Often times when you see postpartum women in images on social media, You see them all made up and wearing jewelry, wearing some nicely fitted outfit that flatters their figure. They are holding their baby, calm and still. If they are old enough, the baby is smiling with them or at them.

That’s not what postpartum actually looks like, though. When I look at myself in the mirror now, I do not totally recognize what I see, at least when I look at my breasts anyway. I have bruises on the tops of my breasts from where I do my breast compressions while pumping milk. I have a scar on the right side of my right breast from the milk clog that I had to take out and thankfully was able to remove relatively easily. My nipples are pointier than they have ever been, and not only that, my areolas are absolutely huge, far larger than I ever thought they would become. I’ve barely had any energy to do my usual skincare routine, and I have only masked my face maybe three or four times since the baby has arrived. That is a huge decrease from masking or using some type of enzyme peel 2 to 3 times a week as I previously did (I am a skincare junkie). The one daily indulgence I do now for myself and my body is to slather warmed shea butter all over myself after my daily morning shower. Shea butter is supposed to help with reducing the appearance of stretch marks, which is why I originally bought it. It’s also good for applying to your breasts and nipples given nursing and pumping. But then, I realized that it’s actually quite luxurious, and the added bonus is that it is 100% natural. I also use it to moisturize the baby, and she seems to enjoy it. And on the mornings when Chris was working, I was barely even able to do that given the baby’s feeding schedule. I looked mutilated. In addition, you can’t see it, but my hands and arms are damaged, with nerve issues that hopefully will not be permanent.

When people ask me if life with a baby is what I thought it would be, I say that in many ways, it is actually easier, as I imagined the absolute worse with a colicky baby, no sleep, etc. We are very lucky that our baby eats well and sleeps well. When she cries, we almost always know what she wants or needs. However, the part that I was not anticipating that has definitely been very hard for me personally has been pumping… and around the clock, surprise surprise. That is like a whole separate job from childcare. Because if you are changing your baby’s diaper or feeding your baby, it’s very challenging to be pumping milk at the same time unless you have a wearable or mobile pump. I also never imagined that my body, particularly my breasts, would look like they were mutilated. Chris says that it looks like someone beat me up, and that is pretty accurate. When my friend came over the other day to help with bottle feeding the baby, she saw my breasts on display pretty much the whole time, and the first time she saw them, she raised her eyebrows, had her eyes wide open, and asked how the hell my breasts looked the way they did. And I explained this to her, and she said, “Shit, I didn’t realize it got this complicated.”

Well, neither did I until I became a mother to my child. Neither did I.

A good friend of mine had not only offered to come for a day and stay the night and help out with bottle feeding the baby, but she also offered to do a grocery run for me at Trader Joe’s. So I gave her a list of things that I wanted, and she graciously brought them all over. While she was over, we caught up on a lot of things that we hadn’t talked about since we had last seen her on the day after we came home from the hospital. She wanted to stay away given the rise in Omicron cases  and the fact that she works at a grocery store and is thus exposed a bit more than the average person.

When she was over, I realized that even when she was helping me with all the bottle feeds and keeping the baby upright after eating, I still had pretty much no free time to myself. I took one one-hour long nap while she was there, and the rest of the time, I was pumping, cleaning bottles, prepping bottles, measuring out breast milk, cleaning the kitchen, preparing food for me and for my friend…. and I was just exhausted. I wasn’t even sure if I felt like I had less to do even though I did have less to do because I wasn’t doing the bottle feeds anymore. What the hell was going on?  I could not believe it. She came specifically to help and relieve me, yet I did not feel relieved. Yes, I did prepare food for her. I did clean all the bottles that she used to feed my baby. And maybe that took up extra time. But I couldn’t believe that I still felt overwhelmed. 

Pumping had really taken over my life, and I really resented it. I resented the fact that I was able to lactate and Chris was not. It started to infuriate me that my body was the only body that was able to produce food for my baby to eat. Even though I was the one who wanted to exclusively nurse her up until the point that I went back to work, I still got angry about this anyway.  This is a huge responsibility for one person, to be a sole food provider for a tiny little human. Yes, there is formula as everyone would remind me, but my breastmilk is the best milk for my baby. How do I know this? My baby spits up less when she has my breastmilk. The baby’s face appears happier when she has my breastmilk. When she has a bottle of formula, she gives Chris a funny look and tentatively takes the nipple of the bottle into her mouth. She has even refused bottles of formula before when we’ve given her breast milk after. These are all signs that she wants mommy‘s milk and not “fake” milk. 

