Pump and circumstanceOne of the most reliable predictors of breastfeeding success is how supportive your partner is. I couldn't ask for more support than Paul has given. Not only does he prepare meals while I pump, and primly tells phone callers I'm "temporarily indisposed" when they call during a pumping session instead of mooing mournfully to explain my unavailability, but he happily takes the wheel, keeping the car gliding smoothly down the highway while my Pump in Style is wheezing a mile a minute.
What, you've never pumped on the interstate?
I've been trying very hard to pump every two hours while I'm awake. Charlie is taking breast milk now, and the amount he's fed increases by a few ccs daily. Before he's taken off his IV, he'll need to be consuming 30 ccs per feeding that's about a cup a day. And his needs will only increase from here, so I've been pumping frequently in the hope of protecting my milk supply, a phrase that brings to mind nothing so much as the armor-plated bra of Xena, Warrior Princess.
Normally I use a rented Medela Symphony. It's a hospital-grade pump, which is code for "could suck the patina off the freedom-loving coppery tits of the Statue of Liberty." To negotiate the five-hour drive home without missing a couple of pumping sessions, though, I purchased a Pump in Style, a battery-powered portable breast pump discreetly sheathed in a fake leather shoulder bag. (That would be the "style" part, I guess, though I do find the plastic nipple cones utterly ruin the fluid drape of my filthy Polarfleece pajamas. Watch the runways this spring, ladies. I am riding the crest of the fashion wave.)
For the trip, I packed up my pumping apparatus and donned a zip-front sweater for easy access. I made sure there was a warm blanket within easy reach so that I could cloak myself modestly as I pumped. And I gave the keys to Paul. At the appointed time, I made him swear he wouldn't intentionally involve us in any vehicular carnage and I unstrapped my seat belt. I unzipped my sweater, unclipped the lanolin-glazed cups of my nursing bra, conscientiously rebuckled my seat belt athwart my naked rack, and hitched myself to the pump.
Now if you've never used a double-pumping system, you might not know this: it is impossible to do it without using both hands. I suppose if you adjust the sucking strength to the "black hole" setting, the nipple cones might not need supporting, but otherwise you need to hold the collection bottles in place. This presents a problem when you're watching TV while pumping and want to change the channel (what, you think I watched "The Price is Right" because I wanted to?), or when, oh, I don't know, you're flying down I-91 in broadest daylight and want to cover your exposed nipples.
We had the blanket, so I let go of one of the suction cones for a moment to try to retrieve it from the back seat. Milk was spilled. Hilarity ensued. Sweater must be laundered, but blanket was retrieved.
Then I tried to arrange the blanket around myself without using my hands. Naturally this involved my mouth. I repeatedly grabbed the edge of the blanket with my lips and tried to tug it into place. The only thing this achieved was to give me a mouthful of fleecy lint, not unlike what you might expect after going down on a Muppet.
Finally I gave up on the troublesome convention of modesty and let the blanket go. The only people who might have seen me were any interested truckers who happened to pass. Just to be safe, when we were within striking range of a truck, I kept my eyes forward, my spine rigid, and my chin high, regally ignoring any slack-jawed stares I might have inspired.
I imagined Queen Victoria passing through the streets of London in an open barouche, infrequently offering her subjects a stiff-armed wave. I'd have waved at the truckers but I couldn't let go of the cones. Nevertheless, as Paul safely steered us clear of curious state troopers and incredulous road crews, I was every inch the naked-breasted, funnel-nippled, sticky-sweatered monarch.
A veritable goddamn Dairy Queen.
Gee, why didn't I think of that?
Since I became pregnant with Charlie, the one piece of advice I've been given most frequently is this:
Talk to a lactation consultant.
It got downright comical, in fact, and became the immediate answer to any number of questions, practical and rhetorical. "How do you get red wine stains out of a white heirloom damask tablecloth?" "Ask a lactation consultant." "Is the Pope Catholic?" "I'm not sure, but I know who you could ask..." "Who's on first?" "Lactation consultant's on second!" ("Yeah, well, Hit-you-in-the-face's on third.")
And I always thought I would talk to a lactation consultant, since until now my experience with my breasts has been purely recreational. In fact, they've been a barrel of goddamn laughs, exactly the kind of companions you'd like to get drunk and do something stupid with, like trying on a chiffon spaghetti-strapped slip dress. (Yes, the police were called, but no citations were issued.)
