This past weekend was the first time going to the field since my daughter was born in February. Army regulations prevent units from having new moms go on overnight trips until your little one is over four months old. So as of June 13, I was on the list to head out to the field. This weekends training schedule was packed, including bussing across the state and being the Officer in Charge (OIC) on the weapons qualification range.
Even without being a new mom, even for the second time, being the OIC of a range is an important responsibility that takes a lot of planning, coordination, management, and execution. There are a lot of moving parts that go into making the range a success and accomplishing the mission. But I also had another mission: pumping and saving enough milk for my baby girl.
I looked to one of my favorite resources on the subject: Breastfeeding in Combat Boots. Robyn Roche Paul is the go-to resource when it comes to knowing about the tips and tricks for successfully breastfeeding in the military. She has been a breastfeeding advocate since she herself became a mother while serving in the Navy, and has been an International Board Certified Lactation Consultant (IBCLC) since 2006.
My husband was able to find a plug in cooler at a garage sale a couple of months ago, and I originally planned on taking it with to store my milk in. But after a test run last weekend, we discovered that it just wasn’t staying cold enough and it wasn’t going to the best choice for the logistics of taking it from our sleeping area to the range and back again. So then I started looking into taking some dry ice in a small picnic cooler. I found a distributor nearby and they were really informative about how to use it – but they advised that I would need to check with the bus company that would be transporting us to verify that they would allow it on the bus. Since the buses are contracted, I would need to talk to the actual bus driver that I would have on the day of and that just wasn’t information that I was able to track down.
So, my section NCOIC helped me to verify that they cooks for the unit would have ice on hand throughout the training exercise. She chuckled a bit about it, but her daughters are actually my age and breastfeeding mothers themselves. The morning of departure, I packed up a bag of ice from my own freezer and tucked it into my cooler. I also made sure I had a couple of special things in my pump bag to make sure that I would have smooth sailing all weekend.
- Freemie – These collection cups for my breast pump were a HUGE game changer. I’m able to use them with my Medela pump as well as with their own model as well! They tuck right into my bra so that I can pump discretely whenever, and wherever I can. I just put them in place, and then I just pull my tan t-shirt back down and pull my ACU blouse back together so that you can hardly tell I’m pumping. The noise of my pump humming next to me is the only thing that gave me away a couple of times! I even pumped in the control tower of the range! They are absolutely worth the investment.
- Battery Pack – Medela has a battery pack that is compatible with their Pump in Style pump and this was amazing for pumping on the bus to and from our training. It was a four hour bus ride each way, and it’s not always possible to pump right before boarding based on what is going on. But with the battery pack I could pump anywhere that I needed to.
- Power Adapter – I also made sure to tuck a power adapter into my bag just in case I needed to pump while in a vehicle I would be able to with ease. I didn’t use it this weekend, but it has come in handy before and I definitely recommend every pumping mom have one in her bag!
- Pacifier Wipes – There are some fancy wipes you can get for your pump parts for quick cleaning on the go. But when I checked out the ingredients compared to the equally fancy but much cheaper pacifier wipes available, they were very similar. So when the best I can do is a quick wipe down this is what I use. You don’t want your milk sitting in your pump parts out in the heat in the field, it’ll cause bacteria to grow.
- The Basics – These are things I always have on hand including my breastmilk storage bags, permanent marker, and extra tubing.
I am very fortunate to be in a unit with many people who are supportive of me and other mothers in the unit that are on this pumping journey. I was able to pump on the bus on the way to our training base, in the barracks, at the range, and on the way back as well. There were some hiccups of course, but these have to be taken with a little grace and press on to not only accomplish my mission to nourish my daughter but also to accomplish the unit mission.
I missed a pumping session due to a required certification course with Range Control, and it made me anxious at the time and impatient to get to a place that was at least semi-private to pump. I didn’t feel comfortable pumping in the van on the way back to the barracks because it was a packed full 12 passenger van but I just had to tell myself that I was already late pumping anyways and the extra ten minutes it would take to get there wasn’t going to make a huge difference. When I got there, I was able to sit down and have a moment of quiet and pump.
The morning of the range, I woke up to pump and the milk started backing up into the tubing!! AHH! It made me panic for a split second, but then I got my wits about me and disconnected the tubing before the milk reached the pump. After calming down from my oh-my-gosh-my-pump-almost-just-got-milk-in-it moment.. I just took my pump cups and the tubing to the latrine, washed everything and started again. And it was fine!
