After writing this, I realized that it paints breastfeeding in a very negative light…which is that last thing breastfeeding and breastfeeding mothers need. My intention was not that, but rather to try to explain to those on the outside of this breastfeeding world the struggles breastfeeding moms face, and why support and understanding is so important. And also, in hopes that other moms going through the same things will find some comfort in relating to my experiences. And lastly, to help those mothers-to-be that plan to breastfeed to gain a better picture of what some of the realities of breastfeeding involve. I feel the need to say (and I explain at the bottom), that I am happy to be breastfeeding, and hope to be able to continue through Aubrey’s first year.
For something that’s supposed to be so natural, breastfeeding is anything but easy. I’m writing this not to spur another debate on breast versus formula feeding, or to place any guilt on any mother out there, because let’s be real, we are all experiencing enough of that without added help. Instead, I’m writing it because I would be willing to bet there are other mothers and mothers-to-be out there, that like myself couldn’t really grasp what could be SO difficult about feeding our babies the way our bodies were meant to. What I couldn’t understand until I was in the throws of trying to make it work, was that there is so much more to it than sticking your baby to your boob and letting them have at it.
For instance, many babies don’t know how to nurse…
The latch is everything. Did you know they aren’t supposed to just suck on the nipple (sorry to the men reading this)? No, if you want to avoid the sore, cracked, bleeding nipples that bring many mothers to tears, you’ve got to work on the latch. Some babies have to learn to latch correctly, as well as some mothers. And if they don’t, mom not only gets the fun of the aforementioned maladies, but baby also suffers from not being able to get the milk out efficiently enough to get full. And the bad news is, the longer baby is away from mom right after being born, the harder it is for them to get it all down.
We were very lucky in that Aubrey seemed to master the latch from day 2 (day 1 she was in the NICU), so I’ve been spared the pains of breastfeeding in this regard. However, even spending just one night in the NICU before getting to breastfeed ended up requiring the help of a lactation consultant to get little one to even find the desire to suck.
The Complicating Factors
If your baby has gas, is distracted, is sleepy, is impatient, doesn’t like the taste of your last meal coming out in your milk, or just isn’t ready to eat they may…pull on and off the nipple, cry or fuss at the breast or even scream at the top of their lungs while they flail their tiny little bodies so hard they about fall off the nursing pillow, spend more time looking at you (or the TV, or Dad, or the dog, or that toy they weren’t done with, or the blank wall that holds infinite amazement for tiny eyes) than actually eating, or practice a few gymnastic moves WHILE keeping your nipple in their mouth. And because of this, what could be a short, efficient nursing session could turn into an hour long struggle to try to hopefully make sure your baby has eaten a sufficient amount.
Unless you go to the pediatrician or see a lactation consultant to do a milk transfer analysis (they weigh your baby before and after a feeding to determine how much milk they took in), you really have no way of knowing how much your baby is eating. Sure you can make sure they have 6-8 pale wet diapers a day, that they are pooping regularly, and that they are gaining weight normally, but you still don’t know how much they are getting. And babies have a way of making your feel like they are still hungry, sometimes no matter how long they have just nursed. There isn’t much more distressing than feeling like your baby is still hungry and you are running dry.
In the first two weeks of Aubrey’s life I spent over 3600 minutes nursing her. I never realized that a kindle was a nursing essential until I found myself nursing Aubrey in the middle of the night, begging for anything to keep my sleep deprived eyes open so I didn’t drop my new precious bundle while she nursed for the 12th time that day. Not to mention that it provides entertainment for the literal hours I spend nursing every day. Early on, and if you are blessed with an efficient nurser you can expect to spend 20-30 minutes on each feeding. As your baby gets older, and especially if they suffer from any of the above factors, 45-60 minutes easily pass by each time you feed your baby.
Not all breastfeeding mothers use a pump, but I would say the vast majority do. You pump to help establish your supply in the early days, and to help increase your supply during baby’s growth spurts. You pump to try to build an emergency stash (that you’re almost afraid to use because you don’t want your supply to suffer from a missed feeding). You pump to fill a bottle here and there so you can have a bit of freedom for a few hours. You pump…so much. And yes you feel like a milk cow. And no, it’s no thing to sit at your computer working to the lovely background tune of the pump working away.