Only lately have they become worthy of the terrified respect I now accord them. These breasts mean business, and as my pregnancy continued and they got larger and larger, I came to understand that they must be approached with the exquisite diplomacy of, say, the 1945 Yalta conference. (Left breast: Stalin. Right breast: Roosevelt. Now who wants to nestle in my cleavage?!)
So it was always part of the plan to get some help with breastfeeding, which for some reason is often called "the womanly art," making me anxiously wonder whether my breasts should be spraying jets of tempera paint, or girded in a prickly net of macramé, or perhaps glazed and fired in a kiln.
When Charlie was born so early, unable to breastfeed, getting that help became imperative.
When your baby can't be put to the breast soon after birth, you need a way to deliver the necessary stimulation to your nipples. That stimulation is what encourages your body to make milk. And you need a way to empty what your body makes. That emptying is what signals your body to make more. If you eventually want to breastfeed, you need to get these processes in motion shortly after delivery. So the day after my C-section, when I incoherently asked one of the nurses about, well, nursing, I was unceremoniously introduced to the breast pump.
There's not much trick to pumping. You plug your breasts into the plastic cones, hit the power button, adjust the suction level from "Dustbuster" to "irresistible vortex that will draw out your soul through your milk ducts and fling it into another dimension," and sit more or less patiently while you drip.
Once your baby is ready to begin nursing, though, things get a little more complicated. It is somewhat more difficult to stuff your nipple into the moving target of a baby's mouth than it is to jam it into the clear plastic vessel of the machine. As far as I am aware, Charlie has no helpful transparent gauge along his side to indicate when he has consumed the requisite 55 cc. And a premature baby doesn't have the stamina of a full-termer they get tired before they get full, so you can't keep them at the breast for long as they try to figure it all out.
Enter, therefore, the lactation consultant.
I learned how to hold Charlie while nursing. I learned how to make an appetizing nipple sandwich for him to gum. I learned how to make him open his mouth wide to take it in. (Since his mouth is small and my breast is large, this requires him to unhinge his jaw like a python. Viper in my bosom, indeed.)
Charlie did well, I thought. He latched like a champ, his lips ostentatiously flanged around the croque madame I'd made for him. He didn't make a squeak of protest as I deftly whirled him around from football to cradle. He could deliver a few strong sucks in a row before having to rest, and his eyes looked up at my face, calm but alert, unblinking.
And do you know what the lactation consultant said to me, after several lessons, after watching us move through the intricate steps of our milky mother-son ballet?
"I think," she said carefully, "when you get back home, you should..."
Wait for it, wait for it, this is gonna be good...
"...Talk to a lactation consultant."
Even cow girls get the blues
Man, this guilt thing starts early.
I don't think any parent is immune, but mothers of premature babies have some fairly specific reasons for it. Some, for example, feel guilty because they fear they did something cheating on bed rest, moving that heavy laundry basket that brought about birth too soon. Others feel guilty because they don't immediately bond with that scrawny creature in the isolette who doesn't yet look like a baby. Still others feel guilty because they can't give their babies breast milk when they need it so very badly.
And others, selfish others, feel guilty because they don't want to.
Well, this other does, anyway.
I've been feeding Charlie expressed breast milk because he's yet to get the hang of getting it straight from the source. I pump at least seven times a day, hunched over a machine that makes a rhythmic wheeze as it pulls my nipples (normally the shy, retiring sort) into alarming purple torpedoes. When I'm not actively pumping, I'm guzzling water before or cleaning the pump parts after. I pump while I'm on the phone, and I pump while I'm online. In fact, I'm pumping right now while Paul feeds Charlie lunch.
Yes. While I am expressing milk, Paul is helping Charlie knock back the previous batch.
This does not seem especially efficient. It offends my sense of order, which is born out of a laziness so profound that it's a wonder my cells haven't hired a service to do the dividing for them. But more than that, it feels deeply fucked up to hand Paul the baby, the baby I'd been enjoying, saying, "Can you take him now? I have to go pump."
Can you take Charlie, whose head fuzz I've been dreamily rubbing with my cheek, so I can go do something I hate?
Plus, for me, pumping hurts. You know what they tell breastfeeding mothers who have sore nipples, fissures, infections? "Check the latch." You know what they tell pumping mothers, whose latch is robotically impeccable? "Huh. Weird. Well, it shouldn't hurt..."
Yeah. Hey! Thanks for the help!
My nipples hurt all the time. It's gone on for twenty-four hours a day for the last seven weeks. "Imagine, if you will," I said to Paul today, and described the situation to him with relish.
"I'd rather not," he said resentfully, "but now I can't help it."
Feel the love, people, feel the love.