The Non Commissioned Officer in Charge (NCOIC) on the range with me was really supportive. He had zero issues with my pumping in the tower, saying something to the effect of “Of course, it’s just natural!” After hearing so many stories of other Soldiers having unsupportive environments, it was a sigh of relief to just be able to do what I needed to do and take care of business.
- At breakfast and dinner each day I replaced the ice for my cooler and it worked out really well. But we were eating in a DFAC which made it a lot easier. But our food service section told me that even if they had been cooking out of the MKT they could have helped me with ice. Don’t be afraid of simply asking for what you need. You might be surprised how supportive people can be with just a simple request!
- I ended up moving my pump from the normal pump bag into my assault pack so that it was easier to take with wherever I needed to go. It helps decreasing the I’m-carrying-a-breastpump-everywhere feeling too. Just another Soldier carrying around a normal assault pack.
- I used a pillow over the pump in the barracks after lights out and before wakeup to keep it from making too much noise and waking up the other Soldiers.
- I wore tank tops under my tan t-shirt to make sure that when I was getting my pump stuff set to go I wasn’t showing my stomach. That might not bother other people but I like to stay as covered up as possible especially at work, and it is also a good-will gesture to put others at ease who might be around when you need to pump.
- Stay flexible. You might not always be able to pump in ideal conditions. You might end up pumping in places you’d never expect, with people around.
The Army doesn’t have a regulation to protect the rights of breastfeeding mothers like the other services, so you have to be pro-active. Instead of focusing on what the Army doesn’t spell out in writing, we can focus on the flexibility that we can have with it. I’ve found a lot of success with being honest about what I need to accomplish my goals and frankly, not making it sound like a big deal. I don’t ask permission to pump; I let people know that I need to go take care of something and I’ll be with them in about 15-20 minutes. If I have a meeting scheduled at the time that I normally pump, then I pump earlier or wait until after if I know for sure that it’ll be a short one. The more natural we make it seem, the less it will phase others and the more pumping can be normalized.
My second appointment during this pregnancy came in my 13th week. I have just cleared by my endocrinologist to start taking my Thyroid medication again and I am starting to feel better already. It is most likely a combination of both the medication and entering the 2nd trimester.
I went to my appointment in uniform, since I was going straight from work and my husband wasn’t coming with this time. I think I make the nurses chuckle a little by already having my weight measurement ready for them rather than stepping on the scale whilst in uniform. The boots alone add 4 pounds! If they weigh me themselves, the wont deduct pounds for clothing so I like to skip that part and I weigh myself that morning.
The midwife I met with today was great. She’s spunky, down to earth and isn’t sugar coating anything. We talked about pain management a bit during this appointment. I had heard that the family doctors can administer gas and air during labor at this hospital, but she indicated that I would have to switch to them as my providers if that is what I wanted to use. Since this group of midwives has a stellar reputation for VBAC success, I am hesitant to do so.
We also talked about epidurals. During my last labor, the epidural did stall my labor for more than five hours so I would like avoid getting one so that my labor progresses. I feel that I would have been less exhausted when I had reached the pushing stage if I had foregone that intervention (since it had worn off anyways). She indicated that that was fine, but to understand that if there was an emergency and a CS was neccessary that they would use general anesthia. I am very claustrophobic, and the inablity to feel my body or move was traumatizing for me during my son’s delivery. I have through a lot about what she said since we spoke, and based on my emotional and mental reaction to the spinal block during my sons delivery, I think that general anesthisia may actually be the better solution for me if there was a true emergency.
I also talked with her about what the group of midwives expects regarding a timeline at the end of the pregnancy. She said that they allow VBAC patients to go until 42 weeks as long as the baby is healthy and there are no complications. Upon 42 weeks, if the cervix has ripened they will opt for an induction using membrane sweeps, foley bulb, and pitocin. They absolutely will not use cervadil or other chemical dialators. If the cervix has not ripened they will schedule a repeat cesarean for 42 weeks 1 day.
I also got to hear the baby’s heartbeat and it was coming in strong at 158 bpm. What a beautiful sound!
As I continue through my pregnancy, I will be seeing a different midwife in the practice at each appointment. I hope to start formulating a list of questions to ask each one so that I can get to know each of them better. This way when I am in labor they are all familiar and I can know what to expect from each of them. If you were seen by a different provider each appointment, what questions would you ask?
