Nine Months and Irritable

Warning: The following is a discussion, (ok its at least partly a rant), on breastfeeding. I have no desire to be nor intention of being "delicate".

Full Disclosure: I am nine months pregnant with my 3rd child. (Read: CRANKY!) I am not "trained" in a schooling sense in the following subject matter. I am simply someone who's been doing it nearly nonstop for 4.5 years, with a few more to go.

I was lucky. For one, my first child was a nursing addict, and always hungry. It forced fast learning. For two, I had sisters who had done this before and were right there on either side of me when he was born. Someone asked if I wanted to nurse him, and I looked at them and said, "I don't know what to do..." and they made it happen. It helps when there are TWO sisters. One handled my breast, the other handled my son and poof! Just like magic, he was latched on and content. It made the hurdle into Dairy Cow Land much much easier.

I let my kids self wean, so I've been doing this for a long time. It means I've hit a lot of bumps and bruises. I've always found that other nursing moms are the best resources for tips and tricks and solutions to problems. Which brings me to my current rage.

My friend recently gave birth to her second child. She did not nurse her first and is determined to make it happen for the second, even tho he's a preemie. When she found herself in pain, and still well within the "postpartum" period, she called her OB, who promptly brushed her off as not having a "real" problem. So she contacted a lactation consultant, who diagnosed her with yeast, but can't prescribe medication. The consultant recommended a medicine and dose that the OB won't prescribe because they don't believe she needs that med at that high a dose. Between my friend's arguing experts she remains in pain and confused. Enter a second lactation consultant, who at least had the sense to check on the baby's latch, which seems to be ok for his preemie age. My friend is sent to a breast surgeon, who she described as "hearing aid old". He informs her, (I almost can't type this it makes me so angry), that there is no such thing as a yeast infection of the breast AND that since the baby is 6 weeks old, (which, BTW, does not yet take him to his due date), that he has gotten all the benefits that he possibly can from breastmilk, so she should just quit. Insert rage here.

So now my friend is udderly confused, (pun intended), and I am noticing that she doesn't seem ok. I don't want to pry, but I decided to put out some feelers and see if I could help. She fills me in on the story and it just doesn't seem like anyone evaluated all the possibilities here. When you have a first time nursing mom in pain, there are a few basic reasons to look into. Each "expert" looked at one or another, but no one went through the whole process with her. Not even the lactation consultants.

We get to chatting and I tell her about the problems I had and how I fixed them. I also told her, and I realize that no one ever says this, but they should, that it does hurt. Especially when you are first starting, and especially if you are doing a lot of pumping, (which you do when you have a preemie). This particular issue really bugs me. I see leaflets all the time spelling out all the benefits of breastfeeding, but no one ever talks about the pitfalls. I get that they don't want to scare people away from trying, but all the women I know who consider their nursing experience a failure were misinformed about what to expect on the con side of things. They all tell me that if they had known what they were experiencing was normal, they wouldn't have quit. We are not stupid. Paint us a complete picture!

Then I asked an innocent question. I asked if she was "lubing up" before she pumped. She had no idea what I was talking about. I cannot describe the shock I experienced when I realized that she had a hospital birth, with a lactation consultant on staff, hired two of them herself, is renting her pump from the hospital, and none of them presented her with a lanolin based nipple cream, (technically not a cream at all, but that's what people call it). I just can't believe they could all miss something so simple, and so necessary. How is this possible?

Now I lived off of this stuff. I just assumed that I was particularly sensitive, as everyone claimed that if you did it right it didn't hurt. Bull. It hurts, unless you spend your evenings hanging irons from them, your nipples are not used to this level of attention, especially the friction. It takes some getting used to. I remember being so sore that I couldn't bear putting the stuff on, and my lactation consultant showed me how to put it on my breast pad instead and then wear the pad. Such a simple little thing that provided SO MUCH RELIEF!!!

I decided right then and there that I would just have to bring her some, right now. The snowstorm of the century had begun, but she's not far away and there's a drugstore on the way. The thought of going through all that nursing and pumping and struggling COMPLETELY DRY was just too much. And MaryLou, my 14 year old Saturn with the squeaky belt, had always served me well. True to form, she got me to the drugstore, and my friends house, and home unscathed.

I feel much better knowing that right now, while we are all snowed in, at least my friend had a tube of relief in her possession. I realize there's no telling if that's the sole cause of her pain, but I guarantee you its a good portion.

So who is to blame? How do we fix this gap in postpartum mom's care? I don't know. For the first six weeks after you have a baby, you are really under the care of your OB. Are OB's trained in breastfeeding pitfalls and problems? If you develop a problem outside of six weeks postpartum, do you see your GP? Are they trained? I realize lactation consultants are trained to support breastfeeding, and breast health is a definite part of that, but since they cannot prescribe meds when needed, and they are often not covered by insurance, where does that leave mom? Midwives might be the answer, but they too are often not covered by insurance, or readily available in most areas. I suppose this is where La Leche League tries to fill the gap, and having a network of moms who have been there before certainly works, but that doesn't seem sufficient in today's world.