When Breastfeeding Doesn’t Work

Friend (and neighbor!) of Feeding the Baby, Wendy Atterberry, wrote this brave and lovely piece for her own site:

I feed my baby formula. Exclusively. Here in Brooklyn that’s one of the biggest parenting offenses you can commit. It’s right up there with circumcision and “crying it out” in terms of emotionally scarring your child for life. I didn’t plan to feed my baby formula. Or, I should say that wasn’t my preference. But ever since I had breast reduction surgery when I was 19, I knew that it was unlikely I’d be able to exclusively breastfeed any babies I had. My surgeon told me it was a “wait and see” thing and that I wouldn’t know whether I’d be able to breastfeed until I had a baby and tried to.

When Jackson was born, I didn’t try to breastfeed him right away. The first 12 hours were just so crazy that I can’t remember why I didn’t try. Did I not know I should? Did no one suggest it to me? Was I too tired? Was I scared that I couldn’t do it? I can’t remember. But I do remember about 12 hours or so after he was born visiting him in the NICU, where he was being treated for jaundice and low blood sugar, and attempting to breastfeed for the first time then. Jackson, Drew and I sat in this small private room just off the NICU and with a pillow on my lap to prop up the baby, I tried to feed him. He was so little, though — only 5 pounds — and his mouth so tiny, that we weren’t able to get a good latch. Consequently, that was the first time I failed at breastfeeding.

The nurses encouraged me to pump to increase milk production and to make some bottles we could feed Jackson. But I didn’t pump. Not really. I tried half-heartedly a couple of times after a nurse showed me how to use the electric pump and stood there waiting for me to give it a go, but I gave up after a few minutes. I’m not sure why I didn’t give it more effort. In retrospect I suspect I was afraid to discover my breasts were empty.

It was only when I left the hospital and in the privacy of my own home, I finally pumped for the first time for real (we rented an electric pump from the hospital). And just as I feared, nothing came out. Well, I shouldn’t say nothing — a very little amount of milk came out. We hired a postpartum doula who came to our apartment and gave us some baby care support and instruction. She asked me if I’d tried to breastfeed yet and I told her I had and that it wasn’t going well. She asked me to show her how I was doing it. She told me I had flat nipples (news to me) and that with that, on top of my low supply and the size of Jackson’s mouth, it was unlikely that I’d find breastfeeding easy.

was able to breastfeed a little bit over the next couple of months, difficult as it was. There were maybe a couple dozen times that Jackson latched on and I was able to feed him the way that nature intended. Those few times never satiated him for long, but we did it. I could say it was profound, the feeling of nourishing my child with my own body, but I was too tired and too frustrated and too anxious to feel relieved. Besides, it wasn’t like my body alone was enough to feed my child. If anything, I was a tease.Here’s a little milk for you, baby, but ha ha, not enough to fill you up! Eventually, Jackson got just as frustrated as I was and began refusing my breasts. I didn’t blame him. It’d be like someone offering me an opened Heineken bottle with only a few warm gulps of beer left. Cruel, almost.

I continued pumping about six times a day — getting only the tiniest amount of breast milk. I’d zip this sports bra looking contraption around my torso and then insert two plastic breast shields into the openings in front and hook myself up to the electric pump and wait 20 or 30 minutes while I was milked. I dreaded the end of a pumping session as much as I counted the seconds until its arrival because it was at the end that my inadequacy was always reaffirmed: I usually got only half an ounce … sometimes a full ounce (and on rarer occasions, maybe two whole ounces if I was really lucky). A newborn baby drinks an average of 24 ounces of milk each day and here I was producing only a small fraction of that, despite guzzling water and “Mother’s Milk” tea by the gallon. I was inadequate. An inadequate mother.

It’s an unbelievably lonely feeling to not be able to breastfeed your baby if you wish you could. Especially here in Brooklyn where you are not only seen as an inadequate woman, you’re seen as a bad mother if you succumb to feeding your baby formula. There’s another woman in my neighborhood whose blog I just started reading who also has trouble breastfeeding her new baby. She writes: “Imagine my surprise when feeding my son a bottle (as I must) in public is for me an act shot through with the sort of shame we are told women in the 1950s were made to feel when they attempted to breastfeed in public.” I wish she and I would have met sooner. Maybe I wouldn’t have felt so lonely. Maybe I wouldn’t have felt like such a failure.

I know I could have tried harder. There were things I didn’t do that I could have. Like, I could have hired a lactation consultant or nursed with a special tube taped to my breast that fed the baby formula while simultaneously stimulating my own milk production. But I didn’t want to do all that. I knew that because of damaged milk ducts I was physically unable to produce much milk and I didn’t want to pay someone to make me feel bad about that. I was doing a good enough job on my own already. There was a limit to what I could withstand emotionally and physically and after a complicated pregnancy and a dramatic labor, the only way I could temper my feelings of inadequacy around feeding Jackson was to stick to a routine. And so I pumped six times a day and fed Jack mostly formula with a bottle of my (hard-earned) breast milk occasionally thrown into the mix.

Just before Christmas, I’d decided I’d had enough with pumping. I was exhausted. And as Jackson’s appetite increased, the amount of breast milk I was able to feed him became a smaller and smaller percentage of his daily diet. The benefit stopped feeling worth the sacrifice and so I quit. It’s been about a month since then and motherhood has gotten so much easier. I don’t hate myself six times a day anymore, for one thing. And slowly, the shame of being inadequate has made way for a much kinder emotion: relief.

I’m relieved that I have the time and emotional reserve to enjoy my baby in a way I couldn’t before. I’m relieved that I can leave my baby’s side for more than an hour. I’m relieved that I never have to worry about suffering the consequences of engorged breasts. I’m relieved that after nearly a year of growing and feeding a baby, my body is mine again. Mine, mine, mine. I can eat whatever I want. I can drink a Gin and Tonic without fretting. I can guzzle a gallon of coffee! I’m relieved that because my baby is exclusively formula-fed, my husband and I can share the duty of feeding him. That means that while my breastfeeding friends are up three times a night feeding their babies, I sleep and let Drew give Jackson a bottle.