When the night nurse comes, Chris is able to sleep a full night’s sleep and I am not. I have to still wake up in the middle of the night to pump to maintain my milk supply. My supply has still not regulated yet, and so I was too scared to remove my middle of the night pump in fear that my output would take a dive, and I really didn’t want to do that because I already was not producing 100% of the baby’s needs. If the baby is having about seven feeds a day, depending on the day, she gets between 5 to 6 bottles of breastmilk / 1 to 2 bottles of formula. This has been huge shift for me because I have finally increased my supply to a point where I can provide approximately 75 to 80% of the baby’s needs, and this was my goal all along. We started initially with giving her only about 30 percent breast milk to 70 percent formula supplementation. I doubt that I could get to 100% at this point, but hey, you never know. I had heard stories of women whose supplies had increased at around the 14 or 15-week mark, so I did not completely eliminate that possibility from my mind. I probably got, at most, one extra hour of sleep when the night nurse is here because when she is not here, I do the baby’s last bottle feed of the night at 10 PM, and then I have to pump before I go to sleep. Then, I wake up somewhere between 2:30 and 3am to do my middle of the night pump. I go to sleep again, and then I wake up around 7:15 to 7:30 to do my first morning pump. 

I think all of this frustration and anger were really stemming from the fact that the pain in my fingers, hands, wrists, and elbows had really been at an all-time high this week. It was almost like my body knew that Chris was not going to be around, and so, why not piss Yvonne off more by ramping up the pain? The littlest things made my hands hurt. I could barely rub soap on my hands without feeling a little bit of pain in my fingers and in the base of my thumbs, and I was really sick of it. The pain in the base of my thumbs felt like a permanent bruising. Some of the pain is due to actions that I chose to take repeatedly, such as hand expression and breast compressions while pumping. But all of these things were to benefit the baby because they would increase my milk output, so can you really blame me? The rest, I was just predisposed to carpal and cubital tunnel before ever even getting pregnant. But it’s not like I could just stop pumping or stop taking care of my baby. I still had to cook because I was hell-bent on having home cooked food. That was ultimately why I prepared our freezer with all kinds of ready to eat homemade foods before baby came… Because I did not want to just eat takeout and delivery in my weeks after giving birth. I wanted wholesome, nourishing food that was not laden with excess fat and salt, which is typically what food is when you get takeout. That’s how restaurants hook you: having extra fat and extra salt to make you want more.

I just felt tired and frustrated and annoyed that pumping was taking over my life and the pain was just getting worse. I felt alone in my pumping journey. I was resenting pumping in general and wished it could be easier. My friend gave me a hand and arm massage while she was here, and I am regularly using the new Thera-gun that Chris bought, but it just wasn’t enough. I just wanted a break, a full night’s sleep, some sort of acknowledgment from the world that what I was doing was really fucking hard. IVF required a certain level of mental toughness, but exclusive pumping required a whole ‘nother level of mental toughness that I never thought I’d get myself into after giving birth. I did not want to end my breast-feeding and pumping journey with paralysis in my hands or limited mobility in my arms and then be a cripple. Because what could possibly be worse than a crippled mom?

One night at around 4am, when it was just Chris and me at home with the baby, we woke up to feed the baby and pump. After her diaper change, the baby started crying loudly because she was obviously hungry. As I was setting up my pump, I noticed that there were drops of milk that were on the kitchen counter below me…. And the drips continued to splatter. And I realized that I was actually leaking milk from my breasts. I am sure I had leaked milk before and it had probably just dried up on my clothes. But this time, it was obvious. The reason for the leakage was not only because my body recognized that it was my usual time to pump, but probably more because I heard the sound of a crying baby — my baby.

I read that this is pretty normal. Lactating women, when they hear the sound of a crying baby (it does not have to be their own child) will start leaking milk from their breasts. In this way, a lactating woman can feed any baby, not just their own. This is a sort of “takes a village,” evolutionary type thing.

Well, I leaked so much that I ended up just hand expressing both breasts. I never even turned on the pump. And I got over 2 ounces in about 20 minutes. I probably killed my hands and fingers doing this, but it flowed so easily that it was pretty quick.

Ever since the baby’s one-month appointment, I suppose you could say that I had become a bit maniacal about researching exclusive pumping and how I could maximize my milk output. One of the things that I had read about in terms of how to maximize milk output while pumping was to do a little bit of hand expression before turning on the pump and connecting it. The idea of this is that you are priming the pump so to speak: you are warming your breasts up for the breast pump, and letting them know that hey, it’s time to start letting all the milk out. This also is supposed to produce a faster letdown on both breasts.  If you are not familiar with breast-feeding terminology, a letdown is when your breasts are literally spraying milk out of them. The way that breast-feeding typically works when a baby is nursing is that in the beginning, when the baby latches on, they will do these fast, quick sucks to activate your breasts to start letting the milk flow. This initially starts out as little drips. But after about a couple of minutes of these short, fast sucks, your breasts will get the signal that your baby needs to eat, and then the let down, or the milk spraying, will start. When this happens, the baby’s sucking is supposed to change from fast and short to long and slow to then gobble up all that spraying milk. This is also how electric breast pumps operate in terms of their settings to mimic a nursing baby. Every woman’s body is different, but a let down will typically last about 10 minutes on a pump, and it may actually be shorter than that with an efficiently eating baby. I have read about babies that were so efficient on the breast that they were able to get all of the milk out in less than five minutes. That’s pretty freaking crazy, and unfortunately, I know that will never be my baby… 

