Thursday, March 25, 2010

Boobjuicing Mama Nirvana!

Hello Dear Boobjuicers and Friends!

I apologize for the hiatus. Moving up the coast and starting a new job appear to be a bit time consuming! But we are squarely in week three of my new gig, and I am in heaven. Well, to the degree that strapping on a small vacuum cleaner four times during the work day can be described as heaven. My new commute is a ten minute walk, and soon it will be a five minute bike ride. I believe I mentioned that, while interviewing, I used this company's dedicated lactation room. They also reimbursed Kiddo's airplane ticket for that interview trip, even though they didn't have to (and most reasonable companies would not). My new boss is very nice, and totally respectful of the whole boobjuicing ritual. We coined the phrase "mama breaks," which is cuter and less "in your face" than "boobjuicing" or "pumping" or even "gotta go see Bessie." (Work is pretty much the one place where I opt for subtle over in your face, on the theory that if someone is uncomfortable, whether that is reasonable or not, they're stuck there if they want to keep their job - they can't really get up and walk out just because I'm all lactivist-happy, like they could in a restaurant or a park.) Anyway, I'm working a longer day, but actually leaving home and returning home about the same time I did before, because my commute is 35-40 minutes shorter. Ahhhh. I've even come home for lunch a couple times.

And... the advantage of working for a larger company... I've got a boobjuicing buddy at work! No, not literally, like in the same room at the same time. Although I have heard of really big companies where effectively that is the case, if one has a cube in a large lactation room... no, we found each other because we each recognized the other one's little Medela freezer bag in the fridge during the day. It's fun to have someone to chat with! Her little girl is four months, so *I'm* the fancy experienced mama who "has been there." Which is an amusing concept... She also gave me a great tip. I asked where she's washing her pump parts during the day, and she said she has (at her sister's suggestion) enough sets of pump parts to make it through the day without washing. They she takes them all home and puts them in one of those dishwasher baskets and washes them all. I mentioned that I am still boiling the parts (sigh), and it seemed daunting to do twice as many parts twice as often (I have two sets of parts at the moment and use one per day so I can boil them all every other day). She wondered if I couldn't try those micro-steam bags. Brilliant! So we have ordered some of the bags, and will try those, and if we like them, proceed to the multi-parts option. Truth be told, I've gotten pretty darn quick at rinsing my parts out, but I'm doing it in the bathroom, and I don't really love that - both too public and too grody. I think I keep them pretty isolated from other people's cooties, but still.

I still haven't bought a second pump. Kiddo is over 13 months old now, and I keep telling myself that "any day now" we'll have him on cow's milk and the boobjuice will be a morning and bedtime ritual and I won't have to pump during the work day. (Of course for that to happen we'll have to get over our gun-shyness at the previous pukisodes and give him some yogurt...) And then I can buy a second pump for the next kiddo, when the time comes and should we be so blessed, and won't it be nice to have a brand new one at that time. Walking to and from work with Bessie in hubby's huge backpack on my tired shoulders is the best argument so far for a second pump. But, soon my bike will be reassembled (stinking movers), tuned up, and all decked out with a rack, panniers, a basket, lights, and (of course!) a bell. Then Bessie can ride in a pannier, and my shoulders will catch a break.

Talking to the guy in the bike shop was funny, and very Portland. I told him all the things I wanted, one at a time, and he very patiently walked me through the store discussing product. When we got to the panniers, he showed me the most popular models, and I said, "Those aren't big enough for my breastpump." No problem, almost totally unfazed he walked me over to the big orange ones (so cool! But too long for my bike it turns out) and said, "Now, these will fit an entire paper grocery bag, full of groceries. But I can tell you from personal experience, if you put 80 pounds of ceramic tile in them, the stitching will pull out." "Ah, Bessie will fit in there." "Cool." Pause. "That's probably more than you ever wanted to know about breastpumps." Shrug. "Nah, it's cool." This was followed shortly afterwards by me nursing Kiddo in their comfy seating area while reading "The Day the Babies Ran Away."

Happy pumping ladies!

