Circumstances led me ‘not having enough milk’ myself. My daughter was three weeks old, losing weight, and only getting 200ml of breast milk each day. I ended up feeding her until she weaned just before my second daughter was born at around 15 months of age. Here is my story:

DD fed for 2hrs after being born. I now know that she was not really ‘feeding’, just sucking, bonding and having cuddles, which was lovely. The various midwives in the hospital popped in to see ‘that baby that’s still sucking’ and laughed at her appetite. We thought it was funny too. Unfortunately she was not properly attached and grazed both nipples. I felt I was not ‘getting her on’ properly, but every midwife who checked in the next few days said she was fine, that I was doing well and that was correct. By this stage each nipple had a scab covering the entire top of the nipple, which would come off each time I fed and bleed. My daughter would vomit bits of blood and scab after feeds, but the midwives weren’t concerned, so I persevered, and was sent home. Needless to say, feeding was very painful and not that enjoyable though of course I enjoyed the cuddles and the wonderful feeling that comes with being able to feed your baby and help her grow.

When DD was born, she was wide eyed and placid. Within 24 hrs she was screaming her lungs out and this continued for 3 weeks. She rarely slept; about 3-8hrs in 24, the rest of the time screaming. I now feel she was hungry but I was so reluctant to feed her because of the pain. I tried to keep her to 3 hourly feeds recommended by the Child Health Nurse and the hospital midwives. We actually took her to hospital at about 10 days old because she was ‘too placid’ – we thought there was something drastically wrong with her!

Our GP sent us to a paediatrician and she was diagnosed with lactose intolerance, colic and reflux. She was prescribed medicine for the reflux and he suggested feeding her a combination of lactose free formula and breastmilk to see if that would calm her and help her sleep/relax. Neither of us were really happy with this diagnosis and treatment, but we were exasperated and didn’t know what else to do.

I was not overly pleased with the course the Paed. had set for us. I knew this path would lead to DD being fully weaned and formula fed in a very short space of time. I was determined not to give in, and to breastfeed my daughter. The medication and formula didn’t help not matter how much we wanted it to, so after about a week, we stopped the medication and took her to the Breast Feeding Centre at a nearby hospital. The lactation consultants there were amazing. I had laser treatment on my poor nipples, which helped them heal and they were able to see that yes, she wasn’t attaching properly and helped me sort it out. DD refused to attach in a manner that was totally comfortable, it was much better and obviously my nipples hardened up and got used to ‘her way of doing things’. In fact, as soon as I relaxed about trying to get her to attach properly and just let her do her own thing, it hurt a lot less. I stopped the lactose free formula and started exclusively breastfeeding again. This was against the Paediatricians wishes, but with the support of the lactation consultants at the BFC. She was still screaming a lot and not sleeping and by this stage, about 3 weeks old, she had started losing weight.

The penny finally dropped that she wasn’t getting enough milk, so I convinced the BFC to lend me their scales so I could weight her before and after feeds to work out how much milk she was getting each feed and in a 24 hr period. This confirmed my suspicions – she was getting 20-50mls per feed and under 200mls in 24 hrs. Failing to demand feed from the beginning and switching to formula had severely depleted my supply.

When I was at the BFC I met a woman who had 5 children. She had come back to catch up with the midwives with her bubba. After feeding her first 4 kids, the 5th simply refused to take her breast. So she expressed for 6 months and kept trying until finally her baby agreed it was better from a boob than a bottle. At the time I was pretty ‘woe is me’ about my situation, so it was great to have a reality check in the form of this amazing mum, who committed to express every day, in between getting 4 kids fed, dressed, to school and everything else, so that she could breastfeed. If she could do it, so could I.

With the fantastic help of the BFC, I started using a ’supply line’ to increase my supply. It is a tiny tube that you put into a bottle of expressed (I had to start with formula) milk and stick the other end to your nipple, so that when the baby sucks your nipple they get milk even though your boobs are empty. The extra sucking stimulates extra supply and the theory is that it slowly increases your supply. On the paperwork that came with it were details of how to use if for mothers who are breastfeeding adopted babies, which I found so interesting.

