I am very disciplined about keeping my dreams in check. I don’t allow myself much time to wish or ponder much other than my reality (which is really good—I promise I count my blessings often). Anyway, in part this habit is an effort to live in the present with my family and “be here now,” as they say. Maybe it’s also a survival mechanism. There isn’t a lot of point in fantasizing about my dream job or what white sand beach I’d like to be lying on when these fripperies aren’t in my cards right now. Honestly, I don’t spend a lot of time doing it.

So I didn’t think about Burning Man much before the start of this week. I watched with casual interest as people I know and love packed up their dusty belongings and trundled off to Black Rock City to be their truest selves for a week. On Monday, opening day of the festival, I imagined driving in to Greeters  and falling into that first welcome home hug, the blowing winds, the light so bright you must wear sunglasses. On Tuesday I realized Asher’s present age (2 years and 7 months) is actually just a few months older than Lucas’s age when he first went to the playa in 2004—our ill-fated Burn, when we stayed only 51 hours.  I looked at a photo of feverish baby Lucas at Burning Man, trying to have fun despite his racking pneumonia.

On Wednesday, I lost my mind. I had a bad day. My son and I argued and my feelings got hurt. I spent a ton of time driving around lost, listening to Raffi. I had a cranky, overtired baby on my hands. I missed my limited opportunity to work on important projects. In short, I went a little nutso, succumbing to stress and worry and letting stuff get to me. I spent an evening gnashing my teeth in a dear friend’s living room, enumerating all the things that feel out of control and frightening in my world, and crying over all the things I wish I could be doing.

I guess I had to say this painful stuff out loud. Sometimes I need to be heard, no matter how ugly my words sound to my own ears. My patient friend listened, offered me her enduring love, and suggested perhaps it’s OK that I don’t do it all.

It wasn’t until today, Thursday, that my friend and I both realized that I unwittingly followed my own tradition of completely freaking out on Wednesday of Burning Man week. (It’s not only my pattern though. Lots of people experience it, too). It’s the halfway point of the festival. It’s the day when I’m swept up in a whirlwind of intense emotion and physical stress, and all of my normal layers of protection peel off me like so much sunburned skin. A good, intense cry—some serious wailing into the wind— is usually needed on Wednesday. A catharsis of explosive proportions is almost always in order. The shrapnel is actually expected by friends and campmates, and they duck or provide emergency aid or ululate alongside me, as they are able.

I guess this catharsis is needed in real life, too. Sometimes I just have to screech so my own voice will drown out the harpies.

Asher is away with his grandmother for a few hours, probably for the first time. I am alone in the house and I’m supposed to be working because I have this little book to edit called Lebanon. 

I don’t want to be all thinky, though. I just want to go outside in the coolish morning and sit in the hot tub in the shade. I want to drink shameless morning cocktails all by myself. Or with a shameless friend, who is over 21 and doesn’t call me “mommy.” 

I have recently discovered my inner drinker. My children helped me find her; she was locked deep within me and yearning to come out into the sunshine. 

I didn’t truly discover the sacrament of coffee until Lucas was a baby. I didn’t truly discover the medicinal use of alcohol until this year. 

Call me Mother of the Year. 

OK. Back to Lebanon, where everything is peaceful and tolerant.

I’m not feeling too great about how things went with Lucas yesterday afternoon. I feel like I ought to know better. I ought to have defused the situation before it escalated into the fight it was. Thing is, Lucas’s behavior is basically bipolar lately. He swings rapidly from adorable “I’m a flower fairy and my magic flower wand will cause all your flowers to bloom beautifully, Mommy” to … well … what I described last night. He went from being totally fine and companionable to hitting me in zero seconds flat.

To all of you who read that and sympathized with me (well, or with Lucas), thank you. I can sum up parenthood by saying this: every day, I wake up and try, try again.

Quoting from Your Six-Year-Old to validate my own experience and remember what’s going on with him:

“Your typical Sx-year-old is a paradoxical little person, and bipolarity is the name of his game. Whatever he does, he does just the opposite just as readily. In fact, sometimes just the choice of some certain object or course of action immediately triggers an overpowering need for its opposite.

