I’ve often heard moms say that they don’t have time to breastfeed because they have older children to take care of. They don’t have time to “sit around nursing all day”. So what if you do stop breastfeeding so that you can have more time to spend with your older children? What does that teach the older children? That baby’s needs don’t matter? That if something is inconvenient then you just switch to something easier, even if the inconvenient thing was better? The truth is kids are really inconvenient (not to mention loud, messy, and demanding). Why is breastfeeding so often at the top of the list of things to be tossed? I love how this mom points out, “Some portion of ‘The Family Schedule’ belongs to you (the nursing baby).”
I was there once. I was surprised when I heard myself think it. I considered not breastfeeding because it would take too much of my time and energy to do it. How could I, of all people, consider that as an option? My situation was a little different than most because my baby was a bit of a surprise and came to us through adoption, so I had no milk. I was needing to induce lactation.
Baby came home to us in July 2009 at 18 days old. My older kids, two boys, "Scootch", 7, and "Curly", 9, were on summer break from school. However, we had decided that when school began again in August they would not be going back. From now on we would be homeschooling. Several people asked me when we got the baby, “You’re not still going to try to homeschool are you?” The truth is the thought never crossed my mind not to. We had taken a long time to make this decision to homeschool. We had decided that this was what was best for our two boys. Now that we had a new baby girl the needs of my boys did not suddenly change. It was still best for them to stay home. The reverse was true as well. This baby needed to be breastfed, regardless of the schedules and needs of other family members.
Baby sister meets big brother
When my boys were babies I took all of the time I needed to make breastfeeding work. Why should it be any different for this baby?
I had about 6 weeks of summer left and I started the process of relactating. It was so frustrating to have this baby and no milk! It took a lot of time. A few weeks into the school year and I was beginning to doubt that I could do it all. To make things even harder she was premature weighing 3 lbs 2.8 ounces at birth, and only 4 lbs 0 ounces when she came home. She had a weak suck and she could not draw milk through an at breast supplementer meaning I needed to spend even more time pumping and bottle feeding while practicing at the breast.
I confided in my good friend, “I don’t know if I can do it. I don’t have the time. How can I do a good job homeschooling the boys when I’m spending so much time with her trying to bring in a milk supply? All the time at the breast, pumping, mixing formula and preparing the bags for the Lact-Aid. Maybe I should just give up on the whole breastfeeding thing.”
My friend could see the bigger picture when I could not. “It is important to the boys too. Their sister is important to them. Let some of the school work and other things go.” That was over 3 years ago and I still remember her words. She is important to them.
Scootch and Baby sister
She was right. This tiny baby girl meant everything to the boys. They loved their little sister. This was just as good for them as it was for her. I couldn’t see it then, but three years later I can see it.
Curly and Baby sister
What did they learn by watching me work so hard to breastfeed her? First, they learned an awful lot about inducing lactation! They would watch me pump. When I first started to get drops of milk Scootch (7) walked up and saw the little bit of milk in the bottle. He started jumping up and down and called for his brother to come see, “She’s getting milk, she’s getting milk!” I had no idea they’d be so excited.
They watched me spend countless hours nursing their little sister. They watched as the bottles were replaced by the Lact-Aid, and then the formula supplements gradually went away altogether.
They learned that their little sister was important. That babies are important and that they deserve to have their needs met. They learned that nursing was important, even if you don’t make enough milk. They learned that everyone in the family is important, and that we do what we need to do to take care of each other. They’ve learned that family is more than just DNA.
We did school work while I wore baby sister in the Moby wrap. When she got bigger, they wanted to wear her in the back pack. They were learning how to love and care for a baby.
They wanted her to have the best, just like I did.
The fact that she was important to them was reason enough to spend the time and work hard for breastfeeding to work, even if it meant I had less time to spend doing certain things with them.
Letting her play with their Legos is proof of how much they love her!
One homeschool project was building a sled for little sister.
Now that she is three, she knows how to pester her big brothers, and she does! She can be the annoying little sister, but these boys love this little girl. They would do anything for her. Taking the time to bring in a milk supply and breastfeed her did not take away from them, instead it gave them, and all of us so much!
Before working to increase milk supply, make sure there is a true supply issue first! Take a look at these articles to first see if you have low milk production:
The golden rule of milk production: The more frequently and completely the breasts are drained, the more milk will be produced: How Mother’s Milk is Made
nurse frequently (at least 12-14 times in 24 hours)
increase skin to skin contact
rest, and stay hydrated
What this process looks like:
Offer baby the first breast and allow him to nurse as long as he likes. When he starts to slow down on his sucking/swallowing start doing some breast compressions. When you squeeze your breast you should see baby respond with an increased sucking/swallowing. Baby has “finished” the first breast when breast compressions no longer get baby nursing more, baby falls asleep or lets go of the breast. When baby has finished the first breast offer the second breast. Repeat the above steps with breast two, (offer breast, use breast compressions and allow baby to finish the breast) then repeat the whole process again with both breasts. If baby is still hungry after taking both breasts two times, then you can continue the process, nursing on one side and then the other, until he is full and/or falls asleep.
