The Beauty in Breastfeeding

I am taking part in Mothering.com's contest "Blog about Breastfeeding" to celebrate World Breastfeeding week!  Here is the link!  http://www.mothering.com/community/a/blog-about-breastfeeding-and-win   Please feel free to enter-- let's celebrate the beauty in breastfeeding!!
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I am a mother.

I am a nursing mother.

I am also a lactation consultant in a busy urban hospital.  My journey to this point has been full of joy, determination, sleepy hazy nights, warm milky cuddles, a tremendous amount of studying, and, I believe, God's hand of grace.  Breastfeeding, not only nature's perfect way to nourish and sustain and grow and love our babies, was also the magical beginning of bonding with my first baby.  The first time I latched my sweet son to my breast, I felt a tingling, shivery sensation that flowed from my head to my toes and deep into my heart-- like I was waking up.  I was, now, fully a mother.  I was a woman.

You see, my relationship with my newborn son had a rocky start.  I was a new gradate nurse with some labor and delivery experience with a fantastic new job in a hospital nursery.  I just assumed that everything would go smoothly in labor and my birth would be complication free.  I was a healthy young woman who had a fabulous pregnancy and had no reason to think otherwise.  I was nervous and excited.  I was completely and totally unprepared for the roller coaster ride of my first birth.

I was admitted to L&D unexpectedly for immediate induction for a diagnosis of oligohydramnios following a routine post-dates sonogram.  I was classified "high risk" and was shackled to the fetal monitor.  Every minute, I felt more and more autonomy slip away as I was told what was going to happen to my body and my baby.  I felt like I was spinning out of control.

Cervidil.  Pitocin.  Body-wracking contractions and ruptured membranes.  No choice but epidural.  Still feeling nervous and excited, but also, in a way, darkened.  This was so much harder than I thought.

Fully dilated!!!  ELATED!  Pushing.  Pushing.  Pushing... Three hours.  Flat on my back, heartburn, sweat, tears.  Exhaustion, disappointment.  The "coaching" turned into yelling.  I felt like I was totally silenced.  No longer a beautiful pregnant woman, but now just a shell of a body.  Just get this thing out of me.

An exam: he was direct occiput posterior.  Attempt to manually rotate... fresh mec, decels... "C-Section."

All of a sudden, I went totally numb.  I couldn't think.  I stared at the ceiling tiles in a daze as they wheeled me to the OR.

Surgery.  Clanking of metal instruments.  "You'll feel a little pressure now."  Pressure, YES!  This was awful.  I couldn't wait until this was over!

And then: "WOW, what a big baby!"  No cries.  He was being suctioned for meconium.  I (as much as I HATE to say it) didn't care.  I was angry.  I was blaming my own baby.  I wanted nothing to do with him.  I am ashamed to admit that.

After what seemed like forever, I was wheeled to recovery.  By now, my baby was doing just fine, and being doted upon by his entourage of waiting family.  I was resting; shutting out the world, trying to process "what the heck just happened to me??"

By the time my arms stopped shaking an hour later, I was able to sit up and was finally physically capable of holding my baby.  Was I emotionally ready?  I really can't describe in words the emotions swirling in my head.  I had been so so so so excited to meet my sweet baby.  He meant the world to me.  I love him.  But, I was reeling from overwhelming sadness and confusion at how the birth made me feel.

The newborn nurse brought him to me and said: "he has to go up to the nursery for low blood sugar... if you want to nurse him, you have to do it now."

::Deep Breath::

Alone with my husband and my baby.  Our new family.  Nervous and excited, I instinctively brought my (adorable) baby to my breast.  He latched on!  Like magic!!!  I looked on with amazement as he nursed perfectly, like he knew how to do it all along.  He was teaching me.  "It's going to be ok, mom."  He looked up at me with such vivid and deep blue eyes and I felt it:  LOVE.  Perfect and pure.  Fire, warmth, glowing.  He unlatched and smiled one of those heart-melting newborn smiles and I saw his sweet dimples for the first time.  Ok, yep.  I am this baby's MOM.


