Forrest was approximately twenty minutes old when a nurse tried to show me how to feed him. Did I mention she was impatient? After 30 seconds of trying (without her actually showing me how he was supposed to latch or how to hold him or really what I was supposed to be doing), she disappeared for five minutes and returned with a nipple shield. She promptly slapped it on my boob and shoved Forrest back up to my chest. There was no explanation as to why I needed a nipple shield; she just felt like I did... or maybe she just wanted to hurry the process up despite the fact that I had absolutely no idea what I was doing.
24 hours later, Forrest had lost over 10% of his body weight. We tried lots of different methods of feed him: SNS, formula, the nipple shield. I wasn't producing colostrum at the rate he needed (a side effect of late preterm induction) and it would be a few more days until my milk came in. I started a strict regimen of donor breast milk and pumping every two hours.
So Forrest was being bottle-fed, something I'd wanted to avoid entirely. We kept trying in the hospital, but that tapered off. The longer we were there (six days in total), the less the nurses tried to get him to latch. The less I felt the need to. He was staying steady at his weight; I was pumping enough to feed him. We went home and I kept pumping. Every two hours throughout the night, usually after feeding Forrest.
However, the day after we were released from the hospital, he'd lost more weight (just a few grams, but a few grams matter when your newborn is severely jaundiced). So I pumped more. I pumped for twenty minutes every two hours and set myself the goal that Forrest would eat two ounces every two hours round the clock.
For weeks, I didn't sleep. My life was consumed by two goals: feed Forrest and pump. I made lactation cookies; I ordered fenugreek seed and took six capsules a day; I chugged water, ate oatmeal, ate a snack every time I pumped. My days and nights consisted of Forrest waking up; feeding him a bottle; getting him to sleep; and pumping just in time for him to wake up again. I lived in terror that my supply would dip or dry up from his lack of latching.
Whenever I tried to nurse him, his weight dipped and it scared me. He was too small to nurse. Breastfeeding babies use about the same energy as running a marathon to eat, so if they don't get enough food, they lose weight rapidly.
The problem with not physically nursing a newborn is this: at around 3 weeks, newborns do something called cluster feeding. It's basically when they want to eat constantly or every twenty minutes. If you're nursing, it helps signal to your body to make more milk so you can account for the 3-4 week growth spurt. Yay! However, if you're baby was late preterm and had trouble latching, you aren't nursing him; so when he cluster feeds, you're giving him bottles. So your body never gets the signal. Your milk supply stays the same as when the baby was 2-3 weeks old.
And if you're like me, you freak out about it.
I started taking steps to try to breastfeed Forrest a few weeks ago. We went to lactation consultants. He did great there! He would latch, eat until he was full, and promptly pass out. But when we were home, it was a struggle; he wouldn't latch or he would just scream endlessly at my boob (not a positive feeling). If he did latch and we had a great nursing session, he would still often wake up thirty minutes later, screaming in hunger and would down a 3 oz bottle. It was exhausting.
My supply started to even out; the more I pumped, the less milk I got. I panicked. I made more lactation cookies; I took more fenugreek. I looked into renting a hospital grade pump to up my supply, but found out that no one in Lane County rents hospital grade pumps. Awesome. My mom bought me a new breast pump and it helped immediately. I tried to stay calm (because stress reduces your supply).
Pumping all the time is painful. It's a different kind of pain than breastfeeding. In the middle of the night, you can't just wake up and feed your child. I wake up at midnight, no matter what, help Danny give Forrest a bottle, then wander downstairs in the dark on my own to sit at my desk and pump for 15 minutes. I do the same thing before I go to bed; i do the same thing at 3 or 4am; and I do the same thing when I wake up in the morning.
When I plan any trip out (a doctor's appointment or even just lunch out), I have to plan when I'll pump. I also have to plan how much breast milk to bring for Forrest, how to keep it cold, and if I should bring some extra formula just in case. I feed Forrest before I leave, put him in car seat, and pump for 10 minutes. When I get home, I often have to sit with Forrest in his car seat beside my desk, rocking it with my foot, while I pump. If I don't pump as often as I'm supposed to (every time Forrest eats or every 2-3 hours), my supply decreases and we have to use more formula to supplement.
