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Breastfeeding Perspectives- Bottle-feeding for Medical Reasons

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Today we’re hearing from Renae.  You can find my introduction for Renae here.  Short version- she’s awesome and she blogs over here.  This is her story in her own words.

Briefly describe your breastfeeding experiences with your first two children.

My oldest son, Simon, was born six weeks premature. I had planned on breastfeeding, but he spent the first three weeks of his life in the NICU and wasn’t allowed to come home until he could take all of his feedings by mouth (whether from bottle or breast), so at that point we were thrilled with anything that wasn’t a tube feeding. He had not fully developed his ability to suck, and it was difficult to build my supply. He got as much milk as I could produce and then we supplemented with formula.

When we brought Simon home from the hospital, I rented a hospital-grade pump, and the early days were a blur of pumping and alternating between nursing and using bottles, not to mention taking fenugreek and eating oatmeal and whatever other things I heard of to increase my supply. My husband was an incredible support and would get up with us for every nighttime feeding. He would warm up a bottle while I tried to nurse Simon, and then he would finish with the bottle while I pumped.

I would go to the lactation consultant each week and feel like it was a lesson that I hadn’t practiced for. It was frustrating to say the least, but she said a couple of things that gave me hope. First, she noted how quickly he would calm down whenever I put him to the breast (regardless of how nervous I was). Second, she said she saw a lot of babies that were not interested in nursing (and how heartbreaking that was to their moms who were trying so hard) but that my son was so eager to nurse but was simply having a hard time growing strong enough to nurse full-time. And so we carried on.

In the end, it took three full months until Simon was breastfeeding exclusively, but our story gets much more straightforward from there. He loved nursing once we both got the hang of it, and so did I. And, actually, so did my husband, who could then more or less sleep through the nights (something Simon didn’t do, even once, until he was eighteen months old).

By the time Simon was sixteen or seventeen months old we were still going strong, and I started to worry that maybe he would never want to wean, that weaning would be as difficult in its own way as getting him to nurse had been. Before he was born, I had in my head that I would breastfeed for a year and then be done. The reality of our experience was that neither of us were ready to be done then. My revised thought was that if he didn’t wean on his own by age two, I would wean him then. As it happened, though, he stopped almost cold turkey at eighteen months, when I was fourteen weeks pregnant with my second son.

Ian’s story is much simpler: he was also born early, but only four weeks. My supply and his sucking ability were both better, and although he took bottled breast milk in the NICU, we somehow managed to make it without any pumping once we got home. Like his brother, he loved nursing, and he, too, weaned himself at eighteen months when I was again fourteen weeks pregnant, almost to the day.

Did you plan on nursing your third child?

When I was pregnant with my daughter, Clara, I started to get nervous about nursing again, but it was more about how I would manage it with the boys running around. I hoped she would take a bottle occasionally, since the boys never did, but it never occurred to me that I would do anything but breastfeed.

 

When did you find out that wouldn’t work?

We knew immediately at her birth that Clara had a cleft palate, but it was not at all clear to us how that would affect her ability to nurse. It was, in fact, a couple of days before anyone told us anything more than “it might be harder for her.”  Unlike with my boys, I actually got to try to nurse her in the recovery room (I had C-sections), and for the first two days, I would put her to the breast whenever it seemed like she needed to eat. She would calm down, and eventually she would fall asleep. Everything seemed alright to me — remember my boys were in the NICU, so I just assumed things were going as they normally do.

After two days, she had dropped more than 10 percent of her birth weight, and the nurses brought in a pump. I dreaded pumping but knew that it would be helpful to see exactly how much she was getting. Sometime in the middle of that first horrible session (there was other chaos having to do with visitors and whatnot that was making me stress out at the same time), we were visited by a speech therapist who was bringing a special bottle for Clara to try. She asked me how feeding had been going and seemed surprised that when I talked about “feeding,” I was talking about nursing, not a bottle. “Oh, honey,” she told me, “you won’t be able to nurse her. She is physically incapable of sucking.”

The therapist went on to explain that because of the cleft, my daughter was not able to close off the air that comes into her mouth through her nasal passage and therefore could not form the vacuum needed to pull milk from the breast. Although it looked and felt like she was sucking and swallowing, she was not actually getting anything; nor would she be able to.

 

What were your feelings about not being able to nurse your third child?

That first day in particular I must have cycled through the stages of grief (minus acceptance) in rapid succession at least five times. By late evening, I had blasted way, way, way past the ugly cry and into what my husband and I call the “hippopotamus cry.” The image that just came to your mind is probably kind compared to what I actually looked like that night.

All that to say, the most prominent feeling I had about it — and, actually, still have — is sadness. I’ve felt surprised, disappointed, angry, confused, self-conscious, frustrated, guilty, depressed, anxious, jealous, and resentful. But really mostly sad.

 

After being an exclusively breastfeeding mom, what was it like to pump and feed?

It was harder than I expected. I knew from pumping for Simon that it wasn’t convenient, but pumping for my third child was a completely different experience than pumping for the first. The most obvious issue I had was the sheer amount of time it took to pump (my supply was never stellar, even with a full-term baby, so I was always pumping for the current feeding, or if I was very lucky, maybe the next one) and then to feed Clara the bottle. And don’t get me started on washing the four-part nipples plus the bottle. Endless.

Even more frustrating, though, were the logistics of pumping. I never had much trouble finding a place to discreetly nurse in public and certainly not when I was at home. But to pump I wanted to be in a room by myself and covered up — not really that practical every two to three hours with a four-year-old and a two-year-old depending on me during the day.

 

How did you know you were done pumping?

Clara was a month old. We had been staying at my parents’ for a weekend, and since there were so many people to help, others would feed her while I pumped. At some point I realized that it had been almost twenty-four hours since I had held my daughter for anything more meaningful than a diaper change.

I had been working under the assumption that giving Clara breast milk was the most important thing I could do for her. There were so many unknowns for us, and I felt helpless and worried that her cleft palate might have been my fault. I told myself that pumping was one thing I could do for her (breast is best!). And since it was so darn inconvenient and uncomfortable, it all felt rather noble.

The problem, of course, was that she was getting my milk, but she wasn’t getting enough of me. And when I finally figured that out, it was pretty devastating. Although the discussion we had about it was a long one, the choice to stop pumping was so obviously the right one, and I think everyone in our family, boys included, was immediately relieved.

 

What was it like to be a bottle-feeding mom after being a breastfeeding mom as far as the practical implications?

To be honest, I don’t know if I’ve ever really gotten the hang of it. I can see how there are aspects of bottle feeding that are convenient (not having to be present for every single feeding comes to mind) and potentially less awkward (as I said, though, I never minded nursing in public), but overall bottle feeding is a lot to think about. Since Clara had special bottles, I was ever fearful of leaving one behind somewhere since I couldn’t just pick up a replacement at Target. And I never really thought ahead enough to make up bottles in advance, so too often I found myself at the mercy of a screaming baby while I found a water source (bring it with me? brilliant, had I only thought of it!) and measured out formula and shook it up and hoped it was approximately the right temperature, and … You get the picture.

What was hardest for me, though, especially after breastfeeding, was that I never felt confident that I was giving her the right amount to eat. Too little? Too much? Who can say? I so buy into the idea that a healthy baby will eat as much or as little as he needs to, and with that, I learned to trust my boys. Clara, though, had to trust me, and I never knew if I was doing it right or not. I am so much more comfortable with it now that she is eating solid foods and now that she is old enough to make her needs much more clear.

 

What was it like as far as your identity and how you felt about yourself as a woman and a mother?

That’s a really interesting question. I don’t have much to say about my identity as a woman as it relates to breastfeeding/not breastfeeding, since I didn’t necessarily strongly relate the two. I certainly loved breastfeeding, but I did not feel any more feminine or empowered by being able to with my boys as compared to my experience with my daughter. Not being able to nurse Clara made me sad, but it didn’t make me feel “less than.”

As to my identity as a mother, there I felt like I had to make much bigger adjustments. I struggled first with the fact that breastfeeding just made so much more intuitive sense to me. I can’t count the number of times, especially at first, that Clara would be crying and I would either reach up to unclasp my bra or sit down (without a bottle) with her only to realize I had been getting ready to nurse her. I’m sure that can partially be attributed simply to habit, but I think it also speaks to how much it had become part of “what I do” as a mom. In other words, I found not nursing rather disorienting.

Along with that, I found myself often either literally making apologies or wanting to as to why I wasn’t breastfeeding Clara. I think it had so much less to do with me thinking others were judging me (though I’m certainly not above worrying about that) than it did with me wanting to somehow hold onto breastfeeding as part of my motherly identity. I mean, I have the breastfeeding cred, and it has been consistently hard for me to let that go unremarked.

 

How did your feelings about not being able to breastfeed affect your relationship with your daughter or your feelings about her?