We enjoyed a lovely breastfeeding relationship into toddlerhood.  I then nursed his little sister.  A whole host of new challenges arose with her, but we figured things out.  When she was 13 months old, breastfeeding saved me again.

I was (surprise!) 12 weeks pregnant with my third child when I began to miscarry.  I was devastated and heartbroken.  I labored quickly and intensely at home, delivering my tiny baby into my hands.  Perfect and beautiful.  But then, I hemorrhaged.  My husband, strong and steady, helped me to the couch.  I lay down, bleeding, and called 911.  I was losing so much so fast.  I was scared.  I tried to stay calm.  The fire department arrived and gave me two 18 gauge IVs.  I felt helpless.  I called for my toddler, my sweet one year old daughter.  She lay next to me and nursed.  "MMMMmmmmMMMM." She played with my hair, looked me in the eyes (oh, she also had those vivid, deep blue eyes with all the wisdom in the world!).  I felt safer with her in my arms.  Honestly, I didn't know what was happening to me.  Would this be our last time together?  My daughter, innocently and adoringly, rubbed her chubby little legs against my bloody body.  It seemed so ridiculous and so surreal at the time; these huge strong firemen standing around, waiting for the paramedics to arrive, keeping watch over my nursing toddler and I.  This is one of my favorite breastfeeding moments of all time.  She kept me strong in her embrace.  I could not slip away... I had to stay strong for these babies of mine!  I survived after a long night of transfusions, surgery, and the strength I was given through the love my children.

I totally fell in love with breastfeeding after that and decided to pursue my IBCLC.  I had to help other women discover this.  My daughter nursed until 26 months, through a second miscarriage, and a long season of grieving.  Nursing was as much for her benefit as for my own.

Then, four months ago, I experienced The Beauty yet again.  After much prayer, yearning, waiting, longing... my rainbow baby came to me.  I had the most amazing home water birth.  After a quick and strong labor, I roared my baby into the world, lifted her out of the water, and stared in stunned silence at the way she was just looking at me.  Vivid, deep, beautiful blue eyes: so wise, knowing, and peaceful.  She didn't cry.  She just gazed up at me sweetly.  Naturally, easily, wonderfully, she latched on and nursed minutes after birth.  That warm tingling shiver raced up and down my spine again.  Fire, warmth, glowing.  The simplicity of it all so stunningly beautiful.

I am a mother.  I am a breastfeeding mother.  It is not something that *I* do, but something that my children do for me.  Learning, growing, thriving together.  There is just so much beauty, strength, and power in breastfeeding.  Nursing opens an incredible connection between mom and baby that, if you let it, can change you forever.

Breastfeeding Assistance

When I first started working in the nursery, I wasn't yet a mom. I shadowed a couple of nurses as they assisted new moms with breastfeeding and that, I guess, was enough to make me an "expert." HA! I had no idea what I was doing, but was supposed to go help women nurse their newborns. I feel so bad for those moms! Sorry!!!

New moms deserve someone who knows what they're doing to help them!

How can someone teach about something as personal as breastfeeding if they've never tried it before? How can they encourage it and offer empathetic support if they've never experienced it?

I am so grateful for my births. I've had an induction and c/s, and an unmedicated vaginal birth. I've breastfed both of my kids. I've had mastitis. I've pumped (stupid 6 week maternity leave!). I've nursed during pregnancy. I've tandem nursed. I've had cracked and bleeding nipples. I've cried over low milk supply. I've cried over engorgement! I've leaked in public. I've nursed in public (and been accidentally "exposed" in public... in church, no less!). I've had pumped milk leak all over my purse. I've donated milk. Husband even tried making breastmilk yogurt (lol.. it didn't work...). I nursed my very hungry son every hour to two hours for the first 4 days after a c/s until my milk came in. I was exhausted. I've had breastmilk regurgitated onto me more times than I can remember. I've been through it.

No amount of second hand experience can replace first hand experience. I am young and my adventures in breastfeeding are recent and current. I can relate and sympathize. I love making a difference; I am so grateful.

