If motherhood doesn't make you crazy enough as it is, there are people out there who will make you even crazier. You suspect these people will be the obvious choices, mostly family members who know how to push your buttons; like your mother-in-law, step-parents, siblings or co-workers, or even just really nosy strangers in public. You don't expect it to be the people you really trust.
In our 4th week we saw our family doctor for the first time. Our care had been with our midwives up to this point. However, due to both the initial weight loss, then the later issue where she neither gained nor lost in 8 days, our midwives asked us to make an appointment with our family doctor in case further tests and follow up might be required. That was in week three.
Our family doctor was away on vacation until the following week, so we made another appointment with our midwives, and with our family doctor the day after that appointment when she was back. We left with a promise to continue supplement through co-feeding while tracking regularly and calling if anything went wrong.
We have had our family doctor for almost four years. We were able to get in with her shortly after we moved to Ottawa. We have always felt we had a good relationship with her. She is someone I trusted faithfully. When she found out we were pregnant she was ecstatic. She cannot deliver babies but offered to follow us through the pregnancy if we were unable to get on with a midwife. She even said, almost lovingly, that if she was there when I went into labour that she promised to catch the baby. Later on in my pregnancy, SuperFox had an appointment. She was so happy for us and insisted we call her "as soon as that baby was born" she told him excitedly. This was someone I trusted & respected.
Over the following 6 days between midwife appointments we tracked details, fed well continuing to supplement with my pumped breastmilk, my supply never being a concern. I spoke with my lactation consultant that weekend who was also concerned about the lack of gain, but we assured her we were back on track, we had appointments set up, everything would be fine and that we would contact her if we needed any further assistance.
On Tuesday we saw the midwives, and things were great! Her weight was up, 7 oz in 6 days. Right on track with healthy weight gain. I was so happy with our hard work and our progress. She had developed a head cold with a cough over the weekend, no fever. There was no concern by the midwives over the chest congestion but instructed that if things got worse to take her directly to CHEO.
The following morning the cold got worse. I didn't feel like I could wait until our appointment that afternoon. So I picked up SuperFox at work and the three of us headed to CHEO. While we were there we gave them the Coles notes of her first four weeks, including the weight gain issues. They weren't concerned about the chest congestion, however her blood oxygen levels were a little low due to her nasal congestion. But after they suctioned out some heavy mucus she inproved and we were on our way. The doctor in emerg had asked about the weight issues, we told him about the recent gain and he seemed comfortable with her whole image of health.
I almost considered canceling our appointment that afternoon. Her weight was on track and her cold was much better, but I remembered how excited our doctor had been to meet our new arrival and so I kept the appointment, to show off this little doll.
When we first sat down with my doctor she caught me off guard by asking what birth control we were planning to use, stressing that breastfeeding doesn't protect you from getting pregnant. My husband joked about "Irish twins". It seemed like a strange way to start the appointment. Then I proceeded to explain that we'd been at CHEO that morning and the congestion.
When she asked a bit about the weight issue I mentioned that I had been pumping after each feed and using some of it to suplement. I also mentioned that I had so much pumped that I had donated this extra breastmilk to a friend in need who couldn't produce enough for her little one. She went to check weight charts (I'm assuming) and came back quite flustered.
She was very upset that our little one hadn't gained back her loss in the first 10 to 14 days. She was shocked that the staff at CHEO hadn't been more concerned about her weight issues. I tried to explain that we didn't know about the initial loss until day 5 and that at day 10 she had oral surgery to release a lip tie and posterior tongue tie, and we had gained before that. I explained that we were seeing a lactation consultant who was also a RN and that we were finally back on track and gaining again but these did not appease her.
Her strict instructions were to immediately stop pumping, that I was thinning my milk production. She then told me to replace every second feed with formula from a bottle. She seemed perplexed that I wanted to pump at each of these replaced feeds to keep up my milk production for after things got better. She said she supported breastfeeding and that "breast was best" but her instructions spoke differently. She didn't give us a timeline but insinuated that these changes could continue for weeks.
I feel very strongly about breastfeeding for myself and daughter. I knew I was producing more than enough milk for our little angel and that we had struggled but were figuring it out. I knew that stopping pumping would make me engorged, that giving my daughter a bottle this early and after all of our difficulties might case nipple confusion. And I was horribly afraid that she would prefer formula and never take my breast or my milk again.
Unfortunately I was not able to express these feelings. I was not able to tell her my reasons for wanting to breastfeed over formula feed and bottle feed. I sat there and cried. She made me promise to make the changes. That it was the best for my child. That there was too big a risk of hindering her mental development if we didn't make these changes and have her "start gaining" (but she WAS gaining again!).
I cried all the way home, I cried well into the evening, I cried overnight when I tried to add a feeding and it was thrown up all over me. I was hysterical for many of the following 12 hours.
Someone I had trusted hadn't listened to me, hadn't heard me, hasn't tried to work with me, and put the fear in me that I was damaging my newborn child. A child that showed no signs of any problems. She was pink in colour from birth, many wet and soiled diapers, lots of alertness, lots of sleep, great muscle tone and just an all around perfect baby.
We have only seen our doctor once more since that appointment. My daughter's weight was up and my doctor was placated by that and by the fact that we had an appointment with a pediatrician to whom she had referred us, promising follow up with him. However, I feel like our relationship has changed.
We have our 2 month immunization appointment and my first post-partum appointment with her scheduled. I'm hoping that these weeks away from her will help me to feel more confident going back to her. A good doctor is hard to find, but so is any doctor. And many doctors taking patients won't take you if you have an existing physician.
I know she was only doing what she thought was best. That as a doctor she has to prescribe the best course as sees it. I know physicians are expected to know EVERYTHING, but that there is much they don't know, other than through exposure and experience. But I felt like my doctor didn't listen to me. She didn't take the time to understand how hard we had worked and that we were getting results. That there were no signs that I was thinning my milk by pumping but rather protecting my supply. That here was a healthy baby who had HAD weight gain issues but who was making great strides forward and who if simply monitored would continue to improve. And that the changes she wanted me to make could have had major medical implications for both myself (engorgement & mastitis), not to mention the emotional toll it had taken on me, but for my daughter too. Such drastic changes might have caused her to start losing again. She might not have taken the bottle or the formula, what then. And giving me less than 2 days for a follow up with her did not give us enough time to make major changes and not fail.
I felt like I was strained at our follow up with her. I really want our relationship to go back to where it was. I'm not sure if I can ever feel safe with her again. If I won't question every prescription, diagnosis or opinion she gives. I am trying to let go of my anger, my distrust and my heartbreak from that one appointment with her but I'm not sure if I'll ever shake the feeling that she created. She made me feel like I was the worst mother, like I was killing my daughter, and I don't know if I can ever forget that.
The best advice that I have received from other professionals, friends and family alike is to trust my instincts as a mother. Trust that I am making the right choices for us. I am learning to trust these feelings but every time she has a feed that doesn't go as long as it should or where she is fussy or not sucking well I feel like I am hurting her. If she sleeps too much or doesn't sleep enough I worry that my choice to continue to breastfeed might cause her major developmental issues. I worry that she might die because I'm not feeding her properly, even though her weight continues to be up. I no longer trust my doctor, and yet I still trust her enough to no longer trust myself.
With love
~sarah~
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