Nursing to sleep

I was lucky enough to have a friend with the same due date as me, so we shared our pregnancies together and now get to ask each other how our babies are doing. Yesterday during an afternoon playdate May got overtired from the excitement of another baby and started to cry. I comforted her with some rocking and singing which almost did the trick (and actually sent my friend's baby to the land of nod), but she was just too tired to succumb to the sandman. I nursed her and about 3 minutes later she was out like a light.

Almost asleep....

Normally nursing to sleep is reserved for these occasions during the day when she is worked up, overtired or in a strange environment. In the evening when it's time for her to go to bed she nurses for as long as she wants and normally is pretty close to asleep (or is asleep) when I put her in her crib. But during the day I tend to avoid nursing her to sleep for naps.

My main worry is that she'll become dependent on it. Although it is still two months until she starts daycare, her ability to go for a nap there without me weighs heavily on my mind. I wonder how other breastfeeding mums have felt. Personally I feel that the ability to nurse May to sleep (or at least very sleepy) is a huge benefit of breastfeeding and I don't see anything wrong with it. She doesn't wake up a million times a night to nurse for comfort (but maybe that will change) and it is helpful to know you have the nursing weapon with you at all times if she is overwhelmed by something.

Equally it is important to me that she doesn't 'need' to nurse to sleep at all times though, especially when she will start daycare. For now I am trying to find that balance between ensuring her comfort (and avoiding all those tears) whilst encouraging her to find comfort in other ways. I guess this is just another thing to add to my growing list of mother's guilt!

Catching some zzzzzz

The most frequently asked question

It seems like all anyone is interested in is whether May is sleeping through the night or not. What exactly does sleeping through the night mean anyway? Some (this seems to be the doctor definition) say it is being able to go 5-6 hours without a feed, whereas I think the most common meaning amongst family and friends is that she sleeps twelve hours. Whilst I'm tempted to lie to them and say she is sleeping through, that's not really the truth.

May is three months old. She has a pretty regular pattern of waking in the night, but she also has completely random episodes, especially for the past week. I think she is now at an age where she is trying to shift her schedule somewhat but I have not quite figured it out. She usually goes to bed with a feed at 7pm. The majority of nights she wakens somewhere between 1am and 2am and again for another feed between 4am and 5am. Normally morning time wake up is 7.30ish. She followed that pattern to the letter almost from 8 weeks old until 12 weeks.

The past three nights May has not been that interested in her 7pm feed and wakes an hour later (I swear she is wearing a watch, she literally wakes at 8pm on the button!) and Dad changes her nappy, reads her book and I feed her again and she goes back to bed. Whilst she mainly sticks to having the two feeds during the night, more commonly in the last week she has been waking on another occasion. Last night she woke at midnight for a feed and then was crying at 1.30am so I changed her nappy in case she was uncomfortable and she went back to sleep. She then woke at 3.40am for a feed. The previous night she woke at 1.40 as usual and 3.40, but then again at 4.30, 5.30 and 6.30!

May then likes to doze on and off from around 7am and I get her up at 7.30. However, for the past two mornings she has been uninterested or refused the feed in the morning. She is a little reluctant to get up even though she is awake and is back down for a nap no more than an hour later. Often she only manages to be up for 45 minutes before she is back in bed for a two hour nap. This means it is closer to 11am before she has a substantial feed.

It is not important to me that she drop the night feeds. As far as I am concerned if May needs me in the night then I have no problem nursing her and comforting her. However, I do feel like she is trying to tell me something with this recent pattern of not being interested in the morning feed and waking up at 8pm, just an hour after I have put her to bed. I think it is up to me to figure out what it is that she needs. Our solution is to follow May's cues rather than impose a schedule on her and I am confident that we will settle into a fairly consistent pattern. Whilst it might seem like she's a bit of a nightowl and perhaps a later waking up time would work for her, I will be returning to work so she will have to get up between 7-7.30am when that happens so I thought it was best to at least have a roughly consistent waking up time. Although she has little interest in eating at that time, she is awake herself anyway. I guess I am finding it confusing to know what is best for her. I hate to think I will send her to daycare without that morning feed, but if she is not looking for it, perhaps it is best that I don't force it on her. Though I will have to pump at that time to relieve some of the engorgement. I wonder if anyone else has this experience of their baby becoming less interested in their morning feed at this age?

