Day 7, Story 7: The Hunger

A short memoir in 3 parts.

My wonderful daughter, Stella. (Taken during her first Christmas season.)

This story is dedicated to Erin, Sylvia, Rocio, and Hatice.

Introduction

At 31, I was the neurodivergent mother of a neurodivergent baby. But I didn’t know that. Not about my daughter and not about me.

She nursed just as the books say a baby should, for about a week. Then she battled. The breast, the bottle, me. 

My sanity frayed because I knew there was a problem that no one else could see.

I craved empathy like a drug addict in withdrawal. I searched day and night and found it nowhere. Not even for sale. Therapists, several lactation consultants, a postpartum doula for Seattle rockstars—we couldn’t have afforded her anyway—seemed to serve only judgment. So that’s all I ate.

We both starved. 

Sick with anxiety, I lost 30 pounds in the first two months of my daughter’s life. I tried drinking olive oil. Straight up. Part calorie loading, part penance. I gagged and spit it up. Just like my baby when I tried to feed her. 

It felt as though a lifetime of not-quite-rightness manifested in an inability to feed my own baby. In the early days, when not alone, I faced doubting doctors, and well-meaning but dismissive or outright annoyed others.

I became a mom not when I gave birth to my daughter, but when I pushed through to the other side of despair, for her.

*

Part 1: The Tube

Stella was born in August. Four months later, baby’s first Christmas was different than I expected. 

Stella’s cheeks were red and raw due to frequent attaching and removal of various medical tapes. I tried different types, hoping to secure her nasogastric feeding tube to her face while inflicting the least possible amount of dermatological and psychological damage.

Meals were not bonding moments. They were medicalized ordeals. Picture, if you will, a portable pump. Like an old school gaming system with a few buttons and a digital read out–but you only win if you can stop playing. 

Along with the pump there were large syringes for gravity feeds, plastic IV-style bags that connected to the pump and smelled like new shower curtains, and hypoallergenic formula that soured quickly. 

The nasogastric tube went down Stella’s throat and into her stomach. When I tube-fed her, I felt more like a surgeon than a mother. Before each tube feeding began, I used a stethoscope to listen as I sent a puff of air, from an empty syringe, down the tube. A telltale popping sound would indicate that the tube was in her stomach. Rather than a lung. 

Then it was time to hook up the tube and run the pump. I’d monitor Stella carefully for any gagging or gurgling. 

Mishaps were common. Sources of trauma. Stomach contents would come up and out of the tube. Blood would surround the tube in Stella’s little nostril. The pump would malfunction and feedings would need to be started all over again. 

The worst of the worst parts was that the tube would come out regularly. It’s astonishing to me, in hindsight, that the emergency room was the only available source of help. Not only were these constant hospital visits expensive, they were time-consuming, exhausting, and traumatizing for my daughter.

After all the waiting, tiny Stella would lay on a hard bed in the harsh light of an exam room. With masked strangers hovering over and holding her down, the tube would be replaced while she screamed. The kind of scream that alerts a mother’s brain to a threat to life and limb. 

The tube would then come out again the next day, maybe the day after. 

So I learned how to put the tube in myself. This process requires planning and calm. First, you lubricate the tube, then you force it down the throat, somehow hold it in place with one hand while making sure baby doesn’t grab or pull the tube and also taping the end of the tube to baby’s face with the other. Finally, you check the tube’s placement with the stethoscope and puff of air and popping sound.

During one replacement effort, my nerves and her screams caused the tube to go in her nose and out her mouth. A little jolt of horror. I tried to insert the tube while she slept. It half-worked once.

To get enough nutrition from a tube, a baby becomes a machine. Stella needed to be fed every three hours, and feeding could take up to an hour. I worried that my extreme tiredness would lead to mistakes. What if the tube wound up in her lung? 

I lived with the fact that this whole disaster unfolded because my milk caused my baby pain. Every time she nursed, she wound up in agony. She would cry and turn away. In hindsight I realize she was fighting for her life. We both were. 

Instead of feeding, she would gnaw her fingers, which smelled of stomach acid.

I worked around the clock to get enough calories into her. I used a spoon, a tiny cup, a small syringe, causing it to simply run down her throat. This wasn’t “feeding.”

