Living With ADD

I've been planning to write a book about all the various ways ADD affects my life for some time now, years really.  I notice something new and say, "Oooh, that should go in the book!" and may or may not make a note of it.  So after several years of working, perusing, mulling over, and contemplating this book I've come to a realization... It's never going to be written.  Probably because I have ADD.

But I still have this feeling that I have something to say about ADD, something that may help others that have it, but that especially help those of you who have a loved one who has ADD, to help you to understand a little something about what you're living with.  And I think it's still worth sharing, even if this book is never completed.  And I don't want to wait in getting it out there to people.  I mean, even if I COULD finish this book, then I'd have to find a publisher, and get them interested, and convince them that other people would want to read this (which I don't really know whether they would or not), and that all sounds like a LOT of work for me.  And really I spend all my time playing catch-up so I don't have time to convince people to read my stuff.

So I've decided instead to post it here, and you can read it or not.  Hope it helps someone, but if not at least I'll have put it out there.  So without further ado...

So the first thing you're going to say is, "This chick doesn't know what she's talking about, doesn't she know it's ADHD?"  Well, I suppose officially it's all ADHD, but I never had the hyperactivity, so I'm writing about what I know.

Another thing I've heard a lot is "I know, you can't pay attention to things," but that's not it.  ADD is about the inability to REGULATE your attention to things.  There are some times I'm so distract-able that I'm doing 5 things at once (and none of them well).  But at others I can get so tuned in to what I'm doing that I forget everything about my surroundings, which can actually be even more dangerous than distract-ability (more on this later).

So lets start with a little background...

My World Before ADD

I was a generally happy child.  After the constant activity that was my older sister, I think my parents were a bit relieved to have a baby who WANTED to sleep in her crib and could play with dolls on her own for a whole ten minutes at a time.  I was into princesses and long frilly dresses and doing my own hair.  In most ways I was really quite typical.  I also showed musical talent quite young, singing before I could talk and playing the piano by ear at age three.

To all appearances I was a bright and happy little girl, so I think everyone was surprised when very early on in Kindergarten I had problems completing the most basic assignments.  I'd be set to copying a page (and a Kindergarten page is NOT a long page) of information, and in the time everyone else had finished I would have written a sentence.  My parents and teachers thought I just needed help with motivation, so they tried everything they could to bribe and cajole me into working faster.  I remember in Kindergarten we weren't allowed to bring toys to school, but someone had the bright idea that I should be allowed a SPECIAL toy, that I was only allowed to play with after I finished my work.  I chose a red stuffed monkey that was a favorite toy (that happened to belong to my sister, I'm also a thief).  I loved that monkey, and that led to a whole other saga where the monkey was stolen and then appropriated by the nursery class, and it must have been months before I got it back and then it was missing an ear.  But I don't remember it making any difference to my work habits.

My "lack of motivation" continued and morphed into "needs improvement" in all aspects of doing my school-work.  And that followed me throughout my school career.  Oh, I don't think I was ever a real disciplinary problem.  I rarely had any trouble learning the material, but I never could memorize anything, from spelling words to multiplication tables.  In second grade I discovered I was a daydreamer.  In third I found out I had an incredibly messy desk.

In fourth I was diagnosed with a writing disorder.  I had trouble putting pencil to paper, but I got permission to give dictation to my mom who started typing all my papers.  It was also in fourth grade that I was tested and found bright enough to be placed in the gifted program.  Every once in a while you encounter a teacher who is truly excellent.  I look back at my fourth grade teacher, Ms. Arnold, and I think she had more of an impact in getting me through school than any teacher up until my tenth grade English teacher.  Oh, I had several good teachers in there (and some bad ones), but she did a very good job at noticing where I was struggling and helping me to find coping strategies.

My whole time at school was about coping with one thing or another, and I developed strategies for dealing with all kinds of assignments.  I'm sure it didn't help that I showed flashes of "brilliance."  I had an amazing memory for brain teasers and absorbed odd information like a sponge.  By 5th grade I would write up little brain teaser tests and give them to my teacher to take.  I look back at my audacity and wonder that they put up with me at all.  I already "knew" I was smarter than my teacher.  But that amazing memory had holes like swiss cheese, and I never knew where they would form.  Sure I could remember where all the states were, but I couldn't spell their names, or remember their capitols.  I could amaze you with interesting facts and I had a thorough understanding of what I knew, but there didn't seem any reason to what I could and couldn't learn.

I spent a lot of time thinking outside the box.  I remember in sixth grade we were given an assignment to write and illustrate a book.  While everyone else wrote a simple story, I wrote a "Choose Your Own Adventure" story about a girl who got sucked into the world of "The Wizard of Oz" (my teacher must have thought me seriously disturbed when she read the ways I killed off my main character).

