Milk-Sharing Stories

This being the final day of World Milksharing Week,  I thought I'd collect just a few of the many, many amazing stories of the gift of milk that I've read this week. Of course, there are even more wonderful stories in the blog hop linky at the bottom of this post for you to enjoy! (The linky will stay open until Sunday night, by the way, for any latecomers.)

A Cross Nursing Story

A few months ago, a friend contacted me and asked me if I'd be available to nurse a baby whose mother was in the hospital and was unable to pump for her there. Baby M didn't take a bottle well, so the stored milk the family had (as well as the donated milk they had received from friends) wasn't going to do the trick. A friend of the family was organizing nursing mothers to go over to their home and nurse Baby M several times a day. For the other feeds, M's father and grandparents would attempt to feed her donor milk from a bottle.

I thought about it for a moment, and then responded to the inquiry, telling my friend that I'd be happy to help out as much as I could, as long as the family was alright with the age discrepancy between Daniel and Baby M (about 5 months) since I know that breastmilk content changes as a nursling gets older. The family got back to me and said they were fine with the age difference, so I signed up for a few time slots to go nurse Baby M!

I went over to their house several times to nurse M, who is an eager and active baby. I enjoyed chatting with her father, playing with her big brother, and getting to know her grandparents. A couple of times, I was even sent home with overflow vegetables from their garden. It was a lovely experience overall; it felt like this might be what it's like to live in a community that's more like a village.

A Milk Sharing How-To

In honor of World Milk Sharing Week (September 24-30th) I'm re-sharing this article I wrote as a guest post for Hobo Mama during her babymoon.

Read to the bottom for more information about milk sharing and how you can celebrate this important week, including a Blog Hop style linky for all your World Milk Sharing Week posts!

We all know that human breastmilk is the best nutrition for human babies, and it has loads of health benefits for both mom and baby. In some cases however, breastfeeding doesn't work out, it takes longer than usual to establish, induced lactation is unsuccessful, or circumstances arise that necessitate early or temporary weaning. In all of these situations, a substitute for mom's milk would be necessary. According to a joint statement from the WHO and UNICEF, "The best food for a baby who cannot be breastfed is milk expressed from the mother's breast or from another healthy mother. The best food for any baby whose own mother's milk is not available is the breastmilk of another healthy mother."

The price of purchasing human milk from a milk bank is prohibitive for most families. However, with the increasing popularity of sites such as Human Milk 4 Human Babies, Eats on Feets, and Milk Share, direct (mom-to-mom) milk donation is getting easier. And what a good thing!

I pumped daily and donated milk to several people for the first eight months after my son was born. I started pumping as a way to cope with a large supply of milk that came with a very strong letdown reflex (which often caused my baby to cough and choke on milk). I tried to down-regulate my supply (by only pumping to comfort to relieve the pressure of engorgement) but my supply was abundant, and I was happy to help out by donating milk.

7 Breastfeeding Troubles & How I Overcame Them

In the spirit of this year's "Talk to me!" World Breastfeeding Week theme, today I'm sharing more about the parts of my breastfeeding journey that have not been easy. My hope is that my words here will be helpful to someone in a small way, even if just to know that you can work through all these things and still maintain a positive breastfeeding relationship.

I've been breastfeeding for fourteen months now, with no plans to wean my son any time soon. It's funny how one day I had never done it before, and the next day, I was nursing my son every hour or two around the clock. Experience like that makes a new mom an expert fast!

Still, I didn't grow up regularly seeing people breastfeeding, and there were definitely times when things haven't gone as smoothly in our breastfeeding relationship. In those moments, I've had to figure out what would work for us to get over whatever bump we had just encountered. Here are a few of the things Daniel and I have been through in this year plus as a nursing diad, and what I did to remedy the situations:

 

Engorgement

I experienced moderately severe engorgement, which started when my milk came in on day two postpartum and gradually decreased over the next few weeks (though, I was prone to bouts of engorgement for many months if I so much as delayed a nursing session). I had a home birth, so when the after-care nurse came to see me at home, she reminded me to be vigilant about taking care to relieve the engorgement and also about watching my breasts and body for signs of mastitis (red, hot spots, streaking, flu-like symptoms). I did have a bag of IV fluids later in the day after the birth, which may have contributed to the mastitis and swelling that I experienced later. So, what did I do?

