Milk Supply and Pumping

I wish there is a gauge or a digital display of how much milk a lactating mother has. I wish there is a more concrete way to tell whether your child is getting enough milk. Well there is none like that available in any market. The only way is via the child's growth.

I tried pumping around 2 weeks postpartum, and only a few drops were expressed. So when I pumped again a few days after and was able to get more than 1 oz, I was really happy. Here is the souvenir photo :)

To increase my milk supply, we always have fresh malunggay leaves on our soup. Plus, Phil bought a malunggay juice.

I am happy with my milk supply, since there is nothing wrong with my baby's growth and since she looks contented after feeding.

However, I still have issues with pumping. I pump less than 1oz from both boobs and around 2 oz when doing it while she is feeding on one boob. So I think I have a problem with milk let down. I am still researching on this but according to some online sources, it could be because of stress, sleep deprivation, or because I am not relaxing. Anyways, I'll post again once I know what to do. :)

Start of My Breastfeeding Journey

I decided to exclusively breastfeed my first born. The first week up to the first month was super hard for me and I guess for my baby too. The past 6 weeks and 4 days was a roller coaster of emotion. At first I thought I was not producing milk, but knowing that her tummy is still so small comforted me. She doesn't need so much yet, in fact according to my OB (thankfully, we had a breastfeeding seminar with her when I was pregnant) babies can survive up to 2 weeks without any food intake after birth and that her stomach is smaller than a grapefruit. 

Below is the estimated size of a baby's tummy.

Breast feeding is a skill that both mother and baby have to learn. I want my baby and I to be the best breastfeeding partner, so I always seek answers for whatever problem we have on our breastfeeding journey.

The key to a successful breastfeeding is a good latch. However, since day 1, we are already having problems with latching. I really don't know what the problem is. May be my nipple is too big for her mouth, or she just really don't know how, my position is wrong, or her position is wrong. At some point there's this feeling that you are producing too little. And sometimes, I think my milk let down is too much for her to handle. Worst, maybe she doesn't want me, my breast, my smell or my sound. So I am always happy when she latches right away when I offer my breast.

According to the books and other online sources, the proper position is a key to a proper latch. So here are some of the breastfeeding positions. (pic source)

I still don't know what is wrong with me and my baby. She can't latch. Latching had been always difficult at the start of every feeding session. Our routine? She'll cry then I'll calm her down then we will try to latch again. It will usually take us more than 10 tries before she can finally latch properly. Sometimes, after a successful latch, my nipple will just slip out of her mouth and then she'll cry again. It was a struggle and I don't know what's wrong.

I came across Lip Tie and Tongue Tie as possible reason for not properly latching. There's a lot of good resources online, here are some of the symptoms:

I immediately checked Pipay's mouth. Her tongue seems Ok. I followed the instructions here to check for tongue tied. I looked for pictures and examples online, and I thought her upper lip is tied. The picture below is  from a mother's blog about daughter's upper lip tie (upper left photo) and their decisions to have it corrected.

Below is my daughter's upper lip and gums. It really looked like a lip tie. So I told my husband, and we researched about it. We learned that it could be operated and that the process is quick and could be done as early as infancy. If not treated it could make breastfeeding difficult (not for some), or there could be speech and dental care problems in the future. 

It was heart breaking knowing that your very young child would undergo an operation. We have to make sure, so we have to consult her pedia first. I told my mother too. And when she checked, she said she think it is normal and that she will check my nephew's mouth too. She texted me, Jared's lip and gums look the same.

I asked our pedia (her first pedia) and she said, that is not lip tie. Whew! We are no longer worried and we decided that my baby was just 'Maarte' when breastfeeding. I also asked the new pedia, she did not check it but she told me that lip tie will not affect breastfeeding.

Difficulty latching is very frustrating. However, it could not mean that something is wrong with me or my boobs, there is nothing wrong with my baby too. I would like to attribute it to he process of learning. I am learning. My child is learning. And we are getting better everyday.

Baby Blues and Postpartum Depression

I am a new mother, and being new to a lot of things is really scaring me to the bone.

When I was pregnant, I read a lot of stuff. And I read Postpartum Depression (PPD). After reading stuff about it, I asked myself, "Am I at risk of having this? Will I be that depressed and hurt myself or my baby?", then I told myself, "Ahh hindi naman siguro. I think my personality is strong enough to have postpartum depression." Well, true enough, I did not experience PPD (Yey for me!). However, I did experience some baby blues and to be honest, at some point it scared me so much because I was so afraid what I feel would develop into PPD.

So what is Baby Blues and PPD?

Postpartum Depression or PPD is a clinical depression which can affect women (and men too!) after childbirth. While Baby Blues is a lighter depression that could develop into a more severe, long-lasting form of depression known as PPD.

