Those of us who work with prenatal and postpartum women are often reminded that materials, classes and discussions need to be “culturally sensitive”. There’s good reason for this, of course; social norms, language, familial structure and cultural traditions can all impact the way women experience birth and motherhood.
But what I’ve started to notice is that nobody is acknowledging the need to be culturally sensitive to one particular culture: achievement-oriented, well-read, invested moms. This culture is made up of women from all ethnic groups, income levels, and religions. What they all have in common is being research-happy, eager to do what is deemed “best” in terms of birth, infant feeding, and parenting, and goal oriented. While these women can handle a lot of detailed, complex information, the way this info is imparted can hurt them in ways that we refuse to see.
If you’re reading this, chances are you’re part of this culture. I know I am. Most of us who frequent parenting websites are part of it. The way breastfeeding is taught, promoted and supported is typically not appropriate for our culture. It is too value-laden, too dismissive of our realties, and too heavy-handed. It’s setting women up to perceive themselves as failures.
Mary, whose story is below, feels she was her own worst critic when breastfeeding didn’t go as planned. I don’t doubt it, but I hope she knows that it’s not her fault that this was the case. We need to change the dynamics so that no mother – regardless of her culture – feels like one way of feeding is “failure” and the other “success”. Babies are not goals. Babies are complicated little people. Women are complicated big people. Maybe it’s time we embraced our complexities instead of judging ourselves on our biological capabilities.
Happy Friday, fearless ones – and happy mother’s day. You rock.
I do not make enough milk.
I write this post as I sit on my couch with my four-month-old baby girl snuggled on my lap. She has just finished a bottle and sleeps soundly, nourished and full. My largely formula-fed child is all health and vigor, sweetness and delight. She grows, she learns and she fills my world with wonder. I am happy but it was not always so. The last few months have been a galling journey from shock, sadness and self-condemnation to eventual acceptance and joy.
I am a junior doctor and was firmly indoctrinated in the “breast is best” philosophy. Intellectually I knew that formula feeding is sometimes essential but I never though it would be necessary for me. I was absolutely certain in my goal of breast-feeding my baby exclusively for at least one year. The idea that this might not be possible never entered my head. Prenatally I took a breast-feeding class, read breast-feeding books and joined the breast-feeding association. I was set.
My pregnancy was lovely and normal. My delivery was hard. 24 hours of slow progressing labor ended in an emergency caesarian for fetal distress. My baby girl spent 48 hours in the special care nursery for treatment of low blood sugar. I received plenty of help and support from the midwives. My baby latched well, she had a strong suck and things looked good. But as the days and then weeks rolled on my milk supply remained very low. She needed significant formula top-ups to prevent her crying with hunger.
I felt huge stress as I anxiously waited for my milk to ‘come in’. As my milk stubbornly refused to do so my despair deepened. At seeing this despair my midwives and family pleaded with me to be kind to myself and enjoy my daughter. Not an easy task when each drop of formula felt like a failure. I developed a raging case of the baby blues and lost perspective. I got it into my head that ’lactation failure’ equated to ’mother failure’. I was despondent.
Once I got home, I cried at every feed, I cried at every phone call to my mum, I cried myself to sleep. I would stand topless and stare at my breasts in the mirror willing them to work. I saw a lactation consultant; I rang the breast-feeding help line. I tried two hourly feeds plus two hourly expressing. I took domperidone, fenugreek, metformin and blessed thistle (all pushed to the highest possible dose). I fiddled with supplementary nursing systems, baked lactation cookies, drank lactation tea, did self-hypnosis and read all the available literature like a woman possessed. All to no avail, I could trickle out just 10-30ml of breast milk no matter what I did.
As a bright-eyed bushy-tailed medical student I learned detailed breast anatomy and hormonal/neural control of lactation. I learned about infant nutrition and medical indications for formula feeding (including low supply). I had a wealth of knowledge but nothing could prepare me for the raw, heart-wrenching and all-consuming emotion.
I felt like an inadequate mother with two delinquent breasts. I bonded well with my baby but my negative self-thoughts drowned my joy. I beat myself up and I made myself cry. Yet those around me were supportive and kind. My family commended my efforts and encouraged me to accept that formula was the only way to keep my baby healthy. My friends gave me hugs. The maternal child health nurse and midwives encouraged me to be pragmatic and were content with my baby’s growth.
The only person judging me was me. I was my only critic.
Eventually this inner critic calmed down. The kindness, support and reassurance from my family, friends and health professionals seeped through. I could see that while I tore myself apart my beautiful baby was thriving on a bit of breast milk and a lot of formula. I was wrong, utterly wrong. I’m no failure. I’m an attentive, responsive, loving mum with a healthy, happy baby. I’m a success.
After four months I stopped the grueling expressing regime and weaned off the medications, I had had enough. Now my milk supply is all but gone, but I feel fine. I’m a formula feeding success. All that heartache was so unnecessary. The self-condemnation was such a waste of energy.
As I move forward into General Practice training, my own experience will help me help other women with breast-feeding difficulty. We need to support each other and treat each other with kindness. I was so lucky to be surrounded by supportive people. Without them who knows how loud my inner critic could have become.
To the mothers out there, I implore you treat yourself with kindness no matter how your baby is fed. You are amazing. Your baby is amazing.
Meanwhile, back on the couch my child is waking up so I shall have to stop typing. I’m off to go play with my wonderful, joyous and amazing baby