World Breastfeeding Week – Day in the Life

Four years ago, I began working exclusively as a nurse lactation consultant.  I will always be grateful to Judi (my manager)  for recognizing my potential for helping moms in the early days of breastfeeding.

What do our Ladies of Lactation do?  Teach, support, assist, support, reassure, support.  Support.

After the baby is born, the learning begins. Parents begin to learn about who their child is.  A baby’s behavior is very often confusing, scary, demanding, and oh yes – there is crying.  Sometimes it’s the baby who is crying, sometimes it’s the mom – and at times the dad may be getting teary.

Since I work part-time, I do not always see the day to day progress as parents and baby figure each other out.  I see the beginnings, the middles, and the discharge days – but on different moms and babies.  This past week, I worked a series of days in a row.  I was able to see a couple of babies get better and better at breastfeeding,  and a couple of moms grow in their confidence that things were starting to come together.  I saw a NICU mom  continue pumping in faith – and then there was the sudden increase in her milk supply overnight – and she looked at me and said with a big smile “It was like Christmas morning!”

Sometimes there is little to no struggle – and yet a mom may still wonder “is this working right?” We encourage, we reassure.

Sometimes there are significant struggles – and we support and help and adjust positions and get deeper latches and give out lanolin and gel pads and set up pumps and explain when a supplement might be necessary.  We explain the possible impact of their baby’s early arrival, or difficult arrival, or circumcision, or bruised head.  We explain the potential impact of too much supplement too soon or too frequently – and sometimes we have to suggest a supplement because baby is.not.latching. No latching = no nursing. We talk about jaundice.

We point out signs of readiness to feed and why their baby’s eagerness to feed moments after delivery is not hunger but instinct.  We warn that there will be sleepy times and when this may become a problem – and that next there are wakeful times and that these will likely occur at night.   Feed, feed, and feed again?  Is this normal?  (Yes, today – not so normal in a few days.)

With earlier discharges becoming more common, teaching about how to verify sufficient intake in the early days post-discharge is crucial.  Watching a feed for a few minutes gives us a good idea how things are going … or not going.  Getting a good latch is important and hearing a mom say – wow, it never felt THAT strong before – is a scary thing to hear as they’re about to head out the door.   Teaching moms to know what a good latch feels like or looks like – is a very important part of breastfeeding success in the early week or two – and minimizes pain!  We can often help.

Sometimes we can support a mom towards the decision that she cannot continue.  Support without judgment.  This may be on Day 2 or Week 2 or Month 2 or beyond.  We listen and  often “hear” what may be hard for a mom to verbalize.

Sometimes a mom has a few questions soon after her child arrives as she wonders…do I want to try?  We answer questions and try to hear what she is saying and give her options.  We support her in her decision – whatever it is.  She is the one who will need to do the breastfeeding so she is the one who needs to decide.  (Not the government, not the husband, not the grandmother…)

Does she want to exclusively pump?  We can give a plan for better potential success if this is her choice.

Sometimes (and NOT rarely) there is the heartbreak of insufficient milk or the baby who won’t (or can’t) latch or too much pain or employment that needs to be resumed far too quickly.  Sometimes maternal anatomy is …. challenging.

Sometimes there is the too early baby and all plans are suddenly changed and there is a pump to hold rather than a baby.  All challenges in attaining one’s expectations and hopes in breastfeeding.

And we see successes!  Yes,  breastfeeding works for many moms and babies! 🙂

The ability to get help from a lactation consultant – both in the hospital – and post-discharge – is often a huge part of success in the first week or two of breastfeeding.   And mother to mother support groups help, too. Without offering any political opinion – I am happy that insurance companies will now be required to reimburse for breastfeeding support when moms see an IBCLC.  When looking for increased success rates for breastfeeding moms, it has everything to do with available – affordable – support for those who desire it – and IMHO – very little to do with hiding formula bags in hospitals.

Tired of the breastfeeding wars on the Interwebs – but so happy to help moms and babies – two by two.

The Long Road to BSN

My first official “get a paycheck” job was at my local McDonald’s in 1976. I wore a uniform that looked like this:

I stood behind the counter – I was required to say  “Would you like fries with that?” as we did the suggestive sell routine.  The words “BUS coming!!” instilled dread into our hearts and made us step it up a bit.  In my months there, I did not get my five cent raise because I did not “smile enough”.  Sigh. As employees, we got some free food if we worked at least four hours.  I indulged at times.  I rarely eat at a McDonald’s and that has been true for decades.  Nothing personal, McDonalds….

THE McDonald’s in Southington, CT

My second job was at a department store called G.E. Madisons. (opened 1961 – closed 1981)

I worked there initially as a cashier and met my future husband there.  Next experience with customer service: I would slide the credit card machine across their card and if the order was over 50$, I had to call the number on the card to obtain approval.  Talk about time consuming – long hold time at holidays – and when the CC company refused to approve  – embarrassing!  I can still remember the sound that this machine makes – and how hard it was sometimes to shove it over the card.

Credit Card Machine

Eventually, I was the switchboard operator and managed in-store calls and incoming calls.  I sat in front of something similar to this: (probably an antique at the time I was operating it!)

Drawn by Me while sitting there on a slow day

From ages 19-21 I attended and completed a 40 hour/week, 24 month allied health program (x-ray tech) through Hartford Hospital.  Following graduation – I worked only briefly as a temp for an orthopedic office.  Bit of a waste of an education in hindsight.  I married during my time in this program. Not at all a mistake. 🙂

I didn’t find an x-ray tech job close to home so instead I worked as a medical assistant in a surgeon’s office in New Britain, CT.  I did office-y stuff in the morning, and assisted the physician in the afternoon.   I worked there until the week I delivered Child 1.  I worked for this surgeon one afternoon a week at his satellite office during the early years of Child 1 and Child 2.

Then my work became full-time MOMMY.  Not having enough children of my own (rolling eyes),  I did childcare for two children (separate situations – one in CT, one in VA) to bring in a few extra dollars.  Then all of mine were in school and I began to look for a part-time “job” outside the home again.

Plow and Hearth Catalog Store had a call center to take catalog orders not far from my home.  I talked to strangers and took orders over three separate Christmas seasons.  I learned more about customer service there – and that “a satisfied customer will tell 2 or 3 people about their positive experience, but a dissatisfied customer will share their annoyance with 20 or 30 people”.  Giving good customer service is priority for a business!  This is still a really nice company with great products and now has an outlet a couple of miles from my home.

While working at Plow and Hearth,  an opportunity came up at Orange Family Physicians as a part-time evening receptionist.  I can still remember how exciting it was to get hired.  I worked with some great people there.  I answered the phone, made appointments, took co-pays – greeted patients, tried to be friendly (of course!) – all part of the job.  I learned over the years how customers could perceive my New England tone/manner as less than friendly.  I learned that I needed to speak in a tone that Southerners would hear as friendly.  I tried to smile more.  Customer service with patients was once again a part of my life.  I did some data entry when computers were not so common for billing purposes, and even did some paper work billing for a counselor who rented space in our office.  As a family practice in a rural setting with no “prompt care” in town, there were occasionally walk-ins that were  quite exciting.  Or bloody.  Or broken.

After a few years  at OFP – I began to think that perhaps I could return to school and eventually become a nurse.  Could I really? Let’s try!  I started with one class in fall of 1999 at PVCC – Algebra.  Yes, the math-averse person that I am who struggled with various maths in high school started with Algebra.  I got an A!  I took a couple of classes each semester, finally entered the nursing program,  and I attained the dream long deferred.  Finally – graduation from a nursing program – May of 2004 on the weekend of my 45th birthday – and it was finally true. I was an RN.

I AM an RN.  Actually – I’m a BSN – having completed that goal at VCU last year – and I am an IBCLC as well.  For now – that’s enough letters.

It’s an honor to work at what I do.

A Love Letter to My Body

One good part about being in my mid-fifties is greater acceptance of the parts about my body I cannot change – while trying to keep it healthy

The stretch marks are barely noticed and are evidence of housing others for brief times.  The soft belly and wider hips from being greatly stretched and padded from those four pregnancies – do not appear to be leaving and that’s ok. The effects of gravity on face and backs of arms – are not so exciting – but age is a privilege not extended to all, so it’s all good. Thinner hair?  At least there is hair.  And thankfully – I can take a pill for those menopausal symptoms for now.

I occasionally catch a glimpse of my face in the mirror when I’m not expecting it – and it reminds me that – no – you do not look quite like you think you do.  Time has altered you.  Being in my fifties, I’ve seen a lot of change already.  I know that this face and body will continue to sag and become more unrecognizable to the me in my head.  Wrinkles will give birth to more wrinkles.  Hands will look older and skin will become thinner. (Hey – something will get thinner!)

But for now – this body carries me places, rises to the challenge of my efforts at exercise, lets me feel the touch of people I love, has arms to return hugs, and provides lodging for this mind and this soul.

As time passes,  this body will begin to frustrate me at times with its increasing limitations.  Aches and pains will likely be present. I glimpse the future as I watch my parents deal with some of these frustrations.  My body will become less able, move slower, even lose balance at times.  It could even become diseased and betray me.

But for now, it’s where I live, and I am grateful for the temple.

I Can Do Hard Things

I have another blog that I’ve kept since 2004.  I recently skimmed back over the number of entries that were tagged “diet” or “diet 2010” or “diet 2012” – and recognized recurring themes.  Defeat and Victory.  And Defeat again.  And dissatisfaction for where I was currently – even at my lowest weight. Still not good enough.

Most entries described dissatisfaction with the number the scale showed. I was quite focused on that number and whether it was going up or down.  If I could just reach THAT number, I’d have succeeded and victory would be maintained of course – because really, wasn’t this just a math thing?  Calories in, calories burned.  Simple.  The number – at least initially – proves that my efforts are being rewarded in a tangible way.

Except that there is a monotony in keeping a food journal, and exercise is mostly dull and certainly – when done right – HARD.  Diet fatigue, lack of self-discipline, and self-indulgence tend to reappear eventually.

I never really struggled with weight until I had a few children. I spent a lot of years in denial that this was truly a problem that would not go away without effort.  Then there were some short-term efforts.

My sole lengthy success in exercise and weight loss was in 2005-2006/7 and I was proud of my efforts.  It tended to be what I talked about, what I thought about – every day.   I have since been quite humbled.  If I eat what I want when I want in the quantities I want – my “set point” is close to 200 lbs.  For now. The years go by and that set point seemed to be rising – thank you Menopause.

So here I am again – exercising regularly – at least 3 times a week ( now starting 40th week – and yes, I am counting) and logging my food (counting again).  Thoughts I experience while exercising include “wow, this is hard” and “almost done” and “I KNOW why people DON’T do this – it’s hard”.   This time around, in addition to logging my food – I’m trying to pay attention to appetite and reducing portions to what satisfies (vs. what makes me feel stuffed).  I do not worry if I clean my plate – even in a restaurant where I’ve paid good money.  (this is a challenge since I am cheap)    I am taking this process a week at a time.  I eat most anything I want but in portions that are budgeted for my day’s allotment.  I have an occasional day I go over.  I weigh myself daily and record every week or so.  I use an online site to log food – and the app on my phone.  (myfitnesspal.com)  I say no to myself sometimes and yes to myself at other times.

Most days eating less food is hard.   But I parent the me that wants to indulge daily and say NO or Not So Much.   Discipline is hard for me. Sometimes going to exercise is NOT what I want to do.  I cannot ever picture loving it – and it’s not important that I do.  That does not mean I cannot make myself do it.  (Grateful that I can!)

