Breastfeeding and hypoglycemia: Will the medically-ignorant please just shut up? (and will the research community please step up?)

I have a blood-sugar control problem. I’m not diabetic. Yet. My fasting levels are normally good: 84-85. But I get a bit high if I eat more than twenty grams of carbohydrate in one go. In high school and college I had all the classic symptoms of hypoglycemia, but was never diagnosed. My aunt once measured my blood glucose at a whopping 33 (anything under 61 is considered hypo). For the first half of pregnancy my fasting sugars dropped into the 70s, and sometimes got down to 60or 61. Second half saw my post-meal sugars creeping upward–  150,160, 165– and I got control of it by lowering carbs and going for a long walk whenever the numbers got north of 130.

Since Piglet was born, though, it’s been a roller coaster. The lows keep getting lower and the highs keep getting higher (three days ago a modest serving of rice and lentils helped me reach a personal record high of 186). Today was scary. I woke up feeling crappy, so I checked my fasting level at 6am. It was 43: lowest reading I’ve gotten since my aunt waylaid me back in high school. It frightened me, so I downed two teaspoons of sugar and three bites of leftover beans from dinner. Forty-five minutes later I checked again: 33. Another spoonful of sugar got me up to 48. My husband went out to buy groceries and cooked me breakfast: I ate half an avocado and a tiny sweet potato. And shot up to 148 at one hour. An hour or so after that I was back down around 50.

All of this sucks. Anything under about 65 and I feel crappy– lightheaded, lethargic, and crabby. Once you get over 150, you’re flirting with incremental, irreversible organ damage. It won’t kill you right away, but it’ll sure make your retirement years hell.

Here’s the problem: there doesn’t appear to be ANY legit medical research on the connection between hypoglycemia and breastfeeding. None. If you search the keywords you come up with tons of stuff on hypoglycemic newborns, but nothing on hypoglycemic mothers. I’m hardly a unique case, though, and further searching turns up a lot of women like me, asking the same questions, i.e. What the heck is going on with my blood sugars? I think breastfeeding is exacerbating my hypoglycemia/making me hypoglycemic– is this possible? What do I do about it? Is this affecting my baby?

In the absence of any real medical input on these questions, a lot of rabid breastfeeding advocates feel the need to jump into the breach and claim there is no connection whatsoever between breastfeeding and hypoglycemia, that breastfeeding is the most natural, wonderful thing on the face of the earth and it is simply not possible for it to have any negative effects on mama or baby.

Which means I can’t find any real, useful, helpful information on the problem.

Rabid breastfeeding advocates: I know you mean well, but you’re full of shit. Back off. I am breastfeeding my child, exclusively. And I want to continue to do so. Denying that the problem even exists is not helpful.

Medical profession: I know there are a lot of medical problems out there. But it’d be nice if you could get to this one. Is my system dumping sugar into my milk supply? Could this be the cause of the colic episodes? Is there something else I should be doing to control it, apart from watching my carb intake and eating protein frequently? How do I keep my sugars from plummeting overnight when I’m not eating?

In the meantime, I guess I’ll lay off the sweet potatoes and rice, keep eating truckloads of protein, and hope for the best.

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Colic and YouTube

Mr. Grumpypants has been, well, cranky lately. He’ll have a couple of minor cranky spells in the morning and afternoon, and then in the evening it is Grand Horrible Screamingfit Crankytime. For one to three hours. Nothing calms him for more than a few minutes. We’ve been playing a lot of YouTube music videos to keep ourselves calm, and sometimes they even work for the baby. For a time. So far, here’s what works best:

1) Way-too-loud waterfall video, ten minutes long: freaking fantastic. It is loud enough to get through to him while he’s still crying, and this morning it got him calmed down enough to nurse, and he fell asleep in under five minutes.

2) Waves on beach sounds. Less hard on my own ears, and seemed to help him sleep.

3) Brahms: Mr. Grumpypants does not like Tchaikovsky, but he seems to like Brahms. If he hasn’t reached Ultimate Screaming yet, it’ll catch his fancy for a few minutes.

