Wednesday, January 12, 2011

On Washing Diapers

In various forums and discussion groups (both live and online) the topic of diaper care has come up and there seems to be a lot that goes into it and a lot that can confuse people. We hear that cloth diapering is better for a number of reasons related to baby health, financial ease, environmental factors, etc., but then when the conversation comes up about caring for those diapers, everything seems to get really confusing. There are special detergents, special diaper creams to use for the baby that are safe on the diapers, line drying, stripping, and more that comes up and it can seem almost overwhelming to the point where you'd want to throw in the towel just based on that! I hope here I can simplify things a bit to make it seem less cumbersome.

First off, don't get too worried about what others are doing to care for their diapers compared to what you are doing. The reason? Most people like different types of diapers (and these days the variety of cloth diapers is astounding). Different diapers have different care instructions. So, consider that before you worry that you aren't doing all the stuff that someone else is. Consider first what diapers they have versus what you use. That in and of itself may make a big difference.

When purchasing diapers, take note of the care instructions. Take these things into consideration when chosing diapers and caring for those that you have purchased:

- Do you need to pre-wash before use? How many times?
- What kind of pail should be used? Wet or dry?
- Do you need to use particular detergents for cleaning?
- Will you need to line dry or can you use a traditional dryer?
- Should certain diaper rash creams be avoided when using these diapers?
- What stain removers are safe to use? Is bleach allowed?
- Are there different care instructions for covers, diapers, AIOs, or pockets made by the same manufacturer?

Try not to get overwhelmed, but prepare yourself with how to care for the diapers. Take note also, if the instructions vary if you choose several different types of diapers to use. How you care for your diapers can affect how long they last, so make sure you follow recommendations.

Here is a more detailed write up of how I care for my diapers:
- First off the diapers - I use Mother-ease cotton terry OS (one-size) fitted snap closure diapers, snap-in cotton terry liners, and Mother-ease Air Flow covers. I also use bamboo terry wipes.
- The pail - I use a 5 gallon bucket from a local home improvement store. Nothing fancy. I add a splash of vinegar and a splash of Clorox 2 (it's bleach free) and fill the bucket about 2/3rds full. Used diapers are emptied of solids in the toilet and placed directly into the pail to soak before washing which is roughly 2-3 days max.

For the diapers:
- Washing - Sometimes I pour off the excess water from the bucket in the toilet, other times the whole thing goes into the washer (I have a top loader). The water level is set as I would for a normal load based on how many diapers I'm washing. I first run the diapers, liners, and wipes through a double rinse cycle (I start the cycle on the rinse setting of a normal wash and have the extra rinse cycle function turned on). When the two rinses are complete, I then add detergent - I use Tide liquid in the same amount as I would any other similar sized load - and run a regular wash cycle on the casual setting (with the extra rinse cycle still on). I will then reset the washer for another double rinse like I did at the beginning. If the diapers are particularly malodorous, I will add a splash of vinegar before the final double rinse cycle.
- Drying - All of my diapers and liners go into the dryer if they have been washed clean. I do not put anything in the dryer that has staining on it. I dry the diapers and liners on a medium heat setting. According to the care instructions for the wipes, they do not go into the dryer. I'll leave them damp and place them back in the warmer adding excess water if necessary.
- For stains - For the diapers, liners, and wipes that have staining, I treat directly with Clorox 2 (as mentioned, it's bleach free) and spread it to coat the entire stained area - this must be done quickly since the diapers and liners will start absorbing the stain remover making it harder to spread out. I let them sit for at least 15 minutes. They are then washed again as mentioned above without the initial double rinse.

For the covers:
- My covers are washed with the rest of the baby laundry. I use Tide liquid detergent, wash on a gentle cycle, and tumble dry on low. Similar to the diapers if there is staining, they are pre-treated and washed again before being dried in the dryer.

So, in a nutshell for me, the process is: Rinse, wash, rinse. Don't dry if stained.

One more note: Stripping
- Many moms notice that their diapers begin to have decreased absorbency after some use. Occasionally this happens because of build-up of detergent, stain removers, or creams on the diapers. "Stripping" is simply a series of rinses to wash away any impurities that may have built up over time and could be affecting the absorbency of the diapers or causing irritation to the baby's bottom. Some times this needs to be done every couple of months or so, but is usually done on an as needed basis. I'm not sure if it's because of the type of diapers I use or the excess rinses I run on my diapers (admittedly it's a lot of rinse cycles) but I have never had to strip and have never noticed a decrease in performance.

I'm sorry if this is long, but I hope it's useful. If you do run into problems, seek the advice of the manufacturer or other moms that use the same types of diapers you do. It will be the most helpful!

