Postpartum Part Two

Or, my nursing nightmare

 
I decided to do a separate post devoted entirely to our nursing struggles because combining it with the PPD piece would have made that post insanely long. Also, I know that a post about nursing issues will probably only appeal to a small segment of readers. I'll let you know up front that I go into a lot of specifics in this post (don’t worry, not in a graphic way, although, you know, it is me, so maybe take that into consideration). It has taken me a long time to write in such detail but I did it because in talking with other women who have had troubles with nursing I've found that we all have appreciated knowing the specifics, since there are so many factors involved in breastfeeding (despite the fact that we're all told it's so NATURAL). 

I want to say up front, too, that in doing this post I'm not intending to start another breast vs. bottle battle in the endless mommy wars. We are all on the same team, seeking to do what’s best for our families. I'm mainly doing this to contribute my own story to the worldwide book of breastfeeding and to help people understand what can go wrong and why, so that maybe they will be more sensitive and less judgmental toward women who desperately want to nurse their children but who, like me, simply can’t make it work. When I was going through it I would talk to friends, all of whom were well meaning but many of whom simply couldn't relate, either because they chose to formula feed or because they were able to breastfeed.  

And if I'm being honest, I'm also writing this to help me process my own thoughts and emotions and to somehow justify to the world why I failed, even though I now know that no such justification is needed. 

Okay, then, here we go. Once we got back home after Caleb was born, the nursing situation I discussed in my other postpartum post did not improve. My milk finally came in around the fifth day, but Caleb still wasn't latching, and the rare times he did, he didn't stay with it for very long before he fell asleep or gave up. Meanwhile it was extremely difficult for me to sit up for the hours it took to try to make the nursing work, since the tear was still hurting so badly. 

We tried giving him some formula through a syringe while he nursed to help encourage him, as the lactation nurse at the hospital had instructed us, but that usually ended up getting milk everywhere but in his mouth and he didn’t find it to be a good enough incentive to keep nursing. 

Hmm, what's in there?

So we made an appointment with a lactation consultant downtown who is basically considered our city’s Grand Poobah of breastfeeding. The minute she saw me in the waiting room struggling to get up from the chair to head to her office, she sympathetically gave me an arm and said, "Oh honey, I've been where you're at. I had the same tear with both my babies. And I'm so sorry." That's all it took for me to burst into tears right there in the lobby. (Admittedly, it didn't take much in those days). 

Once in the exam room, I took off my shirt (trying to nurse in those early days pretty much involved me disrobing entirely), she took one look at me, gave a low whistle and said, “Well those look like they’ve been dragged over the freeway behind a semi-truck, don’t they?” She advised me to get some bacitracin at the drugstore as a baby-safe way to prevent infection and gave me some Medela hydro gel pads to put on my hoo-haws to help them heal. Then she evaluated the situation with Caleb's latch, finally was able to get him latched on after several tries, and then watched as he nursed. She said everything looked normal. But then when she re-weighed him after he nursed, we saw that he had only gained half an ounce. Not good. 

She looked in his mouth and inspected his tongue and said there was a possibility he might be tongue tied but that she liked to give babies a chance to prove themselves before sending them to an ENT for an evaluation. She also said that babies who are born early sometimes have difficulty nursing in the beginning because those last few weeks in the womb are when they perfect the sucking reflex. She then laid out a plan for me that involved taking three capsules each of fenugreek and blessed thistle three times a day, and pumping after every nursing session, for a total of 7-9 pumping sessions a day. She told me to buy a better nursing pillow (called, no joke, My Breast Friend, which is a silly name but I actually did find it much more helpful than the ever-popular Boppy, which ended up serving as a great butt pillow instead!). She also gave me the tip of sitting on a rolled up towel in a warm sitz bath to help make my tear feel better.  

And then, right before we left, she delivered the gut punch. 

"It all comes down to the determination of the mother," she said. "If you really want it, it will be there for you." 