Thanks to this continuous labor, she “ate” just enough to get by, before the tube. She didn’t lose much weight, and she did grow longer, but she didn’t gain any weight either. 

I just needed to try harder. ‘You have to hold her like this,’ said one lactation consultant. ‘You haven’t established a proper latch,’ said another. ‘You don’t seem comfortable. Let her come to you instead of leaning toward her,’ said yet another.

Later I would realize that one of them was at least partially right. Being neurodivergent, I was so used to following the lead of others, so used to being wrong, I couldn’t relax and let someone come to me. Not even my own baby. I felt I had to bend over backward, or forward in the case of nursing, to keep an interaction from falling apart.

At first, no one believed me. But then she started to look pale, even a bit gaunt, with a grayish cast. Her resistance to nursing or bottle-feeding turned into an all-out aversion. By then, the problem was so severe that a feeding tube was necessary. It wasn’t inevitable. 

With the benefit of hindsight, I sometimes wonder how it all would have played out if I was neurotypical and communicated neurotypically? What if I was more reasonable, less brutally honest? More clear, less direct?

“We just have to get her through this,” I would think constantly. After all, she was a healthy baby. She just hated to “eat.” That’s all.

Meanwhile, my daughter and I were alone for up to 12 hours a day, five days a week. Compared to my pre-pregnancy self, I was skin and bones. I couldn’t take care of myself. I really couldn’t.

We didn’t have access to a car most days. Freedom came from taking walks, between tube feeds, through the park and by the shops along the strip near our rented house. Stella and I would stop in just about every day at my favorite coffee joint and paper goods boutique, and the grocery store. 

Here and there, as usual in an area of Seattle so close to downtown, I’d see syringes on the ground during our long walks. They were wedged into the cracks of sidewalks or nestled in the mulch of garden beds. Part of the infrastructure. 

These syringes were functionally different from those I used to feed my baby, but syringes all the same. I noticed that my reaction to seeing discarded needles on the ground was no longer involuntary disgust or general frustration with a system that doesn’t care for people. Concern became visceral rather than abstract. I thought, “That’s someone’s child.” 

Stella and I venture out for one of our walks.

*

Part 2: The Choice

In the thick of the tube feeding haze, Christmas season in full swing, I watched television while Stella napped. A holiday-themed diaper commercial showed angelic infants dreaming in their bassinets with a carol-turned-lullaby as soundtrack. Their smooth, round cheeks were unmarred. Their peacefulness complete. Against my will, bitter tears burned my eyes. I found my entire self twisted with envy, boiling with rage.

Until one week before Stella’s birth, I worked as a copywriter at an ad agency. I’d written prose about large cinnamon rolls and slightly larger ski resorts. I could imagine the creative brief, concept, pitch–the entire process that resulted in that carefully targeted manipulation. But the nerve hit was so deep, beyond the reach of rationality. In the part of me that knew I was defective.

Since then, there have been so many revelations and reversed courses in my path through motherhood, far from any well-worn route. But I now look back to this low, just me sitting alone in the artificial glow of an overwrought diaper commercial, as a catalyst.

During that moment, I knew I couldn’t stay there, in that dark place. Jealousy doesn’t sustain you. It drains you. Anger isn’t nourishing. It eats you. 

I sat in my fury and envy. Confronting the ugliness, I made a choice to not feed it with self pity. It was not going to be easy. I didn’t know how. I just knew something had to change. If not for my sake, then for Stella’s. It was a start, or a promise to start.

That decision soon led me to write. I’d started a blog, half-heartedly. Perhaps I could use it to keep my feelings, unlike the formula, from turning rancid. 

I shared updates with the family on how Stella was faring and how we were managing. Her latest milestone, most recent medical appointment, and how much she was taking in by tube–each milliliter accounted for in a spreadsheet I referenced in reports to Stella’s doctors. Increasingly, I also shared my experience in the struggle.

In the weeks that followed, the blog became a beacon. I began hearing from mothers, across my city and around the globe, who’d found our story. Their babies, too, refused to eat and were given feeding tubes with no plan for weaning from the tubes. No end in sight.

I got to know several of these women, sharing phone calls and emails, desperation and encouragement. We did the same anxious things and thought the same anxious thoughts. Our feelings, stories, and longings were not just similar, but practically identical, despite our differences in cultures and backgrounds.

