Tuesday, September 11, 2007

Breastfeeding and sleep

Welcome Motherwear Breastfeeding carnival.

Please, before you read this, know that mothering is an extremely personal experience. How you choose to feed your baby is your choice. I don't want anyone to feel that I am being critical of mothers who choose not to breastfeed, or who quit breastfeeding.

For me, breastfeeding was something I wanted to do. As a pediatric nurse, I knew it was best and that breastfed children were sick less. I breastfed my first son, Cole. It was not extremely hard for me. We bonded well in the hospital and Cole had an extremely strong suck (could have sucked a nipple out of a basketball), which was important because I have inverted nipples (20% of women do). We went through some difficult issues with a yeast infection, secondary to my taking antibiotics for a bladder infection, secondary to a catheter in the hospital, secondary to a traumatic vaginal birth (he was 9 # 3.2 oz). I had to return to work when Cole was only 8 weeks old. (Beau was in school full time). I missed Cole and putting him in the bed with us seemed the best option, I was the All Night Diner, Cole nursed/snacked 4-5 times a night. I worked ICU then and pumping was always difficult to fit in, I finally gave up pumping at work when Cole was about 4 1/2 months. It was difficult to find a formula that he liked, but we eventually did. I breastfed Cole for 9 months. I had to be on steroids for facial paralysis for a week so I pumped and discarded. When I tried to breastfeed Cole after that he patted my breast and looked at me like "that's nice, what do you want me to do with it" I was so sad, but didn't force the issue. He developed his first ear infection 2 weeks later. He has been a very healthy child, he has had about 4 ear infections, and has mild allergies.

I didn't have much support for breastfeeding. My mom didn't breastfeed and neither did my aunt. Fortunately, I had educated Beau so much on the pros of breastfeeding, that he was a huge advocate and support. I was very shy about breastfeeding Cole in public. I got over it with Quinn and would breastfeed anywhere. I'm always discreet and cover up. Most people don't even realize I'm nursing, especially when wearing a nursing top!

I remember always having sinus and ear infections, as a child. I suffered from severe allergies and in all of my childhood pictures my mouth is open, because I couldn't breath through my nose. I firmly believe that breastfeeding has kept this from happening to Cole and Quinn.

I worked only 2-4 days a month when Quinn was born. Breastfeeding was fairly easy with him, after the first 2 weeks. I had horrible sore nipples from about day 5 through day 12. I wanted to quit, but thankfully, Beau wouldn't let me. Quinn weaned himself at 11 1/5 months. He preferred food! Quinn has only been on antibiotics twice in his 8 years and doesn't suffer from allergies.

Breastfeeding twins turned out to be much more challenging than I expected. I carried then to 37 weeks and delivered them by C-section. They were so small compared to Cole and Quinn and Elizabeth's mouth was so tiny. I had to be adamant in the hospital that they not be given a bottle. Even though I had a birth plan with me that said under NO circumstances should they be given a bottle. While still in the OR, they tried to give Elizabeth formula by bottle. Luckily I was aware enough to shout NO. They did give her an ounce of formula by a oral gastric tube for a low blood sugar. Even that made breastfeeding difficult. It was hard to get her and Kade on the same schedule. Breastfeeding every 2-3 hours times 2 babies, and it takes them 30-40 minutes...My colostrum ran out after about 30 hours. Thank goodness I had asked the lactation consultant about the SNS system and she had left one with me. (this is a bottle that you put formula in and it hangs around your neck and a tube is taped to your nipple, so the baby gets formula while breastfeeding). After having nursed continuously for about 2 hours (back and forth between the two) and they still weren't satisfied, we tried it and Kade. He nursed for 15 minutes, received 15 ml of formula and slept for 4 hours. We tried with Elizabeth immediately after and had the same results. I am so thankful for the SNS system, without it, I would have had to give them a bottle. I tried several times over the next few weeks to build up my milk supply enough to breastfeed exclusively. I would use the SNS system for every other feed, but the twins were not gaining weight well. Elizabeth had not returned to her birth weight at 3 weeks and this was a huge concern. They also both had jaundice and were on home phototherapy for a few days.

You must understand how difficult this time was. Some nights I got only 45 minutes of sleep, total. Elizabeth screamed a high pitch cat cry every night, we could not lay her down at all, she slept in a bouncy seat until a friend gave me a wedge and a Tucker sling. At two weeks, she was put on Zantac for acid reflux and was a new baby!!!