Love,
Suzi

Wednesday, February 24, 2010

The Long-Threatened Thrush Entry

Okay, my new job doesn't start until the eighth, I haven't busted Bessie out yet (I'd better soon but we're all sick so Kiddo keeps waking up at 4:30 to nurse), and I have no excuses... it's time. I have to write The Thrush Entry.

Let me begin by saying that my goal here is to provide some encouragement to other moms who find themselves in this predicament. Maybe also to whine a little bit. Apparently thrush nipples (and milk ducts, in my case) is pretty common, which I totally did not know before it happened to me. Bleh. And it can be really hard to get rid of, and I have had some pretty painful, frustrated moments with it. And I am so glad that I did not let it get the best of me and make me stop nursing my kiddo. I still totally love nursing him (and it's really helping him right now that we all have this nasty head cold/cough) and I would be really upset if nasty old yeast had taken that away from me. So before I dive into this narrative, I will say, PERSIST ladies! Relief is available, and it will be worth it.

So, I blame the antibiotics from the c-section, but realistically, I have been prone to yeast since puberty, so if someone was going to get boob thrush in motherhood, it was gonna be me. I don't remember the exact onset but it was pretty early on. My lactation consultant was the first professional to identify it, and I think we saw her around the two-week mark. At its worst, it felt scratchy and burny when kiddo was pulling milk through the ducts, and the pain did not go away after he was done nursing (one of the signs that it's thrush and not latch problems). I also got stabbing pains in my breasts and into my shoulders and chest cavity, which would occur at intervals seemingly unrelated to nursing. My nipples would be bright red and very tender to the touch, and hurt while nursing. Bright spot - most of these symptoms were very responsive to ibuprofen. Check with your own health care providers of course but most of them let you take this while nursing. They had me on piles of it after the c-section.

I have received varying advice for this infection. Before finding the useful stuff, I was put on nystatin by my well-meaning OB, which did squat, and also for kiddo's mouth. The yeast just laughed at it and went on its merry way. I called a well-reputed breastfeeding center at a very highly-regarded hospital near me in Pasadena. They gave me a long list of totally impractical advice, including going no-sugar, putting all sorts of bizarre crap on my nipples, and something else I can't remember now but I think it involved herbs? This just seriously bummed me out because I knew the no-sugar was not a viable alternative for me at that time (see below) and I could tell that what she was describing for smearing crap on my nipples (including the goo you can buy over the counter for vaginal yeast) was (a) unlikely to work, and (b) not really a good idea for the kid, despite this person being a supposed breastfeeding expert. I'm sure some expert will weigh in and tell me why I am wrong on this point, but it just wasn't useful advice for me in that moment. So that was a serious low point - here I am with barbed wire being sucked through my nipples, talking to a breastfeeding resource, being given crap advice, and months from being willing to even consider weaning my child (which I still have not done, thank goodness). So, mamas, if you find yourself in this boat at the moment, take heart! I got past this point and am feeling much better, and while this yeast is a bee-yatch, there are things that will help, although it will take longer than you want. And again, ibuprofen helps a lot. Do make sure you have a doctor or lactation consultant diagnose your nipples, since latch problems and bacterial infections can feel similar.

The most useful resource I can point you to is Dr. Jack Newman's breastfeeding website. (I highly recommend making a donation if you find his site helpful! Even a few bucks is a help! But of course technically it is free.) My lactation consultant has me using a hair dryer on the girls twice a day (carefully - not to burn them!) and going topless or at least braless as much as possible. To which I would add, breathable tops, preferably cotton, and breathable bras are very important.

I have been through most of Dr. Newman's Thrush Protocol at various points. It will work differently for different women, so don't view this narrative as The Ultimate Truth, but I will relate my experience. Some of the products Dr. Newman recommends are expensive and you will need to find a sort of crunchy granola pharmacy or health store to get them, but it's worth it. There's a great one in Claremont where I used to work - I'm gonna miss her! But realistically most cities have these now, and if not you can try online.

Gentian violet worked well the first couple times and eventually did not. My yeast is getting smarter - not what we want. Gentian violet makes a big mess, and (as you will read in the instructions) this includes kiddo's face. First time I tried it I freaked out that I had permanently stained my child purple, which of course I had not. There is a perennial dry spot on his lip which stayed purple longer than the rest of his face, but that went away too. So get some old/dark towels to put kiddo on when you nurse kiddo with the gentian violet, and have the baby naked or in an outfit you don't care about. Also, gentian violet is not to be found at most big chain pharmacies but little neighborhood pharmacies have it.