I remember another incident in math when we were learning long division.  There was a misprint in the workbook and one of the problems couldn't be solved (with what we were supposed to already know, we hadn't learned about remainders yet).  I spent the entire class working on that one problem solving it out 10+ decimal places, but of course I hadn't paid a bit of attention to the lesson nor the work I was SUPPOSED to be doing.  I was hyper-focused on that one problem because I KNEW it could be solved.

I'm sure there was no measuring the level of frustration I brought to my teachers.  I continued to be a strange conglomeration of gifted, curious, creative and talented. I was an avid reader, but I was slow, SO slow, at EVERYTHING.  I was constantly running out of time on tests, especially standardized tests.  Completing homework assignments and projects took hours each night, all day some Saturdays, and Sunday afternoons after church.  And yet, I managed to absorb most of the material, enough to scrape by at least.

I could paraphrase the Gettysburg address and understand what it was saying, but I couldn't memorize it.  I could read and write poetry, but when I had to give a presentation or was in a play I was a nervous wreck because I could never memorize my lines.  To this day I watch Inside the Actor's Studio and am in awe when they talk about memorizing what they need to know for each day's shooting.  To this day the only thing I can memorize is music, and that takes a lot of work to remember even the simplest lyrics.

I forget what it was I was supposed to memorize and recite in tenth grade, but it's the only time I remember breaking down and crying in the classroom.  I just couldn't do it.  The teacher didn't understand, I had read over it what must have been hundreds of times, but it was simply an insurmountable task.  We had to read some of the most depressing literature that year.  I don't know how The Scarlet Letter and As I Lay Dying fit into the curriculum for impressionable teenagers (I certainly never plan on taking my mother's coffin on an un-refrigerated road trip in the middle of summer), but I do remember that Ms. Gilham taught us how to write.  To this day I credit her with getting me through EVERY writing assignment from tenth grade through college exit exams.  For a child with a writing disorder who was incapable of putting pencil to paper, I certainly do a lot of writing these days and it's all thanks to her.

So I made it through high school with mediocre grades, but with SATs that outshone all but the top handfull of students in my class.

Then when it came to college I seemed incapable of sticking to one major.  I liked Biology and focused on that for a year, then switched to music where I excelled in theory, but made straight C's in voice (I had trouble memorizing arias in various languages), and I barely scraped through music history.  So I switched to art, at which I was a complete failure before dropping out to work.  I simply couldn't pick a major and go with it.  One day I'd have a fantastic idea for a painting, the next day I'd have an idea for a great song, the next I'd be fascinated by the taxonomy of local flora.  I could never settle for even a whole semester, much less long enough to get a degree.  I also found that while all my friends were carrying an 18 hour course load, there were times when I couldn't even handle 12-15.  It just took me so much more time to do anything and everything.  I decided to drop out and work for a while.

So there I was, unqualified for anything, hopping from job to job and never staying anywhere very long (four different jobs in a year) and I knew I had to do something that would get me back in school with some direction.  About that time my best friend graduated from Georgia Tech with a degree in computer science, and started making what at the time seemed like a fabulous amount of money (which sounded nice to me).  But I still had to figure out how to get back in school, so I took a 10 month job in Americorps because I knew I'd have the educational stipend when I was done, and I'd HAVE to use it on school.  My strategy worked.  After a 10 month stint in Americorps I went back to school with a major in computer science.

I had a new strategy this time around.  Instead of summers off, I was in school full time year round.  I also found that if I was completely lost in any given class a few weeks into the semester, or if I thought a course had a completely overwhelming work load I'd just drop the course.  This gave me a bit of cushion and allowed me to have a little extra time to manage my coursework.

It was also during this time that my little brother underwent testing for ADHD.  As the psychologist diagnosed him and described what he was going through my mom said it hit her that he was describing me even more than my brother.  It clicked for her that all of my seeming misfits, the trouble I'd had from the very beginning of school, could be traced to this one problem.  Even though I agreed that her diagnosis was likely, I figured I was so close to finally making it through school that I never bothered to do anything about it.  And I did finally make it through school.  In only twice the time it took all my high school friends I graduated, and figured that since I was finally through with school this wouldn't have any more impact on my life.  Right?

Apologizing for the Trinity

I've been reading some Christian apologetics lately and it's gotten me thinking.  First of all, why is the defense and explanation of Christian beliefs called apologetics.  I don't really feel the need to apologize to anyone for being a Christian.  That's a real misnomer, and I think someone should look into calling it something else.

Whatever, what got me really thinking was something I read about one Christian condemning Bishop T.D. Jakes for saying he believes in the Trinity but not explaining it in the right terminology, so this apologetics expert says the Bishop isn't a Christian.  Now first of all, I don't want to apologize for the Bishop, I don't know what he believes.  I just got caught up by the semantics of the thing.  The Trinity is a really hard concept for most people. The idea that God is three things, that are distinct, but the same, all the time.  I've heard it described as a three leaf clover, all three leaves part of one clover.  But then folks come along and talk about Jesus being FULLY God, and the Holy Spirit being FULLY God, so it's not like the three are interdependent.  And a three leaf clover is whole only with three leaves.  It doesn't just have two leaves and then say, "oh, I think I'll sprout a third."

