Breastfeeding Take Two

Given my issues with breastfeeding Phoebe and Sophia, I was a bit apprehensive about what was going to happen with my next baby.  I went in for my repeat caesarean knowing I wanted to do two things:

1. Have skin to skin contact with baby ASAP

2. Breastfeed baby ASAP

I also went in prepared to get absolutely no sleep for at least 3 nights and put her on the breast every time she cried to help bring my milk in quickly.

 

Baby Georgia was put on my chest for skin to skin contact immediately after she’d been checked over by the paediatrician and weighed.  Looking back at the photos I can calculate that it took 3-4 minutes to put her on my chest so I am very happy with that.  She stayed there for 16 minutes while I was sewn up.  Then Simon (hubby) took her outside to the recovery area and cuddled her for me. 

I was taken to the recovery area and she was put back on my chest about 10 minutes later (30 minutes post birth).  She was very alert and looking for a feed so I started to try to feed her while the recovery nurse was doing my observations.  The nurse told me to wait until she was finished and wait for a midwife to help me.  However, I just ignored her and as soon as she left me for a second  I juggled Georgia onto the breast.  I say juggled because it was a bit tricky with the blood pressure cuff and oximeter still attached to me.  Oh, and she was flapping her arms about, fussing and crying as they do!  I did the “mother led” attachment technique I was taught in special care 3 years ago. 

Georgia had an excellent attachment (something I only know from experience) for her first breastfeed and she stayed attached until I took her off 25 minutes later!  I then put her on the other side and she fell asleep 30 minutes after that.  I had read somewhere that babies were most alert in the first hour of birth and I was concerned that if she spent all her time on one side that the other side wouldn’t get a look in for a long time.  This is why I made her switch sides.  Well, I was wrong because she only slept for 30 minutes and woke up again to feed.   She then fed for 10 minutes, slept for 10 minutes, fed for 10 minutes, slept for 10minutes, etc. for about an hour and then had a decent hour of sleep while we had our first visitors.  Then she started to alternate 20 minutes of feeding and 20 minutes of sleeping (roughly) from 3pm-1am.  Then she finally “crashed” and had a solid 2 hours of sleep 1am-3am. 

It was bittersweet that Georgia was such a great feeder and fed better than either of my twins did in the 2 months I struggled to breastfeed them.  Here is this baby barely an hour old who is able to do something my other children never achieved.

Day 2 she started to spend about 90 minutes doing the feed/sleep/feed/sleep alternation but then have a nice hour of sleep before repeating the pattern again. 

Days 3-5 my milk had started to come in and she was staying longer on the breast before falling asleep.  We started to progress to a little routine:

1.       Feed on one side (about 20minutes) until she fell asleep

2.       Nappy change

3.       Feed on other side (about 20 minutes) until she fell asleep

4.       Sleep for 1-1.5 hours then repeat

She would still have a couple of hours at some point in the day when she would cry quite a bit and keep alternating from sleeping to wanting to be fed but then she would have 2 hours of sleep following this fussy period which was nice.

Day 6 I started to become engorged.  I woke in the night to feed and had a terrible time trying to attach her and I had no idea what to do because I had never been engorged while feeding Phoebe and Sophia.  My nipples were already sore at this point but she really hurt them badly while trying to feed that night.  I had gone from sore and slightly cracked nipples to severely cracked and bleeding nipples in one night!  This was partly due to actually trying to get on and partly due to her pulling off when no milk was flowing and then pulling off again once it did come and she couldn’t cope with the volume of milk! 

It was a sad irony that I didn’t have enough milk to feed my twins and here I was struggling with too much milk for my singleton.  Part of me wanted to pump the milk and keep it for later or give it away but I knew this wouldn’t help with the engorgement that was contributing to my cracked nipple problem.

Reducing Engorgement

The pain of feeding on damaged nipples is excruciating.  I completely understand why mothers give up breastfeeding at this point.  There is that terrifying moment before they latch where you know it is going to hurt like a ***** but you have to grit your teeth and cry about it later.  I needed to find a solution to the engorgement problem ASAP!   Not only was it making attachment difficult/painful but it was probably contributing to my fast let down.  I consulted Dr Google and found 4 techniques/tools that I found helpful for engorgement. 

