As we prepared for Ethan’s arrival I started to get excited about breastfeeding. I was committed to raising our baby “green”. I went out and purchased nursing bras, went to a breastfeeding class and paid ahead of time to have a lactation consultant come support me in our home after his birth. I had heard of the challenge of breastfeeding from many moms  and wanted to be prepared ahead of time.  Finally on August 3, 2008, 10 days late, Ethan Paul Dumouchel, 8lbs 8 oz, arrived after a 13 ½ hr, unmedicated labour, with the support of our doula and Obstetrician. I remember that as soon as they put him on my chest, I felt such relief as I observed his perfect little face and ten fingers and toes. He was perfect and beautiful. His APGAR scores were awesome and they took us to our room right away. Through the night I tried nursing him several times as he woke up hungry to be fed. It was a holiday weekend and so the hospital lactation consultant was unavailable. We got Ethan to latch a few times but every time we would hear large “clucking” sounds and then he would fall off. I felt so frustrated as I listened to him scream. I thought the problem was that my breast was too large for his little mouth. I satisfied him as best I could by squeezing colostrum into his mouth. Matt, my husband and I had decided ahead of time that no formula was to be given to our baby and that we would spend as little time as possible in the hospital so we were eager to be discharged.  I remember the next morning as clear as day in my mind. I don’t think I will ever forget the words of the pediatrician who came to check him over in preparation to discharge us. “Did anyone tell you about his mouth?”, he asked. What we learned next was that Ethan was born with a cleft in his soft palate. This was the reason for the clucking sounds while breastfeeding; Ethan could not get a good seal while breastfeeding with a hole in the roof of his mouth; . I remember the horror that I felt as I listened to the doctor. Seeing my distress he quickly reassured me that it was “the best kind of cleft to have” because of how small it was. At the time neither Matt nor I knew what a cleft palate would mean for us or for Ethan. They discharged us after setting us up with an appointment with the “Cleft Palate Team” a few days later. The nurse was reluctant but I assured her that the lactation consultant that I had hired would be coming to the house that day to help me. My lactation consultant was wonderful. She got Ethan on my breast right away and although I felt him sucking, it wasn’t very hard and he would quickly fall asleep only to pull away screaming full of air a few moments later. She constantly reassured me that “all babies can breastfeed”. After the first night however, it was clear that it wasn’t working. My lactation consultant suggested nipple shields, whichseemed to do the trick in terms of getting Ethan to latch. He still seemed to struggle with gas from swallowing so much air through his cleft. After weighing him two days after birth, it was evident that Ethan wasn’t getting enough sucking on me. I began pumping and syringe feeding him. I would put him to breast first and let him suck for as long as he wanted and then I would syringe feed him. The “cleft palate team” came on the Thursday, four days after Ethan was born. I remember the words of the feeding specialist very clearly. “Only 1% of babies with a cleft palate successfully breastfeed. I am sorry you won’t be able to breastfeed your son. Does that make you feel disappointed?” To me her words were like a shotgun to my heart. One part of me immediately disliked her and wanted to prove her horribly wrong. The other part of me wanted to succumb to the disappointment and accept what she was saying and move on. I couldn’t even respond to her, I just stood and cried. I remember nothing else that she said that day. I couldn’t bring myself to look at the literature that they provided or to talk about surgeries etc, for weeks after. They gave us a bottle called a Haberman feeder which allows a baby to eat without sucking. I had been determined to avoid giving our baby a bottle for fear that he would prefer it over my breast. My lactation consultant told me that everything that was happening with Ethan was normal for a baby with a cleft palate and that she had helped many moms to successfully breastfeed post surgery if they kept offering the breast every time. I found it really hard to believe. I continued to pump and syringe feed every two hours until Ethan was about 10 days old. He hadn’t pooped since he was born and I was worried that he just wasn’t getting enough. I finally caved and gave him the bottle. It took Ethan thirty minutes to finish a bottle and he immediately pooped. We continued with this trend of giving him the bottle after offering him the breast. My lactation consultant kept encouraging me that we would be that 1% and that babies will always prefer the breast.

Ethan’s weight gain was slow and both the Cleft Palate Team (CPT)and some of the doctors discouraged my desire to breastfeed prior to bottle feeding at every turn. I felt as though they thought I was a bad mother for wanting to breastfeed. The feeding specialist from the CPT kept encouraging me to quit. When Ethan was six weeks he returned to his birth weight. I learned later that, whether breastfed or bottle fed, it’s normal for a baby with a cleft palate to have extremely slow weight gain and that it is common for them to not return to their birth weight until six weeks. I continued to encounter many challenges along the way. At nine weeks my milk supply dropped drastically down to nothing. A combination of exclusive pumping, PCOS and stress over Ethan’s slow weight gain forced us to have to supplement with organic formula. The first time we gave Ethan formula I cried. I felt like such a failure. Not only could I not successfully breastfeed our baby “normally”, I could not make enough milk for him. I tried everything and anything that I could. I tried Domperidone, Blessed Thistle and Fenugreek. I also took Goat’s Rue an herb tincture specially formulated for women with PCOS who are breastfeeding . It was shortly after this that my milk supply came back up a bit. Ethan began taking more and more formula and at three months his weight finally took off and started to catch up with other babies. During this time Ethan went on countless nursing strikes as he learned very quickly that the bottle was the easier way to get food. Each time my lactation consultant promised me that Ethan would come back to breast and he always did. I was determined to not let him forget how to latch. As much as I wanted to believe that someday, if I kept going, Ethan would breastfeed like a normal baby, it was a constant battle in my mind. It was that hope and desire that made me keep going every time I wanted to quit and just give him the bottle.  I tried not to take it personally when Ethan would reject the breast but I would often cry in frustration.  All along the way I struggled with blocked ducts, and sore, nipples from pumping. Every time I thought about stopping, my husband and my lactation consultant would encourage me on. When Ethan had finally started to catch up with his weight we introduced a supplementary nursing system (SNS). It was messy and awkward and most days Ethan wanted nothing to do with it, but it convinced him to come back to breast after one of the longest nursing strikes that we had ever had. It had been three weeks and he happily sucked away with his new gratification. I continued pumping and using the nipple shields, SNS and Haberman until Ethan was almost ten months old. At this point Ethan had surgery to repair his cleft palate. I pumped while he was in the hospital and sippy cup fed him after his surgery for about a week. In an effort to prevent him from doing too much sucking after his surgery I used the SNS, squeezing the milk into his mouth and offered the breast. He took to it immediately and refused to use the sippy cup. After three weeks the surgeon informed us that his mouth was healing nicely and he could now suck I pulled out the SNS and let Ethan suck away. The first time I felt Ethan suck on the nipple shield after his surgery I cried. I had no idea what a normal suck was supposed to feel like. I was amazed. Ethan had surgery May 25, 2009. For the entire month of June, I began cutting away pieces of the side of the nipple shield and then finally started to cut away pieces of the nipple. Every time I tried to offer my nipple without the shield Ethan would freak out. Finally on July 7, 2009 when Ethan was eleven months old, I slipped the nipple shield off when he wasn’t looking and he latched on and sucked away happily. It was at this moment that I breastfed my baby normally for the first time. I cried. I had known that I was always meant to breastfeed our child but I had doubts that it would ever happen.  Hope is a powerful motivator; it kept me going when I thought I had nothing left.

