Weaning and more

"medgirl" wrote in message
...
I know this will be a little controversial here, but please bear with me.

DD is now almost 13 months old. I love nursing and feel like I could do
it for much longer if there weren't other issues involved. We are down to
nursing 2x/day, sometimes 3. I am no longer pumping (it's kind of nice to
be done with that). The problem is that I have a a few pressures on me to
stop nursing. One is that I probably need to have radioactive iodide
treatment relatively soon to treat my overactive thyroid.

I think this comes down to how you feel. Something to consider is popping
into alt.support.thyroid, too. I think the other two issues are sort of
secondary, but your thyroid seems to be the big one.

Something else to consider too-you mention she's been dropping down on the
weight curve. Was her thyroid tested at birth?

Jess

I know this will be a little controversial here, but please bear with me.

DD is now almost 13 months old. I love nursing and feel like I could do it
for much longer if there weren't other issues involved. We are down to
nursing 2x/day, sometimes 3. I am no longer pumping (it's kind of nice to
be done with that). The problem is that I have a a few pressures on me to
stop nursing. One is that I probably need to have radioactive iodide
treatment relatively soon to treat my overactive thyroid. The radiation is
not compatible with nursing. I have been putting this off for a while, but
my doctor is pressuring me to get it done. It doesn't help that this doctor
isn't real sympathetic to the breastfeeding thing (last time I saw him he
said, "Are you _still_ nursing?" like it was the craziest thing he ever
heard). The other issue is that I would like to get pregnant again, either
before treating the thyroid or six months after (which is another area of
debate with this doctor), but getting pregnant for me will require another
round of in vitro fertilization, with the fertility drugs not being
compatible with nursing either. And, finally, we have a trip planned in
May, which will be our first trip without my daughter. At the time we made
the arrangements, I didn't think there would be a problem having her weaned,
but as the date grows nearer I am worried that it won't happen.

So I am faced with trying to have her weaned within the next, say, 50ish
days, which is a very emotional thing for me as well as a logistical one. I
have really enjoyed breastfeeding and it will be hard to give it up. The
thing is that it seems very hard to drop the last two feedings. The
nighttime feeding may not be too bad since she's not really nursing to sleep
anymore, but the morning feeding is going to be hard. Does anybody have any
advice as to how to do this? Also, I am a little worried about dropping the
nighttime feeding in terms of getting a little engorged before the next
morning. It just seems like such a drastic thing to go from two feedings a
day to one.

Finally, to add to the confusion, she's been having some problems recently
with weight gain. She was little when she was born, but gained weight
wonderfully for the first six months, although she has always been around
the 10th percentile. At about the time that solids were introduced, she has
started to gradually fall down on the growth chart. When we saw the
pediatrician last week, she was down in the 3rd percentile for height and
weight. The pediatrician wasn't too worried, but wants us to bring her back
for a weight check. I think the problem is that she just has not been as
enthusiastic of an eater as some children. She really doesn't even like to
put things in her mouth, which is kind of weird. It's hard to get her to
eat many new foods. Solids are supposed to supplement nursing in the second
half of the first year of life, since nursing alone isn't going to give the
rest of the calories she needs, but she just really doesn't eat enough. She
has been very resistant to finger foods. She does eat baby foods okay, but
it seems like such a leap to get her to eat any more. Weaning may
complicate this, although I think she is probably getting relatively few
calories from breast milk at this point anyway. Any advice for "fattening
up" a baby?

Thanks to anyone who has read this far. I appreciate any advice!

Sarah
DD 3/1/05

"Jess" wrote in message

"medgirl" wrote in message

I know this will be a little controversial here, but please bear with me.

DD is now almost 13 months old. I love nursing and feel like I could do
it for much longer if there weren't other issues involved. We are down
to nursing 2x/day, sometimes 3. I am no longer pumping (it's kind of
nice to be done with that). The problem is that I have a a few pressures
on me to stop nursing. One is that I probably need to have radioactive
iodide treatment relatively soon to treat my overactive thyroid.

I think this comes down to how you feel. Something to consider is popping
into alt.support.thyroid, too. I think the other two issues are sort of
secondary, but your thyroid seems to be the big one.

Something else to consider too-you mention she's been dropping down on the
weight curve. Was her thyroid tested at birth?

Thanks for your reply. Her thyroid was tested at birth and also after I
started antithyroid medication and was okay both times. I think it might be
a good idea to check it again, though, since she has had exposure to the
antithyroid meds through breast milk. I wasn't on anything when she was
under six months and nursing very frequently, so from my understanding there
probably hasn't been too much exposure (I space out taking the medicine from
nursing and it basically passes into and then out of the breast milk), but
you're right that it's something they should consider.

