It's a BOY!

This is E on the left and C on the right ... TWINS!

You may have read my post on our journey with infant acid reflux - http://gcrealestategirl.blogspot.com.au/2013/02/reflux-hell.html  ... One of my most hellish and painful experiences ... watching my tiny baby scream in agony and be helpless to stop it. I still get tears thinking about those days. 

E is now 12 months old and his doctor has recommended weaning him from the Losec medication that removes acid from his gut in the hopes he is now developed enough to no longer require it. The Losec takes 2-4 weeks to wean from his system so for the last two weeks we weren't expecting any real changes however we have noticed that while E has never been a great sleeper, he had improved over the past few months and has now gone back to his old ways of waking every hour or so the past 3 nights as opposed to sleeping from 7pm-12am then a 2-3 wakeup until 7am. I can't be sure this is the result of his reflux and the Losec weaning but he is waking crying and is extremely restless, settling best propped on my pillow beside me rather than flat on his bed or ours.  

I would prefer not to start him on Losec again but obviously, will do whatever helps him. To this end, I have been doing more research and reading on 'silent' acid reflux and have come across several instances where it has been suggested that breastfeeding mothers taking antibiotics in the early weeks of their baby's birth can be a factor in causing infant reflux.

I had tearing during E's delivery and as a result, was administered antibiotics by IV every 4 - 6 hours for the 48 hours post birth. I was then put on 2 lots of strong antibiotic tablets for the 2 weeks following. I was assured they were compatible with breastfeeding and were to prevent any infections. The sad thing is, they may have contributed to either E developing the reflux or the severity of it.

Here is some of the stuff I found:
This is obviously not a conclusive reason as to why E has reflux but interestingly, my sister, sis in law and two other friends who had babies this past year also experienced a same degree or worse tear than me and received none or one round of antibiotics by IV and nothing further ... none of their babies have or developed reflux.

It makes me sad to think E might have developed reflux as a result of my medications and it makes me angry that the doctors prescribed them to me without consideration to this fact. However I also accept that this may not be a fully proven factor in reflux and I haven't researched any studies etc on this apart from one I found at http://www.bellybelly.com.au/forums/f36/study-links-maternal-antibiotic-use-colic-reflux-98850/ ...

FEMS IMMUNOLOGY & MEDICAL MICROBIOLOGY
Volume 56 Issue 1, Pages 80 - 87
RESEARCH ARTICLE
Influence of antibiotic exposure in the early postnatal period on the development of intestinal microbiota
ABSTRACT
The influence of antibiotic exposure in the early postnatal period on the development of intestinal microbiota was monitored in 26 infants including five antibiotic-treated (AT) subjects orally administered a broad-spectrum antibiotic for the first 4 days of life and three caesarean-delivered (CD) subjects whose mothers were intravenously injected by the similar type of antibiotics in the same period. The faecal bacterial composition was analysed daily for the first 5 days and monthly for the first 2 months. Terminal restriction fragment length polymor-phisms in the AT subjects showed less diversity with the attenuation of the colonization of some bacterial groups, especially in Bifidobacterium and unusual colonization of Enterococcus in the first week than the control antibiotic-free infants (AF, n=18). Quantitative real-time PCR showed overgrowth of enterococci (day 3, P=0.01; day 5, P=0.003; month 1, P=0.01) and arrested growth of Bifidobacterium (day 3, P=0.03) in the AT group. Furthermore, after 1 month, the Enterobacteriaceae population was markedly higher in the AT group than in the AF group (month 1, P=0.02; month 2, P=0.02). CD infants sustained similar, although relatively weaker, alteration in the developing microbiota. These results indicate that antibiotic exposure at the beginning of life greatly influences the development of neonatal intestinal microbiota.
________________________________________
Received 11 July 2008; revised 17 January 2009; accepted 15 February 2009.
First published online 6 April 2009.

With consideration to this information though, I am going to start E on some children's Inner Health plus (a probiotic) in the hope of promoting good bacteria in his gut thus improving and aiding in his digestion.

