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Monday, May 14, 2012

Guest Post: Knowledge and Experience are the Best Tool

This is a guest post written by Dr. Anne Margaux Bautista-Quezada.  Anne is a General Practitioner and works full time at the Rural Health Unit in Malita, Davao Del Sur.  Anne has 3 kids - Reese Leila (3 yo), Kate Lauren (2 yo.) and Glen Marco (8mos. old).  Her husband, Glinard, is also a Physician and is currently reviewing for his Diplomate Exam in Surgery.  
Anne is from my hometown, Davao City and graduated from the Davao Medical School Foundation.  She became a Licensed Physician in 2007.  Aside from being a full-time doctor and mom, she also blogs at Diapers and Stethoscope and owns the online shop The Shop Next Door where she sells baby products. 
It is quite refreshing to read about the experiences of doctors.  We are a doctor-centric  society and we usually believe everything our doctors say.  I am happy that Dr. Anne was willing to share her own experiences - failures and successes in breastfeeding.  Read on. 

"Breastfeeding is easy"... That was my first thought. I remember buying a cheap breast pump while shopping for my first child. I thought, "Why would I need breast pumps and books on breastfeeding? That should be easy I think". I assume during those times that it would be as easy as 1,2,3. 
Why that assumption when it was not actually taught in medical school?  During my first year, we touched on breastmilk vs. formula milk in Pediatrics. During my clerkship in OB-Gyne, we were tasked to give a lecture on breastfeeding during mothers' class. "Poor me", I thought. I don't know much about it, I'm not even a mother and there I was giving a lecture about it and I barely even know how to do it. But it was part of my clerkship or I wouldn't graduate. The visual aids were provided. Again, I went through it mechanically. I never really encountered any books on how to properly latch a child to the breast. Sure, I've heard of mastitis, in one or two books like surgery and pathology. Other than that, I didn't read anything else about breastfeeding.  And this is the reason why I took everything about breastfeeding so lightly.

Imagine my surprise when I gave birth to my eldest child, Reese. Milk was coming out soon after giving birth. I didn't use the breastpump much. I was directly feeding my daughter. But what came over a few days after that, were pain and tears. Everytime my daughter feeds, I'd be crying in pain with sore nipples. She wasn't latching on correctly. I wanted to continue feeding her but I couldn't take the pain. My breastfeeding journey was over by 2 and a half months. It was a frustration.

Next came the blame game. I blamed myself for not knowing much. I was contented with what I knew then. I didn't see the need to read more about it. I blame my medical school for not giving much importance to breastfeeding. I could have breastfed longer had I known all I know now.  Nevertheless, my daughter grew up to be a loving child, having occasional cough and colds but healthy in all aspects.

When my eldest was about 8 months old, I got into the online business. Since I was so passionate about kids, I started selling children's items. This is when I got to know Jen Tan of Next9, Monica and Denise of IndigoBaby. They were all advocates of breastfeeding. I read about their experiences attending
breastfeeding seminars and trainings. Through them, I met other people such as Chronicles of a Nursing Mom. That's when I realized how much people are exhausting to learn about what seemed to me, an easy thing.

By this time, I found out I was pregnant with my second child. I vowed to breastfeed my second child for at least 6 months. I read and read and read. I took all that I could. I even commented on one of the post on Jenny's site on the fact that breastfeeding wasn't taught much on medical school.

When my eldest was 1 year and seven months, she got sick. She had Kawasaki Disease. As I recall how she was up to the point when we took her to the hospital, my heart would ache. The thought of, "If I had breastfed her longer, she wouldn' have had that.'' Of course I wan't sure if that would have been the case.
But that experience made me want to breastfeed my second child longer.

When I gave birth to my second child, Kate, surprise surprise, no milk for 4 days. Not the thing I was hoping for but yes it happened. What does a mother do? Resort to formula milk. However, I was determined - come earthquake or tsunami, I would breastfeed her in any way. I pumped and pumped using my old cheap (P200) breastpump. 

Everyday my breasts would be bigger but no milk would come out. They were becoming heavy and the pain  was starting to affect me. I knew then that my cheap pump couldn't help me. Luckily, I had been browsing the net for cheap quality pumps although I didn't have the courage to buy myself one.  I hurriedly bought the best second hand Medela breastpump. By the time I had it in my hands, I couldn't wait to wash it because I was already crying in pain. My breast was ready to burst. What came after that was 6 months of exclusive pumping. Yes, I wasn't feeding her directly, I still didn't know how to properly latch my baby. Nonetheless, I was feeding her breastmilk. So I was contented.

My breastfeeding career with my second child was over after 6 months. I was on ER duty at times and it was hard for me. Soon after resorting to formula milk, Kate began having various illnesses - flu, upper respiratory tract infections, the things that she didn't have while on breastmilk. I tried squeezing my breast if there was still milk, a few drops were there but she won't take it anymore. That's when I knew that we mothers are goddesses. We can really provide for our offsprings.