I encourage myself with goals concerning health and future mobility and clothes that fit better.  I try to be patient and not be too concerned with the scale.  I try to not talk about it ALL the time.  I try not to get TOO hungry or to bake TOO much.

I don’t wonder about why it’s hard to do. I know why.  Food tastes good and exercise is hard, and my metabolism is not fast.

I CAN DO HARD THINGS (a day at a time).

 

Babies

I have birthed four children and over the years, photographed deliveries and C-sections for many friends. I’ve seen close to 500 babies born while employed as a baby nurse for a couple of years.  Exciting and thankfully only rarely terrifying – it was an awesome job.  I now see new parents and assist them (and encourage them) every work day – but I don’t often see a baby enter the world.

In recent years – I watched my niece give birth to a special little lady in my life. I took pictures for a friend at her last two C-sections, and although I did not see that boy who made me grandma take his first breath, we surfed the internet together on his first full night in his home.  🙂

This past weekend I have been honored to attend – and take a few pictures of the birth of another baby.  His name is Rowan Michael House.  I met his mother as a newborn and she grew up and became friends with my daughters. She even lived with us for a few months as she prepared for her marriage to Cody.

Watching a baby meet his parents never gets old.  How could the miraculous get old?

I watched from the sidelines less than 48 hours ago and saw a father fall completely in love with his son.  I saw a mother at last meet this little one who has been knocking from the inside – and teasing her with the possibility this might be the day – for two long weeks! He’s given her a new understanding of the word patience (which he’ll do again and again) and of labor.  Four grandparents met the person who has MADE them grandparents – a couple of them embracing this role for the first time.  One set of those grandparents are great friends of many years.  🙂

Birth photographer – yeah, I could do that job.  (additional skills with lactation assistance included!)

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If one feels the need of something grand, something infinite, something that makes one feel aware of God, one need not go far to find it. I think that I see something deeper, more infinite, more eternal than the ocean in the expression of the eyes of a little baby when it wakes in the morning and coos or laughs because it sees the sun shining on its cradle.
Vincent Van Gogh

Quiet Place

On my recent trip to CT, my sister and mother wanted to track down the flat marker that indicated the spot where my step-grandmother was buried with her first husband.  Unlike in northern Maine, where there are many headstones with the name Flewelling carved into marble, this small quiet CT cemetery has one marker with this name.

It seems that they are out of place, these two Flewellings – since their life in CT was not where the majority of their lives were spent. We hunted for a bit and finally I saw it.  We pushed the grass back from the edges of the stone – confirmed the name, and then took a few photos to send to her far away descendants.

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As I was wandering through this quiet cemetery looking for the flat marker, I noted a beautiful tall headstone at the perimeter.  I was surprised to see that there were three matching dates of death and began to wonder if it was a car accident or a fire that claimed three family members at the same time.Then I noticed the surname.
Five years ago, there was a family  brutally attacked in their home in a small town in CT.  The mother and her two teen-aged daughters were murdered after hours of torture. The father was beaten but escaped, crawling out a basement window to try to get help.  The help arrived too late for the women.  Their murderers were just recently convicted of these horrible murders.

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The gravestone was crafted with relief drawings at the top. There were potted flowers in front and yellow flowers cradling the sides of the stone, obviously having been tended with love. It was a simple headstone and the location was peaceful – in stark contrast to how they died.  I stood for a few minutes and thought about the horror they endured for hours before they were killed – and the man who survived as well. He lost his family and the life he knew and had to endure the legal trials – yes trials – as each man was tried separately.  I’ve read that this man who lost so much is engaged now – and marvel that years later he was able to find a way to love again.
I took a picture of the stone – feeling somewhat intrusive as I did. As I stood in this place, I remembered the murders but now felt the peacefulness and quiet of this place that felt quite sacred.  The stone was simple but beautiful – and the location at the edge of the small cemetery offered a place of contemplation of lives lost.
The phrase “rest in peace” felt very right as I walked away.