I spent the next two weeks in the following routine, 24hrs a day:
-Feed DD from my boobs
-Place supply line with expressed milk (formula for the first day or so) on nipple and let DD have that as well
-Settle DD to sleep
-1 hr after end of feed, express (luckily we hired an electric pump!) milk for next feed
-crawl into bed for 45 min sleep at night or do a chore/sit down with a cuppa in day
-start again!

At night I would normally set my alarm for 1 hr so that I could sleep in between feeding and needing to express, then express, then crawl back to bed

My partner was amazingly supportive, cheering me on from the sidelines. I must admit though, that he just didn’t understand my determination to breastfeed and would regularly reassure me that it would be OK to ‘give up’. In fact, everyone around me seemed to be trying to convince me that it was OK to stop breastfeeding. The only people who seemed adamant that I could do it were the midwives at the BFC. They were supportive, but at no stage did they suggest formula, and I really looked to them for support as a result.

I felt every emotion under the sun: Desperately tired, extremely proud of myself, completely overwhelmed, angry about the events that lead to the situation to name a few. Every night I would cry saying ‘I just can’t do it anymore, I’m going to give her formula’ and every morning I would wake up saying ‘I’ll just do it for 1 more day’. I lasted 14 days, by which time I had increased the feeds to 60-90ml on average, but at times 120ml. This was pretty exciting as you can imagine.

I had done it. And it was so very worth it.

DD will be 7 this month. She grew out of the lactose intolerance at around age 5, although she is still reactive to cow’s milk protein. I had no difficulties feeding my second daughter and she has no allergies or intolerances.

If you’re reading this feeling it’s all too hard and that there is nothing you can do about your low supply, I am living proof it can be done. I’m not superwoman or super anything, just a normal person.

xx Louise

I had been sick for months and putting on weight. I had a thyroid problem, but it was getting worse and I had started to suspect that I had some kind of gut problem, so I went for an ultrasound.

“Oh, you’re pregnant,” said the technician.

“What?” I asked, leaning over to see the monitor, shocked and somehow expecting to see a jelly bean foetus in a blur of undefined body tissue.

“Here,” she said, turning the monitor towards me, “here’s your baby. Did you really not know you were pregnant?”

I couldn’t answer because there was a ribcage on the screen, and it wasn’t mine. I didn’t really have a giant stomach tumour or an immune system disease. I was 28 weeks pregnant. There was a whole baby inside me, well developed enough to survive if it was born that very day.

I don’t need to tell you that I was in a lot of shock for the next few months. I hadn’t planned or intended to have a baby. On the one hand, my fiance and I were planning our wedding, paying our mortgage and in good jobs, so we were in just the right circumstances to have a baby. But on the other hand, I was studying, had travel plans and was on medication for Obsessive Compulsive Disorder.

As soon as I knew I was pregnant, I stopped taking the Pill (yep, still on it and everything happening as usual) and my antidepressants. By the time I went in to labour, I had all the usual worries and fears of a very pregnant woman as well as increasing anxiety due to the OCD.

At that stage I still hadn’t decided whether I would breastfeed or not. I hadn’t decided anything much! Apart from repainting the spare room (my fiance insisted that if the walls were still magenta, he wasn’t doing any night time nappy changes in there!) and reading as much as I could about childbirth, I hadn’t been able to really face the reality of a baby. I hadn’t even turned up to the breastfeeding antenatal class.

On top of that, I really don’t like my breasts being touched, never mind sucked on and chomped on! But I hadn’t decided to go for bottlefeeding either, because it seemed selfish to me to not even give it a try. I had had 12 weeks of feeling guilty over all the things I had done to my baby already – drank at parties, flown to Seoul to eat street food and hike around the city at -12C, taken my Pill and my antidepressants and stayed out dancing all night. Not to mention not loving my baby or talking to it at all! I felt that I owed it to this baby to make up for six months of unintentional neglect.

I was so proud of myself that I lasted 18 hours into a 24 hour labour before having an epidural, and my little boy was born in the early hours of the 3rd of June. Just like every mother, I promptly went into shock, adrenalin taking the place of exhaustion and I happily let the midwife help my baby attach for the first time. It wasn’t too bad, certainly not yukky like I expected, and I decided that for now, I would try breastfeeding.

