Tuesday 26 August 2014

Weaning - My experience of Mother Led vs Baby Led weaning. Louise David Lactation consultant.

Weaning - mother led vs baby led

At first thought, weaning is just weaning, isn't it? To some the process appears to be very straight forward and to others it can be over complicated by stress, pressure from others and unwillingness from either part of the breastfeeding dyad. When you introduce the terms mother led and baby led it lends the idea that there are different approaches to weaning and that the two can be vastly different.

As with all things mothering, everyone's experiences are different and everyone's reasons unique. I value these differences and I share here my own experience with hope of allowing others insight into another's way. I have had two personal breastfeeding relationships with three children. I share here the stories of my weaning. I lead the weaning of my twins and I later experienced self weaning with my third child, Rhys.

Before i get into my stories i want to point out the difference between self weaning and a nursing strike or breast refusal. Breast refusal happens suddenly and can occur at any age. There is usually, but not always a reason, ie mum sick, baby sick, teething baby, mestruation returned or many other possible reasons. Self weaning is a gradual process and rarely occurs in babies under two or three years of age.

My twins were born in October of 2006 they were 9 weeks early and slowly slowly over weeks and months we learnt the art of breastfeeding. We eventually hit our stride and learned to love breastfeeding somewhere around the 8 month mark. The joys and advantages for us were so very evident, and are what made us continue without any question, if it was the right thing for us to do or not. There were things I loved and things I really didn't love about breastfeeding the twins as they became older toddlers.

Breastfeeding the older baby, Weaning
Kane at 2 and a half.
The things i loved:
Feeding to sleep.
Feeding to prolong a day sleep, if they woke up after only a little while.
A boob to fix a boo boo.
A boob to fix a tantrum/fight with brother.
Extra germ protection as they entered the world of day care.
Reconnection after a long shift at work or a sleepover at grandma's.
The educational factor as they asked for a boob public.

Things I didn't like as they entered toddler hood:
They were getting so big and heavy.
I needed to be comfy to feed and that wasn't always possible.
If one wanted a boob, they both wanted one.

I had some beautiful role models around me at the time I was feeding my twins. Many of my friends were entering their third and even forth years of breastfeeding their babies. I loved the idea of this, the idea of self weaning. I wanted this for my twins and for myself. I wanted to know that my twins had acess to all that the boob was to them, for as long as they wanted. This wasn't to be.  The things I didn't like about breastfeeding toddler twins were subconsciously really bothering me. From the age of two I began to gently encourage the boys away from the breast. At the time I thought of this as self weaning. It made me feel better about it if I looked at it that way.

How I encouraged the twins off the breast:
I would ask them to feed one at a time, they didn't like this and would usually wait till they were abe to feed together, once we could sit or got back home etc.
I would only allow a quick feed, once they snuggled in I'd say ok all done and distract them off another way.
I night weaned them by age two.

Over the next few months they fed les and less, they could go off to bed with out boob If I was at work or get up and start the day with out boob if daddy got up with them.  The last weeks of feeding could go by with a boob or two only every few days. Even after I'd considered them officially weaned we would go to an ABA meeting and one or both would be inspired by the little bubbas breastfeeding and hop on for old times sake.

I managed to breastfeed the twins till they were two and a half. I'm so proud of my efforts. It was only later down the track where I'd have times I wished I let them continue and self wean, I know in my heart I did what was best for us at the time.

Breastfeeding the older baby. Weaning. Breastfeeding Twins
The twins breastfeeding at 2 and a half.

Enter little Rissole 2 years later, the twins are now nearly 5. Rhys the master educator of all things baby and breastfeeding. I'd come to realise and accept that the twins weaning was mother led, I knew I wanted different for Rhys and would try to allow him to self wean when ever he was ready. I had prepared myself for the potential of the next 4 or 5 years if breastfeeding if that's what Rhys wanted and if it was ok for my family at the time. I hadn't prepared myself for the possibility of Rhys self weaning at only 2 yrs old though.