"medgirl" wrote in message
...
Thanks for your reply. Her thyroid was tested at birth and also after I
started antithyroid medication and was okay both times. I think it might
be a good idea to check it again, though, since she has had exposure to
the antithyroid meds through breast milk. I wasn't on anything when she
was under six months and nursing very frequently, so from my understanding
there probably hasn't been too much exposure (I space out taking the
medicine from nursing and it basically passes into and then out of the
breast milk), but you're right that it's something they should consider.

Then I think it comes down to how you feel right now. If you're starting to
feel crappy, then maybe it's time to consider getting your thyroid taken
care of. I know weaning is tough, but you've also got to consider your
health at the same time.

Jess

"Sarah Vaughan" wrote in message

I felt this way as well, although I wasn't on that tight a timeline. If
it helps, I found that it's surprising how much you can come to terms with
it and just say your goodbyes to this phase of your life gradually. I
spent a lot of time while I was nursing Jamie thinking "I won't be doing
this much longer..." and just savoring those moments while they lasted.
And, as the weeks went by, I found myself getting a lot more used to the
idea (though now that it may finally have happened, I'm still finding it a
wrench!)

That's a nice way of thinking of it - savoring those times even more now
that it's winding down.

What's the routine surrounding your morning feed at the moment? Do you
nurse her before or after her solids? And will she drink from a cup at
all, or is it going to be bottles for a while longer?

What happens now is that she nurses immediately upon wakening, which is
usually about 5:30 or 6. She doesn't really eat much breakfast until 9 or
even 10 - earlier than that she's not very hungry and won't take much. She
drinks from a cup a little bit, but not enough to rely on for any great
amounts, so we will probably have to use bottles for a little bit longer.
Currently what she gets in the bottle she takes in the afternoon is a
mixture of whole cow's milk and EBM (I still have a pretty substantial
freezer stash that we are using, but I am no longer pumping).

I doubt if it'll be a problem. You're probably only producing the same
amount (or less) for each feeding as you did when she was feeding several
times a day.

And good for you - for nursing your baby for this long, and for looking to
be considerate and gentle in the way you wean her.

Thank you. I have been following your weaning posts as well - this is such a
special time and I have treasured it so much. It will be hard to say
good-bye to it.

medgirl writes:

: I know this will be a little controversial here, but please bear with me.

OK. If you don't mind a slightly controversial reply (maybe). I will try
to not be dogmatic, but to offer some constructive alternatives. Feel free
to not follow any advice you think is just bad.

First, I think you have a more difficult choice than most. If your
daughter were a more enthusiastic eater, you would surely be less
worried about your choice.

: DD is now almost 13 months old. I love nursing and feel like I could do it
: for much longer if there weren't other issues involved. We are down to
: nursing 2x/day, sometimes 3. I am no longer pumping (it's kind of nice to
: be done with that). The problem is that I have a a few pressures on me to
: stop nursing. One is that I probably need to have radioactive iodide
: treatment relatively soon to treat my overactive thyroid. The radiation is
: not compatible with nursing. I have been putting this off for a while, but
: my doctor is pressuring me to get it done. It doesn't help that this doctor
: isn't real sympathetic to the breastfeeding thing (last time I saw him he
: said, "Are you _still_ nursing?" like it was the craziest thing he ever
: heard).

Is the radioactive treatment ongoing or is it a one time thing. If it is
a single application, then you could just hold off nursing for a while.
If it is ongoing, then it is a stickier problem. I have two thoughts/
questions. 1. How critical is it that you have this done *just now*?
Would be be difficult to put it for for another 6 months? 2. Have you
gotten a second opinion from another doctor, perhaps one who is a bit
more breastfeeding friendly than this one. His attitude makes me suspicious.

: The other issue is that I would like to get pregnant again, either
: before treating the thyroid or six months after (which is another area of
: debate with this doctor),

Hmm. could you clarify. Is he saying wait more than 6 months? Not get
pregnant at all? Get pregnant now? What is his position?

: but getting pregnant for me will require another
: round of in vitro fertilization, with the fertility drugs not being
: compatible with nursing either.

OK. You know more about your situation than I do, so don't get mad if I
make some wrong guesses... I don't know the specific fertility problems
but it is often the case that a woman is more fertile after having one
child, and subsequent fertility treatment isn't necessary. You miight
be able to forgo this. If you do have to have fertility treatments,
I can certainly believe the drugs are incompatible with nursing.
Finally, studies have shown that a woman does bettwe with subsequent
pregnancy if it is between 18 and 30 months after the first.

: And, finally, we have a trip planned in
: May, which will be our first trip without my daughter. At the time we made
: the arrangements, I didn't think there would be a problem having her weaned,
: but as the date grows nearer I am worried that it won't happen.

How long are you going to be apart? A day or two, or a week or longer?

