Sunday, 6 October 2013

Happy National Breastfeeding Week! 1 - 7 October 2013

Naturally enough, my original intention was to start this blog about birth by writing in more detail about the births of my two children.  However, when I realized that National Breastfeeding Week had arrived, I could hardly pass up the opportunity to discuss what my husband refers to as my "new religion." Actually, it is probably an even better place to start.  I say this because, above all else, it was the almost impossible challenge of learning along with my first child how to breastfeed, in spite of poor guidance and advice from some health care professionals, that led directly to the spiritual and psychological revolution that changed my life forever and for the better.

My daughter was born by "elective" caesarean section in 2010 due to frank breech presentation and suspected IUGR.  The word "elective" seems to be applied quite loosely and freely by medical professionals generally, but please do not take this to mean that I wanted and opted for a caesarean.  I spent my pregnancy reading books such as New Active Birth by Janet Balaskas, The Pregnancy Book by Sears and Sears, and Tracy Donegan's Better Birth Book.  I was taking antenatal yoga classes to foster good health and strength and to prepare myself for the hard work of giving birth.  My husband and I, like many other first-time parents, really wanted to welcome our baby into the world with a natural, unmedicated, physiological birth.  However, there was probably no obstetrician in Ireland who was going to entertain a vaginal breech birth, and at the time I had unquestioning faith in my consultant and in the overall *atmosfear* of the maternity hospital.  I did everything I could to try to encourage my baby to turn, from reflexology to acupuncture, from assuming all sorts of strange positions on the floor to resting a bag of frozen peas on my bump in hopes that she would get too cold and turn around.  Nothing worked.  I tearfully - and fearfully - signed my consent and endured a surgical birth.

My daughter was 6 lbs. 2 oz. at birth.  She was indeed tiny, and she did not have the benefit of labour to prepare her for life outside the womb.  She was alert, looking and listening and taking everything in, but every time she went to the breast she fell asleep.  In fact, it was three or four weeks before I emerged from my groggy surgical haze, so whatever pharmaceuticals they gave me in the spinal block must have taken quite some time to leave both of our systems.  In the meantime, I tried to dismiss all the feelings of failure, anger, devastation and sheer terror I had as a response to the surgery and focus on my dainty little pixie.  She was like nothing I had experienced before, impossibly soft and wrinkled with strange, gurgly sounds and calming, breathy sighs. Still covered on her shoulders and back with soft, downy lanugo, she was something maybe like a tiny alien.  Throughout my pregnancy, it was a foregone conclusion that I was going to breastfeed my baby, and like everything else in my life I was very specific about it.  I would breastfeed exclusively until she was six months old and continue as part of a mixed diet until she reached her first birthday.   I took a one-day breastfeeding preparation course and assumed I was prepared with all the information I needed.  After all, it's totally natural.  If cats can nurse their young, why can't I?

Well, yeah, but.....

So there we were in the recovery room with our quiet, observant baby, who had been all bundled up before being handed to us.  (I was so foolish, I didn't know I could ask for skin-to-skin after a caesarean!)  Couplehood had been enhanced by parenthood quite suddenly.  We were all at once smitten with our new charge, overawed as we marveled at her very existence, and overwhelmed by a new and terrifying level of responsibility was literally thrust into our laps.  As weary and woozy as I was, I really wanted her to breastfeed right away, so I stripped all the clothes off her immediately, untied my hospital gown and placed her on my chest.  We must have been a sight, my husband and I bumbling around with my breasts and jumbling our daughter from side to side, here and there, nipples everywhere, trying to get her to latch on.  She would latch on briefly, weakly, sleepily.  I didn't know if she was "feeding" or not, but I had a strong suspicion that this was not quite right.  Today, I'm sure I would react differently than I did at that time.  Introducing her to the breast was probably a wonderful start after all we'd been through.  However, I already believed that I was a failure at birth, so I didn't need much to convince me that I was going to fail once again at this aspect of motherhood.  There was a midwife at the foot of the bed who spent alot of time writing things into the precious red folder.  I asked her a few times if we were doing this correctly, but she didn't seem particularly interested.  There were other midwives milling around, chatting and laughing, and one of them told me that our baby was just fine.  I was not convinced. 

The remainder of our stay in hospital was characterised by variations on that theme.  Baby and I were in a chemical haze.  I was an emotional, tearful wreck, and my husband was trying his best to cheer me on and lift our new family's spirits.  My milk was not coming in, so in between my baby's feeds I was trying to express, day and night, just to keep up the nipple stimulation.  Nothing was coming out.  I asked for breastfeeding help from the midwives time and again.  One lactation consultant tried to be very helpful.  She spent alot of time with us one afternoon and told us that we needed to keep "stimulating" our daughter because every time she latched on she fell asleep.  We were stroking her with cold water on cotton wool.  We even pinched her heels a couple of times. (I couldn't bear to keep doing that one!)  We were told that our daughter had a slight tongue-tie, which would make it difficult for her to latch on properly.  That particular LC was sympathetic and helpful, but we never saw her again.  One lactation consultant is definitely not enough for a maternity hospital of that size.  (I believe that there is another on the staff, but she only works three days a week).  And so many of the other midwives hadn't the first faintest notion what they were doing.  I'll never forget one who squeezed my left breast so hard I had to fight back tears.  I couldn't understand what was wrong with me.  

