My one-year anniversary of breastfeeding

Ok so in reality what it really is, is my son's 1-year birthday. He had his party, which I begrudgingly granted my mother-in-law who was crestfallen when we first told her that a party was not going to happen. Back to the point. One year of breastfeeding, he had his party, now I am having mine.

What are the things I have had to deal with?

1. My mom constantly asking me how much longer I am planning to breastfeed. At first I didn't pay her any mind, I'm used to shrugging off the things she says. Lately though it's been really getting on my nerves, partly because she never stops asking and partly because her motives for wanting me to stop are completely irrelevant. Those motives as I see them are: so I can finally get to doing real exercise and get back to a size 4, so she can take the baby places without me, so my boobs can shrink back to normal size and I can wear correct-fitting clothes again, and so the baby doesn't become too much of a mama's boy.
2. A baby who is big enough to start really hurting me when nursing. He is a high-strung fidgety kind of kid, even when he is nursing to fall asleep he constantly kicks me in the stomach and pinches me.
3. Teeth. Lots of them.
4. Solid food on the boob. This is pretty disgusting. He will be eating fried chicken then 10 minutes later will want to nurse. Open wide! What do I see? Bits of chicken in his mouth ready to be washed down with breastmilk. Ick.
5. Pumping. I am so sick of pumping now I must confess. The good thing is, I hardly ever pump anymore. I have been breastfeeding long enough now that i'm pretty confident my supply is constant. So long as I am not away from him for more than 6 hours at a time then I don't have to bring a pump around. At this age babies also don't drink that much milk anymore, so demand is also lower.
6. Missing my boobs. My old boobs. The reasonable-sized ones that were high up on my chest and didnt' make me look like i was going to tip over because they messed with my center of gravity.

I used to say I will know when to stop breastfeeding because I would never get used to the idea of a toddler walking over to me in his shoes and shorts asking for dede. Yet here I am. You know why I'm still doing it? Because weaning is hard. It is hard for me, hard for baby, hard for daddy. It is a long project and is going to be emotionally draining. So I postpone because I'm a coward. I do expect to be fully depressed once he weans. It'll be so sad. I'll have more freedom, but i'll miss it so.

Babies who play with boobies

I am not shy about nursing in public. Not shy at all. I will whip these puppies out in the middle of church if I have to. Breastfeeding will very quickly change your attitude about your boobs. They are no longer for sexual objectification, they are for the nourishment of your child. So whip them out I did! For many months I enjoyed nursing my baby while staying mobile and not having to bring bottles and formula. At around 8 months, things started to change.

As baby J started to develop fine motor skills he learned how to use his hands. He is also a little bit of a fidgeter. When nursing he plays with my shirt, runs his fist up up and down my chest, or claws at my arm. You can see where I'm going with this.

Now that he is much bigger and starting to walk, he is a little tougher to keep still when nursing. He has started playing with the other boob while breastfeeding. He'll put his hand over the other boob and squeeze repeatedly like he has a squeaking rubber ducky. Once he is done drinking, he will pull off, stare at the bare boob and then start pinching it. Very embarrassing in public! It doesn't help that he has started refusing to stay under a nursing cover. I have tried and tried and tried stopping him from doing this, nothing has worked so far.

Oy. I never thought I'd hesitate to nurse in public, yet here I am, unable to feed him in the middle of the mall because he will be playing with the boobs. 

Leaking breasts

Not all breastfeeding moms are leakers. I am a leaker. It can strike anywhere and at any time. It is a reminder that we are so closely attached to our child that even the thought of him/her will prompt a letdown. Pads are necessary of course, otherwise you'll have milk running down your shirt or you'll be leaving little droplets of milk all over your office floor. Question is, how not to break the bank on those pads.

Reusable breast pads are cheap, I got 3 pairs for P65 or something at SM. Used them once though, then never again. They are too thick, uncomfortable, and bunch underneath your bra that it is plain for anyone to see you are wearing them. Also, I was already having a problem with how large my breasts have become, I didn't need to add more volume to them.

The disposable breast pads are better, but expensive. You can find them at the baby stores for around P400 for a set of 30 or so. Not a sustainable solution if you need to wear a pair everyday for 2 years. I must confess though, I've reused these things 2-3 times. If I only had them on for a couple of hours, i'll use them again the next day. These are better fitting than the reusables, still some volume to them but less, and they stick to the inside of your bra with double-sided adhesive. There is still a bunching problem, but not so obvious if your shirt is fairly loose. All the packaging is annoying though, and I always feel bad throwing all the plastic away.

Finally, the obvious DIY solution I found online. Pantyliners. One piece cut down the middle, one half on each boob. Not for the heavy leakers but a good cheap solution for most. No bunching, no itching, no need to reuse because they're inexpensive, and no unnecessary packaging to clog our city's drains. It covers a smaller area so make sure it is on the right spot of your bra. Don't buy the superslim ones, buy the ones that are thick, they still won't be as thick as breast pads.

With padded boobies you won't have to worry again about hearing someone else's baby cry and leaking all over the place!

