Photo courtesy of Elissa Gurman
When I took my pre-natal class at Mount Sinai Hospital in Toronto, we did a “thank-you” exercise. Every couple in the room was given a thank-you card, from their unborn child, thanking the mother for breastfeeding. As we went around the room reading aloud (“thank you for giving me the best start in life,” “thank you for saving our family’s money”), I began to feel sick. During the lunch break, I approached the instructor and, as quietly as I could, I said, “I had breast reduction surgery—will I be able to breastfeed? What can I do to make it work?”
I had breast reduction surgery when I was 16 years old, and, at the time, my surgeon assured me that the surgery should have no impact on my ability to breastfeed. Within a few years of the surgery, I pretty much forgot about it—my new, smaller breasts simply became a part of my new, more confident self and I rarely gave them or the surgery much thought.
Until, that is, I became pregnant.
Suddenly, everyone who knew about my reduction began telling me that I’d be unable to breastfeed. I was devastated but also defiant—I wanted, like every mother, to give my child the best start in life and to me that meant breastfeeding. And the surgeon had said it would be fine.
I learned pretty quickly that that might not be the case. The ability to breastfeed, as far I as I learned, hinges on three things: hormones, stimulation (your body feeling the baby sucking), and milk ducts. Breast reduction surgery can sever milk ducts and nerves. I also learned that there isn’t much you can do before baby comes to find out if your breasts are going to work or to “make” them work. Until the time comes to actually breastfeed, no one really knows how your breasts will perform.
By the time I went into labour, I was cautiously optimistic: my breasts had been leaking colostrum for weeks and I was armed with breastfeeding knowledge and the contact information of several local lactation consultants.
Nothing could have prepared me for what followed.
I have never felt like more of a failure in my life than in the weeks following my daughter’s birth. When I brought my baby to my breast, she writhed away screaming; I felt like she thought I was disgusting. My breasts smelled like milk, tasted like milk, but did little to satisfy her hunger. One lactation consultant explained it to me like this: the average breastfeeding mother has about fifteen working “holes” in her nipple from which the milk squirts out. On one side, she estimated, I had two or three functional squirters, and on the other maybe five or six. My baby was hungry and frustrated by the excruciatingly slow flow. In short, I could not really breastfeed and, in the hormonal, sleepless fog of new motherhood, I felt not only that I was a bad mother, but that – because of my choice to undergo elective surgery—it was my fault.
When you are a new mom who wants to breastfeed but can’t, there are some things that you try, and, dear reader, I tried them all. I took herbal supplements to increase my milk supply, I went for an ECG to determine if I could take Domperidone, I cup-fed, I finger-tube-fed, I fed through a tube taped to my nipple (note: this is not easy or fun), I went to seven (seven!) different lactation consultants (the worst of whom smiled at me benignly and told me that “nature will find a way”), I pumped and pumped and pumped.
After a couple of weeks, my feeding ritual looked like this: 1) bottle feed pumped breast milk, 2) bottle feed half of formula, 3) breastfeed on both sides, 4) bottle feed remaining half of formula, 5) pump for 15 minutes. This rigmarole needed to happen eight times a day, took roughly forever to complete and involved my daughter screaming like a maniac every time I offered her my breast. For the first time in my adult life, I hated my boobs again. The most frustrating part? Even when I pumped eight times a day, I only produced enough milk to satisfy about 10% of my baby’s needs.
I dutifully trotted my tired, sad self off to the lactation consultant(s) every couple of days, but at each appointment I was filled with more dread. It turns out that even after having a baby, no one really knows what is going on inside post-op breasts: was I struggling to breastfeed because of normal causes (low supply, bad latch) or because of my surgery (severed ducts and nerves)? No one really knew or agreed. And, there weren’t any solutions that truly addressed the special circumstance of my surgery. As I developed case after case of mastitis, I began to wonder: what is the point of pumping and taking supplements to increase my supply if my ducts don’t work? Why work on (painful) latching if the milk can’t come out? Trying to breastfeed began to feel like a game that I simply could not win.
But, here’s the strangest thing: I could not stop trying. I was spending more time with my breast pump than my baby, my breasts were becoming infected, my nipples ached, my baby was barely getting any breast milk, and yet I felt that I had to keep going. I believed that I had to breastfeed to be the “good mom” from those thank-you cards at Mount Sinai. It was as though becoming a mother had undone the work that my breast reduction had been crucial in spurring all of those years ago; my confidence was eroding away.
In the end, I eventually did stop trying to breastfeed, but it took the words of a friend to get me there. We were talking about my breastfeeding struggles and she, a family doctor, took my hand and said, "It is time to stop this. You have done all you can." The relief came over me like a wave, and I burst into tears. Even though I knew I needed to stop, I was too ashamed to pull the trigger myself; I needed someone I trusted to let me off the hook, to tell me that it was okay.
Putting away my breast pump was, in some ways, not that different from deciding to have breast reduction surgery. Both choices helped me to become more confident, by allowing me to focus on the things in life that are important and to forget about those that were holding me back. When I stopped worrying about giving my daughter breast milk, I was able focus on my building my relationship with her and figuring out my new identity as a mother.
It sounds obvious, but it was very hard for me to believe at the time: a good mom is more than a set of working boobs.
Now that the madness of early motherhood is over, I never think about breastfeeding. Not even a little. I have a busy near-toddler on my hands and she is wonderful and perfect, and formula-fed. And, you know what else are perfect? My beautiful, surgically altered boobs.