosteroid production, or cause other untoward effects. Because of the potential for serious adverse reactions in nursing infants from corticosteroids, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.”

In a nutshell, the FDA says if you really need these medications to live, then you really can’t breastfeed. And breastfeeding was something I’d never given any thought to until I was told I couldn’t. Isn’t it amazing how badly we want something we can’t have? I was going to find a way. There had to be a way.

Funny thing, there was actually no way. There are some things you can’t just will to happen. Defeated, I sulked with a cake. Because pregnancy rationale always wins and cake is delicious. And I knew I would do the best I could with what I had.

I’ve been lucky. In our breastfeeding-friendly community, I was often the only mom scooping formula and shaking bottles. Aside from a few snide remarks from passerby…. “breast is best!” (Correct reply is “and formula is the best alternative!”), I’ve found support from the village of breastfeeding moms. I know this is not the norm. Formula shaming is real, and it hurts. Don’t we all just love our babies? We love them so much our hearts ache. Don’t look at the bottle, look at the mom. Look at the baby. It’s that same love you share. I promise. 

Here’s what I’d like to ask from you beautiful breastfeeding moms. Let me join your village. I have a cute baby and cake and I’m told I’m a blast at parties. Here’s how you can include me:

1) My boobs hurt like hell. Please, for the love of God, help me. 

Somewhere in all the formula research I did, I convinced myself that since I would not be able to nurse, my milk would simply not come in. Hey, guess what? I make TONS of milk. I was wildly unprepared. I found myself staring at the wall of nursing pads at target, boobs on fire and leaking through my shirt. Tell me to get a cabbage, what nursing pads to use. Tell me not to bind the fiery monsters too tight, and to take Benadryl. And most importantly, that this too shall pass.

2) Invite me to mom groups.

You probably saw me maneuvering around breastfeeding circle at the natural baby store. I’m just here for a teething necklace and damn, I should have probably looked into what classes they do here first. Now it’s all awkward when someone asks me to join and I sheepishly shake a bottle of formula in reply. Please save me from my awkwardness. Could you invite me to cloth diapering and baby wearing group? And let’s have lunch after class. It’ll be fun, I promise. 

3) Those bottles are not going to wash themselves

When you come visit me, freshly home with my new babe, the sink will be brimming with half empty bottles. I’m so tired, I’m so sore, and I feel like I’ve been washing bottles for days. The laundry can wait, we don’t need another casserole. Please, wash a few bottles while you’re here. I might cry with joy, seriously. 

4) Feed my baby

The one thing I have loved about formula feeding from day one is that everyone I love can feed my baby. It’s amazing to watch, so awkward at first. Get the boppy, am I holding him right? This angle isn’t right, adjust. And again. How do I hold the bottle? Am I doing this right?

But baby knows. Baby leads, and curls in for a warm meal and a nap. And whoever is holding that bottle relaxes into that sweet amazing place, mesmerized by my little one. You will love that moment and I want to share it with you. 

5) Offer me some milk 

WHAT. Oh, that’s so awkward! Yeah, I know, but that’s ok. Just do it. I can’t ask you for your liquid gold that you’ve pumped for days to acquire (Or weeks? I have no idea.). But you can just throw it out there. “If you ever need some milk, I’ve got a freezer full!” I may never take you up on it, but I will know how much you care about me and my baby. I need that. 

In return, I promise to always support you. Hey, you know that moment when you just want to cry to someone about your latch issues and not hear “oh, I’ve been there” in reply? I’m your girl. I have not been there. Tell me all about it, I’ll just listen. I promise.

When you’re struggling, I will be your biggest cheerleader! I’m so proud to say my friend breastfed for a week, a month, a year, still going. Keep going. I know you can do it, and I know you need to hear it and I will tell you this every day.

When you wean that babe and shed a few tears, I’ll be right there to pick you up and take you out to celebrate. This is a milestone! Let’s go get you a sexy new bra and drink cocktails. Bring your tiny purse that could not possibly fit a pump, it goes great with that new non-nursing shirt!

We can be friends, see? We can do so much for each other. It takes a village because everyone in the village is different. If we were all the same we’d be quite boring, actually. Let’s not be boring, let’s be awesome together. I’ll bake you lactation cookies while you clip formula coupons for me. That’s how awesome moms party.

Jessica is a full time working mom to one fabulous little boy and his epic head of hair. When she’s not in the office, you can find her cooking up Pinterest fails, cursing at her sewing machine, or coloring on the walls with her son.

A Year in Review: Starting Out FAQ

It's November...and we couldn't be more thrilled that this month marks one year of tears, triumphs, and tatas here at Adventures in Breastfeeding!

