March 26, 2012

Saying good-bye to breastfeeding

Nine days ago I became a new mother.

About this I am filled with happiness and fear and excitement and exhaustion and weepiness, but also with an emotion I did not expect:  intense grief.  Regarding breastfeeding.  Or my lack thereof.  Let me explain.

I assumed I would breastfeed my daughter, Sophia.  I've assumed since I was a little girl that I would one day do this for my child when I saw my mother breastfeeding my brothers.  I had visions of my child emerging from my body, wet and wriggling, and being placed upon my ample breasts already overflowing with milk and beginning to eat.  My motherly instincts would kick in as I held her to me and basked in the glow of fertility and womanhood. My assumption was so entrenched that while stocking up on baby necessities in the last few months, I didn't bother buying formula and a bunch of bottles:  my boobs would supply what I needed!  Baby feeding supplies?  Check and check. 

I heard people talk about how difficult breastfeeding is and I thought I had adequately braced myself.  I was ready to be patient with both my body and with Sophia.  I was ready for sore nipples and purchased lanolin ointment in preparation.  I bought expensive nursing bras after test-driving a couple.   I thought I was reasonably ready for the challenge.

I was wrong.

The first time I put my baby to my breast, I felt anxious anticipation.  Within a few seconds Sophia had figured out what was going on, and her little lips had eagerly enveloped my nipple and she began to suck.  I was thrilled!  My baby knew what to do, and soon when my milk "came in" from wherever it mysteriously was, I would be able to supply her with the food she needed.  Awash in motherly competence, I beamed with pride as the nurses in the Intensive Care Nursery (ICN) at UCSF exclaimed over how good her latch was and how well she sucked.

"You don't have to worry about those two," Nurse Sue knowlingly informed other nurses who worked in the ICN, "they're as good as anyone I've ever seen at breastfeeding."

Well, of course my child would figure it out quickly. She was her mother's daughter!  She was smart, and it was a sign of the overachievement to come.  She would be walking at 9 months and reading at  3 1/2 years.

These positive feelings lasted for approximately 48 hours.  While I was reflecting upon my good fortune that breastfeeding was practically in the bag, Sophia was being fed formula in a bottle with a nipple that was much easier to suck from and much more productive than mine and had grown impatient with our little suck-on-mom's-nipples-for-half-an-hour-to-get-colustrum-and-help-her-milk-come-in-BEFORE-you-can-eat song and dance.  Soon she preferred to go straight for the bottle when she was hungry.

Who could blame her?

But it felt awful.  At first I just felt a little let down and disappointed that my milk hadn't come in as quickly as I'd hoped.  But after a couple of feeding sessions' worth of watching my baby repeatedly make faces when she realized which nipple she was being given, I started to get upset in earnest.

I was reassured repeatedly by nurses.  This was not abnormal at all, they told me.  C-sections slow down the process, it was explained.  Premature babies may also slow down the process, I heard.  Just give it a couple more days and it will happen, I was promised.

A lactation consultant dropped by my room.  An electric, hospital-grade breast pump was delivered to my bedside so that I could get down to the business of hooking myself up to the machine and pumping every three hours.  The ICN pediatrician stopped by to offer breastfeeding tips.  Each time the nurses' shifts changed, I got advice from all of them all over again.  In front of a small, concerned audience, I was instructed how to "express" milk from my breasts and then subsequently failed to do so repeatedly.  Everyone around me was "Rah-rah-rah!" on the breastfeeding bandwagon and I felt left behind.

While everyone meant well, what it ultimately meant was that my every three hours feedings with my baby began to feel like work.  Work at which I was failing!  Along with other exhausted new mothers on the 15th floor, I shuffled zombie-like in my gown to the nursery around the clock, but I began to hate it. It was stressful and goal-oriented and frustrating.  When the telephone rang in my hospital room or my alarm went off signaling that it was time for the baby to eat, I groaned and cursed.

I felt dread about feeding my baby, and I started to cry every time it was time to feed her.

When I managed to survive another feeding, I went back to my room and fell into bed with relief, only to immediately begin eyeing the clock out of anxiety for the next feeding.

Eventually, my colustrum stopped showing up when I pumped.  It felt like I'd officially failed.  "Your negative emotions are probably affecting the process," I was informed.

Well, hell.

These feelings were not okay with me.  I started electing to skip the attempts to get my baby to suck from my own breasts and began going straight to the bottle when I fed her.  I wanted back the moments we had previously shared when Sophie had her belly full and we would rock in the chair together and snuggle.  My nursery breastfeeding boycott was very controversial.  Nurses confronted me while I was feeding my baby about why I was doing what I was doing.  Had I thought about the implications of this decision?  Her doctor came to talk to me.  A second and much-lauded lactation consultant was sent in to get to the bottom of my situation.  A social worker came to have a little heart-to-heart with me about my feelings.  One nurse took it upon herself to call the lactation specialists and inform them whenever I fed the baby without putting her to my breast so that they could call me on the phone in my room later and ask my why I hadn't put the baby to my breast at her last feeding--why was I stopping breastfeeding?  I felt spied on and harassed, and that was the last straw. 

