by Erin Davis
Not every opinion needs to be expressed, especially when it comes to issues about which people know little or nothing. But who are we kidding? This is the twenty-first century, when it’s perfectly okay to argue facts and science with opinions and feelings, and when being offended is considered by some to equal being right. People seem to search the internet only for answers with which they already agree. And in no subject on this wonderful worldwide web are there more opinions than on parenting in general and motherhood in particular (with the possible exception of politics).
So let me share a story from back in the day, before everyone had access to all the answers (or purported to have them already), when we fumbled along and did the best we could by using good old instinct and a new parent’s handbook. In our house, as in so many others, we consulted the paperback version of Dr. Benjamin Spock’s The Common Sense Book of Baby and Child Care when the questions were too numerous or embarrassing to pick up the phone and call Mom. That was until, of course, Dr. Spock’s parenting methods were blamed for turning out a bunch of spoiled tyrants. So, did we toss our paperbacks and search for other experts? Of course not! We furtively consulted his book and didn’t dare tell our parents that we were going to go ahead and raise a hardened criminal behind their backs! Oh yes, we were rebels, all right.
More than once in my own early stages of motherhood, the burgeoning internet, had I consulted it, might have come in most handy. The clearest possible illustration of that comes via the incident involving our tiny daughter’s bum. Lauren was only two months old when I noticed a little pink bump near the top of her bum crack. Okay—no laughing here—I will confess to you that I thought it was some remnant of our evolutionary development: the last vestiges of a tail, perhaps? (I thought you said you wouldn’t laugh!) After all, are we not still natural works in progress? I had three wisdom teeth instead of four and always considered that an express lane on the evolution highway. Yay, me!
Thankfully, a well-timed visit from my mother changed my mind about Lauren’s “tail.” I asked Mom, a retired registered nurse, to take a look at the bump, which, in a few short days, had become redder and was seeming to cause our baby discomfort. Mom said that it looked like a cyst, and since it was late in the evening, we loaded up our cranky baby and off we went to the emergency room. Sure enough, it was a pilonidal cyst, something known to war veterans as “jeep seat,” and that usually occurs in people between the ages of fifteen and thirty-five. (Word to the wise: if you google pilonidal cyst, please take my advice and do not look at the pictures that will inevitably pop up.) A quick anaesthetic, removal of the cyst and a stitch, and she was as good as new, albeit with a tiny scar to remind her of her earliest encounter with a scalpel. As I say, there’s no doubt I could have used the wisdom of the internet in that case, but at least I had the option of consulting my mom. And I was grateful.
These days, though, we have information coming at us from every direction, and on multiple devices. There’s so much peril attached to the constant barrage of opinion and criticism, and as media savvy as our daughter was, she was anything but immune to it. As empowering as the internet has been in this age of social activism, it’s been equally debilitating for those who are scared, confused, searching and emotionally vulnerable, like new mothers. I was astonished to learn that our daughter, all ready to embrace the experience of motherhood, was bitterly disappointed when after only one push in labour, the umbilical cord around her baby’s neck necessitated an emergency C-section.
For two weeks—or maybe more—Rob and I had been anxiously waiting, phones fully charged, for the day that Lauren or Phil would call and tell us their baby was on his way. On Canadian Thanksgiving weekend, we had an early turkey dinner, eating at about four o’clock in the afternoon of Saturday, October 11. As a fire crackled in the hearth, we were just finishing our dinner when the phone rang. It was Lauren.
“Do you feel like driving to Ottawa?” she asked, a smile in her voice.