• I sent my partner out to the grocery store for a cabbage, which we then put in the freezer (two leaves at a time) for me to keep in my bra between nursing sessions. Cabbage seems to have magical engorgement-relieving powers that even research can't explain. I know it certainly helped me!
• I nursed around the clock, following the "breast on request" (nursing "on demand" or "on cue") philosophy. 
• I did reverse-pressure softening, a technique used to move interstitial fluid away from the nipple and areola to facilitate proper latch when there's a lot of swelling.
• I hand-expressed milk when I was in the shower, and into a burp cloth or prefold diaper before nursing.
• I pumped (just a little) to relieve the pressure and discomfort, and to make it easier for my son to latch.

Blisters

I had a couple of small blisters in the first week of nursing. I remember recognizing them and then working very hard to heal them before I ended up with broken skin. I was determined not to have any cracks or bleeding, because I knew it would take longer and would be more difficult to heal once they got to that point. How did I handle it?

• I worked a lot with Daniel on a wide, asymmetrical latch. The blisters were definitely from not having a deep enough latch, so I had to be really intentional about getting him to open very wide and take a lot of breast into his mouth at each feeding. It was hard in the middle of the night when I was totally sleep-deprived during those first days to wake myself up enough to work on latch, but I'm really glad I did, because I think it saved me a lot more pain down the road.
• I used lubrication, in the form of pure lanolin. I would apply lanolin before each and every nursing session, until my nipples were all healed up. This was annoying when I was nursing side-lying in bed in the middle of the night, but it was really helpful to relieve the friction that had caused the blisters.
• I also used a healing herbal salve on my nipples between nursing sessions. (My midwife advised me about the timing of those two: lanolin before nursing, herbal salve after.)
• I expressed a little extra breastmilk after my son was finished nursing, and rubbed it into my nipples. Breastmilk is a effective (and convenient!) when it comes to healing over-worked nipples.

Oversupply and Forceful Letdown

Having a large milk supply and a forceful letdown often go hand-in-hand. I had a lot of milk. I made too much milk, in fact, for my baby to drink. I had so much milk that my son started to show signs of getting too much foremilk in relation to hindmilk. I also had a very strong letdown which resulted in my son coughing and gagging on milk, as well as pulling off the breast frequently during a nursing session (resulting in milk spraying everywhere). What did I do?

• I used a lot of these techniques outlined by Kellymom: I nursed Daniel "uphill," nursed him when he was sleepy, I would pump or hand-express a little milk before each feeding to remove some of the extra milk so it wouldn't come out so forcefully.
• I nursed on only one side per feeding. This helped Daniel to get more hindmilk and not have to deal with letdown on both sides. He was very full after nursing on only one side, so:
• I would hand express or pump excess milk so to prevent engorgment. I took advantage of my abundant supply by donating my extra milk directly to other moms with babies who needed it.

Painful Letdown

I had a very painful letdown which started at five weeks postpartum and lasted until Daniel was around five months old. After being evaluated by my midwife for thrush, we determined that it was most likely a result of the oversupply issues mentioned above, or it was just how I was experiencing letdown, and it would work itself out. But still, I was in pain! Here's how I worked through the pain:

• I breathed through it. I know that might sound trite, but it was my best coping mechanism. I took deep breaths and stared at my baby as the pain passed, and I thought about how much I adore him.
• I took extra magnesium. I used a powdered magnesium supplement (called Calm) which I take sometimes to help relieve muscle pain. I figured that since the pain was from all those little ducts being stretched out and contracted, that taking something natural to help relax the muscles would help. And it did!
• I treated myself gently. I didn't expect nursing by baby to be blissful every time, and it wasn't. Sometimes I was gritting my teeth through the pain of letdown. I gave myself permission to feel those physical sensations and emotions surrounding them without any guilt. That was probably the most helpful thing I did for myself.

Plugged Ducts

I've had plugged ducts off and on since the beginning. Early on, they seemed to be caused by the oversupply, but more recently, I had a badly plugged duct from wearing a very poorly-fitting bra. That one was totally my fault (though, to be fair, finding a bra in my size is not easy). Plugged ducts seem to be very common, and I've found them to be easy to treat in my body, if I catch them early. So, what did I do about them?

• I used heat to encourage the duct to open. Usually I just get in the shower and let the warm water run over the area that's hard and painful. Sometimes using heat can further inflame plugged ducts, so you have to be careful.
• I used a castor oil compress. Castor oil helps to relieve inflammation, and it will soak through the skin and help to encourage the duct to clear. I would just soak a disposable nursing pad in castor oil and let it sit on the affected area for a while. The only thing to keep in mind is to try to keep the castor oil away from your nipples, because the next time you nurse, your baby could ingest it and subsequently experience the laxative effects of the castor oil.
• I expressed milk. I nursed a lot on the affected side, and then if that didn't work, I would hand express. For me, hand expression works better for relieving plugged ducts than does pumping, probably because I'm able to target a specific area. With my latest plugged duct, I cleared it almost entirely with hand expression, and it was probably the worst one I've had.

