"Have You Thought About How You're Going to Feed the Baby?"

[Contents: medical, gender essentialism, fat hate]

That was one of the questions I got asked yesterday in my prenatal appointment with the midwife.

She's not new to the practice, but I hadn't seen her before, and we actually had a good discussion on the framing of that question. She talked about how she had used to say "So are you planning on breastfeeding?" and after some feedback and looking in to things, realized that could be incredibly stigmatizing towards people who could not or chose not to breastfeed. So, good for her. Especially since so much of the pro-breastfeeding rhetoric that's out there is stigmatizing, shaming, and guilt-tripping bullshit.

I tweeted about this the other day, but I ran across an article entitled "Is breastfeeding the key to mother-baby bonding?" And the answer is NOPE NEXT QUESTION, again, as I tweeted. But if that article is intended to get more people to breastfeed their babies, that's not going to do it. Because what that title is really saying is "fyi, if you don't breastfeed your baby, you're a BAD MOM and you WON'T BOND with your kid." Which is false false falsity false... but when you hear that message often enough, it starts sinking in.

I also mentioned, both to the midwife and to Twitter, that I planned on breastfeeding, in spite of a lot of the pro-breastfeeding stuff that was out there. And that's really the case for me. Honestly, The Man being pro-breastfeeding did way more to convince me to try it than anything I've ever read or heard on the subject. I was formula-fed, as were my siblings, and really, I don't have a problem with formula feeding. (I have problems with formula manufacturers, but not formula in and of itself.)

The thing of it is, I don't know that breastfeeding is going to work, for a couple of reasons.

One, supposedly breastfeeding requires you to consume an extra 500 calories a day, above and beyond what you ate during pregnancy. Okay, I haven't read any good studies on it, but on its face, that passes the sniff test, if you will. It makes sense that you're going to need some extra fuel in order to produce food for an entire other being. You're also supposed to drink plenty of water - again, makes sense. But here's my problem: I apparently can't eat enough to even gain weight during pregnancy. I lost three pounds this past month, as I transitioned in to my third trimester, where "typical" weight gain is a pound a week. Instead I lost almost a pound a week. Let's not even get in to my fucked up issues with food from my past - I really have been pretty damn good about fooding myself on the regular once I got over the constant fucking nausea. But even with that, it seems I cannot eat enough.

I also know that I don't often drink enough water. When I get really dehydrated, I start getting Braxton-Hicks contractions. That's considered typical (although apparently I started getting those much earlier than most people, WHOOPS sorry care providers; I've always been precocious), but jeezy muffin creezy I'm supposed to drink EVEN MORE WATER? Oh fuck.

I just don't know that I'll be able to keep up with eating and drinking enough to actually do this.

Secondly, that's all complicated by the fact that I am hypothyroid, and most likely have Hashimoto's disease. I haven't been officially diagnosed with Hashi's... but I meet every criteria, including the presence of TPO antibodies above and beyond what's considered "normal" in a woman my age. It's also the most common cause of hypothyroidism, so HAHA WELP. There isn't a ton of research in to hypothyroidism of any stripe and breastfeeding, but what's out there suggests that breastfeeding is more difficult with hypothyroidism. The TPO antibodies, so far as we know, are not secreted in breastmilk (which is good), but people with hypothyroidism are more likely to have significant supply issues.

Plus, we just started regulating my thyroid, and fixing all of the problems that come along with a borked thyroid (which, in case you forgot, include severe iron deficiency, severe vitamin D deficiency, a totally wack metabolism, B12 deficiency, and more) less than a year ago. I'm quite honestly a bit shocked a, that I even got pregnant, and b, that I've been able to stay pregnant while some of this shit is still regulating. (And yes, it still is - I can tell from symptoms, but even without that, it was probably fucked for twenty years. It ain't gonna fix itself in nine months.) Even by the time The Kid is born, it will STILL be less than a year that I'll have been in treatment. And while my iron and D counts are still slowly creeping up, they have slowed down their upward movement in pregnancy. In other words, things are improving, but not as quickly, because pregnancy is an additional stress and draw on those resources.

This is why when I got an email from yesterday's midwife about "oh yeah, your blood work was normal, your iron looks good for this point in pregnancy", I laughed. Lady, my hematocrit and hemoglobin slid down again and are both below normal, and my MCV is still below normal. I'm still fighting for iron and having trouble hanging on to it. "I recommend you continue taking your current vitamins and supplements" also made me laugh. THERE WAS NO CHANCE I WAS STOPPING ANY TIME SOON, THANKS. Especially since that's all being managed by my pcp - who is tracking my ferritin, that is, stored iron, not just the circulating iron. It's the ferritin that was dangerously low and that we're working on bringing up. As of December, it was at 51. After supplementing since July. It should be around 80. Yeah. Got a ways to go on that one.

Which also raises the question, how nutritious is any breastmilk I manage to make going to be? And, if it's like pregnancy, wherein the fetus and placenta basically override my needs for nutrients and steal shit like calcium right out of my damn TEETH if they need it... what cost will I have to pay? How healthy is that going to be for me?

Plus, people with  Hashi's are more likely to have significant thyroid problems in the post-partum period. In other words, it's very likely that shit's going to get wild with my thyroid. So with that, on top of "hey things aren't actually totally regulated yet WHEE", and then trying to breastfeed? Oh yeah shit could get real interesting, real quick.

Finally... if you look at the pictures in all of the breastfeeding literature? Fat people don't breastfeed. People with very large breasts like mine don't breastfeed. People like me don't use breastfeeding aids like Boppy or My Brest Friend (NOT KIDDING, THAT'S THE NAME) pillows, because they aren't big enough. If I want to use a pillow to help support The Kid, I either have to make one, or make due with other pillows, because there just aren't purpose-made pillows manufactured to fit someone like me. There aren't a lot of options for nursing bras even in my current size, much less if my breasts get even bigger (which they probably will), or clothing made to make nursing easier. All of those nursing covers? AHAHAHAHAHAHAHHAHAHAHAH nope too small.

I have no idea if any of the lactation consultants will even know how to work with someone shaped like me. You would think they would... and yet doctors and other care providers often don't, so I don't assume they will. Which could mean that for the most part, I'm going to be on my own, without a lot of professional support. Which is also not a guaranteed recipe for disaster - the lactation consultant is, after all, a recent invention - but it's not like breastfeeding was something my family has done recently either, you know? My mom is definitely pro whatever my plans are, but she doesn't have practical experience with them. Even most of the people I know who are pro-breastfeeding, give breastfeeding advice, etc. are not fat folk.

So yeah I'm planning on breastfeeding, and if you want to be all like "WELL YOU ARE GETTING DISCOURAGED BEFORE YOU START YOU ARE BAD", go fuck yourself. I'm also signing up for formula coupons just in case. And preparing for the onslaught of BREAST IS BEST and OH BUT YOU SHOULDN'T SUPPLEMENT and all of the other bullshit, including, I'm sure, guilt from some folks if I switch to formula. Fuck it. Kid's getting fed no matter what. But shit, can we drop most of how we talk about breastfeeding and how we "encourage" people to do it? Because it's really not encouraging at all.