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4.16. To wean = gradually eliminate

There's weaning off a ventilator (breathing machine) in the ICU, and there's weaning a baby. Both are difficult, but as a mother who breastfed (reluctantly) for more than two years, I personally never want to go through the latter again.

1. One can wean off a ventilator using "Synchronous Intermittent Mandatory Ventilation": the ventilator provides a minimum of, say, 12 breaths a minute, and the patient supplies additional breaths. If all goes well, the machine delivers fewer breaths, and the patient breathes more and more on his or her own.

Similarly, the mother desperate for her body back may offer the breast for a reduced number of times or only fixed times a day. For example, 10pm, 4am, 7am, 5pm. Try telling that to the pacifier-rejecting baby who uses you as a human pacifier. All night long.

2. One can also use a T-piece (what it sounds like--T-shaped tubing), which replaces the ventilator and delivers humidified oxygen. The longer time the patient can tolerate without the ventilator, that's progress towards extubation (removal of intubation!) Nighttime weaning is not usually attempted until the patient can maintain spontaneous respirations most of the day.

Perhaps your toddler (who is way too old to be breastfeeding) will accept milk or water in a sippy cup, since she hates bottles and pacifiers with a passion. But as is true of T-pieces, even if the child lasts all day without breastfeeding, she will probably still scream bloody murder for boobies when she wakes up (ten times) at night.

3. Pressure Support Ventilation supplies less and less pressure with each breath, encouraging the patient to take over the work of breathing gradually.

Mom will probably produce less milk due to (depression and) baby being old enough to eat actual food during the day, so if baby can take over intake of nutrients without leeching off Mommy's bones and energy, that would be awesome. Just saying.

Yes, my child is almost seven and I'm done reproducing, but I'm still bitter, see? They should latch a few hungry babies all night long onto the WHO spokespeople advocating breastfeeding for the first two years of life, and see how fast they stop the lactation consultants from scaring sleepless new moms (with jobs and second shifts) with threats of SIDS (sudden infant death syndrome) and "nipple confusion" if the mothers don't breastfeed on demand, and exclusively.

Ultimately, though, the best advice to a new mom or any mom is probably this: Don't let people tell you what to do. Because they will try. And none of them have any idea. Do what works (and is safe) for you and your family.


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