Biting

Now this one is one of the hardest ones for me, because it's about my son's behavior, and not just something that's going on with my body. I even asked the wise and wonderful mentors over at Natural Parents Network what I should do about my son biting me. I tried many things, but many of them didn't work for us. How did I handle it?

• Troubleshoot the cause of the biting. Since babies can't come out and say, "Momma, my mouth hurts." or "Wow, that milk came out fast!" I've had to try to decipher the root cause when my son bites me. He started doing it before he had teeth, and he still bites every once in a while. Some of the main causes for us have been: teething pain, being scared or startled, trying to slow milk flow, and distraction.
• Address the cause. Maybe it goes without saying, but when I figured out what was wrong, then I would take steps to fix the problem. For instance, if teething was the culprit, I would offer something that was alright for my son to bite, give him a teething remedy, etc. If the cause was distraction, I would ask him if he was still interested in nursing, and if not, I would give him something else to do.
• Unlatch (and try again). Sometimes when Daniel bites me, I don't want to nurse him again right away. I think that's only natural when I'm in pain! I hand him to my partner and tell them both that I need a break, and then I take one. Other times, I'm willing to have a little chat with Daniel about biting, and then allow him to latch back on. He's old enough now to totally understand when he's hurt me, and often he cries if I tell him that he's done so. It's sad, but I think it's important to let our kids know when their actions hurt others, especially in this case.

 

Nursing Strike

This one was the hardest of any of the breastfeeding challenges I've faced, mostly because I felt totally out of control of the situation; I didn't know what to do. One day, my son just stopped nursing. He was nursing fine that morning, and he had never refused the breast before, but then all of a sudden, he didn't want to anymore. He still acted hungry, but then he wouldn't take the breast. I knew that babies don't usually self-wean suddenly, and that self-weaning before one year old is uncommon. What did I try?

• Offer, offer, offer. I offered the breast often, and tried not to show my son that I was upset when he refused. I know he's sensitive to my emotions, and I didn't want him to think I was angry with him for declining. I just kept trying, and eventually (after almost three days) it worked.
• Pump. Since I'm prone to engorgement and plugged ducts, I knew I couldn't go very long with full breasts without risking mastitis. I pumped and saved milk throughout the nursing strike, and I even offered it to my son both a bottle and a sippy cup, to see if he would take it (he wouldn't).
• Treat the cause. Some nursing strikes are related to stress caused by sudden changes in the child's environment (a move, new sibling, visitors, etc.), some are because of physical discomfort due to illness or teething, or it could be for one of many other reasons. In our case, there were many of the possible contributing factors: we had just had company in town, Daniel had a bit of a cold, and he was teething. After talking to several other moms who have experienced this type of situation, I determined that the most likely cause for his refusal to nurse was pain. I had already tried several homeopathic and other natural remedies for teething pain, and decided to give Daniel some Ibuprofen. After a couple of doses, he was happily nursing again!

Well, after all of that, you might think that breastfeeding has been an arduous task for me. However, that has not been the case at all! These things have been only little hiccups in our breastfeeding relationship, and they've certainly not soured it yet. I'm looking forward to nursing Daniel until he weans on his own—hopefully at least another year or more!

Do you have a story about your experience breastfeeding through a bump in the road? Do you have any tips to share for overcoming specific breastfeeding challenges? Let me know in the comments!


Though I have a nursing license and I have completed some additional lactation-specific courses, this is not intended to be medical advice, but rather as a "been there" kind of account of my experiences. As always, when it comes to your health, please trust your own judgment and that of your healthcare provider.

Let's help communicate about breastfeeding for this year's WBW! Link up your breastfeeding posts below, and visit NPN to grab the code for your own blog. It will update automatically as posts are added!

Breastfeeding in the News

I've been reading a lot lately about breastfeeding and related topics in the news. Here's what's been going on lately:

• Researchers from the University of Western Australia found that breastfeeding positively impacts academic performance. This is not the first study to conclude this, but this study was unique in that it found that boys in particular benefited from being breastfed for at least six months. "The study showed that, at age 10, boys who were breastfed for six months or longer scored higher in math, reading and spelling compared with boys who were breastfed for less than six months. Girls who were breastfed for at least six months showed a small improvement in reading."


