Tuesday, October 16, 2018

milk supply - when breast milk isn't enough

I don't think anyone prepared me for how hard breastfeeding would be. I thought that I had read enough books and articles. As part of my Bradley Method classes, I even went to a Le Leche League meeting before Edmund, my first baby, was even born.

I knew I had a family history of low supply. My mother, my Aunt, and my sister could all not fully breastfeed their babies. I thought that maybe they had given up too soon. (Sorry ladies! I realize my ignorance now.) I thought if I tried hard enough, nursing would just work.

I was wrong.

I have written about my struggles with nursing in the past - here. It was helpful because primarily, I didn't want to be judged if I fed my babies a bottle of formula in public. What made me want to write about my nursing story again, is I recently read the following article from the NY Times "What to Say When Someone Asks Why You Aren't Breastfeeding." Having a new baby, postpartum hormones, and reading this article brought up so many emotions for me.

I guess, I will start at the beginning.

I started having children in an age where there has been a heavy push for breastfeeding. It is most likely due to a backlash from the decades where formula was touted as being better than breast milk. We now know that there are many amazing properties to breast milk and "breast is best" is being pushed in new mom's faces more than any other phrase.

From the beginning, I wanted to breastfeed my kids. It was cheaper and considered the best for babies, plus the bonding experience sounded wonderful. After having three other children, visiting around a dozen board certified lactation consultants, I have come to really accept that I have low milk supply and fully nursing my kids just wasn't going to happen. While the causes can vary from woman to woman, I was diagnosed with insufficient breast tissue.

Breastfeeding always seems to start well enough. The lactation consultants at the hospital have always said that the baby's latch looks great. The baby is having plenty of wet diapers and stool. While my nipples are getting increasingly store to the added stimulation, I am excited that the baby seems to be doing well.

It is around day 3, that I always notice that the wet diapers aren't keeping up with the recommended number. My milk has not come in yet. They say it should take 3-4 days for your milk to come in. Mine takes closer to 7-8. I am not sure why. It's just what I have noticed based on what I see when I pump.

Eric and I decided that I would skip the hospital grade pump this time around and any additional lactation consultant visits. I had already partially nursed 3 children. What else could they possibly tell me? Also, the pediatrician told me that she didn't have a tongue or lip tie. So, after arriving home from the hospital, I started slowly adding bottles after my nursing sessions. I also started pumping a few times a day to help get my supply in. When you are already exhausted, the added tole of these extra tasks can be exhausting.

I was hopeful that I was making progress. I didn't hear the baby gulping and swallowing a ton when I nursed. I hadn't felt any let downs yet, but I knew that they would come. My nipples were getting really sore, despite religiously using the lanolin on them. I think that Emma is not bringing her tongue quite far enough forward when she nurses. I had the same problem with Clara. Emma seemed to be a tired baby and not a strong nurser at first. She would nurse well for about 5 minutes and then get bored and would cry when I tried to latch her again. By this time, I was up to 4 pumping sessions a day and getting only a few drops out each time. I tried to pump after I tried to nurse so I was hopeful that my colostrum or milk supply was being taken in by Emma. In the middle of the night between Friday/Saturday, Emma didn't nurse well at all. She was 5 days old at this time. She kept popping off and crying after trying to get her to latch about 20 times. I tried burping her. I tried different positions. Nothing worked. Frustrated, I decided to give her a bottle and go downstairs and pump after putting her down. She had barely nursed and I was disappointed that I got almost nothing out of either breast. I felt disheartened, but went upstairs back to sleep. A few hours later when she woke up, I did the same thing all over again. She didn't want to nurse so I was optimistic that I would pump milk out this time. I cried when after 20 minutes of pumping, I had nothing but a few drops of milk. I lost it.

I went upstairs and sobbed to Eric that I was done. That I wasn't producing any milk. This was ruining my love for Emma. I was over it. Let me tell you that Eric is the best. He just held me as I cried and cried. He told me that I could quit if I wanted to. I did want to. He also encouraged me to try exclusively pumping for a day to see if I got anything out. I told him I would try. I didn't want to. I mean, I REALLY didn't want to. I wanted to be done. The only thing that kept me going was my desire for her to get my immunity benefits over the winter months.

I was so upset. I did the only thing that I could do besides pray. I reached out to friends, fellow moms. I emailed and talked to friends and found a whole tribe of women that were in my shoes. They struggled to produce enough milk, just like me. Some chose not to nurse and some chose to supplement. Either way, it was a very personal decision and I found so much comfort in hearing different people's stories. It was especially comforting to hear from those that had chosen not to nurse. Their babies were perfect. Emma would be perfect too, even if she didn't get any more breast milk.

So, I pumped. I got about 4 ounces out that day. It wasn't much, but I was grateful to see something. I kept pumping and trying to nurse. It was hard, but my supply has slowly increased to about 12 ounces a day. To some, this might not seem like much, but I was thrilled. This means that she is getting about 40% of her milk intake from me. I would love for it to be more, but I just can't spend any more time on this than I am. I am pumping 6-7 times per day, on top of nursing 3-4 times per day. I am trying to increase the number of nursings, but the schedule of when I can pump and when she wants to nurse don't line up great. Emma is still not a great nurser. I am going to talk to the pediatrician again about a possible lip tie.

It is working well enough for us.

Breastfeeding is hard. Harder than I ever thought it would be. It can be terrible. It is not for everyone. It's okay to stop. It's okay to choose formula. What is important is that your baby is fed. Period.

I am going to stop the phrase "breast is best" and focus on a better phrase, "fed is best".

-Anna