To kick off our celebration, we're taking a look back at some of our greatest hits. Today I'll share links to posts that would answer questions moms might have when they are breastfeeding newborns. Later this week Missy will highlight AIB posts that would be more relevant for those who are further along in their breastfeeding adventure. Wherever you are on your journey, we are confident you'll find something informative, inspiring, and empowering as we look back on a year's worth of Adventures in Breastfeeding.

Here are a few of our most popular responses to some common questions new moms have when they begin breastfeeding.

I'm pregnant with my first baby! What can I do now to prepare for my breastfeeding adventure?

Congrats! When it comes to finding success breastfeeding, our contributors have 3 important tips to avoid feeling overwhelmed: educate yourself, trust yourself, and get support.

5 Things You Really Need to Breastfeed

Doing It Wrong

5 Things Every New Mom Wants to Hear

I have a newborn and this is HARD! Does it get better?

The short answer is yes. Whether the barrier you're facing is nipple pain (ouch!), postpartum depression, or anxiety about inverted nipples or augmented breasts, chances are you'll find a way to dig in and get through it. A few of our contributors have shared about these obstacles and how they overcame them.

The Vanishing Finish Line

When Life is on Mute

Do Faulty Breasts = Breastfeeding Failure?

 

Am I making enough milk? Do I need to supplement with formula?

Misinformation about breast milk supply and what constitutes a "normal" breastfeeding relationship has got to be the biggest booby trap out there. If you are concerned about your supply, it may be an issue with baby, or it may be an issue with you. It helps to have realistic expectations about how supply is created, how it's not, and how often baby will feed (especially during a developmental leap or growth spurt). But sometimes there may be another issue at play, like a posterior tongue tie. If you've already begun supplementing and would like to try to scale back, you can find some tips here.

4 Myths Busted

Pumping Output is Not an Indicator of Supply

Surviving a Growth Spurt

Diagnosing a Posterior Tongue Tie

How to Stop Supplementing

I had dreams of breastfeeding my baby, but now he's in the NICU. What now?

Any parent who has had a NICU experience knows that it's difficult to put into words the challenges you'll face. Tiffany has shared her story of nursing in the NICU and Analyn wrote about how nursing helped her little girl during a hospital stay. 

Nursing in the NICU

Breastfeeding and Hospital Stays

As I look back at the blog's first year, I feel so blessed by what I see: dozens of posts by women (and men!) telling their stories about fears faced, lessons learned, and victories celebrated. Stories of support and encouragement for moms in tough breastfeeding situations. I know now, more than ever, that I am not in this alone. Boy am I grateful.

Would you add anything to this FAQ list about breastfeeding a newborn? 

Leave a comment below or on our Facebook page!

And don't forget to check out Missy's post on Thursday about FAQs moms have when they pass the newborn stage.

How to Survive a Growth Spurt in 4 Easy Steps

Ah, growth spurts. Those few days that feel like a few years, when you have to double-check to make sure you're nursing a baby and not a piranha, when you forget if you've had a shower in the last week and you KNOW you haven't slept.... Yep, fun times.

But have hope! Growth spurts don't last forever (THANK. GOD.), and in the 21st Century, there are all kinds of resources that can help you come out the other side more or less in one piece, with a slightly fatter baby than you had before. Just follow these steps.....

1. Know what to expect!

Forget the What to Expect books; you're a modern woman and you need the latest information delivered electronically to carry you through this 48-hour hell! There are two resources that will be indispensable to you during these spurts: One is the wonderful Kellymom, with all the answers to the desperate questions that will come up at 3am when you're trying to latch that screaming infant and she's just not having it.

The other is the Wonder Weeks app. This magnificent tool gives insight into what is happening, biologically and developmentally, to that adorable, squishy, screaming, voracious infant of yours. It will tell you when to expect growth spurts so that they don't catch you by surprise!

Pro Tip: Keep a phone charger next to your nursing station so that you can access these lovely resources any time you need to without having to relocate.

2. Keep water and snacks within reach

It always happens: you sit down to nurse the baby and as soon as he's latched, you feel hungry and thirsty. But alas! There is no food or drink in sight and you just KNOW this is going to be one of those 45min sessions.... So make sure you have several gallons of bottled water scattered within arm's reach of all your favorite nursing spots. You need to keep replenishing your body's fluids both for your milk supply and for your own health, so drink up! Also consider the type of bottle that you can open with only one hand, in case the other is occupied with baby.

And as for food, it's whatever you want, mama! A little indulgence never hurt anyone, but that said, it's best to pack as much of a nutritional punch as you can into your snacks, since your little bundle of joy is getting all his nutrients from you right now. I always found I felt best when I ate something with protein, which usually meant cheese, nuts, something with nut butter. Trail mix or a good old-fashioned granola bar worked best, although the bars tended to make less mess since they came wrapped and all in one piece! Again, pile those suckers up right next to your nursing station: you don't want to run out!

