Adoptive nursing--my VERY, VERY long story

I promised a post on adoptive breastfeeding, and here it is! Pull up a chair, because you'll be here for a great long while wading through it all.

This is a difficult topic to write about, because my own feelings about nursing are still so complicated. One doesn't have to be around discussions of mothering very long to find out that breastfeeding is probably just about the most controversial and heated topics out there. I think the reason is because it strikes so much to the core of what mothering is all about, and thus, who we are as mothers.

This post will be a combination of advice and helpful guidance for adoptive mothers, the sharing of my personal story, and introspective reflection on breastfeeding in general. Some of what I write may not appear to be positive, but I hope that my overall tone will be encouraging. Some of what I write may prick the ears of mothers on both sides of the breastfeeding debate. But I think that I have a unique perspective as a mother who has experienced in a very personal way both sides of this issue! I have breastfed. I have not breastfed. I have even done both of these things at the same time. I have believed with every part of my soul that breastfeeding is the best way to feed a baby, and that nursing is one of the most important foundations of mothering. I have felt the bitter sting of failure, the shame of judgment and misunderstanding, and the slow and difficult realization that maybe, just maybe, there is more to the story than meets the eye. I have, with great resistance, been taught a few things, and I'm still learning, still figuring out, what connects a baby to his or her mother, what connects a mother to her baby, what really makes a woman a mother. I guarantee that NONE of us have all of those answers! I'm still reconciling how one thing can be absolutely true, and yet something else, even the very opposite, can be just as true!

Anyway, let's get on with the hopeful and the practical!

I first began to seriously think about adoptive breastfeeding, or inducing lactation, about a year before Dallin was born. I had heard about it prior to that, but had always assumed that it would be too much work, too hard, and therefore not something I would even be willing to touch. Yet, somehow, my mind kept returning to the idea. At one point, I decided that if I couldn't get this out of my mind, maybe it meant that it was something I needed to seriously consider. And so I began seriously researching the subject of induced lactation.

Many people are shocked to find out that you can breastfeed a baby without first being pregnant and giving birth. While pregnancy causes breast changes that do facilitate nursing, lactation is actually maintained by the continued suckling of a baby at his mother's breast. Hence, if you are pregnant and do not breastfeed, your milk will quickly dry up. If you are not pregnant, you can stimulate your breasts to produce milk either by pumping or by a baby's sucking. There are herbs and medications that can help a mother to produce milk for her baby. Now in the beginning, of course, most babies are not going to be willing to suck from a breast that is empty or almost empty. So in order to encourage the baby to nurse, while yet ensuring that the baby receives nourishment, mothers can use a nursing supplementer, a device consisting of a thin tube attached to a bag or bottle filled with either donated breastmilk or formula. The tube is then taped to the mother's nipple. Voila!, baby nurses at the breast, but is able to take in the supplement at the same time. Here are two websites where these nursing supplementers can be purchased: http://www.lact-aid.com/webmap.htm#webmap and http://www.medelabreastfeedingus.com/products/breastfeeding-devices/51/supplemental-nursing-system-sns

Adoptive mothers are able to produce varying amounts of milk for their babies. Some produce almost a full supply, while others produce very little. (I was in the "very little" category.) Even if you make little to no milk, it is possible to continue nursing your child using a supplementer.

Several websites have thorough information and ample support for mothers interested in inducing lactation:

www.fourfriends.com/abrw

http://www.llli.org/NB/NBadoptive.html

http://www.kellymom.com/bf/adopt/index.html

http://asklenore.info/breastfeeding/induced_lactation/faq.html

There are others, but these are the most comprehensive sources. Unfortunately, there really aren't any good books on the topic. The one book I did read was not particularly helpful. The internet is definitely the best source of help, especially as induced lactation continues to gain acceptance!

One doctor, Dr. Jack Newman, has developed several protocols for inducing lactation involving birth control pills (to simulate pregnancy), medication to increase milk supply, and pumping. Some women prefer to not take medications, and to use herbs such as fenugreek and blessed thistle, or to simply nurse at the breast using the supplementer. I fell into this second group. I was not particularly interested in making milk, though that would have been a welcome blessing. I simply wanted to have the experience of nursing, and to have the special bond that I'd heard nursing mothers had with their babies. Having now nursed two babies, my feelings have changed a bit on this. I still am more interested in the bond than in the milk. However, I've learned that in reality, nursing with a supplementer is very demanding, and I think that producing more milk would have helped me have a less stressful experience. It would be nice to be able to put my baby to the breast on occasion without having to warm up a bag of milk, pull out a tube, and fiddle with getting it attached to my body!

Now, on to the specifics of my experiences!

We had three weeks' notice that Dallin would be arriving. He ended up being overdue, so that left four weeks to prepare. I began pumping every three hours, using a hospital-grade double pump, within a few days of our being matched. (These heavy-duty pumps are the best choice fo moms inducing lactation, and can usually be rented from stores specializing in breastfeeding products.) I never saw a single drop of milk prior to his arrival. Once Dallin was placed with us, I simply began nursing him on demand, using the supplementer, which was filled with donated breastmilk for the first week, and then formula after that.

My most special memories of my early moments with both of my children surround those first nursing sessions! Dallin's placement ended at midnight, and it was 1:00 am before we got back to our hotel. I was so tired that I thought I would just give him a bottle that night and try to figure out nursing in the morning. But at 3:00 am, as I sat awake gazing at my brand new little boy, I decided that now was as good a time as any to begin our nursing relationship. I got all my equipment set up, nervously put him to my breast, and it was magic! There in the darkness and the stillness, it was just me and my baby, and wow, what an awesome feeling to actually be nursing him. I first nursed Sariah in the hospital, right after placement, when we had to stick around in the nursery until she could be discharged. The nurses gave us a private room with a rocking chair. James had to take Dallin downstairs to meet up with cousins, and again, it was just me and my new little girl. Once again, nursing was magical! I truly feel that breastfeeding has been an integral part of that early "getting to know you" phase with each of my little babies. There are so many emotions associated with adoption, with it being such a unique way to become a parent. For me, breastfeeding helped in those early days to hasten the bond I felt with my children and to feel like a mother rather than a babysitter.

Nursing proceeded smoothly with Dallin for about the first six weeks. At that point, things began to gradually unravel. I don't have time to go into great detail about all the problems we faced together, but what it boils down to is that I strongly believe he had an undiagnosed case of reflux. His behavior at the breast was unbelievably fussy. He couldn't find comfortable positions to nurse in, and was constantly turning his head and arching his back. Nursing sessions were very long (up to an hour at a time), and yet he took in very little milk and was hungry again shortly after. For some time, the only way he would settle down to eat was if I had the vacuum cleaner turned on. He had other colicky behavior as well. My doctor told me he wasn't getting enough to eat, and if he stopped gaining weight she would insist on bottlefeeding. Luckily, he never stopped gaining, and I was able to keep nursing.

I remember one evening when Dallin was about two months old. Breastfeeding was going horribly. I stood in the kitchen making up bags of formula for the supplementer. Dallin sat in his bouncy seat on the counter watching me. I stood there feeling so lost and overwhelmed and worried about the future, knowing that things could not continue this way forever. I started to cry thinking that we would not be able to continue nursing. At that moment, I looked up through my tears and my baby's eyes met my gaze. He looked right at me, as if to say, "Hey mom, I'm your boy, and you're my mom. I know this is important to you, but it's not what makes us mother and son. I know you're my mom, and nothing will ever change that." That was a precious experience, as I felt the Spirit confirm to me that my son knew me, and that everything would be alright in the end. And yet, when I looked at that sweet little face, I couldn't imagine NOT nursing him! I kept on.

When Dallin was 4.5 months old, I knew it was time to stop. I resisted this for several weeks, but eventually I couldn't ignore the fact that my baby was miserable during feedings. I was willing to endure just about any amount of inconvenience to breastfeed, but I couldn't let my child suffer. So reluctantly, we went to bottles most of the time. I cried as I fed him that first bottle. (It wasn't his first bottle, James had given him bottles in the past--but it was the first bottle I had fed him, and it felt like failure to me.) We devised a system where I fed him most of his meal from a bottle, but then introduced the breast at the end of the session, when he was relaxed and almost full. This worked well for awhile, but gradually he lost interest in nursing, and when he was 6.5 months old, nursing was over for good. I was disappointed, but I also had hope that with my next child, things would go more smoothly. I knew I would have another chance. And I felt vindicated when Dallin continued to have fussy feedings after he went to the bottle. I still cannot fathom how we missed the fact that he probably had reflux!

