Covered in Milk Stains

by Ashley Weeks Cart

Postpartum life is filled with what I have come to refer to as “The Weepies.”

Yes, the propensity to weep, uncontrollably, for little to no reason at all, is a fairly standard aspect of life in the weeks following childbirth. Combine the raging hormones trying to readjust to life post-maternity with the sleep-deprivation, the helplessness and sweetness of a newborn, the mesh underwear and postpartum bleeding, the sore, engorged, lactating breasts, and the overwhelming reality that you have a human being who was once tucked safely inside your belly, now out in the big bad world, and you are entirely responsible for the survival of said human being, a human being that you love more than anything on Earth and would do absolutely anything to protect (otherwise known as the “Mama Bear Instinct”), and it’s really no surprise that tears and feelings are the end result.

Take for example, five days following Addison’s birth, while James and Kimmy skyped with my parents back on the East Coast to showcase the newest addition in real time, I paced around in the background, donning only mesh undies packed to the gills with ice packs and padding, a belly band, and a nursing bra saturated in milk stains, sobbing. Sobbing a symphony of boo, hoo‘s and woe is me‘s and omg‘s because absolutely everything was so unbearably overwhelming that crying seemed like the only solution. Or rather, reaction, because weeping really doesn’t solve anything, but does add to the lovely puffy-eyed look of functioning on 2-hour increments of sleep.

This time around hasn’t been any less tear-filled. Although one of the primary triggers of my weeping is new.

Rather than being covered in lies, I am covered in milk stains. (see Will Farrell in Anchor Man weeping in a phone booth, chugging a gallon of milk, in a “glass cage of emotion.” It’s kind of like that. Only with even more milk.)

Let me explain.

I remember sitting in my OB’s office during the final days of my pregnancy with Addison, worrying about the impending labor and delivery.

My doctor interrupted, “Ashley, don’t stress so much about the birth. It’s one day. It’s what happens after her delivery that you should be thinking about. That’s when the work really starts.”

Boy was she right.

The thing is, I had not expected breastfeeding to be one of those things that qualified as “work.” I knew it would be really time-consuming and a huge commitment. But the actual act of feeding my child from my breast, I did not anticipate being a challenge. Breastfeeding was natural. Instinctive. What problems could we have?!

Oy vey.

If you’ve been reading the blog from the start, then you know that I breastfed Addison with the help of a nipple shield (or THE SUPER NIPPLE, as we took to calling the jumbo-sized silicone nipple I had to strap to my breast in order to feed her) for the first 3.5 months of her life. When she was born, I assumed she would immediately latch on to my nipple, and all would be right in the world. Alas, she was born, she mouthed around on the breast, but could never quite figure out how put mouth to nipple and procure nourishment.

How strange, I thought.

No amount of poking and prodding from the aggressive and intrusive lactation consultant during our two day stay at the hospital seemed to teach her otherwise. Before our discharge, I was handed a nipple shield, and told that that was my solution. And off I went. No further support, education, or resources provided.

And here is where I take a moment to stress that not only was my care and treatment during labor with Courtland 10,000 times more thoughtful and respectful than with Addison, but that our entire hospital stay in little Bennington, Vermont was 180 degrees different and better than our experience at that fancy pants hospital in Beverly Hills. In Los Angeles, we were one of hundreds of other patients. The nurses would barge into our room regardless of whether or not we were sleeping, would drag James and Sunny out of the room for round after round of tests and lab work, and would shove on my stomach, tweek my nipples, and boss me around about my self-care when I was in a total sleep-deprived stupor and unable to fully process the information that they shared. In Vermont, everything was done with such respect for our well-being. They wouldn’t interrupt our sleep. They asked us if we were ready and okay before any testing and examinations. They did things based on our comfort and with our consent. It was truly remarkable.

And best of all, they provided unmatched training, support and resources for everything from infant car seat use to breastfeeding.

You see, Courtland, much like her older sister, approached my breast with utter confusion at birth. She mouthed around, but without any success. Everyone stresses the importance of breastfeeding in the first few hours following birth, yet neither of my children was able to accomplish such a feat. Mamas with success, do not take it for granted.

I had seen that failed rooting before and foresaw the return of THE SUPER NIPPLE. My prophecy was indeed correct.

Based on Courtland’s behavior, I asked the nurse for a nipple shield, but she resisted, encouraging me to work with the many lactation consultants available during my hospital stay to see if I couldn’t get a natural latch. As I came to learn, nipple shields can often impact milk supply and lead to problems with breastfeeding down the road. Things I had not been told in Los Angeles, but that fortunately had not been a problem for me and Addison. I could tell that all of the nurses in Vermont were very hesitant to provide one unless absolutely necessary.

After two days of session after session with a variety of medical staff, it became clear that Courtland, like Sunny, was not going to latch on her own. The nurse practitioner we worked with right before our discharge said she thought that Courtland was tongue-tied and that we should get her to a pediatric dentist STAT to have that taken care of. She said that this would fix the problem and that Courtland would be nursing like a champ once she had fuller mobility of her tongue. In the meantime, I should use the nipple shield. So, SUPER NIPPLE made a grand entrance back in our lives.

We did a great deal of research about tongue-ties when we returned home, learning that in life pre-formula, pediatricians were trained to perform frenulotomies which corrected tongue-ties because that often lead to success for mothers and babies that were struggling to breastfeed. However, with the surge in formula’s popularity in the 1970s, this training died off. Given that there has been a steady return to breastfeeding (now 60% of mothers in the US breastfeed), more pediatricians and pediatric dentists are making the return to considering tongue-ties as a potential hindrance to breastfeeding, but that we should expect a variety of opinions on the matter.

Case in point, we walked into our pediatrician’s office the day after our hospital discharge and were told by the doctor that she “didn’t believe in tongue-ties.” I think that she meant that she didn’t believe that tongue-ties impacted breastfeeding, but we weren’t surprised to hear this given what our research had said. She suggested that we work with Berkshire Nursing Families, an absolutely dynamite non-profit in our area focused on lactation support. It is an unbelievable resource and truly the premiere example of what lactation support and counsel should look like in this country. Unfortunately, it’s a rare organization, but a fabulous model for anyone looking to build a community-based lactation support, education and counseling non-profit. I am beyond grateful to have this free-resource in my backyard, and just as our pediatrician had said, the woman that started and heads the program is remarkable.

We called Rosalee immediately after the doctor’s appointment, as we had learned that the procedure to correct the tongue-tie would cost $450 if we were to have it done by the dentist whose name regularly appeared in all of our research about tongue-ties. He is who the nurse practitioner had recommended we use, but unfortunately, he was out-of-network, and thus it would be an out-of-pocket expense. James and I agreed to get a second opinion before shelling out the money and, even more importantly, before putting our infant under the physical stress of the procedure. Since our pediatrician had dismissed the idea entirely, we thought we’d see if Rosalee suggested a tongue-tie as the problem when we went to meet with her.

I noticed that the first thing Rosalee did after hearing about our struggles with Courtland’s latch was to look inside her mouth. After she looked, she didn’t say anything, and proceeded to work one-on-one with me and Courtland on position, holding, etc. to establish a latch both comfortable for me and baby. By the third try, Courtland was on the natural nipple, swallowing successfully, without any pain or discomfort for me.

Queue the weeping.

Apparently that little girl IS NOT tongue-tied, as demonstrated by her ability to establish a comfortable latch.

I was over-the-moon, and we worked on the other breast to ensure that we could breastfeed comfortably on both sides. I brought up the tongue-tie, and Rosalee said, “That is what I looked for right away, but while there is slight immobility of her tongue, it’s not enough to warrant a surgical procedure or to hinder breastfeeding.”

We went home, elated, ready to naturally breastfeed like it ain’t no thang. To DOMINATE (as James would say) the world of breastfeeding.

But upon getting home, I found it unbelievably challenging to replicate the conditions we’d established while at Rosalee’s office. We would try and try, and I would feel both myself and Courtland becoming exceedingly stressed and frustrated the more we tried and failed to get a good latch. Tears became a regular part of the routine. Tears of frustration. Tears of pain. Tears of hunger. Tears of failure.

Worst of all, Sunny would look on pitifully and say, “Mommy sad. Mommy crying.”

Talk about twisting the knife.

As I sobbed and sobbed about my body’s failure to feed my child, about my failure as a mother, about how I just couldn’t do it, James picked up the phone and called Rosalee. She immediately had us come back in the next day, and soothed my hysterics by reminding me that Courtland was clearly getting enough milk from me given that she was already back to her birth weight and that I shouldn’t be ashamed to use the nipple shields. What was most important was feeding my baby, and it was okay to use the shields as a tool as we worked on learning how to latch properly and comfortably.

After another successful session with Rosalee, I had renewed confidence, but again, upon returning home, have had my up and down moments with replicating what comes so easily when I’m removed from the distractions of home and have a skilled educator and counselor by my side. There are still tears. Tears when I both fail and succeed. Courtland is a very particular little nursling, and the conditions must be just perfect in order for us both to breastfeed comfortably. I know that this will get better with time, practice, and growth, but it is an overwhelming amount of work and effort. I am so jealous of those mothers who can just put baby to breast and be done with it. I have to prop pillows, and sit just so, and hold my breast just so, while positioning my nipple just so, while holding the baby just so, and it is unbelievably exhausting. Unbelievably overwhelming. All during a time when life is already extremely exhausting and overwhelming. Why must it be exacerbated?

And so weep I do.

But I will not give up. This is too important. And I am grateful everyday to have a partner that is an unbelievable champion and support of all things me. I would not make it through the day to day, let alone the hour by hour, without him by my side. He values breastfeeding as much as I do, and like Rosalee, reminds me to use the shield when I need relief. When I need a moment to breath and pull myself together. Rosalee will make a home visit soon to see if she can’t help us establish a comfortable routine and process at home, like we do in her office. And I know exactly where my next tax-deductible donation will be going.

Now I’m off to weep into that perfect little baby’s warm, fuzzy, delicious-smelling head, because I don’t know if there is anything more amazing in the entire Universe than having newborn life curled up happily on your chest.

Not all the tears are sad. There’s lots of happy that comes with the territory, too.