If you have a c-section, you’re already at a little bit of a disadvantage for getting breastfeeding established as well as a vaginal pregnancy. First, unless it’s an emergency section and you were already in labor, you very likely didn’t have the pitocin or oxytocin hormones running in your veins telling your body “Okay, it’s time to have this baby!” Instead you got an IV in the OR, not only to help contract your uterus back to its tiny misshapen balloon shape, but also to cue your breasts to start getting ready to feed someone. And as we all know, sometimes those kinds of medical interventions are not nearly as efficient at getting things started as mother nature is.
Second, you lose the ability to having the same immediate skin-to-skin contact with your baby as in a natural birth. While you eventually get that chance in the recovery room an hour later, you’ve theoretically lost that first hour of baby “imprinting” on your boobs, which again would get your milk production started that much more quickly.
Third, you’ve got a lovely incision at just the spot where you’d either rest a baby while sitting or while lying to breastfeed, which means you’ve got to learn all kinds of alternate poses to hold your baby to breastfeed. And you likely can’t move very much, at least in the first 24 hours, no matter how many meds they give you.
Fourth, if you have an epidural or spinal block, your baby is affected by those pain medications as well, making him super sleepy for the first 24 hours. Great for catching up on your sleep; not so great for making sure he can latch properly.
Needless to say, by the time I had figured out that the baby had latched well and was trying to feed, I had two cracking nipples with blood blisters and a screaming baby who lost nearly a pound in two days and was beginning to get jaundiced. By the time he was 48 hours old, he had started crying at the level of a scream and seemed inconsolable. The crying only got worse whenever I tried to nurse him, and he would bob his head on my chest in frustration. After a few hours of this, and having not gotten much sleep over the last two nights, my husband and I looked at each other exasperated. Around midnight, we called in our nurse and asked her what we could do to calm and console our baby. The nurse’s suggestion was a supplemental nursing system (SNS), which essentially attaches a small tube to your nipple and would introduce a small amount of formula to the baby while he nursed. Reluctantly, we agreed.
One hour later, I was covered in formula and still had an inconsolable, starving baby on my hands. We called the nurse in again. This time she said she could bring a nipple for the formula and we could feed him an ounce. My husband and I discussed this possibility, and I broke down. Not only had I battled over a year of feeling incompetent and incomplete as a woman, but then I had spent every day of my pregnancy worried about its outcome and knowing the odds of preterm labor and other complications. Now I could not feed my baby, a baby who, thanks to UU-related intrauterine growth restriction, did not have the same fat reserves on his body to burn while waiting for my milk to come in, as other 8+ pounders that are today’s average sized babies do.
It took a week for my milk to come in, and a month later every feeding starts with nursing but ends with a bottle. After trying a “nursing vacation” (which is nothing like what it sounds), my supply still isn’t enough to satisfy the little squirmy one for five minutes, much less the two hours everyone else seems to get out of it. I spent a lot of time wracked with guilt, too, thinking that this is something I should have taken more seriously, should have been more aware of, should have planned for better. Was it something I did, or didn’t do, that nursing is not enough to feed my baby? I will never know because we’re past that point. The only thing I can do is bear the brunt of judgment, “Oh, you’re supplementing,” from doctors, friends, and strangers, never knowing if having a small uterus has anything to do with it, like creating an imbalance of hormones. But blaming it all on the UU is taking the easy way out, because there is a part of me that wouldn’t do things differently. A part of me likes being able to allow someone else to feed my baby and give me a break. A part of me isn’t thrilled about attaching myself to a pump at work just so I don’t miss a feeding – and only getting 1 ounce of breastmilk out of a pumping session if I’m lucky. Most days I’m okay with my choices, but every now and then I doubt myself and feel every bit a failure as a woman as I ever have.
Then I look down at my nearly 8 pound full-term baby and think, “Yeah, I did that.”