I was excited to have the chance to nurse a second baby. I spent a lot of time on the internet researching induced lactation again, trying to figure out how to maximize my chances of having a better experience. All in all, I was very hopeful that things would go more smoothly and that I would not have another baby with reflux. In the summer of 2005, we were matched with another prospective birth mother and had a four-month wait until the end of her pregnancy. I kept thinking that I should get on the stick with preparing to breastfeed, but for some reason, I just couldn't get into it. A month before she was due, she changed her mind, and I was very glad I hadn't been pumping or invested much physically or emotionally into nursing.

After the failed adoption, I was extremely wary about getting my hopes up for another match. And so, I basically put any thoughts of nursing far out of my mind. I figured that once we were matched again, I could start pumping. However, I didn't plan on finding out about our second baby only two days before she was born. And never in my wildest dreams did I suspect that those two days would fall right smack in the middle of my mother-in-laws funeral plans! Sariah was placed with us when she was two days old, and I think those four days (two before her birth and two after) would rank as the four craziest days of my entire life! There were not enough days to prepare for breastfeeding, and there were not any spare minutes in the four days I had. I barely had time to go down to the basement, find my box of nursing supplies, and get the supplementer tubes sterilized the morning of placement. But I had heard that advance preparation was not necessary. I knew I could just start nursing and it would all work out.

Sariah had issues of her own that made our journey a challenge. She bordered on being low birth weight, and she was a slow gainer. Her suck wasn't particularly strong, it took forever for her to eat, and she tended to fall asleep too soon. I switched to another type of supplementer with a wider tube, and this helped quite a bit. I remember how exhausting those first weeks were! I had made a goal to give it at least eight weeks, since that is what they tell "regular" nursing mothers. Toward the end of the eight weeks, things did start to get easier. I still made virtually no milk at all. With Dallin, I didn't even see drops of milk until he was four weeks old (so eight weeks of pumping and nursing). With Sariah, I was drops at four weeks--so we cut the time in half. But I could never hand-express more than drops, and I could never pump more than that either. I estimate, based on how much formula she took in through the supplementer, that I probably made around 2 oz a day at my peak. Not much at all.

Nursing went reasonably smoothly with Sariah, at least when compared to my experience with Dallin. I found caring for and using the supplementers time-consuming, but I got into a workable routine with it all. We had our times when things were rough and she was more fussy at the breast, but most of the time it was manageable, and she did well. Both of my children were slow and frequent eaters, taking forever to nurse and then being hungry again shortly after.

Getting up at night was a challenge! We have a family bed, yet I couldn't ever figure out how to nurse Sariah while lying down, so I still had to get up every night. Whoever said that formula makes babies sleep longer has never met my kids! So yeah, I was exhausted! When Sariah was six months old, we made the decision to give her bottles at night so that James could help out more (he had been giving her some occasionally prior to this) and so that we could all stay in bed. Well, that turned out to be not as helpful as we thought. With the ease of drinking from bottles (even with the slowest-flow nipples), and her newfound distractibility during the day, Sariah fell into what is called "reverse-cycling". She ate relatively little during the day, and woke more and more at night to get the bulk of her sustenance, leaving both James and I even more tired than before.

These were challenges, but they were not insurmountable. I was determined to keep going as long as possible, though the last five or six months, I did give in and allow her to have more bottles, simply to keep my sanity. By the time she weaned at almost 12 months, she was only nursing a couple of times a day.

So I did it! I nursed a baby, every feeding with a supplementer, for just shy of a year! This is a marvelous accomplishment, something that very few women have ever done. And yet, my emotions surrounding my experience didn't really reflect much pride or satisfaction.

My primary goal with breastfeeding was to enhance my bond with my baby. While we had plenty of lovely nursing sessions, I'm not sure that my experience lived up to that original goal. I think it could have if it had not been quite so stressful. I had heard story after story about those powerful nursing hormones, and how nursing was the most amazing thing ever, and how the bond between a nursing mother and her child simply could not be matched. I went into breastfeeding expecting to feel overwhelming happiness and love all the time, and it just wasn't like that. Where was the profoundness that I had been promised? As I said, we had many peaceful and happy moments. But I often wondered whether they were enough to justify the amount of work and the physical stress I was under trying to maintain our nursing relationship. If I had been able to provide Sariah with breastmilk, there would have been no question it was worth it. But for the bond alone? For a bond that I wasn't convinced was actually being enhanced anyway? I don't know.

