The Breastfeeding Post

Primarily, it’s taken me so long to write this because I don’t want to complain about anything related to the babies. One of my least favorite parts of infertility- and there were a few least favorite parts- was pregnant people’s incessant complaining about their morning sickness, back pain, swollen feet, etc. A woman I know, right during the saddest part of the whole thing for me, when I was struggling most with the idea that it was a real possibility that we might never have our own biological children, came right out and said “You should be glad you’re not pregnant-this whole thing is ruining my life,” because her morning sickness was getting to her. So I was firmly resolved that if I ever got pregnant, I would not complain about such an incredible blessing. And for the most part, I didn’t. I was pretty morning sick, which is pretty common in a multiple pregnancy because of the ludicrously high hormone levels, but I have never been more delighted to be nauseated in my whole life, which is what I would tell people who wanted to commiserate about how awful it was. (Except to Rob, who was glad when I reached the end of that stage when I would lie on our floor in fetal position, asking whether or not he thought nausea could kill you). This-the not complaining, not the nausea- actually became a bit of a problem. In my effort not to appear ungrateful, I didn’t discuss the low back pain I was experiencing, sure that it was just what you would expect during a twin pregnancy, I ended up in the hospital having contractions because of acute polynephritis at 20 weeks. I became better about at least talking to my doctor more about the symptoms I was having. All of that to say, I am well aware of how lucky we are to have E. and L. So if you’ve dealt with infertility, please don’t read the rest of this post as a lack of gratitude, because that is not the spirit in which it is meant.

I have really grieved our inability to work out the whole breastfeeding thing. I was well educated about the breastfeeding-I had done a lot of reading on the topic, watched friends nurse their babies and fully intended to breastfeed until at least a year, although I would have considered going to 18 months or so. One of the most annoying things to me is how just about every book on breastfeeding spends about half of its content telling you why you should breastfeed, how everyone who’s really committed can breastfeed and then only about 25 pages on the actual mechanics of the whole process, because it’s not like you waste your time reading a 200 page book on breastfeeding if you don’t think it’s worth your while to at least give it a shot.. I had even gotten my hands on Karen Gromeda’s Mothering Multiples, the out-of-print bible on how to nurse twins and read it cover to cover. I knew that it would be a challenge, what with the two babies and all, but I was committed to trying for at least six weeks. I don’t think I really even considered the possibility that it wouldn’t work out according to plan- I mean I registered for a few bottles, but secretly thought I wouldn’t need them and had absolutely no formula in the house when we got home from the hospital. The idea from all the books that if you just do it all right and truly want it enough that you can make it happen was ingrained in my head and I fully believed it.

Anyway, the girls were born (and again, I plan to type up my memories of that soon) via Cesarean. E, even though she was smaller had an easier time regulating her temperature at birth, so after the 30 minutes it took them to get me to recovery, I was able to hold E. by myself and we got to try and nurse. It was the most amazing thing- I remember her tiny face and her huge eyes looking up at me and her knowing just what to do, latching right on and nursing away. She just stayed on for a minute or two, but of my memories of that afternoon, that is among the most clear. Actually, of all the memories of my adult life that moment is one of the most vivid. They wouldn’t let me hold L. in the recovery room; the nurses insisted on keeping her in an incubator and then taking her to the nursery to check her out. So it was a couple hours later that L. and I got to practice our nursing. Neither baby was staying latched very long or able to suck for any lengthy of time, so my first postpartum nurse brought me a Medela Lactina and showed me how to pump; since I delivered late in the day, it wouldn’t be until the next afternoon that I saw a lactation consultant. So every two to three hours, I would try to latch and nurse each baby for about 15 minutes apiece, passing each one off to Rob to feed when I was done, get the girls tucked in and back to sleep and then pump for 20 minutes. On average, I had about 40 minutes to sleep between pumping and starting over (hence the name of this blog). That next afternoon, the lactation consultant came in and we worked with the babies, trying to get them to maintain a latch. She was so encouraging and gave me a plan to work with babies over the next few days. But my milk was slow to come in- as I’ve learned since then this can be caused by a number of factors- a c-section (check), prolonged bed rest (check-at this point I was on my eighth week of strict bed rest and my 14^th week of modified bed rest), prolonged use of terbutiline (check-at this point I was on my sixth week of Brethine); family history of diabetes (check)- and the girls just couldn’t seem to stay latched on. I kept trying at every feeding, but I was getting more and more concerned because we had to keep supplementing them with bottles of formula (initially, they were having a few problems maintaining their blood sugars) and I knew the risk of them developing a nipple preference that would be hard to reverse and my milk was not coming in. I remember taking a shower my second night there and just standing there . with the water washing over me and crying, not wanting to get out because I knew I would have to pump and I already hated it. Our third night there, I called the on call lactation nurse in the middle of the night and she came in and assessed what was going on and said “I think given your anatomy and the girls being a little premature, nursing is going to be very difficult for you.” I was so upset and wasn’t ready to hear what she was saying. So I kept working at it and went home trying to nurse at every feeding.

