Breastfeeding: My sad story and a glimmer of hope!

Science says breast is best and science is right.  Science would also have you believe that every woman can breast feed. In that regard, they would be wrong.  In 99.9% of the time that is indeed the case, but sometimes, just sometimes a woman can have a physiological problem that can prevent her from being able to fully feed her child. Sometimes this can be self-induced such as the case with breast reduction surgery, but other times there can be no known cause.  I fall into the second category.

May 7, 2004

When my daughter was born in 2004 there was no question in my mind that I would breastfeed.  I wanted to give my daughter the best start in life and what better way to do it.  It never occurred to me I would have difficulties that couldn't be overcome.  I had a drug-free natural birth with a nurse midwife in a hospital in Michigan. For the most part it was a wonderful experience and baby went straight to the breast.  They told me right away that she had jaundice but encouraged me to breastfeed.  On her second day she was bright yellow and had to go under blue billirubin lights. The pediatrician wanted me to supplement to try and get the jaundice out of her system and recommended I do so with an SNS so as not to delay or upset my milk coming in.  Several days later my milk had not "come in" in the way I'd read about. No engorgement, pain, leaking... nothing.  I had a visit with a lactation consultant who examined me and knew immediately something was wrong.  She said I had underdeveloped breasts and not enough gland tissue.  She recommended herbs and domperidone to help with my supply.  Unfortunately this whole time Ella was losing weight and the jaundice was not improving.  My father-in-law came to visit immediately after she was born (never make that mistake friends) and he made me uncomfortable feeding so after just two weeks I gave up.  It was a sad day, but being in the US at the time I knew I had to be back in work in four weeks and convinced myself it was for the best.

Roll on 18 months later and my second daughter Ciara was born, this time in Ireland. Again a natural unmedicated birth.  It was to be a homebirth, but the midwife was not able to attend at the last minute so we had to go to the hospital. It was perfect and the midwife was wonderful allowing plenty of skin-to-skin and immediate feeding.  I had also had nine months to prepare and try and address the problems I had with Ella.  I worked with my GP ahead of time and was officially diagnosed with breast hypoplasia and insufficient glandular tissue.  An ultrasound confirmed that I had minimal gland tissue and as a result could not produce a full supply.  This time I was going to try pumping after feeds and add more herbs (fennugreek, blessed thistle to name a few) and a high dose of domperidone (motilium, 90mg 3x day).  None of this actually helped with my supply as far as I noticed which in hindsight makes sense as if the tissue is not there no amount of galactagogues are going to help.  I breastfed Ciara for just over nine months using the SNS to supplement but she continued to comfort nurse even though there was nothing there for about a year.  I would have liked to go longer but she was ready to move on.  Another sad day.

During both my experiences I met lots of people who tried to help whether doctors, lactation consultants or La Leche League leaders and enthusiastic members.  Most meant well, but generally made things worse by telling me everyone could breastfeed and I was obviously doing something wrong when clearly baby was latched perfectly and I was continually attached to a baby or pump.  Six years later there is a lot more known about my condition, but I have yet to find anyone else in Ireland with my problem.  Breastfeeding is atrocious here, most women get very little help and give up within days or weeks.  It makes me so sad to think of all the women and babies out there that were perfectly capable of having a wonderful nursing relationship and full supply who did not do so because no one showed them how or helped them when they encountered more common difficulties.  When you've pumped for 18 hours straight and are staring at a sum total of half an ounce, you would literally kill to have functional boobs albeit ones with mastitis, inflamed nipples or oversupply.

The good news is that this condition does improve slightly with each pregnancy as more tissue is formed.  Women with less severe hypoplasia can even go on to have a full or almost full supply in subsequent pregnancies.  There is much more known about the condition and many books and groups that help.  MOBI (Mothers Overcoming Breastfeeding Issues) has been an incredible resource for me as have two books.

The Breastfeeding Mother's Guide to Making More Milk is an incredible resource for anyone with supply issues be it something like my IGT, breast surgery, PCOS or something baby related such as tongue tie.  There is lots of research on physical, herbal and medical solutions to many of the problems mothers and babies may encounter.

