When my wife was pregnant with our daughter, tucked in among all the typical friends and family pre-baby small talk, there was one question that continually came up.
"Do you plan on breastfeeding?"
In my pre-dad, super-excited-to-be-a-part-of-all-things-parenting mode, there were a few times towards the beginning when I hopped in and said, "Yes. Totally!" I realize now how silly I must have sounded answering a very personal, and gender specific, question for my wife. I obviously was not going to be breastfeeding our child, and that question was not really mine to answer. What I will say is that the breastfeeding question was generally asked within a series of "Are you" questions that did involve me. "Are you planning on putting her in day care? Are you set on a name yet? Are you excited to have a little girl?" Even though my wife was the one with the kid in her womb, we got used to answering these questions as a team.
My wife is a non-confrontational person. Instead of talking with me about my, let's call it what it was, rude and presumptive third-party committal of her mammary glands, she did what a non-confrontational person does when confronted with something. She internalized it and she worried. It wasn't until months later when, in the midst of me spouting off about how glad I was that "we" decided that she was going to breastfeed, because breast is best, and mom is the bomb, and boobs are for newbs, and... OK, only one of those is an actual thing people say. Regardless, mid-way through my bloviating about our decision to breastfeed she quietly said, "I don't know if I want to breastfeed."
I. Was. Shocked. I was flabbergasted. "But, we decided..."
"Actually, we didn't."
"But when we talked about..." And then reality came pouring in. We hadn't talked about it. We hadn't even kind-of talked about it. I had assumed. What else had I assumed?
I think the worst part of the whole situation was that even though I was the one who had overstepped, she was the one who was feeling guilty.
Next came a strange mix of emotions. I felt bad for assuming and I was disappointed that she might not breastfeed. Then I felt guilty that I was disappointed because I knew my disappointment was going to make her feel guilty. Then I was hungry, but not because of any of the other emotions; I'm just usually hungry in any situation.
I think the next thing I said went something like this: "I messed up. I assumed we were on the same page about this. I think you should breastfeed." Here is what I thought I should have said: "I messed up. I'm not sure why, but I assumed we were on the same page about the topic of breastfeeding, which then led me to believe that we were on the same page about you breastfeeding. What I didn't take into account is that breastfeeding is more than just a pamphlet I read while I was bored at your last OB appointment. I can imagine that there is a lot of anxiety around it." But see the problem with either one of those replies? I assumed again. Here's what I REALLY should have said: "I messed up, and I made assumptions. I'm ready to listen."
We got there eventually (to me listening). It took a while of me explaining the benefits of breast milk (she already knew them), praising the other women in my life who had successfully breastfed (she had heard it before), and quoting every time in our relationship when she had mentioned the benefits of nursing (she remembered those too) before she was able to communicate to me, mostly with her eyes, that I was not the one whose input was missing from this conversation. My wife is a very patient woman. Eventually I just shut up and listened. Here's what I heard.
She was nervous, but she was also a little grossed out by the idea -- which made her feel guilty. She was worried she couldn't do it, and she was feeling a ton of pressure that she had to or she would permanently hurt the baby. And she didn't want to disappoint me, because she really wanted to be a good mom... and then she started crying, and I started crying, and we both looked very silly.
I apologized and she apologized and then I apologized that she felt like she needed to apologize and we went back and forth like that for a while. I said if she didn't want to breastfeed I would be totally OK with it. She said she knew that wasn't totally true, but appreciated me saying it. We danced like that for a bit and she suggested that we take a breastfeeding class together. The plan: She would consider my, the class's, her body's, and the baby's input and then make a decision as we got closer to having a mouth to feed. I would support her and love her no matter which decision she made.
The plan worked -- not in swaying her one way or the other, but by empowering her to feel comfortable and happy with whatever decision she came to. The class was wonderful and informative. I kept my mouth shut and listened (not an easy task for me). She read a couple books, and when Duchess arrived she decided she wanted to breastfeed. It was really hard and frustrating at first. My first instinct was to cheer for her the way you would a tired athlete. "GO! YOU BREASTFEED THAT KID! WOOHOO!" But we had gotten better at communicating by then, and she told me what she needed. Whether it was a hug or small words of encouragement, a shoulder to cry on or some of those gel nipple pads, when she asked for it -- she got it.
Yes, I am proud of my wife's decision to breastfeed. It wasn't an easy task, especially when she went back to work and had to pump. But, if I am being honest, I am more proud of what we learned before her milk ever came in. I learned that being an active and involved father doesn't necessarily mean that I have a 50 percent share of every single decision -- especially ones that involve her body. She learned that if she looks at me long enough and slowly raises her left eyebrow I will eventually realize that I am rambling on and on and on. Joking aside -- she learned to talk more, I learned to listen more, and we met in the middle. Breast milk may be healthy for our kids, but I hope seeing us communicate like that will be pretty damn healthy too.
Dr. Ann Borders, an OB-GYN who works with NorthShore University HealthSystem, recommends that her patients and their partners go to a breastfeeding class before Baby is born. In class, they don't just focus on why breastfeeding matters, but what you can actually expect in those daunting first few days. And Borders doesn't just recommend this for newbie families, but also moms who may have tried breastfeeding before and found it difficult. "You're not going to know everything from taking the class, but it gives you a groundwork that you can build on at the hospital once you have the nurses helping you," Borders said. Most OB-GYNs will be able to give you a referral to a breastfeeding class nearby, but if for some reason yours doesn't have any suggestions, a quick online search should bring up options in your area.
