I have been waiting for this week for some time because I wanted to share my breastfeeding story. I feel like I need to share it because it has been something that has been the most wonderfully heartbreaking thing in my life. I have to share it because I feel like a breastfeeding fraud in some ways, and I need to get that off my chest... haha, see what I did there?
This is a long story, but most details can't be left out or it wouldn't be the whole story.
Before I got pregnant, and when I was pregnant, I knew that I would breastfeed. I wanted to exclusively breastfeed (from here on out I will use the acronym EBF) until at least a year. There was no doubt in my mind. I scoffed at the mounds of free formula samples they gave me when I registered at Babies "R" Us. I was horrified when formula samples began to show up in my mailbox from the various companies. I rolled my eyes every time I got a "formula check" in the mail. Didn't they get it? I was NOT using formula. It got to the point that I offered these formula checks to women on my Facebook pregnancy group. I wouldn't need them, so why not pass along the savings?
I remember one time in particular, a well-meaning woman wrote on my post offering formula checks something like "You should keep some of these; I tried to breastfeed my baby and couldn't." I was shocked. What did she think, I was just going to give up if breastfeeding got tough? In my defense, these coupons did expire before my due date, BUT I remember being horrified at her response. It is one of my most vivid memories of being a formula-judging EBF nazi.
Thursday, February 20th. The day of my c-section came. The nurse asked me, "Are you going to breastfeed?" and I of course replied enthusiastically, "Yes!" She wrote it on the whiteboard in my room in all caps: BREAST. I remember asking, "When will I be able to feed him?" knowing that I couldn't do skin-to-skin immediately because of my surgery.
In the recovery room, breastfeeding--I still couldn't feel my feet!
The second we arrived in the recovery room, I undressed myself and Ollie for skin-to-skin. He immediately began to suckle. For the next 24 hours, I fed him constantly. He was fairly lethargic and when they weighed him, he had lost 9% of his body weight in 36 hours. I was convinced it was the c-section IV fluids that had plumped up his weight to begin with; in my mind, he hadn't actually lost that much. The next day, he got down to 11% weight lost, and I had a choice: supplement with donor milk or supplement with formula. My aunt (who is a staunch breastfeeder) said not to do either--give it time, my milk would come in, supplementing was going to cause me supply issues. I reluctantly started feeding him the minimum amount of donor milk (about 20ml), but I REFUSED to do it with a bottle, and used a supplementary nursing system (SNS) either on my breast or finger. I didn't want him getting "nipple confusion" by using a bottle!
By day three, he was still losing weight and his bilirubin levels were climbing. They told me I needed to supplement more and they couldn't discharge us until his bili levels leveled out or started dropping. I was terrified that by supplementing, I was ruining my supply. I asked to see a lactation consultant. Something was wrong. Why wasn't I engorged? Why hadn't my milk come in?
She was a nutty woman who brought me a hospital grade pump to stimulate my nipples so my milk would come in and helped with positioning Ollie a little better. I remember her looking at my breasts and saying, "Sometimes women with a wide space between their breasts have delayed milk production." I didn't think much of that comment until a few weeks later. At the time, that comment, and my c-section, answered my question as to why my milk hadn't come in yet.
So there I was, pumping after every feed, getting the tiniest amount of colostrum. Pumping ruled my last 24 hours in the hospital. I remember my best friend coming to visit me and I was pumping. God love her, she didn't run at the sight of me hooked up like a Jersey cow. My milk was barely trickling in at that point, four days after birth. Ollie's bilirubin was still higher than they wanted, but they let us go home Sunday afternoon. They gave us a small amount of donor milk to take home and a case of pre-mixed formula. They said I HAD to supplement 30ml (one ounce) every feed until my milk came in.
Monday after he was born, we first had an appointment with his pediatrician and then we had an appointment with a lactation consultant. These appointments conflicted in advice. The pedi said we needed to keep supplementing; the LC said to stop supplementing. The pedi said he wasn't getting enough; the LC said he was transferring almost an ounce after we did a weighted feed and that his stomach was the size of a walnut. The one thing the two of them agreed on--pump, pump, pump after every single feed. I will mention at this point, my nipples were torn to shreds, bleeding, and sore. So, feeding a baby every 2-3 hours for 45 minutes, then pumping after? I didn't know how I would ever recover. On the way home, we stopped at Whole Foods so I could get some Fenugreek to help with my milk supply.