Mother Food: A Breastfeeding Diet Guide with Lactogenic Foods and Herbs for a Mom and Baby's Best Health is the second book which is a riveting read regardless of issues you may have.  It's a fascinating insight into breastfeeding throughout time and investigates both modern and historical antidotes for various issues and essential outcomes.  It's a great book for anyone breastfeeding who wants to ensure their milk is the best it can be.

Both books offer suggestions for women with chronic supply issues before and after baby is born which has helped me immensely in preparing for this pregnancy knowing the issues I will face.  My IGT plan of action is as follows:

• Pre-natal natural progesterone supplement to 38 weeks
• Pre-natal supplement of Go-Lacta, Goat's Rue, Alfalfa
• Pre-natal nutritional supplements including prenatal vitamin, Omega 3,6 oils, Evening Primrose Oil, Calcium and Floradix Iron Supplement
• Pregnancy Tea
• Expression of colostrum from 34 weeks to collect and freeze for baby and encourage supply
• Gentlebirth Hypnobirthing and the breastfeeding hypnosis track after birth
• Home waterbirth with no interventions, immediate skin-to-skin and nursing.
• Frequent on demand nursing with breast compression
• Supplement donor milk* using SNS, as necessary
• Post-natal nutritional supplements as above, increasing iron if required
• Herbal supplements of Shatavari, Leptaden, fenugreek, More Milk Special Blend and Blessed Thistle.
• Prescription supplement of high dose domperidone (motilium)
• Pumping after feeds.

* I was lucky enough to find some very understanding, kind and generous women to offer me donor milk through Human Milk for Human Babies. I am so incredibly touched that these women would help someone in my situation and I am blessed that I will be able to feed my son the best I can in my circumstances and avoid formula. 

Our wee man!

So that's the plan and my story.  Little Boy Blue is due any day now and I hope that it will improve this time .  I would love to hear from other Irish Mama's who have IGT, I know I can't be alone! I would also ask lactation consultants, LLL leaders, Doulas, PHNs and midwives to read up on the condition as it can be extremely disheartening to be told you are doing something wrong when in fact you are doing everything and then some right, but baby is still not thriving.  

I've listed some other excellent breastfeeding resources below:

Dr. Jack Newman's Website - Renowned Canadian breastfeeding expert. Lots of articles, videos and research here. A fantastic resource for new Moms. 

Kellymom - A wonderful resrouce by mothers for mothers. 

La Leche League - The breastfeeding advocates. Information on local meetings, a useful forum and tons of great handouts and pamphlets.

Human Milk for Human Babies - Find donor milk or donate milk to mothers and babies in need.

MOBI - Mothers Overcoming Breastfeeding Issues: great articles, fantastic email support group and links to various books and suppliers.

Breastfeeding Mums Ireland - A facebook group for breastfeeding mothers.

Friends of Breastfeeding - An Irish group promoting breastfeeding and lactivism.

Beautiful French Macarons

I have always loved macarons - even just to look at.  They are so sweet and cute that it almost grieves you to eat them.  I tried to make them a few years back and ended up getting into a vicious fight with my silpat and haven't tried again in years.

Hubby knows I just love these little delights and decided he would make me some for Valentine's Day.  Valentine's came and went without the romantic dinner I'd planned to make and without any macarons, but that's quite all right considering I got a new car instead!  We ended up making these together yesterday and thanks to his patience and my kitchen savy they turned out perfectly.  I made a quick vanilla bean buttercream to fill them and we added raspberry jam to some as well.  They were truly sublime.  This is a fairly easy recipe from Martha Stewart that for me worked much better than any I've tried in the past using sugar syrups.  I highly recommend giving it a go for any special events.  I will definitely be making baby blue ones when this little bundle arrives!

• 1 cup icing sugar
• 3/4 cup ground almonds
• 2 large egg whites, old and room temperature
• Pinch of cream of tartar
• 1/4 cup caster sugar

Pulse icing sugar and almonds in a food processor until combined. Sift mixture twice.

Preheat oven to 190C/375F degrees.

Whisk whites with a mixer on medium speed until foamy. Add cream of tartar, and whisk until soft peaks form.