Nursing bras and jog bras

Nobody really warned me about exactly how much bigger one's boobies gets when breastfeeding. I mean seriously, these missiles are logistical problems now, presenting a multitude of fashion dilemmas.

Nursing bras are fairly easy to find in department stores, if you're a cup size A-C and generally Filipino-size all around (i.e. petite and slim), which I most definitely am not. I didn't shop for nursing bras before giving birth because a generous friend gave me a couple of really expensive ones and I wasn't really sure yet that I'd be able to nurse. So by the time I did decide to buy a few nursing bras it was already an urgent purchase. No time to comparison shop online and off. So to trusty SM Megamall I went.

The cheap brands have decent nursing bras but they only go up in size to 38 C, given how badly they fit I would guess I'm at least a D cup. So-en had these for under P400 (apologies I forget the exact figure), and the Avon store had a couple in stock for the same price. The So-en one was tighter even if both were the same size, and less comfortable than the Avon I think because the fabric was less cotton-y. Between the two I recommend the Avon if you can find a store or seller. They are cheap and do the trick, so long as they are the right size for you.

Also spent some time at the Centris Sunday Market looking for nursing bras, there are sellers there that carry export overruns of imported brands. Not a lot of options on size but I did find a couple ones for really cheap (P150) even though they were the wrong size, 40 A, I figured I could make up for the cup size with a larger circumference. WRONG! I would only wear these around the house because they fit so poorly and held nothing up. So don't buy ill-fitting bras, they're a waste of money.

There are a lot of imported expensive nursing bras available online, but I wasn't really willing to pay more than P600 per bra. I only need the convenience when am out with the baby. When at work and all I need to do is pump I can wear a normal bra.

Two months after giving birth I felt ready to go to the gym, maybe do some running. Boy was I wrong. Running with size D breasts is practically impossible without a good supporting bra. So off I went again to buy new jog bras. On these I spend more money, around 800, because I had exacting standards. I hate those bras that you have to pull over your head, so needed ones that snap in the back. Found them at Jockey in SM. Even with supposedly rock hard support and making sure I nurse or pump both boobs empty before i leave the house, I was still jiggling around quite a bit at the gym. When I did finally decide to do a full-trot jog on the treadmill, learned that jog bras were not enough. I did a DIY fix and strapped those babies close to my chest with the stomach binder/girdle the hospital gave me when I gave birth. Worked like a charm! Not exactly comfy but they held me in!

Now that I'm back working full-time I have to invest in good going-out bras. Even though I'm not nursing as much as before it doesn't look like I will be back to my old size anytime soon. They don't have to be nursing bras because i don't take the baby with me so it'll be an easier purchase. Back to Centris we go, there's a lady there that sells overrun Victoria's Secret and CK:)

Gasp! TEETH!

Yes babies are very cute when they start cutting teeth, but teeth can be a nightmare for nursing moms. It's partly psychological really, how can breastfeeding a child with a mouthful of fully developed teeth NOT hurt?! It must, right? The agony of anticipating that pain is probably worse than the pain itself.

Photo credit: http://www.breastfeedingbasics.com/articles/teething-and-biting

Honestly I still don't completely know, my kid has 2 bottom teeth and is now erupting two more on top. I haven't dealt with a whole mouthful just yet. Lemme tell you though, those first two are a b*tch! Not something you can't get over, I did figure out, after much research, how to deal with them. As usual with breastfeeding it's all about latch and not getting lazy about making sure baby is on there properly.

Teething babies are miserable. They are uncomfortable, drooly, and irritable so they will be complaining and crying a lot. Not all teething babies will bite your boobs, however you do not want them to get into the habit of using your boobies as teethers, not pleasant. So here are a few tips:

1. Bottom teeth come out first, and the important thing to remember is that a baby cannot feed while biting so put him on the boob only when he wants to eat. To get the milk out, his tongue has to be on top of the bottom teeth. If he is just hanging out on your boob he is more likely to bite. When you see that he is done feeding, take him off, otherwise he might bite just to keep himself occupied.
2. Ice his gums first before nursing. I would take a little ice cube, wrap a lampin around it and use that as a teether. Works really well because the fabric is rough but thin so he gets the coldness and some friction to relieve his itchy gums. When he is no longer annoyed by his gums and seems calm, then start nursing him. It'll be cold on your boob for a bit so be prepared! DO NOT GIVE HIM JUST ICE! He can choke on it.
3. Make sure he opens his mouth really wide before latching him on. The further down the breastfeeding relationship we got, the lazier I got with latching him on properly. He'd have his mouth half-open and i'd put him on, while ok without teeth, once those two bottom ones pop out this maneuver will get painful.

The two front bottom teeth come out first, and those are the toughest to deal with. Top teeth are easier because their angle while feeding makes it so it's not painful, not a biting, just a little friction. I'm optimistic that since we have weathered the storm of the first two bottom teeth, the rest will be easier to deal with. Here's hopin'!

Pumping on the go

This post was inspired by this post: Pumping and working

It is tough enough to pump every day at work, but that's a walk in the park compared to pumping while traveling or when out all day in meetings. At work I can lock myself in my office and do my business whenever I need to. If i'm just on the computer it is not a big deal to stop working for 20 minutes to pump. On the go is a whole other ball of wax.

