My Journey As A First Time Mom; a #MyStoryMatters Leaky Share

by Kelly Warner

guest post, leaky to leaky

Meet Samuel. This is my rainbow baby, who we welcomed with joy in January, 2014. After struggling with infertility for 5 years, my doctor in Houston told me it was unlikely that we would ever conceive. When we moved to St. Louis we started seeing a fertility specialist, who discovered a few factors that were either keeping us from getting pregnant or not allowing us to sustain pregnancy (an underactive thyroid, being a carrier for MTHFR and either not absorbing folic acid well or clotting after conceiving, and low progesterone). Once we addressed those issues we got pregnant right away, which was so encouraging after having our arms ache to hold a child for years. Unfortunately, we miscarried at 9 weeks and would later miscarry a second time at 6 weeks.   We were in a very dark place but continued to trust God with our fertility. A few months after our second miscarriage we found out we were pregnant again. 40 weeks later, after a snowstorm and before another one shut down the city for a week, our sweet Samuel Bennett was born!

I was so focused on maintaining a healthy pregnancy and having a natural birth that, admittedly, I didn’t educate myself on breastfeeding. Our Bradley Method instructor encouraged me to attend LLL meetings while pregnant to meet other like-minded moms, but I didn’t make it a priority to go. I knew that I wanted to breastfeed for a minimum of 12 months and had hoped that I would be able to make it for 2 years, but I figured I would have the baby first and then it would just naturally come to me. You know, because so far my story has been so natural and easy that it makes sense that I would just figure it out.

We had a beautiful natural birth and our nurses were great about immediately putting Samuel on my breast and delaying all newborn procedures until we had time to bond. He didn’t latch right away but found comfort sleeping on my chest. (In his defense, he did have a pretty long and intense birth that included 4 hours of pushing, his cord wrapped around his neck twice, and the threat of a C-section before I pushed so hard I broke my tailbone and his head came out before the doctor was even suited up to catch him). I kept trying to get him to latch and had just about every lactation consultant and nurse helping too. We were adamant about not using bottles, sugar water, or formula, so when he started showing signs of dehydration, we all panicked. The LC informed me that the combination of my flat nipples and large breasts were making it difficult for Samuel to latch and she recommended we use a breast shield. I was a nervous first time mom, who just wanted her baby to eat, so I took her at her word and began using the shield. I have since come to learn that there are absolutely medical situations that warrant the use of a shield . . . but mine was not one of them. Samuel began “latching” and getting colostrum, but it was so frustrating, painful, and messy for me. Worried that I would give up with breastfeeding, the LC convinced me to rent a breast pump to take home, pump my colostrum, and feed with bottles until my milk came in. Although she unnecessarily encouraged me to use a shield, I have to give her credit for pushing breastfeeding. She showed me how to use the pump and was shocked when I pumped 2 ounces of colostrum in a few minutes. At the time I was super confused why she was all giddy (and felt the need to show my liquid gold to everyone working in the maternity ward) but have come to learn that colostrum is not typically measured in ounces. That gave me hope that I was going to be able to feed my baby – it was just a matter of figuring out how.

My milk came in a few days after we got home from the hospital and my already large breasts became so engorged I didn’t know what to do with them! Seriously, they practically had their own zip code (38-K)! I had a serious oversupply problem and a fast letdown that Samuel did not find nearly as amusing as my husband and I. He’d pull off the breast and get super-soaked in the face or just grimace as a stream of milk shot halfway across the room. I guess when you’re an exhausted new mom you find the humor in anything, because everything else is just so, so hard!

We continued to use the nipple shield but struggled. I can’t tell you how many times I wanted to quit. Thankfully, my husband knew, deep down, I didn’t really want to quit and I just needed to be encouraged to continue. He was up at every diaper change and night feeding with me, sitting at my feet, praying for me. I remember one time in particular: It was 2am and I was exhausted from nursing Samuel around the clock during a growth spurt. My husband and I got up to feed him and I burst into tears when Samuel latched and I felt the “60-second sizzle.” I said I didn’t want to mess with the shield anymore and that I just wanted to feed my baby. He comforted me in that moment and said he had read that night feeding was a good time to try to wean off the shield. So, figuring it couldn’t get any worse, we took off the shield, and together, we re-latched Samuel. I’m talking, all 4 of our hands were trying to hamburger my nipple so Samuel could latch! There were more tears (by me) and more words of encouragement (from the hubs), and finally Samuel latched! This was such a small thing but felt like such a big breastfeeding victory!