But that's essentially where the Holy Spirit came from.  If you read the Bible, there's no Holy Spirit prior to Acts.  And we don't see Jesus doing much before the new testament either.  Oh there's "In the beginning was the Word, and the Word was with God, and the Word was God."  The whole of the old testament was pointing to Him, but He didn't have a name, and we didn't see a whole lot of Him until he put on flesh and walked around with us.  But does that mean that Jesus wasn't distinct until he was born, that this aspect of God sprouted forth at that time, or was he just kinda hanging out before then?  And if he was with God from the beginning, then why do we call him God the Son.  I mean, my daughter came forth FROM me, and I suppose the egg that she grew from has been there all along, but she hasn't exactly been hanging out with me until this last year.

So what I'm saying is that this is an admittedly difficult concept.  I don't know of any Christian who would say, "Oh, the Trinity, yeah I TOTALLY get that!"  When I was growing up in Sunday School they had whole serieses of lessons trying to help us understand how God could be three, and also one at the same time.  I'm still not sure I get it.  Oh, the Bible says it, so I believe it, but I can't say I really understand it.  There are a fair number of concepts like that in the Bible.  Does that make me less of a Christian because I don't really understand it?  Oh, I can quote the scriptures that say it, but it's hard to make it mesh in my mind, so I just have to take it on faith that God (who is infinite where I am finite) can make it work out so that he is wholly three and also one.

So where do you, mister Apologetics man, get off calling into question the fundamental Christianity of a guy who says he believes in the trinity, but just explains it a little differently than you.  You're the same guy that got all up in arms about baptizing in the name of "Jesus" instead of "in the name of the Father, the Son, and the Holy Spirit."  But if those are the three parts of God that are also the one true God then doesn't it amount to the same thing?

I don't get how we as Christians can put up with these divisive people in our midst.  When we should be finding ways to edify each other and to build each other up, we're instead nit picking every word.  I don't feel it's my place to judge whether another person is right with God.  Oh, I know what I believe, and will gladly discuss it with you, but if your beliefs vary slightly from mine I don't see that as a personal attack.  Heck, I see it as an opportunity for me to affirm my own beliefs and dazzle you with my love by trying to understand how you could believe something differently.  I try to be discerning, I may examine the scripture to see the merits of what you believe.  I may change my own personal beliefs through greater understanding of the different ways scripture can be interpreted (and there's a lot of variation to the way some things can be interpreted), or I may find my own personal beliefs are stronger for having been re-examined.  But I WILL NOT condemn you for believing something different from me.

You see, I have a secret.  I know something that many Christians don't seem to understand.

I AM NOT INFALLIBLE!  Therefore, IT'S NOT MY PLACE TO JUDGE!

I'll leave that up to God.  And I have faith that He can sort it all out in the end.  And if I'm wrong, or you're wrong, or we're both wrong (most likely scenario as I see it) then what better way to learn it than by accepting the possibility that I MAY be wrong about everything (though I don't think I am, of course) and that God can teach me differently in His own way, in His own time.

19 is so young!

I keep seeing the images of a 19 year old hiding in a boat, and I can't help but think of what 19 is.  He must have been so scared.  I think of his mother who can't believe what he's done, and I think, what if my daughter grew up to do something so un-imaginably awful.  I wouldn't believe it either.  My baby!  All I would want would be to hold my baby and comfort her.  I feel for his family, for his victims, and victim's families.  But especially for his mother.

Nineteen is so young, and I think back to the year that I was 19.  I was so messed up.  I was lonely, so lonely that I prayed for a boyfriend, any boyfriend, just because that had to be better than being lonely.  That was the year I learned it's better to be alone than with the wrong person.  I dated two guys that year.  The first was, a nice guy.  Benign really, but I wasn't the right girl for him any more than he was for me.  Then I dated the abusive egomaniac.  I remember at 19 telling myself that I really must be something wonderful if he wanted me so much he would try to force himself on me.  It took me a long time to realize I was special on my own.

Nineteen is so young.  He must be so scared.  I have no idea why he did what he did, what he was thinking, what he thought would happen.  But I understand being 19, and young, and confused, and scared and I pray for him, and his family, and his victims, and their families.  I pray for the wisdom of law enforcement.  And I pray for all the other 19 year-old's out there.  We've been there.

Apparently bananas are tiring

What it really means...

I've been doing a lot of thinking lately about Christianity and its various denominations, and what it really means to be a Christian.  So many denominations have split and split again, all over fine points of theology.  I think that's sad.  Churches are splitting over little piddling bits of theology, when we should be focusing on the things that unify us.  So I've spent several middle of the night feedings lately pondering what it REALLY means to be a Christian.