Mom resting with baby after nursing with a starter SNS
When working to increase milk production, increase milk intake, or work to eliminate supplements, spending as much time as possible resting with baby skin-to-skin on your bare chest, encouraging frequent nursing, can make a big difference in a short amount of time. This can also be a chance for mom to rest, with baby napping on her bare chest. It can be a great time to have a movie marathon. If you have older children they can be movies to entertain them while you and baby rest and nurse.
Supplement in a way that supports breastfeeding:
Consider using an at breast supplementer instead of bottles for the supplemental milk. This will provide extra stimulation to your breasts and prevent a preference for bottles.
Lact-Aid at breast supplementer
If you are using bottles make sure you are giving them in a way that supports breastfeeding and minimizes flow preference. Bottle feeding in a way that supports breastfeeding includes:
Using a slow-flow soft bottle nipple that has a wide base and a shorter, round nipple (not the flatter, orthodontic kind).
Starting by resting the tip of the nipple on the baby's upper lip and allowing him to take it into his mouth himself, as if he were nursing.
Keeping the bottle only slightly tilted, with the baby in a more upright position, so he has to work to get the milk out. If you hold the bottle straight down, the milk will come out too fast, and he may feel overwhelmed by the flow (Kassing, 2002).
More information on bottle feeding in a way that supports breastfeeding:
If you are currently supplementing with a bottle at every feeding, baby may expect that the time at the breast is always followed by a bottle. If you are using an at breast supplementer at every feeding, baby may expect the constant flow of milk from the tubing whenever he is at the breast. The first step towards eliminating supplements is to get baby comfortable with nursing without supplements at every feeding. Begin by encouraging comfort nursing between feedings, for at least a few days, before you begin to eliminate supplements. If baby is using a pacifier between feedings begin to replace the pacifier with your breast as much as possible.
The Finish at the Breast Method can be a great way to supplement with the bottle and encourage more breastfeeding. You may have heard to breastfeed first, then finish with the bottle if baby didn't get enough. Sometimes it works better to turn things around as described here. The "Finish at the Breast" Method of Bottle Supplementation
One way to do this is to start by eliminating the first supplemental feeding of the day. First determine what time in the morning you give the first supplement. Try eliminating that first supplement of the day. You may be able to eliminate it completely, or you may need to start by delaying it by about an hour or two. Follow the steps above to nurse multiple times on each breast and use breast compressions. If baby is still having enough wet diapers (5 per day, plus at least 3 poops if baby is under 4-6 weeks old) then after a few days you can eliminate the next supplement of the day. Eventually you will get to where you are only giving one supplement in the evening and that will be the last one to drop.
Common Questions and Concerns:
I’m afraid to cut back on supplements, I ‘m worried my baby will starve!
Taking away one supplemental feeding will not cause your baby to starve or get dehydrated. You need for baby to be hungry enough to want to nurse more as that will increase your milk production. You can always go back to more supplemental milk if you realize you cut back too much too soon.
I tried eliminating the first time I usually supplement, but baby was screaming and refusing to nurse any more before it was time for the next supplement.
Go ahead and give the next supplement. You can simply delay the time of the first supplement instead of just eliminating it. If you were to delay that first supplement by one hour every day, by 24 days you would no longer be supplementing.
My baby seems hungry 10 minutes after taking both breasts. Does that mean it is time to give a supplement?
No. If baby is hungry again soon after nursing on both sides, offer both sides again. And again. Your breasts are never “empty”. As you continue to nurse, your body continues to produce milk.
How can I nurse so frequently? My breasts don’t have time to “fill up”.
Your breasts are never empty and don’t need time to “ill up”. “The emptier the breast is, the faster it tries to refill - similar to an automatic icemaker. Emptier breasts make milk faster than fuller ones (How Mother’s Milk is Made).”
If I eat better and drink more water, will I make more milk?
“Research shows that the mother's diet, her fluid intake, and other factors have little influence on milk production. If the "milk removal" piece of the puzzle is in place, mothers make plenty of good milk regardless of dietary practices. If the "milk removal" part isn't there, nothing else can make up the difference (Smith, 2001).”
The more milk is removed the more milk you will produce. Pumping will remove more milk and help to increase your milk production. However, if you are nursing at least 12-14 times in 24 hours it will be hard to fit in pumping. Some thnigs to ask yourself include: Is it worth the additional stress? Would it be better to spend that time resting with your baby skin-to-skin? If you do pump, you can use it to replace any other milk you have been using to supplement.
Last month my little sweetie turned two years old. Yes, she is now two years old and we are still breastfeeding. A lot. She really likes to nurse.
