I get it. Baby friendly. Breast is best. Nursing is bonding. It’s supposed to be easy and natural, right?
I’ve seen the data. Yes, I support breastfeeding. I support breastfeeding to a fault. Let me explain.
After the birth of my first son almost six years ago, I couldn’t wait to breastfeed. The lactation consultant visited me several times in the hospital to cheer me on and gave some valuable tips. Despite the rocky start, we were on a roll after six weeks…
Then, at eight weeks post-partum, I went back to work. I distinctly remember one night on-call in which I had been up all night, performing c-section after delivery after c-section without a break. The hard rocks hanging from my chest were almost beet red and my scrubs dripped from two circular wet spots on my top. Finally, I found a moment to sit and pump. Before I hit the door of the pump room, I was called for an emergency on the post-partum ward. My temperature reached 102F by the time I made it to the Mother-Baby floor and there I was, faced with caring for a critically ill patient. My inner strength broke and I could not hold back the tears. I still suffer from mammary PTSD to this day.
As physicians, we are often the only provider on-call or in a hospital unit. We can’t take a break when we need to, medicine just doesn’t work that way. Returning to work after eight weeks to take 24 –hour shifts was a challenge and finding the time to pump was almost impossible. The irony is that as OB/GYN physicians, we are anointed champions of breastfeeding, yet many of us never make it past the three-month nursing mark because our careers are not conducive to lactation. It is a dilemma of epic proportions.
I lasted four months nursing with my first. It was a disappointment. I was even more convinced that I would make it to the recommended one-year mark with my second child. My sweet and delightful daughter was a champion nurser at the hospital. Then we went home …
I’m sure you have heard the word “colic”, but until you actually experience it, you don’t truly appreciate the meaning. Sleepless night after night after night… Delirium sets in. Then the guilt. Emotions flow. Tears and more guilt. I read every book about it and tried it all. I was adamant that formula was poison and if I just kept trying harder, we would figure this out. I blamed myself for her suffering.
Three different lactation consultants visited the house. My midwife friend spent evenings with coaching me. Reglan, domperidone, fenugreek, hopps … I tried them all. Pumping produced nothing. I couldn’t understand why we struggled so much as I had successfully nursed my son. I was a complete wreck.
At six weeks, she weighed less than she did at birth. She was failing to thrive. The pediatrician sat me down and looked me in the eye. She told me it was time to let go.
“Motherhood is not defined by your ability to breastfeed, but breastfeeding can be a wonderful part of motherhood. Doesn’t look like it’s so wonderful for you right now.”
She pulled out a can of formula and shoved it towards me.
“We are physicians, we don’t like to fail at anything. We don’t give up, especially when we are determined to achieve something. But, what is more important, for you to succeed at breastfeeding your baby or for you to enjoy this special moment in time you have with your baby? Be a mom. Focus on being a mother and let this one go.”
From a mother’s perspective, there is a grieving process involved when you realize that despite all your efforts, you cannot provide the nourishment to your baby through your milk. But, despite my devastation, I did what she said. And, I was a better mother for it.
So, in essence, I support my patients in their journey to nurse and breastfeed. I encourage them to use the amazing resources we have available in the hospital and clinic. I prescribe their reglan tapers and domperidone. I educate them of all of the health benefits, both to mom and baby. I cheer them on as they pass milestones…
But, I don’t judge them if they stop. A typical maternity leave in the USA is 6-8 weeks. Until the USA is willing to make a bigger investment in supporting women with careers and professions to spend more time at home or be relieved of duties while they are breastfeeding, we cannot shame and ostracize our mothers because they stop, can’t or don’t breastfeed. We all have a different path to follow in this journey through motherhood and we need to respect each other’s efforts.