I told my cousin Jim about my conclusions.  His response, "Yeah, that's what happens when you start thinking theology at 3:00 in the morning, you throw out half the Apostle's Creed."  Still he listened.  Jim's fantastic, and he needs new lungs, so go help with whatever you can (www.jimhenrymedicaltrust.org).

So when it all boils down to it I think all that's really required to be a Christian is to believe in the first half of the Apostle's Creed.  Not even the whole thing!  Not that there aren't plenty of important theological issues that aren't covered here, it's just that they're not core to what it really means to be a Christian.  You can come down on either side of many theological discussions and I don't think it has any impact on the core beliefs of Christianity.  So what does it really mean to be a Christian?


1. I believe in God, the Father almighty, creator of heaven and earth.
Yes, this is core to Christianity.  I have to believe in God, and that he made everything.  Doesn't really matter HOW He made things.  Whether He did it in 7 days or 7 millennia  and whether He created everything as is or used some sort of directed evolutionary process doesn't matter.  What matters is that He did it.  That's not to say you can't believe strongly in your opinion of His methodology, but all that's core belief is that He did it and it was good.

2. I believe in Jesus Christ, His only Son, our Lord.
This doesn't take any belief at all.  Jesus was a historical figure, this is verifiable fact.  If you're gonna believe in God the Father, then he has to be father of something, so it makes sense that Jesus is that son.  There are a lot of prophecies that point toward Jesus, and that He was God's son, so it follows that if God is, then you're going to believe Jesus is His son.

He was conceived by the power of the Holy Spirit and born of the Virgin Mary.
Does it really matter how Jesus was conceived?  Really what does it matter whether the body that bore his human form had ever known a man?  Not saying it wasn't miraculous and all, but God made the whole world, I don't really find one virgin birth that significant.  Not that I don't believe in the virgin birth, I do, I just don't think that it really matters in the big scheme of things so it's not worth arguing over.

He suffered under Pontius Pilate, was crucified, died, and was buried.
Again, historical fact.  The most miraculous thing here is that Jesus kept a good attitude through it all!

He descended to the dead. On the third day he rose again.
Doesn't matter where He was those three days.  For that matter, the rising again is just a symbol of God accepting Jesus's sacrifice for our sins.  What matters is that He accepted it, not how he showed that acceptance, so again even the rising from the dead is not a required belief for Christians.

3. He ascended into heaven and is seated at the right hand of the Father.
Ok, so it makes sense that Jesus is in heaven with the Father.  I'm not sure it's required believing, but I think you could make a pretty good case that Jesus just hanging out in the world wouldn't be in keeping with God the Father accepting his sacrifice, so I'll give you this one.

He will come again to judge the living and the dead.
Really?  It'll happen whether I believe in it or not.  His judgement stands whether I believe in its validity or not.  Yes, I believe He's coming, but I think it would be really self-important of me to think that my belief in His judgement has any impact whatsoever.

4. I believe in the Holy Spirit,
This goes along with God's omnipotence and omniscience.  Yep, gotta believe that God is with us all the time. 

the holy catholic Church, 
The church exists whether I believe in it or not, and whether you call it "catholic" or just a group of Christians doesn't matter.  However you can be a Christian and live as a hermit somewhere, so you don't have to actually participate in the church in any way shape or form.

the communion of saints,
I don't even know what this means.  Is it that we commune with other Christians  (see hermitage) That we take communion? (don't see how that's required either)  I figure if I can't understand it then I can't very well claim that its belief is core to what it means to be a Christian.

5. the forgiveness of sins,
Well, this one's kind of gray to me.  The whole point of Jesus's sacrifice is that it allows our sins to be forgiven.  But outside of my own self-importance it doesn't really matter whether I believe that my sins are forgiven or not.  What matters is does God see fit to forgive them.  And I should live my life the same way whether I believe my sins are forgiven or not, because if I believe they're all forgiven what's to stop me from just going out and sinning all willy-nilly.  That being said, if I didn't believe that my sins were forgiven, then I might be likely to point to one sin that I committed, throw up my hands, and give up.  I don't think that's what God wants us to do, so I think it's important that He gave us hope, a reason to live on and do better.  So I say forgiveness of sins is a core Christian belief if only because it allows us to start anew every day.

the resurrection of the body,
Um, this happens after I'm dead.  Really I have nothing to do with it whether I have a body or not after I die.  Not core.

and life everlasting.
It's nice to think that we have a reward coming for all of our believing, but really God's well within his rights to do whatever he wants with his creation at any time he wants to.  Do I believe that I have a soul that will live forever?  Yes.  Do I believe that you HAVE to believe you have a soul that will live forever in order to be a Christian?  Nope.

I look at this list, really a very short list, and I hear Christians quibbling over immersion vs. sprinkling, predestination vs. free will, wine at communion vs. te-totaling.  It makes me very, very sad.  Here we are claiming to love each other, and love all the people, but we can't put down our harsh words and focus on what really matters.  So instead of one Christian church we have all these denominations, and the ones that are the most similar are the ones that spend the most time throwing stones!

