Okay, so this is going to be a long post. Basically, I’m going to recount my breastfeeding journey from baby #1 to doing it again with baby #2. It’s the one thing that every new mother grapples with, if you’re not one of the very fortunate few for whom nursing is a walk in the park (supply? no prob what. sore nipples? not at all!).
Beyond the mechanics of how to get more milk or how to survive the naysayers, I think the issue of swinging too much to the other side of breastmilk nazi-ism also has to be addressed. So here’s my very chiong-hei take on it all…
Bottom line – Breast may be best, but what baby ultimately needs is a sane and happy mum!
I almost gave up within the first month of breastfeeding but ultimately went on to breastfeed my first child for 20 months. Against hope, the first few weeks of breastfeeding my second child were still difficult, but by God’s grace, it has been 18 months (as of Aug 2012) and counting…
These days, it is almost taboo, if not very delicate to ask whether a mum is breastfeeding her child. Sometimes the answer “yes” is given rather defensively. Other times, the answer “no” is given either in a guilty tone (accompanied by a long explanation) or as if the person who answered was very offended by your question.
The breast-is-best folks have done their job almost too well, it seems, and mums are made to feel so inadequate (or selfish) if they were not totally breastfeeding their baby. Hence, my mantra these days to new mums seeking advice is, try your best, and if it doesn’t work out, do what’s best for your sanity. After all, a happy mum makes for a happy baby! And that’s from bitter experience.
Before I delivered my first child, I attended ante-natal classes which extolled the benefits of breastfeeding, of not giving up, of how it is nature’s best food for your child, etc. So I was determined to breastfeed well. I took pains to ensure that the confinement nanny I hired was “pro-breastfeeding”, as my friend who recommended her assured me. At the hospital, K’s cot label read “total breast milk” which meant that she was not to be fed any formula. The nurses brought her in for me to latch her every three hours, or more frequently if necessary.
However, after we got home, my milk didn’t seem to be coming in. Faced with a crying baby who could not be wheeled out of earshot to the hospital nursery anymore, I wavered. At the behest of my “pro-breastfeeding” nanny, I pumped, to “see how much you’ve got”, and cried when I saw what miserable little came out (less than 5ml). I guess my friend thought that this nanny was “pro-breastfeeding” because that friend was gushing with milk from the world go, and could pump out copious amounts in the blink of an eye.
I phoned another friend who is a breastfeeding counselor, and she urged me to press on, and not give up, come what may. But my little baby did not seem to be producing much urine (or her diaper was simply too absorbent so we couldn’t tell), and we did not want to risk dehydration, so after a call to our paed who said we could give her one feed of formula to “buy time” whilst my milk came in, we decided to open the tin of formula. We had bought a can as stand-by, and the nanny was more than happy to use it. To her, the cries of a thirsty infant simply needed to be soothed by milk.
We visited the hospital’s lactation consultant after our first paed visit, and the kindly consultant saw us even though her office hours were over for the day. She dug her too-long nails into my boob and forcibly squeezed out some almost clear drops – “see? That’s milk! Who says you have no milk?” Although it hurt physically, our hearts were light and relieved, buffered by fresh hope to press on (pun not intended).
Nonetheless, for the first few weeks, I could only pump a miserable 30ml at 3 hour intervals, such that I could only cobble up one 90ml feed after 9 hours. Baby K continued to be on half bm and half fm. I downed green papaya soup, drank lots of red date water, kneaded my breasts to stimulate more milk. I conducted ‘power pumping’ sessions (intense pumping for 10 mins, rest for 5 mins, pump for 20 mins, rest for 5 mins, repeat as necessary) to increase supply but it scarcely helped. Still, if not for my trusty Medela Pump-In-Style dual electric breastpump gifted by a dear friend who hand-carried it all the way from the US, I would have given up within the first few days. A good pump is a lifesaver, and mine was gentle yet efficient.
My online forum mother’s group was a tremendous source of support, as we cheered each other on as we extracted each drop, ml by ml, and cried together when some were accidentally spilt or had to be thrown away. There was something extremely comforting about logging on at 3am as you pumped, and getting chat responses from other parts of the island. Out there, in the silent darkness, were other fellow-sufferers, fighting extreme weariness, dragging themselves out of bed in a stupor, just to pump drops of nourishment (liquid gold we called it) for our babies.
Essentially, all the books I read did not prepare me for this challenge. I totally didn’t expect breastfeeding to be so difficult. Although babies have a natural suckling instinct, bet most folks didn’t know that the correct latch could sometimes be very elusive. Only after speaking to a number of mums did I realise that a good number had to go to lactation consultants before they could get it right.
We persevered though, and my hubby was the other bedrock of support, as we prayed together for wisdom to jointly decide what best to do with respect to K’s milk feeds.