Today, Ethan is a happy, healthy, beautiful, fifteen month old. I nurse him anywhere from 3 to 4 times a day around my part-time teaching schedule. I plan to continue nursing until he is ready to quit. One of the complications of a cleft palate is malfunctioning Eustachian tubes. As such Ethan has tubes in his ears and will need to have them until the soft palate muscle allows the Eustachian tubes to function on their own. Until this time he is prone to ear infections. Breastfeeding as long as we have has helped us to be ear infection. I have never been so proud of anything that I have ever accomplished in my life as I have in the fact that Ethan and I did not give up. I feel joy and happiness every time I breastfeed my son. I am so eternally grateful for what we have accomplished and so proud of Ethan for how far he has come. I never would have breastfed my son if it hadn’t been for my lactation consultant and my wonderfully supportive husband. I now truly believe that “all babies were meant to breastfeed.”

When I became pregnant at the age of thirty-nine, by in vitro fertilization using my partner “Shrike’s” eggs and anonymous donor sperm, one of the things I looked forward to most was breastfeeding.

It was something I’ve always found fascinating, so I’d done a good bit of reading and I had also learned a lot about it from my older sister, whose children were breastfeeding when I was in my late teens and early twenties, so I went into it thinking I knew pretty much all I needed to know, and expecting that we would have no problems.

Boy, was I wrong.

Our daughter, “Peeper”, was born four weeks early. I delivered her vaginally, with no pain medication. Shortly after her birth, we were told that she weighed five pounds, four ounces, and that she was doing very well, especially considering her size and age.

I gave her an opportunity to nurse fairly soon after birth, with the help of my doula and La Leche League leader, DoulaK.

She latched a bit, and DoulaK said that her technique looked good, and her suck looked strong, but she wasn’t especially interested. DoulaK told me not to worry, because she had twenty-four hours before the doctors really expected her to do much nursing.

That night, and the next day, I gave her several opportunities to nurse, often with the help of one of the midwives or labor and delivery nurses. She had a couple of pretty good sessions, but was still very sleepy and not especially motivated.

Her mouth was so tiny that it was difficult to get around my nipple, let alone to get the good, deep latch that she really needed.

Another problem she was having with latching was that my areolas were swollen, making the nipples stand out less, so there wasn’t much for her to grab on to. One of the nurses commented that, “Oh there’s often some swelling after delivery, that will go away.”

I learned later that the swelling was probably exacerbated by the IV fluids I’d received during labor, and a couple of days later, from engorgement as my milk came in, but that a simple reverse pressure technique would have temporarily relieved it, and made my nipples more accessible to her.

One of the lactation consultants stopped by to see us the morning after she was born, but Peeper had just finished nursing, so we didn’t put her to the breast for the LC to observe.

One of the first things she told me when she walked into the room was that, “Most of our preemies need to be supplemented. I recommend a breast pump and a nipple shield and she may need some formula.”

A while later, both devices were delivered to my room, with little or no explanation of how to use them.

When Peeper was about twenty-four hours old, she was weighed again, and was now four pounds, four ounces.

The pediatrician who saw her that night said that he didn’t believe she had really lost almost 20% of her birth weight, because she “looked too good.”

I also later read that babies whose mothers have received IV fluids during labor are often born retaining quite a bit of fluid, and can easily lose 20% with no ill effects because they started out ahead of the game.

The doctor told us that he suspected Peeper’s birth weight wasn’t accurate, but that we’d have to assume she had lost a full pound, and go from there.

I agree that the birth weight wasn’t accurate – or, possibly, was elevated because of the fluids. I’d had very frequent ultrasounds during my pregnancy, and we’d known since 17 weeks that she was small, about 2 – 3 weeks behind her gestational age.

Based on the 10% of birth weight that babies are “allowed” to lose, combined with extrapolating from my ultrasounds, we suspect that she actually weighed about 4 lb 12 oz. That’s the weight that we put on the birth announcements, and it’s what we tell strangers in the grocery store, who are surprised to hear how old she is, because she is still quite small for her age.

But, assuming she had lost 20% of her birth weight, the doctor said that we would have to start supplementing her, with breast milk if possible, or formula if “necessary.”

I was adamant that she not get any artificial nipples, so we were told we could finger feed her using a supplemental nursing system, and could also try using the SNS at the breast, when she was willing to latch.

I was also adamant that she not have any formula, but the pediatrician insisted that she must take in X amount of food (the amount per feeding increased over the next few days) and if I couldn’t pump enough, we would have to give her formula as well.

I had received essentially no instruction on how to use the pump, so I just stuck it on me and turned it on for about ten minutes.

The insides of the bottles were foggy when I finished, but not even a drop of colostrum could be collected to give to her from that first session. It was incredibly disheartening.

I knew that I was producing some, because I was able to express a few drops when trying to get her to latch, but there wasn’t enough to pump yet.

I don’t remember the exact amounts, but the next time I pumped, I think I got about five or six milliliters, and the doctor wanted Peeper to have fifteen, so we mixed it with about ten milliliters of formula.

