When I was pregnant with my first child (my daughter), I literally had no idea what I was getting myself into. And please trust me when I say that I don’t use the word literally when I really mean figuratively. I had the confidence of ignorance. An image in my head of an ideal – an ideal birth, an ideal child, ideal parenting…perfection, based on a set of unfair and largely unachievable expectations. Hopes, dreams, plans. I often say that parenthood is 100% different than I thought it would be; both 100% better and 100% more challenging.
What happens when our hopes and plans are replaced with a reality that is less than ideal and less than perfect? And what happens when the other parents we know put up a front of perfection and shame those who parent differently or are unable to achieve the ideal?
Confusion. Guilt. Shame. Feelings of inadequacy. Feeling less than.
If you are lucky, you adapt, you ignore the mean people on the internet, you move on, you adjust your expectations to reflect reality and surround yourself with imperfect, snarky supporters (people, you know who you are). You still feel shame, fear and inadequacy, but you allow yourself to also feel tremendous joy, love and fulfillment.
Shortly after my second child (my son) was born, I was diagnosed with Insufficient Glandular Tissue (IGT). Basically, I didn’t have enough of the right kind of breast tissue necessary to produce enough milk for my babies. Depending on who you ask within the lactation field, this condition impacts less than 1% or as many as 5% of women. Probably more, as many women choose formula from the start or give up breastfeeding without a diagnosis. I have always wanted to be special (kidding). I find it ironic that the name of this condition matched how it made me feel – insufficient.
In a way that diagnosis was also freeing. I wish I had been diagnosed with it when my daughter was a newborn. I finally knew what was wrong with me. I could finally let go of some of the stress and shame.
After my daughter was born, I wasn’t able to produce enough breast milk. She had to go to the NICU for weight loss (20% of her birth weight), dehydration and jaundice. With formula supplements, she quickly started gaining and became a healthy, beautiful baby. However, my life became about feeding her. Each breastfeeding session took an hour – filling the supplemental nursing system (a bottle with a tube to feed her at my breast), getting her to latch, inserting the tiny tube and then switching sides. After each feeding, I pumped. And then a little while later, we started again. I took several herbal supplements and a prescription drug for which I paid about $200 a month from a compounding pharmacy. My midwife would only prescribe two months’ supply. My life became feeding baby K and building my supply. I ate all of the foods reputed to boost supply, drank my weight in water and tried to get enough sleep.
It seemed like my supply issues could not be overcome, and I was driving myself crazy trying. Then, I got plugged ducts and mastitis. I spent so many nights crying over what was, or was not, coming out of my breasts and got very little sleep. I hated every minute, especially pumping, and I never got more than a couple of ounces. I was miserable. Constantly seeking this unattainable goal – Exclusive Breast Feeding (abbreviated EBF on internet forums) and the ability to stop supplementing with formula. Eventually, when my prescription ran out, my supply diminished greatly to the point where I was barely producing anything.
It never occurred to me that I could combo feed (both breast and formula feed) long term. And I blamed myself. I felt like I had failed her. I was sure that my supply issues were the result of something I had or hadn’t done.
Why? Because the internet forums, websites and the local La Leche League all told me it was my fault. I didn’t drink enough water. I took a Benadryl to combat a severe allergic reaction. I didn’t nurse or pump enough (as if 12 times a day was not enough). I didn’t try hard enough.
I eventually gave up. I switched to formula and almost immediately had a better relationship with her and myself.
When I was pregnant with my son, I promised myself that I would try breastfeeding, but also that I would not be hard on myself if it didn’t work. Luckily, I was able to connect with one of the best breastfeeding resource centers in the country. The physician medical director and her lovely team of health care professionals provided me with my diagnosis, but also resources, ideas and support. With their help, I was able to redefine success.
After the first month, I was able to ditch the pump (at least until I went back to work) and find a rhythm to life and getting to know my son. I nursed and then supplemented. Snuggled and nourished. It was so freeing to get to know my newborn without the added stress of trying to achieve the impossible and empowering to set realistic, attainable goals and to achieve them. I went on to breastfeed (and formula feed) my son until he was 7 months old and went on the great nursing strike of 2013. When I stopped nursing, I felt little disappointment and shame. I was badass. I had achieved success.
I wish breastfeeding was the only area of parenthood about which I felt or feel insufficient, inadequate and powerless. There are so many others. And I imagine every parent has their own areas where they feel as though despite their best intentions and planning, things aren’t turning out the way they expected or hoped.
Now that I am a single mom (something that was never a part of the plan), I am finding sufficiency in a less than ideal situation. And even though it is not what I expected or wanted. Even though being a single parent was not something I conceived during those blissfully ignorant moments of pregnancy with my first child, most days it is pretty awesome. I am comfortable with my imperfection. My insufficiency in breastfeeding gave me something completely unexpected and something completely amazing – resiliency.
Images: Steph, all rights reserved.
That breastfeeding thing, it sounds familiar.
My kids and I were just not compatible. I have tits the size of a New England state and they were small.