The turning point came when K was 2.5 months old. It was the week of Christmas, and my hubby encouraged me to try latching her when we went out, instead of replying on expressed breast milk (ebm) and bringing my pump along. It was such a wonderful surprise then, that I managed to move from almost exclusively expressing to exclusively latching virtually within a day!
I knew latching was more straightforward, as well as less tedious in the sense of not needing to wash and sterilise pumps and bottles, but it was the more frustrating route for me in the first 2 months, since K would cry after every (sometimes hour-long) feed which would prompt everyone to chorus “she’s still hungry! Must be not enough! Better give her formula! Poor hungry baby!”, et cetera, et cetera… It was purely through God’s grace that somehow K stopped crying after every feed that Christmas week and fed well. A bonus was that her feeding intervals lengthened from 2 to 3 hours. It became instantly more convenient to bring her out, since there was less stuff to lug and less stress about having enough ebm to bring out. Since then, I had more time to spend with K instead of pumping away alone, whilst someone else tended to her.
My troubles did not end all at once though. After delivering, the times I’d fallen sick were always accompanied with clogged/infected ducts. I soon realized that those were not viral infections but bouts of mastitis. This happened no less than 5 times in the first 6 months. Apart from the sharp pain in the affected rock hard breast(s), this would tend to be accompanied by fever. Mums who have experienced it agreed with me that it was the worst sort of pain in the world, trumping even the pain during delivery. The best solution, which was to have baby suckle and clear the blockage, actually caused the most intense pain as well. It created such searing agony that I had to grit my teeth and close my eyes whilst tears flowed down my face. At one point, wallowing in self-pity, I felt that my hubby cared more about his daughter getting breastmilk, than about my well-being, since never did he suggest that I stop breastfeeding. On hindsight, I guess he just wanted to encourage me not to give up, and not provide an option for the easy way out. Today, the phrase “mastitis” still sends chills down his spine, since it was an extremely tough period for him every time I contracted it.
Another gruelling part was forcing myself to pump even though I felt so sick and wanted to sleep/rest more than anything. It got so bad one night that it became extremely painful to pump and after the usual duration, all I got was a fifth of the usual supply. I came close to giving up because of the pain. It was too painful to pump the next session, so I hand-expressed. And contemplated giving up breast-feeding again. Every time I got mastitis, the breastfeeding-free life would beckon temptingly.
But we prayed and God was good. The next day it was possible to pump through some of the pain, and it slowly got better. Although eventually the pain went away, my supply had plunged lower than the Dow Jones. I began to despair but reminded myself of the Habbakuk verse “Though the fig tree should not blossom and there be no fruit on the vines…. yet…I will rejoice in the God of my salvation”. Summer and winter were both from God, and this was winter. Shall we take good from the Lord and not bad? The words of Job echoed too.
My worst bout of mastitis occurred when K started solids at around six months old, and I grew lax in feeding her / emptying my breasts at regular intervals. On my birthday, I came down with a 40-ish degree fever, and angry red streaks developed on my breast. It was so painful to latch K that night that my hubby brought me to the Mt Alvernia 24 Hr clinic where I was given an antibiotic jab. Slowly, I got better, and K was able to nurse out the blockages, since a baby’s suckling is far more powerful than any electric pump, hospital-grade or otherwise.
Thereafter, it was a happy journey, and I would confidently nurse her anywhere, armed with a trendy nursing shawl. When I decided that it was getting unnecessarily tiring to nurse her every evening at bedtime, I communicated to 19 month old K that we would stop when she was 20 months old. Although she could hardly speak then, she seemed to understand, and made absolutely no protest at all when I stopped nursing her the night she turned 20 months. She simply held my arm and snuggled down to sleep. What a complete darling.
Nursing Baby B
As B’s delivery date drew near, I faced the prospect of embarking on the arduous journey of breastfeeding again. I tried to encourage myself with the thought that I had only stopped nursing K at 20 months, so surely a break of only 8 months since would mean an easier second time around. Also, I consulted second time mums who assured me that the milk supply would come in faster and at greater volume this time. Some of them gave up nursing their firstborn before the month was up, so their testimonies about successfully nursing their second-borns were heartening.
Although the first week was still fraught with difficulties such as intense soreness (I didn’t realize that the white line on my nipple was a sore until the lactation consultant saw me a couple of days later. I’d thought it was extra milk so I scraped it off and fed it to B, leaving an open wound!) and supplementing with formula, it was indeed much easier than the awful struggle that establishing breastfeeding for K was, 2 years ago.
We supplemented with formula once a day, for my supply to catch up. I really thank God that in the wee hours of day 13 I managed to pump the highest yield thus far – 140ml in about 20 mins after a 3 hour pump-free interval! So within 2 weeks, B became a totally breast-fed baby, just like her older sis.
