mixed messages regarding breastfeeding

1 Feb

I recently had dinner with a wonderful new friend, also a medical student, also a mother of a small child.  After I asked whether or not she or her husband would mind if I whipped out a boob to feed my kid, we briefly got on the topic of breastfeeding.

She had stopped breastfeeding when her child was four weeks old.  She hated breastfeeding.  Her postpartum recovery had been brutal–weeks after delivery, she needed to be picked up after a brief walk to the drugstore, as the strain from the walk had ripped her vaginal lacerations clear open–and she strongly disliked the pain and complications that breastfeeding added.  She absolutely detested the constant feeling of fullness in her breasts.  I don’t remember exactly, but at one point she said something like, “I know, I know, I’m horrible!”

I was so saddened that she was made to feel this way, like it was her obligation as a good mother to breastfeed her child in order to ensure those extra 10 I.Q. points and the other supposed benefits derived from breastfeeding your young (fewer ear infections, allergies, and stomach illnesses, lower rates of obesity, diabetes, and heart disease).  A few years ago, Hanna Rosin offered this refreshing perspective, which called into question all the benefits as being merely associative, and inconsistent at that.

Recently, I noticed at the end of a yoga babies class (more on this later) that practically every mom was breastfeeding.  Can we say “confounding variable”?  These (or perhaps I should say we) are the women breastfeeding, those of us who have the privilege to not have to be back at work two weeks postpartum, who have the opportunity to socially interact with our infants and read stories and sing songs to them, who can attend a yoga babies class in an affluent suburb.

I kind of hit the jackpot with our 8 lb 3 oz babe born at 39 weeks 6 days who, upon placement on my belly, raked her way to the boob and latched immediately.  Compared to many of new moms I know (some of whom have dealt with MONTHS of their kids not latching properly, mastitis, breast abscess, significant nipple lacerations, and poor milk production), I’ve had it way easy.  But the first four weeks were still tough.  There were a few nights when we couldn’t get it together, and I was literally crying over my screaming, hungry child.  And then there were the couple weeks when her spit-up was purple from the nipple blood she was swallowing.

Right now, I breastfeed for three reasons:

  1. For now, it’s convenient.  I can prop her up on the breastfeeding pillow, wedge her between the table and me, and have both hands available to email or read for a good 15 minutes.  When I’m back in the hospital and needing to break away to pump every few hours, I doubt this point will make the list.
  2. There’s the hope of a thinner self.  I still have 7 lb until I’m at my pre-pregnancy weight; 12 lb to get to my pre-med school weight.  Breastfeeding supposedly helps burn off the calories (she sucks the fat right off), which is especially helpful considering I’m lucky to get 1-2 abbreviated “work-outs” in a week.
  3. I honestly enjoy it, and it seems like she does as well.  It’s hard to explain, because we could certainly have similar bonding through other activities.

I initially had the cost benefit of breastfeeding on the list, because formula is expensive.  However, considering how much more we’re spending on groceries so we have enough healthy produce to satisfy my constant hunger while not negating my weight loss efforts, I doubt very much we’re saving much in that department.

I’m already curious what my preferences will be if we’re lucky enough to have more kids later in my career…

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24 Responses to “mixed messages regarding breastfeeding”

  1. ericrosoff February 1, 2013 at 11:43 am #

    You must watch this week’s episode of the new normal. Brings new meaning to “milkshake.”

  2. Donna February 1, 2013 at 2:08 pm #

    Thank you for another GREAT post, Anna! At least 95% of my tears and emotional turmoil during the first month postpartum had to do with my guilt and frustration due to my constant struggle with and desperate attempts at breastfeeding. Seriously, I even hired a lactation consultant and everything! I felt like I had failed as a mother… Your perspective and the article you shared in your post make me feel like a little bit less of a failure, so, thank you again!

    • annaojesus February 1, 2013 at 2:18 pm #

      Oh my goodness, Donna, I am SO sorry you ever felt that way! You are so far from a failure in any respect. I know it’s been a while and our conversations are through Facebook/blog at present, but I look to you as a model of mom/physician. I know a lot of friends who hired lactation consultants; I hope yours was helpful. We were lucky that there was a wonderful lactation consultant at the hospital who gave me a few great tips and some kind encouragement. Also, I think so much depends on the kid. Ari was hungry and ready to eat immediately–that’s all her, and I can’t take any credit for it. Even when times were tough, she was pretty insistent upon continuing to try eating.

      I’m glad you liked the article. I thought it had a nice voice to it 🙂 Thank you for your comment!

