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Sunday, December 4

On Skim Milk Breastmilk and Fat Warm Formula Bottles

I think Larkin is going to terminate our nursing relationship. Sooner than later. 

I think it's breaking my heart. 

But it has been a long road.... far longer than the three months of her life. This has been a 9-year-long road, and I know her move to liberate herself from my weak, thin-flowing lifesource is not entirely her issue. I know I probably can't give her enough of what she needs. 

Nine years ago, while still in the hospital recovering from an unexpected c-section, I remember clearly hearing the term "brick dust" for the first time, ushering me suddenly into the hard, rocky world of breastfeeding insecurity. "Brick dust", if you've never heard the term, is explained as follows, on askdrsears.com: 

"If your baby is not getting sufficient amounts of milk, you may notice a “brick dust” residue on the diaper, due to urate crystals from overconcentrated urine (a normal finding in the first few days), which should disappear after increasing baby's milk intake."

When Noah had a brick dust diaper within his first 48 hours, I was urged to supplement him with formula despite my deep desire to exclusively breastfeed, and being new to all of it, gave in, worried about my new baby's loss of weight and his overconcentrated urine. He improved with the intake of formula and we eventually settled into a decent nursing relationship once we got home from the hospital. I was still teaching at the time I had Noah, but I was lucky to get 12 weeks home with him before having to return to school. During that time, I don't remember having feeding worries, and he thrived. Once I returned to school, though, I began the necessary regimen of pumping at work in order to maintain my supply for my baby back at home. I'd not been very diligent at pumping prior to this return to work... Who wanted to be stuck to a machine when their baby was right there next to them? But once back at work, I stuck to a careful schedule of pumping whenever I'd have been feeding my baby, and I had high hopes that I'd be able to produce enough to keep him fed with my milk even while I was away. 

It became clear, after a few weeks, though, that my pumping output was just not going to cut it. I seemed to pump less and less as the weeks went by, while Noah was growing bigger and bigger and needing more and more. So it was that, several months after his first formula, we once again began to supplement our baby. It was bittersweet, but it was necessary, and we settled into the new normal fairly quickly, able to let go the "ideal". 

With this system in place, the pumping, the supplementing, and the ongoing nursing, Noah and I managed to keep our nursing relationship strong and consistent though his entire first year-- my personal goal. And as he moved toward 13 months old, he slowly and naturally weaned himself and we were done before he hit 14 months old. We were both ready and it was a peaceful transition. 

And then there was Lucy. Lucy was an unhappy baby. Tiny and angry and exhausting. She was a little small for the doctor's liking, and he mentioned supplementation and/or a regimen of pumping on my part, but he was never hyper-worried about it, and for the most part, she latched fine and nursed well. I noticed pretty early on that she favored my right breast, and that was not a surprise: five months before Lucy was born, I'd had a freak infection in my left breast that had required surgery and several drainage sessions, and the breast doctor has warned me that while the damage wouldn't be permanent, some milk ducts had been compromised and would still be healing when baby arrived. Betty the Boob just didn't make as much milk as the right side gal. Because of this, sometimes, just because we still had samples from the hospital, we'd supplement her with formula, but it was not a dedicated regimen... just an option we went with here and there. But I was a stay-at-home-mom by the time Lucy came along, so I was home with her 100% of the time, and I did NOT want to dust off the pump and add that nonsense to my already strained, stressful days. So as the weeks wore on, Lucy and I managed. I tried fenugreek and Mother's Milk tea sporadically, ate oatmeal... wished and prayed over my supply... But mostly we just trucked along, trying our best.

And then she was four months old, and we found ourselves in Utah for my baby sister's wedding. I was the photographer, so I had a few of my sisters lined up to help out with my tiny angry baby for the times I was needed to shoot photos. I'd planned to take nursing breaks that day, but every time I looked at my crying baby and thought about shimmying out of my fancy dress and making the time for Lucy's notoriously long nursing sessions, I just.... couldn't. I was worn too thin. Time after time that day, I told whatever sister had her at that moment, "Just give her a bottle."  At the end of that long day, when it was finally just my baby and I, and I brought her to my too-full breasts to finally nurse, I looked down at her lovely, calm face and thought, "Man. That was SO MUCH EASIER. And you are doing just fine." Within the next month, after that epiphany/breaking point, I made the conscious decision to take our nursing relationship from full-time to once a day, first thing in the morning when milk supply is always the most abundant. The rest of the day I would give her formula. And my colicky baby bloomed into a happy, content little one. 


She ended up weaning from our morning nursing by the end of her 8th month, and by then I was okay. I was ready to let go. Those extra three months of snuggle-nursing her in the mornings was enough to help me transition to no nursing. Because the honest truth was-- mostly-weaning her when she was 5 months old saved my mental health. And it saved hers. We were both immediately happier. And in hindsight, it may have never been colic. She may have just been HUNGRY. Always always hungry. Until I gave in and let us both take the "other path". 

