Since beginning this blog, we have wanted to write about breastfeeding and the current culture that surrounds it. Both of us had troubling experiences when our expectations about breastfeeding collided with the too-often ignored realities that come with it. We want to start by telling our stories, and then offering some thoughts about what women can do to deal with encouragement and discouragement around breastfeeding.
Breastfeeding Woes, or, “Have you tried the football hold?”
I assumed from the beginning that I would be able to follow the plan I’d made for breastfeed my baby without any problem. The plan was to breastfeed her exclusively for six months until I returned to work, then pump (and maybe supplement with formula) until she switched to solids. Although I always gave good lip service to the fact that this might not work (“who knows,” I’d say, “I will try my best barring unforeseen circumstances”)…in my heart I thought it would probably be fine. Hard…but fine.
Then those unforeseen circumstances came on, with a vengeance. My daughter was born 8 weeks early, at 32 weeks gestation, weighing only 2 pounds 11 ounces. After an emergency c-section she was resuscitated and rushed to the NICU, where she would stay until near her original due date. (If you’re curious, she was born early due to severe preeclampsia and growth restriction, and yes, I had planned on a natural vaginal birth before that happened).
I spent at least the first 12 hours in a heavy fog of anesthesia and grief. At some point, a hospital grade breast pump was delivered to my room, with a stack of cheerfully colored handouts: “Did you plan to breastfeed? You still can!” “Breastfeeding Your Preemie.” After a few visits from some equally enthusiastic nurses, I set about forcing my traumatized body to lactate. My husband dutifully ferried tubes with drops of colostrum from my room to the NICU before I’d ever held the baby. So many things I had planned on had been ripped away from me, so I was determined to breastfeed according to my original plan. The hospital staff was manically supportive.
I was able to produce quite a bit of milk, but it was at least 2 weeks before I was allowed to try actual breastfeeding. As I had delivered containers upon containers of breast milk to the hospital, I blindly believed the staff when they said my baby would learn to breastfeed. “She’ll just figure it out,” was a pretty common refrain.
We began trying to teach her to latch on, and I had to hold off the heartbreak as every feeding failed. Her tiny mouth could not latch on, and her taxed, easily over-stimulated nervous system often made her fall asleep the minute she touched my body. The staff kept up the fierce encouragement, and I kept pumping. I kept slapping on that damn silicon nipple shield and I kept hopefully holding her tiny, tiny body to my breast. I kept trying, and I kept failing.
She began to do test weights, which means they weigh her before and after breast feeding to see how much she has eaten. She always needed the balance of her feeding via the tube to her stomach. I think I managed to get her to take a full feeding 2 times before our discharge day arrived. Still the staff ushered us out on a wave of encouragement and vague promises that the baby would somehow suddenly figure out breastfeeding – if only I followed the exhaustive list of tips, tricks, and methods. I came to feel that if a feeding failed, it was because I had used the wrong hold, timed it incorrectly, eaten the wrong food, misunderstood her cries, and so much more.
Not ONCE did anyone look me in the eye and say what I knew in my heart to be true: A preemie as early as my daughter may never get the hang of breastfeeding because of her size, immature suck-swallow-breathe reflex, and the fact that she spent the first SIX WEEKS of her life in a hospital with pacifiers, bottles, and gavage feeding, only nursing up to once or twice a day before being topped up by a nurse. Can you imagine telling a mom with a full term baby that she can bring her baby home, but must create these circumstances and then expect her baby to breastfeed starting at six weeks old?
When we got her home, I dutifully continued the ritual of failure. Eventually I began giving her a bottle of pumped breast milk after all feedings, but didn’t admit why. I remember finally looking at my amazing husband, who did everything he possibly could to support me, and asking him to help me admit that we weren’t really breastfeeding. At first, he didn’t know whether to push me to continue, or allow me to stop.
Giving it up came slowly, and with so, so many tears. But I knew that I had to focus on helping my little baby (still just 5 pounds at 2 months old) to grow and be healthy. And I knew that it was a major blessing to be able to give her pumped breast milk, whether it came from a bottle or my body. Through the many sobbing conversations that happened at the time, I remember saying over and over that I had failed at keeping her in my body until term, I had failed to have the vaginal birth I wanted, and now here I was, failing my precious daughter again. It was unbearably sad. It didn’t help that the doctors kept pushing, never admitting it might not be in the cards for us. In the end I stopped trying to breastfeed after a few weeks at home.
I continued to pump full time for another month or two, then we used up the remaining stored breast milk. Ultimately, she was on some breast milk until – get this- about 6 months old. In a way, I reached my goal after all.
I did everything I knew of to prepare to breastfeed my daughter. I read a book on it, took a class at our hospital, bought the most expensive breast pump on the market (to help when I went back to work), and listened to everyone who told me that only a tiny percentage of women have something “wrong” that keeps them from breastfeeding. I was healthy, educated, and ready.
When my daughter was born, I requested help from the lactation consultant as soon as possible; together, we positioned my daughter in the various “holds” and worked on getting her to latch on. I fed her the colostrum (the first milk that comes in) and when we were discharged from the hospital, I was confident that I could do what I had planned – breastfeed her exclusively for four months and then wean her at one year.
It didn’t happen.
For two days after we arrived home, I sat on the couch or in bed holding my daughter for hours as she would nurse and then sleep for a few minutes, and repeat and repeat and repeat. One morning we realized our daughter hadn’t peed in over a day.
