Tuesday, November 11, 2014

Duct Duct Noose

My son favoured my right breast from the start, possibly due to my "incompetent" left nipple, as the lactation consultant at the hospital had adjudged it. I succumbed to his protestations and made the mistake of allowing him to suckle on my right breast, leading to engorgement and plugged milk ducts on my left. Another joy of breastfeeding.

The first thing I noticed was that my left breast became very hard, with thick sturdy lumps and that there were white dots around my areola. The next thing I noticed was that the inner side of my breast, where the hard lump was, was bright red and hot. I cringed. It looked like the beginning of mastitis and I panicked. I was worried that if I had an infection, I couldn't feed my little one and that at this early stage of breast feeding, my milk factory would close shop and we would be vanquished under the dominion of formula for ever. Before I called a doctor, wondering whether to go to my OB, my GP, or just ask my son's pediatrician, considering we had a scheduled appointment with her the next morning, I checked in with Dr. Google. After a while I conferred with my husband, who likewise had a session with the search engine and we agreed it was time for surgery.

Heat packs, alcohol, needles, tweezers and a pump surrounded me as I lay on the bed, propped up by a pillow, eyes closed, wincing in pain. The heat pack came on first, which felt quite pleasant and then we pumped. A few droplets came out. Next, my husband assessed which milk ducts appeared to be working and we stopped pumping and he got to work. I closed my eyes as he inserted the needle into the uncooperative few. Next, curdling yellow matter frothed out of the popped milk ducts and he pulled it out with tweezers. No wonder my son had refused this breast, I thought, as I looked onto the puss that trickled out. I wouldn't want to be anywhere near that, let alone eat it. When no more came out, we pumped again and as we feared, more of the pussy substance trickled out and the tweezers went to work again. It was probably the least sexiest moment anyone could have scripted.

"I have never seen anything so gross" my husband said, continuing to tease out the puss, transfixed as if viewing a car crash. My breasts had been demoted from objects of desire to objects of disgust. Not only was there no sexy time, there was no dignity. I started to cry. My mind wondered back to when we had first met, when all the huffing and puffing had been reserved for one activity alone. Little had I known then, when we were on our extended third date, a one week sojourn in Puerto Rico, that four and a half years later, my husband would be poking my breast with needles, muting a conference call he couldn't get out of and I would be screaming in pain, our son blithely sleeping through the travesty across our loft, in his makeshift nursery. Every so often, he would stop, unmute his call and provide advice, as I waited for the next thrust of the needle, biting my lower lip.

Occasionally, I would yelp from the pain. My husband stopped his surgery and looked at me. "I hate that I have to do this to you" he winced. I grabbed his hand. "Do it. Ignore me" I yelped. "It has to be done." He nodded. The things you do for your children. We danced this danced three times that day until finally, my breast was shooting out milk. We were ecstatic.

"Let's never speak of this again" I said. My husband nodded. Some things are best left contained in the sarcophagus of faded memory.











Saturday, November 8, 2014

The Land of Milk & Honey

During my pregnancy, I had been advised to attend a lactation course. I didn't do so because I thought the only reason "lactation consultants" existed was to exploit the fear of new parents and commodify an event that was instinctual. I reasoned that as the human race had evolved and survived over hundreds of thousands of years without formula, there couldn't be such a trick to it. If a proto-human breast fed without a lactation consultant, why should I?

I am now convinced that the proto-human must have had the aid of other nursing mothers in the group, not merely for advice but also for nursing itself, as breast feeding is bloody difficult. 

I was flabbergasted when Luca was on my chest, looking up at me with serene, curious eyes and I was told it was time to feed. As instinctual as I had believed it was, neither of us knew what to do. I gently nudged him to my breast and he just lay there, looking at me, as if asking for instruction. We called the lactation consultant in the hospital right away, fearing we may be losing our opportunity to provide Luca with my colostrum. The lactation consultant jovially entered and in a second was kneading my nipple, expressing my colostrum. I cringed through the pain. Then she grabbed Luca's head with one hand and pinched my nipple with the other, creating his first latch. It felt like multiple daggers stabbing me around the circumference of my areola. "There" the lactation consultant smiled victoriously, "that's a good latch." I limped a thank you through my pain and consoled myself with the fact that at least I had milk. 

As I had started to express colostrum from my 19th week of pregnancy, I had been confident that I would have no trouble breast feeding. The first crush to my confidence came when on the first day, after the first successful feeding, I could not get Luca to latch again and a new lactation consultant came in, assessed my breasts and dryly noted that my left nipple was incompetent and needed to protrude more. I looked over at the traitor. Stand up! I directed it. You have a job to do! I was advised that the only way to have my nipple behave appropriately was to keep pumping and keep having Luca breastfeeding. I spent the whole day abusing my breasts with the machine and his mouth until they were scaldingly painful and I nearly passed out from the pain of my breasts, my uterus and the tears of labour. I had also unwittingly made him more famished as he expended a lot of energy suckling without obtaining the needed caloric intake and perpetuated a downward spiral causing him to lose weight and increasing my distress.

