Milk

Sometimes I feel like I'm walking around with a big red letter "F" stamped on my forehead. My son eats formula. And he is thriving.

The first Sunday we brought Sam to church, hunger struck during the sermon, so off we went to the nursing room. I marched in, found the only open seat, tried not to make eye contact with anyone, and popped open the NeoSure bottle. I truly don't think there was any judgement or pity in that room other than what I projected on the situation in my mind. I know that most, if not all, of the women in that room would have hugged me and told me it was okay, had I given them the chance.

Still, I considered making a sandwich board that said something like, "YOU DON'T EVEN KNOW" to wear to church the next Sunday. The fine print would read: 3 months, 2 hospitals, 3 breast pumps, 9 lactation consultants, 12 lactation consultations, 5 nipple shields, 3 ENT doctors, 160 fenugreek capsules, 1 week of fenugreek allergies, 100 days of pumping, 100 gallons of water, 2 SNS devices, 8 boxes of Mother's Milk tea, 60 bowls of oatmeal, 4 mouth issues that make it impossible for Sam to nurse...well, I'd probably stop there. 

Why am I sharing this on this blog? If I'm honest, probably because it's a good stand-in for that sandwich board :). Or because I think it's important to share the tough along with the happy, and you should know that as put together as Sam's nursery looks, we've had our share of struggles in that plush glider. Or because I was shielded from stories like this before I had a baby, and so I was blindsided by our situation. I knew nursing would be tricky, but surely we could pull it off with a little effort and patience and watching movies to stay sane, right?

I'm only something like 37% old hippie soul, but I wanted to have a natural birth, and, by golly, I was going to nurse. I thought the birth would be the thing to really test my limits. Nope. I made it through the birth without completely losing it (that's another story). It was nursing and pumping that almost did me in. 

Sam was bottle and tube fed for three weeks in the hospital. During the first week, he had pretty bad jaundice, so I was only able to take him out of the incubator to hold him once a day. No nursing allowed. Finally, the second week, he was taken off of phototherapy and we were cleared to nurse once or twice a day. With a lot of coaxing, he did relatively well at it for a preemie. We were sent home with vague instructions to "just" increase nursing little by little until we phased out formula and supplements completely. But, at home, we would try nursing, and he would cry and kick and fuss. So would I (although I let out more four letter words than he did). After a couple weeks of struggling, he finally settled into it a little. We had about three weeks where he nursed a LOT...practically all day. But by the evening he would be frantic, even with supplements during the day. And my once-decent supply plummeted. The more I nursed, the more my supply tanked. It didn't make sense. The LCs were at a loss and chalked it up to a supply problem, offering me prescription drugs and pitying looks. So I launched out on my own, trying everything I could think of to boost my supply in between nursing sessions. I resumed pumping around the clock (how do you think I had time to start this blog? I have my hands-free rig to thank). I would nurse, bottle feed, and pump, in a never-ending cycle. Meanwhile, Sam resumed his nursing rebellion. Civil War caliber this time. (No muskets, but there were fingernails.)

Finally, just after Sam turned three months old, a friend recommended that I meet with the best LC in town, who specializes in diagnosing mouth issues that inhibit effective nursing. She was the first LC to actually look in Sam's mouth, and when she did, she immediately saw that he had a lip tie, a tongue tie, a recessed chin, and a high palate. Because of those factors, Sam had never actually been able to get enough suction to draw out milk. (Hallelujah...a tangible answer!) So, she sent us to the only ENT in Atlanta who will clip tongue and lip ties without a "medical" reason, in hopes that it would improve Sam's suction enough to allow him to latch. 

A few weeks ago, we had the procedure done on Sam's lip and tongue. It was extremely quick, and his mouth healed overnight, but in terms of nursing, we didn't see the miraculous results that some people see. Sam had become so turned off to nursing that our sessions were still incredibly frustrating, highly uncomfortable, and emotionally exhausting. He would pitch a huge fit whenever he even got close. 

Finally, I let it go. I stopped nursing. And, for a variety of reasons, I stopped pumping. Last week, I pumped for the last time. Today, I packed up all the parts and put the whole big, messy milk processing plant up on a high shelf. Sam is so much happier and more carefree. He doesn't get stressed out at mealtimes anymore. He is at rest with me instead of at odds. I feel like a human being (much more often, anyway). I'm regaining a sense of normalcy. For us, this was the right decision.

We are still glad we had the lip and tongue ties taken care of. We've seen Sam's bottle-feeding time improve, since he can actually get a good grip on the bottle, and he can now raise his tongue above his lower gum, which he couldn't do before. It will probably make speech easier for him later on. And the lip tie is a genetic issue that my mom and I both had to have surgery for as teenagers, so he won't have to worry about that. 

So, what have I learned from this whole mess? Here are just two excerpts from my long list:

First, sometimes it takes more than perseverance and good technique to make nursing work. Lip and tongue ties (among other physical challenges) are very real but subtle issues that can make or break breastfeeding, or at least make it much harder than it should be. However, most doctors and lactation consultants don't look for or aren't trained to find them (maybe because the medical community hasn't caught up with the breastfeeding boom). In Sam's case, the ties were just two of many factors that kept him from nursing, but I think he would've had a fighting chance if they had been corrected earlier. Not all lactation consultants are created equal, and next time, I'll start with a good one.

Second, my ability to provide milk for Sam is not a measure of my adequacy as a mother. Formula is not actually the devil's drink. It's not spectacular, and, good grief, it is expensive, but it will be okay. It's allowed my preemie to continue to thrive despite many odds. And I will never again judge that mom next to me who is struggling to mix formula while wrangling the little person in her arms.

Oh, and that scarlet "F" on my forehead? It's starting to wear off. :)

--elise