Author: Meghan Crovo

Definition of a Migraine

/ Meghan Crovo

The pain and associated symptoms of migraines are often debilitating and can impede daily life. Migraines do not discriminate and affect people of all races, economic backgrounds, ages, and genders. As such, the definition of migraine in San Diego will look like the definition from anywhere in the world. Simply put, a migraine is defined as an extremely severe headache, but those who have experienced them know a migraine is so much more than that. 

Those who suffer from them may endure hours or days of symptoms. These symptoms often hinder the quality of life and, in severe cases, can make it impossible to participate in routine activities like working. Although the frequency and severity of migraine symptoms will differ between individuals, the most common symptom is a headache that causes severe pain. 

Symptoms

Migraines may start with a warning stage called prodrome, then progress through aura, headache, and lastly, post-drome. Not every migraine sufferer in San Diego will experience these four defined stages.  

Prodrome

A couple of days before a migraine, the patient might notice warning signs indicating an impending episode. Symptoms associated with the prodrome stage of migraine include, but are not limited to, constipation, increased yawning, mood changes, increase urination, food cravings, or neck stiffness. These signs are subtle and easily missed. A migraine journal may allow for patients to pick up on these early symptoms and preemptively treat them. 

Aura

Neurological symptoms, usually visual, such as vision loss or seeing bright flashes, are common during the aura stage. Some patients have described seeing shapes. Sufferers might also observe numbness or tingling anywhere on the body or auditory disturbances like hearing noises. The aura stage can last five minutes to one hour and occurs just prior to the headache. 

Headache

The headache stage is the hallmark of migraines and causes severe pain lasting up to several days. San Diego residents frequently define this Migraine pain as throbbing or stabbing. Pain is often unilateral. However, the patient may experience bilateral pain as well. Along with an unbearable headache, individuals may experience nausea, vomiting, photophobia, sensitivity to smells, dizziness, and anxiety. This list of symptoms is not exhaustive.  

Post-drome

During the post-drome phase of a migraine, patients describe feeling exhausted, depressed, euphoric, or unable to concentrate. The intense pain of a migraine may return momentarily during abrupt head movements. This final stage can affect patients for 24 to 48 hours. 

Migraine Causes and Treatments

The first step to overcoming this ailment is obtaining a diagnosis by a San Diego doctor who understands the definition, treatments, and fundamentals of migraines. Although the cause of migraines varies and is not fully understood, facial nerves appear to play a role. It is believed that these nerves create migraine trigger points due to compression from surrounding structures such as muscle, bone, fascia, or vessels. Release of these nerves through minimally invasive surgery has shown a reduction in frequency and severity among migraine sufferers. Migraine decompression surgery is generally performed on those who have not had adequate resolution with conventional treatments. 

There is Hope

Migraines are common and occur across the world. If you are suffering from them, no matter where you live, you are not alone. If you have not experienced a migraine, you likely know someone who has.  As with anywhere else, the definition of a Migraine in San Diego exhibits just how difficult it is for residents to live with such a debilitating disorder. But there is hope. With a better understanding of migraines and their causes, more treatments have become available, and therefore more doctors trained on the techniques shown to bring relief.

Mothering Your Nursing Child: Myths, Facts, and Planting Seeds 

/ Meghan Crovo

Four and a half years ago, I was told by a dear friend it was disgusting I was still nursing my eighteen-month-old son. I was relatively new to the world of mothering and was unsure how to handle such negative comments about my breastfeeding relationship. It cut deep. The implication my son could do anything disgusting at the tender age of one-and-a-half left me feeling protective over his integrity. 

Now I have more experience, and with more experience comes more confidence. I’m writing this in hopes of normalizing the act of breastfeeding, so hopefully one day no one will have to have their relationship with their child brought to trial. I know this is not the article that will change the world but it may plant a seed and I like gardening. Let us explore some of the more common myths about mothering your nursing child. Whether you are “still” breastfeeding or have never breastfed.

Myth: A nursing child will never learn how to be independent. They are clingy, whiny, and demanding.  

Independence is something we value immensely in our culture starting as early as babyhood. Of course we all want our children to experience a healthy level of independence, but the idea of how we encourage that independence is up for debate. Many purported experts suggest parents ignore their baby’s cries to promote independent sleep, which is not biologically normal for an infant, nor is ignoring your child biologically normal for a parent. We often hear the silly argument that you will spoil your baby if you hold them too much. 

New mothers are told not to give in to their infant’s “demands,” forcing women to oppose their instincts and follow through with erroneous advice. Under the pressure of our culture’s desire to push independence, infancy and its associated needs are treated as though it damages the elusive independence we love. With less than 50% of women still breastfeeding at six months1, it is no surprise that breastfeeding into early childhood is seen as something only for babies and may compromise a child’s independence. 

