Tag Archives: breastfeeding

On nursing an older child

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I am lucky to live in a place where many families choose to breastfeed for an extended period of time. It is very common to see moms nursing their toddlers and preschoolers in public, and so I can feel comfortable nursing my babies in public too. My oldest son is going to be 3 in April, and he still nurses three times a day when he’s home with me. He always nurses in the morning at wake up, at night before bedtime, and he also nurses after nap times if he’s home (but obviously not if he’s at school). Nursing my toddler has been occasionally frustrating, but I also think it’s gotten us through a lot of the tougher periods of his development.

Because my son and I have been sitting down together for at least 20 minutes, at least three times a day over the past 3 years, we have a close relationship, and we read each other very well. Even on days when he’s tantruming every 5 minutes, and I feel like I’m going to lose it, that time to deliberately reconnect is what makes it possible for me to keep going. And, I do actually think we have seen fewer tantrums overall because my son and I have that time of connection.

Of course families who are not nursing can still have deep relationships with their babies, but I think it can be hard to make myself deliberately find the energy to cuddle when my baby is yelling at me all the time. At least for me, it’s hard to bridge that gap when I’m feeling angry and worn down after the eighth tantrum of the morning. But, nursing happens in our family whether I am particularly feeling it or not, which means my son knows that it’s a part of his routine that will always happen, and that his mom will always be there for him, even on a rough day. My son and I have very different personalities, so it’s helpful for both of us to have the encouragement that comes with a built-in nursing routine.

I should also mention that I do think that breastfeeding my son when my daughter was little minimized the separation anxiety he felt from having a new baby in the house. He adjusted to his little sister’s homecoming very well, much better than I anticipated, but that kind of situation can be a struggle for any child. There are new routines, new noises, and obviously all the family’s attention goes to the new baby. I disappeared for a few minutes four times a day when I had to get her down for naps. I couldn’t get up from the couch for my son when I was nursing the baby. Sometimes my son wanted to nurse, but the baby needed to nurse first, because I only have so much milk.

But, my son could still look forward to those specific times of reconnecting with me, and he knew he’d get that specialized attention from me even if I couldn’t give it to him all the time any more. And now, when he sees me nursing his sister, he’ll often come up to the couch and say, “Nursing sister!” and smile at us, which is super cute.

(On a practical note, nursing a toddler when you have a second baby is the best way to prevent clogged ducts and mastitis that I’ve ever found. I had huge oversupply with both of my babies, which sounds great, but was really frustrating and caused a lot of problems for me. Luckily, my son could be counted on to take extra milk when it caused me discomfort, and he was also instrumental in clearing some plugged ducts when neither his sister nor my pump were strong enough to clear them on their own.)

Even though nursing my almost 3 year-old hasn’t been a joy 100% of the time, it’s been great for our family overall, and I think it’s benefited my son’s emotional health a great deal. I’m really glad I’ve been able to offer this for him for so long, and I hope his sister has the opportunity to nurse for just as long, if she wants to.

Book Review: Good Night Sleep Tight: The Sleep Lady’s Gentle Guide to Helping Your Child Go to Sleep, Stay Asleep, and Wake Up Happy by Kim West and Joanne Kenen

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Good Night, Sleep Tight has the dubious distinction of being the first baby sleep book I ever read. You may be noticing a pattern here, but I found this for $1 at the Good Will (I was there a lot when I was first pregnant, and none of my clothes fit), and when I looked it up online, it seemed like a lot of people liked it. I was young, I was innocent, I knew nothing about baby sleep . . . into the cart it went.

Now that I’m old and jaded and substantially more knowledgeable about babies all over, I have very mixed feelings about this book. I’m pretty sure that some of my son’s sleep problems were actually created when I tried to follow West’s advice too closely, but there’s also a lot of good information here.

west-good-nightPros: West’s delineation of the amounts of sleep that are normal for different age groups and the types of routines/schedules that work for different age groups are some of the clearest I’ve found, and the most accurate to what my son was doing from 0-9ish months-old. We didn’t try her “Sleep Lady Shuffle,” but it didn’t seem like a terrible idea and I think it would work well for some families.

