The Breastfeeding Bargain

bargain2

A good friend of mine recently asked me, “How is my wife supposed to feel when she sees you’ve been breastfeeding for 21 months and she couldn’t even do it for 2 weeks?”

This conversation stopped me in my tracks.  I realized that part of the problem is that while breastfeeding advocates like to talk about how a breastfeeding-failure is not an individual one, but a systemic one… they often talk about breastfeeding-success as a personal victory, not a societal one.

I’ll admit that even I am guilty of this.  Because society unequivocally failed me during my first nursing experience, I most definitely made the mistake of talking about exclusive pumping as a personal victory.  Pumping is inherently a more private experience, so at the time, I claimed the success largely as my own.  And that’s what happens when you feel anger about being let down… the reaction is pride for accomplishing something despite the odds.

But I’ve got a lot more experience under my belt now.  And it’s clear to me that in an ideal world, breastfeeding is anything but something that individual women achieve based on their own aptitude and perseverance.

We often talk about the village.  But breastfeeding requires so much more than a village – it requires our entire society.  And every player must hold up their end of the bargain of this social contract – this contract that presumes we all care about our mothers, our babies, & our future.

If breastfeeding didn’t work for you… who didn’t keep up their end of the bargain?

And if it did work… who do you owe?

I owe breastfeeding success to my husband.  I can’t even begin to list the myriad of ways that my husband has supported me. But since he’s a private person, I’ll spare him the laundry list, but from birth to bedsharing and everything in between, it wouldn’t have been possible without his support.  My husband kept up his end of the bargain.

 

Breastfeeding Starts With Birth

Only 18% of U.S. Hospitals have been designated as Baby-Friendly, and support recommended breastfeeding practices.

I owe breastfeeding success to my midwife.  She encouraged and supported a birth plan free from interventions that might have caused my baby to be less alert at birth, to have a depressed rooting reflex, or to have a diminished ability to suck, swallow, & breathe in a coordinated manner.  She avoided the use of synthetic hormones that could have interfered with my body’s own ability to produce the hormones necessary for abundant lactation.  She allowed cheered me on to push in the right position for me, avoiding an instrument-assisted delivery that could have harmed my baby’s head & neck, which would have made nursing painful for him.  Ultimately, she protected me from a traumatic birth that would have delayed my milk.  My midwife kept up her end of the bargain.

I owe breastfeeding success to my hospital’s policies and labor & delivery nurses.  They didn’t require the routine use of IV fluids during labor, which can cause excessive swelling of the breasts and make latching difficult.  They didn’t perform intrusive suctioning, which could have created an oral aversion for my baby.  After birth, they gave us more than a full hour of skin-to-skin and nursing time before weighing him.  He was given the time to regulate his temperature & respiration so his body could produce glucose from his energy stores until we established breastfeeding.  Basically, they avoided interfering with my body & my baby laying the groundwork for this intensely biological process.  My labor & delivery nurses kept up their ends of the bargain.

I owe breastfeeding success to my postpartum nurses. They respected my wishes to delay my baby’s first bath for several days, so that his sense of smell wouldn’t be confused.  They respected my wishes to not keep mittens on him, so he could actively use his hands to find my breast.  They were supportive of me keeping him skin-to-skin on my chest in a kangaroo care top, so that I could respond quickly to his cues, get decent sleep, and encourage my milk to come in quickly.  They only took him away to the nursery for 45 minutes for his hearing test, but used my pumped colostrum as a back-up instead of offering a pacifier or sugar water.  My postpartum nurses kept up their ends of the bargain.

I owe breastfeeding success to my in-hospital lactation consultant.  She was there in under 8 hours from birth.  She encouraged me to have her paged as soon as baby was ready to nurse again so she could observe.  She provided me with reassurance and concrete tips to improve my baby’s latch and my comfort… which is just as important as a “perfect” looking latch.  She followed-up multiple times during our hospital stay.  She didn’t give up on us.  My lactation consultant kept up her end of the bargain.

