Breastfeeding, Expressing and Postpartum Recovery on Transatlantic Flights

Breastfeeding 

People swear on all that is holy that 'Breastfeeding is the best thing for traveling!' 

They say just breastfeed as the plane is going up and down and it's so good for baby's ears and tummy. It will make their little ears 'pop.'

I've made 6 transatlantic trips and one to Europe since Dec 2011, and I was lactating for all of them. This means I have breastfed on a total of 26 flights.  

Everyone assumes it's Edenic to breastfeed on flights but I think like everything there's more to the story.

The legs up against the wall/mom's face position

Pros

• you have milk on tap within reason
• your breast milk is always the right temperature
• helps prevent diarrhea in baby
• staves off dehydration in baby
• you don't have to carry around formula and sample it at Security
• keeps you from having to smell formula on the whole trip
• helps soothe baby
• the act of breastfeeding can clear baby's ears on takeoff and landing
• breast milk may calm baby's tummy
• produces poo that is not so smelly or terrible as non-breastfeeding options - and babies always have their worst diapers on planes.
• you can sometimes even feed baby to sleep
• some gifted, flexible individuals have learned how to breastfeed without troubling the people around them. I saw one Australian mum from London breastfeeding with baby in a sling.
• you can claim you 'need' a bulkhead seat because you're a breastfeeding mum (I heard a Glaswegian mum do this once - successfully)

The legs in the aisle position - works for everyone but flight attendants with trolleys

Cons

• Your nipples get sore from excessive feeding and/or friction against baby while sharing a seat for hours, bouncing baby between connections and staggering through customs and immigration. Packing nipple cream/coconut oil/whatever you use for sore nipples is essential. Otherwise it can negatively impact breastfeeding for weeks.
• You get dehydrated
• If you try hard not to get dehydrated, you end up needing to go to the bathroom constantly. If you are traveling without your spouse, you need to get a stranger to hold baby so you can go to the bathroom. You also end up drinking disgusting lukewarm water. Certain airlines need to learn about coolers and ice cubes.
• You can never find the nursing shawl when you need it
• Baby always needs it now when just about to hand passports to flight attendants to get on bus to get on the plane, and no one offers you a seat on the bus.
• People stare. Think about breastfeeding in front of sleek businessmen. A whole cabin of sleek businessmen.
• The breastfeeding-at-takeoff-to-help-ears-pop trick only works if baby is willing to sit on your lap without breastfeeding for 1+ hour till takeoff. We were on one flight that boarded the young families first, then had delays, and we were sitting 2 hours later without having moved an inch. We had breastfed quite a few times before this point and he had fallen asleep. He woke up with a shriek as we finally took off and cried for hours - finally falling asleep as we were about to land 9 hours later. I then learned that you must exert an iron will to refuse to breastfeed until takeoff if your child is old enough to be distracted with something else - clearly you should never refuse a dehydrated baby or a tiny baby who needs regular feeds.
• Breast milk doesn't calm tummies to the point that baby never spits up. Baby spits up when least expected.
• It can be tricky or even impossible to get a large baby to breastfeed while eating dinner, or without invading the space of those around you or without the passing trolley clonking baby's head or feet.
• Breast milk is not limitless. No matter what experts tell you. Baby wants to feed the whole time but you can't. I have the best milk supply of anyone I have ever met - hence why I am still breastfeeding a 3-year-old - but there is a point about 6-9 hours into a trip when it just dries up. I am sorry but no one is conditioned to breastfeed for 9 hours straight, while stressed, while queasy, while drinking lukewarm water to stay hydrated, while hightailing around airports to catch connections. By the time we are landing on our last flight, I am usually waaaaay out of milk.

Expressing Breast milk

Pumping milk is another vexing issue when traveling. If your body is accustomed to pumping 10 oz a day at certain times, then you are going to want to pump 10 oz.

Toting a pump in the airport seems like a waste of your precious carry-on baggage. Sterilizing and packing pre-sterilized bottles can also be tricky. You probably feel the need for privacy while you pump - and it's hard to pump under a blanket (try it, really).