But what I’m most relieved about is that the love between my baby and me has not been compromised by the way I feed him. The bond we share is, I imagine, just as strong as the bonds breastfeeding women share with their babies. He still eats in my arms, close to my chest. He still feels the warmth of my body against his, hears the beating of my heart. We still look into each other’s eyes and grin like lovesick goofballs.

This morning, I peeked into his bedroom to see if he was awake yet. Just as I stepped inside, he turned his head toward me, opened his eyes and, focusing his gaze on me, lit up and smiled his big gummy smile. I scooped him up, kissed his head, changed his diaper, and warmed a bottle. Then we settled onto the couch, he cradled in the crook of my arm. “You are my sunshine,” I sang, pulling him closer.

And I fed my baby. Like a mother does.

Melissa writes:

When I became 29 I felt the first true yearnings for a baby. A friend announced her pregnancy and I cried my first of many tears of this sort. I knew then that I needed to face the ugly truth that I had known for some time but was too afraid to contemplate. I was infertile. I decided to “attract” a baby into my life by visualizing what it would feel and look like, as if I had already given birth. I spent hours in the bathtub, clutching this ghost child to my chest until it was almost real. If I imagined hard enough, I could feel her gentle suckle - see just her eyes beyond the curve of my breast. 

Four months of acupuncture and I was pregnant. It felt too easy. Twenty more weeks passed, but it was not meant to be. More hours in bathtub, this time consumed by grief. Tight bras and herbs were prescribed to make my milk go away - the last vestige of this particular dream. It was a girl. 

Two years to the day later, I finally gave birth to a real live baby, a beautiful boy. As the first days came and went with no latching, a tightness gripped my throat and chest. It was terror. I was assured that with practice he would get the hang of it, but all he did was scream in a blood curdling way. Was I hurting him? I had come so far, up and over the maze of infertility and catastrophic loss and yet I felt so dissatisfied. I thought that getting a baby into the world would heal my broken heart, but breastfeeding was just too intrinsically tied to my dream of motherhood for that to happen. Was I being selfish to want it all? Beggars can’t be choosers, right? Had I not paid dearly enough (with my first born)? Or at least this is how it felt in those hazy, postpartum days. 

I did not know what women did in these situations. From what I could gather it either finally worked or you just gave up and moved on. I had already tried everything you’ve ever heard of and it was not working, but I could not give up either. I did not even know what to Google. It turns out that the term I was looking for was Exclusive Pumping, and after finally finding some support online, I set out to at least make THIS work. With my rented hospital grade pump I started pumping my milk in the typical intervals that a baby would nurse (every 2-3 hours) and then feeding it to my son, around the clock. It was a messy, time consuming, and complicated business with no end in sight. While just barely doable with a sleepy and docile infant, when I would project the scenario months into the future I felt rising panic. And the isolation that came from having to be close to home and my huge pump was socially devastating. Most of my friends that remain after my time as an exclusive pumper are internet based. When my baby was around three months old, he started having blood in his stool. I examined my diet, trying to find the food culprit, but could not isolate the allergen. I went on a Total Elimination Diet where I only ate turkey, potatoes, rice, zucchini, and pears for months while slowly adding back foods, one by one until I found what was irritating his gut. In doing so, I lost way too much weight and came close to total exhaustion. I felt on the cusp of my breaking point at all times. However, with the help and support of my husband and parents, who also believed in this crazy scheme, I was able to make it through almost 13 months of Exclusive Pumping. I also ended up having many months of frozen milk to feed my son after I “hung up the horns”, as EP’ers playfully call weaning. In summary, I did it, it sucked, I resented it, but I would do it again if forced to.

After the fact, we discovered a few reasons why my son could not nurse. At 3-4 months, his doctor discovered that he had Torticollis, or basically a stiff neck that prevented him from turning his head. It only took a few physical therapy sessions to get straightened out, but everyone agreed that it had contributed to his intense screaming when manipulating his head and body to position for breastfeeding in the days and weeks after birth. As it turns out, I WAS hurting him. He also has remained extremely orally defensive and sensitive to this day. He had a hard time learning how to eat solids and has had the world’s slowest and most painful teething that any doctor or dentist has ever seen or heard about. He is also speech delayed because of his oral motor issues. Basically his mouth, while completely normal looking, is immature and the muscles are uncoordinated - all necessary for successful breastfeeding. It should be known, especially by insane breastfeeding nazis, that sometimes it is impossible to actually nurse a baby, even when you try all known options. Shit happens. 

Three months ago I gave birth to another beautiful baby boy. I was on edge most of my pregnancy, scared about having breastfeeding problems again, and what that might indicate about his future oral development. Just like in my pregnancy with my first son, I read and researched many breast-feeding resources. I had two lactation consultants on call. I felt prepared, but I had felt prepared last time too. After delivery, while the doctor was still down below, wrapping up things, my very caring L&D nurse helped me put him to my breast and voila, he latched and nursed happily for quite a while. Despite being exhausted and spent from birthing a huge 9+ pound baby, all I felt was sweet relief about him being able to latch. Since that day I have suffered with my share of typical breastfeeding woes, but we’ve also fallen into a pretty great little breastfeeding relationship. In general, breastfeeding this time has been strangely healing to my past traumas in ways I could not have imagined. The chip on my shoulder feels a little smaller as the months have passed. I can finally get off the reproductive treadmill and call my family complete. 

To answer the question: How did I feed my baby(ies)? With my first, in my mind only. My second, mechanically and by pure desperation. And my third, with enough ease to finally satisfy by soul.

