|Robbie breastfeeding, April 17|
A few years ago, I asked my mom if my younger sister and I had been breastfed. She told me* that she nursed me for six months and hated every minute of it; at Sarah's two-week pediatrician's appointment, when asked if she was breastfeeding, she burst into tears and the doctor gave her his blessing to stop. "Any benefits the baby might get from breastmilk will be cancelled out if nursing is a bad experience," he said. "She'll know you're miserable."
That story fundamentally shaped my thoughts on breastfeeding before I gave birth. The situation that further informed my approach was Robbie's 36 hour stay in the Special Care Nursery, where he was treated for jaundice after I was discharged from the hospital. I'd nursed him a few times in the recovery room and been sent home with a rented pump, but I wasn't producing enough to keep him nourished on breastmilk alone and so, without even asking us, the nurses gave him formula when I wasn't there and he needed to eat.
I understand that many parents might have been upset to have had this decision - these decisions: formula and a bottle - taken away from them, but we were tremendously grateful. If Robbie had come home when I was discharged, I would have agonized over the right time to introduce a bottle and to start supplementing with formula. There's so much back and forth over the best window in which to give a baby a bottle; if you do it too early, the fear is that s/he'll have nipple confusion, but too late and the baby might refuse to try something new. But Robbie needed to eat and I wasn't there, so he got a bottle and formula on day three. We understood that it was essentially a medical decision, and we respected the nurses' expertise.
The hospital had fantastic lactation consultants, too, and they checked in on me twice before I was discharged and a third time when I came back to nurse Robbie in Special Care. My insurance also covered an outpatient visit a week after Robbie came home, and the LC taught me how to make sure Robbie was latching properly and helped me figure out a few different breastfeeding positions that would ease the tension in my neck, shoulders, and back. Robbie was gaining weight well, and the LC didn't blink an eye when I told her that he got a bottle of formula every day. She was also entirely matter-of-fact when suggesting we use a nipple shield to help with the pain I was experiencing; I asked how long we should keep using it, and she said as long as I felt it helped. (Since then, I've read posts on mommy forums about how you can ruin your baby by over-reliance on nipple shields. Thank God I wasn't plugged into those debates at the time!) Like with the bottle and formula situation, I understood the nipple shield to basically be a medical assistance device that a professional had recommended we use.
Until I went back to work at 11 weeks, I nursed on demand, almost always using the nipple shield. (When I didn't, I slathered on Earth Mama Angel Baby Nipple Butter, which was amazing.) Jon, a night owl anyway, took the midnight feeding and would give Robbie formula then; I'd go to bed around 10pm and wake up in the wee hours when Robbie cried to be fed again. We had a rough week or so when he was about a month old and insisted on cluster feeding from 6-9pm, so I went back to the hospital to attend a mom's group run by the lactation consultants in search of advice. The LC told me that, for reasons we don't understand, many women's supply drops in the evening and the breastmilk isn't as rich then as at other times of day. She suggested that we sub in a bottle feeding instead and noted that formula would probably fill Robbie up more than pumped milk. From then on, Robbie got three bottles of formula a day - at 7pm, 9pm, and 12am - from Jon and I was able to start building up a stash by pumping before going to bed. I could get four or five hours of sleep before Robbie woke me up! On the bad nights, he'd cry with hunger three times between 2 and 6am; on the good nights, which were luckily much more frequent, he'd wake up around 3 and then again around 5 to nurse, and we'd start the first session of the next day around 7am.
By the time I went back to work, I had about 200oz of breastmilk in the freezer. I'd nurse Robbie before work from one side, pump from the other at the same time, and then pack three bottles of pumped milk for the nanny to give him through the day. At that point, he took four ounces at each feeding. I'd nurse Robbie soon after we got home after work, he'd get a bottle of formula before bed at 9pm and then another around midnight from Jon, and then he'd wake me around 3am to nurse before quickly falling back to sleep and not waking up again until my alarm went off at 6am. (We had some bad nights, too, of course! Thankfully, they were pretty rare.) I was pumping twice a day at work, getting about nine ounces total, so I generally only took bags from my freezer stash when they were nearing their use-by date.
Things changed after a few weeks, though. We adjusted bedtime - more on that in another post - and combined Robbie's post-work nursing session with his 9pm four-ounce bottle so he just got six ounces of formula at 7pm before being put down. Robbie stopped waking me up to nurse at 3am just before he hit four months, and soon thereafter Jon stopped waking him up at midnight for a bottle. His bottles during the day increased to four and a half ounces, then to five, and then to five and a half. Last week we went up to six, and his bedtime feeding is now eight!
