(Cont'd from part 1...)
During these first few weeks I had always remained optimistic that eventually I’d get my supply up enough to exclusively breastfeed Aidan. I started researching everything I could find online about how to increase milk supply. To be honest, I was hoping I would find The Answer from Dr. Google, when I should have just started reading The Womanly Art of Breastfeeding to begin with. However, I scavenged the internet until I was certain I had located all quality information before I ever cracked the book.
I continued to pump frequently. I started eating oatmeal daily, taking fenugreek, and drinking plenty of water. I still tried to put Aidan to breast when he showed signs of hunger, but always eventually caved to his cries for the bottle, still believing that I just didn’t have enough milk for him.
Finally, I started reading Womanly Art. My conviction to exclusively breastfeed Aidan was renewed as I learned even more benefits of breastfeeding. I also learned about all the mistakes I’d made in the early days, and the guilt set in. Something else that caught my eye was a condition called “breast hypoplasia,” or insufficient glandular tissue (IGT), which is one of the rare physiological problems (rather than a management problem) that can reduce a woman’s breastfeeding success. What caught my eye were the graphics of breasts that may have this condition: one pair of breasts looked disturbingly similar to mine. I showed my husband, who raised an eyebrow, but put the thought aside.
From Womanly Art, I learned how to bottle feed in ways that support breastfeeding, so my husband and I immediately started using those techniques. We started pacing the feeds, which Aidan handled well. He actually spit up far less, which was great considering we were still supplementing mostly with precious donor milk. I also started trying to supplement Aidan BEFORE breastfeeding, rather than after, so that he would develop positive associations with the breast, not the bottle. The first couple days of this practice were rocky. It was hard to determine how much to supplement him so that he wasn’t too full to take the breast, or too hungry to refuse it. And usually we ended the feedings with a bottle because it was just too painful to watch my sweet little baby screaming as I struggled to get him to latch on. I am sad to think of the time I spent crying during the first weeks of my son’s life, when I should have been spending that time simply enjoying him.
At Aidan’s one month appointment, he had gained well, and the doctor was pleased. He was up to 11 lbs. even (from 9 lbs. 5 oz. at birth). And the doctor said we could just keep doing whatever it was we were doing, in terms of feeding, because he was a healthy size.
Around Aidan’s fifth week of life, I scheduled another appointment with yet another LC, just to see if she had any new insight. She spent at least two hours with me, watching me breastfeed Aidan, and provided some tips on helping him to latch more efficiently. She also helped me to realize that I hadn’t been giving my son enough credit. She suggested that if I supplement him before breastfeeding, that I do not take away a bottle with milk still in it. She said he’d know there was milk in the bottle, which would add to his irritation at the breast. I was skeptical that a baby could tell the difference between a full and an empty bottle, but I was willing to give it a shot.
I left that meeting feeling cautiously optimistic. Given that it really seemed like I’d tried everything (breastfeeding as frequently as I was able, pumping with a hospital grade pump, drinking Mother’s Milk tea and taking fenugreek, eating oatmeal, and even taking a series of prescription Reglan without results), the LC wasn’t sure if I’d get my supply up enough to exclusively breastfeed Aidan, but she was thought there was a chance.
The LC recommended I watch the videos on Dr. Jack Newman’s website, and this resource turned out to be one of the most useful in all my research. It was so helpful to clearly see women breastfeeding while a professional explained the mechanics. Most importantly, I learned a more effective way to use the SNS. I was inspired to try the SNS again, and to start to wean Aidan off the bottle.
The next couple days were nightmarish, as taking away Aidan’s bottle was like taking away drugs from an addict. It was like he was having withdrawals. I tried to put him to my breast with the SNS, and he would SCREAM like he’d never screamed before. He sounded like he was in pain. Over and over, for the next two days, I alternated between attempting to put Aidan to breast and comforting him. Finally, after many tears and hours of grueling perseverance, he started to accept the breast and I fed him via SNS. However, he took in MUCH less supplement, and I wasn’t sure if that’s because he was getting more at my breast, or simply eating less (had we been overfeeding him before?). He did have fewer bowel movements than before, which concerned me. But I was committed to feeding him at the breast as much as possible, following his hunger cues.