There are many stories online about how women can feel humiliated when they find themselves leaking or having to pump in relatively public places. For instance this incident TSA breast pump blunder just fills me with rage. Unfortunately society has put women in these positions where we have to expect to feel humiliated at times, or like me, just develop a thick skin and do whatever it takes to do what needs to be done.

On my first trip outside the country after giving birth I was very anxious about pumping and how I would fit it into all the moving around I had to do. In the end it turned out fine, I just had to suck it up and improvise as I went from point A to point B. My first piece of advice to traveling moms is to bring a manual pump, not an electric one, so much easier to sit somewhere and pump indiscreetly. Second, bring a nursing cover with you along with extra pads and tissues. Here's a hierarchy of options for places to pump in airports:

1. If available look for a lounge or a nursing/breastfeeding room. Odds not high you'll find one but you might.
2. A bathroom for the disabled. In Philippine airports these are typically separate rooms altogether that have a big enough space to lay out your luggage and set up. Just tell the bathroom attendant you will need it for a few minutes to pump and odds are they will even stand there to guard the door for you. Women, we protect each other. Men, they are afraid of us, so even if the attendant is a man go ahead and tell him, he will stand there with his mouth hanging open just agreeing to do whatever you tell him to.
3. The largest bathroom stall in a public bathroom. Or the one in the far end usually, the one that doesn't get a lot of traffic. I also decided to tell the attendant what I will be doing in there so she can tell people waiting in line that it won't be available.
4. In some corner somewhere. When I was left with no other choice, I just plopped myself down on a row of seats in an uncrowded area, put my rolling luggage beside me so I occupied the whole row, and put on a nursing cover. This was quite a success surprisingly, more comfortable for me than th ebathrooms, but if you're squeamish about pumping in public them perhaps not for you.
5. During the flight of course you'd have to use the lavatory. Do it during the time that food is being served so most people are trapped in their seats and you won't be holding up a long line of people desperate to pee. On my return flight the plane was not full, I transferred to an area where I didn't have to sit next to anyone, and again hid under my nursing cover and just pumped in my seat.

*extra tip, when I ran out of milk storage bags I just bought a bottle of water and emptied it out then put the milk in there.
**extra extra tip, ALWAYS consider the ability pump when selecting clothes to wear. Not a good idea to trap yourself in a one-piece dress that doesn't open or pull down the front when you find yourself having to pump outdoors.

Photo credit: http://www.nursingfreedom.org/2010/12/pumping-in-bathroom-is-like-putting.html

Working in pumping sessions can also be tough when you are having a hectic moving-around day of meetings and errands in various places. When this happens to me I would park my car in the most secluded slot I can find and cover up with a nursing cover then pump in the car before heading to a meeting.

I am fortunate enough to have cars to hide out in and to be able to afford an extra pump to bring with me. Many women don't have that, so all you out there judging moms for ceasing breastfeeding when they return to work, back off, it is incredibly hard.

Baby turns his head a lot while nursing

Once baby starts gaining clearer vision and hearing, he will be so excited about seeing things around him that he will become easily distractible when nursing. Even bottlefeeding moms will notice this. Kid is happily drinking away at his bottle then dad walks in, baby turns his head to look... ooh light!, baby turns his head... pretty hair mommy, turns his head. This is fine when attached to the bottle because bottles can travel with the head-turn, boobies, not so much.

Distractible babies can inflict real pain on breastfeeding moms. My baby would look at my eyes, give me a big grin with my nipple between his gums, then clamp down and turn his head. It's really cute but it is PAINFUL! I do the nursing time-outs where after 3 of these head-turns the bra goes on and mom closes up the soda shop. Baby gets a firm "enough!" shout from me, which is greeted by a happy smile btw so I don't think it does anything really.

http://www.drmomma.org/2010/08/tips-for-nursing-strikes.html

It may seem mean to stop nursing your baby when he is really distractible and making it painful, but in my experience, when they are more interested in looking around than continuously eating, then they are not really hungry. When baby J is 100% there to eat, he is ALL BUSINESS, he closes his eyes even and goes to town on the boob.

Now that he is getting bigger I find that he asks to nurse less and less. In fact I offer him a boob every now and then even though I know he hasn't asked for it just because I'm starting to miss our private nursing time.

For more info on dealing with distractible babies:

Kellymom on the distractible baby

Bebeta manual pump review

I've been trolling local sites about discussions of manual breast pumps and was bothered by two things. First, some moms seem to have been told that you should NOT pump in the first 4-6 weeks of baby's life. Second, that manual breast pumps are expensive (P4-6 thousand depending on the brand). Both beliefs are dangerous for a new mom's chances of continuing breastfeeding.

Pumping is not bawal in the first month. WHat doctors mean is that if you CAN nurse then nursing is better, but if for some reason baby is having a hard time nursing because of latch or strength issues it is not bad to pump. In fact you can pump in between nursing sessions to increase supply. It is true that in the first 2 weeks babies should be nursing as much as possible because the stimulating action of their tongue on your breast will signal the arrival of milk in good volume. What WILL be bad for your supply is exclusively pumping in the first month, the nursing is critical, nursing AND pumping is ok too, but pumping ONLY can diminish supply.