Anyway, I figured that it would be good to learn to do hand expression anyway, since I may not always have my electric breast pump with me, and in case I ever get engorged, I could easily let the milk out naturally with my own hands. Because as all of these websites say, you already have a breast pump that you own that’s free: those are your hands. So I learned the techniques to do hand expression, and I guess you could say I went a little bit crazy with it. I did it so much over the course of about two weeks that I ended up giving myself a semblance of tendinitis in both of my thumbs. Now, when I try to do things like  cut my nails, press buttons with my thumbs, and even put thick lotion on my hands, my hands hurt. I was even waking up with all of my fingertips numb. My ring and pinky fingers have limited mobility as soon as I wake up every morning. I have to use rubber bands to stretch out my fingers in order to just reach out for my cup to drink water in the morning. 

This was completely ridiculous. I had already exacerbated my cubital and carpal tunnel issues in my hands, wrists, and elbows, and now my thumbs were becoming disabled. This was all because of my obsession with increasing milk output. I kept telling myself that I was doing this to  give my baby more milk, and in the process, I was disabling my own body. I can’t even put lotion on without pain! So, I decided to reduce the amount of hand expression I was doing and limit myself to a small number of times on both sides per pumping session. This way, I would still feel like I was doing the work, but doing less of it and still having all of my body parts intact.

This is a mother’s sacrifice… And obsession. I hope I do not kill myself in the process I’m trying to get my baby some damn breastmilk.

Around the time when I started using my new flanges last month, I noticed that my right breast was suddenly not producing its usual amount. To give you some context, the way that pumping tends to work, and nursing in general, is that one breast will tend to produce more milk than the other. For the vast majority of lactating women, the right breast produces more milk than the left. Whether this is a chicken and an egg situation, I have no idea, but since the beginning, my baby has always preferred nursing on my right side. And whenever I have pumped milk with my breast pump, my right breast has always produced approximately double what the left produces. That is really frustrating when you see the output and how different they are on both sides at the end of a pumping session. You wish, while looking at this, that they would both just produce the same amount and be more predictable like that. But, that’s just what you have to deal with. So, who knows if it is my baby who created this lack of evenness or if it’s just the way my breasts naturally are, but it’s still annoying regardless of the reason.

So you can imagine my annoyance, confusion, and horror when one day I was pumping with my new silicone flanges after seeing that my output had doubled for both breasts given my elastic nipple situation, and I saw that my right breast actually produced half of what my left breast produced. I looked at the output, put the bottles side-by-side, and just wrinkled my brow. Is this a fluke? I thought to myself. What the heck happened to my right breast? Why was it producing less than my left breast, which was supposed to be the slacker boob? I immediately went to take all of my plastic flanges of both side’s sizes and started doing some experimenting to see if the change in flange was what was freaking out my right breast. I spent the entire afternoon that day trying to troubleshoot. I did a bunch of Googling, to no avail. I had no idea what the hell was going on, and it was making me anxious because I was already an under supplier of breast milk, and to see that my dominant breast was not producing as much as my slacker breast terrified me. Was I drying up?? We are only just a month in! I need to produce more milk for my baby to drink!!

And then, like a knight in shining armor, Andrea, my Cleo lactation consultant, texted me. We were far outside the outreach window after our last meeting, when I was technically able to chat with her and ask for her advice, but nevertheless, she was a super human and part therapist to me, and she was asking me how I was doing. I told her the situation and explain to her what happened. I told her I was freaking out. I needed advice. With zero hesitation, she immediately texted me back and suggested that perhaps, I had a milk clog. She told me that I should go into a hot shower, and slowly and gently massage my breasts all over in circles to identify a lump. And once I found that lump, continue to increase the pressure while massaging and using a hot compress or the heat of the shower water to get the clog out, and to do it ASAP.

Oh shoot, I thought to myself. I have a milk clog already? A milk clog is basically a blockage in one of your milk ducts. When you are lactating, you have all of these milk ducts that are running through your breasts. The milk ducts all run with the same endpoint: your nipple. The goal is to get all of the milk out of your nipple. And at some point, depending on how thick and fatty your milk is, and how much you are pumping and or nursing, some of your milk may get clumped together and clogged up. The fat will accumulate in one of the ducts and just get stuck. This will cause a blockage of milk in your breasts, which would then result in your output decreasing. Women who are most susceptible to clogged milk ducts are, but not limited to: those who are not expressing, nursing, or pumping regularly enough, those who have a baby who is an inefficient eater on the boob (well, that sounds familiar), those who just happen to have fattier milk on average, and women who are attempting to wean off of breast-feeding altogether but do not do it slowly enough for their bodies to register this. If you do not address a clogged milk duct right away and quickly enough, this could result in a lot of pain, and in the absolute worst cases, mastitis, which is a condition that can give you a fever, chills, and have you go on a course of antibiotics that needs to be prescribed by your doctor. No one wants to experience that kind of hell while attempting to nourish their baby.