How wrong my ideas were, when Rhys was 13 mths old his dad and I seperated, the resilience of my three boys and especially baby Rhys will always inspire me. Rhys had to very quickly learn that mummy and boob wasn't the centre of his universe anymore. Slowly over the weeks, when mummy and Rhys were ready, he had his first sleep over with daddy. Rhys and daddy coped very well, mummy coped well too.

When Rhys was at daddy's Initially I would pump, Rhys would have a bottle of milk before bed, when Rhys came home to mum he'd tap at my chest and click his tongue, and we'd reconnect with a boob.

Rhys didn't skip a beat, as months went by he could go camping with dad for four days, come home and hop straight back on where he left off.

Initially my supply coped well. I'd pump when he would normally feed when he wasn't with me. Soon though I noticed I was pumping less and less, he was getting more and more active and busier with his brothers and naturally feeding less anyway.

Weaning, baby lead weaning
Rhys 15 months.

There was a point around him being 15 mths old or so when there could be 24 hours between a boob, I decided to wean one breast and from there on he only fed on the left breast. This allowed the one breast to be emptied more frequently. My breasts involuted and my supply was minimal that I wouldn't be uncomfortable even after Rhys being away for a weekend camping.

Rhys was unphased by all the going ones around him, he was unphased by the low supply, the one breast, he just needed the comfort and security that one little breast provided and he had free access to that.

Rhys thrived in his new life between mums and dads, soon he didn't need that boob the second he walked through the door. He was beginning to wean himself.

I'd offer boob, he'd think about it, might even make mouth to boob, but whatever he was doing would win over. The difference when the twins asked for a boob at this age, I'd reluctantly oblighe or try to encourage them away.

Don't offer don't refuse... 

I believe this statement to be the whole basis of self weaning, it allows the child to have free access to the breast which in turn, allows for baby to regulate the milk supply. 

Don't refuse, however, in my opinion, does not mean never saying no. For example, if Mr 2 year old requests boob in the que at the supermarket, when mum is paying and her hands are full, it's only commons sense. I would say something like "you can have a boob in a minute when mummy has free hands", "let's go find a nice spot to sit down and have a boob together", "we'll be home soon and you can have all the boob you like then".

It wasn't untill I really examined this theory that I realised I actually led the weaning of my twins and not them. With the twins, I found myself not only not offering a feed, but I was frequently refusing feeds. "No honey, later....(insert any excuse and distraction)". It is here in the distinction between the two methods really becomes clear. 

Rhys, baby lead, came and went as he pleased. He really didn't ask much for me to refuse anyway. While the months leading up to Rhys weaning around his 2nd birthday were much like the twins last months of feeding, they were with much less resentment. I enjoyed feeding more with baby lead weaning. Maybe because the pressure was off me making the right or wrong decision? Maybe because he wasn't my first baby? Maybe because it was likely to be my last breastfeeding relationship? Maybe because I was truly prepared to breastfeed for many more years? 

How ever your breastfeeding relationship comes to a close it is natural to have mixed emotions about it. It is so very normal to experience feelings of relief and sadness, both at the same time. If a baby is weaning long before  mum is ready to stop feelings of sadness and rejection, even, can be felt. Some mothers go through a period of mourning for sometime after the breastfeeding relationship has ended.

Emotions i felt with weaning:
Mother lead- 

baby lead-
desire to breastfeed longer

I hope you are enjoying the breastfeeding journey you are on and the teachings your babies are offering you everyday. Above all else, listen to your gut. Do what is right for you and your family. As with all things breastfeeding, there are NO rules. You can't ruin your baby because you decided to wean him or because you decided to let him choose when he is ready to wean weather thats at age 2 or 5 or more.

Thanks for reading...

Louise x

Sunday 8 June 2014

Lactation Consultant Wollongong - Louise David

Dreaming of breastfeeding ~ 

Im dedicated to my profession, thats for sure.