So you'd think the desire to eliminate the middleman would motivate me to get Charlie established in breastfeeding. But I have to confess I'm not too eager to do that, either. Every time I put him to my breast it ends in screaming. He screams because he's frustrated and hungry, and I scream because while his mouth is refusing one nipple, the other is invariably being buffetted by some angrily flailing body part of his.
Besides the pain, I'm tired. I don't mean I'm physically tired, although I am, God, I am; I mean I'm weary in my soul. After everything that's happened, I am ready for something to be easy, a no-brainer, a gimme. Breastfeeding won't be, since Charlie apparently has a colorful assortment of mental blocks either that, or he has inherited my laziness. (Note to self: next time consider donor eggs. Oh. Wait.)
Switching to formula? Now that would be easy. I think of it a thousand times a day, most wistfully when Paul is asleep between the midnight and 8 AM feedings, when I'm up to pump, feed Charlie, then pump again. Yesterday Paul said, "I wish I could do more to help." Yet he balked when I made a simple suggestion. Suuuure, he wants to help.
I can't give up, though not yet, and probably not soon. How can I? I understand the importance of breast milk for any baby, and I know it's even more advantageous to premature babies who need an extra boost when it comes to immunities and brain development. If Charlie hadn't had such a shaky start, if he'd been full term, if my milk supply were no longer equal to his needs, I might feel differently. But given the circumstances, I believe if I can give him milk, I should. And I can. So at least for now, I will.
Parts of me don't want to (specifically, my freakishly distended nipples). But pumping won't kill me. Neither will being patient while Charlie learns. I can tell myself I'm doing it for him, and I am, but I'm also doing it for me: I can't subject myself to the guilt of not doing it. The guilt of not wanting to is bad enough.
Whipped cream and other delights
Boy, howdy, do I love breastfeeding. No, really! How else, after all, could I get an intraductal yeast infection courtesy of the questing mouth of my hungry son?
Right. Not only do I have a yeast infection, probably caught from Charlie, whose walloping doses of NICU antibiotics are likely to blame, I have a yeast infection that has INVADED MY BREASTS. It has CREPT IN THROUGH MY NIPPLES and COLONIZED MY MILK DUCTS.
It's really no surprise. If the last three years have taught me nothing else (and they have not), I've learned that if a disturbing, unusual condition exists, sooner or later I will contract it. So maybe I should be blasé about the FUNGUS CURRENTLY SETTING UP HOUSEKEEPING INSIDE MY BREASTS.
This explains the searing pain I feel every time I pump, and the agony I endure every time my clothing brushes against my nipples, and the white patches in Charlie's mouth that I, uh, carelessly wrote off as leftover milk sludge.
Let me repeat: YEAST. THROUGH MY NIPPLES. INFILTRATED MY MILK DUCTS, TAKING HOSTAGES, DEMANDING SAFE PASSAGE TO HAVANA.
The treatment involves squirting a payload of Nystatin into the moving target of an unwilling baby's open mouth; a single tablet of Diflucan for me; and antifungal cream liberally applied to my nipples. Monistat, the fluffy white coochie cream we all know and love, moonlighting on its day job.
I am so horrified by this turn of events that I am reapplying the Monistat every ten minutes. I wrenched open the tube this afternoon and already it is half gone. So eager am I to get rid of the yeast that I'm slathering this miraculous unguent far beyond the bounds of my areolas, venturing as far east as armpit and as far south as navel.
Yeah, breastfeeding's great. I really like it a lot. Now pass me the motherfucking cream. I think I missed a spot down by my ankle.
Nipple freakishly implacable antipathy
Whoever came up with the term "nipple confusion" is a fool. Charlie's not confused; he is a baby of rare discrimination who knows exactly what he wants. He doesn't have nipple confusion. He has nipple preference. Nipple aversion. Nipple seething white-hot hatred, if you really want the truth.
We dislike breastfeeding, Charlie and I.
We started out in the NICU with the make-a-nipple-sandwich method, which involves jamming a big fistful of areola into a defenseless baby's mouth, stuffing him into muteness as if you didn't want him squealin' to the cops, see?! With this method he'd latch briefly, give three strong sucks, then look bewildered. I'd remove my nipple from his mouth and start all over again. "He'll get it," promised the flaky hospital LC, in between fits of crooning, "There you go, mama. C'mon, baby. Mmmmmama," as if she were a white, female, sub-moronic Isaac Hayes.
