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“Will I really be able to breastfeed as much as I want?”

May 1, 2012

Um, maybe?

First off, what do you want?

If you’re just wondering if you’ll be able to breastfeed at all, then all you’ve got to look at is whether you’ve got what it takes:

  • Do you have breasts?
  • Are you pregnant, or very newly delivered?
  • HIV negative and not about to undergo cancer treatment?
  • Your baby doesn’t have galactosemia?
  • You’re not desperate to take any strong neurological, psychological, or other drugs that you’ve been avoiding during pregnancy? (Check with a lactation consultant or pediatrician referencing Dr. Thomas Hale about what’s safe or not for drugs passed though milk during breastfeeding.)
  • Are you feeling positive about the idea of breastfeeding and wanting to nourish your child with your body?

Yes? Good! (Note that if you have breasts that are hypoplastic, or have undergone breast surgery, or if you have PCOS or another underlying hormonal condition, you may have an uphill challenge with breastfeeding and might not be able to breastfeed exclusively. If your baby has special needs or is a preemie you might have other challenges and stress. The exclusionary categories I mentioned above are for breastfeeding at all. Some breastfeeding, if you choose it, is probably better than none, and may well be hugely rewarding for you and your baby. You may even be able to nurse partially or exclusively if you’ve adopted!)

Now let’s move back to the original question: “breastfeeding as much as I want.” (Sorry, but again, like choosing to be pregnant and planning her birth options, breastfeeding is a CHOICE for women. (And it’s not even a choice for single dads and gay dad couples, but luckily most of them opt out of feeling guilty about that.) It’s your body, you get to choose what you share about it and with whom you share it. It does make me sad that some women feel so guilty/defensive about not breastfeeding, when if you just frame it in terms of choice and women’s rights it’s obvious that breastfeeding is just a choice. Her body, her call, if it’s for zero or eight years. Breastfeeding should absolutely be normalized, breastfeeding moms should be supported, and encouraging breastfeeding should be a societal standard, in as far as it may have health benefits that will cost all of us less $$$ down the line, BUT. Parents should be supported in feeding their babies, and the silly individual finger-wagging does nothing to help this (well, it never really does, I guess). Policies like breastfeeding-friendly education (alongside sex education in say, middle school, when girls are getting OMG boobs – what are those for?), insurance-covered lactation support, milk-banking systems, longer maternity leave and baby-friendly workplaces do help. Those are things that are sadly lacking society-wide, therefore they are NOT CHOICES for any women in the U.S (or any non-women parents). So let’s end the guilt there, ‘cause kids need to be fed and our society makes formula the easy second option for most parents, especially the working kind, which is most of us. Off soapbox.)

(Edited to add: My heart goes out SO MUCH to those mamas who really did want to breastfeed as much as possible, and found the challenges insurmountable, and felt horrible about throwing in the towel. Breastfeeding is a personal choice first, but it also takes skill, planning, and good luck. Hopefully the tips I’ve offered about “breastfeeding as much as I want” below will help any other moms to avoid any sadness or guilt about missing breastfeeding. Guilt should not play a part if your booby dreams don’t work out.)

For myself, after reading easy, hard, and toe-curling breastfeeding stories, and seeing good and bad latches in a variety of clinical settings (feeling myself maybe 2% better prepared than the average well-researched pregnant mum), I’ve decided to settle on a two-goals system for making my booby dreams come true. I’d highly recommend that any mom-to-be try and think things through as to a) why they want to breastfeed and b) how long they want to breastfeed. My own reasons for breastfeeding are as follows:

  • Good food! Pretty much the best stuff out there for humans (although yes, formula companies have been working to try and improve things a little in their own offerings of human-milk substitutes through the years….it’s getting *cough* better). This is what people mean when they exclaim “breast is best!” Breastmilk is the best food for babies, though not necessarily the best for every parent-child situation.
  • Cheap! Okay, so technically “all you need are boobs” but there are a ton of “accessories” out there to support your breasts and your infant’s ability to extract milk from them. And there’s the possibility that you might have to be gulping down an additional 500 calories a day if you’re absurdly hungry and no longer experiencing post-partum weight loss and spending some cash on that extra food. But exclusively using formula does average $110/month on the low end, and can run quite a bit higher if your kid has allergies or poor tolerance for the cheap stuff. I’m budgeting myself a minimum of $664 for the various products I’d like to try while breastfeeding (although I might get some as registry gifts), but I’m also leaving in wiggle room for an additional $740 that I hopefully WON’T need to spend, which puts me about on par with a parent spending on cheaper formula and bottles from day one through twelve months.
  • Time-saver. This is usually laughable in the beginning when you both are learning and everything with a newborn seems so hard, but when breastfeeding works, it is a blissful time-saver over having to mix formula or preparing and heating a bottle. Pumping is not necessarily a time saver, but it is a necessity for most working moms who are committed to keeping up their milk supply (or committed to being cheap). Working moms or others who occasionally want to leave the baby also have the option of going to formula part-time, but they should be aware that they risk supply loss and early weaning by choosing formula over pumping.

The other stuff? Well, long term health benefits are really hard to study unfortunately, though they have shown evidence that breast milk is better for mothers and babies. Studying something like how that impacts health through the generations is pretty much impossible, however. I tend to believe in a holistic “nature AND nuture” view of genetics and environmental health: it’s not one or the other, but a whole slew of factors that can actually go back and intersect to impact a developing child’s immune system, or digestive tract, or even her DNA. Phenotypes are dependent on the preexistence of genotypes, and also on the environment they are exposed to. So yeah, a better food environment may lead to better health outcomes, but if you’re baby’s already got a genetic predisposition in their bones, breastfeeding might help them overcome that challenge a bit – then again, she might always be challenged in a way that another child never had to face, regardless of how that other child was fed. So in some senses, it’s all wibbly-wobbly as far as the benefits go. But know that, if you’re considering breastfeeding because of a family history of diabetes or autoimmune diseases, food allergies, obesity, or just want to see your kid max out their IQ, you’re probably taking a step in the right direction by breastfeeding. Thinking positive about the boob may help you get through some tough times later.

