In 2018, all the literature I’d read on breastfeeding advised that if my son nursed immediately, I should not use my breast pump for the first four weeks of his life. We needed, instead, to “establish breastfeeding.” As I understood it, his hunger would regulate my milk supply and our bodies would remain connected long after his father cut the umbilical cord. It was a picture of impossibly idyllic motherhood, a privilege I wanted so badly to believe could be ours.
My reading did not prepare me for the gray area I felt I’d entered when my child seemed to be taking some of my colostrum but clearly not enough to satisfy his hunger.
Minutes after his birth, our nurse told me that we looked perfect: My son’s latch was beautiful, and I was already cradling him as if I’d been doing it my whole life. In the following days, I unswaddled him each time he cried and I put him to my breast, but I wasn’t sure whether he was actually eating. A nurse squeezed my breast and colostrum appeared, like a translucent pearl I could see but was unable to feel. Just keep feeding, she advised. Her encouragement echoed the literature I’d previously consumed, so I did, believing that I was doing my best to establish breastfeeding.
But on day three of life, my son’s lips flaked with dehydration, and the bilirubin levels in his body were moderately high. On hospital discharge, the pediatrician sent us home with bottles of formula and orders to see her again in two days. The nurses told me not to give up.
@birthmoments
At home, my baby would fall asleep nursing but wake up minutes later crying from thirst. My husband and I knew he needed to eat, and we both worried that my attempt to establish breastfeeding would endanger our child. He was calm at my breast, but he was satiated by the Similac my husband fed him. Even though he struggled, I didn’t think to try using my own breast pump.
I’d read that my milk could take a few days to come in, and pumping too early could create an oversupply when it finally did. The pump, I’d also read, wasn’t as powerful at drawing milk as a baby. I’d also read that introducing a bottle too early might cause the so-called “nipple confusion,” wherein a baby might develop a preference for an artificial nipple over a mother.
I suspect intensely personalized care is difficult and our situation as new mothers so unique—especially for those of us that are so seemingly idyllic—that a pump seems superfluous until it isn’t.
My reading did not prepare me for the gray area I felt I’d entered when my child seemed to be taking some of my colostrum but clearly not enough to satisfy his hunger. My husband and I followed all of the advice we were given, even when it seemed to conflict. I kept offering my breast. We fed our son formula. We’d see the pediatrician in two days. Before then, we just wanted to keep our son alive. As I watched my child suck down the tiny bottles of Similac that my husband attempted to pace feed, though, I knew something wasn’t right.
And at his next doctor’s appointment, my son was immediately readmitted to the hospital and diagnosed with breastfeeding jaundice, which the American Pregnancy Association explains “can occur when a newborn does not get a good start on breastfeeding, has an improper latch, or is supplemented with other substitutes which interfere with breastfeeding.” Even now, that description doesn’t quite align with our experience or all of the compliments we received from hospital staff days earlier. We did look idyllic. There had been colostrum. There had been a good latch.
And yet, when he looked dehydrated, only one nurse suggested that I pump. Most of the others told us both that I’d be pumping too soon, that it wasn’t necessary if we’d seen the colostrum pearl. The pearl was a sign that milk would follow, a sign that everything was alright. Although 90 percent of nurses at our hospital were Certified Lactation Consultants and 10 percent International Board Certified Lactation Consultants, I suspect intensely personalized care is difficult and our situation as new mothers so unique—especially for those of us that are so seemingly idyllic—that a pump seems superfluous until it isn’t.
Back in the hospital, this time on the children’s floor, a designated IBCLC lactation consultant handed me a heating pad and an ice pack. Then she wheeled in a hospital-grade Medela pump and set it between my son’s crib and me. While he slept under the purple UV lights, I pumped.
But for me the pump was the single biggest reason my son, who enjoyed latching on to my breast, allowed us to breastfeed. And the primary reason I breastfed him for 18 months.
This lactation consultant explained that my milk was trapped in my ducts and the pump would help release it. It was possible and perfectly normal, she explained, that even with a perfect latch, we’d still need a pump sooner than I’d thought. Though she couldn’t diagnose why he struggled to breastfeed, I was so engorged it was now necessary to use a pump to express milk. She assured me that it was unlikely that all of the tiny bottles of Similac my son was consuming would confuse him or create a preference for a latex nipple over mine. He didn’t fuss when he latched. He had a good, deep latch. His contentment propelled me to pump, to do everything in my power to help him breastfeed because I could see how at peace he wanted to be when he tried to nurse.
@birthmoments
Until that point in the hospital, I had understood the pump as a villain and a necessity. In a country without federally mandated maternity leave, even before I gave birth my breast pump was a reminder that if I wanted to continue breastfeeding after returning to work, I would eventually feed my baby through a device that Megan Garber described in her 2013 piece on breast pumps for The Atlantic, as originally designed to “treat inverted nipples, and to help infants who were too small and too weak to nurse.” In 2018, the pump may have been on my list of infant essentials, but I’d imagined feeding my newborn exclusively from my breast. For some moms, maybe this is the case. But for me the pump was the single biggest reason my son, who enjoyed latching on to my breast, allowed us to breastfeed. And the primary reason I breastfed him for 18 months. When he was discharged from the hospital, I immediately called the only lactation consultant who accepted my insurance, and I scheduled a home visit.
Betty was kind, calm, and immensely organized. She created a daily schedule that I followed religiously. She told me that breastfeeding was all business. My restaurant was open for 30 minutes and then closed for maintenance. Betty’s schedule required me to pump for 10 to 15 minutes after each feeding session. I pumped an additional 20 minutes twice a day. It was a schedule designed to establish breastfeeding; my pump was just as an assistive device to help my supply.
Those early weeks run together in my memory. The breast, the bottle, the pump became a single unit of time.
Even though my milk had come in, I still struggled to breastfeed exclusively. For weeks, I nursed my son for 30 minutes, then watched my husband feed him refrigerated breast milk while I pumped. I’d watched them, confused. I tried holding him in different positions with little success. I cried everyday, wondering if he’d ever successfully nurse from me—if we would ever establish breastfeeding. Although by then I realized that I’d been buying into a social myth that breastfeeding only looks one way, the myth is powerful. I felt very alone in my pumping, and my isolation brought on postpartum anxiety that my son wasn’t getting the nutrition he needed.
Those early weeks run together in my memory. The breast, the bottle, the pump became a single unit of time. Little by little, my son drank more from my breast and less from the bottle until one day I breastfed him until he was satiated for a single meal. That one meal became two, then several. I pumped in the morning and at night and if I left to run an errand and missed one of our feeds. We’d established breastfeeding, and I’d also begun building a freezer supply that would eventually amount to a little more than 650 ounces of expressed milk over a 10-month period during which I stayed home with my son.
Even so, our first few weeks as a family still haunt me to this day, and I wonder if I would feel differently had the messaging I received around the breast pump been simply that it’s a tool. I’m grateful for the lactation consultants who helped me see it that way, but even so I worry that the popular image of breastfeeding still looks more like the fantasy I’d read about than the reality I experienced. The truth is that the reality of breastfeeding is so individual and intimate. If you’re lucky, it requires your own intuition. But if you’re like me, you might need someone and some tools to help you out.
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