: So I am faced with trying to have her weaned within the next, say, 50ish
: days, which is a very emotional thing for me as well as a logistical one. I
: have really enjoyed breastfeeding and it will be hard to give it up. The
: thing is that it seems very hard to drop the last two feedings. The
: nighttime feeding may not be too bad since she's not really nursing to sleep
: anymore, but the morning feeding is going to be hard. Does anybody have any
: advice as to how to do this? Also, I am a little worried about dropping the
: nighttime feeding in terms of getting a little engorged before the next
: morning. It just seems like such a drastic thing to go from two feedings a
: day to one.

I certainly can't help here. We did not have the medical or fertility
problems, so we let the kids decide when to wean (more or less) and it
was quite late.

: Finally, to add to the confusion, she's been having some problems recently
: with weight gain. She was little when she was born, but gained weight
: wonderfully for the first six months, although she has always been around
: the 10th percentile. At about the time that solids were introduced, she has
: started to gradually fall down on the growth chart. When we saw the
: pediatrician last week, she was down in the 3rd percentile for height and
: weight. The pediatrician wasn't too worried, but wants us to bring her back
: for a weight check. I think the problem is that she just has not been as
: enthusiastic of an eater as some children. She really doesn't even like to
: put things in her mouth, which is kind of weird. It's hard to get her to
: eat many new foods. Solids are supposed to supplement nursing in the second
: half of the first year of life, since nursing alone isn't going to give the
: rest of the calories she needs, but she just really doesn't eat enough. She
: has been very resistant to finger foods. She does eat baby foods okay, but
: it seems like such a leap to get her to eat any more. Weaning may
: complicate this, although I think she is probably getting relatively few
: calories from breast milk at this point anyway. Any advice for "fattening
: up" a baby?

Ice cream, LOL! I certainly sympathise with her eating habit problems, and
know this works against weaning. We did have some weight gain problems
with Clara as a nursing toddler, and our doctor actually suggested the ice
cream!

: Thanks to anyone who has read this far. I appreciate any advice!

: Sarah
: DD 3/1/05

Good luck,
Larry

medgirl wrote:
"Sarah Vaughan" wrote in message

What's the routine surrounding your morning feed at the moment? Do you
nurse her before or after her solids? And will she drink from a cup at
all, or is it going to be bottles for a while longer?

What happens now is that she nurses immediately upon wakening, which is
usually about 5:30 or 6. She doesn't really eat much breakfast until 9 or
even 10 - earlier than that she's not very hungry and won't take much. She
drinks from a cup a little bit, but not enough to rely on for any great
amounts, so we will probably have to use bottles for a little bit longer.
Currently what she gets in the bottle she takes in the afternoon is a
mixture of whole cow's milk and EBM (I still have a pretty substantial
freezer stash that we are using, but I am no longer pumping).

I was going to suggest giving her her solids before nursing as a first
step, but if she isn't used to getting them until hours after she gets
up then that might not work.

What seemed to work with Jamie was substituting in other things (food,
milk from a cup, non-nursing forms of affection and attention) so that
he didn't have the same need to nurse, but still being willing to nurse
him when he wasn't happy about accepting those things as a substitute.
In that way, it just never seemed to become a big deal, although of
course it made a big difference not being on a tight timescale.

So, maybe one way for you to do it would be to give her a bottle first
thing in the morning and then nurse her afterwards. That way, she
starts getting used to the fact that something else happens before
nursing, but nursing still happens. After a week or two of this, when
she's used to that pattern, you could try something else instead of the
nursing, depending a lot on how awake she is at that time of day. For
example, if she's awake and ready to do things you could take her into a
different room from usual to play a game. If she's sleepy and cuddly at
that time of day, you could walk around with her on your hip or shoulder
so that she gets the body contact but doesn't think of nursing in the
same way as if you were sitting down with her. If she still keeps
wanting to nurse, just go ahead and nurse. Hopefully, if she knows it's
still there if she wants it, she'll be more easily distracted by other
things and will sometimes forget about it altogether, and you can
gradually phase it out.

Oh - I forgot to add that one thing that we used with Jamie which I
think was very helpful was a dummy (pacifier). I don't know how you
feel about trying this, but I really do feel it made a difference for
him to have a way to satisfy his sucking needs even when he wasn't
nursing. Then again, he was on and off the breast all day long at the
point when I started the weaning process, so it wasn't really the same
as giving up one or two feeds at a time.


All the best,

Sarah
--
http://www.goodenoughmummy.typepad.com

But how do we _know_ that no-one ever said on their deathbed that they
wished they’d spent more time at the office?

"Sarah Vaughan" wrote in message

What seemed to work with Jamie was substituting in other things

(snip)

Thanks for some great suggestions - I will give them a try!

Sarah

wrote in message
medgirl writes:

: I know this will be a little controversial here, but please bear with
me.