The other “other stuff” is that special bonding time with my baby, and once again feeling positive about using my body the way it’s evolved to be used. These very personal things are key for me in my angelic booby daydreams, but these personal benefits are also very important for me NOT to examine too early in looking at my breastfeeding relationship. First I plan to deal with two preset milestones ahead.

How long will I breastfeed my baby?

Two goals: 1) make it to six weeks, and 2) make it to eighteen months.

First goal: before I get here, I am going to be GUNG HO about the boob and doing whatever it takes to make it work. This is the time to pull out all the stops no matter what. If latching isn’t working, I’ll pull out and relatch, grab a nipple shield, scrutinize for tongue tie, whatever. I’ll pump whatever’s left over and if I really HAVE to supplement, according to a pediatrician and an LC, I will (but not without reading these books and pumping the bejeezus out of my breasts first). I’ll get XY to help me with the 24 hour “cure”. I’ll go to support meetings and read websites and talk to everyone (including the old guy in line at the supermarket) about how to make breastfeeding happen. And if I cry or rage about some breastfeeding hurdle, I’ll only ask XY to listen sympathetically, hug me, and then help me to relatch (or pump, or sleep, or whatever).

For many women, the hard part to get over takes two weeks or less, and after that they’re down the boob-shaped hill to a valley of nursing bliss. For some it’s still longer, around four weeks until things get easier. After six weeks of trying everything I need to try (and going through the six week growth spurt), I will finally let myself have some introspection and ask:

  1. What’s working? What’s gotten better?
  2. What isn’t working? What’s getting worse?
  3. Do the pros outweigh the cons? Can I see myself blissfully caring for a nursling in the middle of the night, or is that image too far distant with the headaches of bad latch, supplementing, and pumping (if we’re having serious problems)?
  4. Am I happy with breastfeeding?

These are questions I don’t want to ask myself until I feel, with everything I know about breastfeeding, that I’ve given breastfeeding everything I’ve got. I think that the guilt and self-defensiveness so many moms feel is from wondering if there was something else they could have done, if maybe it really was just a question of time or knowledge or effort on their part that could have been overcome around the next corner. The question of “when to wean” is a very personal question for any mother, and only she can answer it. But if she has an idea of “when” she’d cross a line and no longer feel guilty or confused about quitting breastfeeding before she initiates it (a line many second time moms DO conceptualize, and then are shocked to find when breastfeeding’s easier the second time), she’s a lot less likely to experience any doubts about what went wrong, and just enjoy the time with her baby.

What would I supplement with if I were having problems? Formula, obviously. However, to the best of my ability, if I’m having serious issues with feeding at the breast I’d like to switch to exclusively pumping my milk. Spending a month or two with a rental clinical-grade pump can do wonders for your supply, and once I’d get in a rhythm I expect I can switch to my own high-quality personal pump (I’m budgeting for the Hygeia EnJoye LBI, since it’s got a three year warranty and can be resold to multiple users – hippie bonus). No, pumping isn’t easy, and it may be more of a time commitment than formula feeding. But I’d rather have the one-time cost of a pump up front than worrying about adding formula to the grocery list. (Plus we own a deep freezer, so I’m not really worried about building a giant breastmilk stash.) I’d keep this up until we had enough breastmilk to get to the one year mark, give the kid a cup of organic cow or goat milk on his first birthday, and call it quits.

Second goal: Well as far as the eighteen months goal goes, ideally, I’d like to have my babies wean themselves. This likely means nursing into toddlerhood, since breastfeeding to two years and beyond seems to be the biological norm according to biological anthropologists. Assuming that after six weeks we had already reached a downhill turn on the nursing battles slope and were headed to that blissful valley, I’d want to at the very least reach the six month mark for exclusively nursing and the twelve month mark for nursing after solid foods have been introduced. After that? Well, eighteen months sounds like a good halfway point between what the AAP recommends versus what the WHO recommends for breastfeeding dyads. The older a baby gets, the less she needs the nutritional benefits of breastfeeding, especially in first-world countries with access to good nutrition and safe water. But if at eighteen months neither of us has any problem with continuing nursing, then I expect we’ll continue to nurse away. The comforting and bonding aspects of nursing won’t have changed, and nursing a toddler, though it may sound weird, can actually be a good foundation for teaching a kid the beginnings of being body-positive, of understanding appropriate touching (“no biting!”) and of recognizing that breastfeeding is a gift that his mom shares with him. If my child weans herself before eighteen months, I certainly won’t stop her. But I probably won’t be trying too hard to stop nursing, unless she’s barely touched table food and still getting 90% or more of her calories from breastmilk. On the other hand, if I’ve reached my child’s one and a half year old birthday and I’m feeling somewhat touched out and want my body back, I’ve no question what I’d do. I’d pat myself on the back for a job well done and start gently encouraging weaning.

If at any time between the six-week and the eighteen month goals something comes up to end breastfeeding early, I’ll try not to feel too sad about ending nursing. I can’t imagine what that might be, aside from pretty awful medical scenarios I’d rather not speculate on. However, having tried my hardest for at least six weeks, and giving it a good shot after that to reach our eighteen month goal, I’m not going to feel any guilt for whatever happens to our breastfeeding relationship. There’s enough else I’ll probably do to screw up my kid to feel guilt over anyway.

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