Time to Wean From Breastfeeding?

In three days from now, I’ll celebrate a milestone with my wee Willow.  We will have made it to 17 months breastfeeding.  As I write that, I’m filled with a mix of emotions.  I’m so proud of myself yet I’m also a little exhausted just thinking about it.  Breastfeeding and practicing attachment parenting while running a company and maintaining an active social life is HARD WORK!

Over the past 17 months, I’ve nursed my child to sleep every single time (except for a handful of times when I was away from her), I’ve nursed her every single time she hurt herself, I’ve nursed her when she was sick, I’ve nursed her when she needed a little cuddle and I’ve nursed her when she first signed “more” and later asked for mama.

I’ve nursed her on a plane numerous times, in doctor’s offices, in parks, in a movie theatre, in the front and back seat of my car, in Wal-Mart, in a mall, while sitting at my desk working, in restaurants and anywhere else the need to feed my child arose.

I have slathered my nipples in Jack Newman’s breastfeeding ointment more times than I can count, I’ve suffered through “rusty pipe syndrome”, worried about foremilk/hindmilk imbalances, spent hours trying to wake my sleepy newborn to eat, dealt with growth spurts/cluster feeding, navigated through proper latches and different feeding positions, wore nipple shields, pumped for hours and dealt with opinions from strangers on the way I am feeding my child (mostly good, some not so good).

But now, at 17 months, I wonder if we’ve reached our end.

Willow, for the past week or so, has started biting me nearly every feeding.  She seems way less interested in nursing and will only nurse for a few minutes before getting bored and moving on.  The only nursing sessions that she actually does well with are those right before bed.  Otherwise, she’s turned into an “angry nurser” and it’s killing both my spirits and my nipples.

I’ve done all kinds of things to get the biting to stop: I’ve tried removing her before she gets to the “done eating, play now” phase, I’ve unlatched her and told her no while setting her down, I’ve tried pushing her face (gently) into my breast when she bites so that she experiences something unpleasant after she bites but I’m seriously at a loss here.

It used to be that she’d nurse while we co-slept and those sessions were peaceful and always amongst my favourite. Now those sessions are horrendous for my nipples as she pulls back (with my nipple still in her mouth), bites and creates a super lazy latch, which causes problems for me.

So I’m not really sure what to do.  Is it time to wean her?  Is this her way of saying that she’s no longer interested in nursing?  Or, is this just a passing phase?  My goal was to nurse her until she was 2 years old but at this point, I don’t even want to nurse her one more time.  I think I might be reaching my breaking point too (and I know this to be true because writing that phrase six months ago would have induced tears for me… now it almost induces relief).

The only thing I’m worried about is that if I do wean her, how the heck do I get her to sleep?  We’ve only ever nursed her to sleep so I have no idea what I would do there.

Leave some advice, if you have any, in the comments!  I really need to know if this is normal behavior, how to get through it or if you think that she might be ready to just wean from nursing.  Thanks in advance!

Open Letter to Pediatricians on Breastfeeding

Here is the transcript of this video:

This past Thursday, January 5, 2012, we noticed that my daughter had a bit of a white patch on her mouth. After taking a look at it closely, I diagnosed it as being more than likely thrush and I called her pediatrician. My daughter’s pediatrician was not available that day but the nurse recommended that I go to the after care clinic and she gave me the name and telephone number of Dr. Andre Engels here in Ottawa. I called, made an appointment for that evening at 7:15pm and my husband and I brought our daughter there.

Dr. Engels seemed like a really nice doctor. He was sweet with Willow, looked at the photographs I had taken of her mouth and looked inside of her mouth and agreed with my diagnosis. Willow did indeed have thrush. He spent some time admiring my camera and telling me that it took great pictures while my husband got Willow ready to leave the office.

After Dr. Engels wrote the prescription for an anti-fungal medication for Willow, I began telling him how fortunate we were that in thirteen months of breastfeeding, this was the only issue we had experienced. Dr. Engels then looked at his chart and back to me and said (and I quote word for word), “So, is it true that you plan on breastfeeding her until she is in high school?” I was incredibly thrown by his comments and was unable to respond so, sensing the discomfort in the room I am sure, he turned to Steve and said, “Well, at least it is legal in Ontario.”