Dani writes:

She is almost ten months. And she is the most amazing, beautiful, perfect thing that ever happened to me. She’s old enough to ask for the breast now: she smiles and leans over me, tugs at my arm, touches my chest, wrinkles her nose playfully. When I lift my shirt and take down my bra, she lets out a little laugh, happy and trusting. I feed her as she fiddles with my hand, collarbone, necklace, sweater, locks of hair. The touch of her hand is light and satiny, then strong as she grips my fingers. Sometimes she laughs with the breast in her mouth, then looks up at me with amused eyes. Other times she is completely focused on nursing, serious eyes mired on my skin, batting her long eyelashes slowly. The eyes get smaller and smaller and become a thin slit as she falls asleep. She continues to nurse and then to suckle for comfort. If I try to unlatch her too early she opens a very wide mouth with eyes still closed. I put her back to the breast, I can never wait long enough to see what would happen if I didn’t…

There is a photo of her when she was three days old, still in the hospital, nursing. She was already grabbing my finger with her tight, surprisingly strong little hand. She was born thin, her hands were bony, her limbs were slim, I could see her ribs. I was blessed with oodles of milk and she fattened up in no time, became chubby. The hands holding my fingers are now pillowy and she has big cheeks.

I never felt the omnipotence that some women describe about breastfeeding their babies. Having abundant milk and feeding my baby successfully were simply a magnificent stroke of luck for which I am infinitely grateful, but which I don’t feel like boasting about—not even to myself. Breastfeeding is, like my little girl, a wonderful and beautiful thing that happened to me, and that I treasure with gratitude and modesty.

[Of course, it takes work. Her mouth was tiny, and even with an OK latch, my nipples cracked and bled. When the scabs healed, the skin was sore for two months. I had oversupply for the first seven months, and countless plugged ducts. One was so bad, it overtook a quarter of my breast, a painful, rocky wedge that felt like it would rip my skin open at every let-down. She has food sensitivities through my milk, and I’ve had to cut off all dairy, soy, nuts and gluten from my diet since before she was 2 months old. Etc. etc. etc.]

When I nurse her, the rest of the world recedes. Worries that loomed so important now seem small. I forget everything, and we both relax into a moment of mutual surrender, contentment, and intimacy. It is the most wonderful feeling I’ve ever experienced, and even if I do it several times a day, everyday, it never gets old.

Giving Her What She Needs

Naomi writes:

“I told Daddy to shave his chest and grow breasts that could give me delicious milk like yours,” my daughter informed me when I returned home from a conference.

M. is currently three-and-a-half and we are in the midst of a long, slow weaning.  Though I sometimes despair she is a nursaholic, I see the irony of my frustration.  When M. was born, my milk never came in.  Like many of the women who have shared their stories, I watched her “nurse” for five days, sucking at nothing with what many consultants pronounced a “beautiful latch.” Jaundiced and dehydrated, Mira ended up in the PICU and we found ourselves in the middle of a nightmare.

I remember crying when the nurse fed her formula, because the lactation consultant had referred to it as “poison.”  I pumped while we watched her in the light box receiving treatment to remove the bilirubin from her jaundiced body, and my milk formed a film at the bottom of two vials.  I can’t describe the shame and insufficiency that flooded me when the nurse said, “that’s ALL you got - ?!?”  How could my body not provide her with this “natural” nourishment?  The thought that I had watched her slowly wither away, believing I was nurturing her, still terrifies me.

We returned home and launched rounds of pumping and nursing and charting and SNSing to try to establish a flow.  It took M. 45 minutes to feed. I pumped for 25 minutes after that, while my partner syringe-fed her an earlier pump plus inches of pasteurized milk from a milk bank.  Then we had a 15-20 minute window before we began the cycle again.  We did this for four weeks, around the clock, except for one two-hour stretch at night.  We were like bots.

I prayed that my pump would match the amount of milk M took from Dave.  If I could pump more than she drank from the jars, we could stop our insane routine.  I found myself begging Dave to give her only a little so that my supply might catch up.  Caretaking my breasts was replacing caring for her.  The milk others had seemed magical – an easy flow that responded to their babies’ needs.  I fantasized that one day I could hold my baby to my breast and trust that my body was giving her what she needed.  Then, I would be the mother she deserved.  In my haze, nursing had become mothering.

Finally, our doctor shared I could take Reglan.  Why didn’t she mention this sooner - ? We watched my vials of pumped milk get larger by the hour.  After five days, we stopped visiting the milk bank – which never charged us for the milk M drank. 

I stayed on Reglan for 18 months and let M. nurse whenever she wanted.  At the supermarket…?  She must be hungry – nutrition was the most important thing, right?  Fussy in the middle of the night - ?  I thought of her in the lightbox and pulled open my nightgown. Once I literally ripped my dress open to feed her, terrified the 15-minute car-ride home would throw off my supply.

Proponents say nursing is “free” but I am grateful to Sarah Blackwood and others for pointing out that women’s time is not free.  The book I have been writing and my social life and sleep and sometimes my sanity came second to feeding my daughter, on the dot, for two years.  That was my choice – my privilege, really.  When, after her second birthday, I ventured out without her for more than three hours at a time, I felt light.  Also: I could wear dresses again!

M discusses nursing a lot.  The second time I tried to read her Maggie’s Weaning, La Leche League’s children’s book, she threw it across the room.  “No!!  That is NOT a good book!”  On a sick day, she informed my right breast that it had a fever and shouldn’t touch the left one.  “Don’t share your germs, breast,” she remonstrated gently.  She used to “pretend nurse” from Dave and then nurse for real from me.  Then she’d pretend one breast was mommy and the other was her dad: she’d pretend nurse from the dad-breast and then nurse for real from “mom.” 

About three months ago, a flight attendant shouted at me for breastfeeding on the plane. Suddenly, I became the center of attention.  I wanted to sink into the floor when a man weighed in that the flight attendant was “well within her right” and that if I didn’t want to adhere to Delta’s rules, I could always “drive and not fly.”  He knew how to calm a child without needing to resort to breastfeeding, he explained – implying that her cries spoke volumes about my deficient parenting.

The pendulum had swung the other way.  Nursing wasn’t mothering any more – now, it apparently meant I was a failed mother.  I remain furious at him – since when were those who don’t nurse entitled to make rules about feeding children?  (Since always, maybe…)  But my encounter shocked me into recognizing I was no longer really feeding my baby.  And that I could give her what she needed without using my breasts.  I wish I’d known that all along. 