Four days later when I left the hospital, Dominic had a name but he still hadn’t had a proper feed. We had tried with every different midwife giving us different advice. I had refused to let him be bottlefed, but had learnt the uncomfortable art of hand expressing so he could be syringe fed some colostrum. I had a little bit of success using a nipple shield, and of course when my Mum came to see us Dominic would attach and drink like a little angel, meaning Mum was reassuring me that he was just fine. The midwives were getting worried because Dominic was sleeping for 7 or 8 hours overnight and not waking up for a feed because he wasn’t getting enough milk to get any energy. So I was pretty stressed by the time I took him home.

Over the next few weeks, my nipples cracked and bled, becoming more and more painful. I was starting to dread every feed, and Dominic still wasn’t getting much milk. We hired an electric pump from the chemist, and it was pretty clear that I was producing hardly any milk. In an hour I could manage perhaps 10mL or 20mL and it was scarcely less painful than feeding him myself.

We had many visits to the local clinic, where the nurses ranged from kind to brilliant, and they were all encouraging, but nobody had the magic solution I was looking for.

Some time in the third week, as I sat on the sofa, both of us crying our eyes out, my wonderful fiance went to the kitchen and made a bottle of formula. Dominic had his first bottle feed with Daddy. I felt a huge pressure had lifted and I realised that if Dominic and I were crying and dreading our feeds, we couldn’t possibly have a good relationship.

So for the next few weeks, I would feed Dominic a bottle whenever my nipples felt too sore to feed comfortably. And a couple of times a week, Daddy would do bottle feeds overnight and give Mummy a rest. My fiance really treasured those times with his little boy, and he delighted in sending me out to do the shopping or visit a friend while ‘the boys’ had ‘boy time’ together.

I was really lucky at this time because my Mum, my sisters-in-law and some of my aunts are very very pro-breastfeeding. They were encouraging me to keep on giving it a go, when I felt I could. My sister-in-law in particular said to me that I should stick to it for six weeks, using formula and expressing to help, but that if I managed six weeks, I could be satisfied that I’d done my best. So I persevered with nipple shields and Lansinoh, and fed Dominic at least a few times every day. During this time I also had Maxolon prescribed by my GP to try and increase my milk supply, which was still very poor.

At the same time, Granny and some other aunts had bottle fed, either from the start or from a few weeks in, and they were quick to point out that there was no shame in deciding not to breastfeed.

I had encouragement from both sides of the bottle/breast divide. And I had it fixed in my mind that if I persisted, even just once a day, until the six week mark, I could then hang up my maternity bras and pat myself on the back.

One evening when Dominic was about four weeks old, I was giving him a pre-bed cuddle when he threw up all over me. Not unusual for Dominic, he was the spewiest baby I’d ever met, but this time it had blood in it. It seemed far too much to be from a cracked nipple, so I shouted for my fiance. We bundled Dominic into the car and rushed off to casualty. Being such a tiny baby, he was attended to instantly, with specialists being hurried out of bed and all the nursing staff fussing over him. It seemed that he had reflux, and that he had thrown up so much that he’d irritated his throat to the point where it was bleeding.

After this drama, as well as combining bottle and breastfeeding, we were now adding reflux medication and formula thickener to our repertoire. That worked straight away, and Dominic’s paediatrician even gave me permission to take my OCD medication while breastfeeding, so ‘anxious cranky Mummy’ and ‘crying spewy baby’ almost overnight became ‘happy Mummy’ and ‘contented baby’.

Suddenly making it to six weeks didn’t seem like such a big trial: I would just keep on rubbing Lansinoh on my nipples, using the nipple shields and topping up with a bottle of thickened formula. I could do this!

Then one day, when he was about six weeks old, Dominic just… latched on! All by himself! No nipple shield, no careful inserting of nipples, no aiming. Within a day I was breastfeeding at every feed, and topping him up with a bit of formula a couple of times a day. Within a week, my nipples were completely recovered and I hardly ever needed any Lansinoh. ‘They’ were right, once breastfeeding worked properly it didn’t hurt at all.

We continued with mainly breastfeeding and a little bit of bottlefeeding until Dominic was six months old. Doing both meant that I could go out to a party and leave Dominic with his Daddy or his grandparents for a few hours. I would still be home within a few hours because my breasts would be huge and leaking everywhere, but at least I knew that if he was hungry, Dominic could have a bottle. On the other hand, breastfeeding is so much more convenient out and about. I could just find a comfy spot and breastfeed any time Dominic was hungry or stressed, and stay out as long as I wanted without worrying about running out of bottles.

I was due to go back to work at the start of January so I started to offer him a bottle for his feeds during work hours, followed by a breastfeed top up, so that hopefully when I was due to go to work I could send him to daycare with bottles of formula. My Mum was very positive about managing part-time breastfeeding as she continued with morning and night feeds for some months when weaning my sister and I. But Dominic had other ideas. Over the course of a week he completely dropped the breastfeeds and had his last breastfeed on Christmas Day. It wasn’t our best feed. I was engorged and a bit sore, and spent ten minutes persuading him to suck just a little bit so I could relax and enjoy Christmas lunch!

At first, we continued to cuddle Dominic during his bottle feeds so that he did not miss out on the closeness he had experienced with breastfeeding. But he decided very quickly that he prefered to lie on his wedge pillow and hold his own bottle, in fact he insisted on it! So these days we sit with him and read a story instead. At ten months, he is a happy, healthy, well-adjusted baby. And as they say, you can’t tell whether he was breast or bottlefed – just that he is well-loved!

I’m really proud of myself for sticking with the breastfeeding for six months. I feel like I gave Dominic the best possible start in life. I managed to balance the nutritional benefits of breastmilk with the benefits of having a calm, relaxed Mum at mealtimes. When Dominic was born, I felt I’d had very little choice, and therefore very little control, about having a baby. With the support and encouragement of my friends, family and clinic nurses, I felt in control of my body and chose to stop breastfeeding when it hurt too much, and persist again when I felt ready to, while still giving my baby the best care possible.

The biggest barrier I faced was the idea that breastfeeding is ‘all or nothing’. That might be true for some, but it doesn’t have to be. If you are finding breastfeeding a struggle you often receive advice that points you to either breastfeed in agony or bottle feed exclusively. You don’t have to do that. You can mix and match, try different things, and work out your own perfect balance.

Here is a list of things we tried, which all more or less worked (and were undertaken with the supervision of a paediatrician):

* Breastfeeding
* Breastfeeding with a nipple shield
* Hand expressing
* Pump expressing
* Using Maxolon to help produce more milk
* Lanolin for cracked nipples
* Bottlefeeding expressed breast milk
* Bottlefeeding formula
* Thickening formula to reduce reflux
* Using a dummy
* Breastfeeding, with a top up of thickened formula at each feed
* Breastfeeding, and topping up once or twice a day with formula
* Having Daddy, grandparents, godparents and family do bottlefeeds
* Dreamfeeds, where you feed the baby right before you go to bed to increase your chance of a longer sleep
* Bottle handles, because Dominic insists on holding his own bottles
* A kidney shaped pillow to breastfeed on
* A wedge pillow to bottlefeed on (once Dominic decided cuddles were not happening during feeds)
* A variety of bottle and teat styles, and now a variety of sippy cups, straw cups, pop-top drink bottles, regular cups etc. In short, Dominic will take the food however it is dispensed!
* Early start on solids (Farex) to help with reflux, while continuing to breastfeed.
* Cabbage leaves while I was weaning
* Hand expressing while I was weaning
* Pleading with Dominic to please have a little bit of a drink so Mummy was less sore (didn’t work terribly well, but I gave it a try!)
* Your obstetrician and psychiatrist will probably defer backwards and forwards to each other, neither wanting to say that it’s ok or not ok to take your medication while pregnant. Get in touch with a paediatrician as soon as you can, and talk to them about it.
* For any OCD mummies out there, start out by not caring which breast the baby drank from last. It’s only going to end in tears because one night you WILL be too tired to remember and you don’t want to get yourself in a state over it! I’m not a ‘germ phobe’, I’m a counter and a worrier, so I haven’t had as many problems as I expected.
* If you have a mental illness, be extra aware of the possibility of postnatal depression. You probably already have a support network set up. Tell all the midwives and nurses about your mental illness and how it might affect you as a parent. I did, and got lots of extra help in the hospital and at the clinic.
* Only listen to family, friends, midwives, nurses and doctors who said things we liked and encouraged us to find the best solution to our feeding problems without pressuring us.

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!)