Now, to many of the people I hang out with, this is totally normal. However, I realize that for most of the people in the US this may seem weird. My minimum breastfeeding goal has always been two years, though I fell a few months short with both of my boys. Why at least two years? Why would you still be breastfeeding a toddler? Can’t she have “regular” milk now? Doesn’t she have a full set of teeth and eat solid food?
Most people are simply unaware of the huge list of benefits of continuing to breastfeed full term. One of my favorite collection of research based information on this is at Breastfeeding Past Infancy: Fact Sheet
While it may seem “weird” to many in our culture, scientific research by Katherine A. Dettwyler, PhDshows that 2.5 to 7.0 years of nursing is what our children have been designed to expect (Dettwyler 1995).
In short:
Weird = Some person’s opinion
Normal = Science
So, if science says it is normal to be nursing a two year old, then why is it so often considered "weird"? Dr. Karan Epstein-Gilboa points out in her book, Interaction and Relationships in Breastfeeding Families, "In western environments, non-nursing or, at most, short term nursing are the norm. Behaviors veering from the normal status are therefore considered abnormal."
Some people may read this and think about how much breastfeeding is promoted as "best" and be mislead to think that we live in a breastfeeding culture. When you consider the fact that in the US approximately 11% of babies are still nursing at 12 months old, knowing that the American Academy of Pediatrics suggests baby is nursed a MINIMUM of 12 months, you can see that we are a culture in which bottle feeding and short term breastfeeding are the norm. The vast majority of children in the US are not nursing on their first birthday. Not normal is abnormal by default.
Until recently, nursing into toddler/preschool ages was often labeled "Extended Breastfeeding". The reality is that there is nothing "extended" about it. It is the physiological norm for human children. Breastfeeding beyond infancy is not extended, simply "full term". Many babies are born before 40 weeks gestation. Do we consider a baby who stayed in utero until 40 weeks "extended gestation"? No, it is normal. It is full term. Same thing with breastfeeding a toddler.
Full term breastfeeding has been in the mainstream media lately with Mayim Bialik being vocal about breastfeeding her toddlers, and child-led weaning. You can find may articles by her and interviews with her with titles like: I Breastfeed My Toddler. Got A Problem With It?
Don't even get me started on people who claim that a mother who nurses beyond infancy does it to meet her own needs, not the needs of the child.
Why at least two years?
There are literally dozens of reasons. Here are just a couple:
The American Academy of Family Physicians recommends that breastfeeding continue throughout the first year of life and that "As recommended by the WHO, breastfeeding should ideally continue beyond infancy, but this is not the cultural norm in the United States and requires ongoing support and encouragement. It has been estimated that a natural weaning age for humans is between two and seven years. Family physicians should be knowledgeable regarding the ongoing benefits to the child of extended breastfeeding, including continued immune protection, better social adjustment, and having a sustainable food source in times of emergency. The longer women breastfeed, the greater the decrease in their risk of breast cancer." They also note that "If the child is younger than two years of age, the child is at increased risk of illness if weaned." (AAFP 2008)
Nursing toddlers between the ages of 16 and 30 months have been found to have fewer illnesses and illnesses of shorter duration than their non-nursing peers (Gulick 1986).
"Breast milk continues to provide substantial amounts of key nutrients well beyond the first year of life, especially protein, fat, and most vitamins."
-- Dewey 2001
Can’t she have “regular” milk now?
I think it is a funny thing in our culture that “regular milk”, or cows milk, is considered such an important part of our diet. There is an entire nutrition category based on a SINGLE food source: cows milk. Every other “group” has multiple sources of nutrition: Grains (rice, wheat, oats, corn etc.), proteins (meat, fish, eggs, legumes etc.), vegetable, fruits, you get the idea. The reality is that although the Diary Council would like you to think otherwise, NO ONE needs to consume any dairy products to be healthy (and many of us would probably be much healthier without them!). Some good info at Cows Milk? and Is Cow's Milk Necessary For Toddlers?
Yes, she can and does drink cows milk, as that is a food that our family keeps in the house. But, the best nutrition she gets is from species-specific milk made by her mama.
Doesn’t she have a full set of teeth and eat solid food?
Yes. She actually got all of her teeth rather early. She is a great eater and powers down lots of food. She loves fruit and chicken enchiladas.
Baby teeth are also sometimes referred to as: "milk teeth". If you look at it, the common time for kids to start losing their “milk teeth” around 5-7 years, coincides with the later age of natural weaning.
Isn't she nursing just for comfort?
Sometimes, yes. I think it is perfectly acceptable to comfort my child, and breastfeeding is sometimes the way to do it. Remember, it is not only about the milk.
I’m glad we are still nursing. I was really glad last weekend when we ended up in the ER after a fall. She didn’t need any pain meds, she was happy and comfortable sitting on my lap and nursing when she wanted.
