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	<title>Pursuing Titus 2 &#187; Breastfeeding</title>
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		<title>Scheduling your Day Without &#8220;Scheduling&#8221; Your Baby</title>
		<link>http://pursuingtitus2.com/2010/03/10/scheduling-your-day-without-scheduling-your-baby/</link>
		<comments>http://pursuingtitus2.com/2010/03/10/scheduling-your-day-without-scheduling-your-baby/#comments</comments>
		<pubDate>Wed, 10 Mar 2010 15:38:44 +0000</pubDate>
		<dc:creator>Mrs. Parunak</dc:creator>
				<category><![CDATA[Breastfeeding]]></category>

		<guid isPermaLink="false">http://parunak.com/pursuingtitus2/?p=70</guid>
		<description><![CDATA[<p>As I travel around the blogosphere, learning from all the wise and wonderful ladies out there, I keep encountering an idea that I feel needs a little more thinking through. Buried in amongst often excellent advice about mothering and homemaking, homeschooling and organizing is a myth, a logical sounding, but functionally unprovable and sometimes even [...]]]></description>
			<content:encoded><![CDATA[<p>As I travel around the blogosphere, learning from all the wise and wonderful ladies out there, I keep encountering an idea that I feel needs a little more thinking through. Buried in amongst often excellent advice about mothering and homemaking, homeschooling and organizing is a myth, a logical sounding, but functionally unprovable and sometimes even dangerous statement that is held out to mothers as the golden key to all sorts of things, including our own sanity.</p>
<p>Before I go into what it is, though, I want to return to my ground rules for controversy. This is something that makes people very emotional. Some of the worst, most uncharitable judgment, condemnation, and pride in Christian parenting circles orbits this issue. So here&#8217;s my rule: We debate ideas, but we love people. And unless there are some sociopaths reading this blog, it can safely be assumed that we all love our children and genuinely want what is best for them. </p>
<p>OK, so that myth I was talking about. It goes something like this:</p>
<p>The Myth: The secret to relaxed, happy mothering is putting your babies on a predetermined feeding and sleeping schedule from infancy. Demand feeding leads to stressed out, exhausted, unhappy mommies who are at their babies&#8217; beck and call. (The other half of this is that demand feeding produces demanding, fussy children who don&#8217;t know who&#8217;s boss. I shared thoughts on that part <a href="http://pursuingtitus2.com/2008/12/26/im-not-raising-my-babies-gods-way/">here</a>.)</p>
<p>The problem with this, and the reason I say it&#8217;s a myth, is that while following a schedule from a book has worked out very well for a lot of people, it has also hurt a lot of people. And though a schedule is simply a tool, a means to an end and not the end itself, following one is often treated as The Test of Good Mothering. I want to unpack this whole &#8220;schedule as panacea for Mommy stress&#8221; idea just a little.</p>
<p>First of all, let&#8217;s be sure what the real problem is. Nursing a baby on demand is not inherently stressful. The main reason for the &#8220;don&#8217;t demand feed&#8211;you&#8217;ll be stressed&#8221; advice is all the other stuff that&#8217;s going on in a mother&#8217;s life and the perceived effect of demand feeding on her ability to cope. The root cause of most of the rough times mothers with new babies face can be summed up with one word: <em>adjustment</em>. If this is your first baby (and sometimes even if it isn&#8217;t), you have to adjust to being completely responsible for another human being. Your freedom is cramped. Your decisions become weighty, even little decisions like when to shower, or exercise, or go out to eat. Our marriages are often in flux as both husband and wife adjust to changing roles and the strain that postpartum recovery puts on intimacy. Many of us are adjusting to breastfeeding, which for a lot of new moms, is really, really hard, and they&#8217;re shocked by feelings of inadequacy and failure. We&#8217;re adjusting to interrupted sleep. Our houses are messier, or at least just more cluttered with baby stuff. And we might be looking a little messier, too, as we figure out how to adjust our beauty regimens to our new levels of energy and time. We may be adjusting to the new needs and patterns of a toddler who&#8217;s dealing with not being the baby anymore. Some women who quit their jobs to be home with the baby are adjusting <a href="http://pursuingtitus2.com/2009/07/17/going-crazy-and-wanting-to-go-back-to-work/">to being home full time</a>. Then of course, there&#8217;s that often under-acknowledged mammoth of all adjustments, the adjustment to being off your high levels of pregnancy hormones. (Heh. When you can&#8217;t get through one of your kids&#8217; library books without crying, you know it&#8217;s serious.)</p>