The older one could latch, but she didn’t have the strength to get the milk flowing. The little one’s mouth was too small.
But I was fortunate: after a week of crying and complete exhaustion my midwife got me both a pump and formula. Afterwards my kid and I grew into a happy team. Although feeding still took at least 30 minutes because that kid simply loves my breast.
Things were not easier with the little one. As I said, she couldn’t latch on. The difference was that by now I had changed my mind. I had formula in the house. As long as the kid was properly fed, everything was fine, I didn’t care.
It was good enough. And even though I now had a baby and a toddler and a pump and bottles, life was much easier. The littel one was a much less fussy baby
Yay for Obamacare! Because of the ACA, we were able to get an electric pump for free (an incredibly helpful price point on my meager salary), which has really helped. My wife had mastitis, thrush, and was just miserable with all the hand pumping and breastfeeding on severely cracked nipples. The electric pump has us back to a point where she can breastfeed half the time, and use the bottle when she’s out, or wants some mommy time while I’m home.
My wife has also struggled with feelings of failure at times, but is now feeling empowered. A little help and hope goes a long way.
I just finished reading a new book call Finding Sufficiency: Breastfeeding with IGT by Diana Cassar-Uhl. I very much recommend it. It was very enlightening. I work as a volunteer with breastfeeding mothers, and I’m always amazed at what we don’t know. I’ve been baffled when a mother who is doing everything “right” doesn’t produce milk. And had the unhappy job of telling a mom we suspect IGT when she desperately wants to nurse. I have also seen how many of the mothers I help go on to find their own path and often do nurse their babies for months or years (with supplementation) and go on to have lovely breastfeeding relationships.
Lactation specialists have noted for some time that certain types of breast are at a higher risk of not producing a full supply of milk. But we are really lacking in good diagnostic tools to alert those mothers of the *possible* problems. How amazing would it be if EVERY woman was screened by her OB or midwife while pregnant??? That would save so many mothers and babies stress. And we also lack the system to track those mothers and babies in those first days and weeks to make sure everything is going well.
My mother has IGT and was never able to produce any milk at all (she has many of the often concurrent hormonal, infertility and endocrine issues as well.) I have many of the physical characteristics (but none of the often concurrent issues) and have exclusively nursed three babies to toddlerhood. Situations like that make definitive diagnosis problematic, but we can definitely do something to screen for those at risk.
Erin – I am on a huge FB forum for IGT moms and have “met” Diana online there. Her book is awesome. I recommend that all IBCLCs have a copy and learn how to support low supply moms. The thing about low supply is that so many factors are in play. I have found that many LCs go directly to – “nurse more” and forget that the primary objective is to feed the baby. For me, once my son was eating and growing, I was far better able to work on supply. I think there is so much value placed on EBF, that women are given terrible advice in cases where there is significant weight loss or other medical indicators that supply is not demand related. We need a better system. And we need providers and volunteers to focus on the woman and child in their care, not their own experience or an ideal. We need to provide support. Period. Obviously, if a mama is seeing an LC or attending LLL, she wants to breast feed or feed her baby breast milk. Let’s make sure babies get fed.
I didn’t have a diagnosable issue with breastfeeding, but especially with my first, I found it to be incredibly stressful. He was gaining and healthy, but would cry and fuss for hours and feeling like I was the only source of relief for him and the feelings of being an overwhelmed new mother were more than I could bear. Getting “permission” from a LC to supplement made all the difference. So much of the messaging around breastfeeding is focued on exclusivity and I thought I was failing if I let anything other than breastmilk pass his lips for the first few months. Handing him to my husband to give him one bottle an evening was the best thing we ever did for all of us.
Diana is a wonderful resource in the lactation community! I really hope her book inspires much more research. I hate having to tell moms that we just don’t know to a lot of their questions.
yes, so important to keep the baby fed and healthy and mom feeling listened to and respected.
I find my biggest struggle as a breastfeeding helper is those first few weeks when we suspect but we aren’t sure how things will go. We have to walk a very careful line of making sure baby is doing well, mom is doing well, and giving breastfeeding the best chance possible. I’ve been surprised many times. With moms who I thought would have major problems from the physical signs who then go on to have full or nearly full supplies. And moms who I thought probably have full or nearly full supplies based on physical signs and medical history go on to make very little milk. I never want a baby to become distressed or a mother to feel unheard or not enjoy her baby. I also don’t want to sell any mother short or discourage about what her body is going to do. (I had a hospital LC do that with my first, and it was heartbreaking. She was so dismissive and mean when she looked at my breasts and said “Oh, you’re going to have to supplement IF you can nurse at all.”)
So I try to balance being encouraging, realistic, and most of all following closely and really, really LISTENING to mom about her goals. Some moms are ALL about the milk. Others put top priority on the relationship and just want baby at the breast as much as possible. Others are kind of middle of the road and want to have the mothering at the breast and to reasonably maximize milk production in a balance. I try to continually ask and reevaluate how mom is feeling and what she wants to do while watching baby’s health. They are some of my most challenging clients, but also the most rewarding.