That really hit me where it hurt. The determination of the mother? You won't find many mothers more determined than me. I had lain still for three months to keep this baby safe inside me, and I'd be damned if I didn't make this nursing thing work for us. There are plenty of qualities I lack, but self-discipline and determination aren't among them. I'm no quitter.

So right here would be a good time to take a brief break from the story to talk about one of the things I learned through this experience. As I’ve gotten older I’ve realized that I'm more often tested in areas where I think I'm strong than those in which I know I'm weak. I think that's because I take pride in my strengths, not my weaknesses. And as the saying goes, “Pride comes before the fall.” You see, I always prided myself in my determination and I thought that my willpower made all the difference for me in life. But through this nursing experience God taught me that sometimes, no amount of my effort or resolve can make things work. Sometimes I'm going to fail, no matter how hard or long I try to achieve something. I've had other failures in life of course, but this one has been the hardest for me to get over. And the most humbling.
 

How about I just stick my hand in there instead?

Post labor Labor Day 

Anyway, back to the story. I went home after that appointment with the Wonderful Wizard of Boobs with renewed determination. On the way back home we stopped at Babies R Us and bought the My Breast Friend, some nursing tops, and the Avent Naturals bottles she had recommended as good bottles to use when trying to breastfeed. When we got home I immediately hooked myself up to the pump (she also gave me a few tips on how to pump more effectively, which turned out to be really helpful...they should really give courses on these kinds of things to new mothers in the hospital!). Then I did the hand pumping she taught me, which she said I needed to do after the pumping because it would get more milk out and stimulate my body to produce more. 

The next time I tried to nurse Caleb, I got everything into place, and with a brain half-functioning from lack of sleep, I tried to remember everything she had showed me. But after many tries, Caleb still wasn't able to latch. It just. wasn't. working. The Wizard had told us that if he didn't nurse, we would have to give him a bottle because the cardinal rule is, "Feed the Baby," by whatever means necessary. So John gave Caleb a bottle while I, feeling defeated, once again started pumping. 

I don't think the nursing troubles were totally to blame for the postpartum depression and anxiety I experienced but they definitely played a role. The rare times that Caleb would nurse, I felt so much more bonded with him. I would look down at his face and stroke his head and think, "This is the way it's meant to be." Me feeding my son from my own body, with food made just for him. 

But most of the time, instead of being a bonding experience, nursing drove Caleb and me further apart. I would spend an hour at a time trying to get him to do it, and when it didn't work, it felt like he wasn't just rejecting the nursing, he was rejecting me. His own mother. I wasn't able to do the one thing for him that I biologically was programmed to do. Meanwhile lactation consultants and doctors and nurses and news articles and smug, judgy moms and friends posting breastfeeding facts on Facebook all seemed to be screaming at me that EVERY woman can and should do this. But I didn't need convincing that “Breast is Best.” I was already convinced. So their input only served to make me feel even more guilty, more defective. 

Instead of me being able to feed Caleb, John or my mom would give him the bottle, half full of formula and half full of milk that I had pumped, since I still wasn't producing enough. And there I would sit in the rocking chair in Caleb's room, hooked up to the pump like a Dairy Gold cow, sobbing as other people fed my milk to my baby.

When I wasn’t pumping, I was laying in bed crying (of course) and not sleeping because I was too busy searching the Internet for solutions (KellyMom became my breastfeeding Bible). Or I was eating (seriously I think all those celebrities who credit breastfeeding for their dramatic weight losses are full of crap. Not that I really cared anyway at the time since I was so obsessed with making nursing work, but I lost exactly zero pounds breastfeeding. I was hungry all the time, and I ate a ton to try to keep my production from waning any further). When I wasn’t doing any of the above, I was guzzling gallons of Mother’s Milk tea and stuffing my face full of milk-boosting supplements.  

Oh yeah, and crying. 