In addition to my daughter's tendency toward breast-induced narcolepsy, we faced the troubling task of filling in a feeding chart.  This was the single worst, most demoralizing, ineffective, inaccurate and psychologically damaging way to promote and encourage breastfeeding I can imagine.  They wanted me to write down every feed: what time she latched on, what time she finished and how many minutes of "active feeding" she'd had.  I was told she should be feeding every 2 hours.  I also had to keep track of her wet and dirty nappies, which provided further evidence that my breasts were not up to the job for which they were intended.  Following these instructions and adopting this mindset resulted in my violating the cardinal rule of breastfeeding: Trying to schedule feedings and neglecting to tune into my daughter's cues.  I still well up whenever I look at pictures from my daughter's first days and see written on the back of my hand the times, like 12:45 - 12:56.  I tried so hard!

Inevitably, I was told that I would have to "top her up" after several feeds a day, so we were handed a box full of jars and teats.  She was losing weight, too much weight.  In fact, she was down to just 5 lbs. 4 oz. by the time we left the hospital, but I was desperate to get home.  I didn't know how I was going to sort out this problem, but I was much too stressed out and depressed in the hospital to think clearly.  She was swimming in newborn clothes that were much too big for her as we packed up and drove home on the fifth day after the caesarean. 

The Public Health Nurse was meant to come check in on us at home to see how things were going.  What a great system, I thought.  Someone to take care of us even after we've left the hospital.  Surely this nurse would be the one to help me get this breastfeeding thing up and running properly.  She rang us the day we arrived home, but I told her not to come over until the following day.  I was cross.  At least give us a day to settle in!  When she arrived, my daughter weighed 5 lbs. 10 oz, and we were instructed to give her a top-up after every feed.  Needless to say, my milk still was not coming in properly, and my daughter would gain a few ounces and then lose them again and again over the next week or so.  The nurse was coming to see us at least every second day.

It was on one of these occasions that my moment finally came.  I had been under the impression that we'd turned a corner, that my daughter was nursing better than ever and had finally put on a bit of weight.  I was devastated when the nurse weighed her and told me that, in fact, she had actually lost a couple of ounces again.  My self-esteem and trust in my body at an all-time low, the stress of worry about my baby's health and self-loathing at a record high, I was unable to hold back my tears.  I bawled my heart out right there in my living room, feeling so small and ashamed of myself in front of this professional woman.  I was utterly humiliated, but through that one moment of vulnerability I opened the door to a whole new life.  The nurse, in a misguided attempt to comfort me, remarked sympathetically in response to my tears, "Oh, I'm sorry.  I know you had your heart set on the breastfeeding."  I was sitting on my sofa weeping openly, but inside me something rose up.  Maybe it was the mammalian instinct of a mother defending her young.  Maybe it was the fury that only a scarred and scorned mother can know.  Whatever it was, it was powerful enough to cut that first thread, to pull that first fibre in the tapestry of my mind which, over the next few years, would all but completely unravel and that would ultimately challenge and change all of my attitudes and beliefs.  "This isn't over yet," I thought.  "How dare she speak to me as if this is over?"  This wasn't breastfeeding support of any kind.  She was no more interested in helping my baby and I learn the time-tested and ancient art of infant feeding than she was in watching paint dry.  She wanted baby on the bottle, gaining weight in accordance with her charts and timetables so that she didn't have to mind us anymore.  It wasn't anything to do with what was best for my baby and I.  She wasn't taking a personal interest in us.  It was all about what was most convenient for her.  This nurse was only ever trying to persuade me to bottle-feed.  Here is your local Public Health Nurse, brought to you by SMA.  The midwives at the hospital were also guilty.  My entire warped view of the medical professions as being the caring and concerned safeguards of our health was suddenly brought into sharp focus.  How naive I had been.  Health care professionals have their own agenda.  Only my husband and I prioritize our baby's (and our own) health and well-being above all else.

That afternoon, I rang a local La Leche League leader in desperation.  It's funny, when I was pregnant I would have said, "Why do you need a club or a support group to breastfeed?  Support groups are for alcoholics and people with problems.  Breastfeeding isn't a problem!"  No, but learning to breastfeed in a culture that does not honour, protect and pass down women's wisdom from one generation to another as in traditional cultures is a heroic, uphill battle.  This leader told me to take to the bed with my baby, both naked, and let her suck constantly as often as she liked.  She told me to cut way back on the "top-ups" and gradually get rid of them altogether.  She told me to stay in the bed with my daughter and recognise my own need to heal after the surgery.  It was the only good advice I'd received, and although round-the-clock feeding and screaming was extremely difficult for the first 3 or 4 days, my milk did come in.  I nursed my girl until she had passed her third birthday, before, during and after my pregnancy with my son.  I attended many La Leche League meetings and learned all about how human beings are "carry mammals" and why I couldn't bear to put my daughter down, make her sleep in a cot or hear her cry.  Most importantly, I learned that the health professions have pompously assumed responsibility for things such as breastfeeding when this is really not their brief at all.  Let them stick to the pharmaceuticals and the surgeries.  If you want to know about breastfeeding, go to the moms who do it.

Happy Breastfeeding Week 2013 to all the bf moms past, present and future!


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