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!)

We hit many obstacles including, poor weight gain, week suck and tongue tie. I was never able to fully breastfeed him as he would get too tired, therefore for 5 months I expressed for Brendan. My milk eventually dried up and even after seeking professional help, which wasn’t helpful (I was in a remote community and only had 1 Dr and 1 community child health nurse) I am very proud to have made 5.5 months of full EBM with NO FORMULA!

When I was pregnant with my second child, I was even more determined to get him to breastfeed. I armed myself with lots of information and knew that should I run into milk supply troubles there were things I could do to help. At just 26 weeks I went into pre-mature labour. Thankfully they were able to stop it and I was given steroids to help my baby’s lungs. I kept going into labour until eventually, at 34+2 weeks, they decided not to stop it anymore. Tristan was born at 34+3 and spent just 6 days in NICU and 2 days rooming in with me. Tristan is also tongue-tied, but not to the same extent Brendan was and therefore breastfeeding is easier for us. He was fully suck fed by day 3 and fully breastfed by day 7. He too started off on a nipple shield, due to jaundice making him sleepy, I was able to wean him off by just 3 weeks of age. Tristan is now 3 ½ months old, fully breastfed and sleeping through the night (9:30 till 7:30)!!. He was given formula in the first 6 days when there wasn’t enough EBM for him.

Update (Jan 2010): Tristan is now 6.5 months old and still breastfeeding!

I have found a recipe for lactation cookies which help increase my supply on down days or when I am sick. They are fantastic and have got me through a few rough patches. They are very addictive and anyone can eat them :D My 2yo LOVES them!

Housepoet’s Famous Lactation Boosting Oatmeal, Chocolate Chip & Flaxseed cookies

Serves: 6 dozen cookies
Preparation time: 15 minutes

Ingredients:

• * 1 cup butter or marg
• * 1 cup sugar
• * 1 cup brown sugar
• * 4 tablespoons water
• * 2 tablespoons flaxseed meal (can be found at any local health food store)
• * 2 large eggs
• * 1 teaspoon vanilla
• * 2 cups flour
• * 1 teaspoon baking soda
• * 1 teaspoon salt
• * 3 cups oats, thick cut if you can get them
• * 1 cup or more chocolate chips
• * 2 tablespoons of brewers yeast (be generous) (IT MUST BE BREWERS YEAST, NO SUBSTITUTIONS)

Directions:

• * Preheat oven at 375 degrees F.
• * Mix together 2 tablespoons of flaxseed meal and water, set aside for 3-5 minutes.
• * Cream (beat well) margarine and sugar. Add eggs one at a time, mix well.
• * Stir flaxseed mixture and add with vanilla to the margarine mix. Beat until blended.
• * Sift together dry ingredients, except oats and chips. Add to margarine mixture. Stir in oats then chips.
• * Scoop or drop onto baking sheet, preferably lined with parchment or silpat. The dough is a little crumbly, so it helps to use a scoop.
• * Bake 8-12 minutes, depending on size of cookies.

I make mine into 2 slices, just make sure the slice is no thinker than a cookie. It’s quicker and easier that way, especially with kiddies running around :-D

Due to the fact that Jayden was breech, I was scheduled for a caesarean at 39 weeks. I had the most wonderful birth experience and was back in the room to greet my husband and new baby within a few hours. I was elated, and could not believe this perfect little person was created by us.

After an hour or so back in the room, we tried to breastfeed. Jayden was still so sleepy and didn’t attach or seem at all interested. Fair enough, he was just yanked out of my belly unexpectedly (in his mind) so I thought we’ll give him some time to wake up.

Jayden didn’t wake up properly for a good few days and was quite unsettled as my milk didn’t come in properly until day 5 due to the caesarean. He was very hungry and not getting much at all because he was too tired to feed – what a vicious cycle it was, so hungry because he was too tired to feed, but too tired to feed because he was so hungry. I had the ‘baby blues’ moment early on day 5 when the midwives decided to give him formula with my EBM (what I could get!) – I felt horrible as formula was something I wanted to avoid at all costs. I reluctantly agreed, as I had to look after my little man as he had lost 430g (over 12% of his birth weight) and was getting jaundiced and very unsettled.

I will always remember the moment when I was attached to a double pump at 4am, trying to express what little milk I could get out, whilst feeling like the biggest jersey cow. I watched with tears streaming down my face whilst a midwife (a total stranger, in my eyes!)  was feeding MY baby. Why couldn’t I do that? What made my body so incompetent that I couldn’t do the one thing that nature intended it to do?

The pump must have done its job, as later that morning my milk came in, and I suddenly resembled a Dolly Parton impersonator. Unfortunately, we now had another problem in that because my breasts were so engorged, he couldn’t attach properly. Nevertheless, I continued to try and offer him the breast at regular intervals.

I had a light bulb moment later that day. After seeing how Jayden quickly demolished the bottle of formula, and now that my milk was in, I decided to try expressing again and feeding it to him in a bottle. All the staff were supportive of this idea, so I got pumping – and the liquid gold flowed.

Now came the biggest test – would Jayden drink it? Yes – he would! You have no idea the amount of relief I felt knowing that I COULD feed my baby MY milk – okay, it might be through other means other than my nipples, but he was still going to get all the lovely liquid gold and nutrients that I was producing for him.

So on it went – I expressed every single feed for my 2-3 hourly fed baby for the first 5ish weeks of his life. Looking back now I think how hard it actually was (especially when my poor husband was trying to sleep next to me with the breast pump going!), but at the time it was just something I had to do for Jayden.

I would always offer the breast to Jayden before the EBM, in the hope that he would attach and feed. The day that he actually attached properly, and I saw him happily sucking away was one of the best days of my life. I nearly jumped off the chair – in fact I would have, if he wasn’t still attached!

This could quite easily be the end of my story, happy ending right here. However, we had another spanner thrown in the works when Jayden was about 14 weeks old. One day I woke up – and suddenly had no milk. After having a fabulous supply with fast letdown, it was just suddenly gone. I couldn’t express anything, and Jayden couldn’t get anything out! I tried to keep Jayden on the breast all day to stimulate the supply, but the poor thing was crying, I was crying, it was just a horrible, horrible day.

Thankfully I was able to get to the Doctor who prescribed some Maxalon which worked straight away, and we were back on our breastfeeding journey again. Phew!

Now THIS is the happy ending.

Jayden is now 14 months old – and still breastfeeding. :)

He was exclusively breastfed until just after 6 months old when we started solids, has been demand fed otherwise. He currently feeds morning and night, and during the day 1-2 time before sleeps.

My initial goal was to get to 6 months, then 12 months and now…we’ll see. I am not going to put a timeline on it; I am just going to let our little man decide when he’s had enough.

It could have been so easy to give up, especially when faced with professionals who didn’t see the big deal about offering formula. I am so glad I didn’t though; I love the bond Jayden and I share when he is feeding, it is like our own little special time together.

I am so glad that I persevered and I feel very proud to know that our little man has been given the best start to life that I could possibly provide him with.

This article in a slightly abridged form first appeared in Nurture magazine’s Winter edition 2009. It’s taken a long time to write (4 + years!) and was hard to be honest, due to the emotions I experienced being unable to breastfeed my daughter the ‘traditional’ way. I hope this is of interest to someone, and may even inspire someone else to do similar. Breast Milk is a baby’s birth right. While I have nothing but sympathy for women unable to breastfeed, and would never ‘blame’ anyone for feeling exclusive expressing is too difficult-I also want to reassure some for whom exclusive expressing may be an option that it is very worthwhile and while not easy at times, very rewarding and perhaps, less difficult than some might imagine.

Warning-this is LONG!!

Just as I was due to give birth to my second child, my first born was aged 3 years and 8 months-and was still breastfeeding morning and night. Liam and I had weathered the trials of the early days of breastfeeding together, and had come out victorious. The fact that I was still breastfeeding, with no plans to wean him at almost age 4 is due to my belief in the benefits of breast milk for toddlers and older children. It’s safe to say I was and am quite a lactavist. And it puzzled me why others didn’t always feel the same way. Sure breastfeeding was sometimes hard-but ultimately rewarding. I had little understanding about the reasons why some women couldn’t breast-feed-really there wasn’t all that much to it was there?

So while I was anxious about other issues surrounding the imminent birth and arrival of my daughter, breastfeeding her wasn’t something I anticipated having any problem with at all. In the early hours following her birth, she suckled a few times half heartedly, but soon gave up. A highly alert baby from the very second her head pushed out into the world, Sienna seemed more interested in observing those around her than in feeding. So the fact she didn’t seem to feed nor attach properly for several hours didn’t concern either the midwives or me. She was probably both tired from a difficult labour, and not all that interested.

Eventually though, hunger go the better of her, and her interest in feeding was piqued by the juicy colostrum on offer. She still couldn’t seem to get a proper ‘grip’ and after a few minutes gave up. I still wasn’t concerned-after all it had taken weeks for Liam to learn to attach. However, a maternity ward nurse noticed something that had pretty much not even crossed my radar yet-the fact that milk was coming out of Sienna’s nose. She informed me she was just taking my baby off for a couple of minutes to examine her, and would bring her back very soon.

Of course, this immediately set alarm bells ringing. I tried to stay calm-but internally I was panicking-why would they take her away like that? I’d had one baby already, I knew that wasn’t usual. The negative voices in my head battled with the voices of reason, alternately screaming ‘something is very wrong!’ and ‘It’s nothing, she’s probably just checking for jaundice or something else normal like that’. When Sienna was returned 5 or so minutes later, by the nurse, the panic levels had risen a notch or 10. However the nurse was matter of fact. “Sorry to worry you, your daughter is fine-but I just needed to check something I suspected-and it turns out I was right. Your baby has a cleft palate-she has a hole in the roof of her mouth. It’s ok, it’s easily fixed these days by surgery. But she isn’t able to get the vacuum seal required to breast feed, so she’ll need to be bottle fed. We’ll go get the equipment and show you”.

I was gobsmacked. In 5 short minutes the relatively uncomplicated existence I had foreseen bonding with my newborn baby, snuggling up in bed to breastfeed and getting to know each other had forever been altered by the utterance of those 6 words ‘she’ll have to be bottle-fed’. Just like that-so matter of fact, and yet so devastating. I thought stupidly, “But I’m a passionate breast feeder! I can’t bottle feed!” It seemed inconceivable. I knew at the back of my mind I ought to be grateful it was nothing too bad- this thing after all could be fixed. I knew nothing about clefts, and the fear and uncertainty about the whole medical side of that especially the idea of my baby facing surgery would come later. At that moment however, all I could think was that they were wrong-I refused to bottle feed, that’s not who I am!

After a few minutes discussion with the hospital staff however, I soon realised that if I wanted my baby to thrive it was in fact going to be necessary to bottle feed her. Babies with cleft palates usually cannot attach to breastfeed, because due to the air escaping out the top of their mouth where the cleft is, they are unable to form the airtight seal required to form the action. So really there was only one thing to say; “Ok then. I need a breast pump”. Because I had functioning, lactating breasts-and as long as I had functioning boobies, my baby would have breast milk. I gave strict instructions that absolutely NO formula was to pass her lips. I think my expression and general demeanour was such that no one in that room dared to argue! Instead, a lactation consultant armed with blue hospital issue Medela pump was despatched to my room immediately, and so began the process of learning to express full time for my newborn daughter.

Sitting in the nursery every couple of hours (when the portable pump wasn’t available) attached to a pump that looked like something out of a 1800s steam train engine, trying to stimulate the let down reflex in such a completely artificial environment and manner was a surreal experience. I am sure the nurses thought me odd insisting on having Sienna in her plastic cradle next to me at all times, rather than lined up with all the other nursery babies. Aside from wanting her close because I am an attached parent, having her to look at, and imagine she was really suckling at my breast (rather than the sterile, inanimate pump) was the best way to stimulate letdown. During these first few hours and days I felt sadness creep in at times, but I was determined not to let it take over. I just couldn’t afford to feel that too much; to allow this to defeat my resolve to feed my child exclusive breast milk, as I believed was her birthright. I was so lucky to have lovely supportive midwives and a lactation consultant (LC) to help me at this time. During the first day of expressing, they brought the pump to me for every feed, because I’d had a post partum haemorrhage requiring blood transfusion and couldn’t get out of bed. The LC spent hours with me, and gave me a calendar from her office with a picture of the Italian town Siena on it, because of my daughter’s name. Small kindnesses like this made it much easier to cope with the challenges of full time pumping. Friends, family and my independent midwife came and visited and brought me information printed from the internet about cleft palates and breastfeeding. They said it was OK to be sad I couldn’t breastfeed her. But I buried that feeling down deep, because I didn’t want to feel it. I was completely scared of falling in a heap and succumbing again to post natal depression as I had in the weeks after my son was born. I just had to make this work-it was as simple as that.

After coming home from the hospital my milk came in full force, and I was expressing at least 250 mls per breast each time. This was immensely satisfying. Despite the annoyance factor of having to get out the pump, wash and sterilise bottles instead of just putting my newborn on the breast I loved watching that gorgeous white-yellow milk flow into the bottles. I loved stocking the fridge up with bottles, and I loved bottle-feeding my baby staring into her eyes, in my arms or in the sling, just as if I were breastfeeding. I was fortunate to have a lovely Maternal and Child Health Nurse (MCHN) and LC from the local Maternal and Child Health Clinic come out, who were fully supportive, even pro attachment parenting and gave me loads of praise and encouragement to keep going with the expressing. The only dodgy bit of advice I ever received was from a hospital midwife on a home visit, who told me I was producing too much milk-she said my body ‘thought it was feeding twins’ and advised me to increase the amount of time in between expressings. Just as stupidly, I followed this advice. Of course my supply diminished, and I cursed myself for listening. As a result, I had to go onto galactagogues such as fenugreek, oats, Motilium and the occasional Guinness sooner to build up my supply. When full time expressing, it is good for your body to produce more in the early days, because you can freeze it and stockpile for later when the supply will naturally drop. To keep milk supply up, not only must you feed every 2-3 hours or so, but the actual action of the baby sucking works to promote and stimulate supply. Of course you don’t get that when expressing. And it’s very hard to keep up expressing every 2 hours over a long period of time. You just…get over it. And your boobs hurt.

I would sometimes curse that I had to get up to express during the night. I co-slept so by rights I should have only had to turn over and let Sienna attach. I’d gotten up to my first baby who slept in a bassinet in my room for the first few months, and experienced massive sleep deprivation as a result. I’d looked forward to full time co sleeping from birth with my second child, and felt ripped off that even as a co-sleeper, to feed her necessitated getting out of bed. Likewise I cursed the fact that the days of grabbing the baby, a couple of nappies and a change of clothes and rushing out the door were gone. Going out sometimes required the planning and logistics of a military operation. Bottles? Check. EBM? Check. Cooler bag for EBM? Check. Breast pump? Check? Bottle warmer? Check. Extra bottles…and so on. I am most definitely NOT an organised, routine oriented type person! I found this aspect extremely challenging.

It wasn’t all bad however. In some ways it gave me more freedom-I could leave Sienna with her dad or my Mum and have some time to myself-to work, study or just relax. I found other ways to form a bond with my baby, such as baby-wearing and skin to skin contacts. The sadness never left completely but it faded-and was largely replaced with gratitude for her health. Sienna was exclusively breast milk fed for one week short of 7 months. At which point she began eating solids, and a week later, some formula was necessary. At 12 months of age in addition to food, she was drinking a ratio of around 80% breast milk and 20% formula. At 15 months it was around 60% breast milk, 40% cow’s milk. And at 20 month it was 30% breast milk and 70% cow’s milk. I expressed until she was 21 months of age, and was getting a pathetic 15-20 mls. I then decided it was time to stop. I had wanted to reach 2 years-but at that point there didn’t seem much point continuing for such a paltry amount. Not to mention I was OVER it. If I never saw another breast pump in my life, it’d be too soon!!

The benefits to Sienna’s heath were obvious when after having the surgery to fix her palate, the nurses all commented that her recovery was one of the fastest they’d ever seen. I just smiled and said ‘Breast milk ‘! And knowing she had that foundation for a healthy gut allows me to worry less that now as a fussy 4 year old her diet is often less than optimal! Being unable to breastfeed also gave me insight and increased compassion to those mothers who are unable to breast feed. Inability to breastfeed when you really want to is a kind of emotional torture. Giving formula when you know it’s not the optimal food, but you have no other choice hurts. It insidiously worms its way into your inbuilt mother-guilt gene, and taunts you with feelings of failure, self doubt, and inadequacy. I will never again judge (even unthinkingly) anyone who tried their best to breastfeed but wasn’t able to. I am not the first and won’t be the last to solely express for my baby. I was so proud and grateful though that I was able to do this for my child. As parents often we find we need to extend our parenting, in ways we hadn’t ever imagined we would. This was the first way I did this for my daughter.

Jayne is the author of Spiralmumma and the woman behind the Australian-based online attachment parenting community, Alternative Baby. You can read Jayne’s story about breastfeeding her first child, Liam, right here on ibreastfed.com.