Monday, January 4, 2010

10 Things I couldn't live without for Breastfeeding

Last month I was invited to speak at Big City Moms Expectant Moms Dinner that focused on breastfeeding. As always, it was a wonderful event with every Mom walking away with prizes, and a lucky few winning strollers by Orbit Baby, Quinny, and Baby Jogger. Preparing for this dinner got me to thinking about my own experiences with breastfeeding. One of the biggest surprises with the entire new baby process was how challenging that breastfeeding can be. It seems like it is a natural evolutionary process that mothers should instinctively know how to do. I've travelled all over the world and seen women of every age and ethnicity easily feeding their babies the way nature intended. And yet, here in the states you hardly ever see that! Unlike in many other countries where exposing your breast to feed you child is not considered a taboo, here it is and I had never really seen a mother breastfeed until I went to a breastfeeding support group after Pooka was born. That's why we have to go to classes to learn how to do it! And my mother and other female relatives did not breastfeed their children so I had no expert wisdom to glean from them. So my best advice for those of you who plan to breastfeed is to stick it out for as long as you can to try and make it work. It took us 6 weeks to get comfortable, and 3 different lactation consultants to get all of our issues figured out. My mommy friends have run the gamut of experiences from relative ease with feeding, to low milk production, poor baby weight gain, and even mommy's who exclusively pump for months because their babies won't latch or went on a nursing strike. The bottom line is that breastfeeding doesn't work for everyone, and if trying to breastfeed impacts your quality of life and happiness with your child than it may not be the right choice for you (and don't heap your choice to formula feed onto the pile of mommy guilt that you will inevitably pile up over the years!).

I also want to share my experience with you, because it is one you are less likely to hear: I made too much milk! How is that a problem? You'd be surprised! Once my milk came in, it flowed like Niagra and I had a very fast letdown. The problem was that Pooka couldn't handle the volume and speed of milk flow, so to compensate she would bite my nipples to shut off the flow so she had time to swallow. Not only was the biting extremely uncomfortable (remember those Texas Tittie Twisters from middle school?), but throughout the feeding she would compress the nipple. This led to blistering and scabbing, but also to a more painful condition called vaso-constriction. Pooka was literally slowing down the blood flow to my nipples, and within five minutes after a feed my breasts would feel like they were on fire and full of pins and needles. But we stuck it out and got through it thanks to the help of the amazing Beverly Solow, a lactation consultant on the UWS. Once I knew what was happening and how to manage the pain Pooka and I were back on track. This leads me to my list of essentials for breastfeeding.

1. Lactation Consultant: In NYC there are multitudes of lactation consultants to choose from and your hospital is likely to have one in-house (unless you give birth at Roosevelt!). Make sure you choose an International Board Certified Lactation Consultant (IBCLC), use this website to find ones in your area. Here in the city, my friends and I have had wonderful experiences with Beverly Solow, Ayelot Kaznelson, and Heather Kelly. Please know that every penny spent on a lactation consultant will pay you back in spades, and if you have a hard time coughing up the $200-300 for a home visit try one of the many drop in groups around town (especially those run by the ladies mentioned above).

2. Breastpump: My milk was slow coming in so my doula recommended pumping after every feeding the first few days. If you are going back to work a double electric pump is a must, but even if you are not they are still a good idea if you will pump regularly. Now that Pooka eats solids I am pumping daily to add to her cereal, so the pump is still a necessity. We have the Medela Pump In Style. Pumps are pricey, so if you don't want purchase one you can rent one from your hospital or local nursing or maternity store. Also be sure to check with your insurance company, ours agreed to pay for half the cost of our breast pump!

3. Hands Free Bra: As mentioned in a previous post, I pumped after every feeding for four days after Pooka was born before purchasing a hands free bra. I would have to prop my arms up on pillows because they would get tired holding the cones to my breasts, and forget reading, napping or holding your baby at the same time. My whole world changed after purchasing a hands free bra. Companies like Easy Expressions make hands free bras, or do what my friend did and cut two holes in an old sports bra. That wasn't an option for me, as my cup size grew from a B to a DD/E when my milk came in (eek)!

4. Nursing Pillow: You wouldn't think your little bundle of joy would feel all that heavy in your arms, but trust me when I say they will. First, your arms are not used to holding anything in a cradle position for an extended period of time (unless you played football in high school or college, but that seems unlikely). Second, getting the latch and holds right is not easy at first and you will need to use both hands, which means you will have a hard time juggling baby. I highly recommend purchasing a nursing pillow like the Boppy or My Breast Friend. I've had experiences with both and have some definite opinions. I purchased a Boppy after looking at both options in the store. I thought the My Breast Friend looked odd and really stiff, and I didn't like the idea of being strapped into it. Then I brought Pooka home (at 5 lbs 12 oz and 19.5 inches long) and discovered that she didn't fit well in the Boppy. She sort of fell in the hole between my belly and the pillow, and I had to roll up a towel and place it across the pillow to fill the gap for the first few weeks. Then I went to a lactation consultant and had the opportunity to use a My Breast Friend and I loved it. Because the pillow is attached it fits tightly to your belly (no gap) and the stiffness was really convenient for keeping the baby stable while getting her latch right. In retrospect I wish I had bought the My Breast Friend for the early months, although the Boppy is a perfect fit now with my older baby and I still use it every feed when I am at home. So check out both pillows an choose which one you think works best for you.

5. Breast Pads: Yes Virginia, you will leak milk! Somehow I thought I might get away with not leaking like the way I had dodged other pregnancy bullets like constipation or severe heartburn. But alas, that was not to be the case although there is the rare woman who doesn't leak regularly (maybe you'll be one of the lucky ones!). So do yourself a favor and stock up on beast pads. I tried both the Medela Disposable Bra Pads and and Lansinoh Pads. Both work great, but I preferred the Lansinoh pads because they had a larger circumference and were a bit thinner. I also have some reusable organic breast pads made by Imse Vimse they I used a lot when I was at home. They are super soft, particularly if you are cracked or scabbed. Oh, and if you produce lots of milk and leak while feeding check out the Milkies Milk Saver to catch and save leaky milk.

6. Lanolin Cream: It was on the list of essentials to have, but I chose an organic olive oil based nipple cream from Mother Love. This cream is great if you have minor irritation, but less effective if you are severely chapped, cracked, or bleeding (I was all three). On my first trip to a lactation consultant she recommended switching to a 100% pure lanolin-based cream, as lanolin is the only cream proven effective at healing nipples. The standard in this category is Lansinoh and it's easy to find and works great. My only concern was were the cream was sourced, since I was rubbing it on my nipples and my vulnerable newborn baby was sure to be ingesting some. I ended up using a Medela Pure Lan 100 because it was recommended by a lactation consultant who shared that it was pesticide free (although I can't seem to find any info to back that up).

7. Itzbeen Baby Care Timer: I couldn't have made it through the first few months without this amazing gadget. Read more about it here in a previous post.

8. Nursing Bras: I bought my first nursing bras at 30 weeks of pregnancy and wished I had bought them sooner. The lovely ladies at the Upper Breast Side pointed out how my underwire bras were leaving marks on the underside of my now ginormous breasts and could potentially lead to pluged ducts (ouch!). Trust me, nursing bras are much more comfortable than standard bras. My first two choices were a Bravado Body Silk Seamless Nursing Bra and an Elle MacPherson Maternelle Bra. To get fitted, head to one of two NYC stores dedicated to breastfeeding: The Upper Breast Side on the UWS, and the newer Yummy Mummy on the UES. The two stores carry similar stock but definitely have different vibes. There is often a wait to be fitted at the UBS, the bras and clothes are kept in closets and brought to you rather than allowing you to browse, and you try things on Loehman's style (no dressing rooms, so don't be shy). But they are the original and certainly know their stuff, as well as advocate tirelessly on behalf of the rights of breastfeeding moms. Yummy Mummy is a more pleasant shopping experience with a beautiful store that allows you to browse the racks freely, try things on in a dressing room, and promotes an overall sense of tranquility. When I shopped there recently there were only a few other women who came in while I shopped. And Yummy Mummy ladies certainly know their stuff too.

9. Nursing Tops: Whichever store you choose, make sure to grab some nursing tops. You won't regret it the first time you feed in public and your torso is covered rather than on display for everyone to see how much baby weight you are still carrying. My favorites for warm weather or as an underlayer are tank tops by Bravado and Glamour Mom (go for the longer length on these) that don't require a separate bra. I lived in these last summer, and wear them now under sweaters and cardigans. I also love my hidden nursing tops and dresses by Mayreau, Boob Design, and Milkstars. Each company approaches nursing access differently. Mayreau does super soft jersey tops that are great when you want a slightly dressier look, using cowls or wrap styles to hide the nursing access. Boob Design from Sweden makes their organic cotton nursing tops and dresses with a hidden overlap right under your bust that you lift up for access. Their designs are sportier and good for everyday, and include pieces like hooded sweatshirts. Finally, Milkstars makes t-shirts with great details like micro-puff sleeves and double v-necks. They use a double layer for the entire front of the garment, and you simply lift the top layer for nursing access. Start with one or two styles , and add more as you find a favorite (and are sure you are going to continue breastfeeding).

10. Nursing Cover: If you choose to breastfeed you will eventually have to do it in public. The funny thing about using a nursing cover is that I don't actually use it for me, but to make sure that others don't feel uncomfortable. By the time I left the hospital and saw multiple lactation consultants I had no shame left about baring my breasts to strangers. These days I'm comfortable enough with my nursing tops that I can feed well in public without flashing any nip, and besides, Pooka loves to try to pull the cover off and expose me rather than concentrate on eating so I don't use one anymore. But you will definitely want a cover for the early months. It takes quite some time to get comfortable juggling your baby, unhooking your nursing bra, and getting a proper latch in public without the whole restaurant seeing your goods! I use a Bebe Au Lait, but Peanut Shell and Itzy Ritzy make great covers too.

So that sums up the bounty of my breastfeeding wisdom. Pooka still breastfeeds several times a day, and when her little hand reaches up and touches my face while she drinks I realize it has all been worth it! Oh, and when in doubt, the absolute best resource for breastfeeding info is the website KellyMom. Go there regularly to keep your sanity while going through this process!

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