Today marks the beginning of World Breastfeeding Week 2014! The theme this year is “A Winning Goal for Life!” Every year thousands of mothers, lactation consultants, birth workers and more come together to celebrate the beautiful and natural act of breastfeeding, and to emphasize the importance of increasing and sustaining the protection, promotion and support of breastfeeding.
According to the World Health Organization (WHO), breastfeeding not only provides the best nutritional support for your child but it also enhances maternal bonding, stimulates psycho-social development, improves physical growth, reduces susceptibility to common childhood illness, improves immune system function, and also has long term benefits including increased performance and productivity and reduced risk of some non-communicable diseases.
The WHO recommends exclusive breastfeeding for at least six months, followed by continued breastfeeding while offering complementary foods for up to two years or beyond. These goals may seem very doable for most women, but for working mothers and especially those in the military, it is very challenging. In order to exclusively breastfeed for six months the WHO and UNICEF recommend several things:
- Initiation of breastfeeding within the first hour of life;
- Exclusive breastfeeding – that is, the infant only receives breastmilk without any additional food or drink, not even water;
- Breastfeeding on demand – that is, as often as the child wants, day and night;
- No use of bottles, teats or pacifiers.
Three of these recommendations present significant challenges for working mothers.
Exclusive breastfeeding – no formula – is the first. Many working mothers, after returning to work from the extremely limited maternity leave find themselves in a rather awkward position of having to explain to their supervisor why it is important that she be permitted to use her breast pump every 2-3 hours for 20 minutes. In the case of the military, the Air Force, Navy, Marines, and Coast Guard do have regulations in place to ensure that mothers are given these opportunities. However the Army does not. So many mothers in the Army, when faced with resistance or are flat out told that they will not be permitted to pump due to “mission requirements,” either give up pumping at work completely, or they pump as often as they can. Usually once after physical fitness training (PT) in the morning, once at lunch, and then if they manage to get a break at some other time they do it then as well. The result of these spontaneous pumping sessions is inevitably a reduction in milk supply, resulting in the use of formula to supplement.
The second challenge, nursing on demand, is closely tied to the first challenge. In that, working mothers aren’t with their child throughout the day and therefore cannot do so. If unable to pump at the same times that the child is eating, a decrease in supply occurs resulting in supplementation with formula.
Third, of course, is no use of bottles or pacifiers. This is just not possible to do as a working mom. The child has to use one or they wouldn’t be able to eat after the end of the maternity leave.
I was very fortunate in my breastfeeding journey with my son. When I returned from my maternity leave, I also happened to be the Commander of my Army Company. I had my own office to provide privacy for pumping sessions, which I simply closed my door and ignored the knocks for 15 minutes. When the new commander arrived, and I became the XO again, we shared an office and it was a bit more challenging. I decided to use the break room twice a day by putting a sign on the door to not be disturbed. I also pumped in my car quite often. Over my year of pumping I also pumped in several different types of vehicles (an LMTV, a HUMMWV, a TMP van) as well as the corner of a crowded training room while using a cover. All not ideal places, but I kept myself covered and discrete as possible.
A great contributor to my success is also all about attitude. The Army does not have a regulation to “approve” breastfeeding. That also means that it doesn’t have a regulation that disapproves it either! So when faced with opposition, I felt empowered to work with them to find a resolution that would enable me to continue to provide for my family – and my child – the very best that I could.
I may not have been able to pump every single time that I needed to, there were several times that hours had passed since a pumping session and I was stuck in a meeting that I couldn’t leave, but I always did when I could. When my son was 10 months old we moved across the country to a schoolhouse environment and it became even more difficult. I didn’t want to be seen as having preferential treatment for pumping (also a common fear among breast feeding mothers in the military) so I would only pump after PT and at lunch. As my supply decreased we did end up day weaning at one year. But a year of breastfeeding in the military is a huge milestone! I’m proud of what we accomplished, even if it isn’t the two years that the WHO recommends. If we could have gone longer, maybe we would have.
So this week, as you see working mothers passing by with newborns, infants, and even toddlers give them a little word of encouragement in their journey. Because this is a tough road that we are on, and positive words mean a lot. Encouraging breastfeeding is simply the right thing to do.