I desperately wanted to take my baby and go home and away from the eyes of all the doctors and nurses and the other mothers breastfeeding in the nursery.  An identical electric breast pump was scheduled to be delivered to my house the day I brought the baby home.  I looked forward to my own private attempts to feed and bond with my baby.  Then an address mix-up and the approaching weekend delayed the delivery by several days.  Now, even my hopes of succeeding at home were fading away, and I felt miserable.  I cried my first night home when I desperately needed sleep to be ready for her next feeding and changing.  "I'm not going to be able to breastfeed our baby," I moaned to my partner.  "I feel like a bad mom."

The next morning Aurelia, a home care nurse, arrived at my house to give Sophie her first check-up.  She was kind and soft-spoken and filled with questions and advice.  I knew in advance I couldn't bear another conversation about breastfeeding, and I prepared to put on a brave face about how it was going.  We sat down in the living room with Sophie and my mother, and Aurelia got down to business.  "I'm hear to check the baby, of course," she said, "but I really want to start with asking you about breastfeeding."  I broke down into a weeping mess and blubbered out the whole situation to her.  Fat, hot tears rolled down my cheeks and I felt embarrassed, but there was nothing I can do to control them.  It was heart-wrenching.

Aurelia was caring and empathic.  She listened to my story and said, "You are not required to do this.  You did your best.  You gave your baby the colustrum that would give her the antibodies that she needed.  That's the most important part.  They are very pro-breastfeeding at UCSF and there's a lot of pressure.  You can't beat yourself up about this. You know, not breastfeeding is a choice, too."

This was a new idea.  I wasn't sure I liked it.

Aurelia kindly helped me by making the phone call necessary to track dow the wayward breastpump that was supposed to be delivered to me, and assured me that it was not too late.  "Your hormones are very active for a couple of weeks.  If you decide you want to breastfeed, there's still time."  My relief was incredible.

Today while laying with Sophia on the bed, one of the lactation consultants from UCSF called me to check in.  I felt my stress level rise immediately.  How was breastfeeding going? she wanted to know.  Have you tried this?  And that?  What about this combined with that?  Predictably, I started to cry.  I explained to her that I felt that the pressure around breastfeeding was affecting my bonding with Sophia.  She softened. 

"Honey, if it doesn't work it's not the end of the world.  She will still grow into a wonderful young woman.  She will still be happy and healthy.  When you feed her formula, hold her skin-to-skin.  Your baby deserves to feel you against her--she deserves that contact and so do you.  Stroke her arms and hands.  It will be fine.  If breastfeeding is not working then don't let it affect your relationship."

I was surprised by what I was hearing, but grateful.  This active breastfeeding proponent was assuring me it was okay if it didn't work for me, and that I had nothing to feel guilty about.  I started letting myself off the hook.

Tomorrow the breast pump is supposed to be delivered to my house.  I still plan to work on breastfeeding at my own pace.  I don't know if it will work.  It may have already slipped through my fingers, and that still hurts me.  But I no longer feel like a bad mom.

March 15, 2012

My/our temple

It is a very strange thing to find that your body has been taken over by another being.  And strange to be a container carrying precious cargo that everyone else has an opinion about and an interest in and my god they are going to let you know!

Before I was pregnant, when I needed mental health assistance it could be very, very difficult to get the help I needed.  Endless phone calls and waits and unreturned messages and frustration and confusion for which I just didn't have the energy.  So it was strange to become pregnant and suddenly find that everyone could not help me fast enough.  My baby's health and well-being are important enough to complete strangers that they want to bend over backwards (to the extent that their budgets allow) to connect me with services. 

Want to take a jewelry-making class with other moms-to-be?  Here's a pamphlet!

Care to try prenatal acupuncture?  Come to our free clinic!

Feel like you want support when you bring your newborn home?  Let us sign you up for a few visits from a home health nurse!

Compared to what I had gotten used to, it has been rather dazzling. 

I am trying to take advantage of every service and opportunity I can manage while it is available, especially now as I'm reaching the end and being pregnant has become very, very difficult.  I was aware that it might, but never would I have been able to imagine how.

At the beginning of my second pregnancy, I was warned that miscarriage, pregnancy, and birth can all being very challenging experiences for women who've experienced sexual trauma.  When I thought about it, it made sense.  I was glad to be warned and I filed this knowledge away with the idea that knowing was half the battle and now that I knew I would be fine.

How I was wrong.

(To be continued.)

March 8, 2012

Introducing...Dear Frijole

Did I mention I was having a baby? 

I've been discussing this topic elsewhere for privacy.  Now I'm ready to share.