"Life is adapting to change, which is why I married you, the most adaptable person I have ever met - until you had children." Danny
"Try to come to terms with your wishes and reality. We are made angry by dangerous notions of what the world is like." Seneca (40 -65 A.D.)
"Expectation management." Danny
Breast is a Beast (sorry, Best)
There’s nothing like having a baby to knock you right off your pyramid. Forget self-actualisation, forget truth and justice, forget beauty, forget knowledge and exploration, forget self-esteem, forget sleep. Someone else’s needs suddenly become your whole responsibility.
For every peak experience there’s a trough, and for me the peak experience of childbirth was rapidly followed by the trough of failure. I was struggling to provide Art’s most basic need. Food. I couldn’t breastfeed.
Helen’s Nipples
As a pregnant woman, lovingly rubbing the swell of my belly, I assumed I would be a laid back sort of mother who would nurse her baby effortlessly. After all, I’ve coped with cardiac arrests, surgery with a book of instructions in one hand and a kerosene lamp in the other, rebel invasions, disobedient dogs and drug addicts. How hard can suckling one tiny baby be? Ha!
“Perfectly natural, why all the fuss?” I would think, just stopping short of voicing my disapproval at the majority of my patients who were thrusting plastic teats in their tiny babies’ mouths by the time they came to see me for their six-week check. Women have been breastfeeding worldwide, along with the rest of the mammalian kingdom, back to before the dinosaurs. Dinosaurs of course didn’t have to worry about breastfeeding (no wonder they survived 150 million years!) So what was my problem?
Big boobs. Women always worry that their breasts aren’t big enough to breastfeed, but it’s the big-breasted women who have the problem. It’s like trying to suck on a basketball … aaah …. aaahh….no way your little baby can get his mouth round them, especially when you’ve got flat nipples and your breasts are engorged with milk. A nice dangly udder is a much better arrangement, or even just nice pert breasts with big sticky out nipples. My friend Helen had the most extraordinary nipples. They were so prominent that they had worn a hole through her squash bra, one juicy nipple poking out on each side. How I laughed! Helen, of course, had no trouble breastfeeding her children, just as she had no trouble thrashing me at squash. I take it all back Helen, my pyramid for your nipples!
Failing at anything doesn’t do much for your esteem, and then there’s the loss of self-esteem that goes with lying in a hospital bed. I’d never seen a hospital ward from the patient’s bed before and suddenly I understood what Phil had been complaining about all those years of his illness. What a palaver. Can’t count how many people came in to mop the floor, change the water in my jug, check I was taking my pills (iron tablets that I was carefully not taking till my tail end healed up as iron can make you constipated, and with the state of my nether regions, constipation was something I could do without), give out the baby bounty bag, take the newborn baby photos, various midwives and students, the consultant ward round (at 1.30pm, ie: slap in the middle of quiet hour, the only chance to get a nap).
And of course the breastfeeding counselor who said ‘breast is best’ six different times in six different ways, then gave me a handful of leaflets with babies at the breast smiling gratefully up at their mothers. Talk about managing expectations! My baby was screaming and wouldn’t start smiling for six weeks (if indeed he ever did, right then it didn’t seem very likely): these angelic babies in the photo were at least four months old.
“Look, it’s not that I don’t know about all the benefits of breastfeeding, but I can’t get him to latch on.”
“Keep trying. Breast is best,” chirped the breastfeeding counsellor and then she left. If I’d have had my wits about me, I’d have pinned her down at the door and forced her to give me some practical help on how to do it, not rub my nose in my obvious inadequacy. Instead, I just burst into tears. And that’s me as a doctor, who has some experience, and loads of theoretical knowledge of what it ought to be like. God help the rest of the new mums. It’s no wonder breast-feeding is at such pathetically low levels.
I foolishly stayed in hospital for four days, much longer than I might otherwise have done. This was my attempt to be ’sensible’ for a change and stay where help was on hand until I could get Art to suck. Trouble was ‘help’ all had a slightly different opinion. Thou shalt never use a nipple shield. Have you tried a nipple shield?
After four days of screaming baby (poor little critter was hungry), screaming mum, tattered nipples, Daisy the electric pump etc. etc., it was obvious Art was never going to latch on. I was finally persuaded to put on the silicone sombrero, peppered with holes, lining up boob, nipple shield and baby, then open wide and plug in. And Art plugged in. He was glued on, and sucked and sucked and sucked. After about half an hour, he just fell off, his face purple with the effort, the circular imprint of the nipple shield round his mouth and excess milk dribbling from the side of his mouth. Total satiation. Total satisfaction. Thank God!
The next feed, I produced my nipple shield from the little pot of sterilisation fluid, plumped up my pillows and applied my fake plastic nipple when the next midwife appeared.
“Oh you really mustn’t use a nipple shield, it reduces the milk flow.”
“But I can’t get him latched on.”
You’ve got to keep trying, breast is best. Pip pip.
Aaaagh!
Think Cow
Things never really improved when I got home. A friend told me the best advice she had was to sit back and ‘think cow’. Clearly, I needed to relax. Five nights without sleep was sending me a bit psychotic (as already shown by scientific and Nazi experimentation). Di said (very gently) that I really shouldn’t use a nipple shield as it reduced the milk flow and detracted from the full natural, audio visual, olfactory, tactile, pseudo-sexual, bonding, hormonal, ecstatic, religious interactive experience that is breastfeeding. She suggested using the breast pump to make a proper teat shape before even trying, but Art was having none of it.
