Wednesday, July 29, 2009

Inducing Lactation: Pros and Cons

The lactation project has been going well. I spend every other night in the bedroom with Ira, while Lyn gets a good night's sleep in the living room. Most of the nights I am able to feed Ira all night without even using the supplemental nurser or a bottle. On the nights I'm going to be feeding him I don't pump or nurse him at all after 3pm so that I am full enough by night time to go the whole night. I worry a little that this will have a negative impact on my supply, but so far the situation is sustainable. We're also actively looking for more opportunities for me to nurse Ira during the day.

Things are going so well, in fact, that we've started calling the project a success. It's great that we're feeling so good about it, but we've paradoxically also been wondering if it is worth it at all. Let me sketch out the reasons to induce lactation and the reasons not to and you can decide for yourself.

Why Induce?

The three biggest benefits of induction are more time with the baby, more decision making responsibility over the baby, and more milk in the freezer.
  • More time with the baby. As soon as I started nursing I began to spend more time with Ira and less time with the pump. However, note that I could have found ways to spend more time with the baby even if I wasn't lactating. Lyn and I might have agreed to do a certain number of bottles each day, I could have worn Ira more, or I could have prioritized spending every possible moment with our son. The real benefit of induction is that this additional time was simply built in. My nursing also frees up time for Lyn to spend with our toddler which has helped strengthen their relationship after the stresses of pregnancy and new-babyhood.
  • More decision-making responsibility for the baby. In my mind, this is really the biggest benefit. I realized around the time I started nursing that I was deferring to Lyn around every aspect of feeding. I counted on Lyn to keep track his feeding needs, and everything else in a young baby's life revolves around the food. When I got involved, it was often because Lyn asked me to do something rather than because I decided something needed to be done. Even as I started to nurse, I treated her as the gatekeeper of Ira's needs. Now that I am nursing Ira -- particularly now that I feed him all night long half of the time -- I feel that I know what is going on with him, and Lyn often also looks to me for guidance. This started happening the morning after my first night feeding him, but it has since spread to a more equal sharing of daytime responsibilities as well. This was a benefit of the induction, but it could be replicated by couples who were committed to sharing nighttime care. However, needing to give bottles creates its own problems, and it would not necessarily be easy.
  • More milk in the freezer. More milk in the freezer means never having to worry about giving the baby a bottle. We always have an oversupply of frozen milk since between Lyn and I we put about 10-15oz a day into the freezer (and at this point have never had to defrost milk to give a bottle). This makes going back to work easier. It would be an incredible help if we had any supply problems. We are also getting to donate some of our excess milk, which just makes us feel good.

Why Not Induce?

