When breast is not best
One week after giving birth, when my husband phoned my obstetrician’s office and insisted on a same-day appointment, the nurse assumed I was having complications with my C-section; bloating and pain that demanded immediate attention. But when I arrived at the office with red, swollen eyes and unwashed hair, she realized my pain wasn’t physical. She ushered me into an exam room and quickly went in search of my doctor.
I have long suffered from premenstrual dysmorphic disorder, so I know the power of hormones, the way they can shake your thoughts into a chaotic, confusing frenzy. I feared the sudden rush and retreat that would accompany pregnancy, the surges of uncontrolled euphoria and devastation that would crash down without warning or reason.
But I hadn’t been prepared for this.
My doctor immediately ran through a litany of predictable questions: Are you sleeping? (No.) Have you been crying more than usual? (Yes.) Have you thought about hurting yourself or someone else? (No.) Do you believe she’s yours?
Of course I believed she was my daughter! I had lovingly carried her for nine months, marveling at every kick and hiccup, endured thirty hours of labor before having an emergency C-section. But now that she was here, I wasn’t sure she recognized me as her mother. I blamed the surgery. Too much time had passed between my doctor pulling her into the world and me holding her naked body against my bare chest; too many people had left their love and scent on her before she breathed me in and felt my touch.
Sitting there in the doctor’s office, remembering that first day of my daughter’s life, I felt my chest tighten.
“She won’t latch,” I said.
By the time I checked into labor and delivery, I’d heard the question at least a dozen times from doctors, nurses, family, friends and even coworkers: breast or bottle? I answered without hesitation. Breast, of course.
In fact, I couldn’t fathom why anyone wouldn’t breastfeed her child. Part of it was familiarity. My mother, her five sisters and most of my cousins and friends had breastfed (some longer than many would deem socially acceptable). The other part of it was logical. Why would anyone pay for a product inferior to the one her body produced for free?
I never considered that breastfeeding might not be possible, though I was vaguely aware that my sister-in-law and former roommate had some kind of unspecified difficulty. I trusted nature, figuring that if I simply cuddled my daughter against my chest, she would instinctively find my breast and know to suckle.
On the morning she was born, after I was released from my hour-long recovery and after my husband, parents and in-laws all held her, I finally drew my daughter to me and studied her. She had almond eyes and bow lips, impossibly long legs and fingers and toes. Her head, covered in a matt of dark hair, was still misshapen.
She was perfect. We named her Jolene.
I tucked my right arm under her back and pulled her to my breast. She opened her mouth, tipped her head forward and began to suck. But it wasn’t my nipple she’d found; it was her own tongue. Undaunted, I tried again. And again.
I rode a wave of adrenaline through the exhaustion and pain of that first day, so my memories of it are smudged and hazy, but I know each time I attempted to breastfeed I was met with the same problem: Jolene was more interested in her tongue than she was in me. So that night, my labor nurse, Jennifer, gave me a nipple shield.
The shield is a small piece of domed and perforated silicone designed to fit over the nipple and make it easier for weak or stubborn babies to latch. At first, it appeared to work. Jolene wrapped her lips around it easily and sucked sporadically.
“Use it for a week and then you can wean her off of it,” Jennifer said.
It sounded so simple and, at that moment, I yearned for something simple. My legs were so swollen with intravenous fluids that I no longer appeared to have ankles. The painkillers given to ease the ache of my incision caused me to vomit every few hours. I wanted something to be easy. So I asked no questions. I used the nipple shield each time Jolene begged to feed and calmly replaced it when she knocked it away with a flailing hand or tongue.
Late in the afternoon on Jolene’s second day with us, the hospital’s lactation consultant — a mousy-looking woman named Pam — stopped by my room, aware that I’d been having some breastfeeding troubles.
“She wouldn’t latch at first,” I explained, “but the nipple shield seems to be helping.”
“Do you know the danger of using a nipple shield?” she asked. “Do you know it could hurt your milk supply?”
My eyes widened and my heart raced. I felt like a child, called upon in class, asked for an answer I couldn’t provide. In that moment, I felt all of my mothering instincts break apart and fall away, like a house giving way in a mudslide.