Cons: West says she breastfed her own children, but it seems like she’s not well-educated about breastfeeding and what’s normal for breast-fed babies (a recurring trouble spot for many sleep books, I’m noticing). This is bad, because a lot of babies won’t be able to be night-weaned nearly as early as she seems to think they should be, and she sometimes suggests formula feeding over breastfeeding for sleep purposes, which is just baloney. If a mother’s willing to breastfeed, she should be supported in that, not told that she’s ruining her baby’s sleep. And we have good evidence that formula-fed babies *don’t* tend to sleep any better than breastfed babies, so encouraging formula here is especially wrongheaded.

Another huge problem for my family, and one of the reasons I end up not recommending this book that often, is that West does not address sleep regressions (common at 4 months, 8 or 9 months, and sometimes 11 months) as a normal part of development. She certainly doesn’t devote any time in the book as to how to get through them. As I’ve mentioned, sleep regressions are really challenging times for everyone, and West ignores the existence of that challenge, potentially making parents feel like they’re doing something wrong when their kid is just going through a normal, difficult stage. She does address some sleep issues like teething and regression in the last chapter, but it needed to be front-and-center in the age-appropriate chapters to be meaningful.

I have such mixed feelings about this book, but I think overall, it doesn’t really fit with my parenting philosophy. Nothing West says is evidence-based, and some of the advice seems actively harmful. For those reasons, I don’t recommend it.

Book review: The Dream Sleeper: A Three-Part Plan for Getting Your Baby to Love Sleep by Conner Herman and Kira Ryan

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Still clearing out the short book review backlog, though this one went and got longer on me.

If you are on this blog in the baby sleep tag looking for a decent book on baby sleep, you may have noticed that I haven’t been impressed by most of the baby sleep books I’ve read. This is really sad, because I’ve read a lot of them! I say that I’ve been unimpressed with the caveat that my first baby, my son, was just not a great sleeper, and he was never going to be a great sleeper no matter what method I used, until he was ready. He never dropped feedings as early as all the books said he should, and despite multiple frustrating attempts at night weaning, he really needed at least one night feed until he was 13 months. That’s not average, but now I know that it’s normal, because “normal” encompasses a wide range of behavior when it comes to the first year of life. But most books don’t tell you this, and when you end up with a baby who doesn’t (or can’t!) respond to common sleep training methods, you end up feeling like a failure for no good reason.

Now my son is 2 and he sleeps wonderfully, and it turns out that my daughter is one of these “normal” babies I’ve read so much about. But if you have a baby somewhere between my son and my daughter, I’m happy to say that I’ve finally found a book I can recommend for you.

When my son was about 9 months-old, he was still waking to eat 2-3 times at night. A friend with a baby 7 months older than my son had read The Dream Sleeper, and it had helped her with her son’s sleep issues, so she got it out of the library for me.

Spoiler: it wasn’t the magic spell that got my son to sleep through the night. But, it’s one of the stronger baby sleep books I’ve read, for a few different reasons.

herman-the dream sleeperFirst, I like how the book is laid out. Its structure was intuitive for me, and it was easy to find what I needed. I also really appreciated how much the authors emphasize that it’s okay to want to sleep! It might sound silly, but when your baby won’t sleep, you can feel guilty about your own need for sleep, and start to feel like your not being supportive of your baby’s needs because you’re so tired. Some parents have great reasons (or a great need) to sleep teach and are doing it for the right reasons, even though it’s hard.

What was really helpful for me, though, and one of the reasons I recommend The Dream Sleeper so highly, is that the authors spend a lot of time on nutrition at different ages and how that affects sleep. This is a major piece of the puzzle missing from most of the other sleep books out there. If your baby is hungry at night because of a scheduling issue over in the day, you will never be able to night wean, your baby will be screaming with hunger, and everyone will feel awful. So nutrition *must* be a large component of any plan to work on sleep.

To this effort, The Dream Sleeper offers useful optional daily schedules for babies of different ages, which actually helped me figure out that I could get the same amount of milk into my son without having to nurse every two hours. We were all much happier, and I still remember how much easier it was to transition him to the new schedule than I expected it to be.