3. Fire up that Netflix queue!

This is hands-down the best advice I got from another mommy-friend during those early weeks. Seriously, if your baby is going to be nursing non-stop for several days, this is the time for a marathon. Never seen Scrubs? Well, there are 9 seasons, so now is the time. How I Met Your Mother? The Tudors? Battlestar Galactica? Doctor Who? (Whoops, sorry, my geek is showing....) Queue up those guilty pleasure shows (sorry, anyone who did not recently give birth doesn't get a vote), plunk your butt down on the couch and just nurse the baby. Forget the dishes that need washing, the inlaws that need entertaining, and the pile of mail that needs sorting. Enjoy your show and don't worry about anything, unless of course your 3-year-old appears to be attempting to burn down the house.

4. Get your support system in place

Husbands, boyfriends, mothers, sisters, friends, and assorted other helpmates are indispensable during a growth spurt. As mentioned above, you will have neither the free hands nor the time to be dealing with chores or unruly older siblings, so someone else needs to be prepared to step in and take care of these things for you. They will also need to refill your food and water as needed (it does sound a little bit like caring for a pet, doesn't it?), bring you the remote control, change the baby, hold the baby while you take a few minutes to pee or even (GASP) take a shower, and say "Yes, dear" as you wax poetical about what damned liars everyone was to tell you that this breastfeeding thing was natural and easy.

This helper should also become an expert feeding pillow-adjuster, amateur psychiatrist, and foot-massager. Make sure they understand that payment is to be rendered in baby snuggles and a few screams as a bonus. DO NOT HESITATE to ask for help when you need it, no matter how silly the request may seem. If you don't have access to someone to help you in your home, make sure you have people on speed-dial who don't mind you calling at any time for a little venting session. Oh, and don't forget to include your lactation consultant in that call list!


.... and two big DON'Ts to keep in mind during these spurts, too: DON'T supplement without express direction from a knowledgable pediatrician, and DON'T try to put your growing baby on a feeding schedule. Both of these actions can harm your supply and negatively impact your baby's growth. Trust your body to feed your baby by nursing on demand!

These are the growth spurt survival tips that worked for me, but maybe you have some I didn't mention. Share your ideas here or on our Facebook page, and nurse on, mamas!

...But You Can't Make Him Drink

Yesterday I shared some things I've learned about asset based community development (ABCD). I told you a couple stories. I took you to Honduras and brought you back to Ohio.

So what in the world does this have to do with breastfeeding? Well, please take a moment to read yesterday's post first, then hop back here to find out.

If you've read anything on this blog before then it's likely you know that breastfeeding in the US is the exception, not the rule. Incidents pop up in the news every few months about breastfeeding moms who are chastised for nursing their babies in public. Here in Ohio, only 21.6% of moms are breastfeeding their babies at all at 6 months. It doesn't take more than a few conversations with other mom friends to hear about advice they were given from their pediatrician or OB that doesn't align with current best practices for breastfeeding.

This is the bottom line: our culture is impoverished when it comes to knowledge, passion, and compassion regarding breastfeeding.

Please please don't hear me wrong. I'm not saying an individual mom is "poor" because she doesn't breastfeed. I'm simply saying that anecdotes and news articles and statistics show us that we are a culture that doesn't value this practice. We believe myths about it. We compare it to defecating. We don't understand it, and in some cases maybe even fear it.

When there is poverty, do you remember what works? Asset based community development.

Yes, there is a need for systemic change. Better education in WIC programs. More baby friendly hospitals. More lactation education in med schools. ABCD can be implemented at those levels. But as I go down this list, I can tell you pretty quickly that I have next to no pull in any of those fields. My sphere of influence consists of my friendships with other moms.

Change will come from grassroots efforts manifested in real relationships. I am passionate about advocating and educating and rallying around the breastfeeding cause, but like I shared yesterday, sustainable change will come when I am willing to let go of that cause long enough to grab onto a close relationship and hang on tight.

I'm digging in for the long haul, just like my wise friend Tracy. I'm not trying to dispense advice or dispute myths in every conversation. I'm striving to be a better listener and evaluate what my friend is showing me she needs instead of starting with what I have to offer. I'm ready to acknowledge that sometimes my friend may simply need to be heard and cared for instead of admonished or corrected. Instead of focusing on everything she doesn't know about breastfeeding, I'm going to simply be present so I can notice what a great mom she is and how much she loves her kids and tell her how much I respect that.

And after listening, after building trust, after I've spent time focusing on her instead of me, I will be ready if she asks me for help. I will be there for her as a collaborator instead of a teacher.

The way I can make a difference in our impoverished breastfeeding culture is by investing in true friendships because I value individual moms. And the payoff is way bigger than the freedom to nurse anywhere in public without criticism, or having bosses who are knowledgeable about your pumping needs, or L&D nurses who understand how crucial it is to have baby at your breast soon after birth. No, these are possible offshoots of this change, but they aren't the ultimate goal.

