Wednesday, December 31, 2008

2 moms, 4 breasts, 1 baby

On Gail's post about gearing up to lactate again, Lex made a really interesting comment (and thanks to Lex for the clever post title). A somewhat condensed version of her comment:

"I'm quite curious as to what your plan is...for how to balance who nurses the baby when. Being able to nurse our baby is incredibly important to me, but I also want to be careful to not get in the way of the baby's nursing relationship with my wife. And, having been the only one to nurse our three other children...I'm aware of a slight feeling that maybe I should just let this be something that only my wife can do this time. She has said that she wants me to nurse the baby sometimes, but we haven't talked about it a whole lot because it is a somewhat charged topic...

My thought was to do something along the lines of what you all are planning: to try to nurse the baby sometime after the first 3-4 weeks... But I'm worried that we'll get to that point and my wife will not want me to nurse, or it will just seem too complicated and easier to stick with what we've been doing. My wife is planning to go back to work when the baby is 6 months old, and ideally I'd like to be the one to nurse the baby when I'm home alone with the baby, and I know that it will be really important to establish a nursing relationship before 6 months if that's going to happen. It all feels more complicated than I want it to . . . the idea of two moms and four breasts nursing one (very lucky) baby just sounds so easy and perfect, but I'm finding that the reality is much more confusing..."
There are two sets of issues issues here. The first is straight up logistics. The second set of issues though is more sticky, the questions of who should decide if both moms will nurse and how to prioritize and navigate potentially contradictory desires, which are more or less questions of "territory." Those issues are a lot bigger, so in this post, I'll start with our thinking about logistics.

Roughly speaking, it looks like leaves are panning out such that we'll both be home for the summer (I'll get 8 weeks), and then in the fall we'll have a schedule where I'm home two days and Gail is home three (both of us needing to get some work done on those home days). We should be able to maintain something similar through to the next September (probably needing to stretch with a one or two day a week Nanny spring semester) when we'd feel comfortable starting daycare at our neighborhood center where Leigh goes. Leigh will continue at daycare, either on her current three day schedule, or possibly a 5 day schedule starting in September, with whoever is home trying to get her home fairly early so there's some slight hope evenings will go smoothly (Ha!).

The general gist as it is relevant to Lex's comment, is that after eight weeks, during weekdays, only one of us will be with the baby, so that mom will be nursing. Our hope is that by both nursing, we will divide pumping duties, perhaps each only having to pump once or twice on a day away (as opposed to the three or four Gail had to do for Leigh) in order to make sure there is sufficient breastmilk around and maintain each of our supplies at a reasonable level. Gail will plan to be start nursing at maybe four to six weeks in order to be set by the time I'm away more often, but we'll have to play that by ear. One of our main goals for both nursing is that we'll be able to handle nights better than we did with Leigh (overall we handled nights OK, but it's one of the spots we both wish we had a do-over). We'll hope to trade off nights (or partial nights) "on duty" once Gail is up and running, with whoever is "off-duty" pumping ASAP in the morning. Weekends will have to be ad hoc, but hopefully both of us nursing will make them easier, not harder, and allow both of us to have nice chunks of time to spend with Leigh.

All of this is our theoretical "best case scenario." For this scenario to work, we're making the following gigantic assumptions:
1) I have no trouble getting started nursing and establish solid supply quickly (Though if breast growth is any indication, I'm all set. These things are huge!)
2) Inducing works for Gail
3) We're both able to maintain sufficient supply by nursing only half a baby (and pumping, though hopefully not pumping a whole second half-a-baby worth).
4) We have a healthy baby that arrives full term and ready to nurse.