There was Erin with her grace, sense of humor, and a baby boy who seemed a lot like Stella and was born within days of her. Hatice was passionate, honest, and generous, and even sent Stella presents from Singapore. With Sylvia, originally from Costa Rica, her soul was so torn apart that it made her courage all the more moving. Rocio showed such depth of devotion and commitment to her premature son, helping him overcome his feeding aversion after months in the NICU.

I still marvel at how we were all able to connect on a little virtual island in the middle of the internet ocean. Alone, together.

Thanks to them, I began to realize that I wasn’t a failure or problematic or a pain in the ass for complaining to doctors constantly. I was a mom, doing her best in a challenging, isolating situation. 

We had empathy for each other. And soon I started to develop empathy for myself. When perceiving an absence of empathy from others, I no longer experienced a free fall into anger, allowing me to be more present. I now had a foundation to stand on.

By the time Christmas came around, I had developed a bit more confidence. I found moments of peace even in the face of the same tube-centered reality. I started to tune into Stella and trust my instincts, rather than look to “experts.” That’s when things started to change.

*

Vintage “Happy New Year” card

Part 3: The Leap

After months of tube feeding, Stella hit a plateau. She never took more than about half of what she needed calorically for the day by mouth, the other half by tube. And aside from some anomalies, that’s where she stayed.

I knew that the tube had to come out. The pain that caused Stella’s feeding aversion was gone. Also eliminated was the pressure from me in trying so hard to get her to nurse, which worsened the aversion. She’d had time to learn that eating was not a threat, not a precursor to pain.

The tube had become more of a hindrance than a help. Making swallowing difficult and allowing a gateway for reflux. Overfeeding was easy, since there was no hunger gauge and only a prescribed amount of formula per day, so vomiting was common. Yet most of her doctors seemed to believe that one day, Stella would miraculously take all calories orally, and only then would the tube be removed. I disagreed. I found research to support my gut.

This situation has become more common. Tube feeding of babies, and resulting tube dependency, has exploded. This is partly due to an increase in premature births, with babies needing more time to gain the strength and oral motor skills that typically develop during a full-term pregnancy.

Also, it’s now easier for hospitals to send parents home with tube-fed babies. The digital pumps are small and portable. But technology advances so much faster than our understanding of its human impact. 

Many babies similar to Stella, following resolution of reflux, milk protein intolerance, or whatever caused eating refusal, remain on tubes. Sometimes for years and years. I knew we had to give her a chance. We had to remove the tube, and see if she would reconnect with hunger and eat enough to thrive all on her own. 

Just after New Year’s, we took the leap. I remember Stella’s smiling, tube-free face that day. How nervous I was, but also hopeful. There was only one thing for me to do–offer the bottle when she showed hunger cues. The rest was in Stella’s hands. No more battles. 

In those first days, she did take more from the bottle. But not what a baby needs to grow and stay healthy. 

After two weeks without the tube, she hadn’t gained weight and Stella’s pediatrician leaned toward putting the tube back in. Panic coursed through my veins and, heart pounding, I told him that she needed more time. He agreed to support one more week without the tube.

Right around the three-week mark, it happened. Seemingly all at once. 

Whereas previously Stella would scream, cry, and panic at the sight of a bottle, she started to lunge and grab at the bottle. She’d even cry when it was taken away empty. Stella drank more than double the amount of formula in one day than she ever had before.

Her occupational therapist declared, “Stella has internalized the joy of eating.”

Trauma leaves a mark, but so does the experience of pushing through. After Stella’s dramatic turnaround, on those days when she ate less, I’d still worry despite knowing all babies are in fact not machines but humans whose hunger varies from day to day. Yet I also fundamentally trusted myself to handle challenges and fulfill the needs of my child. That may have been the biggest miracle of all.

The change was thanks to a baby who knew what she needed, an overwrought Christmas diaper commercial, a largely unknown blog, and fellow mothers who gifted me with understanding. 

The tube was gone. Stella wasn’t hungry anymore, and neither was I.

Not the end (just the beginning)

(Note: Remaining holiday stories can be found here as they are released each day through 12/24, and ever after.)