1.       Heat pack.  I bought a little heat pack so I could put it on the breast when she latched.  This helped with let down and distracted me from the pain.

2.       Reverse pressure.  This was a great technique for me to use when I had the initial engorgement. 

3.       Breast Shells.  These do the reverse pressure for you!  They also prevent your nipples from touching anything which is ideal for healing.  Best $20 I’ve spent in a long time!!!  Without these I would’ve had to resort to nipple shields or maybe even introducing bottles and pumping.

4.       Block feeding.  I started to only offer one side per feed in an attempt to decrease my supply.  I had so much milk that at one stage I was doing 2 feeds on one side and then 2 feeds on the other side! 

Healing Cracked Nipples

When I had cracked nipples feeding my twins I was told by the Special Care nurses to slap on some lanolin and a breast pad and try using a breast shield if it got too painful.  I was told that the cracks were due to poor attachment (which made me feel guilty!!).  My cracks didn’t heal until I stopped breastfeeding and pumping and I found the shield impossible to use while tandem feeding.

Knowing that Georgia had excellent attachment but I still got cracked nipples (prior to the engorgement) it made me think that the cracks would  have formed no matter what.  I also remembered that my nipples were very sore in exactly the same spots when I was only pumping for the twins (ie. no attachment issues were possible!).   I now have a theory that my nipples are naturally “missing” very small pieces of skin that when stretched to the limit cause cracking.   It’s not like I have odd looking nipples -  the tiny creases/dents are miniscule and not noticeable at all.

This time around I consulted Dr Google for ideas on how to heal cracked nipples.  When I came across this website I had an epiphany.  The salt rinse technique reminded me of something I did for a wound I had post surgery years ago.  I now realised that I should treat the cracks as open sores that needed to be mended by new skin growing in the crack.  By squishing the nipple back into my bra protected by a breast pad I was basically encouraging my body to try to “stick” each side of the crack together rather than grow new skin INSIDE the crack.  Also, breastpads are designed to absorb moisture which means you are left with a dry nipple after a few hours. This isn’t ideal if you are trying to achieve moist would healing!  So, here was my new technique for dealing with cracked nipples:

1.     Salt rinse.  This seems to draw the moisture out from the wound.

2.     Lanolin.  This speeds up healing and makes it feel more comfortable.

3.    Breast shells.  They prevent anything touching the nipple.  This means the nipple is nicely coated in the lanolin until you wipe it off before the next feed.  I cannot emphasise the relief I felt wearing these.  If you thought lanolin made your nipples feel better what until you try these plus the lanolin!  They do make you look a bit more "perky" but they feel awesome!

4.    Hydrogel breast discs. These are great to use at night when you can’t wear the breast shells.  In my opinion they are much more effective than lanolin and a breast pad because they don't dry out.

There are also a couple of things I do while feeding to try to prevent further damage.  Firstly, I feed with baby’s chin on the side of the nipple that is least damaged as this seems to hurt the least.  This makes sense because this is the section of the breast that is moving back and forth in baby's mouth.  I also feed with my free hand right next to baby’s mouth ready to unlatch her if she’s about to pull off.  Pulling off without unlatching seriously damages the nipple.  Being able to unlatch baby right before she pulls her head back is an art!  Finally, if she’s particularly frantic and is likely to grab my nipple with her hand I wrap her before trying to latch her on – those tiny fists can hurt!

By following all of these techniques the bleeding stopped within a day and the breastfeeding became "bearable" within two days.  Georgia is now 4 weeks old, so it has been 3 weeks since that night when the bleeding began.  My less damaged nipple is completely healed.  New skin has grown!  It still hurts a bit when Georgia latches on but I would describe it as a “sore” nipple not a damaged nipple which is fantastic!!  The other, more damaged side looks like it is about halfway there in terms of healing.  I will have to come back and update this post when it is completely healed in a few weeks.

What should I buy for baby?

