Strictly speaking, breastfeeding is working out for us.

Natalie has a good solid latch, nurses frequently and without problems, and has been gaining weight. Early December’s mess of blood blisters and bruised areolae (when I say solid latch, I mean FEROCIOUS) soon faded as we all grew accustomed to the intensity of my daughter’s eating style. She’s still sleeping in our bed with us, in no small part because it makes night nursing such a no-brainer. Every two or three hours, she politely requests another helping, and I’m happy to oblige. This is all as it should be.

Scratch the surface, though, and breastfeeding becomes a snarl of questions, moving targets, uncertainty. I’m a female mammal; this should not be difficult for me. But there’s no way to tell how much I’m actually feeding Natalie when she nurses, and I have a mad suspicion that it’s not enough. It took her more than two weeks to regain her birth weight. At her one-month checkup, she was only seven ounces heavier than she’d been at birth, which put her in the 25th percentile for weight. And to this day I fret over any loose skin I see around her neck, wrists, thighs. That should be chub. For the number of hours a day she spends at the teat, my daughter should be a pudgy little butterball, sporting glorious doughboy extremities. At seven weeks of age, she is not.

She’s happy, though, and has a clean bill of health: bright eyes, apple cheeks, clear lungs, strong muscle control, and the full daily complement of wet and dirty diapers. This should be enough. Right? And yet I’m tormented by numbers. Twenty-fifth percentile. That feels far too tiny for any child of mine. When I tether myself to the breast pump, I have yet to produce more than a half ounce of milk per side, no matter how long I leave the thing running. Natalie’s weight gain is excruciatingly slow. And my own weight loss, one of my most anticipated side effects of breastfeeding, has yet to manifest.

I promised myself at the outset that I would avoid coupling my self-esteem to my parenting decisions. If breastfeeding didn’t work out for me, I told myself, then ah well, some people can’t breastfeed, and they’re still fully actualized humans. Besides, this wouldn’t be the first time that my hormones refused to play according to the standard rulebook (see also, my diploma from Remedial Fertility School). Natalie, for pretty much her entire existence, has shown a similar disinclination to follow directions. My first beta took nearly four days to double; I didn’t feel movement until midway through my twentieth week of pregnancy; Natalie was born five days late; and now infant growth charts seem to be the latest object of her nose-thumbing.

So I shouldn’t worry that she’s scrawny, or that my body thinks it can get away with lactating just enough to feed a kitten. Right? She’ll get big eventually, and in the meantime I can tackle the problem in my customary problem-solving fashion. Right? Right? Surely I can just Take Something.

The best Something to take for lactation assistance, according to Dr. Internet (with the sotto voce concurrence of a doctor in my own OB practice, who shall remain nameless), is apparently a pharmaceutical product called domperidone. Conveniently, it is unavailable in the United States. (“I ordered mine from Canada,” the good doctor confessed, keeping her voice to a murmur.) If you’re unwilling to traffic in extra-legal drugs, you can procure a domestic prescription for Reglan, which I’ve now done. I haven’t yet popped a single dose, though, not since Dr. Internet warned me of its scary side effects. (I’ve managed to avoid postpartum depression this far; no reason to induce it chemically!)

Over-the-counter it is, then. I started out with Mother’s Milk tea, then quickly ramped up: a daily glass of beer, expensive herbal capsules from the gullible-yuppie aisle at Whole Foods, and as many supernumerary sessions at the breast pump as Natalie’s sleep schedule would allow. I rediscovered some stale flaxseed and a decade-old jar of fenugreek at the back of my pantry, procured a big can of brewer’s yeast, and baked up a batch of lactation cookies. (I substituted dried cherries for the chocolate chips because I do not like chocolate chip cookies; YMMV.)

But wait, there’s more. Apparently the more you pump between feedings, the more you produce during feedings (and the more surplus milk you can stash in cold storage for future third-party feedings). The amount you pump, in any event, may or may not be an indicator of how much your baby gets when she nurses, since the infant’s latch is apparently more efficient than the machine’s. Or so the conventional wisdom goes. We’ll see if the professionals agree: My mother-in-law has given me an in-home consultation from the Breastfeeding Center for my birthday. And then there’s acupuncture, which worked so well in Natalie’s manufacture; who knows, it may also help her eat.

Some days I feel optimistic, looking down this long list of ways to make Natalie big and strong. Then a few days will pass with no apparent change in my output or her size, and I’ll have to bite back the fretfulness again. I can’t tell if anything is working. Maybe I’m just not giving her enough.

We have a can of formula in the pantry; it was a fabulous parting gift from the hospital, and I’ve neglected to throw it away, on the off chance that …
… um …
… on the off chance that I might actually practice what I preach, untether my self-esteem from my parenting decisions, and provide my daughter with the full caloric payload she needs.

But that’s a moving target too. Maybe there’s some truth to the trope that “if your baby’s gaining weight, you’re making enough milk,” percentiles be damned. (For what it’s worth, Natalie’s in the fiftieth percentile for height and head circumference.) And really, mama in a glass house, what is my own desire to lose the baby weight if not an aspiration to the twenty-fifth percentile?

Why should this be difficult? I’ve never had much of an opinion on baby formula, pro or con, before. But suddenly the thought of feeding Natalie a bottle hits me deep in the anxiety center. If I had to name this strange visceral lurch, I’d call it fear of being replaced: that Natalie will decide she prefers an easy-flowing bottle of rich, copious formula to the constant, grueling labor necessary to extract a scant few drops of mama-milk from the unwilling teat. All blather about parenting decisions aside, if she truly preferred the bottle to nursing, that would break my heart.

That’s the kind of thing you can’t control by planning in advance. Breastfeeding is such a great act of faith: you trust that the baby’s doing what she’s supposed to, that your body’s doing what it’s supposed to, that milk is being made and delivered and consumed and digested all exactly as it should. Any indications to the contrary aren’t just a logistical setback. They shake your faith. And then you’re presented with the choice of either relinquishing that faith and busting out the formula, or gritting your teeth, planting your dogmatic flag and abandoning the reason that was supposed to drive your decisionmaking in the first place.

And breastfeeding is working for us. I can only imagine how complicated things would be if it weren’t.

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