Reduce speed to low, then add superfine sugar. Increase speed to high, and whisk until stiff peaks form, about 8 minutes.

Sift flour mixture over whites, and fold until mixture is smooth and shiny.  It took us about 40 folds.

Transfer batter to a pastry bag fitted with a 1/2-inch plain round tip, and pipe 3/4-inch rounds 1 inch apart on parchment-lined baking sheets, dragging pastry tip to the side of rounds rather than forming peaks.

Tap bottom of each sheet on work surface to release trapped air. Let stand at room temperature for 15 minutes. Reduce oven temperature to 160C/325F degrees. Bake 1 sheet at a time, rotating halfway through, until macarons are crisp and firm, about 10 minutes. After each batch, increase oven temperature again, heat for 5 minutes, then reduce as before.


Let macarons cool on sheets for 2 to 3 minutes, then transfer to a wire rack. (If macarons stick, spray water underneath parchment on hot sheet. The steam will help release macarons.)

Sandwich 2 same-size macarons with 1 teaspoon filling. Serve immediately, or stack between layers of parchment, wrap in plastic, and freeze for up to 3 months.

Linking up with: Transformation Thursday, Hooking Up with HoH, Strut Your Stuff, Making it with Allie, Catch A Glimpse Thursday, It's a Keeper Thursday, Full Plate Thursday, Sweet Treats Thursday

Cop Out Valentine's Cookies

I was drooling yesterday whilst exploring Pinterest and seeing all the beautifully decorated Valentine's cookies.  I even thought of making some and getting out my cookie cutters and all that jazz, but with two sick girls at home and me being 15 months pregnant, I couldn't be bothered, so I made my old standard buttercream sugar cookies with heart sprinkles.

In America you can buy these thick soft sugar cookies in grocery stores that generally come with frosting and sprinkles relevant to the season in question.  They were always brought to work on "food days" back in my corporate days.  They were literally inhaled.  While delicious, a quick glance at the ingredients let you know that they were not the healthiest, full of chemicals and preservatives.  This is my attempt at a homemade version and let me tell you, the real butter makes these simply divine!  They are still inhaled wherever I take them.  I like to dye the buttercream for kids parties, yellow with multi-coloured sprinkles being our favourite, but I opted to leave the buttercream white here and use heart sprinkles for Valentine's Day.  The question is... will they last until then?

Cookie Ingredients (Makes approximately 50):

• 5 cups flour
• 1 tbsp baking powder
• 1 tsp salt
• 12 oz butter, softened
• 1.5 cups caster sugar
• 2 tbsp vanilla extract
• 3 eggs

Preheat oven to 180C/350F.

Sift dry ingredients together, set aside.

Whip butter with sugar until pale yellow and fluffy. Beat in eggs and vanilla. Slowly add dry ingredients until it comes together in a sticky dough.

Using a dessert spoon make one inch balls out of the dough and press down slightly on a cookie sheet.  Bake for 13-15 minutes, until just starting to brown around the edges, you want them to be cooked through but remain mostly white.

For the frosting:

• 2 lb boxes icing sugar
• 6 oz butter, softened
• 1 tbsp vanilla extract
• 3-4 ounces cream
• Food colouring (if dyeing)
• Sprinkles

Beat butter and sugar together with vanilla and half the cream.  Add more cream until desired consistency reached. Dye as needed.  Spread on cooled cookies with a palette knife and dip in sprinkles!  Enjoy! :)

I'm submitting my lazy-ass cop out Valentine's baking to The English Mum Baked With Love Bake-off! 

The Ultimate BLT

A BLT is the ultimate sandwich, but with a few flourishes and top quality ingredients it can really go from standard to gourmet.  Of most importance is of course, the bacon.  Standard Irish back rashers just do not cut it.  Streaky rashers, smoked and without rind are better, but if you can find it, buy the Spanish brand Campofrio Bacon. It's beautifully smoked, the perfect blend of meat and fat and fries up delightfully crispy.  My kids call it American bacon because it's very similar to what we got back in the US.  I've found it at Supervalu's and Centra's mainly and when I see it, I buy it all so that they keep ordering it!  I just fry the bacon up in a hot pan or grill pan until it is crispy but not burnt and drain it.  The rest is easy.  I used a rosemary and apricot jam for my relish here and also frequently use a roasted garlic and fig relish, you can use anything you like. My husband claims this is the reason he fell in love with me! :)

Ingredients:

• 2 slices good white bread, lightly toasted
• 1/4 pound bacon, fried to crispy
• 2 leaves Baby Gem / Cos Lettuce
• 1 tomato, sliced
• 1/4 red onion, thinly sliced
• Good Mayonnaise
• Relish
• German mustard
• Black pepper

Thinly spread mustard on one of the toast slices.  Cover with a thin spreading of your relish or jam.  

