21 months: our breastfeeding journey has ended

i can't believe i'm saying this, boo weaned at 21 months. weaning was definitely not what i expected it to be. no crying fits for her or myself. i was ready and i'm happy to say that boo self-weaned although even now weeks later she will sometimes sign "milk" and look at me questioningly. it feels like boo had a security boob instead of a security blanket and looking back, i believe those last few weeks of nursing were just comfort nursing for her.

i did not experience any discomfort while weaning, my milk supply had to be next to nothing by that point since we were only nursing for a couple of minutes, once per day, if at all.

here is the kellymom link on weaning: http://www.kellymom.com/bf/weaning/how_weaning_happens.html#childled

and here is a little badge i made for myself and friends that have graduated from breastfeeding.

55 weeks and still going!

i can't believe we made it! it's funny, i spent an entire year focusing on keeping boo at the breast, and now that we've reached our goal everyone is asking when i plan on getting her off of it. quite honestly i didn't think i'd make it this far and never really put much thought into "extended breastfeeding". it sort of feels like i'm in a whole new class and need to start doing my homework again. kellymom has a great page on extended breastfeeding which quotes several sources stating the benefits of nursing past one year and also lists the benefits mothers receive from extended breastfeeding:

• Extended nursing delays the return of fertility in some women by suppressing ovulation (References).

• Breastfeeding reduces the risk of breast cancer (References). Studies have found a significant inverse association between duration of lactation and breast cancer risk.

• Breastfeeding reduces the risk of ovarian cancer (References).

• Breastfeeding reduces the risk of uterine cancer (References).

• Breastfeeding reduces the risk of endometrial cancer (References).

• Breastfeeding protects against osteoporosis. During lactation a mother may experience decreases of bone mineral. A nursing mom's bone mineral density may be reduced in the whole body by 1 to 2 percent while she is still nursing. This is gained back, and bone mineral density may actually increase, when the baby is weaned from the breast. This is not dependent on additional calcium supplementation in the mother's diet. (References).

• Breastfeeding reduces the risk of rheumatoid arthritis. (References).

• Breastfeeding has been shown to decrease insulin requirements in diabetic women (References).

• Breastfeeding moms tend to lose weight easier (References).

to be honest, i get a little sad when thinking about weaning. breastfeeding is so easy at this point, especially now that boo knows how to sign "milk" when she's hungry. ultimately, boo is only just now starting to enjoy solids and my much loved lactation consultant susan advised that "she certainly needs to be eating better before you completely wean". i guess we'll just keep doing what we're doing and see where it takes us.

week 47 (where has the time gone??) 323-329 days

as i was walking into my office this morning, my pump bag over one shoulder, my purse on the other shoulder, juggling my keys, cell phone and water bottle i realized that boo will be 11 months old on friday. thats 1 month shy of 12 months which is the equivalent of 1 year. my goal was to breastfeed for at least 1 year. holy crow ive almost reached my goal! i stopped short of jumping in the air with glee, gave myself a mental high five instead and immediately thought of my neglected blog. i rushed into the office to post.

lets talk about nursing bras at 47 weeks postpartum shall we? i retired my original bravado. she was a hard worker, but the racer back style was a deal breaker after a few months. i found these at target and really recommend them. in fact, i just posted a review on target.com. i especially like the soft cup feature. my other nursing bras lacked support and i avoid under wire in my bras to minimize the chance of developing plugged ducts. actually, i've been trying to go bra-less at home as much as possible now. a friend of mine insists that bras make your breasts sag. at first i thought she was crazy. according to antibra.com the main idea is that the ligaments which support breasts in normal circumstances, would atrophy (get thinner and weaker) when breasts are immobilized within bras and don't have to bear their own weight.

the actual act of going sans bra is emotionally liberating. i highly suggest anyone out there who like me is a prisoner to the nursing bra (do you sleep in your bra? have sex in your bra??) give it a shot. let the girls breathe.

week 37 (baby signing) 253-259 days

i've fallen in love with baby signing. i began signing with boo a few weeks ago. i had never thought that babies and sign language could go together, but have recently learned that there is a phenomenon surrounding baby signing and i want in. one of the first signs recommended is MILK. as a mother of an exclusively breastfed baby, MILK is definitely in our vocabulary at home. i've been signing MILK before and during each nursing session. the goal is for boo to stop yelling/whining when she's hungry and sign instead. theres been progress: one afternoon i signed MILK, plopped boo down on the bed to feed her and noticed she needed a diaper change. instead of feeding her first, i started to change her diaper. boo promptly hollered at me and waved her little fist up and down as if to sign MILK!

week 34 (mastitis scare) 232-238 days

i had my first brush with mastitis this week. (mastitis is an inflammation of the breast that can be caused by obstruction, infection and/or allergy.) i forgot to bring milk storage bottles to work in the afternoon (usually i pump around 3 or 3:30pm) and had nothing to pump into. i left work at 4pm with a headache. by the time i got home my left breast hurt really bad on the underside, close to my armpit. an hour later i had a fever and felt like crying. i remembered feeling similar pain the last time i wore the same nursing bra (la leche league brand!). so i took the bra off and went bra-less, letting boo nurse as much as she wanted to in bed with me the rest of the night. no matter how much i massaged the area i could not for the life of me feel a lump that would indicate a plugged duct. my fever broke during the night and the pain was mostly gone by morning. concerned, i checked out kellymom.com and was surprised to discover that its possible to have a plugged duct and not feel a lump. figuring that the issue was indeed a plugged duct, i emailed my lactation consultant susan for advice. her response:

"the headache makes it sound like a mastitis that you happen to catch early - keep treating with hot baths before feedings and pumping after - no antibiotics are needed if no fever returns."

mastitis! every breastfeeding woman's nightmare!! luckily i caught it early and had no subsequent pain or issues. kellymom has a great page on plugged ducts/ mastitis which lists the following warning:

CAUTION: Do NOT decrease or stop nursing when you have a plugged duct or mastitis, as this increases risk of complications (including abscess).

week 29 (officially bitten) 197-203 days

boo has her two bottom front (sharp) teeth and during week 29 i received my first bite. there is a common misconception that once a baby has teeth, breastfeeding is uncomfortable or even impossible. in reality, if your baby is nursing properly, then you should not feel her teeth. It's physically impossible for baby to nurse and bite at the same time, because her tongue covers the bottom teeth when baby is nursing. boo had just finished eating when she bit me.

kellymom has a great page on "When Baby Bites" which includes suggestions on what to do if and when biting becomes an issue.

when boo bit me i was more startled then physically hurt. two small teeth biting down on my nipple is not a pleasant sensation, especially during a late night feeding when i'm only half-awake! i involuntarily reacted by using my finger to break boo's latch and firmly(without yelling) said "no". this reaction was pure instinct and luckily, effective. the Nursing Mothers Companion warns that a strong negative reaction to biting, such as yelling out, could lead to a nursing strike or worse, baby might find your yelling funny and may continue to bite for the reaction.

since my first experience of being boo's new teething toy, i've been bit an additional 3 or 4 times. on each occasion i broke the latch, firmly said no and ended the nursing session temporarily.

where have i been you ask?

if you've been following my blog you might have noticed that i haven't posted in a few weeks. excuse my tardiness...we just bought a home and my free time is suddenly sparse. i'm still breastfeeding boo and i'm hoping to catch up with my posts by this weekend. happy halloween everyone!

ps. does anyone know of a breastfeeding friendly halloween costume??? LOL

week 23 (teething...we think) 155-161 days

boo's daddy and i have been swearing up and down for weeks now that boo is teething. we have all the symptoms (did you know teething can cause "loose stools" due to increased saliva during teething?)  except...teeth. a quick google search turned up this article from dr greene which states that it can take up to 2 months for a tooth to erupt. ouch, poor boo. a quick stop at kellymom provided this:

"Teething is one of the most common causes of frequent night waking during the second six months and through the second year. It can also cause fussy nursing behavior, as some babies experience gum discomfort with sucking. Baby might start to nurse, but then pull off and cry or fuss and not want to nurse anymore. Other babies nurse nearly constantly because the nursing is soothing to them."

(could this be the reason for our night wakings and fussy nursing??!)

she also lists a few things that may help a teething baby such as homeopathic teething tablets and freezing or refrigerating a wet washcloth. boo's favorite is a clean baby sock filled with crushed ice and knotted at the top. heres a list from hippiedippiebebe of the top 10 natural teething home remedies.  

interesting note: kellymom warns that applying orajel (or other topical anesthetics) directly prior to breastfeeding can make breastfeeding very difficult for baby.

week 22 (hunger cues) 148-154 days

22 weeks later and i've finally caught on to boo's hunger cues. to her credit, boo has made the process easier for me by learning how to yell. boo's yell is actually a string of non-sensible noise which is completely different than her cry, and it is loud. her singing is similar, but happily accompanied with a smile. when boo is hungry she simply yells at me until i pick her up and position her to latch. when she sees my exposed breast she opens her mouth wide and scrinches her little nose anticipating the latch-on. there are two ways to view this new habit: first of all, knowing there is a purpose behind boo's behavior makes me feel like a well-tuned in parent. the flip side is that my 5 month old has effectively trained me to feed her.

while googling for helpful links for hunger cues, i stumbled on the breastfeedingbabies youtube account which states "we're here to bring you as much info and 'Best Practice' on helping your baby to breastfeed effectively as we can".

and of course, here is kellymom's link on hunger cues which features a list of common cues in order from early (smacking or licking lips) to late (crying).

week 21 (freezer stash takeover) 141 - 147 days

i've created quite a large freezer stash. in fact, one entire freezer shelf is now devoted entirely to breast milk. thats a lot of freezer real estate to have occupied. confession: we've never given boo frozen milk. frozen breast milk is good in the freezer for 3 to 6 months according to kellymom, but only 4 months according to my lactation consultant susan. ive been building my frozen stash since my freezer broke back in week 8. that means a large portion of my stash is due to expire soon. then what? i emailed susan to ask for her advice. her response:

"that is why you should be rotating your frozen stock - start using frozen milk and freezing the new stuff - when you get to a "less Old" batch frozen then you can do half and half (give have frozen defrosted and half freshly pumped) - milk is good for 4 months in freezer. do NOT shake it when defrosting or heating."

week 20 (the distractible boo) 134-140 days

looking back it seems that i was only able to successfully nurse boo while laying down in my bed during week 20. also, the room had to be quiet and heaven forbid boo's daddy popped his head in to chat, that would always signal the end of a feeding. suddenly it became clear that boo was a distractible nurser. this seemed a little overwhelming at first, especially when boo would pull away to look at something without unlatching first (ouch). a few times i had to actually coax boo back to the nipple by teasing her with it and making silly faces and sounds. turning on a fan to drown out any distracting noises along with threatening boo's daddy with a frowning of a lifetime if he came even close to the bedroom helped keep boo focused on eating. on a positive note, all this laying around in a quiet environment was really relaxing and i found myself singing to boo and stroking her hair and hands more instead of wrestling with her to try and keep her latched.

