Sometimes Even a Tiger Needs a Lactation Consultant

The Minnesota Zoo has set up a Tiger Cam to view its two new Amur Tiger cubs who are being raised by zoo keepers until they are old enough to join the adult tigers on view by the public.  They were born this summer at the St. Louis and Minnesota Zoos and as stated on the sign next to the television screen, they're being hand-raised because their mothers were not successful in nursing them.  I had the same reaction that many who I've told this story to had and that was confusion.  As a mom, I know that many humans have one difficulty or another breastfeeding, but shouldn't nursing be natural for animals?  Turns out a couple of tigers ended up reminding me of what I already knew about motherhood.

A volunteer for the zoo happened to be standing nearby answering questions about the tigers, so I asked her why the tigers had difficulty nursing their cubs.  She explained that just like any new mom, animals can be overwhelmed by motherhood and don't necessarily know exactly what to do.  Hmmm, I can identify with that.  Motherhood is a learning curve for anyone.  And yes, there's instinct.  The cubs and moms knew to nurse, but what happens when there's a problem?  Tigers don't have books on breastfeeding and lactation consultants to help troubleshoot.  I'm taking a wild guess that there's only so much a zookeeper can do to help a dangerous animal like a tiger. 

And there was something else I could identify with by living in a society with smaller families who may live farther apart and that is lack of role models.  The volunteer went on to explain that tigers who are raised in captivity or were abandoned as cubs might not have ever seen another tiger raise a cub, so it's simply less likely they'll know what to do. Gosh, I remember how lonely I felt after Oliver was born and how overwhelmed I felt for being completely responsible for the survival of an infant whose existence still seemed surreal for me.  But I also remember a nurse coming into my room after Soren was born and commenting, "This one one clearly isn't your first."  So cut the new moms some slack, tiger or human. 

Learning about the tigers was an aha moment that even in the "natural" animal kindom, not everything comes naturally, even something supposedly instinctual like motherhood and breastfeeding.  Any seasoned mom knows that labor and delivery don't go as planned, breastfeeding sometimes sucks or doesn't work out and a lot of the time we don't know what the heck we're doing.  And if one more person tells us any part of the experience is supposed to "natural", we just might scream (or cry). 

Weaned

Soren is weaned, at least I think.  A few weeks ago, he refused to nurse one morning, but happily took a bottle.  I secretly hoped he was self-weaning, because then I wouldn't have to make the decision of when and could feel less guilty when it happened.  His nursing strike turned out to be an anomaly though. 

I didn't plan to wean Soren this early, but I think my decision to stop pumping at work about three weeks ago ended up causing my supply to drop and Soren realized he could get a guaranteed supply from the bottle.  I simply had grown tired of pumping.  It didn't just take time from my work day, but because of the timing of my pumping sessions, along with meetings and lunch, it was rare that I even had an hour-long period to devote to anything on my task list.  I remembered back to when Oliver was Soren's age and how my body adjusted along with Oliver's feeding schedule.  Because I formula-fed more and more often in Oliver's last months of breastfeeding, the weaning process was gradual and quite easy on my body. I kept waiting for that natural slow-down this time around until I realized that when you're pumping, you could just keep going.  Chris and I are taking a trip in mid-September - without the kids - and I made the decision awhile back that it would make sense to wean Soren before the trip.  I was not running around New York City with a manual pump stuffed in my handbag.  I decided that ditching pumping had to be the first step in the weaning process, because I felt like my body was never going to slow down on its own. 

I think some women who work outside the home pull off breastfeeding just on nights and weekends, but my body never fell into a rhythm. My tactic was to hold off pumping as long as I could and then only pump minimally, and the first few days went surprisingly well as I quickly stopped pumping during the day.  But then life happened and I missed a feeding here and there because of going out or Soren skipping a feeding for one reason or another.  I started to hit this cycle of missing a feeding, becoming engorged, pumping for relief, and then experiencing what appeared to be a lessened supply based on Soren's dissatisfied reaction.  I didn't want to counteract the drop by pumping a lot to stimulate supply, because I was pumping at odd times and was worried I'd start producing milk at all these wrong times (i.e. when Soren was sleeping) and I'd end up back in a cycle of needing to pump on a schedule (just what I'd been trying to get away from) or unpredictably becoming engorged. 

