Breast feeding is hard. Yes, there I said it. As a pediatrician and a mom, I breast fed all three of my boys but it was not without significant work and challenges.
My oldest son was born when I was in my first year of medical school. He surprised me and came four weeks early which actually worked out well since he was born over Christmas break. Young and maybe slightly crazy, two weeks later I went right back to school. I remember trying to get him to latch in the hospital. Everyone kept telling me it was “natural” and all babies knew how to do it. Well big news flash to me: Nathan did not. He wouldn’t latch and not knowing what I was doing I just kept trying. When on the first night home from the hospital he slept 6 hours, I thought I had hit the jackpot. What I didn’t realize was that he was actually dehydrated and that’s why he was sleeping so much. He had gone into hibernation mode.
By the time I saw the pediatrician, he had lost greater than ten percent of his birth weight and I was told to supplement with formula. Keep in mind, that I was a first year medical student, which means that I basically didn’t know any more than the general population but may have thought I knew a lot about medicine. Being a rule follower, I promptly went home and gave him formula which he proceeded to forcefully vomit at me. I tried again and once again he vomited it right at me. I concluded that this wasn’t working and called the pediatrician who told me to keep trying. After I broke down into tears, he then suggested I call a lactation consultant.
Following instructions, I promptly called the recommended person and scheduled an appointment for that day. She suggested I start pumping and use a nipple shield. I started pumping and there it was, my milk, it had come in. I had something to feed him. I was thrilled. Despite my best efforts and the nipple shield, he still wouldn’t latch on to the breast so I called to schedule another appointment. I saw her a total of four times and spent over 1,000 dollars. Keep in mind, at this time both myself and my husband were medical students and had NO income. Luckily, my mother paid for this cost and the pump rental.
Nathan never latched and I kept on pumping. I wasn’t living on campus so I schlepped my pump all over and pumped in friend’s apartments, pumped while I studied, and I kept giving him my milk. It wasn’t easy and honestly I didn’t enjoy it at all. All this time, he was extremely fussy and had tons of eczema. When he was ten months old, I had to go for a test that involved radiation and I couldn’t give him my breast milk. At this point I had changed pediatricians (doctor number one was not only not helpful or supportive of breastfeeding but wasn’t supportive of my concerns at all so we had parted ways.) I tried formula and this time he not only vomited it at me but also had a head to toe rash. I called my pediatrician who told me to try soy formula and cut all dairy out of my diet. Within 72 hours, I had a completely different child. He no longer was covered in rashes and irritable. He was allergic to milk.
Knowing what I know now as a pediatrician this is painfully obvious to me and something I quickly picked up on with my second son. At that time however, I was like every other mom, I didn’t have pediatric medical knowledge. I listened to my doctor and didn’t question him. I didn’t have feeding or emotional support from my first pediatrician. As I went through medical school and decided to become a pediatrician myself, I vowed I would never treat patients like that.
Fast forward 8 years later, I was now a practicing pediatrician at my current practice for about 15 months when my second son was born. I was determined for this experience to be different for me. I took 4 months of maternity leave and after all, I was a pediatrician myself, I knew more this time.
Nothing could have been further from the truth. This baby was born full term and latched right away. I thought I was set, this time was going to be easy peasy. Two days later, my nipples were cracked and bleeding and feeding this little guy was super painful. Despite my pain, I was making enough milk and he was gaining weight well. I consulted a different lactation consultant who was very helpful. She guided me and listened to me and supported me. Despite following all the exercises, I continued to have pain with feeding and bleeding nipples. I ended up with oversupply which made matters worse. When he was fussy, I quickly took myself off all dairy and soy and started reflux medications. It helped a little but he continued to cry a lot.
In fact, he was basically either feeding, eating, screaming or sleeping. Parenting this time was not more fun. It was worse. I just kept plugging through and eventually around 10 weeks of age, it came together and he started feeding well. Around 13 weeks, his colic resolved and he was much less fussy. It turns out he was in fact also allergic to milk and I stayed off dairy until he weaned at around 15 months. When I did return to work, I was determined more than ever to help parents as they transitioned from pregnancy to parenthood. I felt like I had been there in the trenches having had a colicky baby and struggling with breastfeeding and I needed to make things better. It took some time to get things organized but our practice started screening for postpartum depression regularly and we hired a lactation consultant who could see moms and babies in our office and through insurance.
On to baby number three. This time I was sure I was going to “get it right.” This had been my hardest and most medically complicated pregnancy but despite that, I was hopeful and determined. He latched right away but I quickly realized I needed help and fast. The latch was painful. Within hours of my getting home from the hospital, my in-office lactation consultant was there and helping me. What a world of difference early intervention made. She taught me so much, tips and tricks that as a mom now of three and a pediatrician I didn’t know. Most importantly, she taught me to reframe my thinking. That sometimes babies just want to nurse. That his wanting to be on the breast all the time didn’t mean I was deficient of milk or he was hungry. There were just sometimes he wanted to nurse just to nurse. She also taught me that it was okay to take a break. That even if he wanted to nurse, if I need to take a break and give him a pacifier or a bottle I wasn’t “a bad or lazy” mom. I was doing what was best for my child by protecting my mental health and caring for myself.
As a Type-A, super organized person, I REALLY needed to hear that. I needed to accept that this little being was random and not on my time schedule and was going to do his own thing. The language I was using to measure what I thought was feeding success was ultimately self-deprecating and unhelpful. I needed to start thinking about this differently. I’m not going to lie, that was and continues to be one of my biggest challenges as a parent but I am getting better at it. He’s 16 months old and still breast feeds. For the first time of all three of them I truly loved breastfeeding. It took me over 13 years of mothering and lots and lots of hard work to feel that way.
While I knew we, as a medical practice, had made progress with the changes we had instituted, my colleagues and I felt we had room to improve. With lots of hard work, coordination and brainstorming, my practice in Flatiron and Brooklyn, Premier Pediatrics, has launched The First Month Program. This unique program is focused on helping all parents (whether first time or fifth time) with the transition to parenthood. Our key components are feeding success, emotional success and parenting success. With a lactation consultant on staff in both offices and frequent visits, we aim to help new parents succeed in meeting their feeding goals. Being able to bill through our patient’s insurance we have eliminated the financial hurdle that so many new families are facing. I am hopeful and excited that we can help parents through this exciting but often challenging time. I am hopeful, that our program will help end some of the stigma about talking about struggles when you are a new mom and that my personal story and struggles will help parents to feel they can be more open when they face challenges.