My third pregnancy came as a surprise. I was on my way to losing the weight I gained from pregnancy when  I found out I was pregnant again. This was to be my last pregnancy - whatever the gender of the baby.  I had Hyperemesis Gravidarum in all my pregnancies. I was vomitting more than 15 times a day. I had to be admitted to prevent dehydration. I couldn't take in anything even water. Everything that I ate would come out in 30 minutes. Plus during my third pregnancy, I was already regurgitating blood. My fear overpowered me and I didn't go to the hospital. One of the perks of being both doctors is that help was always just a phone call away - even the OB resident on duty at the hospital. 

When I was about 3-4 months pregnant, I applied for a new job. I started working at the rural health unit here in Malita. I was visiting different barangays while pregnant. Nothing could have stopped me and I was seeing the finish line in full colors. At about 34 weeks, I got sick with Dengue fever. Good thing it was only mild. Though I was having contractions, the doctors were able to control it. I was having palpitations again, which I have not had since my first and second pregnancy. But I got better and was out of the hospital. Two days after, I had vaginal spotting and was back in the hospital again. I was having contractions again but they were able to control it and was discharged.  However, I continued to have contractions at home so my OB, Dr. Malou Monteverde of Brokenshire Hospital, and I decided to schedule for my third CS when the baby was 37 weeks via ultrasound. So on August 14, 2012, Glen Marco was born.

As with my previous pregnancies, longer duration of breastfeeding was the first priority. I was able to produce a few drops for the first 4 days. We were giving him formula milk on a few occasions but I vowed to keep him on breastmilk. I bought a new breastpump. I was still reading blogs about breastfeeding.
I was also able to purchase my very first breastfeeding book from Babymama. As soon as my milk was established, he was exclusively breastfeeding. I also learned to put him on my breast which I had done since day 1. This has helped me feed him longer and established a proper latch.

Unfortunately when Marco was a month old, he had to undergo surgery for hernia. Imagine the heartache of seeing your child crying for food. They also noticed that he had jaundice. They were trying to get blood samples, which they couldn't. During one of our follow-up appointments with his pediatrician, the substitute
doctor requested for blood samples. His bilirubin levels were elevated. I knew what was coming next, to feed him formula. I was concerned. My heart was aching. On one hand, I didn't want to stop giving breastmilk and yet on the other hand, my mind was saying, what if?. So I fed him formula milk for 6 days. A repeat blood sample resulted to a decrease in bilirubin levels. As soon as I got the go signal from his pedia, I fed him breastmilk immediately. It was breastfeeding jaundice after all. 

In my entire breastfeeding journey, I have relied on blogs, books and articles. I have read other breastfeeding mothers' stories, I have joined breastfeeding blog carnivals, I have joined contest online and actually won a breastpump. And when I see patients who are having a hard time breastfeeding, I try to teach them what I have learned. It's easier to teach when I have actually tried it. When my pedia patients are crying while examining them, I tell their mothers that they could breastfeed inside my office.

I do not claim to be an expert on breastfeeding, I do not have any certificates to show you that I am a trained breastfeeding counselor. What I have is all the knowledge gained through experience and constant learning from different people.

Up to this day, my almost 9-month-old son is still breastfeeding. I work full time at the health center. I have vowed to continue breastfeeding for as long as I could. It's not easy, so I count on different blogs and books and stories for inspiration.

Recently, we were able to donate Marco’s extra breastmilk. We were able to give more than 20 bags, about 2 ice box, of frozen milk to the babies of Southern Philippines Medical Center. My family is hoping we can still do it again soon as we continue with our breastfeeding journey.

To other breastfeeding mothers who are struggling with their supply or with how to do it despite the busy schedules, don’t lose hope. Just continue to feed your baby, read up, ask others and pray!


kristine gavilano said...

Hi doctor! Thank you for sharing your experience. I can somewhat relate with you. During my pregnancy, I worked as a volunteer nurse in our local hospital and felt like an expert teaching the new mothers how to breastfeed properly and of course, that's also what I wanted for myself. When I gave birth,I found everything hard and ended up with only 1-month of BF. I was so frustrated and also blamed myself every time my son gets sick. I vow to breastfeed on my second baby when he/she comes. Thanks for sites like this for making us informed and educated about breastfeeding.

Larissa Viado-Ocampo said...

Thank you Dr.Anne and Jenny for sharing this post..  It's very encouraging to know there are a lot of moms who decide to and try their best to direct feed and pump at work just to provide their babies with the best milk we can provide.  I'm a breastfeeding (& pump-at-work) mom too with a 7-month-old baby boy.  The FB posts and articles are really a big help.  Let's continue to spread the word!  

harun sharma said...

Its a very nice blog and in my opinion there are various
reasons for using breast pumps as many women go on work so they require breast
pumps to express breast milk as they have little time, which is later bottle fed
to their child by a babysitter or caretaker.
breast pump

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