Gak is Not Forever

Last week Livia started preschool, a 2-year-old program three days per week at a nearby church. We chose to have her stay for lunch and nap to give me more time to get some work done. (I have picked up a very part time writing job at a local magazine, but we decided to do the 9-2 hours from Minneapolis thinking we could always change to 9-12 later.) So far she is LOVING school, and staying for lunch (from her "womey-womey," aka Wonder Woman, lunch box!) and a rest/nap has been a treat for her.

We were down to one nursing per day, just before her nap. And on Monday 9/10 I nursed her for the last time before that nap. I didn't KNOW it would be the last, but I suspected it, and the tears began flowing. After school on Tuesday (when she didn't actually sleep at school), I asked if she wanted "gak" when we were home. She said yes, but then we got distracted by a Daniel Tiger episode (then carpool to get Jane -- half my day is spent in the car it seems!), and she just didn't nurse.

She didn't ask Wednesday or Thursday either and I didn't offer, and my emotional stability bottomed out. I cried throughout the day, at night and have been short-tempered (even more short-tempered than normal). I got into it with a teacher at the preschool carpool (to be fair she stuck her finger in my face to point to where she wanted me to go next time, but I did NOT react well or really safely given that I was driving a huge vehicle!), and I haven't been my best dealing with all the range of emotions and first-grader upsets that came my way.

Liv DID ask for gak on Friday when we were together again for nap time, but I told her the gak is all gone. (It really is, sad as I feel about it.) She said OK, and we rocked and sang. She eventually went to sleep in her crib (and she slept Wednesday and Thursday at school -- I think the trick is to let her take her shoes off!).

So we made it to 29 months of nursing, and when combined with the 26 months I nursed Jane I was a breastfeeding mom for four and a half years. (My blog post about nursing Jane ending is Num Nums are Not Forever -- funny that the girls had different names for nursing).

Nursing mama was a role I have played for more than half of my motherhood so far. I know it is a brief season in the scheme of it all. But it was so treasured, and I'm definitely grieving the end of it. I'm proud of myself for nourishing my girls in this way. They're both healthy and growing, and I have plenty of mothering left to do. But I still feel hollowed out from the transition.

Self Care and Nursing Shirts

I've been reading some about "self care," which might just be "basic care," as in eating, moving your body, sleeping ... going through the motions of day-to-day living until you feel better. Part fake it til you make it and part genuine survival.

I've also seen a tweet that said "enough with the self care - this is why they think we can't be president" (or something like that). So yeah, there's that. Also an article about a harder kind of self care.

One thing I found mildly helpful was making a list of things that comfort me. I guess ways I can care for myself. That's somewhat trending on Twitter, at least I've seen a few similar lists. But I'm really not feeling much better.

Here's my list so far:

• My babies & husband 
• Cool air ... finally 
• Cake making videos 
• Crochet 
• Offline reading 
• Voyager (mid 7th season) 
• Sleep 
• Dixie Chicks music
• Consignment shopping

My favorite nursing shirt is on its last legs...

Today I wore my favorite nursing shirt, even though it is falling apart at the seams, especially the neckline. It's got a cool crochet inlay in the back, but after 2+ years wearing it with Jane it is a bit torn and tattered. But it's long, has pockets and is comfortable. So I save it for "special" occasions. (I've tried to find a replacement -- but Motherhood doesn't sell anything like it anymore and searches online for "nursing shirt with pockets" haven't been any more successful. I should be willing to pay $50 for a shirt I'd wear every week, but so far I'm not ... I digress.)

I don't know what right I have to feel so bad. It's the fear of the impending tyranny and stripping of rights -- for humans, for women and specifically for me. For my daughters. My disappointment over not seeing the first woman president may be subsiding slightly, but my abject terror of what's still to come only seems to ramp up.

And wearing a comfortable, useful shirt isn't really cutting it as far as successful self care, I'd say.

Also this, "a time to heal:"

Breastfeeding Reading & Yeast Infection Update

I am cautiously optimistic that my deep breast duct yeast infection is under control. I'm still taking grapefruit seed extract twice a day and keeping up with the increased laundry with vinegar rinse, but my pain is gone. (The fear of pain is not, but that's to be expected I think.)