The victory will be evident in the community we will have cultivated. Moms who are empathetic and truly care about each other's tears, triumphs, and tatas. Moms who value each other not because of a breastfeeding cause, but simply because people matter.

You Can Lead a Horse to Milk...

Today's post ambles a bit. I know it may seem at first glance that poverty alleviation work in Honduras and Ohio don't seem to be related to breastfeeding, but if you're willing to keep reading, I'll get there. I promise.

Homemade corn tortillas?
Yes please!

Four years ago my husband and I took a trip with a ministry called Heart to Honduras. Since then we've made it a priority to learn more about healthy ways to get involved in community development. The too-quick summary of asset based community development (ABCD) is twofold:

1. Poverty is about broken relationships, not just about money. This means every single one of us is impoverished in some way in our lives.

2. Healthy, sustainable, long-term development starts with looking at assets and working in partnership to build on those assets.

Before my first trip to Honduras, I went to the doctor for a check-up. When I told him about the trip we were planning, he scoffed. "Honduras?! To build a house? For crying out loud. People go down there all the time year after year to build houses. And there's always more to build. Why do these people still need us to build houses for them?"

At the time I was incredibly offended by his insensitive remarks. But years later it's clear that his frustration makes sense. If I continue to throw money and time at a problem and it isn't resolved, wouldn't that indicate I need to try something different? What kind of message am I sending to people I'm "helping" when I say: "Hey, just take a step back, I'll be able to fix this wayyyyy better than you can." What am I believing then about that person's value or their competence?

Kaleb and Naun slashing that grass

Since that first trip I've been able to spend time in Las Lomitas, Honduras, not fixing or building or teaching, but simply being and learning. When I was simply present I learned how to grind corn into cornmeal and make tortillas. My friend learned how to mow the soccer field with a machete. Roasting delicious, fresh-picked coffee beans, crafting jewelry from trash, maintaining a clean home with only erratic running water... Once I stopped scratching the itch to always be fixing it was so much easier to move from a deficit focus to an asset-based one.

I've learned a lot about ABCD over the past few years, but time and again I'm reminded of how much I have yet to learn. Recently I overheard a conversation a friend of mine, Tracy, was having with someone in our poverty alleviation group here in the states. Let's call this other person Andrew. Andrew was venting about an issue one of his kids was having at school. It was clear he was frustrated with the teachers there. In fact, it seemed like he was frustrated about a lot of things. Tracy gently asked him if he had considered talking with the school counselor. "She doesn't help with stuff like this," he replied shortly. Tracy responded with sympathy and continued to listen.

What!? I exclaimed in my head. As a former teacher I knew that the school counselor would, in fact, help with this issue. I can't believe Tracy isn't telling Andrew how to contact her! I mulled that conversation over in my head for days. How on earth did she have the patience to sit there and listen when she knew the solution to the problem? More importantly....why?

I played out an alternate scenario in my head. One in which I kindly corrected Andrew and gave him some advice about how to approach the counselor, as well as a few other resources on the issue at hand. In this hypothetical conversation, I even shared a personal story about a student I'd had in second grade who had dealt with this very situation and how I helped the family resolve it.

Believe it or not, the scene didn't end in my head with Andrew showering me with gratitude for sharing my wisdom. It didn't end with him contacting the school guidance counselor.

It ended abruptly when he politely listened to me ramble, then completely shut down. As my imagination moved forward, in the future weeks he would greet me every Tuesday night, but wouldn't ever share what was really on his mind. He wouldn't ever again trust me enough to be vulnerable with me.

And it dawned on me: Tracy had played this scene out in her mind before. Heck, maybe she'd even made a few mistakes along the way and lived it out: the dispensation of advice, the taciturn response, the loss of trust. Tracy knew this wasn't true development.

Tracy listened and empathized because she's in it for the long haul. She's patiently backing up far enough to see the whole picture. She's not trying to fix one problem today, she's trying to be a small part of sustainable development in a person's life over time. She recognized that Andrew didn't need advice at that moment.

He needed a friend.

Hang In There, Mama

As I nursed my 16-month-old son to sleep tonight, I thought about what I wanted to write. I could provide useful tips for recognizing low supply, or share my experience with tongue ties, or recommend light and fashionable summer nursing outfits, but I find myself thinking of all the new mothers I know. These are women with fresh and screaming newborns, women with the undisguised tone of desperation and terror in their voices and online posts. I do what I can to help, but repeatedly, I find myself falling back on the most vapid of encouragement:

Hang in there, Mama.

I HATED hearing that when I was living through the horror of new motherhood. Did my more experienced mommy friends really have NOTHING more to offer me than that? No magic bullet solution, no sage advice, no eternal wisdom, or even a trendy mothering "hack" with its own catchphrase and a few blogs devoted to it? That's all you've got for me? "Hang in there????"