This weekend Soren refused to nurse when I got him up in the morning.  I had wanted to hold onto "nights and weekend" breastsfeeding because it's a lot easier than trying to make a bottle for an impatient baby who hasn't eaten all night.  But it didn't bother me to have to make a bottle and Soren enjoyed it just the same.  For the rest of the weekend, I'd offer him the breast first, but he'd maybe take a few sips, before sucking down a bottle.  And with that I decided we had reached the beginning of the end of breastfeeding. 

I still don't consider myself completely finished with breastfeeding though.  My pump is still stashed in my desk at work and another is yet to be packed away at home, just in case.  And my body is still figuring out that it can finally shut off the spigots.  I fell shy of my goal by about three months, but as I told a friend who told me she gave up breastfeeding after four months, once her baby passes the year mark, whether she had fed him breastmilk or formula will seem like a distant memory. 

I'm still wearing nursing bras and yet I can hardly believe that I've left that phase behind with a second child.  I'll never forget how in awe I was to witness an example of natural instinct when I nursed Soren for the first time.  He was not even an hour old and I placed him at my breast and he opened his mouth and flung it forward right onto my nipple with such precision as if he'd done that whole suckling thing a thousand times before.  I'd taken a class on breastfeeding and had read books, yet he knew just what to do straight from the womb. 

I took this picture of Soren (at 7.5 months) because I always liked the sight of him curled up in my lap, especially after he had eaten and was at his happiest.  I'll miss it when he's no longer small enough to fit on my lap.

Support for Breastfeeding from the Medical Community

Breastfeeding has been heavily promoted in the medical community for years now, yet we haven't figured out how to eliminate the barriers nursing moms or prospective nursing moms face.  My friend's recent experience with insufficient support from her baby's pediatrician and a runaround from her insurance company makes me want to bang my head against this keyboard. 

She had brought her second child in for a routine weigh-in at two weeks old and was surprised to learn that he hadn't regained his birth weight.  She was told to supplement with formula because her baby wasn't getting enough to eat.  When she relayed the story of the visit to the pediatrician, the diagnosis didn't make sense to me, because she had not had any problems with supply during the 18 months she breastfed her first child. 

Many moms, especially first-time moms, would have stopped with this one pediatrician's diagnosis.  They would have believed they can't make enough milk and either would have endured the cumbersome process of nursing and then supplementing with a bottle, or they may have given up all together.  If you're already preparing a two-ounce bottle, why not make a full bottle and let your partner get up in the middle of the night?  I know that's the path I would have taken. 

Even if a doctor's recommendation doesn't sit right with a mom, she may not have available or know about additional resources.  Luckily my friend has a whole network of mom friends whose varied experiences with breastfeeding she could draw upon and she knew about a lactation consultant group at one of the local hospitals.  She made an appointment with a lactation consultant and before she took her son back for another weigh-in, she requested an appointment with a pediatrician who supported breastfeeding.  The second doctor still recommended supplementing with formula, but only until the reason for the lack of milk could be identified and addressed.   

Since my friend had never been to a lactation consultant before, she called her insurance company to see who was "in-network" and was told that lactation consulting wasn't covered because it was a "convenience."  She called the lactation consultant back and was instructed that if she told the insurance company it's a "facility fee" the appointment would be covered.  First of all, what the heck does that mean?  And second, has health insurance coverage gotten to the point that we need to know the super secret code word in order to be covered?

If the medical community agrees that breastmilk is healthiest for baby, (and breastfeeding is healthiest for mom) why won't insurance companies willingly cover this type of health issue? And why aren't pediatricians referring more moms to lactation consultants?  When I went to my family doctor because my knee was continuing to bother me when I ran or played soccer, he referred me to a sports medicine specialist, who was better able to diagnose the problem, and who referred me to a physical therapist.  All this was covered under my health insurance plan.  The second pediatrician my friend saw didn't know any more than the first why her baby wasn't getting enough milk.  Pediatricians are generalists when it comes down to it, so they shouldn't be expected to know how to solve every breastfeeding challenge. But she listened to my friend's concerns and what she wanted, and she referred her to a lactation consultant. 

