Ask Moxie

We need data points on nursing to sleep

I've gotten some emails recently from moms who have been nursing their babies to sleep, but are getting lots of pushback from other people about how they need to stop or their kids will "never learn to fall asleep on their own." I know we all know this is ridiculous, since no one goes off to college with their mom along. But I thought it would be helpful if we had some data points about what would actually happen if you just went with it.

My oldest needed to nurse to sleep, and abruptly stopped at around 11 months. He still wanted to nurse at bedtime, but couldn't fall asleep that way anymore. Instead, he wanted his dad to rock him. (That lasted for a few months, then we went into a few months of someone lying down next to his crib, then that was over, and he started going to bed on his own, which shocked and delighted me at the time. You know how with that first kid it all seems so endless?)

My second kid never could nurse down to sleep, so he's no use as a data point for this question.

I've heard of several other kids who stopped nursing down of their own accord somewhere in the 10-12-month neighborhood, but I'm wondering if this is common.

So, if you nursed to sleep at bedtime until your child gave it up on his or her own, how old was your kid?

If you pushed the weaning for that feed yourself, I'm glad you did what worked for you, but your results aren't useful for the data we're trying to get on this post today.

Also, you can give info about naps if you want, but I don't think naps and nighttime sleep always have much in common timewise.

D-MER, or feeling crappy when your milk lets down

This just in from the "Who Would Ever have Suspected This" Files*:

"Dysphoric Milk Ejection Reflex

Defining D-MER:
What It Is

Dysphoric Milk Ejection Reflex is a newly recognized condition affecting lactating women that is characterized by a brief surge of dysphoria, or negative emotions that peak before the milk ejection reflex, or letdown, and then dissipate quickly after the milk release.

How D-MER Presents:
What Mothers Feel

The negative emotions, or dysphoria, that a mother with D-MER experiences often manifest "in the mother's stomach" - a hollow feeling, a feeling like there is something in the pit of the stomach, or an emotional churning in the stomach. Mothers report varying types of emotions ranging from dread to anxiety to anger, these emotions fall on three different D-MER spectrums which are described in more detail below. The common thread between the D-MER spectrums however, is the wave of negative emotions or dysphoria, prior to letdown, that then lifts within another 30-90 seconds, and then usually repeats with each letdown.

A key piece of D-MER is that a mother with D-MER feels absolutely fine except just before her milk starts to flow...."

Ho-ly crap, people. I had no idea. I'm guessing right about now those of you who nursed for more than a day or two are either shaking your heads in surprise like I am, or reading this with your mouths open because this happened to you. Apparently all kinds of women have D-MER, no matter how easy it is for them to nurse, how soon their milk comes in, etc.

If this looks like you or someone you know, read the whole story at the D-MER website. Since this is such new information (and how did they even put it together?--I can't imagine that most women with it would talk about it, because we're not usually allowed to say anything even remotely negative about how we feel during breastfeeding), please go take their survey about it.

The tagline of the D-MER website is "Because Breastfeeding Shouldn't Make You Feel This Way." Seriously.

* Actually, it was an IBCLC (lactation consultant) who sent this to me. She herself had it with each of her kids, but had no idea it happened to other women!

Q&A: weaning earlier than you want to

Second half of yesterday's post, on negotiating things with your mother, is getting bumped for this cry for help. Kirsten writes:

"I am sorry to be so pushy, but I am in a desperate, time sensitive nursing situation. My 13 month old who has been the nursingest baby ever got a cold, started teething and went on a 100% nursing strike. I have been working with a LC and am doing EVERYTHING I can. I have always had a meager supply and take Reglan and I don't let down well for the pump, so even though I have a hospital grade Lactina, I am still only pumping about 6-7 oz. per day. I know I am going to lose my supply soon. The baby, I hate to admit, is no closer to getting back on the breast that she was a week ago, she just get furious whenever she sees a boob anywhere in the vicinity. I wake her up in the night to catch her sleepy, I try in different places/positions/noise levels. People keep saying that it is unnatural to wean this young, but it also feels unnatural that I am forcing my will on someone who seems to very much know that she wants no part of breastfeeding at this point. We are on day 9 of the strike. I wanted to nurse at least another year. I feel guilty, rejected and sad. What do I do?

It would mean the world to me if you would respond and allow other mothers to comment to my dilemma. My supply is only going to hold on another few days."

