Breastfeeding a Toddler in the PICU

On Christmas Eve, my 21-month-old fell headfirst onto a brick landing. We quickly found ourselves in the Pediatric Intensive Care Unit to treat a skull fracture and bleeding of the brain. During our 3-day stay, breastfeeding became our greatest strength and refuge (outside the support and prayers of family, of course). These are some thoughts about our experience:

1) Hydration and hunger. By the time little K had his first meal following his accident, it had been nearly 20 hours since he last ate. What's more, he was vomiting as a result of the injury, so he didn't actually hold down food and water until a few hours later. Despite that, he required IV fluids only once during that time. The nurses marveled over how well-hydrated he was, which I attribute directly to the almost constant nursing we'd been doing while in the hospital. Though my supply was not nearly what it had been, I was able to provide for my toddler's most basic needs.

2) Comfort and calm. With the exception of inserting IVs and any large scans that needed to be done, every procedure and vitals check was completed while K was latched. Though he was obviously uncomfortable and hated all the poking and prodding, he would stay still and quiet while doctors and nurses repeatedly took his temperature, heart rate, blood pressure, felt his head, or flushed his IVs. Though he certainly cried often from fear and pain, he could always be calmed by the breast, and nursed so often that he was probably latched more often than not. In truth, my nipples hurt almost as badly as when he was a newborn, but I wouldn't have traded that ability to comfort him for anything.

3) Surprising attitudes toward breastfeeding. Maybe I've just spent too long in hard core hippie California, but I was completely caught off-guard by some of the reactions I received toward my openly breastfeeding a toddler during a crisis. I expected medical professionals, at least (and especially in pediatrics), to be pretty supportive, but many of them were downright squeamish. One nurse got flustered and closed the curtain on us, saying "You don't want anyone seeing THAT. It's an intimate moment." When I thanked her but assured her that I didn't mind (or care) if anyone saw, she began complaining about her friend who "just whips it out at the food court." Another nurse commented "Well, this isn't the most PRIVATE of places," even though we were behind a curtain and it was just us and her. One doctor practically ran away when he walked in on me breastfeeding, muttering "I'll come back when you're finished," and I had to yell for him to come back. And the majority of the staff did an awkward double-take at first.

On the other hand, there were a few bright spots: one of our favorite nurses, a guy, never batted an eye or made a comment. He made sure K was comfortably on the boob before checking him, and chattered cheerfully the whole time as though breastfeeding was total normal (which it is, but ya know). And one nurse passed us while K was pulling at my shirt and said "He looks like he wants to eat! I breastfed both of mine until 30 months!" Still, I was surprised at overall attitude I saw.

There was also the fact that I was giving my son antibodies that may have protected him from some of the nasty germs that inevitably circulate in a hospital, but since all three of us left with a cold, that wasn't quite as successful as advertised.

Naturally, it was a pretty horrible and frightening experience, but I feel that it would have been so much worse if we were not still breastfeeding. A week later, K is still nursing very frequently, whereas we were down to only twice a day before the accident. Also previously, I was working on setting boundaries with him, limiting when and where he could nurse, but that went out the window during his recovery. I can't help but wonder if this may push back weaning a bit (I was not planning to actively wean yet anyway, but I felt like he might lose interest soon). For now, I'm just happy to continue providing what my little man needs.

See also: Nursing in the NICU

A Year in Review: Big Changes FAQ

Today, we continue our look back at a year of tips and nips (see what I did there?) from the Adventures in Breastfeeding team! Monday, Laura covered the most common questions we hear from moms at the beginning of their breastfeeding journeys, so now it's time to talk about what comes after that! Maybe you're still in the newborn phase and wondering what to expect as your nursling grows, or maybe you're a seasoned pro looking for advice on extended breastfeeding. Either way, we have plenty of great answers and personal stories for you fabulous mamas!

I'm going back to work soon and I'm so nervous! Will I still be able to breastfeed?

You can definitely keep nursing even if you work full-time! We have plenty of tips on how to establish a good pumping routine, the best pumping supplies to have on hand, and a VERY IMPORTANT overview of your legal rights as a pumping mom!

