Breastfeeding And The Medical Profession, Part Two

By Tiffany Holley

Let me start by briefly reiterating what I explained in my previous post of medical escapades:

I appreciate my doctors. I appreciate the medical system that got me through a variety of health issues. They know a lot about what they were trained in…

…But they do not necessarily know anything about breastfeeding.

It makes me so sad to think of all the babies that lose out on this amazing food (and relationship!) because their mother took the inappropriate advice of an ignorant (on this subject) medical practitioner.

Let me tell you some more of what I went through to learn this lesson…

Sadly, the Emergency Room visit and hospital stay I talked about last time was not the end of my troubles.

Over the next few months I underwent two outpatient procedures to treat my (newly discovered) kidney stones. The machine uses sonic waves to break up the stones from outside the body, so there is no “surgery” involved.

The first time, the doctors fought me tooth and nail about my choice for anesthesia, or lack thereof. Since I am unable to pump (physiologically), their advice to pump and discard my milk for 24 hours after the procedure was simply not an option.

I talked to my La Leche League leader, and consulted my copy of Dr. Hale’s book, but all they could do was confirm that the medications in question were not recommended. Nobody was able to offer an alternative.

So I opted to have a spinal block, but no intravenous sedation.

Although I was warned that it would be painful, their primary concern seemed to be that the thumping noise of the machine was rather loud, and the experience might be traumatic. This seemed really strange, since obviously the medical personnel involved are all in the room with this noise – presumably several times a day!

Over the week between talking to the anesthesiologist and having the procedure, several people from the hospital called me, trying again to talk me into breastfeeding-incompatible sedation. It was exhausting!

In all those conversations, no alternatives were offered – and believe me, I asked everyone!

My choice was either to suffer and be traumatized, or give my baby formula for 24 hours, with the possible consequences to our nursing relationship. I would also risk engorgement and other consequences due to my inability to pump out the accumulated milk. And how would the medicine even get out in 24 hours, since I couldn’t pump enough to “flush it through”? Nobody had an answer.

As a concession to their concern about traumatic noise, I brought earplugs… And the staff in the treatment room all laughed that such a big issue had been made about it.

There were some challenges with the spinal that had me bleeding and in tears before the procedure even started, and it seemed clear would lead to a post-op “spinal headache” as well.

The noise was just annoying. I lay on the table and cried during the entire procedure, however, as the spinal immobilized my legs but “did not come up high enough” to numb the pain in my kidney area.

I managed to hold my torso still, but the doctor and technician still felt they could not work as aggressively as they would have if I was unconscious. There was already a plan for a second procedure, but this cast the unpleasant possibility of a third session being needed.

Later I learned that my husband had spent the whole time walking the halls with an inconsolable screaming baby. (The wild advice he got from passers-by, nurses and patients alike, is probably worthy of a post in itself!)

Having had only the spinal, I was able to nurse Mr. Big Baby in recovery, but it was quite a while before we were able to leave.

Needless to say, we were dreading a repeat. Medically, things made it necessary to go ahead, and we hoped that the two months in between would put the baby in a better place to cope with it.

We were much better cared for the second time, however. The anesthesiologist who happened to be there that day was actually the chief of pediatric anesthesiology for the hospital, and he was shocked when I told him what I wanted to do (and had done the previous time).

He explained that there were plenty of breastfeeding-compatible ways to sedate me! For starters, he would use the medications that they would give my child if he were the one going under anesthesia – that way if things did pass through to the milk, it would still be safe.

I was medicated, and the next thing I knew I was sitting in the recovery room with my husband and children coming around the corner.

It had gone much faster, and the baby was less upset. It had also been much more effective, as the doctor felt free to “pummel me” harder. I even got to go home sooner.

This procedure was the best of everything, for everyone. And, according to the anesthesiologist, the procedures he used were common knowledge.

So why did nobody offer those options to me the first time around? Even if they didn’t know what to do, why didn’t they ask someone when I pressed the issue?

I thought I had been diligent… I asked the doctors, nurses, and anesthesiologists for breastfeeding friendly options. I refused to take no for an answer. I stood up for my baby and our breastfeeding relationship.

But I still missed it.

I hope other moms can learn the “take away” lesson that I stumbled upon by chance. If I had it to do over again I would call an obstetric anesthesiologist and a pediatric anesthesiologist right off the bat!

If your health care provider says there is no safe option, it doesn’t mean there isn’t one – it only means they don’t know.

Have you had similar experiences with the healthcare profession not knowing about safe, breastfeeding-friendly alternatives? Please leave a comment on this post to share your experiences!

Tiffany Holley has nursed three children (currently 18 mos. – 15 years old) for a total of 8 years – and counting. She and her family live, breastfeed, urban homestead, cloth diaper, homeschool, and write in Southern Florida (but hope to remedy their location situation soon). You can read about their adventures on their blog, As For My House.