I'm not saying I don't have beliefs about anything other than the basics.  I certainly have no problem with the idea that God created the world in seven literal days (after all, if He's going to create adult people why not create an adult earth, complete with rocks that include a fossil record).  And I can make a case for infant baptism (Acts 16:33) but I feel better about "dedicating" myself to raising my child to know the Lord, and she can be baptized when she's ready (and I pray that she will some day be ready).  I really don't give one flying whoop whether you baptize by dunking or sprinkling, but moisture makes my hair frizz up so I completely understand someone wanting to use as little water as possible!

My point is, none of these issues are worth the time we spend arguing over them!  The church's focus should be on outreach, not on internal squabbling and beating itself up from the inside.

How to increase breast milk supply, or make the most of what you have

I never had a doctor mention to me that I had any risk of supply issues, and had several doctors and nurses give me some very bad advice on how to deal with them.  They ranged from "your baby's getting what she needs despite the fact that she's crying all the time and can't sleep." to "just wait, your milk will come in," to "well if your milk hasn't come in by now (five days after delivery) it's not going to come in so you might as well just give up and use formula."  I can't believe how un-informed I found everyone from  the hospital maternity ward staff to my own personal OB!  I mean, it is your job to advise and care for women who have just had a baby, and to make sure that both mother and baby are cared for properly.  One would think that you could recognize that I have SEVERAL of the most severe risks for supply issues and at least warn me that I may have some work ahead of me!

Especially since supply issues are not the end of breast feeding, and there's a lot that can be done to head them off at the pass, but because I didn't know I had supply issues until nearly two weeks after my baby was born I am STILL constantly playing catch-up.  It also seemed like so many caregivers in the hospital were actually afraid to offer any advice.  For example, when my baby had jaundice I kept hearing over and over that hydration was the most important thing to focus on, and that I needed to make sure my baby stayed hydrated, but no one would tell me HOW!  I mean, this was a day or two after she was born, so of course I had next to no supply yet (no one does at that stage) and I was nursing her every 2-3 hours for 30 minutes at a time.  That's what they said I should do, and yet she obviously wasn't getting enough (not enough wet diapers) and the jaundice was getting worse!

Even once I did know I had supply issues I got conflicting advice from doctors, nurses, parenting books, and lactation consultants.  For example my lactation consultant said to supplement the baby with 1-2 oz of formula before each feeding and then finish up on the breast so she comes to associate me with satiation, while my baby's pediatrician said to breastfeed first when she's hungry and will go after it more and finish up on the bottle.  With such conflicting advice, and so many sources that completely ignore breast feeding supply issues I want to share what I've managed to glean about ways to improve supply and get the most you can or your baby.  I really feel the need to consolidate everything I learned and to let other women going through this know it's NOT that uncommon!

So first some of the worst advice I got starting from the very beginning:
"Don't worry about her nose, it's pointed down so she can always breath, and if she needs to breath better she'll just adjust."  Um, no.  You can definately smother a baby with a boob.  Yes, she'll notice if she's not getting enough air and adjust, but that adjustment will mean pulling back and letting go of her latch to gasp for air.  Which will mean you have to go through the process of re-latching over and over.  This leads to slower nursing (since she's not staying on) and nipple soreness from the re-latching.  For goodness sake tilt her head back or push your boob down so she can breathe!

"Just wait and your milk will come in."  In actuality the longer you wait to deal with a supply issue the more you'll be playing catch-up.  I'm STILL playing catch-up over two months later and there's a LOT you can do to improve things, the earlier the better.

"You don't need a breast pump."  The truth is, the more you empty your breasts, the more they will realize that they need to be making more.  The best way to empty your breasts is by baby, but babies get tired, their appetites wax and wane, they sleep through feedings, and you want to make sure you're emptying every last drop!  One of the best ways to increase production is to pump and feed frequently.  There are lots of different techniques and schedules that can help, and I'll discuss that more later, but suffice it to say I wish I'd gotten the pump when I first wanted to rather than listening to the hospital staff and putting it off until after they said I needed it.

"Fifteen minutes on each breast is enough." Ha!  The more stimulation your breasts get the better, and if your baby's tired or is a sleepy nurser like mine was then she may not be working at it that full 15 minutes, so your breasts may not be empty after 15 minutes.  Once I found out I had supply issues I'd feed her for over an hour at a time switching back and forth between breasts to help keep her awake and interested.

"You need to feed her 6-8 times a day."  More like 10 or more.

"You shouldn't supplement with formula."  You need to get 8 wet diapers a day, and if you're not getting that then you need to do what it takes to do that.  We were getting 4.  We told the lactation consultant that and she wigged out!