Lather the other piece of toast with a hearty helping of mayonnaise.

Layer the lettuce, tomato and red onion on top and sprinkle with freshly ground black pepper.  Top with bacon and remaining slice of toast. 

Serve with chips (crisps) and a pickle for posterity! ;)

The World's Easiest Cookies

As I mentioned on Twitter yesterday, I had a momentary panic as I realised I had friends due for coffee in an hour and nothing made to serve them.  In a situation like that I always whip out my old emergency standard, instant peanut butter cookies.  I happened to have a bag of Hershey's kisses lying around, so I used those as well, but you can just leave them plain if you'd like.  Crunchy, chewy and sweet, these literally take seconds to make and please everyone!

Ingredients:

• 1 cup peanut butter*
• 1 cup white sugar
• 1 egg
• 16 hershey's kisses or other small chocolate (optional)

Preheat oven to 180C/350F. 

Mix all ingredients together and form into sixteen balls and place on ungreased cookie sheet.  Bake for eighteen minutes.

Press kisses into cookies immediately upon removing from oven.

* This does not work well with "American Style" peanut butter that is commonly bought in Ireland.  Try and get actual American peanut butter if possible.  Aldi peanut butter is made in the USA, is cheap, tastes delicious and works perfectly!

Linking up with: Whatever Goes Wednesday, Create and Share, Wow Me Wednesday, Lil' Luna, Wow Me Wednesday, These Chicks Cooked, 

Lettuce, Spring Onion and Cheese Tart

"Cooked lettuce?!?" he asks incredulously.

"No judging til you try it, I promise, you'll love it," I assure him and I was right. He did and so did everyone else who tried it.  This incredible tart is another recipe from The River Cottage Veg Cookbook.  I knew as soon as I looked at it that it would be a winner and it was.

Because I was lazy, I didn't make the pastry from scratch, but instead used the shortcrust pastry from Aldi, which was surprisingly delicious!  I followed the rest of the recipe to a T, adding just a pinch of grated nutmeg.  The result was sublime; a soft buttery velvet custard with caramelised spring onion and baby gem.  Perfect served warm or cold, alone or with a nice salad - this will be a staple for my weekday lunches!

Ingredients: 


For the Pastry-

• 250g plain flour
• pinch of sea salt
• 125g chilled unsalted butter, cut into chunks
• 75ml cold milk

For the filling-

• 1 tbsp rapeseed/olive oil
• 4 little gem lettuce hearts, trimmed and quartered
• 15g butter
• 2 bunches spring onions, trimmed and cut into chunks
• 100g Lancashire, medium cheddar or hard goat's cheese
• 2 large eggs
• 2 egg yolks
• 200ml double cream
• 200ml whole milk
• sea salt and freshly ground black pepper

To make the pastry, sift flour and salt together, or blitz in a food processor.  Add the butter and blitz or rub until it resembles breadcrumbs.  Mix in the milk little by little until the pastry comes together.  Turn out onto floured surface and knead briefly to bring into a ball. Wrap and chill for thirty minutes.

Preheat the oven to 180C/350F.  Roll out the pastry on a floured surface and use it to line a 25cm tart tin.  Line with foil and rice or baking beans and bake blind for fifteen minutes.  After that time, remove foil and beans and bake for a further 10-15 minutes until starting to colour.  

To make the filling, heat the oil in a frying pan over a medium heat.  Add the quartered lettuce hearts, sprinkle with slat and pepper and cook for about 5 minutes, turning once or twice until the cooked surface is golden brown.  Add the butter towards the end, letting it melt then spooning it over the lettuces. Arrange the lettuce in the pastry case.