kellymom has a great article on the distractible baby and offers the invaluable advice of keeping a finger ready to break suction as soon as baby starts to pull away. she also warns that "less frequent/shorter nursing during this distractible stage can lead to a low milk supply, so do your best to get in a few decent feedings during the day."

week 19 (adventures in hands-free pumping) 127-133 days

while pregnant with boo i came across a hands-free pumping bra in our hospital's healthlinks store. the bra featured two large round holes where the wearer's nipples would be. i could not imagine wearing such a contraption and shared a good laugh with boo's daddy over the idea of it. fast forward a few months of pumping three times a day, everyday, and suddenly the idea of being hands-free sounds like a blessing. for the past couple of weeks ive been wearing the easy expression bustier which is a simple one piece design that zips up the front. i immediately discovered theres a learning curve to being hands-free and i apparently am on the slow end of the curve. i could not figure how to adjust the pump flanges with the bra on if my nipples werent centered. i received the following tip from easy expression:

"After you put on the bra and flanges, simply lift the top of the bra out a little bit so you can see nipple placement. The bra will expand out and support the flanges while you use your other hand to adjust your breast/nipple. Once you do it a few times you can do the re-adjust without even looking."

doubting my hands-free ease, i gave it another shot. i used the bustier at home as well as at work. not surprisingly, the more i used it the easier it got. i cringe at the thought of being walked in on at work while wearing the bustier, but the comedic value overrides the fear. pumping hands-free to me means that i can answer the phone at work without having to squish both boobs in one hand (now theres an under-rated skill). it also means i can play with boo in the morning while i pump. i've even joined misty in her habit of typing and pumping (im actually pumping right now!). i may have laughed at being hands-free a few months ago, but it only took me a week of practice to proudly say "look boo, no hands!!"

week 18 (4 month chunk) 120-126 days

boo had her 4 month well baby appointment and weighed in at 16 pounds, 4 ounces!

although boo's pedi gave the ok to begin introducing solids, we've opted to delay solids until 6 months. kellymom has a great article on why its important to delay solids which highlights several reasons to delay including: giving baby greater protection against illnesses, decreasing risks of food allergies, giving baby's digestive system time to mature, and one reason which really sticks out to me...helps mom maintain her milk supply. according to kellymom, babies who start solids early tend to wean prematurely. im doing my best not to be a weaner so this reason alone is enough for me to delay adding solids to boo's diet.

week 17 (mayday mayday pump down!) 113-119 days

during a few pumping sessions i noticed i was collecting less than my normal amount from my left boob. i thought maybe my left side was becoming a slacker. at the next pumping session my right side was the slacker. i finally realized that the suction seemed low on one side. frantic, i googled and found the following from ameda.com:

"Problem: Decreased Suction
Solution: Remove the tubing and white connector from the side of the pump and place a finger over the pump outlet. If you feel suction, the pump is operating properly, but the collection kit may not be correctly assembled or the white valve may be damaged. If no suction is felt on your finger, try unplugging the adapter from the electrical outlet, wait a few seconds, and plug it back into the electrical outlet.
Solution 2: Make sure the collection kit is properly assembled.
Solution 3: Inspect the white valve for a tear or pinhole. This component is critical to achieving proper suction. Replace the white valve with one of the spare valves provided with the product.
Solution 4: Check the tubing adapter on the side of the pump to make sure it is closed when single pumping. If open, close the adapter."

when placing my finger over the pump outlet i immediately felt suction. i inspected the tubing and valve covers next for tears and found nothing. my friend lori warned that it might be impossible to detect a small hole in the valve cover so i decided to give my pump a thorough cleaning and switch out the valve covers with a brand new spare set i had in my pump tote. either my pump appreciated the spa treatment or i did have a faulty valve cover because at the next pumping session the suction had improved enough that it felt like i had a new pump.

week 16 (nightwakings) 106-112 days

breastfeeding has been somewhat of a gateway parenting choice for me leading to other choices such as baby wearing, co-sleeping and cloth diapering. while baby wearing and cloth diapering are going great, co-sleeping is starting to pose a possible problem. boo has become fond of the nightlife. a few weeks ago i could count on a pretty good nights sleep with one or two interruptions (usually at 2am and 4:30am). during week 16, i was lucky if boo stayed down for 3 hours straight. making it worse, at each nightwaking she wanted to eat. my nights were full of flipping boo from side to side and feeding her. i wondered if i was now feeding her too much at night. i emailed my lactation consultant Susan and she responded saying "this is typical at FOUR months due to developmental changes". she forwarded an attachment aptly titled sleep.doc which contained the following:

Parents need to “set the stage” for better sleep and then accept what their own little baby is capable of. Remember they are NOT getting up at night just to annoy you. It is not a conspiracy! Setting the stage involves:

• Making sure the baby is getting adequate calories during the day. Power nursing between 5 PM and 10 PM allows the baby to get more of the rich hind milk to “hold them over”
• Working towards not over doing the calories at night. Bottles at night make babies want to get up more at night. Trying to “stuff” your baby at 1 AM will just make the baby pee and poop more in the middle of the night. Babies go through light sleep phases about every 90 minutes so if they are wet or dirty, they may come to be fully awake. We need their tummies to be as quiet as possible in the middle of the night- this is why I never PUSH feeds between 11 PM and 5 AM.

i love sleeping with boo and i dont want to give up co-sleeping, but i wonder if co-sleeping is the problem. i've read that babies sleep longer in their own crib. an exhausted me is not a good thing. in my constant sleepy state, im less focused (and constantly yawning) at work, my memory is close to gone and just the other day i backed into boo's daddy's car (no damage done). in my desperation i bought a stuffed sheep that makes white noises (heartbeat, waves etc), downloaded a few baby einstein and beethoven lullabies from itunes and rounded it off with the no-cry sleep solution by elizabeth pantley. i hope to be able to report some improvement in next weeks post.

