Tuesday, May 13, 2008

Tandem and toddler nursing

As I mentioned in my introductory post, I breastfeed my toddler and my infant. Nursing two is called tandem nursing.

Let's be honest--tandem nursing is pretty uncommon in the United States and is therefore (understandably) seen as weird. People tend to have questions about it. Online on message boards, people have an easier time honestly saying how they feel and asking questions, so that's generally where I'm asked about it the most. People I know in "real life" who know that I tandem nurse are probably usually a little embarrassed to ask questions.

So I thought I'd address the questions and concerns I've heard regarding both tandem nursing and toddler nursing. My goal has never been to be a tandem/toddler nursing evangelist, "converting" as many moms as possible. Tandem and toddler nursing are not for every family and that's fine with me! What I do want is for people to maybe see these choices as a little less odd or scary. I'd like tandem and toddler nursing to be more normal in our society.

This link is great to answer some of the questions that I have been asked, especially regarding the safety of nursing during pregnancy: http://kellymom.com/nursingtwo/faq/index.html

I definitely did my research on this so here is what I learned about nursing and contractions:

A normal uterus has multiple levels of protection that keep it from going into labor early. The number of oxytocin receptors (oxytocin causes contractions) on a normal, pregnant uterus is low until the end of pregnancy when the number of receptors GREATLY increases, allowing the uterus to respond to oxytocin by having lots of contractions and going into labor. There are other ways the uterus is protected. (See the above link from kellymom.com.)

Orgasm causes contractions, too. Yet most women are allowed to have sex throughout pregnancy. The fact is, most uterine contractions during pregnancy don't lead to labor--our bodies are well-designed not to go into labor until usually 37-42 weeks gestation.

Occasionally though, women have trouble with preterm labor. For some reason their uteruses aren't functioning with the full protection of a normal uterus. In this case, women are usually put on "pelvic rest" (not allowed to have sex). Many breastfeeding experts feel that if pelvic rest is necessary during pregnancy, the mother may also need to consider weaning since for some reason that particular mother's uterus is responding too well to oxytocin, too early. That's why when I started having excessive contractions in my last pregnancy, I cut down our nursing to about 3 minutes a day total--an amount that affects me far less than just getting up throughout the day and going to the bathroom (one of the major causes of my contractions!) By nursing for only about a minute at a time I didn't generally have any contractions; Chickie generally just was not suckling enough to produce much oxytocin at all. I made it to 36 weeks, my release from bedrest, and then didn't go into labor for three more weeks, so thankfully all my contractions didn't send me into preterm labor.

One final word on safety, from that kellymom.com site, "A recent review of research on the pregnant uterus reveals that there is actually no theoretical basis for the common concern that breastfeeding can lead to miscarriage or preterm labor in healthy pregnancies. Instead the uterus has many safeguards preventing a strong reaction to the oxytocin that breastfeeding releases.

Interestingly, experts on miscarriage and preterm labor are not among those who see a potential link between breastfeeding and these pregnancy complications. Miscarriage expert Lesley Regan, PhD, MD, quoted in Adventures in Tandem Nursing, saw no reason that breastfeeding should impact pregnancy, even if the mother has a history of miscarriage or is experiencing a threatened miscarriage."

As for why a mom would want to tandem nurse and/or nurse a toddler:

Let's start with toddler nursing.

There are certainly still health benefits to breastmilk beyond 24 months, though some misguided writers have claimed otherwise. There hasn't been a ton of research, but from a purely logical standpoint, a food that is as complete and healthy as breastmilk doesn't suddenly lose its value when a child hits a certain age. (We might compare it to spinach. Spinach is especially healthy during pregnancy because the body needs extra iron, which spinach has. But it doesn't lose its health values after pregnancy when that extra iron isn't as crucial.) But, hey, with that line of reasoning, breastmilk would be healthy for any age, and yet I know of no society in the world in which adults regularly drink breastmilk. So how long is nursing appropriate?