Meanwhile, the more Caleb got the bottle, the more he preferred it. We started getting really frustrated with the situation. The lactation nurse had given me the name of her assistant, who makes house calls, in case we needed help over the holiday weekend. I called her but she wasn't available, so then I happened to talk to a friend who had just given birth and was having nursing troubles too and she gave me the name of another lactation educator who works exclusively in people’s homes. So I called her and she came right over. 

She evaluated the situation and what do you know? She had another opinion. She said that Caleb was getting too used to the bottle and that we should just try quitting it cold turkey and nursing him around the clock and that he would get the hang of it when he was hungry enough. Sink or swim. She showed me a new trick, nursing while laying down, since it was hurting me so badly to sit in a chair, and although it worked once while she was there, it ended up being just as unsuccessful as any of the other positions she tried.  

Caleb was a little over a week old at this point, and John was preparing to go back on the road since he had taken so much time off before Caleb was born. Fortunately my mom was still there but I was distraught at the idea of him leaving so soon, when everything still was so new and overwhelming, especially with the nursing situation. The night before he left I cried and cried in bed, saying, "I can't do this without you," over and over, while he kept saying, "Yes, you can. Yes, you can." 

My dad came the next day and I felt better having both my parents here to help, but still overwhelmed because the nursing was all on me. Nobody could take that burden away. Both nights John was gone, my mom and I stayed up all night, me trying to nurse Caleb and her sitting across from us, while we tried everything we could to keep him awake while he nursed, wet rags on the neck, fans blowing in our faces, you name it. His jaundice wasn't getting better even though we were holding him in the sunlight a lot, so I called the pediatrician and she told me I needed to come in. I also called my doctor because it seemed like my tear was getting worse instead of better. Fortunately the two doctors are in the same building so I scheduled back-to-back appointments. 

At my doctor appointment we discovered that one of the stitches was actually pulling at the tear instead of helping bring it back together, so he fixed that and I immediately felt a little better. He asked me if I was breast feeding and in defeated tones I told him about the nursing problems. Then he looked me in the eye and said, “Emily, the thing you need to remember is just how far you and Caleb have come. Not too long ago we thought he'd be spending his first few months in the NICU! So either way, whether nursing works out or not, he’s going to get the nutrition he needs. Either way, you WIN.” Unfortunately, these were wise words that were wasted on me at the time. I was fighting the battle to breastfeed, and anything short of that was losing. 

After my appointment we took Caleb to his appointment. The pediatrician looked at Caleb and then at the meticulous charts my mom, John and I had been keeping to document all his wet and dirty diapers, and then she weighed him. He was painfully thin. She said, "Caleb is surviving but he's not thriving. You're going to need to start giving him bottles until the nursing improves because while most babies lose weight for a few days after birth, it's been too long now and he's not bouncing back."  

I burst into tears. (Yeah, that happened at pretty much every appointment for a while). What kind of a mother was I, starving my baby? Then we had to go get his heel pricked once again so his billirubin levels could be re-tested. After it was done he was wailing and the nurse said, "You can nurse him now, that usually helps them feel better." I felt about two inches tall. Yes, nursing was supposed to be comforting for my baby. But I wasn't able to comfort him that way. 

John got home from his trip that night and he was shocked at how emaciated Caleb looked. We started giving him bottles again, and I felt so defeated. But I wasn't giving up. Not me. I was NOT in the 90 percent of women who give up on breastfeeding. I wanted the best, healthiest food for my son and I was going to get him the best if it killed me. 

Holding him in the sunlight to try to make the jaundice go away

Nursing nazi 

So next I called the local La Leche League leader. Of all the lactation consultants I talked to, she made me feel the worst. She said I should have been pumping 10 times a day the whole time and that I needed to do so immediately if I was going to reach my goal of exclusively breastfeeding for the first year. I told her what all was going on and she said, "I know it's hard, I know, but you need to get those pumping sessions in," in a patronizing tone that told me she actually had no idea how hard it was. She also said I needed to start taking Reglan to boost my milk production. That's when she really pissed me off.

