Tuesday, October 30, 2012

Triumphant Tuesday: Breastfeeding After Breast Cancer

By breastfeeding her baby, a mother is giving life. She is literally keeping her child alive through the power of her body. However, what if the mother's life is in danger? Surely being faced with a breast tumour would excuse a mother from breastfeeding duties? To this mother, it was a matter of priorities, and she prioritised her baby. This is Amanda's story.

I'll put it out there...and own it. In America, we are not a breastfeeding society. We know the research has proven breast milk to be superior over formula, but still the idea of breastfeeding gives a lot of people the heebie jeebies. While I was pregnant I was bombarded with stories about how difficult and painful breastfeeding was, and how a lot of people tried but never even made it out of the starting gate. At the same time, everyone and their dog would ask me if I planned on breastfeeding. Some people would ask multiple times. 

My answer was always the same, "I'm going to try, but if it doesn't work out for me and my family then it is no big deal to use formula." (All the self described "crunchy" moms are probably throwing up in their mouths as they read that). I didn't want to set myself up for disappointment and frankly what difference was it to me whether the little sea monkey in my belly drank milk from nature’s tap or milk from a bottle? 

Birth overshadowed by pessimism

When my son was born, it suddenly made a difference. Seeing him struggle to latch on, while listening to a chorus of nurses tell me that he might not be able to breastfeed and I didn't have enough colostrum, devastated me in a way I could have never anticipated. I at least wanted to be given the option to breastfeed. 

Those first few days in the hospital were a roller coaster of emotions. After speaking with a lactation consultant I discovered that I did have colostrum after all...those nurses were idiots..but my son had difficulty latching and my boobs struggled to keep up with my baby walrus' increasing demands. 

I was outfitted with all sorts of alien devices to help the process: nipple shields, a breast pump, collection containers, etc. Overwhelmed was the understatement of the century. I had no idea that breastfeeding could be THAT complex. 

Every time I hooked those breast flanges up and started pumping, I felt like Bessie the freaking cow. Honestly, that happens to this day! I'm not sure my boobs will ever be viewed as sexual objects again. They've become a sort of freaky sideshow act. "Look how far I can shoot milk out of this one babe!" But I digress..

Clogged nipple pores

Next on the menu for me was clogged nipple pores, clogged ducts, and reoccurring mastitis. For those of you who don't know, a clogged nipple pore looks a bit like a pimple.. on your actual nipple. Super hot, right? And it feels a bit like a scalding branding iron every time you go to nurse. Now, I've got your attention! Eight hundred episodes of TLC's Make Room for Baby did NOT prepare me for that shit. On the other hand, a clogged duct feels a bit like you got donkey punched in the tit. Super sore. 


If you are lucky enough to get mastitis, the mother of all boob ailments, then you are in for a real treat! I've had it a few times now..which I'm positive equates to like six tear drops in prison. Mastitis hits you like a ton of bricks. You suddenly just don't feel right. Perhaps, you're coming down with something? A few short hours later and your boob is painted with fire-engine red stripes, you have chills, body aches, and a fever that hovers around 104. If you're anything like me, you have no idea what the f#&k is going on the first time it happens. Hmm..is my boob supposed to be swollen like a Guatemalan cantaloupe? Basically, mastitis is when the shit hits the fan. They pump you full of antibiotics, fluids, and fever reducers. If that doesn't work you have to be hospitalized. HOSPITALIZED! How hardcore is that? Breastfeeding is not for the faint-hearted. (And you thought we were all a bunch of smelly, Pansie hippies).

Despite these hurdles, breastfeeding is a bond that I knew I wanted to share with my son. There was something so beautifully primal about it. So simple. It felt right. However one day I decided to supplement with formula a few times after my son’s hungry cries got the best of me. Giving him formula made me feel like a failure. Defective. Like I was giving up on breastfeeding. Then, nature threw me a curve-ball...

Discovery of a lump

When I was trying to get my son to latch on, I noticed a lump in my breast. I mentioned it to my obgyn at the 2 week appointment. She suggested an ultrasound. I followed through with her request and when the results came through – they were inconclusive. 

I was then referred to a doctor who specialised in breasts. And this is what she said:

"We're worried it might be cancer."