<p>People figure that demand feeding will make all this worse. They imagine a chaotic environment in which the mother is trying to cope with all these adjustments, but she never knows what&#8217;s going to happen next with her baby. She&#8217;d just be starting dinner, or sorting through the overwhelming clutter, or heading outside to admire her husband&#8217;s new chicken coop, when <em>Waaaaaaaah!</em>. Baby Dear wants to nurse. Mommy has to sit down with her Boppy pillow for forty five minutes while the rest of her complicated, off-kilter life goes on hold.</p>
<p>A schedule seems like it would solve a lot of that. It takes so much of the adjustment out of adjustment. You can see on paper what your day will look like and strategize about how you&#8217;ll fit everything in. <em>Ah. I&#8217;ll take a shower at 7:00 before the baby&#8217;s scheduled to wake up. I&#8217;ll read to Darling Displaced Toddler at 10:30 during the baby&#8217;s scheduled nap, have dinner on the table at 6:00 before the baby&#8217;s scheduled feeding time, and snuggle with Ever Valiant Yet Slightly Lonely Hubby at 8:00 after the baby&#8217;s scheduled to be done nursing and asleep.</em> Neat and tidy. You could even plan out your postpartum life before the birth!</p>
<p>But is an external schedule that you impose on your baby really the best way to buy yourself a little predictability? </p>
<p>The way that most scheduling books tell you how to know when your baby needs to nurse is based on time ranges for a given age (or some books will combine age and weight). So, for example, you might read that newborns should be nursed every two-and-a-half to three hours, and that babies need to follow a prescribed pattern for sleeping, eating, and being awake. Then, the assumption is that any time the baby cries, you will know exactly what he needs because he needs the next thing he&#8217;s scheduled to need. So, if your baby already ate an hour ago, and now he&#8217;s crying, the scheduling book would have you assume that he&#8217;s tired and needs to go down for a nap. Some books will mention the feeding cues that infants show when they&#8217;re hungry, but the emphasis is on getting the baby to make it for the full time range.</p>
<p>Do you know what&#8217;s wrong with this picture?</p>
<p>It is based entirely on the baby&#8217;s stats (age or age plus weight). There&#8217;s another person here with stats. Her name is Mommy. What many people don&#8217;t realize is that, while nearly all women are capable of producing plenty of milk in a 24 hour period, there is a 300 per cent variation among women in milk storage capacity. I wrote a whole <a href="http://pursuingtitus2.com/2008/06/05/breastmilk-ice-cream-and-infant-feeding-schedules-how-much-space-is-on-your-counter-top/">post about this</a>, but here are some highlights. Milk storage capacity is how much milk your breasts can hold without feeling uncomfortably full and slowing production way down. Another way to think of it is simply the amount of milk available at any one time. A 300 per cent variation in milk storage capacity means that at any given feeding, a mother on the large end of the milk storage spectrum has three times as much milk available for her baby than a mother at the low end of the spectrum. OK, homeschooling math question: If these two mothers&#8217; babies need the same number of ounces per day, can they nurse the same number of times per day? Answer: No. If the mother with the small milk storage capacity tries to put her baby on a schedule that works well for a mother with a large milk storage capacity, her baby is going to cry a lot from legitimate hunger. That&#8217;s bad for baby and stressful for mom. Scheduling books often alleviate much of this stress by telling parents to expect a certain amount of crying and offer comfort in the idea that babies who are left to cry will not suffer any psychological damage, but that&#8217;s not really helpful if your baby is actually hungry.</p>