Who are these jackasses who are telling you it's "unnatural" to wean this young? All other things being equal, if you lived in a tribal society 500 years ago your baby would probably still be nursing*. But, realistically, what control do you have over 1) a nursing strike that sounds serious, and 2) your supply?

Until we figure out if there's anything we can do to reverse the effects of all the plastics and other things in our environment that are screwing with women's supplies on a large scale, we all just need to back away from the guilt.

And, seriously, how much control can you have over a baby? If you're working with a knowledgeable LC who knows all the tricks to help babies and moms through nursing strikes, and it's not working, then it looks like it's your time.

FWIW, I think a majority of us are conflicted about the weaning process, no matter how old our babies are. Two weeks, two years, three years...you always feel like you should be doing more. You wean and your baby gets a cold or ear infection the next week, and you think it's you. Heck, my mom still feels bad that I weaned myself at 16 months or so--she'd wanted to nurse until two years. But you know what, 34 years later, we're both healthy and happy and still close to each other.

Anyone who's been through a rough nursing strike, who didn't nurse as long as she wanted to, who wasn't able to nurse at all, or has at any point felt disappointed in how things went with their baby or toddler, show some love, please.

* Or someone else in your tribe would be nursing your baby for you.

Q&A: Toddler losing his latch?

Heather writes:

"I don't think you've addressed this before, and I'm having a hard time finding any info elsewhere. I have to attend a conference this summer and will be gone for 6 days. My son, at that time, will be 18 months old. I don't intend to wean before that time, and I don't intend to take him with me. I was wondering how long it takes for a kid to "forget" how to nurse or how to get a proper latch. I intend to pump during that time to keep up my supply, but wonder if he may wean himself in 6 days (which I am sort of ambivalent about, but would probably be sadder than happier). I was also wondering if there are some "data points" on the lengths of time women have been gone from their babies at different ages and what the effect was on nursing."

I'm not sure if there is much info about toddlers losing their latches out there. I know when I weaned my first son (at 2 1/2 years+), after about a week my mom (the former La Leche League leader) said to me casually, "Oh, and you know at this age they just forget how to nurse if they haven't done it in a few days."

Um, OK.

So I thought that might happen when I was away from my younger son for two nights when I went back to work when he was 22 months, but it didn't--he just ramped the nursing waaaay up. (Seriously. He was down to once a day for maybe 5 minutes, and I thought we were almost through, but then I went away all day M-F and he picked up the nursing to 3-4 times a day for longer sessions. I thought he was literally never going to stop nursing, and I would have to eat my own words about "you won't have to FedEx your kid bags of breastmilk at college." But then miraculously he just forgot to nurse for a few days in a row while we were at my mom's a few months ago, and that was that.)

So I definitely think there's an age at which they forget how to latch if they don't do it for a few days. But I don't know what that age is. In my experience, it's somewhere between 22 and 34 months.

Anyone else have data points about toddlers losing their latch?

And does anyone want to share experience about being away from a baby or toddler and how it affected nursing? None of my work trips affected my son's nursing, but he was between 22 and 30 months when I went away, and the trips were all 2-3 nights long.

I suspect that it's as much about your child's personality as anything else, but would love to hear others' opinions on that, too.

Q&A: fussy baby while nursing

N writes:

"My four month old and I got past the initial difficulty beginning nursing (pain, latch problems, mastitis, the usual suspects) and we were off to a really good start with the whole breastfeeding thing.  She is gaining well and healthy.  But she often does this thing at the breast that drives me crazy.  She kicks, screams and thrashes while nursing.  If I hold her where her feet can hit the back of the chair, she'll kick against it, moving her whole body away from the breast while she's latched on (not pleasant).   If I position her where her feet can't kick against the chair, she'll instead scream and whip her head back and forth while latched on (also not pleasant).  Taking this as a sign she's not really hungry, I'll take her off the breast, which is met with shrieks of protest.  Put her back on the breast, we get a repeat showing of Wrestlemania: Baby Edition.  It doesn't seem to be a low supply issue as it's always easy to express milk when she's doing this, but I don't really believe it's that the let down is too strong for her either. Her older sister did this too when she was nursing, but this one is much worse about it.  I can't quite figure out what's going on here.  Any suggestions?  I've been stretched about as far as I can be - literally!"