Know Your Rights: Pumping in the Workplace

Pumping Counts Too: A Working Mom's Story

Working Mamas Must-Have Pumping Supplies

I've got a handle on breastfeeding and would really like to rejoin normal society. What can I wear? What can I eat? Can I finally have a beer? Am I EVER going to drop this baby weight?!

Breathe, Mama: we've got you covered! There are plenty of cute clothes you can wear that make it easy to nurse your babe, and we have a wildly popular pumpkin spice lactation cookie recipe that even your non-nursing friends will be begging for. YES, you can have that beer, and probably another drink, as well! And definitely bookmark this great post on getting in shape while breastfeeding!

Nursing Wear for the Mama on the Go

Pumpkin Spice Lactation Cookies

Pumping it Up!

You Can Drink That?!

I've decided to nurse beyond a year, but I don't know anyone else who's breastfed for that long. What's it like?

What a wonderful thing to do for your child! Though it may not seem like it, you're in great company! Important things to consider if you're going to practice extended (or "biological") breastfeeding are: how to tell the difference between weaning and a nursing strike, knowing the facts so you can answer the skeptics, setting boundaries with an increasingly communicative and independent toddler, and whether to tandem nurse if another baby is on the way!

Breastfeeding After One

My Baby Isn't Even One.... Is He Weaning?

Boundaries and the Breastfed Toddler

Dinner For Two?

Everyone seems to have an opinion about my decision to breastfeed or nurse in public. I feel so alone sometimes....

We totally get it. That's why we talk about our first experience nursing in public (and later without a cover! GASP!), that time someone reported our beautiful nursing photo, and we highlight some of the amazing breastfeeding art and imagery out there.

5 Awesome Breastfeeding Posters

My First Time Breastfeeding in Public

Someone Reported Your Picture For....

Phew! We've had a busy year with all these boobs and babies! And we have even bigger plans for next year! From the bottoms of our hearts, thank you so much for your interest, support, and incredible feedback! Please stay tuned this month for lots of fresh topics, giveaways, and more exciting changes!

And tell us what topics you'd like to see us cover on the blog, or contact us to become a regular or occasional author! Nurse on, mamas!

Dinner for Two?

Lots of questions have come up in my mind as I try to plan for the arrival of our newest nursling. I'm fairly certain C will jump right back on this milk train and I'm totally fine with that but then I remember how difficult it was trying to get the hang of nursing a newborn. I figure I have two options:

1. I can use it as an opportunity to teach my oldest some boundaries

2. I can get creative, toughen up and enjoy the only time I will get to

nurse all of my children at once :)

If we go with door #1, I imagine Dad will have to help out a little more and be my wing man. Unfortunately, he has to work, too so I will still need to be a little creative. How can I distract him from boobies (Is it really possible to distract a man of any age from them, I mean - come on?!) without him feeling rejected? How can he still feel special even though he isn't getting a lot of extra snuggle time with mommy?

• Busy Box - Have a box of toys, coloring books or other special things that he will only get to play with when mommy is nursing sissy. Maybe this way, he will look forward to my nursing sessions with her instead of dreading them.
• Double Up With Story Time - Use nursing time to read him a book or two...or four.....depending on how long we are nursing and what his attention span can handle. I figure with this method, maybe he will feel like he still gets to share time, he's still close to me and sissy and he can feel more involved instead of maybe isolated or turned away.
• Big Boy Snack - Give him a special snack like organic fruit snacks or sweet roasted chickpeas that are healthy but sweet and something that he wouldn't normally get to snack on unless we're nursing.
• Mommy's Helper - Even at 18 months, my little dude is pretty good at following directions and helping out. When he's two, hopefully this won't magically go away, (pretty please, Lord...let it remain!) and he can bring my boppy, water, granola bar or whatever else mommy might need. This, in addition to being borderline child labor, may make him feel like an important part of the process.

If we go with door #2, while it may not be practical, my heart may actually explode from all the cuteness and love I will experience at once. I have always and I mean it...always,  from the first time I walked into a patient's room in L&D and saw her nursing her one hour old baby and her three year old, always wanted to nurse my newborn and my toddler together. There is just something so special about quite literally pouring out so much love at one time. Now, I always said that I wasn't sure if there was enough food in the world to nourish me pregnant and nursing. Come to find out there is. I also wonder if there is enough food in the world to nourish me nursing two hungry babies at once. I guess we will find out. Yes, realistically, if all things go as planned, we should find out. Will I be sore? Probably. Will I be beyond exhausted, absolutely. Will I have this moment to look back on for the rest of my life and even if we don't succeed for long, be able to be a witness to other mothers who doubt if they could do the same thing? Yes, yes, yes. 