• President Obama has requested that "appropriate workplace accommodations" be made for federal employees who are breastfeeding their babies. "The order is required by the new health-care reform law, which mandates new breastfeeding rights primarily for hourly workers in the private and public sectors. But Obama asked the federal govenrment to go a step farther by establishing new guidelines for all federal employees, no matter their status...." I'm quite pleased that President Obama is setting a good example and helping to normalize breastfeeding by providing for federal employees who are also nursing mothers!


• Along the same lines, The Motherwear Breastfeeding Blog commented about a recent Associated Press article about the nursing mothers' rooms on Capital Hill. Affectionately called the "boob cube," the rooms are equipped with everything a woman could ever need to continue doing her job while pumping milk—including hospital-grade pumps and a TV tuned to C-SPAN. I agree with the sentiment, there's "nothing like C-SPAN to get your hormones going"!


• Have you heard about Eats on Feets? It is an organization, (similar to MilkShare) that facilitates local woman-to-woman milk sharing through regional chapter pages on Facebook. If you are a nursing mother who has extra milk to share, check out your local Eats on Feets page on Facebook to get connected with a mom and baby who could use your help. I'm a big fan of milk sharing because human milk is the best food for human babies. Also, utilizing milk from milk banks for healthy babies can be cost-prohibitive and logistically complicated. I have a dream that someday, all parents who want to feed their babies breast milk will be able to do so for free, and for as long as they want. A girl can dream, right?


• The Columbus Dispatch recently published an article called "FDA Sour on Online Breast Milk," highlighting the recent Facebook success of Eats on Feets and warning mothers of the dangers of accepting breast milk from strangers. I totally agree that parents accepting donor milk need to weigh the risks of accepting milk from people they don't know. What the article doesn't mention is that many recipients of donor milk require the donor to provide them with appropriate blood work demonstrating their not only their general health, but their HIV-status. Recipients of donor milk also have the option of flash-pasteurizing the milk they receive, as Shell Walker, one of the founders of Eats on Feets mentions in the article. The bottom line is, parents have to decide for themselves what risks they are willing to take and what precautions and/or screenings they want to take to prevent those risks. As Walker put it, "Yes, there are risks involved. I think it would be absolutely ridiculous for somebody to go to a dark side of town where illicit drug use and sex for money is more likely, and to approach a random woman and ask for her breast milk. Absolutely don't. Please, I beg you." Well said!


• Even more publicity for milk donation: Actor Neil Patrick Harris (You know, Dougie Howser, MD!) talked on the Late Late Show about receiving donor milk for his baby girl. Among other things, he discusses the cost and the ridiculousness of someone in Santa Monica, CA having to ship her milk all the way to the milk bank in San Jose, CA to have it pasteurized, and then shipped back for his baby. All this shipping seriously affects the cost, which is already $3-4.50 per ounce before shipping fees.


• One way to cut down on costs: establish more milk banks! The Northwest Mother's Milk Bank is still working hard to become a functioning milk bank. (Can you donate a few dollars to help the cause?) The closest banks to the Pacific Northwest are in San Jose and Denver, so for Oregon hospitals to provide donor milk (even from Oregon donors), it has to be shipped to one of those banks and then shipped back. Fortunately, even with the inconvenience of having to do this, one Portland hospital (soon to be two) is now offering donor milk to mothers who need to supplement their babies with breast milk. Donor milk had been previously available for babies in the NICU, but beginning in October, it became an option for healthy, full-term babies, too.


• A bit of seasonally-appropriate milk-related news: Playing Mariah Carey's All I Want for Christmas is You was found to increase the milk production in goats at St. Helen's Farm in the UK. Funny story, but it relates to human-milk-producers, too. Breastfeeding Medicine wrote about a trial utilizing listening to a relaxation tape while pumping, and its effects on increased milk production (an average of 50% increase in production over the group who did not listen to the relaxation tape). I wonder what a little more relaxation could do for all of our other bodily functions, if it had that great of an effect on pumping!

What interesting things have you read lately?

Sharing the (milk) love

It's World Breastfeeding Week 2010! As part of my celebration of this week, I'd like to share a few thoughts about milk donation:

I have been blessed with an abundant supply of breast milk. That is to say, I have too much milk for my baby to consume comfortably and of his free will, and I often wake up in the mornings fairly engorged (or in a bit of a puddle). I also have been experiencing overactive let-down since about week four, which is pretty darn painful for me, and it also makes Daniel fussy.