Yeah, I remember this. I think it may be some kind of gastrointestinal growth spurt of some sort, but it was perplexing because there were no other symptoms of other gastric distress--no excess farting or crying 20 minutes after a feed (the classic symptom of a lactose intolerance) or anything like that. It sounds like you don't ahve any of this other stuff either, just the donnybrook on the breast. I never did figure out what caused it, and it went away in about a month or so on its own.

In the meantime, what I did was try to put as much pressure on my son's tummy as possible while he was nursing, and for whatever reason that seemed to work enough that he could finish an actual feed without going all Goodfellas on me.

The way I did it was by doing all my nursing (except for the middle-of-the-night nursing, which didn't seem to bug him) reclining on the couch. I'd have him facing down on top of me, stretched across the length of my body, perpendicular to me. So we were a lowercase t, and I was the vertical line, and he was the horizontal line across me.

That meant that he was nursing face down, but he also had all his own body weight on his tummy on top of me.

I have no idea if this will work for your daughter, but it's worth a try. Readers, can you offer up anything else that she can try if my tummy-pressure thing doesn't do the trick?

More on nursing and sexy thoughts

The people have spoken. From now on I'll separate posts. Special thanks to Rachel for emailing me to bring it up, because I honestly never would have thought of it.

Product review of Cranium Bloom toys below.

The whole nursing/sex dreams question from last week reminded me of something I read years ago (I can't remember where, for which I apologize) which was a stat that mothers who breastfed had more sex (by a lot) in the first year post-partum than mothers who formula fed. I had no idea why that would be when I read that stat, but it stands to reason that since breastfeeding produces oxytocin, which is the same hormone released during orgasm, moms with more oxytocin racing through their systems would be more interested in sex.

(Also, do I need to mention that nursing doesn't inspire sexy feelings toward the baby? It seems pretty obvious to me, but I'm worried someone's going to find this post and wig out about it without having any understanding of how nursing produces hormones so it's a natural physical reaction.)

I wonder how that interacts with the feeling that many of us who've nursed have had at different times, which is that we felt "touched out," or just tired of someone else wanting something from us that involved our bodies.

Sexy hormones vs. overwhelming emotional responsibilities? My suspicion is that sleep is what tips the balance, and that mothers who are getting enough* sleep feel less touched out and have more sexy hormones.

And I have no personal experience with formula feeding exclusively, but suspect that the intersections are probably the same.

Any thoughts you'd like to share on that?

* and by "enough" I really mean "maybe 60% of the sleep you got before having a kid, but enough that you can remember your middle name on any given day."

Mix-a-lot

1. Do not buy The Wonder Weeks for more than US/Ca$20. It is absolutely not worth more than that.

2. I just wanted to call some attention to the new website PPD Connect, a place for moms with PPD (or who think they might have PPD, or are even just feeling a little crappy) to go and tell their stories and get some support from other women who are going through it, or who have been through it. If you're a PPD survivor, you might want to stop by to leave some support and light at the end of the tunnel. http://ppdconnect.typepad.com/

Don't forget you can download my "14 Tips To Prevent Postpartum Depression" PDF over there in the left-hand column for free.

3. And now a question from Tegan:

"Since I've become a breast-feeding mother experiencing the occasional painful clogged duct, I've had no problem finding problem solving tips, i.e.:  warm compresses, massaging the breast, and nurse nurse nurse on that side to clear the clog.  But I've always wondered, does that mean that the baby gets a mouth-full of cloggy coagulated milk at some point?  Just curious."

It does, but they don't seem to care at all. I think it's probably more like yogurt or the skin of vanilla pudding than anything else.

FWIW, you can help prevent plugged ducts by taking flax seed oil or lecithin capsules daily.

Now I'm craving pudding.

4. If anyone's interested in a T-Tapp challenge for the new year, I just signed up for the "6 weeks to a new you" thread on the T-Tapp.com forums.

Q&A: pooping to avoid napping

Happy New Year!