Before I had the twins I planned to breastfeed for 6-12 months. After 2 weeks of sleep deprivation, I was shooting for 6 weeks. I started giving them bottles at 3 weeks (the earliest that lactation recommended to prevent nipple confusion), from then on I alternated between bottle and breast. It was easier, but I was still only getting 4 hours of broken sleep. I had changed my goal of 6 weeks to until I returned to work (13 weeks). A women at the MD's office (a mother of twins, or I never would have paid attention) had recommended a book, at there 3 week check up. I read that book when the twins were 6 weeks old. (You can go back and read my old blogs, most of which focused on sleep). The basics of the method I used: feed the babies every 2 1/2-3 hours during the day, (at night, they will gradually spread out) and instead of the schedule of eat-sleep-wake; you must adjust them to sleep-eat-wake during the day, (at night you stimulate them as little as possible and only change the diaper if poopy). This was very difficult to implement at first. Trying to keep them awake after a feeding was so hard, and my family thought I was crazy (waking a sleeping baby for "wake time" and putting down baby when they were awake for "sleep time". I believe that if I had started the sleep-eat-wake schedule from the beginning it would have been much easier. I had to let them cry at times, while they adjusted to the new schedule. Elizabeth was easy and only cried for a minute or 2. Kade would cry up to 20 minutes at first (I checked and comforted him at 5 minute intervals). Please note, that I was certain he was not hungry and had a clean diaper. It was hard at first, but I was at the end of my rope. I DO NOT SUGGEST THAT INFANTS UNDER 6 WEEKS OF AGE, DON'T NEED NIGHTTIME FEEDINGS. Most infants will sleep through the night by 12 weeks of age, just by feeding them at least every 3 hours during the day and keeping them awake for a short period after they eat (you don't have to let them "cry it out" to implement this method). They were sleeping through the night (7 + hours) at 11 weeks, and from 10p-6a by the time I returned to work, at 13 weeks. The best thing about the book was, it gave me permission to let my babies cry when necessary and the assurance that it wouldn't hurt them. I have twins, and sometimes they both need me at the same time, so even before implementing this method, I could not immediately meet their needs, all of the time.

This is not for everyone, and some feel it is controversial. I never thought I would try this type of method, but when I was ready to give up breastfeeding for sleep, I decided to give it a try. This schedule is to be flexible. I have fed Kade and Elizabeth in the middle of the night, this past week. They are both teething and I believe in a growth spurt. You should always feed your baby, if you believe they are hungry. Having them on a schedule, helps me to figure out if they are hungry, tired, etc. I believe that breastfeeding is best, but I do not believe that I need to be a human pacifier! I normally rock Kade to sleep. I also rock Elizabeth but often she is still awake when I put her in the sling, she doesn't cry, she actually sighs as if to say "ahh, my bed" and goes to sleep. They are so alert and happy. I believe that getting a good nights sleep makes for happier, healthier babies. It has also helped with Elizabeth's reflux; she is awake and playing just after eating, instead of laying down and refluxing.

We have a routine that works great for us. I breast feed them both at 6 am, Kade at 9am, E at 12n, K at 3pm. E at 6pm, and K at 9pm. These times are flexible, we often sleep until 6:30 or 7am and just adjust the times. Kade prefers the breast, he will often take Elizabeth's left overs and drink 1/2 a bottle. I'm fortunate to only work 2 days a week and can go home for lunch (some days) to breastfeed. I now plan to breastfeed until they are at least year old, hopefully longer.

I truly believe that breastfeeding is best. However, I see so many moms who plan to breastfeed, but give up after just a few weeks. Let me give you a few examples that I see in the home health setting as to why many moms quit breastfeeding their infants.

One mom I know was breastfeeding her tiny newborn for 10 minutes, then giving him 1 ounce of expressed breast milk and then pumping (this is what the doctors and lactation people had told her to do). How long to you think she'll be able to keep up with all of that? She didn't know anything about the SNS system, I explained it to her and she was thinking about it. Using it would have cut out one step for her. Many doctors also tell moms to give formula, in a bottle, if their babies are jaundice. I disagree. Whats a few days of phototherapy with all of the benefits of breast milk. And the doctors that tell them that are pediatricians (who should know that breast milk is superior). I cannot stress enough how important it is that you choose a pediatrician who not only supports breastfeeding, but encourages it!

I believe another reason many give up is because of people who believe strongly in breastfeeding and therefore push breastfeeding (there way of breastfeeding). I think breastfeeding is wonderful, even if the mom chooses to only breastfeed 6 weeks, or until she returns to work, or whenever she decides it's time to wean. Many moms (I believe) are overwhelmed by the thought of breastfeeding for a year or more. Especially that first few weeks. I encourage moms to commit to 2 weeks of breastfeeding (without bottles for any reason, no matter what). At the end of 2 weeks, then decide if its for them. The first 2 weeks are hard, but most moms who do this find that it gets easier (much easier than fixing a bottle in the middle of the night and warming it up) and then decide to keep it up for 6 weeks, 3 months, 6 months, or maybe even a year or more.

Here are some links to other breastfeeding moms and their opinions on breastfeeding and sleep. Please note that many differ very much from mine. You should do what works for you and your baby. Please don't let anyone make you feel guilty or less than! There are many "experts on babies" and they don't agree with what is the best method for sleep. It is OK to try different things and determine what works with your family and schedule.


Jen said...

Wow! I honor you for your committment to nursing the twins and your willingness to do what it takes. It sounds like it's been a rocky road but you've managed to find a stride that suits you! Bravo for that!!!