Car Capsules.  If you are having preemies these are essential for safety reasons but if you are having a full termer these are still safer and very convenient if you have a stroller to clip it into.  You will also need some inserts to help stabilise their heads.

Carseats.  If you want to eventually fit three across your backseat look for compact versions.  We got the Safe n Sound Compaq for all three children. 

A good pram.  You need a sturdy, lightweight and easily foldable pram.  Check out Baby Jogger and Bugaboo prams – I think they are the best.  We had a Baby Jogger Citi Mini Double for the girls and have purchased the single version for the next baby.  The Baby Jogger Select and Bugaboo Donkey did not exist when we bought the girls’ pram and I probably would have considered buying one of them.

Bassinet with wheels.  We bought the Kingparrot bassinet (apparently called the Boori bassinet now) for the girls and found it essential.  It has breathable sides, it’s slightly bigger than the average bassinet, it has wheels and you can pop a wedge of foam under the mattress to prop it up if needed.  They slept in the bassinets in the lounge room during the day and beside my bed during the night.  You will also need at least 2 bassinet mattress protectors and 4 sheets per bassinet.  Pillow cases and muslin wraps work well as “sheets”.

Pretty blankets/wraps.  This is what your precious one is going to be photographed “wearing” when they are first born so invest in something nice.  I especially like the stretchy wraps.

Sleepsuits/Onsies.  You’ll need a LOT of long and short sleeved ones.  The wrap across the front style is the easiest to put in followed by the button all the way up the front style followed by the over the head and button at the crotch style.  Do NOT get the Bonds “easy suit”.  Worst. Invention. Ever. However – I am keen to try their new zip wondersuit.

Nappies.  For the girls we used 1244 nappies from when they got home from hospital until they were 3 months old..so that’s  average of 10 nappies per child per day.  We used Huggies but then switched to Aldi when we realised they worked just fine for my girls.  The same goes for wipes – we started out with Huggies but then switched to Aldi.  At 3 months I started to do cloth nappies during the day and disposable at night.  I used Bambooty quick dry sized nappies but if I were to buy some new ones I would get their one size fits all version or try out Bonnibuns and IttiBitti. 

First Aid.  You need baby paracetemol, barrier cream, a thermometer and nipple cream.

Breast Pump and Bottles.  This is only essential if you are going to pump or formula feed.  I hired a Medela Lactina pump for the first 2 months and then borrowed my friends Medela Swing pump.  I found both pumps ok but I hated pumping and blamed it for my cracked and bleeding nipples.  I don’t think this had anything to do with the pump brand though.  I used Pigeon bottles as they have a peristaltic nipple (aka super slow flow) and a good choice for combining breast and bottle feeding.  Look into Dr Brown bottles as well – I hear they are good.  I am looking forward to (hopefully) not having to pump or bottle feed my next bub.  

Baby carrier.  You NEED one of these…two if you are having twins.  It just made it easier to soothe and carry the girls around when they needed to be.  I was using a baby bjorn and carrying one on my hip to get them in and out of people’s houses, get them to a trolley, get them inside the gym, etc…. until they were 14 months old and exceeded the Bjorn 10kg weight limit!  I have fond memories of Simon and I strapping the girls on and going for twilight walks around the neighbourhood.  We would find a pair of swings and swing together with the babies strapped to us – lots of fun!

Baby swing.  Essential if you have twins or a baby with colic/reflux.  We had two of these and would not have survived without them.  The ones we had were quite noisy so if I used them in the middle of the night I used them in the lounge room so as not to wake up Simon and mum/MIL.  I would fall asleep on the Giant PVC playmat next to them.

Giant PVC playmat.  We have wooden floorboards and having this mat has made our life so much easier!  I spent hours lying on this mat sleeping and playing with my girls.  It’s super easy to clean and it hasn’t faded at all after 3 yeas of use, even though we’ve left it outside for hours.  We now have it outside on our deck as a nice soft place for them to sit and play with Duplo.  We sometimes put pillows under it to make it into a “mountain” obstacle course.

A Cleaner.  My MIL paid for 2 hours cleaning once a fortnight for the first 2 years of the girls’ life as a baby shower present and I found it to be essential for my sanity!!!  I paid the cleaner for an extra hour to do our ironing.  She still cleans and irons for us and I don’t intend on letting her go.  It really is money well spent.  