Breastfeeding Myths

Just read this fantastic article that debunks common breastfeeding myths!

Breastfeeding Myths

I hear a lot of excuses and concerns at work from breastfeeding mothers and their families. It's pretty hilarious how many times I hear: "How do I know if the baby's getting enough?" Oh, if only I had a dollar for every time I answered that question!!!

I actually had a teen mom's mother (baby's grandmother) say in the delivery room "that's why I hate breastfeeding... It's not like the breast is clear with measurements on the side of it to tell you how much your baby is eating! You could be starving the kid and not even know!" UGH!!! I was so upset inside when I heard that. I had just helped the mom get her newborn latched (she was doing beautifully!) and I gave my usual little breastfeeding introduction spiel about proper latch, milk transfer, frequency, duration, supply and demand, etc... Mom and baby were just so natural together. And then BAM! The grandmother had to completely bash breastfeeding.

Many moms don't get the support they need. I can't tell you how often a mom says "well, my grandparents came to visit, and I didn't want them to see my boob, so I didn't feed the baby in 6 hours." Or, "my uncle's coming, so, can you give me a bottle of formula for this feeding? I don't feel comfortable nursing in front of him."

So frustrating... Your baby comes FIRST! Tell your visitors to wait to visit! Why is everyone coming to the hospital anyway? Can't they wait a few days til you're home??

And what's with everyone wanting to pump right away? Why do moms all think they have to supplement with formula or water? Who is telling them these lies?

::sigh:: Really... breastfeeding is not nearly as complicated as everyone thinks!!!

A typical day at work

I work as a newborn nurse at a busy, urban, level III NICU hospital.

Curious as to what I actually do? Read on:

(warning, long and detailed post!)

I really love my job. I am so lucky to have the privilege of meeting fresh new babies every day.

When I am the newborn nurse assigned to cover deliveries, this is what a typical day looks like: My job is to check equipment for function, stock supplies, and review prenatal records. I'll update neonatology as necessary (a neonatologist or neonatal nurse practitioner will attend any "high risk" delivery- breech, meconium stained amniotic fluid, prolonged decels on the monitor, any delivery less than 37 weeks gestation, insulin dependent diabetic mother, potential shoulder dystocia, compound presentation, vacuum or forceps, etc... ) and, of course, attend births!

When I first get to work, I will receive report for the previous shift RN about who is laboring-- any important medical history, how far dilated she is, how far along her pregnancy is, who her doctor is, etc. She will hand me the pager so that L&D can page me to an eminent delivery if I'm not on the floor.

If there aren't any women close to delivering, I will first go and check my equipment:

1.) make sure the neonatal code cart is locked and the transport isolette is stocked with an MIE bag and mask, full O2 and air tanks, has a full battery, and is pre-warmed to an acceptable temperature.

2.) check the two operating rooms and then all ten labor rooms for functioning wall oxygen/air and blender as well as functioning wall suction. I also check equipment in the warmer base drawers:

MIE bags and a full term and a premie O2 mask, suction catheters (two of each size- 14f, 10f, 8f, 6f), a stethoscope, 2 endotracheal tubes in all the following sizes: 2.0, 2.5, 3.0, 3.5, 4.0, laryngoscope blades (3 sizes) and handles, extra batteries for the handles, a MSAF kit (meconium aspirator, ET tube, stylet, and 14f suction catheter), CO2 detectors, OG tubes for lavage during codes, and of course diapers, hats, extra paperwork, tape measures, etc...

3.) check to make sure there are enough baby cribs in the closet

4.) check to make sure there are enough security sensors for our security system

In between all of this running around, I continually double check the labor board to see how far dilated our laboring moms are so I can try to manage my time efficiently. I will try to flag down the L&D charge nurse to get an updated report on any new admissions.

I will then flip through charts to review prenatal records for any pertinent data: full term?, Gravida/parity, age, relevant medical history, HBSAG and HIV status, rubella titer, blood type, urine toxicology results, etc. I will check to see if the mom will breast or bottle feed and who her pediatrician will be.

I will then try to make up identification bands for the baby... one less step to complete at the actual birth!

