Breastfeeding Memoirs: Third Time's a Charm

In honor of World Breastfeeding Week 2015, we are sharing inspirational stories from breastfeeding/working moms.  

Today’s story was written by Lilly Penhall.

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Being a freelance contractor has its benefits to a work-at-home mom, that’s for sure. Flexible schedule, control over your workflow, and a certain sense of freedom comes with working for your own business instead of someone else’s. However, when it comes to maternity leave, freelancers don’t have the advantage of six weeks of paid leave that some employers offer. I returned to work two weeks after the birth of my daughter, who is now 18 months old, and started working only ten days after my son was born in June. To complicate matters, I was determined to breastfeed my babies.

My first child, born over 10 years ago, was given formula in the hospital nursery (at the time I lived in a small Texas town where that was standard procedure) and only breastfed for about 6 days until we had such trouble latching that I, being young and uneducated about nutrition, decided to just continue to give her formula.

Many years and a cross-country move later, I started freelancing when I was six months pregnant with my second child, after having lost my sales job for lack of productivity. Sales wasn’t my field, but I was doing it because I needed to support myself; however, at that point my boyfriend and I were combining our finances and I was able to take some time to figure out what to do next. I had been volunteering my graphic design skills for years, but had not really tried to pursue it as a career, thinking my skills were not enough to make a living. Thankfully, having years of experience designing books for self-publication for family and friends, I started advertising myself as a book designer to fulfill that niche market. My business took off right away and I was able to start building a loyal clientele who loved my work and sent more clients my way.

After a full working day in labor at 41 weeks, we had a nearly tragic delivery and my daughter spent six hours in the NICU before I was able to see her, hold her and feed her. When I finally had her in my arms, she had the same troubles latching that her sister did—specifically, on my right breast. She was given a pacifier in the NICU, but whether that contributed to her breastfeeding issues is really hard to determine. I called the nurses at almost every feeding to help me latch her, but it was a frustrating routine that I continued at home, replete with many tears especially during the night when I was tired and couldn’t get her to latch.

I started pumping right away on the right side so that I could at least feed her breastmilk in the bottle. After two weeks, the (relatively) cheap single pump burned out and I was again struggling to get her to latch, which was more difficult now that she was used to the bottle. On top of that, a very demanding client who I had been put on hold when I went into labor, started calling daily and asking when I was going to finish her project. As much as I wasn’t ready to start working, I was guilt-tripped into it and started spending four or more hours a day on my client’s project which limited my ability to breastfeed even further.

At my child’s one month WIC appointment, I expressed my concern to my caseworker and was met with a blank stare and the reply, “You don’t think breastfeeding is easy? I think it’s easier than making a bottle.” She did not offer lactation consultant services or any help at all. My frustration turned inward into anger and depression because I felt incapable of providing nourishment to my baby that was supposedly so easy. I blamed my sagging breasts with nipples that pointed at my toes. I blamed my baby’s severe reflux that caused her to spit up half of what I fed her, leaving her still hungry and crying when I didn’t have any milk left.

I blamed the pediatrician we saw at her two week appointment because he misdiagnosed her thrush as “just dried milk” and it got so severe in her that her entire mouth was white and her skin broke out in rashes, while I had a full-blown candida overgrowth throughout my whole body that left me drained and deeply depressed, as well as an intense burning pain when my milk let down. I blamed my demanding client for taking up all my time, and further blamed myself for taking on the job when I should have been dedicated to my baby. I blamed myself for drinking too much on my birthday when she was one month old—a night when I really needed a break—and bought a can of formula to feed her, thinking my breastmilk was toxic.

Finally, I made an appointment with the lactation consultants at WIC and went in for some help, but by then it was almost too late. I was only producing a small amount of milk and my baby was constantly hungry. Still determined to breastfeed, I had clients write letters to WIC saying that I was working full-time so that they could supply me with a Medela double pump at no cost. When I finally got the pump at six weeks postpartum, even pumping every hour for days didn’t produce more than 2-3 oz of milk over the entire day, plus dry pumping was very painful. As hard as I tried, with all the tears I cried and all my efforts, I couldn’t continue breastfeeding my baby any longer. I remember when I put her to by breast for the last time, at six weeks old, and feeling the strangeness of her trying to drink from me when I was completely dried up. I felt useless and rejected by my own child, but I had to surrender to reality. If I couldn’t breastfeed, at least I would get her the best organic baby formula on the market.

Even with all the trouble I had with my girls, I knew I would try again with my next baby, and this time I would have more tools, more knowledge and more patience. I got pregnant again when my daughter was 7 months old, and we decided to be surprised as to the gender of our new arrival. I continued working from home and taking care of my baby at the same time until she was one year old, when I was offered a really well paying work-from-home job that would require more of my time. We put our toddler in daycare so that I could work full-time for my new employer, a university that needed web design work on a contractual basis.

