For those unfamiliar with breastfeeding, here's some basic knowledge.
1) The "latch" is when baby attaches his open mouth to the mom's breast. It is initiated by the baby and should be instinctive from birth.
2) After latching, the baby's tongue stimulates the mom's body to make milk, generating a heavy flow called a "letdown."
3) Milk production works on a supply-and-demand system, so the more milk is removed, the more milk is made. If separated from their babies, moms can pump milk to maintain their supply. Breast pumps artificially stimulate milk production through suction. You can also use your hands to pump or "express" milk through massaging motions. This is called "hand-expression," and it's much slower and more laborious.
4) During the first few days after giving birth, a mom's body makes colostrum, which is a small volume of milk highly concentrated in nutrients/probiotics. It's like the milk equivalent of lembas bread--one drop is enough to fulfill a baby's nutritional needs and more.
5) Lactation consultants are professional breastfeeding coaches. They tend to approach health care from the mother's point of view, while pediatricians prioritize the baby's health. It's good to have both, if possible.
6) Formula is the most common alternative to breastfeeding. It usually comes in a powder, which you mix with water and bottle-feed to the baby. It's convenient but expensive and comes with its own stressors.
I'll start with my most recent experience and move backwards. Both Maria and Cody were born three weeks early, on the cusp of pre-term. Cody was a TINY and very sleepy baby who could not figure out how to latch and could barely stay awake long enough to even attempt nursing. I started hand-expressing colostrum at the hospital every chance I got, collecting it in a little jar and spoon-feeding it to Cody after every nursing attempt. It was exhausting--I was covered in sweat and the skin on my hands actually got chafed from all the massaging. I only got out a few droplets each time, but it was a huge relief to ensure he got food during that first day.
On Cody's second day, I had an appointment with a lactation consultant. She came to our house and, after listening to our story, checked Cody's mouth and observed us attempting to nurse. She suggested using a nipple shield, which is a small plastic cover that goes over your nipple, with small holes for milk to flow through. Cody was able to latch with the help of the shield, and by the end of our session, he had nursed continuously for fifteen minutes. My body produced way more milk as soon as this happened, so I was happy/relieved about my milk supply.
The nipple shield was meant to be a temporary tool until Cody got stronger and better at nursing. Babies often nurse 12+ times a day, and I wasn't keen on bringing a nipple shield everywhere, having to stick it on before each feeding and sterilize it afterwards. Unfortunately, weaning Cody from the nipple shield was a nightmare--trying to latch or feed without it was very confusing and frustrating for him. It also caused me excruciating pain, comparable to unmedicated labor (which I've endured twice). His arms flailed, his tiny sharp nails scratched my chest, and his mouth was always so lost, not knowing when to open wide or what to do with his tongue. My breasts, sensing it was time to give milk, sprayed/leaked everywhere, while I tried to manage this thrashing, crying baby. It was a mess.
Meanwhile, we brought Cody to an ENT, who diagnosed him with "tongue tie." Everyone's tongue is attached to the bottom of his mouth with connective tissue, and Cody's connective tissue was unusually short/thick, which hindered tongue movement. The doctor performed a surgical procedure in which he clipped part of this tissue to release Cody's tongue. Supposedly this would solve our nursing issues; I'd heard MANY stories about "frenectomy" being a game-changer for struggling moms and babies. Sadly this was not the case for us. Not only was it horrible to watch our newborn scream while part of his mouth was cut by sharp scissors, but we were also instructed to do "mouth exercises" twice a day for two weeks, where we manually forced his jaw open for ten seconds, preventing the tissue from growing back. It was torturous, and the nursing problems continued.
I was able to wean Cody from the nipple shield eventually, and my intense pain from breastfeeding subsided a week or two after that. There is no way I could have lasted longer. As he grew older, different issues presented themselves--he'd get distracted and start babbling in the middle of a letdown, so that he'd get sprayed in the face with milk. He became extremely picky and angry if the flow of milk was too fast or slow, if the temperature was too warm or not warm enough, if I had eaten something different and the taste was off etc. At the time, I thought I might be projecting these opinions onto him, but now that I know his personality, I am positive that his protests were DEFINITELY out of pickyness.
Every few weeks, my nipples developed blisters/cracks and bled, so I'd use only a breastpump, feeding my milk to Cody through a bottle so that I could heal. This problem began around two months in and lasted the entire year (though later on, it happened less frequently).
Miraculously, at seven months, we were still exclusively breastfeeding, meaning my milk was Cody's sole source of sustenance (except for solid food here and there). But around that time, Cody stopped gaining weight, so we started giving him formula before bedtime. It helped him sleep, worked well with my work schedule, and alleviated a lot of my pressure. As his appetite for solid food grew, the pressure on me continued to lessen. I intentionally ate meals in front of Cody, making a big deal about how delicious everything was. Perhaps consequently, he loved solid food and did not resist the transition away from breastmilk.