Just to be clear, I did feel bonded to Sariah, very much so. I just wasn't convinced that nursing was having any kind of profound impact on that bond. I felt that all of our shared activities--wearing her in the sling, having her sleep with us, responding quickly to her cues, nursing AND bottlenursing--all of those things kept her connected to us. In Sariah's case, I honestly don't think she would have lost anything by not having been breastfed. When she did finally wean, she didn't even seem to really notice that something was missing. Now, to be fair, I do think that if she could have nursed into toddlerhood, things would have changed. There is something about both my kids as toddlers, and that is that they tend to get attached to things, mainly bottles and binkies. I do think there's a strong chance that bottles and binkies could have been replaced with nursing if we'd been able to make it that far.

When I look deep into myself, I have to admit that maybe some of my motivations for nursing weren't the healthiest. I think what it ultimately boiled down to is that I wanted to feel like a "real" mother. I wanted to have a physical response to motherhood just as biological mothers do. I wanted to do something really special for my kids, something that no one else could do. The hope of being able to breastfeed prolonged my completely dealing with some of my infertility grief. Alot of my grief simply transfered itself from longing for pregnancy and birth to longing to be able to nourish my children from my own body--and feeling frustrated and bitter when that couldn't happen.

I stuck to nursing out of sheer determination. I would not give up! Yet often, as I sat around other nursing mothers, I felt like a big fake. I felt like I was merely pretending to breastfeed. Other people ooh'd and ah'd and told me how wonderful this was, and how incredible it was that someone who had not been pregnant could make even a few drops of milk. But I didn't feel incredible. I felt like a failure. My mind told me that I had done this amazing and unique thing. But my heart said that I wasn't good enough. Every bottle I allowed her to have filled me with resentment and guilt, and yet I had to admit to myself that I desperately needed the "breaks" they provided.

When I decided to wean Sariah, it was in response to whisperings of the spirit that this was the best thing to do. I was burnt out beyond belief. I felt the Lord telling me that I needed to do this, and I needed to have faith that He would take care of my baby and our relationship if I moved forward. I have found this to be true! We could not possibly be more connected than we are right now!

Yet I have continued to feel grief over breastfeeding. I had to take a break from my associations with other natural family living groups and message boards because of the constant message that good mothers nurse, nursing=mothering, bottlefed babies are to be pitied, and the only salvation in not being able to nurse is if you break your back trying. It was a good 18 months before I got up the courage to return to the circle of like-minded friends and trust that I could be confident in who I was as a mother. And yet, during that time, I missed that companionship of people who shared so many similar beliefs and values in regards to parenting. These were my values too--even the ones about breastfeeding! If I'd had the physical ability, I would have been nursing my toddlers on demand just like all my friends.

I really questioned what makes a mother a mother. I think adoption makes you question this anyway. I know that Heavenly Father has intended that I have this experience. I have often wondered why so many of my friends have gotten to become "crunchier" and "crunchier", having been seemingly divinely led to this style of parenting and living, while I have had the opposite experience. The Lord has been giving me a different perspective, an eternal perspective. In the meantime, I have kicked and screamed and resisted mightily, and yet as I have done so, He has whispered, "Just trust Me. These things aren't as important as you think they are." And I have argued that of course they are important! Just look at all the scientific evidence that proves how important they are!" And He has whispered, "But I have other things for you to learn."

And so I am trying to trust. And trying to have faith that the life He has planned for me and my children is just as wonderful as the life I have wanted for us.

Breastfeeding loss is rarely acknowledged in our society. I have found very few people who understand what I have felt and how I have mourned over this. Many people in the breastfeeding community simply don't understand it, not having experienced it themselves. And because they don't understand it, they often make flippant and hurtful comments and statements about bottles and formula and the mothers who use them. On the other hand, most people in our society don't think breastfeeding is all that important, and so they don't acknowledge it's loss because to them, it's no big deal. "Just give her a bottle. It's no big deal. She'll be fine. Why on earth would you want to nurse anyway?" It truly can feel like no-woman's land for the woman who is caught between these two camps!

