ALL babies are good babies!

I love this! Remember, all babies are good babies! Bad babies don't exist! :)

International Day of the Midwife

On Saturday, May 5th, people worldwide will be celebrating the International Day of the Midwife.  According to the International Federation of Midwives, 

Since 1991 the International Day of the Midwife on 5 May has provided an annual focal point for midwives, midwifery associations and partners around the world. It helps raise awareness of midwifery and extend the influence of midwives in order to lobby and advocate for policy changes relating to maternal, newborn and reproductive healthcare nationally and internationally.

If you are local, you can join me at the Manitoba Legislative Building (450 Broadway, Winnipeg, MB R3C 0V8) on Saturday, May 5th at 12pm for the Internation Day of the Midwife Annual Picnic.  You can find complete details and RSVP for the event on the Facebook page: http://www.facebook.com/events/206512269465261/.

If you can't make it to a local event, make sure to check out the Virtual International Day of the Midwife.  On Saturday, May 5th, starting at 10 hours New Zealand time, there will be a FREE virtual conference.  There will be free online events taking place each hour for a full 24 hours!  There is a wide range of speakers and topics.  And, you don't have to be a midwife to take part.

On May 5th, take part to help show your support and raise awareness for midwives everywhere!

BFARing at 8 months!

My daughter just turned 8 months last week!  It's hard to believe!  But, I feel it's even more surreal because that means we have been breastfeeding for over 8 months now and considering the difficulties in the beginning, there were times I never thought I'd get to this point.  Over the last few months a lot has changed.  Let me recap....

In late November, I started attending a local breastfeeding support group to get help with some of the issues I had been having.  Those issues included my daughter seeming to not be nursing for long (only a few minutes before pulling off, sometimes crying), falling asleep after only a couple of minutes while nursing at night (I know...why complain? but I worried about my supply), and sometimes refusing the breast.  After talking with my public health nurse and my husband, we figured that some of these issues were likely due to nipple preference for the bottle we were using; we think she was learning that she could get more faster and easier from the bottle so why drink from the breast? 

At this point, because my daughter had been gaining so well (sometimes 12 oz./week) and my pumping output seemed quite good, my public health nurse thought that my milk supply might not be nearly as bad as I had been thinking it was - she thought that I may actually have enough milk to exclusively breastfeed.  She suggested that we start to wean and only offer a bottle when my daughter seemed to want it (a lot of the time before this, she would outright refuse a bottle after nursing, or take a bit and spit up).  At first I was giving her (kind of forcing her to have) one to two bottles of 70mL a day because I figured she must need it.  After talking with the nurse again she said I could try and go without and see how she did.

We did this for about a week and weighed my daughter again to see how things were going.  She didn't gain a lot (especially compared to what I was used to previously) but my public health nurse said it was enough.  She explained that at 3-4 months, the amount of weight gained from week to week can drop quite a bit.  Then, it will drop even more around 6 months.

The support group moms and nurses explained that weighing every week probably wasn't necessary and explained that as babies get older, they may not gain consistently week to week but over a longer period of time, the weight gain will show more accurately.  At this point, I had been so set in my ways from my worries at the beginning (meaning that I was tracking everything...feeding times, lengths of feedings, weights from week to week, etc.).  Slowly, I started to let that go.  My New Years resolution was actually to stop stressing about the breastfeeding so much, and luckily, that resolution has actually turned out pretty good.

By about mid January, I was exclusively (but cautiously) breastfeeding.  I was excited at this possibility but very nervous at the same time.  I wanted to do what was best for my baby but also wanted to exclusively breastfeed if possible.  At this time, I was still carrying bottles with me everywhere...just in case!  I also found myself feeding much more frequently, usually every 2 hours (at most 3.5hrs in the day and 5hrs at night).  From what I've heard, many babies still feed frequently and my baby is one of those babies who LOVES to nurse for feeding and comfort!

During this time, I started a few different things to increase my milk supply.  Even though I was exclusively breastfeeding, I wanted to try and make as much milk as possible so I could worry a bit less that my baby was 'getting enough'.  First, I tried Motherlove More Milk Special Blend (especially made for mothers who have had a breast surgery).  For the first few days, I was excited because it seemed like I was making more milk or at least getting better let downs because there were many times that my daughter would be choking on the milk (this hadn't happened before).  But, that seemed short lived.  I thought after about a week that my supply was lower, but that may have just been imagined; I thought it might have had to do with the Fennel in the supplement because I heard that if not cycled, fennel could decrease supply.  I did know that my supply hadn't really increased.  Because of the worry, I decided to stop the supplement.

Next, I decided to try Alfalfa and Motherlove Goat's Rue.  After over a month of taking the herbs, neither seemed to do anything.  During this time, I also tried Fenugreek and Blessed Thistle again, on and off, unfortunately, those didn't do anything either. 

