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02/10/2005

Nipple freakishly implacable antipathy

Whoever came up with the term "nipple confusion" is a fool. Charlie's not confused; he is a baby of rare discrimination who knows exactly what he wants. He doesn't have nipple confusion. He has nipple preference. Nipple aversion. Nipple seething white-hot hatred, if you really want the truth.

We dislike breastfeeding, Charlie and I.

We started out in the NICU with the make-a-nipple-sandwich method, which involves jamming a big fistful of areola into a defenseless baby's mouth, stuffing him into muteness as if you didn't want him squealin' to the cops, see?! With this method he'd latch briefly, give three strong sucks, then look bewildered. I'd remove my nipple from his mouth and start all over again. "He'll get it," promised the flaky hospital LC, in between fits of crooning, "There you go, mama. C'mon, baby. Mmmmmama," as if she were a white, female, sub-moronic Isaac Hayes.

NippleshieldWhen I told the local lactation consultant about this, she rolled her eyes so hard they clacked in their sockets. When they finally rolled to a halt, she broke out a nipple shield, a clear silicone sombrero that comes to a point so emphatic I feared I'd put out one of Charlie's eyes with it. It fits directly over your naked nipple and is used to make it easier for the baby to draw the nipple into his mouth; it's especially helpful for babies with a suboptimal latch or suck and for women with suboptimal anatomy. That would be Charlie, and that would be me.

We tried it, and it seemed to go well. The local consultant watched Charlie and me together and pronounced herself well pleased. "He'll get it," she declared, and sent us off to work on it together with instructions to try at every feeding with plenty of skin-to-skin contact.

And then I had houseguests for ten days straight.

I was able to slip away to pump; at the beginning of the visit I was discreet, disappearing without warning, but by the end I was bellowing, "Gotta pump!" as I trudged up the stairs yet again. Although the guests were family members, I was too uncomfortable to spend time with them naked from the waist up, coaxing a screaming reluctant baby onto my sombreroed nipple.

They weren't even out of the driveway before I'd stripped and presented my plastic prosthetic once again to Charlie. But by that time, his initial goodwill had turned to rancor. He'd open obediently and allow me to draw him aggressively onto my breast, and he'd take a few experimental sucks. But when no milk was immediately forthcoming, he would scream.

And scream.

I'd wait for him to calm down, give him a few milliliters from a bottle, and then try again. And he would scream the scream of the thwarted, the betrayed, the milkless, the pissed.

Now here is where we talk about the letdown reflex, or milk ejection reflex. It's this that causes some women's breasts to leak when they hear their baby cry, and what some women feel as a tingling that precedes a gush of milk. Apparently it's a conditioned reflex that can be inhibited by pain, anxiety, or negative feedback. You know, like the pain of sore nipples being relentlessly hoovered into a mechanical pump, or the anxiety of watching your supply diminish, or the negative feedback of, oh, I don't know, a baby yelling in fury when you're not delivering the goods fast enough.

My letdown, friends, is for shit. So Charlie would give a few healthy pulls, get no milk, and then scream. I can't entirely blame him. Having been bottle-fed for the first ten weeks of his life, he had no patience whatsoever for meals served in a less expeditious fashion. If the nipple of a bottle — even a slow-flow nipple — is a McDonald's drinking straw, my nipples are those whisper-thin coffee stirrers. Now how would you rather drink your milkshake?

A classic case of nipple confusion. But Charlie is not confused. He simply hates my breasts.

I called the local lactation consultant, a mother of a preemie herself, and explained the situation. She sighed. She said, "Well, you can work on it. You can do more skin-to-skin, and you can continue to try. Or" — and here is where I burst into grateful tears — "you can just enjoy your baby."

I needed that permission, thinking, If a hardcore breastfeeding advocate says it's okay to stop, it must really be okay to stop. I've been working very hard for the last ten weeks. I am ready for something to be easy, for feedings to be pleasant and amicable. I'm tired of trying, and desperate to stop being a special case, to stop having to work so much harder than almost everyone at something that should come more or less naturally. I am not going to try anymore.

That said, I'm still pumping. In fact, I'm committed to doing so at least until Charlie hits twelve weeks. I've heard that at twelve weeks a baby has received about 60% of his mother's antibodies, with the rest accruing only gradually thereafter. (I was not able to find a citation for that figure, but it pleases me so I embrace it.) It's important to me to give him that much, especially during RSV season.

Beyond that arbitrary milestone, I don't know how long I'll keep it up; a lot depends on how well I'm able to build and maintain my waning milk supply. To that end, I'm already pumping so frequently I don't know night from day, guzzling so much Guinness I smell like a brewery, and popping so much fenugreek I smell like a mapley brewery. I've also ordered domperidone without a prescription from a shady overseas pharmacy, and will frantically swallow it in giant handfuls immediately upon its arrival.

After that, we shall see. I will report back, unless I'm too busy enjoying my baby. Or slowly decomposing in a drawer in the morgue, a sad cautionary tale against ingesting controlled substances acquired from fly-by-night charlatans somewhere in the South Pacific.

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