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  by Judy Merrill-Smith

"Breast is best." Such a simple fact. If you are planning to be an attachment parent, you want to breastfeed. It's at the very foundation of the philosophy.

But sometimes, things aren't that simple. Perhaps you have a medical condition that won't allow you to breastfeed. Maybe you are an abuse survivor who has unresolved issues that are hindering you. Or, as in my case, you and your baby have breastfeeding problems that never get fixed. You may find yourself holding a bottle for your baby, wondering how you got here, worrying that you and your baby will never truly bond because you aren't breastfeeding.

Bottlefeeding with love is possible. It's not the ideal situation, but you and your baby can have a loving feeding arrangement.

JUDY AND ROSS'S STORY

While I was pregnant, I spent hours thinking about how life would be with my baby. I envisioned breastfeeding him on demand, everywhere: at home, at friends' homes, in the mall. I knew it might be a struggle at first, but nothing prepared me for the problems we had.

Ross has nipple confusion. Actually, I think this term is a misnomer: he's not confused, since he knows which nipple is easier to drink from! When the nurse at the hospital said he had low blood sugar and that they'd like to feed him some formula, I didn't question using a bottle to feed it to him. My milk wasn't in, he was having difficulty latching on ... so my husband and I consented.

Little did I realize that Ross would quickly learn how easy the bottle is. He would latch on and breastfeed for a few moments, then start crying and refuse to continue. He wanted the bottle. Now I know that I should have insisted on feeding him the formula from a dropper or a cup, but at the time, nobody mentioned that option, and I honestly thought a few bottles "wouldn't hurt."

I worked extensively with a lactation nurse at the hospital, even staying an extra day and having her as my nurse for a shift just to work on breastfeeding. We tried several different strategies to get him to breastfeed exclusively. We even tried using a supplemental nursing system (SNS), which is basically a bottle that you hang from a cord around your neck. Two small tubes come out of the bottle; these are taped to each nipple. The idea is that the baby gets nutrition from formula or expressed breast milk while learning to breastfeed. Despite our best efforts, Ross simply learned how to suck on the tubes while avoiding actual breastfeeding. Finally, after a month of frustration and many tears from both of us, I knew that something had to give.

I knew people who had essentially forced their child to breastfeed by offering only the breast -- absolutely no bottles. This led to a lot of distress for both mother and child, but it eventually "worked." I could not see myself doing that with Ross. I already knew that he is very stubborn (a trait he gets honestly from both parents). I could easily imagine him simply refusing the breast indefinitely.

Or, we could compromise. I had been using a breast pump to establish my supply and keep it up during our travails. It wasn't very convenient to use, but I could pump enough milk to feed Ross without using formula. After a lot of thought, I decided that I would continue to offer Ross the breast, and then feed him bottles of breast milk.

I felt it was very important to feed him breast milk for as long as I could. My goal was to pump for at least his first six months if I could. But I promised myself that I would take it one day at a time. I gave myself permission to quit pumping if it got too onerous or if it started to get in the way of our overall relationship. The lactation nurse I had been working with had very wisely reminded me that bonding was the most important thing. If feeding problems were getting in the way of bonding, then we were headed for trouble.

NOT THE EASIEST WAY TO GO

Pumping the majority of my milk was a big challenge. To maintain my supply, I took fenugreek, and I would pump every three hours, plus usually once during the night. That meant that I was hooked up to the pump a lot of the time.

The irony was not lost on me when I would be feeding Ross as he sat in his bouncy chair -- one hand holding the bottle, the other arm holding the breast pump cones to both of my breasts. I would say to him, "This would be so much easier if you would just breastfeed!"

But he never did improve. He quit breastfeeding all together when he was three months old. He stopped around the time my in-laws were visiting, and I was letting them feed him a lot of his bottles. I was so tired and so grateful for the help, but in hindsight I realize that I probably should have kept breastfeeding him, too.

I was usually about 24 hours "ahead" of Ross -- he'd consume a bottle that was pumped the same time the day before. It was easy to tell when he was having growth spurts, because the number of bottles in the refrigerator would start to dwindle. If I started to get ahead of him, I would freeze the extra milk. This could be thawed for growth spurts or for outings. I had to throw out a few bags because I lost track of them and they got too old. This was a stab in the heart!

TIME TO STOP

During Ross's fifth month, he started to become upset almost every time I would sit down to pump. Our usual routine had become that I would sit him in his bouncy chair (his favorite spot) and I would play with him while I pumped. But suddenly, he complained vehemently when I took out the pump. I tried letting him roll around on the floor, but that didn't work, either.

