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Chapter 1

Far from the Land of Milk and Honey

Breastfeeding SEEMS like it should be easy, but it's not--at first

Poor Rachel. A little over four months pregnant with her first child and still just contemplating breastfeeding, the thirty-year-old PhD student is being treated to an earful of horror stories by a rowdy group of lactation veterans, women who'd been there and done that, who'd nursed their children for an average of a year apiece and are excited to chat about the experience--warts and all.

The group had gathered to talk about breastfeeding, but the talk--as estrogen-fueled conversations tend to do--quickly wanders into other territories, like motherhood, work, relationships, body image, and sex. Fueled on brownies, fruit, and caffeine, these six women, educated professionals in their thirties, are in the mood to dish the dirt. When the topic turns to establishing a breastfeeding relationship in the first few days and weeks of a baby's life, the stories practically leap out of their mouths.

"I had a really hard time when my oldest was starting nursing," Maja, a thirty-five-year-old newspaper reporter, says. "He was really colicky, and every time I'd try to nurse him, he'd back off and scream bloody murder. I remember being a couple of weeks into all of this and having dinner with my husband and mother and stepfather, when I burst into tears. I just started sobbing. I blurted out," Maja fakes a tear-strained voice: "'This is so much worse than childbirth!'"

I know the feeling. During the raw, early days of first-time motherhood, I often felt like a ticking time boob. Anything could set me off, and more often than not, the things that got me really worked into a froth had to do with breastfeeding. It was just so much more complicated than anyone told me it would be. I felt awkward, anxious, frustrated, and responsible--about as far from a "natural mother" as a gal could be.

Maja's story gets everyone laughing--a few even nod knowingly--and so she continues, encouraged:

"My labor was long. I mean, I pushed for four hours. But it was over once he was born, and now nothing had prepared me for this second tough period. Here I was two weeks into nursing, and I was still feeling so inadequate. I had assumed that this was something that would be natural. It would just click, but it didn't. It was really painful, and I couldn't imagine getting through it."

A couple of the women cast concerned glances in expectant-mama Rachel's direction. Among many current or former nursing mothers, there's an impulse to gloss over the tougher parts of breastfeeding, an unspoken worry that if you tell a mother-to-be anything but happy, blissful stories about babes at the breast, they'll bail for the "convenience" of formula. Still, for these women, the desire to tell their own stories wins out.

"Somehow it gradually got better. At some point, I realized, 'I enjoy this.' But there was no enjoyment in that early stage. I remember thinking it was at least a couple of months before I actually enjoyed nursing at all." In the end, Maja nursed her son for seventeen months.

Back when I was pregnant, my husband and I had joined a group of other expectant parents at our hospital's breastfeeding class. The two-hour meeting was the crashest of crash courses, I realize now, but at the time (about fifty minutes or so in) I remember thinking, "It's basically just baby to boob. What else can be said about this topic?" We cradled baby dolls, listened to the lactation consultant's pep talk, and passed around flash cards detailing the benefits of breast milk. All good news. All very predictable. So when this klatch of loose-talking breastfeeders launches in on the not-so-rosy realities, I feel that five years ago, talk like this might've sent me running for the hills. I want to figure out how to strike that balance between telling the whole truth and encouraging newbie moms, like Rachel, to give it a shot.

"Both of my kids had breast-milk jaundice when they were newborns," brags Elizabeth, a freelance writer. "The doctor told me they had jaundice from my breast milk. Imagine how that made me feel. My kids were orange until they were three months old."

"My issues have been more along the lines of body image," interjects Karin, a thirty-five-year-old health-care consultant. "I'm so tired of my big boobs. I don't like the way they look. Also, my son won't take a bottle, so too much of the time it's all up to me. I've had these moments where I really want a break. Sometimes I want to be gone for a whole day, but instead I'm stuck with my son."

"I thought, 'If I have to sleep in my bra for a year, I'm going to lose it,'" laughs Sasha, a thirty-five-year-old radio producer. "I didn't realize that it all regulates itself by six months. At the beginning, I planned every outfit based around"--here her voice turns ominous--The "Leak Factor."