I share my passion and respect for all things breastfeeding and birth with my sons daily.

Every evening we talk about our favourite and least favourite things from that day, cuddling a new babe or seeing a babe take to the breast after some difficult time often tops my list.

Last night i dreamt that the children were given a passage of writing to analyse for their homework, they had to read it and share with the class what it was about. I was proud of my boys because they were so familiar with the scene that they were almost bored with it. The rest of the class were in fits of giggles and disbelief, how sad that my boys beliefs would be challenged by their reactions.

I always have the most vivid of dreams and i remember them with great detail. I write here the passage as i see it in my dream from a print out the teacher pasted in their homework book....

"Jamie looked intently, pink flesh against bulbous white. Warmth radiating he could feel it from across the mattress. The noises were familiar, but from some time ago.
He didn't know how to name the feeling he felt or even why he did. 
He wanted to shoo the little creature out of the way and take its place.
Soon enough his mamma invited him to her embrace.
As the warm flow of love reached the depth of his stomach that little ball of angst melted away.
Jamie was home, he is happy. "Happy birthday Jamie" his mamma said. Jamie is 5 today"

My boys that inspire me xxx

Way to go dream land.... where will i go next.

Happy days,

Louise x

Tuesday 27 May 2014

Boob Sandwich ~ getting that perfect latch....

There is so much focus on the baby's position when coming in to the breast, her nose position, her open mouth, tongue down etc etc. We often forget about some of the other basics.

Nearly all nipple pain is a result of a shallow latch and one of the most common reasons for the shallow latch is so so easy to fix.

This is the most common and most simple correction i make when i assist mums and babies with latching.

The mother's hand position....

Not this - Fingers are too close to nipple. Baby will not be able to latch deeply. 
1- step 1 - take handful of breast deep into the breast with your free hand.
2 - step 2 - press thumb into breast, this leads to the tilting of the breast in photo 3. The boob sandwich.
3 - the tilt of the breast in this photo is a little exaggerated but the aim is to present a large amount of breast tissue. The tilt ensures an asymmetric latch. In this position the baby's nose is towards the thumb and chin towards the fingers.

... and again but this time the hand position is for football or underarm hold.
Not this - fingers too close. This is where baby's mouth needs to be.
1 - Deep handful of breast tissue. Nose towards thumb, chin towards fingers.
2 - Thumb into breast to tilt and present breast tissue to baby. Make a boob sandwich.
3 - Move those fingers right away. This is where the chin and bottom lips need to come in.

football hold - mums view

It's simple, how can baby get enough breast tissue in his or her mouth when mums fingers are where the mouth needs to be?

Move your fingers right back, and with a few other tweaks watch baby get that deep latch every time and say goodbye to sore nipples and a fussy baby because now she can get more milk!

Why baby needs a deep latch....
Pain and comfort levels aside, if the baby is not latched deeply into the breast she has to rely very much on the vacuum component of her suck to remove the milk. If she is positioned deeply then the milk is more easily removed. 

See here the deep latch, see how being latched well is important for transferring the milk from mum to baby.

This latch is too shallow. You can even see milk in the corner of his mouth, evidence of a poor latch. If the breast is to full and firm to "sandwich" well, hand expressing to soften around the areola is very helpful.
The "Boob Sandwich" can be a helpful when older babies are teething and doing a lot of busy on/off feeding, always ensuring a nice big mouthful of breast and protecting the nipples.

I hope this has helped, especially if you're in the early days where its so normal to be all fingers and thumbs and it just feels awkward. Keep at it, before you know it you'll be breastfeeding with your eyes closed, quite literally hopefully!

look at this gorgeous latch....

Sunday 11 May 2014

Breastfeeding ~ Choosing to Breastfeed through Depression.

Breastfeeding and Postnatal depression and anxiety -
a story of two mums and their personal struggles that is all too common with many many mothers today.

