The short version of how breastfeeding improved

This post is long overdue. For those of you who supported me in the early days of my breastfeeding difficulties, I wanted to share that in September when Calvin was 6 months old, we saw a new lactation consultant who LOOKED IN HIS MOUTH and said, oh yeah, "this isn't you -- he has a lip tie." That explained EVERYTHING. Lip ties and tongue ties are related to problems in the baby (difficulty latching, failing to establish a good suction and therefore gets a lot of air, causing acid reflux and other indigestion -- eventually leads to malformations in jaw that can narrow the jaw, leading to dental and orthodontic issues) AND problems in the mother (sore breasts, mastitis, under or over supply issues). Lip ties and tongue ties, I am discovering, are highly undiagnosed. We had it corrected with a laser, and within two weeks ALL those symptoms in both me and Calvin were GONE, and breastfeeding become so much easier. So did pumping. It was like a miracle. Within three weeks he preferred breast over the bottle. Who saw that one coming? Certainly not me. I feel so fortunate.

Knowledge about Tongue and Lip Tie passed out of the realm of common medical knowledge in the early 30's when formula was considered better than breastmilk and women were encouraged not to breastfeed. I have scholarly articles from well-respected medical journals if anyone is interested in the research, but for those of you out there who either are having problems breastfeeding, had problems breastfeeding and are curious about a possible cause, or are pregnant and would like some information about something that could affect your infant feeding (whether you plan to bottle- or breast-feed), please check out this link.

How to Diagnose Tongue and Lip Tie

Just to be clear to everyone, I didn't post this hoping to villainize my friends who have opted for formula. I have posted it as a general PSA. The fact is that I have a lip tie, too (it can be heritable) and I still have all the acid reflux, dental, and orthodontic problems that are the later-in-life possible consequences of untreated ties. I would love it if someone had caught it when I was a baby.

Crying Over Spilled Milk

The following was originally posted on my personal blog, spokeschicken.blogspot.com on May 30, 2012.

Anyone who knows me knows that I meet adversity with determination.   And if it’s not working, I assume it means I’m supposed to try harder.  I am accustomed to success somewhere along the way.  This is the story about my milk supply – still not quite enough to feed my lad.  “Big deal,” say some.  “No, that’s not possible – keep trying!” say others.  But here’s my journey from producing nearly no breastmilk to producing almost enough to producing maybe 60%  of what my baby needs.   I have never felt more like a failure in my life.  But after everything I’ve done and gone through, I have to accept that my best is good enough.

I wanted want more than anything to breastfeed my baby.  I always saw myself as exclusively breastfeeding him from the beginning and couldn’t imagine that I’d have troubles with it.  After all – it’s natural.  It’s how we all got here, right?  And animals don’t seem to have problems with it.  Let’s start from the start.  Calvin and I had a rough delivery despite my plans for an easy, natural childbirth – a story for another time – and he was in the Level 2 Nursery for the first 29 hours of his life.  I was recovering from a fever and an infection, too, so it didn’t occur to me to ask for a breast pump in the hospital to initiate my supply in that very critical period.  Despite the hospital’s excellent staff and care, no one thought to offer it to me, even the lactation consultants on staff.  I didn’t breastfeed him until about 18 hours after he was born, and, even then, the schedule was nowhere near the recommended “every 2-3 hours or on demand” because of continued care (injections and IVs on both of our parts).  Why do I bother recounting this part of the tale?  Well, according to the lactation consultants I saw later on, that first couple of days is really crucial to establishing the hormone receptors that tell your body how much milk to make.  That’s a window of opportunity that we missed.  “Keep trying!  It’ll work; it’s biology!” was the message that I went with.  My knowledge from my nutrition program, from the nurses, from lactation consultants, and from well-meaning friends and family all dictated that if I just kept nursing him often enough, my milk would come in. 