“The Six-year-old is wonderfully complex and intriguing, but life can be complicated for him at times, and what he needs most in the world is parents who understand him. For Six is not just bigger and better than Fve. He is almost entirely different. He is different because he is changing, and changing rapidly. Though many of the changes are for the good—he is, obviously, growing more mature, more independent, more daring, more adventurous—this is not necessarily an easy time for the child.”
…

“One of the many things that makes life difficult for him is that, as earlier at Two-and-a-half, he seems to live at opposite extremes. The typical Six-year-old is extremely ambivalent. He wants both of any two opposites and sometimes finds it almost impossible to choose.”
…

“One of the Six-year-old’s biggest problems is his relationship with his mother. It gives him the greatest pleasure and the greatest pain. Most adore their mother, think the world of her, need to be assured and reassured that she loves them. At the same time, whenever things go wrong, they take things out on her.”
…

“At Five, Mother was the center of the child’s universe. At Six, things have changed drastically. The child is now the center of his own universe. He wants to be first and best. He wants to win. He wants to have the most of everything.

“Six is beginning to separate from his mother. In fact, it is this quite natural move toward more independence and less of the closeness experienced at Five that makes him so aggressive toward her at times. On the other hand, his effort to be free and independent apparently causes him much anxiety. He worries that his mother might be sick or might even die, that she won’t be there when he gets home from school.  And in his typically opposite-extreme way, one minute he says he loves his mother and the next minute he may say he hates her.

“It’s not hard to understand why this strong emotional warmth toward and love for his mother, which occurs at the same time he is trying to learn to stand on his own feet, causes him much confusion and unhappiness. It is fair to say that Six is typically embroiled with his mother. He depends on her so much, and yet part of him wishes he didn’t.”
…

“But, rather sadly and touchingly, often when the child has been at his worst, once his temper calms down he will ask, “Even though I’ve been bad, you like me, don’t you?” Or, somewhat inappropriately, at the end of a very bad day a child will ask his mother, “Have I been good today?” It is an interesting fact about child behavior that the less praise and credit a child deserves, the more he wants and needs. The very difficult child needs a great deal of assurrance that he has been good. 

“We must remember that a Six-year-old isn’t violent, loud, demanding, and often naughty just to be bad. There are so many things he wants to do and be that his choices are not always fortunate. He is so extremely anxious to do well, to be the best, to be first, to be loved and praised, that any failure is very hard for him. 

“He is, part of the time, demanding and difficult because he is still, even at this relatively mature age, extremely insecure, and his emotional needs are great. If, with tremendous patience and effort, you can meet these needs, nobody can be a better, warmer, more enthusiastic companion than your Six-year-old girl or boy.”
…

“The child of this age is really a very vulnerable little person, very sensitive emotionally, especially when he is being good. Very small failures, comments, or criticisms hurt his feelings. But if he is being naughty, once he gets started on a bad tack, he may seem almost impervioust to punishment. That is why he needs so very much protection and understanding from his parents.”

It was a fine day today. Except this time, I’m being facetious. It was fine up until about 3:15 or 3:30 when Lucas completely lost his mind. You see, I wanted to put Asher down for a nap, but Lucas wanted to play with Asher instead. So, naturally, Lucas started hitting and kicking me. Of course. That’s what you would do if I tried to put your little brother down for a nap.

I took Lucas by the arm and led him to his bedroom, saying something to the effect of “It is not OK for you to hit and kick me. Now you may go to your room. I will be putting Asher down for a nap now.” Lucas tried to punch me nearly all the way to his room, until he went limp and collapsed on the floor. So I bodily pulled him into his room and repeated my message. Then I closed his door.

Much screaming and gnashing of teeth ensued. In and out of his room he went; every time he came out, I put him back in his room. At one point I held him really close so he couldn’t deck me. That’s when he spit at me.

And that’s when I lost my temper. I shouted. I even said “fucking,” as in “YOU WILL STAY IN YOUR ROOM FOR THE REST OF THE FUCKING AFTERNOON!”

I left, went to soothe Asher, and quickly realized that Lucas had won. There was no way in hell Asher was going to relax enough to go to sleep now. He was crying and fussy and confused about all the drama. Of course. That’s how you would feel if I tried to put your big brother into his room for being a shit.