Thursday, January 6, 2011

On Trying to Breastfeed

On a networking site I belong to for moms I was recently intrigued by a poll that someone posted in a pregnancy forum. The poll asked if moms were planning on breastfeeding or formula feeding. Many of the votes (at least when I originally looked at it) were for breastfeeding. The additional comments had a number of responses saying how moms were going to try and see how it worked out.

I was kind of taken aback. I got the impression that many women, especially first time moms think that breastfeeding is a huge challenge and they get the impression that there is some reason they won't be successful. I really wanted to see if this impression was true so I added my own post to the forum asking moms what "try" meant to them. I straight up told them I was a breastfeeding advocate and for me, formula feeding is not an option. I asked them to what extent they would try and mentioned many possibilities such as lactation consultants, supply boosters, breastfeeding aids (nipple shield, SNS, etc.), support groups, etc. I asked what their breaking point was to where they would decide their trying wouldn't work and why they used the word "try" as though they had the impression there would be problems.

I got a pretty decent response from the moms, though many of them did not answer the questions specifically. There were several that seem to have the same impression that I do that if you say you are going to "try," it assumes that you anticipate problems and it allows a less successful nursing relationship that may turn to using formula instead. Many responded that to them there was no "try" they would or did do it and that their determination helped them. Much like me, it was an "I will" vs. "I'll try."

The vast majority of responses was exactly what I predicted, however. Many moms had previous experiences where they nursed and had challenges and eventually switched to formula feeding and therefore figured they would follow the same course with a new baby. I received many responses with varying degrees of hostility about how not everyone can breastfeed, there were too many complications, and how breastfeeding is "shoved down everyone's throat." Only a few moms discussed how the resources they used when difficulties presented themselves helped them overcome the hurdles and they had very successful nursing relationships with their babies. Another few mentioned how with previous pregnancies, they were uneducated and didn't know any better. This, I believe is at the heart of the matter.

Many of the moms that presented difficulties mentioned using some of the resources I mentioned in my original post that can help overcome hurdles of breastfeeding, but most didn't scratch the surface or go very far beyond one or two things to discover what was wrong and find a solution or management plan. Some list seeing several lactation consultants, but I wonder if they were looking for a quick fix or if they only sought help from a single consultant once (none that stopped breastfeeding said they saw consultants for multiple visits or long-term consultations - of course, they may have, I just don't know). One mom who ended up formula feeding said consultants didn't tell her anything she didn't already know, she didn't take a preparation class, and that she was too intelligent for support groups. She also didn't know what nipple shields or supplemental nursers were. Sorry, but I hardly think she knew everything she claimed to know - or at least enough to allow her to continue.

So, after all this, what do I figure out? My suspicions were true. So many breastfeeding relationships fail because of lack of education, support, and will. I beg every new mom that is looking forward to breastfeeding - especially if she's had trouble in the past or if this is her first child to educate herself and find local support. Breastfeeding rarely succeeds without it.

And one more thing I learned - many moms think that a low milk supply means the end of nursing. Not true! People talk about supplementing with formula when what they actually mean is formula feeding. Supplementing means "in addition to." Some low milk supply issues can only be helped so much - that is true. That doesn't mean that nursing has to be given up completely. Nursing and supplementing can work together and the baby will benefit from any amount of breast milk that he or she gets.

So, for those that are looking to breastfeed for the first time or looking for a better experience than before, please consider the following:

Breastfeeding Classes: Classes are available through community centers, hospitals, birthing centers, and many other places to help you get prepared. They will teach you about how to hold the baby, how to get a proper latch (when the baby attaches to the breast), how milk production works, how to maintain appropriate levels of milk production (supply and demand), what is an appropriate amount for a newborn and how to tell if your baby is getting enough, what are some common challenges and how to overcome them, and many other things. I came from a very strong breastfeeding background and I still learned an astounding amount of information from my class.


Breastfeeding Aids: Many breastfeeding aids are available. They come in the form of nipple shields (for nursing with painful nipples or inverted nipples), herbal supplements or prescriptions for boosting milk supply (if this is an issues), creams and pad for sore nipples, breast pumps and accessories, breastfeeding pillows, nursing covers, supplemental nursing systems, and many many more. Some of these are discussed in breast feeding classes, others you can learn about from consultants or support groups - not to mention where to get them. There are many things that can help breast feeding go smoother or assist you when you meet challenges.


Lactation Consultants: Lactation consultants are invaluable. They can help you on a one-on-one basis to make sure you have a good latch, they can help monitor intake, offer solutions to problems, identify the source of problems you may encounter. It is very common for moms that had c-sections or premature babies to experience challenges to breastfeeding especially in the early stages and consultants can help to turn around some of the negative breastfeeding related effects of the birth and early days and assist moms in having a very successful nursing relationship with their baby. Consultants come in many forms with varying degrees of education. For common problems, a Community Breastfeeding Educator (CBE) or La Leche League Leader (LLL Leader) can be a wonderful asset. For more challenging issues, a Certified Lactation Consultant (CLC), Licensed Lactation Consultant (LLC), or International Board Certified Lactation Consultant (IBCLC) can help. Seek out local consultants so you know where one is in your area and consider a prenatal consultation.