I would also like to thank the Lactation Consultants who helped us on our journey. During the first eight weeks of my sons life, we had a really hard time with breastfeeding. We were battling with thrush, latch issues, oversupply, reflux, and fast letdown. Without the help of Dorothy, my lactation consultant “angel”, we probably wouldn’t have made it even past my six weeks of leave.
And another shout out to Robyn and her amazing book Breastfeeding in Combat Boots who gave tons of information on how to make it all happen while serving! I was able to meet Robyntwo years ago when she came to speak at Madigan Army Medical Center, and she was very encouraging and positive. She gave a wonderful presentation to the medical providers on why it is so important to encourage breastfeeding and how low the numbers are in the military compared to the civilian world.
Being away from home is part the Army life; whether it is for months at a time or even just a few days away, the mission must continue. As our family has grown and changed, so has our need to stay connected across the miles. There are several things that have helped make the distance seem shorter and the time pass faster.
Before this current trip, my husband and I worked to prepare our toddler for what was happening. I have been traveling a lot for work lately, and he has been stuggling with some separation anxiety. We wanted to make sure that we could aknowledge what he was feeling, and comfort him during my absence.
In the week before my trip, we made sure that we stuck to the bedtime routine, but also made sure that both Daddy and I did it together. That way, our Son would know what to expect at bedtime no matter who was there.
We also talked to him about what would come next. When my departure day arrived, we were able to talk to him about each step of the plan. “We are going to go eat lunch now, and then we are taking Mommy to the airport.” Followed by, “now that lunch is over we are going to take Mommy to the airport, and she is going bye bye for a few days.” My husband was fantastic in explaining this to our Son! Building on his budding counting skills he told him “1, 2, 3, 4, then Mommy’s home!”
Saying goodbye is always difficult. I think it is very important to keep it as brief as possible so that my Son doesn’t feel overwhelmed by my leaving and that he can feel my confidence that I will return soon. If I take a long time to say goodbye, he may worry that this is a bigger deal than it really is. So, after a short goodbye I was off!
That is when the hard work really begins. My husband takes the reigns so capably during these times. He made a paper chain to help our Son count down the days until my return. He is very good at reading our Sons mood and knowing whether a call or FaceTime would make him happy or upset. It is so important to try to remember that more contact isn’t always better. Our son is very independent and resilient, but he has bad days too and we try to respect that and not make it worse.
On my end, I check in when I can. Depending on the reason for my trip, anywhere between one to three texts to my husband a day just to say “hello”, “I love you”, or “how’s the boy doing?” If its a good day I get to FaceTime with them at bedtime and be a part of our goodnight routine.
Before I return, we will do much of the same prep as well. My husband will talk to him about the day and let him know what will happen and when. They’ll pick me up at the airport, and we will get to have a happy hello. I try not to make a huge fuss over our hello either though. I feel that if I overemphasize our reuniting, then it would confirm to him that the separation was a bad thing and that in turn increases his anxiety when I inevitably have to leave again.
Traveling with the Army isn’t always easy, especially when it means missing my family. But working as a team to ease those times when we are apart helps to build up our family so that we can tackle the challenges of Army life together.
An article released by the Navy Times today details plans regarding a bill introduced by Sen Claire McCaskill, D-Mo., that would require Tricare to cover breast pumps for Active Duty members as well as military dependents. The Affordable Care Act, introduced in 2013 to improve healthcare nation wide currently requires insurance companies to cover the full cost of renting or buying pumps as well as lactation counseling and support. However, as the single source for healthcare to military personnel, Tricare is exempt from this and most of the requirements of the ACA. At this time, Tricare will only cover the cost of a pump for mothers of premature or at risk newborns.
As an active duty member, it was vital for me to have a quality pump to ensure that I could provide the nutrition needed to my son. Without a pump, we would have spent hundreds of dollars on formula during his first year. This issue is near and dear to my heart, as many Soldiers do not have the funds to secure a pump and therefore rely upon the formula provided by programs like WIC. By ensuring that medical equipment provisions through Tricare are on par with civilian counterparts, we will be able to ensure that our Soldiers are getting and giving the best care during the crucial first years of their children’s lives.
Senator McCaskill’s bill, S1994, is already drawing praise from the National Military Family Association, an advocacy group representing military dependents, retirees and families. “Ensuring that military health care benefits are on par with civilian coverage is one of our top priorities,” NMFA officials said.
Please contact your Senator, and let them know that you would like them to support S1994 and help military families obtain the same benefits that their civilian counterparts are already enjoying.
