Letdown & Ascension

During my first pregnancy, there was never so much as a shred of doubt in my mind that I would breastfeed. I looked forward to exclusive & extended breastfeeding. Throughout my pregnancy, I stopped in at the lingerie section waiting for my cup size to increase so I could finally get out of my too-loose B cups and find a bra that fit me in the band and was available in my cup size. My breasts did not change size at all. I wasn’t sure whether to buy a nursing bra pre- or post-delivery. I was assured by other moms that once my milk came in, I’d need a larger cup size so it was better to wait. It was like ‘Waiting for Godot.’ I just kept waiting.

The natural birth I’d planned for was derailed when I developed cholestasis and got so sick with a mystery illness I thought I was dying and only vaguely cared, which landed me in the hospital as a team of doctors tried to ascertain whether I had lung cancer, Hodgken’s lymphoma or valley fever. It was valley fever, and I had a medically necessary induction at 36 weeks. Unsurprisingly, my sleepy baby wasn’t interested in nursing. We had a rough start with latching. The Lactation Consultants asked if I’d experienced engorgement and letdown. I had not. The kind LCs asserted that maybe it was just late; sometimes moms didn’t have their milk come in until day eight.

We kept nursing on demand. The day after hospital discharge, I remember sitting in my daughter Alice’s unfinished nursery, with my feet up on a bin filled with cloth diapers, trying and trying to get her to latch while she screamed, beet red, in frustration. At her first pediatrician’s visit, we learned she had dropped from six pounds to a mere four-and-a-half pounds in just three days. I sobbed all the way home with the two grocery bags loaded with Similac at my feet. This was not what was supposed to happen. Day eight came and went with no change in my supply.

We tried the SNS but could not establish a latch with it. I set about a regime of nursing on demand for 45 minutes at a time or more, followed by giving Alice a bottle, and then pumping out about five drops over 20-30 minutes. At four weeks I asked point-blank whether my milk had come in and whether it was likely I’d increase my supply. My daughter had just latched beautifully, and the pre-and post-feeding weights indicated she had only transferred 1/3oz in 45 minutes. I decided to throw in the towel. We blamed it on the high dose of fluconazole I was taking for the valley fever, or the valley fever itself.

I felt shame every time I plunked down $20 for another four days’ worth of Similac or fed my baby a bottle. I avoided the baby groups friends suggested I go to to combat postpartum depression, because I’d have to feed a bottle to my daughter in front of other breastfeeding moms. I actually had a few women ask me why I was ‘choosing’ to formula feed my daughter. I smiled apologetically and then just as meekly explained my situation. I was told that ‘all women can breastfeed,’ and those who say that they can’t really just are either ignorant, lazy or don’t have a proper support network.

It was because of this same viewpoint, a popular one, that I had not prepared for the possibility of encountering any difficulty with breastfeeding. I had not known to look for the red flags of no breast change during pregnancy, no engorgement, no sensation of letdown. Instead of taking a proactive approach starting in pregnancy, I was caught off guard and reeling from the emotional devastation, complete shock and recovering from my illness.

My breastfeeding ‘failure’ was still devastating when I became pregnant with my second daughter. This time, I was determined to make it work. I took a breastfeeding class. I read books. I found colostrum crystals on my nipples in the third trimester and thrilled. I still held on to the hope that my issues the first time around were related to the valley fever.

With Picasso, I had the natural birth I’d been hoping for with both children. I was in a state of complete bliss during my labor and delivery and the days following. Picasso was attached to my breast from birth on. The nurses would come in to ask how long she’d been nursing, and I could never really answer. They all commended me for breastfeeding so well.

She’d lost a little weight when we were discharged. At her first pediatrician’s visit she had lost more than 10% of her weight. The supportive doctor encouraged me to continue trying and come back in five days for a weight check. At the next appointment she had continued to lose weight and was showing signs of dehydration. She was not wetting or dirtying her diapers often enough, and when she did wet the diapers were filled with reddish powder. I was told that supplementation was no longer negotiable. With a sinking heart, I called and made an appointment with the Lactation Consultant to get help with the SNS for that afternoon. We did a pre-and-post feeding weight to see how much Picasso was transferring: 1/3oz. Lugging the hospital-grade pump into the elevator, I sobbed all the way to the car, crushed that my breasts still were not able to do their job. We started supplementing with formula, and continued to use the SNS for each feeding for the next four weeks.

When well-meaning people had suggested using donor milk to me in the postpartum period with Alice, it felt too invasively personal. I was too devastated and felt worse when anyone mentioned it. People also liked to tell me that it wasn’t the end of the world to use formula – something I obviously knew, but it would have been nice to have had my body give me a CHOICE in whether to supplement or not. Others told me to get over myself and enjoy my baby, not understanding that I was grieving the loss of a relationship too beautiful to even put into words. No matter what anyone says, bottlefeeding is not comparable to breastfeeding. While I empathize with moms whose babies will not take a bottle, and understand how demanding it can be to breastfeed, it is not the same as losing that nursing relationship. Having one’s body fail to be able to fulfill this basic biological compulsion is devastating.

With Picasso, my last baby, I was ready to fight tooth and nail for her to have breastmilk. Although my husband and I were both unemployed, I spent hundreds of dollars on domperidone and herbal and dietary galactagogues. We rented a hospital-grade pump before getting set up to borrow the same pump from WIC for free. I used the SNS diligently and nursed and pumped around the clock. At two months postpartum, my desire for my daughter to have breastmilk transcended the burning devastation of only making a fraction of what she needed to consume each day to thrive. I did what had been emotionally unthinkable with my first daughter – I sought out milk donors. From two months on, she has been on donor milk in addition to what I produce, and we ditched the Similac.

At three months postpartum, I ran out of domperidone and could not afford to refill my prescription or to order more online (which is much cheaper than the compounding pharmacy’s price tag). My supply crashed from 9oz a day to 1oz a day and I went through two days of weeping at nothing, at everything. The morning after I decided to let my supply go, a woman in Canada offered to send me 700 pills of domperidone for free. My daughter had stopped nursing, but I kept pumping waiting for the dom to arrive. Another Godot experience – after a month of pumping several hours a day for 1oz total, I found out the domperidone was returned to her.

Some online friends pooled their money together to order me a couple months’ worth of domperidone, and when it arrived I literally jumped up and down. I worked at it and got back up to 4oz a day, and then after a couple months, to 9oz. I exclusively pumped from three months to just over six months.

For four-and-a-half of her six-and-a-half months, my daughter has been exclusively breastfed, although most of the milk did not come from me. We’ve been very fortunate to have found donors – so far 16.

At six-and-a-half months, I’ve had to make the difficult decision to pull the plug on domperidone and pumping. I’ve gained thirty pounds from the medication, and as someone overweight to begin with, I’m now experiencing some medical issues as a result of the sudden weight gain. It’s not realistic for me to continue to pump every two hours for twenty or more minutes at a time. I have two small children and if my husband had been employed, I have no idea how I would have managed this regime. I need to be a more present, accessible parent and partner. All of these are compelling reasons enough to quit, but the wound is still gaping. The pain still real and raw.

There’s fear, a frantic fear that a day will come when I won’t be able to continue cramming breastmilk into our freezer. I have put my entire being into producing milk for my child, to such an extent that I hope I’ve set a sort of inertia of milk-coming-our-way out into the universe. Waking in a room washed with colostrum-colored light, one day very very soon, I will be empty of milk. Please God, let the best milk possible fill my sweet baby’s beautiful belly. That’s all I’ve got. Finally - letdown, and ascension.

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Edited 4 February 2012

I made it to seven months and ten days.

I came to the realization, when I tried to quit pumping cold turkey a few days before that, that while I was making only a very small amount of milk compared to others, it was a full supply *for my body.* I spent a few days weaning from the pump, with mood swings galore from the shifting of hormonal continents, and then stopped.

Postpartum depression has kicked in full force, which I now remember happened with my first baby! I really do believe lactation is protective against postpartum depression. I'm working my way out of it.

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STARS DOING SOMETHING

My baby is four and a half months old. Today she has learned to blow raspberries and spent her entire day practicing this new skill – in her carseat on the way to the grocery, cuddled against my chest in her Babyhawk carrier in the Asian market, drifting off to sleep. She is seconds away from rolling over for the first time. She is always ready to smile and laugh. Today she made a dozen new friends in the quilting store. She is thriving even though my breasts are not structurally capable of producing the milk she needs to grow. She drinks 100% breastmilk, though most of it does not come from me.

Picasso’s birth was the most joyous, empowering experience of my entire life. I labored blissfully at home and had a natural hospital birth. We got off to a great start with breastfeeding but she lost 10% of her body weight and then continued to plummet. Signs indicated dehydration. My milk had ‘come in,’ but there was only about an ounce of it a day. Total.

For four weeks Picasso received all supplements through the supplemental nursing system (SNS), at my breast. After four weeks and doing everything in my power to increase my supply, it was not realistic to continue to use the SNS so we began bottlefeeding after each nursing session.

When she was six weeks old, I asked my Lactation Consultants, ‘So, what do you think about donor milk?’ Their response – ‘We are all for it!’

