Being new parents to a newborn is hard. This may seem like an obvious statement, but the way in which it was hard was surprising for me. It wasn’t the late night feedings and lack of sleep – I had expected that and was prepared to give up sleeping through the night for several months. It wasn’t learning how to calm a crying baby and sometimes being frustrated by not knowing why she’s crying – I know eventually I’ll learn to distinguish her cries and know what’s bothering her, or accept that sometimes she just wants to cry and it’s not necessarily a bad thing. For me, it was breastfeeding.
We had gone to breastfeeding classes before she was born, and it was never questioned that we would plan to exclusively breastfeed for as long as we could. Every doctor, nurse, lactation consultant, and source of medical expertise we encountered reiterated the same message, that “breast is best.” And I didn’t doubt that for a minute, I still don’t. But when things didn’t quite go according to plan, it created an immense amount of pressure on me.
The first 24 hours after we were discharged from the hospital, things already started to go wrong. I had been exclusively breastfeeding (EBF) in the hospital and continued to do so at home. For those that are doing EBF, we are told to feed the baby whenever she wants it and for however long she wants to – there is no way to “over-feed” from the breast. So, that’s what I did. I breastfed her 14 times in the first 24 hours we were home. She seemed to be constantly hungry. I had blisters on both nipples, one of my nipples was cracked open and the other one was bleeding. They were in bad shape. Each time she latched onto my nipple brought searing pain. It was so painful I could barely stand it. But I endured it and continued to breastfeed her.
After a day and a half, I noticed that she hadn’t had enough wet or poopy diapers. Since you can’t measure how much babies are drinking when they are feeding from the best, the only way to measure whether they’re taking enough in is to measure how much they are outputting. In their fourth day of life, newborns are suppose to have four wet diapers and four poopy diapers. BabyDumpling had had one wet diaper in nearly a day and a half and no poops at all. We called the pediatrician’s office after hours and they said that not having enough wet diapers was a very bad sign, it could mean the baby’s dehydrated. They suggested we take her to the emergency room. So at midnight, less than two days after leaving the hospital, we were back in the hospital.
The on-call pediatrician examined her and, although she had lost almost 10% of her birth weight (which is on the border of what’s expected, since newborns are expected to lose weight the first few days), she had no signs of dehydration and generally looked healthy. They suspected it had something to do with our breastfeeding technique, and admitted that breastfeeding is one of the most common areas new parents struggle with and was actually very difficult. A lactation consultant (LC) came to work with us for over an hour that night, trying different latching positions, troubleshooting how to keep BabyDumpling awake during the feedings (she often fell asleep very shortly after starting to feed at the breast), and ways to bring my milk supply up if BabyDumpling wasn’t being efficient at sucking the milk out (such as pumping after each feeding). At the time, I was still producing colostrum, so there wasn’t a lot of flow. Colostrum is a very nutritious liquid that is produced before milk comes in, but it is produced in very small volumes. However, since a newborn’s stomach is also very small, taking in a few milliliters of colostrum at each feeding is enough for them. Nonetheless, this was Day 4 and my milk should be coming in at this point. The way milk production works is primarily a matter of demand and supply. The more often and quickly that your breasts are emptied, the more milk your body will produce to meet that demand. The LC suspected that I was “behind” on my milk production because BabyDumpling hadn’t been emptying my breasts sufficiently, so I needed to do more. That meant more feeding sessions, rather than less, and pumping in between breastfeeding.
In spite of this, the doctor nonetheless recommended that we supplement with formula, just to make sure that BabyDumpling stayed hydrated if she wasn’t getting fluids from my breast. So we were sent home with a case of formula, and instructions to try to breastfeed and pump as much as possible.