I am making the best of this situation by expressing my milk for comfort and instead of saving it in my freezer indefinitely, I have decided to donate it. Since I don't have to work outside of our home right now, I don't need to store up a bunch of milk in my freezer for when I return to work. A lot of moms who do return to work, in fact, don't use all of the milk that they have stored because they pump at work for the next day's meals. The freezer stock is used only to supplement the fresh milk supply.

I got interested in milk donation before I was even pregnant, when I learned about human milk banks. The Northwest Mothers Milk Bank is in my part of the country, but it is not yet a fully-functioning milk bank. However, there are hospitals in my area that accept donations, as does the Northwest Mothers Milk Bank. They then ship the milk to the bank in San Jose, CA to be pasteurized, and it is then shipped back to the Northwest to be distributed. As you can imagine, (even without this extra step) processing human milk gets expensive. The processing fee is $3-4.50 per ounce before shipping fees, and this only covers a portion of the costs.

Milk banks pasteurize the human milk they receive, which may compromise some of the components of the milk. (This can be one reason families choose to seek out milk directly from a donor instead of through a milk bank.) However, from what I've read, it seems as though the immunological components of the milk are less affected by pasteurization than the enzymes, so it still has many benefits that infant formula cannot parallel.

For now, I have chosen to donate my milk directly to other families who are in need to cut out the extra expense of a milk bank. I am giving my milk to a mother who has recently adopted a baby and wishes to feed him as much breast milk as she can. I have also begun the screening process for donating to a milk bank, because my good friend Rachel's baby boy Bennett received invaluable human donor milk during his recent stay in the Neonatal Intensive Care Unit (NICU). Their experience inspired me to want to help these babies who are in intensive care. While all babies benefit from breast milk, donated milk is particularly valuable for these little ones when their mothers' milk isn't available (or when it isn't enough). Not all NICUs offer the option of providing donor milk for the babies in their care, but they should!

The idea of milk sharing without the middle-man safeguards of a milk bank can be controversial. La Leche League International has official guidelines on milk sharing, which basically encourages both mothers seeking milk and mothers wanting to donate milk to go through a milk bank. Because breast milk is a bodily fluid, drugs, alcohol, and diseases (including viruses like Hepatitis C and HIV) can be transmitted through it. Many recipients of shared milk will ask the donor mother for milk bank screening paperwork—to prove that she is healthy—before accepting her milk.

Websites like Milk Share exist to provide information about milk sharing and also to connect donors and families wanting milk. This site charges a one-time $20 registration fee to join the mailing list to help cover the costs of maintaining the site. It is illegal to sell human milk so other than that one fee, all of the mothers sharing their milk on that site are doing so free-of-charge. If the milk has to be shipped, usually the recipient covers shipping costs, but hopefully if you are in need you will be able to find a donor close to you!

Why donate milk? I donate my milk for the same reason that I donate my blood: human milk saves lives. Also, pregnant and nursing women are prohibited from donating blood, so why not donate milk if you can? There aren't any needles involved if you do mother-to-mother donation, and if you donate to a milk bank there is only one blood test; you can do it at your convenience, and you will help a baby who is in need. It would be ridiculously expensive for a family to buy enough milk from a milk bank to feed their baby exclusively for 6 months and then up to and beyond a year (as recommended by the American Academy of Pediatrics). There is still a lot of work to be done to increase availability of donor milk for babies of mothers who, for whatever reason, cannot breastfeed them. The World Health Organization (WHO) and United Nations Children's Fund (UNICEF) said it best in their joint statement about milk donation:

"The best food for a baby who cannot be breastfed is milk expressed from the mother's breast or from another healthy mother. The best food for any baby whose own mother's milk is not available is the breast milk of another healthy mother.... Where it is not possible for the biological mother to breast feed, the first alternative, if available, should be the use of human milk from other sources. Human milk banks should be made available in appropriate situations."

If you are a healthy mother of a healthy nursling and you are able to donate milk, please consider it! If you have a freezer stock that's getting close to being 5 months old, consider getting screened so you can donate your milk before it expires. Some moms aren't able to make enough milk for their babies, and a better alternative for these families than using artificial baby formula is using human donor milk. And any breast milk is better than no breast milk.

I hope that in the future, donated human milk will be readily available for all critically ill babies and all families who wish to feed breast milk but are unable to breastfeed.

For more information on human milk banking, check out the Human Milk Banking Association of North America's website. I just heard yesterday about a new documentary coming out soon about milk donation called Prescription Milk. Here is the link to the Facebook fan page. Check it out!