<p>But if a predetermined schedule = problematic, does new Mommy life = chaos, stress, and disarray? Not at all. Let&#8217;s go back to the actual problem: adjustment. Adjusting means getting used to a new normal. It means seeing what happens over and over again until you can come up with workable strategies. Being a mother is a skill, like knitting or playing the violin, and as such, there&#8217;s a learning curve. If you are willing to go through the learning process, you can come out on the other side of the adjustment with just as much predictability and routine as you would have with a predetermined schedule, but you can be much more certain that what you&#8217;re doing is actually meeting your baby&#8217;s needs the best way you can given how your body works.</p>
<p>If you want to be able to schedule your day without &#8220;scheduling&#8221; your baby, there are three things you have to do. 1. Learn the typical infant feeding cues. (According to <a href="http://aappolicy.aappublications.org/cgi/content/full/pediatrics%3b100/6/1035">the American Academy of Pediatrics Breastfeeding Policy Statement</a>, &#8220;Newborns should be nursed whenever they show signs of hunger, such as increased alertness or activity, mouthing, or rooting. Crying is a late indicator of hunger.&#8221;</a>) 2. Get your baby up at the same time every day. 3. Pay attention to what happens when. </p>
<p>As long as you’re getting your baby up at relatively the same time every day (and as long as he&#8217;s over that first month and a half or so where your milk supply is getting established), with a little observation, you can start to predict when he&#8217;s likely going to be hungry or tired and plan accordingly. Your own milk storage capacity is not going to change from day to day, and your baby&#8217;s hunger and thirst levels are likely going to be relatively stable for weeks at a time (except during illness or teething), so as long as <em>your</em> schedule is regular (always getting up at the same time, always sitting down for school with your older children at the same time, etc.), you will most likely be able to see a pattern develop. You have to continue to watch your baby for cues, though, because he may need to nurse more often if he’s about to have a growth spurt or is needing more fluids because he’s getting sick. In that case, you might have a few days when you&#8217;ll need to do things in a little different order. But overall, you can very much get used to what your baby&#8217;s needs are, and can structure your days so that you are able to get things done.</p>
<p>At this point, you&#8217;ll be right where a scheduling mother is. Scheduling books are simply a shortcut that skips the observation phase. Rather than getting your own data based on the real interplay between your body and your baby&#8217;s needs, scheduling books hand you &#8220;data.&#8221; Those &#8220;data&#8221; are perfect for some people and are exactly what they would have found if they&#8217;d done the observation themselves. But for other people, they are light years removed from their baby&#8217;s actual needs and don&#8217;t work well at all. The goal is happy, well-functioning homes where everyone&#8217;s needs are met, and we don&#8217;t necessarily have to all get there the same way. </p>
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			<wfw:commentRss>http://pursuingtitus2.com/2010/03/10/scheduling-your-day-without-scheduling-your-baby/feed/</wfw:commentRss>
		<slash:comments>14</slash:comments>
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		<title>Breastmilk, Ice Cream, and Infant Feeding Schedules: How Much Space is on YOUR Counter Top?</title>
		<link>http://pursuingtitus2.com/2008/06/05/breastmilk-ice-cream-and-infant-feeding-schedules-how-much-space-is-on-your-counter-top/</link>
		<comments>http://pursuingtitus2.com/2008/06/05/breastmilk-ice-cream-and-infant-feeding-schedules-how-much-space-is-on-your-counter-top/#comments</comments>
		<pubDate>Fri, 06 Jun 2008 00:01:10 +0000</pubDate>
		<dc:creator>Mrs. Parunak</dc:creator>
				<category><![CDATA[Breastfeeding]]></category>

		<guid isPermaLink="false">http://parunak.com/pursuingtitus2/2008/06/05/breastmilk-ice-cream-and-infant-feeding-schedules-how-much-space-is-on-your-counter-top/</guid>