The main reasons you should not induce lactation are the excessive work involved, the potential for conflict in your family, the potential for feeling like a failure, and reduction in time available to bond as a family.
  • Excessive work involved. How much work is it to induce lactation? Depending on the protocol, you'll be taking birth control pills for perhaps five months before the baby's birth. Then you'll be taking 6-8 pills four times a day and pumping at least five times a day for several weeks before the birth. That might seem like hard work, but it's nothing compared to doing all of that and taking care of a new baby, a recovering bio-mom, and an older child. The nights that I feed Ira represent half a year of work and probably around 60+ hours of accumulated pumping. There are far more efficient uses of all of that parenting energy, like trying to keep a toddler fed and clothed.
  • Potential for family conflict. Navigating a second nursing relationship in your family is like trying to cross a landmine field. You never know when you are going to accidentally cause a major crisis. The bio-mom might get jealous -- after all, she is giving up something to allow the non-bio-mom to nurse. The non-bio-mom might get frustrated that she's not getting enough time to nurse. For a while at least, every nursing session by the nonbiomom will be a negotiation, and your family might not be prepared to handle that much negotiation. You've also got two nursing relationships to juggle, not just one, and remember that any nursing relationship means frustration for the baby and the mom as it gets started. And then there's the sticky issue of what happens if your baby likes to nurse with one of you more than the other. If the bio-mom had mixed feelings about her partner lactating, she may unintentionally sabotage the project. And I'm sure there's more potential conflict that I haven't thought of but might accidentally step into.
  • Potential to feel like a failure. If you try to induce lactation, you might fail. You might never get more than an ounce from a pumping, or you might never be able to handle a feeding without a supplemental nurser. You should think before you induce about what your goals are and what you'll do if you can't meet them. I would suggest pumping for several weeks before the baby's arrival so that you can get a good idea of whether or not you are going to be successful before a new baby throws your house into chaos. If you aren't pumping a decent amount of milk (perhaps 1.5-2oz a session) by the time the baby arrives, put down the pump and decide that comfort nursing is a great alternative (it is!). But even if you are successful, you will probably always be the lesser of two nursers. You'll have less milk and you'll nurse less often. I tend to feel pretty good about what I pump, but the other day I went head to head with Lyn (not on purpose, we just both ended up pumping at the same time). She got three times the milk that I did in half the time and she had just fed the baby. It can be hard not to feel inferior. Sometimes I have to feed him and then hand him over to her for more, I have to feed him and then do a bottle, or I have to feed him using a supplemental nurser. The potential to feel inferior is a real risk. I'm not usually bothered, but this is in large part due to the fact that I have already nursed one baby and I feel confident in my abilities as a mother. I think this could be much harder for a first-time mother to deal with.
  • Reduction in time to bond. This is really just a corrollary of the first point. Inducing lactation is hard work and it will take you away from your family. Time with the pump is not time with the baby. I spent hours during Ira's first few weeks pumping when I could have been holding him. And I still pump. Earlier today I was pumping while he was sitting in a chair looking at me. It makes a person feel a bit stupid. Then he started fussing so Lyn scooped him up and tied him on in the Ellaroo since I was busy pumping. That could have been me holding him or tying him on.
I know a lot of people have been reading our blog and wondering if they should induce lactation themselves. I'm glad that we did it, but if we had another baby, I doubt that either of us would do it again. It's been interesting and has had benefits, but inducing has risks and costs as well. If you are sure that you want to induce, think through those risks and costs before you start. Or decide that the costs are too great and spend some time thinking of all of the other ways that you can bond with your new baby and become a parent.

Sunday, July 26, 2009

Parenting Roundup

Here are some of the interesting things we've read about parenting recently.

Wednesday, July 22, 2009

The Payoff

We've written a lot about Gail's adventures in re-lactating for Ira, and at our last check-in, it still wasn't clear we were going to get a big payoff from all of that work (piles of herbs and pills, way too much quality time with that pump). At this point, it's still not clear we'll get a huge benefit, but we are starting to see some real perks for both of us.

The most obvious payoff is that (starting a week ago) we are now able to trade complete nights of caring for Ira, who nurses 2-4 times per night. As you'll recall, better sharing of nighttime care was one of Gail's primary motivations, and was something we struggled with when Leigh was a baby. While it would have been possible to trade whole nights by pumping ahead and/or supplementing a bit with formula (and we'd recommend doing so to families that contain more than one parent once supply is established), it does make things nicer that Gail can simply nurse Ira instead of fussing with bottles. Of the three nights that she has done so far, on two of them she had enough milk on her own to keep him happy. On one night, she did need to use a few extra ounces to supplement, and it was kind of a pain, but they did fine. On that night, I heard Ira getting fussy from my perch on the living room futon, reminded myself that Gail had plenty of milk in there (she had set up the supplemental nurser with some extra milk in a cooler at the beginning of the night for just such an eventuality), and relished my chance to just go back to sleep. On the two other nights, I didn't hear a peep.

Logistically, on my "off" nights, (i.e. the nights I sleep!), it seems to work well for me to pump before I go to bed and once in the early morning. That generates enough milk to cover his feedings (I'm still trying not to lose supply even though Ira didn't actually need my milk for those feedings), keep me comfortable, and not interrupt my sleep too much. I set up the pump right by the futon and pump with the lights out in order to stay sleepy. It is way faster and easier than doing a whole feeding for a baby this age, and I don't have to do that whole wondering "does that grunt mean he's hungry?" routine that totally kills my sleep even if Ira is sleeping fine. The pump doesn't really grunt at all.

One of the most wonderful things about this set up is that we can both look forward to both kinds of nights. It is very sweet and cuddly to do night feedings for a young baby. Ira is generally pretty calm and feeds well at night (his daytime feedings are often a bit fussier). He is super cute and snuggly, and I love staring at him in the half light of early morning. I get to love it even more since I know that even though I'm tired after being up every couple hours, I'll get a solid 8-9 hours the next night. After three full nights of sleep (alternating with baby nights of half-sleep), I feel like I'm already starting to pay off some of that sleep debt. I'm nicer. I'm a better parent to Leigh. I might even start to regrow some brain cells. I also love it that Gail is getting those same sleepy snuggles, as well as the rest that she needs.

I craved more of those nighttime snuggles with Leigh, and they were hard for Gail to share for a variety of reasons. Now that I'm on this side, I feel similar pressures. When Gail suggested that it might be time to trade whole nights with Ira instead of having her do one feeding, I balked. My stated reason was that it seemed too hard and like the pumping would be too demanding. But there was also a piece of me that didn't want to give up control. It was only a momentary hesitation before I agreed, but it was definitely there. But now that we're making trading nights work, it feels fabulous. Yes, we could have done it with bottles, but I'm not sure we would have. I think it would have been harder for me to get over my initial hesitation, and Gail wouldn't have had quite as much power to lobby to take on more than just one night feeding.

So, Gail, thanks for all your hard work, thanks for the sleep, and thanks for taking such great care of our son.

Thursday, July 16, 2009

Parenting Roundup

One of the reasons that we started this blog is that, when I was pregnant with Leigh, Lyn could find very few resources to help her learn how to be a mom. We thought that our posts could provide a voice that might help other parents looking to swim in uncharted waters. There are lots of other folks swimming in those waters, both queer and straight, and here are several posts we've found lately that hit home:

Monday, July 13, 2009

Dad talk

Last week we finally got the question.

"Ima, do you have a dad?" Leigh asked.

"Yes, your Grandpa F_______ is my dad," I answered.

"Mama, do you have a dad?"

"Yes, your Grandpa C_______ is my dad," she answers as I began thinking fast in preparation for the next question.

"Do I have a dad?"

Ouch. I knew it had to happen some day, but was very afraid of saying the wrong thing. "No, sweetie. You have two moms, but you don't have a dad."

That was it for that day. She thought for a little while about it and then wanted to talk about other things.

Today, we had part two. Leigh was talking on the "phone" (her hand, I think) as we were all walking to a restaurant to have breakfast. "Hello, Dad?" she said into the phone. I gave Lyn a meaningful nudge.

"Who are you talking to on the phone?"


"Oh, whose dad?"

"Mama's dad." This then led to a round of phone calls that started "Hello, Ima's Dad" and "Hello, Mama's dad."

Then she gets down to it: "But which one is my dad?"

At this point we stepped over to a conveniently placed bench to talk.

Then I said something like the following (only less eloquently), and hoped it was the right amount for a three-year-old: "Honey, you have two moms and you don't have a dad, but you do have grandfathers. Lots of people have a dad, but some don't. It's kind of like how you have a brother, but Mama doesn't have a brother and Ima doesn't have a brother. Some people have brothers and some don't. It's the same with dads. Some people have a dad and some don't."

She seemed to understand and wasn't upset about not having a dad (at least, not that she showed us), but we're waiting for the next conversation to see where she goes with it.

Saturday, July 11, 2009

Non-Bio Mom Manifesto

In our meltdown last week, generously fueled by hormones and sleep deprivation, Gail said something that really hit home. As she wrote, she said that she is finding it hard that as an NGP, she has to choose to parent Ira. Her care for him isn't forced by the only truly essential need he has right now: his need to eat. Yes, she is nursing him, but she doesn't have to, since he could be getting plenty from me.

There are things about Gail's personality that make this particularly hard for her. She loves getting things done, checking things off lists, and moving forward in ways she can measure. Spending time with a little baby does not produce such tangible accomplishments. There's also an overwhelming amount of non-baby work that just needs to get done, and until the last couple weeks, I wasn't physically able to contribute much.

Now that she has noticed this struggle, she is consciously making sure to reach out to Ira. It's amazing what a difference a little insight, time and effort can make. Just a couple days ago she was moderately annoyed with me for not gazing at him quite lovingly enough, convinced I was not truly appreciating his beauty, while she was in what looked to me an awful lot like a new-parent-oxytocin-fueled love-fest.

Folks who know me know that I can get rather up in arms when advocating for non-bio-moms. I'm particularly bothered by an underlying assumption, even within the lesbian community, that a non-bio-mom is secondary, a nice perk, sure, but not an essential member of her family. This message comes through strongly in the small amount of writing on two-mom families, as I've complained about before. It comes through in one-on-one conversations with parents in two-mom families, especially in the deeper fears and hopes we sometimes have the courage to tell each other. If, as a lesbian community, we can't figure out that a family can contain two moms (as opposed to a mom and a back-up mom), then we should not be surprised when the straight world has trouble understanding us.

One of the ways I see this assumption reflected in our conversations is the insistence, usually expressed as reassurance to a non-bio-mom who voices any anxiety or struggle with her place in her family, that she is "different than the bio-mom, but that doesn't mean she is less important." This "Different but Equal" refrain really drives me crazy, especially when I look around at our families. Most non-bio-moms do take on a different role than the bio-mom, but you'd be hard pressed to call it equal in many cases. More non-bio-moms are primarily breadwinners, which, while certainly valuable to support the family, does usually result in less direct contact with their children. More non-bio-moms lose custody in case of separation or divorce. I am not saying this about all two-mom families; there are certainly families where non-bio-moms do plenty of parenting, even so-called primary parenting. But I'd venture that on average, non-bio-moms have less contact with their children than bio-moms. If time represents relationship (and I'd argue that it does to a first approximation), non-bio-moms are not on equal footing, even if you ignore the legal strikes against them (or rather, against us).

Even though I really hate the "Different but Equal" refrain, I'd be hard-pressed to say that my relationship with Leigh wasn't different than Gail's, at least during early infancy. So even though I get annoyed by such statements, I also sort of agree. But if I truly believe I do have a different and equal relationship to Leigh, even though she didn't grow inside me, even though I didn't nurse and nourish her as a baby, and even though she does not look a bit like me, there must be something else that I offered her. What is it? What is the "something extra" that I gave to her, that she wouldn't have gotten in a family with only Gail as her parent?

This has been eating at me for years. Sure, I can see my influence in her mannerisms, the clarity with which she expresses herself, her bull-in-a-china-shop quality, her overt enthusiasm, and her love of connecting with all kinds of people. But none of that seems quite like the answer. The other night, though, I realized Gail had finally figured it out. What I offered to her, that only I could offer her, was my choice. I chose to parent her, and chose to love her deeply, despite a multitude of pressures that said either that I shouldn't love her, or that I was unnecessary. Some of those pressures said explicitly that I'd damage her by my mere presence (those coming from, say, the religious right). Some of those pressures were more subtle, like the ones that said it wasn't important for me to take leave to spend time with my new infant, or the ones that said if I pushed too hard to feed her or spend too much time with her, I'd take away from her all-important "primary" bond to Gail, resulting in some sort of vague but longstanding psychological damage. It is precisely the central challenge of being a non-bio-mom, the need to choose to parent your child, that makes the bond special. To spin something precious out of what looks and feels like nothing at the outset -- no pregnancy, no genetic link, no nursing link, no overt need on the part of your child -- is truly a gift to your whole family, and it is a gift that only you can give them.