I owe breastfeeding success to my in-hospital pediatrician.  Upon hearing my concerns about a possible tongue or lip tie, he examined my son’s mouth and helped us rule it out.  He had evidence-based answers to my questions, and made his own knowledge about breastfeeding a priority.  The pediatrician kept up his end of the bargain.

*I was failed by every single one of these people during my first birth.  However, don’t freak out if you’re in this position right now.  Even if the odds were stacked against you at birth, with the right support, many issues can be fixed.   

 

Coming Home

I owe breastfeeding success to every visitor we had.  My visitors respected the fact that I was breastfeeding, and didn’t ask to feed my baby a bottle.  They made me feel comfortable nursing in front of them, not making me feel like I needed to excuse myself to a private room while in my own home.  They weren’t there to hold my newborn the whole time, which would have interfered with my ability to learn and read his early nursing cues.  They entertained my older child, helped with what was needed, dropped off a meal, and left quickly.  My visitors kept up their end of the bargain.

I owe breastfeeding success to every visitor we didn’t have.  I wasn’t on the clock of a social calendar.  I could nurse on-demand, without regard to a schedule that would have limited my supply.  My friends realized that I was recovering from birth, and it wasn’t imperative that they meet my son immediately.  I was able to soak up the fourth trimester, just being with my baby.  My friends kept up their end of the bargain.

I owe breastfeeding success to my local breastfeeding support group.  Having a lactation consultant as a free resource on a twice-weekly basis gave me a sounding board for little nagging questions.  Weekly weigh-ins gave me reassurance and confidence.  Sharing challenges with other breastfeeding mothers gave me a community.  My community kept up their end of the bargain.

I owe breastfeeding success to every person I ever breastfed in front of in public.  For never giving me the side eye, for never confronting me, for never suggesting I go feed my baby in the bathroom, and for never making me feel ashamed.  Every waiter I encountered was friendly, made eye contact with me, and didn’t flinch if I was nursing my baby at the table.  They made me feel like a real person, one who could go out and participate fully in my life, not having to retreat to my car or house.  The public kept up their end of the bargain…(I was one of the lucky ones).

I owe breastfeeding success to my healthcare providers.  Positioning in the womb can affect neck muscles, and my son’s head was tilted for a few weeks after birth, making it more difficult from him to nurse on one side.  Our pediatrician identified the issue and recommended stretching exercises.  My chiropractor performed 2 gentle adjustments, and his neck was freed to nurse comfortably on both breasts.  Months later, we faced another (significantly more painful) challenge with twice-recurring thrush.  The urgent care physician saw me and my baby during the same visit, listened compassionately to our symptoms, and prescribed us the right (nursing-friendly) treatment.  My eye doctor, my dentist, my NP… whoever it was, they knew what prescriptions were and weren’t safe for nursing, and always took that status into account.  Whether it’s clogged ducts or mastitis or “what cough medicine won’t affect my supply”… you need the right answers for sustained nursing.  I had the right healthcare providers at the right time, and they all kept up their ends of the bargain.

 

Back To Work

Only 12% of U.S. employers offer paid maternity leave.

I owe breastfeeding success to the Affordable Care Act. For providing me with a breast pump to effectively pump milk & sustain my supply while away from my baby. My insurance company kept up their end of the bargain.

I owe breastfeeding success to my employer. Despite no laws requiring them to, they paid for 6 weeks of my maternity leave, and allowed me to take as much unpaid time off as I needed to.  19 weeks at home with my baby allowed me to establish a robust milk supply, which could weather illness and long-term challenges.  My employer kept up their end of the bargain.

I owe breastfeeding success to my co-workers.  Because even though I pump behind a closed door, my experience pumping at work was anything but closed.  I’m thankful for co-workers who were willing to acknowledge it, talk about it, and normalize it.  They more than accommodated my pumping breaks, were always considerate about our meeting times, and never diminished the work I did simply because I had a new priority in my life.  Because pumping at work wasn’t made unnecessarily stressful, my body responded well to the pump and I had enough to send to daycare each day.  My colleagues kept up their end of the bargain.

I owe breastfeeding success to Mamava pods in the airport.  For making the stressful experience of pumping while traveling a little more tolerable.  For providing a clean, private space to pump in, so that I didn’t need to choose between pumping in a bathroom or clogged ducts, mastitis, and a decrease in supply.  My home airport kept up their end of the bargain.

I owe breastfeeding success to my son’s caregivers.  For welcoming me into the room every day to nurse my son at lunchtime.  For practicing paced bottle-feeding so he wouldn’t get used to a fast flow and start to prefer the bottle over breast.  For handling my milk with care, and making every effort to avoid waste.  For leaving the choice up to me about how long I would send breastmilk to school, instead of trying to force my hand because of his age.  My son’s caregivers kept up their end of the bargain. 

*Even with a perfect scenario of paid maternity leave and pumping breaks, every woman does not respond to a pump.  There’s a ton of work to be done here… from onsite daycares to job-sharing and flexible work schedules, we need to create more time and space for women to just be with their babies.    

I Did Not Do This On My Own

Why are we placing this pressure on individual women?  Why is it this crowning personal achievement to breastfeed your child?  True, the odds are often against us.  But our ability to breastfeed is steeped in privilege & access to support.  When it happens in an ideal environment, it’s a communal achievement.

81% of women in the U.S. start to breastfeed at birth, which means most initially believe enough in breastfeeding to want to try it.  But only 22% are exclusively breastfeeding at 6 months.  Whenever I see a ‘fed is best’ article, I worry that we’ve given society a pass.  That by spreading this message that is meant to assuage individual women of their own guilt, which comes from placing the blame on themselves, we’re simultaneously forgiving doctors, hospitals, governments, employers, and our society at large for not keeping up their end of the bargain.  We’re telling society – it’s okay that you didn’t invest in me and my baby. 

But I’m not going to give them that pass.  My friend’s wife was forced to cut her journey short at 2 weeks not by choice, but because she came up against a wall.  I’m not here to convince anyone of the benefits of breastfeeding or shame any woman for any choice she makes of her own free will… I’m here to break down the wallBecause I need to hold up my end of the bargain.

 

Follow me on Facebook

Advertisements

The Fourth Trimester: Take Two

fourthtrimester

I love the newborn period.

There.  I said it.

Not something you hear every day, huh?  Normally you hear stories of intense sleep deprivation, aching nipples, a questionable amount of time since the last shower, and a lot of crying.  And if I was talking about my first child, that might be pretty accurate.  But I’m talking about my second child.  And with a second child comes the confidence of an experienced mother.  A mother who knows what to expect, and more importantly, what not to expect.  And that, I think, makes all the difference – for expectation is the thief of joy.

I expected nothing from my baby this time around. Nothing besides the expectation that he would act like a newborn baby. 

I did not expect that he would eat for a certain amount of time, or at certain intervals.  I just fed him on demand, for however long he wanted to, as frequently as he wanted to.  I trusted that he knew what his body needed to grow.  I didn’t freak out when he wanted to nurse every 15 minutes for 4 straight hours right before a growth spurt.  As a result, I have a healthy milk supply, and a thriving baby who’s become efficient enough at nursing to down 5 ounces in 5 minutes if he’s hungry.

I did not obsess over having a huge freezer stash of milk.  My body responds too well to a pump; it means that daily pumping for a week put my body into an uncomfortable oversupply.  So, I pump once every 5 days, just to have a bottle in the fridge.  If we don’t use it, on the fifth day I freeze it and then pump a fresh bottle.  He’s taken about 6 bottles so far, just to ensure that he’s amenable to them when I go back to work.  I have enough in the freezer for an emergency, and have taken to heart the mantra feed your baby, not the freezer. 

