My breast reduction surgery was my 18th birthday gift from my parents. When I met the plastic surgeon he explained that one of the negative side effects was that I might not be able to breastfeed. But my 18 year old mind was in bikinis and button downs, not on bottles and diapers.
2 years after the surgery I met the man of my life and 8 years later I sat in a childbirth education class listening to the instructor say that it is very common for women who have had breast reduction surgery not to be able to breastfeed, especially if the surgery was the type where the nipple is removed and then reattached (the type I had of course). So when the instructor proceeded to explain the benefits of breast milk and to show a video explaining the whole technique I basically spaced out, trying not to dwell on how my 18 year old selfish and vain act would deprive my baby of “liquid gold”. Instead I focused my whole attention on preparing for a natural childbirth as if that would somehow make it up to my baby.
But then something weird happened. I was taking a shower when I noticed a milky white discharge coming out of my nipples. I didn´t really think about it until a couple of days later when my ob/gyn asked if I was planning to breastfeed. I told her that I probably wasn´t because of my surgery, but she swiftly assured me that she had seen plenty of women who breastfed after surgery with no problems. She then proceeded to pinch my nipples (which for those of you who are wincing didn´t hurt at all since I have no sensibility) and show me how a few drops of colostrum came out. That´s why in my hospital bag I packed breastfeeding supplies along with my robe and slippers. But all my energy and thoughts where centered in this painful but beautiful birth I had visualized for months, I really didn’t know much about breastfeeding and even less about Breast Feeding After Surgery (BFAS). (Big mistake No. 1)
But then my beautiful natural birth turned into a c-section, a subject I don’t really want to talk about except to say that after wards I felt bitterly disappointed and became obsessed with breastfeeding, feeling that it was the only way I could make it up to my baby and myself. That´s why when after a restless night without tummy or baby, when the nurse handed me a beautiful, sweet smelling pink bundle I immediately tried to breastfeed.
And you know what? With a lot of help from my doula I was pretty successful. Lu latched on perfectly and sucked away for a couple of minutes and then slept peacefully for a couple of hours, when I breastfed her again feeling absolutely motherly. When a couple of hours later the nurse removed the epidural my c section started to really hurt, making breastfeeding pretty uncomfortable but , feeling proud of myself and my body, I flatly refused the bottle of formula the nurse offered (Mexican private hospitals really push formula on new moms). But then it was nighttime and the sweet little bundle´s naps between feeding went from 2 hours to 20 or 30 minutes. She seemed to be nursing non-stop but when the pediatrician came by she assured us it was completely normal and that we should wait at least two weeks before expecting her to go long periods of time between feedings.
The first three nights at home where a nightmare, Lu would nurse for a couple of minutes, fall asleep and wake up wailing demanding more milk, but I figured that was normal. However I started to think something was wrong when my milk didn´t come in after almost a week. In fact when I tried to use the breastpump after 20 minutes or so my milk had barely stained the plastic cup. I finally called the pediatrician, who told me I should bring Lu in immediately. She weighed and measured Lu and then turned to us, her friendly face serious. Before she opened her mouth I felt tears splashing down my face knowing she had bad news for us: Lu had lost a lot of weight since leaving the hospital!
The doc told us we should start supplementing Lu with a bottle that very night (Big mistake No. 2) and that I should pump every two hours for 20 minutes day and night and continue feeding Lu on demand. I also started drinking teas, barley water, eating almonds, taking fenugreek. You name it, I tried it. My boobs and the pump became the source of my biggest triumphs (1 whole ounce at once!) and disappointments (just some drops this time) but my milk production didn´t seem to significantly increase, I was pumping maybe 5 ounces in 24 hours.
As for my husband supplementing with a bottle of formula at night it worked OK for two or three days, but then Lu started to fuss and cry whenever I tried to get her to latch on. The fussing got worse and worse until I looked it up on the Internet and heard about nipple confusion for the first time. I was absolutely terrified, my daughter could stop sucking and then my milk would dry up and then all this would be over and… So following tips that I read on the Web (Big Mistake No. 3) I tried to feed Lu with a syringe (nearly choking her in the process), with a cup and finally with a Supplemental Nursing System (SNS) a bottle with two really thin catheters which you stick to your nipples with tape so that the baby would suck on the catheter and the nipple at the same time getting the nourishment she needed form the formula (or pumped milk), stimulating my breasts and avoiding nipple confusion in the process.
Using the SNS meant not leaving the house for more than 30 minutes (if breastfeeding in public is frowned upon, imagine sticking a contraption to your breasts and then breastfeeding). It also meant that every meal became a battle of wills between my tiny baby and me, since getting a hungry baby to latch on correctly to two nipples at the same time proved to be incredibly rough. My strong willed daughter managed to learn how to just suck at the catheter turning it into a straw.
I knew I wasn´t doing this the right way and desperately looked for help. I called the La Leche League hotline. The consultant assured me that even though my daughter was still not gaining weight and my milk hadn´t come in at two weeks, I shouldn´t supplement with formula! I also called a really expensive lactation consultant (who clearly didn´t know a thing about BFAS. Big Mistake No. 4). She didn´t even see Lu nurse but assured me that I was doing wonderfully and should try to supplement with my pumped milk and not formula. So I continued incorrectly using the SNS for a whole month and pumping every two hours (with just 6 ounces to show for the 24 hour pumping)
I was exhausted, angry, scared and incredibly jealous of my husband who just got to enjoy our beautiful, spirited newborn. The unbreakable bond, the closeness that I should have felt when feeding my daughter was replaced by resentment and lots of fear. But I still thought that the little breast milk I was feeding my daughter was much more valuable than that overrated bond! (HUGE Mistake No. 1)
But then on the same day my ob/ gyn prescribed me a mild antidepressant, I had to scream for my husband to take my daughter away from my arms as we both cried in frustration thanks to another SNS battle. Maybe it was the meds, or actually feeling I was endangering my daughter but then and there I decided to completely stop breastfeeding . Cold turkey. I took two Diet Cokes thinking I could make my milk “unsafe” for my daughter and keep away the temptation to breastfeed her.
That night when my husband bottle fed her I locked myself in the bathroom crying like crazy, a thousand destructive thoughts running through my head: she is going to catch some terrible disease, she won´t ever love me, I´m never going to lose the baby weight and the list goes on and on. But then during the 2 am feeding I watched my daughter happily eating form her bottle and felt secretly relived. Relived that I could kiss my daughters sweet smelling head while she ate, that feeding her took twenty minutes instead of more than an hour and a half, that I could actually sleep for two hours straight.
After two days of exclusively bottle feeding I tried, out of curiosity offering Lu my breast. To my enormous surprise she happily and easily latched on and sucked for a couple of minutes. I was thrilled to actually be able to briefly experience the closeness that came from breastfeeding without the paralyzing fear of starving my baby. But eventually Lu stopped sucking when I offered her my breast and then she started fussing. I´d decided breastfeeding would never come between us again, so slowly my low milk supply dwindled even further and then just stopped.
Today my daughter is 7 months old and has been exclusively formula fed for 5. I am happy to say that our bond is very, very strong; she is a lively, happy, funny, healthy baby who throws herself into her mama´s arms and so far, really hates solids.
Would I try breastfeeding again? Yes. Granted BFAS is hard but there were a lot of extra hurdles on my road that I think can be avoided the next time around: total lack of information and support on BFAS, a baby who is not the greatest with anything related to eating, ridiculous amounts of social and self inflicted pressure to breastfeed, the c-section. The next time around I´ll know that my surgery may have damaged my nerves preventing me from even having a letdown, that I won´t be able to exclusively breastfeed, that SNS I need professional help to use the SNS correctly. I´ll also know that for me breastfeeding is only worth it if it leaves me enough time, energy and sanity to be able cuddle and smell and sing and dance not only with my newborn baby but with its precious big sister, the adorable Lu.