Sarah B. writes:

This is what we do, now that Ames is four months old: When Ames naps, I hook up to the breast pump for thirty or forty-five minutes while I sit at the computer and write, email, muck around. Ames wakes up and I feed him the milk I’ve recently pumped in a bottle. When there isn’t enough breast milk to make a bottle, he gets formula. When he wakes in the middle of the night, Ed feeds him a bottle while I prop myself up in bed and pump. We are all up in the middle of the night every single night. The system is staggeringly inefficient, but manageable. I only make about 20 oz of the 30-35 he eats. My son consumes between 58% and 67% breast milk . Am I a breastfeeding mother? How many times has Ames actually fed from my breasts?

One thing I’ve already learned from the amazing stories being written here is that what Ames and I have lit upon is the kind of compromise between breast milk and formula that a lot of women who had difficulty breastfeeding wish they had known was an option. But it still feels so messy to me, the boundaries of it are not clean, and I never knew it would be possible for me to feel so, so much sadness over losing, or never really having had, this relationship with my son.

Like everyone who has written here, I knew that breastfeeding would be “hard.” But my understanding was laughably abstract. I had no idea of the myriad ways in which breastfeeding could be not just hard, but nearly impossible. I tell myself now that if it had “only” been physical pain— for me— that we could have muscled through. But I’m sure women who have had *that* experience think “Well, if it were only an issue of building milk supply, we would have been able to succeed.”

As I’ve mentioned before, my milk was very long in coming in (didn’t come in until Day 8), and came in weakly. I had had a c-section, postpartum hemorrhage, 3 blood transfusions, and severe anemia, all of which mess with your milk supply (and, uh, your sense of being safe from dying). The main way to boost milk supply is to remove as much milk as possible from your body to signal it to make more, but what do you do when your baby won’t get it out for you? All the (really, really wonderful) nurses at St. Luke’s Roosevelt thought Ames had a great latch in the hospital. The midwives advised me to be patient for my milk, speaking in dulcet tones so as not to alarm me. One of the nurses said that Ames and I were a model mother and nursling! As Sarah M. wrote, I, too had felt protected by a robust, but sane, family tradition of breastfeeding. My mother and my brother’s wives had breastfed eight children in total, in a wonderfully matter-of-fact manner. Ames did his job in the beginning….but my body could not do its job in return, and then we just slid together, downward into nursing hell. Ames fell asleep all the time while nursing. My letdown (when I felt it at all) seemed ill-timed. Ames’ latch got worse. When he wasn’t giving up and falling asleep, he wailed and flung his head around.

Here are the things that I tried to make breastfeeding work:

  • hired a lactation consultant.
  • breastfeeding on demand. Sometimes that meant nursing for 50 out of every 60 minutes.
  • skin-to-skin contact. (Okay this was nice to do, breastfeeding nightmare aside. Every new mother needs to take at least one nap per day with a nearly naked baby on her chest!)
  • pumping for 20 minutes after each nursing session. But what if baby wanted to nurse 10 minutes after you’ve done pumping, which leaves your breasts deflated and sad, teaching baby that nothing good comes out of them? This is a conundrum I could never answer for myself.
  • using a Supplemental Nursing System (SNS). In theory, a great solution to the nipple confusion that results from introducing bottles too early. In my experience, however, it seems Ames got very used to the volume coming out of the tube plus nipple, which led to a very specific sort of nipple confusion: he did not know what to do with a “plain” nipple in his mouth. I can’t tell you how many times I googled “Supplemental Nursing System Making Nursing Worse?” that question mark at the end indicating the edge of hysteria that was constantly in my voice.
  • herbal supplements to increase milk supply
  • breast compression while nursing, while using SNS, while pumping.
  • other things? Probably other things. A lot of crying.

Breastfeeding did not work. I am still sometimes stunned by this failure and feel, in a missing limb sort of way, that if only I had done something slightly differently, it would have clicked. Generally this fantasy takes the shape of: me and Ames, apart from everyone (and the internet) telling us to do X or Y, no tubes, no pumps, just me and Ames in a soft field of clover, or in the middle of a mile-wide fluffy white comforter, learning how to do this on our own. I suppose I’ll never know if such a fantasy could have worked; Ames was dehydrated and not gaining any weight (after having lost a lot in the hospital) for too long after his birth. I was scared, I didn’t want him to get hurt. Maybe the pediatrician could have been more supportive (she noted, in one visit, that he was a “skinny baby” and in another that some babies are “too laid back” to get the nourishment they need [n.b., Ames actually is extremely laid back, which makes for feeding hell, but also makes for a sweet, sweet child].) Maybe the universe should have worked they way I thought it did: rewards going to those who GUT IT OUT.

Somewhere—maybe around six weeks? it’s all such a blur—my breasts tended to be full in the middle of the night. Ed had instituted a policy of me going upstairs at 9 p.m., taking a shower, reading, and going to sleep early. Ed fed Ames a bottle at 11 or 12 and then went to bed in our guest room, after depositing Ames in the bassinet next to me. Ames would wake up around 2 or 3, and he and I would spend an hour or two trying to nurse and then supplementing. My boobs had rested from 9-2, about five hours, which is technically not what you are supposed to do when trying to build milk supply/establish nursing. But Ed had seen me slipping precariously close to depression and wasn’t going to let me fall for the sake of these stupid malfunctioning tits. I needed the sleep, Ed made sure I got the sleep.

So one night— this one small little night— Ames woke up and I got him propped up on the nursing pillow. And he ate. He ate from my right breast for probably twenty minutes. He just kept going and I barely moved for fear of messing it up. And when he was done, his head lolled back and there was some milk in his mouth. My baby, satisfied from my body.

He never really did that again. I suppose I’ll always “have” that one time with him, but it isn’t enough and even though we are on our way, now, both of us more buoyant and in the world, I still feel so very foot-stompingly, frustratingly sad that I didn’t get more than what I got. But that is on me. It comes from me and is directed at me, me hurting me over me not getting what I wanted.

So I guess one way you could look at it is that it doesn’t actually have anything to do with the baby.