A meal roster.  Get someone to organise a 3 week meal roster after the baby is born.  Otherwise you will be eating takeaway and sandwiches every night for dinner.

Citi Mini vs. Phil n Teds Thingy

Twice now I’ve had people tell me that I’m stupid for buying the pram I have.  Ok so they didn’t exactly say stupid but they were extremely rude and professed that their beloved Phil and Ted’s doubledeckersqueezethebabyunderneath pram is far superior to mine for a toddler/baby combo.  Their argument is that you can’t go anywhere or do anything with a side by side pram like mine because it doesn’t fit through a door or ....well anywhere really.  Ummm....it is the width of a standard door (and a wheelchair!) and most shops in this day and age allow people into wheelchairs into their shops!

Best. Pram. Ever

Thingy.

My pram is super light, super sturdy and super easy to fold.  It is fantastic for twins or a baby/toddler combo.  It has heaps of storage and you can balance two of those little red shopping baskets on top.  You can fit 12L of milk in the storage underneath!  You can steer it one handed while holding a child on your hip with no problems (essential!!!).  Yes, it is wider than the Phil and Teds thingy.  The Citi Mini is 76cm wide and the Phil n Teds is 64cm wide. But, the Citi Mini is only 12.1kgs and the Phil and Teds is around 13.8.  The Citi Mini is much easier to fold (so I've read, I’ve never folded a Phil n Teds) and has two wheels at the front which makes it much sturdier.  I know neither of my children would’ve been happy to be one stuck in that space down the bottom of the Phil n Teds from ummm...probably 5 months old! Also – I would’ve further aggravated my already painful back injury trying to get them in and out.  

Here ends my completely biased comparison of the Citi Mini vs. Phil n Ted’s thingy.  Now, the Baby Jogger Citi Select and Bugaboo Donkey didn’t exist when I bought my pram so I would seriously look into that those ones if you are a mum looking for a double pram but....just by looking at them they don't seem to be as leightweight and easy to fold as my beloved pram :).  

I guess what really upset me was just how rude these mums with the Phil n Teds pram were....seriously people – get over yourselves – it’s just a pram!

Stubborn Self Feeders

I think there are two ways to present food to babies. 

1. Over protective mum approach.  You sit with them the entire meal and put tiny pieces of food in their mouth and freak out if they look like they are going to choke.
2. Lazy mum approach.  Load up the highchair with a bunch of different finger foods and walk away to do the washing up.

There are two ways babies like to be fed

1. Lazy but smart baby approach.  Baby absolutely refuses to pick up anything for himself.
2. Stubbornly independent baby approach.  Baby absolutely refuses to be fed.  Baby must feed themselves.

I started out as being the over protective mum trying to feed two stubbornly independent babies.  The closer I was to the highchair the less they ate.  I changed to being a lazy mum.  It was hard to convince other carers that the lazy approach really was the best way, especially considering the mess it created (and therefore, it really isn’t a lazy approach!).  I swear the more mess they had created, the more food they had eaten so mess was a good thing!  

My messy 13 month olds!

Baby Food

6 months
I started trying to feed the girls solids at 6 months.  The problem was that the girls weren't really ready for them until 7.5 months.  I feel a bit bad that I was essentially force feeding them rice cereal and purees for 6 weeks.  I would keep them happy with easy-to-clean plastic toys and poke in the spoon between toy chewing.  They were very, very keen to grab the spoon from the get go so it was a rather messy/chaotic activity and I don't think it really achieved much.

7.5 months
I would create all sorts of vege and fruit purees that the girls weren't that keen on (except apple and pear....they were always a winner!).  I would even try to get some mince or chicken in there (even less popular!).  Often the only way I could get them to eat these purees was to mix it in yoghurt. So we would start the meal time with the purees as I had made them and as the feeding session continued I would add more and more yoghurt.  I had also started finger food and often tried to sneak in the mushy stuff between bites of the finger food.