Do you have or know a bub with reflux? Have you heard of this or had any success with treatments other than medication for severe cases?

I recommend going to http://www.reflux.org.au/ for some information if you think your baby might have reflux.

What absolute rubbish!
Breast feeding does so bloody hurt no matter which way you do It those first few times.

I had always been pretty ambivalent about breast feeding before pregnancy.I had always thought I would give it a go but I wasn't overly concerned if it didn't work out. I grew up with a mother who easily bf four children and attended the old version of the Australian Breastfeeding Association, Nursing Mothers religiously. My friends however were a different matter and not one of them ended up bf their babies - 5 girls with 7 children between them in the past 5 years. One friend experienced a traumatic birth and the subsequent treatments and medications required following eliminated her ability to bf then with bub number 2, she just never had her milk come in despite trying every possible medication, remedy and stimulation - apparently this can occur following major birth trauma. The others gave it ago but didn't last long in the face of seemingly insurmountable odds and weaned under some poor advice in my opinion.

Over the course of my pregnancy, I became completely determined to breastfeed successfully and decided to do everything I could to educate myself and make it happen. I read books, joined the ABA, enrolled in one of their classes, read the ABA book Breast Feeding ... Naturally, spoke at length to my mother about her experiences, got S educated and on board with my intentions and devoured everything I could find to ensure my desired outcome. I clearly had in my mind that I was going to be faced with enormous difficulties and breast feeding was going to be the hardest thing I had ever done. I read about attachment, engorgement, mastitis, blocked ducts, let downs and more. Even my obstetrician told me not to worry about the birth and concentrate on the breast feeding.

I went to the ABA class with my mum (S was working) about 4 weeks before my due date. It was a full class with about 10 other mothers to be sharing my desire to breastfeed. The class was very informative and even included a demonstration of a mum feeding her baby and sharing her breast feeding journey. It was her second baby and neither times the feeding had come easily but thanks to the support of the ABA and other mothers she had gotten through it and enjoyed the experience with both of her beautiful children. We were presented with text, picture and video examples of the issues associated with breast feeding and I came away from the class very comfortable that I knew every option available to and support on hand round the clock should I need it.

Fast forward to the moments following the birth when Ethan was placed on my chest for skin to skin. After a few minutes I asked my mum to help me initiate the first feed. Given I was hooked up to all sorts of things at the time, it was a little awkward but mum helped me move him near the nipple and he did the rest, head butting and bobbing against me till he found and attached to the nipple. I remember feeling relief that it had been so easy and then a sharp sucking sensation that had me wondering how on earth I would get used to the feeling. Ethan didn't feed for long and fell asleep at my breast. When we were moved to the ward, a lovely MW asked me if i would like to try feeding him shortly and I told her i definitely wanted to and would really appreciate her help given the moments in the birth suite were a bit of a blur. She suggested washing his head of the dried blood when he woke up and then trying for a feed.

I interrupt here to share that my beautiful niece had been born 7.5 weeks earlier to my brother and sister in law. My sister in law was breast feeding with relative comfort and was a strong advocate for breast feeding. She was using a nipple shield on one side due to Hayley's latching early on and the damage done to her nipple. She had also dealt with jaundice and a sleepy newborn who slept though feeds and had to be woken up often. Chantel was my go to in my last weeks if pregnancy and remains an enormous support to me even now.

Back to the ward... We got Ethan latched after his bath and he happily fed and slept on and off all night. High with adrenaline and hormones I didn't mind that I wasn't sleeping but I noticed by early morning my nipples were feeling a little raw. My sis in law had been texting me through the night while she was up feeding and it really did help me in the early days to feel less alone during those sleepless nights. I remember texting Chantel to ask if breast feeding had hurt her even when she seemed to have a correct latch and if Hayley had wanted to feed all the time. She reassured me that breast feeding had definitely hurt early on (she had no attachment issues) and that Ethan was cluster feeding to bring my milk in and to just go with it. Feeling enormously reassured (if a little sore), I relaxed into what was going to become my life in the coming weeks.