Breastfeeding And The Medical Profession – One Mom’s Story

By Tiffany Holley

I appreciate my doctors. I appreciate the medical system that got me through a variety of health issues. They know a lot about what they were trained in…

…But they do not necessarily know anything about breastfeeding.

It makes me so sad to think of all the babies that lose out on this amazing food (and relationship!) because their mother took the inappropriate advice of an ignorant (on this subject) medical practitioner.

Let me tell you what I went through to learn this lesson…

Towards the end of my pregnancy with Mr. Big Baby, I was under close observation for borderline pre-eclampsia. Somehow, still, we missed the fact that I was harboring a bladder infection – did you know they are often asymptomatic during pregnancy?

Untreated, this developed into a kidney infection (pyelonephritis).

When the baby was about five weeks old, I ended up in bed with raging chills and fever from the worsening infection. The next morning I woke up with a bright red, inflamed and streaked breast. I now also had mastitis.

The ER doctor told me I would have to stop nursing so that I could get myself well. Overwhelmed, tearful, I acknowledged that I had been afraid of that, and agreed.

Since I am physiologically unable to pump any meaningful amount of milk, his advice was not helpful: pump and discard my milk, and feed the baby from my frozen stash (of course I had none) or formula. I had already found someone in my LLL group who was willing to wet-nurse Mr. Big Baby if it came to that…

But still, I would be putting myself in danger of worsening the mastitis issues by becoming engorged, and jeopardizing our entire nursing relationship by potentially losing my milk supply.

After sitting there for hours, I had plenty of time to think through the issues more logically. Eventually I began asking to see my children, who were anxiously waiting outside.

Children are not allowed in the ER, period, they said. They have a separate pediatric ER area to treat children, so they keep them out of harm’s (germs’) way in the adult area. And I was not permitted to leave the treatment area because I had an IV placed.

Undeterred, I suggested that they could take me to the pediatric area, and allow me to have a treatment room there, with my family present (as we had all been together when my daughter had an ER visit).

Again I was rebuffed. I was told that my baby would be able to “visit” me once I was admitted and moved up to a regular floor. That would mean, then, the next day during visiting hours – probably some 24 hours of separation.

The more they came up with these reasons, which sounded more and more hollow, the more adamant I became.

Finally, I told the shift nursing supervisor (who had been called in to deal with my “unreasonableness”, I’m sure) that I wanted to sign myself out AMA, so that I could go nurse my baby.

She was shocked – or pretended to be – and asked how I could possibly want to leave without treatment when I was so ill.

I told her that the hospital was making me worse instead of better, and that I would go seek *better* treatment somewhere else.

Whether she gave in because she saw the light, or because she saw a potential lawsuit, I’ll never know… But give in she did.

They wheeled me and my IV pole out to a (relatively) quiet corner of the ER, and my son eagerly nursed – and nursed, and nursed, and nursed. It had been hours by then, which is an eternity if you are 5 weeks old.

One of her grumbled “threats” as she allowed this was that she was going to go get the lactation consultant from the OB department and “have her talk to me.”
My husband and I sat there wondering if it was really possible that they had a lactation consultant who had so totally sold out to the hospital machine that she would support them on this.

Nope.

The lactation consultant was a sensitive, wise, outgoing woman who was as shocked and baffled by the situation as I was. She became something of a liaison for us for the remainder of this ordeal.

Because there was more. Lots more.

Let me try to condense the next few days for you:

The ER staff eventually moved all of us into a big room in the back of the department to await transfer upstairs. Then the next shift came on and tried to kick my family out again.

We got transferred upstairs. The deal was that the baby could be with me as long as there was another adult(ish) present. I accepted this as a reasonable compromise – after all, I actually was too ill to care for him alone very much!

Then there was a shift change, and they tried to kick my family out.

Then a new doctor saw me, and told me that I needed to stop nursing on the affected breast. (Contradicting all medical literature and wisdom on the subject of mastitis).

Then a new shift came on, and they tried to kick my family out…

Since it was across a weekend, we had the same nursing staff only twice in five days (15 shifts). And, I kid you not, at every single shift change we had to argue the situation all over again.

Some went easier than others. Several times I called on our new best friend the lactation consultant.

I had a protracted argument with the infectious diseases doctor who was considered my primary caregiver. He knew nothing about mastitis, and treated it as he would have treated strep on my breast.

He was horrible, and rude, and I was ready to check out AMA again if I could not be assured that I could receive care from someone else.

On two other occasions I had to threaten to check out AMA to keep them from separating me from the baby. I spoke to several different nursing supervisors.

All of us were stressed out and exhausted by the time I was discharged. It was not good medicine.

Thus ends Round One of my adventures in the medical system.