So, I just lied there beside the baby, listening to Lucas’s tantrum run through its predictible phases and thinking how pissed off I was that he took us to this place and, damn it, I should have handled it better. Somehow. See, there’s really not all that much you can do to a child when he decides to be an ass—that is, there is not much you can do if you’ve already decided that spanking isn’t right. Lucas may not be a big kid yet, but he’s plenty powerful and when one of his blows connects—damn! It hurts. I thought about how convenient it would be if there were a lock on his bedroom door so I could ensure that he stayed put, but then I remembered a friend’s story about how her parents used to regularly lock her in her room.

The screaming changed from “You’re a mean mommy! I hate you!” to “I forgive you, mommy!” to “Do you forgive me now, mommy?” Eventually he got quiet and miraculously he did not leave his bedroom. I peeped in after a while and saw that he had turned off the light and gotten into bed. Another time I noticed the door open a bit, but saw him still inside.

He stayed in his room for an hour and a half. That’s the longest time out ever. I felt I had to make a lasting impression—it is unacceptable for him to hit and kick and spit at me. If it happens again, he will stay the rest of the day in his room, until 5 o’clock comes and he can apologize to me and then explain the day’s events to his father, who doesn’t take kindly to news of Lucas beating on me.

When I finally let Lucas out at 5 p.m., he was all sweetness and roses. He apologized profusely and clearly explained to me what behavior was unacceptable and why he was in trouble. He seems to have gotten the message. 

It’s been a long time since he pulled this type of shit with me.* Somehow, turning 6 has made him insane. Fortunately, the book (Your Six-Year-Old: Loving and Defiant) says it will pass in about six months.

* Since he was 4, I think.

Friday

Working, Asher at babysitters’ house, May Day celebration at Lucas’s school, potluck lunch, Lucas at babysitters’ for afternoon, hair appointment to become more fabulous, 4:30 p.m. vodka and seven, visit with my mom, Ian home from work with more fixings, dinner out, carboliscious Mexican food including nachos and a fajita burrito, evening visit to Chicken Park, bedtime rituals, fell asleep with each of my kids in turn.

Yesterday

Shopping for mom, trip to Lowe’s garden store to purchase new plants, Ian’s labor (shirt off, mattock swinging, digging holes), Lucas’s helping, coreopsis, primrose, orange honeysuckle, purple fountain grass, artemesia, foxgloves, marguerites, agapanthus, muddy baby, sex-on-the-beach cocktails, leftover pork tenderloin and salad, bedtime rituals, TV, lovemaking, snoring. 

Today

Awake at o-dark-thirty, nursing and listening to birdsong, snoozing, Lucas’s 6 a.m. temper tantrum, later in bed alone reading Dr. Doolittle, coffee, receiving handmade gift from Lucas (a heart-shaped necklace made of wet-felted wool and yarn) lax and cream-cheese omelet and breakfast sausage, champagne, brief visit from mom and dad, fancy soaps for my mother, hot tubbing with all of my boys, lunch at Ian’s mom and stepfather’s with Aunt Kellie, VoVo, and DeeDee, fancy necklace for grandma, Lucas swimming, breezy back porch time, Asher throwing the ball for the dog to fetch, Lucas’s temper tantrum, grumpy ride home, nap for me and Asher, chess and a Mary Poppins chapter for Lucas and daddy, waking up, playing outside, crab cakes, more sex-on-the-beach, homemade chicken dinner, crying baby, Lucas in bed early, blogging, and … if I am really lucky, soon sleeping baby, Eskimo kisses, toe nibbles, and spooning.

Happy Mother’s Day!

http://www.dooce.com/2008/05/02/newsletter-month-fifty-and-fifty-one

Quoting from Dooce, Newsletter: Month Fifty and Fifty-one (The author is speaking to her daughter in a newsletter she writes every month since 2004—except for month fifty—about criticism she receives from readers who think it’s wrong for her to write about her child on her website):

“Will you resent me for this website? Absolutely. And I have spent hours and days and months of my life considering this, weighing your resentment against the good that can come from being open and honest about what it’s like to be your mother, the good for you, the good for me, and the good for other women who read what I write here and walk away feeling less alone. And I have every reason to believe that one day you will look at the thousands of pages I have written about my love for you, the thousands of pages other women have written about their own children, and you’re going to be so proud that we were brave enough to do this. We are an army of educated mothers who have finally stood up and said pay attention, this is important work, this is hard, frustrating work and we’re not going to sit around on our hands waiting for permission to do so. We have declared that our voices matter.

“These are the stories of our lives as women and they often include you, yes. …
…

“I will not be discouraged from continuing to document the beauty of life with my family or supporting them with an income from doing so. Leta, some people will one day try to convince you that what I’ve done here is some sort of sickening betrayal of your childhood, and what those people fail to recognize is that I am doing the exact opposite. This is the glorification of your childhood, and even more than that this is a community of women coming together to make each other feel less alone. You are a part of this movement, you and all of the other kids whose mothers are sitting at home right now writing tirelessly about their experiences as mothers, the love and frustration and madness of it all. And I think one day you will look at all of this and pump your fist in the air.”

EDIT: I wrote this post late last night and I’ve been thinking I must add to it. I must add a little about why I do it. I write about my kids and my feelings about my kids in the hopes that someday they will know who I am. That I am human and full of flaws, and still beautiful. That I start every day with hopes and good intentions. That I strive for goodness and warmth, honesty and love in our family. 

If that bus with my name on it claims me before my sons grow up enough to remember me and our experiences, I hope that eventually, they will read what I have written here and know I loved them imperfectly and completely—in the very best way I could.

Lucas, you are six years old today! Six years ago we held you in our arms for the first time. You were tiny; only 6 pounds and 8 ounces. You had lots of dark, dark hair and a wrinkled up face and red skin. We dressed you in mismatched baby clothes—because you surprised us and we didn’t have all the new ones laundered yet. Somehow, we were so focused on the birthing, we forgot that at the end of it, we’d have a baby and a photo op. Somehow, you were both early (two and a half weeks) and late (productive actual labor didn’t start until 48 hours after my water broke). We danced you into this world; we tranced you into this world. When you arrived, you cracked open the sky and all the light of heaven flowed into my life. 

This is not your birthday letter; I need more time to create that. This is just your birthday post, to say “Wow. We’ve made it so far!” Today was stormy, intense, wonderful, aggravating, and sweet, just as six promises to be. I’m looking forward to learning all the amazing and soul-splitting things you have to teach me this year.

Happy Birthday, Star Child. You are the whirl in my whirligig, and you’ve got me spinnin’ right ’round. I love you to the moon, all the way past Pluto, through the next hundred galaxies and back again.

(I promised myself I’d finish this post before Lucas’s birthday.)

Dear Asher,

Today you are 15 months old. I have mentally started this letter to you a thousand times since you turned one three months ago. I can’t really explain why I haven’t really written it until now, except to say that I’m sort of speechless when I think about expressing to you all I feel about you and your first year of life.

So I’ll just dive in, and let the words come higgledy-piggledy as they may. Perhaps I’ll sort them out later on. Perhaps not.

You are a dream come true. You are not the dream I thought you would be, but I’m more in love with you than I thought possible. This is amazing to me. It fills me with overwhelming joy to find myself besotted with you, adoring you, treasuring you. There was a dark moment before your arrival when I wondered if I could. Now I know it’s all OK. We are fine. We are as we were meant to be. I know this is only the first of many important lessons you will teach me.

At 12 months, you were always happy, easy-going, and adaptable, so long as I wasn’t too far away. Your smile was like sunshine and your laugh completely contagious. They still are now, but now, at nearly 15 months, we see another side to your personality. Now you are very good at showing your displeasure when something is bothering you. Now you tell us so clearly what you want and how you want it. Now we see you experimenting with a greater range of moods and expressions. You have a pout that is beyond adorable. You have a glower that would be truly intimidating, if it weren’t so funny: eyes glaring out from beneath knitted brows, lowered head, pouty mouth sometimes featuring a prominently jutting lower lip. What is amazing is how long you can maintain this go-to-hell look. (There is a photography of me as a very young girl wearing Oakland Raiders pajamas and the exact same go-to-hell look. Whenever you flash this look at my parents, they get all nostalgic for the days when I was small and prissy.) You seem to have a stubborn streak in you that may ultimately rival your brother’s. You also seem to have the capacity to hold a grudge for quite a while. Now you throw tantrums when things don’t go the way you want them to, like if we take something away from you, such as a sharp knife or a tiny LEGO piece.

Most of the time, however, you are happy. You are playful and initiate games with us and with Lucas. You still love peekaboo, though it’s not the Ultimate Game it was a few months ago. You like people to chase you through the house, saying “I’m gonna get you!” in a singsong voice. You laugh like crazy when we play chase.

You crawl so fast now! I keep thinking you will walk any day now, but I keep being wrong about that. I suppose I will be wrong until the day I’m finally right! Anyway, it’s impressive how quickly you can cross the room. Sometimes you chase after balls or a pacifier. Sometimes you’re rushing toward me to be scooped up and spun around and nuzzled.

We spend a fair amount of time outdoors now that the weather is so beautiful. You bravely explore the backyard, navigating steps, crossing bark-filled planters, sitting on my flowers. You seem to like the grass lawn and the bark a lot. I see you scratching your little fingernails into the earth at every opportunity. You love coming across a puddle of water from my garden hose. You sit in it, splash, and hoot your pleasure, signing over and over again “water!” The sign is often accompanied by your saying “wa wa wa” as your hands touch your lips.

Your signing is blooming into a truly useful method of communication. I’m so pleased that you are able to make your needs and wants known by using signs. You’re a little inconsistent sometimes still, and you sometimes confuse them, but more often than not now you perform a babyish variation on the signs we’ve taught you. Let’s see … you now use these signs: water, eat, more, milk (sometimes), dog, hat, cold, phone (you made this one up yourself), please (rarely), pluggie (rarely), fish, cookie/cracker. Just today you began signing for “meat.”

You also communicate with a whole range of whoops and hoos and finger pointing. The clever combo of the sign for “more” and strategic pointing usually makes it clear what you want. This combo is very often “more phone,” “more water,” or “more mommy.” Basically, “more” also functions as “I want.” You’re saying “Hi!” with waving now, particularly if you see a child or a beautiful woman pass by. You smile charmingly as if to say, “How you doin’?” You don’t say goodbye yet, but you do wave whenever it becomes clear that someone is leaving, or that we are leaving other people.

Although it used to be very simple feeding you, now your eating is unpredictable. Some days you want only finger foods, or “real” food; other days, you seem to prefer eating only baby food purées. I think your favorite foods are peculiar in one so young as you: onions, meat, strawberries, broccoli, freeze dried apples, peanut butter, stir-fried veggies such as bean sprouts and celery. And things that most babies love, such as bananas and avocados, seem to gross you out. Some days you’ll eat rice, others not. You get a horrified look on your face every time I offer you diluted juice, so I’m thinking you don’t have much of a sweet tooth yet. Which is just fine by me. I had better go cook up some onions for you.

We are having some trouble with your rough hands these days. You delight in pinching my tender spots, especially my breasts and nipples, and frankly, it hurts like hell. I know you think of these items as your own personal property, but they are mine too. We talk a lot about having “gentle hands” and using “soft touches,” but you don’t seem to care to follow our advice. It’s awful when you’re drifting off to sleep (which is my objective) and you knead my skin in your talon-tipped hands until I’m crazy from the pain and irritation. But since I want you to be sleeping, I try to bravely survive it. Sometimes I fail and jump up shouting “Ow! Ow! Ow! Cut it out, Dammit!” This is not a good nap-promoting strategy.

You also hit your brother sometimes or pull his hair. This is largely due to Lucas’s weird need to put his head on you as often as possible. I watch him approach your face with his own, and see you grimace and try to lean away. I think he wants to love on you and cuddle you as much as the rest of us do. Sometimes you’re willing to tolerate his affections. In fact, just yesterday I saw him lean in and you gave him the most giant hug around his head and kissed him in your slobbery way on his cheek.

Shades of sibling rivalry do appear sometimes, however. The worst is when Lucas climbs into my lap or into my bed to snuggle me. God forbid if he gets between you and me! You squeal and whine and cry and try to kill him for touching your mommy. We’re always telling you, “I’m Lucas’s mommy, too, Asher. You have to share, just like he has to share.” Then we spend some time reassuring Lucas that you don’t realize you’re being mean and stingy. You’re just a baby. The great thing about Lucas is that even if he gets angry with you, he rarely holds a grudge against you for more than a moment. It’s really rather remarkable how much he is willing to forgive. Truly, you have the best big brother ever.

