Natural but not necessarily easy

Reproduced from Burlington Free Press 
Published: Monday, August 1, 2005 
By Susan Green - Correspondent

Sonya Sapir, Vickie Durgin and Topaz Weis are nothing if not determined.

The three mothers range in age from 29 to 24 to 43, respectively, and live in different towns: Williston, Monkton and Burlington. They don't know each other, but share a common belief that breastfeeding is ideal for all babies.

This credo does not necessarily mean that Sapir, Durgin and Weis have had an easy time of it. Despite varying degrees of difficulty, however, they remain undeterred when it comes to nursing their children:

"It just makes sense," Sapir says of breastfeeding her 8-week-old son, Colden.

"I like looking into my babies' eyes while they nurse," acknowledges Durgin, the mother of toddler Hunter and his brother Hayden, who turns 1 this week. "At the end of a hectic day, it’s a way of saying, ’mommy loves you.'"

"I want the absolute best for my daughter," says Weis, who adopted 3-month-old Kiki in mid-May.

World Breastfeeding Week, Aug. 1-7, is a time for parents and health professionals to celebrate the advantages of drinking mother’s milk.

"Most pediatricians recognize the nutritional, immunological, social, economic and developmental benefits of nursing," observes Dr. Lewis First, chief of pediatrics for Vermont Children’s Hospital at Fletcher Allen Health Care. "The best thing a mom and dad can do is breastfeed their baby for as long as possible."

Sometimes it appears to be easier said than done. While many newborns take to the breast without a hitch, periodically, challenges emerge even for mothers who are totally dedicated to the idea of breastfeeding.

Dr. Eliot Nelson of University Pediatrics in Williston has found that it’s a delicate balance. "I encourage moms to keep going, but recognize that some may feel anxious or uncertain about breastfeeding," he says. "I try to not to make them feel bad about that decision. Formula is a good alternative these days if nursing is out of the question."

Some pediatricians, like Dr. Pat Colander of Middlebury, are wary of formula and of the vast influence that formula companies have on the medical establishment. When she’s not available, "I dread that my patients who are breastfeeding moms might see other physicians in this area who happen to be on call." In her view, "some babies are naturals (at nursing); for others, it can take a little getting used to."

Colander’s own life reflects that equation. "After giving birth in 1973, I had a breast infection called mastitis," says Colander, "but I turned to the La Leche League, and they got me through it. I was able to nurse my firstborn for 5 1/2 years."

She went on to have four more children, all instant breastfeeding success stories. Colander’s initial hardships are similar to those encountered by Sonya Safir, who nursed Colden smoothly in the hospital but hit a roadblock during her first weekend at home. "My milk came in quickly and the latch got more painful," she says, referring to the way a baby connects with the nipple. "Although he was gaining weight, I wasn't comfortable because I had a blister."

Once Safir applied a medicated cream to her nipple and "got the latch right" about seven weeks ago, Colden’s feedings no longer hurt.

By contrast, Vickie Durgin has been to hell and back twice. Hunter was delivered in 2001 via Caesarean section, which required antibiotics that are known to sometimes cause complications when she started breastfeeding.

"A visiting nurse said he was latching correctly, but I was so sore I would clench my teeth and dig my nails into a pillow," Durgin recalls. "I was at war with myself. Even though the pain was intolerable, I didn't want to stop nursing."

She had a clogged milk duct, both nipples were bleeding, and an ensuing infection emitted green pus. The agony continued for almost three months. "Eventually, I had only two choices: Quit nursing and have surgery to cut open the abscess or figure out how to latch properly," Durgin says. "I’m stubborn, so I chose to continue and was able to breastfeed Hunter for 22 months."

But her ordeal resumed when Hayden was born -- also by C-section -- a year ago. Durgin’s nipple cracked around the edge. A doctor wanted to use stitches that once again would have interfered with breastfeeding.Instead, Durgin’s general practitioner repaired the tear with a medicated substance "like Superglue" said Dr. Jack Newman, a renowned Canadian breastfeeding expert who was in St. Albans to conduct a workshop. She has had no subsequent problems.

For Topaz Weis, the issue has been producing milk against all odds. Even after losing her biological baby while 16 weeks pregnant in January, she began lactating.

"We were already in the process of trying to adopt. I decided to use a breast pump so I’d have all that good stuff, like colostrum," Weis says of the antibody-rich secretion in mother’s milk during the first week. She intended to be ready for any infant that might come into her life.

Weis stopped pumping at the end of February. On May 11, she and her husband received a call from the adoption agency about a 10-day-old baby in Philadelphia that was theirs if they could head for Pennsylvania almost immediately.

"We packed all that breast milk in dry ice," Weis says, "but what took me eight months to pump took Kiki about five days to drink."

The couple quickly embarked on a multifaceted approach. "I’m in the process of re-lactating," Weis explains. "I take herbs like fenugreek, blessed thistle and chasteberry tincture, as well as a drug called domperidone that helps me produce more of my own milk."

The domperidone was prescribed by her primary-care physician, who is kept abreast of what Weis calls the "established protocol of herbal supplements" that she follows.

Kiki’s intake is supplemented by lactating women from across the country who contribute their excess to a "human milk bank" in North Carolina. A week’s supply of frozen milk, which has been thoroughly tested and pasteurized, is FedExed overnight to its Vermont destination. The baby later drinks it through a thin tube placed next to her mother’s nipple, which delivers some authentic Weis milk at the same time.

The downside of this arrangement is primarily expense -- $500 per week, which her insurance company declines to cover. She’s now in touch with three local women who are breastfeeding their children and willing to donate extra milk at no cost, until Weis is able to become the sole wellspring for her daughter.

Meanwhile, she is reveling in motherhood. "Kiki’s such a nice, sweet, good-natured girl, and she sure loves the booby juice," Weis quips.

The "booby juice" has been Kathleen Bruce’s mission in life as a Williston mother of three who became a La Leche League leader in 1988 and an international board-certified lactation consultant in 1993. She helped Safir, Durgin and Weis through their darkest days. They all sing her praises.

"I plan to have more breastfed babies," vows Durgin, whose optimism sounds like a profile in courage. "And I hope Kathleen can be with me in the delivery room."

As a pediatric nurse who once worked with premature infants at Fletcher Allen, Bruce is not stranger to the hospital setting.

"Breastfeeding is a behavior that requires support," she contends. "If a mother is uncomfortable when feeding, she doesn't have to suffer through it. We can always find a solution."

"We" includes her two partners in Lactation Resources of Vermont, a private practice that offers home visits to nursing mothers in Chittenden, Franklin, Grand Isle, Addison and Washington counties.

Bruce is also the online nurse-lactation consultant for Medela, a breast pump manufacturer based in Switzerland and Chicago. "I answer more than 900 questions about breastfeeding a month that are e-mailed from all over the world," she notes.

Her philosophy about nursing, no matter the hurdles, is unequivocal: "Our bodies are able to build a baby and feed a baby. The human race has survived because breastfeeding works, or we wouldn't be here on this planet."

Dr. Eliot Nelson is a bit less adamant. "More than 50 percent of new moms in my practice start breastfeeding," he says. "Others come to it with a less firm commitment: 'I'll at least give this a shot.'"

His colleague, Dr. Lewis First, has a more of an advocacy perspective. "There are so many things you can try before you even think about giving up," he points out. "I’m not here to condemn formula, but immunity protection and health benefits come with nursing. Breastfeeding is the No. 1 choice for babies."