"Drink a beer as soon as you deliver, and every day after and you won't have any problems."  I heard this over and over, and always from women who'd had copious supply and could AFFORD to pump and dump.  Just when am I supposed to be drinking my beer?  All the books say not to drink within 2 hours of breast feeding, so I have the option of drinking a beer bright before I pump or drinking a beer right before I go to bed with my baby.  Neither of which makes sense when I'm trying to give every drop for my child.  Of course there is barley water and we'll talk more about that when we talk about what you can do for your diet to help.

So now you know what not to listen to, how do you get started trying to establish a good supply.  Keep in mind I'm not any sort of medical professional.  All I know is what I learned with my one baby.  So take everything I say with a grain of salt, I may have no idea what I'm talking about.  It starts before your baby is born.  Have your thyroid checked.  Have your complete blood count checked.  Make sure that your hormones are working and that you're not lacking in any nutrients.  Keep taking your prenatal vitamins and supplement to make up for any deficiencies.

Once you have your baby nurse as frequently as you possibly can.  The more nipple stimulation that better.  In fact you might try the pump before your baby's born, just make sure you don't try this until you reach full term since this can trigger labor.  If you have a premi or a baby with health problems this may be harder than it sounds, this is where the pump comes in.  Use breast compression during nursing to help your baby get ALL the milk out, and once you're done with a feeding see if you can express out any milk remaining.  An empty breast is a breast in production mode, so basically you want to empty your breasts as often as possible.

If you need to supplement  do so guilt free!  You don't want to starve your baby, and you want plenty of fluid moving through your baby to clear out waste.  Just be sure you supplement very small amounts at a time.  This is where it gets really frustrating.  Formula seems to only come in 2 oz doses, but you'll probably only want to supplement .5 to 1 oz at a time to start.  I guess the formula companies want you to over-prepare what you need and dump it out when it doesn't get used?  You can however mix up 2 oz and stick it in the fridge, then pour out .5 of an ounce at a time to reheat when you need it, just be sure to use it up within 24 hours of mixing.

Supply can also change throughout the day.  You may have plenty first thing in the morning, but when it comes time for that last feeding at night don't have enough to satisfy for an hour much less a good night's sleep.  So you may find you need to supplement different amounts at different times of day.

I've been given conflicting advice on whether to breastfeed first or supplement first, so I've tried to do a combination.  After all, I have two boobs!  So I generally start with one breast, supplement  then feed from the other breast.  This takes practice to know how much to supplement   If you give to much your baby won't be interested come the second breast, which isn't good for your supply.  If you give to little then you'll end up giving more late because your baby will be hungry, so the whole issue of what your baby comes to associate with satiation comes into play.  And as a baby goes through growth spurts his apatite will change, so it really can keep you on your toes constantly adjusting what you're doing.

Use wide neck bottles!  I'd bought a really nice set of Dr. Brown's bottles before the baby was born, only to be told that these can cause nipple confusion when you try to use them while breast feeding.  The wider nipples are supposed to latch more like your breast, so your baby won't get as confused about what to do when presented with either.  How you offer the bottle makes a difference too.  Don't just pop it in your baby's mouth nipple down.  Gravity will make it flow faster, and if your baby gets used to the faster flow then this can lead to frustration when they go back to the breast.  Hold the bottle horizontally, tilted so there's just enough milk to fill the nipple.  This way your baby has to work for it, and it has the added bonus of helping to prevent the baby from overeating.  After all, it hurts to work so hard to give him what breast milk you can, only to have it spit right back up at you!

There are a variety of herbs that can be used to help increase supply including milk thistle, and fenugreek, and proprietary blends like More Milk and More Milk Plus.  Keep in mind if you have thyroid issues that fenugreek can lower T3 hormone, so go for straight milk thistle or plain More Milk (not More Milk Plus) if you're worried about your thyroid.  These can be harder to find in stores, but you can order them online.  I saw a pretty fair increase in supply when I started on More Milk.

Eat well, and eat foods that can increase production.  This is not the time to go on a diet.  Be sure you're getting plenty of protein (eggs are a complete protein) and fat, and a wide variety of nutrients.  There are some foods that are supposed to help.  Oatmeal's the one I found most commonly recommended, but google lactation foods and you'll find lots of things to try.  A lot of folks recommended I drink a beer a day, but I tried a few alternative routes so that I could avoid having the alcohol in my system that is not good for the baby.  I cooked with beer.  This cooks out most of the alcohol, but leaves the rest behind, besides beer in chili is good!

You can also make your own barley water which has all the good stuff of beer without the alcohol, and it's not as nasty as it sounds.  You basically want to add a cup or two of barley to a LOT of water and then boil the heck out of it.  I found a recipe that called for about a cup of barley to two liters of water (or about two cups of barley if I filled up my largest soup pot with water).  Bring the water to a boil and then reduce the heat to a simmer for several hours until it's reduced by half.  You can then strain out the barley and eat it or throw it out (I added it to soup) and let the water cool for drinking.  I tried several things to make this more palatable.  You can add sugar and lemon to make a kind of thick lemonade, or add a dash of lemon to each glass for lemon water.  I would also sometimes mix it half and half with a strong flavored juice I liked (cranberry grape worked well), but milder juice like apple seemed to be overwhelmed by the barley water.