I didn't answer right away. What was there to say? This wasn't candid camera, some sick joke, or even a bad dream. This was my new reality. A life where I might have breast cancer. In an instant I was bombarded with horrific mental images of hospitals, chemotherapy treatments, and even tombstones. I was petrified. 

My eyes misted over. I felt the weight of everyone's gaze upon me but I wasn't ready to address the elephant in the room. Instead, I found myself looking down, losing myself in the blue/grey abyss that I knew as my baby's eyes.

The squirming bundle in my arms was blissfully oblivious. My son was only a few weeks old at the time, practically brand new, and here I was contemplating a life for him,without a mommy. It didn't seem fair. As if the emotional roller coaster of new motherhood wasn't difficult enough, I now had to contend with this. I didn't feel strong enough.

After 24 years, I had finally found my calling in life. My joy. My passion. My son. And it was all crumbling out from under me. I was drowning. Encumbered by the many questions in my head, I could barely catch my breath.  Why me? Why our family?

Whether unsympathetic or unaware, the doctor droned on about the medical protocol, while I bargained with my God. She told me that we would start with a core punch needle biopsy and "go from there." 

While the gravity of the situation was apparent to me, I still found myself preoccupied with the baby's well being. I only caught snippets of what the doctor was saying, and they put me in a panic. 

"....and I suggest that you discontinue breastfeeding immediately." 

Discontinue? But, how will I feed him? How can he nurse? We had overcome so many obstacles in learning to breastfeed. Now it all seemed for naught. 

Looking back, I am confident that this specialist utilized scare tactics to ensure that I underwent an extremely costly ultrasound guided needle biopsy. I didn't have any insurance at the time, and I mentioned that I would need to "shop" around because I didn't have the 2 grand just lying around. Instead of suggesting payment plans, or another doctor, the specialist tried, and succeeded, to terrify me. She told me she was pretty confident I had cancer and was wasting precious time. She stated that she simply didn't want to see my son grow up without a mother. Essentially she preyed on a young, hormonal mom.


Anywho, I went through with the needle guided ultrasound biopsy. The four day wait that preceded the results was agonizing. I was weepy and irritable. My nerves were frayed from living in a perpetual state of fear and I found myself lashing out at the ones I loved most

The results were cautiously optimistic. The Pathology report suggested a non-malignant, lactating fibroadenoma. Because the specialist was such a quack, I ended up with a terrible case of mastitis. She also pushed me from beginning to end, to quit breastfeeding my little boy. He was only weeks old! I wasn't having it. After the surgery, I pumped round the clock to try and keep my supply up. My milk was full of blood and the baby was uninterested in nursing from the affected side for about a week. But we prevailed! I was told to keep an eye on the tumor, and have another ultrasound in 6 months. When I did, the results were fishy again. They "strongly suggested that I follow-up with my physician as abnormalities had been noted in the films." As if no time had passed, I plummeted down the rabbit-hole again. The all too familiar sense of foreboding enveloped me and the haunting images came flooding back. 

My once squirming bundle was now a mischievous and adventurous, 7.5 month old ball of wonderment and giggles. The thought of being separated from him, temporarily or indefinitely, hit even harder than it had the first time. I was tired of being terrorized by a clump of cells.

Removal of the tumor

A new doctor suggested needle biopsy again but I was emotionally drained from the whole process. I just wanted to get the whole damn tumor out of there and put this mess behind me. So we opted for a complete excision of the lump. The surgeon was hesitant because few doctors have operated on lactating breasts. However, he supported my decision to continue nursing and after a few months, the tumor was removed. 

Then, I ended up getting mastitis again! I have also had to deal with complications from the ducts that were cut (an inevitable outcome). Sometimes when my milk lets down, it will balloon in that pocket where the tumor was before. I suspect it will resolve itself when my son eventually weans. I sometimes have concerns about how this will affect my nursing relationship with future babies, but I am sure I will take it in stride. One day at a time, just like I do now. 

Unsupportive relatives

This would have been an easier journey with some comprehensive support. In everything else in the world, my mom is totally supportive. However, seeing my many ups and downs in trying to breastfeed, she has pushed me to quit many times. Obviously, I am HER baby so when she believed that breastfeeding was "jeopardizing my health", she was really adamant that I should give up. Other family members haven’t been super supportive either. In the beginning, my sister in law flat out told me that breastfeeding was gross and we haven't spoken about it since. I'm far too hormonal and I might just open up a can of whoop a$$!