He left the room and Steve and I turned to each other but we could barely speak as I am pretty sure we were both in shock. You see, you expect judgment on certain parenting choices from friends, family, the general public, etc. but you never expect it from a pediatrician. I was stunned because I had assumed that the doctor would be pleased that we were able to breastfeed and that it had been so successful thus far. I was not expecting to get this type of reaction from someone in the medical profession.

So, here I am. I am writing this open letter, and will also share it with my YouTube community, because I hope that it helps another mother who finds herself in that situation. You see, I was frozen and couldn’t speak because I had my guard down in that office. Normally, when breastfeeding in public, I am always on edge and ready with my rebuttals should someone say something to me about breastfeeding my daughter. Any breastfeeding mother can relate to this. However, in the safety net of the pediatrician’s office, I had assumed that my continued breastfeeding would be accepted – not ridiculed. I am going to share with you some facts about breastfeeding so that if you ever find yourself in a situation where someone questions your choice to feed your daughter or son by breast, that you have something to say in return because I sure wish I had been able to say any of these things in response.

Mostly though, I am hoping that Dr. Engels has an opportunity to read this, or watch my video, and understand the impact that he had on somebody who wasn’t his patient and who was in his life for only a fleeting moment. I want him to know that words have strength and weight and should not just be said in an off the cuff manner. If another mother found herself in that situation, and was not as confident in her decisions as I was, she might leave his office and feel embarrassed or feel like she was doing something wrong. She might stop breastfeeding after that, even if she was not intending to.

If you, reading or watching this, have ever thought it was weird or odd or different for a mother to breastfeed her child past the age of one, I am hoping that this video helps you to understand the benefits and why mothers do breastfeed for an extended period of time. I think that people in general are more approving, less judgmental and more understanding when they are armed with information.

Many people have asked me, “Could the doctor have been joking?” and no, he wasn’t. Even if he were, it was still an extremely distasteful and ignorant joke. Other people have said, “Well, not everyone thinks that breastfeeding past one is acceptable” and no, not everyone thinks that, nor do they need to, but when you are in the medical profession, you generally keep your own personal opinion out of it and stick to facts that can be backed up with scientific research or medical fact. Having the opinion that extended breastfeeding is weird or asking someone if they plan to do it to an absurd age is not based on medical fact or scientific research. What this doctor asked me is offensive and very unprofessional.

Before I go into the facts about breastfeeding, I feel that it is very important for me to state Section 1 of the Human Rights Code, RSO 1990, c H.19, which states, Every person has a right to equal treatment with respect to services, goods and facilities, without discrimination because of race, ancestry, place of origin, colour, ethnic origin, citizenship, creed, sex, sexual orientation, age, marital status, family status or disability. The Ontario Human Rights Commission’s position is that the obligation not to discriminate on the basis of ‘sex’ includes an obligation not to discriminate on the basis of pregnancy, breastfeeding and gender identity.

This legal obligation is reflected in guidance contained in the Canadian Medical Association’s Code of Ethics, paragraph 17.

http://www.cpso.on.ca/uploadedFiles/downloads/cpsodocuments/policies/policies/human_rights.pdf

The experience that I had with this doctor is not simply an issue where I was insulted – this is an issue where I was denied my civil rights.

I want this text / video to contain education that will help others understand more about the benefits of extended breastfeeding so let me share those with you now.

Health Canada recommends the following: Encourage exclusive breastfeeding for the first 6 months of life, as breast milk is the best food for optimal growth. Breastfeeding may continue for up to 2 years and beyond.

http://www.hc-sc.gc.ca/fn-an/pubs/infant-nourrisson/nut_infant_nourrisson_term_1-eng.php#summary

The World Health Organization recommends exclusive breastfeeding for the first six months of life. At six months, other foods should complement breastfeeding for up to two years or more.