Around this time I had my 6 week follow-up appointment with my OB-Gyn. I attempted to explain to him the breastfeeding saga that I am relating here. It was all I could do to keep from crying in my doctor’s presence. He had to have known how important breastfeeding is to me, and he had to have known how distraught I was. Yet, when I asked him if he thought there was anything else I could do, he replied, “Why don’t you just pump and supplement with a bottle. Some mothers just can’t breastfeed.” And I realized he had no interest in helping me to explore what, if any, were the underlying medical issues affecting my low milk supply. He did, however, offer to write me a prescription for Domperidone, though he admitted to knowing nothing about it. He later reneged upon this offer.
Soon after, I read The Breastfeeding Mother’s Guide to Making More Milk, where once again I stumbled across a condition called “breast hypoplasia.” Only this time, one of the graphics of the hypoplastic breasts looked EXACTLY like my breasts. Though it was distressing to think that I might actually have a physiological condition inhibiting my ability to breastfeed my child, I was grateful that answers to the mystery might be on the horizon.
I couldn’t help but feel distraught anew. I cried harder than ever for the next couple days, thinking that all my efforts over the past 6+ weeks were for naught, and that I might never have the exclusive breastfeeding relationship with my son that I’d always dreamed of. I started grieving, but I remained proactive. I scheduled an appointment with a nurse practitioner to discuss my concerns about hypoplasia.
On the day of my appointment with the nurse practitioner, I scheduled a weight check for Aidan. He had only gained 8 oz. in 15 days, so the ped said I need to supplement him more. Plus I had no idea if he’d gained most or all of those 8 oz. prior to or after cutting back on his supplement.
Meeting with the nurse practitioner was much more satisfying than meeting with my OB. The nurse practitioner immediately indicated that she was passionate about breastfeeding. She seemed genuinely interested in helping me to find answers to this supply mystery. She ordered me blood work to test some of my hormones, and I am currently awaiting the results of these tests.
That day I met with the same LC I met with the first time. She began by measuring the space between my breasts, and stated the space was wide enough to cause concern. She was very kind and admitted that she hadn’t really worked with someone with hypoplasia before, and I doubt she usually sees people nearly 7 weeks postpartum and still struggling with low milk supply. She offered to contact her instructors from her IBCLC program for answers. The LC also suggested I go back to basics: relax about the pumping, and just spend some good old fashioned quality time holding Aidan skin to skin, in laid back nursing position, as much as possible.
And this is where I stand. I have spent nearly three days almost constantly topless, holding my nude baby against my chest, offering him the breast as much as possible, and only taking time out to prepare his SNS bottles and write this. And it could be my imagination, but it seems like my supply has gone up some. I am still concerned about Aidan’s low weight gain, as I haven’t supplemented Aidan more as suggested by the ped. Instead, I am trying to just follow Aidan’s hunger cues and feed him accordingly, supplementing him via SNS when the breast hasn’t appeared to satisfy him.
Hopefully tomorrow I will find out the results of my blood tests, and hopefully my nurse practitioner will offer me some direction. I am so curious to find out if my supply issues are due to mismanagement in those early days, or due to a physiological problem, or perhaps both.
I am starting to feel more at peace that I might always have to use the SNS to breastfeed, and that exclusive breastfeeding may not be possible for us. However, I plan to remain as proactive as possible: daily oatmeal, fenugreek, blessed thistle, red clover, Mother’s Milk Tea, More Milk Plus, and frequent skin-to-skin nursing. I am relaxing a bit about pumping, because, as my LC put it, Aidan is far better at emptying my breasts than any machine could be. I am trying to focus more on enjoying these precious moments with my sweet son, rather than focusing on breastfeeding itself, which has sadly been my priority over the last 7 weeks. I have found comfort reading the posts in the LLL forum, especially from women who describe a long struggle, and in the end are finally able to exclusively breastfeed their babies. I still dream this is possible for us.