Friday, July 10, 2009

Choosing to parent

Last week, Lyn and I had a crisis of sorts. Really, it was just a late-night breakdown in which we grappled with the difficulties facing us as we deal with having a new baby. My big revelation came when we were talking about the long list of things I have on my plate and Lyn told me that she wanted me to put baby Ira at the top of the list. I realized that instead of being at the top, he was probably fourth, after taking care of Leigh, taking care of Lyn, and taking care of the house. Not good.

So I decided to put Ira first instead of fourth. But I also realized why and how he had dropped so far down on the list. Back when Leigh was a newborn and I was the gestational parent, I didn't have a choice. When Leigh was little, I got enough time during nursing (which Leigh wanted to do 24 hours a day) to solidify my bond with her. I never had to choose to spend time with her. In fact, it was best for our family if I left much of the non-nursing time available for Lyn to wear her and snuggle with her so that she could develop a bond.

As an non-gestational parent, I'm required to do exactly the opposite. I must choose to spend time with Ira in order to bond with him. This isn't actually something I'm good with. Time with a baby is too unproductive for my tastes. I'd rather be making some sort of progress around the house or feel useful to the family in some other way. Time with a baby is just time sitting around being useless. I felt this same way when Leigh was a little baby, but I didn't have a choice then. I had to be with her, and thus I came to love being with her. I am having trouble choosing to spend time with Ira.

This week has been much better. I've decided to put him first and it's making a difference. When he fusses, I go to him instead of assuming that Lyn will take care of him.  Once he's happy, I take time just to hold him, or sometimes feed him.  I'm hanging out with him more and falling in love with him more. As a result, I'm less available for our daughter Leigh, but Lyn is more available, which is helping their relationship, which did take a bit of a hit during late pregnancy and the first weeks of Ira's life.  A lot of the pressures that we anticipated dividing our family are very real. Being an NGP is harder than I expected, even with all of my advanced preparation. But this week I feel like I'm starting to hit my stride.

Wednesday, July 1, 2009

Nighttime Parenting

I have now been doing one feeding a day for Ira for a little over a week. Some of the feedings have been a little challenging, but overall the project is going well. I have a much better understanding on my son's feeding patterns. I am sometimes deciding when he is hungry and when he is done, and that makes me a more competent and confident parent.

I also get to spend a little more time with Ira. Since I'm doing one feeding a day there is a time built in every day just for me and Ira. I spend other time with him during the day, but it is good to have this guaranteed time. It's also good to have some time that I can just focus on Ira and not have my attention pulled by other things at the same time. And as Lyn mentioned in her post, she is able to get a little more sleep (which was one of my primary motivations for this project).

During one early morning feeding a few days ago, I realized that I could have let Lyn participate in the nighttime feedings more during our last go-round. Feeding a baby a bottle is a more of a hassle than nursing, but it's not that much more of a hassle, and it's considerably less hassle than strapping on a supplemental nurser (which I'm no longer having to do at night). It's also considerably less hassle than pumping five times a day and taking medications and herbs four times a day (note to self: you forgot to take not one, but two, doses today!).

What I'm saying is that last time I could have asked more of Lyn in terms of nighttime care; she did do some, but I could have moved over and shared more of the struggles with her. We shared in Leigh's care at night much less than either of us would have liked, and I thought the reason was that it would just have been more trouble than it was worth for Lyn to do lots of bottles at night. Instead it turns out that the reason for our nighttime inequity was not biology as I had assumed. It was my inability (or unwillingness) to think flexibly and creatively and to share some of the really tough work with Lyn.

Now you might be asking yourself why on earth I would be unwilling to share the really tough work. After all, Lyn was Leigh's primary caregiver for a number of months while I worked full time. I was obviously willing to share the mothering spotlight. Maybe in part that's why I was so hesitant to share the hard and lonely work of nighttime parenting. Perhaps doing that work was a way to prove to myself that I really was the mother and not just one of a pair. I think it was my way of hanging on to primacy. I thought that I was willing to share mothering, and in most ways I did. But maybe I was hanging onto my superior position as bio-mom without even realizing it.