And the real kicker? Pumps aren’t NEARLY as efficient as babies at distracting milk, so it’s completely normal to get absolutely nothing out the first few times you pump, and then, even when you are an experienced pumper, a full-time breastfeeding mom generally only gets 0.5-1.5 ounces (maybe 2oz if you’re lucky or it’s the morning time when you produce the most) of “extra” milk out at a time. Considering babies 3 months and older drink anywhere from 3-5 ounces at each feeding…you can do the math to determine how much you have to pump to even get an extra bottle a day for your stash.
The Ever-present Temptation of Formula
It’s hard to determine if it’s easier to whip out a boob, or to prepare a bottle. I think both have their pros and cons, but specific to our baby, she will take a bottle warm or cold, so the prep time is really non-existent, making it very tempting to skip the whole nursing struggle and just give her a bottle. It’s no surprise that breastmilk is the best food for your baby, but when you are in tears because you are exhausted from nursing around the clock, struggling with this complication or that, constantly worrying whether your baby is getting enough to eat, and you see plenty of formula fed babies doing just fine…it’s hard to maintain your determination. Not to mention the below.
The Guilt and Pressure
Even though the saying “breast is best” is quite literally shoved down your throat from the very moment you announce your are pregnant, the support for breastfeeding doesn’t necessarily follow suit. Every generation seems to raise their babies differently, and for most of the women around my age, our parents and most likely our grandparents, were all big advocates of formula. And why wouldn’t they be? Modern-day formula hit the market strong in the 50’s and because it was new, gave women the same freedom as men, and was more convenient, it became the feeding method of choice. And for that reason, it’s a bit hard for your mother, grandmothers, mother-in-law (and aunt’s, older cousins, and some peers), to understand why you would put yourself through the hassle of breastfeeding. And didn’t you know, formula (especially mixed with a little cereal) is sure to get your baby sleeping through the night?
Then there are the doctors, who at the very moment your baby shows signs of slower weight gain, immediately suggest supplementing with formula. Making you feel like a failure for not being able to produce enough to provide your child with adequate nutrition.
And then there are the lactation consultants, who upon telling them that you have supplemented with formula, give you that look of disappointed condescension, that totally plays into the guilt you already feel for giving up your “exclusively breastfed” badge in lieu of finally finding some peace in knowing that your baby is at least getting one full meal a day, without question.
In other words, formula or breastmilk, it doesn’t matter. You almost can’t win.
The Stress of Supply
Supply, supply, supply. I think that word lives at the top of my brain 24/7. Everything with breastfeeding is about supply, because the bottom line is, you have to produce enough to keep your child growing and healthy. Period.
If you give a bottle instead of nursing, it tells your body it doesn’t need to produce that milk, so your supply decreases. If your baby isn’t latched properly and doesn’t extract enough milk, your body thinks it doesn’t need to produce as much, so your supply decreases. If you are stressed, your supply can decrease. If you aren’t eating a sufficient diet (read: forget about trying to lose that baby weight, because eating enough to produce enough is top priority), your supply can decrease. If you work out (trying another method to lose the baby weight), your supply can decrease. If you start a new birth control, your supply can decrease. If you are sick, your supply can decrease.
It’s not easy to “just mix a little formula in…” or “just give them an extra bottle a day…” because the end result is that it affects your supply. The best way to increase and maintain your supply, is to nurse…and pray.
I found myself feeling pretty at odds with my husband the other day. We are having a small issue with Aubrey’s weight (I’ll explain below), so we have had to up her feedings and start regular weight checks with a lactation consultant. It is enough that weight issues aside, when you are breastfeeding, for the most part, the majority of the care of your baby falls on your shoulders. The reality is, you personally are responsible for their health, growth and well-being. Dads can help change diapers, give baths, take baby off your hands so you can finally take that bath you’ve been dying for, but they can’t nurse in your place. They can’t help with those middle of the night feedings (sure they could give a bottle, but see the above). They don’t have to postpone their dinner so baby can eat first. They don’t have to forego that next glass of wine (that you are SO happy to finally have after already getting through 10 months without). They aren’t present when you are all but fighting with your baby to get them to relax and eat. They can’t help you increase your supply. They don’t have to go to the lactation consultant meetings to pinpoint what is wrong.
Things they can do to offer support, like helping wash your pumping supplies, making sure you have your water/book/burp cloth/etc…while nursing, sitting with you while you nurse to give you some company or read to the baby, bringing baby to you at night so you don’t always have to be the one to get up, being the one to get baby up from a nap and get their diaper changed before you need to nurse them…in reality, they just don’t. They don’t really think to do these things, unless you ask them to. And in my case, I hate to ask, because being a stay-at-home mom is my current “job,” and Will’s is being a JAG. So it’s hard for me to ask him to do his job, and ALSO help me with mine.