At least my friend's breastfeeding story ended on a positive note.  The lactation consultant noticed her baby wasn't latching properly, which means he wasn't able to get enough milk, and because lactating womens' bodies produce milk based on supply and demand, her body wasn't getting the signal that it needed to make more.  My friend was shown how to help the baby get a better latch and was advised to pump after each feeding to stimulate supply.  And while having to pump adds one more cumbersome step to each feeding, she now has breastmilk she can offer him for the next bottle, and she feels better that she's actively doing something to return to exclusive (and bottle-less) breastfeeding.

Thoughts on Pumping

When I decided to go back to work, one of the logistics of being a working mom I really was not looking forward to was pumping.  I told myself I'd give it a try and see how it went.  Unless I worked from home or had my own office with a locking door, I don't think my situation could be more conducive to pumping.  I have a private room reserved for nursing moms, a consistent work schedule, a pumping schedule I can decide for on my own and a boss who wrote her dissertation on the economics of breastfeeding.  And on the few occasions I'd forgotten to take my expressed milk home the night before, the nanny has dropped by my office on her way to take the kids somewhere.

Although pumping has gone really well, I do wonder if my work environment had been even slightly inconvenient for pumping, whether I would have stuck with it.  If I weren't able to take pumping breaks as needed, but instead had to divide my lunch break to be able to pump, I have to say that I'd probably pick socializing with co-workers at lunch or going to the gym and utilizing the precious limited time to do something parents so often have zero time to do: workout.  Or if I had to take a pay cut because I was only allowed unpaid time to pump or had to work an extra hour each day to make up for pumping breaks, I don't think I'd continue.  Since I'm breastfeeding when not at work, and am barely pumping enough to feed Soren the next day, two bottles of milk just wouldn't be worth the extra effort or inconveniences. I don't think I'm selfish for thinking this way, just lucky that I'm experiencing the type of work environment every nursing mom should have.

Used baby gear

When it comes to baby products, sometimes I wonder if recommendations about buying new isn't based solely on concern for safety, but with increasing company profits. First it was only car seats that experts were telling parents had to be purchased new, then when the law went into effect banning the manufacture of drop-side crib, suddenly all second-hand cribs, even if they hadn't been recalled and met current safety specifications, were a no-no.  I've even seen some sources warning parents that used crib mattresses are a SIDS risk and others saying that a car seat shouldn't be reused for a younger sibling because new safety features are being added all the time.  I obviously support strict standards of safety for products used for or by children, but what frustrates me is the blanket ban of classes of used products without either an explanation of why a second-hand product is unsafe or education about how to evaluate whether a product could be safely reused.  Sure it's easier to just say, don't reuse such and such, and buy new instead to guarantee safety.  (But given all the recalls, buying new simply for safety's sake can be a false sense of security.)  But parents are going to continue to seek hand-me-downs and honestly, buying new for many parents is not an option. 

Like many expecting parents, Chris and I were overwhelmed with everything we needed to prepare to welcome home a new baby and we bought as much second-hand as we could to save money.  I thought I was being thrifty when I bought a barely-used double-electric Medela brand Pump in Style Advanced breast pump from an acquaintance.  After I delivered Oliver, a nurse offered to show me how to use the pump, but was horrified when she found out it was used.  She explained that the way my pump was designed, there was the potential for milk to pass through the pumping mechanism, meaning that if my friend had a disease, it could be passed on to my baby.  I was frustrated that Medela is forcing every women who wants or needs to pump into buying an expensive new pump just because it designed a pump in such a way that it could potentially cause a transfer of disease, even though the company makes hospital-grade pumps whose design isn't a health risk for the pumps' multiple users.  I wasn't about to demand a medical history from the woman I bought the pump from, and Chris and I decided it wasn't worth the risk, so we threw it out, despite the voices lingering in my head of my mom and ueber-frugal maternal grandmother exclaiming, "That was a perfectly good pump!"

