Saturday, January 8, 2011

A Tale of Breastfeeding woes and success (at long last)

Long before I was anywhere near to the road of motherhood, I always knew I would breastfeed my child. It seemed counter-intuitive to choose to spend time and money on formula, waiting for bottles to warm up, washing and sterilizing nipples in the middle of the night and so on. Who would choose formula when you were fully equipped with the perfect food for your baby?

Bad mothers, I thought.

Lazy people, I thought.

Women who didn't truly love their babies, I thought.

Women who weren't willing to make sacrifices for their babies, I thought.

Oh, those good old days of ignorance. You know that saying about not judging a person until you walk a mile in their shoes? Well... I wore the soles out finding out just how difficult breastfeeding could be.

During my pregnancy, I read every book, magazine, review, blog and forum I could get my hands on. Before I decided on home birth, I researched. Before I decided on water birth, I researched. Before I decided on midwifery, I researched. I researched the pros and cons of epidurals, the best breast pumps, the highchair I would buy, the diaper liners even the right kind of socks that would say on my newborn's tiny feet. The only thing I didn't prepare for was what to do if breastfeeding failed. I skimmed over the "troubleshooting" sections of the books. I didn't look much into bottle systems or alternative feeding methods. I just assumed I would put baby to breast and away we would go. I mean, what could be more natural?

As it turns out, breastfeeding, like motherhood itself, doesn't always come so naturally. Within two days of my son's birth, I was cracked and bleeding. I was exhausted and traumatized by my 25 hour, drug free, posterior labour. When I wasn't laying on the nursery floor crying, I was sitting in the office of a lactation consultant crying. I felt like a failure as a mother and as a woman. I tried every position known to humankind: football, cradle, cross-cradle, side-lying. I even tried laying my son on his changing table and leaning over him to nurse. I also tried every gadget known to humankind: nipple shields, lactation aids, breast shells, soothies, tendercare pads, cabbage leaves. I also used lansinoh, olive oil, aloe vera straight from the plant, Dr Jack Newman's all-purpose nipple ointment. I tried alternative feeding methods such as bottle feeding, paced bottle feeding, cup feeding and finger feeding. I was given calcium-channel blockers as treatment for Reynaud's syndrome, gentian violet as treatment for Candida infections, pectoral massage as treatment for poor circulation . I went to six lactation consultants in my area as well as Dr Jack Newman's clinic in Toronto. I used nursing pillows, rolled up receiving blankets, back supports and I attempted nursing in every single chair in my house.

You name it, I tried it. Every lactation consultant that saw me was impressed by my knowledge of breastfeeding solutions, and yet none of them could determine what the problem was. There was not a single day in the first twelve weeks of my son's life that I was not in pain. In the early weeks, I could not nurse by myself. Either W or my mother would help me latch him while my whole body clenched in pain, tears streaming down my cheeks. I would look into his eyes and say over and over again "I do this for you. I do this for you. I do this for you".

In between feedings, I would get the chance to sleep while my mother took my son downstairs and cared for him. Often I would lie there, completely tense, fearing the next feeding. I would hear her steps coming up to my room and I would already be crying by the time she opened the door. I dreaded feeding him. I dreaded holding him because he would only root at me for breastmilk. I felt inconsolably guilty about not wanting to feed him, but the pain was just so excruciating. I was devastated by my inability to get through a breastfeeding session without having to take him off and go pump out the milk. I felt as though I had been lied to. I felt as though my midwife, the nurses, all of those book authors had been dishonest about how hard it could be. The truth is that the information was there for me, but I chose not to acknowledge it. In fact, a few days before I delivered, I tagged along with my sister to a get-together at a friend's house. She was six months pregnant with her second child and at some point the subject of breastfeeding came up. She told my sister (who was also two months pregnant) and I about her struggle with breastfeeding. In detail, she described her feelings of failure, her many trips to doctors and lactation consultants, the permanent damage to her nipples and how, after her son failed to gain weight after six weeks of life, she switched to formula. Even as I listened to her speak, I was thinking "Maybe for you...but not for me". I am ashamed to say I judged her then, just as I judged every woman before her.

It's no surprise then, that the universe saw fit to teach me a lesson. There were many times in the 12 weeks that I struggled with breastfeeding that I wanted to quit. Every time I put my son to my breast, I wanted to quit. Even though everyone around me told me they supported whatever I chose, I still felt as though I would somehow be "less". I kept giving myself deadliness. "If things don't improve by two four six weeks...eight weeks, then I'm switching". I went to the store to buy formula several times, but as I read all of the labels on the tins, I'd be overwhelmed with guilt and shame. I'd lean back against the aisles and sob because the ingredients all seemed so clinical. Then I'd get myself together and decide to fully commit to breastfeeding. Again. For real. Of course, an hour later, I'd be back on the nursery floor, unable to get through another feeding.

