Wednesday, December 5, 2007

Thanks, Mayo Clinic. I Appreciate Your Validation.

What am I thanking the Mayo Clinic for? Their esteemed opinion, of course, on the nursing controversy. Yes. The Nursing Controversy. Actually, I don't think there is one Nursing Controversy. The basics question goes: Breastfeed, Breastfeed + Supplement with Formula, Don't Breastfeed. From that comes all of the other issues.It's like there was a Nursing Controversy that mated with Judgmental Onlookers and they had an entire litter of mini Controversies with a side of Judginess thrown in.

Ahem. Not that I have issues around this or anything.

When I was pregnant, I was 100% on board with breastfeeding. I was all geared up to be Milk Jugged. I knew it was what I wanted. It was not only better for the twins' immune system, it was also a better way to bond and attach. And frankly, it was destined to be cheaper too. I was so on board with being Bessy that I didn't even think about supplementing with formula.



But oh, fate has a way of laughing at our plans. Little Man and Soybean were born early early. For the first few weeks, they were on TPN, which is nutrition via IV. After they were delivered, I was in a state of pain and confusion the likes of which can't really be described. I wasn't really able to process much, let alone whether or not to pursue breastfeeding. It was something I hadn't really thought about.

K, though, had. Not through any conscious decision of her own. While I was in my hospital bed in my demerol haze, she went to see the twins for the first time in the NICU. As she stood isolette-side with tears streaming down her face, Gary, the nurse bolstered her up the best he could. He got her moving with things we needed to do. NICU orientation. How to scrub before going into the nursery. And, pumping milk. He gave her a plastic bag with many bottles and labels for me and sent her back with a handbook.

When I woke the next morning, she told me that if we were going to do breast milk, I needed to start pumping. I called the lactation consultants and they brought the breast pump kit. The LC asked me if I could sit up (hell, I not only was in pain, I still had the goddamn catheter in) because pumping is a gravity related activity. And I got right to the business.

For the 4 days I remained in the hospital, I pumped every 3 hours, then walked my breast milk into the wing where the NICU was and left it with the nurse while I visited my babies. I did this religiously even though it would be a while before either baby was fed breast milk. Before I left the hospital, my mom helped me rent a pump for 3 months, an optimistic vision of how long it would take before the twins were discharged.

I pumped diligently for 6 months, amassing enough breast milk that we ended up buying a small chest-deep freezer to store it at home. There were bumps along the way, as both babies initially had difficulty digesting breast milk, which is surprisingly high in lactose. When Little Man was nearing discharge, we began to see if he would latch.

For lots of preemies who start bottle fed, the transition to breast is rough. Sometimes impossible. We tried nipple shields. We tried starting pumping first then having him latch. It was rough. And he was inconsistent about it, though I didn't really give up hope because he would latch. The problem was he would latch and nurse for a five minutes or so and then get bored or tired or just plain over it and stop. Apparently nursing was work, and like mother like son, when it comes to eating, Little Man was lazy. A silicone nipple flowed faster and freer than I ever would.

There were other smaller issues. Preemies start small. So my neonatalogists gave the babies a caloric boost by fortifying breast milk with formula to increase the calories from 20 per ounce to 24. This helps them, since preemies use more calories to breathe since their lungs are often underdeveloped. So, I knew that even if I could get Little Man to consistently latch, we'd still have the issue of making sure he still got a good dose of 24 calorie breast milk which I couldn't produce on my own.

The long and short of this meant that the pump became my new attached accessory. Those of you who are moms already can imagine what this meant. I'd change Little Man. Get him fed. Get him down for a nap and then hook myself to a pump. Lather rinse repeat every 3 hours.

I did feel righteous though. Even though this process sucked, quite literally, it meant that my baby was getting his nutrition from me (his twin sister? digestion problems that were great enough that after the first few initial tries at breast milk, she got no more. In fact, for long weeks after her brother had been discharged, she was fed only via TPN and IV nutrition. She is still on special pre-digested formula). It was almost like we were breastfeeding for real, except without the nursing part and with way more time wasted.

Which would have been okay. Except I had to go back to work. That's when this system became somewhat insustainable. That and my dwindling supply. Believe it or not, it's hard to maintain supply when a baby refuses to nurse and you only use a pump.

After 4 months of being on exclusive expressed fortified breast milk, I broke out the formula samples that we had been given when Little Man was discharged and began to do some formula- some breast milk. Finally we dwindled to all formula with a little bit of breast milk each day. Thanks to the 6 months of pumping, it's several months later and we still have about a month's supply left that we dole out sparingly. However, Little Man made it clear this AM that he prefers the formula, where before he loved the breast milk enough that he would take it even cold. I tried not to take it personally.


Anyhow, all of this is to say that some days I feel proud that I made it as long as I did. And other days, most days, I feel guilt for not toughing it out. Like I cheated my son of something. On parenting sites, I get all twitchy when I read about people's transcendent nursing experiences and I see little jabby questions like, "why would you want to put junior on formula?" as if using formula is going to turn a potential Nobel Prize winner into a sniveling normal person who works a 9-5 in a soul sucking job for the rest of his life (oops projecting again). I usually want to bitchslap someone and say, "listen. I didn't want to have preemies who needed special high calorie breast milk. Nor did I really want to go back to work where pumping every 2-3 hours to maintain supply would be difficult. But I did the best I could, so back off."

This morning in looking up info on organic baby food vs. regular baby food, I ran into this article at the Mayo Clinic site. From the link


How should mothers who choose not to breast-feed handle feelings of guilt or inadequacy?

Guilt has no place in a thoughtful decision about breast-feeding. Instead, focus on your baby. Nurture your baby, and make sure he or she is well nourished. Don't feel guilty for doing what makes the most sense for you and your baby — whether it's combining breast-feeding and formula-feeding or using formula exclusively. If you're struggling with your decision not to breast-feed, it may help to share your feelings with your baby's doctor or another caring and knowledgeable person.


I have such mixed feelings. Sure I feel guilty about not breastfeeding. And I know I made the right decision as every doctor who sees Little Man is surprised by his weight, his happy, non-fussy demeanor and his seemingly good health. My ego about being UberMother was secondary, maybe even tertiary to the needs of my baby and the needs of my sanity and that's why he gets yummy formula instead of yummy expressed breast milk.

I wish instead of being asked to deal with feeling inadequate that I wouldn't have to deal with it at all. A lot of that sense of inadequacy comes from some internal place that is reacting to a sense of being judged by others. Which is self-involved because how many people really notice or give a shit about how I feed my child. Probably not many. But those who do need to, again, back off.

What would ease my way more than a mantra about making good decisions etc. etc., is an ability to overlook the way people stare at me when I whip out a bottle instead of a boob. I'm not foregoing breastfeeding just so I can diet or drink a nightly glass of red wine (which, now that I think of it is not a bad idea), but because my son's nutritional needs were greater than I could provide. I'll feel less guilty if others would be less judgey.

1 comment:

Norah said...

Reading this brought back all the guilt I had about Franny's weight and needing to supplement her nursing with formula. Plus there was the mean lactation lady who told me I'd never be able to nurse my daughter if I gave her even one bottle a day! (I forgot about that bitch until just now.) I know what I went through wasn't the same, but it's weird, that guilt, how real it is, how stabby it is, how it reduced me to tears time and time again.

I'd like to say you have no reason to feel guilty and have that mean something to you, but I know that isn't how mommy guilt operates.