Nursing: the perfect excuse to rest

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These days, nursing my fourth baby, I can say that one of the best things about nursing is the simple brilliance of it – how convenient it is, and how it allows a tired young mother to rest.

Breastfeeding can have its stresses and challenges – we’ve had slow weight gain, tongue-tie, plugged ducts complete with high fever, D-MER, and others can probably chip in with stories of their own. But basically it’s supposed to be pretty much straightforward, or our species wouldn’t have survived. Throw in the facts that nutritionally speaking, breast milk is perfectly composed to meet the baby’s needs, it’s free, and you don’t have to prepare and wash bottles, not to mention worry about hygiene when you’re out and about – and there you have why I love it so much.

Most of the time, on many busy days, nursing is what allows me to put up my feet and rest, at least for a little while, without feeling guilty. We often try to do too much, and find it difficult to switch to a different mode once we have a baby – and nursing is just the thing to force us to slow down, for our own good. It’s healthy, it’s natural, it’s simple, it involves sitting down for regular periods every day and cuddling a sweet baby. It doesn’t get better than this

For those of us who are used to have it all under control, it can be tempting to say to the husband (or whoever there is to help us out), “here, just hold the baby – and I’ll do those dishes”… but no. Someone else can do the dishes, but no one else can nurse the baby. And while sitting down, it’s nice to have a cooling drink of water or a little snack as a refreshment on a hot busy day.

I guess this is what some would call “being tied down by babies”. It has taken me some time to embrace this, but I’ve realized that “being tied down” by nursing is the best thing that can happen to a frazzled mom looking over a messy house. Because let’s face it, we need to rest, we need to slow down, whether we acknowledge it or not. There will be those moments, of course. There will be days when you feel you have done nothing but nurse the baby – but these things slowly and imperceptibly change as the baby grows older. There will come a time when by-and-by, some of the baby’s nutritional needs will be met by solid food, then a bit more… there will come a time when you are able to leave your baby for an evening and go out.

And there will come a time of a bittersweet goodbye, when, with a feeling of a job well done, you relinquish the bond of breastfeeding and continue to nurture your little one in countless other ways. So there’s no rush. Every minute of nursing and snuggling is precious time well spent.
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Nursing on demand and parental authority

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There is a lady who writes in an Israeli magazine, whose articles on parenting I always look forward to. She speaks a lot about parental authority, delegating responsibilities to children, resisting worldly influences and other subjects I find instructive. Her most recent article was no exception. She lamented the fact that so many parents are encouraged to choose the so-called “child-centered” lifestyle, becoming slaves to the child’s choice of friends, clothes, toys, extra-curricular activities, and… nursing on demand.

Nursing a newborn on demand? Why, yes. “In the past,” she writes, “new mothers were told to breastfeed according to a schedule. Now it is recommended that you do it whenever the baby feels like it.”

I felt compelled to send this lady a personal email, in which I pointed out that all the examples she used in her article were good ones, except nursing on demand, which in no way “spoils” the baby or harms the mother’s authority. Quite simply, the fact that the recommendations in hospitals changed is due to finding out that nursing on demand (or rather, on cue) is actually the easiest and most intuitive way to establish successful breastfeeding – which is important not only for the baby, but for the mother’s health as well; try skipping a feeding for the sake of a schedule and you may end up with painful engorgement, complete with a plugged duct and high fever.

She wrote back. Her response was polite but self-assured. “Our mothers breastfed on schedule,” she said, “and we turned out a lot better brought up than the current generation of children.” True? Perhaps. Cause and effect? Not in the least.

I responded and said that, indeed, our mothers were told to breastfeed on schedule – and not coincidentally, it was a generation of formula-feeders. My mother-in-law, for example, was told to breastfeed her newborns every 4 hours. No more, no less. Baby is crying? Let him cry until the set hour. Baby is sleeping and you are thinking of taking a nap yourself? No way – wake him up to nurse. Unsurprisingly, her milk “just ran out” after 1 month, after which she had to give her children’s cow’s milk (as formula wasn’t readily available), and  many years later told me how she “was one of those women who just couldn’t produce enough”.

I also heartily recommended this lady to discuss the matter with a lactation consultant, and to consider all the facts. After all, it is a pity if a new mother who threw feeding schedules out of the window reads her article and thinks, “what if I’m spoiling the baby? What about my ‘authority’ as a parent?”

