Monday, May 07, 2012

A Mommy's Journal: Tomorrow I Quit

We all have tricks we use to get through the tough times. When you push yourself to finish a race that's just outside your comfort zone - "just one more step." When you breast feed your baby and it doesn't come as easily or as naturally as everyone says it should - "tomorrow I quit, I can do it this last time today." I never understood the few mothers who when asked how long they planned to breast feed their baby for included "tomorrow I'm quitting" to their answers; now I understand.
Breast Feeding Supplies
Be forewarned, this is a somewhat long post. It's also about a very emotionally charged topic - breast feeding - and it's not PC. It's a very personal post and one that was incredibly hard to write, much less share.
I've come across few mommy bloggers who've had anything less than an idyllic breast feeding experience. As a soon-to-be or new mom, these bloggers set incredibly high unrealistic expectations. Other bloggers who happen to be mothers have bravely shared raw, honest experiences; their posts helped me tremendously. I, therefore, felt it was important to share my story as most mommy bloggers focus on all the positives of breast feeding, leaving those of us who didn't have a similar experience feeling less than perfect or worse, somehow defective. So, here's my daughter Gates' and my story about our first month breast feeding.
Now I never expected my breast feeding experience to go smoothly. In fact, after talking in person with real mothers who have similar challenges to mine (who don't blog), I hadn't planned on breast feeding at all.
The deck seemed stacked against my daughter and me breast feeding from the outset. Our first challenge was finding a correctly sized, supportive nursing bra. Underwire and sports bras were out; they were too constrictive and could lead to mastitis. I spent weeks - months actually - searching the Internet and contacting lingerie shops in the UK. It seemed as if every time we found a supportive style that might work, the manufacturer had discontinued the line or I couldn't find my size in stock. For weeks, the very mention of the words 'breast feeding' reduced me to tears. "The breast is best" echoed in my head as friends and strangers offered advice (with some admonishing me on my initial decision not to breast feed). Before my daughter was even born, I was going to be a horrible mother. My husband and I agreed that if I couldn't find a nursing bra that fit, we'd go with formula.
Finally four weeks before my due date, I found two manufacturers that had off-the-shelf options, Royce and Panache, one that had a custom option, Bravado!, and another with a few discontinued options, Freya. As for sizing and fit, I had to order blind as the bras were in the UK and I was in the US.
Complicating my search for nursing bras was the fact that averages and rules of thumb hadn't applied to me throughout the pregnancy. On average, most women gain two cup sizes over the course of their pregnancy. In the first trimester alone, I gained one band size (28 to 30) and four cup sizes (E to G). Most women can order nursing bras based on their bust size at 36 to 38 weeks - not me. My cup size again changed drastically (H to K). In total, I spent over $800 on nursing bras, and, with the exception of a couple of bras, I wore all of them. (If you also count sleep bras, sports bras, and every day bras that I bought and wore during the pregnancy, I spent just under $3,000.
None of the nursing bras (K cup) that I found are supportive. As long as I'm not very active, they're a little better than not wearing a bra. Basically when you're caring for a newborn, you're pretty active. This means that I'm pretty uncomfortable for most of the day. "No pain, no gain" was the motto drilled into us during crew workouts in college, so, pushing through the discomfort became my mission.
When our first lactation consultant showed me how to assist Gates in latching, it hurt. The latching didn't hurt; the compression of the breast and the hand expression of the milk did. This pain was despite taking pain medications to recover from my C-section. "No pain, no gain;" I continued to push through. With each breast feeding session I tried mindfulness techniques, forgetting previous sessions and focusing on relaxing and enjoying the bonding experience with my daughter. When I no longer needed pain medications for my C-section, I would discover that breast feeding reduced me to tears. The only way I could breast feed was by taking ibuprofen a half hour before a session as recommended. (The entire time I was downing ibuprofen I kept shaking my head in disbelief that mild pain relievers were recommended and that I'd be living on them for the next six months to a year.)
On our first night at home we were faced with our first breast feeding challenge. The breast pump that we rented wasn't able to double pump as efficiently as the breast pump we'd used in the hospital. To get the same yield I saw in the hospital, I had to pump each breast serially. I was worried that I 'd not have enough milk for Gates. While we were on a waiting list for the better pump, I took matters into my own hands and at 4:00AM purchased the better pump ($1,400). According to Amazon, the pump would arrive in 3 to 5 days. Worst case, I'd have the pump a week from the coming Monday or the 16th, before we'd be able to rent the pump. (Unfortunately, the pump wouldn't arrive until the 19th. Luckily, another center in the city had a pump available that we rented on the afternoon of the 18th.)
My second breast feeding challenge came up over the weekend; my breast milk had a pink tinge. I called an after hours lactation hotline. The nurse reassured me that I'd probably broken a capillary, but that it wasn't harmful to the baby. (I'd learn in a week that the initial nipple shield was too small and that I'd lacerated my nipple.) I continued breast feeding and pumping.
Our second visit to the pediatrician we met with bad news: Gates had not returned to her birth weight. Off to another lactation consultant we went. By this point, breast feeding was anything but an enjoyable bonding experience. We were getting Gates up every three hours to eat. We'd wake up a peaceful babe, and after a feeding would spend hours trying to calm a terradactyl.
It had also become excruciatingly painful to breast feed from the right breast. I realized we needed help and began the search for a postpartum doula who specialized in breast feeding education. We found a doula and a simple position switch (from football hold to cross-cradle hold) eliminated most of the discomfort. It looked as if we finally in the clear.
Within less than a day, it became painful to breast feed from the left breast. I was at my wits end; it didn't seem that we could ever get ahead. I thought I had a clogged duct (it was actually mastitis and an abscess). I tried to break up the clog. I made an appointment with a lactation consultant. Bad news. I had mastitis and Gates was not transferring milk efficiently. Every three hours - after each breast feeding session - I needed to double pump. I pumped. I measured the output and compared the volume to previous days. The volume was still down. I consulted the lactation consultant again; I needed to pump more frequently, every two hours.
I continued to pump. Now I'm not a fervent believer that "The breast is best;" I pumped because I hoped that there was a link between breast feeding and fewer allergies and that Gates wouldn't develop my allergies. Each session, I thought "Tomorrow I quit." (Some sessions I thought "My next session I quit.") My "bar of success" was that whenever tomorrow came I will have breast feed (and/or given Gates expressed breast milk) longer than my initial plan of none at all.
My tomorrow turned out to be Gates' one month birthday (last Wednesday). My milk supply was still inconsistent and very low. My last two pumping sessions yielded less than 10ml between the two breasts. (If I could feed Gates my tears I would have collected a lot more.)
The amount of breast milk wasn't what brought me to the end of my journey; the pain did. I called my OBGYN after what would later turn out to be my last session to inquire about when the antibiotics should start having a noticeable effect. On a scale of 1 to 10, my pain level had reached a 10 - I wasn't able to pick up Gates without severe, crippling pain. My greatest fear was that I'd drop her. I relayed the pain level and my fear to the triage nurse. I was told to temporarily stop pumping and to come into the office immediately to meet with a nurse practitioner. During the exam, fears that something was wrong were confirmed by a look on the nurse's face followed by her going to get a doctor. The doctor had a similar look on her face when she examined me. Turns out I was one of the lucky few who 1) got mastitis in the first place and 2) developed an abscess requiring surgery (specifically an I&D or incision with drainage). Now, whether I breast feed or not, I may still have developed an abscess; I had two factors that increased my risk -- 1) I am over 30 and 2) Gates was delivered after 41 weeks.
During my outpatient surgery, tomorrow came. As I had told cubes, I would know the time I was quitting or when I had reached the last cliff face I just couldn't scale, when I hit it. There wasn't going to be any warning. And, right then in the middle of the surgery, the end of my struggles with breast feeding came. I had no more fight in me. I had no more tomorrows. I wanted to go back to the first week when Gates had just come home from the hospital -- the time I really enjoyed being with my baby, specifically the time I didn't dread Gates waking up from naps. The brief time there was no pain for me as I tried to feed her and no frustration for her when she tried to satisfy her hunger.
There's a lot of pressure to do whatever it takes to breast feed your baby for her first year of life, or at least for her first six months. Everywhere you see and hear "The breast is best." (There's one notable exception from April 2009: Hannah Rosin's "The Case Against Breast-feeding" article that was published in The Atlantic Monthly. Duke University Press provided free access to the journal articles Rosin references in case you're curious.) Everyone who doesn't know your individual circumstances has an opinion when they see you bottle feed. (I met a mom who had adopted a beautiful baby boy that constantly hears why she should breast feed.)
Thinking (and writing) about breast feeding and how I felt when I was breast feeding makes me emotional. There are constant reminders that your decision is second best. I hope sharing my story helps someone else who is struggling with breast feeding. Our pro-breast feeding pediatrician supported my decision and reassured me that I had more challenges than most and had given it "the college try." Getting support from trusted professionals with my decision helped with the feelings of guilt, the notion that I was weak, and the belief that I didn't love my baby enough.
While I was emotionally OK with the path our labor took, it wasn't until I was trying to cope with the pain of breast feeding that I realized I had expectations (a fantasy) of how breast feeding and bonding with Gates should go. I didn't see how invested in breast feeding at all costs I'd become. It was hard to let go of my vision of what breast feeding with Gates should be like. Now that I have, I find that I'm once again looking forward to spending time with her and enjoying our time together. I'm no longer looking at the clock trying to juggle pumping with her feeding schedule.
Anyone else find that breast feeding wasn't what you expected?
Ciao Bella!
Credits: All images taken by Eden Hensley Silverstein for The Road to the Good Life.