Oh yes, we all know about the Leak Factor. Siri, a thirty-six-year-old curator, shares a Leak Factor story that sounds a little like an urban myth. "I had this friend who ran out to get some take-out food when her baby was really young," she says. "She produced a lot of milk, and she had soaked through a pad, a bra, a T-shirt, and a pair of bib overalls by the time she got there. She had so much milk that while she was nursing, she had to use a bottle to collect milk from the other side. She could collect something like four ounces that way."

Kristin, a thirty-two-year-old account manager, rolls her eyes. Clearly she can top that story: "At the beginning, pretty much all of the time I was soaking wet. I would soak through all of these nursing pads, and then I'd throw them in the garbage." She pauses for dramatic effect. "Well, we have a dachshund. They're scent hounds." Seeing where this is going, everyone cracks up. "She'd go and she'd dig through my garbage can, and later on I'd find wads of chewed-up nursing pads all over the house. Eventually she got a bowel obstruction from eating them."

As the laughter dies down, Rachel speaks up tentatively. "I really do admire the decision to nurse," she says, looking around the room, "but I just can't imagine, given how hard it's been for you to do everything . . ." Her voice trails off, and then she finally asks: "What makes you want to nurse for that long? Or even start in the first place?"

That's the million-dollar question, isn't it? But ask any breastfeeder, and you'll hear a million very good reasons.

Everyone in the room jumps to breastfeeding's defense.

"Once you get nursing down, it's so much easier than a bottle," Elizabeth says.

"You are providing the best possible nutrition for the baby," adds Siri. "Breast milk cures all ills. It is instantly calming. It helps the baby sleep."

Kristin gets a dreamy look in her eyes. "Then there are times like when your child is nursing and they're just wrapping up and they're kinda drowsy," she says. "My son would throw his arms back like this"--she puts her arms over her head--"and he'd have milk dribbling out of his mouth and a big smile on his face. I've never seen such a look of contentment."

"My son's start was so hard," Maja adds, "but it ended up being this wonderful experience. There are these times when my second son is hungry and he'll just open up his little mouth and go 'uh, uh, uh,' and you get this confident feeling like," she narrows her eyes and switchs to a sultry voice: "'I can fulfill your every desire.'"

Karin smiles. "Sometimes he'll be nursing and he gets tired and his little hand starts moving all over my face."

"I had a hair puller," Kristin adds almost wistfully.

Then Maja gives us all something to think about. "I have a friend who doesn't have any children, and one day I was complaining about how much time nursing took up. She said, 'You know, it's going to be over so fast.' I remember thinking that even though she didn't have the experience herself, she was just so wise. Now, when I'm nursing my baby to sleep and I find myself thinking, 'I've got to go make one more call for work,' I remember my friend's words, and I'll just settle into enjoying that incredibly intimate moment. I wouldn't have missed that opportunity for the world."

Welcome to the Sorority

To bring a new baby into the world is to say goodbye to life as you know it. For a few days, weeks, or months, formerly quiet, adult-friendly households experience an acutely disturbing loss of control; an already chaotic family can simply be turned on its head. It's a painful, lengthy hazing ritual--a rite of passage--where a woman enters as an innocent and comes out a mother--bruised and battered, perhaps, but ultimately one of the strongest creatures on the planet.

At first, babies seem to need everything, and the adults entrusted with their care and feeding often find themselves at a loss to understand how to make and keep these vulnerable little creatures happy. Because parents (face it) are the source of everything--food, comfort, life itself--for their newborn children, breastfeeding mothers often feel overwhelmed by this awesome responsibility. When nursing isn't a textbook-smooth experience from birth--and more often than not it isn't--many mothers quickly become discouraged.