Imagine the following situation. It’s nearly evening, and I’m busy making dinner. A five-year-old is hanging around and says, “Mom, I’m hungry.” “Dinner will be ready in an hour,” I say. “But I’m still hungry,” she insists. “Alright, then,” I say, “if you feel you really need to eat something right now, you can get yourself an apple.” She proceeds to do so, and settles down with her little snack while I continue making dinner in peace.

Does the exchange above make my household “child-centered”? No. Does it make me less of an authority figure as a parent? No. Would it be better if I barked at my little child, “wait for dinner!”? Again, no. By the way, those who have been reading this blog for a while know I’m very much in favor of regular family meals. But if I get myself an unscheduled snack, sometimes before dinner or right before bedtime, and find it acceptable, why should I refuse when it comes to my children? I’m not speaking about things like sweets and cakes, of course, but about an apple before dinner or a slice of cheese before bedtime.

So what is the difference when we’re talking about a baby? A baby is completely dependent. She cannot get up and get her own snack. She cannot communicate her needs in words or negotiate. All she can do is signal to me that she needs to be picked up and fed – which, if the baby is exclusively breastfed, can only be done by me. So there is no getting around the fact that I must, indeed, nurse when the baby needs it, not when it is most convenient for me. This has nothing to do with authority, and everything with meeting the most basic need of a tiny human being.

Think of a novel concept: scheduled diaper-changing. After all, why must we be slaves to the baby’s whimsical schedule of bowel movements or wet diapers? Why must we hurry with a new diaper in hand every time? As parents, we are the leaders, and thus the baby must follow. She must learn that she is part of a family, and adapt to the family schedule. Thus, from now on, diapers will be changed – regardless of how wet or dirty they are – five times a day, at set intervals, and once at night. Try this for a few days, and you will see how your baby soon stops crying because of a messy diaper!

Sounds ridiculous? Of course. But in my eyes, this concept really is no different from feeding on cue vs. feeding on schedule. Some day, your baby will be able to go to the bathroom without your help. Some day, she will open the fridge and make herself a sandwich. But babies need their parents to provide those primary needs, and it is the parents’ job to do so.

What to do while breastfeeding

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Having a newborn means breastfeeding… a lot. Several hours a day (cumulatively), and during the night as well. I love this, because it allows me to sit back, relax, and take things slowly with the best excuse ever. Keep a snack and a bottle of water handy, because making milk for a baby means expenditure of both liquid and calories.

Breastfeeding doesn’t mean neglecting the other children. On the contrary, it’s a great time for uninterrupted conversation, word games and, of course, reading. We’re really getting through chapter after chapter in the last few days!

I have many favorites among children’s books, most of them classics – Winnie the Pooh, Alice in Wonderland, the Narnia books, and everything by Astrid Lindgren. Revisiting Pippi Longstocking is always a pleasure:

“But don’t you understand that you must go to school?”

“Why?”
“To learn things, of course.”
“What sort of things?” asked Pippi.
“All sorts,” said the policeman. “Lots of useful things—the multiplication tables, for instance.”
“I have got along fine without any pluttifikation tables for nine years,” said Pippi, “and I guess I’ll get along without it from now on, too.”
“Yes, but just think how embarrassing it will be for you to be so ignorant. Imagine when you grow up and somebody asks you what the capital of Portugal is and you can’t answer!”
“Oh, I can answer all right,” said Pippi. “I’ll answer like this: ‘If you are so bound and determined to find out what the capital of Portugal is, then, for goodness’ sake, write directly to Portugal and ask.'”
“Yes, but don’t you think that you would be sorry not to know it yourself?”
“Oh, probably,” said Pippi. “No doubt I should lie awake nights and wonder and wonder, ‘What in the world is the capital of Portugal?’ But one can’t be having fun all the time,” she continued, bending over and standing on her hands for a change. “For that matter, I’ve been in Lisbon with my papa,” she added, still standing upside down, for she could talk that way too.”

Fenugreek: A WonderHerb

Hilbe, a spread/dip made of Fenugreek seeds or leaves, is a staple of Yemenite Jewish cuisine, and is usually eaten at one or more of the Shabbat meals. It goes amazingly with pita bread. The recipes vary, and can include garlic, lemon juice, and various herbs and spices.

Fenugreek itself has some wonderful nutritional benefits, being rich in calcium and magnesium – and also some very special health properties. It has a beneficial effect on blood sugar regulation and is known as a milk-supply booster for nursing mothers. I had taken Fenugreek capsules in the past, when I reckoned I needed to build up my supply, and I reckon they helped a bit, but nothing very dramatic. However, after a Shabbat of enjoying homemade hilbe spread in very moderate amounts, I suddenly felt a very prominent increase in my milk supply, something I didn’t even think of or aim for (since my baby was almost one year old and I figured we have a pretty steady supply-demand thing going). I suppose this effect was due to pre-soaking the Fenugreek seeds for a couple of days, thus allowing the special plant components to activate.

I think that’s really worth noting, as capsules are so much more expensive – and, apparently, less effective – than the real thing. I’m not sure you can buy Fenugreek everywhere, though. In Israel, the seeds are available in health food stores, and the leaves can be found at certain markets in season.

Here is the recipe we used:

– about 1\3 cup dry Fenugreek seeds. Place in a bowl of water for 48 hours, changing the water every day. The seeds will swell considerably.
– a bunch of fresh coriander, about 3\4 cup shredded
– 2 big cloves of fresh garlic
– juice of one lemon

– salt and pepper to taste

Once the Fenugreek seeds are soaked and drained, place everything in your food processor. Blend thoroughly and add water as needed, to reach desired consistency (thicker/thinner, however you like it). Once finished, it should have a refreshing characteristic smell, and look bright green, sort of like this:
Image taken from here.

A word of warning: hilbe has a dominant smell; some like it, some don’t mind, some wish they could do without it. The smell can later come out in your sweat, or even in your baby’s diaper. The Fenugreek capsules don’t smell when you take them, but the smell comes out with a vengeance later through all your pores.

Recently I’ve decided to try growing some fenugreek from seed, to see if the fresh leaves are as good or better as the dried ones we use in various dishes. So far it’s proving very easy to grow – I just made a shallow trench in one of the garden beds, threw in some dry Fenugreek seeds from the store, and almost all of them sprouted. Once the leaves are big enough to use I’ll be sure to let you know how it has turned out.

Nourishing Traditions and breastfeeding

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Disclaimer: this post focuses only on the section on infant feeding in “Nourishing Traditions”, which is just a small part of the book.

As I approached the section on infant feeding in Nourishing Traditions, I was looking forward to a detailed survey of breastfeeding practices in traditional cultures, including perhaps a comprehensive list of foods which are thought to be beneficial for nursing mothers, plus detailed suggestions of milk-boosting diets, meals, beverages etc.

I was disappointed. At the beginning of the chapter, the author says that the importance of breastfeeding your baby “cannot be overemphasized.” However, I felt that the rest of the chapter contradicts this statement by concentrating mostly on recipes for homemade baby formulas, and by providing some advice which is outright detrimental to successful breastfeeding.

Are homemade “natural” formulas better than commercial formulas? Perhaps. Let’s even assume so. But no formula will ever come close to breastfeeding, either in nutritional content or otherwise. Mother’s milk is the food God designed for babies; cow’s milk is the food God designed for calves. It’s as simple as that. Cows’ or goats’ milk protein is unlike the protein in mother’s milk and is less well suited to human infants. Yes, it is possible for a baby to grow up just fine on formula, but on all points – nutritious, emotional and immunological benefits, protection from exogenous diseases, convenience and price – the score of breastfeeding is way higher. Therefore, as I see it, it’s definitely worthwhile to do everything possible to ensure that the baby is breastfed.

The author flatly and unequivocally states that the optimal duration of breastfeeding is “six months to a year”. This essentially means that some babies should be completely weaned as early as six months of age – which is just plain wrong, both according to the current position of the WHO, which states that

Exclusive breastfeeding is recommended up to 6 months of age, with continued breastfeeding along with appropriate complementary foods up to two years of age or beyond”

– and according to wisdom of most traditional cultures. As a matter of fact, I find it astonishing that a book which takes such an obvious stance of learning from traditions of various people around the world blatantly ignores the fact that in traditional cultures, breastfeeding normally continues well beyond one year and certainly beyond six months! In the Jewish tradition, the standard length of breastfeeding is two years.

The statement, “remember that babies should be chubby” (page 601) really grated on my nerves. Is there no room for diversity, no role for heredity to play in the baby’s body build? This expectation from two tall lean parents to produce a fat little butterball baby, makes mothers anxious about their milk supply when in fact they have plenty, and causes them to rush to supplement with formulas and artificially fatten up their babies.

When I came to the final page, titled “Tips for Successful Breastfeeding”, I was dismayed to find much of the same counter-productive advice you often hear from doctors whose knowledge on breastfeeding comes close to zero. Yes, good nutrition and proper rest play an important role in maintaining adequate milk supply. But the author neglects to mention that the most important factor in boosting milk supply is nursing on demand, which usually means often. Again, where is the analysis of traditional practices such as attachment parenting, baby-wearing and co-sleeping, which all encourage frequent nursing?

It isn’t that I think everyone should go the attachment parenting way. Parents are perfectly within their right to offer pacifiers and insist that the baby should sleep in their own room from day one. But if we’re talking about optimizing the chances of successful breastfeeding, people should make their choices with open eyes.

How about this: “If you have any qualms or fears about not having enough milk, assemble the ingredients for homemade formula…” not “check if you really have cause for concern”; not “contact a lactation consultant and/or a La Leche League representative”, not “nurse more often.” Prepare to give formula!! According to the author, “having the supplies on hand can be enough to give you the peace of mind that allows your milk to keep flowing”. Well, you know what? This very strongly reminds me of the well-meaning doctors and nurses who tried to persuade us to keep a can of formula at home, “just in case”. Does having formula around help to keep the milk flowing? I’m sorry, but I’m not buying that.

 Supplementing may be necessary sometimes, but it is just about one of the most critical steps towards diminishing milk supply.

And this: “Lack of adequate milk supply sometimes does occur, especially as baby grows and his appetite increases.”  Yes, sometimes during a growth spurt it may seem as though the milk supply is inadequate. However, by nursing more often, eating well and resting, milk supply can usually be increased. Mother and baby are hormonally tuned in to one another. Infant suckling stimulates milk supply. Lack of adequate supply doesn’t just “occur” (it’s maddening that a serious author implies that a basic bodily function like lactation just stops or decreases out of the blue). It has reasons which can often be traced to things like abrupt night weaning, introduction of solids, spending time away from your baby, giving a pacifier, a new pregnancy, etc.

I’m not saying that mothers who couldn’t breastfeed, for whatever reason, should feel guilty. But I do think that authors should feel guilty if their advice might have undermined breastfeeding for thousands of women.

My final conclusion? Eat the apple and spit out the seeds. “Nourishing Traditions” is a fascinating book with lots of insightful material and valuable advice, and it is kept at a place of honor on my shelf and often referred to. However, on this matter of breastfeeding I quite plainly disagree with a lot of what the author has to say.

Weaning, attachment and separation

The following article was included in my e-booklet, Nurturing Hands

I have yet to have the experience of weaning a baby off breastfeeding; the first time, my milk just dried up because of subsequent pregnancy, but as my child was 15 months old and used to a wide variety of foods, that was alright. The second time, I went on nursing over two years, and somehow, very gradually, without my knowing how it happened, one day my daughter was weaned. I admit I was very grateful for it happening this way. Weaning is a bittersweet experience for me, even after a long and satisfying nursing relationship. I can only imagine what it must be like to intentionally wean a child who cries and frets and demands to be comforted in the best way they have known since birth, and to deny this comfort which it is in my power to give.

I realize sometimes babies or toddlers must be weaned, for a variety of reasons (medical, psychological or practical). It can, hopefully, be done gradually in order to minimize the stress and discomfort. I do feel compelled to speak out, however (at the risk of sounding judgmental), against a practice I noticed among some mothers I know – that of abrupt weaning of an older baby or toddler who is deemed “too old” to nurse, by the simple method of the mother disappearing from home for a week or so.

First off, the modern society’s idea of weaning age does not correspond at all with Jewish tradition. In the Jewish tradition, it is a matter of course that a child is nursed at least until 2 years old, and breastfeeding is quite common and acceptable until even later. In practice, today most babies are weaned off the breast at less than 1 year old (only to be given a bottle of formula in exchange).

A neighbor of mine went for a week-long vacation abroad with her friends, leaving behind her son (then 10 months old) in the vague hope that maybe he will give up on breastfeeding by the time she is back. That hope proved futile. “I don’t know what to do with him,” she complained irritably a day after returning home, “he cried and nursed all night. I didn’t get any sleep!” I had to bite my tongue to keep from retorting. How could she be surprised?

As far as this baby was concerned, his mother, who was always there to take care of him and nurse him, suddenly disappeared for a whole week – an eternity in a baby’s terms – snatching away his best source of comfort and nutrition. He had experienced the trauma of losing his mother, without any possible alleviation in the form of understanding she will be back eventually, because a 10-month-old is unable to grasp the concept of Mom going on vacation. To him, when Mom is gone, she is gone. There is no difference, as far as he is concerned, whether she is on vacation or dead. She is simply not there.

The same thing was done by several other women I know, always saying things like, “oh, he’ll be fine”, “I really need a break from it all”, “I need to wean her because she’s embarrassing me in public” and even “I need to wean because I want to get pregnant again”.

Now, I realize all babies go through the stage when they break out crying as soon as they lose sight of their mother (we’re just past that stage at this time, actually), and learn that she will come back eventually, whether in several minutes (if Mom goes to the bathroom) or several hours (if the baby is in some sort of day care). Now, if you know me, you know I’m all for home education or at least for keeping children at home well past the toddler years, and don’t think an enforced separation from Mom on a daily basis is good for the baby or toddler. Sometimes there really is no choice, however, and families adjust. A week-long separation, though, is really much too long for a baby, in my opinion. In their little minds, they are actually becoming accustomed to the idea of losing their mother forever. See quote from here:

Infants may develop attachments to other members of the family or carers, who can take mother’s place for a while. But if mother does not return soon, some infants can become quite distressed, with crying and an increase of behaviors designed to bring the mother and infant together again. If the separation lasts for some days, the first state of crying and “protest” may be replaced by a mood of quiet unhappiness or despair. In the first two or three years of life an infant has no adult sense of time, and since explanations cannot be understood, the infant seems to despair of the mother’s return, in a kind of grief or mourning reaction.”

For this very reason, quite apart from breastfeeding, I personally would never voluntarily separate overnight from a child who does not yet have good verbal communication skills and a more-or-less consistent sense of time – in other words, a child under 3 or 4 years old. It is simply impossible to explain to a very young child that “Mommy will be back in a couple of days”, and without such understanding, the enforced separation is, as far as the child is concerned, nothing short of abandonment.

I realize that sometimes, such an abrupt separation is unavoidable (in the case of sudden hospitalization, etc). But I would not put a child through such trauma for the sake of a vacation, or in order to wean as quickly as possible (which, above all else, may result in plugged ducts and mastitis for the mother). It’s far better to make an attitude switch and vacation with the baby, and wean, if weaning is necessary indeed, slowly and gradually.

Just one final word: time passes so quickly. The baby who cries when his mother goes into the bathroom will sooner than you know turn into a 4-year-old who is quite happy at the adventure of staying with Grandma and Grandpa for a couple of days. There is no need to rush. Be with your baby; you will never regret it, and really, everything else can wait.

Common breastfeeding misconceptions

The more time goes by on this parenting journey of mine, the better I realize how important it is for every nursing mother and baby to have a pediatrician who is not just supportive of breastfeeding, but thoroughly educated about it – and unfortunately, they seem to be rare.

 

Back in university, I only had one course dedicated to infant nutrition, which emphasized the importance of breastfeeding but didn’t cover many important details such as supply and demand, possibility of poor latch, overactive letdown, distracted nursing, and many other common issues breastfeeding mothers often have to deal with. I know that in medical schools, more often than not even less is learned about this wonderful natural way of feeding babies.

 

Most pediatricians today tell mothers they should nurse their babies – if everything goes smoothly, if no problems arise, and if the baby is gaining weight strictly according to age-appropriate charts. From stories of fellow mothers, many pediatricians have only a vague concept that breasts make milk, and have all too many misconceptions, such as:

 

* It’s very common to have inadequate milk supply.

* A mother’s milk supply can dry up for no reason and it’s normal; it isn’t worth the trouble to check why this happens.

* Whatever a mother does or doesn’t do, it doesn’t affect her milk supply and therefore it’s pointless to try and improve it.

* Each baby needs to eat at such-and-such intervals, and weight gain should be such-and-such number each week.

* Weighing a baby before and after a feeding is a good way to assess how much food the baby gets throughout the day, because the amount of milk a baby gets per nursing session is the same every time.

 

I’m not saying pediatricians have no clue. They certainly have lots of knowledge, and their advice and opinion regarding a child’s health should be taken most seriously. But – and this is a serious but – don’t be overwhelmed by someone’s authority just because he is a doctor. Western medicine often has an impatient, quick-fix attitude, which is good for acute conditions, but many times displays little knowledge and much arrogance towards treatment of anything that has to do with chronic illnesses, allergies, and nutrition.

 

In certain areas, nurses tend to know more than doctors; or less. I had a nurse tell me that even if breastfeeding is going well, it’s recommended to supplement with formula starting from four months.

 

Many medical professionals have an attitude that can be described as well-meaning but misguided. Be careful and discerning.