That afternoon the pedi called to say his levels were borderline for being hospitalized. We could bring him in, or feed and supplement every two hours. His feeding sessions were taking 30-45 minutes. And I still refused to give him a bottle. So that meant all night, we were sleeping in 60-90 minute stretches. I remember Eric sleeping on the couch next to me so we could easily get up and feed him. It was hell. I probably slept a total of two hours. I was terrified of sleeping through my alarm and not feeding him on time. That next morning we took him back to the pediatrician to check his bilirubin levels.
Tuesday afternoon we got the phone call--still no improvement. "You can do the feed every two hours thing, or you can bring him to the hospital for an overnight stay under the phototherapy lamp," she said. After an hour of tears, we decided to bring him in. I could stay there with him so I could nurse him. We started supplement 60ml (two ounces) of donor milk that night. He was out the next morning. The pediatrician said I needed to continue to supplement him 60ml each feed until he was back up to his birth weight.
Little Ollie under the blue lights
I was unknowingly starving my son. I listened to all the advice: nurse on demand, take a nursing vacation, take Fenugreek, power pump, drink gatorade... by day 6, my milk was "in" but not like other moms I knew. I was pumping about an ounce each breast after three hours. I was never engorged.
One of the sleepless nights of nursing, pumping, and supplementing, I began to think back about what the first LC had said. "Women with a wide space have delayed milk production..." What did that mean? Obviously Dr. Google came to the rescue and I began to read about Insufficient Glandular Tissue (IGT). It described me, and my breasts, exactly. NO they didn't change that much in pregnancy. NO I was never engorged. YES they have always been a little bit different than other breasts I had seen. I was devastated at my self-diagnosis.
I joined a wonderful low milk supply support group on Facebook thanks to a fabulous internet friend who herself had IGT and referenced me to the group. FINALLY, other women like me! Women who were pumping milliliters rather than ounces. Women who needed to supplement. Women who were devastated when they realized they couldn't EBF, many of them who had my exact story--delayed milk, told to not supplement, baby winds up in the hospital with high bilirubin levels. Women with breasts like mine.
In finding the group, I also discovered that IGT was not my only milk-making problem. Insulin sensitivity plays a huge factor in breast milk production, and I had all the signs that there was something off about my insulin regulation. Lots of fat around my middle, high amniotic fluid, near hypoglycemic blood sugar levels, being "hangry" (angry when hungry)... the list goes on. So in discovering this, I had a few women tell me about how Whole30 and Paleo eating can not only help me lose weight and get my insulin in check but also help with milk production. Hence, my Whole30 and Paleo focus since having Ollie.
After many, many tears, many hours of beating myself up, many days of pumping, and lots of money being spent on supplements (no, not formula--herbal supplements to increase milk supply!), I can say we are five months going strong. Yes, he gets supplemented. Why? Because without formula, or donor milk, he would die. He wouldn't be in the 95th percentile in height and 75th in weight. He would be starving. I make about 10-12 ounces per day... not enough to cover half of the 25ish ounces he needs. Breastfeeding with low supply has been the hardest thing I have done in my life--I am glad that I have had the resiliency to stick it out.
Many women who EBF think I didn't try hard enough; many mothers who formula feed wonder why I am still trying. I am in limbo. I am unusual. I am part of the 3-5% of women who don't make enough milk for their baby (which if you think about it, is still A LOT of women). The truth is, when I let go (let it go, let it gooooo) the fact that I don't make enough milk, and I remember that it is about more than just the amount of liquid in my boobs, I really truly enjoy breastfeeding.
This is why I breastfeed. This is why I will continue to do it as long as he tolerates my measly supply. I know women can connect with their baby by bottle-feeding. But for me, when he is nursing, there is no better connection that I can imagine for me and my son. I am crying as I type this knowing that I have worked my ass off for him to have 10-12 ounces per day. I could have very easily given up (and many people have gently encouraged it over the past five months). YES the nasty herbal tinctures and exhaustive pumping schedule are not fun--but THIS, this picture, these moments, make all of that worth it.