Why do doctors and nurses know so little about breastfeeding?

It’s frightening that so many people are willing to take their word as law, trusting that these medical professionals know what is best for them.

I beg you, as the only advocate your child has, not to mention for yourself, investigate anything that you are told with regards to your nursing relationship.

As in this case – A simple internet search quickly yields dozens of creditable sources explaining that one important step in dealing with mastitis is to nurse frequently, especially on the affected side.

And if you have the opportunity, do a future mother and baby a favor: print it out and show it to your practitioner!

Tiffany Holley has nursed three children (currently 18 mos. – 15 years old) for a total of 8 years – and counting. She and her family live, breastfeed, urban homestead, cloth diaper, homeschool, and write in Southern Florida (but hope to remedy their location situation soon). You can read about their adventures on their blog, As For My House.

Ask Judy: Is It Too Early To Start My Baby On Solids?

Dear Judy, My baby is four months old and my pediatrician is recommending that I start my baby on solids. I just don’t think he is ready? He isn’t even sitting up yet. What would you suggest? My gut tells me that I shouldn’t be doing it yet. Do you think I am doing any harm by waiting?

As a mother, you should always trust your instinct. No one knows your baby as well as you do! If your gut says wait, then it is best to wait.

In this case, it is also good to look at what pediatricians and lactation consultants recommend. The American Academy of Pediatrics now recommends waiting until a baby is at least 6 months of age before starting any type of solids. They used to recommend starting solids between 4 and 6 months, but last year changed their recommendation to be 6 months. So it sounds like your pediatrician is operating under the old guidelines. The reason that they changed their recommendation is that your baby’s digestive system isn’t ready to digest the complex proteins found in foods when your baby is so young. So your gut is correct – your baby is too young at only 4 months of age to start solids.

In addition, a breastfed baby doesn’t actually “need” anything other than your breastmilk for the first 12 months of his/her life. The only reason to start solids during the first year of life is for the experience of different tastes and textures – not for the nutritional value.

Nutritionally, your breastmilk provides 100% of what your baby needs.

There is no rush to start solids. As a mother, you will know when your baby is ready. Until then, relax and enjoy this time with your little one. It goes so quickly. Before you know it they will be talking and walking! Know that you are doing what is right and feel confident about your decisions.

When did you start your baby on solids? Please leave a comment and share your story with our readers.

What Is A Nursing Strike?

Many babies go through a nursing strike at one time or another. Often, moms will mistake this for “weaning.” It is rare that infants self-wear prior to 12 months old and weaning never takes place suddenly. It is always a gradual process.

A nursing strike on the other hand – typically comes on without notice. All of a sudden you little bundle of joy stops wanting to nurse or starts refusing to nurse when offered. A nursing strike can last for a few days all the way up to a few weeks.

So what’s a mom to do? Your baby has to eat right? Well, the best thing to do is to keep offering your breast at every opportunity and try to do so in situations where the lights are dimmed and it is quiet and free from distractions. Nursing strikes often happen when your baby is just starting to explore his/her environment or prior to particular milestones like walking, crawling, cutting teeth, etc. There are so many other things to see and do! Going into a dark room, and laying down to nurse will often be enough to coax your baby back to the breast.

If the strike lasts for a long time, you’ll also want to pump to keep up your milk supply. Even though you may be able to get your baby to nurse in a dim, quiet room – it may still take a week or two before he/she is ready to nurse in the hustle and bustle of daily life. So hang in there, keep doing what works and remember

“This too shall pass!”

My son went on a nursing strike when he was 13 months old. I was going on a business trip and he and I were traveling alone together for the first time. My parents were meeting us in at our destination to watch him while I attended to “business.” Well – since we were traveling alone and I had my baby with me, I decided to check my breastpump in my luggage – something I had never done before!

Well, our flights were delayed, we missed a connection AND my luggage got lost. And my son chose this day as the day that he would refuse to nurse! He used sign language at the time to communicate and he would often sign that he wanted to nurse. He did this several times through out the day. When I lifted my shirt to allow him to nurse he would start to put his mouth on my breast, and then would pull away – with a look of “disgust” or “disdain” on his face. He would then sign to nurse and pull away again.

I tried hand-expressing my milk in the airport bathroom because after several hours of this, I was getting pretty full – but I have never been able to successfully hand-express – and this day was no different. I’m sure my stress over our missed flights and my baby refusing to nurse didn’t help! When we arrived and found out that my luggage did not, I was even more distraught – because that meant my breast pump didn’t make it either.

Finally, before bed that evening, I was able to coax my son to nurse by lying down in a dark room with him. For about a week, this was the only way I could get him to nurse – by lying down in the dark. Luckily my pump and luggage showed up the next day and my son went back to his old habits and nursed like a champ for a long time!

