*This post is easily the hardest one I have ever written. I've been planning to write it for days, but as it came time to post it I nearly changed my mind. With a deep breath and hope for kind - or at least considerate - reactions, here is my story.
This is the next installment in Nate's birth story, but it's really my story because this is about what I had to decide when it seemed like breastfeeding wasn't working.
I wanted to breastfeed - so much so, that I never even learned anything about bottle feeding (beyond what I already knew from babysitting and friends who bottle feed). I simply didn't bother. I wanted to give breastfeeding my all and I knew that having formula as an "out" would make it more likely that I'd give up on nursing. We got a bunch of bottles and related supplies at the baby shower, but I never even unpacked them. I had them on hand just in case, but I didn't want to organize them because it felt like I'd be jinxing myself. I needed to be 100% committed to nursing, especially since I had breast reduction/lift surgery five years ago and knew this might affect my ability to nurse. As with many things in my life, I believed that sheer will could bring me through. I've always been remarkably lucky in health matters - a quick healer who rarely gets sick in the first place. I knew there was a possibility this wouldn't work out, but I wasn't going to allow myself to think about it. I was giving this my all; that's all there was to it.
As mentioned in Part 2, Nate immediately had a great latch. He latched on in the recovery room and nursed away like a little champ. It was an odd sensation, but it felt completely natural - more natural than being pregnant ever felt. Over the next two days, nursing continued to feel wonderful. No matter how tired I was, I was ready to nurse when he needed me. Every time I nursed him, I felt flooded with a natural joy. I loved sitting there, holding him, and watching him nurse while I stroked his little head and talked to him.
But soon, being tired took on a new - and sometimes scary - meaning. As I mentioned in Part 5, by Wednesday Nate was nursing for 60-90 minutes, snoozing for 20 minutes, and then waking up screamingly hungry and nursing for another 60 minutes.
At one point, I was so tired that I fell asleep holding him - something I consider dangerous. I know it happens, but it's something that scares me. Thankfully the hubby was awake and took Nate from my arms (I didn't even wake up). Later that night, Nate was screaming again (and I do mean screaming, not crying) and the hubby was trying to wake me up to nurse. He nudged me, nudged my face, spoke to me - and nothing. No response. I was THAT tired. This scared the hubby and, later, me when he told me about it.
By 11:30pm Wednesday night, the hubby and I were at our wits' ends. Nate was screaming all the time and crunching up like he was having stomach pain (reminding me of the same thing my nephew did when his acid reflux bothered him) and he didn't have the expected number of wet or dirty diapers, so we really felt like he may not have been getting what he needed... but the lactation consultant and nurses said he had to be fine because his blood sugar was good and his most recent wet diaper weighed enough to show he was getting enough milk.
But he was screaming. Even while nursing, he fussed and fidgeted and expressed discomfort. I wanted to give him formula but I couldn't say it. The hubby knew I wanted to - because I felt we had to - but that I couldn't say it. Finally, we called in the nurse and asked for an ounce of formula, just to see what happened. If Nate didn't calm down, then he wasn't screaming because he was hungry.
But here's how dedicated to breastfeeding the hospital is: the nurse wouldn't give us formula! I can see how some people would be irritated by this, but I actually appreciated it (and expressed as much to the hubby at the time). She had to send in the head baby nurse, who we had actually spoken to earlier in the evening. She brought us 1oz of formula, of which Nate drank about 1/4oz before finally seeming happy. He went on to sleep better and longer that night than he had in the past three days, which is to say he slept for two whole hours instead of 30 minutes.
After those two hours and throughout the next morning, we went back to on-demand nursing and Nate went back to screaming after nursing for 30 minutes at each breast. The lactation consultant visited one last time (we were due to go home in a few hours) and we told her the whole story. She brought me a breast pump and encouraged us to keep up with breastfeeding. I was producing some transitional milk and she explained it would be a few more days before my mature milk came in.
So we went home and I nursed all evening and into the night. I tried pumping, but only managed to get a little milk after fifteen minutes (barely enough to trickle into the canister of the pump). So, together, the hubby and I decided to give Nate a bottle. I scrambled to put one together - to sterilize the nipples I never opened, to quickly read how much water to mix with how much powder - all while crying because I hated it, the whole process. I had some formula on hand because we had received it free in the mail (interestingly, the hospital truly is so pro-breastfeeding that their free diaper bag included no formula - not even any coupons for it - which I think is great).
Nate drank less than an ounce and quickly calmed down. He had another bottle later in the night and I nursed him in the morning. He was hungry again after an hour, but I was okay with that because I knew it was normal for breastfeeding. Later I pumped, only getting about a teaspoon of milk after 30 minutes of pumping. Nate, meanwhile, was content after each bottle.
I know they get formula faster in a bottle than they do milk from a breast. I know it's obvious that he'd seem happier because it's "easier" for him. But I can't ignore that he seemed not just dissatisfied but actually hungry before. The pained, crunching over at the stomach stopped. The screaming stopped. Now he just cried, like a newborn.
My breasts, meanwhile, started to feel a bit heavier - lumpy in spots, although nowhere near "full." So I pumped first thing in the morning, knowing that's when they should be fullest, but there was a teaspoon. I tried to breastfeed one last time on Saturday but Nate wouldn't latch on. He fussed and cried. I won't ever know if this was because he was already used to the bottles or because I was producing so little milk, but I can guess it was both. This was six days after the c-section. I know breastfeeding takes longer after a c-section. I was happy to have a pro-bf hospital that allowed lengthy skin-to-skin contact and breastfeeding in the recovery room. But at that point on Saturday, I gave up, convinced I wasn't producing.
And I cried. And I still cry. I cry as I stand at the sink washing bottles. I cry sometimes as I mix formula. I cry as I feed Nate a bottle and wonder what now distinguishes me as his mother since anyone can feed him - and I couldn't. I cry thinking about the decision I made five years ago to have breast surgery, remembering how I thought it was no big deal if I was ever able to breastfeed. I clearly remember thinking, "Who cares?"
Little did I know that I'd care; I'd care a lot. I didn't know that not breastfeeding would break my heart.
Maybe I didn't do all I could. Maybe I assumed my breast surgery had more of an effect than it actually did. Maybe I could have given it a few more days. Now, I'll never know. I do know that a friend and I have noticed, anecdotally, that women with breast reductions have a hard time nursing with their first child but often have a significantly easier time with their second. It's as though the breastfeeding pathways rebuild themselves the first time around and function much better the next time. I hope it's the case.
The lactation consultant from the hospital called on Monday to see how everything was going. I told her what happened and what I was getting from the pump. She asked, "How are your breasts? Are they full?" I explained that they felt heavier and lumpy in spots, but not full. Her response? "Oh." She went on to make several recommendations, but the tone of that "Oh" said it all. I wasn't crazy. It wasn't working.
I'm not sure I'll ever feel like I did all I could, and I have to live with that. I have to live with hating every part of bottle feeding. I hate worrying about what's in the formula. I hate worrying about the water. I hate worrying whether or not I'm adequately washing all the bottle parts. I hate that I have to pay for something I should have been able to provide for free. I hate that I have to plan Nate's bottles when we go somewhere and that it's possible I won't have what he needs - while, if I was breastfeeding, that would never happen.
I didn't quit breastfeeding because I think bottle feeding is easier (far from it). I didn't quit breastfeeding because I think formula is just as good (I don't). No one encouraged me to quit - in fact, if anything, I was surprised at the amount of support I got for continuing to try. I did months and months of research when I was pregnant. I knew my stuff; I knew the pitfalls . . . and, yet, it all simply wasn't enough. I don't know how long it will be until I can think or talk about this without crying.
To the end of my life, I think breastfeeding Nate will be some of my most precious memories and I'm incredibly grateful to have them.

Introducing Nathaniel Martin
Nate's Birth Story - Part 1, Delivery Day - Prep
Nate's Birth Story - Part 2, Delivery Day - The Prize!
Nate's Birth Story - Part 3, The Hospital Stay - Visitorville
Nate's Birth Story - Part 4 - The Name
Nate's Birth Story - Part 5, The Hospital Stay - When it got hard
From Breast to Bottle - My Story
Nate's Birth Story - Part 6 - The Hospital Stay - When it got scary
Nate's Birth Story - Part 7 - Home - From anxiety to joy