in my never ending quest to read up on all things breastfeeding, i found one of my (now) favorite pro-breastfeeding magazines: mothering. their latest issue has a great article on breastfeeding in mongolia.

misty (aka babygaga's breastfeeding hero) gave me a great link to share with anyone needing a list of reasons to breastfeed. http://www.notmilk.com/101.html

week 15 (macgyver pumping) 99-105 days

latest act of forgetfulness: i forgot to bring milk storage bottles to work. as i sat in my office trying to visualize which of my office supplies would be best at collecting milk (paper clip holder? ha!) i almost gave up and sheepishly drove home. not wanting to explain to my employer that i had to leave early, i decided to jump online and ask the babygaga.com breastfeeding mamas for advice. thanks to some very resourceful (and super speedy!) mamas, less than a minute later i was pumping into two lansinoh storage bags which i had tucked away in my pump tote. for some reason i had thought the suction would be affected, and was relieved to be proved wrong. i simply held the bags around the flanges and pumped. my only moment of panic occurred when i realized that it was time to turn off the pump and yet my hands were literally full. luckily, lansinoh bags are self standing with a flat bottom surface and after a quick balancing act, i managed to turn the pump off without spilling milk all over myself. since my cooler bag was at home with the forgotten storage bottles, i put the storage bags in a large catalog size company envelope with my name on it and threw it in the fridge. incredibly proud of myself i immediately held the envelope out to boo's daddy as soon as i got home with a big "look what i can do!" smile.

week 14 (hello favorite old jeans!) 92-98 days

this week i am thankful i breastfeed because...milestone reached! let me shout it out to the world!! i fit my old pair of favorite (pre-pregnancy) jeans!!!

i'm sure that my new no dairy/soy/nut diet has attributed to my most recent weight loss, but i'm still reminded of one of my favorite benefits of breastfeeding: burning calories.

kellymom.com states that "Breastfeeding your baby, on average, burns 200-500 calories per day".

a post on breastfeeding.com states that " Breastfeeding burns calories. Over 600 calories a day for breastfeeding women who don't supplement with formula. 600 calories! That's like getting two hours of aerobic exercise each day." they reference the following study published in the Journal of American Dietician Association which shows breastfeeding melts off inches around your hips and buttocks.

Reference

Summary: Mothers who breastfed exclusively or partially had significantly larger reductions in hip circumference and were less above their prepregnancy weights at 1 month postpartum than mothers who fed formula exclusively.

Author: Kramer, F.,

Title: "Breastfeeding reduces maternal lower body fat."

Published in: J Am Diet Assoc 1993;93(4):429-33

sure that is an old study, but it definitely put a smile on my face.

week 13 (crash and burn) 85-91 days

definitely a low week for me. my exhaustion hit its peak (i hope). boo hit her 3 month growth spurt and added more late night feedings to our schedule. i had just gotten used to her old schedule! the whole week is one big blur of nursing, working, pumping and dozing off.

an online friend found herself dealing with a chronic case of thrush. Thrush is the term used to describe an overgrowth of yeast in a baby's mouth. for future reference i bookmarked a page from askdrsears.com and another page which is specific to thrush infections on nipples (candida).

According to Dr. Sears, suspect candida as the cause of your sore nipples if:

• Your nipples are extremely sore, burning, itching, red, or blistery.
• You experience shooting pains in your breasts during or just after feeding (especially during your milk ejection reflex).
• The usual remedies for sore nipples aren't working.
• Baby has oral thrush (white, cottage-cheese-like patches on the tongue and sides of the mouth) and/or a yeasty diaper rash.
• Your nipples suddenly become sore after a period of pain-free breastfeeding.
• You are taking, or have just finished taking, a course of antibiotics. Yeast infections are common following antibiotic treatment.

week 12 (boobs ahoy) 78-84 days

i tried to avoid pumping during the weekend, which meant i spent a good deal of it dealing with engorgement and almost caused a nursing strike in the process. (note to self: boo is not fond of overly-full breasts literally hosing breastmilk down her throat.)

whenever i find myself engorged, i worry about plugged ducts. in fact, to date, i have yet to wear an underwire nursing bra for fear of a plugged duct.

"...causing a tender, lumpy, and sometimes reddish area that doesn't improve with nursing or pumping. some moms see a white pimple-like bump right on the nipple, which is a milk blister, or plugged nipple pore. plugged ducts and nipple pores result from a lack of milk movement, often caused by a change in your baby's feeding routine." -the milk memos, page 179

the milk memos mentions the "warm wet washcloth technique": apply a warm, moist compress for 15 to 20 minutes right before you nurse or pump. other recommendations include take a nice long hot shower or bath and massage the breast; massage the area when nursing or pumping; and let gravity help by getting on your hands and knees and lean over the baby to nurse (or hunch over the pump).

of course, good ol' kellymom has a page dedicated to plugged ducts and mastitis.

in the end, i finally admitted defeat and weekend pumped.

week 11 (scary poop) 71-77 days

on wednesday i returned home from work to find that boo's daddy had put aside diapers for me to look at. he was worried. the diapers were filled with green poop mixed with mucus and small traces of blood. startled, i immediately emailed my lactation consultant Susan.