But when you've checked and rechecked that newborn's diaper, when you've swaddled him 18 different ways with at least as many blankets, nursed through the excruciating pain and STILL offered the breast after an hour of continuous latching, and tried any number of expensive gadgets that promise to calm your baby, there's only one thing left to do, and that's to hang in there.

One day, you'll be here.

The day will come when your toddler blows kisses to Daddy when it's time for bed. He'll latch onto your no-longer-painful nipple and do an odd planking motion before settling in and draping an arm over your breast as though it's a pillow. After a few minutes, he'll be out and you'll wait to put him in the crib just so you can enjoy a few more moments of precious snuggles.

When he bumps his head on the playground, your breast will calm him, and you won't feel any self-consciousness about nursing him like that out in the open. In fact, you'll see another mother smile at you, and you'll smile back.

One day, you'll put away that stupid pump for the last time, and just feed your toddler when he signs for milk, asks to nurse aloud, or reaches for your shirt. Your supply will adjust perfectly fine and the thought of not having enough milk won't even occur to you.

When your child's unique personality begins to emerge, when he runs and dances and makes faces and blows raspberries and shows you his belly button, you'll marvel that you grew this little person with your body. That as biologically mundane and culturally sensationalized as breasts are, yours were almost solely responsible for the life, growth, and development of another human.

And the memory of that first week and first month will be a distant battle scar, one you share any time your new-mommy friends cry "Is it really this hard?!" Even though you'll be forced to answer "Yes," you can also say,

".... but it gets better."

"Hang in there, Mama."

You get your milk from where? 3 Myths about milk-sharing

On May 10th I felt lucky to participate in the Best for Babes 1st Nation Wide Milk Walk, to bring awareness to the importance of human milk and milk banks.

Why is this such an important cause? Because there are still a lot of myths and misunderstandings about milk donation.

Myth #1 - It's Weird
Donating or recieving breast milk is no more weird than pouring milk on your morning cereal. Cow milk is for baby cows, human milk is for human babies. It's just that simple.

Myth #2 - It's not safe
There are 2 ways women share milk: either through milk banks or mother to mother. When going through a milk bank there is a screening process to even become a donor, just like there is a screening process for blood banks. I have personally donated mother to mother. I expected the mom I was donating to to ask me questions about my diet. lifestyle, etc. What she told me was "I have seen you give your daughter this milk, that's enough for me." Whatever your comfort level is, there is a safe way to get milk. The argument could also be made that formula can not be safe in certain situations either. There have been numerous recalls, and if not made properly, it can be harmful.

Myth #3 - It's not Important

The WHO recommends that when it comes to feeding an infant it should be

1. breast milk from the breast
2. pumped breast milk
3. donated breast milk
4. formula

Formula is LAST. Breast milk can not be replicated. There are over 100 ingredients in human milk that are not in formula.

Human Milk Saves Lives. 500 U.S. & Canadian preemie infants die annually, and 5000 more are sickened, from Necrotizing Enterocolitis (NEC). Feeding these fragile babies human milk has been shown to reduce the risk of NEC by 79%. NEC causes indescribable anguish to babies and parents. - See more at: http://www.bestforbabes.org/miracle-milk-stroll/#sthash.DITW1i6O.dpuf



At the end of the day, I have felt a special bond with these moms that I have been able to donate my milk to. After the walk, a friend and I decided to get lunch at a local farmers market. We were both still clad with our " I make milk" and "I donate milk" stickers when a woman stopped us and said "Thank you! Because of women like you, my son is alive." Pumping is hard work and I applaud any mother who does so. Pumping for the love of a baby not your own is a gift unlike any other. I can't wait for next year's walk.

My Friend and I half way through the walk

Income and Breastfeeding

This is a post that I feel needs to be written, but I’m honestly nervous about how it will be received because it is such a sensitive issue, rife with opportunities to offend. Please understand that I have no desire to condescend, only to prompt thought and discussion. I welcome feedback and differing opinions, as well as more sources, information, and personal stories that will help to form a well-rounded picture of this societal concern.

Problem: Breastfeeding has significant health and cognitive benefits for baby, and health and psychological benefits for mothers, but those who might gain the most from these benefits - low-income families - are statistically least likely to breastfeed.

What is needed to successfully breastfeed?

Information: Mothers need to know benefits, how to latch, how to troubleshoot a bad latch, diet and nutrition, breastfeeding economics (supply and demand), newborn behaviors and hunger cues, etc.

Time: A breastfed baby feeds around the clock for at least the first month and often much longer. Establishing a strong nursing relationship and adequate supply may take trial and error. The mother also needs rest to recover from the birth and produce milk. Any other demands on mom's time can impede the relationship.