I was working 40+ hours per week until I went into labor, at first from home, then I spent two months working at the university before I went back to working from home as my due date got closer. This time my baby decided to show up unexpectedly 2 weeks early and I was right in the middle of a project. I emailed my bosses from the hospital and told them I was having my baby and I would be back to work in a few weeks. This time, the delivery went more smoothly and my son was placed on my chest directly after birth, as nature intended. He latched right away on both sides and I can’t even express my relief and satisfaction at how easy it has been for him to breastfeed.  It’s the experience I always wanted, but never had. Even the clogged duct I got the first week when I was severely engorged didn’t stop us from breastfeeding; in fact, the colostrum-rich milk I pumped during that time was fed to my older child who had a cold when her brother was born (and it was the last time she got sick—coincidence? Perhaps…)

Although I had intended to wait at least three weeks before returning to work, we had gotten behind on our bills during my transition from contractor to employee back to contractor, so after just one week I requested another project and returned to work part-time at 10 days postpartum. This time, however, I have been able to successfully breastfeed my baby while working because of some things I did differently.

We established a good breastfeeding routine before I returned to work, and we didn’t introduce a pacifier or bottle until he was over one month old. I have been able to pump easily with the Medela and my nifty homemade pumping bra (an old bra with holes cut in the nipples to stick the pump shields through—works like a charm!). I have spent entire days not working when the baby has been more demanding, instead of sacrificing my time with my baby for a demanding client. My son is so easy to feed that sometimes I can hold him and feed him with one hand while working with the other, and when he’s milk drunk I put him in a wrap or carrier and wear him while I work.

I also put a lot less pressure on myself this time—pressure to work AND pressure to breastfeed. I have a more “que sera sera” attitude about it now, and instead of stressing over working while breastfeeding, I relax in knowing that any amount of time I am able to breastfeed my son is awesome and feel blessed that I am able to support my family on a part-time income for now. My boyfriend wants to put him in daycare already so I can work more hours, but he’s only six weeks old and I want to spend as much time with him as I can. I’m increasing my working hours this week, and some time in the next few months I might return to full-time work on-site, but I’m in no hurry.

Breastfeeding while working has not been an easy journey, but I realize that I have many advantages that others don’t. I feel for moms who have to return to work outside the home after maternity leave and all the struggles that brings: pumping in smelly bathrooms or uncomfortable closets for the sake of “decency,” eight hours of engorgement followed by two hours of traffic, bosses and/or coworkers who don’t understand why you get to take so many breaks as if it’s some sort of mommy privilege instead of your other full-time job, etc. I am so grateful for finally having the positive breastfeeding experience I dreamed of, while still able to work and support my family. My goal is six months of breastfeeding, which is much longer than I have been able to do in the past, and I really hope to make it over one year for my baby’s sake. And if I am blessed with one more child, I will breastfeed again for as long as I can, because I know it’s what’s best for all of us.

Breastfeeding... It has to get easier, right???

When I started working with Galit 10 1/2 months ago, I knew immediately that she would be one of the most dedicated, hard-working, and comedic mothers I would ever encounter.  Her breastfeeding journey has been wrought with painful nipples, engorged breasts, and twins who had difficulties transferring milk.  It has also been blessed with sweet moments of tandem nursing, gaining an abundance of milk, and confidence to overcome any challenge that lay in her path.  Happy 1st birthday to your adorable boys, Galit, and happy 1st nursiversary to you!  You continually inspire me!  

Here is Galit’s story, in her own words!

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I had twins at 37 weeks 3 days who were 5.5 and almost 6 lbs (FRIGGING AMAZING) after preterm labor at 23 weeks and 4 months of bed rest!  I wanted nothing more than to provide for them and ensure their health. Breastfeeding started out pretty rough.  My colostrum was hard to obtain and milk took forever to come in.  We were told to supplement with formula to keep them out of the NICU (they lost weight after birth, as all babies do), so we obliged. We went home with two healthy boys after 4 days and they were with me the entire time!

For several weeks, we used a gloved finger-straw-tube thing to help the boys practice sucking.  Then, out of desperation and exhaustion, we switched to a bottle and for several months (yes, months), we had to pull their chins down to help them open their mouths wider and also tilt the bottle up and down to simulate the natural flow of breast milk. No one was really capable of helping my hubby and I because there was just too much to remember.

My schedule was: nurse one baby, nurse the other, supplement both with bottles with as much breast milk as I could pump, then another separate bottle with formula (we were told not to mix breast milk with formula.  We tried several organic versions before finding one that worked for us), then pump. Between pumping 8+ times a day and nursing 10-12 times a day, I had between 10 and 25 minutes to eat OR to sleep at a time, around the clock, for almost two months. Ugh. I was always hungry and tired. If someone didn’t put food in front of my face, I didn’t eat. Great diet plan, aside from the feeling of extreme hunger, lack of energy, and need to consume extra calories to help my body make milk! 

