Residential Space A creative outlet during residency, turned ongoing virtual soap box

Posted on Thursday, February 21st, 2008 at 3:58 am. About Baby Dodds, Ramblings.

Thoughts on breastfeeding at 2:30AM

I have been very fortunate in that I have been able to successfully breastfeed Gabriel for the past seven months. During the first three days of his life, I wondered if it would ever work, and told those around me that learning to breastfeed was the most difficult, most frustrating thing I have ever done. He did not latch at first, and I was exhausted and without much patience. Once milk arrived around day three, then it got easy.

It has been such a wonderful way to nourish my son. He has consistently been either in the 90th percentile for height/weight/head circumference or between the 75th and 90th as an exclusively breastfed baby. His neurological development has been astonishing. Of course, the act of feeding him brings us physically close to one another multiple times per day (and before, per night), and has given me many opportunities to cradle this new little person in my arms in an ongoing hug.

I returned to work last October when he was eleven weeks old and began the much less satisfying – but well worthwhile – experiencing of pumping three times daily. He was still eating every three hours at home, so I continued to pump during his feeding times. This worked well in October (on some days it was stressful, but I made it happen), November and December (elective months with flexible schedules). In January, several things happened – I became the chief neurology resident at UW Medical Center and was running around constantly during the day, and while there was a lactation room in the hospital, it was a good walk from where I spent most of my time. I suddenly had days where I would desperately sneak away to pump five hours from my last pumping session, only to be paged overhead emergently to a patient’s room where an acute stroke was occurring or a patient was in the process of seizing. The next day I would try to compensate by sneaking away more than usual, but the less frequent pumping, combined with passing that six month mark, resulted in the start of a dwindling milk supply problem. However, it was the last week of January that started to kill it – I was on call every other night, alternating with another resident on my team because our third resident went on vacation, and the days when I was not on call were nearly as stressful.

In December I had gastroenteritis, and with the dehydration came a near loss of milk – I thought, “Well, this is it – I’m done breastfeeding.” Gabriel would eat 4-5 ounces in a feeding, and I would only be able to pump 1/2 to 1 ounce every few hours. I really thought it was over, and 120 ounces of milk in the freezer got consumed quickly. Then, about a week later, I woke up at the hospital one morning and was able to pump nine ounces in one sitting. It was back! Breastfeeding would continue.

I think about that experience in December now, as my supply is once again dwindling. After gastroenteritis in December I vigorously built another large freezer stash of emergency milk. Each day this week, give or take, I have had to supplement Gabriel with a bag from the freezer, which is only sustainable for a finite period of time. I am concerned that he may end up on formula, which objectively would not be awful, given that he is now seven months old, and many babies grow up to be healthy, intelligent human beings having never been breastfed. My goal had originally been six months, so if anything I should be proud of myself for sticking with it – but for some reason, I am frustrated and disappointed. I know if I were a stay-at-home mom I probably would not have this problem, and that it arises from my job. I have told that I just have to make pumping a top priority during the day. What happens when you do, but your milk supply is decreased anyway? Then, you find yourself getting up at 2AM just to pump, but unable to get anything.

I can count the number of formula bottles on two hands that Gabriel has had in his first seven months – about three during his first three days of life before my milk arrived, several bottles of Alimentum when I was on an antibiotic when he was a month old and he had some mucousy stools, and one at Christmas when I had to take my grandmother to an ER while I was in Texas and had no pumped milk with me (and didn’t want to take Gabriel to a hospital for obvious reasons). Evan tried to feed Gabriel with formula while I was gone, and Little G screamed for almost two hours until I came home to feed him. When I experienced that episode, I decided to breastfeed for one year, and then transition him directly to regular cow’s milk (babies cannot have cow’s milk earlier than one year of age, according to the AAP).

It has definitely been worth bringing the Medela pump back and forth to work each day, and sneaking away even when time doesn’t permit in order to pump, in order to continue breastfeeding after going back to work. I have watched my son grow from a newborn infant into a healthy, very active, and starting-to-get-into-everything little boy. Pumping at work and knowing he is getting my milk during the days has been my connection to him when I am away from him, and it has permitted me to enjoy those quiet moments in the mornings and evenings when I can feed him in person. It makes me sad to think that our time breastfeeding may be limited, but I’ll appreciate each day where it can be sustained and hope that another one follows. In any case, I know that the important portion of my time with him is yet to come over many years.


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