In the recovery room after my C-section, I joyfully held my tiny, wrinkly baby for the first time. I knew how important it is to get the baby to breast as soon as possible, and I had studied all the proper breastfeeding techniques, so I fumbled him into position and tried to coax him to latch. Eventually he clamped on to my breast, like a grouchy little snapping turtle. My first thoughts were, “Wow, this hurts – and it sure feels weird.” And then, immediately, I felt my very first wave of mommy guilt. Breastfeeding was not exactly the glorious experience I had pictured.
Breastfeeding is natural, but it doesn’t always come naturally to moms and babies. We always stress to moms that “breast is best” – and it truly is – but there are a lot of details we leave out along the way.
Breastfeeding affects a woman’s hormones very profoundly. Nursing suppresses ovulation, so your estrogen level is very low, putting you into a premenopausal-type state. This can cause vaginal dryness, hot flashes, night sweats, and low libido. The vaginal dryness can make intercourse painful (even in women who had C-sections) but can usually be treated with over-the-counter lubrication. These symptoms do improve over time and become less severe when your cycles return.
While breastfeeding does suppress ovulation in general, you can’t solely count on breastfeeding for birth control because you have no way of predicting when you will start ovulating again. You won’t know that your eggs are back in action until you get your period – which, of course, happens a couple of weeks after ovulation…leaving plenty of time for a surprise pregnancy. Natural family planning is not accurate during breastfeeding for the same reason.
Breastfeeding also sucks every bit of moisture out of your body, making many women prone to constipation. If you struggle with constipation, make sure you stay extra hydrated, watch your fiber intake, and take a stool softener if needed.
As a belly sleeper, I remember highly anticipating being able to sleep on my stomach again after the baby was born – however, my tender, swollen bosoms had other ideas. Your breasts are very sensitive when breastfeeding. Not only can you not comfortably sleep on your stomach, you often need continuous support. Many moms need to sleep in nursing bras. One colleague described taping nipple shields to her raw, sensitive nipples so she could attempt to sleep without a bra (this technique was unsuccessful).
The benefits of breastfeeding are numerous. We know that breastfeeding reduces mom’s risk of breast and ovarian cancer, diabetes, and heart disease; and baby’s risk of SIDS, diabetes, obesity and infectious disease. Breastfeeding can also improve bonding. It can be the hardest, most wonderful thing you ever do. But the process can also be full of surprises.
One breast often makes more milk than the other. Sometimes this has to do with your baby’s preference, other times it’s just how you are made. One friend of mine found this out the hard way when one of her twins wasn’t growing as well as the other one, when she was tandem feeding. Luckily, it was an easy fix of trading-off sides.
I always smile knowingly when a patient asks me how she will know if her milk comes in – it is truly a unique sensation that cannot be mistaken. I always thought there should be an audible swoosh as the milk follows like a river from your glands to your cracked nipples. A nurse colleague describes it quite appropriately as “feeling like a softball being squeezed out your nipples.”
Hopefully you love breastfeeding, but if you hate it that’s OK too. My son’s poor latch left me feeling like a human dairy. I wanted to be one of those super moms who could breast feed wherever, but instead, when I had to go back to work 6 weeks later, he wouldn’t latch at all, so I was forced to pump all my feeds (even when I was home with him). While I was thankful that my supply was good enough to keep him fed, I didn’t always love the process.
Despite all of the tricks of the trade, supplements, and lactation consultants, breastfeeding may not work. Women with history of breast surgery, PCOS, abnormally shaped breasts or inadequate glandular tissue may not be able to make enough milk despite all the fenugreek in the world. AND THAT’S OKAY. Give it your all. Mourn the loss of the experience, but remember - in the end, fed is best.
Breastfeeding is a unique process for each mom and baby. Some women struggle with supply, others spray their babies in the face with the force of their milk. As with all things motherhood related, PLEASE DO NOT COMPARE YOURSELF TO OTHER MOMS. Some women may have a freezer full of breast milk, others have to supplement with formula. Some moms can feed in public and never have a chapped nipple, others have mastitis so many times that they know how to spell dicloxacillin. What matters most is that our babies are fed and loved.