Usually all of this leg work gets "interrupted" by a birth or two. In this job, you've got to stay organized and be flexible!

If there are no births (rare!), then I go back up to the nursery to assist with assessments, teaching, admissions, blood work, charts, or anything else they might need.

Once I do get paged to a birth, I go into the room and set up my supplies. I like to have everything as ready as possible so that I can get all of my baby stuff done as fast as possible after the birth so I can hand the baby back over to the mom pronto. I will first turn on the radiant warmer to heat up, turn on my O2 and my suction, set up my baby blankets on the warmer, plug in the scale, set up my erythromycin with gauze and sterile water for cleaning the baby's eyes, draw up my vitamin k for the IM injection, get out an ink pad and a soapy gauze to clean the ink off, and get my transponder attached to a cord clamp. I get all my paperwork out and ready. As I'm doing this, I'm constantly assessing the situation in the birth room: is the fetal monitor on? How is the baby tolerating pushing contractions? Is the baby crowning yet? Will there be a vacuum or forceps? Do I need to page neonatology? Is there a nuchal cord? Is a tight cord clamped and cut before the birth of the body?

Once the baby is born, I hit the timer button on the warmer (for resuscitation purposes if necessary) and double check the time of birth. Most of the time, the baby is born with a lusty cry. If the baby is crying, I know that it has a good heart rate and good respirations. And I can relax a little and just let the mom enjoy her baby for a few minutes while the L&D nurse is stimulating and drying the baby on the mom's chest. After a bit, I'll ask the mom if its ok to borrow the baby for a few minutes... I'll take the baby over to the warmer and do a very quick assessment - pink? crying? good tone? Head to toe look-over. Then I'll ask the dad to get out his camera as I put the baby on the scale to get a quick weight and length. Back to the warmer. Vitamin K IM injection in the thigh, Erythromycin eye gel in the eyes. Complete the identification bands with the time of birth and sex of baby. Footprints. Have L&D nurse double check my ID bands before putting them on baby. Put security tag on baby. Finish measurements (head, chest, abdomen circumference). More thorough head to toe assessment with gestational age exam. Quickly write down anything out of the ordinary so I don't forget! Quick set of vital signs. Triple wrapped with hat (or SKIN TO SKIN with mom with warm blankets over both if she seems up for it). Hand baby to mother for breastfeeding!!!

All in all, I have baby at the warmer for 6-10 minutes before giving the baby back to mom. I'm usually so quick that I am finished with the baby before the mom's perineal repair is finished. I pride myself on being quick... many other nurses take as long as 25-30 minutes! That's a loooong time to be without your baby after birth! Some of these tasks must be done in the delivery room (footprints, bands, security tag, baby meds, vital signs) and the other things (gestational age exam and measurements) only take a minute to do and its really helpful to the nursery to get them done and it helps determine whether or not the baby will need to be on hypoglycemia protocol. Sometimes, if things are really crazy on the unit, I can omit these two things, but I often just throw it in anyway... it doesn't take long.

Once the baby's handed off to the mom, I help her with breastfeeding and tell her to hit the call light of she needs anything... then I clean up my mess (I usually just throw all my soiled linens and trash on the ground since I'm working so fast) and leave the room to finish paperwork. Charting takes a good 10 minutes to complete.

Then, I have to check vital signs on the baby every half hour (and check blood sugar if applicable) before bringing the baby up to the newborn nursery at two hours of age. This can become quite a busy task when there are multiple babies born on the floor!

There are obviously variations to this routine depending on the baby (Premature? Respiratory Distress? Immediate admission to NICU) or the delivery. In a c-section, I will have all of my equipment and supplies set out/turned on and then put on a sterile gown and stand near the sterile field next to the mom's legs. After the baby is removed and the cord is clamped and cut, the obstetrician will hand me the baby and I will take the baby immediately to the radiant warmer for drying, stimulation, and a quick head to toe assessment. If the mother is awake and seems interested, I will (if baby is stable), quickly wrap baby in a blanket and take him/her over to the mom for a minute so she can see the baby right away. I believe that this simple act goes a LONG way to help with bonding in cesarean deliveries. Oh, how I wish I could have seen my baby so soon after my c-section! Then, I'll return the baby to the warmer to complete my "tasks" before wrapping the baby and handing the baby off to the father. Unfortunately, I cannot leave the OR without taking the father and the baby with me (I am the one responsible for the baby), and if the unit is busy, I cannot linger for long. After 10 minutes or so, I lead the dad and the baby to the recovery room to wait for mom.

