To wean or not to wean…

If you’ve managed to get me on the phone in the last three months, you know that the topic I’m thinking about, more than any other, is breast feeding. For a host of reasons, it’s been important to us to feed our girls breast milk (rather than formula) for the first 12 months, if we’re able. (Since most of our peers came to the same conclusion, I won’t expend bits here outlining the many benefits.)

Sam and Cate nursing tandem

However, wanting to breast feed and succeeding at doing so don’t always go together. Nursing, while natural, is learned behavior for both moms and babies. If you know someone who has successfully mastered the skill of breast feeding and nourished their babies for months or years, know that they have accomplished something meaningful.

My boobs hurt most of the time, not just when our girls are nursing, but in between feedings, too. I’m taking 1600-2000 mg of ibuprofen a day (which is a lot), and have been for three months. The lactation consultant was horrified when I told her that.

Apparently, breast feeding isn’t supposed to hurt. Or, while it’s often uncomfortable for the first few weeks as one’s nipples get used to the experience of repeated wet suction, it’s supposed to stop hurting soon thereafter. If it continues to hurt, something isn’t right. In our case, several things apparently are not right.

First, I spent weeks using breast pump flanges that were too small. They chafed and rubbed and felt increasingly awful. No one at the hospital told me I was supposed to switch to bigger ones as my milk came in, and I was too sleep-deprived to figure that out on my own. Six weeks went by before I got the right flanges. And chafing my boobs while pumping made nursing painful, too. Ouch.

Second, I often didn’t (don’t) succeed in getting our babies latched appropriately. Nursing effectively is a little bit about suction and a whole lot about compression. Specifically, an infant must draw not just a nipple (ouch!) but most of one’s areola into their mouth in order to compress the underlying milk sinuses with their tongue and squeeze milk out. But at 35-36 weeks, our preemie girls’ tiny mouths weren’t big enough to grasp my breasts effectively. A silicone shield helped initially, but even after they grew, we still struggled to get them latched deeply enough not to cause me pain. Further, we’ve been nursing tandem since December, which adds another challenge. Even when I get the first baby latched well, it’s easy for her to slip into a shallower, problematic latch, while my attention is turned to latching the second baby. Ouch.

At one point, all this pain convinced me that I had a yeast infection in my breast, and a trip to my OB’s office resulted in a two-week course of antifungal meds. But more research and another trip to the OB led to the conclusion that I never had an infection at all. Instead, I just have “mechanical” issues nursing my babies, which is the third issue.

In addition to sliding into shallow latches, our babies tend to clamp down with their jaws. The upside of our babies getting bottles every day of their lives is that they were able to eat and thrive when I was too weak to nurse them. The downside is that they have learned to do things to bottle nipples that just aren’t okay to my nipples. Specifically, they chomp down harder and longer than is necessary to get the milk flowing, and they mostly don’t let up. Most recently, Sam has learned that she can stop my letdown from hosing milk down her throat by clamping down further. They cut off blood flow to my nipples, and when it resumes after nursing, I get shooting pains (vasospasm) deep in my boobs, and they’re exacerbated by cold. Ouch.

Finally, because we’re tandem nursing (doing two at a time makes it MUCH easier for me to achieve the milk ejection reflex that lets the milk down), I need the girls to wake up and eat at the same time, even when one is still asleep. That means I sometimes have to wake a sleeping baby, and also that sometimes I have a full boob and a baby who’d rather sleep next to it than eat. Ouch.

And I almost forgot the obvious that afflicts every nursing mom: that I can’t sleep when the babies need fed. Since I’ve been nursing at every feeding, I rarely get to sleep through the night.

With chronic pain and frustration from nursing, one might ask why I keep nursing two babies when a lot of twin moms stop after a month or two. I have a bunch of reasons to stop: acute pain, chronic tenderness, risk of injury/infection, schedule constraints, diet constraints, wardrobe constraints, pump and scale rental expense, and anxiety about the whole thing. Bill summed it up: for breast feeding to make me cry so often is Not Okay.

I keep going partly because I looked to my friends’ breast feeding successes and set an arbitrary goal — nurse exclusively for a year — rather than recognizing that attempting to nurse twins is a wildcard. I go on partly because I’m stubborn.

Mostly I’ve kept nursing because of the validation I get from Sam and Cate. They communicate an excitement about nursing — faces lit up with wide eyes and big grins — that we haven’t seen yet over bottles of formula. It’s as if they’re saying, “Booooobs!!!” Their enthusiasm makes the rest of it seem worth it. And occasionally, nursing is comfortable and serene, just like it’s supposed to be. It’s an insidious random reward pattern.

My cousin Mary captured one of our Good Moments

In retrospect, the key phrase in the first paragraph was “if we’re able.” I’m beginning to recognize that continuing to nurse may be a misallocation of my finite capacity. I spend too much time and energy thinking about, preparing for, enduring, and recovering from nursing, and not enough time anticipating their other needs and what comes next. So I’m thinking about weaning our girls over the next month, so that I can become a good whole mom, instead of just a nursing mom.

It pains me to set aside all of the effort and energy I’ve put into nursing over the last three months (I’m a sucker for valuing sunk costs). I need ways to think of what I’ve done as a success: “I nursed twins for 3 (4?) months!” A possible self-serving rationalization could also be that nursing two for 3 months is like nursing one for 6, at least from a wear-and-tear perspective, right?

And to keep me motivated, I need to figure out what I’m moving toward instead of focusing on what I’m giving up. I’d like to think that in addition to eating a more varied diet, resuming caffeine and alcohol, and wearing shirts without buttons, there could be meaningful benefits for both me and the girls if we wean. What do you think? Can you help paint me a picture of improved quality of life?

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5 Responses to “To wean or not to wean…”

  1. amyleland says:

    As one of the lucky people who’s gotten you on the phone recently, you’ve heard all of my thoughts on this, as lacking in the basis of actual experience as they are. :) But I just wanted you to know I’m out here listening, and always happy to talk again if you need a sounding board.

  2. Uncle J says:

    Bobbin –

    Any decision like that has to take into account not only your girls’ best interest (which is almost certainly continued breast feeding, at least in part), with your interests as well. There must be a balance.

    HA was able to functionally breastfeed both of ours for 6 months exclusively, and over a year (perhaps 2) at night and occasionally. But it went easily, and never really created a disruption in her ability to be a whole person.

    Better sleep, lack of pain and more awareness of their other needs are a tremendous benefit both to you, and them. Pick a path and see if it works. If it doesn’t, pick another one. Sam and Cate will never lack for attention or love or food, so you can’t possibly fail.

  3. jbholzer says:

    Watching Shawn with Iz and now you, I realize that I only “dabbled” at breastfeeding. I had no lactation coaching, so no surprise, in hindsight, that my supply soon proved inadequate. But it was never painful the way you describe.

    I think part of your problem is that you are an over-achiever. And weaning is an irrevocable step that you can’t go back on. Both of which are things you already know, but that’s as far as my thought process has gotten.

    Question: does Ibuprofen pass into the breast milk? That can’t be good for the girls if it does!

    Hugs and best wishes – Mom

  4. jbholzer says:

    P.S. I much prefer the side shot of the girls nursing to the full frontal view. Mom

  5. shalton262 says:

    1. I agree with Mom about the side view picture.
    2. I’m concerned that the stress from “trying to do it right” may also be part of the GERD the girls are being affected by. The only one of my 4 breast fed kids to have “colic” (GERD in this decade) was my 2nd and I was trying to feed her when I was in the most stressful environment and it sucked the joy out of everything (pun intended).
    Please try to see this as the success it is and you may find that you can continue to b’feed for comfort (as in comforting baby) as long as you want. It will be more rewarding and enjoyable and a win/win for everyone involved. You are being hard on yourself and I can’t stand to see anyone put extra pressure on my precious cousin. “Step away from the exclusivity” and try to find the joy that’s missing.

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