On Migraines and Breastfeeding

It’s been a rough weekend, I can’t lie. I have been plagued with migraine headaches for the past 5 days. I have taken more Advil, Tylenol and Axert in the last 5 days than I have in the last 5 months. Brutal. It’s gotten me down too.  I hate having the ice pack on my head so much that my kids now ask me if I have a headache again.  I don’t want their early memories of mommy being plagued by migraines.

Yet, during one of the reprieves I managed a 6.6km run, so I guess it wasn’t that bad of a weekend. But the headache that ensued a few hours later was brutal and made me wish I hadn’t gone out when I was feeling better.

My girlfriend made me an aromatherapy rub a few months ago which I forgot about until this weekend. My tummy felt icky after all the drugs I took so I decided to try the rub. Oh my. It was amazing. I’m not sure what was in it but it left a paradoxical cooling heat on my forehead that took the pain away for a good half hour.  Those 30 minutes were a nice taste of heaven.

I can’t help but wonder what’s caused this sudden increase in migraine frequency. I suspect it’s a change in my hormones. The baby is all but weaned. I might nurse him once a day now. I’m finding it much more difficult to let it go this time. Part of me wants to keep nursing him because I’m never going to be able to do it again once we are done.  But on the other hand my vanity sets in and I really want to see the last 10 lbs gone (the sooner the better) and I like to think that it’ll fall off once I stop nursing for good. I wish it wasn’t so hard. I’ve really enjoyed the nursing relationship we’ve had but I know it’s time to wrap things up. He is taking his formula really well and starting to eat some rice cereal but not as often as I’d like.  And I am back to work in 6 weeks.

It’s time.

Mommy Guilt.

Day 6 – January Daily Blog Posting Month

First off, welcome to my new followers.  Thank you for embarking on this journey with me!  I am honoured and flattered that you are following along.

Baby J is going to be 4 months old on the 16th of this month.  I continue to exclusively breastfeed him which is a huge thing for me given how awful an experience it was with my firstborn.  I still have the emotional scars.  Baby J feels like he is gaining well and he is certainly growing!  He is already ahead on the developmental side of things – he is doing everything a 4 month old should be doing and he is only 3.5 months old.  He is laughing at us, grabbing at things and is starting to bring his knees up and pivot on his back.  He could roll over any day now.

He is napping pretty well throughout the day, it’s just his nighttime sleep which I wish would improve.  Selfishly, I admit.  I am tired.  I want to sleep more than 2-3 hour stretches at nighttime. Last night at 4am, husband got up to replace the soother as I had just fed him 45 minutes earlier.  Husband came back and said, “We should be giving him formula at night.”  The thought being that he would sleep longer.  It certainly was the case for our other kids, why not this one?

My plan all along was to introduce formula about 6 weeks before I returned to work, which would be in mid-late February.  But last night and this morning, I am seriously considering introducing it early.  Yet, the mommy guilt kicks in.  It’s only been 3.5 months.  I could do this longer, I should be doing this longer. After all, why did I extend my leave by a month?  So I could hand off the baby to be fed by a bottle, by others?

Ugh.

All of my children were given formula.  My daughter was 2 weeks old when I started supplementing; my middle son was 3 months old when I first started his transition.  By all accounts, I have done pretty well with Baby J as he has been exclusively breast-fed the longest.

So why can’t I just do it now?

Mommy guilt.

The Time Has Come.

This week I had my 6 week postpartum checkup.  She gushed over my son and checked my incision.  Really, it was just a formality.  I did ask one specific question:  When can I start exercising?

And the answer I wanted to hear, I got – I am good to go.

Great!  Now the pressure is on!

My goal is to be able to run the 5 km home from the office by the time I return to work, in March.  A tall order for someone who has sat on her, well you know, for the past 10 months. Sigh … where to begin?

