Why Sometimes You Have To Ignore The Breastfeeding Experts
Breastfeeding is hard enough without contradictory advice.
After breastfeeding two babies, I’ve come to the conclusion no one really knows what they’re talking about. OK, so maybe that’s a little harsh, but it comes from a place of complete and utter frustration. For many women, myself included, breastfeeding is a surprisingly difficult undertaking, and the help provided often isn’t all that helpful. Perhaps the most aggravating part of being on the receiving end of so much advice is that it’s often contradictory. When the experts can’t agree on the dos and don’ts of their subject, then sometimes the best thing a mom can do is listen to some other qualified voices: her own and her baby’s.
When my daughter was born, she initially had trouble latching. After hand expressing into a spoon for several feedings, my nurse thrust a nipple shield into my hand. At her two-day checkup, baby girl had lost too much weight, and I was, in my opinion, bullied into supplementing with formula. I was determined to exclusively breastfeed, so I did everything I could to increase my supply, from pumping and trying a supplemental nursing system to eating lactation cookies and taking herbal supplements. Still, after six months, baby girl wasn’t thriving. On her pediatrician’s recommendation, I upped her formula. I quit nursing altogether a month later, and my little one started climbing up the growth charts.
My mom friends assured me it would be easier the second time around, so I was cautiously optimistic about breastfeeding my son. Unlike his sister, he latched right away. However, upon latching, I would feel a searing pain all the way through my teeth. It eased through the session, but it was only marginally tolerable and never comfortable. I began to dread breastfeeding and even to fear my baby, who somehow managed to make me bleed through a nipple shield. I consulted two lactation consultants (LCs), two nurse practitioners (NPs), and a La Leche League leader to try and fix his latch. He had six weight checks in his first two weeks of life, and when they told me if he lost any more weight, he’d be readmitted for failure to thrive, I opted to exclusively bottle-fed with a mix of pumped breast milk and formula.
My breastfeeding journey was a rocky one, to be sure, and although I felt supported, I also felt confused thanks to a number of mixed messages. Take Exhibit A: The Case of the Inverted (or Not) Nipples. Inverted nipples are a problem because they can make it hard for baby to latch. During one of my prenatal appointments, my midwife took a look at my nipples and said I shouldn’t have any problem breastfeeding. Later, a lactation consultant told me I had inverted nipples, and my daughter’s pediatrician told me specifically I didn’t. The La Leche leader said they were flat. Now, modesty isn’t much of an issue for me, but I’ve had enough of people looking at and making completely different proclamations about my nipples.
I’ve been given nipple shields for both of my babies, but the jury is apparently still out on their use. They can decrease the amount of milk the baby gets, which can negatively affect supply. It’s also challenging to wean a baby from a shield. However, shields also draw the nipple out to help baby latch and can help moms with nipple pain. So there are pros and cons, but most agree they shouldn’t be used unless absolutely necessary and under professional guidance. It was an LC herself who gave me a nipple shield with my son, so I figured it was OK. She made sure I had a medium-sized shield so my nipple would fit comfortably. Imagine my surprise when the nurse practitioner (also an LC) informed me I really needed a small because it would better stimulate my baby’s sucking reflex.
With both my children, I experienced severe engorgement. My breasts were hard, swollen, and waxy. A NP actually congratulated me when they finally looked “human” again. According to just about everyone, my alien boobs were a sign that I had plenty of milk. I just had to be patient. But once the engorgement had subsided, my babies still didn’t gain weight, at which point, the term “low supply” began to be thrown around. After a “full” feeding on both sides, my son was only pulling 10 milliliters from me. Now, either he’s ineffective or I don’t produce enough. A pump isn’t as good as a baby at getting milk out, but my output tells me I have enough milk for about half a baby. I also know my right breast produces more than my left, even though the NP insisted that was my “milk maker.”
Another potential breastfeeding roadblock is tongue or lip tie, which restrict mobility and thereby an infant’s ability to feed effectively. I had multiple people look inside my son’s mouth to tell me what they thought based on experience, but they also insisted they weren’t qualified to diagnose. For that, I’d need to go to an ear, nose, and throat (ENT) doctor. We headed to the specialty center, and the ENT told me he didn’t see either, although he did remark my baby’s gums were extra sharp (no kidding). I checked that off my list of possible causes for our troubles, only to have a friend who studied to be a La Leche leader tell me if the doctor didn’t do the examination with my baby on his lap with his feet facing away, he couldn’t know for sure.
The lack of consistency of information is particularly infuriating when you consider there’s not even consensus about breast milk. Baby-friendly hospitals and LCs will insist “breast is best.” Objectively, yes, breast milk is the ideal source of nutrition for your baby and has incredible benefits. However, it doesn’t mean that formula is bad. Especially if, like me, you have to supplement to keep your baby alive. When I asked the NC if I could just pump, she said, “I’m supposed to say no, but it’s really OK if you don’t breastfeed.” Even the ENT assured me that, although people might try to make me feel bad, my bottle-fed baby would be just fine. And he is.
The sheer volume of advice foisted upon new moms who struggle to nurse is enough to discourage even the most committed of breastfeeding mothers. Nurses, pediatricians, lactation consultants, and breastfeeding advocates would do well to remember that. Of course, everyone’s human, and breastfeeding is not an exact science (it is, perhaps, more art than science). Experts are well-meaning people who want the best for babies, but sometimes the person who really knows best is the one doing the work, day in and day out, of feeding her baby.