A thing that surprised me about breastfeeding is what radically different experiences people have with it. This post is combined from a couple of conversations with other mothers in EA.
There’s nothing EA-specific about this topic, but I do think there are some commonalities in parents who are conscientious, scientifically literate, and particularly aware of the value of their time.
I’ll note that there’s a bit of “Happy families are all alike; every unhappy family is unhappy in its own way” going on here. There’s less to say about the good parts than the problems. But I do find the good parts significant, personally, and feel like breastfeeding mostly worked out well in my family.
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Julia: What seemed worthwhile or not about it?
Person 1: One thing is just convenience. It’s super easy to travel light when you’re breastfeeding.
I think I really enjoyed the closeness of it. Every small person is different, and [my child] has always been very pro-breastfeeding. Even now that he’s a toddler, he will use it after he’s been upset, like a calming-down mechanism. He still feeds to sleep. It’s just very quick and easy relative to other things. It’s not particularly a big drain or hassle on me.
The benefits outweigh the costs for us.
Travel
Person 1: A thing which is related to the breastfeeding: I’ve still not spent a night away from him. And I sort of don’t intend to until we’ve finished, or he can come with me. Maybe I’d find that somewhat limiting, except there’s been a pandemic, so no one’s doing any travel.
At least with my current work, I didn’t do any traveling anyway. With my previous job, that would’ve been a bit different. There’s probably some nudging.
If your default setup is that you’re working from home, then there’s much less pressure.
Person 2: I was relieved with [my child] that when I did start traveling without her, she was happy to nurse when I got home. Even when I stopped bringing the pump with me, if I hand-expressed some milk when I was traveling, there was enough that she kept it up until she was two. At some point I let the milk go dry. And then she continued nursing a bit for the next six months or something. Just purely an activity, no longer any food involved.
A harder experience
Person 3: The weird thing was that it always felt only system 1 important to me. I basically bought the general argument in Expecting Better that it was good in some ways and bad in some ways, and probably overall worth it as long as it wasn’t too hard. But my brain was doing a very strong “you have to do the conscientious, good-person thing.” And then the medical system in general was signaling really hard: “It’s important to exclusively breastfeed.” Tons of posters in the hospitals about it being liquid gold. The midwives were like, “Are you going to breastfeed?” And then they would try and talk you into it if you weren’t going to, and look approvingly if you were going to. So I think I basically imbibed that.
Then when you have problems with breastfeeding, the lactation consultants are so biased. I had a conversation with one of them where they were like, “Is your husband supportive of you breastfeeding?” I was like, “Yeah, he’s really supportive, but he thinks it’s probably not overall worth it.” And they were like, “Oh, so he’s supportive, but not well-informed.” No, he knows way more about it probably than you.
I just had this strong, instinctive, “I have to do this.” Like not doing it would be giving up, it would be not being a good person. And so even though I knew cognitively that it was probably not worth it, it didn’t really feel quite possible to not do it.
I think the biggest reason that I should have given up was how many things went wrong. The baby and I had thrush and it seemed like it wouldn’t go away, although I wasn’t totally sure whether it was just other random pain. Then I pretty often got clots, and that was really painful. And then I would bleed and so it wasn’t actually good milk. I had bleeding nipples because the baby wanted to feed all the time, and I had some sore that just wouldn’t go away. I think eventually my GP prescribed me some really good cream that sorted it out in like three days, but that was at month four or something. And so it was just quite painful continuously.
Before that, they put me on antibiotics in order to try and clear that up. The antibiotics made the baby and me sick, and maybe because of that he started being really averse to breastfeeding. So he would scream every time I tried to breastfeed him.
Then the thing we did was get him to sleep before breastfeeding him, because he would feed when he was asleep. But he actually didn’t want to nap as often as he needed to eat, and it’s harder to get to sleep on an empty stomach. So then we did a lot of walking him up and down, trying to get him to sleep so that he would feed regularly. So a lot of separate things went wrong, such that it was extremely unpleasant for him and me.
Then there was the hassle of expressing milk. I was doing that just before I went to bed, enough that my husband could feed him some during the night. And then also I was going in to work overnight most weeks, so I was expressing a bunch of milk in the office and then freezing it and then carrying it back. That meant I was getting up at night some, whereas otherwise my husband was quite happy to be nocturnal. So I think there are quite a lot of separate reasons for not doing this, in addition to not enjoying it that much.
It really makes you realize why people don’t breastfeed. “Why do people not breastfeed when it’s free?” Maybe because they need that time! I think I just worked way less during that period, because I needed to make tons of time for breastfeeding.