Last week when we had a 4 hour layover at 6am in a strange airport, it was great to be able to nurse her and watch her relax and fall fast asleep.
Some people may be wondering how long we will continue to nurse. Ainsley is pretty much the boss on that one. She will let me know when she no longer needs it.
How important is adoptive breastfeeding? Does it really make a big difference?
From personal experience I can tell you that adoptive breastfeeding is HARD! It is probably one of the hardest things I've ever done. The steps and the physical action of doing it isn't difficult. It is hard in a different way. It is hard to see the results early on. It is time consuming and tedious. It is double the time and effort of breastfeeding and formula/bottle feeding combined. It is so much effort and you are constantly wondering, "Is it really 'worth' it?" or "Is this really going to matter in the long run?" Knowing the positive impacts at the "end of the tunnel" can make all of the extra effort in the beginning worth it. When I first held my new baby, who had spent her first 17 days as "Baby Girl Doe" in the NICU, I knew that I needed to breastfeed her. That is over 17 days of being swaddled in a bassinet. Cozy, fed, and taken care of. She was held, in fact the nurses doted on her. But, she was never held skin to skin on her mother's warm chest. The reality is that ALL adoptions involve a loss for the child. Even a newborn infant who is placed right into the loving arms of his/her adoptive parents is being separated from the only mother they know. Adoption universally involves loss. Babies recognize their mothers at birth and at delivery healthy babies placed on the abdomen of their mother will crawl up onto her chest and, locating the nipple via its familiar smell, will attach to her breast and suckle. Newborn infants desire to remain with their mother and if removed from skin-to-skin contact with her will give a specific "separation distress cry/call" as an appeal for reunion. Maternal separation is stressful for infants, and all adopted children have experienced the loss of their birth mother(Gribble, 2006). There is very little research on breastfeeding and adoption, but the little bit that there is suggests it is beneficial to both mother and child. I believe that this is because breastfeeding isn't just a feeding method, it is a relationship. It's not about the milk, it is about your connection with your child. With the current popularity of informal breast milk donations it would probably not be too difficult for adoptive parents to find human milk for their baby, but that does not provide the skin to skin contact and physical relationship that breastfeeding ensures. breastfeeding is more than just the provision of nutrition; the act of suckling at the breast has an impact on both child and mother (Gribble, 2006)
Breastfeeding naturally puts you in skin to skin contact with your baby which is important to baby’s development and in forming attachments between mother and child. When you are bottle-feeding, you must find additional time each day to hold your baby skin-to-skin. Some benefits of skin-to-skin contact for your baby are better organization of reflexes, stable temperature, and regulated heart rate. Some benefits for you include increased milk production, easier breastfeeding, and better oxytocin release (Moore, Anderson & Bergman 2009). Research has shown breastfeeding to have positive psychological effects for mothers as well. One study compared mothers breastfeeding and bottle-feeding: The researchers found a correlation between positive mood and reduced stress after a breastfeeding session when compared to a bottle feeding session. The researchers suggested that the higher levels of the hormone oxytocin released by breastfeeding contributed to the decrease in negative mood (Buckley & Charles 2006). Bonding is important aspect in adoption, and the hormones released during breastfeeding can facilitate that process.
The World Health Organization (WHO) suggests that all children be breastfed by their mothers, and if that is not possible the baby should be fed the expressed milk from their mother, or nursed by or fed the milk from another mother. The last choice for feeding an infant, according to the WHO is an artificial breast milk substitute, or, formula. WHO recommends exclusive breastfeeding for at least the first 4 and if possible the first 6 months of an infants life, and continued breastfeeding with adequate complementary food for up to two yeas of age or more. So, it is not just infants who need to be breastfed, but toddlers as well. The International Breastfeeding Journal has a research article titled: Mental health, attachment and breastfeeding: implications for adopted children and their mothers by Karleen D Gribble, 2006: What are the benefits? Some of the benefits mentions in this article include:
Breastfeeding calms and provides analgesia to infants, as evidenced in reduced heart and metabolic rates and a reduced ability to perceive pain during suckling
breastfeeding involves maternal skin-to-skin contact, which stabilises blood glucose levels, body temperature and respiration rates
breastfeeding involves intimate social interaction between mother and child, which may result in the release of the anti-stress hormone oxytocin
Oxytocin is released (in the mother) from the hypothalamus in response to skin-to-skin contact and suckling at the breast
The hormone prolactin is released from the pituitary in response to nipple stimulation, such as that occurring during suckling...and is thought to act on the central nervous system to promote maternal behaviour
The increased responsiveness of breastfeeding women to their infants is perhaps a result of the hormonal influences already described, but it may also be related to the physical closeness of breastfeeding. Breastfeeding requires frequent close physical contact between mother and child and some research has found that breastfeeding women seek greater proximity to their babies . Breastfeeding involves infant-mother skin-to-skin contact which both increases a mother's desire to be with her baby and her sensitivity to her infant
Dusty Copeland wrote a very detailed article on the benefits of breastfeeding foster children. In her article, Foster Breastfeeding she answers the question, "Why should we have foster nursing moms?" Breast milk is the normal food for babies. The World Health Organization and Unicef1 state that where it is not possible for the biological mother to breastfeed, the first alternative, if available, should be the use of human milk from other sources." Given the precarious physical and emotional health of some babies in foster care it is possible that breast milk/breastfeeding might assist many children (Gribble, 2006)
I think the benefits to both mother and baby are worth the hard effort involved!
