(not so young) Mothers and Breastfeeding
Janice Merrill Batzdorff
Studio City CA USA
From: NEW BEGINNINGS, Vol. 19 No. 9, July-August 2002, pp. 124-27
When you hear the term "older mother," what image comes to mind? A woman who started having children at a younger age who is still adding to her family? A first-time mother in her mid-to-late 30s or 40s? Someone who has wanted for a long time to have a baby, whose dream has finally come true? Perhaps you've even known or heard about a woman who had a "late-in-life" baby.Or perhaps you are that woman!
A lot of the issues faced by women who would consider themselves older mothers are the same as those faced by all mothers. At the same time, some challenges come more to the forefront as a mother gets older.
Women who give birth for the first time past the age of 35 do so for a variety of reasons, in a wide range of circumstances. Some have chosen to reach a certain level in their trade or profession, or wanted to establish a financial cushion, before having a baby. Others may have married later, or needed to resolve some of the difficulties of their own childhood before approaching parenthood themselves. Still, others may have had to wait until an innovative fertility treatment enabled them to conceive.
Older mothers have babies with their original spouse, with a new partner, or as a single parent. They may have grown children, grandchildren, or stepchildren when they give birth in their later years. They may already be caring for an aging parent or other relative. No matter how unique the situation, what older mothers all have in common is how much they and their babies can enjoy the benefits of breastfeeding including improved health, financial savings, and convenience.
Breastfeeding offers all mothers many benefits, but many older mothers especially appreciate certain aspects. The busy older mother who has many other responsibilities is better able to get to know and bond with her new baby when she breastfeeds. Since metabolism slows down as a person ages, older nursing mothers find it advantageous that the caloric demands of lactation help them to lose weight. Getting more rest by nursing lying down may be appreciated by some older mothers who may not have as much energy as a young mother. And when older children and stepchildren get to watch a baby brother or sister being nursed, they receive a priceless education.
A New Beginning
When it comes to getting started, the older mother who has already had a satisfying experience nursing a child puts her new baby to her breast with confidence. If difficulties arise, she draws on her previous success to carry her through times of doubt. The older mother who previously experienced frustration or perhaps an early weaning may also benefit from her past efforts by recognizing familiar warning signs and seeking the information and support needed for a more satisfying breastfeeding experience.
"My husband and I thought we were the luckiest parents we knew because our first baby began sleeping through the night when she was three days old," says Lisa Part, a 39-year-old mother in Northridge, California, USA who is nursing her fourth child with ease. "I ended up having a low milk supply and had to work hard for weeks to build it up. It would have been so much easier if I had just awakened her to feed her during the night."
"My experience with my other children gave me the confidence to know I could completely breastfeed this child and not to give up," states Nan Vollette, a 48-year-old grandmother of three in Hampton, Virginia, USA who is nursing her sixth child. Her son's health problems at birth resulted in a low milk supply and Nan worked for four months with a finger-feeding system until he became a stronger nurser and her milk supply improved. "I was told by medical personnel that supplementing was not a big deal, that I had tried breastfeeding and it didn't work out, so just move on. That kind of thing ate at my strength but at the same time I felt determined to make it work."
Being able to ask for help and having a supportive husband made all the difference for Anna Adams Gosicki of Scottsdale, Arizona, USA when she was breastfeeding her second child. Anna was a young mother at age 20 when her first child was born, and didn't understand how often she needed to breastfeed. Her nipples also became sore because she had some problems with the baby's latch-on. "My husband was afraid of our baby, and I grew anxious, tired, and scared. I quit nursing too early," says Anna.
When she gave birth to her son when she was nearly 40, Anna experienced similar breastfeeding problems and she knew this time to ask for help. She was shown correct positioning and what to do about soreness. With fond memories of breastfeeding this time, Anna states, "I think breastfeeding is loving, gentle, convenient, and it made me feel good."