      • Donna February 1, 2013 at 11:07 pm #

        What a sweet thing to say! Thank you! I agree that it depends heavily on the baby – hopefully the next one (God willing…) will be more game and willing to latch on for more than 2 seconds…

      • annaojesus February 2, 2013 at 9:01 am #

        I hope so too! I can’t wait for your number 2 🙂 xoxo

  3. Rosie February 1, 2013 at 6:39 pm #

    The longer I nursed my babies, the more weight I lost (including while pregnant, which is one reason we weaned both during pregnancies!), but I’ve heard it doesn’t work that way for everyone. The convenience factor is definitely key for us, and I kind of like my pumping breaks at work – it’s an excused to sit down and have some “me” time, but I imagine being at a hospital would make it more difficult to take scheduled breaks than being a teacher!

    I’ve been blessed to have an easy time breastfeeding all my babies (even the twins, so far) so especially in the beginning it was hard not to get judge-y, even internally, of moms who formula feed. Particularly after seeing how hard the moms in my twins group TRY to nurse their babies and even pump if their babies won’t latch, now I feel like I really understand why some moms choose to use formula. There comes a point where one is a better mom after making certain parenting decisions – whether it’s using formula, letting your baby cry it out, going back to work, etc. And what works for one mom doesn’t always work for the next! I try to remind myself of that every time I feel that little nagging judge-y part of my personality coming out…

    • annaojesus February 1, 2013 at 7:10 pm #

      I’m so glad that nursing was and continues to be a good experience for you! It definitely has been so for me. I hope that, now that I’m no longer eating thousands upon thousands of calories of almonds in the middle of night during Ari’s feedings (they were there and easy, I was starving and tired), I’ll lose the pregnancy weight 🙂

      Regarding convenience, I think it’s easier in some fields of medicine and in some practices. Even in the most breastfeeding/pumping-friendly place, if you’re an ER doc or a trauma surgeon, it’s tough to be able to take those breaks…it’s not that people don’t want to give them to you. If you’re on an outpatient service, timing and efficiency is important, but it’s a little easier to schedule breaks, which, as you said, might be very much welcome.

      I think it’s super easy to be judge-y for, as one woman wrote on my facebook wall, physicians always say “breast is best,” and who wouldn’t want what’s best for her baby? But at this point, we’ve known so many women who have had so much trouble…I can’t imagine round after round of mastitis because your kid just won’t last is what’s best for anyone.

      Goodness, Rosie, more power to you for being able to breastfeed TWO babies at one time, for being able to care for four kids under four! You really are supermom, by every possible definition.

      Thank you for the note!

  4. phantomdiver February 1, 2013 at 8:58 pm #

    Interesting ideas. I guess I’m still in the pro-breastfeeding camp, though I try really hard not to judge women who don’t breastfeed. But when I worked temporarily at Target (don’t ask) and saw women who were buying formula, well, it was really hard to be neutral. I heard women say that they’d always planned to bottle-feed, because breastfeeding just sounded like a lot of trouble and their friends hadn’t and yadda yadda yadda. It really is hard to separate the two groups while controlling for socioeconomic differences.

    After the initial pain and all that, I loved breastfeeding. Loved it. Still kind of wish I could nurse babies, especially when my own new granddaughters root at my chest. I wasn’t able to nurse as long as I wanted; I had problems maintaining enough milk. Still, I managed at least four or five months with each kid, even though I worked full-time outside the home with a roundtrip commute of about two or two and a half hours. And this was before breast pumps that really worked; the only one I saw resembled a squeaky bike horn. I figured that my husband had learned how to milk a goat, and goats have small teats, so I could milk myself—and I did. Three times per working day. In a bathroom stall, because there was nowhere else to do it. And I took the milk home in a cooler with blue ice. So it isn’t like mothers who work outside the home full-time can’t nurse. Not even a little bit.

    Plus my husband always changed diapers at night. He’d get the baby and I’d put the baby to the breast and go back to sleep. (Yep, they all latched on easily. I was so lucky!) Then they’d stir and I’d flip them over to the other breast without even waking up. Then when the baby had finished and I woke up enough to notice, I poked my husband, who changed the baby and took him or her back to the crib.

    The following story doesn’t prove anything, but it makes me glad I breastfed. I didn’t get chicken pox when I was a kid. I had two kids before I got it. And boy oh boy did we ever get monster cases of chicken pox! One cycle later, I was pregnant with Rosie. She and #4 child had very light cases of chicken pox a few years later. These days, I guess kids don’t get chicken pox, but I’m sure you see my point.