When to wean

I tell you all this, because I'm now in a pretty comfortable place with breastfeeding. Knock on wood, we haven't had any issues of late. So now, eight months later when me and the kid finally have our shit together, people are telling me its curtain call. "You only really need to breastfeed for 6 months." "When are you planning on going until?" "You're STILL breastfeeding?" 

So you mean to tell me I went an extra two months, and I didn't have to?! Damnit! Who do I talk to about a refund? 

Weaning is a topic that seems to be coming up more and more these days. Apparently, everyone and their dog thinks they have a right to comment on my boobs. Seriously...there are some very judgemental poodles out there. (Insert laugh here.)

Of course I know that according to the American Academy of Pediatrics, 6 months is the minimum recommendation and 12 months is what society interprets as the "maximum." How about this...I do what I want. Yes, I'm still breastfeeding. No, I don't have an end date in sight. How about I do what works for my family, and you mind your own god damn business. :) Since when the hell did my boobs become open to your interpretation and advice anyway? 

I get it. I used to be one of those people who thought it was gross and cringed at the sight of a kid old enough to walk over and plop a boob right in his own mouth.  But doing time in the breastfeeding trenches has changed me a bit. I don't know if that is what will happen in this house, but it doesn't bother me as much anymore. Even if your kid is old enough to tip his hat before sauntering over and saying, "I'm a might bit thirsty mummy, could I have a bit of milk", I think it's fine. It doesn't make you a freaking deviant.

My son will be 11 months old this week, which means continued breastfeeding solidifies my status as a freak of nature in American society. I'm sure I catch more flack than the average bear, because of my giganto baby who looks like a pre-schooler. Regardless, I think this negativity and judgement is horse crap. There is no magic date circled on my calendar. We will wean, when our family sees fit. 

Mothers who don’t try

I think that Moms who don't even try to breastfeed because of superficial concerns like saggy breasts, stretch marks, the inconvenience, etc are selfish cows. I'm ok with "owning" that. There is no "I" in motherhood. It is all about sacrifice. Besides, breastfeeding is the reason we have boobs in the first place!

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Wednesday, October 24, 2012

Babies Asleep in Walkers

Is there any sight cuter than a baby blissfully dozing in dreamland? YES! A baby blissfully dozing in dreamland IN A WALKER!!

When I found my son doing it, I wondered whether this was a common phenomena. So I enquired on The Alpha Parent Facebook group. The result? Welcome to the... 

'Babies Asleep in Walkers Hall of Fame!'












Jaycee again
She's a veteran sleep-walker (see what I did there?)
















Garrett Take 2:








Do you have a photo of your sleeping cherub in a walker, jumparoo, bouncer, or activity center? Do you have a sense of humour? If so, email me and you could star in the Hall of Fame!

Tuesday, October 23, 2012

Triumphant Tuesday: Commercially-Motivated Medical Staff

As I wrote in the article: '15 Tricks of Formula Companies', getting health professionals on side is a common strategy of formula companies. New mothers understandably carry the assumption that health professionals have significant expertise in the areas they counsel, and that health professionals always have the baby’s best interests at heart. However the reality is that a baby’s interests, and indeed a mother's interests, are often misplaced by commercial interests when a health professional has been corrupted by formula companies. Cera is a mother who experienced this first hand. When Cera became pregnant with twins, the sabotaging remarks of her family were the least of her worries...

“My name is Cera (pronounced Sarah). I am 22 years old and proud mom to beautiful twins. I was blessed to have a boy and a girl. They are happy, bouncy, smiling bundles of joy and my husband and I couldn't be happier. It however didn't start out that way...

Unsupportive Family

My family has a really bad tendency to tell me exactly how they feel at any given time, so when I was pregnant with twins and they found out I was going to attempt to breastfeed they had no problem telling me I was nuts! My mother in law informed me that breastfeeding was like a ball and chain, and that it was embarrassing to do anywhere but at home. She told me that she used formula with her youngest child because she didn't like to breastfeed. That in itself planted seeds of doubt in my psyche about breastfeeding. 

