Tuesday, April 1, 2014
Triumphant Tuesday: Breastfeeding Through Breast Milk Jaundice
Her journey is as poetic as it is real, as heart-warming as it is painful. It is what inspired Florence to author her bestseller, and Winner of the 2013 Los Angeles Times Book Prize, "Breasts: A Natural and Unnatural History". With her characteristically blunt brand of honesty, Williams asks the question "How did humanity ever make it this far?" - what with yellow babies, nipple fissures, clogged ducts, milk fevers, and no ER. But, as we mamma-mammals know, the female body is a resiliently stubborn sod, and Williams' experience is certainly an ode to it...
"I didn't bother to read the sections in the pregnancy books about breastfeeding. I was much more concerned with the pain and blood and gore of childbirth. I got stuck on the terrifying bit about pushing a head the size of a bowling ball through what was now bluntly called 'the birth canal'. I found that part so colossally distracting that I waved off what the books call the fourth stage of childbirth: lactation. I was a mammal. How hard could it be? I would flip through those sweetly illustrated sections later if I made it through the delivery alive.
How wrong was I.
What I didn't know. What I couldn't know, was that childbirth ended up being the easy part. It turns out I was a bit of a champ at it. Nurses filed into my room to watch my breathing technique. In between contractions, they talked about real estate. I didn't need drugs. I didn't even accept an Advil when it was over. "You're tough" said my doctor, shaking his head. My son was beautiful, if a little orange looking. My pride swelled.
But then came the pain and the blood, and it came from breastfeeding, the part of the deal that was supposed to be all saccharine and drenched with love hormones. The first time Ben latched on was wonderful, a little strange, but the fact that he knew what to do seemed a miracle. His strong little mouth created a vacuum like a particle accelerator.
The second time he latched on, it hurt, and the third time, it hurt more. My nipples grew inflamed, then formed canyons of fissures, then bled. They looked mangled. I couldn't wear a t-shirt, much less a bra. My mother-in-law came to visit, and I staggered around the house looking like a crazy bleeding topless person who'd had an unfortunate accident with farm equipment.
The 'Art' of Breastfeeding
I was doing it all wrong. What I learnt the hard way is that neither women nor babies "know" how to breastfeed, despite this enterprise being a fundamental part of our humanity. (To be fair, the babies know more than the mothers. Studies have shown that right after birth they are capable of a heroic 'crawl' to the nipple, which might be colored extra dark for their blurry-eyed benefit). If we human mothers once instinctively knew how to nurse babies, we lost it along with thinks like the ability to make vitamin C. Through our evolving social context, we learned from each other how to eat foods with vitamin C and how to tickle an infant's chin so his mouth will open bigger for breastfeeding. Now, though, we have lost the social transmission that came from living in kin groups. We are replacing it with the paid profession known as "lactation consultant".
Mine was called Faylene, and she made house calls. Friendly but no-nonesense, she showed me the football hold, the lying-down hold, even the upside-down (the baby, not me). She helped me open my son's mouth wider and stuff more of my areola in it, and she showed me how to gently break the force-of-nature suction with my pinky when it was time to stop. It was bewildering, but I was getting the knack.
Then a relative noticed my son was now even more orange-hued. He was diagnosed with a condition called 'breast-milk jaundice', in which some unknown component of my milk was temporarily interfering with the ability of his liver to break down bilirubin. A pediatrician told us that if this weren't corrected by a twenty-four-hour break from breast milk and immediate application of artifcial light to his skin, he would suffer brain damage.
We fed him formula from a bottle for a day and a night while I tried to pump my engorged breasts. Ben looked at my nipple like it was a foreign metal object. Faylene told me this is called 'nipple confusion'. I called her back for more body contortions and face stuffing to reaquaint Ben with the real deal. We were bfinally getting everything sorted out on day 10 when I suddenly felt like I was going to die. My temperature spiked to 104 and my right breast turned to red, hot cement. I went to the emergency room.
Yup, I had mastitis, a blockage or inflammation of the milk duct that triggers a systematic infection. I needed antibiotics, and I needed them fast. I couldn't help but wonder how humanity had made it this far. What happened to cave women with yellow babies and clogged ducts and no ER? Breastfeeding might have helped the species evolve, but not before killing off a good percentage of its mothers with what used to be called 'milk-fever'.
Finally... A Love of Breastfeeding
I would get mastitis three more times that first year. I'm not sure what propelled me to stick it out. Faylene, probably, and a dogged sense of granola-girl duty. But then, once the agony ceased, I found I really liked breastfeeding. In fact, I loved it. Ben and I would settle into our bright-yellow glider at all hours of the day and night. I learnt about things that went on along my street at four in the morning that I never imagined. Sometimes I flipped through a magazine or just marveled at my son's now-porcelain skin. I loved the surges of prolactin, a gentle stoner hormone, and of oxytocin, which, as one writer describes it, produces "slight sleepiness, euphoria, a higher pain threshold, and increased love for the infant". I loved the lazy intimacy with my son, and the way he panted and flapped his arms with joy when it was time for dinner.
We are a team."
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