What I love is how you show affection to me. Sometimes you reach up and put your hands on either side of my face. You hold my face so tenderly and bring your own forehead close to touch mine. When you hold me there, head to head like that, I feel really loved. I can’t explain why you do this, but somehow you’ve come to associate  bonking foreheads gently as an expression of loving devotion. Which is fine, most of the time. When you do it in the middle of the night—when you crawl over me while I’m sleeping and slam your noggin into mine, waking me out of a sound sleep with searing pain—I don’t like it so much then.

So far, you really seem to like other children. When we go to our “Mommy Baby” class, you love to say “Hi” to the other babies and want to touch their faces. Yesterday we were there and you really owned the room. Your behavior was different, as though you finally decided you felt completely comfortable there. You explored every nook and cranny, swept toys of the shelves, got into the tree blocks, and cuddled every Waldorf-style baby doll before biting it in the head. You strutted your new talents (briefly standing unaided) and flirted with the teacher and all the mommies. It was as though you decided to put on all your charm and have a great time. You really seem to like Willow, the cute little girl who visited our house last week with her mom Peggy. You played nicely with Cameron and Gavin and Noah, too. When we visited the farm, you got super excited when we stood by the sheep enclosure and by the chickens. You rapidly signed “dog” repeatedly while whooping with pleasure. At this point, every animal you see is a dog to you.

So, yeah. Standing up is the big deal these days. You can walk a little if we take your hands and help you balance, but you don’t like to do it for long. You know, though, that these new skills are important because we make a big deal out of them, clapping and praising you and telling you how big you are now. You look so proud of yourself. I honestly thought you’d be walking by now, but you seem to be on your own timetable. Given how fast you crawl, I guess walking from place to place would really slow you down.

You are brilliant, too. I am constantly amazed at what you already know. You seem to have figured out the use of nearly every household object. You know that keys should be inserted into locks, that the computer mouse makes the pictures on the monitor change, that the spoon is for stirring. You know what the TV remote does, and how to turn on or change the TV station if the remote had been hidden from you. You know exactly what button to push on the DVD player to make the disc eject. You know what a hairbrush is for and what a toothbrush is for. You adore the phone more than anything else and have figured out its major buttons, including speaker phone. You sit placidly for long stretches flipping the pages of books like a lifelong reader. If you try really hard, you can even use table utensils appropriately. It’s weird to realize that you really are watching everything we do with every object all the time. You learn by watching us, which reminds me to be on my best behavior.

There is more to say. I should talk about cosleeping with you, going places with you, how you’re now into everything and much mischief. But perhaps I’ll save those things for later. I suppose I wasn’t speechless after all.

Asher, I love you completely and forever.

Mama.

P.S. I’m sorry I forgot the camera when we went to your first dental checkup.

A while ago I alluded to my recent crisis. The “crisis” turned out not to be one, so rest easy. I want to write about it because … well … because I learned stuff that other people might want to know.

I was recently sick with a cold; you may remember my bitching about it. The cold seemed to go away, then returned and settled in my lungs as a respiratory infection. This is what colds do in my body. It’s tradition. I relented and went to see my doctor, Dr. Chen on a Monday morning, now two weeks ago.

Right. No, I wouldn’t want that.

So, I left Chen’s office and drove directly to the pharmacy at Raley’s. I shopped for a few items while waiting for the pharmacy people to fill the scripts. While I shopped, I got more and more upset. I put a can of Earth’s Best organic baby formula in my cart and tried to imagine Asher happily taking a bottle. Or a cup. Or anything other than mama milk at bedtime. I bought the drugs, bought my other items, and came home. By the time I got home, I was crying.

Ian had been watching the boys for me while I went to the doctor’s office. He was naturally alarmed by my tears. We sent Lucas out into the backyard so I could fall apart and tell Ian what was wrong. I sobbed as I told him how I didn’t want to take the meds. I did not want to stop breastfeeding. I felt that Asher was old enough now that there was a serious chance that if I stopped nursing him, he would wean. Nursing is a beautiful symbiotic relationship: My body makes enough milk to meet the demand of my nursling. Without the demand, the body stops making milk.

