OK so I need to start with my sister. I have a sister, Lela — she's the chicest, au naturel hippie I know — and I swear her boobs were literally put on this earth to make breastmilk. Her kids drank it until they were at least three. She is a force of nature when it comes to breastfeeding. And I look up to her in basically every way when it comes to mothering, so when Milly was born it was not even a question if I was going to breastfeed. If Lela did, of course I would.
What I was not prepared for was the pain.
Every single time Milly latched I would cry. Every time. The pain was so intense that I started biting my own hand to put it somewhere else in my body — like giving my nervous system another problem to focus on so my nipple could catch a break. I'm doing it right now just to remember what it felt like. Biting my arm. That's where I was.
And you know me. You know I'm a visualizer. A problem solver. So in between crying and biting my own arm I am genuinely designing a product in my head — a pacifier, but for the mom, something to bite down on while the baby latches so your body has somewhere to put the pain.
I was going to change the world from my nursing chair. I was too tired to actually build it, so instead I became the number one buyer of Earth Mama Organic Nipple Butter — a brand my sister surely approved of. Lathering on a jar a day, or so it seemed, just to keep my nipples intact.
That was Milly.
Then comes Ernie.
Fourteen days before he arrives we find out he has a cleft lip. We don't know yet if there's a cleft palate. Those fourteen days I'm preparing for hydrocephalus — they found enlarged ventricles, turned out to be nothing, just a big head — preparing for surgeries, for unknowns, for this whole constellation of things nobody has a map for. I wasn't preparing not to breastfeed.
And then he's born, and the cleft lip we learned about 14 days earlier was wider than we'd imagined, and it was accompanied by an equally wide cleft palate. And here's the thing nobody told me:
When your baby has a cleft palate, they cannot latch. Like physically cannot.
So I'm feeding Ernie through what I can only describe as a hamster bottle — I'll find a picture, you'll understand when you see it — and meanwhile every single person in that hospital is on me to start pumping. Immediately. Because I was told: breast is best. Your baby has special needs. Get him that colostrum. Get him your milk.
And yet I hear from mothers who were never offered one at all. Who wanted it, needed it, and had to find their own way to it. Isn't that something?
So I'm pumping. And feeding him through the hamster bottle. And navigating the surgeries and the appointments and the phone calls and the unknown — all of it at once — and I am not okay.
I couldn't see it then. I see it now.
I was operating like survival was the plan.
Almost everything I'd call postpartum anxiety after Ernie — undiagnosed, untreated, invisible to me while I was living inside it — came from the pressure I put on myself around breastmilk. Because here's what was living in my head:
I've already failed him. I can't also not give him breastmilk.
I thought his cleft was my fault. I know, I know, it wasn't. At least I do now. But that's where I was. And the least I could do — the one thing I could control — was getting him my milk. So I kept going, fighting through my mental anguish and my body's pain.
I bought every pump on the market. Through my insurance, I was able to get a Spectra at low or no cost. I had an S1 from my Milly days, and then an S2 I ordered after Ernie. They weren't making the cut. I felt tangled up in tubes all day, and the suction wasn't intense enough. So I turned to the world of cash pay options. (The world of cash pay that mothers live in during the lead-up to birth and the year following is definitely another topic for another time.)
I bought the hands-free, wear-in-your-bra, on-the-go, very expensive Willow. She had the convenience, but Willow wasn't giving my nipple the level of suction it required. So I thought maybe the Brits had figured it out, and bought Elvie — one American, one British. A little bougie transatlantic pump friendship.
Then, because I am not immune to advertising — I've dedicated practically my entire working life to its effectiveness — especially not the kind that finds you at 2am when you're leaking and crying, I started to question if I was the problem. Maybe I was over-indexing on outsourcing every choice to the algorithms that preyed on me. Like how you buy the fancy Montessori toys that make all the different sounds and crunchy noises, and then realize your baby is as contented by the noise from an empty bag of chips as she is from your $30 must-be-perfect toy.