(Read about the cost of fighting this infection here.)

The search for answers led me to a wonderful book, Dr. Jack Newman's Guide to Breastfeeding. (I also found it in Barnes & Noble's "scratch and dent" for $5, but of course I paid full price!)

I'd recommend this book to any breastfeeding mom and actually any mom considering breastfeeding. It has the science behind breastfeeding well beyond just "breast is best." It explains the tricks and techniques formula companies use to get new customers, including enlisting doctors' help via free samples, office artwork, etc. (Criminal, in my opinion, since at the expense of babies' optimal health!) But even more it has best practices for breastfeeding -- getting started, troubleshooting, etc.

I bought it for the section about thrush/yeast of course. And although the candida protocol information is available on his website there's something about a book that provided me comfort. Reading the other sections have been good for informing my "lactivism," and I've come to believe even more in the power of breastmilk and the perfection of it as a baby food.

Backing up this belief: I have the chubby baby who so far is a somewhat reluctant eater of "real" food but a champion nurser who is big, strong and developing gorgeously.

Cost of Fighting A Ductal Yeast Infection

I am still fighting a ductal yeast infection in my breast -- candida during breastfeeding or however you say it. It's the pits. I've spent significant time and some good chunks of change on my efforts to kill the yeast. I am cautiously optimistic that this infection is nearly gone. Knock on wood and cross all your fingers! Here's a rough estimate of what I've done since early July to get here:

• Six weeks of diflucan -- this is the actual prescription medication, and I'm lucky my insurance covers it. Apparently it was expensive as a brand name but is now available as generic flucanozole. I couldn't convince my doctor to prescribe it longer (I didn't try very hard), although the protocol says it should be continued until symptoms are gone for a full week. (I had not had a full week of symptom free when I stopped the diflucan, but I think I have now, or at least very nearly symptom-free.) 

• All Purpose Nipple Ointment -- another one that needed to be prescribed. I had to get it at a compounding pharmacy that doesn't take insurance. It's $75, although I put in for it to be reimbursed by insurance. They sent a check for $10 without explanation. We still need to follow up on that one, but say $65.

• Grapefruit seed extract -- I have this orally as well as topically as a liquid. I mix the liquid into water (15 drops in a half shot glass) and use a Q-tip to saturate the nipple after nursing and follow up with the APNO. Liquid cost $11. Orally I take 250 mg three times per day. On Amazon it's about $11 for 60 pills, so a 20 day supply. I've probably been taking it for 8 weeks because I started it as soon as it seemed this was likely yeast. I've definitely purchased it five times so far (counting twice at Whole Foods in 125 mg dose, so the bottle doesn't last quite as long) and am working my way through the fifth bottle. (So $55 so far.)

• Gentian violet -- this took me a while to find because I kept thinking I would find it locally. In the end I could have ordered and received it from Amazon several times over, so I just did that ($10) and waited 2 more days. This does help, although I'm not sure how long it's OK to use. The protocol says on for 7 days then stop. If it hasn't worked in 7 days it won't. BUT it can be repeated. So I don't know. I do it, then stop and have symptoms flare and start again. It is HELLA messy and I hate it. I like purple OK but not on my poor baby's mouth. At church this week she had a big purple mustache and I had to get into my infection/medicine with more people than I would have liked (I should have agreed to others' ideas -- purple marker or a bruise). Definitely not what I had in mind when I say I want to help normalize breast feeding. (Update since I started this post - I was able to stop the gentian violet after about 3 cycles, so 21 days total using it. I've been off it for more than a week, and I know it's there to try again if symptoms flare.)

• Probiotics - buy locally at Whole Foods and also bought some inferior ones at CVS ($11 down the tubes) - $22 x two so far. They have to be refrigerated and need to be taken separately from the Grapefruit Seed Extract (which would just kill the probiotics I think). So I don't remember to take them too often, but at least once a day before bed and sometimes in the afternoon too. I think that's a good sign that I don't remember and am getting better!

• Vinegar for washing clothes and towels - minimal cost but for the sake of completion - $2. I wash everything of the baby's and everything that touches my breasts (bras, towels, etc.) in hot water with vinegar rinse. Acidity kills (?) the yeast, or at least inhibits its growth.