A few days later, the day the phone call came, it was raining. A mom whose baby had died was donating all the milk she had pumped. Due to privacy rights, I needed to call her to discuss medical information and be certain each of us felt comfortable with the donation. Let me repeat this: I needed to call a mom whose baby had died to ask her about her medical history. I didn’t want to invade that private, sacred space but I needed that milk could help my baby thrive, so I had to do it.

I’m not good at the phone to begin with – I am a ball of nerves calling anybody I don’t know well, despite previously having worked in marketing (which I was surprisingly good at). I posted a few frantic Facebook requests – ‘Quick, help--what do I say? How do I not cry?’ – and handed my husband Reuben the baby, then went outside to make the call in case the baby cried, so Jeni would not have to hear. I paced the porch, scuffing the dirt with my sandal. Needles fallen from the non-native tree in our front yard pricked my toes. I dialed Jeni’s digits.

She picked up on the third ring.

--Jeni? Hi, this is deborah – I got your number from Jean at UMC Lactation Services. She mentioned you had some milk to donate and I needed to call you to talk about your medical history / medications because I can’t make enough milk for my baby and we would love the milk –

and here I started crying hard, despite biting my tongue and my upper lip to try to keep it together.

--I’m so sorry, I didn’t mean to cry… I was trying so hard not to cry…

--It’s OK, I cry all the time. I’m happy you can use the milk, I’m really happy.

Jeni gave an overview of her medical history (nothing of interest) and medications (nada). She asked my baby’s name and told me about her daughter Caralynn, who had been born with truncus arteriousus and died following three open-heart surgeries and four others. Caralynn was three months, three weeks and three days old when she died. Jeni asked me to look up Caralynn’s Facebook page and let her know who I was, because she wanted to know where the milk was going. I tried to thank her in a way that really expressed the depth of my gratitude, but still felt I had failed to express it.

On the way to pick up Jeni’s milk from the hospital, there was a double rainbow. We’d borrowed big coolers that we loaded with ice at Quik Trip. I wore the baby up to the PICU and let the nurses know we were there to collect the milk. One nurse steered us into the room with the deep freeze. She opened the freezer door and I felt weak in the knees. ‘What love looks like,’ I thought. There were at least two hundred bottles filled to the brim. Biting my lip once again proved ineffective. I felt a profound grief and overwhelming gratitude simultaneously. The tears came quickly as Reuben started to fill our coolers with Jeni’s milk. Reuben pretended the milk wasn’t too heavy, but I insisted he leave me with it at the door and return with the CR-V.

The next few days were a chrysalis. We reduced the formula and gave Picasso Jeni’s milk, which she gulped down with happy sighs. I spent a lot of time thinking and looking at Caralynn’s Facebook page. I had such admiration for the frankness and honesty of all the photos; how Jeni, a photographer, captured difficult moments and showed them being lived. Jeni shared her beautiful daughter’s life so powerfully I felt an urgency to make every second count, and to help my daughters do the same.

One thing that stood out for me was that Caralynn had had a blanket baby made by Bamboletta Dolls (a Waldorf doll maker) and so did Picasso. Picasso’s was red with black ladybug spots and Caralynn’s was solid red.

An anchor of an idea: I’d see what would happen if I put a request out there into the Waldorf doll community for donations to make a care package for Jeni and Chris and Caralynn’s older siblings, Julieann (3) and Christopher (5). It still would not adequately convey my gratitude but it would be a start. I asked Jeni if it would be OK to send a token of appreciation, and asked Julieann’s and Christopher’s favorite colors.

People had been so touched by Caralynn’s story and, unbeknownst to me, many of my friends had been following her story on Facebook already because another Waldorf doll maker, Dragonfly’s Hollow, had sent a doll to Caralynn. People were happy to have a way to channel their grief at Caralynn’s passing into a tangible gift for the Johnson family. Etsy sellers sent donations from their shops and gift certificates. Individuals sent money for purchasing two Bamboletta Dolls directly from the owner, who sold them to me at cost. All in all, we put together a care package whose ‘value’ (as though one can put a dollar amount on comforting gifts) would have been over $1,000. I was blown away by peoples’ generosity. And yet I still didn’t feel like it was ‘enough’ – my gratitude still stretched beyond the gifts I was going to give.

I wrapped and boxed the gifts. The friend who had previously offered to pay for shipping was now, due to unforeseen circumstances, unable to, so I was in the midst of figuring out how to afford it. With my husband and I both unemployed and barely scraping by, paying for it myself was not possible. Jeni’s husband, Chris, had just begun his first deployment so I felt even more adamant that I needed to find a way to get the packages to Jeni. Then she messaged me again. She had the last of the milk she’d pumped for Caralynn at her house. Would I like to come to El Paso and pick it up?