I have touched upon PTSD in previous posts, discussing how people can be on that path and some of the ways that they can seek treatment. One way that helps many is therapy. In the military, there can be many barriers to a Soldier seeking assistance with Behavioral Health. These include Chain of Command conflicts, mission needs and availability of services.
Seeking assistance at the Behavioral Health Clinic on post can be as simple as calling to find out when their walk in hours are, and then going. But sometimes it isn’t that simple. The walk in hours are usually after the duty day has already started, and this can cause some Soldiers to avoid going because they must then speak with their First Line Leader about why they need to be gone. Sometimes if you get lucky, you can go on a day after Staff Duty or manage to find a day when there’s nothing going on and just let them know that you’re running an errand or two and you’ll be back in about an hour.
So what happens during the walk in? Well, you’ll most likely fill out a survey on the computer. It asks questions about how you’re feeling, if you drink or smoke, if you have any conflicts with anyone, whether you’re thinking about hurting yourself, and other questions as well. Once you complete the survey, you wait until a therapist comes and brings you back to their office. Once there, you talk with them about why you are there, what else is going on in your life, and some general back ground questions. Based on that, they will talk to you about making a followup appointment to speak with someone on a regular basis.
From there, you go to the front desk of the clinic to make your follow up appointment, and get an appointment slip. Here’s where it gets tricky for some Soldiers. In many units, it is customary for them to require you to bring your appointment slip in and then they write it on a calendar somewhere so they can help to decrease the number of “No Shows” that they have to medical appointments. Here’s the thing, posting information about your appointments in a place that can be seen by anyone is a violation of your rights under the Health Insurance Portability and Accountability Act (HIPAA). Frankly, it really isn’t anyones business if you’re going to BH or not. But in the military, it can certainly be a tricky situation.
Your unit, mainly your Commander and your First Sergeant, are responsible for ensuring the health and welfare of all of their Soldiers. As a part of this responsibility, they should permit you to seek the assistance that you desire and/or require to ensure that you recover both mentally and physically from a traumatic birth experience. However, that doesn’t mean that they won’t want to speak with you regarding the situation as a whole to ensure that you are okay. I personally don’t know all the regulations regarding this, and whether they can even ask questions or not. My advice on this would be to confide in your First Line Leader first, and discuss with them whether you have to talk to the 1SG or Commander. Best case scenario, you’ve kept your FLL in the loop so they know where you are at and you avoid an awkward conversation with anyone else.
If you are uncomfortable going to the BH clinic on post, there are other options that you can explore as well. Calling Military One Source is a great way of finding out if there are counselors in your area to speak with, and sometimes they are able to get you in with them for several sessions for free. It can be very helpful to be able to speak to a therapist regarding birth trauma, and make a plan of action to not only recover from your past but to move forward.
The terrorist attack on the United States of America on September 11, 2001 and the resulting wars in Afghanistan and Iraq are the events that will set my generation apart from others in the minds of my children and grandchildren. The generations before me had the assassination of JFK, Vietnam, Korea, and Pearl Harbor to mark their generations along the timeline of the United States.
What legacy will my children see revealed from the hardships that we have faced over the past twelve years? What good, powerful and positive changes have we incorporated into our lives and the lives of others as a result of that day? It is not just another day on the calendar to pass through with the mindless action that sometimes overtakes our busy lives. Will my Grandchildren someday have as much disregard for this day, as I did as a child for Pearl Harbor Day?
I can without a doubt say that the course of my life was forever changed on the day that the Twin Towers fell. Most of my colleagues and friends are the same. But what about the rest of America? Does the everyday American realize any change? Or do they still wake to the same life they had before, content to passively support our country without any thought or deed. I would guess that there are millions of Americans who can go weeks, maybe even months, without thinking of 9-11 unless prompted by the media. When less than 2% of our citizens are members of the Armed Forces, does anyone else feel the continued sting of war as much as those who have faced the loss of friends and family through out the years that followed 9-11? How will I explain to my Son that the lives lost on that day and the days of war that followed are not just faceless numbers; that they are men, women and children who matter, who should be remembered. Not just one day a year, but every day.
The second and third order effects of 9-11 are still revealing themselves. I don’t know what my Grandchildren will think of my generation. I do not think we live up to the Greatest Generation, but we are not the least of these either. I pray that we can give them a world where we do not fear every stranger on the street or politician on the screen. Only time will tell if America will recover from the past 12 years.