Guest post by Katie Bowman
I was born in 1971 and I was raised a family woman; extremely few are the times in my life when I ever considered NOT being a mom. My earliest memories include various nurturing activities with my dolls and stuffed animals, which later translated quite smoothly into a very handy helpfulness when my twin cousins arrived. I was four and a half years old, and they were quite premature fraternal twins, named Kevin and Melanie. The import of this detail here is only this: Because they were so premature, they spent the first 4 weeks of their lives in neo-natal intensive care. It isn’t by any means impossible to breastfeed in that situation, but it is quite hard, and they were so small and weak that by the time the efforts could usefully begin, their mother had nothing to give. In the early-to-mid 1970’s, breastfeeding was still looked at as the less preferable option to bottle-feeding, so no one told her how to keep her production up, or even asked her if she wanted to provide breast milk to be given to her new babies when they could be taken off IV feeding. All parties just naturally assumed that bottle feeding meant formula, and that was the way it went. Hence, I always bottle-fed my dollies and my cousins, and didn’t even learn what breastfeeding was until I was pubescent and learning about human biology. . .I believe I was in 5th or 6th grade.
When I found out what breasts were for, I was fascinated, amazed, and mystified. Why on earth would bottles be employed when they were so unnecessary? And how had I gone so long NOT knowing that human babies can and do get milk from their mothers just the same way all the animals most familiar to me at the time did? Calves, piglets, puppies, kittens, foals, ALL the adorable and fuzzy baby creatures took milk from their mothers till they were big enough to chew solid food. . .and people could do that, too!? But if they could, why had I never seen it happening? If it was in our biology to do this, why was it NOT being done?
My mother didn’t take long to explain the why’s and wherefores, and I don’t think I need to run them down here. Boil it down to prudishness, body shame, squeamishness, and lack of honest information on the subject. Throw in a hint of selfishness, and give it a side of legitimate biological issues that went unexplained, and that’s what I got in the way of justification for fighting the natural biological imperative that causes human lactation.
Fast forward to 2006. At last, I was ready to be a mom. My husband and I were blessed quickly, and I had long since made certain decisions. Among them, of course, was the decision to breast feed my child. By this time, I’d had LOADS of friends that took it in their strides as well to breast feed their babies, with only one that had total lack of success. In that woman’s case, her pain tolerances simply weren’t what they needed to be; she was in tears from the sensations of having her baby latched on to her nipples from the start. I knew I wouldn’t have that problem, so I took it for granted that I’d have more or less smooth sailing.
I gave full-term birth to my 8lb 4oz daughter in mid-September. . . and here began my road to tribulation, frustration, exhaustion above and beyond the pale, and ultimate disappointment from my lack of ability to successfully breast feed, despite receiving all possible help and advice.
It all began at the hospital, of course. Textbook smooth-sailing natural birth was quite soon followed by a very promising first attempt to nurse. My daughter plainly had the appetite, and the natural urge to suck. No problem there. On our second attempt, I had observation from my obstetric nurse that reassured me that all looked well and sounded the way it should; all signs pointed to that I’d have all the success that I could hope for. I was feeling great. . .except for the dreadfully uncomfortable hospital bed. For that reason I wanted to go home as soon as my doctors would let me, and since everything checked out fine with dd, I went home the very next day. That was my first mistake, and as I process this presentation, I come to view it as the only one I really made.
By the time I took dd to her first pediatric appointment, three days after we went home, my precious angel had lost almost a pound and was looking decidedly yellow. She’d not had a bowel movement, and it was decided that we needed an ultra-violet light blanket straight away. It was further recommended that I start pumping to get my production up and to supplement with formula, to get her digestive up and running the way it should to process the overload of bilirubin in her blood. I was given small-gauge flexible tubing that I was supposed to use to try to avoid using a bottle, minimizing the nipple confusion, but it didn’t work at all; she was unable to latch on in any way with the tube to contend with, so I had to give in and use a bottle to get my precious thing fed. At each feeding, I’d start and finish with an attempt at the breast, and her latch on seemed to maintain as well as it had ever been. It was about another week before her jaundice cleared, and once her weight was back up to where it should have been, I went back to concentrated efforts to breastfeed exclusively.