The next big "confidence boost" came from my ever loving sister. She had a c-section with my niece and after a couple of failed nursing attempts, turned to formula. If anything I feel that she was jealous of my determination not only to breastfeed, but to feed two babies. She informed me that I wouldn't release any milk because I was not having a natural child birth. I wasn't convinced, so I bit my tongue and carried on. It wasn't until my third trimester when I woke up to a milk soaked bed did I realize that there was hope for me!    

Skin-to-Skin Interrupted

On June 4th I was finally in hospital for my scheduled c-section to bring my twins into the world. I was 38 weeks pregnant and bigger than I ever thought a pregnant woman could get! After the babies were put into my arms, I was more than ready to start the bonding and beauty of breastfeeding. My husband stayed to help and watch as my little 6 pound babies were nestled under my arms and up to my breasts. After both babies successfully latched, I was ecstatic. I beamed with pride and relief and forgot about all of the grief I received from friends and family telling me there was no way with a c-section and twins, that I would never be able to breastfeed. With panic aside, I happily bonded with my husband and newborns. That was until the lactation specialist walked into the room.

She busted through the doors into my room and instantly started barking orders. I knew right away I wasn't going to enjoy the company of this woman. She saw my little baby boy sleeping sound, snuggled against me after he had just finished his meal. She then grabbed him from my hands to undress him, rub him and put an ice cold wash cloth on him. I was shocked to say the least. I fully understood that you have to wake your babies to get them to eat, but to interrupt my bonding time was more than appalling. After she put my son back onto my breast and move onto my daughter, I politely asked if my husband could try and wake her. 

Two days later I was getting into the groove of breastfeeding. I thought all was well and I was in Mommy bliss! However one evening the lactation specialist came into my room with a scale to weigh the babies and 'make sure I was producing enough for them'. This is when we found out both of my babies had lost a significant amount of weight. I was mortified. I couldn't believe it. My baby bliss just melted away with one scorned look from this woman. She lectured me about not waking them up regularly enough (even though I woke them every 3 hours as I was instructed) and she accused me of not listening to her. A flood of tears hit me. I was alone in the room with her since my husband had left to get some clean clothes and feed our pets at home. When he walked back into the room he found me pale faced and bawling my eyes out. The thought that I could be starving my children made me sick

With careful consideration, we asked one of our wonderful nurses to not allow that nasty woman back into our room. After a lot of prayers and help from the nurses, in a few days we got our babies weight back up and breastfeeding returned to a happy experience for everyone. Sadly, this harmony was short-lived. The next day the specialist came back into our room to apologize (even though I didn't want to hear it) and to proceed to tell me that if I didn't have a Medela Breast Pump that I was not leaving the hospital without buying one from her. I was livid! After all this woman had put me through, and now this?? I couldn't believe it! I told her that I had a nice brand new pump at home and she proceeded to tell me that it wasn't good enough. I was now captive!

With my mom at my side, we called every mother we knew and our insurance to try to get me a Medela. Finally an acquaintance of my husband’s friend had one that I could borrow and we got our babies home.

Now my babies are both growing healthy and happy with full tummies that I proudly provide. I constantly get compliments from other mothers and even doctors for not needing to supplement my two "not so little" ones. If I had the chance to speak to any young mothers of multiples that are hoping to breastfeed without supplement, I would tell them to never give up on what you feel is right for your babies. It will get easier in time.”

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Tuesday, October 16, 2012

Triumphant Tuesday: Breastfeeding with Tongue-Tie

Most of us think of tongue-tie as a situation we find ourselves in when we are too excited to speak. In fact, tongue-tie is the non-medical term for a relatively common physical condition that limits a baby's use of it's tongue – and, if left undiagnosed, can be the final nail in the coffin of your breastfeeding relationship. Tongue-tie occurs when the thin piece of skin under the baby's tongue (the lingual frenulum) is abnormally short and may restrict the movement of the tongue tip. This can interfere with the baby's ability to suckle efficiently at the breast, leading to nipple pain and trauma, poor breastmilk intake and a decrease in milk supply over time.

Diagnosis is only the first hurdle however. The decision to release a tongue-tie often depends on a doctor's personal belief about the possible impact on feeding. Currently, doctors are divided in opinion, which leads to a lottery of patchy treatment for breastfeeding mothers.

Emma drew the short straw in this lottery. Here is the story of her struggle to get her son’s tongue-tie taken seriously.