Support: Studies show that early and ongoing support (especially from other women and/or the mother's partner) is crucial to successful and continued breastfeeding. This can come from family, friends, hospital staff, support groups and organizations, etc. If the woman's social network lacks any supportive or knowledgeable figures with regards to breastfeeding, she is much less likely to attempt or continue with it.

How does income affect these factors?

Living conditions: A low-income mother is likely to live in an area with fewer resources available, like birth/newborn care classes that cover breastfeeding. Even if they are available, she may lack the time or means of transportation to attend.

Photo from this excellent blog post

Hospital: She is likely to give birth at a poorly-funded hospital with fewer resources to promote breastfeeding, such as Lactation Consultants, breast pumps, nipple shields, etc. The hospital may provide formula samples because its lack of funding will incentivize the acceptance of promotional deals with formula companies. While she is of course not obligated to use these samples, in the absence of proper breastfeeding education, she may feel it is easier (and more comfortable) to do so.

Job: A low-income mother may have a part-time job or work at a company with less than 50 employees, neither of which are legally obligated to allow maternity leave. This means she would need to return to work almost immediately to keep her job. Even if she is employed full-time at a large company, the standard 6-week maternity leave often ends before the mother's milk supply has been firmly established, especially if baby has spent any time in the NICU. Likewise, the mother’s employer may not fall under breastfeeding laws which require them to provide the space and time for her to pump, not to mention a place to store the milk.

Marital Status: She may be single or have an absent partner, meaning he would be unable or unwilling to provide her any support. Since the trend appears across several generations, the women in her family are less likely to have breastfed themselves, so they may lack knowledge and experience with breastfeeding, making her likewise unlikely to receive much support for nursing from them.

Equipment: Breast pumps can be expensive, and also require specific care, replacement parts, additional gear like bags and bottles, etc. Their use also tends to have its own learning curve.

What can you do about it?

Personal Support: Support the new, expecting, and experienced mothers in your life, no matter their income level. With sympathy and positivity, offer them your knowledge, encouragement, and friendship. Participate in organizations like La Leche League and Nursing Mothers Counsel, or join an online support group to share your experience with other mothers who may not have access to a local support network. Bake some lactation cookies for your sister, give your friend some soothing gels, and tell your online buddy how getting a lip-tie resolved saved your nursing relationship. And give a big smile to every mother you see nursing in public!

Activism (“Lactivism”): The current legal code discourages mothers, especially low-income mothers, from making the choice and attempt to breastfeed. I will not propose specific political solutions to this problem since we will all undoubtedly have differing views as to what is appropriate, but I will say: get involved.

Learn about maternity leave laws, breastfeeding laws, the effect of the WIC program on breastfeeding rates, lack of lactation management education for doctors, and FDA regulations for infant formulas. Share this information with others, find out where your representative stands on these issues (or if they’re even aware of them), and call or email them to share your opinion. Network with other breastfeeding mothers and advocates, attend events, and always be respectfully open and communicative about your choice and struggle to breastfeed.

Giving and Volunteering: Finished pumping but still have a pump in good working condition? Donate it! Consider giving to programs that support low-income families. If you’re feeling truly generous and are able to give of your time, think about volunteering for shelters and organizations that support new moms who are in tough financial and social circumstances. Breastfeeding is just one aspect of the overall quality of life for a new mother and baby, and changing the culture takes time, but this kind of mother-to-mother care will be invaluable for everyone involved.

The choice to breastfeed should be one that is available to all mothers, regardless of income or social status. For too many women today, not only is it NOT a choice, but it is a near-impossibility. What are your ideas to change this? How have you offered support to others? Are you a “lactivist?” Share your response and experience in the comments, and thanks for reading!

More sources:
If you read only one, it should be this paper
Occupational links to breastfeeding
Risks of Breastfeeding Cessation among Low-Income Families
Effects of WIC Participation on Breastfeeding practices
Nurse Practitioner perspective
Length of Maternity Leave as an obstacle
Formula marketing and legislation

Someone reported your picture for...

...containing nudity or pornography.

 This is the notification I got from Facebook 1 hour after I posted this picture on my personal and private page.

Someone I know, someone who knows me, looked at this picture and didn't see a special moment. They looked at it and saw nudity or porn.
I was shocked at first, then I was mad. I wanted to tell whoever hit report that they should have hit un-friend if that's how they felt. I wanted to tell the person how much this picture meant to me. I wanted them to know my struggles with breastfeeding. I wanted them to share my accomplishment for making the goal I had set for myself. I wanted to tell them the internal debate I had about whether to post this picture in the first place.
When I booked my daughters pictures for her first birthday I thought about the kind of pictures I wanted. Of course we needed smash cake ones, and ones of her in her birthday dress. When my husband mentioned that he wanted pictures with her I realized that so did I. I had cried a lot in the days leading to her birthday, we survived a year with 2 kids, we watched the most beautiful baby become a little girl, and I made my goal of no formula. I did it! Through slow weight gain,a case of yeast, mastitis twice, I had nourished her mainly with my milk. Just like any accomplishment I wanted a picture to capture it.