I was crushed.

By the next feeding, I was able to pump enough to match the amount that she was required to take, so we didn’t have to add any formula, but the pressure to produce enough for her was unbelievable.

Each time I pumped I could see that what I was producing was slowly changing over from colostrum to true milk, and I was getting a bit more each time, but the amounts were still tiny, and I was absolutely obsessive about capturing every tiny bit.

I wasn’t at all confident that I could make as much as she needed, but I knew that I wanted her to get every drop that I made, and if we had to “top her off” with formula after that, I could live with it.

That is a lie.

I actually hated the idea of her getting any formula at all, but I told myself I could live with it, because I was being told that Peeper couldn’t live without it, so I felt I had no choice.

Peeper was born on a Monday afternoon, and on Wednesday afternoon, I was discharged and she was transferred to the Pediatric ward, where Shrike and I were able to room in with her.

The routine at that point was that, every three hours, I would put her to the breast and attempt to get her to latch, usually using the SNS.

She sometimes nursed a tiny bit, but more often, she refused. She would sometimes fall asleep at the breast; other times, she actively fought it.

These attempts usually involved at least three people – not counting Peeper. I would hold her body with one arm and support my breast with the other hand, a nurse would grab her head and shove it onto my breast (very counterproductive, in retrospect) and Shrike would try to thread the SNS tube into her mouth at just the right moment.

She absolutely hated the SNS tube, and it would fall out or she’d let go or she wouldn’t latch at all.

This would go on for about fifteen minutes – later, I was actually given a time limit for how long we were allowed to work on getting her to latch before supplementing – and then we would give up, and Shrike would finger feed her expressed breast milk while I would pump for the next feeding.

This process generally took about an hour. Then we’d rest or, if we were lucky, sleep for a couple of hours until it was time to do it all again.

At some point on Wednesday, it was determined that Peeper was jaundiced (as is to be expected with a 36-weeker) and she was put under bililights, which meant that she had to stay in her bassinet, and we could only hold her during feedings.

That evening, the doctors were worried that she was “working too hard” to eat, and expending more calories than she could afford.

They checked her blood sugar and it was a low. After being fed some breast milk, it had not come up enough so they gave her some glucose water (also finger fed with the SNS) and it came right up, but they were now more concerned and started testing her blood sugar at the beginning of each feeding routine (three hours after the last meal).

This continued through the night, and in the morning, Shrike’s mother called to check in on us. I don’t remember her exact words, but she essentially told me to not be “so hung up about the breastfeeding” and that “it’s just important that she eats, and at least she’s getting the milk,” but “if it doesn’t work, it’s not the end of the world.”

I know that she was speaking out of concern for Peeper, and I’m sure that she genuinely thought that she was being reassuring and comforting to me about “not being able to breastfeed,” (which I’m sure she assumed was going to be the case) but the effect was the exact opposite.

What I heard was that I was putting Peeper’s health at risk by depriving her of the food she needed, in order to satisfy my own whims; that it really didn’t matter whether she breastfed, and I was being silly to be so upset about it; and that I should just stop this and do what was best for Peeper.

But I knew damn well that what was best for Peeper was to breastfeed, and I knew that to me, it would be the end of the world if she weren’t able to, and I’d be damned if I was going to give up on her – and myself – this soon.

All day Thursday, I asked for a visit from the lactation consultant, but she was tied up on the labor and delivery floor, so it was evening before she made it over, and she’d not been there very long when the pediatrician came in to talk to us.

At this point, Peeper had been having trouble keeping her temperature up, while laying under the bililights in just a diaper, so the heat in the room had been turned up to about eighty degrees. I was sitting on a chair in the corner of the room, right under the ceiling heat lamp, Peeper was in her bassinet, and Shrike was somewhere on the other side of the room. In the tiny room with us were the lactation consultant, the pediatrician, Shrike’s mother and sister, and one or two nurses.

I will forever think of this conversation as “The Nipple Intervention.”

The pediatrician started by saying that “I know that breastfeeding is important to you, and it is the best thing for Peeper, so we definitely want her to do it, but . . . .”

But.

Both breastfeeding and finger feeding were too much work for Peeper, and she still wasn’t keeping her blood sugar up like she should, and we had to get milk into her more quickly, so we were going to have to give her bottles.

I think I asked if there were any other options, but I was told that no, she must take bottles, or she was not going to be able to get enough food.

I probably express a concern about using artificial nipples, because the lactation consultant said that we could use Nuk nipples which “are much less likely to cause nipple confusion.”

I’m not at all certain, though, what I actually asked about or what concerns I expressed, because I did not feel as though I was in a position to do or say much of anything other than agreeing with the pediatrician’s plan.

What I believe I said was, “Of course, I want to do whatever she needs. It’s not ideal, because I was hoping to avoid bottles, but I have no problem with them if that’s what she needs at this point. If we can use the Nuks, that’s fine with me. But of course, we’ll do whatever you think is best for her.”

What I know I was feeling was that I was being completely ganged up on and intimidated and bullied into doing what the doctor wanted.

I felt very much like I was being told that it was time to stop my silliness and selfishness, and listen to the grown ups, and get serious about actually taking care of my child.

I felt like I was being judged by everyone in the room for my hesitance to agree to bottles before that point.

I felt like I had to agree, without any argument, in order to convince them all that I really did care about Peeper and I really did want her to be okay.

I felt like all of this was about them – the doctors, my in laws, even the lactation consultant – telling me what we were going to do.

And I felt like Shrike was neither being consulted by them, nor was I even allowed to consult with her about it, because she was on the opposite side of the room the whole time.

I also felt, very strongly, that this was not the right thing to do, for me or especially for Peeper.

I made myself be okay with it at the time, because I had no choice, but I knew there had to be another answer.

I knew there had to be other, better ways to get the milk in her without introducing artificial nipples.

I knew I hated everything about the idea of giving her bottles, and I was terrified that they were going to be the beginning of the end of any hope I had of her ever breastfeeding.

After the doctor left, Shrike and I went down the hall with the lactation consultant, and talked with her about it, away from the crowd, out of the heat, just the three of us. She made me feel somewhat better about the decision, but I still was very uncomfortable with it.

