My story begins many years ago, when my friends and family started to have babies. One woman was attending LLL meetings and nurse-ins long before she was pregnant and talked about it constantly. I heard from her all the ways in which it was wonderful and priceless and perfect and had to be done. Everybody nursed and everybody’s mother nursed and I was such an odd duck for having been formula fed. Was something wrong with my mother? Had something been wrong with me? Clearly mistakes had been made and I had the knowledge to make better choices.
My sister in law established a wonderful nursing relationship. I got to meet my niece for the first time when she was 3 months old. I watched her nurse on demand, around the clock, for three days. Every time the baby fussed, she was there with a breast, even going so far as to jiggle them in her hand to see which one was fuller. So that’s how it’s done, I thought.
My sister had a baby and I met him for the first time at 6 days old. I watched my sister pump 16 ounces of thick yellow milk. I asked why she was freezing it instead of storing it in the fridge. She said it was special colostrum and that she would give it to him later if he became sick. I tried to observe her, but she was always under a hooter hider.
Then she had her second baby and her supply seemed low. She pumped every three hours around the clock, feeding the baby from the breast every two. I asked, “You never give her formula?” “No,” she said. “I just can’t. I can pump.” I nodded and wanted to come with her, to talk to her while she pumped and see, but she wanted to be by herself.
It took me quite a while to conceive my first baby. And in that time I read and read and read. And I read and read and read. And then I read some more. I read everything about babies I could get my hands on, from increasing fertility all the way through breastfeeding. I indoctrinated myself with Breast is Best and knew what booby traps were as well. I knew about tongue ties and IGT. I knew about brewer’s yeast and domperidone and foremilk and hindmilk. I visualized myself nursing and nursing in public. I imagined what I would say to anybody who had the temerity to tell me to go to a bathroom or that I was being indecent.
When I finally became pregnant, I just kept reading. I read The Womanly Art of Breastfeeding through, twice. It made me feel anxious, because I knew I would be returning to work, but my sister had already loaned me her double electric hospital-grade pump, so I tried to let it go. I took my hospital’s birthing classes. I took my hospital’s breastfeeding classes. The IBCLC that taught the class didn’t say anything I didn’t already know. I realized I could have taught the class.
A few weeks later Tabitha was born after a relatively short, drug-free, intervention-free labor. I immediately demanded skin to skin contact and held her for several minutes. I allowed them a few seconds to wipe her off and take her vitals and then I asked to nurse her. The nurse helped me build a mound of pillows and I got her to latch well on my second try. I was told to feed her for 20 minutes on each side, every 2 to 3 hours, or as she gave me hunger cues.
We started out really well. Aside from being the sneeziest baby I had ever met, she was chill and had a good latch and suck. I felt a small amount of discomfort but nothing that phased me and certainly no actual pain. The day we were to leave the hospital I was just getting her latched for a 6:00 a.m. meal when the sirens went off. That was April 27, 2011, the day tornadoes destroyed a huge swatch of central Alabama. A nurse hustled in and said, “Sirens, sweetie. We need you in the hall.” So she carried the rocking chair into the hall and I got T-tab relatched and we fed and rocked and cooed and waited for the all clear.
We were discharged and made it home in the only hour that day that was sunny. I spent the rest of the afternoon, on the couch, watching tornadoes destroy things and roll up I-20 at me. It was an anxious start. That first night home I had no idea about how to go about sleeping. I knew I wasn’t supposed to have her in bed with me, yet I was terrified if I put her down in the cradle she would die. I wanted to leave the bathroom light on to see her but my husband couldn’t rest. I ended up on the big couch in our loft. I had waves of dread and terror that would lock my whole body up like I was having a seizure. I would deliberately concentrate on relaxing from the toes up. By the time I managed to get my body normal, another wave would hit.
I kept nursing every 3 hours around the clock, and anytime she seemed to need it. My sister came to stay for a couple days and I begged her to tell me I was doing it right. She showed me how to look for signs of swallowing. She manipulated my breast and helped me see that actual milk was coming out. Except it was day four of her life and was still just little drops of colostrum. She didn’t poop until the seventh day of her life. I was so relieved I bawled.
Eventually exhaustion took over and I sometimes couldn’t even get her latched. She spent about 10 minutes one middle of the night giving me a tremendous hickey on the side of my boob. Through it all I never felt anything I could have identified as letdown. Sometimes she was on and off the breast in 10 minute screaming intervals. I carried around The Womanly Art like it was a bible, trying to find my experience in it to reassure myself. I started having nightmares. Any time I could get to sleep I dreamt of being dunked under water, hanging by my nipples. I would thrash and half drown and then something would hook to my breasts and yank me up, only to redunk me when I caught my breath.
I spent my first day alone with her the day she turned three weeks old, a Monday. I barely moved the whole day, glued to the same spot on the couch. Anytime I tried to break her latch, she screamed. My husband got home, walked in and I started to cry. I kept crying. I cried all night and the entire next day after begging him not to leave. When he left I was crying and when he got home I was crying. I fed Tabitha that night at about 9:30, 20 minutes per side. At 11:00 she was screaming. We walked and rocked and sang and cooed and nothing helped. I kept saying, “She can’t be hungry! She can’t be hungry!” She was probably hungry, but since The Womanly Art told me that 3 week olds “cluster feed” I figured I was doing it wrong. So she cried and I just kept crying.