This varies so much from society to society. Throughout the world most societies wean between a lot later than we do--between the ages of 2-4 is common, some as late as 7. Yet in many parts of the US it's considered odd to nurse beyond a year. Just the fact that so many people throughout the world do it and have for thousands upon thousands of years makes me think that our ideas about it being odd are tied to our relatively new cultural ideas (about the sexuality of breasts, how early kids should be encouraged to be independent, etc.) So to me, the "weirdness" has more to do with who we are as Americans than it has to do with the actual act of toddler nursing.

So why do I do it? Well, quite simply, it still works for us--for both me and my daughter. When it stops working for one of us, we'll need to stop. I've set a lot of limits to nursing--the most recent coming darn close to weaning--during pregnancy because of my physical needs (first physical discomfort, then the contractions). She's at the age where she eats lots of foods and I know I can lovingly set limits and know that she is getting nutrition from other sources, so I am still meeting her needs in other ways. She may decide she's tired of nursing and wean herself--in that case, it will have stopped working for her, so it will be an appropriate time to stop. And she could still be going strong a year from now yet I've decided I'm ready for it to stop--again, an appropriate time to (lovingly, probably gradually) wean.

To be honest, now that I have been tandem nursing for a month and a half, I'm getting tired of it. Chickie definitely isn't! Likely this will "stop working" for me before it stops working for her, and I'll probably wean her in the next several months. However, it's been really nice being able to give her comfort and love through nursing, as she adjusts to our growing family, so I want us to both continue to benefit from that before I wean her. As she becomes more used to this strange new life in which she is not the center of our world, I think we'll be able to naturally transition her out of nursing.

For now, tandem nursing "works for us" in multiple ways. For one, my toddler isn't big on cow milk and can also be a somewhat picky eater, so I feel good knowing that when she's getting breastmilk, it can serve to close that nutritional gap.

The main way it "works for us" though, is that Chickie just gets lots of comfort from nursing, and that facilitates bonding for us. It's very sweet when she's dealing with all those crazy toddler emotions and she is comforted by the breast--it's like a big sigh of relief for both of us! I totally thought toddler nursing was weird when I was pregnant! Then I started reading The Womanly Art of Breastfeeding and started seeing toddler nursing in a different way. I remember one of the authors saying for her it turned the "terrible twos" into the "terrific twos". Well, I wouldn't go that far for us, especially with usually three short nursing sessions a day! But anything that can bring some peace into the craziness of life with a toddler is a beautiful thing.

This tends to be a hot topic, and I remember one long, crazy toddler nursing debate thread on an online message board some months back. Multiple moms brought up scenes they'd witnessed that really bothered them, with toddlers running up to their moms in public, pulling up Mom's shirt, and "taking a sip". Well, a mom who had nursed her toddler (and had tandem nursed) chimed in, saying that would NEVER be acceptable in her family. She said she used toddler nursing as an opportunity to teach her child respect for her body. A 2-year-old is not the same as a 2-month-old. The 2-year-old can grasp the idea that Mommy's body is not his body, and he can learn to respect her. I loved that viewpoint, and as Chickie has gotten older I have set boundaries about things like her lifting up my shirt, and not generally nursing in public any more. (I'm not anti-toddler nursing in public but there came a time I was no longer personally comfortable with it.) Basically I want her to learn that Mommy has comfort zones, and Chickie needs to respect those, just as she will need to respect the bodies of others around her as she grows up. So, toddler nursing doesn't have to be about a toddler "calling all the shots". For us it has been a very healthy way for me to teach her some boundaries, and I think that's been great for our relationship and for her development.

I guess the big question is, is there a good, logical reason for us to NOT practice tandem and toddler nursing? Sure, it totally seems weird to most in our society, because most of us have rarely if ever encountered it--I'll readily admit that! But is "weird" a good enough reason not to do it if it seems like it will work for that particular family? In general nursing has been a positive enough thing for us that I've had to get past society's "weird" factor just to do what seems to be working for our family.


Anonymous said...

Hi Beth,

I love the blog!
Teresa (from Jan 06 moms' board)

*Monica said...

I don't know if you will see this as it is so far back, but I wanted you to know that I tandem nursed my newborn and 18 month old for about 6 months. It was hard and rewarding and I am glad you did what you felt was right instead of caving into pressure from society.