When you're in the hospital or birthing center, or while you've still got your midwife with you after a home birth, make sure you speak up and ask for help getting started. "Every health care person should know the basic mechanics of breastfeeding," said Mary Ryngaert, a board certified lactation consultant with the University of Florida's Center for Breastfeeding and Newborns. "I joke that the person who empties the trash [in labor and delivery] should be able to help someone latch on." Even Borders, whose professional life and research centers around breastfeeding, said that when her first baby was born, she had to ask for guidance. Women should feel 100 percent empowered to ask their care provider to help them start breastfeeding within the first hour after a vaginal birth or two hours after a C-section if the circumstances allow for it, she said. Don't leave the hospital until you've gotten the help you need.
There's a reason why hospitals hoping to earn the coveted "baby friendly" designation for breastfeeding support stress the importance of skin-to-skin: It works. Research shows that essential contact helps relax both the mom and baby, stimulates feeding behaviors and triggers the release of certain hormones that spur breastfeeding. Experts say it's important to do it both early -- ideally right after birth -- and often. "Keeping the baby skin-to-skin as much as possible in the early days after birth is very important," Ryngaert said. "If the mother is 'touched out,' then the partner can hold the baby skin-to-skin. It still helps the baby move instinctually to what [he or she] is supposed to do." If you're not in a "baby friendly" hospital with policies in place to promote skin-to-skin, don't be discouraged. Tell your doctors and nurses that it's important to you, Borders said. As long as your baby is stable, there's no reason why they shouldn't let you hold him or her close.
Engorgement, or a feeling of heavy fullness in the breasts that can be very painful, is common several days after delivery, but Borders said a lot of women don't know to expect it because no one talks to them about it. Having a game plan in place can help curb the pain and keep women from throwing in the towel when they're sore and freaked out. She suggests an over-the-counter pain medication, like Motrin, and ice. Two bags of frozen peas can also work, Borders said, and -- bonus! -- they tend to fit nicely into nursing bras. Some women may also want to take a hot shower to express some of their milk.
Susan Burger, president of the New York Lactation Consultant Association, finds few things as irksome as telling women that they need to try specific holds. Moms hear those tips and get "all twisted up with finding the perfect position," she said. What matters most in her book is that breastfeeding mothers get comfortable, which often means leaning back a bit and putting their feet up. "If she's comfortable, it's so much easier to get the baby into a comfortable position," Burger explained. This is one area where partners can really step in, looking at moms to spot any ways in which they might be uncomfortable, then helping by giving them a pillow, a shoulder rub ... whatever.
Your partner, or your mom or friend can also help by agreeing to sit with you while you breastfeed. Why? Since moms are often extremely relaxed and drowsy while they're breast-feeding, your partner can agree to be on "alert" -- maybe quietly reading a book or checking e-mails -- while you get some sleep. "Invite her to take a cat nap while breast-feeding," Ryngaert said. It may sound like a simple trick, but Ryngaert said it's such an easy, often-overlooked way for women to fully relax while breast-feeding, which only increases bonding and enjoyment, and also, possibly, catch up on some much-needed sleep.
Drop your mouth down to your chest, then open your mouth. A bit tricky, no? Now tilt your head back slightly and open it again. See how much easier that is? Burger said that one of the biggest ways to help babies drink is to make sure their heads are tilted back a bit. You can help support them in that position by putting a forearm under the baby's neck, or even a rolled-up receiving blanket. "There are a lot of different ways to achieve it," she said.
While experts may not poo-poo specific holds, at least ones a professional hasn't personally recommended for you and your baby, they do offer broader positioning advice: "I like to see the baby and mother have almost no space between them," Ryngaert said. "You're not just putting your breast in their mouth, you're really bringing your bodies together," she said. That helps babies bring a big, wide open mouth to the breast, giving them the deep attachment that they need. If you're not sure what that means, a good first place to look is the internet: There are videos online that demonstrate the concept, Ryngaert said, and places like La Leche League have helpful illustrations as well.
Burger said that one of the mistakes women can make is to focus too much on duration and not enough on the frequency of pumping. Often they're too hard on themselves, sitting there for long stretches and pumping away in an attempt to produce more milk, when really, they'd be better served by just a few minutes here and there throughout the day. Burger likened it to training for a marathon: "You wouldn't just go out and run 13 miles," she said. "If you're just starting out, you'd try a mile or two and do that three or four times a week. That's a much better approach." In the same vein, if you can work it into your schedule, frequent, brief bouts of pumping help build milk supply better than sitting there, rather helplessly, and pumping for one long stretch.
Borders said that women shouldn't just write off sore nipples -- which can sometimes become so bad they don't want to breast-feed at all. She recommends something called Newman's all-purpose ointment, which your pharmacist can mix for you. For women who don't have thrush (a generally harmless yeast infection) La Leche League also recommends applying freshly expressed breast milk to your nipples, which can help them heal. The bottom line? If your nipples hurt, don't just accept it. Talk to your doctor about what might be causing it and what you can do.
"Make sure you leave the hospital with the number for someone you can call with questions," Borders said. Many pediatricians offices now have lactation consultants on staff, which makes it easier for women to find someone who can offer guidance when you're they're in for one of those many new baby visits that happen after birth. In many cases, lactation consultants are covered by insurance, Ryngaert said, but places like La Leche League also have a call system where you can speak to someone for free. Many nurses and pediatricians are also board certified lactation consultants, which can help with insurance coverage. Women shouldn't feel pressure to figure everything out in the first week, Ryngaert said. "If a baby needs to go on formula for a time while the mother's milk supply is being established, that doesn't mean the baby's not going to be breastfed," she added. "I've seen babies that didn't latch on until eight weeks." But new moms should never, ever hesitate to ask for help. "If a mother is having more than a little tenderness, she should not just tough it out. She should get some help" Burger said. "And if that person says, 'Oh, it's normal, suck it up,' that's not a good person to get help from, and they should see someone else."
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