The topical grapefruit seed extract seemed to help a little but I found it very drying, even at the more dilute concentration, so I first tried olive oil and then gave up on it. The oral GSE didn't seem to do much. The all-purpose nipple ointment (APNO) works wonders topically but since I had deep breast yeast eventually I wound up on fluconazole (generic for diflucan).

I've probably been on too much fluconazole at this point - I started getting a few random bruises, which realistically are probably from packing and moving, not the drug, but they were sort of out of character for me, so I went off it for now. At this time I am just on the macrobiotics (which I keep forgetting to take) and the APNO, and so far so good. My nipples are still really red but they don't actually hurt. I should add the hair dryer back in.

My OB is a great guy, but he apparently hasn't seen a case of thrush like this, so after the nystatin he was sort of out. So after finding Dr. Newman's site, I printed the appropriate pages, circled the things I wanted and faxed them over with a nice little note. E.g., "please prescribe me this APNO, here is a compounding pharmacy to call it in to, please let me know if you need to see me first." I think some doctors might take offense at a patient sending them articles and instructions but my awesome OB actually thanked me for "the interesting article" and did just what I wanted. If your doctor isn't getting you what you need and isn't cooperating with your instructions then find someone who will. Persistent yeast is shockingly difficult to treat and you don't need some jerk who thinks that MD stands for "I know more than you, you silly woman" telling you that you will feel better soon when something isn't working.

I have done the no-sugar anti-yeast diet before. It is very effective in combating vaginal yeast. It is also a lot of work, and the way I was able to do it in the past was to spend all of each Sunday meal planning, shopping, and cooking. New moms are lucky if they get to spend all of Sunday asleep, thank you very much. Besides this, no matter how little sugar you eat, there will be sugar in your breast milk, because your baby needs it so your body makes it. It is of course a good idea to eat as little sugar as you can, just generally, but certainly if you are combating yeast. But the idea that a new mom who was not previously doing so is suddenly going to be able to go on a totally no sugar macrobiotic home cooked diet is pretty laughable. As a side note, at one point I tried having half a beer after kiddo's bedtime because it is a galactagogue. The yeast just LOVED that. So I stopped. Which is really fine because I don't like beer. I think the yeast really loves wine too. Alcohol works just like sugar for yeast, and of course these beverages also have yeast in them. Just tell yourself when the last of your kiddos is weaned you can go for a weekend in Vegas.

Recall that my dudelet just turned one year old. I have been combating thrush in my breasts and on my nipples for a year. It was WORTH IT. Really. I may be nuts, fine, but I'm telling you, I still totally love nursing my little guy, and I got through it, and you can too. I hope this post will be helpful to someone, and please message or comment if you have any further questions.

Monday, February 8, 2010

Officially Unemployed!

Hello Dear Boobjuicers and Friends!

I am officially unemployed! My last day at my job of 6 1/2 years was Friday, and here it is Monday, and I'm home alone with the Kiddo. Which I did on Saturday, too, as hubby is doing a five day video shoot while we're packing to move out of state. My suggestion. I'm an idiot. But he's really excited and it's very important that he get to do what feeds his soul too, like me. I think I could have planned it a little better though, but so be it.

So after spending Saturday at home alone with Kiddo all day, I have to say: How the everloving crap do you stay-at-home parents do this? Good gravy! I was so tired by the end of the day, and I couldn't figure out why. Several times during the day I felt really stressed and frazzled, and found myself trying to figure out how to get some help. But then I would think about it, and realize - dude, I'm just sitting here. Crawling around behind the kid, taking various potentially dangerous objects away from him, or him away from them, or changing his diaper, or holding him in my lap while I pee (I'm open to alternatives on this one ladies but if he's not putting up with the exersaucer, bouncy seat, or crib, I just figure, one hand for kid, one hand for bathroom activities) - anyway, whatever I'm doing, it's not like I'm dodging live fire or getting yelled at by an employer or a customer or evading a traffic accident. Much of the time it isn't even that loud. And yet I felt really stressed and really bored all at once. And then I would feel guilty for feeling that way - shouldn't I be just overjoyed to have all this time alone with my kiddo? Of course it might be a little easier to feel that way if I wasn't trying to sort and pack all my cares and woes at the same time. But there would always be dishes, and cooking, and tidying...