Sometimes I found it tough to decide what to do, since pumping was so efficient and gratifying. Within 20 mins, the bottles would be filled and ready for a feed anytime she fussed. I don’t subscribe to the demand-feeding aspect of attachment parenting, since I knew being shackled to the baby 24/7, even for one week, was a certain route towards depression for me. Since I had developed intense nipple pain from latching problems in the first week, I started alternating between pumping and latching to allow my sometimes-bleeding nipples to heal.
With latching, one could not tell how much she actually took (although I could tell when she had a good latch and drained the sources well) and it was a constant battle to get her to latch properly in the first month. With the confinement nanny’s help, pumping meant that I could wake at regular hours through the night to pump, and she would be in charge of feeding B whenever she woke. Also, I felt that pumping gave me some me-time in the day, since being at home now meant that I had to attend to two children’s needs and had hardly a spare moment to be alone. So whilst the nanny was around, I pumped when I felt like it.
After 4.5 months, I went back to the workplace, and thanks to an understanding boss (who herself nursed 3 children) and a conducive work environment, I have managed to pump twice a day without too much difficulty. I latch B totally on weekends, and in the night when she fusses. It really is the easiest way of getting her back to sleep, although I acknowledge that it does create some dependency and makes sleeping through the night a tad more unattainable. In any case, I hope to nurse B for at least 20 months, since I was not able to be a stay-at-home-mum with her like I did with her older sister for 14 months. [Afternote: I ended up nursing B for 23 months. O.o Was very happy to finally stop.]
For those embarking on motherhood, what I learnt from all this is that each person will experience a different journey. Take advice from all who would give it, but don’t feel obliged to act on every piece of advice. This will surely drive you crazy, especially since some advice will be directly contradict others. There is enough stress from caring for a newborn that you really don’t need an ounce more from anyone.
Feeding formula in the first week is not the beginning of the end of breastfeeding. Neither is feeding from a bottle. K was mostly bottle fed (roughly 80% expressed breast milk and 10% formula, 10% latching) for the first 2.5 months… I remember feeling very encouraged by a friend who shared that her baby transitioned from almost all formula to all latching at 2.5 months old. It is possible. And that gave me hope and the desire to try to work towards more latching. I don’t think K experienced ‘nipple confusion’ since she switched well between the NUK latex teats and latching even in the first few weeks and months.
I also recall being encouraged by many mums to persevere in breastfeeding in the early weeks, but I have also learnt that it is important to have a good gauge of how much you can take at that point. My advice to new mums would be to supplement with formula if it preserves a tad more of your sanity in the difficult first-month adjustment period. It is more important to have a mum that is not falling to pieces, a happy new mum, than it is to have a 24/7 demand-feeding but utterly exhausted and frustrated mum.
Some people from the formula camp say that breastfeeding is over-rated. Whilst I would not go as far as to say that, I would say that there is nothing intrinsically wrong with formula (some friends shared that their total breastfed kids fell sick more often than their formula fed peers!). I am sure that I bonded with my children as they breastfed, but there was never any soulful gazing into each other’s eyes. They either had their eyes fixed on a spot on my unexciting boob, or just closed their eyes completely! Remember that it does NOT mean that you are less of a mum, or less loving a mum if you do not breastfeed your kid. Any mum who makes you feel so, very likely has insecurity and superiority-complex issues of her own.
Although I have my own issues with the marketing and regular price-hiking of formula by manufacturers who seem bent on extracting every last cent from parents who are held ransom to a brand once their child starts on it, I would not hesitate to go on formula if a lactation consultant told me I was one of the minority who just does not produce enough breast milk. In any case, I myself grew up totally on formula and it certainly did not compromise my IQ (ahem. Backed by proof.). On the other hand, I would take all their claims of added DHA etc with a large pinch of salt since they are artificially added – having fish in the mother’s diet would suffice to provide all the DHA a baby needs, and taking natural sources of DHA, vitamins and minerals from food once baby starts solids is probably much better since these are more easily absorbed into the body.
As with K, when B turned one, I gradually introduced fresh milk as her source of calcium. Whilst there is nothing wrong with formula, my belief is that it is simply not necessary, not to mention grossly overpriced. Friends who are doctors, and friends living overseas all transition to fresh milk after their breastfeeding journey eased in intensity, and our babies are living testament to the goodness of fresh milk.
So take heart, if you are a mum on your own arduous breastfeeding journey. You are not alone, and whether you nurse successfully or not, you are no more or no less the wonderful mum you have set out to be.
not much, but I was so glad to have more than just the next feed “in-stock”.
bumper crop day. For my first, I managed to freeze a tiny stockpile. But for my second it was more or less on the pay-as-you-go system. haha.
The blissed out look of a baby after a good feed.