Confident Mom Interview #1: Meet Suzanne, the Fearless Formula Feeder

When I was forced to give up breastfeeding for the health of my baby, I was heartbroken and plunged into an even deeper and darker postpartum depression. It seemed like a no-win situation: I was failing, and my baby was not getting “the best.” Based on all that I’d been told about breastfeeding, a switch to formula did not bode well for Stella’s mental or emotional health, not to mention her IQ. But then it occurred to me that I had absolutely no in-depth scientific knowledge or statistics about the actual benefits of breastfeeding or actual outcomes for formula-fed infants. All I had were soundbites. In an attempt to inform myself about precisely what formula-feeding meant for Stella, and to maybe try to feel just a little less despair, I started digging around online.

Suzanne, the Fearless Formula Feeder

That’s how I found Suzanne. Her increasingly popular blog, “Fearless Formula Feeder,” is catching the attention of formula-feeders and breastfeeders alike, sparking controversy in lactivist circles and heated debate in the blog’s comment section.  It’s no secret that after all Stella and I went through with her feeding aversion and NG tube, while I still wish I could’ve breastfed, I have found immense comfort in Suzanne’s blog. You can agree or disagree with her message, but you can’t deny that she’s a courageous woman.

I have a feeling you’ll be hearing Suzanne’s name again soon. She’s currently working on a book about formula feeding and the concept and impact of breastfeeding pressure. And with that, I present my first ten-question “Confident Mom Interview,” with the Fearless Formula Feeder.

Life and Times of Stella: Why did you start your blog?

Fearless Formula Feeder: I was 100% committed to breastfeeding. I went into the hospital with everything going for me – I was educated about nursing from classes and numerous books; I lived in a community where everyone breastfed; all of my friends had nursed without problems; my husband was just as dedicated to the cause as I was and completely supportive; I didn’t have a maternity leave end-date looming over my head (being a writer who worked from home)… basically, I was a poster child for the best candidate for a successful nursing journey. I had the will, the drive, the attitude, the desire, and the support necessary to breastfeed.

And yet, I still ended up formula feeding…

Read More

Let them eat sugar

I took newly 17-month-old Stella out for ice cream last week. Just me and her. There was no special occasion other than “mama needs ice cream NOW.”  We headed out on foot at around 7pm to sneak in our treat before her 7:30 bath (which, of course, didn’t happen until 7:45). On the “walk” home, she stopped between wind sprints to request “more more more.” I happily served her bites of my mouthwatering masterpiece: perfectly salted caramel and rich chocolate Molly Moon’s ice cream in a waffle cone made two minutes before we ate it. I didn’t even mind sharing, until I realized she’d finished the salted caramel, leaving only chocolate and destroying the dessert’s mindblowing salty-sweet synergy. Really, the outing itself was a treat that instantly turned into a sweet memory.

So imagine my reaction to an increasingly popular declaration being made on mommy blogs lately: “My toddler eats no sugar or white flour whatsoever.

First thought? Sheer defensiveness. Then, “WHAT DID YOUR POOR TODDLER DO TO DESERVE THIS???” Lemme tell ya, I gave up dairy for two and half months in a last-ditch effort to make breastfeeding work, and it eroded my soul. I’m 27% more evil now. Had I been forced to give up sugar and white flour too, which to me means insanely sexy chocolate and crusty loaves of French or Italian baked goodness, I would not be here today. With no caloric or emotional reserves to draw from, no boost from my extra special favorite foods, the breast pump would’ve eventually worn me down to a pathetic pulp. The way our dryer would wear down my jeans if I put them through an unrelenting tumble cycle every three hours for two and a half months straight.

Maybe it’s because I just finished reading “In Defense of Food” by Michael Pollan, which I highly recommend as an enlightening antidote to our need to control and monitor everything we eat. Maybe it’s because for a few hellacious months, my baby refused to eat and required a feeding tube. In the process of helping her learn to embrace and enjoy eating, I had to let go of my own lingering fear and anxiety around food. (Fear is likely behind parental sugar bans, by the way.) Whatever the reason may be, I find sugar-free righteousness to be ridiculous, unrealistic, unhelpful and practically inhuman. Mark my words: An all-out sugar ban will backfire.