So then Quinn. By the time Quinn came along, I was a veteran. When my baby dropped farther down from his birth weight than they liked, I wasn't surprised. I let them offer him a formula bottle or two. When after weeks of newborn nursing, he seemed to need some supplementing, I did the supplementing. He wasn't angry and hungry like Lucy-- and for the most part, I was pretty confident that Betty the Boob had healed and I felt like I was able to feed him enough, usually. But to be honest, by this third baby, my confidence was not in my ability to make milk. My confidence was in my ability to read my baby and understand that I probably would NEVER make enough milk, but would know how to care for my baby in spite of that. With Noah, a lactation consultant helped me realized I'd need a nipple shield for my inverted nipples in order to have a good start to the latching relationship. With Lucy, while still in the hospital, I decided to see if she and I could do it without the shield. Within two days, I was asking for it again. By the time Quinn came along, I didn't even blink: I told the nurse first thing that I would need one. Forget trying to pretend I might be better at this whole nursing thing the third time: I knew I would 1. need a shield 2. probably not make enough milk 3. feel insecure, so bring it on. Let's get started. Quinn and I, with supplementing, still managed to go a respectable distance in our nursing relationship, but eventually he weaned himself at about 10 months old. And while it wasn't the full year I had once again set a goal for, it was close enough. In spite of my insecurities and my inherent failings in breastfeeding, we made it close enough. 


And here we are. Fourth go-round. Miss Larkin Clementine.  From the get-go, she was awesome: she latched without a nipple shield and hung on. My supply flooded in earlier than it ever had before. I had ACTUAL LEAKING sometimes, something that almost never happened with my other babies (just one more reason to always be insecure about my supply). I thought we were gonna ROCK this nursing thing, finally. And then her first doctor's appointment at 5 days old: her pediatrician (a new doctor) came in with a concerned look on her face and began the age-old yadda yadda about dropping more than 10% below her birth weight and how about we try some supplementing-- feel free to pump to get those extra ounces, or we can give you formula, etc. etc....  And I kept my smile pasted on while she left to get a little 2-ounce bottle of Similac for me to give Larkin; it stayed on while she came back to tell me, "We just need to get her weight up in the next few days-- after that we can skip the formula if she's doing well. I know this isn't ideal, but let's get her strong enough to begin getting better at nursing." and she left the room again and I crumpled and cried as I fed my baby formula. Thinking, "Here we go again. Who did I think I was kidding? I was never good enough at making enough milk to feed my babies." 

Since day 5, it's been such a strange ride. It's a cycle of:
Go see doctor. Doctor gets concerned and says scary things. Mom gets more and more dejected and sad at her inability to help her baby get bigger. Mom and baby go home and mom is sad and worried for a few days. Then mom continues to spend all day and night with her baby and her baby is FINE and thriving and meeting milestones. Slowly mom's natural insight and instinct about her baby come back to zero and above, and her confidence returns. Baby is FINE and happy and doing SO WELL. Surely that means we're on track. 
Then its time for the next weight check doctor appointment, and the cycle begins again. 

Larkin is small. She is steadily gaining pounds and height, just not at the rate that she should be according to the WHO/CDC etc. charts. So her doctor worries and wants to see her growth accelerate a bit more. So we are constantly supplementing her with bottles of formula. More and more as the weeks go by. I'll admit it was with reluctance on my part in the early weeks. Surely with the leaking and the latching and the veteran mama part of it all, this was just a hiccup and Larkin would get the hang of this and we'd get on track. But if I ever slowed down my supplementing, thinking we'd be okay, inevitably the next dr. appointment would show that her growth had slowed, and I should have been continuing with the extra formula more regularly.  Eventually one day, when she was maybe 9 weeks old, there was a day when she was fussing at the breast-- something she's done off and on since week one-- and I stopped trying so hard to get her to settle down to nurse, and instead just made her a fat warm four-ounce bottle of formula and she took it ALL. And then, for the first time in days, after she burped, she just sat in my arms wide-eyed and peaceful and content. For almost 45 minutes. We'd just made it though her fussiest weeks, those classic weeks 6-8, so anytime she was content for longer than 10 minutes it felt like a miracle. So to have the full 45-minute stretch was an uber-miracle. I stopped resisting the formula supplements after that day. I thought a lot about Lucy, and my years-long struggle with breastfeeding supply and confidence, and I just thought, "You know what? If she's HUNGRY, and this has just FED her, it's okay. It's okay. I can still nurse her... but I can also give her fat warm full bottles of formula and we'll both be fine. She'll be full and I will know she has gotten enough and we will be fine."
 So that's what we've been doing. Larkin is almost 14 weeks old, and is due for her next weight check appointment in the next couple of days. But I know from my borrowed baby scale and free growth chart app that she's up, percentage-wise. I think her doctor will be pleased. I think we're doing great. (Of course, this is all that classic cycle, right? Mom is confident. Time to visit doctor and get worried and dejected again.)

Except.... 

She's been doing that fussy-at-the-breast thing at least once or twice a day in the last week. And it's killing me. I've just come to peace about the formula/nursing compromise. But that doesn't mean I'm ready to fully be done nursing.. so when she fights it, it hurts my heart. And I have to wonder if the more she gets those warm, full bottles of easy-flowing formula, the less patient she is with my sad skim-milk slow-flow old boobs. Is she feeling impatient? I'm not prideful enough to stop the bottles in order to get her to want me more again... I know she is thriving under the supplementation. But I had hoped with all my heart that she and I could still maintain some nursing in the meantime. That maybe, like Lucy, if we eventually even had to go down to once a day, we could make it past 6 months. Maybe even that full year I always wish for. 