There are some caveats to my recommendation that you should know about. The Dream Sleeper is a book that recommends a cry-it-out style of sleep teaching, which isn’t for everyone and didn’t really end up working for us. The information on the scheduling and nutritional components of sleep training can be applied to any method, though, and that’s what I think makes the book so valuable.

The other issue I noticed was that the book doesn’t reflect the most up-to-date research that the breastfeeding relationship can be sabotaged by early sleep training. If your baby’s over 4 months-old and your breastfeeding relationship is strong, or if you’re not breastfeeding, this won’t be an issue, but do your research on breastfeeding and sleep before any kind of training effort.

Have a book you’d like me to review? Leave a comment or email me.

Apologies for the radio silence.

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Happy Wednesday, friends!

I’m sorry I’ve been missing in action this week! My partner started a new job on Monday, which is wonderful, but necessitates a new schedule for me. You guys, I am not good at getting up earlier in the morning. I will get used to it, and probably will get more done everyday as a result of getting more hours in the morning, but right now I am just tired and lacking in motivation. Ergo blog silence and guilt and avoidance and more guilt.

I try really hard not to engage in too much “mom guilt” because I realize that even when I mess up, I’m doing my best, and my kids are great and will continue to be great. Despite this, I still feel guilty over objectively silly things, and here’s an example. If you know me in real life, you saw on Facebook earlier this week that there was a day when my daughter was The Grumpiest. She was fussy, wanted to be held constantly, cried when I put her down for naps, and I couldn’t find anything wrong. I was getting frustrated, since I was having trouble getting motivated myself, and it’s hard to be optimistic in the face of constant Grumpy. Then, toward the afternoon, I discovered that I was having a period, my first period in 14 months, and it is really common for a nursing mom’s milk supply to dip the day before and the first day of a period. Sometimes the milk even tastes different, according to toddlers who talk more than mine can. My daughter had been fussy because she’d been hungry – even though I was feeding her on our usual schedule, she wasn’t getting big enough feeds, the fussing was her attempt to try to let me know.

Friends, I didn’t know, but when I figured it out, I felt so bad! Of course, she wasn’t fussing for no reason. It was just that I didn’t know the reason. I can’t control my menstrual cycle, but I still felt guilty that my body, which is supposed to be able to feed this baby, fell down on the job for an entire day. And, of all the weeks of the year, my body chose the week of the new job, when I was already stressed and tired, to start menstruating again. Good job, body! Thanks for your support!

But really, in actuality, my body is a bad ass. I’m not an athlete by any means, but my body can make enough milk to feed two babies, keep enough muscle strength to carry them both through even a Costco-sized parking lot, and get me through the day on precious little sleep. It is silly to feel guilty that I couldn’t maintain that for months without a break, and also, maybe my body is having a period this week of all weeks on purpose. Maybe I should take a break and shorten my to do list and rest. So, that’s what I’ve been doing, and with any luck, we’ll be back on regular posting schedule this week.

I will still do a Friday music post, though. I know hardly anyone reads them, but music makes me happy.

Breastfeeding was hard because I’d been doing it wrong.

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I’ve had two babies, and I’ve had trouble breastfeeding with both of them. Before my son was born, I read all these books, and my partner and I took a breastfeeding class – I was deeply committed to making it work. I knew that some women had trouble breastfeeding, but I thought I’d prepared and had support (and I had been leaking colostrum for months, ew), and maybe the first time would be hard and then I’d just get it.

Anyway, my son was born, and I did alright nursing in the hospital, but then we came home and I couldn’t get him latched without a lot of pain. I was a hormonal, useless mess. My doula had to talk me off a cliff, and my mother-in-law ran out in the middle of the night to get formula. I was able to see a lactation consultant and rent a breast pump the next day. Eventually, we did get it  (my postpartum doula helped a lot!), and now my son is almost 28 months-old and still nursing a few times a day, with no plans to quit as far as I can figure! But it was definitely a bumpy start.

