I breastfed my newborn son in the Target dressing room today. My tiny boy, the one who lost ounce after ounce in the hospital, is now over 12 pounds. Why? Because I have nursed him in restaurants, in the front seat of my car, in the recliner, in bed, on the floor, curled up on my friend's couch, and in the Mommy Room at Babies 'R' Us. I have nursed him in the preschool library and at the picnic table next to the garden. I'm like the "Got Milk?" version of a Dr. Seuss book. I can nurse you here and there, I can nurse you everywhere!
I used to be a formula mom. When my first son was born, I tried desperately to nurse him. But after an unexpected C-section, my body started to fail me. I couldn't stop shaking. I couldn't stand, or walk, or reach over to pick my sweet son up out of the hospital bassinet. I was on so much pain medication that I felt as if I was sleeping with my eyes open. In those first four days at the hospital, I wanted desperately to be present. I wanted to remember my time there with Max. Instead, I could barely hold my head above water, more or less nurse him. I cried, I shook, I slipped into a dark fog that erased my memory of my first few days with my son. I was robbed of the skin-to-skin time that signals to a woman's breasts they should make milk. My stomach had been stapled back together though my heart was still split open. I figured that I'd nurse Max when I felt better.
The darkness subsided eventually, but I had missed the window for welcoming my milk supply. I was devastated, embarrassed, and without an ally. I was angry at myself, and felt betrayed by my body.
I pumped, I used supplements, I sobbed in the shower and cursed the breasts that were filled with shame and regret, but not a drop of milk. As the weeks went on, we also learned that Max's belly suffered from GI issues that made him vomit and choke. He was diagnosed with Reflux, Delayed Gastric Emptying, and food allergies. It was formula (a prescription, hypoallergenic one) that ended up saving him, and I learned to stuff my sadness into my back pocket and take pride in feeding him with love. Max was my first baby, and my first lesson in how mommy guilt could strip your confidence and make you doubt everything that you thought was true. I fed Max with formula, because it was my body, my mental health and my choice, but the pain never went away. I couldn't let go of the hope that I might be able to nurse my next baby.
And then, three years later, Ben was in my arms, and sucking like a tiny piranha at my breast. I was armed with knowledge I didn't have before. I knew I would have to fight to stay lucid in the hospital and need an advocate to help me explain to the anesthesiologist that I was sensitive to pain medication. No matter what, I would need to have this baby on my body, at my breast, every blessed second that I could. I would try everything possible to nurse him, unless he ended up having the same GI issues that Max did. If Ben was sick, then I would choose health. There is no place for pride when your child is suffering. If formula was what he needed to survive, then I would welcome formula with open arms. And with that, my second chance was left to chance.
Our doulas spent the first 48 hours of Ben's life sitting next to me on the hospital bed. Their shadow hands helped me to hold him tightly when the fog crept in. They cupped my suddenly ginormous double D's, squished them into "sandwiches," pulled his tiny rosebud mouth on to my breasts and held him there as he figured it out. They gently nudged my shoulders back, put pillows under my arms, and made sure that I was eating and drinking. My mom and my husband encouraged me to keep going, and took care of everything else so that I could simply sit and nurse. But even with all of the help, even with all of the determination, even though I fought like hell to see straight through the fog of my pain meds, Ben still lost weight. We knew that he wasn't sick like Max was. His blood sugars were fine. He was latching, he was eager, and I had him at my breast 24/7. But he had a slow start. Suddenly, I was failing again at the most natural thing in the world, before we had a chance to even begin.
When the lactation specialist arrived on the third day of our hospital stay, the pediatrician had already told her that I would need to supplement with formula. I started crying before she opened her mouth. F*ck you, I thought. F*ck you and your pump and your weight charts and your fake concern. Just leave me and my baby alone. The feeling of failure was too familiar. Failure and I were old friends. My tears were hot and fell fast down my cheeks and onto my chest, dropping like rain on Ben's soft little head as it burrowed into my empty breasts. But this time, I knew enough to not be afraid. I knew that his weight was still in a safe zone. I knew that nursing him first and then giving him formula would keep him nourished, while still protecting my budding supply.
