About twelve months ago, nearing the end of a nerve wracking rainbow pregnancy (pregnancy after miscarriage, in my case, or other loss of a child), I sat swinging my legs atop the table in the doctor’s office. At the end of my pregnancy, being from a small town, I was transferred to another clinic, where I would be treated by an OB-GYN group. This meant that, in the days and weeks to come, I’d be cycled through a handful of new doctors, made to answer the same questions I’d been answering for months. Is this your first pregnancy? No, this is my second, I lost the first at 17 weeks in a missed miscarriage leading to eventual D and C after I began losing an excess of blood. Always a fun conversation to rehash. How has your weight gain been? Blood pressure? Minimal, and spot on, right until the end when I was induced due to preeclampsia.
Are you planning to breastfeed? Not such a simple answer. I know a good number of mothers who struggled, due to c sections, latch trouble, inability to produce milk, what have you. I had always planned and hoped to breastfeed; ‘breast is best’ having successfully been drilled into my head by this point. That being said, I wanted to remain realistic, it doesn’t always work out, and, at this point I’d noticed that, despite so many pregnant women struggling to adjust to new bras and constant breast changes, I’d remained pretty stable throughout. As a farm-girl cousin of mine put it, I didn’t ‘bag out’. All this in mind, my response was always, I plan to try.
More often than not, this was met with some degree of disdain. What do you mean try? What do you mean if you can make it work? It will work, why wouldn’t it? Some women just don’t get milk till baby comes. You don’t have inverted nipples ( or, you do, depending on the doctors and nurses examining me at the moment. By my understanding of the word ‘inverted’, I don’t ) that won’t be a problem.
Well, lo and behold, the day came when my amazing little girl was born. She was placed screaming on my chest, and quickly whisked away to be wiped and weighed. We were shipped out to another room almost immediately as the delivery room was needed. When it came time to try to nurse, nothing seemed to be happening. I felt no let down, no tingling, no swelling. Nothing. I seemed to be able to get Pepper to latch, as I understood it, but I was met with screams and frustration. Nurse after nurse through those first few days complimented my technique. It clearly wasn’t my hold that was the issue. I insisted i had no milk, not a drop. They told me, it will come, it will come. I tried pumping, nothing. I tried hand expressing. Nothing. I was met with, It will come, babies have such small stomachs, she’s not that hungry yet. I couldn’t seem to explain that I had been able to produce less than a tablespoon of milk, and only through pumping.
Eventually, after days of hands squishing and squeezing and forcing my crying child’s face into my chest, I was told she has a poor latch, she has a great latch, your milk will come, don’t worry, she’s drinking, you just don’t think she is, she’s not really hungry, she has a tongue tie, she has a lip tie, you have flat nipples, you have inverted nipples, you don’t have inverted nipples……..
We were given a syringe and a feeding tube, and a bottle of formula, and were instructed to feed the baby using the tube attached to my finger. I would hold Pepper and she would, essentially, suck formula from a tube while I used my finger to stimulate her suck reflex (oh, because she has a weak suck, too), while my husband depressed the plunger and fed formula into the tube. This was all done so we wouldn’t need bottles, and there would be no nipple confusion. The dream of feeding your child, warm against your body, as she drifts off to sleep at the breast was crushed with this unnatural, sterile process of tube feeding. It felt awkward and strange and not at all ok.
I continued to try and nurse, and even a week later, at, what had become a routine test for bilirubin levels (Pepper was jaundiced), I still had no milk and was still being told, ‘it will come.’
I had had enough. I contacted my local lactation consultant and within a few days I was pouring out my exhausted heart to her. She was the first of the medical staff I had dealt with to suggest I make my life easier and use a bottle. Finger feeding, a system that requires two adults, is not only unnatural feeling, but inefficient. My husband couldn’t stay home forever, and, she said, nipple confusion is, generally, considered a myth these days. I left her office with a prescription for Domperidone, a medication that, when taken in large doses, can stimulate milk production. Women often require it to start their milk off but can then wean themselves once supply is established. I was never able to go off the pills without losing milk.
I continued to do all I could to give my girl the breastmilk I could. I nursed at the start of every feeding, and then bottle fed her either formula or pumped breastmilk. I then pumped after every feeding for ten minutes. Often this meant that my child would lie screaming on the floor or in her bouncy seat as I pumped and sterilized the pump parts. I recall being in tears as her wails pierced my ears and my heart, thinking, how can this be natural? I’d spend ten minutes nursing and cuddling, but every feeding was ended with ten minutes of leaving my child to fuss or cry while I tried to express more milk. FOr many months, Pepper was receiving at least 75% breastmilk.