If the baby warrants some resuscitation, I follow NRP guidelines. Thank goodness, most babies only need a little bit of free flow O2 if anything at all. Thankfully, neonatology is always only minutes away and the L&D nurse is always there if I need a hand with resuscitation.

It is so amazing to have the honor of being in attendance at so many births. Although work is extremely busy and very physically demanding, I absolutely love it. I am hoping to constantly improve my practice to allow more skin to skin and sooner to facilitate bonding and early breastfeeding. I also hope to rub off on more nurses... I think I'm the only one who does this regularly!

My job is incredibly rewarding!

Why I love breastfeeding

My baby girl just had her 2 month shots at her well-visit. The following day, the poor babe was miserable, achy, feverish, and fussy.

The miracle cure? Nursing, of course! As soon as I would put her to breast, she would instantly settle down, and look up at me with her big, blue, sparkling eyes.

It makes me so happy to be able to offer her something so comforting, so soothing.

Before babies, I always had a very small chest. I never liked my breasts. They were small and insignificant. I never thought of myself as "sexy" and, like most teenagers, had a bit of a hard time with self-esteem.

Now, as I am breastfeeding my second baby, I sometimes stop to marvel at my body! My breasts are round and warm with milk. They are amazing! I see the beauty in their purpose. Whenever I feel myself letting down, I am grateful for the wondrous relationship that breastfeeding allows me to have with my child. I can provide her with instant nutrition and comfort even after birth. Some people, after spending several hours visiting with me and baby, will comment "wow, she needs to eat again?! didn't she just eat?" I just giggle a little and explain that breastfeeding is SO MUCH MORE than just infant nutrition. It is a special way that only I can use to bond with my baby. I put her to breast whenever she wants it. I don't mind at all! It is not at all a chore or a burden. My sweet little daughter is instantly comforted by my warmth and I enjoy the skin-to-skin snuggling as I hold her to my breast. It is one of the most rewarding experiences of motherhood. It also helped me to SLOW DOWN and spend time relaxing with my baby. Breastfeeding forces me to just stop and focus on my baby. I know she loves that!

Breastfeeding, though, has not always been easy or fun! With my first baby (who was a very hungry 9 lb 6 oz boy!), my mature milk didn't come in until the end of my 4th postpartum day because I was a first time mom and I had a C-Section. Sometimes milk production is delayed in moms who deliver by cesarean because the body is so focused on healing at the incision site to focus on making milk. Those first few days of motherhood were so exhausting. I tried to rest and recover, while breastfeeding my infant every 1-2 hours. Later, we also struggled with a bout of mastitis and I almost lost my milk supply after a nasty stomach flu.

With my second baby, the first week was grueling. I was terribly engorged for 6 whole days and the baby had a hard time latching. Nursing a baby who suckles vigorously on two cracked and bleeding nipples is NOT FUN! Thankfully, though, I healed quickly after engorgement, and we've had no issues since. (Except that I learned the hard way that I can't eat cheesecake or ice cream, unless I want to clean up puke all day!)

Even with these minor setbacks and challenges, I LOVE breastfeeding! It is such a special gift I can offer my baby. I had a fabulous time nursing my first baby, and we only weaned at 15 months because he was no longer interested. I hope that I can nurse my second baby even longer.

As a nurse in an inner-city hospital, I am pleased with our high breastfeeding rates, but I am grateful for moms who lovingly bottle feed, too. I wish everyone could have the same sweet nursing relationship with their babies that I have, but I'm just glad when moms feed their babies at all!

Why do you love breastfeeding?