“Are you kidding? We’re on our way!” Within half an hour, my sister and her family were headed to our lake house to clean up dinner leftovers, take care of our two little dogs and hold down the fort as we embarked on an increasingly dark four-hour drive to Ottawa. We were guided by a pumpkin-orange moon slung low in the sky, and it wasn’t until we were about forty-five minutes away from the hospital that the moon disappeared from view and a gentle rain began to fall. We had just pulled into a coffee shop parking lot for a comfort stop when my phone rang. It was Phil telling us that it looked as if Lauren was going to be undergoing a Caesarean section. We told him not to worry, told ourselves the same, and drove as quickly as we could (and only slightly over the limit) toward our daughter and son-in-law. We could hear the concern in Phil’s quiet voice; no matter how many books you’ve read or classes you’ve attended, there is nothing that can prepare you for a sudden emergency surgery.
We stayed positive for the remaining leg of our drive, trying not to slide into the places that the mind goes when what should be a normal birth suddenly goes sideways. We hear of this happening all the time (in 2018, tennis goddess Serena Williams shared her story of undergoing a C-section when doctors spotted distress in her baby’s heart rate with each of Serena’s contractions). Had Colin been starved of oxygen? What did this mean for his health, and for that of his mother?
We pulled into the dark, wet hospital parking lot and sprinted to the entrance. Instead of the perfectly orchestrated moment of meeting our grandson and congratulating an exhausted and elated daughter, we were met by a tired but relieved husband and told that Lauren was still out; we’d have to wait for a bit to hold her and coo over the new arrival together.
After we’d hugged and held Phil for what seemed like minutes and he told us all was well, we finally got to see our beautiful grandson in his incubator, decorated with a cut-out turkey with the name COLIN neatly printed on it. The poor sweet boy’s unusually long feet were still a greyish-blue hue. But, we were told, a new son—and grandson—had arrived safely. We all felt so blessed, so happy.
The next day, Rob and I took a bottle of alcohol-free champagne, a teddy bear and a bouquet of roses to Lauren’s hospital room. Still a little out of it from the previous night’s anaesthetic, she smiled blearily at us, so proud of the little boy who’d come into the world with considerably more drama than any of us had wanted or anticipated, but seemingly safely nonetheless. She held Colin in her arms as he tried to feed in those early hours of life; later, while we shot pictures and video, all of the grandparents gathered and took turns holding this beautiful little creature, the first grandson in any of our lives.
Despite knowing how necessary and possibly life-saving that Caesarean section was, Lauren harboured regrets for the rest of her short life about not having given birth naturally. I can’t say for sure, but I believe that those feelings may have stemmed from the prevailing online attitude that it wasn’t a “real” birth experience unless you pushed. I would remind her how truly fortunate she was to have gone through but one contraction, and how she would probably have an option to give birth naturally if she chose to have another child down the road. How much she took my words to heart, I’m not sure; after all, I wasn’t really the poster child for doing things the hard way when it came to giving birth. You see, the moment I found out I was expecting Lauren, I asked my chuckling doctor if I could just go ahead and book my Caesarean delivery then and there, as though it was a mere matter of finishing up with a pedicure and scheduling another in a month or so. And that’s why this chicken crossed the road, or at least tried. To get out of labour, dahling! As it turns out, I needn’t have worried; I sailed through pregnancy, labour and an anaesthetic-aided birth. To paraphrase the Nancy Sinatra hit, “These hips were made for birthin’.”
Lauren put the most pressure on herself, and felt the most disappointment, where breastfeeding was concerned. Looking back, I realize now that she simply did not come from a long line of big milk producers. Who knew this was even something that
can run in families? Even if this lactation limitation had dawned on me while Lauren was pregnant or nursing, I don’t think I would have told her, lest it add to her feelings of discouragement. But as was the case with her blue eyes, Lauren came by this limitation naturally: her cousins, her mother, even her grandmothers (on both sides) and at least one great-grandmother struggled to provide nourishment the way nature intended.
