April 20, 2010

The One About My Boobs

Now that I'm 9 months pregnant and people are starting to look surprised when I tell them there are almost 3 more weeks before this baby is due, the inevitable question also comes up. Are you going to nurse?

Despite the fact that people usually act casual when they ask, it's a loaded question. Depending on what part of the country you live in, the stigma surrounding breastfeeding can be very positive or very negative. Last time I was trying to nurse I heard stories of people in the midwest or other areas who were having a hard time finding support FOR breastfeeding. Where I live, the assumption is that you'll do it, and if you don't, you get judged.

I suppose that many people don't mean to be so judgemental, but they are. Perhaps they've never had children or perhaps they just didn't have any trouble breastfeeding. Maybe, like me, they always assumed that breastfeeding was easy and that it just magically happens and works wonderfully for all women. That any woman who isn't breastfeeding must just be choosing not to. But that's not the end of the story for a lot of women.


So, let's start out with a little history. I did not breastfeed Sam. Not by my choice. It was really, really hard. The full story can be found mostly here, with updates here and here. Here's what happened in a nutshell.

It took us 2 years to get pregnant with Sam, and when we finally did, it was through IUI (artificial insemination). It took four tries. I know now that I had a bunch of undiagnosed conditions - Hypothyroidism, Poly-cycstic Ovarian Syndrome, Insulin Resistance, High Testosterone. All of those can affect fertility. All of them can affect a lot of things, and I had a lot of hormone related problems.

But none of my doctors did any tests. Getting pregnant was the end of their treatment of me. During my pregnancy, my doctor never once checked my breasts, never once asked if they had changed size or shape. Not once did someone bring up the fact that breastfeeding isn't always easy, or that fertility issues could possibly translate to breastfeeding issues.

Once I had Sam, there were lactation consultants. I was clueless. There was fenugreek, nipple shields, and a hospital double pump (aka human milking machine). There was a fussy baby who wasn't getting any food, enough milk to coat the bottom of a bottle, and questions about whether I was giving up and letting my baby down.

The last entry is on May 23, exactly 3 weeks after Sam was born. I decided to let go and stop trying. It was really a difficult decision, and I did feel in some ways that I'd failed. Despite the fact that I still think my body and health had a lot to do with it, I had a really hard time accepting that I wouldn't be able to breastfeed.


On the last day of our Hypnobirthing class, we watched a video about breastfeeding. I decided to go to the session about it despite the fact that I wasn't able to breastfeed Sam, and I'm glad I did. Throughout this pregnancy, I have been a little bit resigned, and thinking that I probably won't be able to breastfeed Danny. Partially because I hadn't learned anything new, and partially because I was just assuming things would go like they did last time. My first midwife took one look at my breasts and said she could see right away that I could have problems, and basically said that it could work out but not to count on it.

I thought I'd go to the breastfeeding session at class just to go. Why not, I'd paid for the class. Part of the session involved watching a video about breastfeeding and how a baby should latch on. And while I was in that room watching that video, it brought up some emotions... anger, annoyance and defiance. I made a few notes during the video when it welled up...

It may be true that breast is best, but saying that the AAP recommends nothing but breastmilk for 6 months makes me feel I did something wrong because my body didn't work properly. There is just not much assurance or support out there for moms who are unable to breastfeed and that choice is taken away from them. I would never CHOOSE not to breastfeed. Despite my difficulties last time, I am fully planning on trying this time. The difference is that I'm not counting on it this time because I know there's a chance it won't work out.

They said frequent skin to skin contact gives you a bond unique to breastfeeding, but I disagree with that. You can provide that for your baby either way, and skin to skin contact with the FATHER is hugely beneficial as well for bonding.

I found myself back in that place of letting myself feel judged for something that I hadn't had too much control over. I didn't know that I needed to do all my own research, I trusted my caregivers to give me good information. Despite all of that, I'm really glad I went to the class because I came out with a little bit of a shift in thinking.

For instance... our teacher showed us a diagram of a baby properly latched on. It basically showed the entire areolea inside the baby's mouth, and the nipple practically in the throat just dripping down milk. Between that and the video? At this point I am 99.9% sure that Sam NEVER latched on properly. Which means that even if my body had wanted to produce milk, it wasn't getting any signals to do it. I think the nipple shield was useless in my case, and that it just taught him food came from a plastic nipple. I think that the lactation consultants I saw were useless, they never tried to teach me about better latching techniques. No one recommended having as much skin to skin contact for the first few days. I just can't believe that none of this was taught in my hospital 'birth' class or discussed by my doctor OR the lactation consultants.