Read More

Goodbye, breastfeeding guilt.

I destroyed the structural integrity of my boobs–what little there was–with an expensive, rented hospital grade breast pump in order to collect 500 ounces of milk that Stella would never drink. It sucked in every way.

Worse was the guilt and anxiety. None of it made any sense, but thankfully, it’s over. I was not able to breastfeed Stella past 11 and a half weeks and I am officially 100% okay with that. I feel a new sense of freedom and confidence. I really, really do. This can only be very good for me and Stella.

In an attempt to completely resolve any lingering bad feelings, I’ve been reading a blog called The Fearless Formula Feeder, where I found a link to this article in The Times. Against a backdrop of breastfeeding mania, this article is explosive. This exploration of the data (or lack thereof) behind breastfeeding’s benefits seems more comprehensive and credible and less emotive and debatable than Hanna Rosin’s notorious Atlantic article,  “The Case Against Breastfeeding”, which I also greatly appreciated. The bottom line is that it’s just not that big a deal. Breastfeeding is wonderful for some women and their babies, but its benefits have been greatly and widely overstated. Guilt and judgment toward formula-feeding moms has been unfair, out of control, and as it turns out, baseless.

I overthink things. So naturally, instead of letting go, I’d been doing a bit of research that helped chip away at my disappointment and breastmilk’s holy image. When you look closely at the actual studies, the mirage disappears almost completely. Of course there are some benefits to breastfeeding but they appear to be relatively small.  Furthermore, while there’s no way to know for sure, most of the benefits shown are likely due to the fact that breastfeeding moms are a self-selected population and are simply “the kind of moms” who tend to be more educated in general and in regards to childcare, more responsible, interested and engaged as a whole, and more financially ABLE to give their kids “the best” in many areas. It’s difficult if not impossible for studies to account for this.

The media tends to jump on any studies that suggest potential breastfeeding benefits, while completely ignoring the many, many studies that show no difference between breastfed and formula fed babies. Science has not been able to back up the “breastmilk as miracle cure” message. The main advantage of breastfeeding, in my experience, is that you don’t have to deal with the hassle of preparing and cleaning bottles, and you avoid the cost of formula. On the other hand, if you are frustrated with a feeding or parenthood in general, plastic bottles are great for throwing across the room–a major plus that can’t be overlooked. Ahem.

Like Rosin and the author of the Times article, the Fearless Formula Feeder is by no means anti-breastfeeding. She simply wants to defend formula feeders, and cleverly calls herself a “factivist.” It’s interesting to now look back and think about the “facts” I received about breastfeeding from all kinds of people and sources. I remember hearing in childcare and childbirth classes, in broad terms, that “breast was best.” This message is also plastered on every can of formula (thanks for rubbing it in, by the way). I was told that breastfed babies are smarter and healthier, and have better bonds with their mothers. More specifically, I heard that breastfed babies have fewer incidences of diarrhea and ear infections.

At the end of the day, I know my child better than any study. Here’s what I’ve experienced: Stella’s brilliant, ahead of the curve in every area. We share an incredibly close bond. She’s 14 months old and has never had an ear infection. And, drum roll, please… her eight-week bout of diarrhea STOPPED with her first bottle of formula. Just sayin’.

At this point, my only regret is that I didn’t stop breastfeeding sooner, so as to more quickly relieve her pain, prevent her feeding aversion, and end our stress and suffering. I was not able to stop until all hell broke loose and Stella wound up with a feeding tube. Why? Because of all the “facts” I heard about breastfeeding. It simply wasn’t possible that we could fail at breastfeeding, because breastfeeding is perfect and miraculous. I contacted a La Leche League leader and the very rude Jack Newman and several other breastfeeding experts over the phone or via email, and these well-known experts’ conclusion was that I must be doing something wrong. One supposedly all-knowing Ph.D. / IBCLC, after hearing the horrors of our situation, suggested, “Hold her more securely–don’t let her feet dangle. Babies need to feel secure.” If I could have punched her through the phone, I would have. Other high-profile experts said the problem was latch and that at Stella’s advanced age (10 weeks), it was too late to fix. This was stated with disapproval and disappointment, because clearly I hadn’t enforced proper latch. I cut out dairy and soy and tried even the dumbest suggestions. This led to a lot of crying and failure and desperation. To all that, I can now officially say, “BULLSHIT.”

