When Breast is Not Best

February 12, 2014
Trying out the Haberman bottle and a different feeding position.

Trying out the Haberman bottle and a different feeding position.

“Do you want to try putting him to breast?” the NICU nurse asked tentatively and, just as tentatively, I answered “okay.”

It was a few weeks after my baby Ben was born and while I already held him skin-to-skin most days, we had not tried breastfeeding. Considering I could not even hold him until he was a week old and in stable enough condition, I had not allowed myself to think about breastfeeding. In fact, I was dreading it.

Ever since my mid-pregnancy ultrasound when I had first learned about Ben’s cleft lip and palate, I had to deal with the possibility that Ben would not be able to breastfeed. While babies with just a cleft lip can usually breastfeed, babies with a cleft palate usually cannot. Most doctors describe the sucking ability of babies with a cleft palate as trying to suck a straw with a hole in it. It just doesn’t work.

Nonetheless, the lactation consultant eagerly shared with me some positioning techniques that she thought might help a baby with a cleft breastfeed successfully. Unfortunately, the techniques did not work and that first breastfeeding session was not a success. Ben could not suck well at all and the subsequent sessions pretty much went the same way. I tried, Ben tried, the lactation consultants tried, but in the end, we all knew it wasn’t going to work. At least I could still express my breast milk with a pump. That did work for a little while. Then, it didn’t.

After about six weeks, my milk started drying up. I would produce less and less with every pumping session. “You have to do it every three hours, around the clock, ”drink more water,” “try fenugreek” were all things well intentioned people advised me to do. But, easier said than done. Between trying to pump on a schedule, learning how to feed Ben with special bottles, and dealing with the stress of NICU life in general, I quit pumping rather than try to increase my milk production. I did my best and that was all I could do.

All of the NICU staff who were involved in Ben’s care applauded my two months of pumping. Just as I outwardly applauded, and secretly envied, the moms who brought in countless, brimming bottles of breast milk, exclaiming they were going to need another freezer at home just to be able to store all that milk. Here I was doing my best to squeeze out 10-15 milliliters every few hours, while also trying to feed Ben every 3 hours, and hearing all these moms who were overloaded with breast milk was a little hard to take sometimes. Oh, how I envied them! It was sort of like high school all over again and they were the cool girls that I wanted to be like, but never felt I quite measured up. It was such a huge relief when I decided to quit tormenting myself and accept that I was not going to be like the “cool” girls who could provide their babies with lots of breast milk. I was going to be Ben’s mom and provide him with lots of formula and lots of love and enjoy this brief period of time when I am just the coolest person in the world to him.

A birth defect like Ben’s is only one of the many reasons why a baby cannot breastfeed. Furthermore, there are many reasons why a mom cannot breastfeed. Whatever the reason why, if you are unable to breastfeed your baby, please do not beat yourself up about it. Nor should you feel guilty if you choose not to. While I commend every mom who breastfeeds or exclusively pumps, I feel those of us who do not have been judged pretty harshly by our peers . So much so, that we rarely can have an actual discussion about this topic. It almost always turns into a heated debate. Just the other day, a mom of a baby with a cleft asked for advice from the members of an online support group on the best ways to fortify her breast milk. All it took was one member to share her opinion that using formula should be the last resort, and, well, you can imagine the response. I really wish all these “parent wars” would stop. As mothers, we must get better at supporting one another, lifting each other up, instead of bringing each other down. Our job is hard enough, but especially hard when you are the mother of a preemie or a baby with special needs. All that should be expected of us is to give our babies all of our love and attention, along with meeting his or her nutritional needs by whatever means we deem fit. That is the best we can do.