When I got the disc with all the birthday pictures,and I saw the look in my girls eyes as she nursed my heart felt happy. Then I debated with myself. Do I put this picture on my Facebook page? I started slow, first my breastfeeding support group, then my local mom group. In the back of my head all I could think was "Do it! This is huge part of who you are, this is how you feed your baby. If this was a bottle in her mouth instead of a breast no one would bat an eye." I took the plunge and posted it along with the rest of her birthday pictures. I'm not sure what I expected, but I can tell you having a friend of family member report it wasn't it.

The upside (and thank goodness for great friends) is the response I got when I called the person out.

To the small minded family or friend who reported my breastfeeding picture. I have breasts. I use my breasts to feed my child. I'm proud of my accomplishment in using my breasts to nurse her this long which was neither easy or without personal sacrifice. A nursing mother is not obscene or immoral in any way. I'm not going to hide because breasts make you uncomfortable. Feel free to remove yourself from my friends list because I don't have time for your b.s.

Before I knew it so many of my friends stood by me. My mom friends, male friends, child free friends, formula feeding friends. They ALL made me cry again and they showed their love and support for me. Because of that I will never be afraid to show who I am , a proud breastfeeding mommy!

Wordless Wednesday: A Comprehensive Approach to Breastfeeding Support

5 Things Every New Mom Wants to Hear

My postpartum recovery was no walk in the park. Even for moms with quick physical recoveries, this time is marked by blurry eyes, hazy memories, and an uncanny feeling of déjà vu.  I was blessed by the support of my husband, friends, and family and I learned a lot about what new moms most desperately need to hear in those early days. 

1. "I'd like to bring you a meal."

Garfield is not a fan of cute baby onesies

We had many visitors who were excited to see Boo. I won't lie, my favorite visits were those that involved steaming pans of lasagna or homemade chicken noodle soup. Someone thoughtfully brought gift cards for takeout. Some friends brought adorable outfits for Boo and (I'm not proud of this) I bitterly thought to myself, I can't eat that onesie!   Other friends asked if I wanted them to bring a meal, and it put me in an uncomfortable position. I am a person who hates asking for help so of course I said, "No, don't worry about it!"  What I really wanted to say was, "Do I want a meal? Does grass grow? Is pizza delicious? DOES MY DAUGHTER POOP?!?" All new moms are weary anyway, and breastfeeding moms typically eat meals that could feed a small nation. So yes, food is good. "I'm bringing you dinner! What food do you love/hate? What's a good time?" Don't be surprised if your new mom friend falls down and kisses your feet after hearing those words.

2. "It's okay to feel that way."
The first few days/weeks/months are an emotional roller coaster.  Mom's body is on hyper-drive trying to shift from sustaining a baby inside the womb to sustaining that baby by way of her breasts.  Lots of hormones changing.  All the emotions happening.  If she is sad/happy/stabby/nervous reassure her and let her know you're there to listen.  If you think she might be suffering from postpartum depression (PPD) give her a hand in finding the help she needs.

3. "Go take a nap."
After countless visitors visiting and doctors doctoring and lots of bodily fluids uh....flowing, anyone would be beat tired.  Now add in a tiny creature who needs to be fed or changed or cuddled 24/7, and mama's exhausted.  The only reason she may want to stay up would be to chow down on the delicious meal you brought her. ;)

4. "You're doing a great job."
If your mom friend is like me, it's possible she read every word published about pregnancy and childbirth under the sun but for some reason forgot that she would need to care for and nourish this child after the little bug popped out.  For me, most days I was getting by in survival mode and after the chaos died down I realized I hadn't the faintest idea what I was doing. It was simultaneously terrifying and awe-inspiring.  I felt much more confident when another mom held off on the advice for a bit to build me up.

5. "What kind of support do you need from me right now?"
This is where it's important to acknowledge that every mom is different.  I think it's safe to assume that every new mom wants to eat and sleep, but moms have other needs that vary so much from each other.  Some moms need to complain and vent just to get out their frustration.  Others unload to a friend because they need to hear that it's okay to try something different.  If you have even a little doubt about what your friend needs from you, simply ask her.  Tell her that you care about her.  That she's a great mom.  And that you want to provide whatever support she needs, whether that's simply an ear to listen without judging, a referral to a lactation consultant, or an account of your experience and what worked for you.  I'm often guilty of automatically providing support to other moms that I know I would need in that situation, but sometimes that's the opposite of what they want.  Listen - truly listen - and let her know that you are there for her no matter what.