I tried to assure her that retreating from her breastfeeding battle and choosing formula was not the worst thing that could happen. She herself had arrived three weeks early, and we almost immediately began augmenting her meals with formula delivered via a tiny tube taped to her daddy’s finger. If she didn’t put on weight, they weren’t going to let us go home together—and we wanted to leave! So we embraced what the hospital’s kind nursing staff offered us as an option and gave her what we felt she needed: a combo meal to go . . . home. There was no judgment that we perceived at that time: the nurses simply offered it as a way to help our baby put on weight. And there was another benefit to that tiny tube, either taped to my breast or to Rob’s pinky: the fact that her dad fed her as often as I did, even in those early days, was probably a harbinger or at least a symbol of the unusual closeness that this daddy/daughter combo would share, in large part because he was the one who woke, fed and prepared her for her day, every morning, while Mommy was on the radio.
Lauren fought so hard to feed Colin. She shared with me during evening phone calls her nervous countdown to each doctor’s appointment, and she would report in to me regularly about his weigh-ins, literally frustrated to tears. His continued failure to grow at a rate that she and her doctor considered normal or satisfactory worried her and her husband. From what she told me, this was truly the only source of any sadness or consternation in her new calling as a mother. Somewhat reluctantly, she admitted to me that she felt as if, for the first time in her life, she might be on the verge of sliding into depression. Her tears mixed with her baby’s as she struggled to give him the nourishment that he needed when he needed it, which was at all hours of the day and night. And I can tell you from the early days and weeks after Lauren’s death, a baby cries harder when you’re rocking him and crying too. It’s as if the shaking of your chest as you sob transfers straight to that baby in your arms. I can only imagine the pain she felt at not being able to feed her sweet boy, and they cried together.
I was reluctant to push Lauren or even nudge her in any direction; she was the kind of daughter who did not take well to advice that she didn’t want to hear. She would call from work when she needed help with the pronunciation of a foreign newsmaker’s name or from home when an appliance wasn’t working and she needed her dad’s help. But if Lauren had her heart or mind set in one direction, you might as well have been talking to the wall. So that’s why I didn’t come straight out and tell her to stop fighting and supplement with formula. Believe me, I’ve asked myself a thousand times why I didn’t try harder, but deep down, I know the answer: she’d have taken out her frustration with the entire situation on me. So instead of going hard with the formula suggestion, I continued to try to encourage her in any way that I could: we talked about natural herbal supplements like fenugreek and blessed thistle, and she took them right away. Her breastfeeding buddy—someone with whom she was teamed up by the city’s public health department—cheered her on, encouraging her not to give up and to keep trying to breastfeed, even when Colin’s weight was on a low percentile for a baby his size and age. On top of that, one so-called friend boasted of having enough milk for both of their babies, while Lauren struggled to produce enough just to keep her own baby growing and healthy. Thanks a lot! Her frustration mounted and she found herself at her wits’ end. What more could she do? Soon enough, Rob and I would pick up that heavy yoke of frustration, sadness and desperation as we, too, searched for answers to questions arising from a seeming breach of the laws of nature: as sure as a mother should be able to produce the milk her infant needs, parents should expect that their child will live a full and long life. How could this all have happened?
Our initial, unending “why?” soon turned to “how?” We knew from conversations Rob had had with the coroner in the first forty-eight hours after Lauren’s passing that getting a response to this deeper question would not be a speedy process. There were numerous tissue samples to examine, tests to run and possibilities to rule out. Those in the coroner’s office promised to be thorough in their efforts to give us answers, and we have every reason to believe they were. But very early on, the coroner was examining whether a drug that Lauren decided to take in her desperation to augment her milk supply might somehow have interacted with an undiagnosed heart defect.
She would have had no reason to be tested for any possible heart problems; even before surgery for gallbladder removal just a few years earlier, she had not had an electrocardiogram. Now, given that the drug she was prescribed, domperidone, is believed to interact with abnormal cardiac rhythm in some patients, we wish that the test had been run. Had those results shown a problem and been part of her medical records, she might not have received the prescription.