DoulaK stopped by that evening to visit, and we talked with her for a long time. She was very reassuring, but also suggested some other possible feeding options, which the lactation consultant dismissed as not being appropriate in our situation.

While DoulaK was there, Peeper nursed for quite a while – probably the best session we’d had since the first day.

Over the next day, Peeper’s blood sugar stabilized, and her weight continued to go up, and we were discharged on Saturday.

The bottles had done the trick, I suppose, in getting the milk into her more quickly and easily, but they’d also done their damage, and she was almost completely refusing the breast by that point.

For weeks, I pumped and Shrike bottle fed Peeper, and we slept in two and three hour bits in between.

My nipples got incredibly sore, and I was in constant pain, not only when I was pumping.

I’d started with pump flanges that were too small, and used too high a suction setting on the pump (because of a lack of training) and that started the damage, which just got progressively worse.

Feeding wasn’t Peeper’s only health concern. She was born with a congenital heart defect (two holes in her heart, which were surgically repaired when she was twenty weeks old) and she had some questionable results on her metabolic tests, so there were weekly trips to the cardiologist an hour away, and one train trip to a Children’s Hospital four hours away.

For every trip, we took the breast pump along, and I pumped in the hospital lactation room, and parking lots, and riding down the interstate.

When we were at home, I still offered the breast at almost every feeding, but it became harder and harder to deal with her refusal to latch.

It was impossible to not take it personally, to not feel like she was rejecting me.

The worst part was that not only would she not latch, but she would fight against it, and would wrap her tiny little hand around my very sore nipple and push it away, saying what sounded all the world like, “Uh-uh! Uh-uh!”

I don’t know how many times I handed her to Shrike for a bottle, crying, and asking, over and over, “Why won’t she do this? Why doesn’t she like me?”

I can’t even begin to count the number of times I talked to DoulaK on the phone during that time, and she always had a recommendation for something I could try to ease my nipple pain, or to encourage Peeper to latch, or just to help us to bond, in the absence of an actual breastfeeding relationship.

Most importantly, she always listened to my concerns and my feelings and validated them, she always encouraged me to keep trying and she always assured me that Peeper would eventually get it.

She reminded me that Peeper still wasn’t even supposed to be outside of me yet, so of course, she was having trouble. Many full term babies take a couple of weeks to learn to nurse well; I just had to be patient and give her time to mature.

She also told me, over and over, that she had faith in Peeper and that it might take a while, but that she knew she would be breastfeeding eventually.

Her confidence in our ability to work through this was invaluable at a time when I had none of my own.

I also can’t tell you how many hours I spent on the computer researching nipple confusion, and breast refusal, and nipple pain, and everything else I could find.

In my research, I found very little information on how to solve nipple confusion, only information about how to prevent it – warning after warning to avoid introducing artificial nipples.

This is when I learned that syringe feeding or cup feeding would have been viable options for us, had our doctors and our hospital been willing to do either.

Both techniques are used in NICUs with babies much younger, much smaller and much sicker than Peeper, and I am still very angry that neither was made available.

We were very lucky that Shrike was able to take a month off work when Peeper was born, because as hard as things were those first few weeks, at least she was there the whole time, doing all of the bottle feedings, and most of the diaper changes, and a lot more of the hands-on baby care than I was.

I felt at times like actually parenting Peeper was Shrike’s responsibility, and my job was to pump and hand them milk.

Shrike was incredibly supportive through it all, and never once suggested that I give up on trying to get Peeper to breastfeed.

In fact, there were many, many feedings when I just wanted to have Shrike give her the bottle and get it over with, but she encouraged me to “give her a try” first.

I know that, even though she usually turned me down, if I’d ever let myself get away from offering Peeper frequent opportunities to nurse, we’d have had no hope of getting her back to it.

And, as much as I was missing the opportunity to feed Peeper, and as much as I was not bonding with her, she and Shrike were able to bond in a way that would not have been possible if she had been breastfeeding from the beginning.

That, I suppose, was the silver lining in the very dark cloud that I was living in at the time.

It doesn’t make sense, but as jealous as I was of their relationship at the time, there was also nothing that made me happier than to see them together, and to see Shrike holding her, and talking to her and caring for her.

When Shrike returned to work, though, things got much more difficult for me. Now, for ten hours of the day, I had to do it all myself.

When I’d try to put Peeper down long enough to pump, she would cry. Then I could cry, telling her, “I am doing this for you!”

Several times, I pumped while holding the bottles to both breasts with one hand and elbow, as she lay on my lap, taking a bottle from my other hand.

“You know,” I’d tell her, “There’s really a much simpler way to do this. How about we cut just out the middle man, huh, Kiddo?”

I was using a Medela Pump In Style, and anyone who’s used one will tell you that it “talks.” The noises that it makes are incredibly voice-like and when you add in a dollop of hormones and a heaping helping of sleep deprivation, it becomes something of an auditory Rorschach test.

I’d heard the pump say all kinds of crazy things, from “Loser McCain, Loser McCain,” in the days following after the presidential election, to “We’re losing control, we’re losing control,” after failing for a third time to catch a urine sample for some metabolic testing that Peeper needed, but now, the bastard really turned on me.

On the first or second day that I was home alone with Peeper all day, I was pumping while she lay in her bassinet and we both cried, and the pump was saying, “It’s such a pain, it’s such a pain.”

Well, yes, I couldn’t argue with that.

Then it changed to, “It doesn’t pay, it doesn’t pay.”

And, for a moment, I started to believe it, and that is the closest that I ever came to giving up.

I knew I needed help to get past that, so I picked up the phone and called DoulaK, and told her, through my tears that, “We’re having really rough day, here. Do you have a minute?”

We talked for hours, and she told me that I sounded much like every mother of a newborn that she talked to.

Not necessarily a mother of a one-month old, mind you, but a newborn, because that’s what Peeper really was at that point.

She was just starting to “wake up” and realize that she was no longer a fetus but an actual baby.

She’d learned how to cry. She wanted to eat all the time. I was pumping as often as I could, and barely staying ahead of her.