Even though I could barely speak, I told the lactation specialist my plan. My voice wavered as I said that I would nurse Ben. Just nurse him. And then I would give him any colostrum that I had pumped, but I would only do it through a supplemental nursing system, so that he would still be at my breast. And then, only then, we would give him formula. Only through the supplemental nursing system. And only until my own milk came in.
The lactation specialist looked down at my tiny boy, and back up at me. She agreed that it was a safe choice. "It's going to be fine" she said. "Formula isn't the end of the world." The formula mom in me wanted to jump up and hug her for realizing that feeding with love was the most important thing. But I wasn't a formula mom anymore. I was a breastfeeding mom. I was a mother who was still hoping and praying that milk would fill my breasts, so I squeaked out "No, you see... you don't understand. I couldn't breastfeed my first son." This is a big deal lady! Didn't you read my article on the Huffington Post?I wanted to scream at her, to will my body to jump from the bed and throw the adorable little formula bottles in the trash. What if all of the rumors were true? What if hospitals really did push a formula agenda, and I was being pressured out of breastfeeding? But I simply cried. And thanked her. And watched her walk away.
The difference this time was my confidence. The difference was that I had a child who wasn't trembling from low blood sugar, and vomiting up whatever he ate. The difference was that I had armed myself with information, support, and an unexpected resilience. And just as my voice became strong and proud, I could feel my milk begin to come in.
I don't hate formula, I'm grateful for it. It saved Max's life. He is brilliant and strong, and beautiful and healthy. Formula was the right choice for us then. But moms have the right to choose. I wanted to try.
And so it began. Our nursing dance. I put Ben to my breast around the clock. His latch was terrible, we worked on it. My technique was terrible, we worked on it. We kept going. Each drop that went into Ben's mouth was more than I had ever made before, and suddenly I understood the magic of watching your body produce something that allows your baby to live and grow and thrive. There was magic in my boobs, people. I had a superpower. I could sustain life and nourish my child, with just my body. I was all that he needed. Just me, my leaky boobs, and maybe a few nursing pillows.
Somewhere in between a 3:00 a.m. nursing session and surfing the Internet for "nursing camisole size large" I realized that I had misunderstood all of you breastfeeding moms. When you chanted "What's your superpower? I make milk!" I used to secretly scream at you to go f*ck yourself. "Oh look! My little angel is milk drunk!" you'd coo. And I'd want to puke. There was nothing cute about posting a picture of your baby drooling milk out of their mouth while fast asleep. It all just seemed so self-congratulatory and boastful to me. Until I realized how damn hard it is to actually succeed at breastfeeding. It's not easy to nourish your child with every last calorie that you make. It's upsetting to feel the weight of being responsible for a tiny human being 24/7. To not share that burden with anyone else. To be afraid to leave the room, more or less actually go out of the house alone, because your precious child could starve to death when you are the only one who has the parts to feed him.
Three billion things can go wrong when you breastfeed. But even with a bad latch, tongue tie, thrush, a clogged duct, and a crazy oversupply, I still think that nursing this little boy is the most amazing magic that I've ever felt in my life. I am the only thing that is keeping my child alive right now. You're damn right that's a superpower. When my breasts are engorged and I'm in pain, or when I swoop in to a room and soothe my screaming baby with my body, I want to shout it from the rafters, just like all of you did. This time, my breasts make milk. That is my superpower. And yet I have seen that breastfeeding moms get tested too: the nasty stares, the mean comments, the endless questioning that makes you doubt yourself: "Are you sure he's getting enough? He'd sleep longer if he took a bottle. He'll never be independent if he's attached to you all the time." The Mommy Wars have fueled the embers of fear and failure on both ends of the feeding spectrum. The simple act of feeding your child now comes with having to defend your choices.
One afternoon at playgroup, I looked across the room at another mom. She was standing up, frantically bouncing her tiny son as he refluxed and puked over her shoulder. "I'm sorry" she whispered. "He's a fussy baby" she said, to the ground. When the group leader asked everyone to share their nursing story, she wept quietly. "I pump all the time, but I don't get anything" she cried. "I'm doing the best that I can". And suddenly my tears fell fast and furious. I don't belong with the successful breastfeeders I thought. My pride at having milk, my celebratory touchdown dances on Twitter and Facebook, were exactly what I had hated when I was a formula mom. There had to be a way to celebrate my breastfeeding success, without making other moms feel like I had felt. In my heart I am still a formula warrior. I watched the mom across the room as she shuffled through her diaper bag to grab a bottle. Her pain was fresh, and suddenly I was right back in the living room of our old townhouse, wearing a path down the hallway as I bounced/shushed/cuddled a screaming newborn.
I am a formula mom. I am a breastfeeding mom. I know what it feels like when your breasts "let-down," and I know what it feels like when your heart "lets-down." The beauty of our stories is that we are all feeding with love. I've been to the jagged edge of each feeding choice. I have nourished both of my children in the best way that I could, pleading each week with the scale in the doctor's office, praying for just a few more ounces. My superpower isn't my milk, it's my steadfast love for both of my boys. It's my determination to heal them, to grow them, to go to the ends of the earth for them. That is my superpower. That is my strength.
As playgroup ended, I walked over to the new mom, who was finally cradling her quiet boy as he finished the last drops of his bottle of formula. "I've been there" I whispered. "You're doing an amazing job. I can tell how much you love him". My own baby began to fuss. I tucked him gently under my nursing cover and looked her in the eye. "I know this is hard" I said. "But you're doing it right". As Ben latched and the pain shot through my breast I took a deep breath. This is hard, but I'm doing it right, I told myself. Our bodies, our babies, our choices. We leaned back against the wall of the playroom, the new mom and I, and cradled the best pieces of ourselves. We sat together, our eyes locked on the soft faces staring back at us, each waiting for the quiet peace that being "milk drunk" brings.
Dr. Ann Borders, an OB-GYN who works with NorthShore University HealthSystem, recommends that her patients <em>and</em> their partners go to a breastfeeding class before Baby is born. In class, they don't just focus on why breastfeeding matters, but what you can actually expect in those daunting first few days. And Borders doesn't just recommend this for newbie families, but also moms who may have tried breastfeeding before and found it difficult. "You're not going to know everything from taking the class, but it gives you a groundwork that you can build on at the hospital once you have the nurses helping you," Borders said. Most OB-GYNs will be able to give you a referral to a breastfeeding class nearby, but if for some reason yours doesn't have any suggestions, a quick online search should bring up options in your area.
When you're in the hospital or birthing center, or while you've still got your midwife with you after a home birth, make sure you speak up and ask for help getting started. "Every health care person should know the basic mechanics of breastfeeding," said Mary Ryngaert, a board certified lactation consultant with the University of Florida's Center for Breastfeeding and Newborns. "I joke that the person who empties the trash [in labor and delivery] should be able to help someone latch on." Even Borders, whose professional life and research centers around breastfeeding, said that when her first baby was born, she had to ask for guidance. Women should feel 100 percent empowered to ask their care provider to help them start breastfeeding within the first hour after a vaginal birth or two hours after a C-section if the circumstances allow for it, she said. Don't leave the hospital until you've gotten the help you need.
There's a reason why hospitals hoping to earn the coveted <a href="http://www.babyfriendlyusa.org/" target="_blank">"baby friendly"</a> designation for breastfeeding support stress the importance of skin-to-skin: It works. Research shows that essential contact helps relax both the mom and baby, stimulates feeding behaviors and triggers the release of certain hormones that spur breastfeeding. Experts say it's important to do it both early -- ideally right after birth -- and often. "Keeping the baby skin-to-skin as much as possible in the early days after birth is very important," Ryngaert said. "If the mother is 'touched out,' then the partner can hold the baby skin-to-skin. It still helps the baby move instinctually to what [he or she] is supposed to do." If you're not in a "baby friendly" hospital with policies in place to promote skin-to-skin, don't be discouraged. Tell your doctors and nurses that it's important to you, Borders said. As long as your baby is stable, there's no reason why they shouldn't let you hold him or her close.
Engorgement, or a feeling of heavy fullness in the breasts that can be very painful, is common several days after delivery, but Borders said a lot of women don't know to expect it because no one talks to them about it. Having a game plan in place can help curb the pain and keep women from throwing in the towel when they're sore and freaked out. She suggests an over-the-counter pain medication, like Motrin, and ice. Two bags of frozen peas can also work, Borders said, and -- bonus! -- they tend to fit nicely into nursing bras. Some women may also want to take a hot shower to express some of their milk.