I realized that Ross was getting old enough to figure out that if I was pumping, then I couldn't pick him up at the same time. The pump was starting to get in the way of our relationship! So, I decided that after his six-month birthday, I would start to wean myself from the pump.

I was very sad about this. I had been so proud of myself for pumping for this long, and that he hadn't had a bottle of formula since he was a week old. Buying that first can of formula hurt a lot. I wanted to put a paper bag over my head as I stood in the checkout line, because I felt so ashamed and that I had failed. All of the sadness that I had felt while we were struggling with his feeding problems returned with a vengeance.

I was fortunate in that I could talk to people who understood my sadness. By this time I was involved in an attachment parenting group, and the moms there empathized with my sense of loss and supported my decision to end the pumping. My husband also was very supportive through all of these trials; I couldn't have done it without him.

As I write this, Ross is 7 months old and I am down to one pumping session per day. I have decreased very gradually to avoid problems such as engorgement or a plugged duct. I will pump for the last time this week, since we are driving halfway across the country to visit relatives for the holidays. Now I am feeling better about the end: I am still sad, but I realize that Ross and I are attached better because I am not letting physical sustenance get in the way of our emotional and spiritual bonds to each other.

BOTTLE-FEEDINGS WITH LOVE

I have found very little written about bottle-feeding with an emphasis on attachment. The Sears devote a small chapter to bottle-feeding in "The Baby Book," and they do give some suggestions (which I build upon here), but frankly the tone of the chapter has always made me feel uncomfortable. Some of us can't breastfeed, and I feel we don't get much support from the attachment parenting community. Mainstream moms aren't very helpful because they usually don't understand why you have this sense of loss over not breastfeeding, and of course, the myths about breastfeeding and that formula "is just as good" just compound my sense of being in a "no-woman's land."

So what can you do to make bottlefeeding the best experience it can be under the circumstances?

1. If you are able to express breast milk for your baby, think about trying it. Breast milk is better than formula, of course. Don't make long-term commitments; this is a difficult task you are undertaking. You will spend a lot of time tied to the pump, and you will have to take it with you if you go anywhere for more than a few hours. I didn't go many places for quite a while! But I was very committed to giving my son breast milk, so I had the drive to do it.

2. No matter what is in the bottle, give it to your child with love. Hold your child while feeding her and don't prop the bottle. I have seen mothers in stores with their babies in the portable car seat, a bottle propped up to their lips while they ride around in the shopping cart. How sad.

3. Pay attention to your child during the feeding -- leave the television off if you can't resist watching it. To make the experience more like breastfeeding, consider taking off your shirt or rolling up your sleeves for skin-to-skin contact, and hold the bottle as if it is coming from your breast. Of course, this is most important for a newborn. You will find that older babies will be much squirmier and playful and interested in everything else in the room, just as breastfed babies are.

Having described some "rules," let me be the first to say that I've broken them all at some point. Ross is something of a high-need child. He seemed to be hypersensitive to all manners of touch at first. Picking him up and holding him would actually make him more upset at times. Then, at two months old, we figured out that he had acid reflux. The only place he seemed comfortable was the bouncy chair, where he was relatively upright and untouched. So Ross has had many a feeding not being held. It took months before he was comfortable being held much of the time.

I've also propped the bottle for brief periods. He would start to get sleepy in the chair, and I couldn't pull the nipple out of his mouth without awakening him. But I would have to go to the bathroom desperately, and I'd be alone with no one to take the bottle for me. I'd carefully prop up the bottle with a receiving blanket, dash into the bathroom, and then dash back to hold the bottle until I could safely take it out of his mouth.

Being Ross's mom has been an honor, a joy, and a terror -- sometimes all three at the same time. I firmly believe that I am practicing attachment parenting even though he is not breastfeeding. It is possible to bond well with your child even under the most trying circumstances. Do what's best for your family, and never give up on your child. There were days when I thought I was raising a future ax murderer; all of my attempts to show love were rebuffed with howls. But today he is a happy little boy sitting on my lap as I type this. I couldn't ask for anything more.

FOR MORE INFORMATION:

The Pumping List: the website is http://www.enscript.com/pump. This is a high-volume email list that discusses pumping and related topics. I didn't have time to subscribe -- too much time spent pumping! -- but I know moms who recommend it highly.