There are situations when a mother has an older baby, a baby beyond the newborn stage, who is not breastfeeding. It may be an adopted baby. It may be the case of a child who has weaned and the mother wants to get the baby breastfeeding again. Whatever the reason, there are ways to help transition an older baby, or even toddler, to the breast.
Kellymom.com has some good information on getting baby to the breast. She suggests that, especially with an older baby, you think about coaxing baby to the breast. These are just a few of her suggestions:
Your goal is to coax baby to the breast. Do not attempt to force your baby to breastfeed. Forcing baby to the breast does not work, stresses baby, and can result in baby forming an aversion to the breast. As baby gets better at nursing and is able to get more milk via nursing, he will grow to trust that breastfeeding works and will have more patience when latching.
Lots of skin-to-skin contact can help your baby nurse better and even gain weight faster. Keep your baby with you as much as possible, and give him lots of opportunities to nurse (even if you're not successful). Get skin-to-skin with him, first when he is sleepy, right after a bottle feed (or however you're supplementing). This way baby has the opportunity to sleep and wake up happily, skin to skin at mom's chest, and mom is right there to catch the earliest hunger cues. If baby moves toward the breast and then falls asleep before even mouthing the nipple, or after sucking twice, then these are positive baby steps, not failures.
Carry your baby close to you ... "Wear," carry, hold and cuddle your baby as much as possible; carry baby on your hip while doing other things, play with baby, and give baby lots of focused attention.
Sleep near your baby. If baby sleeps with you, you'll get more skin-to-skin contact, plus baby has more access to the breast... If baby is not in the same bed, have baby's bed beside your bed or in the same room so that you can catch early feeding cues, breastfeed easier at night, and get more sleep.
Nipple shields can be helpful at times for transitioning baby to the breast. Talk to your lactation consultant about using this tool.
Comfort nursing is often the first to come, followed by nutritive nursing. Offer the breast for comfort any time you see a chance- at the end of a feeding when baby is not hungry, when baby is going to sleep or just waking up, when baby is asleep, and whenever he needs to comfort suck If your baby is actively resisting nursing, then try encouraging comfort nursing after baby is comfortable with skin-to-skin contact. After baby is willing to nurse for comfort, you can then proceed to working on nursing for "meals" as well. You are working to seduce your baby back to breast. Again, coax, don't force!
There are more things you can try:
Offer the breast when he is not hungry.
Try giving him most of his feeding by bottle and then switching over to the breast.This is known as the Finish at the Breast method.
You can change the way you bottle feed to help the transition. There are methods of bottle feeding that are more supportive of breastfeeding.
If you have tried all of the suggestions above, without success, there is another approach you can try. I will describe steps in a method that is often used to teach older infants to breastfeed. How quickly you go through these steps will depend upon how your baby is responding. You will need an at breast supplementer to do this.
First, only mom feeds the baby (both solids and bottles). Baby is always held by mom when being fed.
Don’t allow baby to hold his own bottle. If baby is used to holding his own bottle you may need to gradually get him used to you holding it. Put a sock over it so that it looks more like a piece of clothing than a bottle.
When baby is comfortable with mom holding the bottle, and being held by mom while feeding, you are ready to try the at breast supplementer (abs). The first step is to thread the tube of the abs through the bottle nipple he usually takes, and feed him that way (you can use a tapestry needle to thread supplementer tube into the nipple, it only needs to stick out a little).
Next, move the bottle nipple over your own nipple. Once he is comfortable sucking on the nipple with the abs over your nipple you are ready to try and move him to your breast. Toward the end of the feeding try and switch him to your breast.
Once you get baby to latch on to the breast directly, you may try to feed at first with the abs (even if you have a good supply) as baby may like the faster flow he is used to getting from the bottle.You can eventually wean off of the abs (usually very quickly if you have a good supply).
Here is how one mother describes her progress:
From Child of My Heart All the next day I bottle-fed him in the nursing position. He was content, but I found it so awkward. Breastfeeding leaves you with one hand free, and I'd never really realized that bottle-feeding takes two hands! The next day I began to work on the gradual transition to the breast. My first step was to thread the tiny tube of the nursing supplementer through the same type of bottle nipple he was used to. Then I placed the bottle nipple (without the collar) over my breast for the feeding. This way Joshua got used to being against my skin, while still sucking on his familiar bottle nipple. His formula now flowed from the supplementer rather than the bottle and to all outward appearances, he was breastfeeding.
