When Breastfeeding Isn't a Choice
By Whitney Swance Starczewski
“Whit. Whit. Wake up,” my husband whispered. “It’s time to pump.” Although my phone alarm had gone off, and the overhead light directly above my hospital bed could have woken someone from the dead, my leaden eyes had other plans. I had given birth to my son, Noah, two days prior at 28 weeks gestation after being diagnosed with severe pre-eclampsia. Coming three months early, he was sent directly to the NICU, where he would remain for the first 59 days of his life. As for me, the Percocet combined with the round-the-clock blood draws and vitals checks had completely wiped me out. I could hardly keep my eyes open during the day, let alone stay awake of my own volition in the middle of the night. I wanted, needed sleep. Nevertheless, I persisted. Heaving my legs over the side of the bed, I pulled down my night gown, attached the hospital-grade breast pump, and pumped away.
“You’re almost done,” he said softly, rubbing my back, and nudging me awake. “Only a few more minutes.” I was slumped over, not realizing my eyes had closed again involuntarily. Besides the pump, which still chugged steadfastly away, the room was silent. Willing myself to remain awake, I looked down at the two little plastic collection cups for encouragement. Not again. They were empty. Not one single freakin’ drop. I wasn’t expecting the cups to be full per se; I had only given birth a few days ago after all. But I had been pumping and hand expressing diligently ever since Noah was born. Shouldn’t I be producing more milk by this point?
Little did I know then that the answer was yes.
I had always planned to breastfeed my future children, despite the many challenges I knew I would have to encounter in doing so. Painful breasts and nipples, waking up at all hours of the night to nurse, sideways looks for breastfeeding in public, pumping in cars and bathrooms – none of it discouraged me. Months before my due date, my Boppy pillow was purchased, nursing tanks hung in my closet and idyllic daydreams of me rocking and nursing my newborn to sleep danced in my mind.
I had supported women who formula-fed, but “breast is best” always resonated personally. For one, I was well-aware of breastfeeding’s myriad benefits – antibodies, nutrients, vitamins, mother-baby bonding, the list is long. Why would I deprive my child, and myself for that matter, of the many benefits of my “liquid gold”? Plus, breastmilk is free!
Despite her own struggles, my mom supported my decision unequivocally. Although she had breastfed me as an infant, she has since bemoaned the whole experience. Her mom, my grandma, hadn’t nursed her two daughters and my mom felt as if she didn’t have anyone else to turn to for advice when I didn’t latch well. And, she didn’t care for the sore boobs either! So, when my younger brother came along two years later, she decided formula-feeding was the way to go. Who could blame her? Giving birth in 2017, in the breastfeeding-friendly city of Madison, Wisconsin, and surrounded by lactation specialists and experienced friends, I felt confident that I wouldn’t have to face a similar lack of support.
My problem was that I had always considered breastfeeding to be a matter of choice. I would learn soon that for many women, like myself, it’s not.
The first two months after Noah was born, I dedicated myself entirely to producing as much breast milk as possible. I became obsessed. At the very least, I pumped every three hours, day and night, at home or behind the privacy curtain in Noah’s NICU suite. I consulted lactation specialists, YouTube videos and Google searches for breast massage techniques to increase milk flow. I “power pumped” – pumping for an hour-straight, ten minutes on, ten minutes off. I hand expressed in the shower and after every pump session. I sought the advice of a breastfeeding medicine doctor, experimented with three different types of pumps, purchased bottles upon bottles of expensive, milk-increasing supplements, took anxiety-inducing Reglan pills and even considered ordering Domperidone, a drug only available abroad since it’s not FDA-approved. And, when I missed a session, the guilt was overwhelming. “You don’t really want to make more milk, do you?” I would badger myself and then feel awful that I wasn’t “doing all in my power” to make the breastmilk that my premature son so desperately needed. Meticulously, I recorded every drop in my pumping journal and was ecstatic when I would finally produce two ounces in one session! But, most times, despite all my efforts, I could barely produce one…
Although I knew stress could be contributing to my low production levels, I subconsciously interrogated myself anyway. Aren’t I supposed to feel my milk “let down”? How much milk do other women make 3, 5, 7 weeks after giving birth? Maybe I’m making so little because Noah was born three months premature? Maybe my body’s under too much stress right now? Or is it because I’m separated from my baby that my body isn’t quite making the connection? What is wrong with me???
My prolactin hormone. In the end, I would find out that my prolactin hormone levels were off. Prolactin is the hormone that tells your body you just had a baby and should produce breast milk. My prolactin levels were unreasonably low for a woman who had just given birth and my doctors couldn’t ultimately pinpoint why. It wasn’t because I wasn’t trying hard enough, because I didn’t care, because I was lazy or selfish, my inability to make enough milk was rooted in a biological cause. In other words, it was out of my control.
Accepting that there was nothing more I could do, I allowed myself to stop trying. Honestly, it was a relief. I immediately felt lighter.
I had only been able to keep up with Noah’s nutritional needs for the first month or so, when he weighed less than 3.5 pounds. As he grew, my breast milk alone no longer sufficed and he was often fed with a combination of my milk, donor milk and NeoSure formula. When he was discharged from the NICU, weighing a little over five pounds, he was consuming formula 100% of the time. As a preemie, my breastmilk had been like medicine for Noah. Indeed, the doctors and nurses in the NICU qualified it as such on several occasions. I still like to think it helped keep him healthy during his NICU stay, and beyond. Although I mourn the closeness associated with nursing, and regret that Noah couldn’t continue benefiting from the immunity boost my milk would otherwise offer, I take comfort in knowing that I did my very best in adverse circumstances. “A fed baby is a happy baby” goes the old saying, now I know how much it’s true.
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