    Waaaaay too long. But it’s a big subject.

    • annaojesus February 2, 2013 at 9:00 am #

      Hello! Thank you so much for your thoughts, I value them. I’m so glad you loved breastfeeding. I do as well; but I guess I can understand why it’s not some women’s cup of tea (cup of milk?). I know a couple women who absolutely understand the value of interacting with and bonding with their babies. They make sure to incorporate skin-to-skin time regularly, and they are incredibly devoted to their babes and thoughtful about the care they provide. I can’t imagine that their kids’ I.Q. is going to be ten points lower than if they had been breastfed.

      Manually expressing yourself at work, that takes commitment! Seriously, wow! I tried when my milk first came in and Ari wouldn’t take the boob because I was seriously concerned about mastitis…it did not go well.

      Although I think most places of employment are required to let women pump, it’s very difficult in some settings. During my husband’s ER shifts, for example, he feels guilty taking a minute to run to the bathroom, he almost never has time to eat anything. I know female ED docs who make it work, but it’s very tough.

      You bring up an interesting topic regarding chickenpox ( http://kellymom.com/bf/can-i-breastfeed/meds/vaccine-protection/). You’re absolutely right that breastfeeding provides immunity but, unless you were breastfeeding Rosie and #4 when they got the chickenpox, I don’t think it would have been a factor. For reasons I’m not sure we actually understand, the symptoms of chickenpox tend to be much worse in adult males, then adult females. Chickenpox is generally milder in children, which is why my mom made me get on a slip-n-slide with the neighbors when they had the chickenpox so that I would get it early on. Considering it is thought to cause one third the cases of stroke in young children, I’m glad we now have an immunization.

      Thank you so much for taking the time to comment. I love the dialogue!

      • phantomdiver February 2, 2013 at 9:39 am #

        Whoa! That’s very interesting about chicken pox and adult males and females! My husband had already gotten it in childhood, so he got to nurse all three of us, first Patrick (our oldest) and then, when Patrick had given it to us, Meg and me. We all got high fevers and a million pox. No fun. So maybe Rosie and Timmy (#4) just got a less virulent strain.

        Ouch! Stroke from chicken pox! I’m glad we have shots against it, too! It’s cool how that has changed so much in such a short period of time. My husband and I (born in 1958 and 1956) had mumps and both kinds of measles. Our nephew, born in 1961 (I think), got the MMR vaccine, as I recall. Our children (born in 1981, 1983, 1986, and 1988) got the MMR vaccine, of course, but not a chicken pox vaccine.

        When I had the kids, there were no provisions at work for nursing or expressing milk. I had to use lunch and legally-mandated break times to go to the bathroom with my bottles and cooler. If I’d had the kind of job where one can’t take a break, I don’t know what I would have done!

        I don’t know how expensive an effective breast pump would have been, but milking myself worked out fine. My goal was 4 oz. per expression, so 12 oz. per working day. Friday’s milk went bad no matter what we did, so the kids got formula on Mondays. I don’t think I ever got mastitis. I just ran out of milk before I really wanted to quit nursing, and I didn’t know of any way to keep it going, so I quit early, after only a few months. Oh, and I was on asthma medication when I had Timmy, and he was having only one poop a week, so I put him on formula at that point even though his doctor said he was fine. He then pooped a whole lot more and grew just fine, but I’ve always wondered if he is only 5’6″ tall because of that early start. Not that he’s hideously short, and he does have a short sister, and he doesn’t blame me, but height is more important for men than for women in our society.

        You’re probably right about how “breast is best” is overstated. Seems to me that it should be the default, because it’s how we’re built. I wonder if we are now “breeding” more women who don’t nurse easily; maybe they would have had fewer children when they had to use cow’s milk or something. Kind of like how some dog breeds can’t reproduce the usual way now, because their breed standards have taken precedence. Please don’t be offended at my comparing people to livestock. We’re all animals, though people aren’t produced as part of a breeding program!

        Old people talk too much. Be glad you don’t have to listen to me in person! 😉

      • annaojesus February 3, 2013 at 10:34 pm #

        Re. chickenpox: I know, right? So bizarre! I’m sure there’s some scientific explanation somewhere…maybe I’ll find out my fourth year, when I’m hopefully able to do an infectious disease elective (it’s not my strong suit, so I’d like to get more exposure…so to speak 🙂 )

        I think you probably know where I stand on vaccines. If you want to check out something pretty great, Paul Offit, a professor at Penn, on the Colbert Report ( http://www.colbertnation.com/the-colbert-report-videos/372812/january-31-2011/paul-offit). If folks don’t want to vaccinate their kids for their kids’ sake, do it to protect the 500,000 Americans who can’t get vaccinated. Scary stuff!