I continued this exhausting process until she was about 7.5 months, at which time I resorted strictly to bottle feeding, while still pumping regularly to give her all I could. At about 9.5 months, my supply had dropped so low that she was receiving less than 5 ounces of breastmilk a day. I quit pumping.
Now that Pepper is nearly a year old, she’ll be ready for homogenized milk and will be using cups at meals rather than a bottle. This phase of my life is nearly passed, and while I do miss the closeness of nursing, however short our sessions were, I do not miss the constant sterilizing, the endless pumping sessions, the fussing at the breast and the inevitable breakdowns.
I spent so much of my time as a new mother feeling like a failure. Breastfeeding advocacy groups shoved their slogans down my throat, breast is best, make breastfeeding mainstream, and even, hearttbreakingly, ban the bottle.I knew that people though, seeing me bottle feed my child, that she wasn’t getting breastmilk. I felt that I was constantly being judged, as though I chose not to breast feed, or that I was too lazy. At follow up appointments, doctors and nurses always assumed, when they saw a bottle, that it was formula only. I corrected them constantly and was always met with surprise. ‘Wow, you still pump? that’s a lot of work. I wouldn’t blame you if you stopped.’ I was never afraid of the work. I was always willing to put in the time and effort. It was out of my control. I couldn’t produce enough. I couldn’t breastfeed exclusively. I wasn’t built for it. I did everything I could to feed my child breastmilk, all at the expense, really, of my own mental health.
Now that I’ve broken free of that monkey on my back, and I can step back and see signs of postpartum depression and anxiety. I was on edge and nervous, I was emotional and uncomfortable, and constantly judging myself. I felt I was being judged by the world around me, by doctors, by nurses, by friends, by family, by the whole world that set me up to believe this would be easy. Struggles at first, maybe, but sooner or later, it all falls into place. I know of at least five other mothers in my small town who have had babies in the last year who have struggled with breastfeeding and ultimately had to concede to bottle feed and often strictly formula feed. At least four of them are suspected to have insufficient glandular tissue. Everything I’ve read touts this as a rare issue, a scenario that befalls only 1 in 1000 women. Add to the struggles that come with inability to produce due to a c section, stress, trouble with latch and tongue ties. Add to that the pressure from doctors and health groups to breastfeed, with no acknowledgement nor warning that it truly may not happen, and you’re setting up scores of women who are already riding the roller coaster of hormonal dips and spikes and often postpartum depression to bully themselves further. Women all around me are feeling guilty, feeling like failures, feeling like there is something wrong with them.
When I give advice to these women, who, often tell me they feel bullied by doctors that., above all else, breast is best, I remember how hurt I felt when people would say, oh, you should quit, it’s a lot of work, knowing that some of them had no struggle at all and still found it taxing. Normal breastfeeding is a lot of work, you have NO idea how hard I worked to feed my child and the toll it took on me. I will not tell another woman that she should quit, that she shouldn’t quit, should or shouldn’t take pills to increase supply, should or shouldn’t bottle feed, but I will also never accuse her of being unwilling to work for her child. I know first hand that laziness was not my problem. What I have told some women who’ve discussed this with me, while struggling with their own nursing battles, is that while breast may be best, no one can dispute the value of a happy mom.
Doctors, I beg you to take some time and prepare new moms for this possibility. Don’t shrug off their concerns, don’t act like it will work because it always works. Moms, I urge you to seek a lactation consultant. be kind to yourself, we all know you’re doing the best you can, and if you must stop, that’s your call. You know yourself best, and if you’re anything like me, no matter how often you hear, ‘the milk will come’, you know it just may not. DO what you have to do to stay sane. In the sleep deprived world of being a new parent, you can and should only expend your energy on things that are worth it. Do not get bogged down.
Breastfeeding advocates: do not judge us who have to formula and bottle feed. You don’t know the story. Do not assume laziness, do not assume an unwillingness to experience discomfort. You may have no idea the struggle that mom might be enduring.
There are a few sites that offer support to moms fighting to breastfeed despite the obstacles, or facing judgement, but far fewer than I think there should be. This article spoke to me, and raised some of the questions I found myself asking. La Leche League offers some resources and advice regarding IGT as well. You might find, in discussing struggles with others, that there are more women around you facing the very same problems.