Tuesday, February 19, 2013

Back Alley Milking


Remember when we were inundated with those "Got Milk?" commercials?



Well, my mind has been inundated with “How you gonna get that milk?” lately.

A family does have a few ways to provide breast milk even if they haven't had a pregnancy – either using someone else's breast milk, try to induce lactation, or just pass and use formula (which is what I am leaning towards.)

Option #1 - Purchasing breast milk or procuring donated breast milk


It can be difficult to find a milk bank that will sell directly to an individual. It is also cost prohibitive at $6 -$8 per ounce. Although typically this milk is donated to the bank, the bank passes along the cost associated with processing the milk.


Purchasing milk online is untested. Since diseases, alcohol, and many drugs can be passed in breast milk, there is considerable risk in choosing this more affordable option ($1 per ounce).


Option #2 - Induced lactation


The plus is that this option provides all the healthy immune-boosting elements you want because it is after all breast milk, but it is a difficult time commitment with no guarantee it will work. Domperidone, the drug commonly used to increase prolactin (hormone), has been taken off the market by the FDA due to cardiac risks associated with its use. Proponents of the drug are very quick to point out that these unfortunate events only occurred after the drug was given intravenously and if one is inducing lactation, the drug would typically be taken in pill form.  We do know that the drug is passed through milk, but I couldn’t find any study that addressed infant risks.  Also just a little FYI - I have been informed by one of the  lactation consultants that this option is not just for the ladies, and my husband could attempt to induce as well.   (SIDE NOTE: He is not responsive to the idea.)


I have met with two lactation consultants, each with a different plan of attack if you will.


Consultant 1: Recommends the Goldfarb Neman protocol with Domperidone.  This plan requires you to take birth control pills along with Domperidone for six months, and then begin pumping with a hospital grade pump. Domperidone is a drug which has lost its FDA approval, and cannot be purchased at non-compounding pharmacies in the U.S. From what I understand, the drug itself is illegal but the ingredients to make the drug are not. So a compounding pharmacy can legally make the drug for you. If my doctor refused to write a prescription, the lactation consultant told me not to worry because “she knows a guy”.  The entire conversation sounded more like an encounter from Breaking Bad than an appointment with a lactation consultant.  Although this plan has a 90 percent success rate, I felt I needed a second opinion.


Consultant 2 - Plan A: Recommends Goldfarb Newman protocol with Reglan.

Again you take the birth control pills along with a drug called Reglan. Reglan has been notoriously associated with depression.  Although it is FDA approved, there has been a great deal of backlash against this drug. I think I had Consultant #1's disdain for Reglan in the back of my mind because I evidently seemed rather discouraged and Consultant 2 suggested we could try a more “natural approach”.


Consultant 2 - Plan B: Modified version of Goldfarb Newman taking a combination birth control pill (in my case Necon 1/35) It is important to take the active pills only and continuously for 5 months in an attempt to mimic pregnancy. After the 5th month, you rent a hospital grade breast pump and then use it rigorously. Or she went on to say: “If money is tight, you could dry feed your partner 8 times a day until milk arrives.  I did turn quite red as the 7th grader inside couldn’t help but be a tad embarrassed.   The success rate with this option is not as high as the others, but the consultant refused to give any kind of estimation. She did say that I have a better chance of success because I have breast fed before.  (In an effort to honor Parker's memory, I pumped my milk after he passed and was fortunate to be able to donate it to his NICU.)  Therefore, my milk ducts are developed, and my body does not need to undergo all the changes necessary for breast feeding. She felt confident that if we chose this more natural option we could be successful.


There's a lot to think about, but the reason I am leaning towards formula is because we are considering trying for a third child in July.  Time isn’t doing anything but acting against us, and if we chose to do another IVF cycle I would be unable to induce. But whatever we decide we need to do it quickly because no matter which plan I choose the longer the time frame you have to try to bring in milk, the higher chance of success you have for it to work. Ideally, one would have 6 months +, so since our Yankee Doodle is due July 4th the clock is ticking.