This woman was an example of why lactation consultants are sometimes known as nursing nazis. She was militant in her approach and cold in her delivery. What's more, in her zeal to have me breastfeed she was recommending a drug that is known for its terrible side effects. Fortunately I knew about Reglan (here's when some of this story comes full circle) because it originally was used to aid digestion in gastroparesis patients. Some GI doctors still prescribe it, but mine doesn't because he believes the side effects can be too detrimental. And after researching it, I agree with him. That's why back when I was trying to fix my gastroparesis I ended up ordering the domperidone from Canada, because even though it's not FDA approved it actually has proven to be a safer drug than Reglan in treating gastroparesis. 

When I told the La Leche leader that there was no way I would take Reglan and listed some of the reasons why, she had no idea what I was talking about. So in effect, she was recommending a drug to me, and probably countless other women, without knowing what it actually did other than boost milk production. However well meaning, she was just plain being reckless, in my opinion.

I got off the phone with her and felt worse than I did before. I was angry that she was so set on the importance of breast milk that she was willing to compromise my health, but I also felt even more guilty because I felt I wasn't doing all I could to make this work. So for a few days I tried to keep up the 10-times-a-day pumping schedule, and ran myself further into the ground. 

John was becoming increasingly worried about me but he was incredibly supportive about my desire to breastfeed and was willing to do whatever I wanted to try to make it work. So after a few days of me pumping nonstop and still not getting anywhere, he said if I wanted to try calling the other at-home lactation consultant that the Grand Poobah had suggested, we could pay to have her come out and evaluate the situation. 

Light bulb moment 

This proved to be the turning point in our understanding of what was going on with Caleb and me. The woman came out and, as her predecessors had done before, tried countless techniques to get Caleb to latch and keep nursing, and after many unsuccessful attempts, she said something that I had suspected all along but hadn't felt confident enough as a mother to trust my instincts. She said that it looked like Caleb was in pain, particularly when he nursed on the left side, and that it looked like he was trying to nurse but wasn't able to do it. After hearing about his difficult delivery, she wondered if his head being stuck sideways for so long in the birth canal had injured his neck. 

She said that if we were open to it, she would schedule an appointment for us with a friend of hers who does something called cranial sacral massage. She said it's still considered a bit of a "fringe" treatment, but she had seen firsthand the positive effects it can have on babies. I was concerned about doing anything to Caleb that might do more harm than good, especially an alternative treatment that many medical professionals still dismiss as "hocus pocus." But after researching it for myself and remembering how another "hocus pocus" treatment had helped my stomach, I decided we should give it a shot. So I called her and made the appointment.  

A couple days later we found ourselves in yet another strange room, trying once again to nurse in front of an "expert" who we hoped would have the magic bullet for us. The massage therapist said it definitely looked like Caleb had tension in his head and neck. Reluctantly I handed my baby to her and watched as she gently touched him. Her touch was feather light and I wondered how it could do anything to relieve the tension. But when she handed him back to me and we tried nursing again, the difference in his ability to latch was like night and day. He no longer flinched or twisted his body and he was able to open his mouth bigger than I had ever since before.

Safe to say, in the basement of that women's home that afternoon, I became a convert to cranial sacral therapy.

Cranial sacral therapy. What I would give to feel this relaxed!  (This baby isn't Caleb, by the way.)

Yet while Caleb’s latch had improved, he clearly was still struggling to nurse. The therapist then examined his mouth and sucking reflex and tried to get him to stick out his tongue, but it barely moved. She said it looked like he was tongue tied (something I had also suspected) and she recommended we meet with an ENT doc in town who is known for specializing in fixing tongue ties and for his conservative approach in only snipping the tongues that really needed it. 

Tongue tied 

“Great,” we thought. Yet another appointment we have to make and expert we have to pay to see. But we were encouraged by the massage's effect on Caleb's latch and wanted to make every effort to make this work. So a few days later we took him to yet another specialist. After the ENT doctor examined him, he said Caleb definitely had a tongue tie and that releasing it would not only help his nursing but his long term speech and eating/drinking abilities. 