Baby Blues or being moody, weepy and irritable after giving birth is so common (about 8 out of 10 mothers) that they are already considered normal. Below are some of the things that you may feel:

• Worried about your baby's health, even though he's fine
• Anxious
• Unable to concentrate
• Tired, yet unable to sleep
• Crying, without knowing why
• Mood swings
• Sadness
• Irritability

PPD may appear as Baby Blues at first, but it would be more intense and longer lasting that it will affect your ability to care for your baby and to handle other daily tasks. And if untreated, it may last for months or longer. Below are some of the symptoms:

• Loss of appetite
• Insomnia
• Intense irritability and anger
• Overwhelming fatigue
• Loss of interest in sex
• Lack of joy in life
• Feeling of shame, guilt or inadequacy
• Severe mood swings
• Difficulty bonding with your baby
• Withdrawal from family and friends
• Thoughts of harming yourself or your baby

Here are some of the possible causes of depression:

• Physical Changes: After giving birth, your body changes rapidly. There is a dramatic drop in your hormone level that may contribute to depression. Other hormones may also drop sharply which will make you feel tired, sluggish and depressed. Changes in blood volume, blood pressure, the immune system and metabolism can also contribute to fatigue and mood swings. Plus the changes in your breast as your milk comes in.
• Emotional Factor:  New responsibilities can feel overwhelming. Your transition to motherhood and adjusting to new routines. You may feel anxious about your baby's well being. You may feel less attractive or struggle with your sense of identity. You may feel that you've lost control over your life. Any of these could contribute to depression.
• Lifestyle Influences: Many lifestyle factors can lead to depression, including a demanding family member, difficulty breastfeeding, financial problems, lack of support from your partner and other loved ones.

Baby Blues goes away on its own so no treatment is necessary. Reassurance, support and rest is what you need. Sleep deprivation can make it worse, so sleep when your baby sleep. However, help is very much needed if it is already PPD.

My Experience

Mine has been just the baby blues. And I would like to blame being sleep deprived as the major factor or the trigger of all the drama.

Before giving birth I already had difficulty sleeping, and when I was at the hospital I barely sleep. I was tired from giving birth, and I feel weak. Since my baby and I stayed in the same room, I had to wake up to check her out, to feed her or because we have visitors. And it was worse when we came home. There's a lot to think about. There's a lot to worry about. There is a never ending worried feeling for my child. I even question myself if I can make it. Yes, the questions. I asked a lot. Am I going to be a good mother? Is she feeling good? Am I producing enough milk? Can I still do the things I do back when I was not yet a mother? and more questions, some are unreasonable, some unanswerable, some are just stupid questions. Aside from those questions, I also felt sad because I miss a lot of stuff. I miss being pregnant (duhuh!), I miss going to the dept almost everyday, I miss drinking softdrinks (patakas na lately and in moderation pa rin), I miss sleeping the whole night, I miss cuddling with my husband, I miss being able to go anywhere.

The result? Almost everyday of tears. I cry when I am alone with just me and baby. I cry when I see Phil. I cry when I remember stuff. I cry when we talk about certain things. I cry.

I was so afraid of the sadness. I was so afraid that by being sad and teary, I am not being a good mother. I was afraid I am having PPD. So I did the bravest thing I can do during those time, I told Phil. Everytime I have the urge to cry, I tell him. He knows almost all my crying episodes. His reaction? He laughed at me. The Phil laugh that would either make you mad or make you laugh too. Well, I'll end up laughing at myself too. But of course, he'll hug and kiss me too, he'll say something to make me feel better. Phil is the medicine for my baby blues. My drama episodes ended, and I am more confident as a mother now. :)

References:
Mayo Clinic
Baby Center

Pedia Contact

Here are the contact details of our Pedia.

Liza Vinluan-Santos, M.D.
Pediatrician
Fellow, Phil Pediatric Society

Cellphone No: 0918 904 6881 / 0922 419 2934

Philippine Children's Medical Center
Q. Ave, QC
Tel. Nos: 9246601 to 25 local 274
Room 7
Mon - Sat 11am-2pm

Hospital Affiliation:
Capitol Medical Center
Children's Medical Center

1st month Celeb and Pictorial

Last Tuesday was Purple Raine's 1st month. We went to the dept to celebrate it with friends and to meet Richard Eaton who looks like Jack Bauer of the TV series 24.

We want Pipay to have a new born pictorial, but the package at the Picture Company was expensive, while the packages in Pic-A-Boo are not so good since they don't provide a high resolution copy. So we took her pictures ourselves instead. We bought a pink hairband and browsed the internet for ideas.

However, our Pipay was awake during the pictorial. So she was makulit, malikot and iiyak iyak. Eniwez, here are some of the results of our amateur photo session with our angel.