When Leslie Ann Ostyn of Grant, Michigan, USA told her husband that she was pregnant at age 44 with the second child they had awaited for 18 years, his first statement was, "We are not going to have any friends!" In fact, Leslie Ann finds in her interactions with young mothers, "I am frequently called on to give the 'grandmother' perspective. I know I am helpful but it doesn't fulfill me and makes me feel pressured to be perfect."
An older mother might be the only one in her entire circle of friends with a baby. If she has achieved a high level of competence in her professional or personal life, or has become adept at juggling multiple responsibilities, she may have unrealistic expectations about how easy it will be to care for an infant and to fit nursing in with all her other activities. For that reason, the information and emotional support provided by attending La Leche League meetings can help out a lot.
Ann Dunnewold and Diane G. Sanford in their Postpartum Survival Guide speak of the immense confusion and frustration the first-time older mother faces because of the lack of control she has over her pregnancy, birth experience, and even her child. "The day-to-day tediousness of caring for an infant may come as a shock.... Suddenly you are working on someone else's timetable, after being in charge of your own timetable for years." Dunnewolde and Sanford urge the older, new mother to scale down her expectations, focus on her strengths, and set aside 10 minutes each evening with her spouse to ask each other about their day.
So many new mothers thrive on the camaraderie that develops among the women who attend La Leche League meetings. An older mother, if other members of the Group are much younger, might have different interests or concerns. If so, she might help her Leader to plan an enrichment meeting on a topic she and other older mothers would find especially helpful. In addition, she may ask her Leader to help her find a nearby Group that has more older members or to put her in touch with other older mothers. LLL Area Conferences offer another place to meet mothers in similar circumstances.
The most common concern that older breastfeeding mothers share is fatigue. This may be partly due to physiological changes that come with aging. It could also be caused by the workloads that older mothers tend to carry, caring for their other children, working outside the home, and participating in their community.
Getting adequate rest is necessary for producing a good milk supply and for preventing breast infections. Most older mothers find it essential to take naps. When that is not possible, they may be able to revitalize themselves by doing meditation or yoga, breathing from the diaphragm, relaxing in a bubble bath, listening to soothing music, or getting fresh air. Cutting back on caffeine including soft drinks, coffee, and tea is also recommended, as well as avoiding eating large meals just prior to going to bed if falling asleep at night is difficult.
Bringing their baby to bed with them is also helpful for many mothers. Karen Zeretzke, a mother of eight in Baton Rouge, Louisiana, USA who gave birth to her last two children while in her 40s, enjoyed these merits of the nighttime family bed: "The babies felt secure, we all got more sleep, and if I roused, watching them sleep was so comforting."
"Eat a healthy diet and guard your rest for the first three years," was the sage advice that Leslie Ann Ostyn followed after the cesarean delivery of her second child when she was almost 47. Though recovery was more difficult compared to how she felt after the vaginal birth of her first child, she found, "I was quicker to listen to my own body and knew I would and could take it easy being a new mother. I had come to accept that a baby will change your lifestyle and that is okay."
The cesarean birth rate tends to be higher for older mothers, and even more so for the first time older mother, whose labor is typically longer.
Some obstetricians use the term "premium baby" to describe "any baby especially desired by the mother-particularly the older, first-time mother," explain Diana Korte and Roberta Scaer in A Good Birth, A Safe Birth. "The need to 'guarantee the product' (so to speak) results in increased cesareans for these premium babies."
The impact that a cesarean birth has on establishing breastfeeding differs from one older mother to another. "The pain during the early weeks made responding to this baby slower and more difficult," states Patty Spanjer, a 51-year-old mother from Dalton, Georgia, USA who is currently breastfeeding her fifth child, the only one to whom she gave birth through cesarean section. "I needed help handling him, getting up, holding my older child, and with food."
The need to recuperate after this major abdominal surgery, may, however, help the otherwise unstoppable, busy older mother to truly step back from all her other obligations to focus on nursing and getting to know her baby. Her disappointment at not delivering vaginally can add to her determination to breastfeed. A first-time older mother may also be so thrilled to finally have a baby to hold and nurse that she has no second thoughts about the method of birth.