Reduce heat in pan and add the spring onions.  Saute gently until just softened and scatter over lettuce in the tart case.  Crumble or grate the cheese on top.

Lightly beat eggs, egg yolks, milk and cream and season generously with salt and pepper.  Pour the mixture over the tart filling and bake for about 35 minutes until golden.  Serve warm or at room temperature. 

Hey Facebook: Breastfeeding is Normal!

As some of you may be aware, Facebook has been removing pictures of women breastfeeding their children on a regular basis and in some cases, even banning these women's accounts.  In most cases they are beautiful tasteful photos with very little skin and/or nipple exposed.

Regardless of your choice to breastfeed, no one can dispute the scientific evidence that it is the best choice for your baby and the biological fact that it is indeed what our boobs were made for, despite what the porn/TV/film/advertising industry would have you believe.

The benefits of breastfeeding are undisputed, not just for an individual child, but for society as a whole.  Breastfed children grow up to be smarter and healthier than their formula fed counterparts making for a more productive society. Mothers who are allowed and encouraged to breastfeed will inevitably miss less work because of sick children and employers are beginning to realise this.

Whether or not you personally choose to breastfeed is beside the point here, the point is everyone should be given that choice and supported if they make it.  It is against the law in Ireland to discriminate against a breastfeeding woman, yet looking at the bigoted, misinformed and plain idiotic comments on this Journal post, it is clearly evident that the public at large are uneducated and clearly not supportive.  We must support mothers no matter what choice they make and even more so when they are making the best and normal choice.

If you are nursing or have nursed or just support the cause, consider coming out to the protest next Monday at the Facebook Headquarters in Dublin.  It is a chance to tell the media, the public and the censors at Facebook that not only is breastfeeding the healthy and optimal choice for society, but it's utterly and completely normal!  If you can't make it, consider changing your Facebook picture on the day and leaving a message of support for the girls!

The details are here.

Chatouka: North African Breakfast Stew

I stole my Mom's copy of River Cottage Veg Every Day! recently and have been absolutely amazed with it.  It's been awhile since I've gotten really excited over a cookbook.  It seems they are all celebrity chef's (and I use the term lightly considering some of them in Ireland have no formal training) trying to pawn off their latest gimmick.  It's gotten tiresome and I find myself avoiding cookbooks for the most part.  This book is a refreshing new take on vegetables.  He says it's not necessarily for vegetarians, but it's certainly not a book of side dishes either. There are some stunning recipes and I shall be working through many of them.

This dish is a gorgeous breakfast full of smoky flavour and rich vegetables.  It's a fabulous start to the day and leaves the kitchen smelling divine.  Keep the olive oil to a minimum and it's quite low in fat as well.  I recommend adding just a pinch of sugar to temper the sharpness of the tinned tomatoes, otherwise I found it perfect as written.

Ingredients:

• 3 tbsp olive oil
• 1 tsp cumin seeds
• 1 large onion, sliced
• 1 garlic clove, crushed
• 1 red pepper, finely sliced
• 1 yellow pepper, finely sliced
• 1/2 tsp smoked hot paprika
• pinch of saffron threads
• 400g tin of chopped tomatoes
• 4 eggs
• salt and pepper

Heat olive oil in a large oven-proof pan.  Add cumin seeds and fry them gently until flavour is released.  Add onions and saute until softened, about 8 minutes.

Add garlic and peppers and continue to cook over a low heat for about twenty minutes until the peppers are soft and wilted. Add paprika and crumble in the saffron, then add the tomatoes and season with salt and pepper.  Cook gently, stirring occasionally for about 15-20 minutes.

Pre-heat oven to 180C/350F and make four hollows in the surface of the stew.  Crack an egg into each hole and sprinkle with salt and pepper.  Bake for 10-12 minutes until white is cooked and yolk is still runny. Alternatively, you could separate the stew into four ramekins and crack the egg on top.

Serves 4

Apologies for the lousy pictures.  My camera is playing up. If anyone knows where to get a Nikon SLR tuned up, please let me know!

Link/Recipe Parties: Strut Your Stuff, Full Plate Thursday