Heather writes:

"I am not sure if this is a problem others have run into or not, but my 10 month old daughter has been pooping a lot lately either 20-30 minutes in her naps or right after I put her down she wakes up and poops, thereby ending the nap. This is a typical day all of a sudden: 20 mins into a nap I hear her babbling away in her crib, not crying and wait and wait thinking she'll fall asleep, because she *must* be tired, right? Well, 45 minutes go by and I finally decide to go check on her and the smell of poop hits me the second I walk into the room.  I couldn't sleep with poop in my pants either, so I feel bad and change her diaper.  By this point, she is in no frame of mind to go back to sleep so we go downstairs and play until she seems tired enough to try again.  We go through the whole routine, I nurse her to sleep, plop her into the crib, close the door gently behind me and I hear, "bah? bah! mamamama!" and it starts all over.  I check 10 mins later and she pooped again!  This has been going on consistently for three days now.  Is she doing this on purpose?  Could she possibly have control over her bowels and be avoiding naps? I should mention she has a very solid routine and normally takes two 1 hr 20min long naps on the 2-3-4 schedule that you sometimes talk about.  Oh, and she usually poops *after* she naps or when she wakes up in the morning.  So, this is totally out of character for her, but becoming a new routine that I feel I can count on, unfortunately."

I feel bad laughing, but that was my first reaction, because I'm a 12-year-old boy sometimes.

I think the pooping has more to do with the nursing than with the napping. Many many many babies poop after they nurse, and it sounds like something about her digestive pattern has changed to make her poop shortly after nursing. (Why do the baby books not tell you that your kid's poop patterns often change right after a growth or digestive spurt? Both of my kids were like clockwork, with a new pooping pattern after the 3-week, 6-week, 3-month, and 6-month growth spurts. It's totally normal, but I get a surprising number of emails from people who are concerned when their kids go from 6 times a day to once a day, or something like that, and you'd think one of the big-name doctors would have thought to put that down.)

It wouldn't surprise me in the least if part of the big 8-9-month sleep regression had something to do with digestion, or if the increased movement around this age changed pooping patterns, or something like that.

Anyway, the point is that I think the trick is going to be to figure out how to get her to poop either before she nurses down, get her to nurse and poop and then fall asleep, or some other possibility.

You're really stuck between a rock and a hard place, because the whole point of nursing her down is that it always works like a charm, and why mess with something that works so well? But if she only goes down but doesn't stay down, then your beautiful system isn't working so well anyway.

In your shoes, I'd do pretty much whatever I had to to figure out how not to stop the nursing to sleep (having had a child who would not nurse down for naps and one who did, I really think nursing down makes everything so much easier for everyone because it's pretty much a guarantee). I wonder if you could mess around with the solids you're feeding her to see if you could get her to eat some poop-inducers at non-nap times to see if that would leave her without anything to poop out during naps. Raisins, pureed prunes, and squash were big poop-producers in my apartment. (Also, if I drank coffee--even decaf--and then nursed, both my boys would poop. Go figure.)

That's all I can think of, other than trying to get her to stay awake until she poops and then get her down, which makes me feel exhausted even thinking about the logistics. Of. (Some bad grammar for the new year. Did I mention I have some sort of illness that has left me with no voice today? It must be affecting the sentence-writing part of my brain.) OTOH, if you've been trying to get out of nursing to sleep for the nap, this is the perfect time to do that.

Any comment help?

Q&A: Abrupt weaning, and autism (no causality!)

Hmmm. I've republished the entire website, and the comments still aren't accessible. Continuing the dialogue with Typepad's tech support people...

Katy writes:

"As there's been some talk of weaning recently, I thought I'd email and ask a question about weaning abruptly.  We recently found out that our 18 month-old son has autism.  After scrambling to get him services (speech therapy etc.), the next thing on our list is to try eliminating gluten (wheat) and casein (dairy) from his diet which has had great results in many kids on the spectrum (as a side question, I'd love to hear from people who've had positive or negative results with this kind of dietary change). 

Anyway, we decided that Christmas break would be the best time to try it as he won't be in his full-time daycare/therapy program where they give him his lunch and snacks and we'll be able to fully monitor everything he eats.  However, I'm still nursing him and my options are either to wean him or cut out gluten and casein myself, something that rather daunts me as I'm a big dairy person and the holidays seem like an extra hard time to be on a special diet. So I'm thinking of weaning him; this also seems appealing as he's become a nursing maniac in the last month, constantly lifting up my shirt and wanting to nurse, as well as waking lots in the night demanding to nurse.  I'm feeling very frustrated with him as I feel like he's constantly pawing at my body and the night nursing involves lots of sucking, snoozing and groping of my other breast - to the point that my body feels so sensitive I could scream (and, of course, I'm not getting good sleep).  So my questions then are:

  1.  Is this just an awful time to wean if he's so interested?  What's going on with this 18 month nursing mania?

2.  If I weaned him, how would I deal with the constant demands for nursing?  He has limited language so I don't know how well just telling him that he can't nurse anymore would work.  I hate the idea of just saying no to him.