When I told the local lactation consultant about this, she rolled her eyes so hard they clacked in their sockets. When they finally rolled to a halt, she broke out a nipple shield, a clear silicone sombrero that comes to a point so emphatic I feared I'd put out one of Charlie's eyes with it. It fits directly over your naked nipple and is used to make it easier for the baby to draw the nipple into his mouth; it's especially helpful for babies with a suboptimal latch or suck and for women with suboptimal anatomy. That would be Charlie, and that would be me.
We tried it, and it seemed to go well. The local consultant watched Charlie and me together and pronounced herself well pleased. "He'll get it," she declared, and sent us off to work on it together with instructions to try at every feeding with plenty of skin-to-skin contact.
And then I had houseguests for ten days straight.
I was able to slip away to pump; at the beginning of the visit I was discreet, disappearing without warning, but by the end I was bellowing, "Gotta pump!" as I trudged up the stairs yet again. Although the guests were family members, I was too uncomfortable to spend time with them naked from the waist up, coaxing a
screaming reluctant baby onto my sombreroed nipple.
They weren't even out of the driveway before I'd stripped and presented my plastic prosthetic once again to Charlie. But by that time, his initial goodwill had turned to rancor. He'd open obediently and allow me to draw him aggressively onto my breast, and he'd take a few experimental sucks. But when no milk was immediately forthcoming, he would scream.
I'd wait for him to calm down, give him a few milliliters from a bottle, and then try again. And he would scream the scream of the thwarted, the betrayed, the milkless, the pissed.
Now here is where we talk about the letdown reflex, or milk ejection reflex. It's this that causes some women's breasts to leak when they hear their baby cry, and what some women feel as a tingling that precedes a gush of milk. Apparently it's a conditioned reflex that can be inhibited by pain, anxiety, or negative feedback. You know, like the pain of sore nipples being relentlessly hoovered into a mechanical pump, or the anxiety of watching your supply diminish, or the negative feedback of, oh, I don't know, a baby yelling in fury when you're not delivering the goods fast enough.
My letdown, friends, is for shit. So Charlie would give a few healthy pulls, get no milk, and then scream. I can't entirely blame him. Having been bottle-fed for the first ten weeks of his life, he had no patience whatsoever for meals served in a less expeditious fashion. If the nipple of a bottle even a slow-flow nipple is a McDonald's drinking straw, my nipples are those whisper-thin coffee stirrers. Now how would you rather drink your milkshake?
A classic case of nipple confusion. But Charlie is not confused. He simply hates my breasts.
I called the local lactation consultant, a mother of a preemie herself, and explained the situation. She sighed. She said, "Well, you can work on it. You can do more skin-to-skin, and you can continue to try. Or" and here is where I burst into grateful tears "you can just enjoy your baby."
I needed that permission, thinking, If a hardcore breastfeeding advocate says it's okay to stop, it must really be okay to stop. I've been working very hard for the last ten weeks. I am ready for something to be easy, for feedings to be pleasant and amicable. I'm tired of trying, and desperate to stop being a special case, to stop having to work so much harder than almost everyone at something that should come more or less naturally. I am not going to try anymore.
That said, I'm still pumping. In fact, I'm committed to doing so at least until Charlie hits twelve weeks. I've heard that at twelve weeks a baby has received about 60% of his mother's antibodies, with the rest accruing only gradually thereafter. (I was not able to find a citation for that figure, but it pleases me so I embrace it.) It's important to me to give him that much, especially during RSV season.
Beyond that arbitrary milestone, I don't know how long I'll keep it up; a lot depends on how well I'm able to build and maintain my waning milk supply. To that end, I'm already pumping so frequently I don't know night from day, guzzling so much Guinness I smell like a brewery, and popping so much fenugreek I smell like a mapley brewery. I've also ordered domperidone without a prescription from a shady overseas pharmacy, and will frantically swallow it in giant handfuls immediately upon its arrival.
After that, we shall see. I will report back, unless I'm too busy enjoying my baby. Or slowly decomposing in a drawer in the morgue, a sad cautionary tale against ingesting controlled substances acquired from fly-by-night charlatans somewhere in the South Pacific.
It happened one night
Usually Paul tends Charlie around midnight. I take the 4 AM feeding because I need to be up to pump anyway. This generally allows each of us to get a short stretch of unbroken sleep, although it's imperfect; pumping every two to three hours plays hell with a girl's slumber. I'm philosophical about that, since I know that if Charlie were nursing I'd be up then, anyway.
I say "usually" and "generally" because we've been known to switch off when one of us needs to crash. Last night Paul was in dire straits, so I volunteered to be on duty all night.