Where do I fit? What do I believe? Well, I believe that breastfeeding is best for mothers and babies, but we live in a mortal world, we're here to be tested, and sometimes the lessons of mortality are more important for our growth than what is necessarily "best". I believe it's important to strongly encourage expectant mothers to breastfeed their babies as long as possible. I believe there are many societal obstacles to breastfeeding, and we need to get rid of those! We need to get rid of formula samples in the hospital. We need to get rid of greedy formula-company advertising. We need to have easier access to breastfeeding support for moms. We need a society where breastfeeding mothers don't have to hide themselves in bathroom stalls or mother's lounges or underneath nursing covers but can come out and live their lives in the open, proudly nursing their babies. I believe nursing can be a powerful tool in helping mothers parent their babies. I wholeheartedly support all of those aims of the breastfeeding movement! And it's very hard for me to fathom why anybody would choose to bottlefeed a baby if they didn't have to. It's hard for me to see others squander what I perceive to be a precious gift.

Yet I have a very hard time with anyone who implies that the life I have given my children is somehow less good because they could not be exclusively breastfed. They are living exactly the life that Heavenly Father has wanted them to live. They have everything that He wants them to have in order to learn and thrive here on earth. I sometimes hear the slogan "Breastfeeding is a child's birthright". I'm not comfortable with statements like that. I think there are ALOT of things that are a child's birthright, and most of the children in this world are lacking at least some of them. The biggie that comes to mind is from our own Proclamation on the Family: "Children are entitled to birth within the bonds of matrimony". Now there's a birthright for you! How many children on this earth are getting that one? My point is that our understanding of the gospel plan of salvation teaches us that this life is primarily meant to be a time of testing. In order for us to be tested, we have to have trials, we have to be exposed to things that are less than ideal, or at least less than our ideal.

So, where does all of this leave you and me? I know much of this probably sounds pretty negative, and I want to make sure I end on a positive note. I share my story not to discourage anyone from inducing lactation. On the contrary, I heartily encourage any adoptive mother who even thinks she might like to try, to give it a go! Many women have much easier experiences than I have had! I just think it's important to go into it with your eyes wide open. Examine your reasons for wanting to nurse. Arm yourself with good information, and find yourself great support. This is something else that I was lacking in both my journeys. I had support, but most of it was long distance. I had no lactation consultant, no La Leche League, no in-person contact with people who were thrilled with what I was doing and had the know-how to help me on a continual basis.

And yet, I'm going to do it again. Yes, you heard that right! I've been mulling this decision over and over in my brain for almost two years, and this past week, I finally decided. I'm going to induce lactation again! I've spent hours and hours in a state of self-reflection, weighing out the pros and the cons, and the pros have it. I simply cannot imagine having another baby and never having the experience of nursing him or her. The special moments I shared with both Dallin and Sariah, while they may not have been every moment, were often enough that I don't want to miss out on that with another baby.

However, I have considered this very carefully, and I'm going to plan as much as I can for balance. For two months, I will give it my all. I will do everything in my power to create a good nursing relationship, and to make all the milk that I can (within reason--I'm still on the fence about taking medication). After that, I will assess where we are at. If things are going really well in the milk-making department, I will continue to give it my all. If they are not, I will drop the guilt and be happy with a combo breastfeeding and bottlefeeding relationship with my child. I am not going to run myself into the ground to try to do something that just isn't going to happen.

I'm actually very excited that I have finally found a solution that works for me! I am still banking on the idea that maybe the third baby's the charm. I have yet to have a baby who has a great, strong suck and who is totally addicted to nursing, so it's very possible that this will be the one. And I'm also banking on the hope that this baby won't arrive on two days' notice, and I'll actually have time to pump and prepare ahead of time, assess my body's response, and make educated decisions about medical intervention before I have a new babe to care for.

I have done enough soul-searching and wrestling before God that I think I am comfortable in my own skin and can separate this from my worth as a mother, but just nurture the experience and let it unfold however it will. But I know if I don't at least try, I'll always wonder "what if?"

And that, my friends, is the end of this very, very long post! (I can't think of a great way to tie it all together, so yes, I'm just going to abruptly cut this off.)