No matter what you're drinking, you want to make sure you're drinking plenty to stay hydrated.  After all, you're drinking for two now, and much of what you're drinking is being passed on to your baby.  You don't want to get dehydrated.

You'll also want to be sure you have a breast pump.  I read a lot of suggestions that sound like good ideas but don't really work in the real world.  Who has enough hands to hold a wriggling baby to one breast and a pump to the other simultaneously?  Some folks suggested pumping after every feeding to make SURE the breast was empty, but I never seemed to have time for that.  However I do pump when I wake up in the middle of the night, if it looks like she's going to sleep through a feeding, and very frequently during my work day to try to make things as empty as possible.  The type of pump you use does matter.  I've heard some women swear by the medicinal grade pumps that can be rented, and I wish I'd tried one of these before I bought the one I'm using.  Some women have better results with different flanges.  I got a lot of advice that suggested you should try different pumps, but at $300 to buy a decent electrical pump, or $50 a month to rent that could get very expensive very quickly.

Every little bit of breast milk you can give your baby helps.  It cuts down on tummy ailments and helps your baby's immune system.  Even with all that I've tried I still only make about a third of what my baby needs, but it's worth it to know I'm doing what I can to keep her as healthy as possible.

Myths about breastfeeding

I've run across SO many websites dedicated to dispelling the "myths" surrounding breastfeeding, but it seems like so many of them are afraid to say anything unpleasant about breastfeeding for fear it will convince you not to try it.  Now I'm all for breastfeeding, heck it's been really difficult for me and I'm still working to make it better, but I think it's worth sharing that it's not all puppies and rainbows.  I would encourage every mother to breast feed as much as she is able.  There are lots of health benefits involved for all parties, and even if you can't stick with it for one reason or another, every bit that you can do helps both you and your baby.  But if you only hear the good things about breastfeeding, never informing yourself about the ups and downs involved then how can you prepare yourself for what you'll need to do to give breast feeding a concerted effort.  So without further ado here are some myths I see all over the internet that I wish someone had dispelled for me.

Myth: Breast feeding doesn't hurt if you do it right.
Ha!  My nipples have ranged from slightly sore to downright painful for the last two and a half months.  From the week my baby was born I would cringe just to have my towel brush against my nipples when I got out of the shower.  Ever tried to dry your face without your towel touching your nipples?  Maybe if you're more flat chested than me, but I can't seem to manage it.  Now things might be better for you if you're used to having someone suck on your nipples five hours a day, yes that's 10 feedings a day at 15 minutes per breast which is the MINIMUM my lactation consultant recommended to get started, so it just stands to reason that women who haven't breast fed before are going to be sore.  It doesn't help that she sometimes kicks one boob while feeding from the other.

Now there are lots of things that can help, starting with getting your baby to latch properly.  The lanolin cream really does help, and they make these really fantastic gel nipple pads that are cooling and soothing and really fantastic!  The pain gets better with time, well, it comes and goes really.  You'll get a schedule going and be fine for a couple weeks (sore but fine) and then your baby will go through a growth spurt and be ravenously hungry and rub your nipples raw again.  Keep in mind, I haven't had anything like bad nursing problems, no cracked and bleeding nipples like I've read about.  But you'll want to have a few thick bras that  are really protective (and hide the lines from the gel pads mentioned above), and don't be afraid to take a little Ibuprofen now and then.

Myth: The pounds just melt off.
I'm sure they do for some folks, but don't count on it.  I lost weight pretty fast for the first few weeks home from the hospital and then stalled out with about ten pounds to go to my pre-pregnancy weight.  I was talking to a retired GYN nurse who works at my daughter's daycare and she says that's about par for the course.  She said it's because breastfeeding tends to cause fluid retention (makes sense, if you're providing fluid to your baby then your body would want to have plenty of fluid on hand) so most women stall out somewhere around 5-10 lbs above their pre-pregnancy weight.  Of course you can then watch what you eat and probably slowly lose more, but you want to be careful about that when your breastfeeding because you don't want your body to think you're starving.  You also don't want to loose weight to fast because that can release toxins into the breast milk.  Either one can hurt breast milk quality or quantity, so don't plan on slimming down quickly.