		<description><![CDATA[<p>There is a question that ranks right up there with childbirth method, homeschooling, and whether or not you&#8217;ll let your children watch TV. Proponents of both sides promise you a happy, healthy child if you follow their advice, and a maladjusted, sickly child if you go with the other side. There&#8217;s been a lot of [...]]]></description>
			<content:encoded><![CDATA[<p>There is a question that ranks right up there with childbirth method, homeschooling, and whether or not you&#8217;ll let your children watch TV. Proponents of both sides promise you a happy, healthy child if you follow their advice, and a maladjusted, sickly child if you go with the other side. There&#8217;s been a lot of rhetoric spewed back and forth, along with condemnation, hurt feelings, and accusations. What am I talking about? The mother of all parenting questions: Are you going to feed your baby on a schedule (or &#8220;flexible routine&#8221;), or are you going to feed on demand (or &#8220;cue feed&#8221;)?</p>
<p>I used to find the debate frustrating and bewildering. I knew what I believed in my heart, but I was disturbed by so many other Christians who just as strongly believed something else. Then a couple of years ago, I stumbled across some information that finally helped me understand how people could have such enormously different experiences with feeding their babies.</p>
<p>Breastfeeding is a supply and demand process, and the way the &#8220;demand&#8221; is communicated to our bodies all depends on something near and dear to the hearts of countless women: storage space.</p>
<p>Think of it in terms of your kitchen counter. Imagine you and a friend are working in the kitchen serving up ice cream for a church party. You&#8217;re scooping out bowls of ice cream, and your friend is carrying the bowls to the hungry people. Well, imagine if every time you filled a bowl, it was instantly passed to someone, and maybe your friend was even standing there a moment, waiting for you while you scooped. You&#8217;d probably be working as fast as you could, dishing up ice cream at lightning speed. But what if your friend started walking around with a couple of bowls, and she couldn&#8217;t find anyone who needed any? You might notice that your filled bowls were starting to accumulate on the counter. In fact, you might be running out of space to put them, and by then, you certainly wouldn&#8217;t be feeling any pressure. You might look around, stretch, chat for a minute, etc., maybe even stop entirely, and have some ice cream yourself! Your &#8220;ice cream bowl production&#8221; slows to match the speed with which the bowls are removed from the counter.</p>
<p>It&#8217;s just the same with your breasts.  It turns out that empty breasts &#8220;hurry&#8221; and make milk at a rate of about two ounces per hour, while full breasts slow way down and only make milk at a rate of 1/3 of an ounce per hour (and it&#8217;s a good thing they slow down production because otherwise we might explode). (Learn more <a href="http://www.llli.org/llleaderweb/LV/LVJunJul01p54.html">here</a>.) Put another way, empty breasts make six times as much milk in an hour as full breasts do. If your breasts are full, you have to empty them before you can make very much more milk. If healthy women are emptying their breasts regularly, they can have what is for all intents and purposes an unlimited supply (giving them the ability to nurse twins or even triplets).</p>
<p>Now, here&#8217;s where the storage space comes in. Imagine you&#8217;re back in the kitchen at your church party. How many bowls of ice cream are you going to fill before you give up on your friend and quit? It might depend on how much space you have on your counter. If you live in a farm house with acres of counter top spreading out before you, you might fill eight or ten more bowls before you decide to give up. But what if you live in a tiny newlywed apartment with barely enough space between the dish drainer and the coffee maker to cram in more than about two bowls? Are you going to fill ten? Not likely. You&#8217;ve got no place to put them.</p>
