The Highs and Lows of Nursing a Toddler

I haven't joined the carnival of breastfeeding for sometime now but I couldn't let this month pass without joining for the topic was quite near to my heart and current situation - extended breastfeeding.   I had previously written about the challenges of weaning and to date, we still have not completely and successfully weaned.  

I purchased Maggie's Weaning in hopes of getting N to understand what weaning is.  I think she does understand what I'm asking for her and every time we get to part when Maggie has her weaning party, she gets teary-eyed and says that she doesn't like the book. So it's safe to say that at 39 months, N is still breastfeeding and doesn't look like she's going to wean anytime soon. 

Let me start with the challenges with nursing a toddler.  My biggest challenge actually results from my environment - dealing the comments from people around me, particularly from colleagues at work.   It's no big secret that I'm a breastfeeding/pumping mom since along with my colleague Claire, we spearheaded the establishment of a breastfeeding awareness festival and lactation rooms in our organization.   And most of my colleagues are amazed that N is still breastfeeding until today.  What I dislike most is the comment "She's still nursing until now?!" with raised eyebrows and an incredulous voice.  

I know I shouldn't feel defensive but I really feel irritated by the need to justify that I'm not harming my daughter by allowing extended nursing.  But sometimes the comments do get to me and I wonder if nursing has already become a habit for my daughter and whether we both will have difficulty breaking this habit later on.  

As a toddler, N is the little acrobat when nursing - standing, sitting, in the bathtub, while reading a book (her favorite nursing position).  Plus she never learned not to grope! She also has this weird habit of wiping my breasts before latching on.  

Nursing is also no longer a cure-all for her troubles.  There was one instance when she got upset because her nanny threw away a tissue paper she saved and she sobbed, howled, ran out of breath and no amount of nursing could sooth or distract her.  But it is still a cure for some things.  Just recently, she got some itchy issues with her privates and to prevent her from scratching, I just let her nurse - still works perfectly!

Why do I still allow her to nurse as a toddler?  I'm holding off actively weaning her because of our vacation which started last week.  We are thousands of miles away from home and she will be sleeping in new places and meeting new faces.  I want her to have a comfort zone and nursing is currently her favorite comfort zone.  Also, as a working mom, I really treasure our nursing moments - the bonding moments.  She is really quite busy and active and nursing is our quiet time.  Plus, when I'm tired from the day, nothing comforts her faster during the night than popping my breast in her mouth!
Nursing a toddler definitely has its plus and minuses.   N promises that she will stop when she goes to big school this June so I will most likely start actively weaning her when we get home from our vacation this May.  Wishful thinking?

Breastfeeding Rooms in the US

Hot on the heels of our own Breastfeeding Promotion Act of 2009 is the US' health care bill recently signed into law by President Barrack Obama which includes provisions on providing non-toilet rooms for pumping moms.

According to CNN, in page 1239 of the health care bill that President Obama recently signed into law, employers are required to provide "a place, other than a bathroom, that is shielded from view and free from intrusion from co-workers and the public, which may be used by an employee to express breast milk." [The local counterpart would be lactation stations mandated by Republic Act No. 10028, which are "private, clean, sanitary, and well-ventilated rooms or areas in the workplace or public places where nursing mothers can wash up, breastfeed or express their milk comfortably and store this afterward" and shall not be located in a toilet.] Noticeable is the fact that the authors of the law have realized how unsanitary it is to express milk in the toilet, yet so many working moms end up doing so because of the lack of available facilities.

However, depiste the grant of the breastfeeding station, the rights given to nursing moms by the law is still limited. Among the limitations enumerated in this New York Times blog are exemptions for companies with less than 50 employees [if company can show undue hardship], no guaranteed pay for time spent expressing milk and no requirement for access to a place where expressed milk can be stored. Also, there is an upper limit that the reasonable break time is only for employees nursing her child for 1 year after birth. I think the upper limit is based on the American Academy of Pediatricians' recommendation to breastfeed babies up to 1 year. But some moms, like me, continue to do so even after their babies turn one. In my case, I continued to express milk for Naima at work until she turned 2 years old. So does this mean that women who continue to breastfeed their babies beyond 1 year are no longer given reasonable break time to express milk for their toddlers?

I'm glad to note that our own law defines a nursing employee as "any female worker, regardless of employment status, who is breastfeeding her infant and/or young child (who is defined to be a child up to 36 months old). Also, the exemption for employees do not specify any number of female employees. Rather it is whether the establishment of the lactation stations "is not feasible or necessary due to the peculiar circumstances of the workplace or public place taking into consideration, among others, number of women employees, physical size of the establishment, and the average number of women who visit." I'm not sure if this is a better provision as it would depend on how the implementing rules and regulations will be construed.

In any case, having the requirement of breastfeeding stations clearly written in law is a major step. Hopefully, a detailed lactation program will be set-up in my workplace by the time I have my second baby.