• Paper towels to limit yeast from towels on my hands after washing and limit chances of re-infection (not entirely convinced this is necessary) - $4, estimated because we use paper towels normally. I just kept a roll in the bathroom to use with each hand wash there and have used about 4 rolls over the time I've been doing this.

• Jack Newman book: Dr. Jack Newman's Guide to Breastfeeding, includes the candida protocol I am trying to follow. $22.

• Lactation consultation - should have been $95, although maybe insurance would have covered it. I got my consultation free because while I was waiting for a call back in the hospital waiting area I was hassled by a security guard about breast feeding and that I needed to go to their special rooms/couldn't just nurse in the lobby even covered up. I tweeted my indignation, which got the communications people's attention and I was given a personal apology and the consultation for free, which was nice. It was helpful because they were the ones who agreed that it was more likely yeast. They weren't used to seeing such big/older babies though. If nothing else it made me feel like someone in the medical system actually cared about me/my pain at that point (when my doctor was out of town).

• Monistat 7 - before I got the APNO - $11

So adding all that up we're at $224 actually spent (not including the $95 the lactation consultation would have cost). I'd gladly throw money at this problem just to get better and it was the TIME more than anything that has been hard to deal with. I've been robbed of pleasure with my baby, and while we're still nursing and everything is great with her growth and health I am battered and beaten down from this experience. I hope I can bounce back and continue to get better until completely, truly healed. And I hope you never experience this. If you do/found this via Google please feel free to email me for empathy!

Breastfeeding Madness

I've written about breastfeeding before, including a recent post on The Mommy-Go-Round. And when I talk or write about breastfeeding I AM INSUFFERABLE!

It's so easy, she said. Anyone can do it, she said.

NOPE NOPE NOPE.

Consider me humbled, crow eaten and in awe of moms who make it through breastfeeding challenges. If I experienced this the first time around and didn't know how easy it is to "open bra, push baby to breast, go back to eating/reading/scrolling" I'm not sure we would have made it to seven months of exclusive breastfeeding, let alone 26 months total! 

Everything went great with Jane (although reading back in the posts I did have a bout of mastitis that I cleared up without much trouble). But for the past couple weeks I've been in the land of eat-your-words, because breastfeeding has been anything but easy.

To start I had a sore nipple, maybe seemed like a milk bleb. I did hot compresses and lots of nursing to get it open, but it kept hurting and last Wednesday night I got the shock of my life when knife-like pains started internally in my breast, basically all throughout the milk ducts, after my last nursing of the evening.

I've done so much internet sleuthing, but it didn't seem like mastitis (no fever/chills) and didn't seem like yeast/thrush because Livia didn't have any symptoms and mine weren't typical and it was only on one side.

I started calling the doctor's office right away on Thursday afternoon after a terrible bout with pain, but because I felt some better when I called on Friday they didn't seem to be in any rush to have me be seen. Then I had to wait over the weekend to come in, and it got worse and worse (a couple hours of level 9/10 pain after each nursing on the right side).

So far I've been to a nurse practitioner (who diagnosed mastitis even without any mastitis symptoms) and prescribed an antibiotic. Then I had a lactation consultation, and they think it sounds more like yeast, and they recommended treating with diflucan. My doctor's office prescribed that, but only one dose, which is what is recommended for a vaginal yeast infection, with a second dose 7 days later.

The lactation consultants all referred me to "Tips from the Trenches," and the handout on yeast (and everywhere else on the internet) recommends a much longer-term dosing (instead of one dose you take a double dose and then one dose daily for 14 days). So far the doctor's office has said "no way" to that and told me to continue the antibiotic (even though an antibiotic can wipe out the good bacteria that can help fight off the yeast organisms).

I also got some advice on a better latch with Livia. She was pretty wild during the consultation -- slipping on and off the breast and chomping more than usual. It's most comfortable when she's calm/sleepy and can just get down to business. But having to TRY with the latch after months of pain-free automatic nursing has been difficult.

But the PAIN has been the worst. My nipple is still sore (got some prescription cream for that now, although I had to ask if that was OK/it was never offered as an option) so nursing/initial latch is painful. But it's nothing compared to the feeling after nursing is done and the yeast starts attacking.