WHO also states that breastmilk is the ideal food for newborns and infants. It gives infants all the nutrients they need for healthy development. It is safe and contains antibodies that help protect infants from common childhood illnesses such as diarrhoea and pneumonia.

WHO states that beyond the immediate benefits for children, breastfeeding contributes to a lifetime of good health. Adults who were breastfed as babies often have lower blood pressure and lower cholesterol, as well as lower rates of overweight, obesity and type-2 diabetes.

WHO states that breastfeeding should not be decreased when starting complementary feeding.

http://www.who.int/features/factfiles/breastfeeding/en/

A Dewey 2011 reference states that in the second year (12-23 months), 448ml of breastmilk provides: 29% of energy requirements, 43% of protein requirements, 36% of calcium requirements, 75% of vitamin A requirements, 76% of folate requirements, 94% of vitamin B12 requirements and 60% of vitamin C requirements.

According to the American Academy of Pediatrics, the role of pediatricians and other health care professionals should be to protect, promote and support breastfeeding enthusiastically and, in consideration of the extensively published evidence for improved health and developmental outcomes in breastfed infants and their mothers, a strong position on behalf of breastfeeding is warranted.

The AAP also states that pediatricians should promote breastfeeding as a cultural norm and encourage family and societal support for breastfeeding. They also need to recognize the effect of cultural diversity on breastfeeding attitudes and practices and encourage variations that effectively promote and support breastfeeding.

http://aappolicy.aappublications.org/cgi/content/full/pediatrics;115/2/496

The sad part is that, in a study performed by the American Academy of Pediatrics, which involved a survey sent to 1602 active Fellows of the AAP, only 65% of the pediatricians surveyed recommended exclusive breastfeeding for the first month of life. Only 37% of pediatricians recommended breastfeeding for 1 year. The majority of the pediatricians surveyed had also not attended a presentation on breastfeeding in the previous three years however most said that they did want more education on breastfeeding. They concluded that pediatricians have significant educational needs in the area of breastfeeding.

http://www.pediatricsdigest.mobi/content/103/3/e35.full

Things need to change. My experience is unfortunately one of many. The attitude that our society has toward breastfeeding, and more prevalent to my experience, extended breastfeeding, is narrow. We especially need to work on creating more education for pediatricians and providing them with ample access to lactation consultants who can advise on such issues.

I hope this video reaches a mother who, like me, was ridiculed for breastfeeding past one year and I hope that it helps her realize that her decision is the right one. I hope it also provides other mothers with information that they can use to present to their pediatrician should an issue ever come up.

And to Dr. Engels, should you ever see this video, I would really appreciate knowing why you chose those words that evening and what your intentions were behind saying them. What made you think that breastfeeding my 13 month old daughter meant that I would breastfeed her until she was in high school? How do you support other breastfeeding mothers? What part of me breastfeeding my daughter is “legal in Ontario”? I have so many unanswered questions about our interaction and I’m hoping that this helps me receive answers.

I Have a High Needs Baby

Willow is a fantastic baby and no, I am not just saying that because I am her mother — she really is a fantastic baby with an over the top personality.  BUT, and there is a but, the girl definitely knows how to shake things up and drain the energy from her two loving parents at times.

After trying to put Willow to sleep at 7:30pm and failing, I took her for a walk in the carrier to see if the fresh air would calm her down.  We walked for about thirty to forty-five minutes before heading back home to try operation fall asleep again.  This time, she fell asleep rather quickly and I was thinking, “WOOHOO! Bachelor Pad time!” (Yes, an insanely guilty pleasure of mine…)

Thirty-five minutes later, she fussed herself awake so Steve went in to calm her down… no luck, so I went in.  Nursed her to what I thought was “back to sleep” but when I unlatched her, she came awake and was angry.  Super angry.  Fast forward to an hour and a bit later (and some gripe water for the gas she had and a clean diaper in case that was bothering her), we were back in bed again and nursing her back to sleep.  I get her to sleep by ten forty-five, leave the room, sit at my desk and BAM, awake again.  As I’m nursing her back to sleep for the fourth time, I’m thinking to myself, “Is this normal?  Do I need to submit to cry-it-out?  Where have I gone wrong in getting my child to sleep at night?!”