Susan Burger, president of the New York Lactation Consultant Association, finds few things as irksome as telling women that they need to try specific holds. Moms hear those tips and get "all twisted up with finding the perfect position," she said. What matters most in her book is that breastfeeding mothers get comfortable, which often means leaning back a bit and putting their feet up. "If she's comfortable, it's so much easier to get the baby into a comfortable position," Burger explained. This is one area where partners can really step in, looking at moms to spot any ways in which they might be uncomfortable, then helping by giving them a pillow, a shoulder rub ... whatever.
Your partner, or your mom or friend can also help by agreeing to sit with you while you breastfeed. Why? Since moms are often extremely relaxed and drowsy while they're breast-feeding, your partner can agree to be on "alert" -- maybe quietly reading a book or checking e-mails -- while you get some sleep. "Invite her to take a cat nap while breast-feeding," Ryngaert said. It may sound like a simple trick, but Ryngaert said it's such an easy, often-overlooked way for women to fully relax while breast-feeding, which only increases bonding and enjoyment, and also, possibly, catch up on some much-needed sleep.
Drop your mouth down to your chest, then open your mouth. A bit tricky, no? Now tilt your head back slightly and open it again. See how much easier that is? Burger said that one of the biggest ways to help babies drink is to make sure their heads are tilted back a bit. You can help support them in that position by putting a forearm under the baby's neck, or even a rolled-up receiving blanket. "There are a lot of different ways to achieve it," she said.
While experts may not poo-poo specific holds, at least ones a professional hasn't personally recommended for you and your baby, they do offer broader positioning advice: "I like to see the baby and mother have almost no space between them," Ryngaert said. "You're not just putting your breast in their mouth, you're really bringing your bodies together," she said. That helps babies bring a big, wide open mouth to the breast, giving them the deep attachment that they need. If you're not sure what that means, a good first place to look is the internet: There are videos online that demonstrate the concept, Ryngaert said, and places like <a href="http://www.lalecheleague.org/nb/nblatch.html" target="_blank">La Leche League</a> have helpful illustrations as well.
Burger said that one of the mistakes women can make is to focus too much on duration and not enough on the frequency of pumping. Often they're too hard on themselves, sitting there for long stretches and pumping away in an attempt to produce more milk, when really, they'd be better served by just a few minutes here and there throughout the day. Burger likened it to training for a marathon: "You wouldn't just go out and run 13 miles," she said. "If you're just starting out, you'd try a mile or two and do that three or four times a week. That's a much better approach." In the same vein, if you can work it into your schedule, frequent, brief bouts of pumping help build milk supply better than sitting there, rather helplessly, and pumping for one long stretch.
Borders said that women shouldn't just write off sore nipples -- which can sometimes become so bad they don't want to breast-feed at all. She recommends something called Newman's all-purpose ointment, which your pharmacist can mix for you. For women who don't have thrush (a generally harmless yeast infection) <a href="http://www.lalecheleague.org/faq/heal.html" target="_blank">La Leche League also recommends</a> applying freshly expressed breast milk to your nipples, which can help them heal. The bottom line? If your nipples hurt, don't just accept it. Talk to your doctor about what might be causing it and what you can do.
"Make sure you leave the hospital with the number for someone you can call with questions," Borders said. Many pediatricians offices now have lactation consultants on staff, which makes it easier for women to find someone who can offer guidance when you're they're in for one of those many new baby visits that happen after birth. In many cases, lactation consultants are covered by insurance, Ryngaert said, but places like La Leche League also have <a href="http://www.llli.org/resources/assistance.html" target="_blank">a call system where you can speak to someone for free</a>. Many nurses and pediatricians are also board certified lactation consultants, which can help with insurance coverage. Women shouldn't feel pressure to figure everything out in the first week, Ryngaert said. "If a baby needs to go on formula for a time while the mother's milk supply is being established, that doesn't mean the baby's not going to be breastfed," she added. "I've seen babies that didn't latch on until eight weeks." But new moms should never, ever hesitate to ask for help. "If a mother is having more than a little tenderness, she should not just tough it out. She should get some help" Burger said. "And if that person says, 'Oh, it's normal, suck it up,' that's not a good person to get help from, and they should see someone else."
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