The Fact That You Can Do Everything Right, And Things Still Go Wrong
Sometimes mothers just can’t produce enough, even with the help of supplemental herbs, prescription pills, the help of a lactation consultant, and trying every trick in the book. Sometimes, babies have other issues like reflux, colic, lactose intolerance, or any of a wealth of other possible problems, that make breastfeeding impossible. And sometimes, everything can go perfectly fine, but for some unknown reason, your baby just doesn’t gain weight steadily.
Aubrey was born a little on the small side at 6 lb 6 oz, landing her in the 8th percentile. At her two week appointment she was up to about 7.5 lb. At her 6ish week appointment she was up to 8.6 lb and had jumped up to the 21st percentile, gaining weight faster than the normal rate. All was good.
Three weeks after that we went home to the states to meet the family, and I weighed her the day we arrived, surprised to find that she still only weighed 8.6 lb. She seemed happy, was meeting her milestones, and was sleeping well so I just continued on as normal. Three weeks after that, the day before we left to return to Turkey I weighed her again and she was up to 9.7 lb, which was still a little low, but a good increase so I assumed everything was ok.
About three weeks after that we finally got in for another doctor appointment and discovered she still only weighed 9.7 lb, dropping her all the way into the 0-1 percentile.
I couldn’t believe it. She was finally starting to outgrow her newborn clothes, and fitting some 3 month pieces. She looked like she was filling out. She had started sleeping through the night. She was SO much happier than the grumpy baby we had dealt with since she was born. She was about a week ahead on all of the developmental milestones she was supposed to be meeting. If a scale wasn’t involved, I would never have guessed that anything could possibly have been wrong.
So we were told to start waking her if she slept longer than 8 hours and make her nurse, and to add back in another feeding, and to meet with the lactation consultant to make sure Aubrey was nursing effectively and enough milk was actually transferring.
After meeting with the lactation consultant we determined that Aubrey’s latch and suck/swallow were all great. Outside of being a distracted baby (which is completely normal developmentally at this age), method-wise we were doing everything right. The scales weren’t working properly that day so we weren’t able to do the milk transfer, but judging by Aubrey’s swallowing, and the fact that after the feeding she seemed content and happy, we were hopeful that she was getting enough. The consultant instructed to me add yet another feeding back in each day, and to come back the following week to do it all again.
So here we are. Back to feeding every 2-2.5 hours. Me constantly worrying whether she is getting enough to eat and praying like crazy that she puts on weight. I’ll admit I’ve given her some formula at the late evening feedings when she is too impatient to wait for my letdown, at least a few ounces to get her over the initial hunger and to a point where she will slow down and suck long enough for the let down to happen. I don’t feel guilty about it. I pump to make up for the lost minutes as much has possible, and have peace in knowing that she has a full tummy (and in the fact that that is the only feeding each day where we “have” to supplement).
I can’t tell you how disheartening it is to see so many other babies, breastfed AND formula fed, doubling their birth weight in two months, or developing those adorable little baby fat rolls and chubby cheeks, while our baby is as lean as Jack Sprat. While other parents are wishing their babies would stay little, I’m praying mine will get bigger.
And all I can do is to continue nursing. Either until she starts putting on weight, or until we determine that it’s really not working and we need to switch to formula. I’m thankful solid foods will be coming into the mix in a month or two, banking on that fact that they will help add in some calories. This whole experience has really tested my faith in ways I never would have imagined.
So why put yourself through all of that???
Sometimes I don’t know how to answer that question except to say, it’s what feels right for me. Some of the sweetest moments I’ve had with Aubrey was when she was nursing. Some of the moments when I felt the most fulfilled and accomplished as a mom, was when she was nursing. Although we’ve given her some formula (and please believe me when I say I hold NO judgement for moms that go that route), I do believe breastmilk is the healthiest option for her, and I want to give that to her, no matter how hard it is to make breastfeeding work. It is a huge sacrifice, in time, in effort, in energy and patience, in convenience, and often in sanity, but I want to do it for our baby.
If the day comes when I have to accept that it’s not enough and we have to make the switch, then I pray I will accept it with grace and understanding, and hopefully without the feelings of failure that seem to want to creep in.