I guess the first thing to do is to get some muscle tone back, there’s quite a bit of flab going on, to be honest.  I know, I know, I just had a child so I shouldn’t be too hard on myself.  The initial plan was to start going for walks and I think that’s a good place to start.  The baby loves to be in a carrier, so taking him out for walks is good for him, as well as for me (he’s almost 10 lbs now, so the extra weight I’m carrying offers increased resistance, right?).  As much as I’d love to get out there and start running, the last thing I need is to do too much too soon and risk an injury. I think it’s also important to get some flexibility back – I started doing some gentle yoga stretching a few days ago.

The other concern I have is the impact exercise will have (if any) on breastfeeding, or more specifically, my milk supply.  A quick Google search came up with a few hits from the usual suspects:  La Leche League, (I found this great article on Postpartum Fitness from the La Leche League), KellyMom, BabyCenter.  The general consensus from these sites is that exercise doesn’t affect breast milk supply, though go to any “mom forum” and you might read differently.  I have personally heard from some friends that exercise did in fact, affect their supply.

So, I decided to do a little bit of research, because really, what else have I got to do these days?

A Google Scholar search came up with this study from 1994, published in the New England Journal of Medicine.  Thirty-three women, all exclusively breastfeeding and 6-8 weeks postpartum were randomly assigned to an exercise group or a control group (no exercise).  The exercise group were supervised and did aerobic exercise at 60-70% of maximum heart rate for 45 minutes, 5 days a week for 12 weeks.  Energy expenditure, dietary intake, body composition and the volume and composition of breast milk were assessed.  The results showed that aerobic exercise 4-5 times per week, beginning 6-8 weeks postpartum had no adverse effects on breast milk supply and significantly improved the cardiovascular fitness of the women.  Interestingly, the rate of weight loss was not different between the two groups.  Bearing in mind that the study size was quite small, it’s encouraging to see that exercise didn’t appear to affect a woman’s milk supply.  The article also goes on to discuss the importance of keeping hydrated before, during and after exercise, as well as keeping one’s caloric intake up to support breast-feeding. While weight loss is of course the eventual goal, it is important for me at least, to recognize that this probably won’t happen as quickly as I’d like since I do continue to keep nursing.  In the long run, that’s not so much a concern as I know my body and it naturally reverts back to what it knows (at least, I hope it does this third time!).

The Society of Obstetricians and Gynecologists of Canada published a joint Clinical Practice Guideline with the Canadian Society of Exercise Physiology in 2003, titled “Exercise in Pregnancy and the Postpartum Period”.  Here’s an excerpt:

Exercise and Breastfeeding

Breastfeeding is the best method of providing optimal nutrition, immunologic- based protection, and emotional nurturing for the growth and development of infants.51 Therefore, exercise frequency and intensity should not interfere with a mother’s ability to breastfeed. Although exercise does not negatively affect milk production or composition,52–54 lactic acid has been shown to be increased in the breast milk of women exercising at maximal intensity, but not in those exercising at moderate level.55–58 There is controversy as to whether this short-term increase in lactic acid makes the breast milk less palatable to the nursing infant.55,56, 58–61 Mothers who find that their baby does not feed as well right after exercising may consider feeding the baby right before exercising (which may also make the breasts more comfortable during exercise), postponing feeding until 1 hour after exercising, or expressing milk prior to exercising to be used after exercising. The growth of breastfeeding babies of exercising women is normal, even for the infants whose mothers are losing weight as part of their exercise regimen.53

RECOMMENDATION 6

Women should be advised that moderate exercise during lactation does not affect the quantity or composition of breast milk or impact infant growth. (I-A)

Well, that’s good enough for me.

The other “mom forums” also had a few good suggestions, like nursing before exercising.  This makes complete sense to me – a well-fed infant will sleep while mommy goes out for a run!  The other suggestion I read was taking baby with you – ie. in a carrier while going for a brisk walk, or using a jogging stroller!  Brilliant!  We happen to have a Chariot and husband has been talking about buying the jogging handle attachment, though I’m not sure how we’d fit three kids when it seats only two?  Hmm … might have to think about that one a bit.

In any event, it appears I have no excuse not to get started.  There is a pair of Guess jeans that are desperately waiting to be worn again, and LOTS of left over Hallowe’en chocolate that is taunting me.

Get ready. Get set. Go!