Breast pumps do not need to be expensive, there are ok manual pumps out there for less than 1,000 pesos. Moms who cannot afford to drop a lot of money on a pump when they are not sure that they will be able to breastfeed will just not buy a pump. I think this is a mistake and jeopardizes the chances of successful bfing over the long term. Since some moms seem to think they need to spend at least 4,000 pesos for a manual pump, they end up delaying the purchase to be safe, no sense in spending that much cash if their supply is not enough. In fact the decision process should be reverse, you buy a pump to increase supply, not decide to buy a pump only if there is enough supply.

One of the most important things you need to consider when buying a manual breast pump is that it can be operated with one hand. You'd be surprised how many models out there need two hands to operate. And believe me, when you have a baby you need that other hand to be free. The Medela electric pump I inherited from a friend came with a manual pump that needed two hands, I never used it. The second thing, buy one that has a bottle where the milk will go, you'll see what I mean when I discuss my Chicco purchase below.

I bought my perfectly useful manual breastpump for 700 pesos, some sulit people are selling it for 500-600. It is a Bebeta pump that I picked up from Shopwise (in Libis). It's got some minor issues (described below) but it is a decent pump and has paid for itself over and over.

Photo credit on top of photo. Not an endorsement of seller.

There is only one problem with this and once you learn how to deal with it you can pump without interruption. If you are pumping at an angle where milk travels into the silicone cap on top, or if the silicone cap is wet inside from the wash, you lose suction. So before starting to pump make sure that cap is bone dry on the inside. The whole thing comes apart so it's not that hard to do, a lampin does an excellent job of wiping off all moisture. Then once you start pumping do not hold it at an upward angle, hold it slightly downward so the milk just flows downward. I do not put on the silicone tube thing that goes on the flange, it will help with suction but I find it's not completely necessary.

This thing has taken me through many night-pumping sessions and a 3-day trip to Bangkok. For a few weeks I used only this instead of the electric because it's gentler on the boobs. I never felt the need to buy a more expensive manual pump.

The first one I bought was this Chicco thing that the SM lady recommended. I didn't want to buy the more expensive Chicco manual pump because it was too much money to drop when I had an electric at home, I just needed a back-up. When I got home I found to my dismay that not only was the reserve too small for any real pumping, it was also not recommended that the expressed milk be given to the baby, although honestly I don't believe that part. So stay away from this one:

Photo credit: Chicco

I still don't understand what it's for, but it's apparently not for expressing milk that you want to feed to your baby. Go figure.

Plugged ducts: Dealing

I've had 3 episodes of plugged ducts since I started breastfeeding. It doesn't get easier to deal with, but at least the accumulating experience makes me confident that I can fix it before infection sets in. I've heard some scary stories of mastitis from friends and these were enough to scare me into acting quickly as soon as I suspect a plugged duct.

Lately I've been prone to these. I started working again and my unpredictable schedule makes it hard to schedule regular pumping sessions. One is prone to plugs when the breasts are not emptied out regularly, they get engorged and milk solids block the ducts so that even after pumping or nursing a part of the breast remains full. It can be painful, you will be able to feel a lump on your breast, it will be tender like there's a bruise, sometimes there's a redness on to the skin and it feels warm.

Moms who plan to breastfeed should have small hot/warm compresses handy. These are useful for a lot of things, faster letdown, soreness, mastitis, and plugged ducts. A lot of websites say it helps to take a hot shower and let the water run against the part of the breast with the plug. In the Philippines though not all homes have hot showers, so warm compresses are a must. A low-cost option is to put some uncooked rice in an old sock and sew it closed, then microwave for 30 seconds at a time until warm, you can use this indefinitely but make sure you don't get it wet!

Place the warm compress on top of the breast where the lump is, massage the lump from the outside of the breast toward the nipple, do this for 5-10 minutes then start pumping or nursing. Nursing is better, especially if you have an older baby, because his suction will be stronger than a pump. What you are trying to do is soften up the milk solids plugging up the duct, then suck it out (literally). Joke all you want about getting your husband to suck out the plug, but don't do it, your baby has a stronger suck I promise. If you're pumping, keep the warm compress on while pumping.

The plug might not go the first time, repeat the process every 2 hours until the plug is gone and you can feel the duct drain off the milk. Soreness may stay for another couple of days, but you'll know the duct is clear if the lump is gone.

So remember, as soon as you feel that lump do the warm compress thing, don't wait for more milk to accumulate in there because it will get more painful as that happens and then infection is next.

For more: Dr. Sears on Plugged Ducts

Local myths (pamahiins) about breastfeeding

I understand that as a developing country not everybody gets a good science (anatomy and reproductive health) education, so it was no surprise that I heard many many myths about breastfeeding. Even the real science behind bfing can be bizarre after all, why wouldn't the whole mystical process inspire mistaken conclusions about how best to bf your baby? A couple of the strangest I encountered:

1. The left boob only has water, and the right boob has rice (this is Asia after all, rice is a staple so why shouldn't Asian mommies have rice in their breastmilk)? This only naturally means that the baby should drink from both at all meals.
2. Don't breastfeed if you're tired, cranky, or in a bad mood because your milk will be sour. Who wants to drink sour milk? Maybe this one was thought up by a tired and cranky mom to get her husband to take better care of her.