Concurrently, I stopped being as regimented about my daytime pumping. My goal was always to breastfeed until Robbie was six months old and I wanted to maintain my supply in the months between going back to work and that milestone, but it was just too hard to stick to the twice-a-day schedule at the office. My colleagues were super understanding and were always happy to move meetings to accommodate my pumping, but I just found myself getting caught up in work more and more. At the beginning, I pumped when my calendar reminders went off at 11am and 3pm; that first session eventually got pushed back often enough that I now pump sometime between 11:30 and 1pm depending on what else I have going on. If I pump on the earlier side, I'll try to pump again at 4 or 4:30 before leaving the office for the day. Either way, I do still pump once in the evening. My supply has decreased a bit, and I can't pump in one day the 18 ounces of bottled breastmilk that Robbie needs for the next day. We supplement with two or three bags of frozen milk a week, and sometimes I'll top up a bottle of breastmilk with formula if it needs it.
At this point, I only nurse once a day during the workweek. I still nurse on demand - more or less echoing his every-three-hours schedule with the nanny - on the weekends, except for that bedtime bottle feed. I can't say that I enjoy the weekends of breastfeeding significantly more than the weekdays of pumping. Don't get me wrong, pumping is truly inconvenient, but at least I can do other things while I'm plugged in. Robbie gets so distracted when he nurses that each session will take much longer than it should (even though he nurses much more efficiently when he is actually latched than he did when he was a newborn). It's so sweet when he looks up and smiles at me, but sometimes I just want him to focus! Plus, since I'm not used to breastfeeding regularly, I find myself in serious discomfort by Sunday afternoon.
I'd be totally okay if my supply keeps decreasing and we have to keep increasing the amount of formula Robbie gets over the next month before we officially start weaning. Honestly, the reason I want to get to six months because we fly to Ireland in early July and I hear that flying with an infant is a lot easier if s/he can nurse, especially on take-off and landing. Once we're back, I'll stop my daytime pumping session and, eventually, phase out the evening one, too. I expect we'll run out of frozen milk before Robbie turns nine months old, at which point he will be exclusively on formula except for our morning nursing session, which doesn't have a pre-planned end date, and whatever real food we introduce over the summer.
Now, I've heard so many horror stories and I know I'm lucky. Breastfeeding was never really difficult for us; thanks to the nipple shield, Robbie was able to learn to latch well and any pain I've felt has been minimal, and I've never endured blocked ducts or mastitis. But it's also never been the transcendental experience for me that some women seem to enjoy. I certainly don't think Jon's been at a disadvantage in terms of bonding with our son because he's "only" been able to feed Robbie with a bottle. I'm glad that Robbie's been able to get the antibodies he needs from my breastmilk in these first months, but I'm also glad that he's been able to get the calories he's needed from formula when I haven't been able to - or, quite frankly, wanted to - provide them. Jon fed Robbie for the first time the same night we brought him home from the hospital, and it's been a relief not to be entirely responsible for our baby's nourishment.
Maybe I would be less ambivalent about breastfeeding if I'd struggled more with it. As is, though, I so appreciate my mom, the nurses in the Special Care Nursery, and the hospital's lactation consultants for helping me understand what "fed is best" looks like for us.
*It turns out that I remember Mom's story wrong. Like, she has no idea where I got all these details from - they're almost entirely inaccurate. She emailed me this correction:
So here’s the real story… I breastfed you for three weeks. It was fine, but not the cosmic experience that I was told it would be. I also never knew if you were getting enough to eat because there was no way to measure what your intake was. So at three weeks I started to wean you. I don’t think that you suffered at all and I was happier. When Sarah was born, I tried to nurse her, but it just didn’t work. The part about the pediatrician is that when he asked me at Sarah’s 2 week checkup how the nursing was going (because I said that I was going to nurse her) I burst into tears and said that I was bottle feeding her. His immediate response was that was fine; that pediatricians keep going back and forth about whether or not breast milk is better than formula. By bottle feeding Sarah, you were able to feed her when you wanted to (I thought that it was important not to ignore you just because there was a new baby in the house).
Regardless, the story I seem to have invented had a big (positive) impact on me!