You know how in the hospital, they try and get you to write down every time the baby eats, how much or how long it eats, how often you change it, etc? And how then, when you get home, you reflexively keep doing it? Just like with your first baby, when they tell you “She needs to eat every three hours, minimum around the clock,” so you actually WAKE YOUR SLEEPING NEWBORN to feed her (second time moms assure me that you are never naïve enough to do the next time around). Well, being the compulsive, OCD type person I am, I wrote down how long E and L attempted to nurse, how much pumped milk they ate, how much formula we supplemented with and how much I pumped each time I pumped. Should you ever need to visit my archives, just give me a call and we’ll set it up. Looking back on it now, for six weeks, I fruitlessly attempted to breastfeed two babies at almost every feeding and I was pumping 8 times a day sometimes less than an ounce of milk total at each session. Again, since that time I’ve learned that to build a full milk supply for multiples most moms have to pump 10 to 16 times a day, rather than just 8 . By the end of my first week home, I had huge blisters because the girls had difficulty getting a good latch and was in a fair amount of pain. That second week home from the hospital, I remember sitting out on my front steps, crying in the dark and calling my friend Jenni to ask how long it was going to be this hard. The next day we had an outpatient lactation consult where they weighed E. and L. both before an after they nursed. In thirty minutes, neither baby got more than one third of an ounce. The LCs also diagnosed me with thrush, so I began treatment for that. We went back every two weeks until the girls were sixteen weeks old; by this time they were beginning to resist nursing- getting milk from their bottles was so much easier for them. At her best, neither baby got more than an ounce in a half an hour of nursing. It was around this time that I moved to trying to nurse them each once a day; they were pulling away and crying every time we tried and it was so sad for me and becoming so traumatic for them. At my last lactation consult, the LC finally said, after checking their latches “Your girls have really high arched palates. Normally, they would be less so by now; you might need to try occupational therapy for them if you want to get them to nurse.” Sometime in the week following that session, I really began to accept that this wasn’t something I could make happen by working at it- I could see from the blisters it left every time E or L tried to nurse. All of this time, I had been pumping to increase my milk supply so that when the girls learned to nurse, they would have something to eat and had finally reached an reasonable supply of milk, so I didn’t feel as much like I was pumping and getting nothing. So by 20 weeks, my milk reached its maximum, which provides about three fourths of the girls milk needs. So when the day came that they refused to latch on (at around five months) I had been pumping for so long and had worked so hard to get my milk supply up that I didn’t want to quit. Well, I did want to quit, but I felt stubbornly committed in a way I can’t explain even now.

Every mom has something that’s really important to her- co-sleeping or the baby sleeping in its own room, Avent versus Dr. Brown’s, staying at home or working, pacifier or thumb- and for me it was breastfeeding. And the funny thing is, whenever anyone tells me a story about the horrible things that happen to them and why they quit nursing or whatever, I feel a lot of compassion and DON’T think to myself, “well, you should have worked harder” or whatever. Frankly, I’m not sure why it is breastfeeding was that thing that was so important to me. I guess the most likely reason is that after everything- the endometriosis, the surgeries that didn’t help, the over 120 injections Rob and I had to give me for the IVF, the high risk pregnancy that no one I knew could really relate to, I just wanted my body to do its job. I wanted to have one thing that was kind of like what the other moms were getting to experience with their babies. I just wanted to be normal because I felt like it would be, on some psychological level or something, healing. Plus, I’ve read the repetitious first chapters of the breastfeeding book and know that it’s good for their immune systems, good for their tiny digestive systems, prevents premature graying in adulthood, bunions, male pattern baldness or whatever else they’re claiming right now. (And actually some of the better studies suggest that breastmilk in infancy any reduce the incidence of Type II diabetes in high risk populations, which, thanks to my family history the girls and I are). So anyway the girls are nine and a half months old and I pump five times a day to provide three quarters of the milk they eat each day. When Julie at alittlepregnant wrote about her experience with breastfeeding, she said something to the effect that she did everything she could. Not everything that could be done- but everything she could do. And that’s where I’m at about the whole thing. I did everything I knew to do to make nursing work. In retrospect, I might have pumped more often in the beginning to provide all of their milk, hired a lactation consultant to come to the house daily the first few weeks, taken the girls to infant occupational therapy to work on their latches, but really, I have to remind myself-I did everything I felt able do at the time. I’m sure other moms might have done more and that more could have been done, but it’s only in these last few weeks that I’ve been able to stop blaming myself for the fact that breastfeeding didn’t work out. I actually had to stop just now and change that last sentence from “the fact I failed to breastfeed.” I think that’s how I’ve viewed it, that it was some sort of personal failure on my part that I couldn’t breastfeed and that I’ve needed to be ashamed about it. Rob points out that when people ask if I’m nursing, I could probably just say yes and not treat them to a detailed description of what “kind of breastfeeding” means, but if this post proves anything, it’s that I don’t tend to be a person of few words. Anyway, that’s my breastfeeding story for posterity. I’ll keep you updated as this particular saga draws to a close.

(The picture is of L. trying on her crocodile Halloween costume the morning before. E. is sitting in her swing laughing, blissfully unaware that she, too, will soon be wearing a crocodile costume...)