So, I do what any responsible and intelligent parent does — I Google, “wide awake baby at night.”  I sift through a few of the articles and see the phrase, “high needs baby” … I am intrigued so I Google that term.  The first article that pops up is an article from Dr. Sears called, “12 Features of a High Needs Baby.”  As I read the article, my eyes are wide and I wish I could wake Steve up to tell him that I just figured out why our daughter was so… well… her.

For anyone who is around Willow, for anyone who cares for Willow and for other parents with high needs babies who want to hear our experience, read on…  This is going to shed SO much light on why she is the way she is.

The following explains the 12 characteristics of a high needs baby and I’ve grabbed the very basic summary of each point.  I also share with you how Willow “fits the bill” so to speak.  If you don’t know Willow, this part may be boring so just read the summaries of each characteristic instead.

“INTENSE”

“The cry of a high need baby is not a mere request, it’s an urgent demand. These babies put more energy into everything they do.”

“Intense babies become the intense toddlers, characterized by one word — “driven.” They seem in high gear all the time. Their drive to explore and experiment with everything in reach leaves no household item safe.”

Willow is a lot like her momma in this regard.  I tend to jump into whatever I am focusing on full force and I don’t let much get in my way.  Willow is a lot like me (in fact, we’re both Sagittarians, which is even more trouble! haha) If you walk out of the room while Willow is in her exersaucer or playing on the floor, she’ll yell at you to come back (for my nine month old, it is usually a grunty yell) and if she wants a toy or something you have and you don’t give it to her, she can go from peaceful baby to nightmare child in a second.

“HYPERACTIVE”

“This feature of high need babies, and its cousin hypertonic, are directly related to the quality of intensity. Hypertonic refers to muscles that are frequently tensed and ready to go, tight and waiting to explode into action. The muscles and mind of high need children are seldom relaxed or still.”

O.M.G.  If you’ve met Willow, you know that her hands and feet NEVER stop moving.  She twists her ankles, opens and closes her fists and she is constantly moving.  In fact, one night, after a particularly rough day, I even Googled “ADHD in infants” because she is THAT busy.  Willow loves to move and jump and stand and pretend walk and… well… stay active 99.9% of the time that she is awake.  It also makes breastfeeding right now nearly impossible during the day because she is SO distracted.

“DRAINING”

“High need babies extract every bit of energy from tired parents — and then want more.  Perhaps “siphoning” is a more accurate term because what you are really doing is transferring much of your energy into your baby’s tank to help her thrive. You will need to muster up as much of a positive attitude as you can; try to think of these “draining” days as “giving” days.”

I’m not even going to tell you the number of times I’ve texted Steve to tell him how drained I was.  Willow needs a constant stream of energy poured into her from anyone who is around and she really dislikes being alone.

“FEEDS FREQUENTLY”

“”Schedule” is not in the high need baby’s vocabulary. Early on these smart infants learn that the breast or bottle is not only a source of nutrition, but also a source of comfort. Not only do high need babies breastfeed more frequently, the need for breastfeeding lasts longer. These babies are notoriously slow to wean.”

If any of you remember back to the early days, and I know Steve will remember this clearly, all I did was nurse Willow.  In fact, I spent the first two-three months on the couch, top off, wearing only a nursing bra, and I fed her. And fed her. And fed her.  I called a lactation consultant to see if maybe there was a reason for it and I doubted myself a lot with regards to my milk making abilities.

Now, Willow nurses pretty much all night, every night.  If I am near her and she isn’t being stimulated by her surroundings, she wants to nurse.  I am being literally drained all day and all night.

“DEMANDING”

“These babies convey a sense of urgency in their signals; they do not like waiting, and they do not readily accept alternatives. Woe to the parent who offers baby the rattle when he is expecting a breast. He will let you know quickly and loudly that you’ve misread his cues. The concept of “delayed gratification” is totally foreign to infants, it must be sensitively and gradually taught when the child is developmentally ready to learn it.”

