Before She Was Born…
No matter how prepared I thought I was – the one thing that was harder than childbirth was breastfeeding. Everything I did to prepare myself was centered around the goal of having an exclusively breastfed baby. I knew all the benefits of breastmilk, and all the “evils of formula” and my supportive group of mamas lent books, articles, and recommended documentaries to watch just in case I ever forgot.
I catered my entire birth experience (post) to making breastfeeding easier, including refusing any pain medications during a natural birth, choosing a WHO Baby Friendly Hospital, and letting Kara do the “breast crawl”. God save the soul who dared to offer my baby a bottle.
After all that – it still wasn’t easy. If anything – it was harder because of the expectations I set.
Hello Baby! The First Night…
The first few moments after Kara appeared were as beautiful as I imagined it to be. They plopped this gooey hot mess of a baby on my chest and she started “crawling” toward my breast and started nursing. I felt like all my preparation paid off. But as the night progressed and the adrenaline wore off, that first night signified the official start of “baby bootcamp.”
During the first night, Kara had dirtied more than the “required” number of diapers and by the next day had lost about 10% of her birth weight. I reminded myself of how it’s normal for babies to lose weight the first day or two. Her apgar score was 9 and her bilirubin levels were normal, but because they were on the low end of the normal range combined with the weight loss, so it was suggested that I supplement her… with formula. That was so upsetting. I felt like they were telling me I couldn’t do the one thing (ok – second thing, pushing her out would have been the one thing) nature intended me to do – feed my baby. I was skeptical of the attending pediatricians who didn’t seem to care one way or whether Kara had formula or breastmilk and who seemed, in my tired, sleep-deprived mind, all too focused on the numbers and not on the long-run health of the patient and I hated the onsite lactation consultant, who spent not more than 5 minutes with us when she determined Kara’s latch was perfect, but didn’t address the scorching pain I felt every time she nursed. I felt justified in my skepticism, because, unlike the pediatrician and lactation consultant, the attending midwives were supportive of nursing and offered gentle encouragement, “just keep nursing, your milk will come in, it’s only colostrum baby needs.” I was convinced there was only one way – the breast way – and anyone who got in the way of that would feel a mother’s wrath. Nipple confusion, poor latch, formula dependency. All of these were threats to breastfeeding success and the thought of them amplified the anxiety I felt. But no matter what my gut was telling me, every time the pediatrician came in to weigh Kara, I could not shake the feeling of doubt. What if I’m starving my baby?
To Supplement or Not to Supplement: Other Mamas to the Rescue…
I was so confused and felt so alone…so I resorted to what any know-it-all does when in doubt of the specialists around them – I asked the village. I spent hours that first night, not sleeping, but texting. “they’re trying to get me to supplement” …”I don’t know what to do.” “they won’t let us leave the hospital until the baby’s weight stabilizes.” Finally, one of the night nurses saw me and posed a question no one had asked before, “do you have any friends who are breastfeeding?” The thought hadn’t crossed my mind that you could supplement with other people’s breastmilk. Fortunately, I am incredibly blessed to have amazing women in my life who all happened to be breastfeeding. They not only offered words of encouragement, but even bags of their own expressed milk. Relief poured over me, finally, a solution I felt would not compromise everything I wanted. Two hours later, when my friend dropped off a bag of her milk, we treated the 5 oz of milk like the elixir of the Gods (although, she is pretty Godly if I do say so myself!).
But the anxiety didn’t end – it was only subdued and I kept wondering, “why didn’t the pediatrician or lactation specialist suggest supplementing with breastmilk instead of formula?” I distrusted the pediatrician’s recommendation to supplement 10ml at each feeding, 20ml the next day, and finally 40ml and sided with the midwives recommendation to start with a minimal amount – 5ml – and gradually increase, if needed, just to buy time for my body to catch up. I was living in a state of fear, not knowing whose recommendation to follow. So I went with my gut, certain I wasn’t crazy because the midwives were reaffirming what I believed and supplemented Kara minimally, stretching out the 5oz for as long as possible.
And They Call It…SNS (Supplemental Nursing System)…
Due the hospital’s baby-friendly designation, no bottles were provided, so we supplemented using a process called SNS where the expressed milk is drawn into a syringe connected to a tube that’s placed on the nipple while baby is nursing. That way, the baby still associates the breast with milk. It seems simple but it’s a pain in the ass and in retrospect – looks like some crazy science experiment. Khoi had to draw 5ml of bagged milk into the syringe – careful not to spill – and hold the syringe in his hand for a while to warm up the tiny amount of milk. Then, as baby is nursing, he had to take the tip of the tube and place it in that tiny little space that would appear between Kara’s lips and the flesh of my nipple. He then wiggled it into place and only when Kara’s nursing lips created enough of a seal around it would she start sucking the milk. Khoi would stand there and gently squeeze the syringe, squirting bits of milk into baby’s mouth to encourage her to keep sucking, while making sure the nursing action didn’t dislodge the tube, while I watched with sadness and relief as my baby happily fed. The first time wasn’t too bad, but after a few times, because Kara’s latch was starting to tear my nipple apart, the tiny plastic tube felt like a little dagger against my nipple whenever Khoi tried to wiggle it into place. I gritted my teeth through the pain of her nursing and the pain of the little tube. Anything to feed Kara. No one ever helped me figure out why nursing hurt so much it started to bleed, but now that we were supplementing, we were discharged.
Oh the Pain!
The next few days out of the hospital were at times the worst moments in my life. I cried. A lot. With the bleeding nipples, I cringed every time Kara started nursing. We had weight checks every few days with a different pediatrician each time who all, instead of helping us with breastfeeding, would suggest increasing the amount we supplemented at each feeding. At every visit, the pediatricians would give us a weight gain “goal” to reach by the next visit, and it became like a little game. As I watched the bags of donated milk dwindle along with the fear that over-supplementing would not allow my body to increase its own milk production, I supplemented less than what the pediatricians wanted, and instead, just nursed Kara all the time. At one point, I think I clocked in at least 15 nursing sessions in a 24 hour day. I wanted to prove them wrong – that I didn’t need to supplement as much and that my body was producing just enough milk to meet my baby’s needs. But a week went by and the pain became unbearable. It was so unbearable I had to buy a nipple shield, but that only slightly dulled the pain. A friend convinced me to go to a La Leche League meeting. It was nice to finally be in an environment of people who supported breastfeeding, but it didn’t address the issue of pain. The women there thought maybe Kara had an attached frenulum. I brought it up during one of her follow-ups, but the pediatrician ruled that out, but again, offered no other suggestions, but to visit a breastfeeding support group.
Finally, A Real Solution…
I was hesitant to go at first, but I was out of options so I went to a breastfeeding support group held at a local hospital. It changed my life. Within 5 minutes, the lactation consultant was able to identify the problem, took my hand and made a trivial adjustment to where I placed it, and the pain was gone. What a miracle – I nearly cried. It was an environment of other mothers, fathers, and babies who were going through the same frustrations we were and there was someone there who not only believed in our innate ability to nurse, but actually helped. And it was incredibly simple – it wasn’t a structured class or a group where you have to sit around in a circle and talk about things. You just show up, weigh your baby, let the lactation consultant know what your challenges are, she watches you throughout the entire latching on process (not just after baby latches, but how you put baby on – this was HUGELY different than what the lactation consultant on rounds during our hospital stay did), and then you nurse your baby. Afterwards, you weigh baby again so you know exactly how much milk she ate. For once, there was evidence that my gut was right – I was making milk – and there was a solution to the pain. Diane (the name of the lactation consultant) save us. I felt tears…of JOY. After about a week (I was going every other day), Diane said let’s try not supplementing. So I did and Kara still continued to gain weight. I continued to go the entire time I was on maternity leave.
Visits to the pediatrician after that were less stressful because I was no longer unsure of my ability to feed my child. Kara reached her birth weight at 3 weeks and by her one-month visit, the pediatrician said that we could now stop supplementing since she had actually surpassed her birth weight. I told him I stopped supplementing two weeks ago and quietly enjoyed the look on his face.
Mission Accomplished! But was it worth it?
We made it to the 12-month breastfeeding mark (with the help of pumping once I returned to work). Kara is now over 15 months old and I still nurse her at night. She’s never had an oz of formula, but it was not easy. Saying it’s hard is a huge understatement. Hard is measurable – the amount of depression and frustration that comes along with challenges in breastfeeding is immeasurable. That’s something breastfeeding advocates seem to glaze over. Earlier this week, I read an article about a woman who thought she was doing the right thing by exclusively breastfeeding and her baby passed away from dehydration. I cannot even come close to imagining her pain, and it made me question a lot of things. Particularly, it made me question why I was so rigid – so distrustful of “the institution” and why for the first few weeks of parenthood- I was living in a state of borderline depression. It made me ask myself, “was it worth it.”
Mama Knows Best.
Ultimately, the short answer is “yes”, to me, it was worth it, but I might have done things differently. I still support breastfeeding, but I realize there is no “right way” and that like all other things in parenting (as I’m still learning), a little bit of flexibility is just as important to the well-being of the family. If mama ain’t happy, no one’s happy. So if you ask me which is best, “Fed is Best” or “Breast is Best”? I’d say, “Mama Knows Best.” Always.
You Are Not Alone…
To all the mamas and even papas out there – I hope you know that you are not and never will be alone. My angels came in the form of friends, family, midwives, nurses and a very gifted lactation consultant. If you reach out – you will find your angels, too. But you have to reach out and do it soon. If you are in the San Diego area and need a place to start, check out the post “What I Learned Breastfeeding and San Diego Resources for the Breastfeeding Mother.”