After a couple months of serious struggles with nursing, we were desperate. The boys both had extremely tight frenulums (tongue ties), hampering their sucking abilities and leaving them very inefficient (45 minute feeds to take in less than an ounce), and me in incredible pain due to their pinching. We were told to have them clipped to allow their tongues to work better (ouch, but not too bad). This didn’t do enough (the frenulums were posterior and thick), so several of our doctors recommended we have them lasered (under their tongues and under their upper lips). Holy hell, this sucked so hard!  Then, worse, for a month and a half after the laser (until they healed), we had to stretch their wounds every time they ate. They cried. I cried. It was a very hard decision and experience, but we did what we thought would be best for our babies, for nursing, and for other reasons. So we resorted to these “drastic” measures. They eventually healed and can do all sorts of things with their tongues now! Oh the trouble they will get into some day. 

When they were about a month old, I got mastitis. I thought I was dying. The pain, all over my body, was horrible. I cried all the way to the hospital (and I’m not a crier when it comes to physical pain) and got antibiotics.  It took about four days before I felt okay enough to try breastfeeding again. I was in so much pain I couldn’t handle the babies biting/pinching, so I was only pumping. So much pumping. My parents (and in-laws) came to help care for the boys, as I couldn’t even hold them. 

Then, thanks to the antibiotics, I think got thrush (a yeast infection in the nipples. I had never had a yeast infection before, thus I am conjecturing that antibiotics was the cause).  I didn’t show any symptoms, aside from what I called “fire needle nipples.” The pain went all the way up to my armpits.  This lasted for 3.5 months. AAACK!  We had to sterilize everything, including pump parts, bottles, bras, and even my boobs(!) all the time.  My attempt to destroy thrush was energy and time consuming, to put it simply. I continued to sterilize everything after each use until I stopped pumping (at over 9 months). I still change nipple pads several times a day.  I’m so very thankful the boys never showed any signs of thrush, as I probably would have gone cuckoo! 

I ended up getting mastitis again a few weeks later (OMG!).  Thankfully, Robin came to my rescue with her “mastitis protocol.”  I healed within 1.5 days, with NATURAL supplements, pumping, massage, heating pads, hot showers, etc. without antibiotics! YIPPEE!  In total, I’ve had mastitis 10 times (WTH?), 5 of them pretty bad, leaving me mostly dysfunctional. Damn you, Plugged Ducts!  I know how to deal with it now (phew!). I worked for months to restore my milk production to the level it was before infections and scar tissue hampered my supply. I still produce less on the left side, as compared to my right; however, I still made enough to feed both my boys! 

In addition to dealing with mastitis and thrush, I had severe breast (and surrounding area) pain, for several weeks.  I was mostly pumping and wasn’t nursing more than once or twice a day due to the intense discomfort (So. Many. Bottles.). I discovered I have vasospasms but, thanks to Robin’s protocol, the pain is now gone! Thank goodness for Robin.  Phew!  My daily supplements can fill an aisle at Sprouts, but at least they are all actually helping, homeopathic, and aimed at health rather than disease. 

Big milestone: at about 3 months, I realized the boys were only being bottle supplemented with MY milk. I was finally producing enough to feed two growing boys and we were off formula! HOORAY!  From 3 – 5 months, I was weighing the boys before and after each breastfeeding session to see how much they were taking in (as if I wasn’t doing enough already).  We rented a scale from a local hospital to make sure the boys were eating enough.  Then one day, at about 5 months, I looked at their thighs and BAM!  I noticed they were chunky monkeys!  We immediately returned the scale! SCORE!  

At 8.5 months, we were meeting and overcoming new “opportunities for growth.”  These “opportunities” have slowed greatly, but they still come.  With 4 new teeth, one of my boys bit me. Hard.  I instinctually yelped, so he cried. I soothed for 5 minutes and we tried again.  He bit again. Hard. I yelped (no self control) and he cried harder, longer.  15 minutes later we tried again. Guess what happened? He bit. Again. I yelped (OMG control yourself, Mama!) and he was hysterical, hungry, and absolutely refusing to nurse, for 45 minutes. I gave him a little bottle of my pumped milk to calm him and his belly and put him down for a nap.  I was sure he would never want to breastfeed again.  Thank the heavens, as my hubby suspected, when he awoke, our baby had forgotten the morning ordeal and all was normal again. PHEW!  

So, was all this craziness, horrible frustration, and extreme pain worth it? HECK YES!!! So far, my boys have always been healthy!  In their whole first year, they’ve never even had a sniffle! Holy cows!  I’ve had two colds and my hubby had three! Was it the breastfeeding?  I’d like to think so. In addition to their health being friggin amazing, we get some great bonding time. I pet their heads, they give me smiles, hold each others’ hands, and sometimes giggle while nursing. They eat 3 solid food meals a day now, and I nurse them 5 times a day as well. The enzymes, antibodies, and good stuff my milk provides for them is so important.  Breastfeeding is just the BEST and I’m SO grateful my body has provided. 

We’re learning, growing, and laughing so much every day. We’ve hit the latest “golden age” of our babies and are enjoying each moment.  It’s just amazing. 