I spotted a Nazi torture chamber device on the bottom shelf at Tescos, which you clipped on to the nipple and left on all day. It said on the packet that if you wore it every day for months then you’d get nipples that would put Helen to shame, without resorting to plastic surgery. It actually said that on the leaflet, not the bit about Helen’s nipples of course, the bit about plastic surgery. Really? Women would actually do that? Anyway, Art still couldn’t get a grip. The nipple shield at least got him fed. Vikki, another midwife, gave me a book called, yes you’ve guessed, Breast is Best.*
Breast is Best could be summed up in three words: thou shalt breastfeed. There was one line in it that particularly got me. It went something like this: If you’re at your wits end and ask someone what to do, and they advise you to give up, then ask someone else. Of course there was no way that Breast is Best advised using a nipple shield and if indeed you had succumbed on the advice of some philistine that didn’t know any better, then you needed to get your baby off ASAP. They suggested gradually snipping away at the tip until there was nothing left, like my baby teeth when they finally came out, worn down by teeth grinding, leaving only the rim left, like a sucked down polo.
A GP friend of my mum’s hypnotised me to stop grinding my teeth when I was ten. Worked perfectly after only two sessions, which just goes to show the power of the old mind over matter thing. Hmm, perhaps Art and I should have tried hypnosis, to relax us into the perfect breastfeeding pair? Think cow.
Strictly Breastfeeding
Breastfeeding is just like ballroom dancing, you see. You just need practice, and preferably with a partner who knows what he is doing. And some are born naturals and some are not. Obviously I just have two left boobs. Of course in other countries they accept that a firstborn baby and first born mother is as bad as throwing two virgins together on their wedding night and are very practical about it. Give the new mum someone else’s experienced baby and give the baby an experienced mum, then once both sides have got the idea, swap back. (And I think they have a similar solution to the virgin problem too.) A new reality TV show, Strictly Breastfeeding?
Naturally our sensitive Western sensibilities would consider this disgusting. We in the West seem to think sobbing uncontrollably, alone at four o’clock in the morning, trying to read Breast is Best through your tears, with a baby plugged into his plastic sombrero for hours on end is a preferable, more tasteful option. So no sleep, no self-esteem and there wasn’t a lot of bonding going on either.
Bring Me Sunshine
Breastfeeding badly all night is one of the most depressing, lonely experiences I have had. Friends told me that it wouldn’t last forever and it would get better in time, but how long? Years later? Months later? Weeks later? Days later? Even hours later was too long for me at two in the morning. What had happened to the optimist? Perhaps you can only be an optimist whilst you’re climbing Maslow’s pyramid, then become a pessimist on the way down? Sometimes I put on the radio, or a talking book, as even the telly had shut down, apart from Open University, although I did watch the full, unabridged Oscars and the full General Election results.
Somehow breastfeeding badly at 8:00am after no significant sleep didn’t seem so bad. It must be something to do with the prospect of daylight through the window, stimulating your pineal gland and boosting your melatonin levels. Melatonin helps jet lag, insomnia, increases lifespan and improves your sexual drive – if you believe the internet adverts.
You can get light boxes for people with SAD(Seasonal Affective Disorder), which seems to help their symptoms of depression, and for shift workers, to counter their body’s totally unreasonable desire to be asleep in the dark of night. Those residents of Nordic countries use them regularly to get them through the winter. Maybe this is the answer for the world newborn mums? Sit in front of a light box pretending you are basking in the
Danny finally confiscated Breast is a Beast, whoops, sorry, Breast is Best. It now lies at the bottom of some
All this tending to other’s needs makes you neglect your own needs. My undercarriage was rather shambolic and needed attention. In my capacity as doctor, the Senior Registrar sewed up my second degree perineal tear, rather than the duty midwife. The SR made a beautiful job, or so she told me, with neat, unseen, sub-cuticular sutures that wouldn’t need removing.
It all fell apart at day six. Di said she couldn’t remove those fancy stitches as they were sort of buried. By the next day, they weren’t buried at all. I could feel them, forming a little ladder of stitches all down my perineum. With a bit of imagination, I could just about use them to strum out House of the Rising Sun.
In
Well my tail-end healed eventually, as everything pretty well does, no matter what you do. The body is truly a remarkable thing. In fact there are a number of studies (that if I get keen I may even quote and reference for you at the end, but then again both you dear reader, and I, may get too tired to bother) that have shown you can get just as good a result by not sewing up the smaller tears at all. Just leave them open in the first place, to heal from the bottom up. Gets a neater, less infected end result in the long run, with much less pain and subsequent problems, but we in the West don’t like it as it’s untidy (just as we don’t like swapping babies for breastfeeding practice). Gosh, we do make life difficult for ourselves sometimes.
Looking back, I wonder why I did find it so hard. Danny, with his IT Consultant hat on, says it’s all to do with expectation management. You’ve got to lower your expectations, right down to the bottom rung. Expecting, wanting, my higher needs to be fulfilled (ie: to carry on having a life like before), or even expecting my all my basic rung needs (like sleep) would be fulfilled. Art needed milk, and that was it really. That should have been my only expectation. Forget self-actualisation, forget truth and justice, forget beauty, forget knowledge and exploration, forget self-esteem, forget sleep. Think cow.
Breastfeeding References:
* Breast is Best by Dr. Penny Stanway. Actually full of useful info, if rather religious! I believe it has been updated and reissued in 2005.
See also www.breastfeeding.co.uk. Again lots of useful info and support if you can get past the religious fervour.
What To Expect When You’re Breastfeeding by Clare Byam-Cook. Advocates not beating yourself up and having a life too. She’s also done a practical video Breastfeeding Without Tears.
So That’s What They’re For by Janet Tramaro. Lots of useful and fascinating info, and tries to hide her religious fervour by amusing anecdote.
The Accidental Optimist's Guide to Life, copyright Emily Joy 2005
Links to publisher eye-books web site: