‘Like a cheese grater raking across my nipple’: why I kept trying to breastfeed for so long

The baby was born. I woke the next morning and felt an instant, brutal claw across the heart. I saw the baby in her little plastic cot, I saw the back of the baby’s head and thought at once: the baby is dead. The baby’s floss of hair was matted with blood. The baby had been crushed or gored by a forest predator.
I sat up. It wasn’t true, of course. The baby was fine, only sleeping stiffly with her gnome’s face tightly shut. I swung my legs over the edge of the bed, still dopey and numb from the epidural. I looked at the baby evenly. A nurse swiped her head around one of the blue flannel curtains – it was still dark; the cubicle was lit cloudily by the lamp at the nurses’ station. In the ward a different person’s baby began crying, then another.
The nurse asked, Has that baby been fed?
Last night, I said.
What? asked the nurse. What, not fed since last night?
She never woke up, I said.
The nurse was appalled. Feed her right away, she said.
I jumped on to my spongy legs. Somehow they carried me across the space to the plastic cot to tip the baby over, lift the baby up, cradle the baby and return to bed. The baby woke and looked at me with black, dilated eyes. After a moment she began to cry shrilly as I rolled up my top and released one slightly – only very slightly – engorged breast. When the baby latched, the pain was like a cheese grater raking across my nipple. I gasped, closing my eyes until the burn passed because I couldn’t yank the baby off me, no – this feed would be the first of many painful and durational obligations. Not even the first. Childbirth had been the first – the pain so personal it felt vindictive, all that bucking and baying and vomiting. How mortifying to have left the baby to sleep all night unfed. But didn’t they wake for it, naturally? Didn’t they instigate it? Why didn’t I know this already?
I cooed her new name as she fed. I was still getting used to it. The name had been chosen in Norway, during the lunch break of an art event in Svolvær. Speakers were mingling on the icy stoop of a workmen’s club and ladling dal – dispiriting as every conference catering experience of my life – on to paper plates. On long piers by the shore there stood huge wooden drying racks for fish and, although there was no fish drying just then, the whole region stank, and the smell would become linked with my nostalgia for that early and agile and totally notional portion of pregnancy when I felt healthy and smug and had no real responsibilities. The name we chose appeared on a list of storms slated to take place in 2023 and 24.
How do you pronounce that? my partner asked.
So many people have asked me the same thing ever since.
On her first night alive I had left her all night without feeding. She hadn’t woken once. Now, as she tried to feed, the latch came and went. It was unbearable. Each time the baby re-attached herself I pictured the surface of my nipple as swollen and grainy and scraping her lips. This image was an inversion of the sensation I was experiencing: of the baby’s mouth sucking urgently on what felt like an open wound. I simultaneously pictured and experienced the sensation, a telepathic sympathy with visual correlations – a ragged nail bed, say, or a mouth ulcer – that were also sense memories, standalone examples of pain. Telepathy would become an important new context for everything we went through now.
The nurse was back. Have you really not fed her all night?
No. I wished I could cry, to piss the woman off. But I could not. I still felt stunned and a little stoned.
The doctor, I suppose, will be around to see you soon.
The baby appeared fine. She was sucking away when the breakfast trays were delivered. By now my tit was completely numb, and I was able to cradle the baby against it with one arm while using the other to reach for my cornflakes and toast. I ate every last bit, blackened crusts and all, then slurped the milk and drained the pot of tea. I hadn’t eaten in more than 24 hours, and breastfeeding made me feel like a running tap; every minute she drank left me thirsty and ravenous and then finally high.
The baby detached and settled limply against my arm. My breast looked pointed and slack as a piping bag. I tucked it into my bra and whipped out one of the plastic sheets they had given me to catch blood and mucus. I laid this out and placed the baby on it, opening the nappy to reveal a smear of black pulp, no messier than the seed-thickened droppings of a little bird.
Good little clever bird, I said.
The latch – the baby’s ability or, as we later considered, willingness to attach securely and ergonomically to my breast – did not improve. A lactation consultant called into my cubicle and mashed the baby’s face into my breast while performing some sort of practised twist, and succeeded in making her feed – proving she could feed – for about 10 minutes.
After the 10 minutes, she stopped. But she wasn’t full. She howled and howled and latched again, badly. My breasts never became milk-plump enough to allow her to latch easily.
I was not unhappy. As far as I knew, this was all normal. I still hummed with adrenaline from the labour, which had lasted a mere five hours. I felt sleek and oiled by that hormone you get in pregnancy that makes your joints supple and bendable to the point of easy freakery. Very thirsty, though. I was thirsty all the time. At 3am on the third day a night nurse skidded into the cubicle, where the baby was wailing and I was palpating another listless unready breast.
Do you want formula? the nurse asked.
There was a pause between us. In the world of midwifery, formula is taboo. I’d been instructed during my antenatal Zoom class to forgo buying any formula milk, any bottle machines – to avoid so much as looking at these treacherous toys designed for the corrupt and the weak of heart. But this woman – and I remember her even now, young and pretty and losing patience – anticipated me and added:
It won’t stop her taking the breast.
It won’t? I asked.
It will just mean you get some sleep.
Oh. OK! I said. The baby took a tiny bottle, a doll’s bottle, of Aptamil and fell asleep. The next day we took her home, blasting through the hills of Clare at a time of year when things had yet to open and integrate. It was grey, oppressive, and unceasingly strange to me to look out at this place, once familiar and now transformed by something menacing, and feel as though I were floating beside my body rather than occupying it.
Three days later the public health nurse arrived and took one look at the baby and said, No, no. She is thin. She is close to jaundice.
Oh, I said. I was taken aback.
The nurse turned to me anxiously. The breastfeeding?
Well, it’s not going all that well.
I was given a contact number for the local lactation consultant, a service I would have to pay for. I was, by now, beginning to feel a creeping guilt. The original proposition – to breastfeed exclusively – had seemed an obvious one, an easy one, for a woman like me: healthy, spared any calamitous birth injuries, granted a whole year of maternity leave. My complacency was born of the same ignorance that had left me outraged by the insanity of labour contractions, but my ongoing commitment to the original proposition related to shame. If I couldn’t do it, I would be letting the baby down. I’d read a lot of ranting about the crimes of Nestlé and a lot of gushing at the womanly art of breastfeeding. There would be no other children. There would still be a career. Some embarrassment lingered, too, about the epidural, since I’d spent months practising hypnobirthing techniques and determining to avoid medical intervention where possible, only to demand this intervention within minutes of the amniotomy. I have met myself, I told a friend in a rueful, abrasive WhatsApp voice note in the days after the baby was born; I have met myself and I am not the kind of person I thought I was.
But I still wanted to be a person who could breastfeed.
I was sitting in my feeding chair, an armchair hauled upstairs to the bedroom, when the lactation consultant arrived. By that time I had been awake, for the most part, for a week, blasted out of bed by the baby’s cries to feed every two hours, and stewing with anxiety in between; walking and feeding and tending and shopping and washing and vibrating with excitement all day. The lactation consultant sprinted up the stairs and declared frankly, That baby needs formula milk right now. She was a spry and vigorous countrywoman who spoke sharply, telling me my nursing bras were ornamental. She clearly didn’t suffer fools, and I imagined that she probably met all manner of fools in her line of work. Fools like me, who had no idea breastfeeding was difficult. Who couldn’t even buy a proper bra.
I never advise this, she said. I never say this, but that child needs formula now or it’s back to the hospital.
Oh, I said.
During most of these exchanges with professionals in the early days of motherhood, I was monosyllabic in this way, all Oh and Wow and Ah. At best I was capable, sometimes, of a blunted curiosity. I did not feel anxious, but dissociated.
It also happened, at that particular moment of friction with the lactation lady, that my six-year-old stepson, who was visiting, charged up the stairs with a helium balloon crying, Where’s my baby, where’s my baby? The consultant looked at me with further, irritated, concern.
You need rest, she instructed, or you will not be able to produce milk. Let me take a look at you. Women with your physique – you are like me, she added, I’m like that – women with your body type, I have found it is harder for them to breastfeed.
Small breasts, I offered.