You can ask your airline ahead of time if there is somewhere clean and private for you to pump while traveling.

If you need to pump during a 6 hour Seatbelt Sign saga then you will be one uncomfy passenger. I know there are Seatbelt Sign eras which are fairly lax but we were on one trip that was extra turbulent and the flight crew shouted at anyone over the intercom who dared to stand. So it really depends.

If the extra 10 oz are not consumed by baby on a regular basis - say at an 11 pm night time bottle feed with dad - but instead you stick it in the freezer or pour it over your older child's cereal, I would recommend weaning yourself over the month or two prior to the trip from 10 oz a day down to no more than 2-4 oz. Your baby might need an extra few ounces or your body will probably absorb those extra ounces without too much trouble.

You could just assume baby will drink 10 extra oz than usual on the trip but baby might go off breastfeeding in response to getting a cold or wanting to wean or just general travel - you never know. It's better not to add the pain of engorgement and possible mastitis to your itinerary.

If you express milk before your trip to feed baby during travel, you are allowed to bring more than the normal 3 oz limit. Remember you may have to taste it going into security. I always felt this would be weird so I've never done it but I know mums who have.

If you have to leave baby behind

If you leave your breastfeeding baby behind on your trip and want to maintain a good milk supply, you may have to tote pumping equipment through the airport so you can pump regularly to maintain a good supply for a very young baby. If you save this milk you pump, you may not be able to bring it through security if it's not for a baby on the actual trip.

Heathrow was shamed recently for not allowing a pumping mom to bring four gallons of frozen breastmilk through security and home to her kid in the States. Heathrow has now made changes to its policies to be more friendly but other airports may not be on board yet.

Postpartum Recovery

A lot of people find delivery of a child changes many things in their lives - not just the C section scars but the huge hormonal changes of having a baby to cause all sorts of issues. The tricky thing about planning a big trip in the postpartum stage is that you often plan the trip months or weeks before the baby is born, or soon thereafter, so you don't know the full effect of labor and delivery.

Here are some common postpartum recovery issues

• hair loss - this makes a difference if you can't do anything to cover it up on a long trip and people take lots of photos on your visit. Most people find they're back to normal after a year.
• difficulty regaining pre-preg shape - a lucky few lose all their weight by 6 months but it always took me 9 months to 18 months.
• excessive sweating - usually over by 3 months but may continue a bit longer
• incision pain if you have a C-section - final checkups usually at 3 months
• tearing during labor - which should be healed by your 6 or 12 week checks
• bleeding/lochia - could be over in 3 weeks but might last 3 months
• lack of return of normal periods so you don't know if you're pregnant or not
• hemorrhoids/piles
• backache - usually develops after a weakening of abdominal muscles and you need to recover and work on posture though in some cases as with me you'll need physio therapy to get back to normal
• joint ache - I found this was gone by 3 months but I knew someone for whom it didn't end till total weaning
• mastitis - this can develop any time but the three times I got it were in conjunction with trying to wean too swiftly whilst generally overdoing it
• other infections - bladder, etc
• stress incontinence - needing to go to the bathroom more and not being quite so in control anymore - usually over by 4 months if you're good about your exercises
• sleep deprivation - usually not so bad after your baby weighs more than 12 pounds and becomes capable of sleeping through the night
• postpartum thyroiditis - I never had this but supposedly it's similar to:
• postpartum depression - some people find it doesn't go away till they finish breastfeeding and that travel exacerbates it

Most of these problems you can technically travel with but will make things a tad more complicated. It is definitely something to keep in mind while planning a trip. 

I was always desperate to take my new baby back to the States to meet the family. I eagerly suggested travel a month or six weeks postpartum but my parents wisely counseled to wait till four months. Waiting till four months can smooth the bumps in your travel experience and go a long way toward recovery.

How to transform a jacket into a travel vest

On an aircraft you are probably going to be separated from your luggage.

