In which I reference the fact that I teach about cheese and also lactate

Read this first: New Study Finds Link Between Breastfeeding, Always Knowing What’s Right For Everyone

Mike and I have made our careers in milk— carefully fermented milk, actually— and we’ve learned a lot about the molecular structure of milk and about the lactation cycles of various ruminants.  I’ve read books about what makes a good milker, about how to assess an udder, about the volume and butterfat content of differing breeds of cows and goats.  I’ve made pie charts and bar graphs and cleverly captioned pictures of babies to illustrate how and why an animal comes into milk, and what makes certain milk good for cheese.  I’ve attended multiple hours-long lectures identifying defects in milk.  None of this was lost on me as my due date grew closer and the fact that I, a human, a grown woman with opposable thumbs and language skills, was going to make all of the food my baby would need for a whole six months.  FROM MY BODY.  So weird and so, so awesome.

I was so excited to breastfeed, and I wanted to do everything I could to make it happen.  Not everyone can, or wants to, breastfeed, but I desperately wanted to, and I am so glad I dug into that conviction early on, because it wasn’t without some struggle.  Just after she was born, Winnie went straight on my chest, and began nursing within minutes (my mind is still blown by how these teeny babes are wired for survival— check out this Breast Crawl video to see how many feeding skills they have at just moments old!).  The lactation consultant happened to be doing her rounds right as I was moving from the birthing room to the maternity room our first day, and she helped boost my confidence and gave me some pointers, and our daytime nursing staff was such an amazing source of support, as well.  Things shifted our second night.  I’m going to qualify this story by noting that our hospital was, on the whole, great, that our doctors were amazing, most of our nurses incredible, and the staff was kind and competent— also, we were new parents, and sleep deprived, and also I had just gone through the craziest exertion of my life.  That said, I think my understanding of what happened was pretty accurate, so here it is.

Our first day with Winnie was bliss, and our first night was, well, a different kind of bliss, one in which she woke up about every half hour to an hour to feed.  As I learned in our lactation class the next morning, this kind of cluster feeding was a totally normal way for a baby to help stimulate milk production and fill her teeny tiny belly with colostrum on the regular. A second lactation consultant came by to say hello that afternoon, and assured me everything was normal, and that Winnie’s latch was great, and that I was producing plenty for my little babe.  But it was concerning to hear those cries so often, not to mention exhausting. I must have made some comment to the night nurse about being concerned about my milk coming in, or my nursing skills, or something, because the second night, things started to go awry.  She started offering lots of unsolicited advice about my nursing practice (like, for example, not to allow Winnie to use me “as a pacifier”— always a favorite little phrase, since I’m pretty sure pacifiers are basically straight up nipple knockoffs). She started asking if I could hand express “anything” and asked me to do so until she “felt better about” my level of production (this is fewer than 48 hours postpartum).  She brought me a breast pump and showed me how to use it, to stimulate milk production.  I became concerned that I was only pumping a few drops, that my milk hadn’t come in (spoiler alert: it was TOTALLY NORMAL that it hadn’t come in, and it would, WITH GUSTO, the next day.)  I was pumping, and fretting, while Winnie napped on Mike’s chest, during which time I probably should have been getting some sleep, as well.

At around midnight, about 36 hours after Winnie was born, this same nurse came to take Winnie for her Hep B vaccine (which I had fully encouraged).  Winnie had been laying on Mike’s chest doing skin-to-skin under a blanket.  While moms’ bodies regulate temperature pretty perfectly for newborns, dads’ bodies can sometimes overheat— something we learned later, from about three different providers in the retelling of this story.  When Winnie was taken to receive her vaccine, her temperature was elevated (it was still under 100.4).  The nurse calmly explained this to us, and I explained that she had been toasting up under a blanket with dad, and asked if she could take the temperature again.  And here’s where things got weird.  She wouldn’t take the temperature again, and told us that she thought that Winnie was dehydrated, based on her temperature, and that because she believed Winnie to be dehydrated, she recommended we start formula right away.  I asked if there were any other indicators of dehydration (all the while I’m choking back tears and trying not to beat myself up for not taking care of my child, my hours old child!).  ”She’s lost a lot of weight,” she said.  This was news to me.  ”Really?!  How much?” I asked. “An ounce,” she said, “which is almost 7% of her body weight.”  That is, in case you were wondering, TOTALLY NORMAL.  And I knew that, because I had discussed this with my doctors before her birth, and read my books, and knew my shit— not in the way, of course, that a health care professional does, but such that I felt pretty okay advocating for myself and my child.  I should be clear, too, that I get her concern— I know that an elevated temperature in a newborn is a Big Deal, which is why my whole heart sank when she first mentioned Win’s temp.  But as the conversation progressed, my alarm bells started to go off, the first of my parental gut feelings became clear, and I dug in my heels (respectfully, and with every intention of re-evaluating my position.)

So back to our discussion about birth weight— really interesting stuff.  I replied that it was my understanding that anything under 10% weight loss was within normal in the first few days, and that didn’t seem like a reason for concern or an indicator of dehydration.  She countered that the AAP had recently revised their stance, and that newborn weight loss over 7% was no longer considered normal.  Huh.  That’s interesting, and also completely false.  Seven percent weight loss remains the average neonatal weight loss, meaning Winnie was actually below average.  Were there any other indicators of dehydration? Winnie was active, had plenty of wet diapers, I was producing, if not the buckets of milk she thought I should be, at least SOMETHING, and Winnie was nursing vigorously.  It was clear to all of us that we were at an impasse.  Mike was becoming increasingly frustrated.  I was exhausted and upset, feeling as though I had failed so soon.  The nurse repeated her recommendation to start formula, and told us that if we didn’t, and if Winnie’s temperature continued, that she would likely end up in the NICU.  I would like to think that her motivation for saying this was purely professional, from a place of concern— but my gut told me that we were locked in a power struggle, and that throwing out the NICU was a scare tactic.

I asked if we could wait and see, if we could continue to monitor Winnie’s temperature, and I assured her that we would take action should her elevated temperature continue.  ”Well, we’re going to have to take her temperature every hour then,” she said.  Great.  Please do!  Lord knows I love me some data.

Hey, here’s another spoiler alert: guess who had a normal temperature for the next, say, eight months or so?  Yep.  And I marathon nursed that night, determined to make this thing work.  At this point, I knew I could.  I have absolutely nothing against formula, and I know that there are plenty of mothers for whom breastfeeding isn’t possible or desired.  But that wasn’t the case for me, and no-way-no-how was anyone getting in my way.

The next morning, I was dead-tired, but I felt renewed and strong.  I saw a third (third!!) lactation consultant, spoke with her about the events of the previous evening, and recounted them to my OB-GYN, as well.  Both providers were shocked, apologetic, and completely understood my frustration.  My no-nonsense, data-driven, evidence-based OB looked me straight in the eye and told me I had learned a valuable lesson in going with my gut.

I had never been so excited to be home as I was when we arrived home with Winnie.  We slept and nursed and slept and nursed for the next few days.  We made it over that hump in the hospital, but nursing was by no means a breeze from there on out.  We struggled with latch, with cracks and bleeding, but by week three, we were through the worst of it, and in the groove.

At four months, I went back to work, and my heart ached.  I cried through every pumping session, looking at pictures of my baby girl.  Because of the demands my job at the time, my pumping sessions started to dwindle, as did my supply.  I was determined not to let my work interfere with my ability to feed my child, and so, when I couldn’t get away during the day to pump as often as I would need to, I would set a series of alarms at night, waking every two hours to pump overnight to make sure Winnie had enough breastmilk to take with her the next day. It was terrible, but in the end, maintaining my supply was absolutely worth it.

I left that job, thinking about all of the time I would save not commuting, not setting up a pump and washing bottles, and instead putting my babe to my breast when she was thirsty.  Of course, working from home with a child in said home was nearly impossible, so Win stayed with her awesome caretaker/surrogate grandmother/auntie Norma a few days a week, and stopped taking a bottle on her own.  She went to daycare, too, when Norma was away, and while she had a great time, she just didn’t want (my) milk while she was away.  So pumping was done, forever and ever (and maybe too soon, like the three times I’ve forgotten that I’m a nursing mom and found myself in a public bathroom hand expressing milk into a wad of one-ply Kimberly Clark).

Now, of course, I’m nursing a toddler, and those whispers of “If they can ask for it, that’s just weird!” or “If they’re walking and talking, they’re too old!” ring in my ears.  I know that the World Health Organization recommends nursing until the age of two, and that Winnie and I are in charge of this decision and no one else, but I can’t help but feel a little self-conscious when Winnie lisps, “NURSE, PLEASSSSSE!” at the playground and tugs at my shirt.  It’s fine, it’s Brooklyn, it’s my child for goodness sake, but there are lots of messages surrounding this relationship— “you MUST breastfeed your child— all good mothers do, of course—but not too much!  And not where others can see/be aware of it, unless you have tiny boobs and your baby loves eating under a blanket.  Never “whip” or “flop” or let anything just “hang out”, okay? Maybe just stay home?  And definitely wean before it gets too weird, you know, for others— you don’t want him attached to the boob in college do you?”

At 15 months, Winnie nurses morning, night, and lots in between when we’re together, and maybe three times a day when we’re not.  She drinks from a cup, eats EVERYTHING we put in front of her, and has an independent streak that I, as a grown woman, envy.  We’re both fine with the whole lot of it, and I can’t even express how euphoric I still get with each successful latch and contented sigh (that’s got to be oxytocin or something, right?). That said, if none of this nursing had ever happened—if Winnie had been on formula from the get-go, or a few months after the get-go, or whenever— we still would have built that bond.  I love nursing my daughter, but more than that I love feeding her, holding her, sustaining her, reassuring her that between the three of us in our little family, we’ll take care of each other.

So weird, and so, so awesome.

Milestones

We’re taking our first trip out of the five boroughs next week to Cheese Paradise— the American Cheese Society conference in Madison, Wisconsin.  I’m on a panel and will be taking the Certified Cheese Professional exam, which is fun and exciting, but I’ve yet to be in a situation where I couldn’t nurse on demand.  Because Mike will be watching her during these times and she may very well be hungry, I’ve been pumping here and there to store up breast milk for this growing bean.  For such a cute little nugget, she goes from zero to hangry pretty darn quick, a trait she comes by honestly.

Last night we tried a bottle for the first time, as I’ve heard horror stories about bottle rejection and envisioned myself abandoning questions about short chain fatty acids to rush to a screaming babe, leaving a breadcrumb-esque dairy trail in my wake.

We’d been talking about introducing the bottle for a week now, and last night seemed perfect— all was calm, she was alert and just starting to get hungry, the bottles and accoutrement were washed and sterilized.  I heated up a few ounces of frozen breastmilk, silently thanked years of babysitting experience for improving my bottle-warming skills, and picked up my snuggly bean.  Oh, and promptly started bawling.

I really, really did not want to give her that bottle.  In my head I envisioned our nursing practice falling right to pieces, losing that incredibly precious bond, my milk supply suddenly dropping off.  Of course, that’s ridiculous- we fed her all of an ounce before switching to the breast, and I pumped a couple of ounces after she had had her fill to protect my supply and provide a little more backstock.  Mike and I took turns feeding her with the bottle (using the lowest, slowest nipple made, so as too not initiate flow confusion), and she went along with it all like a champ.  She switched right back to the breast after the bottle and didn’t seem frustrated at all by the flow, and nursing this morning went beautifully, too.

I’m so glad that she’ll happily eat what she needs while I’m unavailable, but I’m still a bit heartsick watching her grow up.  I know that so many babies start on bottles far earlier than she did, but I had incredibly high hopes for and not-insignificant corresponding fears about breastfeeding.  Because I wanted this so badly for us and because it has, in all ways, surpassed every single expectation I could have possibly conjured, I’m beyond protective of the process.

We also started visiting daycares this week, which is its own special kind of torture, and a subject for another day.  I’m beginning to believe that motherhood is not unlike being a Sesame Street martian: