Mommy wars: battle of baby feeding

When Lydia was several weeks old, I sat uncomfortably in my former pediatrician's office awaiting the lactation consultant on staff. Ever since my milk supply had come in, Lydia had increasingly been having problems nursing, and I called the doctor out of concern that she was not eating enough. Her weight check confirmed she wasn't gaining weight. When the lactation consultant came in, she asked me to nurse Lydia so she could see what was going on with us. I felt nervous allowing someone else to see that my breast feeding relationship with Lydia was anything but "natural" and "a beautiful bonding experience," like all my books had led me to believe it would be. Lydia would try to eat and within minutes be screaming and writhing, as if in pain. I would keep trying, only to have her often refuse to eat, and both of us in tears by the end of our feeding sessions.

The lactation consultant watched Lydia scream and arch her back as if in agony within minutes. She frowned. The latch looked fine, she said. "Well, why don't we try a bottle of formula?" I cringed, but I consented. I watched the nurse prepare a bottle, and as she gave it to Lydia, I sat next to her quietly shedding tears. She said because Lydia took the bottle so well, she probably had GERD (or commonly known as acid-reflux), which would make feeding in a reclined breast feeding position painful. She gave me a prescription for GERD medication, advised that I try to feed her in an upright position and/or express milk and bottle feed Lydia, and sent me on my way. I called my husband and my mother, who both knew my feeding struggles intimately, and tried to tell them the diagnosis. But every time I got to the part of the story about giving Lydia a bottle, I started crying so hard that I was unintelligible. I felt like a complete failure as a mother because I could not do what I had always been told was the most "natural" thing in the world.

Because of those feelings of failure, I wasn't ready to give up on breast feeding. Rather than spending quality time with Lydia in a relaxed way in those early weeks, every time she got hungry, I'd attempt to contort our bodies so I could breast feed her in an upright position somehow, fail within a few minutes, hook my breasts up to a machine, pump milk, and then give her a bottle. While I would pump milk, I could not hold Lydia - she would cry, hungry and wanting to be held. Since she was hungry every two hours, it felt like all I did 24-7 was attempt to breast feed, pump milk, or give her a bottle. I went to the weekly meeting of La Leche League hoping to find support, only to find all the other moms happily breast feeding at the meeting and discussing the importance of it while I silently hoped and prayed Lydia would not get hungry while I was there. I dreaded having to take out my bottle of expressed milk and feed her the "unnatural" way in a room full of breast feeding advocates. I called yet another lactation consultant; this was probably the fifth lactation consultant that I would have seen by that point, and I decided this was my last ditch effort.  I was sick of spending every minute of the day fighting the battle to breast feed, which I believed by that point had taken a negative toll on my relationship with Lydia. However, I had heard wonderful things about this consultant (she heads the Breast Feeding Center of Ann Arbor), so I figured why not just hear what she had to say.

Unlike with previous lactation consultants, she actually examined Lydia. She said her mouth was very small. I told her about the GERD diagnosis, and she expressed skepticism. If the medication hadn't already helped, she said, it was unlikely Lydia had GERD. I frowned. She then watched me feed her, and as soon as Lydia began to writhe and scream, she said, "She's choking on your milk. Her mouth is very small and she probably has a sensitive gag reflex. Let's just try feeding her with a nipple shield." I had never even heard of a nipple shield, but was at the point where I would have tried anything. Lo and behold, Lydia then nursed for 40 minutes straight. It was as if she was a different baby, and I wanted to weep from joy and exhaustion.

In the following weeks, I continued to feed Lydia with a nipple shield, and went to a support group hosted at the Breast Feeding Center of Ann Arbor for mothers with breast feeding challenges. We sat in a circle and shared our struggles - failure to latch, low milk supply, etc. Women wept, babies cried, and lactation consultants offered help. It was very therapeutic and I am grateful for those women who helped me to feel I was not a failure because I had problems feeding my child in the so-called "natural" way.

By the time I had Anna, I was already a wounded soldier in the breast feeding battle. I was extremely anxious about breast feeding her, and breathed a sigh of relief when she seemed to be doing great at first. Then my milk supply came in, and a new battle began. The symptoms were very similar to Lydia's, but this time I'd learned the weapons of war. I immediately called in the cavalry (the lactation consultant who'd been such a savior in Lydia's case), but this time there was no easy solution. Anna scoffed at the nipple shield, but she wouldn't let the discomfort stop her from getting enough to eat. She choked, she writhed, she refused to nurse from my left breast, but she was determined to get enough milk to survive and gain weight. My lactation consultant basically told me she was getting enough nourishment, but had trouble with the "swallow, suck, breathe" coordination. She gave me some good ideas for how to make her more comfortable and encourage her to nurse from the left breast. (To this day she will only nurse on the left breast if I put her in one specific position.) I attempt to make it as much of a bonding experience as I can, but we've had to find other ways to bond together.

Image from Topinambour

All of this has led me to reflect - why was so much of my self-worth coming from my ability to breast feed Lydia? Why did I turn into a blubbering mess when a nurse gave my daughter a bottle of formula? Why was I willing to spend all my waking hours attempting to get Lydia to drink breast milk? Why did I think I was a failure as a mother if I failed at breast feeding?

The current most popular parenting philosophy, attachment parenting, places breast feeding at the top of the list of best practices for raising a healthy, happy child. Dr. Sears - the attachment parenting guru - has a whole section in his book and on his website about why breast is best, and the information he gives on possible challenges makes it sounds like you can just easily overcome breast feeding problems like mine. Public health officials take the same stance. Advertisements by the Michigan government adorned buses in Ann Arbor when I was a new mother to Lydia, encouraging mothers to both lose the baby weight and breast feed with the slogan: "Slim faster. Breastfeeding burns calories." New York City subway ads make it clear that formula is inferior for the health of infants. Article after article in the news told me that the science was clearly on the side of breast feeding. Thanks to the attachment parenting craze, public health agencies, and the media, when I registered for baby items, I never thought twice about registering for a breast feeding pillow and other breast feeding-related items. I made no room for myself to fail, because breast feeding was clearly what "good" moms do. I recently read a book entitled, "Bottled Up: How the Way We Feed Babies Has Come to Define Motherhood, and Why It Shouldn't," which I heard about from a Facebook post by another mother who struggled with breast feeding. As the author Barston (2012, p. 3) put it, "For many women of my generation, social class, and educational level, breastfeeding is seen not as a choice but as a given."

The author herself tried and failed to breast feed her son after suffering "latching problems, an undiagnosed tongue tie, nerve damage in one breast, severe and sudden postpartum depression, a traumatic birth, jaundice, and a milk/soy protein intolerance which didn’t get better despite an elimination diet." She wrote the book for mothers who try and fail to breast feed, and feel shame and self-condemnation as a result. She explores the history of the lactivism movement, the science behind breast feeding advocacy, the societal judgments made about bottle feeding mothers, and the challenges that many women (herself included) face when they fail to breast feed. She argues that the new defining battle in the mommy wars is not the issue of mothers' work, but rather how mothers feed their children. She discusses the science often cited by breast feeding advocates, which is largely based on population studies with lots of confounding variables. Even if breast feeding is associated with slightly better health outcomes for babies, the benefits are typically marginal; Barston contends these benefits should be weighed against the costs for individual moms and their infants. As Barston puts it, "[b]reastfeeding is usually a beautiful, mutually beneficial act between mother and child. But breastfeeding isn't necessarily the right choice for every mother and every child, whether it is for medical reasons, psychological reasons, professional reasons, or a myriad of other reasons that are, frankly, nobody's business. Under certain circumstances, breastfeeding becomes a painful, emotionally fraught, conflicted act" (p. 4). She concludes the book urging breast feeding advocates to quit focusing on the detriments of formula, and instead find better ways to support women who want to choose to breast feed. I know in my own personal experience, it was shocking how many lactation consultants actually had no clue how to help me, and baby books were completely useless for women suffering real challenges to breast feeding. My pediatrician admitted to me that in all her training and residency, she received 30 minutes of training about breast feeding. Who are women supposed to turn to if pediatricians and most lactation consultants have no clue how to solve breast feeding challenges?

As I was driving home for lunch one day (ironically to breast feed Anna), I heard a story on NPR by an science journalist - Florence Williams - whose major interest was the environmental toxins in breasts. Her book, Breasts: A Natural and Unnatural History, was an emotional roller coaster for me to read as a breast feeding mom. Williams had breast fed her two children, and became interested in investigating breasts after she sent her breast milk to be tested for various environmental toxins and was disturbed by what she found. She asks: "[h]as all the ruckus - all the maternal guilt, the physical and metal introspection, the madre-a-madre name calling, the battles with the medical establishment - been worth it? Is milk, au naturel, really so superior to formula that we must make each other feel bad about our failures and choices?" Williams asserts that the "honest answer to this question is yes and no." (p. 169) She details the emerging immunobiological research, which has identified several unique components in breast milk (e.g. oligosccharides, lactoferrin, etc.) that have such amazing immunity-boosting properties that researchers hope to use to them fight cancer and HIV. The emerging research on breast milk components and their capacity to heal and protect is amazing, but paradoxically, research is also finding new components in breast milk that are potentially extremely harmful. "DDT, PCBs, trichloroethylene, perchlorate, dibenzofurans, mercury, lead, benzene, arsenic. When we nurse our babies, we feed them not only the fats and sugars that fire their immune systems, cellular metabolisms and cerebral synapses. We also feed them, in albeit miniscule amounts, paint thinners, dry-cleaning fluids, wood preservatives, toilet deodorizers, cosmetic additives, gasoline by-products, rocket fuel, termite poisons, fungicides, and flame-retardants." (Williams 2012, p. 198) It turns out that breasts accumulate more toxins than other organs, process them differently, and - thanks to biomagnification - pass them off extremely efficiently to nursing babies. Williams is careful to note that breast milk is just one way that children ingest these toxins - they pass through mothers' placentas, and formula-fed children catch up to the alarming levels of toxicity of breast-fed children by mid-childhood. However, when I read Williams's review of the research on toxins in breast milk, I couldn't help but feel more ambivalent than ever about breast feeding. I thought, "So I've been killing myself to breast feed, thinking this is the best thing for my children, when in fact I might be harming them with poisons in my breast milk?"

Before I had kids, I thought any woman who read the news and parenting books should know that breast feeding is the "right" choice. Bottle feeding and formula feeding moms were just amommymous to me - I was ready to make unfair generalizations about and look down upon their choices. Now that I'm a wounded warrior, I know that like all the choices parents make in caring for their children, there is rarely a one-size-fits all answer. I now am quick to tell friends who are expecting to come to me if they have breast feeding problems, because I know personally the self-condemnation and lack of support out there for mothers who struggle to feed their infants "naturally." I see that there is no one "natural" way to feed one's child, but rather that infant feeding is just one dimension of parenthood that can be done lovingly in a multitude of ways. While I am certainly not anti-breast feeding, I would now assert that there is no one "right" or "natural" way for mothers to feed their infants. And rather than seeing the challenges I've had as a curse, I've come to see them as a blessing in teaching me humility about having any dogmatic views on parenthood choices.