I must  note that thankfully, at that difficult point in our lives, not all voices of authority shared an insane breastfeed-at-all-costs mentality. A renowned lactation consultant and a wonderful pediatrician helped me make the decision to stop breastfeeding. They said I may want to consider formula-feeding and that it would be okay. That breastfeeding’s toll was clearly too high, and that it simply wasn’t the be-all-end-all of child health. I didn’t believe them at first. But eventually, I was able to do what was best for us. I will always be grateful to them for being so sane, for being a voice of reason and compassion not just for Stella but for me, too. Thank you, thank you, thank you.

Goodnight, milk.

Stella wasn't sad to see the milk go. In fact, she was delighted.

Stella wasn't sad to see the milk go. In fact, she was delighted.

A couple of weeks ago, I threw out 341 ounces of frozen breastmilk. That was just the bottom shelf. I still need to clear out the top one.

It has been six months since the last of it was pumped, rendering my precious milk expired. At the beginning, every half ounce was sacred. Toward the end of my pumping days, I didn’t bother saving the milk. It sat out for hours, until I forced myself to pump again at which point I would dump the previous yield down the drain. I was so bitter. So exhausted. I’d had it with pumping. Stella had been diagnosed with cow’s milk protein intolerance and fed hypoallergenic formula through a tube for a good month, and still I pumped. The odds of returning to breastfeeding seemed grim at best. Still, it was hard to stop. I didn’t want to give up. I wanted her to have “the best.”

I’d been meaning to throw the milk out for some time now, but couldn’t let it go.

When I stopped breastfeeding, when Stella had her NG tube, I was an emotional wreck. But I was consumed with tube- and bottle-feeding my baby and completely focused on getting Stella over her feeding aversion. I never really allowed myself to think very deeply about the loss. So I never got to grieve my milk or my vision of breastfeeding and what it represented to me. I never really embraced the choice that I made–the only choice that seemed logical, the one that enabled Stella (and me) to thrive. I want to accept it completely and I’m not sure why it’s been so hard to do.

I’ve thought about this a lot lately, since dumping those 341 ounces. And perhaps the answer is simple. Formula-feeding is not what I wanted for Stella. I failed. Or that’s what it feels like. And a very small, insecure part of me wonders if there is simply something wrong with me. My milk made Stella sick. It didn’t protect or nourish her or do anything it was supposed to. I used to joke to myself, in the weeks just after Stella was born, that my breasts were being both destroyed and redeemed by breastfeeding. They were being stretched to the limit with the influx of milk, so I knew I could say goodbye to any perkiness. On the other hand, they’ve always been small and had really only been a source of ridicule from about fifth grade on, so I found it quite astounding that they had the amazing power to nourish my baby. To help her grow! For me, it was empowering. Unfortunately, that didn’t last.

I wrote about our attempt to give her a dairy-based formula. I never followed up on how it went. Let’s just say that the switch was not successful. Her intake started to drop slightly and she developed a couple of red splotches on her face.  We were very quick to switch back to hypoallergenic Elecare,  so we can’t be 100% sure if the milk protein was really bothering her or not. But my gut tells me something was off. It helps a little bit with the recurring thought that maybe, if I’d kept avoiding dairy and soy for just a little while longer, and kept trying to feed her, she’d have come around to enjoy nursing, and get the benefits of breastmilk without all the pain she’d been experiencing. Of course, that’s simplistic thinking, and dismissive of the severity of the issues we faced at that time. But the idea lingers.

So. yes. I’ve been reluctant to throw out my milk. I kept hoping that maybe someday, I could give her some.  My brain kept whispering, annoyingly, “You know, you could add a bit to each of her bottles and she’ll get the benefits!” But it’s clear now that, no, she will never have my milk again.

Every time I read about yet another benefit of breastmilk, I cringe. Each time I read some judgmental comment or article by some zealot who equates formula with poison, I seethe. (For that reason, I can no longer read Mothering magazine.)

Perhaps that’s why I painstakingly calculated the total number of ounces. I needed some proof, some evidence of how hard I tried. I will get the final number soon, when I gather the courage to toss the rest. Maybe then I can finally let go.