Defining my Breastfeeding Experience: Inclusive Breastfeeding

Written by Aran Tavakoli

It has been nine months and I just put away my pump. Getting it ready for storage was bitter sweet. How many hours have I spent with that machine in the past 9 months? Its usefulness outweighed the annoyance.  Once again, at this point in time, I am redefining my breastfeeding relationship with my baby. 

Breastfeeding has been an extraordinary journey. I have experienced and learned so much. I keep searching for a word that captures and defines my experience, but I can’t find one. I believe the breastfeeding community is actually missing a term for mamas that fall into their own camp. There is the exclusively breastfeed group and the formula group. Research often distinctly divides mamas and babies into these two groups. But, there is an ever-growing group of mamas that breastfeed and give formula to support their breastfeeding relationship with their baby. The current words used to describe this group include combo feeding or more commonly, low supply needing supplementation. 

From the true definition, I do not "exclusively" breastfeed my baby. However, I do exclusively give my baby all the breast milk that I have.  But he needs more to be happy and healthy, so he also receives formula and when he was really little, he received donor milk. Honestly, I am so tired of the “low supply” conversation, I wish there was a different word for how I feed my baby. A word that matches the pride of the mamas who do exclusively breastfeed their little ones all that they produce.  

Per Merriam-Webster, ‘exclusive’ is defined as, “not shared: available to only one person or group.” ‘Inclusive’ is defined as, “covering or including everything: open to everyone: not limited to certain people.” 

Thinking about it, I have never been an exclusive type of person, so the opposite of exclusive is inclusive. I have inclusively breastfed my baby for 9 months (way longer than I would have thought in the beginning!). This is the word that I am using to define my breastfeeding experience. 

In the inclusive camp, mamas know the best and worst of both worlds. The best of breastfeeding includes that joys of nourishing your baby with your body and making personalized milk. Then there is the best of formula: the intervention that provides life saving nutrition to support healthy growth and development. The worst of breastfeeding includes the sometime difficulties: mastitis, plugged ducts, yeast, blebs and so on! On top of breastfeeding, there might also be pumping, all the equipment and time that is required. For formula, besides the cost, the worst includes the bottles to be cleaned, sterilized and cleaned again. 

In the inclusive camp, the mamas are incredible as they work so hard to maintain their milk supply for their little ones, while also accepting help in the form of formula or donor milk. It is not one way or the other, it is all the ways: the breastfeeding, the pumping, the supplementing, the love, the dedication, the tears and the sweat (especially on hot days)! The inclusiveness of the experience. 

I don’t want to use a breastfeeding definition that makes mamas feel bad that their milk supplies are low (I worked through that one) or that they feel badly for needing to use formula (I worked though that one, too). Saying that, 'I inclusively breastfeed" is so much more positive and empowering than saying, "I have low supply and need to supplement." My lactation consultant, Ashley, always said to me, “He is getting your milk.” That has become my motto. He’s getting my milk, the amount doesn’t matter, and he is getting my milk.

So...Mamas who Inclusively Breastfeed, shall we adopt a new term?

Breastfeeding My Type 1 Diabetic Daughter

Almost 2 years ago, a dear friend of mine found out that her 19 month old daughter had type 1 diabetes and was fighting for her life.  Here's Theresa's triumphant story of how she was able to preserve her breastfeeding relationship while healing her daughter.  

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About a month ago a friend alerted me to a Facebook post that brought a wave of memories flooding over me from a day that changed my life forever as a parent.  A day that I will never forget, even though I wish I could.  It was literally the worst day of my life, but one that I will always be grateful for because it was the day my daughter’s life was saved.  

The Facebook post was from a worried mom whose child was hospitalized after being diagnosed with type 1, “juvenile,” diabetes that very day.  The mama was breastfeeding and was terrified not only for her child's life, but that she would lose the best way she knew to feed and comfort her baby.  A little over a year and a half ago I was in her shoes.  At 19 months old, we were told that our daughter had type 1 diabetes, was in diabetic shock, and needed to be rushed to the emergency room.  She came very close to losing her life and was in critical care for a week at a children’s hospital. 

While she was at her sickest (almost admitted to the ICU), she was not allowed to nurse.  For as comforting as breastfeeding can be, not being able to do it during a time of crisis was torture.  My daughter was barely conscious, was in pain and terrified while she was awake, and I could not even hold her because she wanted to nurse.  I hope no other mama has to experience the excruciating helplessness you feel in a situation like that.  Our children's hospital has no lactation consultants and, by the time they could find a pump for me, we had already skipped about 7 or 8 feedings.  I was scared to death and in physical pain myself.

When we were finally given the okay for her to eat, I had to fight tooth and nail to be able to breastfeed her.  The doctors finally consented to her having breast milk, but because she was not a tiny baby, the doctors did not think it was important.  They told me that she absolutely had to drink from a cup or bottle.  (I had a manual pump at home and did not respond well to it at all.  I could not imagine how difficult it would be to have to exclusively pump.)  I begged them to let me nurse her.  It was my milk after all, whether it came from a pump and was poured directly into a cup or came straight from my breast.  No mother should ever have to beg to be able to feed their baby.  It took hearing our daughter scream and sob hysterically for the doctor to finally take pity on us and let me breast feed her.  As I held my tiny girl in my arms, it was the first time I began to feel like there was a possibility that she would be okay. Still, we were encouraged to not let her nurse after that.

