The following post is a detailed account of my initial experiences with breastfeeding. Skip this if you’re squeamish.
Glossary (for the non-baby-having readers)
Nipple: The little nub at the end of a breast. Usually two, in my case this became four
Areola: The area surrounding the nipple. Slightly darker than the skin of the breast unless you go all National Geographic like I did and end up with what look like deli slices
Latching on: The act of baby positioning himself on areola and drawing nipple all the way back to his soft palate without choking, bucking, coughing, punching or biting you
Let Down and/or Milk Ejection Reflex: The hormonal response of the milk ducts releasing milk after stimulation, usually from looking at your baby, or hearing your baby cry. In my case this reflex is triggered by; the wind, getting out of the shower, getting into the shower, hearing my kids fight, watching sad TV, singing or hearing other people sing, drinking hot liquids, looking at pictures of kittens, smelling baked goods, thinking about my feelings of failure, laughing really hard, and Daniel Craig as James Bond.
Lanolin: A natural ointment made from sheep oil to coat your nipples post-feeding and keep them from cracking. This product has been udderly (hahah) useless to me until only this week. It also happens to be the best lip balm I’ve ever used.
APNO: All Purpose Nipple Ointment is a prescription nipple cream to be used post-feeding that contains antibiotics, a steroid, Ibuprofen, and an antifungal but is somehow still safe for baby. Developed by Toronto breastfeeding god Dr. Jack Newman, this shit has saved us from formula feeding thus far.
Breast Pads: Highly absorbent disposable pads with an adhesive backing to line one’s bra and catch leaking milk.
Nipple Shields: A thin piece of silicone shaped like a nipple that covers the nipple like a little dome while breastfeeding allowing milk to flow through and providing the nipple with protection.
Standing here at the almost-two-month mark of new motherhood, I have often remarked that I wish someone had been completely frank about the various challenges I might face in pregnancy, labor, and with a newborn. I’m not sure yet if some of my mommy friends were seriously sugar-coating their experiences, or if we all hit a point where we find a rhythm, the pain goes away, and we are left with such baby bliss that all of the serious bullshit feels like a fuzzy memory. Whatever the case, I’ve taken it upon myself to share in candid detail some of my early postpartum pitfalls because I’m the kind of person who likes to be prepared for worst-case scenarios. Breastfeeding has been the suckiest experience of motherhood thus far.
Today my son is nearly seven weeks old, it’s Friday, and we’ve had three largely pain-free days of breastfeeding. This feels nothing short of a miracle. Notice that I haven’t said that these days were free of mess or horrifically awkward attempts at the so-called “womanly art” of feeding. Each attempt continues to be a frothy, violent, milk-soaked debacle unless I catch baby at just the right semi-sleepy moment. I must also be armed with an arsenal of props that includes bibs, burp cloths, saline solution, lanolin cream and super absorbent breast pads. We still feel very far from being able to pull this off in public with any degree of grace, but I’m grateful that we’re making little steps forward.
If you read my birth story, you’ll know that we had a very short hospital stay. In the moment, I was happy to be sprung early and sent home. In hindsight those additional 24 hours probably would have saved us from the agony to come because we would have been granted a visit by the lactation consultant on staff.
I should have realized we were headed for trouble when my very first attempts at breastfeeding left me with dark purple hickies on the tips of my nipples. Feeding didn’t feel exactly comfortable at first, it was quite pinchy, but I thought I was doing everything right. I bathed my nipples in naturally antibiotic breast milk and slathered them with some lanolin after each feeding. Despite these efforts, those purple hickies eventually became deep, bloody cracks. The cracks scabbed over because I was trying to be topless as much as possible, as per the Dr. Jack Newman website (this guy is supposed to be THE authority on breastfeeding) and thus, each time we fed, the scabs were ripped off afresh.
Soon the pain became unbearable. My nipples were red and inflamed, and I was popping Advil like some kind of junkie. This coincided with when my surge of postpartum hormones kicked in, and so I began to spiral downward into despair. With each attempt at feeding, I’d be in tears of pain and frustration. The baby would be stressed out. I would be swearing and sweating profusely. Our existing children looked on in horror. I felt like such a failure, and I was beginning to worry that I was doing permanent liver damage with all of that Ibuprofen. Showering felt like I was being slashed with razors and life was pretty damn miserable. Each night at about 8pm after the girls were in bed, I’d sit in the bathroom (having a sitz bath for my stitches) and sob. I really began to fear that this was the new normal but I was determined not to give up.