The hospital offered daily breast feeding classes but having attended my ABA class and with my sil and mother to turn to, I gave them a miss. I did however make use of the lactation consultants to check attachment etc. Ethan fed around the clock while we were in hospital two nights (I chose to leave earlier) and I headed home confident but with very raw cracked nipples that made me tense for every feed - which was constant. My sister in law continued in the early days with her midnight and 3am text messages that comforted me more than I can say. It was the dead of winter in a freezing house with a baby that refused to sleep and I was struggling. I thought there was something wrong with me. I wasn't having any letdown feeling, I never felt my milk come in or get engorgement, IT HURT, Ethan developed a sucking blister on his lip and wanted to feed all the time, I had to be doing it wrong.

I tried nipple shields but Ethan wouldn't accept them so I spent lots of time under our bathroom heat lamps rubbing my raw cracked nipples with breast milk and letting them dry and I made an appointment with a private lactation consultant / midwife in week 2. Best thing I did! I shared all my concerns and problems with her and she proceeded to weigh bubba. He had put on well above the average weight gain since birth and she pointed out he was clearly getting more than enough milk. She reassured me that everything was okay and to continue with what I was doing. Buoyed by her reassurance, I continued with what I was doing - particularly demand feeding and lots of skin to skin.

Eventually the cracks healed, I got a let down sensation and my confidence grew and now here I am 7+ months on, still breast feeding and expressing. I had a very easy start to the breast feeding side of motherhood and am eternally grateful for it as it certainly made dealing with the next chapters a little easier.

I love breast feeding, there are endless pluses apart from the obvious health benefits including the quiet moments and cuddles, the portability, the knowledge you are giving your baby the best possible start, the absolute ease but our journey is not without tears or frustration. Let me tell you that even our charmed journey started with pain and a little damage and a lot of tears. It may be the most natural thing in the world but early on, it is also uncomfortable, sore and very Tiring. There are many times even now I say that it feels like life is being sucked from me on occasion. It is exhausting, claustrophobic at times and worrying... Do I have enough milk, is my baby satisfied...

Heading back to work at 4 or so months meant supply was a constant worry for me in addition to pumping under pressure. I invested in a Medela swing pump, a la leche hands free bra and some brewers yeast tablets. My first day back was a nightmare with pumping a non event, I just couldn't get a let down. I cried my eyes out devastated that I would have to wean. I researched increasing supply and set about doubling my water intake and baking lactation cookies. I was consuming about 5+ cookies a day and seeing the results in fast efficient pumping in no time with no supply issues. I eventually got sick of the cookies and after talking to a helpful health store assistant, discovered brewers yeast tablets. I haven't looked back since and am now easily pumping 3 times at work for 25 mins a time removing enough milk and then some for us to continue Ethan on breast milk.

Breast feeding takes time, effort, perseverance, commitment and a lot of patience. It's not easy in a lot of instances and the best thing any mother to be can do is decide early on that they want to breastfeed and then set about educating themselves in every aspect to ensure the best outcome. It is stressful, painful and draining but it is also beautiful, rewarding and so much more. Buy a membership to the ABA, it's one of the best things I did.

One of my favourite breast feeding memories is when Ethan was a little older - around 4/5 months - and he started pulling off during a feed, look at me with surprise like 'mum? Where did you come from?' Then give me a smile and start giggling before feeding again. This would go on 3 or 4 times and was the cutest little dally.

Even now though after so many months, breast feeding is not without its challenges. Ethan has started biting me at the end of his feeds. Only today this started and its really a nip but it really hurts! Everything I've read tells me a baby can't bite when latched properly and it seems he is doing it at the end of a feed, playing around. So far I just pull him off, end the feed and give a loud firm NO. One time elicited laughter, another tears. We will keep going but I will watch carefully and pull Ethan off before he can play around now.