Another mother describes their progress:
From We Are Breastfeeding During the third week, I began put the tube of an at-breast supplementer next to the bottle nipple. I planned to put this tube next to my nipple while breastfeeding so he could get more milk at the breast. He needed to get used to that idea, so I pulled the tube through the bottle nipple with a needle, and then filled the supplementer bag with milk......At the end of the third week I put the bottle nipple closer to my breast and then right over my breast. Then I could move him toward me into a breastfeeding position. We were almost breastfeeding even though he had not yet latched on. He got milk from me while being held in my arms. He felt my skin next to his belly. He felt my breast against his cheek. He looked into my eyes. He smiled back at me.
What gifts has breastfeeding given you or your family? This is the topic for the December Carnival of Breastfeeding. I’ve really had to think about this one a lot before writing about it. I think it has been a little bit different with each child I have breastfed.
Breastfeeding my first child gave me the gift of teaching me how to be a mother. I quickly developed a close relationship with my baby by figuring out his subtle cues that he was ready to nurse. Through this process I learned how to mother. I learned that nursing is not just about feeding. I think this is the biggest difference between breastfeeding and bottle feeding. I’ve heard it said before that “Bottle feeding is a feeding method, but breastfeeding is a relationship”. I don’t think that is always true for every mother who breastfeeds, for some it is just a feeding method. They develop a relationship in other ways, just like mothers who bottle feed also develop a relationship with their baby. I’ve heard it described as the difference between “breastfeeding” and “nursing”. When you are breastfeeding you are “feeding” your child. When you are “nursing” you are mothering your child at your breast. As a breastfeeding mom I could keep all of my focus on my baby. I never had to take my focus away to prepare a bottle, I could bring baby right to my breast.All I needed to do was nurse and mother my baby at the breast, and as an added benefit, that took care of him being fed as well! Breastfeeding my first child gave me that gift, the gift of showing me how to mother my child.
Shortly after the birth of my second child I became seriously ill. This made breastfeeding very challenging at times. For me, breastfeeding was never an option, in was how I was going to care for my baby. There was never the possibility that breastfeeding wouldn’t work, or that bottle feeding was an alternative. Especially after nursing my first baby. I had just learned how to mother my child at the breast. If I didn’t breastfeed then I’d have to learn all over again, a different way to mother!
Fortunately, breastfeeding was well established by the time I became ill. It turned out to be a real blessing, a gift. Nursing allowed me the ability to care for my baby even on days when I couldn’t get out of bed. If I had been bottle feeding, it would have been very easy to turn the care of my baby over to someone else. Think of the countless hours of skin to skin contact and holding between mother and baby that would have been lost if someone took over care of the baby so that I could “rest and get well”. Breastfeeding my second baby gave me the gift of staying close to my baby, and allowing me to still be a mother when I could do little else.
My third baby was adopted. I did not get to have the joy and physical connection of feeling her grow and move inside me. I didn’t have the opportunity to give birth to her, to see her come into the world and hold her warm little body. I did not know I was going to be her mommy, and meet her, until she was 17 days old. I didn’t need to breastfeed her in order to feed her. She had done well her first 17 days in the NICU on bottles of formula. With the children I gave birth to, breastfeeding was easier than formula feeding. No bottles or formula to prepare or wash. Just lift shirt and insert baby. Nighttime feedings with a full supply of milk were a breeze, I never even had to get out of bed! Now I was in a situation where I had a baby, and it was going to be more work to breastfeed. I didn’t have a milk supply, I still needed to use formula (along with some donor breastmilk). Breastfeeding this baby meant at breast supplementers, pumping, and taking a prescription medication to induce, and hopefully bring in, a milk supply. It would have been easy to bottle feed this baby.
However, the first time I put this baby to my breast, at 18 days old, weighing 4 lbs 0 ounces, I was given a gift. I laid back on some pillows on my bed. I took off my shirt, and stripped her down to only her diaper and laid her on my chest. She immediately threw herself down and latched on to my right breast. Her body completely relaxed. I felt her say, “This is my Mommy. I am so glad to be home.” She is still nursing at 17 months old. The physical and emotional bond that has formed between us is amazing. What an awesome gift!
I always knew I wanted to breastfeed my children. I couldn’t imagine doing it any differently. I was lucky enough to give birth to two beautiful boys and I enjoyed breastfeeding them both. Not that it was easy or without struggle, but it was what I wanted to do and loved doing it. In fact, I liked it so much, and felt so passionate about breastfeeding that I became a La Leche League Leader, so that I could help other breastfeeding moms. I really took to the idea of “Mothering through breastfeeding”. It wasn’t just a feeding method for me, but a relationship with my child.
