One of the criticisms I often see about this website is that it might “scare women” out of breastfeeding, due to all the negative experiences shared in these Friday stories.
I understand where these critics are coming from, but the way I see it, everything else we see about breastfeeding is blindingly positive. No one speaks of the (sometimes rare, sometimes common) problems that can and do arise. So when these problems strike one particular woman, she feels alone and surprised.
I don’t see how allowing women to tell their stories can ever be a bad thing. Of course most women who breastfeed aren’t going to develop sepsis like Leslie (whose story is below), but for the small but very real number that do, isn’t it better that they know the signs? By that same argument, isn’t it better if women are armed with information and resources about more common issues like mastitis, IGT, and tongue ties, so that they can be more proactive rather than suffering in silence?
Happy Friday, fearless ones,
With three thriving children, my husband and I are through having babies, so the whole breast milk vs. formula debate has an aura of been-there, done-that for me. But, because my story and the message I want to get out are a bit different than many, I thought I’d share it with you.
With my first (who is now 7), I went through the standard new-mother breastfeeding hells (that I wouldn’t wish on my worst enemy, but that won’t surprise any regular reader of FFF) — you know, bleeding nipples, Reynaud’s Syndrome, screaming baby, unhelpful consultants, latch problems, psychotic sleep deprivation, wishing I’d never conceived (or been conceived myself), hating my baby for being hungry, etc. Eventually, I ended up just pumping and feeding the baby expressed breast milk. It sucked, but it was better than fighting The Nursing Wars with my baby. Unfortunately, I had HUGE oversupply problems, which pumping exacerbated. I mean, I could effortlessly pump out 50 ounces of breast milk a day, no problem. Well, actually, big problem — it took ALL of my time; I felt like my value had ben reduced to that of a farm animal (and I have two Ivy League degrees); we had to buy an extra freezer; and still my supply just kept increasing. If I didn’t pump, I’d get painful engorgement, plugged ducts, mastitis, soaking wet tops, etc. It was literally impossible for me to empty my breasts of milk — I could have pumped 24 hours a day without running dry. I asked a lactation consultant about it, and she just suggested I donate my extra milk — neither she, nor anyone else, had any reasonable idea how to stabilize, much less reduce, my oversupply. Indeed, no one took my oversupply problem seriously — “Lucky you!” the obnoxious woman at the breastfeeding center exclaimed.
So, there I was about five months post-partum and pumping at least five times a day. One Sunday morning, my right breast hurt fairly badly, and I felt lousy. I knew I had mastitis. (I’d had it twice before.) My regular OB/GYN was out of town, but the on-call OB/GYN covering for him called in oral antibiotics for me. My husband went and picked them up and I started taking them immediately.
Three or four hours later, my right breast ached more (pumping was blindingly painful and I couldn’t make myself do it), and the red infected area had spread. Also, my temperature was going up (at that point, 101 degrees). I called the covering OB/GYN back — she was very irritated that I’d bothered her again, told me that it could take up to 48 hours for the oral antibiotics to work, that I should see my regular doctor if I wasn’t better by Tuesday, and not to call her again.
Now, here’s where I was/am really lucky: My mother was staying with us, and she’s very, very science savvy. She knew, and was worried, about sepsis, so she called my sister, a breast cancer surgeon, who lives across the country. My sister said to circle the red area on my breast with a Sharpie marker, so we could see if it was really spreading. A couple hours later, it had definitely spread, my whole breast was excruciatingly painful, my temperature was over 102 degrees, and I was deteriorating mentally — I just kept crying, over and over, that I didn’t know what to do, and that I just wanted to be left alone in a dark room.
My mother insisted that I needed to go to the ER. She and my husband sought my opinion, but I could only cry (in pain? in fear? in fever?). All I really remember is that I insisted that before going to the ER, I had to email my boss that he wouldn’t be getting the case memo he was expecting the next morning — I can’t explain why I felt that was so critical, when I couldn’t even take responsibility for my own health crisis, except that I was so sick, I couldn’t think straight.
Anyway, my mother won, and by 9pm that night, I was taken to the ER. My temperature was over 104 degrees, my white blood cell count was over 30, my entire right breast was red, inflamed, and dimpling, and I struggled to answer basic questions like my name and birthdate. Due to my doctor sister’s advocacy (she called the ER ahead of my arrival and insisted the ER call her as soon as I was admitted), the ER was all over my sepsis. I spent literally no time in the waiting room; I was taken straight back to a treatment room; within 20 minutes, my blood had been drawn, and within 55 minutes, I had a central line in my neck and was getting IV antibiotics (vancomycin).
