05/23/2008

The breast-laid plan

I probably shouldn't admit this, but you know what I'm looking forward to with this baby?  The possibility of giving up on breastfeeding.

Let me say at the outset that nothing would make me happier than a good nursing experience.  But nothing would make me sadder than the kind of experience I had with Charlie.  (Note to universe: I am saying that in a rhetorical senseI know there are worse things than ending up with a healthy, thriving baby who enjoyed the benefit of expressed breast milk for the first six months of his life.  I'll thank you not to kick my ass in new and unexpected ways just to show me who's in charge here because, hey, you know what?  I get it.)

Vibroboot Charlie was born at 10:22 PM.  Shortly after midnight I was out of recovery, in a hospital bed, tethered to a urinary catheter and a bag of mag, sheathed in vibrating boots to prevent blood clots, and asking rather incoherently for a breast pump.  After protesting that the baby, as yet unnamed, wouldn't be able to be given anything I made, the nurse decided it was easier to cooperate than argue, and wheeled it in.  And my long lactational nightmare began.

From the start I knew it would be a long time before I'd be able to do much for Charlie in the concrete sense.  If all I could do was make milk, then by God, make milk I would.  I did, pumping eight times daily for months.  And the milk came — by the femtoliter, at the start, and  eventually, with everything I would learn about pumping and the assistance of domperidone, five to seven ounces per pump.  Amazing how that seemed like a lot at the time.

For a lot of reasons — his reflux, my low supply, his screaming, my crying, the slow-dawning realization that I was well within my rights to stop torturing us both — Charlie and I never took to nursing.  So for months after we were home, I continued to pump.  At most feedings, Paul would give Charlie a bottle of expressed milk while I sat hunched miserably over the pump, giving my baby nourishment but utterly failing to enjoy it.

It wasn't until he was five months old that awareness began to creep in: There's something bad wrong with that.

By that time, Charlie had sailed through all of the temporary danger zones a preemie has to endure: the life-threatening possibility of NEC, the question of whether he would grow adequately, the first few months of life outside the more-or-less sterile confines of an isolette.  Providing him with breast milk was now a matter not of life or death, as it had initially seemed to me in my preemie panic, but of similar weight to the decision any mother makes when she considers feeding her healthy, full-term infant.  What about immunities?  Allergies?  Those critical six IQ points?  And what about suppressing ovulation so that I don't conceive again too quickly?  (Yeah, hey, what about that?)

And what about the manifold benefits to the entire family of a mother who actually likes feeding her baby?  Who gets more precious mood-stabilizing sleep?  Who isn't forever slipping away, from either a happy baby or a cranky one, a beleaguered husband or a resigned one, to pump?  Who cuddles her son close instead of holding him out at a distance, away from the breasts that had hurt nonstop since the midnight of his birth?

In a lot of ways I'm proud of what I did for Charlie.  I did it as much for myself, knowing that I'd punish myself for not making the effort if he didn't flourish.  But in other ways I'm sorry — sorry that I did it for so long, anyway.  It was right for me to quit, and I wish I'd done it sooner.

Before I even got pregnant this time, I made myself a promise.  If the baby comes early, I'll pump through any NICU time.  I'll pump until we have a chance to make a solid try at nursing.  And preemie or not, I will make a solid try at nursing.  But I will not make myself crazy.  In this one aspect of pregnancy, birth, and early motherhood, I am looking forward to this chance for a do-over.  I cannot wait not to make myself crazy.

(Now go get a load of Jiang Xiaojuan.)

11:37 AM in It was the breast of times, it was the worst of times, Jesus gay, I'm pregnant. | Permalink | Comments (113)

08/10/2008

The only post I will ever write about nursing our second son

Ben nursed exclusively for the first ten days of his life.  My milk came in on day 3 postpartum — a revelation to me, since the sudden engorgement made it clear that my breasts never really did quite what they should have with Charlie.  (Apparently a premature delivery and a full tank of mag can do that to a girl, no matter how much hippie-smelling funk the fenugreek induces.) 