My husband and I always talked about adopting a child who needed a family. We thought, if we can’t have kids of our own then we will adopt. Even if we can have kids of our own, maybe we will still adopt. After the birth of our second son it became clear that going through another pregnancy was not going to be good for me or our family. My doctor told me not to risk it, that my health was at stake. But we wanted another child. Well, here was our chance to adopt!
We chose to adopt a child out of foster care. We found an adoption agency that places foster children into adoptive homes. We went through all of the training, the homestudy, and all of the waiting. We were open to adopting one or two children (there are lots of sibling groups needing homes) between the ages of 0-5 years old. I knew that I really wanted to breastfeed another baby. I also knew that it was much more likely that we would get a toddler. There was also the issue of would it be okay to breastfeed a foster child? Would I just not tell anyone and do it anyway?
Either way I spent hours researching adoptive breastfeeding. I joined adoptive breastfeeding discussion boards like Ask Lenore and Four Friends. I read every book on the subject, includingBreastfeeding an Adopted Baby and Relactation. I read the article Foster Breastfeeding over and over. I tracked down foster moms who had breastfed their foster babies in California (some successfully, and one who described a baby being taken from her home after the baby’s doctor “turned her in”).
On Monday July 6, 2009, we drove to South Lake Tahoe (about a 2 hour drive) to meet with a social worker. We were one of a few families they were considering placing a newborn girl with. We knew that the baby was a “safe surrender” baby, and that she was born premature. They had already asked if we would be able to go stay in Reno (where she was in the hospital) so that we could have daily visits with her in the NICU until she was ready to come home. It would be a few more weeks until she was ready.
We learned at that meeting that we had been chosen to bring her home if we wanted. Also, the hospital had just called and she was ready to go home! The social worker asked if we could go out to Reno, spend the night in the hospital with the baby, and take her home the next day. Of course we said yes (and I cried, a lot!).
At one point in the meeting the social worker looked at me and asked, “Are you going to breastfeed her?” For a moment I wondered if this was a trick question. My heart skipped a beat. But it wasn’t a trick. “We were so excited to see that you are a La Leche League Leader, and were hoping that you would plan to breastfeed her.” I knew this baby needed to be breastfed and I wasn’t going to have to do it “behind closed doors” as many fost/adopt moms told me they did.
I told them that I would if I was allowed. They couldn’t think of any reason why not, but decided that we would not talk about it any more, or put it in writing anywhere. You just never know how someone might react. People can be weird about breastfeeding.
In that meeting we also learned that this little baby was a bit of a miracle. All of the doctors and nurses at the hospital could not understand why she was alive and doing so well. She was born in a campground in the mountains above Lake Tahoe. Her birth mother did not know she was pregnant. In fact she did not know she was giving birth until she heard the baby cry. The birth mother was taken to a local hospital while the baby was flown to the NICU in Reno. To this day I don’t know if the birth mom ever saw the baby, or even knows if it is a boy or a girl. She gave very little information at the hospital when she surrendered the baby (I won’t get into the paperwork mess that her in one hospital and the baby in another at the time of surrender lead to). She said that she drank alcohol about every other week and smoked a half a pack of cigarettes a day. She told them she did no illegal drugs, however she tested positive for THC (as well as alcohol) at the hospital after the birth.
The baby weighed 3 lbs 2.8 ounces at birth. She was exposed and unreachable by rescuers for 30-45 minutes after the birth. (Even a full term newborn can quickly succumb to hypothermia right after birth, not to mention a 3 lb baby.) At first they expected she whould be in the NICU for about 2 months. She surprised everyone when she needed no help breathing and was quickly eating and gaining weight.
When we went to meet her at the hospital she was 17 days old. The NICU nurses were very nice. They had all “adopted” her temporarily. It was clear that she was a very special baby to all of them.
However, she was exclusively bottle-fed formula that whole time and I was wanting to breastfeed her. I was told by the NICU nurses to “just shove it in there” when I held the bottle nipple to her mouth, waiting for her to open like she would for the breast. I was shown the “right” way to hold her and give her the bottle, with her on my lap, away from my body. She was to be fed on a strict every 3 hours schedule. We were told to not hold her too much. “You can’t hold her so much like that when you get her home. You need to put her down so that she can sleep. She really needs to rest.” I smiled and nodded, knowing that we would be leaving in a matter of hours and that when we got home this baby would not get put down for the next several months.
The NICU doctor told us that we MUST keep her on the special 22 calories per ounce formula until she was 12 months old, no matter what her pediatrician said, no matter how well she was growing. Again I smiled and nodded, knowing full well I was going to do everything in my power to get her off of this formula. I had my own “special formula” in mind for her.
We gave her a name we had picked out for a baby girl years earlier. The next morning when we took her home she weighed 4 lbs. 0.8 ounces.