Susan's response:
"If it is green alone I don't worry BUT the blood does usually indicate a food sensitivity - and the most common is DAIRY,SOY and PEANUTS - so please totally remove these from your diet for 3 complete weeks - if you go on www.infantreflux.org their blog pages have pretty good info on MSPI (milk soy protein intolerance) you need to read labels and it will take at least 2 weeks to notice any difference." (side note: i appreciate my lactation consultant.)

i had never realized how many foods contain dairy and soy. suddenly i have to say goodbye to some long time favorites. wheat thins? soy. eggos? milk and soy. mothernature.com has a pretty long list of foods to avoid when cutting out dairy. 

boo didnt poop again until 5pm the next day, and it was a blow-out, and orange (her normal color) with no traces of blood. i emailed Susan again asking if i should still be concerned with a food sensitivity. i had assumed i'd see green for at least 2 weeks until my non-dairy/soy/pnut diet had settled things down.

Susan's response:
"I would still give it up just in case due to the BLOOD - that way if you see blood again we have already started the elimination. UNLESS you see a opening at the anus that could be the reason for the blood."

after checking her bottom, i ruled out an opening at the anus and stuck with the non-dairy/soy/pnut diet. over the next couple of days we had a couple of "bad" diapers, but the majority were fine. the plus side of this is that boo is breastfed; i just need to adjust my diet. the down side is, i suddenly feel like the poop patrol.

week 10 (hormones to the rescue) 64-70 days

"The act of breastfeeding releases hormones which have been found to both relax the mother and cause her to experience nurturing feelings toward her infant."

my second week of working full-time was easier. i feel more confident that i can be an exclusively breastfeeding and working mom. my pumping sessions at work allow me to take a break and think of nothing but boo and the release of prolactin and oxytocin during let-down supposedly help me relax. the mamas on the babygaga.com breastfeeding thread have been wonderful. i've found support, advice and some much needed laughs.

i read "The Milk Memos: How Real Moms Learned to Mix Business with Babies-and How You Can, Too" and highly recommend it to any working/breastfeeding mama. it covers literally everything and helped remind me that there are other moms in the world who work and breastfeed and many of them are having as an emotional go at it as i am.

i wonder if sleep deprivation is causing my short-term memory to fizzle out. on two separate days i forgot to bring bottle caps and then the actual bottles (!) to work. to compensate for the lack of caps, i rubber-banded tissue around the bottles and did my best to make sure the bottles remained stable during the ride home. i didnt even try to compensate for the lack of bottles and just drove home to feed boo. i read in the milk memos that 1 mom actually pumped into coffee cups when she forgot her bottles!

to avoid my mistake, here's a list of items that shouldn't be left at home:
-breastpump w/all the parts: pumps vary but generally all include the following:
.2 breastshields (breast flanges)
.2 pieces of tubing
.2 sets of valves
.ac adapter
.collection bottles (with caps!)
-tissues or burp cloths to wipe up spills and dry breasts after pumping (seriously)
-something to clean your pump parts with, a few options:
.small container of liquid dish soap
.antibacterial wipes
.microwave sterilizer bags
-cooler bag w/ice packs
-lunch bag (if you're storing your milk in a community fridge)
-car power adapter (if you're pumping in the car...)
-pictures of your baby! (these can help with your milk let-down)

i'm thinking of buying a 2nd set of all pump parts just in case i lose anything or say the adapter stops working.

boo's daddy brought up the question of how much milk boo should be eating during the day. he felt the older she gets the more milk she'll drink. i found a calculator on kellymom.com which also gives the following information:
"Current breastfeeding research does not indicate that breastmilk intake changes with baby's age or weight between one and six months. After six months, breastmilk intake will continue at this same level until -- sometime after six months, depending in baby's intake from other foods -- baby's milk intake begins to decrease gradually.

The research tells us that exclusively breastfed babies take in an average of 25 oz (750 mL) per day between the ages of 1 month and 6 months. Different babies take in different amounts of milk; a typical range of milk intakes is 19-30 oz per day (570-900 mL per day)."

the good news is that i'm still over-producing, meaning i'm expressing more milk than boo needs during the day. i was worried that my supply wouldn't be able to keep up.
here's my current work day:
6am - wake baby and feed; pump bottle (approx 5 oz) for while im away during the morning
7:30- go to work
10 - pump at work (approx 6-8 oz)
12pm - go home for lunch and feed baby; drop off 10am milk
2:30 - pump at work (approx 4 - 5 oz)
4:30 - go home and feed baby; freeze 2:30pm milk or store in fridge for the next day

week 9 (feeling alone) 57-63 days

this was my first week back to work full-time. after keeping my spirits up while working 2 weeks part-time i thought that transitioning to full-time wouldn't be difficult. i made it through the morning just fine, went home at lunch to feed boo as usual and then burst into tears on my way back to work. my 2pm pumping didn't yield very much. i couldn't concentrate on my work. i left early and anxiously sped home. i was exhausted, overwhelmed and wondering how i was going to do this working mom gig.

boo decided it was a great time to have a growth spurt. at night she seemed to want to eat and eat and eat. i felt like i couldn't keep up with her. my letdowns felt so small and her crying broke my heart. i was worried i was underfeeding my baby. i was worried that my supply was decreasing. the fact that i wasn't expressing as much milk during my 2pm pumping as i normally do in the morning only added to my worry. now i felt overwhelmed at home as well as at work. thats when the fact that i'm alone set in. i have no friends or family that breastfeed or have ever breastfed for that matter. theres no one to ask advice from except my lactation consultant, susan. my world has been so baby related lately that i've managed to alienate the friends that i do have. boo's daddy is amazing and (half) listens to every little nugget that i spout out, but it's not the same as having a friend who's been there, done that. someone who understands how overwhelming breastfeeding can be; how guilty i feel about returning to work; the sense of loss i feel when i leave boo. in short, i need a boob friend. i decided to join a breastfeeding thread on babygaga.com. cyber friends would have to do for now.

in regards to my supply woes, i remembered when my freezer stash was ruined during week 8, i had emailed my lactation consultant and asked her how to add an extra pumping session to my schedule. in her response she had also sent me the following info on increasing milk supply.