When a new mom doesn't have the support she needs to get through the rough spots, the temptation to throw in the towel and pick up the formula can be pretty strong. And, honestly, who can blame a mother with a squalling infant and an aching breast for giving in and giving a bottle? Even though studies reporting the benefits of breast milk have been widely related in the media, formula is still readily available, widely advertised, and in the beginning at least, comparatively neat and tidy. Plus, if you're like most American women of childbearing age, you've probably grown up with few examples of openly breastfeeding mothers, so you might not have many women to turn to when problems arise. This means that if you're going to succeed at breastfeeding, you've got to be pretty determined.

"For the most part, our moms did not breastfeed us, and our friends are delaying childbirth or they are not breastfeeding. So there's not a community of breastfeeders out there like there used to be [before our mother's time]," explains Deborah Dee, MPH, who is doing research at the University of North Carolina-Chapel Hill School of Public Health on the impact that breastfeeding-support programs can have on low-income women in rural North Carolina. Dee believes that the relatively low rates of breastfeeding in her region, and in the country as a whole, are due to a number of deeply embedded societal factors, including a low level of community support for nursing mothers and the general acceptance of formula- feeding as a viable, healthy option for infants.

"Part of the problem is that we are in this transitional period of more women going back to breastfeeding, but we don't have that seasoned knowledge base anymore," she explains. "In the distant past, if there were latch problems, for instance, a woman could talk to her mother or sister or her neighbor, and that person would say, 'Oh, you have to do this. Let me show you.' Now it has become so much more official and time-intensive. You have to call a lactation consultant or go to a La Leche League meeting. And if you are back to work already or you have other small children, how do you find the time to do that? There's been a breakdown in support for breastfeeding, and that's what's making it harder for women these days."

Catherine Adeboye, RN, IBCLC, a lactation consultant at Regions Hospital in St. Paul, Minnesota, says that women who somehow come to believe that nursing in all cases is an easy, natural act are more likely to give up when times get tough.

"Sometimes moms feel like they've been sold a bill of goods," she says. "The books and the literature they give out at the clinic say, 'Try breastfeeding. It's easy. It's natural. It's convenient.' But for most women, the first month is not easy or natural or convenient. It's a lot of work and maybe even some struggle. Women need to know that ahead of time. But they also need to know that eventually most mothers get to the point where breastfeeding is easy, natural, and convenient. Most moms love nursing their babies once they get past those early struggles."

Call it The Hump, The Lump, The Awkward Stage. Or call it something much worse. (Sometimes, I still remember the first few weeks of my daughter's life by the endearing name I'd given them: The Shits.) While the first few hours of a baby's life are essential to getting a child started on the breast, it's the days and weeks after mother and child leave the hospital that are often what ultimately determine the success of the nursing relationship. Babies who seemed to latch on correctly at the hospital mysteriously begin losing weight. Mothers with constant nursers start to feel like worn-down, broken-down milking machines. Babies fuss and cry for hours on end, the breast providing only fleeting relief. It's a depressing thought, I know, and if this is your first time through it, it may seem like it will never end.

But it will, and it does, even when you feel like Robin from Ontario, Canada, who added this post to the mothering.com bulletin board: "Where are all the pleasurable feelings I'm supposed to be getting from nursing? Where are the relaxing hormones? . . . I feel like I'm losing my mind."

Jane Swigart, PhD, a San Francisco psychotherapist and author of The Myth of the Perfect Mother: Parenting without Guilt, believes that the postpartum period can be one of the most trying times of a woman's life-- both emotionally and physically. Mothers are adjusting to a new life, a new family, and a new set of responsibilities. Learning to breastfeed at the same time as an infant--babies aren't born knowing how it works--adds to the stress for new mothers.

"Having a new baby is lonely and terrifying, mainly because you are in an altered state and so extremely vulnerable," Dr. Swigart says. "For a time, you revert back to when you were a little baby. That's normal, but for some women it's terrifying. I remember when I was trying to breastfeed my daughter when she was a newborn, and my sister looked at me and said, 'You're going to smother the baby!' It totally unnerved me. People say the most horrible, ignorant things during that time, and if you don't know better, you have no backbone to stand up to that."