The next time I'm complaining about sleep deprivation (probably tonight, lol) I'll keep in mind your comment about 45 min of sleep. Total. Always good to put things in perspective!

Crunchy Domestic Goddess said...

good for you for keeping up with breastfeeding even though you didn't have much support apart from your husband (and kudos to him for his support!). i can only imagine what it's like having twins so i commend you for keeping at it, even though you had your fair share of bumps along the way.


Jodi Lyn said...

thanks for your comments! The first 3 weeks of breastfeeding were the hardest thing I have ever done. Now it's easy and I'm so very thankful I was able to stick it out!

rachelntwins said...

Good for you and I'm sorry you had to go through so much! My girls (twins) were born at 38.5 weeks and I think that little extra time makes a difference. We were out of the hospital in 2.5 days, nothing but breast...Did have VERY sore nipples for two months and sleep deprivation but now thankfully are going 5-7 hours consistently and chubby little ladies. I did the sleep-eat-play routine from day one, only crib sleep, kept them on the same schedule and always double feed (except in public). If I didn't know about sleep and bf from my first, we would have been screwed with twins!

Terhune family said...

My baby (just one!) is 8 weeks old and not sleeping well at all for me. My mom had her and she would sleep for 4-5 hours at a time! I have two older children and need to get some sleep! I am doing the sleep-eat-wake schedule, but it's not going so well at night. What book did you read early on?

Jodi Lyn said...

Terhune family,
Baby Wise is the name of the book, the Motherwear bloggers did not want me to put the name in,some felt it was a controversial sleep method..I did too,until I read the book). I didn't read it until they were 6 weeks, it took 2-3 weeks for them to settle into the schedule and in weeks they were sleeping 7+ hours. After their last feed (around 10p or 11p) there is no "play time" keep things as low key as possible, change the diaper before the feed, keep the lights low etc. Also, make sure you are feeding her every 2 1/2 - 3 hours during the day, even if you have to wake her up. I also highly recommend using a pacifier (unless you have a thumb sucker). All 4 of my children had a pacifier in the hospital, it did not effect my breastfeeding at all. Good luck and let me know how it's going!

Terhune family said...

I haven't actually read the book, but I have friends who have. I do what you have described... she did sleep 5 hours last night. We have some trouble with her staying asleep after the initial 3-4 hour stretch. Does it say anything about that? I let my other two cry and they learned to go to sleep on their own - I just didn't really do it much at 2 months.

Jodi Lyn said...

I loaned the book out. It sounds like she's progressing. If she wakes up before 5 hours i would try givivg her her pacifier and patting for few minutes. Good luck

Mon said...

Hi Jodi Lyn are you still out there? I am a mother of 3 wk old twin boys and wanted to ask your opinion on a few things. I know this post was started almost a year ago so I wanted to see if you are still there before I tell you my life story. THanks mon

April said...

I just wanted to say it's nice to hear someone advocating the sleep-eat-wake schedule, even though it is so "controversial," (I wish it wasn't--it may be hard at first, but it is not "wrong" or "cruelty," as some say, and I have a very happy baby as a result). I figured it was Babywise from what you said. It worked so well with my first baby (now 10 months old), and I think it is the only thing that will save us with the twins we are expecting when the first one is 15 months. I am so nervous about breastfeeding twins. I remember being so awkward for the longest time with my first baby...I can't imagine getting two to latch on at once. Are you supposed to reserve one breast for each baby, or alternate?

Crys said...

My twin boys just turned 11 months and are still not sleeping through the night. They want to nurse all night long and touch my skin. It's so hard since they alternate their feedings. I've heard of the book and a friend has told me to try it--but I get absolutely no sleep when I do since they will cry for an hour sometimes and ends up waking the other...

BTW, I was told by the lactation consultant to alternate breasts since one will nurse better--but I ended up giving each baby their own side--the bigger baby did not take well to being squashed :o)

teafortwo said...

This is a really old post, but I just wanted to add that I also used the sleep-eat-wake schedule with my twins. It was a life saver. They are 2 years old now and sleep a big nap in the afternoon and 11-12 hours at night! Perfecto! They are also still nursing 2X a day. From 3 months old they refused a bottle and I was secretly really happy that they preferred mommy! OK, I quit my job so I am lucky I could be with them the whole time, but just wanted to get the word out that it IS possible to breastfeed twins and even to do it until they are 2! The first 6 weeks to 3 months are rotten, but it passes and becomes bliss when you can go out with your babies and diapers and nothing else because the food is always ready!

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motherofthree said...

I too am a mother of 6 week old twin girls and of a 2 1/2 year old boy. I exclusively breastfed my son for 3 months and my twin girls until now,which is not that bad during the day but gets really hard at nights. I usually get 3-4 hours of broken sleep. I really want to continue brestfeeding, but I am willing to give them 1 or 2 bottles of formula in order to get some sleep during the night. Can you give me some more information about the method you used to get them to sleep some more?