I was looking at taking seven days’ worth of drugs, plus two more days of dumping my milk and using formula “just to be sure.”

Breastfeeding Asher is crucial to me for a lot of reasons. When he was first born and I got so shockingly sick with a uterine infection and then septicemia, my milk did not “come in.” In the hospital, they had me on something like ten different drugs to combat the infection and save my life (three different antibiotics—Flagyl, Levaquin, Vancomycin—steroids, an anticlotting drug called argatroban, two asthma drugs, potassium chloride, phosphorus, insulin, mucomyst (a drug I was told was supposed to protect my kidneys from all the other drugs they were giving me), guaifenesin, dilaudid as needed for pain, and Xanax).

It was only through great effort and single-minded determination that I eventually became able to breastfeed my infant: I had to pump every three hours around the clock for weeks. Following doctors’ instructions, I had to dump out my milk for six weeks before I was allowed to feed my baby my milk. 

Doctors have an incomplete understanding of lactation and medications. Drug studies are not done on nursing mothers or babies, therefore little hard evidence exists to prove that continued nursing when taking meds is safe. Serious research on breastfeeding and the nature of breast milk has only been done in the last 20 years. Therefore, to the established medical field, breastfeeding while taking medications is not safe. To the drug companies, it’s less risky simply to say “ask your doctor” or “don’t take while breastfeeding.” They avoid lawsuits that way. Same with the doctor. I gather from what I’ve read that very little time is spent on lactation in medical school, so doctors who may even be pro-breastfeeding don’t really know much about it. They take the conservative stance, as my doctor did: Don’t breastfeed while taking meds.

But, two of the biggest experts in lactation and breastfeeding, both MDs, say most medications are fine to take while continuing breastfeeding your baby. Only a very small percentage of most drugs makes it into breast milk, usually less than 1%.

Tom Hale, MD, (a lactation and drug specialist and author of Drugs and Mother’s Milk, 13th ed., and Drug Therapy and Breastfeeding), Jack Newman, MD, (researcher and author of The Ultimate Breastfeeding Book of Answers) and the American Academy of Pediatrics (AMERICAN ACADEMY OF PEDIATRICS: The Transfer of Drugs and Other Chemicals Into Human Milk) all say its OK to breastfeed even when taking these specific drugs (prednisone and azithromycin) and not to worry about baby. The 2001 AAP publication (Table 7) says there is “no reported signs or symptoms in infant or effect on lactation.”

In fact, there are lots of medications that are safe to take while breastfeeding, but your doctor may not know that. Whether a medication is safe to take depends on a number of things, such as:

* maternal serum drug concentration

* whether the drug is absorbed through the gut; many medications are delivered in other ways, therefore almost none enters the milk

* whether the medication binds to protein

* the size of the drug’s molecules (“In the early postpartum period, large gaps between the mammary alveolar cells allow many medications to pass through this milk that may not be able to enter mature milk. These gaps close by the second week of lactation.”—Spencer, MD; Gonzalez, PharmD; and Barnhart, PharmD, American Family Physician, July, 2001)

* age of the infant (premature and newborn infants are more at risk if they absorb mother’s medication through her milk, as their livers don’t filter the chemicals out of their bodies as efficiently as older babies and toddlers)

* amount of milk the infant is receiving (young infants nurse more than older babies and toddlers)

* the drug’s half-life (drugs break down within the body, so if you time the medication well, such as by taking it immediately after a feeding or during baby’s longest sleep, the drug may well be out of your milk by the time baby feeds again)

* dosage and frequency of dosage (a drug that you take frequently is better than a longer-acting dosage; if you take it frequently, it means the drug breaks down relatively quickly)

* whether the medication is one that is normally prescribed to infants and babies if the medical condition were theirs and not mother’s

* whether the medication will affect the mother’s ability to make milk for her baby (oral contraceptives fall into this category)

Jack Newman, MD, in The Ultimate Breastfeeding Book of Answers, (published by Prima!) has a whole chapter on breastfeeding while on medication. He says, “The essential question in all this is: Does a small amount of medication in the mother’s milk make breastfeeding riskier than not breastfeeding? The answer … is almost always no. Breastfeeding with a small amount of medication in the milk is not riskier than feeding the baby formula, except in a few specific situations. It is almost always less risky. There are safer and less safe drugs for mothers who are breastfeeding, but the majority are still safe. Health risks exist for both the mother and the baby when the mother does not breastfeed. This may not just be a question of taking the baby off the breast for a week or 10 days. It may be a question of permanent weaning, since off the breast for a week often means, in practice, off the breast forever.”