When we got home I called my LLL co-leader and she drove into town and up the mountain to my house to bring me a hospital grade, Medela Symphony breast pump and a Starter SNS. I needed to get started on bringing in a milk supply! I also went on-line and ordered a Lact-Aid, the at-breast supplementer of choice of adoptive moms. On-line I also ordered domperidone (a prescription that has the side effect of increasing prolactin levels, that is not available in the US) from a pharmacy in New Zealand.
I took my baby up to my room and lay back on the pillows on my bed. I took off my shirt and put her in only a diaper. I put her warm, tiny little body on my bare chest. She wasted no time. She threw herself down and latched onto my right breast. She started sucking and her body completely relaxed. She was home. She had found her mommy. Now, I just needed to make some milk!
The first few weeks I tried to put formula in the Starter SNS and then the Lact-Aid and feed her at the breast. She could latch on great, but her suck was weak and she could not get any of the formula through the tube. I went ahead and got a full sized SNS to try as, unlike the Lact-Aid, liquid would flow out just with gravity. I bottle fed, and then tried the SNS a couple of times a day. Eventually she could get an ounce from the SNS. Gradually I increased the number of feedings at the breast. Soon she could nurse with the Lact-Aid and get formula from that as well.
After about a month I did all of the daytime feedings with the Lact-Aid. I ordered more parts so that I only needed to wash and prepare the Lact-Aid supplies once a day. Soon I fed with the Lact-Aid around the clock and completely eliminated all bottles. I stopped pumping at this point, as she was nursing very frequently. I encouraged her to nurse for comfort, or for what little milk she could get between formula feedings.
She was such a good little nurser! She would nurse for a while on one breast, then let go and move to the other side. This is what breastfed babies will do naturally after finishing one breast, but I had to move the tube over to the other side so that she could keep eating. She would nurse and nurse for hours, even when she was getting very little milk. We would often take “nursing vacation” days when Papa took her big brothers out for the day. I carefully watched her weight gain to make sure I wasn’t being too stingy with the formula. I wanted to give her the smallest amount she needed so that she would nurse more and get more from me to help stimulate my supply.
Soon I was able to nurse her first thing in the morning and satisfy her. I would just keep nursing her until it became so frequent that it was clear she needed some formula.
I was so excited when I realized I could go from about 3am until 10 am without using formula. Then I could go until 11am, then 1pm, then 3pm! Before I knew it she would get formula at about 2 am and I didn’t need to give more until about 4 in the afternoon. I could go out of the house with her all morning and not need to bring bags of formula! I was exclusively breastfeeding for more than half the day! She soon gave up her pacifier that she came home from the hospital with. Once you have the real thing, no substitutes will do!
When it got to the point that she needed two, 2-4 ounce servings of formula in the evening I stopped using the Lact-Aid. If I had to fill one more bag or clean out the tubing one more time I was going to go crazy!! She was 5 months old when she was only breastfeeding with the exception of two bottles of formula in the evening, getting a total of 4-8 ounces per day. She would nurse both before and after the bottles of formula. I really wanted to breastfeed exclusively, but this was pretty darn good!
At 6 months old I started to offer her solid foods. She LOVED them! She was on WIC and they gave her an obscene amount of jars of fruits and vegetables and boxes of baby cereal. She gobbled it all up. Within a week we had dropped one serving of formula and the next week we dropped the last one. She was now EXCLUSIVELY BREASTFED! (Well, along with some solids, but close enough!) She never had a bottle again. In fact, the one time I left her at 9 months old for a few hours, she would have nothing to do with a bottle.
I thought that when she turned one year I would stop taking the domperidone. As I tried to wean off of it my supply really dropped. Baby got pretty frustrated. So, I did some more research and decided it was safe for me to continue to take the domperidone longer and ordered another 6 month supply. Making More Milk describes a study showing no adverse effects for people taking 120 mg/day for over 10 years, and although for a while I took as much as 160 mg/day, I am down to only 90 mg/day.
At 15 months old she is still going strong. I really enjoy nursing her to sleep at nap time and bedtime. I love cuddling in bed with her early in the morning and hearing her gulp down my milk. I can’t imagine stopping any time soon.
When I breastfed my boys my goal was to nurse them for at least two years, as this is the suggested minimum by the World Health Organization. I learned about so many benefits of breastfeeding well into toddlerhood, that I really wanted to do this. Sadly, I only nursed my boys 14 months each. We ended early for different reasons with each, but both times I was disappointed that I did not make my goal. I still feel like I let them down, even though I know that I did the best I could at the time with the given circumstances. I am hopeful that I can nurse my daughter at least 2 years, and as long as she wants. I got another chance.
ETA: In February 2012 Cafemom sent out a crew to interview me about breastfeeding my adopted baby. The kids and I actually had lots of fun. The film crew was great and they really fought to get here. They needed to get new tires on their van to make it to our house due to the snow storm.