Christopher came home from work on Wednesday to find Tabitha in her pack and play dozing, while I was on my knees, face in the carpet, sobbing. He got my phone, called my sister and got one of the pre-mixed bottles of Similac the hospital sent home with us. My sister, bless her, listened to me be hysterical until she could get through to me to tell me that I really didn’t have to do it if I didn’t want to. That I could make it one more day if I wanted. Christopher hollered, “She hasn’t stopped crying for three days!”
“You haven’t stopped crying for three days?” My sister asked.
I just cried some more.
“I am giving her this bottle,” Christopher said.
“He’s poisoning her!” I bawled at my sister.
“He’s not!” She shouted. “Take a break. Let him give her a bottle. Nurse her again later if you feel like it.”
I don’t remember the rest of the conversation, but Tabitha ate that two ounces in about two minutes, then downed another two ounces and promptly passed out for four hours. I stood in the shower for a little while feeling like I ought to cut myself.
I bought a cabbage and dried out during a case of what I now know to be double mastitis. I had a 103 fever, chills, aches and nausea and was absolutely cooking a cabbage leaf every 15 minutes.
My lowest moment was a couple months later when my sister-in-law, she of the heft them around to see which one is full, arrived for a visit with her own baby, three weeks older than Tabitha. We met for lunch with all our kids and she nursed my niece. My mother-in-law, who was looking after T-tab, pulled out her bottle of formula. I thought I was going to evaporate from shame.
Fast forward a few months. I am pregnant again. I was trying, but I didn’t expect it to happen so fast. I felt myself start lactating around 8 months. A few times it was enough I needed a nursing pad so as not to leak through my clothes. I convinced myself that I knew what I was doing. I was going to get it right. I was going to be relaxed and chill and drink plenty of fenugreek tea and just power the hell through it all. I would certainly not freak out. I knew how to have a baby and I knew how to nurse one and I knew I just needed to try harder.
Daphne arrived somewhat more quickly than we wanted her to. She was induced and the care we received while birthing and for the rest of our stay was subpar to the point of negligence. I spent two hours with the charge nurse going over all the things the nurses had failed to do, done incorrectly, and ignored. I saw the hospital LC twice and told her that I had a terrible time with my first and only made it to three weeks. She told me that I would do much better this time and that I should just relax. I agreed. All I had to do was relax. After all, my problem last time was anxiety and now that I knew what having a newborn was like, there was nothing to worry about.
Except I had no idea how to have a newborn and an 18 month old. And Daphne took her time. I decided not to deliberately break her latch unless I just had to. But if I let her nurse to sleep, she would eat for almost 90 minutes, then sleep for 30, then start again. I found myself grieving my time apart from Tabitha. I grieved my time apart from Daphne. If I played with Tabitha outside for 20 minutes while my mom or husband watched Daphne, by the time I got back in I was agitated to the point of screaming. I decided that I would start pumping so that I could have a few ounces for Christopher, a born night owl, to feed Daphne while I went to bed as early after the 9:00 p.m. feeding as I could. I would give Tabitha her bath, rock her down with a bottle of (cow’s) milk, then get ready for bed and head downstairs. I’d top Daphne off and go to bed for as long as I could, hoping Christopher could make the bottle of expressed milk last.
Soon, when I was nursing, I started to get nauseated. At first I thought it was simple exhaustion, as that’s what I experience when overly tired. Then I noticed a real feeling of let-down—my armpits tickled, then my breasts felt fuller. Yet in the moment right then, my stomach bottomed out with nausea, like a terrible rollercoaster and I had an urge to get up and run out of the house. This continued, the same nausea and rising panic, with each feeding. About a week after she was born, I was standing at the sink drying pump parts when she started to cry. My milk let down, I retched into the sink and was halfway to the front door by the time I realized what was happening. I resolved to start pumping exclusively. I figured I would be doing that anyway, since I had to go back to work in about 7 more weeks, so why not just get into the rhythm now.
Fast forward a few days and I’m sitting behind the pump, bible open, praying out loud for peace, because I was still sick and panicking and flipping out. I heard the timer go off and turned the pump off. I broke the seal on the left flange and my nipple was a mangled, bloody mess. I pumped as much blood as I did milk. I said, “It ate my nipple! I’m done!” I fed her the last of my expressed milk that night (not the bloody stuff) and mixed up four four-ounce bottles of formula to get us through the night.
I went forward knowing that I was doing what was best for both of us, although I was melancholy. I cried a little, but I found I spent more time loving her while feeding her a bottle than I did while nursing her and breathing deeply and looking up at the ceiling begging God for peace. I dried up in about two days with cabbage and advil and red wine.
I started googling, “panic and nausea while breastfeeding.” There’s not a lot out there, but what there is leads me to believe I suffer from something called Dysphoric Milk Ejection Reflex (D-MER). Essentially, dopamine has to drop to let prolactin work and I am particularly sensitive to the dopamine drop, and weak on the oxytocin following the prolactin. I never got a warm and fuzzy feeling from nursing, only nausea and flight-level panic.
I think I would very much like to have another baby. I’m willing to admit that part of it is wanting to get it right. They say that D-MER is easier to cope with when you know what it is and that it won’t last forever. It’s a crummy reason to have a baby, I know. But still, I would like another child. And if that gives me another chance to get it right, I’d welcome it. (And be just as happy to give another child a bottle of the perfectly fine generic formula that has made Tabitha and Daphne healthy, vigorous, smart and cheerful.)
In the spirit of Ending the Mommy Wars, I’m Sarah and this is my story of D-MER and Formula Feeding, told with guerilla sincerity. I support you.