Fast forward a few months and I am still breastfeeding exclusively.  For the most part, my daughter's weight gain has been good and the public health nurse and my daughter's doctor have been satisfied.  A couple of weeks ago I was a bit worried that she hadn't gained a lot and checked in with the public health nurse.  She reminded me that weight gain slows quite a bit at six months and thereafter since my baby girl is so busy learning and exploring!  She said to check it next month and check back in with her.  In the meantime, I have been continuing (and have increased slightly) her solids, which I started at around 5.5 months, and feed her on demand.  I'll be weighing her again late next week and hopefully the weight gain is within the expected range.

There has been so much change these past few months.  I've learned a lot about letting go and accepting where I am, as well as learning that things can and do change.  These past few weeks I have been thinking a lot about possible future pregnancies and little nurslings...wondering how things will work out and encouraging myself to breastfeed as long as possible to give my baby girl the best now and to encourage more milk supply for future babies. :)

My BFAR Introduction - Part 3

This post is Part 3 of my introduction.  To read my experience of just prior to my breast reduction up until the end of my pregnancy, and after birth up until my hospital (unexpected) discharge, please visit and read My BFAR Introduction - Part 1 and My BFAR Introduction - Part 2.

Once I returned home from the hospital, I started taking the fenugreek and the blessed thistle once it seemed the symptoms of my suspected mastitis had subsided.  At three weeks when I still hadn't seen enough of an increase from the herbs alone, I agreed to start domperidone and my midwife had my doctor write me a prescription.  I started at 90mg/day and went up to 120mg/day (at approximately 8 weeks pospartum).  I continued taking the fenugreek and blessed thistle until my daughter was about 10 weeks old, since my supply did increase and I was told that it should be safe to wean off the herbs.  I also decided to stop the herbs because of the cost; when you are taking herbs regularly, it can start to get pretty expensive.

We were using an SNS system (feeding tube and syringe) until approximately 7 weeks. I tried the Medela SNS when we arrived home from the hospital on day 14 with little success.  I just got frusterated because of the flow (I was used to using the suction method when my baby girl was using the feeding tube and syringe at the breast) and she wasn't very good at taking the nipple with the tube attached. When I tried it was very early on and I hadn't yet come to terms with the reality of BFAR, which I think made using the SNS system more difficult for me, especially psychologically.

At 6 weeks, we introduced a bottle once every day or so to get my daughter used to it.  We used (and still use) the Medela Calma bottle to reduce the risk of nipple or flow preference.  At 8 weeks we started to use the bottle more and more to supplement, knowing that when Lyla was 9 weeks old we would be taking a trip (Blissdom Canada blogger conference) and would need to be using the bottle more.  Before we left for our trip, I was no longer using the SNS system and was switched to the bottle for supplementing.

At around 3 months, my baby girl started what I thought were nursing strikes.  I would try to put her to the breast every 3 hours as I had been doing and she was start to scream and refuse to eat.  Looking back, I have realized that the seems to do this when she probably isn't very hungry.  Because, if I wait, she does eat.  We realized that about a month and a half ago that we were likely over feeding her because of symptoms such as excessive spitting up, weight gain beyond recommendations, refusing her supplement, etc.

A few weeks ago I started to use the 'finish the first breast first' method instead of timing each nursing session and keeping her on for 15 minutes on each side as one of my lactation consultants recommended.  I realized from talking with other people that it is the frequency of feedings that can be more important than the length of time on the breast.  And, as babies get older, they tend to get more effective and don't need to be at the breast for as long.  Although I no longer keep track of how long my baby feeds at each breast, I do still keep track of when I feed her because I find it helps me remember when I feed her last and I like to see how many times I've fed her from day to day; I find the information useful.

At the advice of my public health nurse, we switched to feeding on demand and giving the supplement only when she wanted it.  Currently we are giving her about 140mls of supplement each day (divided into 2 bottles).  Sometimes she doesn't take supplement all day or takes only 1 bottle of supplement.  I find that I am having to feed her more frequently (on average about every 2 hours).  Because I have been feeding her more frequently, I have had to drop most of the pumping that I was doing.  But, she has continued to gain weight within the recommended range, which is promising.

The most I've been able to produce so far (known by pumping instead of feeding at the breast) is 95mls per feeding (which I think is pretty good), however, I usually seem to get around 65-80mls.  This is much more than I was able to pump in the first weeks and I attribute that to the Domperidone I am currently taking and the fenugreek and blessed thistle that I took in the beginning.  Also, I am told that babies are far better than a pump and generally get more milk.  I find this encouraging.

I am choosing to share my journey here because after researching BFAR online and hoping to read about other people's stories, I found very few.  Most of the ones that I did find talked about how lucky they were to be able to breastfeed exclusively, instantly from birth.  This wasn't my reality and at the time I was reading those stories, I wasn't ready to hear 'how lucky they were'; I needed to read about other women who had gone through what I did - I needed guidance.  My hope is that my story will be empower women to breastfeed in the way that they define it, despite difficulties.  I believe that all women can successfully breastfeed no matter how much milk they make!  Breastfeeding has been a bumpy road for us but so far, I'd say it has been worth the effort.  I am enjoying the experience of providing my daughter with at least part breastmilk.  I am also enjoying the bonding and attachment experience we are gaining through this journey.