Nothing much to draw on, she explained. It happens. You need rest and protein. You’re not one of those vegans?
No.
Good. She didn’t smile. She produced a doll’s bottle of formula milk, an unsponsored film prop, and watched the baby take it greedily and suck without restraint. Then the baby transferred back to the breast and turned her face away and cried.
Ah, said the consultant. She’s a cute one. She prefers the teat.
This made sense. The teat was reliable. The breast was not. A solution presented itself – pump into a bottle, feed her that way. My pump was yielding mere greasy flickers of milk after 40 minutes of exertion, but everyone was determined, and a plan to continue breastfeeding with formula as a supplement was decided upon. At this point the great threat to breastfeeding success was the abundant, standardised flow of formula – satisfaction guaranteed – as opposed to my phantasmal milk supply, which increasingly felt like a moral failing. What was I eating? How often was I eating? I was going to have to eat an awful lot more.
Protein, protein, protein, the lactation consultant said. And lemon water first thing every morning, for the constipation.
Two things I had never known existed – nor given even a peripheral thought to the need for – now became central to my life. The first was a worm-thin rubber straw, to be threaded through the baby’s lips as she latched, with the business end immersed in a bottle of formula. She would, it was hoped, mistake the flow from the straw for my milk and relearn trust in the breast. It was a delicate operation and rarely worked because the worm-thin straw made the baby gag.
There is a photo of me, taken at this time, looking softly happy, rollneck rolled up and baby apparently latched. At my elbow, almost out of sight, is a single-serve bottle of Aptamil and the tiny plastic bottle I used for attaching the straw. It is one of my favourite photographs, one of many I had taken or took myself with baby at breast, because it achieves what I wanted those photographs to achieve – to make normal a process that never felt normal for me. The presence of the formula bottle is a snake in paradise, as is the nipple shield – the second novel and canonical object to enter life at this time – visible in the form of a faint and extra aureole above the baby’s mouth. Only I know what it is, and that it’s there, and that every feeding session required logistics and sterilisation and peril, and that by now my partner had returned to work and I was alone all day.
The supply remained paltry. I lost weight and my complexion turned kind of yellow. I look back on this time and remember no painful emotions, however – only the animal compliancy of process, day upon day. A sense of tidy and productive urgency and, after this, a growing sense of diffuse happiness. The baby was beautiful, the radio played all the time. Day and night tessellating. I lived in a green zone of suspended animation, life pared to its nobler necessities like laundry and long walks, the baby growing plump from formula and wedged between us every morning as we talked and drank coffee in bed.
In the dark, during the small hours of ambient sound, of two Velux windows that depicted a lighted bungalow on the mountainside, strange things happened. Things stranger than the telepathic countdown to the baby’s demand for milk, which I experienced as an articulate interruption to whatever dream I was having and a seltzer tingle in my breasts. One night in the feeding chair I looked down and saw the baby apparently smiling for the first time, but not happily; she was smiling grotesquely, her face fogged over by another face, and I knew where I’d seen the smile before, it was clear immediately that I had seen this febrile grin in the video for Windowlicker by Aphex Twin, which used to play on MTV when I was babysitting as a teenager. This is when I realised I was hallucinating. I felt angry at whatever entity had bled into my consciousness in this state of open-minded vulnerability and concocted a cheap hallucination, and I shook it off, looking away and looking back, to find the baby’s normal adorable features restored.
Despite bliss – and truly, it was often bliss – my milk supply did not increase. The baby, entering cluster-feed stage, fed and dosed in cycles so short that, what with the battery of accessories involved in setting up the mixed-feeding conceit, I largely just sat in the feeding chair for hours attempting, sometimes, to hold up Anna Karenina with a single hand. Even now I can’t explain why Anna Karenina except to point to the same high-minded, mildly manic impulse that kept me breastfeeding at all – a desire for excellence to the point of pantomime. I discussed my breasts with doctors and nurses and relatives and other mothers on Instagram and in the local support group. I took milk thistle and fenugreek. I hosed pouches of skyr, a nutrient-dense Icelandic dairy product, into myself.