Older mothers who have had a vaginal birth after cesarean (VBAC) find that a variety of factors, not just their age or the type of birth, affects their breastfeeding experience. Though bedridden for several weeks due to the complications after the cesarean birth of her first child when she was 35, Jodi Dembicer-Gross of Woodland Hills, California, USA recalls with fondness, "My baby was in bed with me and not only did nursing go smoothly, but we also took wonderful naps together." Comparing how she felt after giving birth to her second child with a VBAC at age 38, Jodi reports, "I definitely had more energy to nurse after my cesarean birth than after the VBAC. I think it is because I had exercised much more during my first pregnancy and was in better shape physically. Trying to keep up with a three-and-a-half-year-old at the same time I was nursing my second baby was also exhausting."
Back pain presents a challenge for some older mothers. The need to sit in one place for the extensive nursing of a newborn might exacerbate the situation. Becky Ross, a 43-year-old breastfeeding mother in Aurora, Colorado, USA used pillows for support and did yoga and simple stretches following her daughter's birth last year. Nonetheless, compared to when she was nursing her sons 15 years ago, the pain is considerable. It makes it hard for her to get up early to get her boys off to school. "When I was nursing before, I could sleep in, but now I am up at 6 am whether I got a good night of sleep or not. I find that I am tempted to stay up late to spend time with my teens or just to get some 'me' time."
Low Milk Supply
An older mother with a low milk supply may wonder if her age is the cause, particularly if she did not encounter this problem when nursing babies to whom she gave birth when she was younger. According to Lisa Marasco, IBCLC, a La Leche League Leader and Assistant Area Professional Liaison who has done research on insufficient milk supply, "It is not known for sure that advancing age can impact milk supply, though some lactation professionals believe that they see this happening."
Many factors can affect milk supply, including conditions such as hypertension, anemia, and severe postpartum bleeding. Nonetheless, with hard work, good guidance and support, and lots of patience, an older mother will, in most cases, be able to build up her milk supply. Ann Conlon-Smith, a mother in Raleigh, North Carolina, USA who lost a lot of blood after her cesarean delivery of twins at the age of 47, found herself with a low milk supply that lagged for three months. "It was an awful time and I was terrified-I didn't know if I was 'too old to breastfeed' or just what had happened. I used lots of milk bank milk, pumped continuously, and put the babies to breast all day and all night." Determined for her twins to receive no less than their singleton siblings did, Ann persevered and her milk supply did improve.
When breastfeeding has been going well, an older nursing mother may, at some point, become unusually exhausted. She may feel breast tenderness or nipple soreness, particularly at midcycle and during the last week before menstruating. The day before her period starts she may also get irritable. These are common symptoms of perimenopause, the transitional time in a woman's reproductive life leading up to the actual cessation of menstruation.
It may be hard for a woman who has fairly recently given birth to imagine that she is perimenopausal. However, this phase in her life may begin anywhere from a few months to 10 years prior to her actual menopause. The degree to which a woman even notices her own perimenopause, explains Lonnie Barbarch in The Pause, depends on how sensitive she happens to be to hormonal changes, as well as on factors including her diet, exercise pattern, and life experiences.
If the symptoms of perimenopause make it difficult for a woman to nurse or care for her baby or family, she may wish to explore ways to ease her discomfort. Options include vitamins, herbs, acupuncture, homeopathy, dietary changes, and natural and synthetic hormones. Susun S. Weed recommends a variety of specific herbs, nourishing foods, meditations, exercises, and nutritional supplements in Menopausal Years: The Wise Woman Way. However, before trying any of these methods while breastfeeding, it is essential that someone knowledgeable be consulted. The mother who hopes to continue nursing will ideally seek the expertise of someone who can respect that choice.