I hadn’t realized how close El Paso was. All I needed was money to fill the gas tank to get there and back – and three generous ladies chipped in and paid for this. My steadfast friend Emily volunteered to go along for the ride on her day off. A relieved Reuben stayed home with our older daughter Alice, and Emily and I went, baby in tow, to El Paso on the two-month anniversary of Caralynn’s passing. Picasso was the exact age, to the day, at which Caralynn had died.

In addition to making phone calls, I’m also afraid of driving on the interstate. I spent the first half of the drive gripping the steering wheel and feeling slightly queasy, especially any time I had to pass a truck or was passed by one. At the Dragoon Road exit I drove over a bump and had a flashback to a summer 2010 flight. Flying over a tornado zone, our plane encountered turbulence that was ‘a 14 on a scale of 1-7’ according to the flight attendants, who had also believed we were going to die. I grounded myself.

Emily and I used this time to catch up. I hauled out the Lactina Select breast pump in gas station parking lots with the windows down, diligently collecting my 5mls at a time. Emily bounced the baby or walked her around. I downed a crazily indulgent 54oz soy mocha Reuben had made me before I left.

It wasn’t just fear of the interstate. I also worried I’d say something stupid that I’d obsess about for weeks. How would I know how long to stay? I’d always felt socially inept. Again, I focused on why I was going: to deliver the big boxes and pick up two more weeks of breastmilk for my baby.

Then we were approaching Fort Bliss and I had to pay closer attention because we were driving over a mountain. It was the first time I’d been on a military base and I joked with Emily I was a little disappointed that there wasn’t a gate with armed guards to ask what we were doing so I could tell them we were going to pick up breastmilk. Instead, we drove straight into a comfortable neighborhood with grassy lawns, tall trees and beige military houses. The mid-afternoon light softened my nerves. I found Jeni’s house number and balanced the three big care package boxes while Emily carried Picasso. ‘What if it’s the wrong house?’ I thought, but then Caralynn’s name and birth- and death-dates were scrawled on the door in washable paint. We were definitely there.

‘Give me that baby,’ Jeni said. Picasso immediately smiled and vocalized for Jeni. I set down the boxes on top of the washer as Jeni asked. She had ordered a mushroom pizza for us and she reheated it now. This was all so surreal – meeting the woman who had been our first donor, seeing Caralynn’s siblings, sitting on the floor changing a diaper in eyeshot of Caralynn’s memorial shelf which I’d seen photos of on the Internet. Jeni showed me her camera, the Canon T3I which was the same digital SLR I’d been wanting to replace my SLR (which was stolen when our house was robbed).

I asked Jeni if it was OK for me to bring the care package boxes into the living room for her and the kids to open and she said of course. I gave Julieann and Christopher their boxes and Jeni hers. I tried to eat my pizza but was too excited.

‘WOW,’ shouted Christopher as he opened his box. He lifted out his blue and black Jellybeans pony and pulled out a red plastic whistle. Julieann had a purple one and the kids began blowing into their whistles hard. ‘Oops,’ I said. ‘I didn’t think the whistles through very well, did I?’ Julieann hugged her new Bamboletta and pony and then asked to take a bath with her new bath goodies.

Jeni opened her gifts more quietly, admiring each one while talking to us and the kids. She seemed to be very moved by the locket, noticing the little details like Caralynn’s birth stone.

She said she liked the blue and white of the journal and ceramic mug – they were the same colors she’d chosen for Caralynn’s nursery, which I had not realized when trying to intuit what colors Jeni might want around her at this time. She thanked us. As we gathered our things to go, Julieann hugged me and said, ‘Thank you for my special surprise.’ Then she asked us to go so she could have the juice she had been promised!

Emily and I hoisted the cooler into the trunk of the 2003 CR-V and I finally got to give Jeni the hug I’d wanted to give her since that first awkward phone call when I had to ask her medical history in order to receive the milk. I wished her the best of luck. I tried again to express my thanks.

Driving into the sun I realized I hadn’t taken a single photo so I snapped some terrible pictures through the window with my crappy point & shoot. It was rush hour, and we calculated when we would stop for coffee on the way home. Emily had memorized the exits that had Starbucks signs. I was going to need to pump soon.

Emily drove once it started to get dark, since my eyes were ruined for night driving by the RK surgery I had stupidly had at age 17. I sat in the back with Picasso, who was having a rough time getting comfortable enough to drift off. Emily pulled over at a huge parking lot off the interstate.

