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By Kate Krontiris, Principal Investigator for Make the Breast Pump Not Suck Hackathon and Paid Family Leave Policy Summit
When our daughter Nyaanina was born two years ago, she had a particularly intense form of jaundice that required her to be under special blue lights immediately. After three hours under the lights, we’d get her for barely 30 minutes, and then we would begrudgingly hand her back to the nurses to return under the lights. During those precious minutes holding this new, warm soul, I would do my best to get her to feed from the breast — a choice I was determined to stick with, over formula. Our doctors had told us that the only way for her to improve was to make her excrete as much as possible. Although many women don’t start using a breast pump until weeks after birth, I was hooked up to one on day two, so that we could ramp up my supply as rapidly as possible (or so I thought). I remember the lactation consultant at the hospital giving me a quick tutorial on the machine and handing me a bunch of syringes to collect the colostrum my breasts would produce.
Our process was this: I would attempt to feed her at the breast, then hand her over to her dad, who would try to keep her awake to drink another serving of pumped milk, while I then attached my body to the uncomfortable and noisy breast pump in order to produce her next dose of boob juice. I didn’t really understand how the machine worked, but I knew I was supposed to ramp up the suction to a certain level and then just let it stay on for a while. When we left the hospital after five days, we had to go through this process every 1.5 hours, around the clock, for a week — and then every 2–3 hours, around the clock, for a few weeks after that.
Thankfully, my milk came in pretty quickly, but the crushing pumping routine led to an oversupply that overwhelmed my daughter’s ability to drink all the milk available. Trying to swallow from a veritable fire hose, she compensated with a latch that left my nipple cracked. I would cringe every time she attempted to feed on my injured side. I had heard people tell me “breastfeeding is not supposed to hurt” but that seemed both incorrect and also impractical. Breastfeeding is not supposed to hurt too badly is probably a more accurate statement — but for a first-time parent who has just gone through the pain of labor, how was I supposed to know when was too much pain?
I have a picture of myself from this time. In it, my daughter is trying to nurse on my functioning side while I’m using a pump to collect the milk on the injured side. My eyes are hollow, almost empty, my face is pale. I’m exhausted and emotional, trying to keep up with the round-the-clock pumping cycle. I remember feeling like I wasn’t actually getting to know my new daughter, so focused was I on keeping her body alive and healthy. My own body had lost a lot of blood during the birth and was struggling to keep up with the energy requirements of feeding another human while at the same time healing itself. I remember bursting into tears without warning and for reasons I couldn’t explain.
After a few weeks, I realized I wasn’t going to be able to tough it out and got the help of a lactation consultant. She was kind, warm, engaged — and actually had some strategies that I couldn’t find for myself online. We visited a pediatric dentist to see if Nyaanina had a lip or tongue tie restricting her latch (maybe, said the dentist, but if we wanted to pay $500 they could just clip it for us anyway. We declined.) We took her to a chiropractor to try what I remember to be basically a baby massage and a lot of chatter about how she’d probably take a big poop after the session (also not clear what help that was). The lactation consultant got us onto a “block feeding” routine which if memory serves involved exclusive pumping on the injured side while Nina drank from the healthy side. This support eventually sorted us out and after a few more weeks, Nina and I settled into a breastfeeding relationship that lasted for a year.
When I finally emerged from this fog of new parenthood, I wanted to find out why the experience had been so horrible. An ethnographer, my immediate method was to talk to other parents. As I have begun to speak with them, I have learned that not only was my experience common — I actually had it good! I had an electric breast pump, I had a specialist covered by my insurance, I could afford to take unpaid leave, I had a supportive partner and family, and I had the belief that I was the kind of person who breastfed. Over the past few months, as I’ve been speaking with parents across the country as part of our Make the Breast Pump Not Suck project, I have come to see that many, many people don’t have these privileges.
And an interesting thing has begun to happen. Instead of feeling negativity, powerlessness, and confusion about my own experiences, I’ve begun to sit in a welcome sense of gratefulness. Somehow, in the process of tapping into this silent but broadly shared experience of birth and breastfeeding, I’ve begun to see how things could have been and how the systems that structured my experience actually work. This knowledge has made me feel deeply thankful for the supports I did have in place — and it has given me a sense of greater agency over how to navigate my body’s needs within the context of the larger healthcare system.
At the same time, however, I’m beginning to notice a quiet but very palpable sense of rage brewing inside myself. It sparks when I hear repeatedly, from people in different parts of the country, that the insurance-provided pumps new parents are receiving for free seem to be falling apart after a few months, and are noisier and less effective than the very same model sold in the store to people with means. It sparks when I learn about black and brown parents, after long hours of labor, finding themselves in post-partum conversations with (mostly white) lactation consultants who either assume they aren’t going to breastfeed and don’t ask many questions to find out how it’s going — or micro-aggress to kingdom come with pushy and condescending advice, focusing overly on shoving mom’s nipple into baby’s mouth, instead of building a relationship that allows mom to feel pride in learning how to do this for herself. It sparks when I hear — again, from many, many parents — how breastfeeding stopped when mom returned to work after 6 weeks of leave, none of which was actually paid, but rather taken at 60% of her salary as “short-term disability.” And it sparks when I hear parents wonder, again and again and again, whether there was something more they could have done to coax their bodies into the “breast is best” ideal that is glorified in online forms, in their pediatricians’ offices, and in that uniquely American “have it all” approach to womaning.
There is a quiet thunder of pain, shame, anger, dismay, and powerlessness that so many new parents feel about their reproductive experiences. Somehow, people who live very different lives in this country of ours all share an understanding that this isn’t really a topic one should speak about, even among family and friends. Only after the birth experience do we quietly discover that our friends and family members have also gone through painful, disempowering, and confusing experiences. But our culture makes it clear that those truths are not meant to be shared, further reinforcing the idea that we should be financially penalized for having children, that medical professionals are the true experts of our bodies, that this is just a situation where we should grin and bear it.
Recently, in her much lauded Golden Globes speech, Oprah said “what I know for sure is that speaking your truth is the most powerful tool we all have.” I have come to see that this is as true for the #MeToo movement as it is for effecting much-needed change in pregnancy, birth, and breastfeeding outcomes in the United States. So the story above is my first attempt at doing this, so that I can contribute to the broad awakening I think we need to have. I welcome both the sense of gratefulness and the feeling of rage that have blossomed from the seed of my own daughter’s birth. The first has offered a modicum of personal healing for my own experiences, and the second gives me fuel to make things better for others.
Up next for future posts: I’ll be discussing some of the systemic, institutional, and intersectional issues that affect parents’ abilities to feed their babies breastmilk, including: insurance and pumps, paid family leave, and biases in health care delivery, among others.
This post is cross-posted from Kate Krontiris’ blog and was originally posted on January 18th, 2018.