Finger food was waaaaaaaay more popular than the mushy stuff.  Their favourites were - watermelon, orange (no pith/skin), cream cheese cubes, avocado chunks, cooked pear chunks, cooked apple chunks, canned peaches, cooked zucchini slices, banana, kiwi fruit.  It probably took a couple of months for them to master eating all of this but we started presenting them at around 7.5 months.

8.5 months
This was the start of the "everything on toast" stage.  They LOVED toast so I would spread all sorts of things on toast like cooked pumpkin, homemade hummus, cream cheese, Vegemite, etc.  In between bites of toast I would try to feed them something like:
- tuna rice (cooked rice, tuna and sour cream mixed together)
- beef stew
- beef bolognese
- scrambled eggs (adding cream seemed to boost its popularity!)
- baked beans
They started to love itti bitti frozen veges around this time too (pea, corn and carrot mix is a goodie).  I also encouraged them to self feed yoghurt with a spoon at the end of the meal which they LOVED!  They always had a bath afterwards :).

9.5 months
I continued the 8.5 feeding strategy but added in untoasted bread, crackers and corn thins.  I also started to give them roast chicken, meatballs and pan fried fish.

10.5 months
Dinner ideas:
- toasted sandwich (ham, cheese, tomato)
- wholemeal pita bread toasted sandwich (frozen vege and cheese filling)
- omelette (frozen vege and cheese filling)
- pasta with basic cheese/cream sauce or passata
- mexican mince with tortilla
- udon noodles with veges
- fried rice
- satay chicken made with no sugar/no salt peanut butter

Vegemite on toast for brekkie. 12 months old.

11.5 months
Mine started to eat regular food like curries and stirfrys and LOVED all the intense flavour.  I am blessed to have pretty good eaters :).

Breaking the rules
As you can tell - I didn't follow the recommended ages for introducing eggs or peanuts.  There is no history of allergy in our families and we were careful to watch them after eating these foods.

Fast Food for Toddlers

P&S sharing an unpeeled apple at 13 months

I am lazy when it comes to feeding my children....and I have a budget.  I have come up with a list of foods that are healthy, cheap, and can go from your fridge/cupboard to the plate in under 10 seconds.  I ALWAYS have these items in my house.  Now that’s fast food!!

Carbohydrates

• Bread (multigrain is best)
• Cornthins/ rice cakes (mine LOVE these!!!)
• Fruit bread (try to get one where most of the sugar comes from the sultanas)
• Rice crackers (plain are best as they have less salt than others)
• Wheat crackers (try to get ones without tonnes of salt)
• Cereal (mine like Weet bix and museli)

Protein

• Milk (full cream, unflavoured)
• Shredded cheese (mine eat it straight from the freezer!)
• Yoghurt (full fat plain or greek)
• Cream cheese
• Canned chick peas (look for no added salt variety)
• Canned baked beans (look for no added salt variety)
• Canned Tuna (I buy the stuff in springwater and mine would eat it straight from the tin if I let them!)
• Cashews (some people say nuts are a choking hazard but mine have been eating them since 18 months with no troubles)
• Peanut butter (no salt, no sugar variety)

S eating a corn thin with cream cheese at 13 months.  That's a pea stuck to her face.

Fruit

• All fresh fruit can be served within 10 seconds...I don’t bother chopping things like apples, bananas or pears.
• Canned fruit (don’t buy the stuff in “syrup” but the stuff in fruit juice)
• Frozen berries (they will eat them frozen!) 
• Dried fruit (mine like sultanas and apricots)

Vegetables

• Vegemite (not really a vegetable but wasn’t sure where else to put it!)
• Carrot
• Cucumber
• Snow peas
• Cherry tomatoes
• Capsicum
• Mushroom
• Celery
• Canned corn

Losing the Baby Weight

My Baby Weight Story

Before I thought about having kids I was skinny.  Then when I started to think about getting pregnant I became average (why watch my weight when I’m going to be pregnant soon anyway??).  Then when I got pregnant I became overweight.  There are a few reasons why I put on 20kg while pregnant. 