I'm sure there'd be benefits to both and we may will not be able to see all sides until we are faced with it and deal with whatever may come. As much as we sometimes fight our children finding their independence, it may be a good opportunity for C to learn how to share more, to help more and to know that mommy doesn't love him any less just because sissy is here now. On the other hand, what better way to bond with your sister than to hold her hand while snuggled on mommy's chest? What if my princess is a slow gainer like C was? It may not hurt to have him boosting my supply by increasing that demand and creating a more substantial supply of hind milk for her to bulk up with. 

As it has been all along, C is the boss of our breastfeeding relationship. It seems like every time I think it's over, he proves me wrong. Every time I have wanted to give up, he gives me a reason to trudge on. Time will tell and I'll be here to share the adventure.

Til next time, mamas.

Keep Calm and Nurse On

~ Jessica

Boundaries and the Breastfeeding Toddler

There are a lot of things you may think of when you think of breastfeeding a toddler and boundaries - but is setting boundaries with that toddler one of them?

We hit the 18 months of breastfeeding milestone last week and that got me to thinking about how our breastfeeding relationship has changed.  We’ve gone from hours of my son being latched to a quick little drive-by - just enough to fuel him up for more playing and exploring.

He has also developed “preferences” when it comes to nursing - and I’m not just talking left or right side!  L “needs” to have both of mommy’s boobies out at the same time because he likes to hop back and forth when nursing.  He also really loves playing with my belly button.  Neither of these things make nursing a toddler in public very easy!

At the same time, his communication skills have taken off recently and his vocabulary is exploding at a rapid rate (just yesterday he said Minnie and Lambie - this Disney-momma’s heart exploded with excitement by the way!). However, even though his vocabulary is great, and he knows that “num nums” means it’s time to nurse and will even say it at home, he is still adamant that the only way he asks to nurse is by attacking my shirt and trying to rip it off.  Again, this makes nursing in public a little - um - awkward?!  I can't tell you the number of times he's been sitting in the shopping cart at Target and flipped out trying to rip my shirt off.

NOT the right way to ask for Num Nums!

So what am I supposed to do in these situations?  I’ve always been a nurse on demand kinda momma and I was really struggling with setting boundaries with L when it comes to “num nums.” It all came to a head last weekend when I was at a La Leche League meeting and L wanted to nurse when he saw all the babies eating.  He started with the tugging and then insisted I unsnap both sides of my nursing tank.  When I wouldn’t he started melting down - like full on freak out!  I was a little embarrassed but thankfully I’ve been going to that meeting for 18 months and feel really comfortable with everyone there.  

One of the leaders, who is also a friend, saw my struggle and asked what was going on.  I explained to her that L will only nurse with both breasts out and freaks out if he only gets one side.  Plus, he wanted to play with my belly button.  I was actually quite frazzled in that moment - I felt the same way I did when he was only a few weeks old and we went to our first meeting to seek help with what was eventually diagnosed as a tongue tie.  That leader told me it was okay to set limits and it was okay for him to get upset with it.  She said I could tell him "No" to having both breasts out and if he got upset it was okay.  That was a very freeing moment for me.  I’d never want to deny my child food, but he’s getting to the age where he can understand waiting - and at 18 months I know my child won’t starve if he refuses one nursing session because he doesn’t like the conditions.

He’s also at the age where I can starting teaching him that we ask for “num nums” instead of attacking mommy’s clothes. I’m not saying that I’d ever deny him food if he doesn’t ask instead of grabbing but I do try and stop him from grabbing and instead use the words I’d like him to use in the future.  Is this really any different from teaching him other life lessons - like the stove is hot or using caution when climbing up the slide?

This is all still very new to me - I hate to think of my son upset because he wants to nurse in a certain way and I’m not letting him, but I know that it’s important to our long-term breastfeeding relationship that I start setting new boundaries now.  Also, I’m not saying everyone - or even anyone else - needs to set these same boundaries with their little nursling.  What I am saying is that the breastfeeding relationship is a two way street and that both of you need to feel comfortable.  If you’re nursing an older child it is certainly okay to set small boundaries - ultimately I think they will enhance your relationship as time goes on.   