Newman goes on later to say, “You should not assume that your doctor or even your pharmacist knows much about drugs and breastfeeding or that they are concerned with helping you continue to breastfeed. Often the information they may use to decide if a drug is acceptable during breastfeeding domes from the drug manufacturer itself, found in a book called the Compendium of Pharmaceuticals and Specialties (CPS) in Canada and the Physician’s Desk Reference (PDR) in the United States. The manufacturer is concerned about its own medical legal liability, not the importance to the mother and baby of breastfeeding.”

Tom Hale, MD, Ph.D., professor of pediatrics at Texas Tech University School of Medicine, has a website and a Q&A forum which discusses specific drugs. He answers the questions himself and specifically discussed prednisone and azithromycin, as well as many other medications:  http://neonatal.ttuhsc.edu/lact/

This site is a clearinghouse of info and links to many good online  sources: http://www.breastfeedingonline.com/meds.shtml

The American Academy of Family Physicians introduces the topic of breastfeeding and medications in this way: “Physicians receive little education about breast-feeding and even less training on the effects of maternal medications on the nursing infant. Yet, concern about potential harm to the nursing infant from maternal medications is often cited as a reason to advise discontinuation of breast-feeding. Overwhelming evidence demonstrates the benefits of breast-feeding and the deleterious effects that can result from premature weaning.” You can read the full article here: http://www.aafp.org/afp/20010701/119.html

Here is an easy-to-read table of drugs and their relative safety/risk when breastfeeding: http://www.ukmicentral.nhs.uk/drugpreg/qrg_p1.htm

La Leche League’s website (http://www.llli.org/) has three articles specifically about medications in mothers’ milk. One is written by Tom Hale and he says “In a 14-month-old breastfeeding baby, the volume of milk provided is often so low that the dose of maternal medication transferred to the infant is minimal to nil.” This is exactly Asher’s present age.

William Sears, MD, a huge proponent of Attachment Parenting and breastfeeding has a website, too. Here’s an article on the benefits of breastfeeding “from top to bottom”: http://www.askdrsears.com/html/2/T020300.asp

This is just a small sampling of the information that is available. It was enough to convince me and Ian that it was safe for me to take the medications my doctor prescribed to me and to continue breastfeeding our baby, with no interruption or big change in our routine. I made an effort to take my meds after Asher had nursed and right before his longest sleeping period of the day, but otherwise we continued life as normal. Within 24 hours, I felt about 40 percent better for having taken the drugs. The day after that, I felt enormously better and very grateful I had done my research and decided to take them.

We carefully observed Asher during this time. He didn’t change in any observable way, except for the better: He gradually got over his cold after a few days. His mood improved and he returned to his normal happy, healthy self. 

I’m returning that baby formula to the store unopened.

The moral of this story is this: Do your research before you take the advice to stop breastfeeding your baby, and don’t assume the doctor knows all the info. Don’t risk losing the most perfect symbiotic and health-promoting relationship two human beings can have. It’s too important to throw it away.

So last night was weird.

And fun.

And this morning I’ve flip-flopped between feeling embarrassed and giddy.

I met my mother for coffee and a mini shopping trip. I took Asher along of course. 

I got him dressed. 

Well, I took him in the outfit he slept in. But I put socks and shoes and a coat and hat on him.

I got myself dressed. 

We drove to meet mom. We chatted and drank coffee. 

Asher cooed at the passing people.

They cooed back at him.

We shopped a bit.

I drove home and put Asher to bed for a nap.

I worked while he slept.

I crept around the house silently.

He woke.

We played.

We ate lunch at around 2 p.m.

I mused about last night while he ate dried blueberries and bits of lunchmeat.

I looked over to where I had removed and left my black boots earlier while Asher was sleeping.

Two.

Different.

Black.

Boots.

Oy.