I was exhausted, I was discouraged and I was devastated.

All my life, I’d looked forward to having a baby, and now that I had one, nothing was going the way that it should.

My baby was early, and she was tiny, and she had a hole in her heart, and she might have a metabolic disorder (she doesn’t) and I couldn’t even feed her.

For four weeks, I’d been holding on to the lactation consultant’s prediction that Peeper would pull it together and learn to nurse by her due date. Now that date had come and gone and she was no closer than she was at a week old.

Yes, she’d had a few days here and there when she’d suddenly decided to latch, and a couple of times she’d even nursed several times in a day.

But each time I thought she’d turned a corner, the next day, we’d be right back where we’d started.

That was almost worse than if she’d never latched, because I would get my hopes up repeatedly, only to be disappointed time and again.

But, I did have that glimmer of hope that she was not completely refusing the breast, she did still know how to latch, and she was still willing to do it on occasion.

In the hospital, I’d been given a couple of different nipple shields, but Peeper wasn’t able to latch with either of them, because they were so much bigger than her mouth was at the time.

LadyKay had told me that a nipple shield had done the trick in getting her son over his nipple confusion (after having been given bottles in the hospital, when he was jaundiced), and suggested I might think about giving one a try.

I was hesitant, though, because it hadn’t worked before, and I also knew that they can often cause more problems than they solve, so DoulaK had been hesitant to recommend that I use one just yet.

This day, though, she suggested that I consider it.

The main concerns with a nipple shield are nipple confusion – a moot point, since we were already there, and nursing with a shield was better than no nursing at all, and that the nipple doesn’t receive as much stimulation as it would if the baby were latched directly, so it can cause a reduction in milk supply. However, my supply was well-established at this point, and I would still be pumping, so I wasn’t too concerned about that

I thought about it for a few days, and when Peeper was just over five weeks old, I tried the nipple shield.

She latched immediately.

And nursed.

I was very careful not to get my hopes up, because she’d tricked me before, but I kept offering the breast, with the shield, and she kept taking it.

I believe it was a Wednesday that we first used the shield, and from Thursday afternoon through the day Friday, she did nothing but nurse, nap, poop, and nurse the other side.

For about thirty-six hours straight.

Her tummy was full enough that she didn’t fuss for a bottle, and my breasts were empty enough that I felt no need to pump.

I called DoulaK on Friday and said, “You told me to call you with some good new for a change, so I am!”

This time, we really had turned the corner.

We gave her a couple of supplemental bottles over the weekend, mostly because I was freaking out each morning that “She’s not eaten in five hours! If she won’t wake up and nurse, make her take a bottle!”

Of course she was sleeping longer, she’d been cluster feeding like crazy, and if I’d waited thirty minutes or an hour, she’d have been awake and asking to nurse again, I’m sure.

On Sunday, Shrike’s parents watched her for an hour or so while we went out to get a Christmas tree, and gave her a bottle while we were gone.

She turned six weeks old the next day, and (with the exception of the day after her surgery, before we were allowed to pick her up) she’s not had a bottle since.

Within two or three weeks, I had weaned her off of the nipple shield, and we were home free.

It’s hard to believe, as I sit here typing, while Peeper naps and nurses in my lap, that this is the same kid who refused to latch for six weeks.

Now, she refuses to unlatch!

She is still small for her age, but all her doctors have been thrilled with her growth – especially considering her heart defect, which often causes babies to grow slowly.

Her growth has been a huge thing for me.

Especially in the early days, I was so worried that if Peeper wasn’t growing as fast as her doctors wanted her to on breast milk, they would insist that we give her formula.

Even now, every single time I put her on a scale, I hold my breath, as I wait for its verdict, as I wait to see whether it will say that I am doing my job, that I am a fit mother for her.

In those first days and weeks, all we were asking of her – all they were asking of me – was that she eat and that she grow.

If she couldn’t do that – I couldn’t do that – I felt like I would be failing her.

As it turns out, she could. And I could. And we have.

She is almost a year old, and she is thriving.

With the exception of about two ounces of formula in her first eight days (the 10 cc I mentioned above, and a couple of times that I was away from her briefly and she ran out of the pumped milk available) she was exclusively breastfed until she was six months, six days old.

Now almost a year old, she continues to breastfeed on demand. We started offering her finger foods at just over six months, taking a baby-led approach to the introduction of solids. She’s loving her “chewin’ food,” but is still nursing just as much.

I know that it’s only a matter of time before she’s getting enough nutrition from the solids that she starts cutting back on her nursing, and I’m a little sad about that, but I’m also proud of what a “big girl” she’s getting to be.

Of course, our nursing relationship will be changing significantly over the next several months, as she eats more and more solid foods, and will continue to evolve as she matures, but I’m looking forward to breastfeed as long as Peeper wants and needs to.

Peeper and I got off to an incredibly rough start with nursing. We were dealt some bad cards, and, I now realize, we were given some bad advice from the pediatricians and some other people at the hospital.

I also now realize that we encountered some people who claimed to be, or perhaps even truly thought they were being supportive of our efforts, but were, in reality, sabotaging us.

I am still very angry about that, and am still very, for lack of a better word, traumatized, by the whole situation, especially the “nipple intervention.”

But, more importantly, we also had some very, very good advice and support and encouragement all along the way.

We got great technical advice from DoulaK and my other La Leche League leader, my sister, and one of my midwives, and incredible emotional support from all of those people, as well as Shrike, of course, and my mother, our therapist, and many friends.

Without their help, we never would have made it through those first six weeks, and I would have been absolutely devastated if Peeper had not learned to breastfeed.

I went into it probably knowing a lot more about breastfeeding than most people who’ve never done it, I was absolutely committed to making it work, and I had a great support system.

And I still doubted, everyday, whether we would be able to do it.

I totally understand, now, why women give up on breastfeeding, especially if they are not lucky enough to have that kind of support.

But there is no excuse for them not having that support. There’s no excuse for hospitals pushing formula when a baby doesn’t need it. There’s no excuse for them not offering alternative feeding methods to avoid the introduction of artificial nipples and there’s no excuse for women not being told where they can turn for help.

Shrike tells me that Peeper wouldn’t be nursing today if I weren’t so damn hard-headed, and I like to think she’s right.

I’ve done a lot of things in my forty-one years, some of which I’m pretty proud of, but there is nothing that I’m prouder of than sticking it out and having enough faith in Peeper, and in myself, to give her the time to mature and trying one thing after another until we finally hit on the answer, and doing what it took to get us through those first six weeks to bring us to the point where we are today.

As awful as those early weeks were, and as hard as some of the other things we’ve been through with Peeper have been, from worries during my pregnancy about a possible neural tube defect, to her open-heart surgery, I think that I am a stronger person for it, and I am a better mother for it, and Peeper, Shrike and I are a stronger family for it.

I spend a good portion of my day (and night) with Peeper at my breast, and sometimes I get tired, and sometimes I need a break, but I never, ever take it for granted.

And I never will.

Visit Whozat at her blog Lucy & Ethel Have a Baby: The Adventures of Shrike & Whozat (& Peeper!)

My 1st daughter, Isabela, was born on May 3, 2002 via c-section.  I remember being so groggy from the pain meds. but I demanded to have my baby so I could nurse her during that 1st crucial hour after birth.  I held her up to my breast and she started nursing right away. It was beautiful!  I nursed her for 45 minutes before they took her to the nursery so I could get some rest. I nursed her every 3 hours- just like the books said to do- and wrote every feeding down on the schedule card the nurse gave me.  My milk came in on day 3 and Isabela was back up to her birth weight when we went home 2 days later.  I loved nursing my baby. I loved holding her in my arms, skin to skin, rocking and singing to her as she nursed for hours. But things soon took a turn for the worse. I had an overactive let down and Isabela gagged and vomited every time she nursed.  She had terrible gas from gulping so much air and would cry in agony from the pain.  She also had colic.  She would scream and refuse to eat for hours every night.  One night I broke down and gave her a bottle of espressed breast milk.  She chugged down the whole bottle and fell asleep for 12 hours.  The next night I gave in again.  After a few days she would no longer take the breast. She would scream and arch her back and thrash her head around until I gave her a bottle.  I felt like a failure. How could this have happened?  I read all the books and took the class at the hospital where did I go wrong?  I  refused to give up.  Maybe she would not take my breast but I could still give her breast milk.  From that day on I pumped every 3 hours during the day.  I even pumped while driving and on an airplane!  Thankfully I had an abundant supply and I was able to pump and feed my baby girl until her 1st birthday when I quit- because that is when all the books said you should stop.

When I became pregnant with my second child I was determined to make breastfeeding work.  I swore that I would not give this one a chance to get used to a bottle because I would not offer one- ever.  On January 20, 2006 I gave birth to another beautiful girl, Olivia.  Just like Isabela I got to nurse her within the 1st hour after her birth and just like her sister she nursed beautifully.  She nursed on demand and I did not use the schedule card they gave me.  But problems arose again, this time before we even left the hospital.  Olivia was an aggressive nurser.  She would attack my breast and suck so hard that my nipples cracked and bled.  It was so painful to nurse her and my milk was taking forever coming in.  The LC kept telling me I needed to give her a bottle of formula after she nursed because she was losing too much weight. I cried and refused.  I was so upset thinking that our breastfeeding relationship was over before it even began. How could something so natural be so hard?  Later on that day the LC came back in and asked me to massage my breasts to see if we could get any milk to let down. So I did and I squirted her right in the face!!!  We both laughed.  She then convinced me to squirt some formula on my breast to get Olivia to latch on and start nursing and it worked.  When we went home my breasts felt so deflated and Olivia cried so much. I tried pumping but got nothing.  I ended up giving her a bottle of formula.  It was a terrible decision.  I reminded myself that I was going to tough it out and not resort to the bottles.  The next day was terrible but I did not cave in.  She cried and cried but I kept nursing her all night long.  This went on for a couple nights and finally she slept for 4 hours and I woke up with a soaked bed!  I was finally engorged with milk!  Olivia was always a fussy baby, she had colic and refused to eat but I knew that it was not because she was hungry.  She had colic and there was nothing I could do but try and soothe her. I found that if I gave her a pacifier until she calmed down I could take it out of her mouth really fast and replace it with my nipple and she would eat until she fell asleep.  She soon because dependant on my breast for everything. She would nurse for comfort, nurse when she was upset, nurse when she was shy,  nurse to fall asleep. She woke up many times during the night and had to be nursed to fall back asleep. I was so tired that I began to resent nursing. I could not wait until she was 12 months so I could wean.  Then that say came. Olivia’s 1st birthday.  I was ready to wean but she was not in any way ready so we  continued.  She was still waking 2 or 3 times a night to eat and I was still exhausted.  When Olivia was 16 months old I started getting back spasms. I had to go to the hospital and get a morphine shot and was prescribed Percocet for the pain. I was told that I could not nurse while on the pain meds.  I had no idea how Olivia was going to handle this.  When I got home from the hospital all I could do is lay in bed in pain. My husband had to take off work to take care of the girls.  Olivia tried several times to nurse but I would not let her. She cried and cried for days. Finally, a few days later she fell asleep in my husband’s arms and slept the whole night!!  When I was weaned off the meds I tried to nurse her again but she would not take it.  My husband and I laughed and he said to me, ” Never thought she would give it up that easily.”

On November 30, 2008 I gave birth to my 3rd daughter, Eliana.  The 1st time I nursed her it felt different than it did with Isabela or Olivia.  It was calm and peaceful, relaxed, unrushed.  I knew that second that everything was going to be different this time around.  I was right. Ellie was a patient nurser.  My nipples never became sore or cracked. My milk came in right on time. We came home from the hospital and things remained the same.  She nursed on demand.  She never arched her back or fussed at my breast, she never refused a feeding, she never had colic, she never even cried!  We co-slept and neither of us had to fully wake to nurse, we just got things started and fell back to sleep.  Now she is almost 6 months old and has never sucked an artificial nipple.  She is 100% content with mommy’s breast and is happy all the time!  I love the bond we have formed and I will not put a time limit on our nursing relationship.  She can nurse as long as she wants.