For me, looking back, the surgery was not worth it.  I believe as a 17 year old girl, I was very naive to make such a huge decision - one that would greatly impact my future.  Although I don't want to blame anyone for my decision, I wonder why my parents didn't discourage me from making that decision at that early point in my life, or just not allow me to get the surgery until I was mature enough to make that decision.  In my opinion, age 17 is not mature.

Even though I do have some regrets about my surgery, this diary of my BFAR experience is not to discourage others from making a similar choice if that is the right choice for them.  Looking back, I believe that this is a decision that no one should enter into lightly and one that I believe I unfortunately did.  I think that any women contemplating a breast reduction should consider the fact that one day she may want children and breastfeeding them may be very important to her, even if neither seem like they would be a possibility at that time.  And, if even after considering that, a women decides that a breast reduction surgery is her best option despite thoroughly researching all her options (e.g. alternative medicine for back and neck pain, the reality of BFAR, etc.) - a step that I wish I would have taken - that is something that I support; a breast reduction is the right option for some women.

My BFAR Introduction - Part 2

This post is Part 2 of my introduction.  To read my experience of just prior to my breast reduction up until the end of my pregnancy, please visit and read My BFAR Introduction - Part 1.

Within about 30 minutes of my little one being born, I put her to the breast.  Everyone I had seen breastfeeding before this made it seem so easy.  I was surprised that such a natural act as breastfeeding came not so naturally, at least for me.  It took a few attempts but Lyla latched on like a pro (a vigorous one) and I slowly started to get the hang of it.  In the beginning I'd watch for her cues to know when she was hungry and feed her on demand.  It seemed as if I was nursing forever since our nursing sessions were usually at least an hour long.

I've been lucky that my daughter has had no latch issues! She was very eager the first couple of days and caused some blisters, which for the most part have healed (expect for another blister she caused around week 20).  On day two, our midwife came back to check in and weigh her and she had dropped 10% of her birth weight (from 8lbs 4 oz. to 7lbs 3 oz.).  Although, it was a good sign was that my milk had already started to come in.  I was happy about this since my other midwife told me that it could take up to 7 days or possibly longer for milk to come in for women who had had breast reduction surgery.  Although, because of the reduction in weight, I was advised to feed every 2 hours and pump after every feeding starting at day 3. I didn't start pumping after every feeding until around 1 week and I usually didn't pump in the middle of the night (with feeding every 2 hours I needed the sleep).

On day 5, Lyla still wasn't up to 7% of her birth weight lost, although she was gaining about 3/4 of an ounce each day.  Because of this, our midwife advised us to start supplementing with 40ml of breast milk (or formula if we didn't have enough breast milk on hand) every 2 hours at least until she was up to her birth weight again.  Our midwife set us up with an SNS (Supplementary Nursing System) to ensure that I was receiving as much breast stimulation as possible.  Our SNS system consisted of a feeding tube and a syringe that in the beginning, I needed my husband to help with at every feeding (luckily, he was taking parental leave with me during that time).  Despite a lack of sleep due to the intense feeding and pumping schedule, Lyla was gaining weight at a good rate.

I started taking Fenugreek and Blessed Thistle on day 7.  By about 36 hours later after I thought I saw a bit of an increase in my supply, but unfortunately, I had to stop...

At 9 days postpartum, we hit a set back when I became sick (with a fever as high as 104F) with a suspected infection of the uterus lining or mastitis.  I had to be admitted to the high risk postpartum ward, luckily along with my baby girl.  Being in the hospital was not where I wanted to be, especially since I thought I had escaped that with a very successful home birth.  Unfortunately, the first weight they took showed she lost a bit more weight from where she had been up to previously.  They figured that me being sick probably had something to do with it. We continued our feeding schedule of 2 hours and supplementing as our midwife had previously suggested.  It came aparent to us in the hospital that the medical staff was not very well educated on dealing with moms who were trying to breastfeed post-reduction.  Although everyone was supportive of my decision to breastfeed my daughter, the advice they gave is was all over the map. 

Luckily, on day 2 of my hospital stay, I met with a great lactation consultant who gave us a new plan of feeding every 3 hours and supplementing with 70ml per feeding.  The extra hour in between feeds worked much better for us and allowed us to catch up on sleep.  During the time in the hospital, I learned how to use the SNS system on my own, which helped to save a bit of my husband's sanity.  On day 14 postpartum, I was discharged - still with no answer as to why I had been there in the first place.  Although the experience was not fun, we felt fortunate enough to have gained from the experience - both in my daughter's weight (who was at her birth weight by the day after she arrived home), in knowledge and in confidence! 

This is the end of My BFAR Introduction - Part 2. 
Please read My BFAR Introduction - Part 3 for more of my story.