Turns out I didn't need that expensive pump.  Like so many other baby products I bought because everyone else said I needed them, I didn't evaluate the need for a double-electric pump based on my particular circumstances.  I was a stay-at-home mom who spent little time away from my baby and I didn't have time to pump anyway. 

But going back to work after Soren's birth made me look into breast pumps again.  I almost considered not pumping at all, given how unappealing it seemed to me, and then the prices of new pumps were stressing me out given all the other expenses I was incurring to get ready to go back to work.  Breastfeeding is touted as being cost-free, but that's only if you breastfeed on demand and never leave your baby, which really, how many can logistically pull that off, or want to do that?  So then you have the cost of bottles, the pump and a myriad other accessories associated with storing milk or cleaning bottles and pump parts.  But I had a supportive office environment and I didn't want to jeopardize my milk supply for breastfeeding outside of work, so I decided I'd give pumping a go.

When a friend offered to sell me her also barely-used Pump in Style Advanced pump during search number two, I told her I'd been down that road before.  Even though she assured me that her pump had not been "contaminated," and she's someone I trust greatly, I realized I wasn't going to consider buying even her pump if I didn't finally examine one and see for myself what the big worry was concerning milk getting into the pumping mechanism.  I happened to stop by another friend's house the next day, and I asked to look at her pump and have her explain to me how it worked.  I'd always assumed the milk passes through the two, long thin tubes that connect the breast shields and bottles to the electric pump, so as soon as that nurse in the hospital after Oliver's birth said that the pumping mechanism couldn't be sterilized, I never questioned the actual potential for contamination..  But once I saw that only air passes through the tubes and the expressed milk drips straight into the bottle and that it would take a major malfunction for milk to backup through those looooong tubes to reach the pumping mechanism, I completely trusted buying my friend's pump off her. 

And then I got really mad that so many women are being scared off from buying affordable, but used, equipment.  As a parent-to-be and then a new parent, I had no idea what to look for half the time.  I couldn't tell a useful piece of baby gear from a worthless, albeit, still safe, piece.  I trusted something just because it was new, even though I had no idea how to eveluate if the product would prove to be safe, (or eventually be recalled) and avoided everything I heard from whatever source, regardless of credibility, could be unsafe.  After being entrenched in the world of baby gear for a few years now, I feel like I have a better handle on evaluating used items.  There are many things I will buy off Craig's List or from consignment sales, and there are a couple of things I'll only buy from trusted friends like car seats and breast pumps.

Even if I threw one perfectly good pump away, I'm happy I didn't end up buying a brand-new one like I'd thought I would have to.  My friend has some extra cash for something she'll never use again and I'm keeping one piece of baby gear out of the landfill.

"Rosa Parks of breastfeeding"

I wrote last about feeling lucky that my new job is supportive of female employees pumping at work.  When the woman who told me how to reserve the designated room for pumping popped by my desk on Friday to see how things were going, the guy who sits next to me announced that she's the "Rosa Parks of breastfeeding." 

When my co-worker returned from maternity leave three years ago, she tried using the nursing room, but found it often occupied with people wanting to use the phone or taking power naps or what not and then she ended up wasting time looking for a private place to pump.  After pumping in a storage room, her frustration sent her to Human Resources where she very nicely asked for a dedicated room where nursing mothers have priority.  She matter-of-factly explained the dedication pumping entails, because a woman needs to commit to pumping multiple times a day in and day out or else her milk supply drops and/or she encounters health complications.  The room where a woman could pump in private already existed in our office, but without the simple assurance that she would have access to it when she needed it, her chance at success with long-term pumping was jeopardized.   When she was denied, she drafted a petition and went from desk to desk to talk to her co-workers about the issue and build support.  Who knows why it took a petition, but Human Resources changed course and relabeled the room the "Nursing Room," updated its employee manual to say that nursing mothers have priority for the use of the room, and the world went on turning. 

Although my co-worker experienced some backlash for her effort, (in the form of negative comments from fellow co-workers, such as the one who said that's not something that should get priority) by the time I arrived three years later, the culture had changed.  So I thanked her for paving the way for the rest of us, because I'm not sure if I would have had the guts to stick myself out there like she did.