Okay, to be fair, I'm overstating the matter. I *have* done this before - hubby has gone on shoots or social outings, and I do fine. I do better with errands than with sitting at home. I do best when I manage some walks and some social engagements. So it's not like I can't imagine ever figuring out how I would do this. If I had to. But I'm glad I don't have to. I really do better with the contrast between breadwinning work and mommying work, rather than too much of either. And I hope I remember that the next time I sit down to strap on Bessie and get pumping!

Thursday, February 4, 2010

Happy Trails to Me!

Hello Dear Boobjuicers and Friends!

I have exciting news! Kiddo, Hubby, Bessie, the girls and I are all moving to Portland, OR! That is where my sister and her husband live, and their family plan is for us to have kids for them to play with. Can we say, "Free Babysitting"? Every time we have visited them there since they moved, it has gotten harder and harder to come "home" to California. So after 18 months of courting a firm in P-town, I got a great offer for a really exciting new job, and off we go! I'm really stoked, as you may have noticed.

This company seems really great - I had a lactation break during my on-site interview. In their dedicated lactation room. Awesome. To be frank, that's how it should be, for any company, but unfortunately we aren't there yet as a country, so when you happen across it, it's so exciting.!

Plus, our new apartment is 0.4 miles from the office. Ahhhh. Remember when I said that a commute while boobjuicing and breadwinning was a major downer? Well, now I can walk home and nurse at lunch if I want. Ahhhhh. It's kind of a small apartment, but I don't care - the idea of having kiddo number two four blocks away during that crazy time after resuming breadwinning post birth is so exciting, I think I'd be willing to live in a shoe to make it happen. Well, a boot. I mean, it rains a lot in Portland.

So I'm strapped to Bessie at the moment on my next-to-last pumping work day for a WHOLE MONTH. I don't start the new job until 3/8, so I get a pumping vacation! During which we are packing, moving, unpacking, and oh yeah, hubby is getting in one last film shoot before we leave L.A. - my suggestion. For which I have kicked myself a dozen times. But I know we'll both be really glad we made it happen once he's done. Interesting thing about the pumping vacation, though - during the week we had off to go find housing, I realized that pumping affords me a break from exposure to the thrush in kiddo's mouth, and from getting chewed on... maybe I'll be glad to see Bessie again... And I don't really get a month off from pumping, because I'll need to stock up the fridge and freezer before my first day. Even if I had a supply of breastmilk accumulated, it would be impossible or prohibitively expensive, I think, to get it to Portland without letting it thaw or stay out of the fridge for more than a couple hours.

Well, wish me luck!

Much love,
Suzi

Tuesday, January 19, 2010

Geeking Out on Boobjuice: Web Resources!

Hello Dear Boobjuicers and Friends!

I'm composing an email to a family member who thinks I'm crazy for letting Kiddo choose when to wean (I'd be upset but it's such a prevalent attitude that it would be a waste of energy) and it occurred to me to share some of these websites with my beloved boobjuicer friends.

Here's Dr. Jack Newman's website. If you only use one breastfeeding resource, use him. That said, I didn't find his latching instructions particularly helpful from afar - latching is really something best taught in person, so if you are having latching challenges there really is no substitute for a visit with a lactation consultant or at least another boobjuicing mom. But, he's got really helpful articles on pretty much anything else you could want to know about breastfeeding, including thrush (yes, I really will write that entry one day - it's just not a fun topic, you can see where I would be more excited about some of these other topics). Dr. Newman's website is facing funding challenges, so if you find him helpful, I would encourage you to follow the website's instructions to donate some money. I gave the same amount that my lactation consultant charges for a half-hour phone consult - except it's Canadian dollars, so I'm curious to see how many greenbacks 50 Loonies cost on that day. If he were actually charging me by the hour I've spent on his website, I'd owe him a lot more.

