Nipple confusion

Owen suffers from nipple confusion and it's all my fault. I have a feeling this won't be the last time in my motherhood career that I utter those words "it's all my fault." As I'm quickly learning, motherhood comes with built-in guilt. If you don't do it to yourself, someone else will do it for you—family members, other mothers, teachers and even the American Academy of Pediatrics. All well meaning, of course.

But back to boobs. Throughout my pregnancy, I didn't have strong opinions on circumcision, co-sleeping, vaccinations or taking pain medication during labor. We were attending natural childbirth classes but I knew that if I ended up pleading for an epidural, it wouldn't be the end of the world. I figured we'd never done this parenting thing before so we'd see how we felt when we got there. And if it's one thing I've learned in my life, it's that the second I start to make plans, something changes.

One thing I did feel strongly about was breastfeeding. That was definitely part of the plan. So of course, that was the one thing that got screwed up.

My mom had always spoken fondly of breastfeeding me and my brother—the closeness she felt holding us and being our sole source of nourishment in the wee hours of the night. In college, I wrote a paper about the superior qualities of breast milk to formula (antibodies, perfect balance of nutrients, tailor-made for your baby). And because I grew up in California, I've been indoctrinated with the virtues of healthy eating habits and the edict that "natural is better."

Not only that, studies say that infants who are breastfed have lower rates of cavities, are less likely to become obese and may even be smarter than their formula-fed counterparts. Breast milk, according to some researchers, can actually raise your IQ.

None of these studies mattered much to me because I was already a convert. I likened feeding your baby formula rather than breast milk to giving them Velveeta cheese instead of Tillamook. It was just like those evil food companies to come up with a way to get mothers to feed their children processed food right from the start. No child of mine was going to eat McDonald's style his first six months of life.

Bottle boy

That's how I used to feel, anyway, because like I said, whenever I make plans, life happens. First, I was in labor for 2 1/2 days. Yes, 52 hours. So I didn't sleep for two nights before Owen was born because the contractions kept waking me up. Then during labor, the fetal monitor picked up an arrhythmia in little Owen's heart. Soon after he was born he was whisked away for an EKG and had to stay in the nursery rather than room with me so they could monitor his heart 24-7. (Turns out the arrhythmia is nothing serious, although it's something we continue to monitor.)

Then, after going through one of the most physically demanding experiences of my life — drug free I might add (yay me!) — the nurses kept waking me every two hours to breastfeed. They'd wheel me down the hall to the nursery where I fumbled with my new baby, smooshing his swollen face into my chest, navigating the wires hanging from his, trying to get him to latch. It was an awkward dance and most of the time I couldn't get Owen to wake up. He too, was exhausted from his birth.

By the time they discharged me from the hospital two days later, I hadn't slept in five days. Even worse, Owen had to stay in the hospital another night because they were still waiting for the results of his heart tests. I had 24-hour access to the nursery but no where to sleep. Exhausted and near tears, I broke down and told the nursery nurses to go ahead a feed him formula for the night so I could go home and recuperate.

Next came the news that I may not be able to breastfeed because of a medication I was taking. I had been cleared to breastfeed on the medication before he was born, but given his heart condition, his pediatrician wanted to check with the cardiologist. So for the next week we fed Owen formula while I pumped, trying to get my milk to come in and storing it in the freezer while we waited for word from the cardiologist.

Finally we heard back from the cardiologist that breastfeeding was fine. But by that time I had developed some postpartum anxiety and I knew that if I didn't get long stretches of sleep each night, I'd end up a basket case. Breastfeeding requires getting up every two hours to feed the baby. Not the best recipe for sanity, even for mothers without anxiety issues.

So my mom and Dave took the night shift, formula feeding him so I could sleep. My plan was to breastfeed him during the day. But by then he had gotten used to the bottle and it was difficult to get him to latch correctly. He'd get frustrated, I'd get frustrated and I'd finally give up and give him a bottle of the breast milk I had pumped.

Cousin Johanna helps with dinner

What they don't tell you until you're pregnant and sitting in childbirth classes is that babies don't breastfeed by sucking on the end of your nipple like you would think. Nope, they're supposed to open wide and fit your entire nipple and areola into their sweet little mouths. The nipple should be toward the back of their mouth, that area right behind the bump in the roof of your mouth. By compressing the nipple against that area, they get milk.

But that requires a different kind of sucking than how you suck from a bottle. It's a totally different experience to suck on soft fleshy breast tissue than hard plastic. Hence, Owen's nipple confusion and the reason lactation consultants warn you not to introduce pacifiers or bottles until breastfeeding is well established.

Breastfeeding, as natural as it seems, is learned behavior. Sucking is a reflex babies are born with, but both mom and baby have to learn how to position the breast in the baby's mouth to make that sucking comfortable and effective for both parties.

Whenever I tried to get Owen to latch on he'd suck superficially for a few minutes, then pull himself off, shake his head back and forth panting in frustration and start to cry. I couldn't seem to position him like our lactation consultant had taught me and frankly, I didn't have the patience to work through both of our frustrations. In other words, I'd failed as a mother.

At least, that's how I felt. I'd sob to Dave that Owen wasn't getting the antibodies he needed and would never go to Harvard. Dave rubbed my back and reminded me that my health and peace of mind was more important no matter what La Leche League said. Being calm and stable was what Owen really needed from me. As much as I hate the cliché, I had to put my oxygen mask on first.

So I did. But over the past few weeks I've also been pumping three to four times a day to give him breast milk with a bottle. It made me feel like I was doing something right to give him at least a few ounces a day of the real thing.

Everywhere you look women are pressured to breastfeed. The American Academy of Pediatrics, pediatricians, parenting websites, baby books and every childbirth pamphlet you will ever read advocates breastfeeding. Even the formula companies push breastfeeding as some kind of politically correct marketing campaign.

The other day I was standing in the baby food aisle at Target trying to find the right brand of formula, and on the front of the Enfamil canister was a warning label that said, "Experts agree that breastfeeding is best."  Great, I'm even getting shamed in the aisle of Target.

Over the last week, pumping numerous times a day has gotten harder and harder and my milk supply has continued to dwindle. Owen is six weeks old now and as much as I hate to admit it, I'm seriously considering quitting altogether. As he continues to suck down bottle after bottle of formula making eager, noshing noises, I may have to swallow my pride and realize that being a good mother is more than providing just the right balance of nutrients.

As the cardiologist told us at our last appointment, I don't have to be the perfect mother, just good enough. As a perfectionist, it kills me to settle for good enough. But given the way I feel about Owen, I have a feeling that good enough is going to be more than enough.