Myth: Breastfeeding is free.
Nope, there's still no such thing as a free lunch.  Yes, breastfeeding is more cost effective than formula, but it's still far from free.  Here's a breakdown of what you can expect to spend on breastfeeding:

• Lanolin - I go through a tube every month and a half or so, and the tubes run about $8 at my local Kroger.  It might be more cost effective to buy them online or in larger sizes, but I haven't checked.
• "Soothies" Gel Nipple covers - You may not need them all the time, but they're great help for the worst soreness, and you can put them in the fridge for even more effective soothing.  They run about $10 a pair and I forget where I got this last set.
• Sleep Bras and Nursing Bras - No, they're not the same thing.  You'll want extra protection for your boobs, so even if you don't normally need support while you sleep you'll probably want to get a couple of sleep bras (I got Medela sleep bras, $15-20 on Amazon.com, and wore them 24/7 for my maternity leave).  You'll also want some nursing bras, preferably something without under-wire for the first little while.  I got one actual nursing bra, and then found that my really old stretched out Victoria's Secret bras could be pulled down for nursing pretty conveniently.  Unfortunately, they don't make them like they used to, and you couldn't do this with their memory foam bras, and Victoria's Secret now appears to be addicted to memory foam.  You can get nursing bras that unhook from the top to fold down, or with stretchy bra cups that just pull to the side or down.  I found the second to be more convenient, but they're less supportive than the ones that unhook, so you'll have to figure out what works best for you.
• Vitamin D drops and other baby supplements - Our pediatrician recommended that unless our baby eats 32 oz or more of formula a day we should give her vitamin D drops daily.  My husband's been the one to buy these, so I don't know how much they are, but I'm sure they're not terribly expensive.  I've heard of other folks needing other vitamin and mineral supplements as well, but we've never needed more, possibly because we're feeding both breast milk and formula.
• Bottles - Unless you're never planning on leaving your baby with anyone else, or for that matter never planning to need to feed her in her car seat on the way somewhere, you'll need to get some bottles.  How many will vary according to how long you'll ever be away or how often you want to wash dishes, but my lactation consultant strongly recommended using the wide nipple bottles because they're more like a breast which can reduce nipple confusion.  However I haven't seen any wide neck bottles in consignment like I have standard size bottles, so you may find these to be more expensive than if you were exclusively bottle feeding.
• Breast Pump - Wile I've heard some people have great success with hand expression, the few times I've tried it I got much less than pumping and it took a very long time.  Breast pumps can ranbe from about $50 for the cheapest hand pump I've seen, to around $1000 for a hospital grade pump.  That's to buy.  You can also rent for about $50 a month, and there are accessories to buy to go with that.  I got a decent electric pump for $300 and it works pretty well, though some folks swear the hospital grade pump works better.  I kind-of wish I'd tried it to see if it worked any better, but at this point it seems like a waste.
• Lactation Consultant - I'm sure this is optional for most folks, but I found our lactation consultant extremely helpful and have been very glad to have someone to go to when I have questions.  I'm sure there's a wide range of cost here, but four our board certified (IBCLC) consultant it was a little under $200 for her to come to our house for three hours, and then she was available to help us by phone and email thereafter.
• Lactation support foods, herbal supplements  and medicines - You may not need these at all, and some of the foods probably shouldn't be counted.  After all, you have to eat breakfast anyway, and it doesn't cost any more to eat oatmeal (which supports lactation) than any other breakfast.  Still, there are a few things I got specifically to help with lactation including: hulled barley (for making barley water, $10 for a pound on Amazon.com but much cheaper if you buy in bulk), More Milk or More Milk plus (an herbal supplement to increase breast milk production, about $20 for a 2-3 week supply, more cost effective if you buy in larger amounts), and I also got a prescription galactogogue that was $100 for a three month supply.
• Specialized nursing pillows if you want one - I just used bed pillows, but some folks swear by their Boppys.
• Your time - It takes longer to breast feed than bottle feed, and takes more work from your baby to get the milk out.  The slower flow is actually one of the benefits of breast feeding since it prevents overeating which in turn can reduce spit-up.  It also makes a baby more aware of when she's full.  I mean, it's the difference between scarfing your food and having a leisurely meal, you have more time to detect satiation.  This can lead to better eating habits in your child's life moving forward, but it also takes more time at each feeding.  My baby can take a bottle in 10 minutes or so, but at the breast takes 40 minutes to an hour per feeding.  That's probably on the long end of things, but if you believe your time is worth something then you'll want to tally that cost.  Remember the adage "Time is money."  I also recently read that breast feeding mothers have reduced earnings over the first five years of their child's life than bottle feeding mothers.  It's possible that's because they're more likely to be stay at home moms or work reduced hours, but it's still worth keeping in mind.

Sure, your actual costs may not add up to the projected $600-1800 cost of formula for the first year.  Many of the costs of breastfeeding are optional, and my largest expenditures have been covered by FSA.  Bottle feeding may also have additional costs due to more child illness and doctor visits; here's a study that says that the extra medical costs to never breast fed babies average $331 to 475 (http://www.ncbi.nlm.nih.gov/pubmed/10103324).  But I'm so tired of hearing about this "free" feeding method.  I wanted you to know what to expect.  

I still think breast feeding is totally worth it.  There are lots of good reasons to at least give it a good try.  If nothing else, it can be an amazing mother/baby bonding experience.  But if we can take the rose colored glasses off and prepare ourselves for the reality of breast feeding then we're much more likely to be successful when we hit the bumps in the road.