milk ducts
i have been having some significant challenges on the milk duct front lately. i believe it started after we got back from our trip to vermont in august. my first MASSIVE clogged milk duct, like the size of a oval teething wafer, which, after doing some light research on breast anatomy, i believe is actually an inflamed lobule caused by the clogged milk duct. this side view of the breast i found can shed some light on the parts in question.
i have experienced small clogged ducts infrequently, like the size of a large blueberry two to three times, in my over four years of nursing, but never this large or with this frequency. here i am thinking i have got this breastfeeding thing down. i am an expert, basically. but no. i am not. there is always something new to learn. things are always evolving in breastfeeding, in motherhood, in life.
juniper became a much more distracted nurser at the six month mark. and when teething began, it got even harder during the day. she is now nursing two to five times in the night. and right now i am okay with that. this is a season. each time i notice one of these massive plugged ducts -- i have had three now, two on my left side and one on my right -- i think okay NOW this is never going to happen again because i am going to be SO. CAREFUL. and then it happens again. after that third massive one resolved, i noticed several smaller ones on the same boob pop up a few days later. CURSES. this has to be useful for some kind of spiritual illustration. always be vigilant?
i have been thinking a lot about my breastfeeding experience lately. the care of these milk jugs has taken up a considerable amount of my time in the past several months. i have been trying a number of things: heat compresses, massage, ibuprofen, lecithin, hand expression, nursing on the affected side more frequently. last week i noticed my right side was noticeably larger than my left. awesome. googled how to fix that. nurse more often on the smaller size. did that. and then got a massive blocked duct on my right side. AWESOME. i have also been getting milk blebs on the side with the blocked duct. milk blisters? all sorts of problems here. it has been real fun. REAL. FUN.
so many things swirling around in my head in the past several weeks. months. years? constantly second guessing myself in motherhood. is bina a picky eater because she's nursing? would she eat better if i stopped? no. she would not. i would just be sacrificing a key source of nutrition for her and hoping her palate would change so that she would make up for that in table foods. i keep consulting this fact sheet from kelly mom on breastfeeding past infancy. it has brought me comfort regarding bina AND juniper. juniper for the issue of not being too interested in table foods. bina for eating mostly oatnut bread, yogurt, milk, cheese, and unsweetened applesauce. also hamburgers and meatballs. girl likes her iron. as it turns out, there is a lot of nutritional benefit found in breastmilk for children beyond one year of age. this bit from the fact sheet in particular blesses my mama heart:
In the second year (12-23 months), 448 mL of breastmilk provides:
29% of energy requirements
43% of protein requirements
36% of calcium requirements
75% of vitamin A requirements
76% of folate requirements
94% of vitamin B12 requirements
60% of vitamin C requirements
for those of you wondering as i was, 448 mL of breastmilk is 15oz. and then this bit also brings me comfort (parts in bold noted by me):
It’s not uncommon for weaning to be recommended for toddlers who are eating few solids. However, this recommendation is not supported by research. Research does indicate that in situations where breastfed toddlers have an increased risk of malnutrition, this appears to be due to inadequate complementary feeding or reverse causality (the mother is more likely to continue breastfeeding a child who is ill or growing poorly). In one study of 250 toddlers in Kenya, solid food intake increased after weaning, but not enough to replace all the fat, vitamin A, and niacin that the child had been getting via breastfeeding (Onyango 2002). According to Sally Kneidel in “Nursing Beyond One Year” (New Beginnings, Vol. 6 No. 4, July-August 1990, pp. 99-103.): Some doctors may feel that nursing will interfere with a child’s appetite for other foods. Yet there has been no documentation that nursing children are more likely than weaned children to refuse supplementary foods. In fact, most researchers in Third World countries, where a malnourished toddler’s appetite may be of critical importance, recommend continued nursing for even the severely malnourished (Briend et al, 1988; Rhode, 1988; Shattock and Stephens, 1975; Whitehead, 1985). Most suggest helping the malnourished older nursing child not by weaning but by supplementing the mother’s diet to improve the nutritional quality of her milk (Ahn and MacLean. 1980; Jelliffe and Jelliffe, 1978) and by offering the child more varied and more palatable foods to improve his or her appetite (Rohde, 1988; Tangermann, 1988; Underwood, 1985).
so all that to say. i love kelly mom. and we are going to be just fine. my kids are growing. they are SO active. they are happy and loving little humans. i adore them. except for when they drive me completely up a wall like when we are attempting our fall family photoshoot and bina is having a meltdown the entire time because she does NOT want to smile. also, regarding weaning:
Scientific research by Katherine A. Dettwyler, PhD shows that 2.5 to 7.0 years of nursing is what our children have been designed to expect (Dettwyler 1995).
i find myself somewhat self-conscious about nursing my four year old in public. in the good ol' united states of america, this is considered weird. "oh, she's STILL nursing?" but outside the western culture, nursing beyond infancy is not only NOT weird, it is normal. listen, if you are a mama and you are unable to nurse for whatever reason or choose not to, you do you. this is not a diatribe against formula or meant to impose feelings of guilt on other mamas. this is me sharing my experience and frustrations with societal norms and the opinions of others based on nothing but their own ignorant perceptions (the most frustrating i have come across happen to be mothers who HAVE breastfed, ironically). we are afraid of the unfamiliar. i mean, i do not like the unfamiliar. it is uncomfortable. i did not set out to tandem nurse. i did not plan to nurse bina for over for years. this is just where my breastfeeding journey has led. for lots of different reasons. and you know what? i am right in the range of what our children have been designed to expect. is it hard as hell sometimes? yes. do i want to quit sometimes? yes. and do i keep doing it anyways? also yes. i am simply doing what i think is best for me and my children. the journey is a roller coaster. it is painful. it is sweet. it is raw. it is beautiful. it is what it is.
and let me tell you. these plugged ducts have been making me re-think my breastfeeding relationship with my children. why is this happening NOW? what am i doing WRONG? why does it KEEP happening over and over? what the WHAT? my latest plugged duct just resolved this morning. do i hope it is my last? yes. do i expect to have another one? also yes. sigh. i do not know how long this back and forth clogged milk duct problem is going to plague me. i have been fortunate in my breastfeeding journey up until this point to have avoided reoccurring clogged ducts. i know other mamas that encountered these from the beginning, sometimes leading to the dreaded mastitis. i believe i have an oversupply of milk this round probably partly due to the tandem nursing arrangement. this oversupply combined with juniper's sub par day nursing could be the reason for my problems. keeping the duct work clear and flowing is necessary. which makes having a four year old nursling quite handy. maybe i just allow her to nurse more frequently than the twice a day she has been doing. she is more than happy to oblige. and apparently my milk is still a source of great nutrition for her, ESPECIALLY if her table food intake is not as great as it used to be. WHO KNOWS. trial and error, trial and error. and all the grace.
this has probably been the hardest two month period in my nursing journey since the first eight weeks with bina. the first eight weeks were by far the worst. every feeding was painful. for eight weeks. i managed to survive those first eight weeks. i have survived the last two months. i do not know where this breastfeeding journey will end up. this could be the beginning of the end. or it could be a blip on the radar. i find myself incredibly disappointed when i think a feeding went really well and then i find the clogged milk duct remains, or that a new one has formed.
again, i am not exactly sure why this is happening. but it is happening. i am taking things one day at a time and constantly recalibrating. now that i have worked through three massive plugged milk ducts, at least i know that when i find one it does not mean that i am going to develop mastitis or an abscess (which is the worst case scenario i jumped to when i found the first massive plugged duct). i know that they typically resolve within 24-72 hours. when my breasts go back to being their soft squishy selves after holding a boulder inside for that duration of time, i am so so so happy. if nothing else, this recurring problem has shown me that i do in fact need to be vigilant about the care of my breasts. just because i have been doing this for over four years does not mean i am an expert and face no challenges to my milk production. i have to take care of my milk jugs. ensure a proper latch. not tolerate a funky one that results in discomfort. try my best to ensure that the milk jugs are fully emptied on a regular basis. this is hardest to do while traveling or out of our normal routine. that is when i need to be extra vigilant.
seasons of difficulty make us slow down. pain demands our attention. especially when it is chronic and affecting something that is used frequently. for me, my breasts for breastfeeding two children. i have taken for granted that i will not have issues with my boobs. and i can take that for granted no longer. here's to more mindful care of my milk jugs. more intentional evaluation of their health. anticipating problems and addressing them before they become massive. because it sure is easier to address a small problem before it becomes a big one. and isn't that a lesson we all need in life. maybe that is my spiritual illustration. nip it in the bud, brittain. have eyes to see the problem and be quick to address it. if you get distracted and neglect the care of what ails you, you are only hurting your self and prolonging you healing, physically and spiritually. how's that for a lesson from the milk ducts?