Recently, I just couldn't do it anymore. Torturing myself to pump around the clock wasn't working. I felt pride at Forrest's 2-pound weight gain thanks entirely to my body and hardwork, but I was exhausted. I wasn't sleeping; I was yelling at Danny all the time; and I would spend hours crying during the day. When Forrest didn't sleep, it created a cycle of frustration; I needed him to sleep for at least two hours so I could pump and eat something, but he often took an hour to fall asleep or he wanted to play.
I started using more formula. I gave up on the idea that I would ever be able to exclusively breastfeed. It wasn't worth the pain I was feeling, the emotional upheaval, the constant stress. When I gave myself the permission to supplement (and to sleep longer than 3 hours during the night), I felt better, freer. I was happier. Danny and Forrest were happier too.
When I was pregnant, I looked forward to breastfeeding. It's an intense bonding experience and it has always felt like the right thing to do. It's entirely natural. So why didn't Forrest and I get it? Why didn't we "click"?
I've spent a lot of time coming to terms with the fact that Forrest and I had a lot of factors against us when it came to breastfeeding. He was born small; his mouth was too small to latch at first and the process of nursing was an energy drain. Bottles use significantly less calories for him to eat out of and it's much easier for him.
Knowing the facts, though, that a vast majority babies born at Forrest's age and size never latch and never successfully breastfeed don't change the sadness I feel. Late at night when I give him a bottle, and it's very still, dark, and quiet, I wish I could be nursing him; I wish I could have experience of being heart-to-heart with him. I worry that we won't bond properly or he won't love me because I couldn't do this one thing for him. I have to remind myself that I made a lot of decisions that I didn't like to ensure both his health and my own: being induced early; bottle feeding instead of causing additional weight loss; round the clock pumping.
I'm still not giving up on breastfeeding entirely. One of my favorite things on weekday mornings is watching Good Morning America! while I nurse Forrest; he almost always chugs a whole bottle afterward, but spending time with him, just trying, is enough. I get the experience without the anxiety.
We've recently had to start mixing breast milk with formula. The closer I get to going back to work, the more aware I become that I need to be freezing milk. I stock pile a little each day, but it leaves a gap in his day-to-day eating. We fill that gap with Enfamil Supplementing formula. Giving him this first bottle of half-and-half mixed milk was painful. I felt like a failure. If I was a good mom, I thought, I wouldn't have to do this. I would be trying harder.
It didn't change him though. None of the decisions I've had to make--abandoning exclusive breastfeeding and using formula--have changed who Forrest is or who he will be. As his pediatrician said (when she found out I was pumping 12 times a day, a fact that made her widen her eyes and say, "You poor thing"), "he will still be just as smart, talented, and perfect as if he was breastfed." I tell myself this every time I give him a bottle: using this formula doesn't change who he is.
I find myself frequently resenting the emphasis on breastfeeding: it can often feel like a personal slight, especially if you're struggling when you don't want to be. I spent an entire pregnancy enthusiastically talking about the benefits of breastfeeding, my excitement about it, my insistence that I would avoid formula at all costs. I spent that entire pregnancy also being told that "breast is best" and hearing the dangers of formula. Breastfeeding is built up so high that when you are unable to meet the requirement, you feel like a failure.
I've heard it from almost every single mom I know: if you don't succeed at this one apparently simple task (even if there were incredible odds against you), you feel as if you've failed. But we haven't failed! We feed our babies everyday; we sit up with them, we wear them, we spend hours pumping and reading articles about upping our supply. At the end of each day, our babies are full and growing and content. Isn't that what being a mom is about?
The minute I gave myself permission to abandon the things that weren't working, I actually became a better mom: I cried less, I slept better, I actually produced more milk. Is this the story I wanted for feeding Forrest? Absolutely not. But that's ok. Sometimes, your expectations have to change and it doesn't mean they change for the worse.