<p>Breasts are just the same. All women can make plenty of milk for their babies over a 24 hour period, but the amount that the breasts can hold without feeling uncomfortably full and needing to be emptied varies greatly. There is a 300% variation in milk storage capacity (counter top space) among women (Learn more <a href="http://www.llli.org/ba/May99.html">here</a>). We&#8217;ve all got a nice freezer, a Costco bag of plastic bowls, and a perfectly functional ice cream scoop, but how many bowls can sit on our counters before we stop filling them is not the same. If we don&#8217;t get the milk emptied out of our breasts, production will grind to a halt.</p>
<p>Now, think about something else. Chances are, all that &#8220;emptying&#8221; is going into your baby&#8217;s little tummy. That&#8217;s his food and drink for the day. So, that 300% variation also means something else. It means that when two babies nurse and take in almost all the milk each of their mothers has at any given time, the babies are actually getting different amounts of milk. Therefore, in order to take in exactly the same number of ounces of milk per day, two babies with different mommies are going to have to nurse two different numbers of times. It’s sort of like plate sizes at an all you can eat buffet. If your friend has a turkey platter for a plate, she’ll only need to go through the line once to get enough to fill her up. But if you have a salad plate, you’ll need to go through the line several times to get enough. And babies have different metabolic rates and activity levels, not to mention different sized little bodies! All these things have an effect on how many times they need to “go through the buffet line.”</p>
<p>OK, enter the schedule. Let&#8217;s say you buy a book that your friend said worked great for her, and the book says your baby should nurse every three hours or so, and that he shouldn&#8217;t need any more than that. You try your best to follow the book, but pretty soon, it appears that you&#8217;re not making enough milk. What happened? Storage space strikes again. Your breasts filled up, didn&#8217;t get emptied, and slowed production. If women have a 300% variation in milk storage capacity, then one schedule is not going to work for all of them.</p>
<p>This accounts for the wildly varying testimonies of different families trying to follow the same &#8220;book&#8221; schedules.  I remember one father of a schedule fed baby who told me that the only problem he and his wife had was dealing with the jealousy of other parents when they heard how this dad&#8217;s baby slept through the night thanks to her wonderful schedule. But I have also read the words of other parents whose babies were on the exact same schedule who had very different experiences:</p>
<blockquote><p>The reason why my baby was sleeping so long was her blood sugar was dropping so low she couldn&#8217;t wake up. She, in fact, was going into a coma. She may have had a pre-existing condition, but following Babywise (a scheduling book) reduced my milk supply and gave me a false picture of normal, healthy feeding and sleeping patterns, making her health problem truly dangerous. We almost lost our baby.  &#8211;<a href="http://ezzo.info/Voices/dpSept07.html">D.P.</a></p></blockquote>
<blockquote><p>After being admitted to the hospital, it took several                          specialists nearly 2 hours to insert an IV because his                          veins collapsed every time they inserted the needle due                          to his critical state of dehydration.</p>
<p>We can honestly say this was the hardest moment of our                          lives, knowing that our son was suffering and had been                          suffering for nearly three weeks because he had not been                          fed enough due to our foolish implementation of a feeding                          program taught by Prep (a scheduling program). &#8211;<a href="http://ezzo.info/Voices/journey.htm">Jeremy, Lori &amp; Son</a></p></blockquote>
<blockquote><p>We went to his 4-month appointment and he weighed in                          at 11 pounds, 6 ounces. He had lost nearly a pound in                          2 months, where he should have gained at least 3.</p>
<p>I was horrified&#8230;.</p>
<p>I still didn&#8217;t want to screw up my baby&#8217;s schedule.                          Mr. Ezzo (an author of scheduling books) promised me I&#8217;d have a demanding brat with &#8220;metabolic                          confusion&#8221; if I did. So I sadly sent my husband out                          for formula, and started pumping my milk to try and get                          my supply back up.</p>