Milestones and The Top Five

A few weeks ago, we hit the goal we had been working toward for the last year. That's right, we made it! One year. Slow weight gain. Working twelve hour shifts. We made it. No formula, just mama's lovely, albeit skim, milk. I posted previously about my son starting to wean and that has progressed a bit but there are still days that he wants to nurse all day long and I'm totally fine with that. I told my husband today that I thought he would nurse til he turns two, to which he replied, "Are you surprised?". This leads me to my favorite top-five ever. The answers to the question I have been getting since we reached that year mark:

How did you do it?

5. Find a breast-friendly pediatrician

     While this is not number one on my list, I cannot stress how important this is. I've probably mentioned
     a handful of times now how big of a role our pediatrician played in our breastfeeding success. Find a
     pediatrician that you trust. Find a pediatrician who has positive feedback from breastfeeding mothers
     in your area. There are pediatricians in my are who are wonderful and sweet, maybe have shorter wait
     times in the office, but who would have encouraged supplementing in a heartbeat with my son. We
     went for my son's one year check up last week and the pediatrician laughed at the growth chart. Literally
     LOL'd. Maybe it's because it resembles a stock graph or something totally unrelated to infant growth or
     maybe because he was right. Remember I mentioned that our pediatrician, while my son was hovering in
    the second percentile for months, told me not to sweat it and around 6 months he would shoot up? He
    did. He jumped from the 2nd to the 23rd then at a year, he jumped to the 64th percentile for weight. We
    never supplemented with formula and we started solids slowly at 6 months, per the recommendation of the
    AAP. I trusted him and he trusted my body and my choice to EBF. He was a great fit for our family. At
    the end of our appointment, he asked if C was still a breast guy and I said yes. He said that was great and
    that we were in no hurry to wean. Swoon.

4. Don't be afraid to ask questions.

     No one expects you to know all of the answers. I tell first time moms in the hospital all the time: You
     have never done this before and neither has your baby. It is a learning process for both of you and every
     time you sit down to feed, you will both learn something about feeding and each other.

     There is no shame in asking questions. Reach out. Reach out to moms who have done this before you.
     Reach out to moms who will keep it real with you. Positive feedback is great, but if you are doing
     something that will be detrimental to your nursing relationship, it helps to have someone you can count
     on to help bring you back to center. One day, it will be your favor to return and you'll be grateful that
     you asked questions so that you can pass on the wealth of knowledge you have acquired.

     Asking your gal pals is a great idea but these gems will become your best friends:

Kelly Mom - the web's breastfeeding Bible

LactMed Drugs and Lactation Database

     Kelly Mom also has a Facebook page and there are many other social media pages that serve as great

     and informal resources on lactation. Please remember that advice given by friends, bloggers, etc. is 

     wonderful and generally accurate, but it does not replace that of an IBCLC, MD or other professionals

     trained in lactation. 

3. Stand your ground

     You know your baby and your body best. If you aren't comfortable giving your baby a pacifier, don't
     If you aren't comfortable leaving your baby with grandma to take a bottle so you can get some sleep,
     don't. Are you keeping track of wets, dirties and temperament and know that your baby is getting
     enough despite what feels like the rest of the world telling you otherwise? Tell them to shut it! Are
     there times you are going to want more sleep and that bottle will sound tempting? Absolutely. Just
     remember that you made this choice and you are the only one who can decide to go the other route.
     

2. Trust your body.

     Yes, there are women who, for various physiologic reasons, are unable to produce breast milk. The
     odds that you are one of them? Slim. Women tend to start doubting themselves when babies don't
     latch right away, aren't sleeping through the night when other babies of the same age are or may not
     have regular dirty diapers....or a plethora of other reasons. Remember: You were made for this! 
     Women are designed to lactate for our young. Am I saying there won't be stumbling blocks or that
     this beautiful and natural thing will come as easy as your natural labor - oh, wait...just keeping you on
     your toes! There will be times you will doubt your ability to produce wonder food for your baby and
     you will question the strength of your body and mind - nurse on. You've got this!        

1. Surround yourself with people who are supportive of your choice to exclusively breast feed.

    I tell moms in the hospital all the time: You will get a ton of feedback and advice about breastfeeding -           mostly from women who have never breastfed. There are so many support resources available:

    Adventures in Breastfeeding (ofcourse!)

Local Le Leche Groups

...as well as local hospital and community

based support groups.

     Becoming socially accountable for reaching breastfeeding goals goes far. I refer to it as positive peer

     pressure. Of course, there is nothing wrong with giving medically indicated formula, but there is something

     about knowing how your friends will react if you were to bring a bottle of ready-to-feed to a play date

     that keeps a breastfeeding mom motivated to trudge forward, even in the hardest growth spurts or

     sleepless nights.

I am so thankful to have come this far in our nursing journey and cherish each session now. The hardest thing is knowing that any day now I could nurse my sweet boy for the last time but the best thing is knowing how far we have come. When you doubt yourself, remember that you can do this. 

Til next time, mamas...

Keep calm and nurse on.