We live in the city so we don't hear a lot of these, but whenever I visit my in-laws in the province their helper likes to school me on all things baby and breastfeeding. She thinks using a baby carrier/sling will make the kid bow-legged...so there...

Funny moments in breastfeeding

What many moms neglect to tell other moms, is how bizarre and funny the breastfeeding experience can be. It's not even having this little "pet" baby suck on the end of your booby, that's nothing. It's witnessing your body do these strange things, or rather, your boobs do these strange things. Seriously, there's MILK squirting out of your BOOBS! That's totally weird. Literally I have laughed out loud while I pump milk as I witness the stuff coming out of the boob at full force. Other funny things:

1. There were drops milk all around our room during the first month. In the first few weeks you will find yourself basically topless most of the time, there's hardly any point bothering to put on a shirt when you are on boob duty every hour. So, you walk around and leave a trail of milk behind you.
2. Once I was sleeping beside Baby J, woke up, reached over him to pick up my phone on a table beside the bed. On the way there SOMETHING latched on to my boob! It was like some 6th sense the baby, had, there's a boob coming at me! Wake up and grab it!

Photo credit: http://www.myspace.com/breastfeedingsupport

3. Several times, I turned over in my sleep and ended up sleeping either on my side or on my stomach. When I woke up in the morning the sheets beneath me were drenched in milk.
4. The experience of attempting to shove my milky boobs into an old bra was hilarious, it was like trying to fit a melon into an egg cup.
5. The bottomless milk duct. No matter how empty I think my boob is from pumping and nursing, when I squeeze on this one milk duct, milk goes squirting out and hits the ground 2 feet away.
6. Seeing the baby try to latch onto your boob through your shirt...funny. Seeing your baby try to latch onto your friend's boob through her shirt...funnier. Seeing your baby suck on daddy's nose in hopes of getting milk...funniest.
7. Babies will go through this phase where they're feeding and you're watching them, then they will look up, see your eyes, and smile at you with a big grin with your nipple in their mouth. Funny also.
8. Lately, my baby will be nursing on one boob and fiddling with the other boob. It's embarrassing in public but kinda funny at home. Not a behavior I encourage, but sometimes he just likes to have something to fiddle with and that other nipple is right in front of him.

Milk not coming in? The importance of pumping

All pregnant women who want to breastfeed should have a pump before they give birth. Full stop. No negotiations.

It does not have to be a fancy branded electric pump, if all you can really get is a manual pump (new, borrowed, used, doesn't matter) then get one. In fact for me the manual pump got more milk out. Yes yes you can hand express, but that will really take a lot of time and patience which you DO NOT HAVE when you have a newborn.

Since I had such a medicalized birth (c-section, induced labor, epidural, da works) it took probably a full week before my milk came in in any real volume. I had colostrum only for a week and had no idea. The only reason I found out that my milk had not come in yet was at my baby's first week checkup with the pedia his weight had dropped significantly (insert mom meltdown and hysterical fear here). At that point I desperately wanted to supplement with formula but my doctor said wait a week, make sure I nurse as often as I can and in between, pump and feed expressed milk.

So I did that. I was attached to the pump between feedings for a full week almost every hour. Eventually the milk came, then the problem became too much milk (that's a different post). Pumping as often as you can is so incredibly important during the first two months as you establish your milk supply. Even if you do end up deciding to supplement, you can still move to exclusive breastfeeding eventually if you pump religiously at least every 2 hours (even at night) and every time the baby takes a bottle of formula.

When pumping, pump until nothing comes out and then keep pumping for another few minutes before stopping. Also, squeeze your boob and massage from the outside in while pumping, Piga-in ng husto! It will be frustrating seeing 1 ounce of milk after half an hour of pumping but this is normal, eventually you will get more.

I am lucky that my pedia held out on the formula and my baby at 7 months has not had a single drop. However for some moms it REALLY can get scary when baby is not gaining weight or is losing weight so I understand the instinct to grab the can. What is important to know is that even if you supplement, you can still move to exclusive breastfeeding when you have enough milk. and that pumping and nursing are the most important things you can do to bring your milk in. The more you pump and nurse, the more milk you have.