• I had twins that weighed 4.3kg and a big placenta and all that amniotic fluid, etc.
• I had pregnancy hormones that told me I was STARVING all of the time
• I felt sick if I didn’t eat every hour
• I was sedentary due to pelvic pain
• I had steroid shots.  These made me retain even more water!

I have now lost all of the weight.  How did I do it?  S-l-o-w-l-y is my answer.  I didn’t rush out to join a gym when the girls were 2 weeks old or try 20 diets.  I took it very, very, slowly!

0-3 Months
At first I was still eating loads of food and not exercising.  I remember eating a lot of chocolate during those 2am, 4am, 6am feeds!!!  I would eat a HUGE fruit salad for afternoon tea to try to keep me satisfied but I would still need to eat a HUGE dinner and snack during the night.  Trying to cut back food when I was sleep deprived, stressed and lactating just was not an option.  The only exercise I did during those first three months was walk, bend down and practise getting up off the floor.  As I’ve mentioned previously, pregnancy was not kind to my body and getting up off the floor was impossible because I had lost a lot of muscle tone in my legs.  By the end of 3 months I could (just) get myself off the floor and bend down to pick something up off the floor and walk around the block.

3-7 Months

This is what I call the “walking to avoid crying” stage.  The girls were always very fussy in the afternoon after their second nap.  I quickly worked out that the best solution was to put them in the pram and just walk.  I didn’t want to walk (sooooo tired...zzzzzzzzzzzzz) but it was better to be pushing the pram at a snails pace than trying to jiggle them in my arms for hours.  So I would just walk and keep walking until both of them had had a third nap.  Sometimes it only took an hour, sometimes two.  At first I avoided hills but after a while I would deliberately go for the hills to challenge myself and get a bit of exercise.  I would always take the baby carrier and would often end up carrying one in the carrier and push the other.  I had stopped breast pumping by 3 months and felt that all my hormones had settled down.  I didn’t feel the need to eat in the middle of the night and I quit eating so much cheese and chocolate.

7-10 Months

mmm...I was slack.  No more walking the streets (too hot!) and a lot of walking the shopping centre with iced coffee in hand....mmmm indeed.

11-18 months

I joined a gym!!!!! Have you ever tried to have a shower with 10 month old twins in your care?  At 10 months they have 2 naps (usually not at the same time!), they move (and can open drawers, pull themselves up on things, etc.) and are not happy with any form of restraint (playpen, highchair, etc.).  This was my number one incentive to join a gym – the crèche!!!  And the baby free showers that come with having a crèche!  There were some days I would drive all the way to the gym, settle them in crèche and then have a really long....shower!  No workout required.  Most of the time I would actually do some exercise but I was really there for the shower for the first couple of months.  I would typically try to do about 20 minutes cardio (treadmill and elliptical) and 15 minutes of weights (5 different weights machines) three times a week.  Once I started working out I started to cut a little bit more of the unhealthy stuff out of my diet...bye bye juice, ice cream, greek yoghurt and nuts!

18-24 months

The weight loss really slowed down at 18 months.  It was time to join those crazy gym classes!  With some encouragement from some friends I did a Body Pump class.  The first time I used 0.5kg weights on each end and just focussed on the technique.  I was in AGONY!!!!  I thought I was going to die from all of those lunges and squats!  Death by lunge...mmmm not the way I wanted to go.  I persisted with the class and slowly added on the weight as I gained more muscle.  Now I can lift ten times the weight I started with!  I still haven’t got the hang of those hard core aerobics classes (e.g. Body Step) but there was this basic cardio class I could keep up with and didn’t require a lot of coordination.

24 months

So I’ve lost all the pregnancy weight and now I’ve moved on to trying to look more tone and fit.  I am really looking at what I’m eating and realising how addicted I am to chocolate and sugar.  One bite of chocolate cake and I’m hooked...mmmm cake!!!  So I’m working on my self control around sugar.  I also tend to eat the girls’ leftovers which adds in extra calories.  They eat healthy food but I’ll tend to eat their leftover dinner at 5.30pm then eat a full sized dinner at 7.30/8pm with hubby as well!  I'm certainly not skinny but I'm healthy and happy with my body.