The funny thing is that I never intended to breastfeed. I know it's surprising given my profession, but breastfeeding has presented many challenges during my career. As many of you probably have already learned, health care providers do not know very much about breastfeeding. We're taught all the reasons why 'breast is best' and that we should relentlessly encourage breastfeeding, but we're not equipped with any knowledge on how to make this happen. I've learned a bit over the years, but especially early in my career, I dreaded seeing a patient with any breastfeeding issues, other than a straight forward mastitis. I felt so inadequate and I felt guilty that patients wasted time at my visit, which amounted to receiving the advice, 'you need to see a lactation nurse...' While it is important to promote breastfeeding, sometimes I think we need to ask 'at what cost?' I recently read a case report from a Cardiologist. She was called to assess a postpartum woman who was experiencing shortness of breath. Fearing that she could have a pulmonary embolism, the cardiologist ordered a CT scan. She kept looking for the results, only to discover that the OB resident cancelled the test, as the contrast dye would be contraindicated in a breastfeeding woman. The cardiologist had to make the case that the patients's breastfeeding would be significantly compromised by her death in order to start facilitating the care that was needed. I read another story with very tragic results after a postpartum woman with schizophrenia had her psychiatric meds discontinued in the hospital, as they were contraindicated in breastfeeding. Fortunately, I've never dealt with such dire circumstances, but there have been occasions where I've felt I was sub optimaly treating a patient as I needed to find medications that would be compatible with breastfeeding. I have seen two breast cancer cases that involved a delayed diagnosis due to breastfeeding. In one case, a mass had been attributed to being a blocked duct. The patient presented to me two months after she stopped breastfeeding as the 'blocked duct' hadn't resolved. The other case involved a woman who refused to have a breast biopsy done as she was still nursing her 18 month old.
My professional experience offered one more aspect to discourage me from breastfeeding. I'm not proud to admit this, but it's vanity. A few years ago, I picked up one of the pregnancy magazines in our waiting room as it featured a story on "The 10 things no one tells you about breastfeeding". Ah-ha! This article would share my observations after spending many years examining naked women (not to sound pervy, but it is my job). Breastfeeding has the potential to overwork the elasticity of your skin and can leave your breasts looking like deflated balloons. However, the article did not shed any light on this potential outcome. The enlightening tidbits? It may hurt at first (not surprising) Milk may leak out of your boobs (duh) Your husband may like the enhanced size of your breasts... (DUH!) and You may find that you love it! There was no truth revealed in this article. It was all propaganda to promote the breastfeeding agenda.
I had other ideological objections. The feminist in me resisted the notion of being classified as a food source. The idea of needing to pump breast milk sounded inhumane, it would make me feel as if I were a cow. Breastfeeding in public? I fell on the side that if you need to nurse in public, you should use a modesty cover. I didn't understand why some women had the desire to be exhibitionists, just because they had a baby that needed to be fed. My friend Alistair offered his observations on the issue; "Men like boobies. We really like boobies. It doesn't matter if there is a baby attached, Our eyes are drawn like a moth to a flame." That was the final consideration. I had always regarded that breasts were sexual. I feared that Husband wouldn't be as attracted to me after witnessing me feeding our baby.
Once again, infertilty changed my perspective. After discovering how hard it was to have a baby, I felt a greater obligation to provide the best that I could if I were fortunate enough to have one, including breastfeeding. I've been so fortunate to have enjoyed such good health as a child and even as an adult, that I would feel incredibly guilty if I didn't offer the same opportunity to my baby. I decided I would give it an honest attempt, but I wouldn't hold any expectations, nor would I set any goals to make it to X number of weeks or months. (Although Husband keeps reminding me how much we'll save by not needing to buy baby formula.) When we attended our baby basics and breastfeeding class, I diligently took notes as the nurse declared the commandments for successful breastfeeding.
Thou shall only offer breastmilk to the baby
Thou shall not give formula unless absolutely necessary
Thou shall not introduce a bottle prior to 3-4 weeks
Thou shall not use a pacifier in the first month (if at all...)
Thou shall not pump in the first month
We started feeding almost as soon as I was out of the OR and continued to feed every two hours throughout that day, and much to my surprise, it seemed to be going pretty well. However, in the early hours of the morning, it seemed that she wouldn't want to stop feeding, or at least engage in some non-nutritive sucking. I could see the writing on the wall. "I have the feeling we're going to need to supplement with formula and give her a pacifier." I told Husband. At this point, it didn't even phase me. Just some thing else not going according to my intentions. Sure enough, the next night we had to give her formula as her weight loss was getting close to the 10% threshold. I am so glad the hospital nurses recommended using the Supplemental Nursing System (SNS) as I've spoken to a few other friends who commented that they never had that option, the nurses went right to the bottle. The night before she went home, she was happily fed, but still wanting to suck, so another nurse suggested using a pacifier. No! We were determined to hold our ground on being anti-pacifier. "I'm going to put one in your take-home bag, just in case..." the nurse knowingly offered. It only took less than an hour of crying for us to reverse our stance on pacifiers and yield to the Soothie.
My milk still hasn't come in by the time we were discharged from the hospital. I kept asking, how I would know when the milk was in. "Oh, you'll know..." was the answer I received from several different nurses. As soon as we arrived home, I put the baby in her bassinet, pet the cats, and then cracked open a beer (as recommended by the nurse who taught the breastfeeding class). I'm not that big of a beer drinker, but after abstaining for almost 10 months, it was delicious. It could have been a Bud.Light.Lime and it would have tasted like Champagne. (More than one occasion, John Oliver!) After the next feeding, she spit up all over me. It was white and thick. Yes, they were right. I would just know when my milk came in.
She continued to feed rather well, although we still used a little Similac at night when she was fussy and needed a little extra encouragement to fall asleep and maybe stay asleep for just a little bit longer. We referred to is as "The Sixth 'S'" and I almost felt as if I were drugging my daughter to make her sleep, but I didn't feel guilty enough to stop doing it. (It did stop working for us after a few days). I did discover some other breastfeeding secrets that no one tells you. Nursing sleep bras are the best things in the world! Seriously, why hasn't the word gotten out on these. So much better than sports bras! It CAN be sexy! I was reluctant to make this purchase because of her name, but the Jess.ica Simp.son line available at Destin.ation Mat.ernity, offers some lacy and feminine nursing bras. Additionally, I don't know if it was the three beers talking, but Husband came into the nursery as I was feeding Jate and commented, "It really is a beautiful sight, when it's your wife and your child." Pumping is not that bad... It's oddly satisfying. On a few occasions, I became so engorged that I had to pump for comfort. (BTW, it's not pumping, but having to hand express, that makes you feel like livestock). I was so encouraged by the production, that I actually danced around the house. I've already started freezing some milk.
So, I'm not at that point of You may find that you love it!, but I'm rather satisfied. I acknowledge it doesn't take any special skills, but mere luck. I'm fortunate that my baby has a good latch and I've been able to produce enough milk plus a little extra for the future. For the record, Myrtle wasn't able to breastfeed. Little Myrtle never latched well, and she didn't produce much with pumping, but this is the last category I ever expected to hold any bragging rights. Yet at times, I do feel like giving myself a little pat on the back. I'm pleased that at last, some part of my body is cooperating. Plus, I broke some of the rules and still made it work. So yeah, I'm a little smug about that.