"I'm worried about her weight," Dr. O. said as he set Sophia down in the plastic bassinet next to my bed. One day old, she was five pounds even, down seven ounces from her birth weight. What I heard was: You're messing up, you slacker.
"Work on frequency rather than duration," he told me. I nodded, feeling confusedly that the baby was his, that I was only her wayward caretaker. Dr. O. had a mustache that was half-brown and half-white, split exactly down the middle. On TV, this detail alone might have cast him as goofy, lovably incompetent. In real life, he carried so much authority that in his presence I felt a vague sense of guilt for some ill-defined wrongdoing.
I was messing up -- of this I felt sure. Sophia was a much-wanted, much-tried-for baby, but I thought now that I'd made a terrible mistake. I wasn't tough enough to be a mother.
My nipples, especially, weren't tough enough. They stung with blisters as dark as currants and I was not taking it well. How could I get through the pain of labor only to suffer this new pain? Not breast-feeding was unthinkable. I loved the idea of my baby relying on my body for her nourishment; all that nourished me would nourish her. I loved the idea of denying myself for her sake. I wanted to nurse but now I dreaded it, the dread and the wanting abrading each other.
I attempted to carry out Dr. O's prescription, feeling more doomed with each infelicitous and painful nursing. Sophia screamed more than she suckled, her mouth stretched open like a gash. Perhaps this was how eating disorders began, I thought, establishing mealtime as a realm of suffering all around, teaching baby how her appetite hurts.
The lactation consultant stopped by our hospital room a few hours later. Helen had white hair, lovely posture, and like Dr. O., one peculiar feature: a black eye. Unlike me, she had her shirt on. Unlike mine, her bruise was not one we'd scrutinize.
We talked about the state of my nipples, and about latching and positioning problems, and, most horribly, about supplementation with formula, which according to my understanding was practically tantamount to supplementing with cigarettes.
"We have to make sure she's gaining weight," Helen explained. "She's not what we call a healthy full-term newborn."
I must have looked stricken.
"She's small for her gestational age," she quickly revised.
Helen taught my husband and me how to feed Sophia formula through a syringe, which I favored over a bottle; baby books and seasoned mothers alike had warned me against introducing an artificial nipple until the baby was expert at breastfeeding.
I agreed numbly to try pumping, to encourage my milk supply. After twelve minutes the machine had coaxed out one clear drop of colostrum from my left breast.
"Tell me, Hilary," Helen said gently, as she showed me how to disassemble the breast pump pieces to be washed, "did your breasts grow much during your pregnancy?"
I felt strangely excited, sensing obliquely that she was about to elucidate the mysteries of my body. My breasts in fact had grown only a tiny bit; I hadn't needed a supportive maternity bra by the end of my first trimester, as pregnancy books said I would. I hadn't needed any kind of bra, ever.
"Hmm." Helen nodded once I told her. "You might have to supplement. It's very possible you won't have a full supply."
I looked over at Sophia, her tiny fairy beauty; she was lying on her side in the bassinet, watching me with incongruously wise-looking brown eyes. A medical obstacle to milk production amounted to permission not to breastfeed, freedom from the pain and struggle of nursing.
Yet how could I want such a thing? If only I could endure these early difficulties and keep nursing and pumping, perhaps I'd save myself months of regret.
My milk hadn't come in by our last morning in the hospital, Sophia's fourth day, but I carried a fragile optimism. Before we packed her up for the journey home, Sophia suckled for fifteen minutes on each side -- her longest nursing yet. My breasts were spongy, the left one especially, and a tiny bit bigger.
The morning of her sixth day, she again suckled for fifteen minutes on the left side; Chris and I counted thirty-seven little ticking noises that signified her swallows. I pumped a full ounce, my largest yield yet. Soon after, Dr. O. called to check in, as he'd been dutifully doing since we returned from the hospital. With a tentative sense of triumph, I told him about the fifteen minutes, the thirty-seven swallows, the whole ounce I had pumped.
"An ounce," he repeated. "That's from both breasts?"
I felt his disappointment. He told me that if my milk was in I should have been able to pump more. That my milk should have come in by now if it was going to at all. He advised me to go out and buy a bottle. "It's not going to happen with this baby," he said.
Bottle-fed, formula-fed, Sophia became calm and agreeable.
And yet I pumped; for a week more I pumped, as though to squeeze out in entirety my guilt and regret and shame. It didn't work.
In the months that followed, I told my story to anyone who seemed liable to listen. I went over and over the details in my own head and with others, as though by revisiting the circumstances of those first weeks, I had the power to change them. Or as though to be told once and for all that it was not my fault, that I had done all I could, that I was not a bad mother, that Sophia would still thrive, that she and I would still be close, that breast-feeding wasn't so great anyway. No one could reassure me enough.
Literature about nursing was dangerous, none more so than a book I had read and greatly admired during my pregnancy, Sandra Steingraber's Having Faith: An Ecologist's Journey to Motherhood. I revisited passages again and again, perhaps hoping the book would change its mind about the wonders and pleasures of breast-feeding. But the words were still there, more eloquent and romantic than ever: "Ten to twelve times a day . . . we two become one again. As with a lover, the world contracts when we are together." And: "I suspect that few mothers, if given accurate, complete information and a real choice in the matter, would opt to feed their babies an inferior food source that retards development [and] carries with it the risk of death and disease." This freedom from harm, from suffering; this lush, ecstatic intimacy -- these were the province of breastfed babies and the mothers who nursed them. I was giving my baby death and disease in a bottle.
I envied mothers who breastfed without difficulty, but I was threatened more by the ones who overcame difficulties. I spoke with women whose babies spat up blood, who endured four months of toe-curling pain before their nipples toughened. I spoke with others whose newborns weren't gaining enough weight and needed to be supplemented -- mothers who nursed their babies with a formula-filled syringe pressed against their breast like a claw.
I felt tortured by the possibility that extra work like theirs might have paid off for me. What made me saddest was not the memory of how little milk I had, or how unpredictably Sophia latched on, or the blood that smeared my breast during one of our last nursings, but the memory of her opening her mouth to my nipple for the first time, knowing just what to do with it; the trickle of milk, even days after I'd stopped pumping, that ran like a tear from my nipple when I held her to my chest.
Dr. O. was a thorough and attentive pediatrician, but months after the fact, I still felt wounded and enraged by his hastiness and certainty in advising me to buy bottles. I imagined that in the hands of another pediatrician, a female pediatrician, I might have had more success. I imagined firing him or confronting him about having so pointedly discouraged me from trying further. I never quite found the nerve for that, but finally, during one of Sophia's well visits, I told Dr. O. that I wanted to talk again about what happened with breastfeeding. I half-expected him to be irritated with me for bringing this up again, to close the discussion with a brisk assertion of medical fact. Instead, he nodded, shut his office door and listened.
"It's been really hard for me," I began. "It still feels hard."
Dr. O. didn't approve entirely of the language of breast-feeding advocacy. "Just because formula doesn't offer all the benefits of breast milk doesn't make it dangerous," he said. "We're lucky to have a nutritious alternative. It can be life-saving." He reiterated his conviction that formula was necessary for us, that I would not have been able to breastfeed fully. He recalled enough details about that first week with Sophia to convince me he was really talking about me, not some generic mother. I hadn't realized how hungry I was for his absolution. I felt ready to believe him.
I walked away with an easeful certainty that I'd done all I could. I danced with my dark-eyed, gurgling baby and my love for her as I fed her a bottle was uncomplicated by guilt and regret; for a while, I let myself enjoy what I had, rather than grieve for what I didn't.
"Why not?" some people asked when I said I couldn't breast-feed. I hated the question, which felt rich with suspicion and accusation, yet it had been my question, too: Why not? Was it my fault or Dr. O's? Was my biology to blame or my laziness or something else entirely -- perhaps some buried memory of trauma I had experienced as a nursing baby myself?
The other question entered softly and for a long time stood in the back of the room. "Why?" Why did this matter so much? Why was it so important as to obscure, if not obliterate, any other pleasures motherhood might offer? Why, when I had a baby who looked at me with beautiful, textured, rapturous eyes; a baby who lay on her back and kicked her legs with such forceful delight that she shook the bed; a baby who at eight months looked straight at me and said, most incredibly, "Mama"?
And yet sometimes even now, a few weeks before Sophia's third birthday, I feel a pull of loss at what we didn't share. Sometimes an aching love overcomes me, the sort of love that begs for some extraordinary act of nourishment and protection and merging. The other day she brought over to me a playmate's soft doll and a doll's denim mini-skirt. "Mama to put on the sweet little jacket," she said. I am filled with such tenderness I want to pour it all back into her, to pour every drop of myself into her. I want to take her back into me, where she will always be warm and fed and loved, where no one will ever hurt her or laugh at her for calling a skirt a jacket. I knew, as she grew inside me, that our contract obliged me to release her to the world. But I wasn't prepared for how abruptly our bodies would separate, for how soon upon leaving my womb she would grow without me.