Grief and Solidarity

D.L. Mayfield writes:

We were two kids with a baby, a baby who came way too early. Sick with fever, shivering in the makeshift NICU (our hospital wasn’t equipped with one), I actually wondered what all the other older and wealthier and more prepared mothers must have thought of me.

Sigh. The things we waste our lives wondering about.

The feeding thing was the only element I felt like I had control over: I couldn’t control my blood pressure, liver, or platlete count; I couldn’t control my baby’s heart rate or oxygen counts or her ability to swallow. But man, I could pump that stuff out. 

And for 3 weeks, it was all about me and the pump. No other life for me. I focused on getting well, on my baby getting well, and on pumping.

After 3 weeks we slid into the nightmare territory of mastitis, and I woke up bone dry. Long story short: no amount of herbs and massage can make up for a body that has had enough, already.

It pains me to say that I needed a professional lactation consultant to spell it out for me: “honey, this doesn’t happen very often … but you are done. Just … done”. 

I grieved it, like any great dream lost. And the grief still appears, randomly, when I think we’ve forgotten all about it.

The weirdest part was the guilt; and in that way of grief and magical thinking I couldn’t stop wondering about all the other mothers in majority world nations: they couldn’t afford/didn’t have access to formula, so how could i give it to my daughter? It made me despondent, this lack of solidarity. Never mind that the very circumstances of our story (HELLP syndrome, a 32 weeker) would have meant certain death for both me and my baby in any similar situation. Grief is not very rational.

But it does abate, after a certain amount of time. We are all growing up over here, and learning to live in the grace and glory that was given to us.  

Jamie writes:

I gave birth to my son 9 weeks early, after a hideous, foreshortened pregnancy that included bleeding gushes, trips to the ER, and bedrest.  When I delivered him, I did so with the calm I only have during a crisis:  before, I was inconsolably anxious about carrying him to term, and after, I worried constantly about his health and prematurity.   When I gave birth – with an epidural, after only 15 minutes of pushing – he was whisked away from me, assessed and immediately taken up to the NICU (the neonatal intensive care unit).  My husband ran after him.  I stayed in the room alone and made awkward conversation with the sweet medical student who was supposed to explain breastfeeding and postpartum care to me.

I was then put in a recovery room, where a lactation consultant brightly chirped about the importance of breastfeeding and then handed me a stack of reading material and an enormous breastpump.  I had never seen one and didn’t know how to use it; my sister showed me how to put it together. I carefully cleaned all the parts and tried to pump.  It hurt, and I got nothing out.  I dutifully tracked this “progress” in a notebook, as my reading materials told me to.  I did this every hour and a half, writing, “7:30 pm; pumped 20 minutes; nothing” over and over.  A couple of times, I triumphantly wrote, “9:30 am, pumped 20 minutes, ONE DROP!”  In between incessant pumping sessions, I would go visit my son one floor up, who was in an incubator, with an oxygen mask covering his whole face, an IV in his tiny vein in his foot, and wires attached to his chest and abdomen.  Then I would go back to my room and pump again.  Once that first night, a mother came into the NICU and triumphantly held up her 5-oz. bottle of milk, crowing, “I guess my body just WANTS to feed my baby!”  And I burst into tears, because not only did my body not want to feed my baby, it didn’t even want to keep him safe in my uterus.

My son was born at 4 pounds and spent 32 days in the NICU.  I spent every day there, usually for about 4-5 hours a day.  I would pump at the NICU, in the open – you could pull a makeshift room divider around your chair to simulate privacy, but I uncaringly exposed myself to anyone in the room.  When my son came out of the incubator, I would hold him while I pumped and he received my breastmilk through a tube down his nose, so he would associate me with food.  A few weeks later, when he could try nursing, I would situate myself with a nursing pillow, carefully undo his wires, and try to help him eat.  To prepare to do so would take about 20 minutes; on a good day, he would latch for about 20 seconds, and then we’d give him the rest of the milk through his tube.  A week or two after that, he could nurse sometimes, and we would have to weigh him before and after to make sure he was consuming food.  Sometimes he did, and sometimes he didn’t.  I started using a nipple shield to help his tiny, preemie mouth; the chirpy lactation consultant warned me that he might have nipple confusion and that I should really try not to use the shield.  I remember looking at her and saying, “Nipple confusion is the Cadillac of worries here.  I just want him to eat.”

When he came home, I continued to nurse with the shield and I pumped all day.  Then I lost the shield, so we did without.   He fattened up beautifully, and I’m still nursing.  But even now, some days are a struggle.  For a while, we didn’t know how much he was eating, and every time someone told me to trust my body or my baby — because it makes/he takes what it/he needs! – I wanted to punch them in the face.  Nature and my body had already failed this baby.  Or when people chirp, “Breast is best!” I try not to let my head explode.  Breastmilk, I now know, doesn’t convey vitamin D, which my little preemie needs to help his skeleton harden.  It also is a crappy conveyer of iron, which develops in fetuses during the third trimester, which my son missed out on.  Formula supplementation isn’t just a convenience for us, it’s a nutritional necessity.  I wish there were more disinterested nutritional information like this, rather than inflated and judgmental claims about the miracle of breastmilk or the tragedy of formula. 

He’s now 7 ½ months old, and I still nurse, pump, and give him formula, plus some disgusting pureed food that he inexplicably seems to like.  Post-NICU, I have had to deal with low supply, over-engorgement, too-fast flow, a minor dairy allergy, and enormous amounts of self-doubt, anxiety, and shame.  I’m embarrassed to admit that when I did have too much milk, I felt a small, smug sense of victory, like I was getting this mothering thing right.   And when it looked like I had low supply, I felt like a failure and that my son would get sick immediately.  I still talk about nursing constantly, in terms of when to wean my son.  (Responses to that have ranged from disgusted shock that I don’t plan to nurse until he’s 2 to disgusted shock that I’m still nursing at 7 ½ months.)  I’m grateful for this forum and for everyone’s stories.  I hope my story is helpful, too, particularly to those of us with preemies.

Lisa writes:

I’m a Type A-minus — big into to-do lists, calendars, project management and deliverables. Therefore, I am prone to a lot of planning ahead and I have often weathered storms of disproportionate disappointment when something I planned for did not go exactly as anticipated.