Breastfeeding through growth spurts

Breastfeeding through growth spurts can be harrowing, and I suspect, the reason why many moms who set out to exclusively breastfeed, end up supplementing with formula. When baby goes through a growth spurt he can make you feel like you are not making enough milk, in reality what he is trying to do is to make your body adjust to his demand. Supplementing with formula through a growth spurt diminishes your supply, the best way to deal with a cluster feeding baby undergoing a growth spurt is to just be there if you can be. What to expect and how to cope:

1. Expect baby to basically camp out on your boob. We had our first growth spurt at 2 weeks. He went from nursing every couple of hours to nursing ALL THE TIME. Literally, on the boob from feeding to feeding. I'd put him on there, he would be there for an hour (no joke), and then he would sleep. In an hour he would want to be on the boob again. This can go on for 2-3 days. I once had some guests in the house, they were there for 3 hours and the entire time except for the time it takes to switch boobs, he  was on my boob under a nursing cover. Good thing our guest was also a nursing mom, she made me feel ok and explained that maybe the baby is just making me make more milk.
2. Get comfortable and surround yourself with entertainment. It will get boring. Thankfully, the pain is not so bad because for me the pain was bad when he was latching on, it'll last for a minute then i'd be fine. SInce he was nursing almost nonstop the pain was few and far between. Have a nursing station where you can raise your feet up, keep your nursing pillow there, celphone to have text conversations with your friends, have water and snacks on hand, a book, and a tv.
3. Have your husband or partner or maid check up on you every half hour. Just to ask if you need anything. Useful for bringing you water or changing the tv station etc.

When it seems like the baby is just never full and you think your milk is not enough, take comfort in knowing that you won't need to supplement. What the baby needs is just more time on your boob. It is temporary and you can weather that storm. Sometimes baby is just comfort nursing, not really drinking but he just wants to be near, hey, that can't be a bad thing.

Nursing in Public

Being willing to nurse in public is a big part of successfully breastfeeding a baby exclusively for six months. Infants EAT ALL THE TIME! Especially during those growth spurt days, o lordy, they will refuse to leave your boobies alone. So if you are like me who goes stir crazy after 2 days in the house, you will have to accept the idea of whipping your boob out anywhere anytime.

Yes there are options. You can go to nursing/bf-ing stations, there are some nice ones in some malls, or to a quiet roomy restaurant with hidden corners, but sometimes your kid is already screaming bloody hell and there is no time to walk to the other end of the mall. A few tips to make it easier on you.

• Get two nursing covers, one for your diaper bag one for your purse. Get covers that are lightweight and more importantly, have that wire along the top so you can see your baby while sh/he is eating. Some covers don't have that wire, I had one, threw it out because it got so annoying. You need to see down to your boob so you can aim that thing into the baby :)
• Wear stretchy shirts or button-downs for easy access to the milk bags. When wearing button downs, unbutton from the bottom to the breast, so it's like pulling up your shirt from the waist. This makes you feel less exposed, less boobage out in the open public air. 
• Buy nursing pads or cut some pantyliners into two and stick them onto your bra. If you're a leaker like me, these are necessary. 
• If your baby takes a pacifier, take one along with you everywhere. It will calm him down while you look for a place to sit and nurse and set up for a comfortable feed.

Sadly, in Manila there is not much else to do but walk around in the mall on weekends. A really nice nursing friendly mall is Shangri-la Plaza, the Rustan's Dept store has a plush bf-ing room with changing station in their baby section. Eastwood Mall also has a bf-ing room, comfy enough with a changing station. Megamall, not so good, bf room is tiny and cramped and inaccessible. 

In our country breastfeeding in public is completely acceptable and breastfeeding in general in encouraged. So nurse away!

Weaning from Bottle to Boobies

At week 2 or 3, Baby J had gone from breast to drinking exclusively from the bottle (breastmilk). We had to move to the bottle in week 2 because he had lost weight from birth, a lot of weight. After I had my first mommy meltdown we went into feeding frenzy mode. When babies nurse we have no idea how much milk they are actually drinking, J was nursing enough times per day and for long periods, but it turns out my milk hadn't come in fully yet and I had no idea. So I pumped and bottlefed for a full week just to be able to track exactly how much he was consuming, every ounce was recorded. A few times a day I'd nurse him just to get the stimulation but not really expecting him to get milk. At the end of that one week, he started to reject the breast and wanted only the bottle. Enter the second mommy meltdown.

It was terrible, I was awash with hormones, exhausted, frustrated, scared for my shrinking baby, and now I was being rejected. I couldn't accept that our nursing relationship was over, I missed him too much, so we set about figuring out how to put him back on the breast. It CAN be done, with some strategies I found online and some patience, we were able to nurse again. Here's my list of tips, as always most come from kellymom:

1. Attempts to put him on the breast should be well-timed. Don't try to do it when he is really hungry, he will be frantic and frustrated. Try it when he is relaxed and sleepy, either before sleep or as soon as he wakes up to feed.

2. If he clearly doesn't even want to try, don't force the issue. Try to put him on the breast every time you think he might be in the mood, if he doesn't want it, move on to the bottle. Angering him by forcing the breast will just make him dislike the boob even more.

3. Have lots of skin-to-skin when attempting to nurse, you will both be more likely to succeed if you don't have clothes. That skin2skin stuff really works, even if you think it's hokey and too crunchy granola, do it, it works. Trust. This is the same reason why babywearing and cosleeping work for nursing moms.

4. Get your boob started by expressing some milk, if your milk has let down already by the time he starts drinking he will be less frustrated about the slowness of the boob compared to the bottle.

5. Finally, follow all the other pieces of advice on latch (wait for fully open mouth, fish lips, he should be facing the boob and not have his head turned) so that he can get a lot of milk.