For more great information on Nursing Strikes, please visit the links on Kelly Mom

Ask Judy: How Can I Even Out My Milk Production?

Dear Judy, I’m feeling a little bit lop-sided lately and I was wondering if there was a good way to “even everything out?” My son typically only nurses from one side at a time.

It is not uncommong for babies to prefer one breast over the other. Most lactation consultants will tell you to start nursing your baby one the opposite breast each time that you nurse. This is because a baby sucks “harder” when they first latch on and will feed more vigorously on the side that they start on. Then if you switch sides, the 2nd side won’t get as much stimulation as the first. If you switch sides each time, then your breasts will get equal stimulation to produce milk and should have similar production and “fullness.”

Since your son only nurses from one side at a time, you should always switch sides with each feeding. If you are doing this and you are still feeling un-even, then try feeding from your “less full” or “smaller” side for 2-3 consecutive nursing sessions. After this, switch to the other side for one feed and then nurse from the smaller side for 2-3 consecutive sessions again. During this time, your “larger” or “fuller” side may get engorged. You can pump or hand-express this side to relieve the pressure, but do not completely empty the breast as this will send your body the signal to make more. After a day or two of “favoring” the smaller breast, you should notice a difference in your production on that side and you should be able to return to your normal routine of switching sides after each nursing session.

Did you ever have uneven milk production? What did you do to “even it out?” Please leave a comment on this post to share your experiences and give advice to this mom!

Ask Judy: How Much Food Should I Be Giving My Baby?

Dear Judy,
I need some advice on how much solid food to give my 7 month old breastfeeding son. I started solids exactly four weeks ago. He gets oatmeal in the morning and a jar of food in the evening. How much baby food does a 7month old breastfed baby need to consume in a 24-hour period? I feed my baby oatmeal in the morning & solids in the afternoon and we breastfeed about 5-6 times a day. Also, when do I graduate him to stage 2 foods? When is it OK to give him mixed jars? His Doctor said that I should give him three meals a day with solids. At his 6 month appointment, my son was 20.2 lbs with only breast milk.

Thanks for your note. For the first year of a baby’s life, all he/she needs is breast milk in order to get the proper nutrition. The only reason to give your baby anything other than breast milk is so that they can experience different tastes and textures. Having said that, most people start their babies on some kind of solid food when they are about 6 months old. The American Academy of Pediatrics recommends giving your baby exclusively breast milk until age 6 months and then gradually starting solids at that point.

Keep in mind that your breast milk should still make up the majority of your baby’s diet and will fulfill all of his nutritional needs for the first year of his life. Traditionally, in this country, we tend to start our babies on cereals as a first food. This however, is not necessary and is not practiced in other countries. It doesn’t actually matter what your baby’s first food is (meat, cereal, vegetables or fruit). The only thing that matter is the consistency of the food. When your baby is only 6 or 7 months old, you will want to make sure the consistency of the food is smooth or pureed.

Most pediatricians will recommend that you start one new food at a time so that you can look for any possible allergies or reactions that your baby has to a particular type of food. One you have give your baby foods independently, then it is fine to start mixing them together. Stage 2 foods are typically more than one food mixed together in the same jar. The consistency of them is still pretty smooth, so as long as your baby has already tried them separately, then there is no problem giving them together. Stage 3 foods are typically more “chunky” and are meant for older babies who know how to chew or are used to eating food.

There are a few foods that most pediatricians will recommend avoiding during your baby’s first (and sometimes 2nd) year of life. They include peanuts, milk, honey and a few others. Also, if there is anything that you or your spouse are allergic to, it is probably best to avoid giving that food to your baby until they are a little older.

As a mom, you are the best judge of when your baby is ready for the next type of food. Look for their cues and follow their lead. If your baby isn’t ready for lots of food right now, don’t push it. And if they are, then let them explore. But keep in mind, that you should always nurse your baby prior to giving food and don’t worry if your baby isn’t eating a lot of solid foods – he is getting all he needs from your breast milk!

When did you start your baby on solid foods? What was his/her first food? Please leave a comment on this post to share your story!

Breastfeeding Info on Blog Talk Radio

Be sure to stop by Blog Talk Radio today to listen to my interview with Karen Angstadt from Intentional Birth. Karen has a weekly show that airs on Monday’s, but has graciously offered to move her show for this week to Tuesday (today) so that I can be a part of it. We will be talking about all things breastfeeding – so please stop by and listen in. You can listen in live at 10 AM or you can listen in anytime by viewing the archive.

Hope to hear you on our call today!

Karen Angstadt is a Birth Mentor, Wise Woman and Mother. She runs a site called Intentional Birth and has a regular show on Blog Talk Radio on Mondays at 1 PM EST. She is a great resource for all pregnant or new mothers!
Empowered pregnancy. Conscious parenting.

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