It’s a point of embarrassment. I am a lactation counselor and also work for a milk bank, but my dirty little secret is I can’t hand-express. It’s a tool I know about, of course, but since I focus on helping mothers adjust to breastfeeding and working, rather than clinically initiating breastfeeding, I feel like it’s OK. Ironically, during my lactation counseling training, when I ended up staying overnight unexpectedly without a pump, it was a problem. I even sought help from a classmate, but still I remained blocked.
My deeper emotional charge around hand expressing says a lot about how my labor and delivery affected my own breastfeeding initiation. I was 43 and had experienced four pregnancy losses before I finally delivered my only child. That final, fifth pregnancy was great, albeit tentative. I wanted my birth experience to be similar, but despite my best efforts, it wasn’t. After three days of labor, I had an unplanned C-section and was in a lot of postpartum pain. My milk was delayed due both to the drugs used during my C-section and the edema I had from being overhydrated.
During my hospital stay, there was a race to try and get my newborn daughter latched. On the second day, a lactation counselor tried to teach me how to hand-express. I couldn’t figure it out and was still groggy, in shock and in a lot of pain. Ouch! She hand-expressed for me, getting out the tiniest drop of colostrum. Oh, it hurt. I did not want to do that again, and I didn’t for a long time.
After that, a longer breastfeeding nightmare ensued. It was a rough go, but we eventually prevailed, and after two weeks of formula feeding and pumping, my daughter effectively latched and is still nursing today. I have tried to hand-express a few times since then, but that painful incident stuck in my mind as the first step of a hellish trajectory that echoed the trauma preceding it. Each time I tried, I bruised myself, as if I was unconsciously repeating the pain and harshness with which I had learned to associate hand-expressing.
Then recently, for the first time ever, my three-year-old independently decided not to breastfeed upon waking. This was after she had been home for nearly two weeks with a virus and nursing constantly. It happened that I was going on a business trip and would be gone all day long, and by then, I didn’t even know where my pump was. I was in the shower, and it was also two days after my first ever lactation counseling webinar, which focused on breastfeeding and self-care, including the importance of relaxation and empowerment. So I decided to follow some of my own advice, to relax and try hand-expressing again despite my past experiences.
This time around, I had some key advantages: I much better understood the mechanics of the breast; I knew how not to bruise myself; and I knew how to hold better posture. I didn’t feel much pressure, internal or external, to accomplish this task because I knew that somewhere in my home I had a pump if need be. I wasn’t engorged, just a little uncomfortable. I didn’t need to worry about my milk supply or even saving my milk, I just needed to take a wee comfort measure to take the edge off.
I thought about it more as an adventure than an effort — a little personal Mount Everest, a hill I wanted to climb because it was there. I knew how to be kinder to myself in all kinds of ways.
With all of that in mind, I actually did it! I hand-expressed in the shower. I didn’t have an amazing stream spray out like what I remember seeing the woman in the movie Breast Milk do. (At 15:11 in BreastMilk: The Movie, Part Six” on YouTube, she sprays her milk into a bowl while cooking — wow.) Mine were just little drops coming out in sporadic plops, but I did it! Both breasts were relieved, and I got to check off a little box on my personal list of breastfeeding accomplishments.
Do I wish I was that mom who could spray it out, that I had a stronger supply and mostly that I never had initiation problems or an unwanted C-section? You bet I do. What hand-expressing gave me back was a sense of knowing at least it was possible. It might have happened just this once at the beginning of the end, at our third-year mark, but it was there, and I did it.
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