Thursday, October 14, 2010

Just Another Way to Fight? When Breastfeeding Doesn’t Work
I’ve been helping women breastfeed for over twenty five years. I love watching mothers learn to read their baby’s cues, and help them figure out how fun and easy it can be to breastfeed. Here in Vermont and New Hampshire, most babies begin their lives breastfeeding. (In 2005, 78% of Vermont babies began their lives breastfeeding, at 6 months 54% were still breastfed. In New Hampshire the numbers were 75% and 47%.)
Fun and easy? Well, maybe – by around three months of mothering. But I hate it when everything seems to go wrong, especially when I’m helping a first time new mom in the hospital.
Here’s a scenario, the one that makes me want to cry. Mechelle.was 42 weeks pregnant, the baby’s head was still high, and she had a birth that started with cervidil and ended two days later with a cesarean section. She had pitcoin via IV in-between, and came out of surgery exhausted, with feet and hands swollen, and breasts she swore she had never seen before. And that was before the milk came in!
Mechelle’s baby, Roger, was very coneheaded. He acted like he had no idea what to do when he came to breast. The first day, he slept most of the time. Mechelle had a hard time moving into a position where he could latch on. When Mechelle’s OB discharged her to home, Roger had lost more than ten percent of his birthweight and was jaundiced, so he needed to stay in the hospital and go under the bilirubin lights. And it seems like her milk hasn’t come in yet. And the baby still isn’t nursing well.
Mechelle had never seen anyone breastfeed. Her girlfriend Kylie told her that breastfeeding really hurt but it was good for the baby, and she herself “toughed it out” and Mechelle should, too. So the breastfeeding must be going okay – after all, her nipples certainly hurt.
Now, maybe Mechelle will tough it out too. As far as she’s concerned, this breastfeeding stuff is starting to look like hocus pocus, and the baby just cries and cries when he comes to breast. He’s still pooping meconium at day 5. If you were Mechelle, what would you do? She really wants to do what’s best for her baby and it sure seems like he’s not eating well.
When I began, I knew that anyone could breastfeed a baby, if they just got good help. I determined that I was going to provide that help. But sister, let me tell you, what I sometimes want to provide is a breast full of milk, and the chance for everybody to cry a little bit and eat a little bit, and get over this temporary hump.
Because for many, it IS a temporary hump, and if we just can apply some tincture of time things will go fine, Now, that I can help to provide.
But over the years, I have come to know that there are times when we may end up changing the definition of breastfeeding, to cover the creative ways we are feeding babies. Here’s a couple of real life examples.
• A baby with a cleft palate, exclusively fed with breastmilk by bottle. The mother was given a hard time in downtown Brattleboro for using a bottle. Must she explain everything to the concerned bystander?
• A mother with a history of polycystic ovarian syndrome, who used IVF to get pregnant and didn’t have any breast tissues changes during pregnancy. She breastfed formula with a supplementer taped to her breasts.
• An adoptive mom who got milk from all her girlfriends – when AIDS/HIV was a new problem (we still advise not sharing milk)
• A baby with a very high palate who was unable to latch well enough to get a good supply of milk, and ended up formula fed because his mom was going back to work soon and felt she needed the very most to just fall in love with the baby – and the breast stuff was not helping.
• A mother whose baby’s blood type was a funky match for hers, who was told they could leave the hospital sooner, and the jaundice would go away faster, if she gave the baby formula for a day or two.
• A childhood sexual abuse survivor who had flashbacks when her baby came to breast.
I could go on. Which of these mothers should we blame? Which one was the bad mother who “chose” not to breastfeed?
The mother who is unable to breastfeed or who has to wean before she wanted to, experiences the loss of something very important to her and her baby. She may experience the same stages of grief as the person who is coping with the loss of a loved one: denial (I’ll just take herbs and my milk will come in….), anger (Why does my body not work right? Why is this baby so stubborn?), bargaining (If I can just nurse this baby, I'll never ask for anything again.) depression (It makes me so sad to see other mothers nursing their babies) and finally, acceptance (I know that this is not something I can control, and I did everything I could. I’m still a nurturing, good mom, who just happens to need to use formula.). It is good to know that these are normal stages of grieving, and allow for time to work through each one.
Too often, moms don’t get the help and support they need. That’s how La Leche League and the International Lactation Consultants Association came about. We need to support breastfeeding, to make it easier for moms and babies to get safe breastmilk supplies for supplementation when it is needed, and to make sure we do everything in our power to help it work.
And when it doesn’t work, we need to be good to each other and to ourselves, to help breastfeeding and formula feeding mothers who are feeding their babies with a bottle establish the intimate relationship that breastfeeding makes so easy, and to know that we are doing the most important work in the world: nurturing and nourishing a new human being. And a new mother!