The problem was that, because my nipples were so injured already, breastfeeding was extremely painful. And, improving the latching helped a little bit, and would help to prevent blisters and cracking in the future, but in the present, I had to breastfeed with essentially broken nipples, and it was like torture. PapaDumpling pitied my situation, and in order to give my nipples a break, the day after the ER visit, he told me to skip a couple breastfeeding sessions and just pump instead while they fed the baby formula. Pumping did not hurt as much as breastfeeding, but since my nipples were so sore and sensitive, it wasn’t that pleasant either. However, since the doctor and LC had said we would need to do more breastfeeding, rather than less, to get my milk supply to “catch up” with the baby’s demand, I was back to breastfeeding (while still pumping) the next day.
My whole family was also trying to help by giving me suggestions on things I should eat or drink to help milk production. A lot of these suggestions were probably based on old wives’ tales, but at this point, I was willing to try anything. I was eating/drinking whatever they gave me, even if it tasted awful, which is unusual for me; having been a picky eater my whole life, I normally never ate anything that I didn’t like the taste of. However, despite following the LC’s instructions, and eating and drinking all sorts of things that were supposed to help my milk production, my milk supply was still not increasing very much, and was negligible compared to the volume of formula BabyDumpling had at every feeding. Over the next few days, my body transitioned from producing colostrum to producing milk, and during that time, there should have been a very noticeable increase in volume. Most women report feeling their breasts swell or engorge when their milk comes in, but I did not feel anything. BabyDumpling was drinking about 60ml of formula at every feeding, and I was only producing about 10ml of milk. Working so hard to do everything I could to increase milk production, not seeing results, and seeing BabyDumpling essentially do a full formula feed after each breastfeed, filled me with despair. It seemed pointless. I cried a lot in that first week.
I think I had a case of the baby blues, which are the least severe form of postpartum depression and very common (in 70-80% of women). I recognized that my frequent crying was probably driven by hormones, and that my emotions may have been exaggerated. Nonetheless, my outlook on breastfeeding in the foreseeable future was grim. From my perspective, continuing to breastfeed meant I would have to feel pain every 2-3 hours (and the pain persisted for up to an hour after the feeding), around the clock, for months. Not only was the pain unbearable, but it also felt like my life would consist of nothing but constant feeding. It took nearly an hour to breastfeed her, since she fell asleep so often on the breast, and once that was done, I’d have to pump for another half hour. Meanwhile, my husband or mother-in-law would feed her formula and burp her. By the time she settled down to sleep, and I finished pumping, we would have maybe an hour break before we had to start all over again. Of course I was sleep-deprived, and they often told me to take a nap while she was sleeping, but one hour was not enough for me to sleep. I am not a power-napper, it takes me at least 30min to just to fall asleep, and if I knew I was going to be up again in one hour, I wouldn’t be able to fall asleep at all. I also can’t really leave the house, because every trip outside would take at least an hour and I would miss one of her feedings – since the LC at the hospital determined that I should try to be breastfeeding her more frequently, missing a feeding was definitely not recommended. I imagined myself strapped to the bed for the next 3 months, just breastfeeding and pumping, breastfeeding and pumping. I knew being a new parent would be hard, but that literally seemed like a form of torture.
I have to admit that the first two weeks of BabyDumpling at home were the longest two weeks of my life. Of course I was happy to have her home, and I loved her with every fiber of my being. But I was miserable. Every time BabyDumpling woke up, I wanted to crawl into a hole so that I wouldn’t have to breastfeed. I dreaded each breastfeeding session, and it was worse that they were so frequent. I wasn’t counting the passing of time so much as the number of feedings I had had each day, and each day seemed to stretch on forever.
What made me really depressed had nothing to do with the breastfeeding itself. The real reason I was so upset was the guilt I was feeling inside. In my head, there was a voice that kept saying over and over, “I don’t want to breastfeed. I don’t want to breastfeed anymore. I don’t want to do this anymore.” However, because I knew “breast was best” and – what mother doesn’t want the best for her child? – I felt immensely guilty for wanting to give up. The logical part of me knew that it had only been a week, that things could still turn around if I kept at it. I read stories online of other women whose milk “never came in” until week 4 or 6 or some really long time after it was suppose to – and that they kept trying the whole time. But the emotional part of me was cracking – I wanted to give up. I felt guilty each time I missed a feeding because I had been asleep or because I went to the grocery store, but I also felt relief that I could skip one breastfeeding session, and then I would feel even more guilty for feeling that way.
To me, it seemed like breastfeeding was my job, my responsibility. Breastfeeding is something only the mother can do. And not wanting to breastfeed, or wanting to take the easy way out by bottle-feeding, was me shirking my responsibility as a mother. As much as PapaDumpling and I were a team, I felt like this was on me. If I couldn’t produce enough milk to feed our baby, if I wanted to give up and stop breastfeeding because I couldn’t endure the pain, that was on me, not on him. By not wanting to breastfeed, I was failing both BabyDumpling and PapaDumpling. And so the guilt builds.
In the beginning of Week 2, I cracked and told PapaDumpling I didn’t want to breastfeed anymore. He told me not to give up, to try it for a little longer. I knew he wouldn’t let me give up, I wouldn’t have let me give up if I were him either. PapaDumpling tried to help, by suggesting different things I could eat or try, but it just made it worse because it reiterated how much we needed to keep trying to breastfeed, and how weak I was for wanting to give up so early.
Things started to get better in Week 2 for three reasons. One, I and the rest of the family began to accept that feeding formula is okay. Just because breast milk is best doesn’t mean formula is bad. Two, I think my baby blues were going away. Three, we got a LC to do an in-home consultation and she took the burden off me by basically saying I was doing everything I could and there was nothing more I could do. The LC came to our home a week after our ER visit, I walked her through our postpartum journey, she watched me breastfeed BabyDumpling, and we discussed everything we had tried with breastfeeding. She determined that I had low milk production and there wasn’t a clear reason why. It didn’t seem like there was any physiological or environmental explanation for it. Sometimes, it is what it is. For some reason, hearing her say that made me feel a wave of relief. PapaDumpling’s suggestions for things I should do or not do made it feel like there was something that I did (or didn’t do) that was wrong. His perspective was that if we could just fix that, whatever that was, everything would be ok. But hearing the LC say, “Well it sounds like you have tried everything, and I can’t see a reason why your milk production is low, but sometimes this just happens,” made me feel like I could now just accept it and live with it, instead of trying to fix it. The LC made some suggestions to keep breastfeeding more sustainable, such as limiting the breastfeeding time to 20 minutes. Her theory was that since the baby wasn’t efficiently sucking the milk out of my breasts, there was no point having her there for an hour, it would just take too much of a toll on me. But, since having her suckle on the breasts would help send a message to my body to produce milk, I should still do it, but for a shorter amount of time before letting her get her fill of formula. Meanwhile, the pump would be the real mechanism to empty my breasts of milk.
After that, my whole attitude toward breastfeeding relaxed. I no longer felt dread each time I had to breastfeed, I accepted that BabyDumpling would get her fill from formula afterwards and I would pump what I could. The pain also subsided once my nipples healed, partly because my nipples were hardened and less sensitive to her sucking (newborns have extremely strong sucking power!), and partly because I was not letting her stay on my breast for as long as I used to. As a result of all this, I no longer wanted to stop breastfeeding and therefore was not saddled with the feeling of guilt. Now I could enjoy being with BabyDumpling instead of feeling dread each time she awoke from a nap and wanted to feed, and what a difference that makes on the mental wellbeing of the mother.
It is now three weeks since BabyDumpling was born, and guess what? My milk production is up to almost 80% of what BabyDumpling needs to eat at each feeding! She’s still not efficient at getting all the milk out of my breasts (she gets impatient feeding from the breast because the flow of liquid from breast is much slower than bottle, and she’s gotten used to chugging from a bottle), so a lot of the breast milk she’s getting is from what I pump, but I continue to breastfeed her several times a day just so she still gets some nipple time.
