It's lunch time. Mary gets restless with spoon-feeding and pushes my hand away. "No, I want spoon."
She is a year and a half old. I stuff my anxiety about the mess and let her practice scooping her own yogurt. While she needs to practice gaining control of her little muscles, I need to practice letting go of controlling every little thing. This exchange of power, exchange of energy, has been ongoing since her birth.
When my daughter was five months old, she weaned herself. We were both relieved to end the battle to extract more than a few drops of milk from my body. I gave up hours of pumping and nursing that yielded only a few ounces a day; she gave up unsatisfying feedings and freed herself to experiment with new skills and foods.
I'm glad we experienced breastfeeding in the best way we were able, and I know every drop helped to grow her into the sweet little pixie she is today. Still, I struggle to understand where my body went wrong, why it failed to operate in the easy, natural way I had imagined when I was pregnant. In fact, my body has a long history of not functioning "normally," thanks to polycystic ovary syndrome (PCOS).
In fact, thanks to PCOS, it took me seven years (and at least a dozen doctors) to finally conceive. Thanks to PCOS, my pregnancy was complicated by obesity and diabetes. But did it also – even tangentially – factor into my daughter being born five weeks early? And were each of these factors like little obstacles that combined to diminish my ability to produce breastmilk?
My daughter was born via C-section after 30 hours at the hospital, waiting for nature to respond to pharmaceutical coaxing. At 35 weeks gestation, we had found ourselves in the labor and delivery unit for the second time due to unexplained bleeding.
Wake up in the third trimester of pregnancy gushing blood, and the ground gives way. Your husband's office is too far away, the hospital is too far away, and the hot, dark breath of fear is too close. When it happens a second time, you know the pregnancy phase is ending and the mothering phase is beginning.
Throughout pregnancy, I suffered idealism about how much control I'd have over my daughter’s birth. In my inexperienced imagination, natural childbirth was best, medicated vaginal delivery was an acceptable alternative, and C-Section was a path of last resort, only to be weighed with pressing medical complications. For months I'd dreaded the possibility of a C-Section, but when it was go-time, I felt so relieved. I was exhausted, uncomfortable, terrified, and relieved to have the process out of my hands.
As the doctor opened me up, I felt the most disconcerting tugging and pressure in my belly. I may never know what vaginal delivery feels like, but I do know the sensation of being turned inside out. The doctors announced my daughter’s delivery at 12:46p.m. When I heard her first bleating cry, I told my husband it couldn’t be real. With everyone’s attention focused on the tiny baby, I turned my head and vomited all over the operating room floor. It was only the beginning of my body not responding to motherhood in the beautiful, hazy sunrise-lit way I'd imagined.
When my husband and I brought Mary home from the hospital, we felt invincible. That feeling lasted about 24 hours before I was sobbing in hysterics, certain we were all going to die. Mary would die of starvation, I would die from failure, and Nick would die of a broken heart.
We were just getting the first clues that I was not lactating normally. Mary was not getting enough milk, and she was too sleepy to nurse, but too hungry to rest. At her 5-day check-up, she'd lost too much weight and was re-admitted to the hospital for jaundice. I sobbed on the hospital shuttle bus while other (probably confused) passengers cooed over my tiny one. I wondered how they could smile when I was devastated, and my baby was sick.
Where in the timeline of my daughter's birth had lactation slipped away from us? Was it before her conception, in my inherently irregular chemistry? Was it when we left the operating room, abruptly separated for more than an hour? Was it in the days that followed when anxiety and stress overwhelmed me? My frenzied mind insisted I would be able to breastfeed, if I just did everything perfectly.
I pumped, squeezed, and nursed for hours. I took all the herbs, drank the tea, and followed the diet. When I'd done it all for months, and still couldn't come close to sustaining my child on breastmilk alone, I wanted biology to take the blame.
There is no one study that connects PCOS with lactation failure. Instead, I found comfort in a cluster of dotted lines. This study says obesity is to blame, that study blames androgens. One says PCOS is associated with increased rate of C-section, while another correlates late pre-term C-section with lactation difficulty.
The more I dug into medical journals, the more certain I felt there must be a connection between PCOS and my inability to breastfeed. Still, as researchers wrote in a 2008 study, "PCOS is not currently recognized by lactation professionals as a risk factor for breastfeeding problems, little research has been done on the topic, and evidence is largely anecdotal."
It's very hard to get help for a problem that is not officially recognized as a problem.
A friend with elementary school-aged children tells me you reach a point where the manner of your child’s birth and how she was fed as an infant makes absolutely no difference in a practical or social way. Moms eventually stop discussing, evaluating, and judging their relative experiences in the delivery room (or operating room or birthing tub). When your third grader excels at soccer, no one wonders if it's because she was exclusively breastfed.
Now that my toddler is robust and thriving, I can let our rocky start recede. But with the prospect of a second pregnancy on the horizon, there are some things I plan to do differently. I feel like I've learned something and can translate our old struggles into new achievements, making room for the fresh struggles we'll face next time around.