(No) Thanks for the Mammaries

In 1998 most moms-to-be knew that breast was best way to feed their babies, but I had my doubts. Having undergone a breast reduction more than 10 years earlier at the age of 18, I had concerns about my ability to breastfeed. During the surgical procedure milk ducts and nerves are sometimes cut, making breastfeeding unlikely or impossible.

My surgical records were no longer available, so I combed the bookstores for information. I also spoke with my OB, a lactation consultant or two and my impending child’s pediatrician about whether I would be capable of giving my child nature’s perfect food. “Try it and see,” they all suggested. Even La Leche League lacked detailed information. I found many websites that cheerfully debunked the “myth” that a woman who’s had a breast reduction cannot breastfeed. Well, here’s my story.

My boy was born two weeks early after a lengthy labor. He was delicate, bright-eyed, long fingered, cone-headed and a lightweight at well under 6 pounds. Tired from his arduous journey into the world he had little interest in my breast.

The little one lacked a talent or enthusiasm for latching on. In my extreme concern I begged every nurse in sight to assist me with breastfeeding basics. In fact, prior to leaving the hospital I insisted that the discharge nurse observe us. “I don’t hear that sighing sound they told us the baby would make when he swallows. I’m not sure he’s getting anything,” I worried. After observing us for a moment she offered the reassurance I craved and I left the hospital feeling as confident as a first-time mom can.

We took him home and he began to suckle, but he wasn’t wetting his diapers. When we visited the pediatrician’s two days later for a weight check she reported he’d lost several ounces since he came home- his weight was down to 5 pounds. She diagnosed FAILURE TO THRIVE. It’s the kind of news you hear in capital letters. To the parent of a previously healthy child this diagnosis initiates an internal dialogue that sounds like this: “You idiot! How’d you get to be a parent? Did you really think you could be responsible for this child? You incompetent fool!” Well, that’s the cleaned up version of it anyway.

Of course, in retrospect my husband and I were idiots. But I wanted so much to breastfeed my child. Vague as they were, those prenatal words of encouragement kept me ensconced in denial.

The pediatrician referred me for an “emergency lactation consultation,” loaded us up with baby formula and tiny bottles and sent us on our way. Formula? Bottles? What about nipple confusion? According to what I’d read, this would ruin any chance of breastfeeding. Of course, the baby’s well-being was our primary concern. But it wasn’t until the lactation consultant began her instruction in the womanly art of bottle-feeding that I felt justified in letting the formula flow. Increasingly concerned about our situation I realized bottle-feeding formula was now the best thing for my boy.

Even so, he wasn’t much more enthused by the bottle than he’d been at my breast. Who could blame him? By this time he was tired and weak. How’d you feel if you hadn’t eaten since birth? By the day’s end both his input and output were below expectations and we sadly returned to the hospital we’d so joyfully left days earlier.

The ER crew fussed and fawned over our tiny boy. Wasted as he was he still had enough energy to let loose some mighty loud cries when they poked his minute veins in an effort start an IV. The pediatrician on call reassured us this was a good sign. He related tales of little ones who were so dehydrated they barely whimpered as the doctors prodded their thin veins.

The ER doc explained that dehydration is not uncommon in firstborn children. He also detailed the confluence of factors that landed us in the ER: my infant’s lack of sucking interest/ability, the fact that it sometimes takes longer for the milk to come in the first time around, and of course, my breast surgery. Still, I couldn’t help feel that this whole situation was my fault. Never in my life had I felt like such a failure. People far less capable, with far fewer resources managed to keep their children healthy. What was wrong with me?

And yet, I had not hit rock bottom. That came later when it was apparent that my milk had finally come in. My gigantic breasts felt like they were filled with lava. I excused myself into the restroom attached to our ER cubicle so I could relieve my burning breasts. It was all in vain, of course. There I was pumping away, the steady beat of my hastily borrowed Pump In Style drowned out by the howls of my newborn as they attempted yet another IV insertion. My body produced more tears than breastmilk that night. And, due to a problem with my tear glands, I don’t generate many tears. By morning my husband, baby and I were camping uncomfortably in the pediatric unit. My blazing breasts ached without relief. The milk may have come in, but with my misaligned ducts it sure wasn’t coming out.

