Diane asked:
>
> Those of you whose firstborns are older than 28 or so:
>
> How did you learn to breastfeed effectively?  How did you learn to  
> hand
> express?  How did you learn to breastfeed lying down?
>

My first-born is 28.  As an RN with a master's degree in maternal- 
child health who had read books like Karen Pryor's "Nursing Your  
Baby" and LLL's "Womanly Art of Breastfeeding," and had attended the  
LLL series of 4 meetings as a graduate student in Denver, I thought I  
knew it all.  Working full-time as a nursubg instructor and clinical  
nurse specialist, and parenting two step-children (ages 9 and 11)  
whose mother had died several years earlier, I didn't have the time  
or feel the need to attend LLL meetings while pregnant.  But then I  
had a baby with major problems latching (traumatic forceps delivery  
for abruptio placentae, jaundiced baby, got an infection on the  
eyelid under the mask required by the bili-lights requiring treatment  
with antibiotics, very sleepy baby who didn't open his mouth except  
to yawn and then it would snap shut like a mousetrap on my nipple,  
took over three weeks to regain his birth weight, a pediatrician who  
wanted me to follow every nursing attempt with a bottle of formula,  
etc.).  In the hospital I think they attached me to a Gomco suction  
pump - all that was available.

The more trouble I had the more determined I became that I would work  
this out. I called a retired LLL leader who was friend of a friend a  
number of times.  She encouraged me to go to LLL meetings.   I did go  
then, traveling across town to go to the meeting titled "Overcoming  
Difficulties."  Eventually I found a nearby group and went to that,  
where I found a cohort of both new and experienced mothers with  
babies the same age as mine, as well as some older ones who served as  
role models and provided "anticipatory guidance."

In those days there was only a bicycle horn - type hand pump for home  
use.  I learned to express by just doing it - into a tea cup on the  
kitchen table. Sort of trial and error.  I think there may have been  
some basic diagrams and instructions in the breastfeeding books.  I  
remember reading that you could layer the milk in a plastic baby  
bottle in the freezer, and to cool any new milk in the refrigerator  
first before adding it to the frozen milk.  I had a six month leave  
of absence from my teaching/nursing job, but when I thought about  
finding child care for a minimum of 10 hours a day I quit that job  
and never went back to it.

I couldn't at first get the hang of nursing lying down.  At a LLL  
meeting, one mother who knew how demonstrated to the rest of us on  
the living room floor of the house where the meeting was held.  That  
helped us all figure it out.  We all tried it and got tips.

I remember watching in awe the mother of twins who came to the  
meetings and was doing great.  That inspired me.  Then a couple of   
years later another regular-attending mother of our group had twins.   
Then 10 weeks after her, I did.  So I had these great role models in  
that situation.  We did not have time to talk on the phone, but I  
remember the one with twins 10 weeks older than mine sending me a  
letter in the mail that said, "When you have a terrible day like I  
did yesterday, just remember that the next day may go much better!"   
She also told me that one day she felt awful and had a headache and  
realized she hadn't been drinking enough fluids.  She corrected that  
and almost immediately felt a lot better.  So all these tips and  
support guided me along.  I nursed my first son for a bit over 3  
years and the twins for nearly 4 years.

In those days LLL did not have many of the tools to help with  
physical challenges like tongue tie, or that much information on  
latch techniques, craniosacral therapy, pumps, finger feeding, cup  
feeding, reverse pressure softening, etc.  Support was mostly active  
listening and encouragement and cheerleading mothers on through the  
difficult times.  The information I had earned in nursing school was  
totally unhelpful.  (Babies first put to breast at 12 hours of age  
following a trial feeding with water to be sure no tracheal- 
esophageal fistula present; start with 5 minutes at each feeding the  
first 3 days, 10 minutes per feeding the next 3 days, then up to 15 -  
20 minutes a feeding thereafter; baby will get all he needs in first  
10 minutes; feeding on a 4-hour schedule, etc).  Actually, I've seen  
many of the breastfeeding community's interventions recommended in  
the past are constantly changing over time.  I think we are coming  
around to more hands-off, cheering a mother on again, creating a  
supportive environment to let baby use inborn skills, rather than  
trying to push a certain type of latch (remember nipple preparation  
with a rough towel, and the "RAM" approach for getting the baby  
latched?).

Anne Altshuler, RN, MS, IBCLC, LLLL
[log in to unmask]
Madison, WI  USA

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