To some women, they may have heard these things before, and it may seem like common sense. But for a 25 year old holding her first baby? Not so much.


So, back to that question. When someone asks me "Are you going to nurse?" I find myself unable to give a yes or no answer. What I want to say is "of course." But I know from experience that things don't always turn out the way you think they will. I feel the need to say yes, I will try, but I couldn't last time. I think part of the reason is because I think that a lot of people don't realize that women even go through what I did, and that there isn't a lot of support out there when it happens.

All that being said, I am feeling much more hopeful this time. There are a lot of things I know now that I didn't know then, and here are a few reasons I'm feeling more optimistic this time:
  1. Latching: I am much more confident now that I know how to look for a proper latch. I know more techniques for trying to get the baby to latch on, and if he's not doing it right, I feel MUCH more able to recognize that.
  2. My breasts still have not increased in size much this pregnancy. However, I have noticed a change in the shape. They both look a little rounder, and in the past 3 weeks I've started to be able to get a little fluid from both sides. I don't remember that happening this early last time, so I'm taking it as a good sign.
  3. Those medical conditions I listed above? They're being treated now. I'm on (safe for baby) medications for PCOS, Insulin Resistance, and Hypothyroidism. I am healther, I lost 30 pounds before I got pregnant and was able to conceive on my own this time. So, on the whole my body is a healthier entity than it was when I had Sam.
  4. Better Support: I have a close family friend who is a childbirth educator and doula who I trust. I have my midwife. I have other resources I've found on my own. This time, I know exactly where to look and who to go to if I have trouble. I feel much more supported, and that makes a huge difference.
  5. Skin to Skin: I plan to do as much skin-to-skin contact as I can in the first few days after baby comes. I didn't know last time that this could make such a difference, but this time why not add it to the mix?
  6. Natural Delivery: If everything goes as planned, I'll be having a natural, drug-free delivery this time. I don't know that having drugs during labor necessarily affects the ability to breastfeed, BUT I do think that if you already have factors going against you, it probably doesn't help.
  7. Less Stress: In terms of breastfeeding, and the birth in general, it's going to be a less stressful environment. I'm a lot more relaxed about both things, and because I have a midwife and will be at the birth center, the baby will be given to me right away. She won't mess with him, give him shots etc. for a good hour after he's born, and he'll be with me right away.

I'm excited about the idea that it might work this time. But I know that if it doesn't, I will be okay with that too. I feel so positive either way, going into it, and so much more confident.

So, will I nurse? The answer is, "I hope so!"

What are attitudes about breastfeeding like where you live? Did you have problems? What kind of support did you get/not get?

Some Resources for Breastfeeding Moms:

Dr. Jack Newman and/or Newman Breastfeeding Clinic & Institute - Lots of information about breastfeeding, inlcuing really great articles and videos of babies latching on properly.

La Leche League International

San Diego County Breastfeeding Coalition

Mothers Overcoming Breastfeeding Issues (MOBI Motherhood International) - This website and their Yahoo group provided almost ALL my support last time. It's now a nonprofit, and a wonderful and supportive environment for issues from improper latch to preemies to just having a lack of support in your real life.

Low Milk Supply - Information & Support for Breastfeeding Mothers


LceeL said...

They ought to give this post to any young woman who is pregnant or plans to become pregnant - not because it's about breast feeding, but because it's a lesson plan for being in charge of your life, your body, and your pregnancy.

Athena said...

Nursing is ridiculously hard to start. My twins were preemies and were completely unable to suck when they were born. After two weeks in the hospital they could get about 1 teaspoon- that's right one teaspoon- from a session of nursing. I was pumping and feeding them with bottles and tubes. It was frustrating and heartbreaking, but after several weeks they got it. I nursed them both for over a year until they abruptly quit at about 14 months. Breastfeeding takes patience and confidence that it will eventually click.

Kat said...

I was not able to nurse either of my girls. And with my first I felt like such a total failure. Especially after the lactation consultant informed me that everyone could nurse. But after putting me through the milking machine - and only getting a combined total of less than 1/4 ounce after an hour - there just wasn't anything there. It was much easier the second go round. I tried again...but with the same results - minus the overt feelings of failure :-)

Dumblond said...

Ouch. I remember trying to breastfeed my firstborn. Oh it was painful. Not only did I have cracked and bleeding nipples but having had a C-Section, I had to try and find ways to nurse him without disturbing my surgical site! I almost gave up...but then one day we just clicked. It was really weird. And when my daughter was born, it was no problem.
I hope things are able to work out for you this time and if they don't, at least you tried. There is nothing wrong with giving your baby formula.