The next couple of days stormed through an emotional turmoil, in which Luca didn't latch and I was dry. We both cried throughout the days and nights together. My husband came home once and found us both wailing on the glider, exclaiming that both his babies were crying and rushing over to calm us both. To some extent, I did feel like a newborn. My body felt mutilated, my nipples drawn out and bleeding from Luca's initial latches, not being able to walk from the pain of my stitches and bleeding so profusely that like my son, I was also wearing diapers. Combined with lack of sleep, I was a somnambulant waking in and out of torture, not recognizing my own body. I had been prepared for lack of sleep after labour, but I had not expected the wear and tear that ensued, the constant pain that overwhelmed me. I could hardly stand the first few days and after two weeks, still can't walk more than a few minutes without unbearable pain. There was no space between the pain and the feedings, the days and nights lulled together into one throbbing experience of being reduced to two milked udders. I was told I was going through "recovery", which seemed a euphemism of grand proportions.

I was also flummoxed at how difficult - and how painful - breast feeding was - I had seen many women breast feed while multitasking or even in company and they seemed to not only feed their babies without much ado, but were not in any pain. I felt inadequate. My husband pointed out that the women I referred to, the "better" kind, may all have gone through the same painful process in the beginning, as I had seen them months into their breast feeding regimen. This made me feel slightly better although I still felt inadequate, looking over at my increasingly ravenous and distressed son, knowing my lack of milk was the cause of his turmoil. 

We quickly caved in and gave him formula. I continued to pump and became ever more disappointed at the miserly drops that I produced. Other parents are more resolute in their choice to only breast feed, avoiding supplements until a full milk supply arrived, but we caved in the first day, only hours after it was apparent he was famished and not urinating, and possibly becoming dehydrated. The reasons we were given against supplements did not persuade us. First, we were told that providing formula would lead to "nipple confusion" but the mothers that pumped and provided their milk through such method before their babies could latch were using a bottle also. Besides, our little ravenous monster seemed to want to suck on anything. Second, we were told that he could get accustomed to the formula and not want breast milk. I was a little incredulous that we could produce a powder that would contain the hormones that breast milk has to connect mother and baby and was confident that these hormones would reel him in, even if he were particular to formula. It turned out that when he was starving, he did not want to work - the suckling takes a lot of energy- and wanted the bottle, but he didn't care whether it was formula or breast milk - just that it came to him as soon as possible. 

In any case, we reasoned that even if we had to continually supplement, he would be obtaining the antibodies, nutrients and hormones of breast milk. Further, if I were low on certain vitamins and minerals (for breast milk is only as good as the particular breast produces) he would be obtaining the missing elements from the formula. So while we were against providing a powder to our son, knowing that the corporation that produced it had only its bottom line as a concern, we were more resolute that he wouldn't starve.

The only good news that graced us after the first couple of days was that my left nipple had rejoined the ranks but unfortunately to a dry front. The pump distended my nipples to grotesque proportions and as painful as it was to endure and as distinctly unpleasant as it was to view the mutilation of my breasts in their metamorphosis to udders, it did not solve the situation, for Luca was still hungry. 

On the third day, I started getting in more milk but insufficient for our hungry hippo, and we were still supplementing. We were advised by our pediatrician that Guinness may aid in production. I am more of a hoppy drinker and not particular to stouts, but I gave it a shot. The barley used to make Guinness contains polysaccharides that aid milk production.Whether or not it was merely a coincidence, the milk flowed on the fourth day. I was ecstatic. However, our hungry hippo still wanted more. In the morning and evening, he wanted to cluster feed and after sucking out all my milk, we needed to supplement.

We were trying everything - different nursing positions, different diets (avoiding cabbage and eating figs in order to entice him with what we hoped would be sweeter and less gassy milk, according to my mum's advice) and even different methods of feeding. At first we did a schedule of 20 mins on each breast every 2 hours, then thought he was not getting the fatty hind milk resulting in his continued hunger and switched to feeding from one breast only as long as he wanted every two hours and then returned to the 20/20 regimen after his doctor's instructions due to his decreased weight. We were flabbergasted that he still needed supplement despite the grand opening of my factory, which was producing up to 1 1/2 oz per breast and despite his constant feedings. We had reasoned that it must only be due to a growth spurt and couldn't understand how he was losing weight. The doctor asked if he were latching property. We both firmly agreed that he was - I knew a good latch when pain burst forth and even when he was fussy, we got him to latch together, me holding him while my husband propelled him to my areola. Latching in our house was a family affair. 

After trying so many different things and out of ideas, I couldn't stop the tears at the doctor's office - with all the breast feeding, the gymnastic latching and the supplements - he was still losing weight. And then the doctor proved why it serves to have a medical degree. There was snot up his nose, preventing him from breathing properly and therefore suckling sufficiently to be satiated. Our poor little son was expending so much energy trying to suckle that he was losing weight and always hungry. When she showed us how to take the snot from his nose, he cried bitterly but the snot flowed out. The mystery was solved! As much as I was a milk factory, he was a snot factory, countering the flows of my production. 

While he hates the repeated operations of sucking out his snot, he is one happy hippo after feedings now.