This is our "New Normal" chart - what would you add to yours?

And don’t forget to take advantage of the amazing support available to breastfeeding mothers - find a local La Leche League meeting or other local group, seek out online support forums or even connect with us on the Adventures in Breastfeeding Facebook page.  Extended breastfeeding is less common than most of us would like - it’s sometimes harder to get support or even get your questions answered but help is out there and often crucial a continued breastfeeding relationship. 

The good old days when nursing looked "easy" and we could still pose for a professional photo session!

Have you set boundaries regarding breastfeeding with your older toddler?  If so, what were those boundaries and how have they worked out for you?  Share your stories in the comments below!

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."

If I would have written myself a letter...

...with what I know now, what I'm doing now, and read it before all of this started, I would have laughed. Hard. I breastfeed my toddler and even though I thought he was ready to wean, (a few times), he is nowhere near done. The kink in this whole thing is, when I try to hand express, there's hardly anything there!

Is it ok to comfort nurse my toddler?

I really struggle with this for some reason. Some days, I feel like a super-mom for continuing to nurse him but other times I feel like just the opposite and that I'm using nursing him as a crutch to delay learning other coping mechanisms. Toddler trips and bangs his head: whip out the boob. Toddler isn't feeling great: snuggle and snack all day in bed. Then the thoughts come full circle and I realize that I am a good mom. The same people who side-eye me when I even talk about breastfeeding my son beyond a year, compliment me on how happy he is, how well-behaved he is, how healthy he looks. Would all of this be if he wasn't still nursing? 

Let's dissect this for a moment, shall we?

Toddler bangs his head and wants to nurse. Toddler nurses. Toddler feels better. ===> Weirdo Mom With No Coping Skills or Awesome Partnership?

Toddler is sick and wants to nurse all.day.long. Toddler nurses. Toddler feels better. ===> Weirdo Mom With No Coping Skills or  Super Efficient Way to Get Toddler Antibodies and Fluids at the SAME TIME?

So I guess I answered my own questions. In my mind, there's no difference in my son using me or a blanket/toy/[insert other lovie here] when he's down, ill, hurting (physically or emotionally). Actually, there is a difference. The lovie isn't going to provide DHA, immunity, a strong bond. Like any lovie, he will grow out of me eventually but for now I will enjoy it. I just have a hard time believing that one of these is more ok than the other: 

15.5 months vs 6 months

Til Next Time, Mamas

Keep Calm and Nurse On

The Breastfeeding Experience I Don't Talk About

I have come to realize I talk a lot about most of my breastfeeding experiences. But there is one thing my family doesn't know, one thing my closest friends don't know. In fact that only people who know are my husband and the few women I know won't judge me.
I nurse my 3 year old.


I'm not ashamed or embarrassed about this fact. The reason I don't talk about it might be more surprising.
I weaned him at 20 months.
Why on earth would I start nursing a preschooler who was already weaned? We weaned when I developed a huge aversion to breastfeeding when I was pregnant. As much as I wasn't ready for our nursing relationship to end, it felt like nails on a chalkboard. I was open to the idea of resuming and tandem nursing. L had always found love and comfort at my breast so I was prepared that he would ask to nurse again once he saw his sister doing it. Sure enough one day after his sister was born my son looked at me with his big blue eyes and put his mouth to my breast. I told him it was ok, his body relaxed but he didn't suck. He had forgotten how to nurse.

Helping his sister nurse

Then one day when he asked to nurse I said yes. This time he imitated his sister in sucking. It was for maybe 10 seconds and when he was done he pulled my shirt up and said " thanks for sharing with me mommy" It has happened a few times since then, and each time has been loving and tender. It has been a great tool for those days when he is having tantrums and is harder to handle.
Some people may not understand this decision and that's ok. When I see my boys body relax because he is getting the comfort he needs. When he is asking for my attention in a positive way. I know I'm doing what's best for him. I don't know how long it will last. But for now I'm enjoying more snuggles with a boy who is growing faster than I would like. And every time I hear " thanks for sharing with me mommy" and I watch him run to play, I smile.