As I mentioned earlier, my wee girl is not a patient girl.  If she’s hungry, she wants it now.  If she is tired, she will go from slightly tired to cranky and overtired in a few minutes.  If she wants a toy and can’t reach it, she freaks out.  She knows what she wants, when she wants and how she wants it.

“AWAKENS FREQUENTLY”

“Infants with a maturer stimulus barrier may sleep through a slight discomfort, such as being too cold, too hot, slightly hungry, or even lonely. These nighttime discomforts awaken highly sensitive babies.

While you can put some infants down in their crib and they fall asleep, high-need babies have to be deeply asleep before you can put them down.

High-need babies seem to take longer to develop sleep maturity. They are more prone to awaken during the vulnerable periods of transition from one sleep stage to another. Yet high-need infants often seem to be totally “zonked” when they are in the stage of deep sleep. Eventually, these infants are able to spend more time in deep sleep, yet they do not “sleep through the night” as early as less sensitive babies.

High-need babies demand whatever day and night parenting style gives them a sense of well-being, and that usually means sleeping in physical contact with someone, preferably mother.

Infants with a maturer stimulus barrier may sleep through a slight discomfort, such as being too cold, too hot, slightly hungry, or even lonely. These nighttime discomforts awaken highly sensitive babies.

While you can put some infants down in their crib and they fall asleep, high-need babies have to be deeply asleep before you can put them down.
High-need babies seem to take longer to develop sleep maturity. They are more prone to awaken during the vulnerable periods of transition from one sleep stage to another. Yet high-need infants often seem to be totally “zonked” when they are in the stage of deep sleep. Eventually, these infants are able to spend more time in deep sleep, yet they do not “sleep through the night” as early as less sensitive babies.

High-need babies demand whatever day and night parenting style gives them a sense of well-being, and that usually means sleeping in physical contact with someone, preferably mother.”

Umm… yeah.  All of that.

“SUPER-SENSITIVE”

“High need babies are keenly aware of the goings-on in their environment. While you can carry on normal family life without waking most sleeping infants, these babies often awaken at the slightest noise. Super-sensitive infants are unlikely to accept substitute caregivers willingly.”

I remember my dad, not long after we moved in to their house, had commented one night about Willow being a light sleeper as she would wake easily with the slightest noise and he’s right – she is an insanely light sleeper.  We have been using a white noise machine from the time she was little as any noise would wake her up.  We have to tip toe past her door and make sure that nothing loud wakes her up.

“NOT A SELF-SOOTHER”

“High need babies need help to fall asleep. They must learn to trust their parents to help them. This will help them learn to relax on their own, a skill that has value for a lifetime. Crying oneself off to sleep is not a good way to learn to relax. The best way for a baby to learn to relax and fall asleep is to have his behavior shaped for him by a parent. Once a child learns to relax on his own, he’ll have no trouble falling asleep, when he’s tired, on his own.”

Willow has never, ever, ever been able to fall asleep on her own – except for when she was a wee newborn and all she did was sleep anyway.  I have never been able to set her down in her crib and have her doze off to sleep on her own.  That just does not happen.  She needs to be nursed to sleep, every time and without that… she won’t sleep.  Although, she will also fall asleep in the car or while in the carrier but those are external soothers – she doesn’t know how to self-soothe whatsoever.

“SEPARATION SENSITIVE”

“High need babies know which situations and which persons they can trust to meet their needs, and they protest if these expectations are not met. Loud separation protests also reveal that these babies have a capacity for forming deep attachments — if they didn’t care deeply, they wouldn’t fuss so loudly when separated. This capacity is the forerunner of intimacy in adult relationships.”

Willow makes strange sometimes and while I am always making excuses for her, like she’s tired or she’s cranky, she just really doesn’t want to be with many other people than the people she is with on a day-to-day basis.  This part of Willow is getting more and more apparent as when she wants her momma, no one else will do.  She also doesn’t want to sleep alone, at night, whatsoever and she sleeps fine if Steve or I are in bed with her.  It’s super awesome but at the same time, we all need our alone / down time.