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Showing posts with label lactation. Show all posts
Showing posts with label lactation. Show all posts

Saturday, October 5, 2013

31 for 21 challenge: Day Five. The End of an Era

The choice to breastfeed Josiah was an easy one.  It had been unsuccessful with the first, but a perfect experience with the second.  I saw no reason it couldn't be the same with Josiah.  I read all the negative reviews about breastfeeding a child with Down syndrome.  "It's rarely successful because of the low muscle tone," "...because of the common failure to thrive, these babies commonly need additional supplementation," and so on.  By all accounts, I had no reason to believe I should try.

Anyone that knows me, however, knows that I will stand up for what I believe in.  I believed it was right for me, and my child.  So, there the dream began.  While still pregnant, I made my intentions known.  I was going to do the impossible (or at least very difficult): I was planning on breastfeeding my baby with Down syndrome.

I knew right away that Josiah had low muscle tone.  Although he understood what to do, and demonstrated some interest, sucking was not easy for him.  It was obvious.  He worked hard for every sip of milk he took.  It was time consuming, exhausting, and tested every ounce of patience I had.

Josiah breastfed exclusively, for about five months.  He weighed 9 pounds at five months.  Our first weighed 15 lbs at the same age.  Our second, weighed 13 lbs.  On 3/12/12, I wrote the following in my blog:

"We took Josiah to the cardiologist today for his first office follow-up appointment, since his surgery.  His EKG was great!  Then, they weighed him.  He weighed in at 9lbs 1.3oz.  At best, given that each office has it's own scale, he neither gained nor lost weight.  At worst, he lost 2oz since last Friday (at the pediatrician's office).  I cannot begin to describe the feeling of complete exasperation, frustration, and despair.

Perhaps it seems like a small thing; perhaps it is.  All I know is this: Josiah weighed 7lbs on 10/12/2011.  Today, 3/2/12, he weighed 9lbs 1oz.  He will be five months old, in ten days.  At J1's four-month check up, he weighed 15lbs.  J2, at the same check up, weighed 13lbs.  I know the DS plays a role in the slow weight gain, but this isn't right. 

We (the professionals and family alike) believed that the heart problems were contributing to his slow weight gain.  That excuse can no longer be used.  Today's appointment confirmed that Josiah's heart is perfect (a wonderful piece of news that I cannot negate).  Is it the Down Syndrome?  Is it a feeding issue?  Is he not getting enough calories?  Does he simply need more calories than an average child?  Should we start feeding him cereal?  UGH!  The questions race through my tired mind.

The surgeon was very pleased with the outcome of Josiah's surgery.  Josiah's heart "sounds perfect."  His color is good.  "He looks like a different kid."  "He looks more mature in the way he's moving around."  However, "I expected him to come in here having gained a lot of weight so this is disappointing."  (Yeah, tell me about it!)

Up until now, Josiah has been exclusively breastfed.  He doesn't like the bottle; he won't drink from a bottle.  Since surgery, he's been eating every 2-3 hours.  It seems impossible to me that the child has gained no weight but numbers do not lie.  I don't know what to do....that's the feeling.  I hate that feeling.  I'm tired and feel I has so little left to give....

We made our way out of the cardiologists office.  I immediately walked down the hall to the pediatrician's office.  I talked to our favorite nurse M.  I voiced my frustration.  I asked if we should start Josiah on cereal.  I assured her we were doing everything we could to properly nourish our son.  She already knows that we are.  She said she'd call me later.

We did a few errands, picked up Jesse from school, and made our way home.  I was exhausted.  I left a message for our EI worker K.  I know I'll hear from her as soon as she's available.  This afternoon I fed Josiah...off and on....like usual.  I went to the store for groceries and bought a different type of bottle - maybe Josiah will drink from this one.  It's worth a try.

I talked to M from the pedi's office.  The MD said we can start Josiah on cereal.  I needed more than that.  I didn't know what I needed, but that wasn't enough.  I guess I wanted an instant fix....  I was so emotionally spent, my mind couldn't form concrete thoughts by which to gain more information.  I ended the call for lack of knowing what else to say.  Carl was very supportive of my frustration level.  He called the MD's office back again and spoke with our pediatrician.  The pedi is sympathetic to the situation and understands the frustration level.  He suggests the OT (as the cardiologist did), a nutritionist (specifically with the DS clinic), formula if possible, cereal, the new bottle, and high-calorie formula if we request such.  We'll see the pediatrician next Thursday for another weight check.

I called the lactation specialist KF and heard back from her promptly.  We chatted for some time.  It's nice to have someone who knows the frustration of breastfeeding a baby who doesn't gain weight.  She offered some great suggestions.  One by one, I'll try them all.

I talked to K for quite some time after.  She is another fantastic support.  K will put in a referral for OT early next week.  It will be, specifically, for feeding.  I've entrusted that task to her.  We'll see K on Monday and will discuss the details further.

Tomorrow, I'll email A from the DS clinic.  I'll explain what's going on with Josiah.  I'll ask her what I need to do to initiate a consult with one of their nutritionists.  I'll probably hear back from her on Monday.