Eventually, we were able to meet with the hospital's diabetes dietician who helped me calculate the average amount of milk I produced per feeding.  We looked at the amount of milk I was able to express with a pump then, by using the general amount of carbohydrates contained in breast milk, we were able to determine a rough estimate for carbohydrates per feeding.  Together we came up with a plan to space out her feedings as much as possible to keep her blood glucose stable (after each meal and to go to sleep).  The dietician was a lifesaver and a champion for us!  She spoke with our doctor on our behalf and convinced him that including breastfeeding as part of our daughter's nutrition was in her best interest.  The doctor has since become supportive.

Continuing breastfeeding brought my daughter so much comfort in the months of learning to live with daily multiple injections and painful finger prick blood tests.  It was something normal and peaceful for both of us during a stressful time of adjustment.  It supported her overall health.  It was a perfect source of nutrition for her combined with solids and was amazing for bringing her blood glucose back up to a safe level if she began to drop low at night (we do use a fast acting sugar, like juice, instead if she is below a safe threshold).  I am so thankful that we were able to continue our nursing relationship until she was 32 months old.

Type 1 diabetes (T1D) is a life-threatening, autoimmune disease in which a person’s body attacks their pancreas, causing it to stop producing insulin, a hormone needed to properly process carbohydrates in the food we eat.  People with type 1 diabetes check their blood glucose levels every few hours and must inject insulin several times every day or continuously infuse with insulin through a pump.  There is no known cause of type 1 diabetes and, at this time, no cure.  It will never go into remission and cannot be reversed.  As a mom, you can't help but wonder if you caused it somehow but, it just isn't possible that you did.  It is not connected to poor diet or lack of exercise.  Our daughter never has had a drop of formula, never had sugar other than that naturally occurring in fruit, never drank juice prior to needing it to treat hypoglycemia, and eats primarily homegrown, organic solid food.

Not many people think that a baby or toddler can develop type 1 diabetes, however it is definitely possible.  Not all doctors think of it either and it is commonly misdiagnosed as the flu, with deadly results.  It is very important to know the possible warning signs.  I would recommend all moms be aware of any major changes in nursing.  A sudden onset of increased nursing (past the length of time a growth spurt or teething would account for) along with much more frequent wet diapers can be a signal of diabetes.  Diaper rash (especially without a history of it) and yeast infections can be symptoms of high blood glucose.  Also, consider vitamin D supplements if a blood test returns low for vitamin D levels and investigate further if the test results are extremely low.  The researchers think there may be a link between low vitamin D and diabetes, however they don't know if it is a cause of diabetes or a symptom of it.  Our daughter had increased nursing and wet diapers, weight loss and developed labored breathing. Thankfully our pediatrician picked up on the problem and took action immediately.

Warning signs of type 1 diabetes can include:

 • Extreme thirst

 • Frequent urination

 • Drowsiness, lethargy

 • Sudden vision changes

 • Increased appetite

 • Sudden weight loss

 • Fruity, sweet, or wine-like odor on breath

 • Nausea or vomiting

 • Heavy, labored breathing

 • Stupor, unconsciousness

 • Sugar in urine

Most importantly, if you feel that something is wrong, go with your gut and keep asking until you find answers!  A quick finger prick test to check the blood glucose level can rule out diabetes.  For this test, a small drop of blood from the tip of the finger is sampled.  Results are often immediate.  A simple urine test can also check for abnormalities.  Undiagnosed and untreated T1D can become deadly very quickly.

If you have a little one diagnosed with diabetes, ask to speak to the nutritionist about continuing to incorporate breastfeeding into their nutritional plan.  By pumping once and measuring the amount expressed or by weighing the baby before and after feeding they can help you determine the general amount of milk and therefore carbohydrates they receive at the breast with each feed.  (Because it is an estimated number and not exact, they can often account for the difference in the allotted carbohydrate plan.)

Also, there are amazing support resources available for small children with T1D!  Facebook groups like “Diapers & Diabetes” and organizations like JDRF offer support for families, education, a place for children to feel encouraged and like any other child, and help navigate the uncertain and ever-changing waters that are type 1 diabetes.  Additionally, JDRF funds research and is constantly striving to improve life for type 1 diabetics.  Most importantly, they are fighting for a cure for type 1 diabetes.

*** Please note that these are just our experiences.  I'm not giving medical advice and don't claim to be an expert on diabetes--I'm just a breastfeeding mom doing everything she can to keep her daughter healthy!  Seeing her grow and thrive, and watching her play momma and nurse her baby dolls, I think I might be doing an okay job.

