Wednesday, May 14, 2008

Boobs are my bag

Ooh I have just read this post from Lisa. I am so envious. How inspiring.

Somehow I have forgotten to attend any conferences or workshops this last year. I am aghast, as I love going to those things. I wonder if its because of the rostering hassles of being a rotational midwife. I move around a lot, each 8 weeks or so, and am constantly unsure of whether I will be on nights, or whatever. I am also a bit vague and unorganised about making roster requests in advance, especially when I don't know the area I will be working in, or its a new area for me.

Its a big hospital, I am often a long way from where I must go to make the request (if I remember to do it). I am often tired. I don't have access to the computerised in-house rostering program either - what a nuisance. Some areas make rosters 6-8 weeks in advance, some only 2 weeks in advance. Its one of those health system workforce things that I haven't quite adjusted to yet. I am such a slow learner about some things. Sigh.

Anyway I have resolved that i will make roster requests to give myself ONE day at home per week with no 'kids', which means Thursday currently. Unfortunately, given that visiting midwives tend to need continuity of clients, that means that out of the last 8-9 weekends I have worked 6 of them - both days! Groan. I start again on Friday and work 6 days straight, then get a week off, including my first weekend in a month! There has got to be a better way! I have made requests for my first few weeks in LBS for mid-June. Lets see what I get!

Its fairly self-inflicted, and think of all the money I get working on weekends. Anyhoo.... I think I have finished whining about that. You're probably very relieved. (This is my daughter in 1993).
I have had an interesting couple of weeks on the road, and met some interesting families. I have seen some incredibly large and engorged breasts!!! They could easily be feeding twins, but they each had only one small baby to deal with all that milk! Then later in the day I would see other scrawny babies whose mothers were a bit half-hearted about feeding them diligently, who were not gaining weight. I could have put them in my pocket and taken them to the next house and put baby to the breast of that over-supplied woman! If only I could do that! Or feed them myself!

I have noticed that I am experiencing let-down again while on VMS. I used to get it on the postnatal ward, especially when I first started in midwifery. Its never really left me, even after more than 18 years since I last breastfed a baby. (ooh there it is again, just thinking about it). I don't mind. I don't leak or anything, but I still experience it. I feel it means that I am just very connected to this field, and that it means that my body is passionate about breastfeeding too! See what I mean - body and soul!! I am coming to realise that I know a lot about this area.
The photos throughout this post are mostly of a much younger me, from 1989, when I was breastfeeding my daughter. Above is our first mother-daughter photo - she is about 8 minutes old and I am having a quick cuddle before she went to intensive care. (Yes, I am on the floor. Yes I am naked. Be grateful I cropped out the cord hanging out! TMI?) She was born with a cleft palate as part of a syndrome, so was unable to feed directly. In fact she never went directly to the breast. Below is the breast pump I used in hospital - this photo was taken when Steff was a few weeks old, and we were still living in hospital together.
I am moved to see this photo of Patty, age 3, with his sister aged 3 weeks. Still being nursed on her stomach as all babies with her syndrom are (Pierre-Robin Syndrome). It was pretty hard for him to lose his Mum to this strange little sister. Maybe not much has changed in 19 years.This one, with me being sooky, is of my last express, when she was 29 weeks of age. I always cry at big occasions. I was sad but triumphant, and baked a boob cake to celebrate my achievements. (My hair is pretty bad here, I had just got up, and it was shorter as it had all fallen out postpartum. Did that happen to you too? I always lost my hair after giving birth.)

I did try to express directly into her mouth one time, but as she had a gag reflex from hell and thought every attempt to put anything into her mouth was a threat/an attempt to kill her, she retched and vomited straight away after the first few drops, losing far more nutrition than those drops had given her. Sigh. It was too confronting and directly wasteful/punishing to see this milk wasted in this fashion, and she threw up so much on a daily basis that her growth was severely compromised anyway, so I didn't try it again.

This photo is from one of those rare times when Stephanie actually fed orally in a coordinated fashion, where she cried with hunger and accepted her mouth being filled (delivered from from a soft-sided squeezy bottle because she couldn't generate the suction to get it from a bottle like regular babies), then swallowed - without gagging. It was a miracle to us to see her do it, hence the photo.

She only did it 7 times in her first year of life. It still brings tears to my eyes to think of those sessions.