For me breastfeeding was not something I was able to learn by reading books or taking classes. It was a learning rollercoaster with ups and downs and twists and turns but at the end of each ride I came out knowing more than I did when I started.  Breastfeeding was not always easy but I am proud to say that all my girls were given mommy’s milk- even if one only drank it from a bottle :)

I was having ultrasounds twice weekly because the doctors were very worried about twin-to-twin transfusion syndrome, a dangerous complication that happens sometimes with identical twins.  I drove to one of my Thursday ultrasounds, thinking that it would be more of the same: they are still different in size and very small, so you should lay around and do nothing all day.  Instead, they took a very long time to do the ultrasound, and when the doctor came in afterwards to give me the report, the first thing he said was, “So we have you scheduled for a c-section at 7:30 tomorrow morning.”  I was shocked!  I was only 35 weeks pregnant, and not feeling ready for the twins to be born.  But they had measured the blood flow from the placenta, and felt that Baby B, the smaller twin, was not getting enough oxygen and nutrients.  So it was time for them to come out.  Both babies were breech, and the doctors refused to allow me to even attempt a vaginal birth.  They told me that at 35 weeks, the babies should be healthy enough to come  home within a few days, and that “they might have to spend a day or two in the NICU, but it’s no big deal.”  I can’t believe they told me that!  And I can’t believe I bought it!

So the next morning, Jonah and Owen were born by C-section at 8:17 and 8:18 in the morning.  They were not breathing very well, so the nurses whisked them off to the NICU with nothing more than a quick wave to me.  My husband went off with them, and I was sent up to recovery.  It was so strange to be in the labor and delivery ward of the hospital with no babies.  I could hear babies crying in neighboring rooms, and I ached to be holding my two little ones.  When I went to see them in the NICU, they had their faces covered (for minimal stimulation), and were positively covered in wires and tubes and monitors.  We were not allowed to touch them or even talk to them above a whisper that first day, and the news just kept getting worse and worse.  I will never forget the moment when the doctor said to me about Owen, “Well, we don’t have many more tricks up our sleeve.  If he doesn’t respond to the Nitric, we’re going to have to call Boston.”  Both babies had severe respiratory distress syndrome, and they didn’t respond to hardly any of the treatments for the first 24 hours.

Meanwhile, I was pumping and trying to build my supply so that I could nurse them when they were strong enough.  At first, we were adamant that they not have pacifiers or bottles, but when the nurses said that bottle-fed babies go home sooner, I gave in.  It was two days before they even were able to have the first drops of colostrum swabbed on their gums.  Slowly, they started to be able to take little bits of my milk from a bottle nipple, once they were off the ventilators.  It was five days before we got to hold Jonah, the stronger of the two.  I kept asking when I could nurse them, but the nurses told me that it would make their oxygen levels drop, and they had to be on a certain type of ventilator, and all kinds of other excuses. 

I had plenty of milk, and I was pumping every 3 hours around the clock to build a supply for my little guys.  The hospital finally told me to store it at home in our freezer because theirs was full! 

But we still weren’t nursing.  Jonah was in the hospital for 2 weeks, and I nursed him 3 times before he came home.  Owen was in for 3 weeks, and I only nursed him once while he was there.   Once Jonah came home, we worked really hard to get him latched on and nursing.  He was getting stronger every day, but it was so hard to nurse him (he would nurse for an hour every feeding), then offer him a bottle of milk so that we could be sure he was getting enough, then pump so we would have milk to offer.  And I tried to go to the hospital every day to visit Owen, who was still there.  It was insanity! 

And it only got crazier when Owen finally came home.  We nursed every single feeding because I was so determined to get them on the breast.  And it was the same routine: nurse, bottle, pump.  All day and all night.  Owen had to have some special high-calorie formula that we mixed with breastmilk instead of water, because he wasn’t gaining weight very well. 

And when Owen came home, I started having excruciating nipple pain.  It felt like broken glass was coming out of my breasts at every feeding.  My husband would come home and find me nursing the boys and sobbing.  I started taking painkillers just to be able to feed them, because I refused to switch to formula.  Our doula told us that it was almost definitely thrush, so I went and got checked out by my doctor.  She told me that the boys’ latch looked good, and it probably was thrush, but she wouldn’t treat me unless their pediatrician also treated them.  Their pediatrician then told me that he wouldn’t treat them unless I was also being treated.  It took me three days to finally convince them that someone had to write the prescription first.  And so we all took nystatin, which did nothing for two weeks.   Then, my doctor switched me to Diflucan, and we used gentian violet along with it.  And, even though everything in our house was purple for a week from the gentian violet, it worked! 

We had four glorious, pain-free days of nursing before the pain returned.  And so I went nuts.  I read everything I could get my hands on about yeast.  I became the Hygiene Nazi, treating everything that touched breastmilk as though it were toxic waste.  We put vinegar on everything, and used grapefruit seed extract and gentian violet, and many courses of Diflucan.  Nothing worked. 

So I was in immense pain all the time, but we finally did get the boys solely on the breast, with no bottles at all.  What a triumph!  I wish I remembered more of it, but I spent so much time in a haze of pain that it all seems like such a blur to me.

Finally, six weeks after the pain returned, a lactation consultant at the support group I was going to said, “maybe it’s not yeast.”  The thought had never occurred to me (or, apparently, to my doctor).  So I went to the doctor and insisted that she culture my breastmilk, although she didn’t think it was necessary.  It’s a good thing we did, because it turned out that I didn’t have yeast at all; instead, I had a raging staph infection in my nipples. 

She put me on dicloxacillin, which didn’t make me feel better and gave me an allergic reaction.  When I told the doctor that I was still having pain, she told me she was just going to prescribe another course of Diflucan, because it was probably just yeast from the antibiotics.  I would not take any more meds without being cultured, so I insisted that they wait and do another culture.  And it’s a good thing, because it turned out that the staph was MRSA, a medicine-resistant form of staph. 