It's the weekend now....two days, at home, with my wonderful family.  I'm going to try to relax a little.  I'll attempt some of the new suggestions given to me.  Hopefully something will work.  I'm going to try to not let it become all-consuming (although it already feels that way sometimes). 

In the end, everything will work out.  Even the cardiologist said "this is just another little hurdle we have to climb over."  Everything will work out.

Climbing up the down staircase isn't always easy....but it's worth every single step <3"

And so it continued...  I continued to breastfeed.  Ultimately, we added cereal and began supplementing (minimally) with formulaLittle by little, Josiah started gaining weight.  The peanut that once fell 'below the line' on the DS  growth chart, now charts on the 90th percentile.  On the 'normal' growth chart, he didn't even plot on the chart, now charts at around the 50th percentile.

I have to give credit to an unknown friend and support.  By that, I mean a person whom I have never met.  She is my friend KF.  She is a lactation specialist and has been an unwavering support during every frustrating moment.  She returned every call, called me consistently, researched, and supported my every attempt to make it all work.  Without her, I am convinced that my breastfeeding quest with Josiah would have failed.

Instead, Josiah is turning two in 8 days.  He has breastfed this entire time.  I worried about having to wean him, but HE made all the choices.  In the early part of summer, he decreased his nursing to once a day (first thing in the morning).  I could see the end coming near.  In August, he had the croup & we enjoyed what I call 'the last hoorah.'  For four days, while sick, he breastfed 4-5 times per day.  I kept asking him if this was his last hoorah.  Once well, he went back to once per day.  If he was testing me, I proved that he would get anything he needed.  If it was just for comfort, he got that too.

Regardless, yesterday he woke up and decided he was all set.  He didn't nurse.  He had no interest.  He's growing up and I know it.  I didn't push and told him it was ok to be a big boy now.  And so it was.  We went the day without breastfeeding.  Today, like yesterday, he woke with no interest in breastfeeding.  Day two and he's done it all himself.

Though I miss that certain bonding time, I have been fully prepared to see it end.  I will forever remember, and enjoy, the last hoorah that Josiah gave to me in August.  He knew I would miss it.  He, too, knew he was letting go.  And so it is.  We have reached the end of an era.  He's almost two, almost 27 pounds, and has said good-bye to breastfeeding.


“Never give up on what you really want to do. The person with big dreams is more powerful 
than the one with all the facts.” ~ unknown author

Tuesday, October 9, 2012

31 for 21 Blog Challenge: DAY NINE: Breastfeeding Beyond One

When I was pregnant with Jesse, I never questioned whether or not I would breastfeed him.  I, also, never dreamed that it wasn't (always) an easy chore.  Unfortunately, being a new Mom - I just didn't know how to handle a very lethargic baby Jesse.  I didn't have the proper support in place to make breastfeeding a success.  Day nine proved fatal to my breastfeeding quest.  Jesse got a bottle; it was all over.

While pregnant with James, I was determined to breastfeed.  More importantly, I was determined to succeed.  This time, I had begun talking to my friend K (a lactation specialist).  By the time James was born, K and I had a great connection.  Unlike Jesse, James just 'got it' from the first moment he tried to nurse.  He wasn't lethargic.  It wasn't a battle.  It just worked.  He began baby food on schedule and the breastfeeding decreased.  As the months went on, I worried about the day I would have to stop nursing him.  We had decided on one year.  I worried that I'd traumatize him.  Well, James independence shone through.  At ten months, he weaned himself.  He decided.  It was all over.

When we learned that Josiah had Down Syndrome, I was not less anxious to breastfeed.  Of course, I wasn't without my doubts, fears, and anxieties.  I was fortunate enough to reconnect with K, so I knew I had the best support person in my corner.  I've written previously about my experience with breastfeeding, Josiah's weight battle, etc.  With great perseverance, we have successfully breastfed our baby with Down Syndrome.  Yes, we supplemented when necessary.  Yes, we introduced baby food when suggested.  However, the whole time, I have continued to breastfeed him.  In a few days, Josiah will turn one.  One was always the 'cut-off' in my mind.  Not this time.....

I am convinced that breastfeeding Josiah (or any child with Down Syndrome) has immeasurable positive benefits. They include:
  • increased protection from infection and bowel problems
  • increased mouth/tongue coordination
  • increased stimulation
  • increased muscle tone
These are in addition to the positive effects of breastfeeding on 'normally developing' children, such as:
  • breastfeeding is more nutritious
  • gives immune protection
  • minimizes allergies
  • helps digestive system mature
  • lowers risk of SIDS
  • promotes eye and brain development
  • is more economical
Why would I stop now???

Studies indicate that breastmilk in mother's who have been lactating for year or more, have a significantly increased fat and energy content.