One thing every mother to a toddler has in common is they likely hear “mommy” 1,440 times per day (guess how many minutes are in a day) followed by an emotional plea if that “mommy” did not elicit an immediate response. Breastfed toddlers are not clingy, whiny, dependent, and demanding, but rather toddlers are clingy whiny, dependent, and demanding. Take the breastfeeding out of the equation, and you still have all the whine, but with one less tool to comfort the child. 

Diane Bengson, Author of “How Weaning Happens,” says, “Toddlers have many needs that linger from babyhood, including the need to cuddle, the need to be comforted, and the need for help when falling asleep. These needs are all naturally met through nursing, and it is a wise mother who recognizes and honors her child’s need to be dependent. Trusting the child in this way builds self-confidence needed for later independence.” 2 Becoming independent is a milestone, just like crawling or walking. Children will hit it when their developmental ability is ready. As with any other milestone, one of the best ways to encourage it is to provide a safe environment for the child to explore comfortably. A child feels safest when their needs are met, including their need for dependancy.3  

Myth: Immunities from breastfeeding are no longer valuable or needed past the age of one. I’ve also heard this one with six months as the cutoff.

Simply put, that’s like saying after the age of eight, eating vegetables is no longer healthy. Let’s jump right into the research. A toddler’s immune system is only sixty percent developed at the age of one,4 but don’t worry about your little one’s developing immune system; nature has it all worked out for us. 

As your nursing toddler gets older and therefore takes less milk, the immunities in breastmilk increase in concentration, so breastmilk still plays a vital role in protecting the young immune system.5 And it works! Breastfeeding children between sixteen and thirty months have been shown to require less medical care due to illness than their non-breastfeeding peers,6 and we continue to see this trend. 

In another study, looking at three-year-old nurslings, the same results were seen.7 The importance of protecting these young immune systems with mama’s milk is critical. It can mean life or death, especially in developing countries. In Guinea-Bissau, children between the age of one to three years old, who were no longer receiving breastmilk, had a mortality rate that was three-and-a-half times higher than their nursing counterparts.8

Myth: If they are old enough to ask for it, they are too old to get it.

Even very young babies ask to breastfeed. Turning their head toward the breast, bringing their hands to their mouth, rooting, and finally crying are all ways a baby will ask. A child whose language skills are good enough to say “milkies” is asking just the same as a baby who cries for the breast.9 

This sentiment comes from a culture that doesn’t fully understand breastfeeding; not only does it indicate a lack of knowledge about the existence of hunger cues, but it also suggests breastfeeding is only about the milk. Nursing a child offers nutrition, yes, but nutrition is a small fraction of what else the breast offers. 

The subtle nuances between mother and child during a nursing session are pieces of interactions that teach trust, safety, commitment, and respect. The baby’s need for warmth, comfort, safety, sucking, and nourishment are all met at the breast, and it does not stop when the child is old enough to use words instead of cues. If one understands the depth of a nursing relationship, one understands the bizarre notion that asking for the breast is somehow a sign the child should not get the breast. If a child asks for a hug, should the mother refuse? A kiss?

Myth: A nursing child will not learn personal boundaries and could become socially awkward.

For a baby, the breast is as close to being in the womb as possible; the warmth of skin to skin, the sound of mom’s beating heart, the comfort of sucking, the nutrition, and the familiar smell of mom are all part of the comforting package. It creates a baby’s natural habitat and allows the baby to feel safe like he did in the womb.10 

Comfort at the breast continues into childhood. As the breastfeeding relationship matures, it changes, but the breast remains a safe place. Consequently, toddlers will often seek the breast when they’re scared, hurt, or overstimulated. We all learn best in a safe environment, so what safer place to teach personal boundaries than at the breast. 

Breastfeeding in mother’s arms is often where a baby will experience his first bits of gentle discipline; earlier in the breastfeeding relationship, this may mean mom not allowing baby to bite. As baby gets older, he will learn boundaries when mom requests that he not tug at her shirt when asking for milk or pull on her hair. For some (okay, most), playing with the other nipple is off-limits. Pulling at mom’s hair may be discouraged, but standing up may be permitted. Every nursing dyad will have different boundaries for their relationship, but one thing for sure is that boundaries will always be present, and therefore taught.

We have seen that children who breastfeed longer than a year tend to adjust better socially than their peers who were not. One study that focused on children who were nursed past one year found a significant link between the length of the breastfeeding relationship and how teachers and parents rated the children at six to eight years of age in terms of social adjustment. 