Pumping at work

One of the best parts for me about being a stay-at-home mom was that I didn't have to pump.  I breastfed on demand and pretty early on in Oliver's life decided that he was going to get formula the few times I wasn't around to feed him myself.  I realized that pumping was time-consuming and a chore and didn't want to be a slave to the machine.  Well, as of today, pumping is now a new way of life for me. 

I started a new job today and among the usual matters one handles on the first day, like meeting with HR, setting up your e-mail and voicemail and figuring out where everything is, I had to track down a place where I could pump and then interrupt my orientation to go do so.  Thankfully the office culture at my new job is supportive of nursing women.  When I told my boss that the HR rep didn't think I could reserve the dedicated nursing room, she took me over to the desk of someone who'd know the real answer - another nursing mom.  (And yes, I can look up when the room was available and block off time on my calendar so I have the room reserved and no one tries to schedule me for a meeting during pumping sessions.)  And I'm lucky I work in a flexible office environment.  I know women who are teachers, flight attendants, doctors and delivery truck drivers who face many more challenges if they choose to pump at work. 

Despite the favorable set of circumstances I was heading into, pumping had gotten off to a frustrating start when my attempt at stockpiling bottles of expressed milk yielded me three ounces by the first day of work.  Since I was nursing full-time on demand a baby who still didn't have an eating schedule and nursed quit frequently, finding time to pump, let alone reasonable quantities, was nearly impossible.  The lowest point was when Soren woke up unexpectedly early from a nap and wanted to eat and I ended up feeding him the bottle I had just pumped because my body hadn't had the time to produce more milk.  Then were the two times Chris was home with Soren and fed him a bottle of my liquid gold when I was just minutes away.  I finally gave up one night when the kids were in bed and I couldn't bring myself to pump, because I was paranoid that would be the night Soren would wake up earlier than usual and I'd be dragging myself from my warm bed down to the kitchen to heat up a bottle.  I reminded myself I wasn't opposed to formula and enjoyed the last few days of not being attached to a pump.  My gamble might be working out.  The number of ounces I was able to pump today was a little more than what Soren actually ate, so he should be set for tomorrow.

Breastfeeding in public

Every now and then I come across a story in the news about a woman being asked to leave an establishment or cover up because she's breastfeeding.  These stories make me raging mad!  In Minnesota and most other states, (but, frustratingly, not all) breastfeeding is legal in any public or private location (so, yes, that means restaurants) and breastfeeding is exempt from any public indecency laws.  I don't care whether you think breastfeeding is disgusting or if public breastfeeding is okay in one location, but not another, or if a woman should still cover up "out of respect" no matter what the law says.  Sorry, folks, breastfeeding is protected under law. Period.  So I would hope these women had the courage to tell these busybodies to go mind their own darn business or put a blanket over their own heads if they don't like what they're seeing. 

Regardless whether the law protects the right to breastfeed anywhere, perceived perception by strangers, or even a woman's own friends and family, is intimidating.  I know the stories of bad experiences and my own unease about potentially exposing too much flesh when I was still new to breastfeeding were what made me so anxious about feeding my baby in public.  I was always so afraid of Oliver waking up when I was out and about and wanting to be fed that instant.  I'd meet friends at the mall that first winter as a mother to walk and would make the trek far out of my way to find the lounge of a restroom to feed him even as I passed 100 benches along the way.  And on top of that, I'd pull out my nursing cover even though I found it hot (for me and baby) and cumbersome to use.

Within the span of the year I breastfed Oliver, my comfort with breastfeeding quickly increased until it felt like second-nature.  And I stopped caring what others thought.  The nursing cover that once gave me the much-needed confidence to breastfeed in public went mostly unused.  Now I wonder if the cover had brought more attention to the fact that I was breastfeeding when in reality, without one, few probably even noticed what I was doing.  At least Chris's cousins didn't this past Thanksgiving when they swarmed me to get their first peek of a "sleeping" Soren.  They cooed at him as they leaned down just a couple inches above his face to get a better look (you know, since he was turned towards me with his face pressed against my breast) and a few seconds passed before they realized that he was not only awake, but eating.  Only then did they scurry out of the room.  I had a good laugh about the irony.

