Sunday, 26 July 2015

Breastfeeding Women are Smug

DISCLAIMER: Not all breastfeeding women are smug, although I'm sure we all have encountered some who are. Those women who intend to breastfeed until their babies go off to college and believe that infant formula contains arsenic and cyanide. Tine Fey does a great job characterising these Teat Nazis (TNs) in her book, Bossypants, and she offers great advice if you happen to encounter a TN: lie about your own experience. Just proclaim that breastfeeding is the greatest thing in the world. I know there are a lot of women who make every effort to breastfeed, and for whatever reason, it just doesn't work out. Many women and their babies have additional challenges that present barriers for breastfeeding. I don't think it's appropriate for anyone to criticise or comment on another mother's feeding method, and it's wrong for women who do breastfeed to express a feeling of superiority. That being said, I do confess I feel a slight sense of personal smugness. As an infertile woman, I felt let down by my body at so many times. My ovaries are little bitches, my uterus was an asshole, but my breasts are rock stars. I know it's too early to celebrate, perhaps even premature, but so far, breastfeeding is going rather well.

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.


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  2. Yay for cooperating boobies (and baby)! I agree, it's more luck than skill, but there are things you can do that can help with some of the typical challenges. The first few weeks I asked everybody I met for suggestions and advice, and some of it ended up being quite good (for me). The other thing that helps is when baby learns the skills to feed effectively (because you and your boobs are only half the equation). I think you are right to not put a lot of expectations on yourself, but at the same time it's OK to be happy (even a bit smug) when things go well!

  3. Glad to hear things are going well. Breastfeeding, like any aspect of parenting, is going to be different for everyone & it's best to keep an open mind.

  4. I'm so glad you're finding success breastfeeding! I am 20 weeks pregnant and also conceived with IVF (my primary issue, besides being old, is a pituitary tumor which was resected, leaving me with hormonal deficiencies).

    I am prolactin deficient, and my endocrinologist tells me that most likely I won't be able to breastfeed. I desperately want to, and I will try everything to make it happen though! We'll see. So people who have the natural ability - I am jealous and wish I didn't have to worry about this!

  5. I'm so glad breastfeeding is going well... it's such a nice change after everything else not working the way it was designed! (I hope I'll be able to breastfeed!)

    It used to be that formula was considered best. It was shoved down everyone's throat, and if you couldn't afford to formula feed then you were less of a mother. Now that's what's happening with breast feeding. I say - do what's right for you and your baby and forget about everything else. :-) It's lovely that you're able to breastfeed and Jate is happy! Congrats again and enjoy your little one!

  6. We broke some rules as well with bf and Izzy never had a problem. I think that nurses feel the need to warn you about what bad things could happen even if they only happen to a small percentage of babies. I'm glad things are going well! :-)

  7. So good that breastfeeding is going well... feels like you guys deserve it after the journey to arrive here. And rules are meant to be broken I think- my husband tried to convince me those first 10 days that it was okay to sleep through a feed and let him feed them (that it was survival mode) but I was crazed and determined and it made me crazy. Turns out he was right and one good night of sleep proved that! Keep up the good work momma and I hope you are able to get some rest :)

  8. You deserve to be smug, but ugh--bf hasn't worked out for me, but I feel like my uterus did a stellar job growing the babe. So I'll call it one for three as well.

  9. I'm so glad it's working for you! I think I would have actually crossed the line into liking it (maybe!) if I had the experience with my son first. It went much better the second time, but after the difficulties the first time, I was only prepared not to hate it.

  10. All those rules from lactation consultants is part of what made me give up and just pump. Seriously. Despite telling her I was going back to work, her goal was to get them off of all bottle feeding even though most of it was breast milk. That apparently wasn't good enough. Lactation consultants really need to ease up and work with women and their circumstances or they just drive them away.
    Um...ok just hijacked your post for a second. Glad it's all working and you even have extra. Nice of one of your body parts to step up and do it's job.