It killed me to sit in that room as I watched a nurse hold my squealing baby down on the table while the doctor injected his mouth with a local anesthetic and then took a tiny pair of scissors to his tongue. But as I sat there crying and feeling like a terrible mom, I told myself that this was for his long term good. 

The doctor handed him back to me and told me to start nursing immediately. He said that many babies show an immediate difference in their sucking ability. But he cautioned that the most ideal window to get it done was within the first two weeks of life and that after that the rates of nursing success started to drop off because babies have a hard time learning how to suck differently and unlearning bad habits they've developed. Caleb was at three weeks, but I was confident that we had gotten all his issues resolved and that it would be smooth sailing from here.

But as he struggled to nurse in that room and we tried for over an hour, the hope that had surged so strongly a few hours before began to falter. We headed home (stopping at Jack in the Box so I could drown my sorrows in curly fries and a chocolate shake) and I once again fought feelings of depression and defeat. 

This isn't Caleb's tongue, but it gives you an idea what it looked like.

(By the way, I recently read this article "Twenty Things You Don't Know About Tongue Tie" and it totally confirmed my experience with tongue ties, massage, the whole nine yards.) Also, I now know several mothers who have had tongue tied babies and resulting nursing troubles, which leads me to wonder why in the world they don’t check for that first thing in the hospital after the baby is born? If the medical community is so intent on getting more women to breast feed, why aren’t they instituting this relatively simple inspection into their post-birth protocols?! 

Last ditch effort

After a few days of Caleb still refusing to nurse we decided to go back to the Grand Poobah, even though we weren't sure if our insurance would cover the visit and at this point we had already spilled a lot of blood and treasure to try to make nursing work.

She once again struggled to get him to latch and finally decided to try this contraction called a Supplemental Nursing System (SSN) which is basically tubing attached to a container of milk. The tubing dribbles milk into the baby's mouth while he nurses, giving him incentive to keep nursing. It's supposed to be helpful for mothers who have a slow let down or not enough milk. The problem with us was that it was difficult to get the whole thing hooked up alongside the nipple shield we still had to use. Plus despite the extra help from the supplemental milk, which was dribbling everywhere, Caleb still refused to latch on. 

Me, John and the Grand Wizard finally got it to work, but I was thinking, "How in the world am I going to be able to do this on my own when John's not around?" And yet she still remained convinced that eventually Caleb would get the hang of it, so I tried to believe it would too. She said that she normally didn't do this but that if we were still having difficulty in a few days she would make a house call over the weekend to come help me in my own home environment.

"I can tell how important this is to you and I want to do everything we can to make this work," she said. 

She also evaluated how much milk he was getting out of me by doing the weighing before and after and measuring it against how much milk he had drained from the SSN. He wasn't getting much. She asked if I was pumping after every nursing session and I told her I was. Plus I was taking all those herbs. She said the next step would be to take a prescription medicine like Reglan but that she knew that not all mothers were comfortable with that option. I told her I wouldn't take Reglan but that I did have domperidone at home. She looked surprised and said, "How in the world did you get your hands on that?" I said, "Well funny story..." and told her the whole gastroparesis situation. She said, “How the hell did you even get pregnant?!” I had to smile at that one. For a brief moment, it brought my head out of the fog and reminded me how lucky I was to even be here holding this miracle baby and to be dealing with issues like how best to feed him, rather than how to keep him alive. 

She told me that domperidone works even better than Reglan for breastmilk production and suggested I start taking it again. I was wary of doing that, since my stomach had been working so well ever since I got pregnant and I was worried if I took something that would mess with my digestion it would start acting up again. 