I'm glad to say that I haven't had a single bad experience, not even a dirty look, (although I've seen plenty of kids, young and not so young, stare) directed at my public breastfeeding.  This gives me faith that our culture's opinions about breastfeeding are indeed changing.  Or maybe public opinion is simply coming full-circle.  I was sitting on a bench at Target last week feeding Soren (cover-less) when a woman who I guessed was in her late 80s walked past, stopped and asked how old my baby was.  I thought it was unusual for a stranger to make small-talk with me while I was breastfeeding, because most people are too embarrassed to look at me, let alone talk to me, (Chris's cousins case in point) under such a circumstance.  She made remarks about what a precious age and how lucky I was and as she turned to continue on her way, said, "It's so nice to see that."   

Breastfeeding from the Trenches

WARNING: The following blog entry contains the word "breast" in every other sentence. If that makes you uncomfortable, cease reading.

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My goal was to breastfeed for six months and I made it! (And then some.) Right after Oliver was born, though, I wasn't sure if I'd make it even six days. Six weeks felt like an eternity. Six months suddenly seemed impossible. Before Oliver was born, I had decided on six months, because I'd heard it was a recommendation by some well-respected organization whose name I can't remember. In those first two or three weeks, all I could think was, "This sucks," and about how sad I was that I wanted to give up on something I was so confident beforehand that I could do.

Breastfeeding, in theory, is not difficult - no bottles, no mixing and warming formula, it's readily available and ready to go. It's the details, the ones that are glossed over or not talked about unless you hang out with a breastfeeding woman and hear about what the commitment really entails. Although there's a lot of education among my generation to promote breastfeeding, and doctors, hospitals and workplaces are lining up in support, much of the details about breastfeeding remain a mystery to those, like me, who just didn't have a lot of exposure to the practice until I was doing it myself. You rarely see women breastfeeding in public, and unless you're close friends with someone breastfeeding, you're not going to be privy to the ups and downs. Thus, I was surprised by how lonely, overwhelming, frustrating and boring the experience initially was.

I was lucky in that I didn't have any "mechanical" challenges to overcome - Oliver figured out how to latch quickly, I never experienced painful clogged ducts or mastitis, and my milk supply, while a little late to come in, was always adequate. Other than some clumsiness as I figured out how best to position Oliver and encourage a good latch and a lot of really uncomfortable engorgement - all really unavoidable when you're a newbie - my foray into breastfeeding was "by the book." Yet, why was it still rough going?

I recently listened to a podcast about breastfeeding and the guest on the show, a nurse and lactation consultant, was the most straight-forward of any breast-feeding proponent I'd encountered about the reality of breastfeeding. Most focus only on the benefits of breastfeeding and why you should do it. Sure, this woman did that, but not while also gushing about what an "intimate experience" it is, or how it's a "selfless act" or how it's the ultimate form of "bonding." Please. If I hear any more of these descriptions, I'm going to gag, because I find these cliches about what the experience is supposed to be like and the phrases hardly described my own.

The lactation consultant's job was to promote breastfeeding and help women correct challenges, but I also appreciated how forthright she was. It's monotonous, she said. You're going to feel like you're never going to do anything else but feed your baby and that you're never going to move from your position on the couch. Oh, and it's boring and lonely, she continued. Back in the day, child-rearing was more a collective effort and you most likely had a mom, cousin, sister around - someone, thus, to talk to to pass the time away. You weren't sequestered in your office or a lactation room pumping or alone at home all day. I listened to that podcast 10 months too late.

I feel so naive now, but that podcaster wasn't kidding about breastfeeding being time-consuming. I'd never done the math. Well, first of all, I never even thought about how long it could take a baby to eat, not that I could have planned for that since you just can't know ahead of time what kind of eater you'll have. Multiply that by 8-10 times in a 24-hour period. And when some book I read during pregnancy said that most newborns need to eat every one to two hours, it didn't mention that that's every two hours from the last time he started eating. So if he ate at 9:00 a.m., and it took him 45 minutes to eat, it's already 9:45 a.m. and he's going to want to eat again in another hour and 15 minutes, not at 11:45 a.m. So I was unprepared for how long I'd be stuck in one position with a baby literally attached to me. Hours a day.