So I bought the Medela Harmony hand pump, then the Haakaa silicone breast pump. The last one I bought was $13.99, and I wish I could tell you it worked. None of them were cutting it.
I spent probably two thousand dollars on pumps and their accessories in the first three months of Ernie's life, just trying to get this kid breastmilk.
I got mastitis twice.
My body could make the milk — same genes as Lela, same boobs — but no gadget could replicate the suction of a baby, or reduce the stress of being a pump-to-feed mom. And the stress was doing something to my supply, and the worry about my supply was doing something to my stress, and round and round it went.
The second time I got mastitis, I called the hospital convinced I had breast cancer. Like genuinely convinced I was dying. I had a fever over 101, severe chills, a hard painful lump, red streaks across my chest, and boobs the size of melons. I was not out of left field. I was a new mother who hadn't slept in months and whose body had been at war with itself since the day Ernie was born, and something felt very, very wrong.
Dartmouth Hitchcock told me that breastfeeding is actually a protective factor against breast cancer, and that cancer during lactation occurs in approximately 1 in 3,000 women. They prescribed antibiotics — approved for breastfeeding, possible side effect: diarrhea in the baby. I had a hospice nurse visiting my house every week to weigh Ernie. If the mastitis antibiotics caused diarrhea and made him lose the weight I'd worked so hard for him to gain, I would lose my mind.
They also told me to tuck chilled raw cabbage leaves inside my bra for twenty minutes every two hours. Raw potato slices if I ran out of cabbage.
I think about that prescription now and I smile. State of the art technology. Best in class doctors. And a little side of folk remedy, just for good measure. I don't know if every health system would tell a mother to put vegetables in her bra. It feels uniquely Dartmouth. I mean that as the highest compliment.
One of my best friends — I've called her Lou since high school — is an RN. She came over to play with Milly for a few hours because I was unable to move, let alone mother a toddler. She's one of those people who is also a sister in terms of what I share with her. The only people who see me naked are my husband, my children, and, on this particular afternoon, Lou.
She came into the bedroom to find me in a diaper below — there was a lot of bleeding and tearing, they'd had to use a vacuum to get Ernie out — and naked on top, boobs covered in purple cabbage leaves, an ice-cold towel wrap on my head.
I was not okay. Based on her face, she knew it too.
Lou left. The inflammation subsided. And then my mother-in-law called from the UK.
"Just stop pumping," she said. "You don't have to put yourself through this. Just use formula. Plenty of mothers do. It will be fine."
I could hear her words, but I couldn't believe them. Because stopping felt like failing Ernie.
With Milly, when I returned to work at Amazon, I attempted the mother's room for about a month. After too many incidents of leaving with wet milk spots on my blouse — feeling like I was infantilizing myself in the place where I needed to be most grown up — I switched to formula without thinking twice. I breastfed her in the morning and at night, and during the day I sent her to daycare with formula, without an ounce of guilt.
I went with Earth's Best Organic. It was before Bobbie dominated the cultural zeitgeist, and the red packaging with the little barn made my inner Vermonter feel like she was making the right choice. I also thought Lela would approve.
With Milly, switching to formula didn't come with an ounce of guilt. With Ernie, it was the opposite. Two tons of it.
It took me a long time to find my way out of that.
But here's what I know now: the breastfeeding pressure doesn't just live in your body. It lives in your head. It becomes the thing you're using to measure whether you're enough. Whether you're a good mother. Whether you've made up for whatever you think you did wrong.
You didn't do anything wrong.
Fed is best. Formula is food. Your mental health is part of your baby's health.
This is the part they don't put in the medical journals.
And anyone who tells you otherwise — I say, fuck off, bye.
Dartmouth Health published Ernie's story today, too. You can read it here.
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I've shared mine.
Now I pass it to you.
peace is in you