I longed to have Jolene back inside of me, where she had been safe, and my body had nourished her with beautiful ease.
I silently allowed Pam to take my daughter in her hands and force her, repeatedly, onto my breast as Jolene fidgeted in protest, her fragile but remarkably strong legs kicking my belly, sending lightning strikes of pain through my tender abdomen. When she got no food for her trouble, she whimpered and pulled away. Eventually the whimpering turned into screams.
“It’s possible she sustained an injury during the birth,” Pam said, holding Jolene up and regarding her with concern. “That might be why she’s screaming.”
Or maybe she’s angry because you’re grabbing her neck and forcing her face onto my chest, I wanted to say. I didn’t. By then, I’d lost my fight.
That night, Jolene was hungry. I propped her long body on the mound of pillows I’d built in my lap and attempted to feed her. It didn’t work. Instead of calmly trying again, as I had on the morning she was born, I felt my entire body tense. I looked up at my husband, David.
“Why can’t I do this?” I asked.
“You can,” he told me. He took Jolene in his hands just as Pam had done, but gentler, and pushed her toward me. I cried as I watched her: head shaking, tiny lips open, tongue searching. She wanted to eat so badly, but she couldn’t figure out how and I was powerless to help her.
It went on like that for hours, and then for days after we brought her home. We tried finger feeding her, attaching one end of a delicate tube to a syringe and the other to my husband’s pinkie, rewarding Jolene with drops of pumped breast milk when she sucked. But she looked more like a science experiment than a baby.
Eventually, as Jolene’s appetite grew, we switched to a bottle, against the advice of all five lactation consultants (yes, five) I had turned to for help. They saw the bottle as a gateway drug — a sure path to formula feeding.
Instead, each one implored me to keep trying to breastfeed. One attempted to bribe me with a canvas bag: “I don’t give these to just anyone, but I know you’re a dedicated feeder.” Another tried to flatter me into not giving up: “You have beautiful nipples for breastfeeding.” Jennifer, the labor nurse, who called often to cheer me on as I continued my quest, suggested it was a “structural issue” and a quick trip to the chiropractor for a jaw realignment would solve all of my issues.
But no one asked if I was doing the right thing for me. No one asked if I was bonding with my daughter — which I wasn’t. I regarded her with fear; dreading each time she needed to feed.
I was so concerned with breastfeeding that I couldn’t appreciate the pink glow of healthy skin, the way she turned her head toward my voice when I spoke. I could only focus on what I wasn’t providing her.
My fears drove me to obsession. When I wasn’t holding her against my chest, I was pumping. When I wasn’t pumping, I was searching the Internet for advice. I subsisted on oatmeal, bananas and chocolate cookies. The antidepressants my doctor prescribed weren’t enough to shake the guilt loose.
Finally, when Jolene was nearly a month old, my husband grabbed my shoulders and said the single word I’d been secretly longing to hear: “Stop.”
Feeling both regret and relief, I agreed to halt my all-consuming quest to breastfeed. In my attempt do what was best for my daughter, I’d accomplished the opposite for my family. There were adequate replacements for breast milk; there was no replacement for me.
The decision did for me what the antidepressants could not.
For the first time, I actually felt like a mother.
I told Jennifer this the next time she called. It was the last time I talked to her. I like to believe she quit calling because she felt it best for my family, but I think I was really just a lost cause.
One recent Sunday morning, Joey, as we call her, now three years old, looked up at me and declared. “Mommy, you know about true love.”
“I do?” I asked. “Who’s my true love?”
My heart swelled.
It’s moments like these that remind me: not breastfeeding did not scar or ruin my daughter. And my worth as her mother will be the sum of a million little choices over a lifetime, not the direct result of one made in the first months of her life. As my husband so aptly puts it: “Breast milk is not love.”
Sometimes, when I see a mother breastfeeding her infant, I momentarily ache for that fundamental and physical connection Jolene and I never got to share. Then I ask myself this question: If I’d had the strength to keep trying, would she have eventually breastfed?
But I’m a better mother for not knowing.