I'd had this image in my head of the happy, adoring mom nestled in her glider in the softly lit nursery as her baby quietly suckled. Forget that it could be the wee hours of the morning. Forget that those feedings could last 45 minutes and you could be bored out of your mind staring at the wall. Forget that you can't be doing anything else at that moment. Suddenly I wanted to be doing dishes, the laundry or mopping the floors. Menial housework would have felt liberating. So the reality was me sitting cross-legged on the couch, for sometimes hours at a time (it took Oliver so long to eat that by the time he was finished, he was hungry again) and often crying because "HOW COULD THE BABY STILL BE HUNGRY!" and all I wanted was the freedom to go do something else, anything else at that very moment, because it was 6:00 p.m. in the evening and I was ready to call it a day. I'd probably already had a baby latched onto my breast for eight hours that day. Staring adoringly at my baby boy, as awe-inspiring as he was, was not enough entertainment for me, so either the TV or computer was on, because this is how I kept myself from falling asleep with my baby in my arms in the middle of the night, or to keep me from dying of boredom. That was the reality of what our nursing sessions looked like.

I so desperately needed a break, but breastfeeding isn't a commitment you can back out on whenever you don't feel like it. To keep your milk supply up, you ideally should be either feeding the baby every time he or she needs to eat, or at least pumping. Uncomfortable engorgement is probably nature's not-so-gentle reminder to feed, or else. So even getting away for a few hours entailed either being back for a feeding, or finding somewhere to pump, as well as a way to store the milk and transport it home, unless you just dumped it.

It was this realization that I couldn't take a break or that I couldn't roll over in the middle of the night when awoken by the baby's cries and tell my husband, "It's your turn to feed the baby," that left me really overwhelmed much of the first few week by this responsibility as my baby's soul source of nourishment. I had felt proud, for instance, when the visiting nurse weighed Oliver in our kitchen after his first week of life and announced he'd gained a pound and was healthy, (sustaining another human being with my own body was awe-inspiring) but still overwhelmed. I had carried the baby, I had given birth to the baby, I was physically recovering from the birth (after a long labor followed by an unplanned c-section) and now I was the only one who could feed the baby when all I wanted was a goddamn nap? I was frankly resentful of my husband, resentful of all the pro-breastfeeding sources that had convinced me the only responsible, healthy way to feed my baby was by breast and resentful of even my own stubborness to not give up because I would have had to admitted to everyone that I had failed.

Breastfeeding was also often very lonely at the beginning. I've never been a night owl and despite having gone to college, never pulled an all-nighter. But once Oliver arrived, I was up multiple times each night, sometimes for hours at a time. Those nights were so lonely and unpredictable, (how many times would I be awakened, how many minutes, or even hours, would I be up at a time?) I started to dread nightfall.

So those nights were lonely - and cold. How did I miss the part about night sweats? I took a class on breastfeeding, I read books, I listened to podcasts. In all of this, how could night sweats never have been mentioned? The first time I woke up soaked through all my clothes with slightly damp sheets underneath my once soundly-sleeping body, I was convinced we had the thermostat set too high. Not only was I sleep-deprived and alone to take care of a screaming and hungry baby, I was also wet and cold. When I dragged myself out of bed, I had to wrap myself in one of Chris's ridiculously large hooded snowboarder sweatshirts that came down to my knees to keep from shivering uncontrollably. I eventually laid down a towel on my side of the bed to keep from soaking through a fresh set of sheets every night and kept a spare pair of pajamas nearby to change into before going to feed Oliver.

Those were the emotionally-laden, steep-learning curve first months. But as the woman who ran my parent support group at the hospital said, bottle feeding is easier in the beginning and breastfeeding is more difficult, but breastfeeding eventually becomes easy and bottle feeding becomes difficult. She told our group this weeks after Oliver was born and just when breastfeeding was starting to feel like second nature for me. I was happy I'd stuck with it. The night sweats stopped, Oliver's night-time feedings started to drop, he slowly became a more proficient eater and the out-of-control engorgement and springing a leak (literally) without warning ceased seemingly overnight. Oliver and I had found our nursing groove and when his six-month birthday arrived, I saw no reason anymore to stop. Those first few weeks with the steep learning curve suddenly seemed like a distant memory and breastfeeding felt like something I was comfortable with and like I always knew how to do.