I unbuckled Picasso from her car seat and drew her close under the stars – so many, many stars doing something so much stronger than ‘twinkling’ but I don’t know that there’s a word for it. Stars doing something, me telling my baby to look up farther than she could possibly see. She stopped crying. I wanted the stars to stay like that, then it occurred to me that the stars are always like that, it’s just that other stuff gets in the way. And what I wanted to say about my gratitude to Jeni, as well as my gratitude toward the other milk donors, and the people who donated for the care package, and the many people who gave to me, and for my healthy and thriving family– what I wanted to say about that, the ache in my chest all the way home, it still was too big to say. It filled and refilled and the only way I’ve found to even begin to skim the surface is to give what I am able, when opportunity arises.

I pumped in the front seat while Emily held the baby. After opening every door of the car at least ten times to reorganize snacks, drinks, diapers, bottles, pump, etcetcetc, we were ready to leave. I stayed in the backseat with Picasso, who was not yet asleep. Once Picasso was asleep it was too risky to speak to Emily so I stared out the window. We listened to Loreena McKennitt, the same CD for three hours. As we hurtled toward home, the mountains glowed as if lit from within but it was only (only!) (only!) (only?!) the moon.

Here is a link to Caralynn's Facebook page. Here's a link to Jeni's blog. Please send some love!

let's give away some peace

yesterday, a 22-year-old man shot 19 people in a safeway supermarket during my congresswoman's 'congress on the corner' event. six people were killed, including a federal judge, an aide, and a 9-year-old girl who was excited about politics and just wanted to meet congresswoman gabrielle giffords.

at the end of the day i wrote the following:

i feel so drained from today. just so drained. i would be devastated by a shooting like this occurring anywhere in this country, but having it happen in my state, in my city, to my congresswoman (for whom i'd voted)? at a grocery i've shopped at once or twice? is like having the air sucked out of me.

a nine-year-old child is dead. instead of 'holding my own child a little tighter tonight' like everyone suggests i do to help me feel better, what if i - what if we all - pretended our own child had, G-d forbid, been shot and killed? what if we pretended this shooting had happened at our own neighborhood market? what if we could all hear the sirens, have our houses shake with the airlift helicopters passing over?

would we still be able to continue on with our days, not voting in elections because we 'lack the time' or interest to educate ourselves about the candidates or the issues? would we stand by and let things fall down around us? if we all pretended this had happened in our own home, to our own people?

because frankly, the united states is not as vast as we think it is. regardless of which state in which we reside, today's shooting DID happen in our own home, to our own people. this country has a wound over it, and we press tired bandages to the wound so we can pretend it is not there, rather than letting it show to the air - letting it heal.

it's time to pay attention - to our words and actions and how they add up to bring about our reality. it's time to respect ourselves enough to respect others, and the earth. it's time to slow down and evaluate what is truly important.

i wanted to write something different, something with direction; i have not seen a lot of people mention today's shooting other than my tucson friends, despite there being quite a number of posts about football, food, dolls, movies, and other things. i know this made the national news. i am scared to think that people did not hear about it, did not care, that it did not register enough to cause pause for a moment.

because i am shaken to the core. i do not want to pretend this kind of tragedy cannot touch me, i want to figure out how i can create even the smallest changes that start to put things right again.

today i am continuing to send healing thoughts to those recovering, to those who were witnesses, and to those who have lost friends or family to this violence. i hope you will join me in an effort to think about how words and actions impact the people around us and the earth, both now and for future generations.

and along those lines -

i am offering $50 store credit to one lucky person. this may be redeemed for or applied to any in-stock item(s). i will offer free US shipping along with this. (international customers may use part of the $50 to cover the postage.)

in order to enter the giveaway, please be a fan of my facebook page. *AND* in order to enter, you must tell me one thing you personally will do to put peace in the world. it doesn't have to be anything monumental, or require any huge change on your part - sometimes the smallest things add up to the greatest results.

here are some examples: i will pay attention to the language i use and challenge any hateful language i hear spoken. i will challenge my preconceived notions about other cultures. i will take my children to a peaceful protest. i will take my children on a neighborhood walk and we will pick up garbage from the street. i will start recycling one type of locally recyclable item i previously threw into the garbage. i will take tupperware containers with me to restaurants where i expect i may need to take food home, to minimize use of styrofoam. i will take my children to a cultural event.

i am looking forward to hearing your responses! one entry per person, and it must contain at least one tangible commitment to bringing about peace. thank you so much. the winner will be selected by random number generator on wednesday, january 19 at 11.59 PST.