But here we are, not even 4 months, and I fear she's getting less and less willing to work for this. And I am so sad. What a sad, wimpy way to go. Out with a whimper, not a bang. 

Maybe I'm jumping to that conclusion too quickly. Maybe it's a phase-- an off-week, and she'll be back at it soon, and we'll have another few good weeks again. Maybe? 

But tonight, as I pass her to her daddy for a bottle after trying in vain to get her to settle into a nursing session for the second time in just a few hours, I'm not so sure. I think she's trying to break up with me. 

This has been a long, hard, draining road. Nine years. I'm so tired of feeling not enough. So sad that I was never that great at this. 

So... I'll keep you posted. But if you see me in the meantime, I could probably use a hug.

(Thanks for reading all of that. ♥ )

6 comments:

  1. Hugs sent from California. It's hard not feeling like you are enough for your babies. Know that in a few years time you will be past this and your babies will never even feel the not enoughness you feel. They will love you for so much more than your breastfeeding relationship you had.

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  2. As you know, supply wasn't my issue. But with Allie, her "not wanting me" was. I can remember the days of struggles and tears--mostly mine but some hers. I remember nursing for the the last time before deciding to exclusively pump. My heart broke over it. And no amount of logic fixed it. (I'm crying while typing this thinking about it all again.) My heart hurts for you even as my head knows yours head gets it. Love you!

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  3. Hey sis...

    I know from my work that it is a deeply visceral need to feed the fruit of your womb. That no amount of thinking and reason can really resolve it when it's hard.

    But I do share with my families something that mom has probably already reminded you of, and that is that of the 7 of us, some were breast, some bottle and that

    1) it wasn't mom's decision - we each decided which we'd be and

    2) we are all fine, as are our relationships with mom (and when there are rocky spots, it's not because we didn't nurse...)

    I saw your struggles when I was there last month, and it made my heart ache for you both. I'm sure your "guilt gland" (another useful tidbit I frequently share) has been feeding those feelings of inadequacy.

    But I also know that, nursing or not, Larkin will be cocooned with your love and nurturing, that you've gotten her through the most critical time w/ the immunities and such, and that, in the long run "All shall be well, and all shall be well and all manner of thing shall be well"

    Love you, sis - looking forward to the next time I can give you a hug!

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  4. Hugs. Lots and lots of hugs and silent agreement. Moms never feel like they are enough. You never feel like you're doing all you can. It's so hard. And the difference between each child is night and day.

    Max hated nursing. My oversupply and crazy forceful letdown choked him every time. The turning point was 1 month in at Thanksgiving. My own mother told me I needed to give up and switch to formula. We were at our home and I went to the pantry and found one of the free cans I got in the mail and slammed it on the table. I ran upstairs and cried and cried. It was awful. But Max wouldn't take it. I remember crying while making every bottle. So, I sucked it up and I exclusively pumped because I refused to give up. I resented every pumping session. I resented pumping while someone else fed him. I resented it all. I began to resent him. I think nursing and the other challenges of mothering without a tribe around me began my long slide into postpartum depression that I'm just now beginning to see the other side of 4 LONG years later. Anna was a natural. She loved nursing. She could care less about my issues. We made it 13 months. It was beautiful. I am so grateful she's mine because she started my healing process. But I still had all that doubt and all that resentment. I was waiting for the other shoe to drop and everything to change so I often didn't enjoy it as much as I should have.

    Being a mother is hard. The description of a "guilt gland" is so great - as it seems that often gets turned on too much especially in the early weeks with all the hormones. So I will not offer advice - in fact I refuse to do that - I only offer solidarity. You've got this. The feelings of inadequacy will always be there - we just have to stuff them somewhere and tell them to "shush" as we are enough. When those kids look into your eyes with all that love, you know you are enough.

    And here's my little secret for you today. I'm in awe and jealous of you. Your home. Your life. Your big support group. Even on your rough days, you manage to plow on and your next few are happy, beautiful, peaceful, calm. You are amazing, Emily. You are here to do good things. You are raising amazing people. You are and will always be enough just as you are. And whether you know it or not, you inspire me to be a better mom. Hugs.

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  5. None of us is immune to the guilt gland or the wishful thinking that it could all be the way we imagined it in our mind's eye (or maybe our heart's eye?). Even with 60 months of exclusive nursing under my belt, part of me still wonders if I did my babies and myself a disservice by not supplementing! What if the terrible colic, sleeplessness and sensitivity that plagued
    3 of my 4 babes was MY fault, on account of my milk somehow, and if I'd just given up nursing, we could have enjoyed their babyhood so much more. See? You'll never outfox the guilt gland m'dear. It's designed to make sure we all need a hug sooner or later! XOXO

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  6. You know how I feel your pain. I'm sad you have to go through this. Hold on 'till you get through.......its this day, not you, that's bound to go away

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