4) Andres Segovia: I like Segovia. But for reasons I cannot fathom, my six-week-old son is totally mesmerized by him. Is it the chunky glasses? The bald head and wispy fringe of hair like his own? I don’t know, but I’ll take it.

And because we are desperate and we’ll try anything, we’re also giving colic massage a go. Here’s a good instructional video:

Currently, what seems to work best at the worst times is the colic hold:

Mr. Grumpypants is too big and too heavy to do this one-armed like the guy in this video, but we (usually my husband) do the two-armed version and walk him around and around and around the apartment. This can work for a good while, if he’s not too freaked out, but it’s not foolproof. Eventually one’s back gives out, or he freaks out and starts yelling again anyway. But once in a while, he just goes to sleep, or stays calm enough long enough that I can nurse him and we can all go to bed.

For extra insurance, I’m also eliminating eggs and dairy from my diet for a while, to see if that helps, and I’m looking for an alternative to my daily dose of leche de magnesia, in case that’s somehow crossing through my milk and upsetting his stomach. The stuff certainly makes me fart like crazy, and I have run across a couple of mentions of mothers’ stool softener/laxative use affecting the breastfed baby, so…   perhaps a big chunk of vitamin C in the morning instead?

Block nursing continues. I honestly can’t say it’s making any difference, but at least I can tell when the breast is actually empty now. They were never getting emptied before. We’re settling into a pattern, where it’s about four hours to empty one side at the start of the day, because he nurses only short sessions before falling asleep again, at night, and when we get up in the morning, my boobs are on the verge of exploding. Sometimes I have to express the side he’s not nursing. We’re still having problems with massive let-down response. He pulls  away choking and coughing, and I scramble for a rag to soak up the river of milk running down my side.

Breastfeeding in public… in Lima

The boy is almost six weeks old. I took him to church today for the second time. I’m still not used to the additional planning and hassle of taking a baby with me, but I’m learning. At least I don’t have to worry about bottles and formula. But then… I am an American, and I’m not absolutely sure what the “rules” are about breastfeeding here. Back in the US it can be a charged political issue, depending on where you are. Which means that however you feel about breastfeeding, if you do it in public, someone is going to feel that you are A) making a political statement, or B) committing a terrible breach of etiquette.

I’d seen women nursing just about everywhere here, and the children being nursed are a surprising range of ages, so I figured wherever I need to feed him, it’s probably OK.  But I’m still a bit timid about it, so I try to find an out-of the-way spot and not expose acres of skin.

At church, he wanted to nurse for most of the liturgy, so I nursed him in the pew for a while, and when he got fussy and needed a diaper, I went out to nurse him outside and in the church hall. No big deal. The pew was tucked into a corner and nobody even noticed. After church we caught the bus to the mercado, and went to lunch at a pollo a la brasa place. The boy had passed out in his sling as soon as we left church, and stayed asleep through most of lunch. As we were finishing up, though, he got cranky and hungry again, and we had to scurry to pay and leave so we wouldn’t be those people with the screaming baby in the restaurant. We walked out, and looked for a good place to sit and feed him. He cried all the two blocks up to the merchants’ street, where there are nice shady benches.

Those benches are in the middle of a large and busy pedestrian thoroughfare, but I spotted one that was sheltered on one side by the back of a vendor’s booth–something resembling privacy– so we sat down there, next to a nice-looking middle-aged couple, and I rearranged clothes and sling to nurse him. He happily settled in for lunch. The woman next to me asked how old he was, and whether he was a “mujer” or an “hombre”, and what was his name. Then, a lady with a three- or four-year-old boy in tow stepped out of the foot traffic toward me, speaking rapidly and enthusiastically to the boy. I picked out the words “bebe”, “leche” (milk), and “teta” (breast)…  something to the effect of “look! the baby is drinking milk from this lady’s boob!”  Everyone around us seemed to think this situation was totally normal, so I mustered my best smile-and-nod, and we did the usual round of questions again– age of baby, yes he’s a boy– and she did the usual cooing and “bonito!” (or “que lindo”, or “chiquito nino” etc.), and I said “gracias” and she went on her way.