Nursing Naima

Naima is 23 months today - one more month and it's that terrible two's period (not too terrible I hope :D). Stan and I keep talking how we miss a baby and that Naima is no longer one. She can talk - mix of English, Tagalog, Fookien, Mandarin and Bisaya (with some sign language!). And enjoys playing tricks on Stan and her yayas.

She has also lessened her expressed milk intake but still enjoys nursing with Mommy Jen. Naima likewise enjoys nursing her babies and here are some photos taken by her yayas while I was at work.

nursing baby nica

toddler nursing position - she's all over!

smiling for the camera

my favorite position! side-lying :D

She is growing up pretty quickly (and I can hear my mother-in-law in the background nagging me about another baby :D)

Toddler Moms and Relactation

Since I joined L.A.T.C.H., I have received several inquiries connected with relactation. The ages of their babies vary from 1 month to 16 months. For a mom to successfully relactate, a lot of dedication, special strategies and medication is usually necessary. Thus, I always refer cases like these to the International Board Certified Lactation Consultants (IBCLC) in the Philippines. There are currently just 5 with a couple more applicants trying to complete their certification.

However, I also give the moms some reading materials on relactation so they know what to expect before they contact the IBCLCs. Here are some of the materials I share:

1. Kellymom

2. La Leche League International

3. Idaho Public Health (PDF)

4. Dr. Jay Gordon

For moms with toddlers, however, I also advice them not to stress out about relactation anymore. As a toddler, it is more important for him/her to learn how to eat healthy foods and have a balanced diet. In fact, milk is gradually replaced by solids beyond the first year. In fact, some kids completely stop drinking milk by age 2 and get their calcium and other requirements from foods such as malunggay, orange juice, cheese and yogurt. In my previous post, I shared the thoughts of Dr. Francesca Tatad-To, on the importance of having a balanced and healthy diet instead of filling up toddlers with milk. Thus, the best advice I can share to moms with toddlers is to focus on their children's diet and making sure that they are fed with healthy nutritious food, rather than worrying and stressing themselves out with relactation.

The Challenges of Nursing a Toddler

Painting by Jonahmar Salvosa of Velvet Escario-Roxas, nursing her eldest daughter J.Hye

Now that Naima is a walking, talkative toddler, I've been hearing a lot of those "up to when will you nurse her" questions and comments. Several oldies had suggested that I wean Naima when she started walking. Others are surprised upon seeing Naima's full set of teeth (she has about 16 now) and ask me if Naima ever bites when she nurses (she doesn't).

When the Milk Code was first enacted, milk companies were required to put this statement on their products: "Breastfeeding is best for babies up to 2 years." However, despite this requirement, members of my generation were most formula-fed babies. Formula milk marketing was so widespread and pervasive. In fact, I can still remember the theme songs of these milk companies when promoting their products! The wording of the required warning was eventually changed to "Breastfeeding is best for babies for 2 years and beyond."

However, despite this 2-year age minimum, several friends, acquaintances, relatives are still amazed that I continue to breastfeed Naima at 21 months. In the early days, I myself did not think that I would be able to sustain breastfeeding beyond 1 year. At her 1^st birthday, I wasn’t ready to stop and I didn’t think that she was yet so I extended my goal to 2 years old. Now that Naima’s 2^nd birthday is fast approaching, I don’t think that she will be weaning anytime soon. So, I’ve decided to continue breastfeeding Naima when we are together and just wean from the pump by the end of this year.

Breastfeeding trials are not limited during the early days of breastfeeding. Nursing a toddler also presents its own unique challenges. My current pet peeve with Naima is twiddling. Every time she nurses, she loves to twiddle my other nipple, given the chance. Nursing during the day is not so problematic since she is awake and immediately removes her hand when I tell her. But nursing when she is half-awake is beginning to be difficult. I always remove her hand but she struggles and puts her hand back to my other boob. If I cover the other breast, she whines and moves about, disturbing an otherwise peaceful nursing setting.

Naima is also now enjoying solids – very much! She eats frequently and drinks less and less milk. She also has irregular nursing sessions e.g. no more schedules. She nurses whenever she pleases which could be every hour or in intervals of 5 hours! This is why I always take her with me wherever I go during weekends as I never know when the nursing mood strikes her. This leads to another challenge à trying to nurse in public. When Naima was younger, I use a nursing cover when we had to nurse in public. But now that Naima is a wriggly toddler, she refuses to nurse under a cover and wants to see my face when nursing. Happily, I’ve gotten over my issues about nursing in public, although now that she’s a toddler I’ve been more conscious of unwanted comments from other people.

Nursing a toddler certainly has challenges. But every time we cuddle, Naima nurses and touches my face, I can’t bear the thought of weaning her yet. I really look forward to our nursing sessions, especially since I work out of home and am away from her about 10 hours a day. These sessions are our quiet bonding sessions. At this time, I certainly don’t look forward to the day when Naima will simply stop asking for “MIK, MIK, MIK.”