<p>It didn&#8217;t work. Within a week I was feeding J. 75%                          formula. &#8211;<a href="http://ezzo.info/Voices/justintime.htm">K.M.</a></p></blockquote>
<p>You can find links to more schedule feeding testimonies <a href="http://ezzo.info/voices.htm">here</a>. Of course, these are rather extreme cases, but they demonstrate graphically one end of the schedule response spectrum. And because there is such a spectrum, following a one size fits all schedule, no matter how well it worked for your friend, does involve risk. You have no idea whether your breasts will be able to store enough milk to continue to produce when feedings are spaced according to the schedule. You have no idea whether your baby will be like the daughter of the schedule feeding dad I knew or like one of the babies in the tragic stories I just quoted.</p>
<p>So, if your baby’s nursing needs can’t be predicted by an external schedule, how do you figure out when your baby needs to eat? Well, pretty much the same way you figure out when your older children need to eat. Not when they get so hungry that they’re crying (crying is actually a <em>late </em>indicator of hunger, according to the <a href="http://aappolicy.aappublications.org/cgi/content/full/pediatrics%3b100/6/1035">American Academy of Pediatrics Policy Statement, <em>Breastfeeding and the Use of Human Milk</em></a>) but long before then, when they either wake up, or when they say politely, “I’m hungry, Mommy, may I have a snack, please?” How does a baby who can’t talk tell you politely that he’s hungry? By making nursing cues, any kind of “increased alertness or activity, mouthing, or rooting,” according to the <a href="http://aappolicy.aappublications.org/cgi/content/full/pediatrics%3b100/6/1035">AAP</a>, what we call at our house a “nursey face” –smacking his lips, opening his mouth, turning towards you, sucking on a fist or your shoulder or cheek. My current baby has always tried to throw herself down into nursing position when she wanted to nurse, taking a sudden sideways dive toward “lunch.”</p>
<p>Let your baby&#8217;s behavior tell you when it&#8217;s time to hit the buffet line, and keep that ice cream scoop going by keeping your counter tops clear.</p>
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			<wfw:commentRss>http://pursuingtitus2.com/2008/06/05/breastmilk-ice-cream-and-infant-feeding-schedules-how-much-space-is-on-your-counter-top/feed/</wfw:commentRss>
		<slash:comments>19</slash:comments>
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		<title>When You &quot;Don&#039;t Have Enough Milk&quot;</title>
		<link>http://pursuingtitus2.com/2008/04/21/when-you-dont-have-enough-milk/</link>
		<comments>http://pursuingtitus2.com/2008/04/21/when-you-dont-have-enough-milk/#comments</comments>
		<pubDate>Mon, 21 Apr 2008 10:53:13 +0000</pubDate>
		<dc:creator>Mrs. Parunak</dc:creator>
				<category><![CDATA[Breastfeeding]]></category>

		<guid isPermaLink="false">http://parunak.com/pursuingtitus2/2008/04/21/when-you-dont-have-enough-milk/</guid>
		<description><![CDATA[<p>Shortly after I began my own journey of  breastfeeding, people started sharing with me stories of women, either themselves or friends, who &#8220;couldn&#8217;t&#8221; breastfeed because they didn&#8217;t &#8220;have enough milk.&#8221; At first I simply joined in the sorrow and horror, thinking this or that poor woman&#8217;s inability was an unfortunate fluke. But as time [...]]]></description>
			<content:encoded><![CDATA[<p>Shortly after I began my own journey of  breastfeeding, people started sharing with me stories of women, either themselves or friends, who &#8220;couldn&#8217;t&#8221; breastfeed because they didn&#8217;t &#8220;have enough milk.&#8221; At first I simply joined in the sorrow and horror, thinking this or that poor woman&#8217;s inability was an unfortunate fluke. But as time went on, and I heard more and more of these stories, I began to see some common threads. I also realized that it was more of an epidemic than a few flukes. If you&#8217;re a breastfeeding mother and have just discovered that your baby isn&#8217;t getting enough, PLEASE be encouraged. <strong>Don&#8217;t give up. Get help now.</strong></p>