Then something great happened: I dealt with a few years of infertility. This was a gift because I learned how to live with things that were out of my control. I learned how to grieve for my thwarted expectations, then let them go before the grief could do lasting damage. I learned how to harness my innate anticipatory planner to roll with what was, not what I thought should be. I booked surfing lessons, a zipline tour through the northern California redwoods, a class IV whitewater rafting trip.

Naturally, that’s when I got pregnant.

Cue the Type A-minus panic. How could I bring another human being into a world I had not carefully prepared in advance?

Fortunately, somewhere in the exhausted furze of the first trimester, I had the one valuable insight of my life: A small voice said, Let go of your plans. Parent for who is in front of you, not who experts say you should be parenting.

"We’re banning the word ‘should’ from our vocabularies!" I declaimed to my spouse, then passed out in a puddle of Chubby Hubby at 7 p.m.

And that is how Type A-minus ends up sailing through pregnancy not giving a damn how she will bring her baby into the world or how she’ll feed it.

I had a scheduled C-section, and after the nurses brought me my daughter, I immediately tucked her against me for skin-to-skin contact and thought, “What the hell — let’s give this nursing thing a try.”

Here was the worst thing about nursing my daughter: The lactation consultant who came in, berated me for not knowing my daughter was improperly latched, and set off a tsunami of fears I had not known were lurking.

Here was the best thing about nursing my daughter: How it helped me connect to all sorts of people. My husband calls me “warm, but reserved,” and I have never fully shaken my adolescent fear that if people see my flaws, they’ll want nothing to do with me. But I had no choice in nursing: I was not perfect (only one breast produced milk, and my daughter never took it without a nipple shield), I could not hide it, and people seemed to like me anyway.

What’s more: people seemed to like me more. In a craze of postpartum hormones, I posted about the LC on Facebook and my friends list rallied to my defense. My mother talked about how the nurses thwarted her attempts to nurse in a naval hospital in 1972; sharing an old, secret pain created a new bond between us. My friends chivvied me through despairing two a.m. emails (“i’m never sleeping >90 min at a time again, am i?”) and pissy anecdotes about having to evict napping men from the nursing room at work. Strangers would discuss feeding their kids with me as I nursed in parks, in stores, on an airplane. My nephews took pictures with their DSes and turned to their own mom to ask, “Did you like feeding me like that? Did I like it?”

I firmly believe that how I (or, more accurately, the team of doctors) delivered my daughter had no bearing on bonding with her. And I believe the same about nursing her.

This is not because one method of having a child or feeding it is innately superior and produces serene mothers who waft about in flattering, soft-focus lighting. It’s because of that one unexpected insight: Do no go into this gig with expectations. Banish the word "should" from your vocabulary. Commit wholly to being the best of who you are in the moment you are in. That is what you and your child need. The rest is merely details.

Hester writes:

I went into breastfeeding all wrong; pregnancy, too. I’d been an athlete (or “sportive” as my Dutch college roommate called me) and thought I could control my body’s response, even in injury, to which I thought pregnancy and childbirth were equivalent. This feeling of pregnancy as malady should have been a bad sign. I should also have known that I had misjudged when pregnancy brought dislocating changes that I couldn’t stay on top of, ones that felt like alien possession, total entrapment. I’d heard a few friends say that breastfeeding was harder than they’d thought, but I felt (this is super obnoxious and hard to admit) like I had a higher pain threshold, that I was used to and better at overcoming the flesh failures (I’d had three ACL reconstructions in my knee from basketball, I live with three herniated disks in my spine). The day before my labor was induced (ten days past due, zero dilation, zero effacement) I swam 45 minutes of freestyle. I was not one of those women who wanted a “natural,” drug-free childbirth—meds have treated me pretty well, and I’ve used them liberally, head and body. But 46 hours of pitocin-driven labor, even with epidurals, were more than I could bear. I kept thinking “why am I fucking this up?” during the pushing. I thought it was a competition. When I tried to breastfeed in the hospital I wasn’t successful but I didn’t care—I was already slipping into the PPD that would occupy my next six weeks. Our baby was struggling a bit from the long, hard labor—she’d swallowed meconium and had had to be suctioned. A horrible nurse, the one awful medical provider we encountered, told us that our baby wasn’t nursing because the suction was like “oral rape.” I pumped, I tried to nurse, they gave me shields for flat/inverted nipples. I forgot they had given me the shields. I was sent home late the second afternoon and only realized at 2am that first night home that I was on the hook for feeding this baby. Hideous, sucking panic. My husband tried to feed her a bottle of formula; she wouldn’t take it. Failing again. I remembered the shield, forgot that I had a boppy to ease my wrecked back and neck, contorted myself with five pillows. My baby took a little milk through the shield. Rather than think of this as success, I remembered reading that the shield was bad to use. More airless panic. I couldn’t nurse in public with the shield and felt all the more trapped. (I used the shield for 5 weeks, after my lovely and wise friend Emily assured me that she’d done so for 6—still competitive, asshole me, had to beat that sequence.) I thought nursing was painful through the shield; what a ninny I was, after abandoning it, and succumbing to real, toe-curling pain. I struggled through. I nursed while watching episode after episode of Deadwood in the middle of the night. Every time Al Swearengen said “cocksucker” I swelled with righteousness, until I thought my baby was turning her head at the “cocksucking hooplehead” references. I stopped watching Deadwood while nursing, and sorely missed the motherfucking cocksucking hoopleheads. I had six mastitis infections in eight weeks, six episodes of 103˚ fever, cabbage leaves, ground-glass feeling while nursing. I didn’t stop nursing because I was unattractively competitive with friends who had done so successfully; and mostly, primarily—explanatory for all the above—because I hadn’t yet gone back on anti-depression/anti-anxiety meds. At week 5 of my daughter’s life I broke down sobbing in the parking lot of the PNC Bank and told my husband “I can’t nurse anymore, I need to go back on meds.” I thought that I couldn’t nurse on Lexapro; my doctor said no, you can. Sweet flooding relief to be back on Lexapro fought with darkly belated anger at the doctors for not telling me I could go back on meds immediately (or have stayed on them while pregnant). But still I nursed. It got easier. The PPD eased. When my baby was 11 weeks old we went to Paris for 6 weeks, something I would never have imagined possible if not for my husband’s quiet confidence and inexorable support. It was a revelation; I could be mobile, I could nurse standing on a streetcorner if I had to, I could nurse drinking kir. Happiness, mostly. At eight months my baby started biting me while nursing. I tried all the tactics; still she bit. I bled through clothes, I scabbed, I rotated her around, I cried from the pain while she nursed. At MLA, with my parents in an adjoining room to watch my daughter while I served on a search committee, I had fever and ague. I went to the emergency room and was diagnosed with staph infections; the emergency room doctor said of nursing “why the fuck are you still doing this?” I sobbed hugely, but with relief, being given medical authorization to stop. Twenty-four hours later my daughter started sucking down full bottles of formula, started eating the solids she’d refused before, and thrived. I thrived too. She is more splendid every day.