I continued to pump out a few ounces before EVERY feeding to soften my breast tissue so he could latch better. It was really annoying to be tethered to my pump and time-consuming to have to constantly be cleaning out pump parts (and during the winter, which made my hands crack and bleed), but it was worth it to be off the shield and begin having a successful nursing relationship with my son. Plus, it allowed me to build up a good stash of breast milk that I donated to my friend to give to her adopted newborn.

By the time Samuel was 6 months old my supply had finally regulated. It was so freeing to be able to feed on demand and not have to pump first. Samuel was healthy and happy and in the 50th percentile for his weight, and an added bonus was that he was a really good sleeper! Shortly after he turned 7 months old, however, he started waking up multiple times at night to nurse. We brushed it off and assumed he was just teething or going through a growth spurt, but it continued for weeks. I called my pediatrician and asked her why she thought his sleeping pattern changed suddenly. We ruled out ear infections, viruses, the Bubonic Plague, and continued to be dumbfounded . . . until my ped asked if it was possible that I was pregnant. I probably offended her for laughing so loud on the phone, but, come on! Me? Pregnant? I mean, sure, it was a possibility I could be pregnant, but I was exclusively breastfeeding, had not introduced solids, and remember how it took the stars aligning for me to have a healthy pregnancy with Samuel? I hung up the phone, dug out an expired pregnancy test from the Dollar Store, and took the test . . . and then proceeded to take another 3 before I believed my eyes! I told my husband and he didn’t believe me, so he went to the pharmacy and bought the most expensive digital pregnancy test . . . which told us the same thing the 4 tests prior did, only in words instead of hieroglyphics. I. Was. Pregnant!

guest post, leaky to leaky, pregnant photo

Once the initial shock settled we were thrilled for our news, but clearly my milk supply had already begun to decrease. Ahhhh the irony! My ped suggested starting a supply-boosting supplement that was safe while pregnant, but cautioned that it was likely we would need to supplement with donor milk or formula. Having just donated all of my pumped milk to my friend for her adopted baby, we were forced to supplement with formula. We chose the only organic formula that we can buy locally and hoped that it would be palatable. Only, Samuel wouldn’t take it. Clueless about what to do, I emailed Jessica from The Leaky Boob for advice and was so humbled that she took the time to answer me. She encouraged me to get a Supplemental Nursing System (SNS) to keep stimulating my breasts to produce milk while getting Samuel the supplementation he needed. He had lost so much weight he dropped to the 5th percentile, so we were ready to try just about anything. All I can say is using an SNS is like trying to juggle flaming arrows while blindfolded! I feel it apropos to high five any mom that has successfully nursed with an SNS. First off, that thing is impossible to set up alone (thankfully my husband is really supportive of me breastfeeding). Secondly, the tape that is supposed to keep the tube in place is worthless! Thirdly, my son was so offended that I was trying to sneak that tiny plastic tube in with his latch. Needless to say, we gave up.

After giving up on the SNS we tried to introduce a bottle. By this time Samuel was close to 9 months and had only had a bottle when I pumped my colostrum the first few days of his life. If he was offended about the SNS tube, he was not having the bottle either. We must’ve bought one of every brand of bottle on the market only to find out he would rather starve. We tried syringes, medicine droppers, spoon-feeding, sippy cups, open cups and this kid was not impressed. The only thing that he took a liking to was a straw – and not a sippy cup with a straw because that’s far too juvenile for a 9 month old – a straw that you, a grown adult, would get at a restaurant. He’d sip on the formula throughout the day but never really had a “feeding” like he would with breastmilk. We sneaked it in smoothies, made popsicles, and just about anything to get that kid to drink milk.

Keep in mind I’m still pregnant through this . . . I’m tired, hormonal, my nipples are sore, and I’m nauseous! I lost 10 pounds from throwing up and not being able to eat food while pregnant and still nursing Samuel. Those days were ROUGH! I kept telling myself that, “This, too, shall pass.”