<p>In my experience, low milk supply is an extremely common reason for women&#8217;s giving up nursing. Despite the recent resurgence of support for breastfeeding, we still live in a culture that has been grossly affected by bottlefeeding ideas, and high on that list of ideas is the notion that many women aren&#8217;t able to produce enough milk for their babies. The belief  that so many women fundamentally can&#8217;t breastfeed becomes a self-fulfilling prophecy as women who are faced with challenges just assume that they are one of these poor mommies who &#8220;can&#8217;t&#8221; and throw in the towel, when in reality, they could have been entirely successful <strong>if they had gotten help.</strong></p>
<p>Women are willing to give up on their breasts extremely easily, far more easily than they would give up on other body parts like, say, their teeth. We would all find it sadly ridiculous for someone to say, &#8220;Wow, my teeth are full of cavities. I guess I&#8217;m not meant to use my teeth. I&#8217;d better have a feeding tube put in so I can bypass chewing.&#8221; Most of us would say, &#8220;Why are you giving up? Why don&#8217;t you go to the dentist and find out what&#8217;s wrong?&#8221; We should apply the same logic to our breasts. They are body parts, and like any other body part, if they aren&#8217;t doing their job, <strong>something&#8217;s wrong</strong>. For your baby&#8217;s sake (and your own), <strong>find out what the problem is. </strong></p>
<p>It would really be very surprising if women&#8217;s bodies were as dysfunctional as they appear to be in this day and age.  Think about it. Before formula, if a mother couldn&#8217;t produce enough milk, her baby died. Don&#8217;t you think the Lord would have designed a system that would work a lot more often than the one we seem to have? He would have. And He did. True, we live in a fallen world. And true, there actually are a few women with deformed breasts who really can&#8217;t produce enough milk. But they are very, very few and far between. (If your breasts look remotely normal, you probably aren&#8217;t one of them.) For 99.9% of women, breastfeeding challenges are not insurmountable. <strong>Don&#8217;t give up. Get help now.</strong></p>
<p>A major issue is that it is most often the baby&#8217;s doctor who first recognizes that there&#8217;s a problem. (Praise the Lord for well-baby checks!) But unfortunately, the doctor equally often does something extremely unhelpful. After seeing that the baby is not getting enough, he immediately recommends formula. Why is this so unhelpful? Well, quite simply, breastfeeding is a supply and demand process. If your baby is getting formula, his demand for breastmilk will go down, and therefore, unless you are undertaking serious measures to prevent it, your supply will go down even further. What usually happens next is that women give up entirely. Supplementation, unless carefully managed, is the absolute worst thing you can to for low milk supply. Sadly,  an awful lot of women assume that since a <strong>doctor</strong> told them to supplement, there must really be no other option.</p>
<p>You may be shocked to learn that your baby&#8217;s doctor is most likely not an expert on breastfeeding. (See this <a href="http://pediatrics.aappublications.org/cgi/content/full/107/3/584">article</a> for more information.) A pediatrician is an expert on childhood diseases, and most importantly for you right now, on infant wellness and proper growth and development, so you should absolutely take the news seriously that your baby is in trouble. However, a pediatrician is rarely in a position to tell you what to do about your low milk supply. Pediatricians are not specialists in breastfeeding. In fact they receive very little training in medical school on this topic. Some may have educated themselves, of course, but you cannot assume that just because the person is a doctor that he is qualified to diagnose and treat your milk supply problem. Indeed, pediatricians rarely try to treat low milk supply. Instead, they usually just give the common advice: &#8220;Supplement with formula.&#8221; Or even, &#8220;Switch to formula entirely.&#8221; This is not a treatment. It&#8217;s a bypass.</p>