In the second year, 448ml of breastmilk (approximately 15 ounces) 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 experts:
  • children weaned before the age of 2 are at an increased risk of illness
  • breastfed children between 1-3 have fewer illnesses, illnesses of shorter duration, and lower mortality rates
  • some of the immune factors in breastmilk increase in concentration during the second year
  • cognitive achievement (IQ scores and grades in school) and breastfeeding have shown the greatest gains in children who were breastfed the longest
  • longer breastfeeding duration = improved social development
  • longer breastfeeding duration eases transition to childhood
I know these benefits were always there.  My mindset about continuing is different now.  Again, it simply didn't work with Jesse.  James weaned himself at 10 months.  Josiah shows no signs of weaning and I have no intention of suggesting it.

One year down :)


 "There are three reasons for breast-feeding:
the milk is always at the right temperature;
it comes in attractive containers;
and the cat can't get it."
- Irena Chalmers

Friday, March 2, 2012

Exasperated!!!

We took Josiah to the cardiologist today for his first office follow-up appointment, since his surgery.  His EKG was great!  Then, they weighed him.  He weighed in at 9lbs 1.3oz.  At best, given that each office has it's own scale, he neither gained nor lost weight.  At worst, he lost 2oz since last Friday (at the pediatrician's office).  I cannot begin to describe the feeling of complete exasperation, frustration, and despair.

Perhaps it seems like a small thing; perhaps it is.  All I know is this: Josiah weighed 7lbs on 10/12/2011.  Today, 3/2/12, he weighed 9lbs 1oz.  He will be five months old, in ten days.  At Jesse's four-month check up, he weighed 15lbs.  James, at the same check up, weighed 13lbs.  I know the DS plays a role in the slow weight gain, but this isn't right. 

We (the professionals and family alike) believed that the heart problems were contributing to his slow weight gain.  That excuse can no longer be used.  Today's appointment confirmed that Josiah's heart is perfect (a wonderful piece of news that I cannot negate).  Is it the Down Syndrome?  Is it a feeding issue?  Is he not getting enough calories?  Does he simply need more calories than an average child?  Should we start feeding him cereal?  UGH!  The questions race through my tired mind.

The surgeon was very pleased with the outcome of Josiah's surgery.  Josiah's heart "sounds perfect."  His color is good.  "He looks like a different kid."  "He looks more mature in the way he's moving around."  However, "I expected him to come in here having gained a lot of weight so this is disappointing."  (Yeah, tell me about it!)

Up until now, Josiah has been exclusively breastfed.  He doesn't like the bottle; he won't drink from a bottle.  Since surgery, he's been eating every 2-3 hours.  It seems impossible to me that the child has gained no weight but numbers do not lie.  I don't know what to do....that's the feeling.  I hate that feeling.  I'm tired and feel I has so little left to give....

We made our way out of the cardiologists office.  I immediately walked down the hall to the pediatrician's office.  I talked to our favorite nurse M.  I voiced my frustration.  I asked if we should start Josiah on cereal.  I assured her we were doing everything we could to properly nourish our son.  She already knows that we are.  She said she'd call me later.

We did a few errands, picked up Jesse from school, and made our way home.  I was exhausted.  I left a message for our EI worker K.  I know I'll hear from her as soon as she's available.  This afternoon I fed Josiah...off and on....like usual.  I went to the store for groceries and bought a different type of bottle - maybe Josiah will drink from this one.  It's worth a try.

I talked to M from the pedi's office.  The MD said we can start Josiah on cereal.  I needed more than that.  I didn't know what I needed, but that wasn't enough.  I guess I wanted an instant fix....  I was so emotionally spent, my mind couldn't form concrete thoughts by which to gain more information.  I ended the call for lack of knowing what else to say.  Carl was very supportive of my frustration level.  He called the MD's office back again and spoke with our pediatrician.  The pedi is sympathetic to the situation and understands the frustration level.  He suggests the OT (as the cardiologist did), a nutritionist (specifically with the DS clinic), formula if possible, cereal, the new bottle, and high-calorie formula if we request such.  We'll see the pediatrician next Thursday for another weight check.

I called the lactation specialist KF and heard back from her promptly.  We chatted for some time.  It's nice to have someone who knows the frustration of breastfeeding a baby who doesn't gain weight.  She offered some great suggestions.  One by one, I'll try them all.

I talked to K for quite some time after.  She is another fantastic support.  K will put in a referral for OT early next week.  It will be, specifically, for feeding.  I've entrusted that task to her.  We'll see K on Monday and will discuss the details further.

Tomorrow, I'll email A from the DS clinic.  I'll explain what's going on with Josiah.  I'll ask her what I need to do to initiate a consult with one of their nutritionists.  I'll probably hear back from her on Monday.

It's the weekend now....two days, at home, with my wonderful family.  I'm going to try to relax a little.  I'll attempt some of the new suggestions given to me.  Hopefully something will work.  I'm going to try to not let it become all-consuming (although it already feels that way sometimes). 

In the end, everything will work out.  Even the cardiologist said "this is just another little hurdle we have to climb over."  Everything will work out.

Climbing up the down staircase isn't always easy....but it's worth every single step <3