 I wanted to share what I have learned in my research undertaking and although I appreciated the lactation consultants meeting with me, there was not a whole lot of insight beyond what one could find on asklenore.com.  If this is something you are considering, I bow to your awesomeness so best of luck

Friday, February 15, 2013

First off I am a HUGE fan of Frank O’hara.  If  you are unfamiliar with his work. He is a gem in American poetry, and wrote a number of incredible pieces.  This particular favorite was  inspiration to my husband's Valentine.

Having a Coke with You

"is even more fun than going to San Sebastian, IrĂșn, Hendaye, Biarritz, Bayonne
or being sick to my stomach on the Travesera de Gracia in Barcelona
partly because in your orange shirt you look like a better happier St. Sebastian
partly because of my love for you, partly because of your love for yoghurt
partly because of the fluorescent orange tulips around the birches
partly because of the secrecy our smiles take on before people and statuary
it is hard to believe when I’m with you that there can be anything as still
as solemn as unpleasantly definitive as statuary when right in front of it
in the warm New York 4 o’clock light we are drifting back and forth
between each other like a tree breathing through its spectacles

and the portrait show seems to have no faces in it at all, just paint
you suddenly wonder why in the world anyone ever did them

I look
at you and I would rather look at you than all the portraits in the world
except possibly for the Polish Rider occasionally and anyway it’s in the Frick
which thank heavens you haven’t gone to yet so we can go together the first time
and the fact that you move so beautifully more or less takes care of Futurism
just as at home I never think of the Nude Descending a Staircase or
at a rehearsal a single drawing of Leonardo or Michelangelo that used to wow me
and what good does all the research of the Impressionists do them
when they never got the right person to stand near the tree when the sun sank
or for that matter Marino Marini when he didn’t pick the rider as carefully
as the horse

it seems they were all cheated of some marvelous experience
which is not going to go wasted on me which is why I am telling you about it"

So on Valentine's Day when he showed up with two Diet Cokes to share.  I was completely swept...


Thursday, February 14, 2013

When my child grows and asks “how do you know when you find love?"
I will be reminded of something once said by the Rasta purveyor of love himself Bob Marley “Only once in your life, I truly believe, you find someone who can completely turn your world around. You tell them things that you’ve never shared with another soul and they absorb everything you say and actually want to hear more. You share hopes for the future, dreams that will never come true, goals that were never achieved and the many disappointments life has thrown at you. When something wonderful happens, you can’t wait to tell them about it, knowing they will share in your excitement. They are not embarrassed to cry with you when you are hurting or laugh with you when you make a fool of yourself. Never do they hurt your feelings or make you feel like you are not good enough, but rather they build you up and show you the things about yourself that make you special and even beautiful. There is never any pressure, jealousy or competition but only a quiet calmness when they are around. You can be yourself and not worry about what they will think of you because they love you for who you are. The things that seem insignificant to most people such as a note, song or walk become invaluable treasures kept safe in your heart to cherish forever. Memories of your childhood come back and are so clear and vivid it’s like being young again. Colours seem brighter and more brilliant. Laughter seems part of daily life where before it was infrequent or didn’t exist at all. A phone call or two during the day helps to get you through a long day’s work and always brings a smile to your face. In their presence, there’s no need for continuous conversation, but you find you’re quite content in just having them nearby. Things that never interested you before become fascinating because you know they are important to this person who is so special to you. You think of this person on every occasion and in everything you do. Simple things bring them to mind like a pale blue sky, gentle wind or even a storm cloud on the horizon. You open your heart knowing that there’s a chance it may be broken one day and in opening your heart, you experience a love and joy that you never dreamed possible. You find that being vulnerable is the only way to allow your heart to feel true pleasure that’s so real it scares you. You find strength in knowing you have a true friend and possibly a soul mate who will remain loyal to the end. Life seems completely different, exciting and worthwhile. Your only hope and security is in knowing that they are a part of your life.”
Grand kisses on piazzas in Venice are nice (ok, so a little more than nice), but the true beauty of love comes from the completeness and joy you find in the everydayness of your life.    Then I’ll say “but wait untill you are 30 to date”.