OK. If you don't mind a slightly controversial reply (maybe). I will try
to not be dogmatic, but to offer some constructive alternatives. Feel
free
to not follow any advice you think is just bad.

First, I think you have a more difficult choice than most. If your
daughter were a more enthusiastic eater, you would surely be less
worried about your choice.

: DD is now almost 13 months old. I love nursing and feel like I could do
it
: for much longer if there weren't other issues involved. We are down to
: nursing 2x/day, sometimes 3. I am no longer pumping (it's kind of nice
to
: be done with that). The problem is that I have a a few pressures on me
to
: stop nursing. One is that I probably need to have radioactive iodide
: treatment relatively soon to treat my overactive thyroid. The radiation
is
: not compatible with nursing. I have been putting this off for a while,
but
: my doctor is pressuring me to get it done. It doesn't help that this
doctor
: isn't real sympathetic to the breastfeeding thing (last time I saw him
he
: said, "Are you _still_ nursing?" like it was the craziest thing he ever
: heard).

Is the radioactive treatment ongoing or is it a one time thing. If it is
a single application, then you could just hold off nursing for a while.
If it is ongoing, then it is a stickier problem.

The radioactive treatment is a one-time thing, but the radioactivity is
excreted in the breast milk for quite a while afterwards. To put it in
perspective, pregnancy is not advised for at least six months. I read one
case report of a breastfeeding mother who had radioactive iodine. During
that time, her milk was tested for radioactivity until it was felt to be
safe for her to nurse her baby (a 13 month old) again. This took about a
month. I just can't imagine that a 13 month old is going to go back to
nursing when he hasn't been doing it for a month. It seems like he would be
weaned, like it or not.

I have two thoughts/
questions. 1. How critical is it that you have this done *just now*?
Would be be difficult to put it for for another 6 months?

It's not critical, but I have been putting it off for awhile. The other
issue is that if I do it, it will delay any attempts to get pregnant again,
and I'm not getting any younger. The whole infertility thing kind of
derailed any sort of childbearing "timeline" I had, but it's still a
consideration.

2. Have you
gotten a second opinion from another doctor, perhaps one who is a bit
more breastfeeding friendly than this one. His attitude makes me
suspicious.

I agree. I'm suspicious, too. He phrases it to emphasize that I need to
remember my own health, which is obviously a factor, but it's not the only
factor.

: The other issue is that I would like to get pregnant again, either
: before treating the thyroid or six months after (which is another area
of
: debate with this doctor),

Hmm. could you clarify. Is he saying wait more than 6 months? Not get
pregnant at all? Get pregnant now? What is his position?

His position is no pregnancy until at least six months after radioactive
iodine treatment. He is very discouraging about trying to get pregnant
while I'm still getting medication for hyperthyroidism, because it crosses
the placenta and can cause complications in the baby.

: but getting pregnant for me will require another
: round of in vitro fertilization, with the fertility drugs not being
: compatible with nursing either.

OK. You know more about your situation than I do, so don't get mad if I
make some wrong guesses... I don't know the specific fertility problems
but it is often the case that a woman is more fertile after having one
child, and subsequent fertility treatment isn't necessary. You miight
be able to forgo this.

I wish this would be the case, but we have not used any birth control since
having my daughter and still no luck. It's now been almost a year since I
have had my periods back, so I guess we "re-qualify" as infertile again.
With the severity of the endometriosis, it's really a long shot.

If you do have to have fertility treatments,
I can certainly believe the drugs are incompatible with nursing.
Finally, studies have shown that a woman does bettwe with subsequent
pregnancy if it is between 18 and 30 months after the first.

That's interesting - I hadn't heard that. It does make some sense.

: And, finally, we have a trip planned in
: May, which will be our first trip without my daughter. At the time we
made
: the arrangements, I didn't think there would be a problem having her
weaned,
: but as the date grows nearer I am worried that it won't happen.

How long are you going to be apart? A day or two, or a week or longer?

About five days.

(snip)

Ice cream, LOL! I certainly sympathise with her eating habit problems,
and
know this works against weaning. We did have some weight gain problems
with Clara as a nursing toddler, and our doctor actually suggested the ice
cream!

Probably not a bad idea, really. :-)

Thanks for your response, Larry.

Sarah

wrote:

Is the radioactive treatment ongoing or is it a one time thing. If it is
a single application, then you could just hold off nursing for a while.

There is a concern with ablative radioactive iodine treatment (not just
a scan) that is not only related to the baby's dose, but to the fact
that the RAI concentrates very, very heavily in milk, leading to the
potential for an increased risk of breast cancer in the mother. Dr Hale
has posted about this on Lactnet several times. It's one of the very
very rare situations where pumping & dumping doesn't mitigate all of the
risk, and it is often recommended to wean around a month before
treatment to ensure involution.

Lara