As I unabashedly pumped away, the resident popped his head in. Dr. P.? Oh-my-God! He was a friend of a friend who’d once attended a party at our house! I quickly covered myself up while my husband jumped up to offer a handshake. At least we knew he’d pay special attention to our boy.

The impossibly slow IV drip filled our baby up although it was many months before my son plumped out. He continued to be what the professionals termed a lazy eater. The nurses taught my husband and I little tricks to keep him awake and interested eating. We continued to use these techniques long after his little IV scars healed.

A lactation consultant brought me a Supplemental Nursing System that consisted of a bottle that is turned upside down and worn like a necklace. Attached to the bottle are two long, thin tubes that are taped near the nipples to deliver formula. Heck, my husband could even breastfeed with this! (But he drew the line at “pinky feeding” for which we taped a feeding tube to his little finger.)

Although I stuck with the supplementer for a while it felt unwieldy and completely unnatural. I had fancied myself to be the kind of liberated mother who would whip out a boob in any public place, but I could barely tolerate my husband seeing me in my milking apparatus. Once it was apparent that the only way I was going to breastfeed was not just as a supplement to formula, but an inconvenient, artificial and contrived one at that, it was not hard to abandon the idea.

Okay, it was hard; it was a difficult and painful reality to accept. For a while I continued my round-the-clock pumping efforts, but I never collected more than an ounce or so at a time. Of course, there are moms with pudgy breastfed babies who can’t seem to pump worth a damn, but considering I practically starved my child the operating assumption was that I was nothing more than a human pacifier. At some point pumping simply lost out over sleep.

So much of the early relationship between mother and child is based on feeding, but my baby was well over a month old before he readily welcomed this type of nurturing. Day after day, several times each day we would sit as I patiently attempted to keep him awake long enough to finish his small bottle. I tried not to take his disinterest personally—can this little baby really resent me? But in those lonely, sleepless, hormone-colored weeks as a new mom it was hard not to.

And while bottle-feeding certainly has its advantages, in my crowd of breastfeeding moms I often felt awkward with my cumbersome bottles and stinky formula in tow. I didn’t get many direct questions about my choice, just the occasional patronizing or quizzical look. And then of course there were the well-meaning strangers such as the lady behind the deli counter who admired my cutie and then asked if I was breastfeeding as she handed over my sliced turkey.

When I had my second child in 2000 I was determined to supplement the bottle with my breast for at least two weeks and rallied my husband for support. This time it was clear that I had a guzzler on my hands. My breasts fared a little better, too: my milk came in earlier and I actually produced an occasional squirt as opposed to the trickle I’d had the first time around. However, it was clear I wouldn’t come close to even supplementing the demands of this hungry guy. And I had my toddler to chase after and sleep to catch up on. Like his brother, my new boy would have to settle for “the next best thing.” It was a much easier decision the second time around. Rather than feeling like a failure, I felt that I’d learned from my mistakes. I was not blinded by naiveté and felt confident that my decision was best for the entire family.

Both boys bonded well with all the nurturers in their lives: me, their father and four loving grandparents who eagerly helped out with all those bottles. They seem none the worse for their early dining experiences. Indeed, they are lively, funny little boys, and, despite the IQ points they supposedly lost due to bottlefeeding, they seem pretty intelligent.

My firstborn’s rocky start was an early lesson that most parents receive eventually: we’re not quite the perfect parents we had hoped to be. I learned to go with the flow (or not, as it may be), switch to Plan B and trust that my children will continue to thrive.

Endnote In 2001, La Leche League finally published Defining your Own Success: Breastfeeding After Breast Reduction Surgery.