The logistics of it all never ceased though. Even as the number of times a day he nursed dropped, I still planned my day around when he needed to eat and I had to consider where I'd be when this time rolled around. Would there be a quiet and comfortable place to sit and nurse? After a few months, he was too easily distracted if I was even talking to someone else, and as he grew, I literally needed space around me. Nursing in a plane seat, at a popular storytime where crowds packed into the small bookstore, or even in a chair with arms that came too high, was impossible. I was limited in what I could wear based on how easily I could breastfeed in it. Dresses, form-fitting anything, button-down shirts were all out. The only bras I could wear were unsupportive nursing bras that left me feeling frumpy in anything I wore. The warmer weather did make breastfeeding easier when away from home - suddenly feeding on a park bench was an option - but not when dressed in a sports bra and sweating profusely during a muggy Minnesota summer day.

As much of a positive experience breastfeeding turned out to be for me, I'm honest with people that Oliver was never exclusively breastfed, and that was by choice. When it was first recommended while still in the hospital that we supplement with formula because Oliver was supposedly jaundiced and my milk hadn't yet come in, I was upset, even though I eventually relented. Knowing what I know now, maybe I wouldn't have supplemented with formula, but knowing what I knew then, I made the best decision I could have. Although I felt a lot of pressure at the time, I had to make a choice and move on and formula supplementation is what we did.

Formula quickly went from something that wasn't even an option to a welcomed supplement. Chris often gave Oliver a bottle in the evening in the early weeks to give me a break and I truly believe that daily respite kept me from losing my mind. I also refused to be a slave to a pump, (an option I could forgo as a stay-at-home mom) so formula allowed me extended or overnight breaks. When away from home, I pumped for comfort, not to save up for future feedings, and then relied on patience and persistence to bring my supply back up when I was back to exclusive nursing. Because of Chris's work and school schedule, I was responsible for Oliver, the house, and of course myself (hey, I've got to eat and shower sometime) for extended time periods, and pumping required time I didn't have. Even if I knew I was going out for awhile, I literally didn't have time in the days leading up to my few hours of freedom to stockpile bottles of breastmilk. I did pump some in the first three or four months, but then decided that for the limited times Oliver was away from me, he'd get formula. And that I wouldn't feel guilty about it.

I travel in a very breastfeeding supportive circle, which is awesome, but I have friends who brag about how little formula or no formula their babies have had, and I refuse to let breastfeeding be an all or nothing deal. I gave what I could physically, mentally and logistically and consider what I accomplished a success. I just hope other women feel comfortable continuing with breastfeeding even if they have to, or choose to, supplement with formula. Sure, "breast is best," but formula isn't considered poison in my book.

When Oliver turned one, I had reached my revised goal of breastfeeding until age one, which is the recommendation by the American Academy of Pediatrics, which supports "exclusive breastfeeding for approximately the first six months and support for breastfeeding for the first year and beyond as long as mutually desired by mother and child." Earlier in Oliver's life I didn't know if I'd be sad when I would eventually decide to wean him, but his lessening dependence on breast milk ultimately made my decision to wean at a year less guilt-ridden. It was amazing to notice that even in just the last month of his first year of life, nursing him took two or three minutes and sometimes he'd literally take a few sips and be done. I had begun transitioning him to cow's milk at eleven months, so by the time his first birthday rolled around, I was only nursing him in the morning. One morning a week after his birthday, he threw a fit when I tried putting him to the breast. I'd been holding onto one nursing session a day just to keep my milk supply there in case I regreted my decision to wean. But when he "announced" he was finished, the mix of emotions I thought would be there weren't. We're both ready for the next stages in our lives and it'll be then, that despite frustrations and challenges, what I'll remember above all about my breastfeeding experience is the sight of my once small cuddly baby who had nursed to sleep in my arms drunk on mommy's milk.