I went home and decided to call my GI doc to see what he thought. He said he didn't think it would harm my stomach to take the domperidone again, so I decided to start taking it. After a couple days I definitely noticed my production going up and my stomach seemed to be doing fine, so I felt very relieved and thanked God that he had somehow sewn a silver lining into all the digestion issues I had faced in the year prior. I never would have expected that this drug I had bought from Canada for my stomach would eventually be used to help me breastfeed. Life is funny like that sometimes. 

We took Caleb to the cranial sacral massage therapist once more to see if that would help again, and she said there was still some tension in his neck but that it felt much better than it did before. She did one more treatment and it appeared to help again, for that day at least. But the SSN was a nightmare at home and after many messy, frustrating attempts we decided to ask the Grand Wizard to come to our house. She did and saw firsthand what we were up against. She finally was able to get it working, but she could see the desperation and the hopelessness written on our faces. She said, "The issue here, along with all the other things you've dealt with, is that you've got a smart, stubborn kid on your hands. He knows the bottle is easier and he's not willing to be patient enough to nurse. And really, would you rather have a dumb bunny?" No, we just wished our smart bunny would nurse!

The boy and his bottle

As she was leaving our house, she tried to encourage me by saying, "You're smart, you've done your research, and you've done everything you can to get your baby breast milk. If you want it, you can make it work. It just comes down to how determined you are to get it." 

I know she was trying to help, but her repeated comments, which were echoed by all the other LC's I saw, about how breastfeeding success or failure always comes down to the mother was complete B.S. and did more harm than good. I understand that they probably deal more often with mothers who don't care as much as I do about breastfeeding, but I think they're doing a disservice to the mothers who do care a lot about it by placing the burden all on their shoulders. It has taken me a long time to come to terms with this, but sometimes there are factors beyond a woman’s control in breastfeeding (as with many other things in parenting), that make it ultimately unsuccessful no matter how hard she tries or how badly she wants it. 

My beef with the breastfeeding “experts” 

And while I'm at it, here's another beef I have about our society's approach to breastfeeding. I don't know why I wasn't making enough milk. Maybe it was something I was born with, or maybe it was the result of Caleb's poor sucking ability that didn't stimulate my body to produce enough.

Regardless, LC's often tell women that everyone produces enough breast milk and that only like 1 percent of women don't make enough for their babies. I understand that there are instances when pediatricians probably wrongly tell mothers that their babies aren't gaining weight fast enough and give them bad advice to start using the bottle. In fact, I am positive that some of you reading this have already thought, “If only she trusted her abilities more and listened to the doctors less when they told her Caleb wasn’t gaining enough weight, it would have worked out.” I know this because I have talked to women who have said their doctors told them the same thing but that they persevered and that their kids turned out fine. I’m glad it worked for them and their kids ended up being okay. But each situation is different and with all that we had going wrong with the nursing, I know without a shadow of a doubt that we would have had to resort to supplementing at some point and I’m so glad I didn’t let my stubbornness negatively affect Caleb’s health and well being, especially after all we went through during the pregnancy to even get him to this point. 

And regarding the issue of milk production, women not making enough breast milk is not something that has just appeared out of nowhere in the last 20 years. Back in the day, before we had formula, there were these people called wet nurses who nursed other women's babies when they couldn't make enough milk. And if mothers didn't have access to wet nurses, or if their babies couldn't nurse due to tongue ties or other problems, they either fed their babies cow's milk (which sometimes killed them) or their babies starved to death. It was as simple as that. So to tell women struggling with production that it's all in their heads and that they actually should be making plenty of milk for their babies is not only cruel, it's historically and scientifically inaccurate.  

For the record, I haven't read this. I'm guessing it wasn't a bestseller.

What’s more, women are told that breastfeeding should work for them because their bodies are designed to do it, but there are plenty of other instances in which our bodies don't function as they should. Yet you don't ever hear of someone telling a person with a leaky heart valve, "Well, this is how your heart should be functioning, so if you think it's not functioning right, it's all in your head." So why do we do that with women and their bodies' ability to produce breast milk?  