We found our rhythm and made the most of our cuddles and nursing sessions until Samuel started throwing fits when I offered him the breast at nap-time or bed when he was 13 months. After a few days of us both crying at every feeding, I assumed he was no longer interested in nursing and wanting to wean. I stopped offering it and we just, kinda moved on. Looking back, I honestly believe he was having a nursing strike from being frustrated from having to work so hard to get any breastmilk.

In May we welcomed our daughter, Felicity Claire, into the world. Once his sister was born he started showing interest in nursing but it was as if he had forgotten how it all worked. He constantly talked about my “ba-ba’s” and wanted to touch them for his sister’s first month of life. 4 months later, he asks for milk at bedtime and smells and touches my breasts asking for more. It breaks my heart that I likely cut our nursing relationship short, but I am glad we were able to overcome so much and still make it 13 months.

guest post, leaky to leaky

So far, Felicity nurses like a champ and I feel so much better prepared this time around. While I wouldn’t wish my struggles with breastfeeding on anyone, I am glad I had to persevere through them. Not only did it show me how much support I have, but it highlighted how important a good support system is for breastfeeding. I hope that other moms find support to help them reach their breastfeeding goals and that my story encourages them in their journey.

____________________

guest post, leaky to leakyKelly is a mother of two from St. Louis, Missouri, who lived a good chunk of her adult life in Houston, Texas.  She and her hunk of a husband struggled with infertility for 5 years and had multiple miscarriages before having their first child in 2014.  Prior to starting a family, she taught 7th grade life science at a college preparatory charter school for low-income, minority students in Houston.  When she’s not nursing her 5 month old or telling her 21 month old to stop throwing balls at his sissy’s head, Kelly enjoys hanging out with her husband, binge-watching Gilmore Girls, and writing music.  Despite many struggles with breastfeeding, Kelly nursed her son for 13 months; 6 of those while pregnant with her daughter.  In addition to being passionate about breastfeeding, Kelly loves baby wearing, cloth diapering, staying up to date on car seat safety, and having grandiose dreams of being a midwife someday. In the meantime she’ll stick to chasing her sports-nut toddler around the neighborhood and hoping that she remembers to put her boob away before answering the front door.  

 

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Nipple confusion, bottles, and alternative feeding options

On January 17, 2012 in the United States, Medela, best known for their pumps, launched their latest “feeding innovation”, the Calma.  The Calma is a bottle that seeks to eliminate nipple confusion and flow preference by making a bottle fed baby work for its milk, similar to how your little one must compress and suck at your breast to get milk out.  According to Medela, this “supports an easy transition from the breast to the teat and back.”

As a registered International board certified lactation consultant, I am very skeptical of these claims.

I have often heard that nipple confusion is a myth, foisted on mothers to keep them stuck to their brand new babies, to keep them from leaving the house, to subjugate us all.  This is simply not true.  Nipple confusion happens.  I have seen numerous cases of it in my practice.  Babies become nipple confused for three reasons – flow preference, difference in movements, and difference in feel.  Medela has the right idea on part of the equation.  Babies that are given a lot of bottles in the early period can decide that it’s not that fun to work a breast when this plastic thingy is way easier.  Most bottles, even the slowest flowing, flow faster than milk from a breast.  However, your baby also moves their mouth differently to get the milk from a bottle than from a breast.  The jaw and tongue movements are not even close to the same, and trying to transfer the movements from one to another can frustrate and upset your baby.  After all, if your baby is new, this whole eating thing is new, too.  Why complicate it?  There’s a bonus too: a baby nursing at the breast will develop their mouth in a way that will help with prettier smiles and better speech, too!

The third part of the equation is the different feel.  If you are giving your baby a softer breast and a harder silicone, they may very well like the way that a bottle feels more – especially since that silicone is, again, delivering milk faster and the mouth movements are different.   Medela hasn’t really done anything to cure that.  I’ve seen and felt the Calma, and, I assure you, it will not be mistaken for breast tissue anytime soon.

The easiest way to prevent nipple confusion is by waiting to introduce a bottle until four to six weeks (three to four at the earliest) and to simply offer the breast more than the bottle.  Some families have other situations, though, that don’t make the whole four to six week thing possible.  So what is a modern mom to do?  For many of us, it is not feasible to never give milk from anywhere but the breast.  We have work, and school, and other children, and obligations, and, man, sometimes Mommy just needs a day (or an hour or two) off.   But babies still have to eat during that time!  And what if your baby has issues with latching at the breast, or you are inducing a supply, or you need to do some supplementing?