Supply was not a problem, and Ben had a beautiful latch, and I had the invaluable assistance of a cadre of knowledgeable nurses.  Aside from his routine weight checks in the nursery, Ben was never taken out of my room.  He spent his days and nights wearing only a diaper and a light blanket for plenty of skin-to-skin contact, and I brought him in close every time he started making interesting shapes with that curious pink mouth of his.  We had the peerless support of a donut delivered straight from the bakeries of Heaven itself.  Hot and cold running Lansinoh.  A leopard-print nursing bra, for crying out loud.  Everything should have been great.

And it hurt every goddamn time.

I had always heard the first two weeks of breastfeeding are the most difficult, not an instant blissful communion but a hump to get over by dint of determination and endurance.  And endure I did, wincing with every chomp, twelve times a day, chanting to myself with every beat of the rhythmic mangling, The first two weeks are the toughest.  So it wasn't strictly the pain that made me — say it with me, friends — talk to a lactation consultant.  It was the pediatrician, casually mentioning in the course of her routine examination that Ben's pretty mouth is tongue-tied, not severely, but enough to warrant a consultation with an ENT doctor.

And because I like a good specialist as much as the next heavily medicalized God-bless-American, I also called the lactation consultant.

She watched me feed Ben.  She saw his jaw working fast, clamping down over and over.  She saw me stiffen and grimace as he worked.  She checked the position of his lips, properly flared in an ardent fish-kiss, and watched the motion of his tongue, which was not clearing his lower gum during sucking to form the comfortable cushion it should have.  She suggested a tongue exercise for us to do with Ben.  (Open mouth, insert pinky, initiate sucking, press gently on back of tongue, and savor the cries of one righteously pissed-off newborn.)  She was encouraging, positive, and relatively sanguine about our chances of eventually getting Ben to nurse without making me dread each feeding.

Dread.  It's precisely the word.  She said only the right things, but she told me exactly what I did not want to hear.  She recommended that while we wait for our ENT appointment, I bottle-feed to limit damage to my nipples, and pump ten to twelve times a day to keep my supply from dwindling.

Oh, how we all did laugh.

I talked with her a bit about my history with Charlie, in which my hatred for the pump figured prominently.  I think she somehow mistook me, because she warmly told me that I should be proud of working that hard for him (I was and am) and that I have no reason to feel I'd failed him (um, what?).  Failed, what a ridiculous word under the circumstances, one that has nevertheless a dangerous resonance.  When we left her office I could already feel the crazy creeping in.

How much influence ankyloglossia has on an infant's feeding is up for debate.  The main problem seems to be the pain it can cause the mother, coupled as it often is with near-constant nursing to compensate for the less than optimal sucking action.  Of course breastfeeding such an infant can be done, especially with a relatively mild case like Ben's.  The trouble is, I am not willing to do it.  The pain while nursing, the pain while pumping, the bad place it all takes my head and heart — I don't believe it's worth it.

While we waited for our appointment with the lactation consultant, Paul leafed through the breastfeeding brochures racked outside her office.  "A mother's love knows no bounds," he intoned in an ominous voice, reading from one.  Talk about a dangerous resonance.  I can't look at Ben without feeling a rush of that mother's love.  But I can't look at the pump without feeling a bound so definite it might as well be a concrete wall.  After Charlie, I don't equate any mode of feeding with love.  With Ben, though, when I know my giving up after ten scant days to be a decision borne of purest selfishness, I can see how someone might.

For the last two days I've been feeding Ben a combination of formula and the milk I've pumped solely to reduce engorgement.  I can't describe the feeling of well being I have as I hold him and give him, yes, a bottle.  I hear his squeaks of enthusiasm as he drinks, and I see his eyes getting heavier, and I watch the fleeting sleep-smile that's no less enchanting for being only reflex.  And of course breastfeeding has incomparable advantages, but the signs of a contented baby seem, to my biased eye, to be the same in any infant who's being held close and fed with love.  I remember them from Charlie.  I want to enjoy them this time without pain, drama, or stress.  I want to enjoy this baby.