What made the difference? It’s possible that my stress level effected my milk supply, so that once I relaxed, my body started producing more. It’s also possible that, like some of the women I read about, I just needed more time to increase my volume, rather than my milk coming in all of a sudden. It could have also been some of the supplements I was taking (e.g. Fenugreek). Who knows? At the end of the day, my baby is super healthy, I am happier now, PapaDumpling is happier now, and this is a more sustainable feeding philosophy that works for us.
Every new parent faces their own challenges. For us, it was breastfeeding. And while breastfeeding is a common challenge, the way that it can be dealt with is different for everybody, depending on their unique situation. I think one of the reasons that this was so hard on me was that I was blindsided by it – I was prepared for a lot of challenges in pregnancy and delivery (many of which never affected me), but I was not prepared for how difficult breastfeeding would be. My attitude to breastfeeding had been similar to my attitude toward pregnancy and delivery – my body would know what to do. It would just happen naturally. And when it didn’t happen naturally, I found it really difficult.
I would like to mention that, in this respect, I do not think the doctors and nurses did a good job in preparing us. They talked so overwhelmingly of the positives of breastfeeding that it gave us no other choice – and did not go into depth about how and why breastfeeding can be challenging. They didn’t talk about formula-feeding at all, other than to mention it in passing. The only time formula was mentioned in our prenatal classes was when one nurse said, “It’s totally fine if you decide to formula feed,” but the way she said it made it sound like it was totally not fine. It was only after we were faced with these breastfeeding challenges that we started hearing from everyone, “Oh yeah, all new parents struggle with breastfeeding. A lot of people would have given up already in your situation” – wait, really? Because y’all made it sound like everyone out there is breastfeeding and when I couldn’t do it, I felt like I was the only one who was a failure. They were pushing the ideals of breastfeeding so hard that they neglected to discuss the difficulties in reality. I came across these excerpts from an article written by a female obstetrician (Is Breast Always Best?: A Personal Reflection on the Challenges of Breastfeeding) who only realized this after she herself went through it, and I highly identify with what she described:
[…] The joy I had anticipated when my daughter latched on, however, was replaced by searing pain. It was normal, I was told, my breasts just needed to “toughen up.” Two days later, I was still shouting expletives through every feed, and the baby had lost more than 15% of her body weight. I was told she had a tight frenulum, or “tongue tie,” that was causing a painful, ineffective latch. The pediatric otolaryngology fellow performed a frenulectomy the next day— and although my pain improved, my milk production did not. The hospital pediatricians instructed me to supplement with formula. Before I could do so, our hospital asked me to sign a release stating that I knew that breast milk is the very best form of nutrition but that I had nonetheless chosen to deviate from the practice of exclusive breastfeeding. I cried as I signed the form, feeling like I had let my baby down before even taking her home from the hospital.
[…] It took my recent experience as a patient to make me realize that there is a group of women whom we as practitioners are inadvertently alienating—the mothers who, despite motivation, persistence, and utilization of all available resources, are still unable to breastfeed. Is continued reinforcement that “breast is best” helping this population? Many of these women are already self-flagellating and facing judgment from family and friends—do they truly benefit from the additional scrutiny of their physician? Or, by promoting the idea of breastfeeding as an ideal of motherhood, are we as a community simply reinforcing the feelings of anxiety, guilt, and inadequacy that inevitably plague new mothers?
I feel there needs to be more recognition of how and why breastfeeding is challenging, and that although there are a lot of benefits to breastfeeding, it is not the only way, and all of the options need to be considered in light of the physical, mental, and emotional health of both mother and baby.
If there’s anything I have taken away from all of this, it is that breastfeeding is damn hard and I have so much respect for women who breastfeed. Bravo moms, seriously, bravo!