1. Nurse as often as the baby will nurse. If you are back to work, try to really push feedings before and after work and nurse full time on your days off. If your baby is eating solid food, make sure that the solids are given only during the time you are not available to nurse and pump while you feed solids on your days off.
2. Pump for 15 minutes IMMEDIATELY after you finish nursing. Use a double pump (renting a hospital grade pump is helpful) for a full 15 minutes even if you are not getting any milk. Pumping is for the stimulation to the breast.
3. Pump after as many feedings as you can. Using a “hands free” pump bustier makes frequent pumping easier and decreases your tendency to watch every drop go into the bottle.
4. Pump right before bed for additional stimulation.
5. Take 2-3 Fenugreek capsules with each meal. Google “Fenugreek and Breastfeeding”. Fenugreek can be found at Whole Foods, GNC, and Lindberg Nutrition etc. Fenugreek takes about 4 days to show any effect at all. Do NOT take Fenugreek if you are pregnant. Some women will also take Fennel capsules (3 per day) along with the Fenugreek.
6. Some women feel that eating REAL oatmeal (not instant) daily will help supply.
7. REST – take a nap on your days off. Rest has a significant impact on milk production.
8. Take a long bath with your baby every evening. While in the tub, drink lots of fluids. When you get out, nurse and then pump.
9. Before pumping, take a small amount of vegetable oil and massage it into the entire breast. You do not need to “kneed” the breast- rather rub the oil in like you are rubbing lotion well into the skin. Rub over the nipples and areola.
10. Do ALL of the above, consistently for 14 days. Milk supply will vary from day to day and the more you worry about it the less you pump.
    

#7 stood out to me. rest. i miss rest. rest is good. i resolved to devote my weekend to resting and increasing my supply.

the week ended with boo's 2 months well baby check-up. she weighed in at 12 pounds, 6 ounces.

week 8 (freezer breaks, stash ruined) 50-56 days

week 8 will live in infamy as the week our freezer broke. approximately 80 ounces of frozen milk thawed and was ruined. brings new meaning to the old saying "don't cry over spilt milk". unfortunately i did cry. after consulting my lactation consultant, i decided to maintain my current feeding schedule. the milk pumped during the weekend will start my new freezer stash. on a positive note: ameda's mother's milk freezer bags do not leak when thawed.

i began reading breastfeeding made simple: seven natural laws for nursing mothers, by nancy mohrbacher and Kathleen Kendall-Tackett. it reminded me of the importance of skin to skin contact and i tried to increase my skin to skin time with boo. the book also describes breast storage capacity which is the amount of milk the breast stores between feedings. i believe i have a large storage capacity. boo generally only nurses from 1 breast per feeding and while pumping i tend to average 3 ounces per side in less than 10 minutes. one morning i pumped 4 ounces from the right side only. that was a shock. theres an article on kellymom.com that addresses breast storage capacity and how it affects milk supply.

going back to work made me realize the value of nursing pads. the disposable nursing pads from lansinoh have been working out great. they seem to be able to absorb a pretty good amount of milk.

monday is the start of my return to working full-time.

week 7 (first week back at work) 43-49 days

both boo and i survived my first week back to work. luckily i saved enough vacation time so that i only work 8am - noon for the first two weeks back. working part-time definitely made the transition easier on all of us, including daddy. i wake boo up at 6am and try to get her to eat. by 6:30am i pump (approx 4 oz) and make a bottle to be used while i'm gone. i'm out the door at 7:30am. i pump at work at 10am (approx 6 oz) and am home by 12:20pm. i feed boo immediately when i get home.

there was a lot of crying. boo still isn't in love with the bottle.

pumping at work wasn't as awkward as i envisioned although it did have it's moments. the people i work with are 85% male. luckily i have my own office. i had emailed everyone letting them know that at 10am a "DO NOT DISTURB" sign would be on my door. i couldn't decide on a proper way to say that i was pumping my breast milk. i was afraid of offending someone for some reason. so i ended the email with "my daughter is not a formula baby..." to my surprise most of the men took this to mean that boo would be coming to the office for me to nurse her. i know this because they asked if boo was still around. when i'd respond that boo had not been to the office, i'd watch the realization that i was actually pumping cross their faces. that is a look that still makes me laugh today.

another moment for me was figuring out what to do with everything after i pumped. i had brought a brown paper bag to put the bottles in to keep them incognito in the office fridge. however i hadn't given thought to the flanges. flanges look like funnels and should be washed after use. how is that done discreetly? we have a kitchen in our office and a restroom down the hall that we share with the other office suites. all i had in my office was an old home depot plastic bag that my predecessor had left behind crammed between the file cabinets. nothing odd about a girl walking down an office hallway to the restroom swinging a home depot bag right? on day 2 my brain kicked in and i started to put the flanges in the cooler bag (minus the ice packs) and toted that to the restroom. my modesty surprises me.

week 6 (last week of maternity leave) 36-42 days

week 6 was, in short, exhausting. boo developed a few new habits. she now poops in the middle of what seems like every feeding and then stops eating until 10-15 minutes after her diaper change. possibly a new pacifying trick, boo would suck out milk only to let it drip down her cheek. unfortunately, if i was distracted during that feeding, i wouldn't notice this until after my bra was soaked with milk. on a side note: out of the 4 nursing bras i own, the original bravado is my current fave.

