In a world that values breastfeeding above all else, I was made to feel ashamed that I struggled to nurse my twins. What I wish I knew then that I know now.
Mother holding twins
Credit: Masterfile

Sitting in an airport lounge in St. Louis with my 4-month-old twin girls, I'm proud of myself for being so prepared. In the clean bottles I keep in a plastic baggie, and with a little water from the nearby coffee stand, I've mixed the perfect-temperature formula. I've just started feeding Molly, with Pearl still in the stroller batting a green froggy rattle. Everything -- incredibly -- is going well.

And then: "I breastfed my twins."

A woman, a complete stranger, is standing there, looking down at me and my babies. She's carrying a bag overflowing with kids' stuff. At first I wonder if I have misheard or missed some kind of introduction. Perhaps she wants to compare twin stories. I think I see them, two boys, 7-ish, with their dad, over by the water fountain.

"It took a lot," she goes on. "But I really felt it was important to breastfeed them."

I feel my face flush, and I know I'm about to burst into tears. Her smugness shames me into silence. And the shame runs deep. I am unable to nourish my babies. If I were a mother bear, my cubs would die.

Breastfeeding has passionate advocates -- as it should. As we hear repeatedly, breast is best: nature's perfect elixir. And it's great that breastfeeding is on the rise. There are banks of donor breast milk and websites where non-lactating moms can obtain it. La Leche League has picnics in towns across America celebrating the benefits and joys of breastfeeding.

But what about those of us whose breasts don't gush? And who give up nursing because of mastitis, or work, or a dozen other, personal reasons? There are even moms who simply choose not to breastfeed at all. However, none of us is passionate about bottle-feeding. No one blogs about how wonderful plastic nipples feel. There's no proud slogan: Bottle Feeding Is Second Best.

And study after study suggests it is second best. Formula-fed children exhibit higher rates of asthma and diabetes; they suffer more infections; and they get diarrhea more frequently. They even have a lower IQ. We bottle-feeding moms are relegating our children to a sad fate, right?

Let me confess my envy. I would love to have breastfed. I yearned to have my babies suckling, their little heads pressed against my body. Molly and Pearl were born prematurely at 30 weeks by emergency cesarean due to my severe preeclampsia, and I felt an intense need to sustain them outside my womb, as it had failed to keep them safe within. I wanted to make up for the terrible trauma of our birth experience.

During the girls' seven-week stay in our local hospital's neonatal intensive care unit (NICU), I did try. Right after their birth, I was able to produce colostrum and a tiny but sufficient amount of milk. As they were too small to suck (and, indeed, too small even to breathe by themselves), they were tube-fed a combination of my expressed milk and a special formula designed for preemies. My supply was not good, but I was determined to persevere.

I pumped as if their life depended on it, every three hours in the ward's pump room. I pumped while looking at their photographs. I pumped while sitting beside their incubators. I drank lactation tea (which gave me diarrhea). I downed lactation drugs. I meditated, I cried, I begged my body to produce more milk. And when one overeager lactation nurse counseled that "supply will meet demand," I pumped every two hours for 72 hours. The result? Very sore breasts and complete exhaustion. But no increase in supply.

On average, after 20 minutes of pumping my breasts produced 10mls of milk: 2 teaspoons. Although this had initially been enough, my babies were growing and needed more. And more.

More on bottlefeeding guilt

I began to dread the pump room and to hate the pump with its merciless hiss. I would see the vats of milk other moms miraculously produced and I'd hide my measly offering in my bag. Once, in the pump room, I overheard a happy, pumping mom chatting with a female visitor in the cubicle next to mine. "Look at you go, girl," the visitor said, awed by the output. They began discussing another friend they knew who was failing to breastfeed her newborn. The pumping mom said, "I just think she's too uptight. I mean, it's the most natural thing in the world."

But not to me. Just as Molly and Pearl became strong enough to latch on and suck successfully, my supply actually began to dwindle. I was, by Week 4, providing merely a taster to their power-packed formula. By Week 5, I was dry. I admitted my defeat to the NICU medical team. These were the nurses and doctors who'd kept my girls alive and ushered them toward real health. One of the doctors, an especially smart, funny, compassionate woman, said, "You know, most of us sitting here were formula babies. That's how it was in the '60s and '70s."

I think there's this myth that today's bottle-feeding moms just shove the bottle in and walk away -- to smoke or drink in bars, perhaps, or to pursue our important careers. Besides being unnatural, we're not dedicated enough. But it takes serious commitment to bottle-feed. When the girls came home from the hospital, I continued to feed them every three hours with doll-size bottles. There was no sleepy turning over with a breast, no rush of hormones to send me back to sleep. Instead, there was the measuring and mixing and heating at 2 a.m., the endless cleaning of bottles and nipples for two, the rigorous round-the-clock feeding schedule around which my entire life revolved.

I held and cuddled my sweet babies as I fed them; so did their dad. We nurtured them as much as moms who breastfed. And I think I worked extra hard to deepen our bond because I worried that without the natural connection of breastfeeding it might not be strong enough.

My love and care didn't feel like second best. Then Molly developed asthma, and Pearl struggled with terrible reflux, vomiting the contents of her bottle for weeks. Their suffering felt like my fault. I kept thinking, "If only I'd been able to breastfeed ..."

Now, as I move deeper into motherhood I realize that playing "if only" is pointless. If only my kids would clean up their toys. If only lunch could make itself, and the world would spin a bit slower on Sunday evenings. If only we could always be on the right side of statistics and studies. It would be nice too if unicorns really did exist.

Confounding the confusion, there's a new study by The Ohio State University that suggests that children who are breastfed are actually at a slightly higher risk for asthma -- which Molly still struggles with -- than those who are formula-fed. Are breastfeeding moms now grabbing their kids' inhalers and saying to themselves, "If only I had bottlefed ...?"

I still find myself saying "if only" but for a totally different reason: if only I had had more compassion for myself in those first six months when I was totally overwhelmed. I was convinced that I was failing my babies because I couldn't breastfeed. Maybe I felt the mom in that airport was judging me, because I was judging myself. In fact, every external indicator was telling me I was doing just fine. The girls were fine. They are fine. And that lovely, warm, dancing, whirling, laughing now-5-year-old fineness has nothing to do with breast or bottle.

I'm so lucky. We're so lucky. We have clean water, fresh air, good food, a strong community, a loving family -- the things that really help our girls thrive.

And choices. We have choices.

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