        I certainly find myself in favor of breastfeeding, but I don’t know how much of the preference is influenced by my mother (who breastfed me when I know it was not the norm in her friend circles) and by my close friends, the majority of which breastfeed. Bottom line is that I really enjoy my time breastfeeding. I’m sorry you had to stop before you wanted to. I’m not sure how it will be when I’m back in the hospital full time April-July, then back at home more in the fall…

  5. Dad February 2, 2013 at 2:06 pm #

    Not to compare you too much with your Mom, but she said the same things as you. She just enjoyed the experiences, and her difficulties were minor. SS
    He was pretty convinced that it was the way we were designed, and that the unknown benefits were significant. Did you know that for a while she was active in the “Leche League” ???

    Dad

    • annaojesus February 3, 2013 at 11:10 pm #

      Hey, thanks Dad! I had no idea that she was active in la Leche League. Very cool! Lots of love! xoxo

  6. Sloane Rosenthal (@SloaneRosenthal) February 6, 2013 at 10:44 am #

    Hi Anna:

    Thanks for sharing this, and I’m so glad breastfeeding has been a good experience for you so far! It can be so, so easy to get caught up in the guilt and dogma associated with nursing, and after having been through that experience, pretty much my #1 wish for new moms is that they feel supported and at peace through whatever choice works for them.

    As you may know, I was also a grad-student-mom, and I suffered from really severe PPD/PPA after Maya was born (and for quite some time thereafter, unfortunately). My situation was complicated by a wow-I-wouldn’t-have-known-this-was-a-thing-but-for-google Dysphoric Milk Ejection Reflex — basically, I felt desperately sad and sort of disconnected and crazy every time my milk let down (which I think we figured out was something like 5000 times in the ten months I nursed her). It was worse when pumping (because of some unrelated issues), and since I had to go back to school two weeks after she was born, it was always a struggle in many ways — and the fact that everyone kept telling me I was supposed to feel euphoric and snuggly was not so helpful, as you can imagine. But because I was struggling with PPD, breastfeeding was also a huge blessing, because it was something that made her so happy and because (having really, really, totally excessively bought into the “breast is best”/OMG-this-is-the-only-important-thing-i-do-as-a-mother deal) it was something I always felt like I was “doing right,” even when I felt pretty much like I was never going to be able to do anything right, possibly ever again. It’s an experience I can look back on now with mostly fond feelings and a bit of humor (wow! so many hours of my life I’ll never get back that I wasted on desperately worrying that my milk supply would plummet if we gave her solids a minute before she was six months old, and so on). Mostly, I guess, I wish someone had told me that there could be breastfeeding complications other than low milk supply, and that the fact that it made me feel really shitty (at least for a few minutes every time) didn’t mean that I wasn’t meant to be a mother or that I wasn’t trying hard enough. I eventually found those people, but it took a long time. But, we made it work, and I am really glad I kept at it for as long as I did.

    Anyway, I guess the bottom line of my ramblings is pretty much “Oh my goodness! so many feelings,” but I’ve been reading and enjoying your writing for a while and felt compelled to chime in. I don’t know if you ever read the blog “the Skeptical OB,” but she had a really funny post up a few weeks ago that, while perhaps overly harsh, shed an intriguing light on how we do or don’t support mothers who are struggling to nurse their children. (See http://www.skepticalob.com/2013/01/what-if-we-treated-erectile-dysfunction-like-we-treat-breastfeeding-difficulties.html).

    I hope you and your family are doing well these days!

    Sloane

    • annaojesus February 6, 2013 at 11:57 am #

      Hi Sloane,

      How are you doing?? Wonderful to hear from you! I couldn’t agree with you more regarding your wish for new moms to feel supported. Thought I think, in general, I lucked out with regards to breastfeeding, I’m convinced that a large part of why it was a positive experience was because there was a band of new moms I knew (practically all of John’s close friends had kids in 2012 🙂 ) who were incredibly supportive. They also told me about their challenges with breastfeeding, so I think that helped me kind of anticipate some tough times rather than assuming that breastfeeding would always be a euphoric experience.

      Sloane, I don’t know how you do it. I knew you were grad student mom, but I had no idea about the PPD/PPA or that you had to return to school after two weeks! I can say without question that the first four-six weeks of Ari’s life were some of the most challenging of mine (and probably her’s too, so far…it must be tough to have a rather traumatic transition into the world, then essentially be starved for a week :/), and I had the luxury of being at home.

      Dysphoric Milk Ejection Reflex sounds both saddening and frustrating. I’m really impressed that you can look back on the experience with humor now–dude, you have character! Did you feel like it improved once you identified it?

      I loved what you wrote about breastfeeding being something that made Maya so happy. I feel the same way. Especially in the morning, Ari just seems so elated! That said, she loves her food, so she seems pretty happy with a bottle as well. (I’ve heard about a lot of babes who wouldn’t take a bottle, so we tried to introduce it to her at 3-4 weeks. When I have to be on the wards in April, I just don’t want her to NOT eat at all for 12+ hours.) So, even though I feel like I have no idea what I’m doing, breastfeeding does make me feel like I’m able to do something right.

      So many feelings…I feel like that appropriately sums up motherhood so far. To my knowledge, I did not experience PPD/PPA (though I guess there’s still time for me), or even really baby blues, but I still crumpled a few times out of shear exhaustion. But I also don’t think I’ve ever smiled this much in my life. Ever.

      I’m flattered that you read my blog. Thank you, and thank you for commenting. I love to hear your thoughts.

      Thank you also for pointing me to the Skeptical OB. I’ll enjoy reading the post during our next BF session 🙂

      Congratulations on your graduation, long overdue! xo

  7. Rachel March 3, 2013 at 7:21 am #

    Hi! I read your article on NYT and subsequently spent the last 30 minutes reading your blog…30 minutes that should have been spent writing a paper 🙂 I’m a full time MSN student at Penn with a 6 week old….and member of the tried and failed breast feeding club. I was so excited post delivery when the baby latched on right away with no apparent problem…but within two days it was toe curling agony (the latch on pain for the initial minute was so much more intense than the dull ache from the c-section). After the baby lost weight at her 2 week appointment, I freaked out, convinced all those lactation specialists and my determination to try and do what’s ‘best’ may have been detrimental to her development. She’s now exclusively bottle fed, and I’ve come to the realization that I’m actually happier now that I’m not tied to a breast pump or sequestered into a room without company (funny how my personal description of breastfeeding is still so negative!). I wish it would have worked, and still, despite knowing that there’s nothing wrong with formula, I still wish I tried harder to continue to pump. Then again….carrying a breast pump on the PATCO & Septa lines, pumping before and after class, and at clinical probably wouldn’t have helped with the sanity issue! I’m looking forward to reading your linked article by Hanna Rosin. But now back to this disaster of a paper!

    • annaojesus March 3, 2013 at 8:54 pm #

      Hello! You are a full time MSN student with a six-week-old?!! WOW! It might not be true for everyone, but I found that many things (sleep especially) improved exponentially after the 6- to 8-week mark. I hope you’re enjoying motherhood so far.

      I’m so sorry that breastfeeding caused so much pain, and on top of recovery from a c-section no less! Ugh! Sounds horrible! But I’m really glad that bottle feeding makes you (and consequently your daughter, I’m sure) happier.

      Breastfeeding has been a relatively positive experience for me, but I worry about when I return the wards…we’ll see how long I can keep pumping up. I’d like to continue breastfeeding because I enjoy it, but if pumping takes so much of the joy out of both breastfeeding and med school, I’ll reevaluate.

      I hope you like the Rosin article–I found her tone refreshing.

      Best of luck to you and your family, and on your paper! Thanks again for your comment!

  8. sohila zadran June 18, 2013 at 9:02 pm #

    Thanks for ones marvelous posting! I genuinely enjoyed reading it, you may be a great author.I will be sure to bookmark your blog and definitely will come back someday. I want to encourage you continue your great writing, have a nice afternoon!

    • annaojesus June 26, 2013 at 10:12 am #

      Hello there! What a kind, encouraging comment! Thank you–it meant a great deal to me. I hope you’re well!

  9. Cathern August 15, 2013 at 2:33 am #

    An outstanding share! I’ve just forwarded this onto a colleague who had been conducting a little homework on this. And he actually ordered me lunch due to the fact that I stumbled upon it for him… lol. So let me reword this…. Thanks for the meal!! But yeah, thanx for spending time to talk about this matter here on your blog.

    • annaojesus August 15, 2013 at 4:45 pm #

      hahaha! What a WONDERFUL compliment–thank you! Just one question for your colleague: where’s my meal?! (I’m kidding, promise :)). Would love to see/read more about your work and his! Many thanks!

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