I started feeding Charlie at 10:30, confident that he'd be finished and sleeping peacefully by the time I needed to pump at 11:30. Somewhere along the line, though, he started getting pissy. He'd suck on his bottle, but a few pulls in he'd start arching back, making a terribly angry face, and screaming. After a few rounds of this, I concluded that he wanted to suck but had a full stomach, so I put his pacifier in his mouth. He'd suck on that for a while, then repeat the same routine of angry contortions. I tried to pretend we were playing a game of charades at a sophisticated '30s house party, but he remained unamused by my guesses: swaddling? No. Rocking? No. Jiggling? No. Swing? No. Shushing loudly into his ear to drown out his angry yowls? No, and quit that, goddamn it.
Nothing was working, so as a last-ditch effort I shucked off what little clothing I was wearing and put him to breast, sans nipple shield, sans ceremony. I thought he might find some comfort noodling around with my nipple, smelling my scent. (Because the fenugreek has apparently infiltrated my every gland, I smell like the unwashed nether folds of Mrs. Butterworth, thanks for asking.)
My friends, he nursed like a motherfucking champ.
He latched. He sucked. He gulped and swallowed and practically chewed with his mouth open and drank the contents of his finger bowl. When I switched him to the other breast once he'd seemed to slow down, he took to it like, um, like a mammal to milk.
That boy can nurse.
However, since I'd managed to get in some pumping while he howled unhappily in the swing, I knew my breasts weren't full, so when he dropped off my breast a while later and still looked hungry, I investigated the bottle I'd been trying to give him when our peaceful mealtime went to hell. I thought maybe the milk had gone sour, so I can't believe I did this, much less that I am confessing it I put the nipple in my mouth and gave it an experimental suck.
Nothing happened. No milk, though the bottle was half full.
A few more sucks and...something...worked its way free. The holes in the nipple had been blocked, and all of Charlie's formidable sucking power could not dislodge that...something.
My boy was yelling, and my boy nursed at last because he was practically starving.
We finally slept, with Charlie dropping off exhausted and me eventually drifting off after making grand plans to sweep into the lactation consultant's office, Charlie nursing contentedly in his sling, modestly declaring that it was really nothing, after all. Just a little patience was all it took! (It goes without saying that in my vision, I was svelte, Charlie was cherubic, and the sling had an impeccable cut, making me look fashionable and maternal all at once.)
This morning I pumped a bit first to get my letdown going, and put him to breast again, eager to hold the ground we'd gained last night.
And he would have none of it.
He screamed. He wailed. He would not latch. He would not suck. He hated my breasts again, or still.
I'm fucked. As long as I lactate, I hope. As long as I hope, I'll try. And as long as I try, I suspect he will scream. I am fucked, my friends. Just fucked.
Here's to the ladies who pump
Nothing funny here, folks just some straight-up information that might be useful to those who are facing some heavy-duty pumping. I learned a lot of this late in the game, so I'm posting it in the hope that someone who's just starting out might benefit early on. It's mostly Medela-specific, but some of it might apply universally.
- Lube it. Grease up your areolae with lanolin before you start. It will help create a good seal within the cones and will reduce irritation from the friction. Do this every time; the difference when you don't is noticeable.
- Soup up your collection kit.
- If your cones are uncomfortable you may need a different size. Older collection kits come with only a single-piece unit, so if that's what you have you might consider switching to a newer set; Medela has now moved to a two-part system that allows you to swap out the cone as necessary.
- Speaking of swapping out cones, the Medela SoftFit breast shields, which are made of some kind of flexible space-age polymer okay, silicone are infinitely more comfortable for me than the standard hard plastic set.
- If your cones are uncomfortable you may need a different size. Older collection kits come with only a single-piece unit, so if that's what you have you might consider switching to a newer set; Medela has now moved to a two-part system that allows you to swap out the cone as necessary.
- Go hands-free. I do this by the simple method of pulling up the cups of my nursing bra enough to hold the cones in place. There are more esoteric ways of doing it, ranging from special bras to the rubber band trick. If you want to move around while you pump, these methods are a better bet than mine, but I spend my time pumping in front of the computer, so I don't need the cones to be all that secure. Note that the SoftFit breast shields are not compatible with Medela's hands-free pumping rig; you'll have to engineer your own.
- Acquire multiple collection kits. Stock up especially on the membranes, which do wear out eventually, acquiring little tears that will compromise effectiveness. I don't mean just one extra set, either I have four and still spend more time cleaning parts than I'd like. Which brings us to...