We called our pediatrician’s office, concerned, but remembering that the hospital, the breastfeeding class instructor, and friends and family had said that the milk always “comes in,” that the baby won’t starve, and that you just need to hold on. But we weren’t told to hold on; we were instructed to take her immediately to the E.R. and shamed for the fact that we hadn’t realized we should do this sooner.
We rushed our little one to the hospital, where they administered blood tests, searching for the answer to what was going on. My partner and I were terrified that something was terribly wrong with our daughter. What if her bladder wasn’t fully formed, or something worse was going on?
The mystified doctor finally suggested we give her some sugar water in a bottle, as her only abnormal level was low blood sugar. Our daughter greedily downed the sugar water and her next blood test came back normal. Still stumped, the doctor sent us home with the instruction to give her some formula and see if she peed. If she didn’t wet a diaper within 8 hours, we needed to go back for more tests.
As we hadn’t been informed in any of our research about what to do if we had to give her formula, my partner just bought a major name brand formula and we fed A. from it. We also purchased disposable diapers with a stripe on them that would turn blue when she had peed. The hours ticked by and we kept staring at the stripe, feeding her more formula and hoping that something horrible wasn’t wrong.
When the stripe turned blue six hours after our E.R. visit, I cried. She was okay but I wasn’t. My baby had been hungry all those hours that she tired herself out nursing and I hadn’t been feeding her. I was failing her.
We called lactation consultants, I met with our doula about it, I ate oatmeal, drank more water, took supplements, drank Mother’s Milk tea, used the breastpump for up to 10 hours a day, and even started taking a prescription medication for it.
And in return, I stopped sleeping. I couldn’t bear to be alone. I had no appetite. I would wander the house at night, terrified to lie down because I knew I was exhausted but couldn’t stop panicking long enough to fall asleep. I couldn’t even enjoy being with my precious daughter because I cried when I tried to breastfeed her (and failed) and I cried when I gave her formula.
After two weeks of this crushing regimen, my partner told me that I had a choice: to let the guilt over it consume me or to let it go. We decided as a family to let it go. After a month of my own ritual of failure, I stopped and we moved on.
My partner found an amazing website, By the Breast, and we purchased breast milk from a wonderful mom nearby. She had a six month old and was producing more milk than he needed. We spent over $1000 on breast milk so that I could feel better about the fact that I couldn’t breastfeed my child, and I am so grateful that we were able to do it. We researched formulas and ended up importing one from Germany and combining it with an organic one we could buy locally. It was a lot of of work and I wish someone had told us ahead of time about the possibility.
Now that we are nearly to A’s one-year birthday, I still wonder: was I one of those (supposedly) very very few women who just can’t breastfeed or did I fail at it in some way? I’ll never know because ultimately, we chose my mental health and happiness over longterm sacrifice to the mighty breastpump.
The thing that strikes us most about our two narratives (besides the palpable heartbreak) is the sense of judgment and misinformation. The encouragement for women to breastfeed comes from a good place, meant to be supportive and encouraging. But we cannot possibly be the only two people who, originally so receptive of that message, are left feeling…dare we say it…betrayed?
It is no surprise that the act of breastfeeding is intricately tied to perceptions of womanliness, education, and a “natural” way of being. But it also makes a lot of troubling assumptions about who and what “should” be most important in women’s lives. In other words, to have children is to sacrifice, and sacrifice is often implicitly considered women’s duty, her natural role. So when breastfeeding requires sacrifice, it seems some women are made to feel as though they are not sacrificing enough, and it would work if only they did.
For example: there is a ubiquitous belief that any person, no matter their size, genetics, or circumstances, can achieve a very thin figure if only they commit themselves 100%, full effort, full devotion. It’s an intoxicating myth because it makes an idealized body available to anyone. But it’s also easy to see why it’s garbage. We all know that there are factors involved that mean even with “100% commitment” we might never reach that ideal body. But because we believe the myth that with that commitment, it’s possible, when people don’t reach that ideal it’s implicitly blamed on them. Ridiculous, right? And unhelpful? Why can’t we see that something similar might be happening with breastfeeding?
There is a link here to the work of researcher and author Brené Brown, who talks a lot about shame. So much of our lives are built around feeling shame, which Brown talks about combating through the willingness to be vulnerable and compassionate, among other things. Motherhood and preparing for motherhood can bring out deep feelings of shame over so many things (which can often get pushed out onto others through judgment and criticism). In fact, we started to type some out and just got exhausted thinking about the length of the list. Our experiences as new mothers, particularly in the realm of breastfeeding, demonstrate how motherhood is set up as a shame-filled exercise.
Jen notes that she has had many friends and family members gratefully tell their own unsuccessful and secret breastfeeding stories to her after hearing her story and has also had friends judge her for her decision to stop trying after a month. Those reactions can teach us a lot about the people who share them; not that the judgmental ones are bad people, but their self worth on this issue clearly comes from the standpoint that the mother sacrifices as much and for as long as she needs to.
When we do the important work of encouraging women to breastfeed, let’s try to find a balance between encouragement and shame. Yes, successful breastfeeding does require some pain, sacrifice, and commitment. And women need strong cheerleaders to make that happen. But there is a manic, cruel strain of cheerleading that has refused to take account of physical, emotional, and social circumstances that make breastfeeding harder for some women than others. It’s not an equal-opportunity function! It’s not as if breastfeeding will work 100% of the time, given adequate support and information. It’s Just. Not. True.
Something needs to change in the way we cheer-lead: a more sensitive, observant approach. Maybe this can only come from women sharing their experiences of breastfeeding and LISTENING to one another, instead of repeating taglines.