The lady next to me pointed out that he had mushed half his nose into my boob and I should rearrange him to breathe more easily. So I did. Hardly had she finished helping me with my latch when another woman with a slightly older boy in tow stopped by to admire the baby (all the while he is still eating) and to chat with the woman next to me, while they both peered at the baby and discussed the color of his eyes. The maintenance ladies in our building had almost the same conversation about him when we first brought him home– apparently it is a generally known fact here that all gringo babies have blue eyes, but few people ever have a chance to verify this firsthand, so when an actual gringo baby comes along, it must be checked out.

It all reminded me of those anxiety dreams I had back in school, where I’d show up for class, but had forgotten to wear a shirt… I’d feel terribly self-conscious about it, but nobody seemed to notice, so eventually… it was ok and didn’t really matter. Breastfeeding is not political here, as far as I can tell. It’s perfectly normal, and having a cute baby in your arms gives everyone permission to come talk to you, whether the baby is eating or not. I’m still not sure how to react to this, but so far smiling, nodding, and saying “thank you” to compliments seems to be acceptable.

Oversupply and block nursing, topless zone

I gave up on block nursing. I’d been going 3-4 hours a side, and it didn’t seem to make a difference.  So this morning I went with whichever side was fullest.  And the screaming started at noon.

Today was day three without eggs, so I don’t think they’re to blame. I may still eschew butter for a while jost to see, but…

I found another blog describing very similar troubles, and it points back to oversupply.  She mentions block-nursing for up to ten hours a side, in the beginning.  So maybe 3-hour block are just not long enough, and I need to give it another shot. How do you tell when the breast is completely empty, exactly?

Since the screaming episodes started, our house has become an intermittent topless zone. As soon as the baby gets fussy, my husband and I are both shucking our shirts– him because he wants to avoid urp on his clothes, I because it’s easier to nurse that way.  We tag-team it, me nursing, my husband burping the kid, and both of us pacing the floors.

Also: the rolling over was not a fluke. He did it a third and fourth time this morning!

Boob alarm, unintentional bed-sharing

The baby has his own bed. Sometimes he even sleeps in it. But with the advent of colicky evenings, he’s been spending less time in his own bed and more in ours.  Not on purpose: it’s just that after three hours of screaming, I am so wiped out that when he finally calms down enough to nurse, I fall asleep feeding him. The big puffy comforter is already off the bed because it’s way too hot for that. That’s about as safe as we can make it. He prefers our bed, and as much as I’d prefer he sleep in his own… I’ve ceded the moral victory for now, in favor of getting more sleep.

During the day, I may have to change up our habit of nursing while lying down. It’s easier for both of us, and it’s nice that he drifts right off to sleep when he’s full– no danger of waking him up by having to put him down or move him– but lately he’s been using a boob alarm to keep me from leaving and doing productive things while he sleeps (as long as he’s sharing our bed, I’m sleeping well enough at night to make this possible). When he’s right on the verge of sleep, he flails his arms around a little until one hand lands on my boob. Then, he goes to sleep. I try to sneak away, but the hand alerts him. Without even waking up, he reaches out to get a better grip on me. If I leave anyway, he wakes up and wants to nurse again. Arg! One the one hand it’s incredibly cute, and on the other hand it’s quite frustrating.

First foods, potty update, sharking, screaming, atrophy

My son’s carnet has food recommendations on it. Delightfully, it says in very clear terms that for the first six months, he should have nothing but breastmilk. When it comes to introducing solids from 6-24 months, it recommends a lot of the things you’d expect, like avocado and bananas and rice, and also quinua, higado (liver), and cuy (guinea pig).

The pottying continues. I can’t really tell if we are saving any diapers, but we are certainly staying well clear of diaper rash, which is a huge relief.  We’ve had a couple of incidents where he griped at me while nursing and I did everything *but* put hom on the potty– burped him, pulled him away for a minute in case it was a gushing let-down that was the problem, walked him around…  and then after all that he let loose a massive poop in his diaper and felt much better. And if I’d been paying better attention, we probably could have kept the diaper clean. On the other hand, we’ve had pretty good luck catching him at the usual times, like when he first wakes up. Pretty good for only five weeks old. I’m not sure if the lack of rash is more attributable to going potty more and getting him out of poopy diapers very quickly, or if it’s because we rarely use wipes– I rinse him off in the bathroom sink instead. Either way, rash free = good

I had been coming down with a cold I was sure would become bronchitis, but I put off taking the antibiotics until I could confirm an infection with the arrival of yellow or green phlegm. It never happened. I still have a wee bit of congestion, but I think I can safely say I killed this cold without any drugs. Yay!