I think it would have been better if I’d gone into it thinking that it wasn’t that important. I went in thinking it would be fine to stop, but planning to do it. And so stopping felt like giving up, and I’m just very averse to giving up. And I think it might have been good to go in planning to do a mixture. And then if breastfeeding is great, maybe stop the formula to try and make sure that he continued breastfeeding, but the default is a mixed strategy. I think that would have meant that I got less fixated on this.
This happened to a friend of mine as well. She got really fixated on exclusively breastfeeding in a way that she totally didn’t endorse during or after. She’s like me, really Type A, conscientious. Society is telling me I have to do this regardless of cost. So I guess I have to do it, because I need to be a good person.
Healthcare providers
Person 3: This wasn’t all in my head. It was just at the point of COVID where people hadn’t locked down yet, but it was clear it was going to be bad. We had moved to my in-laws’ to bunker down for a few months, and I’d gotten pretty sad. I had gone to my GP and asked about my dose of SSRIs, and we were still having this thing where we had to get the baby to sleep in order to breastfeed him. So I wrote to this lactation consultant that I’d been swapping emails with and was like, “Thanks for your help. But I really can’t handle this, so I’ve decided I’m going to stop.” And she wrote back, “No, you shouldn’t decide to stop.” And I felt like I’d been very clear to a medical professional, “I am not coping, I’ve literally upped my dose of SSRI because I’m so sad.” And she still was like, “No, you shouldn’t do that.”
So it wasn’t just that my brain was doing a ridiculous type-A thing. But I found that pretty difficult to deal with sensibly. But thank goodness for my husband and colleagues, who all were very sensible throughout this. My husband was pretty fed up by that point, he was like “A, you’re miserable. B, I have to spend tons of time trying to get the baby to sleep so you can breastfeed him, when does it really matter all that much whether we’re breastfeeding him? Why can’t we do the easy thing?” But he then was like, “Well, apparently you’ll be miserable if we don’t do it. I suppose we’re doing that.”
Standard health care professionals seem pretty good. Midwives and lactation consultants, they were more leading me astray than helping. But the GPs were pretty sensible.
I think our GPs are basically a bit scared of the midwives. Two separate GPs tried very strongly to give me permission to stop breastfeeding, and one of them literally said “Ignore the breastfeeding mafia.”
Person 2: When my baby wasn’t gaining enough weight, the pediatrician was clear that his main goal was her health and her getting enough calories. But at week three, he said something like “I don’t think we need to try anything extreme yet.” I was like, “By extreme, do you mean formula? Because I’m ready to try that now.” He was like, “Yeah, you can try that now.’ But he didn’t speak the word.
We tried formula and it was great for a few days, her weight gain shot up. But then it didn’t keep working. I was thinking of it as the option of last resort. But then when we tried it, it didn’t work either. We ended up trying rotating through all these different combinations of breastfeeding and pumped milk in bottles and formula in bottles.
The lactation consultants didn’t tell me anything crazy, but also nothing worked that much. She was just a difficult baby to feed. They were trying to find out, is something wrong with any of us medically? Is something wrong with her latch? Is something wrong with her tongue? Is my supply okay? And all of that was okay. For whatever reason she was fussy.
Person 3: I thought they weren’t trying to figure out: is anything wrong? If yes, fix it. If no, at what point might it be sensible to stop? And at what point is the cost just going to continue like this? Instead, their aim was just to make sure that at all costs I continued breastfeeding. They were like, “Oh yeah, that’s going to resolve.” And then it didn’t resolve. And then they were like, “Maybe try this thing that might work,” and then nothing made any difference.
Person 2: It drives me crazy when people say “It gets better if you stick with it. If you make it to six months you’ll be really glad you did.” That’s survivorship bias – the ones who were having an easier time were more likely to make it to six months! Though it did actually get better for me.
I also had bleeding nipples, luckily it was just due to having babies with an aggressively strong and tireless sucking reflex. When my milk came in and my babies were no longer like “why is hardly anything coming out of this thing???” and they didn’t have to suck so hard/long to get milk out, it cleared up. I’m glad I stuck through the initial few weeks of pain.
One thing where I was really lucky is that both kids had actually gained weight at their first weigh in. Most breastfed babies actually lose weight at this first weigh because it’s hard to gain weight on just colostrum/before your milk comes in. For me the fact I was in incredible pain at first was fine because I knew I was successfully feeding them and this let me get over that initial hump. I think it’s a lot harder when you have to weigh the other benefits of breastfeeding against potentially inadequate calorie intake… this is something I never had to worry about.