<p>Now it may be the case that problems have gone unchecked for so long that by now you are producing almost no milk at all, and that your baby is truly starving to death. In that case, of course, you&#8217;re going to have to supplement. In fact, even if things are a lot less grim, you still might have to supplement some. But that is why it is imperative that you get the help you need to manage the supplementation properly so that you do not lose your milk supply completely, and so that you have a chance to build it back up again. I do not know your situation and cannot presume to tell you what the best treatment is in your unique circumstance. However, there are people who can tell you what to do. <strong>Don&#8217;t give up. Get help now.</strong></p>
<p>Your first step should be to contact <a href="http://www.lli.org"> La Leche League</a> . This organization is one of the world&#8217;s foremost authorities on breastfeeding, and offers support free of charge. The leaders you contact are mothers who have undergone extensive training (much, much more than the average pediatrician). They will be able to tell you if you can tackle the problem on your own with their help, or if things are so grave that you need to see a professional lactation consultant. A professional lactation consultant is someone with the letters &#8220;IBCLC&#8221; after her name. That stands for International Board Certified Lactation Consultant. Just as you would be leery of a &#8220;doctor&#8221; who was not an M.D., you should be leery of &#8220;lactation consultants&#8221; who are not &#8220;IBCLC.&#8221; The world is, unfortunately, full of them. There are a lot of &#8220;credentials&#8221; that you can get after attending a very short (as in one week) course. These women may not have the expertise you need. Find someone qualified to help you.</p>
<p>Why am I encouraging you to fight so hard to protect your milk supply? Formula is not good for your baby. It lowers his immune system. It causes his gut to stop functioning normally, making him prone to allergies. It even lowers his IQ and raises his risk of developing certain cancers, high cholesterol, obesity; and of dying of SIDS.  You can learn more about all this <a href="http://www.womenshealth.gov/breastfeeding/index.cfm?page=227">here</a>. Switching from breastmilk to formula is the equivalent of switching from fresh, organic produce, prepared by a gourmet chef to eating all meals at McDonald&#8217;s and popping a multivitamin. Formula is a processed food based either on highly allergenic cows&#8217; milk or equally allergenic soy, with nutrients added in to mimic breastmilk. Problem is, we don&#8217;t even know all the good things in breastmilk. We&#8217;re discovering more and more all the time. So how could we possibly get all the necessary nutrients into a man made formula? Further, there are living cells in breast milk that we know benefit the baby&#8217;s immune system that we have no hope of getting into canned or powdered formulas. Formula use should only be temporary and only a last resort. Make a commitment to your baby that you will provide him with the best nutrition possible. <strong>Don&#8217;t give up. Get help now.</strong></p>
<p>Breastfeeding has benefits for you, too. Every 12 months you breastfeed, your breast cancer risk is reduced by 4.3%. (Learn more <a href="http://www.abortionbreastcancer.com/abc_summary.htm#Inceased%20Childbearing%20and%20breastfeeding">here</a>.) Breastfeeding also reduces your risk of ovarian cancer, lowers your stress level, increases your bone density, and helps you lose weight. (Learn more <a href="http://www.babycenter.com/0_how-breastfeeding-benefits-you-and-your-baby_8910.bc">here</a>). Make a commitment to yourself, too, to do what&#8217;s best for your own health.</p>
<p>Now if you lost your milk supply long ago with  a previous baby, please don&#8217;t read this and feel guilty. As mothers, we all do the best we can with the information we have at the time. My purpose in writing this is not to make you feel guilty about the past, only resolved about the future.</p>
<p>Don&#8217;t take dire pronouncements lying down. Take your baby&#8217;s doctor seriously. Believe that your baby is in trouble. But don&#8217;t just supplement. Find out what&#8217;s wrong. For your baby&#8217;s sake, for your own sake: <strong>Don&#8217;t give up. Get help now.</strong></p>
<p>Note: This post is not to be considered a substitute for the professional judgment of a medical doctor or International Board Certified Lactation Consultant.</p>
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