In just a few days, I realized something was wrong. Nursing was new to me still and naturally the sensations took some getting used to, but quickly the discomfort increased to pain, and my nipples started showing signs of trauma. I knew it for what it was, and made an appointment with the lactation specialist at the maternity ward where I delivered my girl. I went with high hopes, and was reassured that I was doing everything right. After some observation time, I was told that there were a couple of things that should be kept in mind as I went forward with my attempts to be my daughter’s source of nutrition.
Firstly, there was my breast structure to consider. As it turns out, I was quite right to have been concerned that my exceedingly large breasts would add to the challenge. Also, while they aren’t inverted per se, my nipples are quite flat in their relaxed state, and do not distend much even at their most aroused. Secondly, there was an unforeseen challenge with my daughter’s oral structure. In the process of working with us, the lactation specialist noted that my daughter’s tongue was “tethered.” This means the little strip of skin that connects the underside of the tongue to the soft palate was not very stretchy and came all the way to the tip of her tongue, making it harder for her to maintain latch-on or even establish latch-on at all. The specialist recommended that I speak to dd’s pediatrician about the matter.
At the very next well-baby check-up, I shared with Dr. Rosenbloom what I’d learned, and what a struggle nursing had become. I don’t know what I’d expected. In fact, I was by that time so rest-deprived that I was all but running on auto-pilot; I don’t think I expected anything. But what I got was more bad news. I was assured that, while the lactation specialist was certainly well-meaning and not precisely wrong in her observation, dd’s tethering was not acute enough to be a significant factor in our problems with nursing. According to Dr. Rosenbloom, if the baby is capable of extending the tip of his tongue past his lower gum line, then that is well enough to establish a latch. Tethering can be remedied, but is only recommended as a last resort for the most extreme cases. My daughter was not an extreme case, and the idea of cutting on my daughter was not one I found I could entertain. I was assured that, ultimately, the chances that an untethering procedure would help were quite small.
After another week of painful attempts to nurse, full of frustrating and unsuccessful efforts to help dd open her mouth wider to accommodate more breast tissue, only to find her grip slipping nonetheless in mere moments. . .after another week’s worth of accumulating nipple trauma for me and nipple confusion for her. . .after another well-baby visit that weighed her in lighter than the week before rather than heavier. . .having tried everything I was told to try. . .I had to give it up. I was exhausted, scraping by on an average of two and a half hours of sleep per day. My nipples were split and raw, on the verge of bloody. Nipple covers hadn’t helped, nothing had helped. I was realizing that this incomparable bond that was touted as the most important reason for nursing, (after the nutrition factor, of course,) was not happening for us anyway; both of us were too stressed out from trying to make nursing work to receive that bonding benefit. It wracked me emotionally; I felt like a failure. I felt like I was letting us all down. So I made a compromise for as long as I could. I decided bottles wouldn’t have to mean formula, and embarked on a schedule of expressing and bottle-feeding that gave the best of both worlds; my girl got all the breast milk she could handle, and I got the pleasure of feeding her without physical agony.
The challenges in an all breast milk bottle feeding schedule are few, but they are great. Expression takes time, and needs to be done every 3 hours. Cleaning bottles and pump parts takes time. Add in the time it takes to feed the baby, and you’ll see it makes for a full day that doesn’t leave much room for anything else. But the peace of mind that I retained as a result of continuing to give my daughter breast milk was well worth it.
After a couple of weeks, I found that I could improve efficiency a bit by hand expressing rather than using the electric pump; sure, the pump expresses both sides at once, but it doesn’t have as strong a draw, and I had to finish by hand anyway. If I never got the pump out, I didn’t have to clean and sterilize it. I started getting a little more sleep, which was more of a factor than I’d known; as it turns out, if you don’t give your body the rest it needs, your milk production can and probably will drop off. Still, the moments I had that weren’t centered on feeding and production of milk were few, and I still wasn’t getting enough rest to have enough energy for anything else during those moments. For this reason, we made the switch to formula when my daughter was four months old. Another heart-breaker, particularly when the switch brought with it a constipation issue for my girl that persists to this day. . .but she’s also thriving. Off the charts for weight and head circumference, and in the high percentiles for height. She has a wonderfully diverse palate, loves her veggies and fruits, takes a pass on sugary drinks, and is in every way I could have hoped a mommy’s girl.
On that last point in particular I was given by my friends little hope. “Girls are daddy’s girls when they can be. When have you ever heard of a momma’s girl?” I thought for sure that, without nursing, I’d be left on the sidelines in favor of daddy by now. HAH! No way, my friends. Even without that “incomparable bonding experience,” . . .I TOTALLY win!