But it didn’t.  It turns out that we had what is called an “inefficient eater.”  So even though he would spend up to an hour on each side, he was getting very little indeed.  Some milk was there – he just wasn’t drinking it.  As a result, I became painfully engorged – and not just for the usual 24 hours.  For 3 days.  I did everything you’re supposed to do: warm compresses, hot showers, leaning over basins of water, massages, and above all, continuing to nurse while hand-expressing, but it was bad news for the milk supply.   Two weeks later, we found out he still wasn’t gaining enough weight despite my very best efforts…. He still didn’t eat.  This kid loves to breastfeed! … or at least to be on the breast.  But he just wasn’t eating. 

So I became determined.   I tripled my protein intake.   I doubled my already considerable water intake.  I took really expensive supplements.  I ate more oatmeal (considered a galactogogue).  We paid to have a lactation consultant spend a long couple of home visits with us.  The scale she had told us that he was only getting  .6 oz of milk from me after an hour of eating.  What?!  That’s not much at all!  Two weeks in, he hadn’t literally sucked enough to establish any kind of milk supply.  So we rented a hospital grade breast pump and eventually bought the best home model of it that money can buy.  I started pumping after every time he ate – even if that meant I was pumping 14 times a day for 20 minutes a pop.  Dan was home with me, so I had help during that time.  I was on a mission.  “It’s biology!  Supply and demand!”   That’s the message I ran with. 

Meanwhile, rule number one of low milk supply is “feed your baby!”  So we did.  We used a supplemental nursing system for the first three weeks, but he could take a half-hour to work through a mere half ounce, so that wasn’t a good weight gain option.  Plus, it was such a stressful contraption that it took all the joy out of breastfeeding him.  So we started using nipple-friendly, slow-flow bottles just to get some food into him. 

Well.  He LOVED that.  And soon he started refusing the breast.  But he was a much happier baby.  Not being hungry all the time will do that to a person.  That said, I can’t possibly describe the emotional anguish I experienced every time he screamed at my breast, knowing that there wasn’t enough milk to feed him – despite my slowly- building supply and my increasing optimism that someday I still might be able to exclusively breastfeed him.

I won’t go into the rest, but I just want you to understand how hard  I was working despite knowing that he still had no interest in breastfeeding, and I cried every single time he refused my breast.  (That’s a lotta tears!)  I desperately wanted this to work. 

After pumping after every feeding for 6 weeks, (and with great effort to trick him back onto my breast by luring him with the bottle) he took my breast again and started breastfeeding.  We noticed that he started turning down the bottle after breastfeeding, indicating that he had had enough.  Then we noticed that, when I was at school, Dan was able to give him enough breastmilk from the prior day’s pumping that he didn’t have to use formula every day.  In other words, it was working. 

Two weeks later, school ended, and I was home alone with Calvin every day.  And to my surprise and great delight, he seemed cool with exclusively breastfeeding.  I had the best week with him!  I was feeding him all the time, and he seemed full.  And for a week there, he was a good eater.  I was cautiously overjoyed!  ….Then, things started turning.  He started sleeping more and crying more.  And refusing the breast again.  And getting seriously crazy similar to how he behaved before we realized he was starving all the time.  And then it hit: mastitis in my left breast.  He never did like lefty as much because it’s slower (lefty’s the one that was the most engorged and blocked at the beginning, and I don’t think it ever fully recovered), so he doesn’t totally drain it most of the time.  But YOU try pumping after every feeding when you’re home alone all day with a kid who screams when you put him down.  I just don’t have the gumption or resilience or whatever to say, “Hey, kid.  I know you’re miserable right now because your cries are hurting my eardrums, but try to chill out in your bouncy seat for another 20 minutes until your mom is done pumping.” 

Oh, yeah – mastitis is bad-news-bears for milk supply.  A 32-hour fever of a 102 before you recognize what’s going on will do that to ya.  So it’s back down again to about 60% of what he needs.  And I am devastated.  No, seriously.  Devastated.  I am in mourning over my milk supply.  That’s where I finally broke down enough to need to write about it. 