I am enjoying this baby.  I don't dread his waking to eat.  I don't put him down with a feeling of resignation as I lurch off to the pump.  Feeding him, which at this point constitutes the bulk of his conscious moments, brings only pleasure.

That's not to say I'm completely okay; in fact, I'm rocked with ambivalence a dozen times a day, telling myself, There's still time to keep pumping, to keep the supply going, to give him another week, to see how it goes.  And then I swing wildly in the other direction: But why exactly would I do that?

Despite the obvious nutritional superiority of breast milk, I can't think of a reason good enough to continue — that's how strong my resistance is.  I promised myself I wouldn't get crazy again.  I promised Paul, and I meant it.  I promised Charlie, if silently, not to subject him to a mother made unhappy that way.  Three good reasons not to.

However we nourish our children, we all want to give them the best in ourselves.  It's just that for Ben, his mother's best isn't milk.  It's time, peaceful feeding, and the recognition, won through experience, that sometimes embracing "good enough" is the very best of all.

10:27 AM in It was the breast of times, it was the worst of times | Permalink | Comments (395)

08/18/2008

Don't make me post a recipe, too.

I don't know where to go from here.  My first feeling based on the comments from my last entry is gratitude — from most of you I felt warmth and understanding, even from those whose stories are radically different from mine, and, man, what an amazing gift that was.  Thank you.

My next feeling, though, is defensiveness, the almost irresistible urge to say, But wait, we did have his tongue clipped, and we did try again.  My God, of course we did.  And You know, I am still pumping, just not with crazy-making frequency, so Ben gets human milk at least three times a day.  And After two days on the bottle we gave on the lactation consultant's advice, Ben wouldn't latch worth a good goddamn.  And But.  And And.  And so on, graf after graf of fevered justification.  But then I rein myself in — uh, okay, mostly — and remind myself that although I feel buoyed by the support of my friends inside the computer when I'm lucky enough to get it and occasionally crestfallen when I don't, it's Ben and Charlie and Paul to whom I ultimately need to answer.  And Paul understands; Charlie, despite my frequent pestering, doesn't read my blog; and every time Ben makes that captivating baby bird mouth I smile instead of grimacing.  All answers good enough for me.

My friend T., who had difficulty nursing her own two children, said something to me that rings beautifully true: Don't let anything get in the way of your relationship with your kids — least of all yourself.  Depending on your situation, of course you can read that any number of ways, and I recognize there are those who will say that by giving up on nursing, that is exactly what I've done.  But in our circumstances I interpret it as meaning that it would be emotionally ruinous for me to indulge my own lingering issues at the expense of being the relaxed, happy parent my family and I deserve.

And that really is all I'm going to say.  Except that I still want to make out with anon of comment #45 et seq., although despite professional encouragement I still haven't settled the contraceptive issue, so maybe we should wait until we're really sure we're ready.  And that I have a few choice remarks to share with Jonnelle of comment #256 and a few other commenters who've offered similar views in the last two weeks.  And that Ben's jaundice has resolved, he has regained his birth weight, and I am taking back everything bad I ever said about ready-packed prefab food for kids because it turns out that the Campbell's Cream of Lunchables we're feeding him ten times a day really isn't that bad after all.

What, humor's not working?  Then how about that last refuge of someone who'd really like to change the subject, a picture of a baby?

11:36 AM in It was the breast of times, it was the worst of times | Permalink | Comments (295)

09/10/2008

He's depraved on account-a he's deprived

Some kids imitate their mothers nursing, reenacting that exquisite mother/child tableau, small faces serious as they cradle a beloved doll close, touchingly aware of the importance of the business at hand. 

Not Charlie.

I'm pretty sure this is the only time a breast pump has made me smile.

09:41 PM in It was the breast of times, it was the worst of times | Permalink | Comments (67)