Breastfeeding is always a controversial subject. Please know that the following post is not meant to judge breastfeeding mamas or formula feeding mamas. The expectations that I had of myself are not ones that I have of other mothers. This is simply about my struggle to decide what's best for our family.
This afternoon, I stood at our kitchen counter & cried.
Due to wake up from his nap at any moment, I needed to make a bottle for Liam. I had put the can of Similac on the counter, then walked away. I had come back and taken off the lid, but walked away again. One last trip into the kitchen had me filling a bottle with water, digging out the scoop & bursting into tears.
Liam had his weight check appointment on Friday. In the past two weeks, he had gone from 11 lbs 4 oz up to 11 lbs 11 oz. Even with my plan to increase Liam's feedings, he's really not gaining any faster than he was before. An average baby gains somewhere around 8 oz/week. Liam's gaining around 3.5 oz/week and our doctor thinks that there's room for improvement.
The problem is not really with the fact that Liam's a tiny guy-- He's alert, hitting all of his milestones ahead of schedule and is perfectly healthy-- It's that he's not following his own growth curve (which of course, is measured on a standardized growth curve). The issue is more that he was in the 41st percentile for weight at birth and now he's beneath the 3rd percentile. (His height has gone from the 96th percentile to the 58th percentile.) Even if a baby is small, most pediatricians like to see them hover around the same percentile, although that will fluctuate a bit with growth spurts. If Liam had been born at a weight around or below the 5th percentile, no one would raise an eyebrow at his small size.
We talked for a long time at the appointment on Friday about what's best for Liam... and that really is what this has to be about. Not what's an emotional issue for me, not expectations I put on myself, not what other people might think. LIAM. It's about him.
I was very clear regarding my feelings about exclusively breastfeeding. I asked the our doctor to level with me, and if we're at a point where he truly believes that there is no other option than to supplement, to tell me. He said that he didn't believe we were there yet.
Then he asked me to make another appointment to bring Liam back for another weight check in two weeks.
After I left, I felt like I was starting the whole emotional roller coaster all over again. Do I supplement? Do I try more Fenugreek? Add another pump session to my day? Nurse for an hour and a half instead of merely an hour? I considered going back to the lactation consultant today for another weighing session before and after we nursed. I tearfully looked at those formula cans sitting in the corner of Liam's room.
And then, I thought, "What am I doing?!"
I've spent the last 4 1/2 months doing everything I can to provide breastmilk for Liam and I've done well. I've nursed him, pumped for him, visited lactation consultants for him, taken herbal supplements for him. I would do ANYTHING for him to get him what he needs to be healthy.
...and what he needs at this point to be healthy is formula.
Liam has a fantastic metabolism and needs more food than an average baby. Unfortunately, he does not seem to be an incredibly efficient nurser-- and this, I believe, is really our problem. We nurse for 35-40 minutes and he gets 5 oz. When we nurse for an hour, I doubt he gets much more. After he eats, I'm often able to pump an additional 5-6 oz. He can suck down a 10 oz bottle in less than 10 minutes. The boy can put away some food, he just can't seem to get it himself...and if he can't get it himself, it's my job to provide it for him. He wants to take 8-10 oz bottles 5-6x/day & our doctor wants me to give this to him.
I simply can't keep up. I can't pump 40-60 oz a day. And, I can't keep killing myself trying.
So tonight, I did it. After a conversation with Erin about how supplementing is going with her twin girls, I made Liam a 4 oz bottle of formula. I added in 4 oz of breastmilk, telling myself that he's still getting some of "the best." But, my stomach churned and I taunted myself, "You will never again be able to say that he's an exclusively breastfed baby."
I took a deep breath, I wiped away the tears and I fed him. He didn't bat an eye-- just sucked down the whole thing.
The new plan is to see how pumping goes... I'm going to try to pump as much as I can (the goal is around 20-30 oz/day instead of nursing), then supplement the rest with formula. The plan is for his bottles to be half breastmilk, half formula. This is reassuring to me, that he's still getting breastmilk. Additionally, I think that I will probably nurse once a day-- I just won't use this as our primary feeding method because I know he's not getting as much milk as he needs. I'm pretty certain I can keep up with this and perhaps have some extra to build a freezer stash to ensure that Liam gets some breastmilk in every bottle. But if there's a circumstance where no breastmilk is available? Well, we're no longer formula virgins. He'll be ok & so will I.
I've felt like breastfeeding, no matter what challenges we've faced, has been what I have to do to be a good mother. I would sacrifice so much for him! Anything! But we've reached a point where doing what's best for my son no longer means being an exclusive breastfeeder.
It's not how I planned. It's not what I wanted.
It's what he needs. So, I'll do it.
And just maybe, that's the decision of a good mother.