It goes without dispute that breastfeeding is the gold standard for infant feeding. We know the undeniable health risks of not breastfeeding for baby and mum. But what about the health risks of depression when the woman identifies breastfeeding as the sole or major contributing factor to her low mood. The health risks I speak of are serious indeed; harm to the baby or self harm to the mother, also psychosis and even suicide. It is dark and scary to think about, but this is real. Women need non biased, non judgmental support by family and health care providers to help them identify and address their mental health issues postnatally and to find the method of feeding that is right for them and their family.

Just as every baby is different, so to is every family. As much as I am and always will be the avid supporter of lactation, I am the first to acknowledge that breastfeeding is NOT for all families. Whilst the thought of continuing to breastfeed for one mum may seem depressing, difficult and impossible, for the next mum, the thought of quitting breastfeeding can be equally as impossible and heart wrenching.

Susan with Cooper and Miles.
This photo is forever imprinted in my mind. I first seen this photo when my twins were 8 months old and i related to my dear friend on such an intimate level, this photo was how i had been feeling the last so many months. To me this photo reflects completely the internal conflict of complete and utter love and adoration for your children and complete and utter fear that you might make a decision that impacts them negatively and the hopelessness over not really having control.
Let me introduce two mums, first time mums of twin boys born a day apart from each other. These mums were proud as ever about the dramatic entrances these four little men made into the world and how far they all had come, given their rocky starts to life.  For both mums parenting twins was hard from the get go. The shock of reality was such a blow; the hardest part of all was the reality of breastfeeding. The idealistic quiet nursing sessions, the fantasy of returning the sleeping babes their beds was so far removed from the ceaseless tandem feedings, the pumping, top ups of formula, low supply and the constant unsettledness of the two demanding creatures that they somewhere, deep down, adored. Breastfeeding was staring these mums in the face. Its like there was a forked road ahead and above the road was a massive neon sign flashing BREASTFEEDING. If life was going to look up a decision had to be made, the decision was to continue to breastfeed or, let it go. Both options difficult, both involved different struggles, but they eventually had same end result, the promise of a more settled, more manageable and eventually even, a happier day-to-day life.

One of these mums was me. I chose to continue with breastfeeding. I knew it was a going to be a struggle, I was fearful of how long the struggle could carry on for but what I was more fearful of, deeply, deeply, fearful of, was the depth my depression may go if I decided to no longer breastfeed. For my mental health I HAD to choose the road to continue breastfeeding.

The other mum, Susan, a friend of mine who was so pivotal in my early parenting journey, chose the other road. For her and her family not continuing to breastfeed wasn’t the end of the world, the difficulty of day to day life whilst struggling with breastfeeding and the impact it was having on her and her family was. This truly was the hardest decision of her life to date. For this family, to let breastfeeding go and take the road that meant leaving the feeding fight behind was the road to lifting her moods and finally after a long journey a happy family.

Everyone’s journey is unique and we all find healing in different ways. I finally mastered the art of breastfeeding somewhere around the 8 month mark after a slow and difficult up hill battle. My depression was continuing but manageable. Breastfeeding and the journey I went on was something I was proud of and i continued to breastfeed the twins until they were 28mths old. I am to this day certain I made the right choice. I still fear the place I could have gone, had I chose to stop breastfeeding.

After giving up breastfeeding her twins around 12 weeks of age Susan experienced much difficulty with her emotions. Life was settling in to some sore of more mother friendly routine but she was plagued with guilt for not being able to continue breastfeeding. Susan valued breastfeeding so strongly and wanted so badly to give to her babies this gift that only she could. Susan is a strong woman, she had a wonderfully supportive husband and family and grew a strong network of mother friends. This support got her through. She became proud of her breastfeeding relationship with her twins, she was proud of the fact she was able to identify the problem and the solution and she was gratified by the fact that she chose the best decision for her family. Susan never hid the fact that she was disappointed that breastfeeding didn’t work for her and her boys. Susan was always supportive of others breastfeeding, she supported many a new twin mum of the Multiple Birth Association and the Australian Breastfeeding Association. Choosing to give up breastfeeding the twins was potentially a crippling decision, but because of the support around her the difficulty the decision brought upon her was much shorter lived. The decision became critical in resolving the depression and anxiety she was experiencing.