Cry, the doctor advised. If you feel like crying, crying brings the supply in. He also prescribed crying for postnatal depression and, in that regard, it probably worked. I lay on the sofa and howled like a child. I took to crunching around the quiet country village in the dead of night, between feeds, piping hot with adrenaline and repenting of every single decision I’d ever made, including being kind of lax with contraception that time. I hated my life and then, on other days, the pendulum would take an energetic upswing, joy would overtake me, I liked nothing better than excusing myself to sit under the baby for hours on end. By now she was taking much more formula than breastmilk, though, and suffering catastrophic reflux and gastrointestinal pain. This meant a daily routine of painful breastfeeds followed by formula top-ups followed by baby curled in agony and bellowing followed by intervals of an hour or so before it all began again. I sat in the feeding chair and listened to fat crows thud about on the roof slates. One day I heard every incremental movement as an ancient slate detached itself, skied hoarsely down the slope of the roof, and smashed with the precise, almost deliberate density of a dinner plate outside the front door.
I envied, in some respects, those women who successfully breastfed. I envied them in the same way I envy people who enthuse about their parents introducing them to Bob Dylan and Joni Mitchell or Bert Jansch in smoke-filled kitchens (whereas my childhood was punctuated by whole Sunday afternoons of Garth Brooks’s No Fences in surround sound). The way I envy the children of professionals I met at college, young people who’d learned Latin and attended actual operas or just had families that didn’t think their graduate studies were a baffling mistake. My envy, that is, came with a flipside of triumph derived from reverse snobbery.
On a cold day, when the baby was two months old, I travelled to a literary festival to meet a friend. It was not possible to bring the baby into events, and so I didn’t attend a single one. My friend and I met in a coffee shop. Sitting there, facing a man I’d known for years with another underperforming breast, another fussily obfuscated latch, in the path of blasts of wind that travelled through the room every time the door opened, I felt exposed. My friend kept rabbiting on about his trip to New Orleans; had I seen, he pressed, all those photos of Mardi Gras? I had been in hospital, having the baby, when those photos appeared on my phone. There had been so many they were still loading and glitching after the fact. I showed him, now, my own photo, taken moments after the baby was born and revealing the conical shape of her head as sculpted by my pelvis as she corkscrewed into the world. His face fell in horror, and we were amused – Oh yes! I said, so many things they never tell you about.
The lactation consultant receded. Keep supplementing, she said, and pump. We can revisit.
We did not revisit. Her profile photo on WhatsApp showed her enjoying a meal with two girls I took to be her daughters – how many babies, I thought, how many mothers and jaundice and latches and atmospheres, the dim rooms of how many chaotic houses, has this woman seen? And did she know, when she looked at me, that I would fail, that there was no hope for me? I suspected this. I suspected everyone could see how daft I had been.
What more to say? The supply, emphatically, did not come in. The abandoned pump accrued mould where it fell behind a radiator. The nipple shield, being translucent, disappeared for hours at a time. Formula became king, but also generated pain and reflux responses so shocking that my mother-in-law left the room during a session, shaking. The GP was invested in this cause, and when lactose-free Aptamil produced the same effect, he had us order Nutramigen through the pharmacist. It smelled like a cross between Ovaltine and chicken feed. My stepson composed a tender song: She smells like a chick-en, she smells like a chick-en. He himself had been breastfed, fully breastfed, without controversy, by the woman before me – my partner’s ex – who was, evidently, good at it. I was not good at it. This felt embarrassing.
I asked my partner, Would you hold it against me if I just quit?
Of course not, he replied.
I quit. More or less from one day to the next. Afterwards, there was no leakage, no mastitis, no punishment. The whole thing had been a cosmic comedy. I put the baby on soya formula to ease her symptoms of intolerance, which disappeared overnight. It is strange, now, to remember this all at what feels like a great remove, but was in reality less than a year ago. A year from now I might have forgotten the present time, the present stage of the baby, who is weaned and fat, charging around like a puppy. Would she like a pancake?
Panshake! she agrees.
Is it bathtime?
No-no-no, in a breathy, wondering tone. She beats out of the room on her hands and knees.
This essay first appeared in the summer 2024 issue of the Dublin Review