i successfully challenged myself to keep up with pumping in the morning and am now expressing approximately 6 ounces total each morning. out of the 6 ounces, i put 4 ounces in the freezer. i've been using mother's milk freezer bags (helpful hint: write the date on the bag BEFORE filling with milk). i lay each bag flat on a plate in the freezer so that it will freeze flat, then i put the frozen milk bags into a large ziploc. to practice my return to work, i've been leaving boo and daddy for a few hours each morning, so the remaining 2 ounces i pumped went straight in a bottle for daddy to give to boo. with me out of the house (and out of his ear), daddy felt more comfortable and confident in his abilities and was able to get boo to accept a bottle a lot easier. since boo is a slow eater when bottle-fed, we began researching the shelf life of non-refrigerated/frozen milk and if reheating a warmed bottle was acceptable. i was surprised to find that in addition to the storage guidelines i quoted from the nursing mother's companion in the week 4 posting, la leche league cites that milk can be stored in a refrigerator for up to 8 days! Here is info taken directly from their website:

Your milk is a living substance so precious some call it "white blood". It is essential to store your expressed (pumped) milk properly to maximize its nutritional and anti-infective qualities. Human milk actually has anti-bacterial properties that help it to stay fresh. Giving your baby the freshest milk you have pumped ensures its high quality.

This information is based on current research and applies to mothers who:

• have healthy, full-term babies;
• are storing their milk for home use (as opposed to hospital use);
• wash their hands before expressing;
• use containers that have been washed in hot, soapy water and rinsed.

Storage Guidelines

All milk should be dated before storing. Storing milk in 2-4 ounce amounts may reduce waste. Refrigerated milk has more anti-infective properties than frozen milk. Cool fresh milk in the refrigerator before adding it to previously frozen milk.

Preferably, human milk should be refrigerated or chilled right after it is expressed. Acceptable guidelines for storing human milk are as follows. Store milk:

• at room temperature (66-78°F, 19-26°C) for 4 hours (ideal), up to 6 hours (acceptable) (Some sources use 8 hours)
• in a refrigerator (<39°f,>
• in a freezer (-0.4 to -4°F, -18 to -20°C) for 6 months (ideal) up to 12 months (acceptable)

-http://www.llli.org/FAQ/milkstorage.html (Page last edited Sat Feb 21 14:09:52 UTC 2009.)

if milk can be stored at room temperature for 4 hours (ideally), and my practice outings were less than 3 hours, the 2 ounce bottles i made in the morning were left out instead of refrigerated. according to kellymom.com it should be safe to save the left-over milk and use it at the next feeding.

i found myself on kellymom.com and workandpump.com a lot this week reading up on back to work basics. workandpump has a great page with 7 steps to boosting your milk supply. one step notes that breastmilk is primarily made up of water, protein and fat and you need a pretty high daily intake of protein and water to keep milk production up. must drink more water!

my nursing in public skills have improved. i've gotten in the habit of wearing a long, stretchy cami under my shirts so that when i lift my shirt up to nurse, i pull the cami down to expose my bra. the shirt covers my cleavage while the cami covers my belly.

my anxiety and disappointment levels are boxing it out over which is greater in regards to my returning to work. maybe thats the real cause for my exhaustion this week. i wish i could stay home with boo.

week 5 (nursing in public) 29-35 days

my lactation consultant recommended that if boo didnt take a bottle we should offer just one ounce of breast milk by bottle every day. getting her to suck on a finger and then sliding the bottle into her mouth worked and boo finally accepted a bottle from her daddy on the third attempt. she promptly spit up, but we called it a success, regardless.

i had my postpartum breastfeeding class this week. designed to help make breastfeeding easier for mom and baby, the class was a 3 hour roundtable during which we could address our breastfeeding questions and concerns. despite my initial hesitation to attend another 3 hour class, it turned out to be a very informative and helpful experience. not only was i able to address the clicking noise i hear while boo nurses, but i was also surprised to learn that my lactation consultant recommends having 100 ounces of milk in the freezer before going back to work. currently i have approximately 12 ounces in the freezer. some of the other topics discussed included pacifier use, spitting up, hyperlactation, pump use, baby slings and nursing in public. another benefit of the class turned out to be checking out the gear other moms use. i currently have a hotslings sling which i've discovered is awkward when positioning a newborn under 2 months of age. a few of the moms had different types of ring slings which i plan to look into.

i found myself holding a crying boo in the mall for the first time this week. i was without a baby sling or nursing cover (which in my opinion resembles a shower curtain around the neck). swallowing my anxiety, i settled down in a corner booth in the food court and fed boo with a blanket thrown over her and my shoulder. not surprisingly, no one seemed to notice. 

boo seems to be eating every 2 -3 hours during the day and around every 3-4 hours during the night. i'm concerned that i won't have enough milk stored for when i return to work. i seem to have a million excuses to avoid pumping, however i'm trying to commit to pumping after boo's first morning feeding. i feed her on one side only and then pump. typically i get approximately 4 ounces total. 

week 4 (saying hello to the pump) 22-28 days

boo does most of her feedings on one breast per feeding and is starting to eat more than every 2 hours. since i'll be returning to work when boo is 6 weeks, my lactation consultant had recommended i begin pumping when boo hit 2 weeks. my apprehension of the pump delayed the process. i'm using an ameda purely yours double electric pump. the noise is minimal, there is barely any discomfort and i'm able to express a couple of ounces in just a couple of minutes. i'm freezing only 1 ounce bags to reduce wasted milk.

refrigerated milk: use within 72 hours. take the milk out of the refrigerator just before using. gradually, over 5 to 10 minutes, warm the milk to room temperature in a container of warm water. do not warm the milk in a microwave or on the stove.

frozen milk: use milk within three months if it has been stored in the freezer compartment of a refrigerator. always use the oldest milk first. thaw the milk either in the refrigerator, where it can remain up to 24 hours, or in water just before feeding, gradually increasing the temperature to warm. do not defrost the milk in a microwave or on the stove. whatever milk the baby does not take must be discarded. breast milk should not be refrozen. 