When it looks like thrush but is not thrush

I think I googled every article about thrush when I was struggling to breastfeed May in those early weeks. I had no idea that it existed, what the symptoms were and how to treat it. It looked like a pretty classic case, I had a burning sensation that began towards the end of a feed rather than pain at the beginning. The burning continued after the feed. The sensation of clothes or towels against the skin was deeply uncomfortable. My skin was red and raw. I had a crack on my left side. When it first started it was more on the side of being uncomfortable, that's the best way I can describe it. Being new to breastfeeding I didn't even know that how I felt was not normal. My midwife and I spoke about it and we decided to try Daktarin cream after each feed to see if that would clear it. Sugar and anything with yeast (such as bread) was also eliminated from my diet in an effort to combat it too. It appeared to be cut and dry, a yeast infection.

Four days passed with little improvement. I began to imagine that perhaps things were getting better only to find as the day wore on and the nights approached I was in increasing pain. By the middle of the following week the pain had now spread as a deep tissue pain in the breast. To describe that pain is very difficult, it is not like anything I have ever experienced. It was like a stabbing sensation and felt like it needed counter pressure when it would come on which was straight after a feed and last on and off for at least an hour. With May feeding every two hours it was a constant cycle of feeding, applying cream, pain and my tears. A week following the onset of symptoms I went to my family doctor to receive a prescription for fluconazole, an oral medication to combat thrush. I have a lot of faith in my family doctor, but when it came to breastfeeding I think the knowledge was limited. May came with me to this visit which involved quite some logistics to time feeds and get her out of the house at less than 3 weeks old. An examination of her milky tongue caused some concern and so the decision was made to also treat her with miconazole gel after each daytime feed. Though she had no other symptoms and was not having any other significant issues. A single large dose of flucanazole was prescribed for me alongside continuation of the cream.

May was such a tiny baby at that time. Therefore it was vital that the gel given to her was applied in very small parts so she would not choke on it. This meant rubbing small amounts onto her gums and tongue. Adding this routine to our feeds involved time and frustration for both her and me. Days passed and instead of seeing improvement in my pain it worsened. A return visit to the doctor was in order to receive a course of treatment of the fluconazole. May was once again bundled up and off we went to the practice. I was given a course of 10 days of drugs.

When three weeks of symptoms and pain had gone by I was starting to feel desperate. My feeding relationship with May was nothing like I had expected. With each feed that passed I would dread the next one. I would just begin to feel the pain subside when I would hear her looking for me and my heart would fill with dread. Those special bonding moments over a feed were nowhere to be found and I started to seriously doubt my energy to continue breastfeeding her. I found the nights particularly difficult when I could not fall back asleep following a feed because of the pain I was in. However, nursing May was something that I felt could improve if we could just find the solution to my pain and the support from my mid-wife was invaluable. She reassured me that we would find the answer and that things would get better. Whilst I felt like I was failing as a mother, my mid-wife told me I was brave and strong. With no improvements following almost three weeks of treatment it was time to consider that my classic case of thrush was not actually thrush. If it had not been for my mid-wife I would have never got to the bottom of my problems with feeding May and may have given up breastfeeding. Another trip to my family doctor resulted in an opinion from his female colleague that I was overproducing and needed to pump following a feed and to discontinue all medication. There were strong indications this was certainly not my problem. It was time to see a specialist.

It was the specialist that confirmed my mid-wife's suspicions that I was suffering from a bacterial infection rather than a yeast infection. May was examined and it was suspected that she never suffered from an infection at all. There was a huge sigh of relief that I could discontinue the oral treatment of May which had been taking place after each feed for almost two weeks at that point. A combination cortisone and anti-bacterial cream was prescribed for me. I should have felt on cloud nine, but to be honest that was the fourth doctor visit I had that week and at that point I just felt that it was another opinion on what was causing my problems without me knowing that this would be the solution that would work.

The cream was only to be used for five days following each feed and slowly but surely things started to improve. The raw redness began to heal, the deep pain was starting to subside. The light at the end of the tunnel began to shine. Those three weeks of constant pain, which became so unbearable, were probably some of the worst weeks of my life. After a pain-medication free birth I thought I was prepared for anything, but I can now safely say that childbirth is not the worst physical pain I have experienced. Emotionally it was also difficult. I still struggle with the thoughts that I let May down by being reluctant to nurse her, especially when she was looking to comfort nurse. She was such a tiny baby and needed me. I remember the positives though, that we stuck together through our difficult nursing relationship and that now, three months in, we are bonding more than ever before as she smiles up at me from a feed. I am so grateful to my mid-wife for the support she gave me to believe that it would get better and that we would find the solution. A cut and dried case of a yeast infection was not so clear after all and I have learnt that many things can easily disguise themselves as being thrush.