I did not expect that he would eat at certain times of day.  Like I said, I fed on demand, and I didn’t even try to predict it.  To not plan my day around having to pump this time around meant I could go anywhere.  I just left the house whenever I wanted to, without regard to the time.  If he got hungry, I nursed him.  In parking lots, in dressing rooms, in restaurants, on walks, at the park, wherever.  And it felt so freeing to be unchained from the pump this time around.  Have boobs, will travel.

I did not expect that he would take scheduled naps. I didn’t stress myself out about “nap times” and fighting to get him down to keep on a schedule.  I just followed his cues, and whenever he got fussy after a period of awake time, I put him down and he went right to sleep.  Except for the few times he didn’t, of course, in which case I held him, bounced him, rocked him, nursed him, or whatever else he needed from me to drift peacefully off to sleep.  I didn’t worry about holding him too much or spoiling him, because those things aren’t possible. All in all, he’s been a wonderful napper, and all I had to do was listen to him and let him set his rhythm.

I did not expect him to sleep long stretches at night on his own.  Over the last 12 weeks, it always seems like the first question that people have asked me is how is he sleeping? How many times does he wake at night? Truthfully, I have no idea, and I don’t care.  He sleeps with me, and when he stirs, I stir.  I nurse him right there in the bed, and after he latches, we both drift right back to sleep.  There’s rarely any crying, I don’t have to get out of the bed, and I don’t have to spend a bunch of time getting him (or myself) back to sleep – it’s quite literally, dreamy.

I did not expect that much of myself.  I let my husband wait on me hand and foot for the 3 weeks that he was off on paternity leave.  I didn’t prepare a meal, I didn’t wash the dishes, and I didn’t feel guilty about it at all.  Instead, I took a shower every single day. I took a nap with my son every day for at least the first 6 weeks.  I let my body heal from birth.  I didn’t care about losing weight right away; I know my milk supply dips when I cut calories, so that’ll just have to wait – all in good time.  I didn’t worry about how much I “accomplished” each day.  Snuggling my son while watching 6 seasons of The Good Wife is accomplishment enough for me.

This feeling of freedom and ease with motherhood did not come easy or automatically.  I remember going through all of this with my first, where every decision about every aspect of her life had to be carefully considered and decided upon.  It made the newborn period stressful – when everybody has an opinion, and you’re not quite sure what yours is yet because the sheer number of decisions and the total upheaval of your pre-parent life is just so overwhelming. This time – there are no decisions to be made, just instincts to follow.

And I feel so free. 

And I don’t mean to make it sound like it has been easy.  On the contrary; my neck and shoulders are constantly sore, it’s frustrating to always eat in a hurry with one hand, the dynamic of parenting two children can be tough, and I really don’t get much done.

But I know this too shall pass.  

Unfortunately, it will pass.

The only times I’ve cried have been about how fast he’s growing and how fast it’s all going.  I’m writing this post as I watch my son on the baby monitor; it’s the first time I’ve put him down to sleep for the first stretch of the night in his crib.  I used to put him in the bassinet in the living room – but he has started spinning in his sleep (he has already rotated 90 degrees since I began this post), so the bassinet is officially too small.  And it’s the first of many things that he will outgrow.

And now the fourth trimester is over.  And I’ll never have a newborn again.

The only thing I’ve expected is change.  Change coming at me so exceedingly fast that it’s a blur.  Where one day, his hands in his mouth means he’s hungry, and the next day it means hey, I found my hands!  Where one day he fits curled up on my chest, and the next day I’m putting away the tiny clothes forever.  Where one day he’s looking off into space at blurry shapes, and the next day he’s staring into my eyes, smiling his mega-watt, heart-melting smile.

So, forgive me if you think I take and post too many pictures of my kids.  Because I’m having a moment.  Like, some of the best moments of my life.

 

Like what you’re reading?  Follow me on Facebook!