Many mothers find during the normal course of breastfeeding that the baby seems to need increased time at the breast just when she is hoping to nurse less. This may occur as the baby approaches a developmental milestone, during illnesses, or when the family is going through a stressful period. Nighttime feedings may also increase when the baby becomes so fascinated by his surroundings that he won't stop to nurse enough during the day. There is a tendency for the first-time older mother in particular to wonder if her child will ever outgrow his need to breastfeed. It may seem as though she will never be able to return to her accustomed level of accomplishment.
It is helpful to remember that each time she nurses her baby, the hormones prolactin and oxytocin are released, giving the mother a sense of calm. By providing her child with the health benefits of breastfeeding, such as reduced incidence of ear infections and allergies, an older mother also paves the way for her workload to be more manageable as she, herself, continues to age. The infancy period is actually a short length of time that might not come again, especially if the mother is approaching the end of her fertility.
One More Baby
The older nursing mother who wishes to conceive another child sometimes faces tough decisions about her existing breastfeeding relationship. If she has not resumed ovulating since giving birth, she may decide to decrease the number of feedings at the breast or to wean. Yet there is no guarantee that she will then be able to conceive, or that she will carry a baby to term, as there is a higher rate of miscarriage among older women.
It is sometimes recommended that a woman ask her own mother when she stopped having periods as a gauge for determining how long she might expect to be fertile. However, even when a woman continues to menstruate in her later years, she does not necessarily ovulate every month. In addition, American women are seeking medical help for menopause four to five years younger than in the recent past, reports Gail Sheehy in The Silent Passage: Menopause. This may be due to postponing childbirth, having fewer children, as well as synthetically controlling menstrual cycles.
Weaning the older nursing baby in order to conceive may also present challenges. Doctors are not always supportive of breastfeeding a toddler in general, much less when the mother is trying to conceive or is already pregnant. Oftentimes it is the high need child or one with food allergies who thrives on extended breastfeeding. A lot of work may be required to help him adjust to fewer feedings at the breast.
The older breastfeeding mother who needs fertility drugs in order to conceive is hampered by the fact that there doesn't seem to be any study available that evaluates the effect of such drugs on the nursing baby. Weaning is therefore the safest option. Again, even when the mother chooses to wean, there is no guarantee that she will have another child.
While it is both helpful and inspiring to read about other older, breastfeeding mothers, this can, unfortunately, lead to disappointment when a woman draws conclusions about her own fertility based on someone else's experience. All the mothers quoted in this article did give birth in their mid-to-late 30s and 40s, but that does not mean that someone else with the same desire will be able to do so. Furthermore, an older mother may have conceived her child with the help of reproductive technology and chooses to not disclose that information.
While she and her family were grieving deeply and endlessly the drowning death of her two-year-old son, Gregory, Ann Conlon-Smith recalls how desperately she wanted one more child. "I had no idea that suddenly I would no longer be able to become pregnant, when four times previously, I got pregnancy exactly when I wanted to, and even when I did not intend to! I wish my doctor had told me that because of my advanced age (46) I might need to work with a reproductive endocrinologist or fertility clinic. We finally did just that and conceived our precious twins."
Reflecting on the eventual weaning of the last children she intends to have, Ann states, "I wonder what it will be like to miss seeing their eyelids flutter and close in rest and to feel that deep relaxation and rest that I never feel in any other way. I think I will always miss it. It will remain the most cherished memory of my young children's lives and their connection to me."
1. Barbach, L. The Pause; Positive Approaches to Perimenopause and Menopause. New York: Penguin Putnam Inc., 2000.
2. Dunnewold, A. and Sanford, D. Postpartum Survival Guide. Oakland, CA: New Harbinger Publications, 1994.
3. Korte, D and Scaer, R. A Good Birth, a Safe Birth: Choosing and Having the Childbirth Experience You Want. Massachusets: Harvard Common Press, 1992.
4. Marasco, L. "Insufficient Milk Supply: Common Factors and Relationship to Polycystic Ovary Syndrome" [thesis]. Pasadena, CA: Pacific Oaks College, 2001.
5. Weed, S. Menopausal Years; The Wise Woman Way. Woodstock, New York: Ash Tree Publishing, 1992.