When I got pregnant again, I didn’t even consider that nursing a newborn would be difficult. I nursed my son through the pregnancy, and I was looking forward to nursing a new little baby who theoretically wouldn’t be trying to do cartwheels while latched, like toddlers do. But I was wrong. Again.

My daughter is a bigger baby than my son was, and her head and neck were so strong when she was born that, whenever we nursed, she would latch and then arch, yanking the nipple along with her. It hurt, and it caused bruising, clogged ducts and serious discomfort for me until she was old enough to control her head a little better. I tried all the recommended nursing positions, visited a lactation consultant several times, and the only way I could find to nurse her without her hurting me at least some of the time was on my side. Since you can’t just lay down in the middle of the grocery store aisle when your baby gets hungry, this limited my ability to get out of the house for a few months after she was born.

I will be honest – I hated nursing her for many weeks. I felt like a failure for considering pumping and bottle feeding, or even just formula for her when I was still nursing her brother, but every plugged duct took an entire day of constant, painful pumping and nursing to clear, and although none of them turned into mastitis (a breast infection), every single one felt like an emergency. I wasn’t sleeping and was still healing from the birth. I didn’t have the energy for an emergency.

But, with some luck and a lot of support, I persevered, and as my daughter started to get better at nursing in other positions, I started to realized that if I could nurse upright if I leaned back and put her belly-to-belly on top of me. It wasn’t perfect, but it meant I could nurse her in the car, or on a park bench while my son played. None of the lactation consultants had recommended this position to me, and I wondered if maybe there was some risk associated with it, or some reason I didn’t see other mothers using it.

And of course, as soon as our nursing problems were mostly figured out, this article turned up on my feed: Many Moms May Have Been Taught to Breastfeed Incorrectly: Surprising New Research by Nancy Mohrbacher, IBCLC, FILCA.

Take a minute and open that in a new tab and look at the photos! (If you’re at work, be aware that it’s women breastfeeding, not that anyone should shame you for that.) Look at them! They’re in a reclined position, belly-to-belly with baby, with one arm supporting baby’s head. That is exactly what I had been doing successfully with my daughter, the baby who had such trouble in traditional breastfeeding positions, and here were a bunch of other moms doing the same thing! I was floored, and wished I’d seen this article when I had my son two years ago.

The article explores the idea that the ways that women are taught to breastfeed now are just not working for the vast majority of us. Mohrbacher says that 92% of women report trouble breastfeeding in the first week of their baby’s life, and that the most common reasons women give up on breastfeeding are trouble latching, nipple pain, and worries about producing enough milk. These are exactly the issues that come up when I talk about breastfeeding with other parents, especially with moms who chose to give up breastfeeding because it was just too painful and frustrating. Throughout the article, Mohrbacher argues that most of these problems are exacerbated, if not outright caused, by our poor breastfeeding postures, and that teaching new parents this alternative posture (which she calls “natural breastfeeding”) would alleviate many of these issues.

The article is a fantastic read, and I strongly recommend it, especially to expecting parents who are planning to breastfeed. Please share it around! There is nothing wrong with formula, and it’s true that sometimes breastfeeding doesn’t work, but I know far too many mothers who had their hearts set on breastfeeding and weren’t able to for exactly the reasons mentioned – pain, latching trouble, or concern with milk supply. Knowing about this nursing position could save a lot of breastfeeding relationships, and I personally think they’re worth saving.

Book review: Mothering Your Nursing Toddler by Norma Jane Bumgarner

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Another short book review to clear out the backlog.

bumgarner-mothering-nursingYes, I have a nursing toddler (going on 28 months!), which is surprisingly different from having a nursing baby, and I went looking for some help on what’s “average” for this age. Recognizing that there’s a lot of variation in what babies do at any age, I was really looking to see how often toddlers were nursing, how many moms were doing on-demand nursing versus sticking to a schedule, how and when moms chose to wean, and the like. This book was published in 2000 and so is a little older, but there’s not a lot out there on nursing toddlers in the US, sadly, and this book was recommended on some parenting blog or other.