I showed our midwives the state of my nipples. Strangely, they didn’t have much to say about it beyond advising me to keep working on the latch. On a day when they were particularly awful (my nipples, not the midwives) the midwife who came for my home visit witnessed the horror, but nobody bothered to call me and follow up. This was about the time that my lovely next-door neighbour, a fellow mom told me about the Jack Newman all-purpose nipple ointment. This cream was apparently a miracle, but only certain pharmacies could concoct it, and it required a prescription. One of the moms at school who had been noticing my Facebook posts about breastfeeding let Nekky know that our neighborhood pharmacy could dispense the APNO. I called my midwives immediately and asked for a script, wondering with more than a little irritation why they hadn’t thought to mention this remedy to me. Hours later, when I had the cream, the irritation I felt with my midwives turned to anger as I realized how immediate the relief was. I was moments away from deciding breastfeeding was impossible, but this cream made all of the difference. Each new mom should be handed a script for the APNO before they get their baby because once you need it, you need it urgently.
Noah and I soldiered on for a week, using the APNO cream, but then the pain started to return. My nipples were so deeply cracked at this point that it looked as though I had four of them. The breast pump finally came out, and Noah was introduced to the bottle. He was still getting breast milk, but now there was an extra step. I was terrified that this meant he wouldn’t take the breast again. This also meant I was pumping all day long, and god forbid if I had anywhere else to be. A busy day meant I’d be up late into the night pumping to make sure all of our feedings were covered. I was also super emotional, and feeling like a failure because I couldn’t feed the baby the way I wanted to, so I was incredibly sensitive about the idea of anyone else bottle feeding Noah. Luckily, my partners were wonderfully supportive with this, and helped me explain over and over again to the kids why this was still a job for Mama C, even though it looked like something they could do.
I made a follow up appointment with the lactation nurse. She said she hadn’t seen nipples so bad in all of her eighteen years, and said she had no idea what I should do. I made her watch us latch. Part of my problem was panicking a little as the baby began to freak out with hungry wailing. I wasn’t patient enough to wait for him to present a nice, wide open mouth and was latching him on with too shallow a latch. I was also letting him hang out and pacify, which is great with healthy nipples because it stimulates milk supply, but in my case was bad news. The baby would grow sleepy while pacifying and would slip in his latch, resulting in a painful pinching. The lactation nurse recommended I try nipple shields, which were horribly awkward and painful to use. She agreed that if those didn’t work I should continue pumping exclusively until my nipples healed. I did this for two weeks. Then after two days of trying my left breast, then having to quit again I finally called my local chapter of La Leche League, the non-profit breastfeeding advocacy support group.
Ladies, if you’re having any trouble at all, or feeling remotely uncertain about feeding, don’t wait to ask for help, and go straight to the pros at La Leche League. I should have called them the second I noticed nipple hickies. They were quick to return my call, and the volunteer I spoke to was very sympathetic and encouraging. She emailed me some amazing resources, including the awesome Kelly Mom website and she also sent the dates for the next La Leche League meetings. They are next week, and I’m going to attend. I’ll let you know how that goes.
The thing that finally did it for me and got us breastfeeding successfully was moist wound healing. It sounds gross, doesn’t it? Its actually quite simple, and amazing. I quit the APNO and instead mixed up a simple saline solution. By this point my nipples were looking and feeling much better, and I made sure to have some milk stored in the fridge just in case. After each feeding I bathed each nipple in the saline solution for about a minute per side. The instructions recommended using warm saline, but I eventually settled with room temperature. After the saline rinse, I expressed a little milk with which I coated each nipple, and when this was almost dry, I applied a moderate amount of lanolin. This is working like a dream.
The Kelly Mom site also showed me how to latch. There I read the very sensible advice that all people, babies and nipples are different and so the “correct” latch is the one that feels the best for you. I tried the asymmetrical method where the nipple teases the baby’s top lip and then the baby is brought with an open mouth to touch bottom lip to the bottom of the areola and the nipple slides in after. It sounds complicated, but it’s not. Here’s more detail if you’re interested. My midwives and the lactation nurse were showing me a method where the baby is jammed onto the nipple in a more centered position and that really just wasn’t working for me. I felt a bit dismayed when I realized that this asymmetrical latch is what I tried first with Noah, which the midwives quickly “corrected”.
Kelly Mom also gave me an obvious, but very helpful method for dealing with my overactive milk let down which would usually choke baby and have him violently thrash about with my nipple still in his mouth. After latching him asymmetrically in a cross-cradle fashion, I seat him upright instead of have him lie in my arms. Gravity helps with swallowing – something you don’t think about when everything else is going wrong.
I’m lucky that this baby can move smoothly from breast, to bottle to pacifier. I’m lucky that I’m producing too much milk instead of not enough. I’m lucky that I’m anatomically structured well for breastfeeding and that the baby is also built to eat this way. I’m lucky to have great resources available. If I weren’t so damn stubborn I may have thrown in the towel, but I really wanted to breastfeed this baby as long as I can, and I didn’t want to give up.
That’s the advice I’d give to new moms; stick with it and prepare for the worst. I’m sure most people have a much easier experience with navigating breastfeeding, but I find it so helpful to know that there are many of us for whom this so-called “natural” act seems impossible. Hopefully by sharing our experiences and resources we can all get to a place where everything is working just the way we’d hoped.