Susan finally fulfilled her deep desire to breastfeed when her daughter was born, the couple went on to have a very special and healing breastfeeding relationship which continued into her third year of life.

Things are finally smooth sailing at 8mths of age.
We both made the right choice. We both made our decisions based on what we knew at the time and what we thought was right for us and our families. As good as breastfeeding is for baby, is it still as good for her if mum is unable to look at her baby and smile? Is ceasing breastfeeding because mum can get more sleep or have someone else help with feeds better for mum if her depression is only going to be worse off due to feelings of guilt and failure? Mums don’t need to be told what is best, they certainly don’t need to be judged. They need support.

Once the mother is feeling supported and her struggles are normalised by the network around her, they don’t seam as big and insurmountable anymore. If though, despite the help and care she is receiving, in spite of the mothers groups, breastfeeding groups, counseling etc, she continues to struggle and her depression continues or worsens this may signify a more chemical depression and therapy may need to continue with the introduction of antidepressant medication.

Breastfeeding became my safe place,
providing me so many quiet moments in the day.
With the right support and medication where appropriate breastfeeding is able to continue, breastfeeding actually plays an important role in the maintenance of keeping depressive symptoms at bay. One of the main hormones released when breastfeeding is Oxytocin, this chemical is known as the love hormone. Oxytocin is an endorphin, a natural opiate. The release of it in to the nursing mothers blood stream reduces and counteracts the effects of adrenalin and depressive symptoms are lessened. I am sure in my case, as a breastfeeding mother with depression, my symptoms were more stable due to the numerous sessions of breastfeeding day and night. For me, breastfeeding appeared to act as antidepressants had in the past.  

Most women concerned about their emotional wellbeing will make contact firstly with their GP, sometimes even before talking about how they’re feeling with their partner. An ill informed GP might hastily put the woman on medication and insist that therefore breastfeeding would need to be ceased.  It is true that medication may well be warranted, but it is often not the first line treatment unless the PND is particularly severe. A mother and baby friendly GP will start by ensuring the mother is aware of and has access or referral to community supports and psychological counseling. This GP will also know that very few antidepressant medications are contraindicated in breastfeeding.

Getting proper support from a counselor or psychologist is imperative to getting to the bottom of your grief. If antidepressant medication is indicated in your situation counseling is still important to gain a deeper 
understanding about your depression, its origins, its triggers and also to learn strategies to cope for long term maintenance of your depression.

Some women need to look outside the square of GP and regular counseling as breastfeeding your baby can resurface other difficult emotions related to their breasts and body image. For example, breastfeeding can be a massive stress to women who have a history of sexual abuse or eating/body image disorders and specific therapy related to these will be integral in reaching a level of acceptance and salvaging the breastfeeding relationship whilst also managing their depression and/or anxiety.

Some personality types and breastfeeding don’t blend well together, but what ever your personality one thing that’s for sure is breastfeeding is the biggest test of patience most mothers will even experience. Breastfeeding and rules do not mix. Timing feeds, schedules and routines can make for stressed and deflated mums. I believe this has to do with our expectations about motherhood and newborn babies behavior. What our generation knows culturally as normal infant behavior is based on formula fed babies. When our breastfed babies don’t sleep much, want to be held all the time and feed frequently we think something is wrong. We blame ourselves. We think we have failed.

In my practice the most common people who instill this self-doubt in new mothers are unfortunately the health professionals. Be them midwives, child health nurses, lactation nurses, pediatricians or other, we constantly hear “give them a dummy, don’t give them a dummy, don’t feed to sleep, don’t share your bed, baby should only feed this long and this amount of times”. Most often than not the moment of undoing is when mum begins to listen to this advice over the advice of her own gut. Ignoring our deepest instincts can become truly exhausting and disheartening, no wonder we become depressed.