-the nursing mother's companion, kathleen huggins, r.n.,m.s. page 189

to assure that she develop a great start to breastfeeding, i was told that boo should not receive any bottles until 4 weeks. waiting longer may cause her to reject the bottle altogether. at 4 weeks its recommended to give the baby at least 1 bottle every  4-7 days. boo refused her first bottle.

week 3 (the foremilk/hindmilk lesson) 15-21 days

boo began to start taking a long nap in the afternoon. she started to spit up...a lot. at one point she seemed to vomit out everything she ate. startled at the amount of milk that poured out of her mouth, i cried. at times boo would nurse for a few minutes then suddenly pull off and fuss, especially in the late afternoon and evenings. my lactation consultant identified this as gastro-colic reflex and advised to take her off the breast, burp, soothe and re-latch. 

it seemed boo was pooping less and one time her poop had a greenish color. the baby health books all cite that green poop is normal. however after browsing the la leche league forum i learned that in breastfed babies fussiness and green poop are symptoms of hyperlaction syndrome resulting in a foremilk/hindmilk imbalance. to fix: nurse on one side exclusively for 2 hours before nursing on the other side. if the unused breast is uncomfortable, pump or hand express to relieve pressure.

boo has a milk stained tongue. apparently some breastfed babies develop a white milk stain on their tongue, this should not be confused with signs of thrush which are white, cheesy patches.

week 2 (the honeymoon continues) 8-14 days

i continued to limit my visitors through the 2nd week.  boo seemed to hate my right boob and would often pull away choking and crying. my milk letdown was too strong. suddenly i realized that my left boob was noticeably larger than my right. 

lopsided breasts: "when one breast receives more stimulation than the other, milk production in that breast increases, commonly resulting in a lopsided appearance. providing more stimulation to the smaller breast will usually even out the size difference between the two. start each feeding on the smaller side for a day or so." - the nursing mother's companion, kathleen huggins, r.n.,m.s. page 145.

i began to try different positions while boo nursed on the right side. the football hold seemed to work the best. i still used the cross cradle hold on the left side.

i began to hear a clicking noise when boo nursed. "you should not see dimples in her cheeks or hear clicking noises as she sucks. these signs would indicate she was sucking on her tongue and not on your breast." the nursing mother's companion, kathleen huggins, r.n.,m.s. page 107. when i hear the clicking noise, i pull boo off and re-latch.

overnight it seemed boo became gassy and began to fuss more. convinced my diet was to blame i began to over-analyze what i ate.

week 1 (the baby honeymoon) 0-7 days

boo was born on april 26th, 2009 at 11:43am. breastfeeding began 10 minutes later when the attending nurse smooshed boo's face into my right boob.

in recovery, i was given a feeding log and the nurses repeatedly advised me that boo needed to eat every 2-3 hours. accordingly, every 2-3 hours a nurse would walk in and ask approximately how long boo had nursed on each breast. i would tell them she nursed maybe 10 minutes on each side but i wasn't sure if she was actually eating or pacifying. the nurse would mark this down on a paper and walk away. no matter how many times i said i thought she was just pacifying, not one nurse took notice. on april 28th boo had her first doctors appointment and we learned she had lost 9 ounces. the pediatrician asked how my milk supply was. my milk hadn't come in yet. concerned, the pediatrician made another appointment for the following day and said my job for the rest of the day was to feed the baby and sleep. exhausted and ready to cry, i wondered for the first time if i could successfully breastfeed. 

miserable, i reviewed the material received from breastfeeding classes i had attended in march. shocked, i realized i had completely ignored all the advice the lactation consultant had given. instead of aggressively feeding as recommended, boo had been pacifying and burning calories. my new "aggressive" nursing regimen began that moment. 

while you have colostrum: with baby only in a diaper (cover both mom and baby with blanket for warmth), wake her every 2-3 hours between 6am - 10pm. take the baby off the breast every 5 minutes. lay the baby down to rewake and then re-latch. continue to take the baby off the breast and re-latch until she will not wake back up.  baby should feed at least 7-8 times in a 24 hour period.

once milk is in: with baby only in a diaper (cover both mom and baby with blanket for warmth), wake her every 2-3 hours between 6am -10pm. take the baby off the breast as soon as swallows slow down or stop. lay the baby down to rewake and then re-latch. continue to rewake and re-latch until she will not swallow anymore. change diaper, have tummy time, or redress baby during rewake periods. typical feedings will be 45-60 minutes in the first 2-3 weeks. letting the baby pacify for several minutes will make the feedings take too long. baby should feed at least 7-8 times in a 24 hour period.

keeping a feeding log helped me track the feedings. the next day the pediatrician happily reported that boo had gained 1 ounce and promptly made another appointment for 2 days later. at the next appointment boo (now 5  days old) weighed in 4 ounces heavier. for the rest of the week i took what my lactation consultant called a "baby honeymoon". i limited my visitors and concentrated on breastfeeding every 2-3 hours. my milk was in, my engorgement was manageable...i was a breastfeeding machine.