Breast of Burden

The pump. The poop. The panic. A dispatch from the nursing wars.

About a year ago, when I was eight months pregnant, my husband and I attended a prenatal breastfeeding class at the hospital where I was to deliver our first child. The class was led by a chubby, exuberant earth-mother type with a thicket of frizzy hair. Brandishing a flannel breast--complete with perky cloth nipple--and matching cloth baby, she demonstrated how to grapple the doll into a "football hold," and what a proper "latch" between newborn mouth and maternal bosom was supposed to look like.

Like all expectant parents, we had long since absorbed the mantra "breast is best." We'd heard about the lifelong health benefits that come from nursing, about research suggesting that breastfed babies are less likely to be obese and more likely to be intelligent. We'd learned that nursing might be our best bet for helping our child avoid the potentially lethal food allergies that plague one of his parents.

Besides, everyone kept pointing out, the process was natural. Baby arrives amid joyful tears, you press the tiny scrap of humanity to your breast and voilà--the two of you bond while, out of sight, a crack medical team whisks away the placenta and any other icky bits that might clutter this magic moment.

Breast milk is free, the experts would add, and it can help mom regain her pre-pregnancy shape. Then, as if we needed further convincing, they'd deliver the clincher: Unlike poop produced on formula, the stools of breastfed babies were "sweet-smelling." With such a miracle waiting, right there in the extra-large, off-pink nursing bra I had already begun wearing, it was hard to imagine anybody would turn to the bottle.

So why, my barge-sized middle wedged into a seat in the packed auditorium at Abbott Northwestern Hospital, did I feel like I was on the receiving end of a pep talk? And why did I suspect there was some dark underbelly to this process that we weren't hearing about? Why, when I asked other mothers about breastfeeding--mothers who had happily confided the messiest, most personal details of their pregnancies and deliveries--did so many of them turn evasive?

Reality set in with a vengeance the night we brought Baby home from the hospital. He had been born with jaundice, a mundane problem suffered by about half of all newborns. Because of their immature livers, babies with jaundice need help getting rid of bilirubin, a chemical produced during the normal breakdown of old red blood cells. The condition is treated by exposing the infants to blue, fluorescentlike "bililights."

The hospital had equipped us with a big metal suitcase that had a mattress in its bottom half and the special lights in its top. We laid Baby, naked, in this giant aluminum clam and took turns standing vigil all night long so he didn't knock off the fuzzy goggles that protected his eyes. He cried for much of the night, much as he had in the hospital.

Every hour and a half, I would take him from the light box and try to nurse him. He'd bleat piteously, and every other feeding it seemed as if a few drops of colostrum, the antibody-rich fluid that precedes milk in a woman's breast, might have actually ended up in his tiny tummy. But mostly my little family just cried together.

By the time dawn crept into our living room, my husband and I had begun entertaining thoughts of nipping out to the store, buying a can of infant formula, and giving everyone a break. In our sleep-deprived states, we saw the situation like this: For three straight days I'd watched helplessly while the baby howled for food and comfort, certain that I'd made a mistake when I thought I was mother material. My husband was supportive, but a good attitude couldn't render him capable of lactating. And he didn't like seeing either Baby or me this miserable.

I'd gotten plenty of advice in the hospital, some of it both practical and supportive. But too much of it was dispensed by nurses who groused that they had too many "high-need" mothers to care for. The lactation consultant (a nurse with extra training in breastfeeding support) who visited me for half an hour praised me for standing up to the night-shift nurses' demand that I let them give Baby sugar water through a baby bottle. She did what she could to fine-tune our "latch," and then left.

We were scared of the bottle, you see, because we'd been told time and again that the first roadblock to successful breastfeeding was the dread "nipple confusion." While babies have to learn to suck to get Mama's milk, the artificial teat lets liquid trickle down their tender throats without much effort. And because breastfeeding is strictly a matter of supply and demand, this can set up a vicious cycle: A mother placates a hungry infant with a bottle. Baby in turn fails to stimulate milk production. The dry breast gives Baby no incentive to learn how to suck. In a word: Introduce the lazy rubber nipple, and Junior may reject the breast for all time.

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