I'm not sure anything else I've done in my life has required more endurance than breastfeeding Cody for ~13 months. I have yet to run a full marathon, but after all this, I have no doubt that I can do it. I’ll never forget all the times I discovered with horror blood in his mouth, only to realize it was coming from me. I’ll never forget the times I was driven by frustration and desperation to yell at my own baby, losing my temper with him when he was only a few months old! I’ll never forget screaming in pain and fury when we were weaning from the nipple shield, never forget nursing through tears and sobbing afterward, even in front of Maria. I knew breastfeeding was only a tiny fraction of the relationship I would build with Cody through his whole life...but it still felt so paramount. All I can say now is, I gave it my all and have no regrets.
When Cody was about three months old, we took a family road trip to Saugatuck. One afternoon we went to Saugatuck Dunes State Park, where there was a beautiful but longer-than-anticipated hike, and I ended up nursing Cody at the beach. The sun was shining, my feet were buried in warm sand, and Cody's tiny baby toes barely brushed the ground. The gentle waves of the lake murmured and sighed, Eliot lay serenely beside me, and Will and Maria played sand castle a few yards away. That is my favorite memory of nursing Cody.
Maria's story involved a lot less blood and a little less sweat and tears. When she was born, we tried nursing right away, but I didn't know that hand-expressing colostrum was an option, and I had no idea what successful milk removal should feel like. I saw her mouth attached to my breast and assumed/prayed that she was feeding properly. Unfortunately, she was not, which we found out at her first pediatric appointment. We had to return to the doctor's office for four consecutive days, meeting with a different pediatrician each time to check her weight. Each doctor had her own solution/suggestion for our problem, and it was interesting to observe the differences, and how each one made us feel. One pediatrician began by asking what problems we were having, which rubbed me the wrong way, because she simply assumed things were going badly. Then she started spouting all these suggestions, a lot of which I already knew and was doing, and some that overwhelmed me because they weren't feasible without insane amount of sacrifice…like pumping after every single feeding, waking Maria up to feed regardless of how much sleep she got, changing my diet etc. and if Maria hadn't gained weight by the next day, we should supplement with formula. This formula-or-not issue felt like a test that we might fail, and that stressed me out more than the actual thought of using formula. Another pediatrician began the appointment by asking if we had questions and listening inquisitively to our thoughts, then being extremely encouraging about certain details of our report. She told us to "keep doing what we were doing" and trust our instincts, which made me feel like a human, rather than a faulty milk machine.
We supplemented with formula after a few days, and Maria's weight went up. After losing those crucial first hours/days of proper milk removal, my body couldn't generate the full amount of milk Maria needed at this point. A week later, Maria and I both got thrush, which is a yeast infection that passes between mom's breast and baby's mouth. I had to disinfect and apply topical cream after every feeding, and Maria took several medicines (which were apparently all delicious). The infection was painful for me, and it definitely hindered Maria's progress of learning to nurse properly. It took a month to get rid of the yeast completely.
We combined formula and breastfeeding for the whole year, which had pros and cons. Pros: we knew exactly how much Maria was consuming from the bottle, and Will could participate in feedings. Cons: it's really complicated to keep track of breastfeeding, formula-feeding, and pumping all together. Every day involved a list of calculations to ensure Maria had eaten enough. We washed nursing cloths, bras etc. with hot water to prevent additional infections, sterilized every bottle and nipple and breast pump part, and timed feedings so that I could nurse and Will could bottle-feed right after. Sometimes I pumped one breast while nursing Maria with the other. It was a constant flurry of milk-related activities, and if you know anything about my daughter, you'll know that she is ALWAYS HUNGRY.
My most special memory of nursing Maria was one night during my first month of being a mom. I had slept about an hour before it was time to feed, and it ended up being a very long session with endless diaper changes and pain, because my thrush-ridden skin had started peeling. I wanted to eat a snack when it was all over, but Maria wouldn't stop crying. After forty minutes or so of torture, I woke Will up for help. He took over and I went to sleep, but had to get up in an hour to breastfeed again. This time, I actually cried from the pain, and it was a low point...until "The Light" by Regina Spektor came on Spotify. (I usually had music playing in the background.) I always knew it was a song about Regina's daughter as a baby, but when I listened this time, I suddenly realized that many of the lyrics are from the baby's point of view--
The light was shining in my eyes before I closed them
And all the dreams I had the night before were gone
The faces that I'd seen looked so familiar
But I forgot them all when I saw the sun
I know the morning is wiser than the nighttime
I know there's nothing wrong, I shouldn't feel so down
So many things I know, but they don't help me
Each day I open up my eyes to look around
The light comes shining in my eyes
The light comes shining in my eyes...