The doctor put me on Levaquin, another antibiotic that the culture indicated would work, but told me that I couldn’t nurse while I was on it.  And then told me that I could.  I asked our pediatrician who told me it was fine, and then another doctor in his practice said it was absolutely not.  I kept asking doctors, and kept getting conflicting answers.  Finally, I decided that I wouldn’t risk the health of my two boys who had already been so sick, and I decided that I would formula feed them for the fourteen days while I was medicated, and just pump.  I had to go stay with my parents so that they could help with the logistics of managing and feeding two babies and pumping.  After 24 hours of having the boys reject the bottles and then, finally, gulp down the formula and spit it all back up, I decided that I couldn’t do it.  I did a lot more research, and found some information saying that it was probably all right for me to nurse while I was on the Levaquin.  I still was wary of it, so I decided to nurse every other feeding, so at least they would still get the benefits of breastmilk, and any harmful effects from the medicine would be limited.  It was a disaster.  They had a lot of trouble keeping the formula down, and my supply dropped because the pump was not getting as much as the babies normally did. 

But the medicine was working!  By the end of the fourteen-day course, I was pain-free again.  And once I was done with it, I started nursing the boys for every feeding again, and trying desperately to build my milk supply back up. 

Unfortunately, the pain came back after only four days.  I had another two cultures done, because I wanted to make sure we were treating the right problem.  I was afraid that we had yeast again from the antibiotics.  But both cultures came back negative.  I was at my wits’ end.  I couldn’t understand why I was still in so much pain.  I went to my doctor, who told me that she just couldn’t understand it either.  She said that our latch looked good, so I probably just needed some time to heal up.  She told me to pump and bottle feed the boys for a week to let myself heal.  “No nursing for at least a week!”, she told me.  This didn’t sound quite right to me, but I didn’t know what else to do, so I tried it.  Again, it was a disaster.  My breasts no longer would let down for the pump.  I would pump for 20 minutes and get only an ounce of milk.  Needless to say, my supply plummeted.  We had to supplement the boys with formula, which they again had trouble keeping down.  I went against my doctor’s advice and nursed them once a day, in the evening, just to make sure they would go back to the breast after a week. 

After 4 days, they rejected the breast completely.  Every time I tried to nurse them, they would scream as if they were being terribly hurt.  It was horrible.  They had decided that the bottle was much easier, and they didn’t want to nurse anymore.  I stopped all bottles immediately, and we cup-fed them to make sure they were getting enough to eat.  They still refused the breast, and cried all day and all night.

I was completely at the end of my rope.  Friends and family were telling me to just give up and switch to formula, but I felt like I didn’t know how to be a mom without nursing.  It was so important to me, and I felt like Jonah and Owen really needed it, that I refused to quit.  I cried and cried and spent hours and hours researching on the internet.  Finally, even though we didn’t have the money, I bit the bullet and paid for a private lactation consultant to come out to the house and consult with us. 

She will forever be an angel in my mind.  In the space of about 15 minutes, she had diagnosed and then fixed our latch problem.  I felt so foolish that I had been ‘doing it wrong’ for four months!  As for the nipple confusion, she said to just keep doing what we were doing, and that now that they had a better latch, it would be easier for them to get milk from the breast.  Within a few days, my supply was back up, the boys were nursing like pros, and I was pain-free!  I can’t believe it was so easy after all that pain.  I had been told by two other lactation consultants, my doctor, and the boys’ pediatrician that our latch was very good. 

It was beautiful to nurse without having it make my toes curl in pain!  I was thrilled, but the boys were not happy babies.  They were covered in rashes, and spitting up constantly, and too uncomfortable to sleep, ever.  We were all exhausted, and I did more research.  Although my doctor told me that what I ate wouldn’t affect the boys, I thought that something I ate might be bothering them.  I cut dairy out of my diet for two weeks, and they got much better, and then worse again.  I decided to do the Dr. Sears total elimination diet.

So for two weeks, I ate nothing but rice, millet, summer squash, turkey, sweet potatoes, and pears.  I was ridiculously hungry and lost a twenty pounds, but it helped a lot.  The boys’ rashes disappeared, they stopped spitting up entirely, and they started sleeping longer stretches at night.  They seemed much happier. 

After a couple of months, we figured out that they were reacting to dairy and soy in my diet, which explains why they always had so much trouble with the cows’ milk formula. So now I eat anything but dairy and soy. Now that the boys are a year old, I am able to eat a little bit of cheese once in a while.

One day, when the boys were 7 months old, I noticed that my nipples were getting sore again.  We had started nursing in some new positions, so I just monitored their latches closely, hoping it would go away.  It didn’t, and one day I woke up to find that one of my breasts was red and hot.  I had had this for months before, and I figured it would go away, but later that day I started to feel hot and really tired.  Before long, I had chills and was in really bad shape.  I figured out that I had mastitis, and was put on antibiotics.  Within a day, I was feeling better and I thought that was the end of it.  Unfortunately, I had it again as soon as the antibiotics ran out.  The same thing happened twice more, and I ended up with three courses of antibiotics within 8 weeks.  I was sick from the antibiotics and worried about taking to many meds, especially because I was also on Diflucan so that I wouldn’t get thrush from all of the antibiotics.  The fourth time that I woke up with a red breast, I decided to give it 24 hours and see what happened, as long as I didn’t get a fever.  I kept a heat pad on my breast all day and after every feeding I swabbed my nipple with grapefruit seed extract, let it dry, and applied Bactrim and a clean nursing pad.  After 24 hours, the inflammation was gone!  

Still, five months later, this happens about once a week, but it always goes away with heat and super hygiene.  I had given up on it until recently, when a friend sent me a video about something called inflammatory breast cancer.  I was scared into getting some answers, and will be seeing a breast health specialist this month and getting a mammogram and an ultrasound.  So far, no one has been able to give me any answers, but I’m hopeful that we will figure this out.

Our nursing relationship has been worth every bit of trouble.  It has been amazing to watch my boys grow from two tiny, sick, skinny babies into happy, healthy, chubby mama’s boys.  They will be a year old this month, and they are complete milk monsters.  Their first baby sign was the sign for milk.  They don’t even know what to do with a bottle.  Aside from the disastrous (and, thankfully, occasional) formula, they were exclusively breastfed for 7 months, when they started solid foods. 

I think we have made it this far on sheer determination, but I hope the next year will be easier; my initial goal was a year of nursing, but now I think we’ll do two!