My pain is worse in the mornings after the first feed, although I do have pain throughout the day after nursings. PERHAPS it's because I go so long in the night between feeds (Livia and I like to sleep) and I have been hesitant to nurse on the right overnight because I know the pain will wake me up totally. But tonight I'm going to try and nurse on the right and hope the morning pain is more manageable. I'm also going to take some ibuprofen in the night, which might help.

In my own opinion, not being an MD or nurse, I have a very stubborn and strong yeast infection that will need the bigger course of diflucan. In the meantime I'm trying grapefruit seed extract, taking high doses of probiotics to counteract the antibiotic and still looking for gentian violet locally (as usual if I'd just ordered it on Amazon once I suspected yeast I could have been using it already). For the pain I'm taking double doses of ibuprofen spaced 6-8 hours apart. It doesn't really touch the pain at all, unfortunately.

There's also the risk of re-infection and the breastfeeding literature says baby and mom should be treated simultaneously to prevent spreading it back and forth. So far Livi has no symptoms so her pediatrician won't treat for it. I hope it stays that way, and that if she does get symptoms we can do some gentian violet or similar to knock it out fast. There's lots of extra laundry in that towels and burp rags, baby clothes and bras all have to be washed in hot water with vinegar rinse. All the breast pump parts and any pacifiers/toys that go in her mouth have to be washed AND boiled (daily!). I've already melted some of her best toys doing that, so I've been limiting what I let her put in her mouth to things that are definitely washable/boilable or that I don't care if they get ruined.

I plan to write a Mommy-Go-Round post after all is said and done -- and to eat my crow in a more public way. And I have a lot more to say about the experience emotionally. But in the mean time, that's where I am now.

Num Nums are Not Forever

This week I said goodbye to an important part of my parenting life up to this point. Jane stopped nursing, after just over 26 months. I'm feeling lots of feelings about it.

I have thought of myself as an accidental hippie mama in this respect, but really I am an intentional lactivist and wholly believe that extended nursing has been a boon to her health and development. It's also been pretty great for me, what with regular releases of feel-good hormones (and you know I need all the feel-good-ness I can get!).

Now that weaning is over I can feel the difference, but at least our weaning was gradual. I haven't had any engorgement or pain issues. When I started drafting this post, everything felt fine emotionally. But a couple days later and the hormonal bottom has dropped out so to speak. I've had a terrible, no-good, horrible day with lots of crying and am trying to regain equilibrium. I'm chalking it up to the hormonal shifts that come with completed weaning, although it is probably a lot of things together. I just didn't know it would hit me so hard.

I'm quite proud that we made it so far, but I'm actually more surprised that we've completed weaning! I was starting to think it wouldn't happen, mostly because we both love it so much. It had started getting more challenging, with her being so big and unfocused about it.

I wanted the perfect children's book to say goodbye to nursing, but I never found a good one. We did read "Ready to Wean" a lot (affiliate link), and talked about the concept, so it was at least partly an intellectual assent on her part too. She did understand why we were going to stop and was able to agree to "no more num nums."

We didn't set a firm deadline, but it just sort of happened, as I suggested not nursing one night before bed (extra singing and cuddles in its place), and we kept dropping until even the nap nursing was gone. The last time we nursed was very briefly on Sunday 1/12 before her nap.

My body had a very difficult time getting pregnant, and it's never been a well-oiled machine. But I found out that it can feed a baby to perfection. For the first 6+ months of Jane's life she was all breast milk all the time, and she was the chubbiest, most beautiful and healthy baby. Her doctor often proclaimed her "perfect" and pointed out how proud I should be for providing her with that nutrition.

But it was really just the easiest thing. I didn't have to think about it after the first month or so, and after six weeks we stopped tracking and just went to feeding on demand (mainly because Christmas travel screwed up my note taking). It's the feeding her food that's been so much more difficult!

Jane's been pretty healthy, avoiding most fevers and colds thanks in part I'm sure to the protective qualities of breast milk. I'll be interested to see if she gets sick more often now, although it's not a fair comparison since she's much more out in the world these days and her immune system is more mature.

It's a bittersweet time, as I'm going to miss the special bond -- and the guaranteed soother. But I'm glad to have this baby girl continue to grow into childhood.