- Throw your rig into the dishwasher. Every part of the Medela system is dishwasher safe except the SoftFit shields and the tubing that connects the collection kit to the pump itself. Even the tiny white membranes are dishwasher safe, but I haven't come up with a good way to contain them within the dishwasher so that they don't get lost and mangled. However...
- You can use a collection kit more than once before washing it. Some women use the refrigerator trick, where they put their pump parts into a Ziploc full of water then refrigerate; it keeps any remaining droplets of milk from spoiling. I, however, live dangerously: since breast milk keeps at room temperature for up to 10 hours, I don't bother. I usually use a setup twice before washing. Since I'm pumping every three hours, I stay well within that time limit. Plus...
- Reduce the number of parts in play by pumping directly into the bottles you feed with. I'm using Avent bottles, which are incompatible with Medela pumps, but I bought a set of couplers that allow me to pump into Avent bottles, eliminating Medela's collection bottles entirely. I cap those and refrigerate; when it's time for a feeding I just clap a nipple on the bottle and go.
- A manual pump is probably insufficient for more than just occasional use. While I get my highest yield per pump with the Avent Isis man, is that thing comfy it takes much longer than a double electric and makes my hand and shoulder sore to use it more than once a day.
- Conventional wisdom says that if you're going to be pumping exclusively, you'll need a hospital-grade pump. I don't know if this is because they're more efficient and extract more milk, or because they're heavier duty and won't wear out like a pump made for occasional use might. I have both, a rented Lactina and a Pump In Style, but have no opinion about which is better for my milk supply. I prefer the Lactina only because it is much, much quieter you'd be surprised how grating that wheezing noise can be at 4 A.M.
- If you have a choice in hospital-grade pumps, the Medela Symphony rocks the motherfucking house. It has two independent pump actions so that if you lose suction on one breast say your jury-rigged hand-free arrangement slips the other side keeps pumping unabated. It also has a gentle letdown cycle; on other pumps you can mimic that by manually adjusting the speed and suction, but in the dark of night it's nice not to have to.
- Don't make yourself suffer with low supply. There are plenty of ways you can increase supply if you notice it's dwindling increasing the number of pumps, decreasing the time between pumps, so-called power pumping, herbal supplements, et cetera. For me the biggest increase has come through profligate use of domperidone. It's not approved for use as a galactagogue in the U.S., but it's easily available on the Internet without a prescription if you're feeling bold. With domperidone my supply has doubled, allowing me to keep pumping happily well, not happily, since this is me you're talking to instead of being discouraged by the fact that Charlie's demand was far outpacing my supply.
Pumping mothers, what other tips do you wish you'd had when you were first starting? Let us give the Internet the rich, nutritious hindmilk of our collective experience.
I've got a secret
There's something I've been keeping from you.
First, the background. I am beginning to suspect, to my dismay but not my surprise, that Charlie has colic. The yelling has diminished now that the Prevacid has taken hold, but there are still three or four nights a week when he howls for no apparent reason, for a few toe-curling, jaw-clenching, sphincter-twitching hours at a time.
Since we've gotten the reflux more or less under control and he's no longer arching in pain, the screaming is easier to take. Instead of sobbing along with him, I march around the room with him tightly slung, singing loud enough that I can't hear his cries, or I bounce him on my knee emphatically enough to surprise him into silence for a moment, or pat my hand gently over his mouth while he shrieks so that it makes a "bah-bah-bah-bah-bah" noise. (It amuses at least one of us.) The goal is diversion, to distract him from yelling for even a blessed moment so that Paul can hear me when I ask for a motherfucking drink.
This is how I discovered the shameful secret I am about to reveal. Charlie, I found, can latch.
A few days ago, in yet another creative attempt to divert him, I unbuttoned my shirt, yanked loose the cup of my nursing bra, unceremoniously flung Charlie across his Boppy, and presented him with a fleshy ultimatum, ramming him onto my nipple with an authority I had not known I possessed. And he latched like he'd been born to it as, in fact, he was.
I did it again tonight. And he did it again tonight. He suckled for a good five minutes, swallowing diligently, until he remembered he was supposed to be screaming and I swear I could see the tiny Christmas tree light-sized light bulb go on above his head and geared up again into full voice.
Here is what I plan to do with this information: absolutely nothing.
I was surprised by how I felt about his latecoming aptitude specifically, not much. I'd have expected to feel elated, or relieved, or even, if I'm honest, chagrined. Instead I feel neutral, as if he'd done a trick I'd seen before that didn't impress me then. Big deal, you can latch. Come back when you can photosynthesize.