It was also confusing to think about having a milk clog when at that moment, I didn’t even feel anything. I wasn’t having pain, and in the beginning when Andrea suggested I massage around and look for a lump, I really did not feel one. But a few hours after this, I started feeling pain on the right side of my right breast closer towards my armpit. And when I started massaging in that area, I realized that there was a lump that was right there. And that was really freaky. That night, I told my night nurse that I had a clog, and she gave me this serious look. She said that I needed to spend time in a very hot shower and take a wide tooth comb and comb HARD down towards my nipple. Constantly put pressure on the lump and push on the lump towards the nipple over and over and over again until the clog came out. The grossest and messiest clogs actually come out as big thick white clots… and yes, that big, thick white clot is going to come out only one way, and that is through the tip of your nipple! I was terrified to think of what this was going to look and feel like, but alas, all women’s bodies are very different. For some women, it will come out as a big white clot, as though it’s a big fat white booger. Sometimes, that big white booger coming out of your nipple can also have blood in it. This is not for the faint of heart as you can tell. For other women, it will come out as milk gushing out of your breast like a fountain, fast and furious. And for others, they will not feel anything. It may just come out while pumping or while nursing your baby. And in that way, that would be the most ideal because you would not lose any of the milk.

So I spent the next couple of days trying to get the clog out. I used the wide tooth comb method, and I repeatedly used my Haakaa manual breast pump filled with Epsom salts and warm water and suctioned it onto my right breast. This is basically supposed to use heat, the healing power of Epsom salt, and suction to suck out the clog. I am not sure which method was actually the reason for my success in getting the clog out, but in the end, I was finally able to remove it. The lump was no longer there when I rubbed the right side of my breast, and my output had slowly but surely returned back to normal. I never experienced a big white booger flying out of my breast thankfully. I also never experienced milk spraying everywhere. So lucky me, no big mess. However, what was remaining was a big fat scab right where the clog was on the right side of my breast. And that eventually resulted in a very visible and ugly scar.

So I guess this is yet another postpartum scar, and one that I was not anticipating… at least not this early. I was anticipating getting a milk clog at some point during my breast-feeding journey, as most of my mom friends had warned me about this. I thought that I was preparing in advance by purchasing a bottle of sunflower lechithin pills and putting it in my cupboard. I even took one pill a day for the first couple of weeks as my milk came in to sort of smooth out the fattiness of the milk in case a clog were to appear that early. I increased my dosage during the period when I had that clog. Who knows if this actually helped. But I would like to think that since I spent money on these pills that they did help.

Our night nurse Cheryl has been a great help, support, and resource to us since day 2 of our baby’s life, when we returned home from the hospital. At 9pm sharp that evening, she showed up with her expertise and wisdom in tow. She has taught us how to properly swaddle (and not using the usual method), how to bathe our baby, how to manually stimulate her when constipated. She has given us tips for burping, for increasing my milk supply, and for ensuring the baby does not get gassy from the foods I eat. She is now helping us stretch her sleep so that hopefully in the near future, our baby can sleep through the night. Given she is with us on average about four nights a week, she has spent more time with the baby than anyone else other than the two of us.

She wasn’t very talkative in the beginning, but as time has gone on, she’s become more conversational and open about everything. She knew that I was struggling with my milk supply and encouraged me to keep going. She also has very strong opinions that “breast is best” and encouraged me to continue nursing despite the baby’s weak suck. She told me the story of one of her previous clients who was adamant about NOT breast feeding in any form, whether that was directly from the breast or pumping. She was dead set on her baby being 100% formula fed even before birth. As soon as she got home from the hospital and her milk came in, she asked her doctor to prescribe her medication to dry her milk supply up. Honestly, I felt pain hearing this; I have tried so hard to increase my milk supply, and then there’s this woman who wanted the total opposite and just didn’t want to give any breast milk to her baby. To each her own, but ouch.

Cheryl made it really clear she hated this approach, but hey, it was her client, so she had to keep her mouth shut and just deal with it. Every mother has their own journey and their own decisions to make, and that includes how to feed one’s child. “I think that’s really selfish, but hey, I don’t judge,” Cheryl said, rolling her eyes. “Everyone has to choose for themselves. I never said anything.”

Well, we are all entitled to our own opinions. I just thought it was funny that she had to try to pretend not to care while working for this client.