After two hours of my pushing, my son Samuel, took his first breath. As soon as I saw him I knew I was going to breastfeed no matter what. It's natural, it's normal. Making sure I give Samuel and myself all the "benefits" of breastfeeding was very important to me. There is a strong family history of allergies and asthma that I didn't want Samuel to inherit it. I don't understand when mothers don’t attempt to breastfeed. I think it's sad they won't even give it a go.

Sent to NICU
Samuel in NICU

When Samuel was born, because there was meconium in the amniotic fluid, the pediatrician sent him to the NICU for monitoring and tests to check if he had an infection. Samuel was put on antibiotics as a precaution. As a result, he got thrush which took a while to clear up.

Samuel was born at 6:49pm, yet it wasn't until 3am the following morning he was released from the NICU and was allowed to breastfeed for the first time. I became so anxious about nursing him in the hospital that I couldn't get him to latch and needed the help of a midwife every time I wanted to feed him. That night he fed for an hour, sleep for an hour, then wake screaming for more. As a first-time mom I didn’t know this was normal newborn behaviour. In fact, the midwife told me to give him formula because I couldn't possibly keep up with him as he was so big. As she suggested formula I could feel my face falling. The midwife was polite, but in an overbearing, condescending sort of way. It seemed like she thought formula was much the same as breast milk. Up until that point I had been confident in my ability to feed my son. It felt as though everything had come crashing down. I was in tears. I knew giving formula would negatively impact my milk supply so I didn't. The midwife tried to help me manually express some colostrum, but as you'd expect we didn't get much and I was very stressed out at the time. My son was barely 24 hours old and I was already failing.

Once Samuel fell asleep, the midwife took my observations, and my pulse was through the roof (I think I was on the verge of a panic attack). She asked if I was in pain; I said I was stressed. She then gave me panadol to help me sleep. The next time my baby woke – I was so drugged up that I didn’t hear him.

Baby weight loss

By the time we left the hospital Samuel was had dropped from his birth weight of 4.424kg (9 pounds 12 ounces) down to 4.1kg. On the drive home I was bawling. I had tears streaming down my face. I cried through each feed for the rest of the day.

At his two week check he still hadn't regained his birth weight; in fact he had lost 45g. The only advice the health visitor offered was to top him up with formula. She even asked who my GP was, so she could keep tabs on me. This was my lowest day in a long time. I spent the rest of it in tears. I couldn't even feed my own baby. I had failed at being a mother.

After a phone call to the Australian Breastfeeding Association (ABA) I started to feel little better. I just kept feeding on demand (which was a lot). Samuel also had a handful of formula bottles when I knew he was hungry and I couldn't satisfy him.

At his 10 week check he only weighed 4.6kg. I was devastated. Things were not helped at times when my mother saw Samuel and she would regularly comment on how small he was. Every time I spoke to her she asked if he was still feeding as much.

Investigating the latch

I decided to ask a professional to check his latch, so we saw a lactation consultant at the hospital I gave birth in. I asked her specifically about tongue tie and lip tie and she told me he was fine and he just had a small mouth.

I had a feeling his tongue didn't look normal so later that day I called the ABA helpline and described his tongue. The counsellor told me I had described a tongue-tie perfectly.

I went to see our regular doctor about the tongue-tie. He told me that because Samuel could move his tongue somewhat, he was fine. My instincts told me otherwise. 

Determined not to give up, I saw a THIRD professional; this time, a IBCLC who was able to direct me to a FOURTH professional – a laser dentist.
Samuel was 10 1/2 months when the tie was cut. I returned to work two days a week when he was 6 ½ months and negotiated to pump at work. 

He is now 12 months and we are still breastfeeding. The unhelpful voices are still there: every time I talk to my mother she tells me he will wean in a month or two and she asks me whether I think he still feeds as much as he used to. When I see my doctor (the one who would not treat the tongue-tie) he tells me I should wean Samuel now that he is 1 year old. I have learnt to ignore such negativity. I plan on letting Samuel self wean. Needless to say I am in the market for a new doc; but I can't get a refund on my mother.

I really enjoy breastfeeding my little boy. I often think that, if instead of making me feel bad, the health visitor had suggested an IBCLC, I wouldn't have spent those precious first moments as a new mother worrying about my sons weight gain and feeling like I was a failure. When I look at photos he does look skinny; it breaks my heart to think he was hungry because no one suggested anything helpful, like an IBCLC.

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