Luckily, being a modern mom means that we have some awesome options available to us.  There is spoon feeding, where you can hand express colostrum or milk directly into a spoon and give it to your baby.  This works best in the beginning, when your baby isn’t taking in much milk yet – it would be a fairly long process for a family feeding an older infant.  To spoon feed, you simply use a clean spoon, hold the baby in an upright position (like sitting) and put the spoon at the lower lip, giving small amounts and letting the baby go at their own pace.  A spoonful can be considered a full feeding if you are dealing with a newborn.

Cup feeding is another option.  Cups are widely available, cheap, and easy to use.  Your infant won’t take the cup from your hands and drink like a big kid, of course, but will instead lap at the milk kind of like a baby animal might.  There are special cups sold for cup feeding, but it might be easier and cheaper to just use a shot glass.  With cup feeding, like spoon feeding, you’ll hold the baby supported and upright.  You’ll put the cup to the lips and tilt slightly so that the baby can easily lap at the milk (not so it’s pouring into his or her mouth.)  Allow the baby to eat at his or her own pace.  It may take a while, but that is ok!  Babies shouldn’t be gulping down their feeds – when they do, they often overeat, which can hurt their tummies and set a bad precedence of wanting more than they need.

You can also use what’s called a supplemental nursing system, or SNS.  SNSs are generally a bottle type thing hooked to a long tube.  You put the milk in the bottle part, and then you can do one of two things with the tube.  First, you can use it on the breast, either by sticking it in a nipple shield (which you should only use if followed by a lactation consultant for sizing and to negate any potential complications that might arise) or by taping the end near the nipple so that the baby gets an extra boost of liquid while nursing.  This can be really helpful if you’re relactating or increasing a milk supply, if your baby needs to be supplemented but is nursing well, or if you have a preemie or baby with suck issues that maybe doesn’t milk the breast as effectively as they should be.  You can also use a SNS to finger feed your baby.  With that, you attach the tube to your finger, and the baby sucks the finger to get the milk.  A lactation consultant can even help you use this method to train or retrain your baby to suck properly.  SNS systems can be hard to clean, so please carefully read the instructions and check with a health care provider for any extra precautions you should take if you have a preemie or immune compromised baby.

If you have an older baby (4 months or so) that’s just now getting around to taking milk in another way, you can try forgoing bottles altogether and working on cup training or using sippy cups.  Sometimes the difference is interesting enough for an older baby who has rejected bottles.  As with any of the other methods, the goal is to allow your baby to learn and go at their own pace.  Be prepared for this to be a messier endeavor with an older baby who is starting to show some independence.  You will probably have to help them to hold and tilt the cup – they may not be content with the idea of you holding it all yourself, and you may have some spills in the process.

But what if none of these methods work for you?  Maybe your care provider is balking, or you are annoyed and uncomfortable with one or all of the methods, and you really, really just want to use a bottle.  In that case, instead of purchasing the reportedly $15 a piece Calma, I would try Fleur at Nurtured Child’s method of baby-led bottlefeeding.  In fact, any time you are bottlefeeding, you should use this method.  It is the ideal way to feed a baby from a bottle and encourage any care-takers that will be feeding your baby with a bottle to utilize this method as well.  In choosing a bottle, there is no really good evidence that I have seen showing that a certain bottle or nipple is better than another for breastfeeding.  There are a lot of nipples that are supposed to be similar to your breast in look and feel, but in my time in the bottle aisle, I never saw any that made me go, “That looks EXACTLY like my boob.  That one, right there, with the wide base and medium sized nipple!!”  My kids never really liked the wide bottomed nipples, although they are often touted as being awesome for breastfeeding babies.  When it all boils down to it, most of that is hype.  When selecting a bottle, select the one you think might work that is in your budget.

