Zoloft and Breastfeeding

I am still not convinced that taking Zoloft is the way to go for me since I am fairly certain this will pass eventually. I would rather ride it out by trying the diet and exercise route before committing to something more serious. Frankly, I hesitated even posting about it, but decided to go ahead in light of the long history of women struggling alone.

There is no shame in numbers.

I'd like to personally thank Andi from Mama Knows Breast for sending me some awesome linkage about taking Zoloft while breastfeeding (Note: the search cannot be directly linked to because it expires. My search string was "breastfeeding and Zoloft"). She also mentioned that Dr. Thomas Hale, a pharmacology expert, had ranked it an L2 drug (L1 being safest, L5 being the most unsafe). I found this link on Kellymom regarding Dr. Hale's view on Zoloft. Also, Jen at The Lactivist also has some great information regarding breastfeeding and Zoloft. In short, taking Zoloft while breastfeeding appears to be safe for both mother and child - obviously, you would need to discuss this with your doctor if contemplating this path.

Regardless, I am comforted knowing that if things get worse and I don't feel I can go it alone that Zoloft will be an option.

Depression: It's depressing.

When I first learned that Owen Wilson had attempted suicide, my heart went out to him. I am not a particular fan of Wilson's, but suicide attempts always, always get to me. Years ago, I went through some dark days myself. Therefore, I am well acquainted with that pressing sense of despair and loss of hope for the future. I remember lonely nights spent planning and contemplating. The Note was written, but not sent. Fortunately, I was able to work through it. And I certainly hope Wilson does.

One thing I am extremely grateful for in my life right now is my children and my husband. I don't think the days are going to darken to the extent where I will be writing The Note - I won't let it get to that extent because I DO have hope. After all, I see The Future every single day in a certain pair of brown-hazelish gemstone eyes. And now, a second set of eyes have upped the ante in this poker game of Life.

But still. The sadness lingers. I saw the doctor today for my post-partum checkup and it was a bit of a disaster coordinating the kids what with their crying and all. I ended up crying myself and I did admit that I've been struggling emotionally lately. Fortunately, my doctor knows me well enough to know when I am serious. At one point, I confessed that I feel guilty for being so damned sad when I don't have any real problems. I have several friends right now who do have real problems. Why am I being such a wimp about this? She pointed out that "depression doesn't know problems".

I left the office with a prescription for Zoloft.

I am not happy about this, but I am also not happy about being Not Happy. Still. I am hesitant to just immediately start popping pills. I looked at the side effects for Zoloft and am leery of some of them. I am going to think about it over the weekend, but at this point, I am thinking I would rather concentrate on getting my lifestyle in order with more exercise and better eating.

At a minimum, I think some chocolate covered Choxie Pistachios are in order.

Are you sleeping?

Tanya at the Motherwear Breastfeeding Blog has an excellent post about a book by Dr. James McKenna's titled, Sleeping with Your Baby. It's a book chockful of useful facts about the benefits of co-sleeping. I've written many times about my ignorance of co-sleeping and my reluctance to embrace it before I had my son. However, once I learned the benefits of co-sleeping, I never looked back.

I can't express how incredibly important co-sleeping has been for me. In short, it's saved my sanity and these past few weeks as I've dealt with some major post-partum blues have only served to verify that for me. I'm through the tunnel now, but I can't even imagine how much worse it could have been had I been sleep deprived. The first week with Anjali was the usual tough one with a newborn - every feeding required a diaper change, she was still too small for me to nurse while lying down and I was still recovering the birth. However, since the 2nd week, I haven't really lost that much sleep unless we're suffering from colds or I eat Greek food or ice cream (which disturbs her tummy just as much as it did Arun's. Sigh.)

As rabid of a co-sleeping advocate I am, it's not that I think everyone should absolutely, positively sleep with their children. No. Quite the opposite - not everyone is cut out for it, even babies. For example, my younger sister could not, would not, sleep with my dad and step-mom. She simply slept best on her own despite their efforts to get her to sleep with them. However, I wish more folks would at least consider co-sleeping and at a minimum, become more knowledgeable. I am tired of the tragic stories being trafficked that portray co-sleeping as dangerous. I am tired of folks pressing their lips firmly together when I "confess" my co-sleeping sins.

I will definitely be reading this book. It's almost as if I see at my personal mission to help end the myths and ignorance that surround co-sleeping.

Mama Knows Breast: A Book Review

Correction: Oops! There IS an index. My bad!

On Thursday, I received a copy of Mama Knows Breast: A Beginner's Guide to Breastfeeding by Andi Silverman. By Friday evening, I had finished it after just two sittings.

In short, this is a quick, easy, interesting read that will make an excellent gift for a mother - new or experienced. The author has an engaging tone and a moderate, non-judgmental voice that should make any mother feel at ease, even if she ends up supplementing or not breastfeeding at all. I would feel totally comfortable giving this as a gift, without feeling pushy towards the mother.

The book is divided into 8 chapters that cover the topics of pros/cons, basic breastfeeding instructions, pumping/supply maintenance information, breastfeeding etiquette, spousal support, sex, public nursing, and finally, weaning. This little gem is small, compact and easily held in one hand. Despite its small size, it still can get you through the entire process of breastfeeding - from the first latch to the last.

There were a few things I found lacking. This book can't be used as an "end all, be all" reference - it covers the highlights, but it doesn't have an index (I am a total Index Whore - I love me a good index). To make up for the lack of an index, it does provide an ample list of extra online resources, though. I also was disappointed in the paragraph regarding co-sleeping - it was a few sentences, mostly which served to highlight the dangers, rather than the benefits. Considering that co-sleeping can go a long way in supporting a breastfeeding mother, I'd like to see more about this in a future edition.

However, overall, I just loved this book and declare it to be an Inhaler * . The illustrations are quirky and the text is light and humorous. I enjoyed that because breastfeeding can be very stressful, scary and downright painful to a new mother. Per my quick Amazon searches, there simply aren't any fun, positive books regarding breastfeeding. Who wants to read a textbook if they don't have to? I'd rather have a friend holding my hand - and this book does just that by walking you through it in a reassuring and comforting manner.

Again, I think this would be a great, unique gift for a mother planning to breastfeed, which is why I posted it here over at Rancid Raves as well as here.


*in-hal-er
noun
1. A book so compelling or suspenseful that it must be consumed immediately in only a few sittings.
2. A book so easy and enjoyable to read that it can quickly be consumed in only a few sittings.

Dear Diary: Nursing a newborn in public with a todder sorta sucks

Pun not intended.

I am totally comfortable breastfeeding in public. Do I relish it? For the most part, no. Oh sure, I have many pleasant memories of nursing my son in various parks and beaches. My favorite memories of public nursing are in San Francisco and Boston, for sure. However, nursing a newborn while keeping an eye on a 21 month toddler is vexing, to say the least. While Anjali is latched on for dear life, Arun is running around like a mad man. It becomes a very tenuous game of keeping him near me and keeping her latched on. It's not too bad for situations and places where I am familiar with the surroundings and can have a game plan. A particular childen's discovery center we go to, Wonderscope, has a toddler area that is contained. Arun can run free, but can't actually escape too far. I just plan to breastfeed while we are in that area. The malls are a bit trickier. We have one mall that has a nice nursing area in the Nordstrom's store. The problem is this - while I don't mind, I know gals who are not comfortable going into fancy-schmancy department stores and therefore, may be intimidated by using the Nordstrom's mother's room. The other mall nearby has a play area in the food court that is somewhat contained. However, it is crowded, noisy and often full of obnoxious kids not being supervised by their parents. Every single time I am there, I have to jump up at least a few times to save Arun from getting pummeled. And I do NOT feel comfortable nursing in my car in most places - even my local Target. I feel like a sitting duck for purse snatchers and carjackers. It doesn't help that 2 years ago, a guy died in our Target parking lot because a purse snatcher ran him over with a car.

Today was stressful - we went to the Children's Museum of Kansas City. Not only was there NO contained place to nurse Anjali, the museum is located in a mall as well. I was able to keep Arun contained in the stroller by chucking chunks of Larabar at him, but it was stressful once the Larabar was finished since I had forgotten to throw some Hot Wheels into the daypack.

Still, breastfeeding overall is easier to do while on the go. I can't imagine having to pack formula, bottles, etc. When we head out the door, I just pack water and a few Larabars in the daypack - then, we shoot out the door.

Two for the price of one

Caro has an excellent, entertaining post about the Unforeseen benefits of nursing a toddler through and beyond pregnancy.

Although my toddler weaned about 6 months before my newest kid was born, I was still able to relate to much of this post. She is correct in that the less amount of time there is between weaning and birth of the new child, that will translate into a smaller amount of time for your milk to come in. I nursed Arun into my 2nd trimester and my lactation consultant did tell me that my milk would come in earlier with Anjali - which it did. In Caro's case, there was NO time between weaning and birthing, so her milk came in a mere 18 hours after birth! Also, I think Caro is right in that there seems to be less nipple soreness with all the nursing so close together. That and the fact that an experienced mother has the latch and positioning down pat.

Anyway, it's very encouraging to see such a smooth transition for everyone involved!

The Milky Way.

Bryan over at Sympathy Pain has linked to a great article on how we gals go about making breastmilk. Definitely go over to Bryan's site and check it out! The only comment I have about the article is that it says the following:

During the first days of nursing, you may feel some cramps in your abdomen as your baby sucks. This usually mild discomfort signals the release of oxytocin, which helps shrink your uterus back to its pre-pregnancy size.

Mild discomfort? That's putting it mildly!! For me, the initial cramping like that was VERY painful. Not quite as bad as early labor, but far worse than menstrual cramps.

Next, I want to discuss semantics - what do you call all the different kinds of milk in your house? We have soymilk, cow's milk and mama's milk. I want my son to be clear and as such, I call them all by their "proper" names. In a related note, he calls food in general by the word "bop-poo" (we think it stems from his word for "apple" which is "bappull"). Even before Anjali was born, he would point to my breasts and say "bop-poo", so we think he may remember or have an inkling that he used to eat from them, too. However, he calls ALL nipples "bop-poo", so the poor kid has A LOT to learn.

Beer, Babes and Boobs

As I was writing a post about beer on another site, I realized that folks may question a breastfeeding mother who openly admits she consumes alcohol.

The La Leche League is very clear about its stance on alcohol consumption for a breastfeeding mother.

The effects of alcohol on the breastfeeding baby are directly related to the amount the mother ingests. When the breastfeeding mother drinks occasionally or limits her consumption to one drink or less per day, the amount of alcohol her baby receives has not been proven to be harmful.

Dr. Jack Newman, member of the LLLI Health Advisory Council, says this in his handout "More Breastfeeding Myths":

Reasonable alcohol intake should not be discouraged at all. As is the case with most drugs, very little alcohol comes out in the milk. The mother can take some alcohol and continue breastfeeding as she normally does. Prohibiting alcohol is another way we make life unnecessarily restrictive for nursing mothers.

Also, the ole "Pump n' Dump" maneuver is not needed. Your body produces milk in a quasi-JIT environment - pumping n' dumping does not get rid of the alcohol any faster:

As alcohol leaves the bloodstream, it leaves the breastmilk. Since alcohol is not "trapped" in breastmilk (it returns to the bloodstream as mother's blood alcohol level declines), pumping and dumping will not remove it. Pumping and dumping, drinking a lot of water, resting, or drinking coffee will not speed up the rate of the elimination of alcohol from your body.

Obviously, the message is not that a breastfeeding mother should go tie one on at her local pub. However, it seems clear to me that she should be able to enjoy an alcoholic beverage of her choice while relaxing and watching the latest episode of her favorite polygamists. Say, a pint of Boulevard Lunar, perhaps?

Does your milk smell like soap?

Over the weekend, a breastfeeding friend of mine expressed concern that her milk smelled "soapy" - as if she hadn't rinsed out the bottle enough. I told her that she perhaps had an issue with the enzyme lipase and would need to scald the milk before freezing it. Unfortunately, that was ALL I could tell her - I didn't know what caused it, for example. So, of course, Dr. Google came to my rescue and directed me towards Kelly Mom. Basically, all human milk has lipase, but some of us gals simply have more of it - I've always suspected I had this issue, but since my son rarely took a bottle, I never bothered to worry about it much.

Anyway, per Kelly Mom, the solution is simple:

To scald milk:

* Heat milk to about 180 F (82 C), or until you see little bubbles around the edge of the pan (not to a full, rolling boil).
* Quickly cool and store the milk.

Scalding the milk will destroy some of the antiinfective properties of the milk and may lower some nutrient levels, but this is not likely to be an issue unless all of the milk that baby is receiving has been heat-treated.

Five Breastfeeding Mistakes

My husband had told me about this article, but failed to send the link. Which, hello - not helpful. Then, my friend Alicia thoughtfully sent it - thank you! Because these fingers are too lazy to start walking all over CNN.com in search of the article. Know what I mean?

Anyway, the article highlights some common breastfeeding mistakes - here are the "short n' sweets". The article provides more details.....

Mistake 1: Moms go it alone
Solution: Get out of the house -- fast

Mistake 2: Moms forget about their successful breast-feeding friends
Solution: Invite one over

Mistake 3: Moms assume they don't have enough milk
Solution: Rethink your baby's nursing behavior

Mistake 4: Moms get intimidated breast-feeding in public
Solution: Have snappy comebacks at the ready

Mistake 5: Moms panic when milk doesn't gush out
Solution: Realize that at the very beginning, you're not going to see a lot of milk

After reading this, it highlighted even more so how fortunate I was in my experience. Not only did I have my sister, but I also had a good friend who was active in her Leche League group - both my sister and my friend were just a phone call away. Even if I had not had such awesome lactation consultants at my hospital, I was still a bit ahead of the game in the way of support.

In short, if you are a new mother the moral of the story is "Buddy Up to Your Buddies".

Breastfeeding Style

In one of my favorite Wise Baby Tomes, Baby 411, the author explains 5 different breastfeeding styles on page 100:
1. The Barracuda - This little guy attacks the breast and gets down to business. Mom's nipples sometimes pay the price for this style. Be prepared.

2. The Excited Ineffective - Yes, this is the baby who is so excited to eat that he loses his latch. Calming, then reattempting to latch helps until baby figures out the routine.

3. The Procrastinator - The baby who waits until the milk lets down to bother with eating. There is no rush. Be patient and keep trying.

4. The Gourmet - She must mouth the nipples, have a taste test, then begin. Again, there is no need to rush. Let her do her thing.

5. The Rester - He takes his own sweet time. He eats for a few minutes, rests, then continues. He will eventually finish the meal and eat well but you can encourage him by rubbing his back or head.

My son was a Barracuda. He always got right down to business and ate quite quickly. Anjali? Um, not so much. She is definitely a Rester. Couple this with the fact that she likes to comfort nurse and basically, she would be happy to just suck ALL DAY LONG. It's been an adjustment for me, to say the least. There's been several times when I've pulled her off and got ready to head out the door when she made it quite clear that she was NOT done eating. I am still learning that I need to give her PLENTY o' time to do her business.


Totally Tangential: Regarding Wise Baby Tomes, I also swear by Toddler 411. Toddler 411 continues where Baby 411 leaves off - hands down, these two books are the ones I would own if I could only have two. They have absolutely everything you need for your child up to about kindergarten in 2 concise volumes that are easy to read, entertaining (you'll laugh out loud) and most importantly, are conveniently organized as a reference tool. The overall tone of these two books is that of a "Hey, you'll be okay, Grasshopper." -- a tone that is comforting and reassuring.

My other favorite parenting tome is the excellent The Science of Parenting - I enjoy this book because I am fascinated by the biology of what's going on with babies and toddlers. There are often valid reasons for what they do simply because their little brains and nervous systems are still developing, yet we desperately want them to act like little, logical adults. This book goes a long way in explaining why parents need to manage their expectations regarding what their Precious Progeny is actually capable of doing at their particular developmental stages.

Good Grief

This article covers the recent controversy with Katie Price giving an interview where she totally puts down breastfeeding. The article includes photos of Katie feeding her baby with a specific brand of formula which apparently, violates a UK law where the promotion of formula for children under 6-months of age is prohibited. In the OK! article, Price is quoted as saying

It's brilliant -- I have 20 crates of teats and bottles. I don't have to sterilize or heat anything, you literally take the teat out of the pack, screw it on, throw it away. I don't care what people say - you don't have to breast-feed. They gave me a tablet that dries your milk up so my boobs haven't hurt or leaked or anything. I don't want a baby drinking from me -- the thought of it makes me feel really funny. I think only a certain person could handle my knockers!

Good grief, for someone who is supposed to be comfortable with her body image, this reeked of issues. Normally, I put these articles underneath "celebrating celebrities" but frankly, there is nothing to be celebrated in such a piece. It makes me angry to think of how many young girls who idolize Price will be reading this article and will come away with a negative image of breastfeeding.

Growing up

Last night, I went to the La Leche League fundraiser to celebrate World Breastfeeding Week. I didn't know a soul there, but at a minimum, I thought my son would have fun. We had a great time and I met some new people. I will definitely be looking into joining one of the chapters in my area.

Before I had children of my own, I had a distorted perception of the La Leche League. Some of this perception was based on media, some based on personal experiences. By the time I figured out that the League would actually be a good fit for me, I was already involved in the breastfeeding support group at my hospital. I didn't really have the time to get involved in something else an the support group was enough for me. However, this time around with my daughter, the support group at my hospital probably won't work for us unless I can get my son into a specific day for his mother's day out program. Simply, it's too difficult to drag an active toddler to the support group. The support group is comprised mostly of new mothers and frankly, most new mothers are leery of a grabby toddler around their newborns. I understand that and to be respectful, don't feel comfortable taking Arun there now. So, I will be looking into the La Leche League as an alternative. And after last night's activity, am looking forward to joining something new.

I wonder what other ill-conceived perceptions have held me back from new experiences?

Look at what the Stork brought in.

Stork magazine has a very cool article with photos featuring model Jessica Hebert breastfeeding her daughter. My favorite photo is the one of Jessica and her daughter with both of them completely naked. It was so artfully done and is simply beautiful.

Stork also has a great article titled Latching on to a Lactation Consultant which provides helpful information for finding a good consultant. As the articles states,

You may want to consider some of the following questions: Can you relate to this person, either in terms of personality or lifestyle or both? Do you feel you connect with this person and that she understands a bit about who you are as a person? If she runs a support group, attend that group once when you are still pregnant. Observe the types of questions that are asked and the answers the consultant gives. Does she really listen to the women in the group? Does she seem to give individualized advice or generalized bits of information to the new mothers? Much like a great personal trainer, a good consultant will help you define your breastfeeding style and meet your breastfeeding goals. She should be confident, creative, considerate and cheer you on. Don’t settle for less than that at this fragile time.

I can't agree more with the premise that you should find someone with whom you click. I've heard so many stories about new mothers not getting along with their LC and that can really hamper a new mother's efforts towards breastfeeding. I was fortunate in that I really got on quite well with both of the consultants at my hospital - I can't imagine how much more stressful it could have been had I not cared for them.

A few good things.

The Pool
Remember the baby pool? Well, we have a winner! Bethany of Ice Cream Mama came in with the correct guess of 8 lbs, 1 oz. It's a damned shame that ice cream doesn't ship well because we have two awesome local ice cream places here. Congrats, Bethany and I will be contacting you for your particulars so that I can mail your non-melty-like prize. It will be lame, but hey, bragging rights are priceless, no?

NYC Hospitals Remove Formula Samples from Gift Bags
In support of World Breastfeeding Week, NYC hospitals took the forward step of removing formula samples from the free goodie bags that are dispensed to new mothers. As the article goes on to say:

Instead, new mothers will get a tote bag stuffed with disposable nursing pads, a mini-cooler for breast-milk bottles, and pint-sized T-shirts for the babies that proudly declare "I eat at mom's."

Awesome!

News Roundup

News Roundup
Here's an interesting article about pregnancy advice regarding alcohol consumption - it gives a nice perspective of how some Europeans regard the issue.

An article on Why Women Don't Nurse Longer. A pretty standard article that lists all the usual reasons.

And great scott - here's yet another article about co-sleeping. Confession time: These articles piss me off (is that language allowed here???). Sleeping with my children feels so right and natural - it boggles my mind how the "experts" declare it to be unsafe. Yes, have some common sense - don't crowd your kid out with comforters and pillows, don't go to bed drunk and if you are heavily overweight, don't sleep with your children. But for the rest of us? Co-sleeping can go MILES in comforting parents AND babies. These days, I can't even remember when Anjali wakes up. I don't bother fumbling for my glasses to see the clock because that would be wasted effort. I roll over when she squawks, get her latched on and she begins nursing. At some point, I must pull her off because by the time the sun rises, she is no longer attached to my breast. And truly - I love waking up and seeing her little face furrowed in sleep. Precious. Simply precious. Also, for the record, my own doctor is 100% on board with co-sleeping and even admitted that she thinks parents should sleep with their children, but she would never push that opinion on her patients.

It makes me sad to think of how many parents are afraid to sleep with their own children because of articles such this.