Twenty-two years ago today, I was home with my first baby determined to breastfeed. We were four days in, and things weren’t going so well. I am a competitive person, and once I set a goal for myself, I usually have enough motivation to push through anything in my way. I don’t give in too easily, and I refuse to admit when I am unable to do something. I WILL do it. Breastfeeding was no exception.
Looking back, I made so many mistakes. Each time I tried to fix a problem, I just made things worse. I didn’t realize it at the time, but I was under-minding any chance of being successful at breastfeeding. I didn’t know who to turn to for help. None of my closest friends had babies of their own. The only person in my family to successfully breastfeed longer than a week was my grandmother. She was supportive, but I don’t remember sharing my struggles with her, so she didn’t have any suggestions to offer.
Probably my biggest mistake was not educating myself prior to my daughter’s birth. I did not take a class, nor did I have any breastfeeding books on hand. I doubt that I even realized either of those things existed because my mindset was “breastfeeding is normal – it should be easy-peasy”. If I had taken a class, I would have understood a few REALLY IMPORTANT pieces of information that would have made a huge difference in our breastfeeding relationship. I would have learned who to turn to (and when to turn) if things went wrong. And, I would have had a sense of reality about breastfeeding – it’s not always easy-peasy. “Normal” doesn’t mean “easy”. There are a lot of “normal” things that take work.
Here are a few of the mistakes I made:
It Takes Two to Make a Thing Go Right
I underestimated how important it was to consider that there were two of us in this relationship – me and my baby. Two of us who were each having our own unique experience and set of problems. Two of us needed help. I focused on one problem rather than the series of problems – my baby would latch for a few seconds, my baby would scream and refuse to finish nursing, and as a result, my baby was diagnosed with “failure to thrive”. I saw that as one problem. It wasn’t. It was a series of problems that snowballed very quickly.
My birth experience likely affected the breastfeeding relationship
I made many mistakes during labor that resulted in me having just about every intervention under the sun. I thought I was well prepared. I wasn’t. Had I been better prepared, I would have made different decisions. Instead, my baby was exposed to various narcotics, internal monitoring, Pitocin, and medication to counteract a drop in my blood pressure - the result of an epidural. By the time she was born, she had experienced some trauma that made her reluctant to want to nurse during that important Golden Hour.
The Almighty Latch
I had the most wonderfully, attentive nurses during my hospital stay. But I mistook their kindness and compassion for “oh, everything’s ok and there’s nothing wrong with a baby who hasn’t properly latched before you go home”. Regardless of how well I thought breastfeeding was going (or in my case, not going), I should have asked to have an evaluation by a Lactation Consultant. We never established a good latch before we were discharged, and we were sent home not ready to do this breastfeeding thing on our own. Always ask to see a Lactation Consultant before leaving the hospital. Nurses are trained in basic breastfeeding assistance, but that is in no way enough to help a mother who is struggling. Lactation Consultants are extensively trained in breastfeeding.
She Sells Sea Shells by the Seashore
It only took me about 16 years to realize my daughter likely had a tongue tie. As a high school student taking a foreign language, she would laugh at herself for being unable to “roll her R’s” or curl her tongue. Combine that with her inability to properly latch or stay latched for more than a minute, and it made some sense. As I got deeper into studying women’s healthcare, I realized how much tongue and lip ties can affect breastfeeding. I believe it’s very likely that this was a huge issue for us that went unaddressed. Fortunately, we are much better at diagnosing this in 2017 than we were in 1995.
The Dreaded “Failure to Thrive” Diagnosis
I was in this breastfeeding relationship for the long run – for better or worse. Until the day when the pediatrician diagnosed her with “failure to thrive”. She wasn’t gaining the appropriate amount of weight for her age. What parent wants to hear those words? My child isn’t thriving because of me? I can’t sustain her? What happens if she failed? Did that mean what I thought it meant? I was failing her and that was a deal breaker in my breastfeeding quest. I wanted a healthy, fed baby, not a hungry, non-thriving, partially breastfed baby. Note to all of your new parents out there: “failure to thrive” is simply clinical verbiage that notes that a baby is not gaining weight according to some pre-established scale. The diagnosis says “we need a game plan to keep an eye on this baby’s weight gain”. For a breastfed baby, this game plan should include a trip to a lactation consultant for assistance and monitoring. After all, breastfeeding is kind of an important way to feed a baby and if it’s not working, wouldn’t it make sense to fix it? Instead, pediatricians tend to jump right to the “give your baby a bottle of formula right now” as a solution. And, that’s exactly what I did. It went down-hill from here rather quickly.
Not all Nipples are Nipples
After that “failure to thrive” diagnosis, the first thing I did was give my daughter a bottle of formula, which she drank in its entirety. Nothing boosts a new mother’s confidence more than hearing a pediatrician tell you that your breastfeeding is so bad that your baby isn’t growing and then seeing your baby drink down a bottle of formula like she’s been starving for the past week. I didn’t realize how offering that bottle just sabotaged our breastfeeding. It takes much less effort for a baby to get milk from a bottle than it does from a breast. A bottle doesn’t require a deep latch, and the milk is immediately available. Breastfeeding requires a baby to work a little bit harder for the milk. It requires patience. A hungry baby is neither patient nor willing to work hard for milk. A hungry baby is a crying baby, and a crying baby wants fed immediately.