The children who experienced access to the breast the longest were consistently recognized to be better socially adjusted.11 The authors do recognize the study was not controlled for certain mothering behaviors exhibited by breastfeeding mothers versus their bottle-feeding counterparts. But does it matter? Does it matter if this positive outcome is due to the act of breastfeeding, the nourishment of human milk, or the behaviors typical of women who mother through breastfeeding? Either way, breastfeeding played a role.

Myth: breastfeeding into childhood is not normal.

Our culture is a bit mixed up. We see manufactured infant feeding apparatuses as normal, while the biological norm for all mammals is considered abnormal. The public often thinks of breastfeeding as a private act. Ask any mom who breastfeeds under a cover, away in a room, car, or bathroom what her experience is with breastfeeding in public. 

Many women report that family members or even strangers have expressed that breastfeeding should be kept away from the sensitive eyes of teenagers and lurking men. Apparently, they are incapable of seeing the breast as multifunctional. If you are unsure of this, go to any breastfeeding article in mainstream media and read the comments. It’s all backward. 

Since the biologically normal way to feed a baby has slipped behind closed doors and under blankets, we don’t see moms nursing babies, and we rarely see them nursing toddlers. What else are we in society to conclude, but that it doesn’t happen, and if it doesn’t happen, it isn’t normal; not true.

Research done by Katherine A. Dettwyler shows the human infant was designed to breastfeed well into childhood and that it is normal for a child not to wean as late as seven years of age, with a range of 2.5 to seven years.12 The American Academy of Pediatrics recommends that breastfeeding continues for as long as “mutually desired by mother and child.” 13 The American Academy of Family Physicians agrees and has a similar statement of their own.14 The World Health Organization and UNICEF recommend breastfeeding to a minimum age of two years old.15

This last myth, “breastfeeding into childhood is not normal,” I believe is what led my friend to question my breastfeeding practices. After regaining my composure, I replied that baby and I enjoy the relationship and so continue to do so. My supportive and knowledgeable husband quickly shared that it is good for his son and his wife. 

A few days later, I received a call from my friend. In his shock of hearing about my breastfeeding experience, he began asking other moms about their breastfeeding relationships and discovered many were nursing well into childhood. With his newfound knowledge, he called to apologize. I guess I planted a seed.

References:

  1. Breastfeeding Report Card: United States / 2013 – 2013breastfeedingreportcard.pdf
  2. NEW BEGINNINGS, Vol. 23 No. 3, May-June 2006, pp. 100-105.
  3. Baldwin, EN. Extended Breastfeeding and the Law. Mothering. 1993 (Spring);66:88.
  4. Huggins, K. The Nursing Mother’s Guide to Weaning. Boston, MA: Harvard Common Press, 2007.
  5. Goldman, A. S. et al. Immunologic components in human milk during the second year of lactation. Acta F’aediatr Scand 1983; 722:133-34.
  6. Gulick, E. The effects of breastfeeding on toddler health. Pediatr Nurs 1986; 12:51-54
  7. van den Bogard, C. et al. The relationship between breast-feeding and early childhood morbidity in a general population. Family Med 1991; 23:510-15.
  8. Molbak, K. et al. Prolonged breastfeeding, diarrhoeal disease, and survival of children in Guinea-Bissau. BMJ 1994; 308:1403-06.
  9. Wiessinger D, West D, Pitman T. “The Womanly Art of Breastfeeding” New York: Ballantine Books, 2010, p.453
  10. Dr Nils Bergman 2004, Kangaroo Mother Care, Viewed 16 March, 2014 <http://www.kangaroomothercare.com/olanders.aspx&gt;
  11. Ferguson, D. M. et al. Breastfeeding and subsequent social adjustment in six- to eight-year-old children. J Child Psychol Psychiatr Allied Discip 1987; 28:378-86.
  12. Dettwyler KA.”A Time to Wean” from Breastfeeding: Biocultural Perspectives (Stuart-Macadam, P. and Dettwyler, K., ed.), New York: Walter de Gruyter, Inc., 1995, p. 305-345.
  13. American Academy of Pediatrics Section on Breastfeeding. Breastfeeding and the Use of Human Milk. Pediatrics. Feb 2005;115(2): 496-50.
  14. American Academy of Family Physicians. AAFP Policy Statement on Breastfeeding. 2001.
  15. World Health Organization. Global strategy on infant and young child feeding (Document A55/15). 16 April 2002.
  16. (Gulick 1986). The Breastfeeding Answer Book, Third Revised Edition, pp. 202 (Van den Bogaard 1991) The Breastfeeding Answer Book, Third Revised Edition, pp. 202 molbak 1994 The Breastfeeding Answer Book, Third Revised Edition, pp. 202