Of course, I was admitted to the hospital with a diagnosis of sepsis from mastitis, and spent the next four days getting IV antibiotics. Thanks to my mother’s and my sister’s sophistication and persistence, my sepsis was treated very promptly — before I had any major organ failures — and I made a full, fairly easy recovery.
Overall, I received excellent care at my hospital. My only criticism — and it’s a big one — is that the hospital (the same one where I’d delivered my baby five months earlier) refused to let me use one of its breast pumps to relieve my terrible engorgement the night I was admitted. I hadn’t been able to pump for most of the day, and at that point I was regularly producing 40-50 ounces of breast milk per day; the engorgement and resultant pain were unimaginable. The hospital said it didn’t want one of its breast pumps contaminated with whatever bacteria had caused my mastitis and my sepsis. Not only was that selfish — it’s a hospital for heaven’s sake! — but my breasts were so full of pressure that the antibiotics had trouble getting to the underlying infection site. So, refusing me a breast pump actually jeopardized my health. (When the infectious disease specialist found out, he was livid and read the riot act to the maternity care unit.) Unfortunately, I was too sick and weak to fight that one that night — the next day, my husband brought my, ahem, hospital-grade breast pump from home.
ALL of my doctors — including my regular OB/GYN (who was back by then), my internist, the infectious disease specialist, my sister (the breast surgeon), and the surgeon who put in my central line — uniformly advised me to stop lactating, because another bout of mastitis could very easily kill me. My infant son’s pediatrician was in accord — she said formula was fine, and I’d be nuts to risk my life just to give him breast milk. Finally — FINALLY — I was prescribed a drug (bromacriptine) to stop producing breast milk. (Rarely, it can cause strokes, so no one would give it to me before.) I cried as I took the drug to stop lactation, because I half-thought it made me a bad mother, but I didn’t seriously consider not taking it. Unbelievably, lactivists tried to change my mind on that, claiming “breastfeeding is the most loving thing a mother can do for a child,” but their efforts had the opposite effect. Apparently, my life, and the possibility of my child growing up without his mother, mattered less to them than breastfeeding. Well, screw that. If someone doesn’t value my life, I don’t see why I should value their opinion.
When I got out of the hospital, we used up our freezer full of breast milk, and then switched to formula — and the baby was fine. A couple years later, with my second, I tried breastfeeding again, but got three breast infections in the first three weeks. As I said before, screw that — we promptly switched to formula, and again, the baby was fine. (For the record, in fact, my second formula-fed kid was recently tested as having an IQ of 152.)
With my third, we went straight to formula in the hospital. Surprisingly, the only person who gave me a hard time about the formula was our new pediatrician. (By then, our beloved, old one had retired.) When I explained that breastfeeding was dangerous for me because I’d previously had sepsis from mastitis, he condescendingly replied, “Well, you think you had sepsis.” No, asshole, I had sepsis, and I have the scar in my neck from the central line to prove it. My husband and I switched pediatricians immediately — who needs that kind of questioning and doubt from their kids’ doctor? Our next (and current) pediatrician appropriately couldn’t have care less how we fed the baby, so long as the baby continued to thrive.
Here’s the thing I hope others reading this take away from my story: If something seems really wrong with mastitis, go to the ER and ask about sepsis. Do NOT just let some irritated, on-call doctor on the phone bully you into waiting a few days for oral antibiotics to kick in. If I (actually, my mother) had obeyed the on-call OB/GYN that Sunday, I would have just grown sicker and sicker until Tuesday; statistics say I probably would be dead now.
Waking up healthy one Sunday morning, developing mastitis and then sepsis, and being told I might die, was among the most terrifying experiences of my life. It all happened so fast; I hadn’t done anything wrong; I couldn’t handle the situation myself; and — but for my mother’s and sister’s insistence in taking me to the ER — I probably would have died. Seven years later, I still think about that every day. And, every day, as I mother all three of my beautiful, thriving formula-fed children, I am grateful.
Feel like sharing your story? Email me at firstname.lastname@example.org.