If you want to learn more about type 1 diabetes, www.jdrf.org is a wonderful resource.  For a glimpse into our life with it or to help fund a cure, please visit:

 http://www2.jdrf.org/site/TR/Walk-CA/Chapter-SanDiego4053?px=2922459&pg=personal&fr_id=2382

or watch our story at: https://www.youtube.com/watch?v=2Fc6r8HEnn0

My Village of Breastfeeding Support

 Over the next few weeks we will be sharing stories of triumphant breastfeeding mamas and their biggest supporters who helped them reach their personal breastfeeding goals.  If you would like to share your breastfeeding story and thank your biggest breastfeeding cheerleaders, check out the details in our recent blog article.

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Here is Stephanie's story.

It has truly taken a village to help me be successful in nursing both of my babies!  I knew I wanted to breastfeed, but, after the birth of my first son, my passion and commitment to it were a surprise to even me.  I was also caught extremely off-guard by the difficulties both of my boys encountered as we began our breastfeeding journeys together.  Tongue ties, lip ties, low weight gain, low supply, poor latch, pain/cracking/bleeding, overactive letdown, and more were all hurdles we had to cross.  There is absolutely NO way I could have made it to 13 months formula-free with my first son and still going strong and formula-free at 6 months with my second without these amazing people.

My husband!  My passion and commitment to breastfeed my babies surprised him also, but he never questioned it and stood by me no matter what decisions I made!  He became just as committed and passionate about it, knowing it was the best thing we could do for our boys.  He came to appointments, helped get the baby latched on time after time, stood up for me when others questioned why I didn’t just quit, and let me cry when it all just became too much!  He has truly been my rock through all of this, and I can sense his gratitude for the sacrifices I have made to give our boys this amazing gift!

My Lactation Consultants! Four different lactation consultants have come alongside my babies and me in our journey together.  Every single one of them encouraged me that I could do it when the hurdles seemed insurmountable.  They provided a listening, sympathetic ear when I just needed to vent or cry or talk it out.  They provided help, advice, referrals, and life-changing solutions that kept us going!

My tribe of other breastfeeding Mamas! Friends I have known since childhood, friends I’ve made in recent years, and people I met through the breastfeeding process made it all possible - others who had or were experiencing some of the same challenges, some who didn’t have trouble but believed just as passionately in the benefits of breastfeeding, some who visited, some who called, and one who even created an on-line community to connect us all!  There were many people in my life who didn’t understand why I didn’t give up when they saw the emotional and physical toll it was taking on me, but these other Mamas got it!  They knew why I couldn’t quit, why no challenge was too big!  

My virtual breastfeeding community!  Although I will never meet most of these women in person, the support, advice, commiseration, and encouragement they have provided have truly been critical!  To be able to jump online in the middle of the night when it just seemed like I couldn’t do it and have others on there to tell me that, yes, I could do it got me through many rough moments!  They have calmed nerves, answered questions, given virtual hugs, and just been an amazing support system!

My babies! Even from the very start and even in the face of all of our challenges, my babies have always loved nursing!  They didn’t quit so there was no way I could!

Breastfeeding in the Operating Room

Over the next few weeks we will be sharing stories of triumphant breastfeeding mamas and their biggest supporters who helped them reach their personal breastfeeding goals. 

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This story is from Dawn.

I have to thank my hospital TEAM for my breastfeeding success! 

When I gave birth to my son 5+ years ago, it wasn’t what any first time mom would like to experience. I was having problems with maintaining my blood pressure and when my little boys’ heart rate dropped too low, I was rushed into an emergency c-section. It was an extremely frightening process that didn’t even enter my mind as a possibility. The months that followed were hard. We struggled at finding a proper latch and feeding became such a difficult task, I dreaded it.

It never occurred to me that our difficulties at latching could have been because of the birth experience.

In early 2012 we received good news, we were expecting! I did my best to set everything up for a different birthing experience. I searched out a CDC accredited Baby Friendly Hospital in my area, researched VBAC’s and educated myself on the benefits of skin-to-skin.  It wasn’t until closer to my due date that I was informed I couldn’t have a VBAC.  No hospital would even consider me as a potential VBAC candidate because of my small heart issue as well as my age.  After fighting and pleading, I had to acknowledge that I had no other option, but another C-section.

I may have lost that battle, but I was going to do everything in my power to have skin-to-skin with my little girl. I was aware of the evidence-based research on the benefits of skin-to-skin and its success rate with c-section births. I talked to my pediatrician about this and he agreed.  (I since found out that it is the pediatrician who is in charge in the OR!)  I wrote my birth plan with the intentions of doing skin-to-skin immediately after the c-section unless there was a medical reason not to. 

Alas, I wasn’t able to make it all the way to my scheduled c-section date. This time I was low on amino fluids and baby’s lack of movement put me into the hospital at 36 weeks. With concern, my OB and the pediatrician, agreed, that under supervision, they would monitor me and try to get us to the 37th week and do the c-section. 