Whether checked in the hold, last minute 'gate checked ' or you put it in the overhead compartment before you swapped seats with the kid three rows back, your luggage will not be accessible. There are some items that you just need on your person at all times. Riffling through a million bags for that one thing can be frustrating, if not fruitless.

The best thing is to have all essentials on your person. In pockets.

Me in travel jacket in France

If you have the sewing skills or knows someone who does, you can design a travel vest or jacket. You can get really creative but remember you have to wear this through an airport with hordes of sleek business men and women. If you look nice, you will feel more confident push forward to catch a tight connection and to stand up for yourself against obstructionist airport staff. Peter Pan says first impressions are the most important and if you are meeting a group of students you will travel with for weeks, you might also want to ensure you are not wearing a sack.

Next, size 14 - a size or two bigger than I usually wear

Here are the steps:

Write a list of everything you need. It may be short like this:

• Kindle
• Phone
• Pen for immigration docs, visa waivers 
• Tissue
• Chapstick
• Mints
• Earbuds

Or long like this if you have kids:

• Nappies/diapers
• Wipes
• Nappy bags
• Travel sickness bracelets for everyone 
• Extra onesie
• Baby medicine 
• Plus everything on other list:
• Kindle
• Phone
• Pen for immigration docs, visa waivers 
• Tissue
• Chapstick
• Mints
• Earbuds

Collect these items to figure out how big your vest needs to be. The more items you take, the longer and more bulky your vest must be to accommodate.

Now decide how big to make the pockets. 

My kindle-sized pocket for my kindle

Keep in mind pocket placement. There may be parts of your body you don't want to look bulkier than they already are (bust, hips, tummy....). 

Some people including myself have an arch in their back so putting a pocket to the small of back can be a good option. I can fit 4 diapers in the back pockets and it is actually really comfortable and supportive when sitting!

I knew some people who put clothing for two days in sewn-in back pockets. They said they looked like they were wearing their coats over a backpack - i.e. it looked funny. So know how far into 'funny' you want to go.

Top tip: always do one item or type of item per pocket if you can. I once took a jacket, cut an incision to the lining, added an invisible zipper and used all the dead space between the jacket outer fabric and lining as one giant pocket. The result was lumpy and disorganised and I had trouble finding items quickly.

The best thing for finding items quickly, staying organized on a long trip and keeping your Kindle from getting scratched is to have separate pockets.

Never place a pocket behind another pocket. One or both will bag out or the stitching will interfere. The one exception is something really thin like a kindle might go behind another pocket. Just make sure the seam line doesn't interfere.

Pocket empty and open - note waterproof lining

Pocket full

Pocket closed

1. Find a coat or vest you like. Charity or thrift shops are great for this. Find a washable one as you will want to wash after every international trip to remove the airplane smell, spills and stains.
1. Try to find a vest or coat with a lining. If your vest or coat is not waterproof, consider lining the pockets with waterproof fabric.
2. If you plan to breastfeed, try to find one without a zip as the zip can catch breastfeeding babies in the face
3. You can alternately design and construct a vest or coat if you so desire. 
2. Choose pocket fabric. You need at least half a yard. It should match your jacket lining as closely as possible.
3. Lay out your items. Cut an inch more than you need in two layers of fabric.
4. On the phone pocket, cut an extra three inches for a compartment for your pen which is the most useful item you will pack. Also consider velcro or snaps for this pocket to allow Earbuds to attach while in the pocket. We love listening to Rick Steves podcasts when we travel.
   
   
5. If using zippers, apply zipper according to manufacturer's directions. If using velcro or snaps, apply now.
6. Consider how warm you want to be. If you are taking a heavier coat, remove sleeves to make a vest.
7. If keeping sleeves, consider adding a cuff pocket. When you pull a small item out of the cuff, it feels like magic!
8. With right sides together, sew pocket front and back. Press. 
9. Sew to garment. I recommend hand stitching to avoid pocket shape seams which alerts pickpockets. If a side of the pocket lines up with the seam then go for the sewing machine on that side if you like.
10. Fill the pockets!