So to see half a dozen little babies daily, attach at the breast and suck for all their lives are worth, and do it every two hours! Wow, what a miracle. What a privilege to feed your baby that way. I know ... I did it for nearly 18 months with Patty. He fed heartily, lustily, frequently until that time, and was still feeding to sleep most times, and waking to feed in the night when I decided I'd wean so I wouldn't be getting up in the night to him just to feed. It seemed like a good idea at the time. If I'd known that it would be the last time I would have a babe at my breast I would have gone on.....

I have breastfed two children. In very differing fashions. My only reason to have another child would have been to have another beautiful period of feeding. I did love it so. I think I did it well. This photo is from 1996, Patty 10, Steff, 7.

So this is another aspect of my life that I can bring to my practise.Its not about me, and I rarely mention it to any mothers I care for, but when they are pumping to establish or boost supply I can genuinely identify with their task.

I remind them that growth spurts happen, and to let them happen, and to surrender to it. These are the periods where the baby wants to feed constantly, a mother will say 'I have no milk' or 'my milk dried up'. We hear it a lot. But with the right information and support from her family, and only if she wants to (because some women don't really mind whether they feed or not, and I'm not gonna force them) our imparted knowledge will mean that she knows how to maintain and boost her supply, and the lactation bond will continue.

I like boobs. And babies. And bumps. Lucky I'm a midwife, hey?


alice said...

Oh, Laura Jane, what a wonderful post! Thank you for writing it. Here's to celebrating boobs! :)

widget said...

A beautiful post. I don't have children of my own but I watched two friends last year deal with feeding in their own intruiging fashion. One was so stressed as there was no nutritional value in what she was supplying her beautiful son, and the other was SOOOOOOO BIG that her tiny little girl was almost drowning in the goodness. It was amazing at how different each woman is.

Laura Jane said...

When your friend says no nutritional value in the milk being supplied, that is technically incorrect Widget.

ALL breastmilk has a similar caloric value when averaged out. However the hindmilk (from later in the feed), has a much richer fat content compared to the first 10 minutes worth of milk. 10-12% Vs 4%.

For a baby to grow it must have the stamina to extract the latter hindmilk from Mum's breasts.

There are also babies who are struggling so much that they need added calories to all feeds (breast or formula) in order to grow. My daughter was one of those! I not only had to express full time for her, but she needed an extra 40% calories added to the milk in order to gain weight, and still she struggled. Yet the same milk had grown her enormous big brother by over a pound per week!

In addition breastmilk contains all sorts of goodies that ONLY a mother can supply her child i.e. immunoglobulins, normal family skin flora; and the oxytocin (the love hormone) released by both mother and child during breastfeeding increases bonding and brain development.

A working breast is a beautiful, mysterious and wondrous thing!

Jennifer said...

Breastfeeding was absolutely a highlight of having had a baby -- just a wonderful, warm, close experience. it is magnificent that you have two tales to tell, to share with women who are going that route.

Lesley said...

Love those early pics, Laura. And what a cutie little Patrick was (still is, all two and a half metres of him)!

Kelley said...

Beautiful post. I fed Moo until she self weaned, wasn't as fortunate with Too and Boo managed 8 weeks each on the pump and couldn't do it any longer. I beat myself up for a long time about 'giving up' but I guess you do what you can at the time.

Janece said...

Lovely post Laura Jane. I happened over here via the wonderful Natalie at Chickenblog. :)

Alby Mangroves said...

Wow, reading this post has made my eyes water! I'm breatfeeding at the moment, and will continue as long as she'll let me. I love it, and I really feel for your distress with your daughter. It wasn't easy for me, and I really had to work at it to get it right, but BY GOD I was determined and somehow, we made it, albeit initially with a nippleshield and a lot of hand expressing as well.. Fantastic post. xo I feel sorry for the mums that give up too easily or just can't do it - I feel they're really missing out.

Julie said...

You bring tears to my eyes. You have done an amazing job feeding your daughter. Brings back all my breastfeeding horrors, tongue tie, mastitis, nipple shields, pumps, cracks and vasospasm. Yay! Anyway, got through it all fed No. 1 for 22 months and still feeding 11 month old. Will be very sad to stop.

Do you see much vasospasm, I think its more common than people realise. I kept getting told in hospital the pain I was having was from incorrect attachment so they kept pulling her off and putting her on again (cracked nipples as a result) it ended up being vasospasm which I had for about 4 months. I think I had it the first time too looking back.