As I listened, I was so moved that I sat crying and crying as Maria lay in my arms, sucking away so sweetly (but causing me so much pain!). I think I was weeping out of happiness and thankfulness and awe at the little girl in my arms. I'd been feeling SO down, almost resentful of Maria for keeping me up so late, having to sacrifice my body and sanity night after night for her...but now acknowledging the absolute innocence and purity of MY very own baby...I realized that this moment was all I've ever wanted.
The last time I breastfed Maria, she had just turned one and was already eating four full meals of solid food a day and drinking cow's milk from an open cup. At this point, nursing was just five minutes of cuddle time in the mornings before the real food came. This particular morning in her bedroom, we sat in our usual rocking chair. She latched, took a few sucks, then detached and glanced at me with a casual, peaceful smile. Sounds of Will preparing breakfast in the kitchen drifted through the open door. She turned her head toward the noise, slid easily off my lap, and walked out of the room without a backward glance. And that was it!
Amid all the publicized high points of parenting--social media posts of kids hugging each other and being cute and happy and hilarious--we should also share reality. For example, here is a typical day when I went back to work but was still breastfeeding:
5am Wake up
5:30am Exercise while waiting for Cody to wake, no cardio because boobs are heavy with milk
6am Nurse Cody
Do morning stuff
8:30am Drop off Maria at preschool, pull into neighboring YMCA parking lot, set up my wearable breast pump
8:45am drive to work while pumping, pour milk into prepared bottle and refrigerate at work, refrigerate breast pump parts to prevent bacteria
Do work stuff
12:30pm Pump in lactation room, store milk in another bottle and refrigerate, wash breast pump parts, eat lunch
More work
3:30pm Pack the bottles of milk, set up my wearable breast pump on the car, drive home while pumping
Do family stuff
6:30pm Nurse Cody
7pm convince kids to go to bed
8pm alone/snack time while reading food blogs
8:30pm Wash all pump parts and bottles, organize milk, pack for the next day
Hopefully sleep through the night
Does this seem overwhelming? ALL breastfeeding moms do some version of this if they work! Many don't have lactation rooms, wearable breast pumps, private transportation, or a one-hour lunch break! This is reality.
Breastfeeding is brilliant and miraculous when it works. When it doesn't for whatever reason, it can consume your life. Mastitis (serious inflammation of the breast), thrush, blisters, cracks...I've experienced it all. So here are a few game-changers I'd love to pass on:
1) Practice hand-expressing milk before you have your baby if possible, or immediately after, just in case breastfeeding doesn't go well. You can collect the colostrum and spoon-feed. Removing that milk AND feeding your baby in the early stages is CRUCIAL if you want to breastfeed long-term.
2) Sleep boosts milk supply. I would regard any advice that prioritizes feeding before sleeping with MUCH skepticism.
3) Breast milk has magical healing powers. I put it on wounds, bug bites, rashes, basically anything topical.
4) If you feel blockage/inflammation, use warm compresses right before nursing to loosen the milk, and use COLD compresses after nursing and in general. Don't mix the two up, like I did!!
5) Get your partner involved. Even if breastfeeding goes smoothly (which does happen for many women), it's still a huge sacrifice that should not be borne by one. In a way, it was a blessing that I had such a hard time, because Will was involved from the beginning by necessity. He was pretty much my lactation consultant after we used up the appointments covered by insurance. He strongly advocated for a laid-back breastfeeding position that made a huge difference in both kids. When I was dealing with severe pain nursing Cody, he took over literally all nighttime duties except feeding. All I had to do was wake up, nurse Cody, then retire to the living room where I slept on the floor futon (and prayed to God for the pain to go away) while Will changed diapers, bounced Cody, got spat up or peed/pooped on etc. in our bedroom. We kept this arrangement even while I was on parental leave and he was working full time. His theory was, the more I slept, the more milk I'd produce for Cody, which was true.
Aside from these practical lessons, I've learned to joyfully and willfully give everything I've got to my kids, only to have them reject or dismiss my efforts without a second thought...and to be OKAY with that outcome. If there's an area where you're simply unable to be at peace with the sacrifice you're making, DON'T do it! I was okay with the breastfeeding sacrifice, but I was not willing to give up my daily exercise time or alone time for snacking. Even if the kids were howling and crying for me, I gave myself those thirty-minute sessions. For other moms, it might be the opposite. Bleeding nipples? No way. Being with my baby first thing in the morning and last thing at night? Doable.
Every interaction with my kids is an exercise in prioritizing the journey above the end result, no matter how tempting the reverse is. With every new failure, we repair and regroup. If I can still find a ray of happiness/excitement to TRY AGAIN when all else has failed, I'm doing okay.
In the words of Pete the Cat, "it's all good." :)