3.  How would I get my milk to dry up? (Moxie, you mentioned something about mint tea in the previous message about weaning - do you have other recommendations?)"

I'm sorry you got this diagnosis, but I'm glad you have a diagnosis. I'm hoping that other parents of kids with autism will jump in with help.

Answers in the order in which the questions were asked:

1. It depends on your definition of "awful." 18 months is just a tough time all-around, and if you're still nursing, it tends to be one of those times the mother just can't deal with it anymore. So, yes, it's going to be really difficult to wean at this age because he's so needy and wants it so much. But it might be worth it for you not to have him nursing anymore. So "awful" here is totally subjective, and you get to pick your own poison.

Personally, having nursed two kids through the 18-month I-can't-stand-this-for-one-more-second, it-makes-me-feel-like-a-worn-out-old-sow, stop-stop-for-the-love-of-all-that's-holy-stop phase, I think it's easier just to self-medicate through the nursing with chocolate and do the weaning in two or three months (why is 21 months so much easier than 18?). But if you have to do it now, you have to do it now.

2. You got me. That's another reason I waited the 18-month phase out. Someone out there has done this, though, and will have something for you.

3. Bear in mind that drying up your milk is NOT going to prevent your hormones dropping when you wean, so be really aware of that and do some extra T-Tapp Hoe-Downs every day, make sure to keep up your Omega 3s and B-complex vitamins, and get as much sleep as you can. PPD on top of all of this would not be good, so do whatever you can to prevent it during the weaning process.

The things I know that help dry up milk are mint and sage, so you can brew mint tea and alternate that with "tea" you make by boiling fresh sage leaves. These aren't going to hurt the kid if you're still nursing while drying up your milk.

If you want your milk to dry up more quickly, you can take the old-fashioned Sudafed (the kind that can make you drowsy) for a few days, which will dry up every liquid in your body, so you'll need extra handcream while you're taking it. But if you're still nursing while you're taking it, it can make your child either super-drowsy or hyper, so use with caution.

All-in-all, I think weaning over Christmas is going to really suck. But going off dairy and wheat yourself is going to really suck, too (eggnog! Christmas cookies!).  If it were me, I'd probably delay the entire project until January, but  you just have to decide which is going to cause the least problems for you.

Now, I'd really like to hear from parents of kids with autism, specifically about navigating the condition, and especially about dietary changes that can help. Thank you guys so much.

Musings on low milk supply

I don't know if you've noticed any difference, but you can now access this site at www.askmoxie.org thanks to a wonderful reader who fixed that for me. The moxie.blogs.com/askmoxie URL will also still work, and all the archives are in the same place. If anyone needs a great web design person in Toronto, let me know and I'll hook you up.

Infant Hib vaccine recall in the US.

Can we talk a little more about low breastmilk supply? I have a theory, and I'd love to run it past you to see if it makes sense. I think that the conventional wisdom that very few women have low supply was probably true back before WWII. But that our environment and the way we have babies now has changed our bodies so that low milk supply is more common.

Apparently, when you breastfeed a baby, the milk-producing cells in your breasts multiply and increase their output. So you'll have more milk for subsequent babies. Also, I've heard from an LC that girls who breastfeed develop more milk-producing cells later on than girls who don't, because the act of nursing somehow stimulates the production later on. So I'm wondering if the reverse is true, that those couple of generations who were told to use formula caused us to lose some of the capacity to make milk that our ancestors had 4-5 generations ago.

At the same time, we have so many toxins in our environment now, especially plastics, that we know are messing around with our bodies. There's definitely a link between plastics and hormonal problems that may cause PCOS and infertility, so it seems like that could cause low supply, too.

And at the same that all that's been happening, the way we give birth has changed so much over the last 100 years. There was a whole generation that was basically knocked out cold during delivery, but they didn't breastfeed, so we don't know how that would have affected milk supply. Now, almost every woman is given pitocin and IV fluids, at the least. We know IV fluids cause edema of the breasts in some cases, and edema delays or reduces milk production. (Again, conventional wisdom is that your milk comes in by day 3, but I know dozens of women who didn't get any until day 5 or later after a labor involving IV fluids.)

It seems to me that this might have created/be creating a perfect storm of low production for a higher percentage of women than "should" have low production.

Any thoughts on this? Do you think I'm way off, partially on the mark, forgetting something? Any other theories?