Eventually, my mother sat me down and told me that the thing that was truly bringing me down was expectation. Just when I would get to a point where I was semi-okay with my breastfeeding routine, I would go to a clinic expecting them to magically solve the problem and when they had no answers for me, I would be devastated all over again. I wasn't happy with my routine, but I wasn't totally unhappy with it either because I really felt that if I could just stick it out for long enough, dear baby's mouth would get bigger or his suckling instincts would get sharper. So, for ten weeks, I breastfed once a day (twice on a really good day) for as long as I could stand (usually no more than 5-6 min) in order to keep the milk flowing. I would probably have just pumped exclusively, but I found that every time I pumped, I would get less milk than the time before. I'm not sure why, but the pump seemed to be much less effective than my son. Of course, baby is the best pump of all. Also- I was concerned that he would forget how to breastfeed if he was bottle-fed exclusively. My hope was that, at some point, I would be able to breastfeed twice a day, then three times a day, four times a day and then exclusively.

It's important to mention that this pumping/bottle-feeding of breastmilk situation was only possible because I had an abundance of milk. It was really the only thing I had going for me in the breastfeeding game. In fact, more than one lactation consultant pointed out to me that flow was certainly not an issue as I had enough milk to feed five babies. I have talked to many women who had a problem with supply from the very beginning. Many of them would be hooked up to their pumps for 45 minutes to an hour and still have less than two ounces total from both breasts. For those of you with low supply, there are a few things you can do to boost supply. As far as herbal remedies go, fenugreek and blessed thistle are among the first recommended. Mother's Milk (also sometimes called Milkmaid) tea is also frequently recommended. The herbal remedies are very effective, although the level of success often depends on how many weeks postpartum you are. If your baby is over four weeks old, you may want to consider prescription medication to boost supply. Even though I had no problem with supply, one of my lactation consultants wrote me a prescription for Domperidone to increase my flow. The theory was that if the flow was faster, my son wouldn't need to nurse as long and therefore wouldn't inflict as much damage to my nipples. I had the script filled and I'm glad I did because there have definitely been periods where I felt my supply was low and so I take the Dom for a few days until I feel confident about supply again. Another happy side effect of it is that I was able to put away over 150 ounces of extra milk in the freezer.

So where are we now with breastfeeding?

Well, at sixteen weeks, I am finally feeling like I'm where I want to be in terms of my nursing routine. I breastfeed dear baby almost exclusively- I pump and bottle-feed only when I am going out because I'm incredibly clumsy and not very skilled at breastfeeding with a nursing cover. It's amazing how much I've learned about nourishing a baby in such a short amount of time. What kept me on the nursing track was the fact that I had enough milk to pump and bottle-feed while I was biding my time, waiting for nursing to finally work. Had it been necessary to supplement with formula, I would have switched. Had I not been lucky enough to have my mother give me a top of the line Medela double electric pump, I would have switched. Had my son's health been jeopardized in any way (ie: failure to thrive/gain weight), I would have switched. The most important thing is that dear baby never goes hungry. Whether nourishment is received via breast milk or formula is not the issue. Your child will bond with you and grow, regardless of whether you are able to breastfeed successfully or not. My biggest regret is that I spent so much of his babyhood crying and withdrawing myself from him because I was stressed, depressed and in pain. I'll never get that time back. It was my choice to continue nursing just as it would have been my choice to switch to formula. I chose to continue breastfeeding at the cost of not being able to fully enjoy my son's first weeks of life. I will never judge another woman's choice to nurse or bottle-feed her baby again- the decision is much more complex and personal than I ever realized.

During my struggles, the sister of a friend of mine contacted me via Facebook. She had been a baby nurse for years and helped many women who had difficulties with breastfeeding. She had one client who delivered at the hospital where she worked that was having a rough time with breastfeeding from the first latch. On the day that she was discharged from the hospital, she was gathering up all of her breastfeeding gadgets: finger feeding tubes, bottles, lactation aids, etc. She said to the nurse, "Can you tell me what benefit all of this will have for my son when he has to come visit me in a mental institution, because that's where I'm headed if I have to use all of these contraptions every day!". I think the message here is that it's important to not lose sight. Yes, in terms of health benefits for the baby, breast is best. But here in the real world, being able to mother your child with strength and confidence is what is truly best. Mamas, we have to stop judging and pressuring one another and realize that success in breastfeeding is more of a lottery than anything.

Like my mother always says, "you can only do as much as you can do".

Diadima xo


  1. I love your blog thanks to your cousin Holly! I too had troubles bfing but it was d/t having a preemie and low milk supply. I tried everything under the sun including fenugreek with blessed thistle but had to go on domperidone since nothing else worked.

  2. Hi Denise- H told me that she had introduced you to the blog. I am glad you are enjoying it. If there is ever any topic that you would like to see covered, let me know. Domperidone is very effective in boosting lactation and I am happy to hear that you also had success with it. Lately, I am using only fenugreek- but I have a stash of dom in case my supply ever drops again.