In case you missed it, you can read part one of this post about dealing with potential breastfeeding problems and an underweight baby here.
As soon as we had gotten home from the pediatrician’s office I had downloaded the World Health Organization’s (WHO) charts for healthy baby weights. Pickles wasn’t even on them, her weight was so low. Hmm, I thought, well that doesn’t sound good. But she had been gaining, and I remembered the words of my midwife, who had also pointed out Pickles’ low-end weight gain during her many post-partum visits. “If you were both the size of bears I might be worried, but look at the two of you. She’s probably just going to be small.” Was she just gaining at her own pace? Or was this a serious problem? Was she going to be a dwarf? Did she already have a tapeworm? Had her metabolism stopped working? Was she going to die?
One little rock, and there goes the whole mountain. It doesn’t take long for me to jump from worry to WORRY WORRY DEATH DEATH DEATH FUCK HOLY SHIT WAAHHH. Not long at all. I feel like I spend most of my emotional life trying to get the emotional voices in my head to listen to the intellectual voices. The intellectual voices are almost always right, but the emotional voices just seem to put their hands over their ears shouting “lalalalalala” every time they try to talk the emotional voices down off the ledge. The two of them spend a lot of time screaming at each other in there.
It was the doctor’s opinion that I didn’t have enough milk to feed Pickles. But did you know it is actually really rare that a woman’s body is physically incapable of producing enough milk to nurture her baby? There is only one condition that does it, and it is a lack of tissue in the breast. All the other issues a woman might have with breast milk supply usually come from outside factors—things like c-sections, bad latch, lack of support or information, painful nipples, breast surgery, and on and on—and many of these factors are fixable. Why would a doctor assume I had this rare condition immediately, without asking a single god damned question? Why would she recommend something less healthy than breast milk for my baby without even examining my breasts to see if I actually had the rare condition that she claimed was causing the problem? Forgive me for the repetition, but I still can’t believe that a pediatrician could know so little about breastfeeding, a subject that impacts every single one of her patients. It strikes me as ludicrous, as irresponsible. But you’ve got to be your own advocate, other people be damned.
After getting my sack o’ herbs and talking to our La Leche League leader, I made an appointment with the midwife filling in for my own during her vacation. Turned out I was kind of glad that Clara was on vacation. She may be Ina May-esque in her philosophies when it comes to birth, but when it comes to feeding she is of the “one bottle won’t kill her” school. (And no, one bottle won’t kill a baby. Formula doesn’t kill babies. Well, unless you’re talking about the African babies who starved to death because free samples got them onto formula, their mother’s stopped lactating, and then, when the family couldn’t afford to keep buying formula, could no longer feed baby. But formula comes with a set of risks that I preferred to avoid opening the door to.) But Anna, Clara’s replacement, turned out to be an adamant proponent of breastfeeding, which not only made me feel comfortable with her, but meant she was also very well informed.
When Anna arrived at our home, the first thing we did was to weigh Pickles. Her scale showed 100 grams more than the doctor’s. It didn’t put Pickles on the weight charts, but it did mean that she had continued gaining at her pace, that her weight hadn’t stalled completely. Then we talked. She asked me about our breastfeeding habits, how often, how long, and did Pickles generally seem pretty content? She examined Pickles, who didn’t show any physical signs of being malnourished, and whose head was developing just fine. (Development of the head is apparently a far more important benchmark than weight gain, the brain being our most important organ.) We told her what Clara had said, what the doctor had said, and that we had both been “underweight” babies. She asked me about the birth (and was relieved to hear that despite the c-section, we were successfully breastfeeding as soon as I had been stitched up). She watched Pickles latch on and drink. This is the kind of care I wish the health care system offered. At least it still exists in certain corners of the industry.
So what now? There was one option remaining, and that was that maybe I did have that rare condition. Anna examined my breasts. “I just took a seminar about this, so it could be I’m just seeing it everywhere because of that, but your breasts look like the breasts we saw pictures of during the course.” Awesome. Because having small breasts in a country obsessed with big breasts wasn’t awesome enough (America being that country, Germany is less with this), their smallness had to fuck me over as a mother too. Thanks body, thanks a lot. But Anna presented a plan. I should pump my milk to see how much I had, and then feed it to Pickles using a contraption she would bring me, a bottle attached to two tiny tubes that would allow me to supplement Pickles’ diet directly at the breast, thus avoiding any interruption of breast feeding, any nipple confusion, or any further depletion of my milk supply (through a lack of sucking).
When she left to pick up the supplementary feeding contraption, I felt a little better, like maybe there was a chance that there was nothing wrong with me, and that we could get to the bottom of Pickles’ low weight. The Beard was glad to see me less freaked out, and he headed off to work. A half an hour later, Anna was back with the feeding contraption, which she showed me how to use. But suddenly she was talking about formula again, about how I could feed Pickles as usual and then offer the formula to see how much more she drank. If it was a lot, she obviously wasn’t getting enough. If it wasn’t, then the problem lay elsewhere. But why was she talking about formula again already? When we had just discussed a plan to figure things out without it, putting off supplementation for one week of detective work before going down formula road? I was confused. She left. I started to cry. Stupid broken body. I felt so angry at it, that it could let me down like this, that it couldn’t even feed my baby. Maybe I was never supposed to have children. Maybe I should have died at birth myself (I was a footling, born by planned c-section, so it is likely that I would have). I called the Beard, and he came home. He can be stunningly optimistic sometimes. It helped.
We decided to go through with our week of detective work. I would take the herbs, and we would borrow a baby scale from the pharmacy so we could track Pickles’ weight ourselves. I tried the pumping experiment, but the pump hurt my nipples something fierce (while pumping and for several days afterwards), so I decided not to take that road. I made a conscious effort to eat more, double-checked that I was drinking enough. I offered Pickles a drink more often, and I started using the compression method (explained in an article here), which helped Pickles get all of the milk out. And at the end of the week Pickles had, according to the numbers we’d observed on our own scale, gained absolutely nothing. A slow weight gain was potentially acceptable, but no weight gain in an infant is bad news. I had enough evidence. I went to the organic grocery store, and I bought a box of powdered formula.
Apparently this is the longest story ever. Because here I am finished with another post, and I still haven’t even told you about what we’re doing with feedings now and how it’s going. I almost did it here. But sometimes a sentence just feels like it is the end of a post, and I like to go with that. So once again, tune in again later for The Tribulations of Baby Pickles or Operation Tube Milk.