I wish that not nursing had been an option for me. I wish that I knew that I could combine formula feeding and breast. I wish I had not spent the first 6 weeks of my daughter’s life fantasizing about driving to the next street over and sleeping in the car, thinking they’d never look for me just one block away. I wish that feeling that nursing was more important that my mental health had not kept me from returning immediately to the SSRIs I need (or at the very least, I wish I’d been better informed about nursing on SSRIs). I wish this forum had existed then.

Adrienne O’Keefe writes:

I am a researcher at heart and a good student.  I follow directions very well. When it came to breastfeeding, I took a class, educated myself and read literature- I was all set! I thought these things, plus my certainty that nursing was the best choice for me and my child, would be enough.  I knew people said it was hard but I’ve never shied away from hard work. What I didn’t know was there were medical complications from my birth experience which effected my body’s ability to start nursing off right.  I didn’t know that every nurse who came into my room during a breastfeeding session would give me differing, contradictory, well-meaning but often uneducated advice. In my effort to be a good student, I was all over the place.  My first nursing session started with a nipple shield given to me by my nurse. I was still using it a week later (with my milk trickling in) when a lactation consultant informed me shields should be used less than 24 hours, due to its interference with stimulating milk production. This was only one piece of my low-milk supply puzzle.  I found an article which listed contributing factors and I met 11 out of 15.

I then became a researcher about low-milk supply and how to correct it. The first two weeks I nursed for 20-40 minutes each breast, pumped for another 20 while my husband gave our son a bottle, washed the pump equipment, went to the bathroom, drank some water and started the routine again.  I kept waiting for a magic moment when it would all be over, when I could get off the treadmill.  I just knew I could ”overcome” this problem through hard work and determination. The problem or PROBLEMS with this way of thinking are numerous.  In her post, "Breastfeeding is Not Free", Sarah Blackwood explained some of these problems far more eloquently than I can but in short, my sanity, my health, my marriage, my bonding with my precious, beautiful son were overshadowed with my hormonal obsession to “fix” myself.  I was wrong, my body was failing my son and I was “less than”. And if there was a carrot that dangled the promise of ending the milk race, I chased it- no matter how crazy or costly to my sanity or health.

I recognize, this might not be the message everyone, or even most people, would take from this scenario.  I met a few who managed to find balance between nursing/supplementing without it costing an armload of self-doubt and recrimination.  In reality, my son was FINE and even I could recognize he was fine.  But it wasn’t enough for me because I couldn’t let go of the vision I’d had of what nursing would be and accept the reality which was OUR nursing relationship. I was afraid one more “mistake” would cost me the whole thing.  After about 3 or 4 months, we settled into a routine and I settled into more acceptance just in time for our world to be blown apart by acid reflux (but that’s a story for another tumblr).  If I could go back in time, I would give that devastated, exhausted, fragile woman a hug and tell her, “Everything is going to be alright.  In fact, it is right now, don’t miss it!  You are ok just as you are- look at that baby boy who loves you so much- no matter how his belly is filled.” And instead of coming up with a rebuttal listing my failures and disappointments, I would believe her (and then go take a nap).

Feeding “Professor X”: Vignettes

JDW writes:

Fountain

A six-week old baby boy is latched onto the left breast of his mother, who is sitting cross-legged on the couch. We can hear the boy hungrily swallowing and then he pulls his head back, releasing from the nipple. A strong spray wets first his cheek and then eye. As he squirms back his neck and shirt become wet. The nipple near his cheek is freely spraying milk in three separate streams. The floor below is dotted with milk. Mom, laughing, reaches for a rag to staunch the flow.

Calculation

In a small room in the pediatric ward of a large suburban hospital are the following: a NICU incubator with blue/red UV lights on, inside is a four-day old baby boy who, when not under the lights, looks like he bathed in suntan lotion; a grey and green semi-reclining chair, in which sit a mother and a father who have had little sleep; two large pink cups of water with straws; a whiteboard with the record of feedings made throughout the night at two hour intervals for 10-12 minutes each and the weights of soiled diapers as measured on a creaky scale in the bathroom; several other instruments and monitors, including a pale green “double barreled” hospital breast pump; a small collection cup for breast milk with less than an ounce of milk in it.

A nurse walks in, picks up the collection cup and says to the mother “oh honey, there’s almost nothing here. You’re not going to be able to breastfeed him – I’ll get some formula.”

Yesterday

December 21 in old town Orange in southern Ca – it’s seventy degrees outside and sunny. Mom sits in the passenger seat of a nondescript car with the door open and Dad standing in the open door, looking at a map on his smartphone. Her breastfeeding tank is down on the right side and a baby boy is breastfeeding. He’s almost finished eating and is playful. He sucks, smiles, and then tosses his head and shoulders back, throwing himself off of the nipple. He returns to the breast, sucks, smiles, and tosses. While this is going on a large SUV pulls up behind the car with two middle age women in the driver and passenger seats. The passenger asks the Dad if he is leaving. He replies “nope, we’re feeding our baby.”