Giving up breastfeeding was a decision I made with no small degree of grief. A month later I'm over it, and have even grown to appreciate certain advantages of bottle feeding. (Those certain advantages are called sleeping through the 2 AM feeding, nonchalantly sashaying out to the spa for a massage and exfoliation, and never, ever letting my father get even the quickest, most accidental glimpse of my tits.)
I can't imagine retracing those painful plodding steps between anguish and acceptance, much less setting myself up for several weeks of sore nipples, patient positioning, and making myself available for every single one of Charlie's evening clusterpaloozas just when I've started enjoying him.
Will I regret it? Doubt it. I'm a little apprehensive since I know there's no turning back once I stop lactating. But I'm looking forward with indecent pleasure to throwing out my pumping gear, having regretfully concluded I cannot lawfully burn it under current EPA regulations a clue that I won't be sorry to see the end of this mammalian phase of motherhood.
No one ever said on her deathbed, "I wish I'd spent more time with my tit in a plastic cone."
This is not my last pump, but it's close.
Over the last couple of weeks I've dropped the domperidone and have gradually increased the time between sessions, thereby reducing the number of pumps in a day little by little. I'm down to two.
It's almost the end of the line. My supply has been dwindling noticeably and drastically. It's never been plentiful; I topped out at around 24 ounces a day. After fourteen hours without pumping, last night I pulled an ounce and a half. I'm not sure I need to today, but I will because it feels too strange not to. If the yield's like last night's, the milk will be thin, mostly just water and useless.
I am deeply ambivalent about stopping, as much as I was about continuing. I can accept the various risks associated with discontinuing breast milk, mostly. The single place I get stuck? Antibodies. Before Charlie's six months adjusted, he's not making many of his own. Now, I can tell myself that we'll limit his exposure by keeping him away from crowds and sick people, something easily done where we live. I can pretend that because he wasn't especially sick in the NICU, he won't be in the same kind of jeopardy that other preemies might if he were to come down with an illness. I can give him bottle after bottle of the milk I've frozen, knowing that although it's not as rich in infection-fighting properties as fresh, it's better than nothing.
But it's all just rationalization, and not especially effective at that. The bottom line is that I'm willingly giving up, intentionally cutting Charlie off from something he probably needs.
For me, pumping is an inconvenience and not an impossibility: because Paul works at home and happily takes on child care, I'm able to find time to do it. My desire to stop is simple selfishness not because it's been a rough eighteen weeks, although it has, but because I'm eager to be more present. I've spent hours a day at a remove from the life of this little family we worked so hard to build, and that more than anything else is making me crazy.
Now, we can argue until the cows come home and who doesn't like a good dairy metaphor in a post about pumping? Am I right or am I right? Hah? Hah? Know what I'm sayin'? A'ight. Yahtzee! Also, boo-ya and other inarticulate interjections about whether that's true selfishness. But I know it for what it is; now that he's becoming more aware, more interactive, more fun, I want to spend time with Charlie for my sake.
That's why I had a baby, after all.
I believe I'm doing the right thing for our family. I want to invest in the now, in the daily enjoyment of my only baby's only babyhood, rather than in the future, continuing to pump as a hedge against the lurking possibility of illness.
Have I made the right decision? I don't know. I don't know that there is a right decision versus a wrong one, when both have significant benefits and disadvantages. I might as well flip a coin. If Charlie gets sick, I'll feel I've made the wrong decision. But if I'd kept pumping, I know I'd regret that, too. I already do, knowing I've missed a lot in these first few months of his life. That felt right then; this feels right now.
So I have the convictions. The real test will be whether I have the courage of them. I feel vulnerable. I'm worried, probably unrealistically, that I'll be called upon to justify myself, by his pediatrician, by his neonatologist, by outraged strangers who see me giving a bottle. While I was still pumping, I felt safe from the criticism I imagined might come my way, even planning snappy retorts in my head should someone be rude enough to question me, something biting and witty like, "Mind your own goddamned business."
At times I am downright Algonquin.
Now I'm not so confident. In my mind I see myself stammering, rushing to explain, to people who are, after all, in no position to understand and have no right to any answer. But then if my composure is the only casualty, I'll be comfortable letting it go. I think I can take the heat in exchange for familial warmth.
Broad where a broad should be bra'd
I've been away for the last couple of days visiting my good friend T. We drank a great deal of wine, we shoveled down embarrassing quantities of pork-free mousse truffée and saffron-spiked risotto, and we did what you can do only with the closest, most honest of girlfriends: we shopped for bras.