Breastfeeding had been going really well, except for being engorged way too often. That seems to have slowed down, but I’m still dealing with a seriously overactive let-down. I can’t always feel the let-down happening, but I can tell it does, because the boy chokes and sputters and pulls away and gets cranky. And often when he pulls away, my nipple is actually shooting out milk, so that it sprays onto his face and neck. Not sure there’s anything I can do about that except wait till it slows down before I offer him the breast again. The worst problem here is that sometimes he doesn’t want to let go, so instead he bites down on the nipple to stop the gushing, kind of like the way he was latching our first few days– little shark bite! Ouch!

The hardest thing this last week has been recurring episodes of evening screaming. The only thing that consoles him– and it doesn’t always work– is lying face down on my husband’s arms while my husband paces the floors. I am so out of shape and the boy is so heavy that I can’t keep this up for more than a few minutes, so the lion’s share of the chore goes to my husband.  It’s maddening, because we don’t know what is causing him to scream. He seems in pain, but we’ve tried all the exercises for baby gas relief, and they have no effect whatsoever. The timing is curious. It doesn’t happen every evening, but it only happens in the evening. So far the pattern is consistent: he screams and kicks and writhes and acts like he wants to nurse but when he’s put to the breast he can’t calm down, gives up after a few sucks, and reverts to screaming. A little before midnight, he finally manages to nurse (always on my right side!), and then goes to sleep. The screaming is nerve-wracking and exhausting. I wish we knew what was wrong.

One month old, gas, growth, slinging, bronchitis?

Four weeks old, actually. That’s still a couple of days shy of one month. He’s been growing at breakneck speed, and some of his newborn onesies and sleepers are already getting hard to fasten. We’ve started a “donate” bag.

Last night we had our first major gas episode. The poor kid was inconsolable for over an hour, which is so atypical of his behavior the neighbors asked about it this morning. We tried everything– changed his diaper, took him to the potty, wrapped him up warmly in blankets, removed blankets, walked him around, tried to nurse…   he kept signalling that he wanted to eat, but then when I tried to nurse him, he’d pull away after a very short time, crying and arching his back. Finally we landed on the solution of cradling him on our forearms (we took turns) stomach-down with his arms and legs dangling, and pacing around the apartment. That worked, and after a while he fell asleep. Poor guy…  he was so obviously in pain, and we were all so very tired.

The sling takes more getting used to than I had expected. When we bought it, we walked out the door of the store, took it right out of the bag, and I put it on and put the little guy into it, and it was perfect. Now that we’ve got it home it has proven somewhat more difficult. If the baby is awake, he tends to have his own ideas about how to get into the sling, and this complicates the process. Legs and arms don’t go where I expect them to. I think we’ll get it with more practice. I just hope we can manage something good-enough for the embassy appointment in a couple of days.

Oversupply is still a nagging problem. I’m trying out block nursing– where instead of trying to nurse on both sides each feeding, or alternate at each feeding (neither of which was working well), I am alternating sides every three hours even though he usually nurses more than once in that span. I’m kind of afraid the overabundance of milk may be what led to last night’s gas episode, so I’m really hoping this works.

I’m coming down with a respiratory infection. It started as a scratchy throat, then my sinuses got irritated and my nose started running, and now the nasal congestion is becoming throat congestion, which then usually marches down into my lungs and becomes bronchitis. I’m terrified at this prospect– I don’t know how I will manage if I get a bad case of bronchitis. I’m debating whether or not (and when) to take my emergency stash of azithromycin. I really, really don’t want to be taking antibiotics (or any other medications) while nursing, but if the choice is between that and bronchitis, then antibiotics seem like the lesser evil. It’s been less than a year since the last episode, and I don’t think I can deal with three weeks of hacking cough and six weeks of recovery from rib fracture AND take care of the little guy.