Small of the back pocket, empty

Small of back pocket, with diapers

Maintenance: check seams every time after a long flight or a wash. Hang to dry. Press.

Travel vests or jackets are a great way to stay hands-free and even luggage-free a lot of the time. You can avoid being in a pinch without that essential item by sewing a special pocket for it. A breastfeeding mom can use this extra layer as a breastfeeding shawl. It can be tied around one's waist in hot weather. Usually European off-peak travel season, when it is cheapest to travel, is bound to be chilly or freezing so you will never be sorry you brought your travel jacket. The best way to be on top of any situation when traveling is to be prepared with your travel vest/jacket.

And when it's really cold in the Loire Valley, you can use it as a cozy toes!

The Pedestrian Life with Kids

As if parenting wasn't a marathon on its own, we decided to do it without a car. 

Of course we got our in-laws to pick us up from the hospital after having the baby. After that I thought it would be smooth sailing. Here are my initial thoughts:

Pros:

• this will help me lose my baby weight!
• healthy lifestyle example for the kids
• good for the baby too
• creating the sort of the world I want my kids to grow up in - with fewer emissions, living responsibly
• giving the frugal example to my kids

Cons:

• a tad slower maybe
• less motion sickness while walking
• more motion sickness when using public transport - buses and trains tend to make me more sick than cars

Almost 5 years later here are the updated listings:

Pros:

• it did help me lose baby weight and then a bit more which left me a bit thin and frail and open to every cold and infection (including mastitis - three times! Okay maybe this should be a con. It IS possible to lose too much weight and run yourself ragged.)
• healthy....ish
• living responsibly, smaller footprint
• giving frugal examples to the kids
• not having to strap in children into car seats - I mean seriously car seats are mind bogglingly difficult sometimes. They leap in the buggy and off we go! A lot less twisting and bending over shadowy carseats is probably good for my back.
• being able to pay more attention to my kids - when driving, you can't make eye contact and talk to your kid like on the bus!
• napping - both children can nap on the way to a destination or one child can nap while the other plays, rather than everyone being locked in the car for the duration of baby's nap

Cons:

• curbs - the city centre is better about having slopes for buggies and wheelchairs, these days in the outskirts we do a lot of lifting the buggy over tall curbs
• pushing a buggy makes your butt look bigger because of the angle you have to walk at
• the baby who wants to breastfeed ALL THE TIME - I know some people have a knack for slings where the baby can continually suck but I never managed that. Partially because in Edinburgh there is always someone looking down at you from a tall building so in a rural landscape, you could probably get away with it, but not in Edinburgh. Also if you walk an hour with a baby in a sling, things come undone no matter how carefully you set them up.
• everyone judging your parenting and life choices - seriously in a car no one can tell if you have two kids under the age of two but on the street you can not only see the condemnation in their eyes but hear the shocked murmuring ('Do you suppose they're twins?'...'Hasn't she ever heard of birth control?')
• When you are far away from shops and friends and your toddler announces he's hungry or thirsty, having eaten your cute picnic in the first ten minutes of the trip
• when it starts to rain and you forgot the rain cover
• when the wheel pops off the buggy after a three hour ordeal to the diy store to get a toilet seat, and when you go to take the toilet seat out it falls out of its wet cardboard packaging and scratches itself on the ground 
• your child gets pooped on by gulls
• your child gets sniffed or licked by passing dogs
• your child gets icy winds, sand, rain rushing into his delicate soft face, causing him to scream, and all the old ladies in the nearby bus shelter to laugh hysterically at you as you beat a quick retreat into the shelter and explain 'Och when mine were wee, I used to be known to walk backwards in this sort of weather!'
• breathing problems - this hasn't happened to my children, but other kids who seem predisposed to breathing problems seem to get more frequent flare-ups if pushed in the buggy. A theory is that buggies are at the level where all the smog and car emissions and dust, etc, are at their worst. One lady I met at a bus stop claimed that the reason modern kids have more outbreaks of asthma is because the old silvercross prams were much higher off the ground and less likely to expose the kids of bygone eras to low-lying gases and dust.
• cold - some children, particularly premature babies, are more susceptible to the cold. Even healthy children will have huge body temperature drops if you're out long enough - say on a three hour walk. You may be warm from pushing the buggy but the kids aren't! So wrap up and I mean socks, shoes, three layers, a hat, and something for their hands.
• kid's hands - always hard if the toddler refuses to wear gloves or mittens. I have been known to sew scratch mitts onto toddlers' shirts in the past. Or if the temperature isn't so bad, sometimes I allow them to keep their hands inside the cosy-toes.
• mud splashes - thinking of when waiting for a 26 bus and a different bus from the one we wanted, a 19 bus, wallowed into a mud-filled hole in the street and splashed my toddler and me from head to toe with greasy mud. It smelled like the worst city runoff and stained our clothing, buggy and cosy-toes permanently. 
• cyclists - generally a friendly bunch but when they cycle on the sidewalk which is illegal here, it's rather annoying not to mention downright dangerous with small children in tow
• storage - in a car, you can bring everything but the kitchen sink. Even in buggies with generous storage space, only 1/2 is really available since the remaining space is full of rain covers, coats, and other emergency items relating to the buggy. Some people carry around an extra buggy wheel for example. This means you are more frequently caught out without that one essential item (usually water, which is heavy, bulky and tends to leak - not my favorite thing to pack, or a third change of clothes or a bag to pick up the dog poo all over the children's playground or a towel. My kids always seem to choose the wet slides to go down or the biggest puddles to jump in, or the ponds at the parliament to fall in, so this is the one thing I always seem to be without!).
• kids who need a toilet when there is none around - and in freezing temperatures it's kinda hard to ask them to pee outside! With an audience.
• kids who announce they've wet their pants just after you leave whatever fun place you've been but when you still have 30 minutes before you're home - if you had a car, you could change them inside a semi-sheltered space, but a buggy is fairly exposed in terms of wind, rain and people staring at wee guy's privates. I once changed him in a shop behind some crates. When I got up I realize the security cameras were pointed straight at us. No one said anything though. Thank goodness for the British! A Parisian would have given me a stern lecture and the Germans would have marched me out to wherever they put homeschoolers.
• toddlers in a tantrum
• toddlers in a nosedive tantrum
• motorists - When I was a snotty 3-year-old I remember walking on the sidewalk nearest the road and Mrs. Walters, a family friend, saying, 'Don't do that, you might get run over.' to which I replied with 110% obnxiousness 'Cars don't drive on the sidewalk.' to which the wise Mrs. Walters replied, 'You never know where cars will go.' So then 25 years later, we got run into by a car when the kids were in the buggy and we were crossing the street! The kids were fine, the driver had been reversing and his mirror was broken and he paid for the buggy, so I don't think he's the worst person ever, but it was terrifying. I am officially sorry, Mrs. Walters, you were right. And Defensive Pedestrianizing was born. I now behave as if cars were an alien species bent on eradicating the human race.

I originally decided to raise kids without a car to lose my 'baby weight,' and for other reasons but I have since noted that anyone who raises more than one kid without a car for more than two years goes to phsyiotherapy. It destroys your body. Yes I burned off that baby fat but if you injure your back, neck, wrist, or leg you have no time to rest and recover. Even with a car, you might feel you have no reprieve and just keep re-injuring the body part. But without a car it's truly merciless.

If you want to push your kids around a city in a buggy for a year or two, I think you could get away with that but NOT if 

• you have pelvic girdle pain (particularly if you were planning to use a buggy board, which my friend's phsyiotherapist told her is the worst for your back)
• postpartum depression
• any serious recurring injury of back, neck, or limbs (having said that, I struggled with my left knee for years but it never bothered me while pushing the buggy until this week - so it just depends)

Walking with kids can be a great way to be healthy, save money and teach kids it's important to act on our beliefs like wanting to look after God's creation as good stewards. But there are definitely downsides.