Support Groups: Support groups are not just for the down and broken. With so many challenges and perceived challenges to breastfeeding support groups are wonderful. They provide a low pressure environment to discuss anything you have questions about. Many of the moms may have experienced something similar and can tell you what worked for them. You may also learn about breastfeeding challenges you never knew were a possibility and how they can be overcome. You also are more likely to learn to more confidently nurse in public and learn some tricks to doing so discreetly. By being surrounded by other nursing moms, you are more likely to succeed with your breastfeeding goals. Support groups are available at community centers, hospitals, churches, shops, through La Leche League (which also offers educational discussions), and many other places. Consider finding a group and joining before the baby is born for an eye-opening and educational experience.

Sunday, January 2, 2011

On Weaning

When it came to weaning my oldest, I wanted to take the easy approach - I wanted him to self-wean. I had heard horror stories about how difficult it was to initiate it as a mom. I also would have been comfortable nursing until the age of two which is recommended by the World Health Organization, but much longer than that, I wasn't too keen on. At 15 months, my little one showed no sign of slowing, which was fine, but I wondered if he would call it quits on his own (which I preferred) or if I'd have to step in once he got a little older.

My "easy" approach, and what I really hoped for, was to get pregnant, have my supply drop, and then have him wean because of a lack of supply. Well, it kinda happened that way. But, as my sister once told me, we make plans and God laughs. I really believe this is true sometimes.

I did get pregnant. My little one was about 12 months old when I got pregnant. As I said, at 15 months he was showing no sign of slowing, so the reduction in milk supply seemed to not be an issue. Until it was. Around 16 months, he started to be really bothered by it. We had weeks, I'd say 2-3 at least where he'd ask to nurse so I'd oblige. I followed the recommendations for easier weaning that said, "Don't offer, don't refuse" - a supposedly gentler way to ease them through the process of self-weaning. But that time period was pure torture. He'd ask, and I'd nurse him, but after several moments of not getting much of anything, he'd sit up and show me the signs for "milk," "more," and "please." I'd change sides so he could nurse on the other side. Again, after a few moments, he'd sit up and request, "more milk please" signing frantically. We went back and forth several times, each time, he'd get more and more frustrated. Fussing and crying was added into the mix of frantic sign language. Eventually, he'd climb down off of my lap and stand in front of me, tears streaming down his cheeks, crying and signing incessantly. It broke my heart. I was helpless. And this happened several times a day for weeks. Every time I'd sit down, no matter where, he'd beg me to nurse. Every time, I was completely lost. There was no way I could help my little boy. I felt like a terrible mother. His world was falling apart, and it was my fault. What had I done to him? Occasionally, I'd try to offer him a sippy cup with milk. He had started drinking cow milk by this age, but when he wanted to nurse, he refused the sippy cup and swatted it out of my hand. I cried along with him many of those times because I had no clue what to do about it. There was no way I could ease his pain.

It did get better though. Eventually, he would take the sippy cup here and there. Then, he'd take it more frequently. We were able to reach a time when he'd nurse even with little supply for short sessions and then go about his business. Our main nursing sessions became when he went to bed for a nap or for the night. He started sleeping through the night more frequently by this point too. Some nights he'd wake up and scream and cry and I'd nurse him back down. Other times, he'd awaken, but go back to sleep on his own. This was around 17 months of age.

After a while though, the lack of milk available made him nurse for even shorter periods of time. It wasn't long enough to settle him down for sleeping. I'd always offer milk in a sippy cup before bed, but turned instead to standing and swaying to settle him down for naps and bed time. We've been doing this for a couple of weeks now.

Looking back, I really don't want to experience those early times of reduced supply ever again. It was horrible, heart-breaking, and made me question my mothering ability. After he came to terms with it, weaning was a dream and couldn't have gone smoother. I had no angst about him not continuing for longer (after all, I really had no intentions to tandem nurse. Kudos to those who do it, but it's not for me). I was at peace with letting him grow up and ease away from it. I miss the cuddle time with him immensely, but the nursing itself, I'm not mourning the loss of. It happened like I wanted, but not how I expected. I really thought it'd be easier, but I didn't anticipate his reaction. I only hope that other moms that experience forced weaning due to pregnancy acknowledge that this can happen - it may not, but it is a possibility. I don't think anything can really prepare you for it, but there you go - the info is out there.