Sunday, August 28, 2011

Third World Green Daddy 21: Magic Formula

A few months ago Sam had a big development in his eating habits. He'd always been a voracious eater, and in fact he'd already started eating things other than breastmilk. But one day we were returning from a long trip somewhere or other, and his appetite simply exceeded his mother's milk supply at that moment. My wife Caro had been working long, hectic hours, traveling a lot in the closing months of the ecotourism project she was coordinating in the Valle de Tenza region.

It seems that that particular day her personal stress and Sam's massive appetite met head-on. The baby wanted more milk than Caro could give, and became furious with hunger. He started hollering and screaming like a madman, and at that moment we took a strategic decision we'd been mulling over as a possibility for some time. As soon as we got back to our hometown, we stopped at a pharmacy and got some infant formula for the baby.

We had thought before that if Caro's milk supply or her schedule ever impinged on her ability to feed Sam exclusively breastmilk, we could buy formula as a complement to, if not a total replacement for, mother's milk. It isn't an ideal solution, because the limits of the unknown in nutritional science (as in any science) mean that no matter how much they fine-tune infant formula to approximate human milk, it will never be as good. There will always be minor compounds in mother's milk that elude our best efforts to replicate it exactly, so it will always be better to go with mother's milk.

Until that moment, Caro's and my work schedule had allowed us to keep Sam on pure breastmilk. For almost three months our health plan had given my wife paid leave, so she could be at home and relax with the baby (though she still ended up having to do a lot of work from home during this time). After her leave was up, Caro worked days at our local university, expressing her milk in the morning and evening with our nifty electrical breast pump, which provided enough bottles to feed the baby between the times she was home. Caro returned to the house for lunch, and could always come home from her work nearby if there was any need. Even when she had to go to spend a few days in the field, her work environment was flexible enough that Sam and I could accompany her, and thus she could keep him fed even during important meetings. But the day of our long trip, Sam's pressing hunger forced our hand, and we started a new era of infant formula. It will surely not be the last synthetic invention we introduce Sam to. My apologies to Nicholas Kristof, who admonishes us Third World types to stick exclusively to breast milk.

Even after the fateful day (during which my mom happened to be present, and was I think surprised at our resorting to formula given our generally pro-natural stance on childrearing), Sam continued to eat mainly breastmilk. As before, when Caro felt her milk supply getting low, I'd prepare lots of hot panela (molasses) water with milk and fennel, which is a common Colombian remedy for increasing breastmilk. Only rarely would we (or the babysitter, whom I'll talk about in another post) open the metal tin to spoon out four dollops of sticky powder to mix with four ounces of boiled water. The infant formula thus represented a valuable insurance policy, a rarely-used backup option that nevertheless gave us the peace of mind of knowing that Sam would never go hungry.

Formula was not without its drawbacks. We noticed that it seemed to constipate Sam, or otherwise give him digestive problems. If we gave him formula right before bedtime, he'd spend much of the night grunting and straining to poop or fart or something. Again, despite the best efforts of nutritional science, it seems that synthetic infant milk just isn't the same as human breastmilk. It also seemed as if certain brands of formula were less digestible than others, and like a little dog changing brands of kibble, Sammy got gassy and irritable when we couldn't find our typical brand (Wyeth S-26, I believe) at the pharmacy and had to buy another.

Recently my wife has moved to Bogota for a few months as she works in a short-term gig at the UN. This move has entailed a lot of stress for everyone, as Caro and I had to move out of our hometown apartment, divide our stuff between the house rehab in our hometown, my in-laws' house where I'm staying these days, Caro's sister's house in Bogota, and finally the new apartment. Caro had to find a Bogota school to accept my daughter-in-law for the last four months of high school, all while working a more typical 9-5 job far from the house. Amid all this, tragedy struck with the illness and eventual death of a close family member. Caro spent over a week running to and from the hospital, hardly sleeping.

All these factors conspired to drastically lower my wife's milk supply. All the fennel and molasses in the world can't make up for a sever lack of sleep and monumental amounts of stress. This leads to a vicious cycle, as Sam gets frustrated at not getting milk from the breast, and either loses interest, which frustrates Caro, or wakes up hungry and screaming at night, which exhausts Caro. His nascent teeth also at times lower his desire for breastmilk, and he prefers to drink from a bottle.

For the weeks since then, Sam has been mainly dependent on his formula for his sustenance, increasingly complemented by real food. I'm not talking furtive spoonfuls of strained, boiled guava mash. Sam eats half plates-full of paella, lentils, yogurt, crackers, whole fruits, potatoes, water, even olives in vinegar! When he does eat guava now, we spoon the flesh directly out of the fruit and give it to him, seeds and all.

Another drawback that's come up now with the formula is the cost. For a month's supply of Sam's heavy consumption, we're spending upwards of $30US. It may not seem like a lot, but we sure notice it on our tight budget.

Recently though, breastmilk has been making a comeback. I have undertaken a revitalization campaign for Caro's milk supply. Those of you who know me personally can imagine how intense and annoyingly single-minded I am about this. I have been plying Caro with fennel-molasses-milk, and enforcing a two-to-three-times-daily pumping routine, even when Caro's long work hours make her tired and unenthusiastic about the Milk Augmentation Campaign, as I call it in my more Maoist moments. It's also important for Sam to try to breastfeed, even when not much milk comes out, because it stimulates the glands to produce more. My implementing the campaign is made the more difficult by the fact that I am only in Bogota with Caro and Sam some two or three days a week. The rest of the time I am in far-flung rural villages in Boyaca, working on two big projects. I'll write more about this new professional situation in a future post.

Despite my being far away, Caro humors my obsession by heeding my phone requests for frequent breast feeding and pumping. It seems the campaign is working. Caro's milk supply is steadily increasing, and Sam is slowly consuming more milk and less formula. A recent doctor visit confirmed our belief that it's important to keep giving Sam breastmilk, even if in small doses. We're hoping we can continue breastfeeding until a year of age or so, when Caro and probably Sam will be happy to be done with this phase of their lives. Even in her moments of low milk supply, Caro was able to maintain the closeness and shared warmth with Sam through things like holding him close at bedtime as he fell asleep. At this point she doesn't feel as if breastfeeding is the only path to that emotive bond, and by the time Sam's a year old, it won't be that important nutritionally, either. We have friends here in Colombia whose work schedules have permitted them to continue breastfeeding to two years of age and beyond, and in some cases it frankly gets a bit pathological, like a reluctance to let the kid advance to the next stage of life.

Whatever our personal preferences in the matter, I don't see Sam breastfeeding beyond this first year. As the title of this blog series indicates, sometimes our green childrearing aspirations must give way to the Third World reality of our having to work long hours in multiple jobs to make ends meet. We always try to navigate these two poles as best we can, and I think that's what makes our life interesting and worthwhile.

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