Now, prior to this, we made sure to talk with all the right people about our wishes for skin-to-skin.  Everyone was on board: our OB, the hospital’s labor and delivery nurses, and staff.  In fact, the hospital staff has been championing the change in procedures to allow skin-to-skin in the OR without success. 

The day of my C-section, my regular pediatrician was out of town and his standing replacement wasn’t comfortable at all.  I had to conveince the standing pediatrician that this was in my and my baby's best interest.  The hospital's Head Labor & Delivery nurse helped us get to a compromise!  She is my angel!  She proposed that if everything looked good my little girl would be immediately placed on my chest, without ANY other intrusion.... meaning the vernix would be wiped off her while she was on my chest and she would be weighted and measured later. 

When the hour came for us to have the c-section more drama around skin-to-skin unfolded, this time all the way up to the director of the Family Birth Center.  The director of the Family Birth Center was completely opposed to it and tried talking my OB out of it.  We were lucky we had enough support and commitment from the labor and delivery nurses and my OB to move forward. We finally got our wish!

I have to admit, because she was coming 3 weeks early, I wasn’t sure we would even get the option of skin-to-skin, but our little girl emerged perfectly!  She was screaming and quickly confirmed in perfect health! 

When she was placed on my chest and covered with a warming blanket, I was in awe.  This little 6 pound bundle was just perfect.  After a little while, she actually scooted and rooted for my breasts and eventually latched and nursed!   I just didn’t think I would get that experience since she was early.  The remembrance still makes me cry.  It was such an amazing experience.  I was so happy I had the team in my corner and the hospital went forward with my wishes.  

When I was first told I would have to have another cesarean, I felt completely out of control and very disappointed.   Creating a birth plan around my c-section allowed me to take a bit of control back and talking with all parties that come with a c-section allowed me the skin-to-skin connection that was deeply important to me.  

It has been over a year since Beth was born.  We are still nursing strong and have a connection that I attribute to the wonderful team that helped me get skin-to-skin in the OR! 

Side note:  I have since heard that they have allowed other moms the same experience!  The hospital team not only helped me, but also have persevered in getting policy “changed” at the hospital!  

Dawn Alva

Rumina Nursingwear

Creating a Sense of Community When Using Donor Milk

In an effort to demystify milk sharing, for the next few weeks we will be sharing stories from breastfeeding moms who either donated their excess breastmilk or supplemented their baby with someone else’s milk.  For more information about milk sharing, both informal and through milk banks, please visit our article: Supplement Options: Donor Milk, Milk Banks, and Formula, as well as our Boob Group podcast episode, Low Milk Supply: Donor Milk, Milk Banks, and Formula.

Today on the San Diego Breastfeeding Center blog, I am honored to share Cara's story, which demonstrates how a sense of community can blossom through supplementing with and donating breast milk.  If  you would like to submit your story to be shared with our readers, please email me at robinkaplan@sdbfc.com.  Thank you so much, Cara, for sharing your inspiring story with us!  Your daughter is so lucky to have you as her mother!

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I feed my daughter a mix of my breast milk, formula and donated breast milk from 5 different women. Not only has donated breast milk benefitted my daughter's digestion and overall health, it has introduced me to other moms that I'm now proud to consider part of my community.

We were only two days postpartum, after a beautiful unmedicated birth, when the first hospital-based lactation consultant looked at my breasts and her face fell a little bit. She informed me with a matter of fact tone that I might have breast hypoplasia/Insufficient Glandular Tissue (IGT).  She said not to try too hard or be too hard on myself, as physiologically I might never make enough milk for my daughter.  It turns out, she was right. When my milk finally came in, my daughter only transferred 10ml per feeding - less than half an ounce.  However, through herbal supplements, medication, and pumping after each feeding I've managed nearly 4 months later to increase that amount to 20-30ml per feeding, but that's another story for another time.  Bottom line: I've only ever made 8-10 ounces of breastmilk a day, max. Not nearly enough for my daughter.  So at 4 days postpartum, after my daughter's weight dropped too far and my milk supply was not increasing: my husband helped me begin supplementing with formula using a syringe and feeding tube at the breast.  I was just relieved to have a plan, and as my daughter thrived I was grateful for formula and the nourishment it was offering my baby.

At 6 days postpartum we met with a local IBCLC.  She guided us on how to continue trying to increase my milk supply, and in the meantime how much to supplement.  And she also mentioned donor milk.  

I originally brushed off the idea of donor milk.  While it made sense since human breast milk is the best food for babies, it seemed like it would be awkwardly intimate to use another mother's milk, and I was also afraid of disease. My husband and I were not in a place to pay the high price for formal milk bank donor milk, and informal channels made me nervous.  I was also clinging to the hope that all the work I was putting into making my own breast milk would pay off and I might someday be able to exclusively breastfeed.  A few weeks later, however, I had to come to the painful realization that would never happen.  I cried as I realized I would be supplementing my daughter’s diet with either formula or donor milk for the long-term.  