And while I also understand that we primarily live in a bottle culture and women over the past 50 years haven't been encouraged enough to breastfeed, I think in their zeal to bring back the boobs, LC's and medical professionals have mainly served to just put a lot of guilt on mothers without providing them the necessary support to actually be successful in breastfeeding. Doctors tell women that "breast is best" for their babies, but the only support a woman receives in the hospital after giving birth is a few lessons from various nurses who all give her contradictory advice, maybe a visit from a lactation consultant if she's lucky, and then a pat on the back and a "Good luck!” on the way out the door. 

Meanwhile, most doctors are actually clueless about how breastfeeding works and what's involved because they receive next to no training on it during medical school. So they know that breast milk is important but have no idea how to support their patients in breastfeeding. Then you have lactation consultants who are often very expensive and not covered by insurance (although I think the rules just changed on that) but who also could often use some work in terms of their own education and their bedside manner.

If we really want to get back to the olden days and reclaim a woman's God-given ability to feed her baby, let's look at everything that went into breastfeeding cultures back then. Breastfeeding may be natural, but for many mothers, and babies, it doesn't come naturally. Back in the day, women often lived in communities with other women who could help them learn how to breastfeed and support them if it wasn't working. They also had the aforementioned wet nurses. And let's not even get into all the environmental, economical and nutritional factors these days that might be inhibiting a woman's ability to nurse. 

All that to say, I think as a culture we still have a ways to go in terms of our breastfeeding support and understanding. This isn't a “Waah, nobody is helping me” type of complaint. I’m a huge believer in self-motivation and personal responsibility. It's more of a logical argument that if the medical community is going to advise women to breastfeed their babies then they need to be educating their doctors about how breastfeeding works and how to identify things like tongue ties, as well as encourage them to work in conjunction with, rather than separate from, lactation consultants. And apparently I’m not alone in this opinion, as this article on CNN.com can attest.  

But please also hear me when I say that this little rant isn't to say that women should or should not do everything they can to make it work. Breast milk and breastfeeding was really important to me, both because of its health benefits for Caleb and me (it lowers breast cancer risk, which runs in my family) and because of the bonding element in nursing, so I made it a priority. I absolutely believe in breastfeeding as the best option. But I also believe we can be doing a better job at supporting mothers in their efforts to make it work and in offering understanding and encouragement rather than shaming them if it doesn't.   

Admitting defeat 

Okay, time to climb down from that soapbox. After that home visit we tried a few more days to make the SSN work, but John was heading out of town again and it was clear that it wasn't working. So I decided to keep pumping and just try to nurse a couple times a day, mainly for the bonding aspect. It was just too much to continue trying to nurse for an hour at each feed, usually unsuccessfully, and then feed him a bottle, burp him, change him, eventually put him down for a nap and then pump for 20 minutes before he woke up again, when we would repeat the whole cycle.  

It killed me to give up on full-time nursing. I was completely devastated. And to be honest, I still get jealous when I see women breastfeeding their babies. But I had to make the best decision for my family. The unsustainable schedule I was keeping was bringing me very close to a complete nervous breakdown. Caleb needed breast milk, but he needed his mom more. So I decided that I would still pump as often as I could for as long as I could. 

HAHAHA! What drugs is this lady on? Because I'll have whatever she's having!

I ended up pumping for seven months. For the first five months I pumped for every single feed, usually about seven times a day. I'd pump for about 20 minutes, followed by 5-10 minutes of hand pumping. Since that whole process typically only produced four ounces of milk at most, I would feed him a bottle which was filled with part breast milk and part formula. Then I would play with him for awhile and once I put him down for a nap I would frantically try to get a pumping session in and pray that he stayed asleep long enough for me to do it. He was a baby who wanted to be held constantly so I couldn't even set him down for a few minutes if he was awake, which is why I had to wait for the naps. It made for a very stressful schedule and meant that I basically couldn't leave the house because I was tied to the pump.