Very early on, I had a phone conversation with one of the nurses at the hospital in Omaha where Clara eventually had her palate repaired. She was talking about frustrations we might have (probably as it related to feeding, since her cleft really affected little else at all), and she said, “Remember, it’s not her fault.” I don’t know that it would have even crossed my mind to blame Clara, but that phrase was from then on in the forefront of my thoughts, and I had so much compassion for her when things were rough for us, perhaps more than I might have had the nurse not said that. And as I’m still sorting through some of my feelings about not being able to breastfeed, I feel so fiercely defensive of her part in not being able to nurse (i.e., that it was not her fault).

As I alluded to earlier, I think that for that first month I was too focused on what kind of milk she was getting and not tuned into getting to know her. But after I stopped pumping, none of my fears about lack of attachment or bonding were warranted. We may yet have our share of mother/daughter troubles in the years to come, but I’m pretty sure not breastfeeding will not be at the root of them.

 

What was the hardest moment of this journey?

What first comes to mind is a moment one day when I was standing at my kitchen counter stuffing cabbage leaves in my bra. Besides the fact that I so foolishly stopped pumping cold turkey and was in a stupid amount of pain, I was fighting so hard against the reality of our situation. I didn’t want to be trying to dry up my milk; I wanted to be feeding my daughter! I didn’t want to accept the term “birth defect” or to think about the inevitable surgery she would have to have to correct it. I didn’t want to be making a decision that was hardest for me but best for my family. I didn’t want to give up that part of my identity that was “I am a mom who breastfeeds.” I didn’t want to be in pain, physically or emotionally.

 

What has been the biggest lesson you’ve learned?

I have come to understand in new ways that I am not alone: I am not alone in things not going according to plan or in any of my feelings about that; I am not alone in having a child who could not breastfeed or in any of my feelings about that either; I am not alone in the sense that I am in this with Clara, in this with Jason, in this with Simon and Ian; and, of course, I am not alone in that God is faithful in every circumstance.

 

What advice would you give to someone who after successfully breastfeeding other children has learned they won’t be able to breastfeed their child for medical reasons?

I think I would encourage her to feel how she feels without wondering how she should feel. It’s okay if she needs to grieve and if that takes a while. It’s also just as okay if it doesn’t bother her the way it did me, or if she perhaps secretly feels relieved. And I would probably encourage her to separate as much as possible her feelings about breastfeeding, whatever those feelings may be, from her feelings about herself and her feelings about her child.

 

Did you have any misconceptions about bottle-feeding before your experience?

I’m not sure this is the spirit of the question, but one of my favorite experiences came as I was sitting at a conference surrounded by earthy granola hippies I was sure were judging me for bottle-feeding, and I was feeling all defensive and self-conscious and a little self-righteous. A woman, whose name I have forgotten, sat down next to me and said that her daughter too had had a Haberman bottle. I immediately felt sorry that I had spent so much time that weekend thinking about myself and my insecurities. More than likely that kindred woman was the only person who gave the slightest thought to how I was feeding my baby. (And I don’t know why feeling self-conscious is such a consistent theme with me. I rarely give a second thought to how others feed their babies, so I don’t know why I tend to think everyone is so concerned about how I feed mine and, more than that, that they are judging me negatively for it. It sounds rather ridiculous when I admit it out loud.)

 

Has being a bottle-feeding mom changed your perception of breastfeeding?

I wonder sometimes if I have rose-colored memories when it comes breastfeeding. It seems to me that after the initial three months with Simon that it was fifteen months (with Simon) plus eighteen months (with Ian) of smooth sailing. I wonder if I remember my experience with such unqualified fondness because I couldn’t nurse Clara.

 

If you had to guess, what do you think God wanted to teach you through this experience?

I wish there were a word that would signify a mix of “dependence,” “humility,” and “I thought I was in control, but I see now that I’m not.” I feel like I started to learn that in some respects when the weeks leading up to Simon’s birth and his early arrival were so far off from what I imagined. But at the same time, I remember thinking when Simon was born that if I ever got pregnant again I would “do pregnancy better,” and in significant ways, my pregnancy with Ian was better, and with Clara was the best of all. So when Clara was born full-term, I was pretty sure of myself and basically thought, “I’ve got this.” God got us through the pregnancy, sure, and that was the hard part, but I could more or less take it from there. Clara’s cleft and its implications (for breastfeeding, but also for her life and health more generally) put an emphatic stop to that nonsensical thinking.

As the time that Clara would have naturally weaned (had she followed her brothers’ examples) draws closer, I can feel this aspect of our story taking on less prominence in my heart and thinking. Every day she’s becoming more independent in every way. This is a good thing, and it happens with each child regardless of how she is fed as an infant. I can feel a healthy shift in me to turn my attention to what God is continuing to teach me through this precious little human that I have the privilege of knowing and caring for and that not two hours ago fell asleep in my arms with a little help from the bottle.

 

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