Despite my enthusiasm for this plan (and as you'll recall, I was the one pestering Gail to consider it), Gail reminded me the other day that we do need to tread with caution, because chances are that all will not go perfectly smoothly. We consider this an ideal worth laying the groundwork for, but we are still planning to prioritize my nursing relationship with this baby, as it is likely my only shot at this experience, and it is one I've wanted for a long time. Depending on how things go, this prioritization may end up reducing the amount that Gail contributes. If the med side effects prove intolerable for Gail, or if she develops the problems with plugged ducts that plagued her time nursing Leigh (and caused a nasty abscess. I promise, you don't want the details), than we'll drop it. Her health is more important than this pipe dream. I'll pump more and we'll find other ways to handle nighttime duties. If we have a baby with health challenges, or who arrives early, it's hard to know whether both being prepared to nurse is a plus or a minus, so we'll have to figure that out if we get there. Mostly though, we're heading in with some confidence in our abilities to negotiate complicated logistics and surprising emotions as a team. We also love a challenge, and feeling like we're blazing a new path.

More later on the sticky emotional issues around decisions like this.


amy said...

sounds like you guys have a fantastic plan! had i followed through with inducing lactation it would have been to "co-nurse" exactly as you guys describe. To make nights easier, to better balance available time with our 3 year old, etc. i produced an incredible amount of breast milk for the 15 months that i nursed her so i am hopeful that i can get it back easily if we decide that it makes sense to. melanie also travels a few times/month generally for her job so having me lactate would make feeding easier though we are hopeful that she builds up a decent supply by pumping. she won't travel before cooper is 12 weeks old so that will hopefully give her the time or give me the time to make it happen. lots to navigate but certainly good problems to have ; )

hope you guys have a nice new years eve...

Lex said...

Wow, a whole post tailored to my comment! Thanks! As I've said before, I truly LOVE getting to read all of your thoughts on all of these issues, since they're clearly such well thought-out thoughts, and are things that I/we think about a lot too.

I think the biggest piece of the challenge logistically speaking will be maintaining the milk supplies. I am a La Leche League leader/student lactation consultant, so I have come into close contact with all sorts of breastfeeding struggles (and it sounds like you all had your fair share with the plugged ducts, etc. last time around). Milk production is based on a supply and demand model, and I just don't know how possible it will be to maintain a healthy supply (not too much, not too little) with a lot of fluctuation on the demand side of things. Breasts do best with consistent demand.

I've only ever worked with one couple who tried to do this. One mom used the jack newmann protocol to induce lactation (she had never been pregnant before), and the other mom gave birth to their twins. The babies were full-term, but right away the gestational mom started having breastfeeding issues: nipple pain and some post-partum depression requiring that she sleep more at night. Luckily, the other mom was there to step in, and she had an amazing supply. But, of course, it wasn't quite a full supply for twins. The downside was that since the gestational mom hadn't had a chance to fully establish her supply before the other mom started co-nursing, neither mom had a full supply for the babies. The whole set-up came to a sad end when both moms ended up giving up on breastfeeding after 2 months. The experience left me with the lesson that the most important thing when attempting "both moms nursing" should probably be to maintain the gestational mom's full milk supply.

So, part of our plan (if you can call it that yet) is that anytime I nurse the baby, my wife will pump (unless she has just nursed and I am comfort nursing). I won't help out with the nighttime nursing until after the first year (when supply won't be as much of an issue), unless my wife is really struggling before then (I am the best nighttime nurser because I sleep so deeply, and we cosleep, so I literally sleep right through nursing). Or, I will help as more of a comfort nurser.

I do think that you guys have an ideal set-up with your work schedules. It sounds pretty perfect. I really hope it works out in the best case scenario kind of way.

Gail said...

We are concerned about supply, especially as I remember supply issues felt pretty crazy from maybe 2mo-6mo, but settled down a little after then. It's good to know that you've helped someone do this before Lex, although I wish the results were better! Still, it's a good example to learn from.

I think it's going to take a lot of in-the-moment problem solving, which luckily Lyn and I enjoy, and being sure we don't get too attached to it going some particular idea way.

giggleblue said...

thanks for taking so much time to lay out your plan, and thanks to lex for offering her expertise.

my partner has mentioned a few times want to induce lactation, but she hasn't really done much on the research end of it, and isn't super serious about it.

it's interesting to hear how this situation plays out in both the first pregnancy as compared to the second. so i have a question. was co-nursing considered during the first pregnancy?

i know lex mentions that they considered it, but her partner was not interested. did you guys consider doing this before or has this been something that has come about more so from your experiences with the first go around and nursing?