I found out about domperidone’s history only one day after Lauren died. My friend Lisa Brandt emailed and asked if, by any chance, Lauren had been using it. I remembered our daughter mentioning that her cousin was taking it for her own problems breastfeeding, and my own dad was on it for a short time because of a medical gastrointestinal problem. Its similarity to the name of a favourite champagne, Dom Pérignon, had made it immediately familiar. When I called Lisa and told her that Lauren was indeed taking the drug, Lisa’s response was “Oh my GOD!” Delivering what was the second biggest shock I would get that week, she told me that she had been taking it for a medical issue. She’d stopped, cold turkey, when a story came across her news desk that in 2004, the US Food and Drug Administration, which had not approved its use in the United States, issued a warning specifically to nursing mothers about the potential harms, including the reported risk of cardiac arrest from intravenous use. In late 2014, in the United Kingdom, it was withdrawn from the market as a non-prescription drug, and British doctors are instructed not to prescribe it without conducting a medical assessment of their patients to determine if it’s suitable for them because of the risk of cardiac side effects.
Lisa also told me about a young woman at her radio station who said she had been taken off domperidone after heart tests had revealed a pre-existing murmur. The woman, who was Lauren’s age and also had a young son, had been taking it to encourage breast milk production. The drug is approved in Canada for certain gastrointestinal conditions, but its use in stimulating lactation is “off-label.” Health Canada and the manufacturers have advised that the drug may have cardiac side effects in certain patients.
As soon as I got off the phone with Lisa, I contacted Lauren’s cousin Meaghan, herself a young mother of a son just a few months older than Colin. We talked about her own situation.
There certainly is a lot of pressure. I never felt pressure from others, but from myself. Breast is best! What parent doesn’t want to do their absolute best for their child?! I struggled so much with both of my babies to nurse them. When it came to the decision to formula feed my second child, I felt horribly guilty. I felt like we wouldn’t bond, he wouldn’t love me, that I wasn’t giving him what was best. . . . The list goes on. I personally don’t care what other people think, but I have received more looks and “side eyes” from pulling out a bottle to feed my baby than I ever did pulling out a boob! It’s crazy! There’s a huge divide between moms that formula feed and those that breastfeed. “Fed is best” is an idea movement that is making progress now, and that’s where I stand.
“Fed is best.” Have you ever heard of this? Until my niece mentioned it, I certainly hadn’t, or I most definitely would have looked into sharing the website www.fedisbest.org with Lauren. After having read more about it, how I wish the organization, founded in July 2016 in the United States, had been in existence during t
he time of her struggle, just to offer Lauren an alternative point of view to consider when it came to her and her baby.
* * *
WE were even more devastated now; as grieving parents—admittedly not scientists—it seemed possible to us that our daughter had died taking something exactly as it was prescribed. I can tell you in all honesty that in the days and months following our daughter’s death, with all of the emotions we slogged through, truly the only time we were angry at our situation was when we learned that a prescription drug our daughter was taking perfectly legally in Canada was not approved in the United States and was strictly limited in the United Kingdom.
Could it be that Lauren’s passing was not just some horrific accident of nature but caused by something completely preventable? This became the question that moved to the forefront of our minds. The coroner had voiced his preliminary suspicions to both Rob and Phil, but we held onto hope that perhaps we’d finally get some answers with the official coroner’s report.
It was April 2016 when a copy of the report was mailed to us. Receiving it was one of those life moments that takes you out at the knees. After my radio show, I had made the short walk from the station to our condo across the street and was in a cheery mood. Another harsh Toronto winter was finally leaving town and spring was in the air. I said hello to our building concierge and, as I usually did, got the mail from a small room adjacent to the lobby. As I sifted through our mailbox contents, ready to pitch junk mail and flyers into the recycling, I stopped when I saw the official Ontario emblem on an envelope from the Office of the Chief Coroner that had been curled to fit into the box.
I felt an icy shock run through my entire body. I numbly closed the mailbox and took the elevator to our floor. When Rob greeted me inside our apartment, he could tell by my face that something was wrong.