Wednesday, September 10, 2008

Suh...suh...suh... Something from the Comments!

Oh, how I love questions! I am such a Dear Abby wannabe...

Brandi writes:

I do have a question for a seasoned BF mother. D is 13 months and eats table food like a 6 year old. So obviously my supply is diminishing. We nurse for 2 naps, bed time, and first thing in the am. I am worried that I am drying up tho. Any suggestions? He shows no interest in stopping as T did when she was 14 months (broke my heart.) I welcome any advice you have. THANKS!!

I suck at weaning. Pun intended. I really do. I actually had to wean Mary Grace "by abandonment" (as the LLL so lovingly puts it) and take Claire to St. Thomas, leaving MG at home with Daddy when she was 28 months old. I nursed her throughout my pregnancy with Claire, which was hideous and painful and annoying to the extreme, and then for 9 months I nursed both of them.

I really should be a size 2.

I have been nursing non-stop since August of 2005, which is ridiculous. I am D.O.N.E., and I would LOVE to wean Claire. However, because of her weight issues (she's not on the weight chart - she's in like the negative-5th percentile), I hesitate to wean her. At least I know she's getting nutritious breastmilk, even if she doesn't eat anything else, and if she's going to put on weight, I'd rather have the fat come from me than from some cow.

So, all this back story is to explain my first thought when I read your question, Brandi, which is, "Oh my God, girl, wean while you can!!!" There's kind of a natural order to breastfeeding, and as they start to eat more table food, they nurse less, and your supply naturally decreases (which sure beats abrupt weaning and breast engorgement - owie! - which can lead to plugged ducts and even mastitis, which is bad news).

There are really two distinct types of nursing. There's nursing where they're actually getting milk, which is what one would expect, and there's also what we call "noodling" which is when they're using Mommy as a pacifier. Noodling happens when they nur5srse for comfort, or for attention, and both of my kids have noodled at nap and bedtime. I suspect that your baby is getting very little actual milk at this point, except maybe in the morning because sleeping causes you to produce more milk.

Noodling annoys the crap out of me. It feels horrible, to me, and I try to discourage it as much as I can. I am not a pacifier, and I don't like it when they treat me like one! However, they both have been big noodlers, and never took pacis, so if I wanted them to quit crying so I could, say, write this here blog post (hee...) I did what I had to do. Claire is noodling right now, in fact.

If baby gets in the habit of noodling, it's going to be harder to break the habit (eventually, when you're ready) than if you don't let him get in the habit in the first place. In my humble opinion, it makes weaning a LOT harder, down the road. Of course, this doesn't stop me from letting my kids noodle. I really should practice what I preach. (You can tell the difference between nursing and noodling because when they're noodling you can't hear them swallow. You also won't feel a let down, and their tongue moves differently. The tongue thing feels like they're flicking at my nipple to me, and it makes me want to crawl up the walls).

You have two choices, really. You can allow the natural decrease which will naturally (and gently) discourage him from wanting to nurse. You can try to develop a new going-to-sleep routine that doesn't involve nursing, and see if he gives it up. Or, you can boost your supply.

I worry, though, that if you boost your supply and he's not nursing enough to keep up with it, you'll get engorgement -> plugged ducts -> mastitis. I really wouldn't boost my supply for a 14 month old, if I were you, but it sounds like you aren't ready to wean yet. Is he your last baby? Are you just having a hard time letting go? Are you afraid of getting your period back?

I think, before you do anything, you really need to examine your motivations and make sure that it's a good idea. Of course, I encourage you to breastfeed as long as you both find it beneficial, and how long that is, whether it's 14 months or 24 months or 34 months, is completely none of my business (or anyone else's!).

So, how do you increase your supply? Well, you get as much sleep as possible (she says to a mother of 4, hahaha!). You drink a lot of water. You drink a lot of dark beer (yes!). You eat oatmeal (I prefer mine in cookie form!). You can also go to the health food store and get brewer's yeast supplements or fenugreek supplements. You know you're taking enough fenugreek when your whole body smells like maple syrup. If your husband comes home, kisses you, and says, "Are we having pancakes for dinner?" you're there. There's also a "Mother's Milk" tea that is not made from mother's milk, but contains herbs and spices that are supposed to help your supply. Frankly, I thought the fenugreek pills worked a lot better than the tea, and I didn't love the taste of the tea, but it might be less drastic and less likely to lead you down the oversupply -> engorgement -> plugged ducts -> mastitis trail.

I would try the tea and the beer (think Guinness) first, and if that doesn't pump you up (hee) add in a batch or two of oatmeal cookies. If you still don't feel like you have enough, then try the supplements. There are also prescription medications - reglan and domperidone - that will increase your milk supply, but at this point I don't think a doctor would give them to you. Reglan caused my severe postpartum depression, too, so be very very careful of it. Domperidone isn't widely available in the U.S., and if you can beg, borrow, or steal a prescription, you have to have it compounded (made from scratch, by the pharmacist). So, because of side-effects and availability, I really doubt that a doc will give you either, unless your doctor happens to be a La Leche League Leader or something, and even then, it would be a trick. I couldn't get domperidone out of either of my doctors (OB/GYN or family doc) when I was having supply problems with MG, even though I found a compounding pharmacy. You can get domperidone from online pharmacies, but those scare me. I'm always afraid that I'll get the wrong medication and die or something.

I hope this helps! Good job nursing past 1 year for your two little ones. That's amazing, and you deserve a medal.

(Apologies to Ze Frank for the title!)


Sarah M. said...

Don't you hate how the universe is so unfair sometimes??? I personally feel that jean size should be in direct proportion to how long you nurse. Think about how much the nursing rates in the USA would skyrocket!! haha!

Anyway, thanks for writing this. Levi's hitting 8 months and nursing hasn't been horribly pleasant lately because sometimes he does "noodling" thing too. I'm so glad it isn't just my kid!! My goal with him was originally 2 years. I'm now rethinking that. :|

susan K said...

# 1 was weaned at 9 mos (I know!) because I was preggo with #2 and it hurt. A lot.
#2 weaned on his own at about 15 months.
#3 weaned with my help at 15 months because it became a wrestling session each time and I was really resenting each nursing session. My wise dh from across the room wondered why I was still nursing if it was such an ordeal and whether I was too close to see what was happening. I stopped offering, he stopped asking. :-)

Finally #4 was weaned by me at 12 months because I had such horrible ppd that I couldn't deal with trying to get meds, educate a doctor and nurse. Something had to give and nursing was it.
Weaning is unique to each pair.
I was a LLL leader for 10 years, my baby is now 9.