Sarah A. writes:

I did not have the birth experience I wanted. Four days in the hospital trying to ripen my cervix. Preeclampsia. Only allowed to walk around for twenty minutes twice a day. A botched IV that probably contributed to the pitocin not working properly. An epidural that sank to my right or left side (depending on which one I was lying on), numbing only half my body. My baby’s heart rate making the doctors unhappy. A c-section on the fourth day in the hospital. Substantial blood loss. Four more days in the hospital in recovery.

I did breastfeed and kept breastfeeding thanks to the wonderful support of my husband, my aunt (a former lactation consultant), and my mother. I breastfed my son with wonder and attention in those first days, even though it took five days for my milk to come in, even though he lost so much weight in the hospital the doctor said we should supplement with formula. I focused on feeding this one, this baby, my baby.

Thirteen months, three rounds of mastitis (two in the first twelve weeks), back to work, pumping three times a day in an office. How do women get any work done while they pump?

My son had an anaphylactic reaction to eggs at 9 months old. After pulling over on the side of the road on the way to the doctor’s, after an indescribable ten minutes of not knowing if my son was dying, after the emergency responders told me he was stable (over and over again), after we got to the hospital and they filled him full of benadryl and epinephrine—I breastfed him. This is my body next to yours, this is our body, this is my life and love filling you to sleep. This is what I can give you now in calm, in peace. We retreat from tubes and bright lights and hard, cold beds. Your father holds my hand and I hold you to my breast.

Breastfeeding is very, very hard. No time, no schedules, no night, no day. Just feeding, gazing, sleeping, talking, singing, sleepless. You need support and you need to remember that what you are doing is worth it for your baby, and especially for you. This is your superpower. This is your magic.

Jen B writes:

After it took medical intervention to conceive, and then again to labor, I thought the one thing I had left that my body could maybe, just maybe, do right was breastfeed my son.  I took classes.  I requested lactation support.  It wasn’t until many months later that I realized, in my haze of sleep deprivation and adrenaline and newness to motherhood, that many of the same institutions that had encouraged, perhaps even pressured, me to breastfeed had let me down.

We never achieved a good latch in the hospital.  A parade of lactation consultants visited me over three days to tell me, one by one, that I was Doing It Wrong, and all promised to return with something that was going to Fix It.  I never saw the same person twice.  The nurses were swamped and didn’t have much time to help, either.  On our first night home, a shitty latch still my only accomplishment with my son at the breast, he began crying incessantly around 3am and I came completely unhinged.  He could not latch.  I could not feed him.  And he was hungry.  Through body-shaking sobs I fed him a free sample of formula from my OB’s office.  I felt like a complete failure.

Our pediatrician congratulated me for this decision, as he was indeed hungry and losing weight, and insisted (there was never a discussion around supplementary systems) I continue to give formula until he gained weight.  He did within days, and then my milk came in (then thanks to severe engorgement — even the arrival of milk was traumatic — my relationship with The Pump began).  We soon figured out the latch, and nursing got better, but the seed had been planted that I should measure and monitor and record every aspect of his feedings, that nursing my son was a series of data points more than bonding experiences.  And so I tracked, with precision, and that obsession grew.   Incidentally, how many times do you think the pediatrician asked to see my carefully scribed breastfeeding log?  Right, never.  Yet I continued to track his food consumption for nearly a year.  This is how crazy breastfeeding made me.

I’m not sure why I stuck with it through three bouts with mastitis, hours spent hooked up to The Pump to produce miniscule amounts of milk, erstwhile round-the-clock nursing and nighttime cluster feedings.  Determination?  Spite?  And yet I don’t regret soldiering on.  When my son self-weaned at 11 months, it was nearly as distressing as those early weeks when we struggled to get our start with breastfeeding.  It was only a few weeks later, when hours and hours of my day were freed to do exotic things like take a long shower, that I felt relief.  Relief that the struggle was over, at last.

If I have another child, I will breastfeed again.   But I will know to go easier on myself, to trust my instincts over contradictory and hypocritical medical advice.  I will try to enjoy it.

Tyliag writes:

I’ve been thinking about how to write this a thousand different ways a thousand different times. I think everybody who expressed their opinion about breastfeeding has reiterated my point about a thousand times, which is that breastfeeding, or not breastfeeding is an individual act, and it shouldn’t be viewed as a statement on feminism or motherhood or even as who we are as mothers. The act of breastfeeding is like a snowflake, no two experiences are ever going to be the same.

Which is why I find the act of judging someone or our own self-judgment on breastfeeding so upsetting. The story I’m about to tell isn’t completely about breastfeeding but about parenting on the whole. I currently have a three month old and the whole act of breastfeeding and parenting while still not completely painless, is not even as closely fraught with the anxiety, pain, frustration, and fear I felt with my son.

I don’t know where to begin when talking about my son, except to say that he is no longer with us. We lost him ten days before his second birthday a year and a half ago. I judged myself and felt judged by every freaking body on every decision I made and we made as a family up to and definitely including the decision to let him go. Nothing about his life and my life as his parent was quote unquote normal. And every decision felt laden with doubt, and the fact that he and his medical troubles seemed to dog us at every turn didn’t help.

And the fact that there were people in the medical profession who should know better JUDGING us didn’t help. I once had to almost literally restrain my husband from crawling over a conference table and smacking a Neurologist (who should’ve known better) from judging us about decisions we were making. Nobody, and I do mean NOBODY, should tell a parent, especially a parent of a special needs child that they know more about that child’s care than that parent! Because we are living in the trenches not that doctor, or nurse, or lactation consultant, or any other health care professional for crying out loud! If it is working for you, good. If it isn’t working for you, change what you’re doing tell you find what something that does and for God sake’s don’t beat yourself up about it or let any FREAKING body do the same. Because they don’t know what you’re going through, they haven’t walked a mile in your shoes and they don’t know the decisions you’re making on a daily basis until they have to make them for themselves, period, end stop.

Also, if you find that you are beating yourself up about breastfeeding or your parenting skills in general, take a deep breath and remind yourselves, that the decisions you are making could be worse, with much bigger ramifications.