The number of times I have broken down and cried for 2 hours at a time about this whole thing is absurd.  Let’s not go into the full-scale meltdowns I’ve had when he spits up a lot of what I just fed him.  No matter how much I tell myself, “I just have to accept that I have what I have,” I can’t seem to feel OK about it.  The fact is that I had enough for him – he just didn’t drink it.  And he’s simply too much of a handful for it to be realistic me to keep up with the pumping while I’m home alone with him all day. 

Why am I recounting his?  To deal with the number of times I have thought that I had finally come to terms with my situation only to have a complete emotional breakdown about it 2 days later.  To publicly announce the shame I feel so I can try to get past this.  Partially, it’s so that other mothers out there who might have low milk supply who have also tried this hard can read something they can relate to.  Partially, it’s to address the people who don’t understand. 

How many more times do I have to answer the question, “well, did you see a lactation consultant?”  Yes, two.  And I had several hour long home visits and lots of phone calls from both of them.  “Are you eating oatmeal?” … yes – around 2 cups a day.  “Are you eating enough protein?” “Drinking enough water?”  “Taking fenugreek, fennel, golacta?”  “Drinking nursing tea?  Beer?” “Co-sleeping?”  “Nursing all the time?”   Yes, yes, yes!  Well-wishers say, “Just nurse more often!”  Well, given what a lazy breastfeeder he is, that’s what got me into this mess – twice!  For the love of god, I’ve done everything a person can do. 

Through it all, I’ve had every nipple and breast ailment that accompanies breastfeeding that a poor woman can have.  Engorgement, cracked nipples, two cases of nipple thrush (yeast infection), vasospasms that make my nipples turn  cold and white, milk blisters, blood blisters that exploded in his mouth and made him spit up blood (absolutely frightening!), blocked ducts, and finally, a breast infection (the mastitis).  My husband pointed out to me that this is the first time in his recollection that I have not listened to what my body was telling me.  But it’s more complicated than that, see?  My maligned nipples might be telling me one thing, but my every biological and emotional impulse is telling me “feed this baby from your boobs!”  I desperately want to provide milk for my baby.  Furthermore, I like breastfeeding.  The connection is wonderful.  But the look on his poor face when he realizes that the bulk of the milk has run out before he’s full is not. 

Oh, yeah, did I mention that my milk was giving him bloody diarrhea?  We’re working on that one – presumed cow allergy, so I’m cutting out all dairy.  Really, it was just yogurt since I am sensitive to dairy, too.  Still, it’s too bad because it seemed like eating a lot of yogurt increased my supply.  Add that one to the list of “Oh, well”s.

I hate feeling implicitly judged by people who tell me it should work, not because I think they’re actually judging me (though I am sure some secretly are), but mostly because I am judging myself.  I have wanted so much for this to work for the last three months.  I have worked so hard, and I am used to things working out when I try hard enough.  But what I have to remember is that breastfeeding is a two-person job, and three months in, he’s still asleep at the wheel.  No amount of hand-expressing and poking and prodding to wake him up can drain my milk into his mouth.  And to those of you who say, “pump while he’s sleeping!” – what am I supposed to do when the kid only sleeps on me?

The fact is that I have been so obsessed with my supply that I haven’t enjoyed what a fun and engaging baby he is.  And I think that, finally, I think I have to accept where we’re at so I can get on with my life and enjoy my kid and prevent him from getting so hungry that he goes insane.  I will provide him with milk as long as I can, whether it’s 6 months or 3 years, and I have to feel OK with what I can do.  My breast may be his absolutely favorite place to enjoy a warm snack and take a long nap, but it is not where he gets enough food to eat.  And it’s not for my lack of trying.

P.S. Appropriate responses are messages of support.  Please don’t ask me if I’ve tried anything or offer advice.  I’ve done my research and tried everything.  At this point, it’s important for me just to feel good about what I have.

UPDATE: 
Please read my post at http://spokeschicken.blogspot.com/2013/03/the-short-version-of-how-breastfeeding.html
Believe it or not, things improved because of a lot of support and help from a friend of a friend.  I'll write the whole story up one of these days, but in the meantime, I just wanted all you out there who can identify with this process all too well that there is hope.