I did this for about a week, and at the end of it he was back on the breast almost full-time. At around 4 months he was going seamlessly from bottle to boob and back with no problems!

Breastfeeding is a Challenge for Many

This long thread of posts from breastfeeding moms who had problems always helped me stick to my bf-ing plan. It was comforting to know that I am not the problem, many others have trouble as well.

The consensus? It's all worth it.

Hospital births and breastfeeding

Having a medicalized birth in a hospital can have long term impacts on the chances of exclusive breastfeeding. In this area I have to hand it to the Philippine Milk Code, their regulations in hospitals work really well, although in its present form the code is unnecessarily restrictive in other areas.

The Medical City adheres to some basic rules which are listed in the nursery. First, regardless of manner of delivery, the baby is put to the boob as soon as he is cleared by doctors, in our case under 2 minutes even if I had a c-section. Second, babies are not given any formula by hospital staff and all the staff we encountered encouraged breastfeeding. Third, rooming-in is encouraged by the floor staff, although it was discouraged by our OB. Rooming the baby with you as soon as possible I think is critical to bf success, that baby will want to be on your boob constantly, and scheduled visits to a nursery will derail this. Fourth, even when we pressed, our pedia never recommended a baby formula brand.

Most important, Medical City had midwives making rounds every couple of hours checking in on mom and baby. They are the de facto lactation consultants. Be prepared though, if you have never had a baby, you will be surprised at how midwives will just reach in there and pinch your nipple to get the baby to latch properly. At that moment you will realize, those are milkbags and no longer your property but your kid's. They taught me to use warm compresses to make the milk flow and made me feel better that the little droplets of colostrum I would get at every feeding is enough because the baby's stomach is only as big as a calamansi.

Digression: One warning about midwives in hospitals, they will teach you how to swaddle and bathe your baby, don't try to do those fancy moves at home! They have the most complicated expert ways of swaddling, very hard to replicate, find a simpler method or buy a swaddler. They bathe the baby with one hand while holding his entire body in the other, moving him from batya to batya, not safe if you're not an expert, stick to a little tub.

Yes I am a Cliche: Attachment Parent

I never set out to be a Dr. Sears attachment parent. I thought I was a Manila Mom at heart, with yaya on hand wherever I went and leaving most of the tasks of infant care to someone else. I don't believe that having a nanny takes the bond away from the mom, same way I don’t believe that formula-fed infants have less of a bond with his mom than breastfed infants. Yet somehow I ended up being a full-blown breastfeeding, baby-carrying, co-sleeping, cloth-diapering, crunchy granola Dr. Sears fan-girl. 

Intermission: Check this out! Babywearing around the world. 

It all changed between childbirth and month 2 of having an infant. It all changed because of breastfeeding. I am stubborn, and goddammit I wasn’t about to get beat on this breastfeeding thing! With the pedia on speed-dial on-the-ready in case we wanted to buy our first can of formula, I slogged through the constant nursing and all the pain and sleeplessness associated with it. When you're nursing a growth-spurting infant, co-sleeping is a survival tactic. It will help everyone in the family get more sleep and stay more sane.

Exclusively breastfed babies can either poop a lot, or hardly poop at all. Our baby pooped EVERY SINGLE TIME HE ATE! That meant 12 or more diaper changes in a 24-hour period for at least 2 months. That's a LOT of diapers to throw out if you're on disposables. I never thought I would cloth diaper, it sounded like a lot of laundry, but when you need a dozen disposables a day they no longer are affordable! We could see the money being thrown into the garbage, all covered in poop. So cloth diapering it became. Then as you start to move around and try to get work done around or outside the house you have to bring your baby with you, hence, the babywearing, which incidentally also helps you make more milk.

The whole Dr. Sears attachment parenting system all cascades down from a singular decision to breastfeed exclusively. Since I did all of it, the babywearing the co-sleeping the everything else, there was really little room for a yaya. Of course I am very fortunate to be able to do this because I didn't have to go back to work full-time after 2 months. I am in awe of all those who did and successfully maintained the bfing (see chronicles).

All the other tenets of attachment parenting are based on what will make life easier for you if you breastfeed. Not that it's impossible to do on the bf part and have baby in a crib and stroller and disposable diapers, it is possible, it's probably just harder on mom. 

Green baby poop and oversupply

When my exclusively breastfed baby was still tiny he had a lot of poop issues. Foremost of which was green explosive liquidy poop. For about 2 months his poop was like this, and he was going every single  time he ate! Incidentally the reason why we went from disposable diapers to cloth was the sheer amount of diapers he needed on a daily basis.

I was aware that the consistency and frequency of his poop was normal for exclusively breastfed infants, I also knew that the green poop was not. On top of this, whenever he was feeding he was pushing my boob away, fussing, arching his back, and being generally frustrated. I KNEW he was hungry and needed to be fed, so it wasn't like I was forcefeeding him or anything. Other things that signaled something was wrong was constant gassiness, really loud adult-like toots, lots of spit-up, and other GERD-like symptoms. My pedia said this was all within normal, he just needed to grow bigger. I insisted on seeing a specialist when he started having blood in his stool, the specialist said it was all within normal so long as he was growing and gaining weight.

