March 10, 2011 Breastfeeding

The day after the baby was born, Bruce wheeled me up to the neonatal intensive care unit to see him. The nurse standing by his bassinet asked if I’d be breastfeeding.

“I guess. I hadn’t really thought about it,” I said.”Did you?”

“For six long weeks. Until I got so stressed out about it, I had to go on Prozac,” she said.

I didn’t know why it would be so stressful, but I’ve found it best not to delve into matters of one’s mental stability.

The breast pump

When we got back to my room, I slid into bed and looked over at the green breast pump machine that had been parked next to my nightstand since I arrived. The machine had two dials on the front, and two cup holders in the back. Sitting in the holders were two plastic bottles, each of which had been screwed into the bottom of a suction cup that looked like a little megaphone. It looked intimidating. I left it alone. A nurse came in that afternoon and wheeled it over to show me how to use it. Just before she arrived, the food service people had brought my lunch. I wasn’t hungry, but I was thirsty and had asked them to bring me a couple of cups of Italian ices, which had arrived just as the nurse walked in. As the nurse instructed me on how to use the machine and helped me fit the little plastic megaphones onto my nipples, all I could think about was how my Italian ices were melting on the tray table next to me.

That afternoon, they brought the baby down from the NICU in a plexi-glass bassinet that was on wheels, and they left him in my room. Shortly afterward, a lactation nurse came in to show me how to breastfeed him. She showed me several different holds, like the cradle hold and the football hold. She also showed me how to get the baby to latch onto my nipple.

“Make a sandwich,” she said, flattening my nipple and part of my areola between her fingers and then sticking it into the baby’s mouth. She would laugh after everything she said. I made a sandwich, as she suggested, and stuck it in the baby’s mouth, and sure enough, he started to suck.

For the next three days, the baby would stay in my room all day, and I would breastfeed him every three hours, until about 10 p.m., when a nurse would come by to bring him back to the nursery.

“Do you want us to bring him back when he’s hungry?” she’d ask. It was either that or they would give him a bottle.

“Of course,” I said.

The Bassinet with the Bum Wheel

And so they’d wheel him back in, at 1 a.m. and again at about 5 a.m., while it was still dark outside. Before he even got to my room, I could hear him crying and the rhythmic screech of the bum wheel on his bassinet as they wheeled him down the hallway toward my room. I’d then here the loud knocking on my door. Bam, bam, bam. For the first feeding, it was cute. By the second feeding, I was dog tired, but I was still looking forward to seeing him. By the fourth feeding, when I heard the sound of the bassinet wheels, I felt dread, and thought, “Again? You must be fucking joking.” But sore as I was, I propped myself up in bed and latched him onto my breast using the reading light. I didn’t want to turn on the overhead light because Bruce was sleeping in a pull-out chair on the other side of the room.

On our last night, they told us the baby had jaundice and that I wasn’t yet producing enough breast milk to flush it out of his system. Jaundice occurs when red blood cells die more quickly than the liver can process them, creating a buildup of bilirubin, a yellowish byproduct of that process. Babies usually excrete bilirubin through bile and urine, but if they’re not getting enough food, it remains in their system and turns their skin yellow. Given that I’d had a c-section and the baby was three weeks early, my milk hadn’t yet come in, so while I had been feeding him, nothing was really coming out , so there was nothing to move the bilirubin through his sytem. The nurses suggested we leave the baby in the nursery that night and give him a bottle of formula. Hopefully, that would get things moving, they said. The baby got his first nickname, Billy Rubin, in honor of his first affliction.

That night, I awoke several times to sound of a bassinet being wheeled down the hallway with a screaming baby inside it, but the sound would move past my door and disappear into a room down the hall. I missed him already.

The day after we got home from the hospital, we had our first appointment with the pediatrician, who informed us that the baby’s bilirubin level was still too high. He suggested we continue to supplement the breastfeeding with formula. They sent us home with several sample boxes of Similac.

For the next four days, I kept supplementing the breastfeeding by giving him a bottle of formula, and we had to go back to the hospital every day for blood tests to determine the baby’s bilirubin level. They would scrape the bottom of his foot with what looked like a little square piece of glass to make it bleed so they could get a blood sample to test. I cried the first time they did it. He barely noticed. His bilirubin level kept rising and then finally, on the third day, it peaked. By day four, it had come down significantly.

I hoped that meant we could stop giving the baby formula because by then I’d read up on it, and breastmilk was far superior. The milk digests more easily, it fortifies the baby’s immune system, and it contains all the vitamins and nutrients they need. Studies show breastfed babies are also more intelligent.

Moreover, everything I’d read said supplementing with formula can actually hurt one’s ability to breastfeed. That’s because every time you supplement, it’s a meal the baby did not have at your breast, and milk production rises and falls based on the baby’s demand for it. If the baby has fewer meals at the breast, the milk supply declines, and the mother can get into a downward spiral where less breastmilk necessitates more formula, and giving the baby more formula results in lower milk production. I felt like I was standing on the edge of a vortex, about to lose something I realized I really wanted.

But once the baby’s bilirubin level went down, the pediatrician said the baby wasn’t gaining weight fast enough, so he wanted us to continue supplementing with bottles of formula. He sent us home with several more free samples of Similac.

Formula, Formula, Everywhere

For the next several weeks, I continued to breastfeed, but the pediatrician kept having us go back to his office in order to monitor the baby’s weight. And every time we went there, they would say he wasn’t gaining weight fast enough, and they would tell us to increase the amount of formula we were giving him.

It was heartbreaking. Every time I gave the baby the formula, I would watch his eyes glaze over, like he’d been hit with a sledgehammer. I felt like I was feeding him wallpaper paste. I began to think all things wrong with the baby were the result of the formula. It made the baby cry. It would give him a big head, like all those other formula babies. He would probably be stupid.

Breastmilk, on the other hand, seemed to make the baby happier, more docile. It made his cheeks rosy and his eyes dance. He seemed smarter.

The baby also seemed to crave the formula, as if there was something in it that made him addicted to it. I imagined the heads of the formula companies sitting at a table before a congressional committee, denying that they had put anything in the formula to make it more appealing to infants.

The next time we went to the pediatrician, he had the baby lie on his stomach, and we removed his diaper. As the doctor put a stethoscope to the baby’s back to listen, he noticed a little hole just above the baby’s behind.

“He’s got a little dimple here,” the doctor said.

He then noticed a little spec of dirt in the dimple and picked it out. He then told Bruce he could put the baby’s diaper back on. With the baby still on his stomach, Bruce lifted his legs into the air like a chicken, and suddenly, the baby projectile shit across the room, sending feces onto the doctor, the outfit he was wearing, the outfit we were going to change him into, and the blanket we had been using to cover him. I was tempted to say, “Must be the formula,” but I didn’t.

Fearing the baby wasn’t getting enough milk from me, I called a lactation consultant. She came to the house and weighed the baby before I breastfed him and again afterward and found he was 1.5 ounces heavier. She said that was okay but suggested I take an herb called Fenugreek, which is known to increase milk supply. She also said I should drink a lot of water, something I hadn’t been doing. You can’t produce milk if you’re dehydrated, she said. I now keep a pitcher of water on the counter and an 8 oz. glass. Every hour, I take a Fenugreek capsule and two glasses of water. I then mark down what I’ve taken on a blackboard I placed next to the pitcher.

I feed the baby every two-and-a-half hours, despite the fact that when giving formula, one need only feed every three or four hours. I’m trying to ignore the fact that the baby is getting formula. I’m treating him like a breastfed baby, and breastmilk goes through their system faster. Frequent feedings also deplete the breast of milk, which in the breastfeeding world is a good thing. It signals the body to produce more milk. I feared if I only fed him every three or four hours, my milk would dry up. At night, I allow myself three hours in between feedings so I can grab that extra half an hour of sleep. Sometimes I wake the baby. Sometimes I just pump the milk and let the baby sleep. I haven’t slept more than three hours in a row since the baby was born.

But I’m becoming exhausted, and it’s beginning to show. When I’m nursing, I’ll sometimes rub my breast thinking it’s his arm. I tried to open my front door using my car door key. And when I turn on the stove to boil the babies bottles in order to sterilize them, I sometimes put the pot on the back burner and then light the front one. One morning last week, I correctly turned on the back burner but then forgot about the pot. The water boiled out and the bottles began to cook. I didn’t realize it until an odd smell wafted into my office. After about 10 minutes, I realized what the smell was: plastic!

The exhaustion has made it difficult to keep track of the feedings. I try to write each one down on a chart, but there are large gaps where I’ve forgotten to enter in a time. And on some entries, the letters are slanted and seem to run off the page where I started to fall asleep as I was writing.

Under standard breastfeeding protocol, you begin each feeding with the breast you ended with in the prior feeding, but I keep forgetting which breast that was. So I have a safety pin that I’m supposed to pin to my shirt underneath the breast I used last. But I keep forgetting to move the pin from one side to the other.

I desperately wanted the breastfeeding to work. I would spend an hour feeding him, and if I pulled him off my breast, and he cried as if he were still hungry, I’d feed him for another hour. There were times I fed him for nearly three hours, only to have him cry at the end of the feeding anyway. And when he’d cry, I’d cry, out of exhaustion and frustration. I don’t know when the breastfeeding changed from being just a whim to being all I think about, but I’ve never worked so hard at something in my life, and to have it still not work was just depressing.

It wasn’t just about the health benefits, or the bonding. It’s the whole experience, the way he makes these little squeaking sounds when he sucks, like he’s speaking to people from another planet who will soon be returning to pick him up. In between the squeaks, he makes quiet little eating noises that sound like ants making paste. Sometimes he thrusts his fist in to the air, as if he’s saying, “Charge!” Or he’ll lie on his back and eat like a fat Roman.

The Widow's Peak

And his hands are so tiny and delicate, they look like Little crustaceans that would snap if you bent them. Yet they have all the detail of adult hands, so when he’s eating and places one on the side of my breast, his fingers spread out like a starfish, it’s like there’s a little person down there interacting with me. And while one hand is on my breast, the other is often clenched into a fist, waving in the air, like Mussolini giving a speech. Sometimes I’ll feel a prickly pain inside my breast, and I’ll think I’ve gotten mastitis — a painful infection one can get from breastfeeding – until I realize he’s placed his hand underneath my breast and is jabbing me with one of his razor-sharp nails.

I’ve spent hours looking down at his head, staring at his widow’s peak, or the little indentation on the top of his left ear, which looks like it was made of clay and someone pressed down on it before it was dry.

The next time we went to the pediatrician, we saw the female doctor in the practice. I hoped she would be more breastfeeding-friendly, but as soon as she put the baby on the scale, she said we had to increase the amount of formula he was getting after each feeding.

“He’s gaining, but he’s not gaining enough,” she said. “He needs to gain an ounce a day.”

Breastfeeding Became A Weighty Issue

“I thought they only had to gain ½ an ounce to an ounce a day,” I said, quoting the lactation consultant who’d come to my house. The consultant said she’d gotten her figure from the American Academy of Pediatricians.

“No. An ounce a day,” she said.

As we left the pediatrician’s office, I stopped by the reception desk to make our next appointment, and there was a handsome man standing at the counter holding court with the women behind the desk. He was a rep from one of the formula companies.

After we got home, I went back out to refill my prescription of Percocet. I was still really sore from the Caesarean delivery, particularly with the baby lying on my lower abdomen every time I breastfed. But the truth was, I was profoundly depressed and miserable about the breastfeeding not working. I was beginning to think we would never get out from under the supplementation spiral, and soon my milk supply would diminish to nothing. The Percocet made me feel better.

When I got on line at the pharmacy, the man in front of me turned around and looked at my scarf and hat with ear flaps and said, “You look like you’re going skiing.”

“It’s cold out,” I said.

“I know. I didn’t wear enough,” he said, rubbing the arms on his fleece jacket.

“I don’t ski,” I said. “At all.”

“I do,” he said. “I miss it. I would ski the expert slopes. I wasn’t very good at it, but I would do it.”

“So why don’t you ski anymore?” I asked.

“A baby. Work,” he said.

“Life gets in the way of living sometimes,” I said, thinking I was pretty clever, at least for the drug store crowd. “How old is your baby?”

“Nine. I guess she’s not really a baby,” he said. “But I loved skiing. There’s nothing like getting up there and finding a back trail and smoking a joint, and then skiing down it.”

As he said that, I came to for a moment and remembered a life outside of breastfeeding and that there were things in it that I loved.