It is a balancing act. I think the best thing is to listen, watch and prioritize the woman in your care. It sounds like you are awesome.
One thing I will never ever do: Ask a woman who isn’t breast-feeding “Why?” That’s none of my business and seriously, the research doesn’t hold up the “huge benefits”. If she wants to breastfeed, I’m fully supportive and want her to have all the things and time she needs. If she doesn’t want to, I’m still fully supportive.
Giliell, I think that gets to the heart of the matter for me–it’s no one’s business why a mom does or doesn’t breastfeed. It continues to amaze me how many people think they have a say or that their opinion matters on what women do or don’t do to feed their babies.
I produced very sufficient breastmilk, and managed to “EBP” both my kids for 4-6 months, pumping at work after I returned my eight week maternity leave until each kid was 12 months old, and then continuing to breastfeed on evenings and weekends until they were 15-18 months old. Sounds great, right? No problems?
BIG problems. My younger daughter refused to drink from a bottle. EVER. We tried every kind. Wouldn’t drink formula OR breastmilk. So despite my pumping she basically starved during the day until she was old enough to start eating some solids and drinking from a sippy cup. Ask me how fun that was, for me or for my sister who was taking care of her. Also — I have to travel for work sometimes. Ask me how fun it was to ditch conference sessions so I could pump in a hotel room and then try to get the pumped milk back home without spoiling and without freaking out airport security. Ask me how fun it was to try to pump enough extra in advance to last the whole trip. When my freezer stopped working an we had to throw out my carefully hoarded stash, I just about cried. I didn’t have any spare for leaving with a babysitter in the evening, so we never got to go out. And being the only one who could get my kids back to sleep in the middle of the night? I didn’t love that either.
I am glad I breastfed for as long as I did, I would do it again (I did do it again after the first time.) But the sacrifices of time and freedom, the pain, the anxiety… To tell women they must do this or be bad mothers is in many cases the same as telling them that they can’t have a job and be good mothers (many jobs don’t let you pump like mine did), can’t ever go out in the evening and be good mothers, can’t let their husband take a turn getting up and night and be good mothers… And in cases like yours, it basically means telling them that they can’t be good mothers no matter what they do.
Breastfeeding has its rewards too, of course, and it’s great for those who can and want to do it, but to judge anyone for not doing it or for not doing it sufficiently? It’s SOO unfeminist, it’s really just evil.
Your story and your comments are so important. Everything is a trade off. I hate the phrase – breastfeeding is free. For me, it literally wasn’t, but for others they are trading their health, time, sanity, enjoyment of parenthood…
Thank you, thank you, thank you so much for this post. It’s like everything I struggled with in the first month of my daughter’s life was given the voice it deserved — finally. That is all. Carry on with your bad selves.
Insufficient, inadequate, a failure… I felt all of that, which is why, as my youngest child is now 6, I still to this day google queues like “how many women can’t breastfeed”. I guess what blew me away with my experience was how it was handled. First of all, my inability to lactate is certainly IGT, I’ve never had large breasts, even during pregnancy. But my first born was 10lbs, and immediately gave me blood blisters on both my nipples, causing breast feeding to become so excruciating that I easily gave up and blamed the issue on his size. I felt happy to not have to experience that extreme pain anymore, but shamed by my friends who would tell me that I’d have lost more weight if I had breastfed. So with my second, after having felt the shame, I wanted so badly to breastfeed, I didn’t even buy a single bottle before she was born. But after several days of being home with her, I could tell there was a problem. She would latch and suck and then stop and cry, cry, cry. Then, she became lethargic. I took her for her one week check up and she was a whole pound lighter than at birth. So they referred me to the lactation specialist who just avoided telling me the truth. She asked “did your breasts get larger during your pregnancy?” When my answer was “no”, I could see on her face that I was the problem, or rather my breasts. But she didn’t tell me this. She just prescribed herbal remedies and a routine of pumping. After a week or two of following this horrible schedule and never producing more than an ounce out of either breast, again, I quit, and have never felt the same about myself. I had to find the truth about my condition on the internet. I’m abnormal. Only 1-5% of women are failures like myself and no doctor or laction nurse ever had the guts or decency to tell me to my face. Why?! Still, 6 years later I am still asking, Why wouldn’t she just tell me?? I saw it in your face, lady. If you’d just been honest with me, you’d have saved me the pain of being a quitter and a failure all over again. And still I am asking, is this IGT problem really that rare? And, why me? So, I’ve taken it upon myself to try to get the word out; I tell other women about my insufficiencies so that maybe, if they spread the word with me, I can help someone else who’s doctor or lactation nurse doesn’t have the guts to say it to their face: some women literally can’t breastfeed. And that’s ok. Because God made man who made formula and your offspring will survive. And forgive me, but, I HATE all the hype about “breastfeeding in public”… I hate that women feel the need to show it off in social media posts. It. Hurts. My. Feelings. Because you made me feel like I was less when I desperately wanted to do that, but couldn’t. I’d love to see some famous woman get behind that.