Plus I couldn't take advantage of him being on the bottle, because even when John would take a night shift or a friend would come over during the day and help feed Caleb, I would still get up to pump. I never made enough to get a good backlog of milk going to freeze for later so we just kept the bottles stored in the fridge and tried to use a consistent milk-to-formula ratio each time to keep Caleb's tummy from getting distressed. 

Every time I mixed formula, I felt like I was preparing rat poison for my baby. I know that sounds crazy, but it's how I felt. I HATED using formula. In fact to this day I still feel guilty when I'm making Caleb's bottles, even though I know that it's fine. In direct contrast, I always felt so good when I could pour breast milk into his bottles. It truly was like liquid gold, and there were a couple times when I accidentally spilled some, and boy, let me tell you, sometimes you do cry over spilled milk.

My own personal stash of liquid gold

Even when we went out, I brought the pump with me and pumped in the car or in the Nordstrom women's lounge or wherever I could find a private spot. And I always felt "less than" when I saw a women next to me nursing her baby, and here I was hooked up to a mechanical pump while my husband fed a bottle to my baby. One time when Caleb was only a couple weeks old we were at Starbucks and a woman saw me holding Caleb and said, "So are you nursing?" She might have just as well asked, “Do you want some more salt in those wounds?” I mean seriously, who the heck asks that to a complete stranger anyway? I should have just said yes, but I was so shocked I told her the truth, that I was trying to make it work but that I was mainly pumping. She gave me a weird look and then walked away. 

Once Caleb hit three months I decided to try to start weaning off the pump because with him being awake more it was getting harder to get the pumping sessions in and I knew that the first three months were the most important in terms of a baby getting breast milk. By the grace of God, I had never missed a feed. But I was desperate to start dropping at least one or two pumping sessions, particularly the middle of the night and early morning ones because it sucked to get up and feed him and change his diaper then settle him back to bed and not be able to go back to bed myself until after I pumped while watching early morning infomercials, then pray that he slept a couple more hours until I got up and did the whole thing again.

I was more than ready to start dropping pumping sessions, and then I found out that there was a specific way I should wean so that I didn't get plugged ducts. I had to remove one pill at a time, every three days, before I could even start removing pumping sessions. At this point I was taking nine pills a day each of Fenugreek and Blessed Thistle and three pills a day of the domperidone, so it took quite a while. Then I started weaning off the pumping sessions, dropping one session a week. Once I got down to two sessions a day, I stayed there for about two months (pumping like 30 minutes because it took longer at that point to get the same amount of milk as before) because at that point I was like, heck, I might as well try to get him to six months. Then after he hit six months it took me a while longer to drop the remaining two because I was so careful about not getting mastitis.

So before I knew it, Caleb was seven months when I finally stopped pumping completely. I'm glad I did it slowly because I really think that was the best for both my body and his. Did it contribute to my postpartum depression to be pumping that much and be so stressed out and tied down by it? Probably. But when all is said and done, I don't regret it. As insane and difficult as it was to keep pumping, it was what I needed to do to feel okay about things.

While I’m slowly making my peace with the situation, I don’t know that I will ever fully get over it. And yet as Caleb gets older and we enter new and different stages in parenting, I’m already gaining a larger perspective on what it means to be a mother and to care for all aspects of a child. Sure, breast is best, but Caleb needs so much more from me than my boobs.  

Back when I was in the thick of the nursing nightmare, a friend of mine who also struggled with breastfeeding her children sent me this blog post she had read. I was still beyond solace at that point, but the writer's final words stuck with me. So to end this chapter, I will adapt her conclusion for my own.

It has taken me a while to grieve the loss of nursing my baby. But it was only when I started to let go of our nursing failure that I could finally let in the light shining from Caleb’s sweet face, from those gummy grins that told me we were going to be just fine.

My boobs (heck, most of my body) might not work right. But my heart does. And it will always belong to him and his Daddy.