I was frustrated that my baby had to go through this, I knew he was in pain and there must be something I could do! Turns out, I wasn't asking the right people. We don't have lactation consultants, so I googled. There were plenty of resources so I was kind of lost among the possible diagnoses, until one day... I was feeding him in the middle of night while we were both lying in bed. He unlatched for a second because I was shifting my position and I saw a SPRAY of breastmilk hitting him in the face. It was like a high-pressure hose, I kid you not. That's when I knew it was oversupply, too much milk, the opposite of what most nursing moms worry about.

You never really think that oversupply can be a problem, it must be a good thing right? Well it turns out that oversupply caused most of the symptoms my baby was having, especially the green liquidy explosive poop, AND was exacerbating his reflux causing the blood in his stool and spit up.  He was pushing my breast away while feeding because he was trying to slow down the flow of milk. One of the blogs I was reading said, imagine if you had to drink from a garden hose going full stream, that's what he was trying to deal with while he was hungry and angry.

The green poop was because of a foremilk-hindmilk imbalance (caused by the oversupply), too much foremilk also gives him gas which explains the explosiveness of his poops and toots. AGH! My poor baby! He had to deal with all of this and he was in pain, and hungry all the time!

I reversed everything I was doing to bring my supply up and eventually things all settled into normal poops and baby happiness and easier less frequent nursing. For months my husband and I were obsessed about the color and consistency of his poop, after doing all of the following his poop turned mustardy (the best kind!).

1. Stop the galactagogues. I was drinking 3 pills of Fenugreek (can be purchased for P800 per bottle at Health Options stores Solgar brand). Fenugreek really really works, ergo, bad for those with oversupply.
2. Reduce the pumping sessions. My first instinct was to pump before feeding him to fix the foremilk imbalance problem, but I was told this was just going to make things worse. Made perfect sense of course.
3. Most importantly, block feed for a few days until your supply adjusts down. This means using only one breast for a number of hours. In the morning the left, afternoon right, etc etc. The non-feeding breast will get engorged, when it gets to that point switch.

Eventually I was able to get a reasonable supply amount going, enough to bf exclusively and about 5 ounces extra during the day to pump and store.

Stuff that Helped me Breastfeed

Ok so as I said before, I needed a lot of gadgets to help me get through all the challenges that nursing my tenacious little infant presented. Below is a list of the ones that helped the most and where I got them. 

1. Nipple shields. The ones I used often were Avent brand that my mother-in-law found at SM Megamall (around P800 for a pair). I’ve also seen them at the Hypermarket in libis and in Rustan’s. They were recommended by the midwife at the hospital when she noticed that baby J just couldn’t latch on properly. Frustrated and scared, I asked my mother-in-law to find me nipple shields so these were sort of an emergency purchase, no time to read reviews or comparison shop. Eventually I found a better kind, Medela brand available at Rustan’s (I think 1,200 a pair), but by then the baby wasn’t using them as much anymore. Take note that these things have sizes! I made the mistake of buying smalls and ended up never using them, buy the mediums to be safe.

I used these not so much to prevent soreness, they don’t do a good job of that, but to help baby latch. For latch these are great. You place them on top of the nipple and the baby’s suction will pull your nipple into the shield’s shape. For us the problem I think was that my nipples were flat and almost inverted, then the baby’s mouth was too small. So I credit these shields for my success in nursing, used them until he was about 3 months old. There are certainly downsides to these, including inefficient milk transfer (see kellymom for a full discussion), but women like me just cannot nurse without them. Just wean as soon as you are able, when baby is big enough to learn how to nurse without them.


For more see: Medela site on nipple shields

2. Breast shells. Great invention these things. Also used Avent brand since these were cheapest at Amazon when a friend was able to bring them home. I have seen them at SM stores as well for P1200, really expensive considering they were $12 on Amazon. When nipples get sore from friction with the baby’s tongue as he nurses, the pain sometimes gets worse when it then chafes against your bra or top. The shells protect your boobs from friction against clothing, giving them time to heal up and you some freedom to move around without pain. Put on some Lanolin (available at most baby sections in department stores and possibly Mercury Drug) after nursing then wear the shells.

3. Manual breast pump. I had an expensive brand electric pump which I used at home, a Medela that a friend gave me, that one is for the everyday pumping. For travel and overall mobility, have a manual pump. I bought a cheap one at Shopwise (P700), it doesn’t even have a brand, but it works well. These actually feel like they have more suction than the electric pump. You will need it for when you’re on road trips, on weekends out of town, for dealing with plugged ducts when you need stronger suction.

4. Warm compress. Warm wet heat is best for dealing with plugged ducts and mastitis. Believe me these are a b*tch to deal with and you want to make sure you are vigilant about checking for them and getting to fixing them before they get infected. If you don't feel like spending, make your own: put some bigas (uncooked rice) in a couple of socks, sew up the open ends, microwave for 30 seconds until warm. 

Some of these are tricky to find the Philippines. If you are not in a terrible hurry I suggest going online and checking if you can find these on the many mommy sites on multiply.