If you are giving milk due to a breastfeeding problem, be sure to discuss methods and supplements with a medical professional with good lactation training.  Ask a lot of questions.  If supplements are ordered, get a LOT of information on them.  Why do you need to supplement?  How long does your medical professional want you to supplement?  How much should you supplement?  How often should you supplement?  Can you use your own expressed breast milk?  What is the plan of action for weaning from supplementing?  If your baby isn’t nursing well at the breast, you will likely need to do some pumping along with the supplementing to keep your supply healthy while you work through the problem.  Find out how often you need to pump and how you should store your breastmilk – especially if your baby is hospitalized and you are transporting it.

There are other feeding options for more serious problems, such as cleft lip/palate as well. That type of situation needs to be followed very closely by a lactation professional and physician to ensure that the baby’s unique situation is being addressed.

If you are going to be separated from your baby for another reason – work, school, or just going out – remember to think of your magic number.  This is the number of times your baby breastfeeds in a normal day (and, yes, that can vary.  Just take an average.)  You want to be sure that you are replicating that amount of times by a combination of pumping and nursing.  This will help to keep your milk supply plentiful.

In the end, there is no product on the market that can magically be just like your breast and provide your baby the exact same experience.  Luckily, there are many options for your baby and your family that will help you to achieve your breastfeeding goals.

 

 
 Star Rodriguiz, IBCLC, is a breastfeeding peer counselor for a WIC in the Midwest and has just started her private practice as an IBCLC (her Facebook page is here, go “like” for great support).  She also sits on the  breastfeeding task force in her town, is helping her  community’s Early Head Start redefine  their breastfeeding support, and is the  driving force behind a local breastfeeding campaign.  In  the remainder of her free  time, she chases around her nursling and preschooler.
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Dear Nurse Julie- a letter to my labor and delivery nurse

Dear Nurse Julie,

You were in my life for about two and a half days 13 years ago, I’d never met you before nor have I seen you since.  It may have been brief but you made a huge difference in my life and I owe you a deep debt of gratitude.

I had prepared so much for the birth, read everything I could get my hands on including an OB text book, took a childbirth education class, and practiced Bradley method relaxation for weeks at home with The Piano Man.  We knew what we wanted for our birth and after a complicated pregnancy, we were prepared to fight for it.  When I went into labor at 41 weeks and 4 days we were ready.  The Piano Man was an amazing advocate for me, actively intercepting anyone that entered the room and questioning every procedure (no enema!) while helping me relax and focus on the work of birthing our daughter.  Together, he and I made a great labor and birthing team.  I’m pleased to say that 5 babies later and one on the way, we still do.

Our bags were packed, there was film in the camera (remember that?  Cameras that used film?), we were so ready to have a baby.  Except for one thing: we had done nothing to prepare for breastfeeding.  The thought hadn’t even occurred to us.  We knew that was how we were going to feed out baby once we had her in our arms but we read nothing, took no classes, and never even thought to see if there was anything we needed to know before breastfeeding.  Both of our mothers had breastfed, we knew a few friends that had so really, how hard could it be?

All our nurses were nice enough and the birth was mostly amazing with some traumatic experiences.  Earth Baby was born at 6.39am and we met you shortly after with the shift change.  Instantly I felt connected to you, your smile, your warmth, and your genuine congratulations on our baby as if you hadn’t seen hundreds of births and newborns every week.  After I was all stitched up, hydrated, and my blood loss dealt with you asked me an incredibly important question: “are you ready to breastfeed your baby?”

Nobody had mentioned it.  I knew it was in my chart because something I had read about birth plans suggested to ask for it to be put in my chart.  Still, you were the first to say anything about it.  Having just lost a lot of blood with a partially retained placenta and manual D&C, I was feeling weak and more tired than I had ever felt in my life.  Holding my baby, let alone breastfeeding her, completely wore me out.  Like a dear in headlights I told you yes, but only because I remembered that it was the plan.  Your response: “good, because she’s hungry and I think she’s ready to eat well for you” jarred me out of feeling my exhaustion and into the reality that my baby needed me to meet her needs.  I really was ready to feed my baby.

I don’t remember how long you stayed in my room but somehow, you made me feel like I was the only mom that needed your attention.  Perched on the side of my bed, you helped me get into a position I found comfortable, plumped plenty of pillows to support Earth Baby and I, encouraged me to drop the shoulder of the hospital gown, and talked me through latching Earth Baby for the first time.  Your encouragement for how well we were doing, what a healthy strong latch Earth Baby had, and suggestions for positions made me feel like not only could I breastfeed my baby, I already was and doing great!  You answered every one of my questions, no matter how basic or obvious the answer may have been, as though it was a pleasure to answer my important concerns with patience and care.  Even when Earth Baby was latched and I was comfortable, you stayed and chatted, telling me about your 2 boys, that you had breastfed your second one but not the first, and telling me about how you were drawn to OB nursing and how you loved helping moms.