I wish for all mums to be able to be supported in their family unit, however small or large that network is, to not have to fight for what she feel is right. If she is supported then she is able to safety to explore and dig deep, to know what really is the right decision for her at this particular point in time. For me, I owe the success of continuing to breastfeed through depression to a close network of mummy friends, my twin mum friends, breastfeeding or otherwise, who I could look at them and their babies a few months older than mine and think, “they got there, they’re still alive, maybe well be ok”, and stubbornness.

Be stubborn, if everyone around you thinks they know what is right for you and it is different to what you think is right for you, then stand firm. If you think giving up breastfeeding going you make your depression worse, fight for it. Its worth it!

Final Words...

For my third baby, Rhys, i never even once had to consider the option of not breastfeeding. My experience with the twins provided all evidence i needed.

It was again, albeit a different one, an experience of breastfeeding through depression.

I have chronic clinical depression, mothering with such a mental health disorder has been constantly challenging and i am to this day battling and learning as i go, for the first time ever i think I'm actually winning.

I will blog more on my mothering journey in the future, for now though, never give up hope that things will get better. With the right treatment and support you can find the light. I did and I'm finally smiling again.

Community Support and Counseling Services:

Do you know a mum who is expecting?
For a mum who may have a history of depression or PND, knowing they have support lined up for after baby is home can provide such piece of mind. Find out about my gift certificates here.

Until next time...

Louise xxx

Tuesday 6 May 2014

Louise David ~ Birth Photography

Wollongong Birth Photographer... 

Many people less appreciative of the birthing process than i ask, "why on eath would someone have a birth photrapgher present at their birth?". Our inability to comprehend each other is equal. Them, why you'd have one? and i, why you wouldn't? ...

To me, as a mother and a practicing midwife and Doula, birth is an unequivocal event in ones life. The anticipation of months of growing up and dreaming of this little life inside you is shared by your partner and loved ones by your side. To think you could fall so much in love with something you've not even laid eyes on yet.

Finally the physical and emotional preparation for the labour and the birth pay off as your innate birthing ability takes over. The lounge room, bedroom, bathroom, hospital room or operating theatre is overpoweringly taken over by emotion. Palpable raw energy of this powerful process that is going on. Finally, inevitably the baby arrives. The feelings that those witnessing would have thought couldn't get much more, explode exponentially! There are always tears... happy ones.

This is why one would want a birth photographer. 
To capture this magic. 
Im so excited to offer my service to women of the Illawarra. 
Whether your birthing at home, Wollongong hospital or out of the local area, consider inviting me to join you. For someone who respects birth and birthing women so much it would be an honour to capture you in your finest moment.

"I love to look back over my birth photos, i see a photo that captures the pain of a contraction and then a photo that captures the moment of his birth and i can relive that extraordinary explosion of feeling relief, pride and every other exquisite emotion all at the same time... I'm so happy i have my birth journey captured, it really is my finest moment"

Sarah on the photography of baby Taj's home birth

Click on the link below to see the photo montage of Hannah's labour and Eden's birth.

Edens Birth

I was so humbled to be present at and photograph the birth of my oldest friend as they welcomed their first baby to the world.  Hannah was such a goddess as she stayed strong through the relentless hours of contractions. The lack of fear and the control she possessed made me so so proud of her. She reminded me why i am a midwife, why i love birth and home birth and why i want to immortalise these moments in time by doing this.

 Wollongong Birth Photographer - 
Louise David Lactation Consultant

Take a look at my website for more of my work. You can see more photo montages and find out about birth photography prices and what i offer.

You can also find out about the other services i offer including home visit lactation consultation, breastfeeding education, Doula services and postnatal midwife services.

Don't hesitate to call or email me to find out more.

Until next time, 

Louise x