I really didn’t like it. I thought the author’s tone was pedantic, and there were lots of unquestioned assumptions about, well, everything, from the composition of families as a mom, dad, and kids, to styles of discipline and limit-setting, and even to why parents were choosing extended nursing. The book included a lot of personal stories, which I did find interesting, but they are all twenty to thirty years-old at this point, and thus not always relevant to today’s society.There also wasn’t much practical advice, and since that’s what I was looking for, I didn’t find it helpful.

If you  don’t need practical advice and are interested in stories from moms nursing toddlers in the 1990s for some kind of cultural research project, then this is your book!

Got a book you’d like me to review? Leave a comment with your suggestions or email me.

Further thoughts on the 4 month regression.

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As predicted, I fell off the face of the internet for a little while, but my daughter seems to have figured out how to sleep with her fancy new brain with remarkably little intervention from me. The 4 month sleep regression is unpredictable, and this might be the eye of the storm rather than the end of it, but she has slept from 8PM-5AM for two nights in a row, and has been putting herself to sleep for bedtime and naps with no or very little fussing. I am ridiculously proud of her, and also relieved. Even if this is just a respite, my back and shoulders deserve the rest – rocking a 15lb baby to sleep 5-6 times a day is a lot of work!

This is also completely different from our experience of our son’s 4 month sleep regression, which lasted for months, and our son required significant intervention from us to learn to handle his new sleep patterns. I have vivid memories of rocking in a dark room for what seemed like hours, counting to myself to determine when it might be safe to try to put him down in his crib. As a second-time mother, I wonder how much of the trouble was really his different personality and temperament, and how much of it was just me getting in the way of him teaching himself sooner, but I really do think he was just a very different kind of baby from his sister.

Anyway, in my efforts to get through this regression with my sanity intact, I have been reading a lot about this age, and there are two articles I found in particular that I want to recommend strongly for any parents going through this period.

First, Ask Moxie has a great, lucid post explaining what the heck is going on during the 4 and 9 month sleep regressions, and reminds us all that it’s normal for these regressions to leave you feeling defeated and frustrated, even though they’re normal developmentally for your baby. The comments are good reading to help you feel like you’re not alone! A reminder about sleep regressions

(I do feel like I want to mention that, though she’s right that lots of babies seem to only take 20-40 minute naps as newborns, my daughter was the unicorn baby that would take 3 hour naps and always needed to be woken up to eat. So, these babies do exist, and are just as normal as the 20-40 minute nappers!)

Second, I love this article from KellyMom: Wakeful 4 month-olds

It addresses the supremely problematic advice a lot of parents get from their pediatricians, families, and an unfortunately large percentage of books on parenting and sleep, to resort to cry-it-out when their 4 month-old suddenly stops sleeping at night.

“Has NO ONE stopped to consider the developmental stage of the breastfeeding baby that begins at about four months and can go on to 6 or 7 months? Think about your four month old breastfeeding — what are they doing? This baby is on and off the breast — so interested in the world around him he can hardly stand it. “Oh look! There’s the dog! Hi, Mommy, I love you SOOOO much! The phone?! A car went by. The TV is on. Big sister comes into the room….hey, there’s just too much going on for me to concentrate on eating. I think I’m full now. I’ll see you later…..” – Jan Barger, RN, MA, IBCLC

Of course, of course, of course a baby distracted from breastfeeding during the day is going to be more hungry at night! I am moderately conservative when it comes to sleep training – I think there are a lot of gentle, limited-cry methods that are a great help in teaching babies how to sleep independently, but I don’t think cry-it-out is the Devil when used appropriately. The problem is that, in my experience, cry-it-out is almost never used appropriately. You do not wean a baby by leaving them to cry in the dark by themselves. You alter their daytime schedule to make sure they’re eating enough, you feed them in a quiet place so they can concentrate on eating, and then, only if needed, you work on night weaning in a gentle, supportive way. A lot of babies will drop night feedings on their own once parents ensure that they’re getting full feedings during the day, so why not try that before leaving them to cry at night?

I hope these two articles will be helpful to other parents going through this regression, especially if you’re going through it for the first time.