Months after I'd stopped lactating, I was still wearing the bras I'd bought while pumping. I don't mean the nursing bras. No, those I've collected in a tidy pile, awaiting the beginning of leaf-burning season. I predict the stubborn smears of lanolin will serve as a crackerjack accelerant, and I look forward to the merriest of blazes. Those bras, God damn their every straining hook, have been out of commission since before my final pump.
I bought the ones I'm referring to for those days when I needed to feel normal for a short while, when I'd venture out for a few hours without Charlie or the pump, sporting a smooth profile unbroken by the ugly hemispheric seam of the nursing bras. They are reasonably plain with a smooth cup and underwires, the kind of bra I might have bought in any case. But because of the staggering load the cups were required to carry, the center of the bra came up to the hollow of my throat a veritable turtleneck of a bra. And because that center is where the wires converge, every time I bent my neck, I risked catastrophic tracheotomy-by-undergarment. (The manufacturer, mincing no words, has christened it an Ultra Full Figure bra, with rigid straps, a sturdy inner sling, and no padding; the photograph here is entirely misleading because it shows the bra on a woman whose bosom measures a modest 34B, and because the cups are much smaller overall, the center support does not encroach even marginally on her jugular.)
Not only were they ugly and overly modest, so much so that they practically came emblazoned with the Taliban Seal of Grudging We-Probably-Won't-Have-You-Stoned-Today Approval, and not only were they potentially lethal in the wrong hands or on the wrong rack, they were very obviously the wrong size. I could gather a great handful of slack fabric where strap met cup. While I can unfortunately also do that with my skin, a quick nip into the lingerie department at Nordstrom cannot fix that particular problem. But I could buy a better bra, so off T. and I did go.
A digression, if you will: because I am, you know, old school, I used to buy my bras at Orchard Corset on the Lower East Side. Here is how it would go:
- Enter grubby-looking storefront.
- Before the door has closed behind you, get eyeballed by a large Hasid, who subsequently declares, "Wrong size."
- Wait no longer than a nanosecond before he's plundered the cubbyholes behind the counter, located an array of sturdy-looking apparatuses for you to try on, and handed them over without lifting his eyes from his book.
- Admire posters on the wall featuring undergarments from a bygone era the pointy-breasted models harken back to the Cuban missile crisis both temporally and geometrically.
- Proceed hastily to the stockroom, where the proprietor's wife wrestles your rack into submission.
- Fall in love with new bras, new shape, new you, sparing a moment to wonder at the store owner's laser-like accuracy.
- Pay 50% off retail price.
- Repeat at two-year intervals.
In the absence of an old-world bra shop, I've found any Nordstrom to be a reasonable substitute. They carry my preferred brand, and I've never been steered wrong by their saleswomen and their pink paper measuring tapes. But today was a little different.
Two things happened when I took off my bra in the fitting room. First, upon the baring of my breasts, Charlie, who'd been sitting cooperatively in his stroller, began to shift and fuss. I guess he does remember those early days.
Second, the fitter sighed, eyed my cast-off bra, then glanced at my breasts, and groaned in her heavy Eastern European accent, "What happened?"
You know, I ask myself that all the time. What the fuck happened, indeed.
T. then came in with a handful of hangers and gave her expert opinion as I put on bra after bra. "Four boobs," T. would say succinctly when I tried on one that divided each breast into two separate wobbly mounds of flesh. "Back fat," she'd warn, when I tightly battened down the hatches on another. And when I tried on a sheer lace demi-cup model, the kind I desperately wish I could still wear without hilarity ensuing, she was kind enough not to hoot aloud, restricting herself to gentle counsel: "You know, they may make those in our size...but they're not," she advised, "for us."
No. No, they are not.
The saleswoman did her best to convince me that I needed a significantly smaller size, but I, my back fat, and my rib cage, which I capriciously allow to expand now and then to accommodate my lungs during respiration, were not fooled. Instead, I purchased three new Wacoals that are two band sizes and one cup size smaller. I am not back to my pre-pregnancy size, but then I doubt I ever will be. I don't like the look of my new shape or the feel of the stretch marks as I run my hands over my skin, but I accord these changes the strange combination of pride and resignation that I feel when I consider other scars I've honorably earned. My breasts have changed for good or if not for good, forever.
But as far as my bras go, I am closer to normal than I've been in a year and a half: elegantly holstered, impeccably hoisted, and in no immediate danger of being stabbed in the throat by my underpinnings.