So, the more I offered a bottle, the more she learned how much easier it was to drink from a bottle. If she did in fact have a tongue tie that went untreated, this bottle thing was the way to go. It wasn’t long before she had zero patience for waiting on breastmilk. It was too much work. What I thought was the answer (a bottle) was probably my biggest enemy. Did I mention she also LOVED the pacifier I gave her when she was fussy? Yeah, that’s not a real nipple either…
Let the Let Down, Let Up
I had a strong let down that produced too much milk, too forcefully, and a baby who did not approve. As soon as I would feel it, she would 1.) gulp, 2.) choke, 3.) scream. The breastfeeding session would end with her screaming, me leaking breastmilk everywhere, and a hungry baby that wanted fed again 20 minutes later. An impossible schedule to keep up for very long. That was not enough time for me to eat, use the bathroom, let along shower or sleep. This could have been resolved if I would have learned to pump through my let down and then latch the baby on once the forceful let down, let up a bit. It would have given her the instant satisfaction that she needed, the fattier hind-milk to help her gain weight, without filling up from chugging the fore-milk that didn't offer much calories.
Supply and Demand(er)
I did not understand the production process of breastmilk. The concept that breastmilk was made by supply and demand was foreign to me. Since I hear so many other women also say the words “I didn’t make enough milk to feed my baby”, it’s apparently a foreign concept to a lot of us. Here’s the deal: Most of us make enough milk to feed our babies. The more often a baby nurses, the more milk the mother’s body makes. Every time she nurses, her body tells her to produce more milk. Likewise, the less she nurses, the less milk she will make. If the baby isn’t nursing frequently, the body will think it doesn’t need to produce that much milk and will make the adjustments accordingly. So a mother who is struggling with nursing may see a decrease in milk supply as a result. Sometimes babies will nurse frequently in order to boost that supply too. But, that is often interpreted as “oh my baby must be eating all the time because I don’t make enough milk and he’s hungry. I should give him a bottle too.” Trust that your body and your baby will work together to regulate the amount of milk that’s made. Exclusive, frequent breastfeeding is your best way to increase your milk supply.
Where’s My Invite?
I never attended a La Leche League meeting. I’m not sure why I was so intimidated by the thought of showing up to a meeting. I think I needed an invite. I needed someone to ask me to come, or explain to me that these meetings don’t require an invite or a RSVP. I could have just shown up. These meetings simply exist for breastfeeding moms to help one another. I’m embarrassed to admit it, but even though I breastfed four children for more than four years of my life, the first LLL meeting that I ever attended was when my youngest child was ten and I happened to be in the same building as a LLL meeting. I overheard the tears, the advice, the love, and the support that happened between the women in this meeting. I could have used all those things when I was struggling to feed my first. Don’t wait for the invite. You don’t need one. You don’t need an appointment, and you don’t need to pay anything. You don’t even need to be on time. Just show up.
No Shirt, No Shoes = Service
I should have devoted a few days to focus on these breastfeeding problems instead of looking for the quick fix. I didn’t slow down. I was excited to show off my baby to everyone, and so we went out running around before she was even a week old. What I really needed was a few days of being tucked into bed with nothing but my newborn while someone else prepared meals and took care of any other household chores. I’ve heard many midwives suggest a “nurse-in” to new mothers who are struggling with breastfeeding. It’s thought that most breastfeeding issues can be fixed when a mother does nothing more than snuggle up skin-to-skin with their new baby for a good 24-48 hours. I needed to spend more alone time with my baby rather than being out and about. So, take off your shirt, take off your shoes, and go on a stay-at-home honeymoon with your baby.
Take a Dose of Reality
While I was determined (read: stubborn) to breastfeed, I needed a dose of reality. My determination alone was not enough to overcome the problems that were snowballing. I needed to take off that invisible Super Woman cape I gave myself and admit that I needed help from a professional lactation consultant. I needed to realize that I was not qualified to fix these problems, and that my attempts were just making a problem, worse. I needed more than the one lactation consultant appointment that I went to (which, by the way, ended in the LC labeling my daughter as having “mal-behavior”. Yeah, that helped my self-confidence, too). The fact is, I didn’t know as much as I thought I knew, and I was not educated enough about breastfeeding problems to fix what was wrong. Normal and easy do not always go hand-in-hand.
I devoted six months of pumping and feeding my daughter breastmilk from a bottle. If you’ve ever done this, you’ll know that this basically meant my whole entire waking moments were devoted to feeding her (every two hours consisted of 15 minutes of pumping, 15-20 minutes to feed her the bottle of pumped milk, and start it all over again in just over an hour). I felt guilty and relieved all at the same time the day I said I was done.
I’m here to tell you that twenty-two years later, she’s thriving.
Wendy Trees Shiffer, MS, FACCE, LCCE is a mother and maternal-fetal health educator. She is the founder and program director for Family Trees Birth Programs serving childbirth professionals and new parents.