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  • Writer's pictureErin Stevens

Milking It

Inception: pic of me breastfeeding while writing this

Even for the same person, no two pregnancies, no two births, and no two postpartum experiences are exactly alike. At 6 months postpartum now with my second daughter, I'm reflecting a lot on just how different things have been. It's no more apparent than in the breastfeeding journeys.

If you've read this blog, looked at my book Instagram, or talked to me at all since I've become a mother, you know that breastfeeding was a struggle with my first daughter. She lost too much weight initially, gained a little, lost again, then put on slowly despite frequent, on-demand feedings with an apparently good latch and no anatomical problems on my end. Seeing multiple lactation consultants and having frequent check-ins with pediatricians never elucidated the cause (I have my own theories, none of which matter now), leaving me with mixed messages on just what to do about it and a deep sense of failure. I did triple feeding for way too long, supplemented with formula for a short time, and ultimately transitioned to exclusively pumping, which brought us to 1 year and 6 weeks with some amount of breastmilk in her diet, with continued comfort nursing before naps and bedtime until she was 9 months old. During pregnancy, my goal had simply been to make it to 6 months of breastfeeding, knowing that may have been difficult to accomplish given the unpredictability that comes with the schedule of an OB/Gyn physician. I say that I surpassed that goal...with an asterisk.

This time around, I truly don't think I changed much to result in a different outcome. I even had two issues theoretically working against breastfeeding success. My baby has a prominent tethered labial frenulum ("lip tie"), which can make latch difficult and decrease efficiency of milk extraction. This has never caused a problem, and when we saw the pediatric dentist about this early on at the suggestion of the pediatrician, she advised not undergoing revision (laser surgery to cut the tie) and made me feel a little silly for even making the appointment. I had a portion of retained placenta in my uterus after birth resulting in a delayed postpartum hemorrhage requiring surgical and medical management. Retained placental tissue can result in lower breastmilk supply, a large blood loss can also reduce supply, and I was separated from my baby during the procedure, forcing use of a bottle before I had planned (fortuitously I had recently started occasional hand expression after feeds just to see what I could get so had a small amount of milk frozen). Despite these risk factors, we have had the direct breastfeeding success that I could never quite reach with my first. Latch has never been a problem, and I've never had to deal with nipple cracks, blisters, or other injuries. Supply has not been an issue, and we have a full deep freezer of breastmilk. She's a great eater, and she's growing as she should. I pump because I have to at work and can decide to pump outside of work if it's what's most convenient for us. Getting to 6 months didn't feel like a challenge at all, and I'm simply assuming we will make it past a year.

Exclusive pumping and primarily directly breastfeeding each have their owns pros and cons. Exclusive pumping allowed me to decide when my breasts were needed. It gave me direct knowledge of my baby's exact intake every day (super helpful for a Type A anxious mom). It allowed my husband to participate in feeding earlier and more often, allowing daddy-baby bonding and giving me the opportunity to do other things during those feeding times when needed. But it was also really f'ing hard - mentally, emotionally, and physically. I had to either bring pumps, pump part cleaning wipes vs multiple sets of parts, milk containers, and a way to keep the milk cold anywhere I went or be at home to pump at the right times, This made me feel limited in what I could do and where I could go. Pumps can malfunction and pump parts can break, which felt like the end of the world when I needed to pump to get my baby her source of nutrition. There's a lot more to-do and need for proper positioning and level of awakeness to pump during the night and the first morning feed (rather than sleepily - but still awake - plopping a boob into the baby's mouth in a side-lying position...I'm not saying anything about how or where we sleep, don't come at me about unsafe practices...), and my sleep was worse for it. Direct breastfeeding can be done anywhere I can have my baby and doesn't require excess baggage or setup. But it requires extra thought of how and when to pump when I do need to (if I'm bringing my toddler to swimming lessons and my baby will be hungry while I'm away, something I had to consider today). I don't always have extra milk right in the fridge when I'm away on call. My schedule is more determined by the baby's demands, and that can interrupt when I can be available for other tasks. In both cases, there's never a true break. I have to think about emptying my breasts and feeding the baby one way or another around the clock every day, even if I'm really tired post-call or relaxing on the weekend or want a day out and about.

Breastfeeding is not every parent's choice, but it was mine, and I'm glad I could make it happen both times around. I'm grateful for both of these experiences. I believe both were beneficial to my daughters and to me in many ways. I hope both girls realize someday all the love that's gone into every ounce of breastmilk they've ever received. And I certainly hope my equipment holds up against the two tiny razor blades my baby seems to have had installed in her mouth...

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