Here's a list of state laws regarding breastfeeding. We West Coasters have it good, although notice Louisiana's laws regarding child care centers. Interesting!

Here's the World Health Organization's website about breastfeeding. Mostly they are focused on developing and economically challenged countries, but they have information about the health benefits of breastfeeding too. They are another worthy organization if you are motivated to reach out with your wallets to your fellow boobjuicing mamas across the globe. Their babies need food. What mama doesn't have a visceral, emotional reaction to a baby needing food? Which actress was it a year or two ago who got into the tabloids for breastfeeding a stranger's baby while touring in Africa? I completely understand that impulse. Of course if I did it the poor thing would get thrush. And I don't really know the circumstances of the situation - was the mama gone? Did the mama ask her to do it? Did she just pick up some random wailing infant and whip out the girls? I don't know, I just know that reading the story, I felt an overwhelming urge to nurse my kiddo. But I digress.

Here's a great, somewhat hippie granola flavored website on breastfeeding and other parenting topics, Kellymom.

Notice I have not cited La Leche League. We owe a debt of gratitude to LLL for their lactivism in this country, but I and many other moms find their tone a little hard to take. Perhaps they have changed since they made my mom feel guilty, I don't know. I do know that The Womanly Art of Breastfeeding made me want to slap someone, and was not as informative as The Nursing Mother's Companion.

If you have a low tolerance for hippie granola-ness, you should stick to the medical websites (Dr. Newman, American Academy of Pediatrics) and the NGOs (WHO, UNICEF). I would encourage you to try to turn on your granola filter, though, and try some of these other websites. We are, as a country, still recovering from the formula companies' success in convincing women that we are inadequate to feed our children and that big multinational manufacturing companies with (mostly male) scientists in white coats can do better than God and Mother Nature. So the most open, unapologetic breastfeeding resources are still a bit on the fringe at this point. Dr. Martin Luther King Jr. was fringe once, too, as were the suffragettes. Think of yourself as cutting edge cool and keep nursing!!!

Much love!
Suzi

Sunday, January 17, 2010

The Ugly Truth

Hello Dear Boobjuicers and Friends! I write from relaxing Portland, land of tea, dogs, and cozy cloudiness. More on that in an upcoming post.

So, my friend and fellow boobjuicer Mama A.K. ran up against the ugly truth recently as she resumed her paying job as an academic, a 45 minute drive from her home and baby. No one tells moms this, because (I suspect) we are so eager to make sure that mothers breastfeed as much and as long as they can, that we don't want to say anything to discourage them. While well intended, I think this is (a) patronizing, and (b) counter-productive. This leads to moms starting to pump at work and getting smacked in the face by the ugly truth, instead of knowing in advance what to expect. These same breastfeeding advocates would not, I hazard a guess, try to "spare" you the ugly truth about birth and send you in to Labor and Delivery not knowing that you would be pooping on the table. When we have good information in advance, we can better prepare ourselves. So I am going to tell you the ugly truth.

Pumping at work is a pain in the ass.

You will not like it. At best, you won't mind it, and maybe even will appreciate a chance to close your door or lock yourself in your lactation room away from your co-workers a few times a day. At worst you will find it inconvenient, uncomfortable, and frustrating.

It's worth it. Do it anyway.

There. Was that so bad? I mean, you *knew* that in your gut, and somehow you had this nagging feeling that the breastpump manufacturers, your lactation consultant, and that La Leche League lady you met at the grocery store were hiding something, casting their eyes to one side and using flowery language to not quite lie to you. Well, I shall not do you this disservice.

When I started pumping at work, I became convinced that I must be doing something wrong. It was really hard to get my work done when, by the time I had chased off my co-workers and managed to start concentrating on something, it was time to go wash my hands and strap Bessie on again. I wasn't getting nearly as much milk as I thought I was supposed to (I have since learned some tricks - see earlier post). I was constantly worried about Kiddo running out of milk at home, and in my anxious state, didn't see that (as hubby brilliantly pointed out when I was complaining about this later) at worst we are 45 minutes apart and he could always bring Kiddo to me if I couldn't leave work. And pumping is not snuggly like breastfeeding. You can kind of get that bliss moment after let down by looking at pictures of your kiddo, but no cute nursey noises and no baby in your arms or on your lap.