It showed.

Once I was moved to the postpartum wing, you continued to visit me.  You’re ongoing support regarding everything I was experiencing from peeing for the first time after giving birth to changing my baby’s diaper to breastfeeding helped grow my confidence that I could, in fact, take this baby home and not kill either of us.  When I told you my nipples were hurting you showed me how to position my baby’s chin lower on my breast so she took a big mouthful of nipple.  When I was still drained from the birth, you explained different positions and helped me practice using them.  Constantly considerate, you never touched me without asking and receiving my permission first and even then you rarely handled my breast choosing instead to carefully and patiently explain how I could do it myself.  I can’t even begin to tell you how far that went in helping me not be afraid or feel strange about my own body.  From the bottom of my heart I thank you for that gift, it has remained with me to today, growing stronger over the years.

When the grumpy nurse, who’s name I can’t recall because for the last 13 years I’ve referred to her as “grumpy nurse,” told me I was starving my baby because my breasts were empty and not meeting my baby’s needs, I cried.  A lot.  Earth Baby had lost over a pound in just a matter of 2 days and the grumpy nursery nurse that made me cry told me I’d never be sent home with my baby if I didn’t agree to give her formula.  Oh the things I know now!  All those fluids we had in labor… but back then I had now idea.  I caved.  Still weak from the blood loss, recovering from a 4th degree tear, and afraid my baby was hurting I agreed to a bottle of formula.  My heart ached, I never meant to starve my baby and my fears were confirmed, I was already failing as a mother.  She whisked my baby away, a satisfied smile on her face as she told me I was making a good choice for the good of my baby, and ran off with my daughter to feed her the bottle of formula.  I sobbed.  You came in shortly after and was surprised Earth Baby wasn’t with me.  When I told you why I saw the storm clouds gather in your normally incredibly friendly eyes and you told me you’d be back.  What I didn’t know is that you must have marched out to that nurses station, called our pediatrician, asked him about the situation, advocated for our breastfeeding relationship, asked him to call the nursery, and headed down there to get my baby back for me.  When you walked in about 15 minutes later with grumpy nursery nurse and my daughter, I had already spoken with our pediatrician who called me to assure me our baby was going to be fine breastfeeding and at this point did not need any formula.  He told me that he had spoken with you and trusted you that Earth Baby and I were doing great breastfeeding, that my milk was coming in, and that I was already a pro.  I cried again.  Someone believed in me.

Somewhere I still have the picture of you and I and Earth Baby just before we were discharged.  My face is red from crying having just gotten Earth Baby back.  You had told me that we were going to be fine, that I was a natural, that Earth Baby was lucky to have me as her mom, and that you enjoyed working with me.  That’s what you told me.  Some many had dismissed me as a young mom and at 20 I was, but you stuck with me respectfully teaching me as though my age was of no consequence.  What you taught me without directly saying so was that I could feed my baby, my body was amazing, I didn’t need to be afraid of my breasts, and I could advocate for myself and my baby.  My husband believed in me but I knew he was just as clueless as I was.  But you?  You were not only an experienced mother, you were a nurse that saw mother after mother with new babies and you believed in me.  If you said I could do it, I probably really could.

Today, 13 years later, I owe a lot to you.  For starters, my breastfeeding relationship with Earth Baby which lasted a year and then extending on to 4 (now almost 5!) babies.  Thanks to you, today I now help support other mothers with their birthing and breastfeeding journeys.  Thank you for supporting me even when I wasn’t sure how to support myself.  Thank you for giving me the courage to be the kind of mother I naturally was but was insecure about stepping into.  Thank you for being kind and encouraging when I was most vulnerable.  Thank you for making a difference in my life and the lives of my children.  You have touched more than you know.  I want to be like you and just love helping moms.

I hope it shows.

 

Sincerely,

 

Jessica Martin-Weber

The Leaky Boob

 

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