When we determined E was going to be born prematurely, I set my sights on a new goal.
One might think by this time that I might have learned that I really can’t force my body into doing…well, much of anything when it comes to conception, pregnancy, or babies. One, alas, would be wrong.
I knew, from consulting with the neonatology staff, that breast milk was “liquid gold” to premature babies, helping to ward off all kinds of infections and most especially the devastating condition necrotizing enterocolitis (NEC). Since I felt like I’d failed in pretty much every other way in human reproduction, I was absolutely determined to make all those things up by breastfeeding that baby.
I did everything I could to ensure breastfeeding success, from consulting with lactation before E was born to making sure I had an excellent pump. I talked with the NICU staff to make sure she wouldn’t be given formula. I made a promise to myself that I would not supplement or settle, but that I would pump and persevere no matter what to form a successful breastfeeding relationship.
E was born.
And PCOS, along with prematurity, bit me in the rear end.
It was a slow, excruciating downward trajectory. I tried just about everything. Pumping more. Power pumping. Eating oatmeal. Fenugreek. Blessed thistle. Relaxing. Dark beer. More water. Pumping beside the baby. Getting up bleary-eyed in the middle of the night to extract an extra ounce or so. Going back on my met.formin with the NICU staff’s blessing. Hands-on pumping and breast massage. Using a hospital-grade pump. Lactation consulted with me more times than I can count, at my request. New pump flanges and parts. Skin-to-skin time with the baby. Non-nutritive suckling. Nearly lost it when my doctor wouldn’t prescribe Reg.lan, because of its known potential for causing depression (which I was already having issues with). I had a D&E for some shreds of retained placenta.
I did manage to make, eventually, about a half-supply (8-12 ounces a day) on a good day. This was okay for a time because E was taking so little of it due to her prematurity, but I knew at some point she was going to need more than I was producing.
During the whole mess, I started googling. Website after website, message board after message board told me that as long as I was absolutely determined and kept at the pumping, I could definitely increase my supply enough to exclusively breastfeed. There were buttons and images and cute little pins about the importance of breast milk and how most women could breastfeed (women who used formula, these implied, were just slackers who were making excuses or uneducated about the wonderful benefits of breast milk). Preemies could definitely learn to breastfeed, they crowed, and I ignored the fact that the vast majority of these babies were beyond 30 weeks at birth, sometimes far less premature than my daughter. I kept at the pumping with a vengeance. Surely things would get better when E was big enough to actually attempt real breastfeeding.
It didn’t, despite a great deal of time, energy, and various experts. I finally started, at the advice of the neonatologist, giving E a half Neo.sure, half breast milk mixture. I felt awful and guilty.
A few things helped me clarify and sort out some of the feelings. I got a wonderful comment on the blog that pointed out how it might be possible for me to increase my supply enough to exclusively breastfeed, but went on to say that it wasn’t something the commenter would necessarily recommend. I considered this and realized that she was right: there might be a way to do it with medication and maintaining a very heavy pumping schedule, but I hadn’t counted the potential cost of this action as closely as I’d been in the habit of doing during infertility treatments. All I’d been thinking for weeks was how “breast is best” and I needed to do anything that would make it work. The comment made me step back and, for the first time, realize that there might be a line I didn’t want to cross.
Several family members also gently reminded me that I needed to do what I needed to do, and if I couldn’t breastfeed, E was going to be fine. I just couldn’t accept it. I finally called the lactation consultants to get their opinion. Lactation simply told me that if I wanted to continue trying more and more extreme things to get E latched, they were happy to work with me, but that as frustrated and upset as it was making me, it was also okay if I was ready to stop. The consultant told me I’d done a great job to do as much as I had already. I don’t know why, as a grown adult I felt like I needed permission from a medical professional, but for some reason, I did. It was helpful to hear those words spoken out loud. I was actually in a tentatively okay place, the first real even semi-okay place I’d really been in since E’s birth.
Then I had a hard day in which things fell apart in those minor, seemingly silly ways and suddenly all I could think was I have to figure this out. I have to get my supply up. I have to get E breastfeeding. I went online and found the same echo chamber of message boards preaching how essential breastfeeding is to a healthy child and that anyone could manage it.
And a few panicked, tearful hours later, realized: I’ve been here before.
It was so similar to what I’d gone through because of infertility, all the insecurities and exhaustion rising up again. Just like every failed treatment. Just like all the disappointment at never once having a normal pregnancy. Just like every disappointment that my body would not do what I asked of it, what seemed to come naturally to most others.
There is always someone to tell you that if you (fill in the blank: tried harder, just relaxed, did another treatment cycle, ate whatever diet, etc.) everything would go back to being okay. The message is so often try harder. Or you just didn’t try hard enough, want it enough, go far enough, you don’t need to count the cost, you just need to keep going.
Often these are people who had issues that were more manageable and fixable. Or didn’t really have most of the issues at all. Or got inexplicably lucky. Or any other number of variables.
It’s good to have options. It’s not good to have pressure.
I took a good, hard look at what I was doing and made some decisions. My daughter was not going to latch and breastfeed no matter how hard I tried. The First Steps therapist pointed out some issues she has with her suck (most likely connected to prematurity) which meant getting her latched to my breast was going to be all but impossible. I had the worst of all worlds with regards to feeding: pumping meant I couldn’t go get my daughter and soothe her when she cried in the middle of a session, I had to wash all the equipment constantly, my finicky half supply meant a rigid pumping schedule with no sleep to maintain the little I had, and I still had the expense of formula. Continuing to try to get her to breastfeed I also identified as a huge trigger for my postpartum depression. I felt rejected and furious with myself every time she screamed as I tried to get her to take my breast.
There needs to be more balance on these issues. Not everyone can conceive “naturally”. Not everyone has a beautiful, “natural” pregnancy or birth. Not everyone can breastfeed or even produce milk (or, for that matter, wants to do so). It’s time to stop judging people for every damn thing, many of which are not actually choices.
I was recently re-reading Bill Bryson’s book A Walk In The Woods, an account of hiking the Appalachian Trail. It’s a humorous book as Bryson and his erm, interesting friend Katz – the only person who would accompany Bryson on the journey – attempt to hike from Georgia to Maine. The two weren’t able to hike to the end of the trail, so Bryson writes that he had some ambivalence about stopping. He hadn’t been able to accomplish his goal. His friend Katz had a different take on the situation: “As far as I’m concerned, I hiked the Appalachian Trail. I hiked it in snow and I hiked it in heat. I hiked it in the South and I hiked it in the North. I hiked it till my feet bled. I hiked the Appalachian Trail, Bryson.” (p. 271)
That’s how I feel about breastfeeding right now. I pumped eight times (or more) a day. I took virtually every supplement in the book. I was able to give my daughter enough to keep her exclusively on breast milk for two months. I got up every night for a long time. I dragged my pump around. I worked really hard to get her latched.
At this point, I’m dropping pumps bit by bit, allowing myself to get some much-needed sleep. I give E whatever I get out during those and my supply is dwindling down. I hold her. I cuddle her. I enjoy her. There’s a good chance I’m only going to get to do this once, and I want to have as many happy memories as I can during this time.
I’ll let Bryson sum it up for me: “We didn’t walk 2,200 miles, it’s true, but here’s the thing: we tried. So Katz was right after all, and I don’t care what anybody says. We hiked the Appalachian Trail.” (p. 274)
I breastfed that baby. I don’t care what anybody says.