It doesn't matter if you are going to your other job 15 hours a week or 50, it's going to take some getting used to. There are a lot of things you can do to ease the transition, like starting back to work part-time at first, asking to telecommute to keep the baby near the boobies (did I mention I finally got back my telecommute Wednesdays? SOOOooo helpful), and, if you live near your work, going home to nurse at lunch time. Remember that it's not forever, and as your kiddo starts getting more and more nutrition from solid food, it will get easier to keep up with kiddo in supplying the good stuff for while you are off earning a buck. In fact, as my kiddo started nursing less (down from 7 times a day to maybe 5 when I'm with him all day at this point) I actually felt really sad for a while, somewhat to my surprise.

It will get easier!!!

The really hard part for me was from resuming work (Kiddo was about 3.5 months) through about 9 or 10 months, with some times easier than others. One thing I learned was that, for us at least, commuting was just NOT worth it when trying to breastfeed a little guy, and we decided to move work and home much, much closer together. Another trick I may employ soon is to have two pumps, one for work and one for home, so that you don't have to cart the thing back and forth. This is expensive of course, but if I take, what, $300, and divide it by, say, a year of being away from kiddo four times a week, with two weeks off, so that's 200 commutes, that's a buck fifty a day to not have to cart my breastpump around. Seems reasonable to me. But I haven't bought a second one yet so I can stand as proof that it *can* be done.

Meanwhile, you get to complain all you want. It's hard. It can be quite stressful. And you are earning your battle scars. The folks at work may not understand. But we boobjuicers will. You can complain to us all you want. Just keep pumping and nursing. It really, really is worth it. You will be so proud of yourself when you get through this difficult period and can look back at what you accomplished. At those sessions where you sit there with a vacuum on the girls for twenty minutes and get like half an ounce, remember that you are protecting your milk supply and that is very important, even if you don't get a lot of milk every time.

It's worth it. Keep pumping.

Much love to you all!

Sunday, January 10, 2010

Back in the Saddle Again

Hello Ladies! I hope you all are having a fabulous start to the new year. Something about the change of year reminded me about coming back to work post kiddo, and how jarring it was to try to fit myself back into grownup land, even though I had been looking forward to it. I'll share a reminders list I developed for myself which I still find useful, even to this day. Maybe some of our pumping moms are heading back to the workplace soon and will find it useful. Ladies, send me your additions to the list!

1.) Don't forget to put your shirt back on after pumping.
I just know I'm going to do this one day - lose track of which things I do in what order and open my office door when I'm all boobs-a-go-go. Luckily there's another mom in the office across from mine - hopefully if it happens she'll catch it rather than, say, one of my interns. I'm pretty sure that would be harassment.
2.) Similarly, don't feel the girls to see if they are full when you are walking down the hallway.
I've done this. I don't *think* anyone saw before I realized what I was doing, but I was embarrassed anyway. It can't be that much better than some guy adjusting his genitals while in the lobby.
3.) Don't babytalk the clients.
"Awwww... Did missus smithy get her quarterly performance report? Yes she did! Yes she did! That's a GOOD client!" Yeah, not a good idea.
4.) Don't inflict your newfound enthusiasm for breastfeeding/cloth diapers/perineal massage on the non-parents in the office.
Perhaps you work in a birth clinic - then you would be the exception. But the rest of us are going, at the very least, to be disappointed by the lack of enthusiasm shown by the target of our latest gush on how great these new breast pads are. We don't mean to be That Parent, but we've all done it. Try to find another mom to point it at. At the very least, she probably owes the universe some pay-it-forward from when she was there.
5.) Try to wipe off the layer of baby spooge before you walk in the door.
This is a toughie - which of us has been free of spitup, snot, pee, and mashed bananas for 20 consecutive minutes since giving birth? But along the lines of number three, you don't want to explain "no, it wasn't a bird..." in a big meeting if you can help it. Maybe now is the time to start keeping a spare blouse in the office.
6.) Be gentle with yourself!
This is a big adventure and you will figure it out. And it will be worth it!