So I began looking into donor breast milk.  I checked out the Human Milk for Human Babies Facebook pages, but was too uncomfortable with the idea of taking milk from strangers, so I sent an exploratory email to the moms I know in the area, asking if they or anyone they knew had extra milk they could donate.  Somehow breast milk from friends or friends of friends made me a lot more comfortable.  I only sent that email to 6 other mamas, but one friend responded that her friend had some extra milk due to an oversupply.  Another friend/co-worker responded that she herself was weaning her toddler, and had just stopped pumping at work.  She offered to resume pumping once a day and donate that milk to us.  I was blown away with gratitude - what a gift… but, also nervous.  Do we trust other milk enough to feed it to our daughter?  My husband and I made a decision together: to trust.  We decided these moms were feeding this milk to their own babies, so we would choose to feed it to our baby as well.  

I first accepted donated breast milk from my friend and co-worker.  I supplied her with breast milk storage bags which she filled and labeled.  For her it was very little milk, just 4 ounces or so a day, but for us and my young baby that was a significant amount.  I was so grateful, and felt humbled.  This was a gift I could never repay.  I would normally be uncomfortable with this imbalance - accepting a gift I couldn't repay - but was willing to do anything for my baby.  And my friend's attitude helped tremendously - she was so kind and sweet and seemed honored to give this gift to my baby.  A few days later, this friend texted me asking if my daughter liked her milk.  I laughed as she explained that it felt like she'd made a casserole for someone -- and wanted to know if she liked it!  My daughter certainly liked her milk, and I texted her a picture of my daughter in a post-meal milk-drunk stupor with a happily full tummy.  After all - that happily full tummy was the reason we were doing all of this.

The friend-of-the-friend was also incredibly kind, and we set up a time to pick up the milk from her.  She made me comfortable by asking if we were OK with the two cups of coffee she has in the morning.  Just her awareness of this issue made me feel she was a conscientious Mama aware of how her breast milk could affect her baby, and my baby.  She did request that we not tell her husband - as he would be weirded out by it all.  This honestly made me a little uncomfortable as I was so recently myself overcoming the 'weirdness' factor.  But she also seemed honored to help out and with an oversupply was happy her milk was going to good use.

I then met a woman with oversupply at a breastfeeding support group.  She was exclusively pumping and had repeated bouts with mastitis so was pumping far more than her daughter needed in a day.  I picked up some donated breast milk from her - feeling comfortable because we'd met a couple times at group, and I knew she'd struggled to do her best for her baby.  We laughed a bit sadly as we realized we were in similar conundrums.  Both pumping all the time - me in an effort to build supply and her in an effort to stave off mastitis.  She seemed happy to help my daughter, and I promised to provide her with replacement breast milk storage bags.  Somehow - buying donor moms breast milk storage bags feels like I'm repaying them just a bit - or at least making it a bit easier for them. 

By 8 weeks of age my daughter was thriving with about a quarter to a third of her diet coming from my breast milk, and the rest a mix of formula and donor milk.  I was first afraid to tell my daughter's pediatrician that we were using donated milk.  At my daughter's two month appointment I tentatively brought up donor milk - then quickly mentioned I was aware of the risks of contracting diseases and the like.  Our pediatrician didn't seem fazed at all that I was using donated breast milk - and she even encouraged it.  She brought up the fact that women with new babies have been tested for infectious disease during their prenatal care - so the risks are very low.  She was very comfortable with us feeding my daughter donated breast milk, which made me even more comfortable myself!  

I was also so grateful for the donated breast milk as it also seemed to help my daughter’s tummy, as she began struggling with constipation from the iron in formula.  We switched formulas to a brand we thought was better and cheaper - double bonus.  However, my daughter started straining to pass hard little pellets, and stopped eating as much. We were very concerned.  We began to consider giving her apricot nectar to help her bowels and with the hope she would start eating enough again.  However, before the fruit juice, I wanted to try one more thing - my friend/co-worker had just given us about 12 ounces of breast milk so instead of spreading that amount out over a couple of days, I decided to try feeding it to her all in one day to see if it helped her tummy.  It did!  It made me sad to realize formula was affecting her so negatively, but so happy to have a tool on hand - donated breast milk - to help my daughter gently.  We switched back to a brand of formula we knew worked better for my daughter, but she still had sluggish bowels.    

Having seen the benefit of breast milk on my baby's tummy I decided to give Human Milk for Human Babies a try - milk from strangers.  This decision was also encouraged by an internet community I had found of other mamas with low milk supply - some of whom were exclusively feeding their babies with donated breast milk from many different mamas. I posted a request on the Human Milk for Human Babies Southern California page on Facebook.  Immediately after posting I panicked realizing the post might go up on other people’s news feeds.  While my husband and I had become comfortable with donated breast milk, and I was open about my low milk supply struggles with friends and family, I was NOT open about using donated breast milk.  I just didn't want to have to defend our decision, when we had been a bit conflicted about it ourselves.  I'm still not sure if it went up publicly or not, but I decided to only deal with it if someone brought it up. They didn't.  

First a woman in Anaheim asked if I would make the 3-4 hour round trip drive up there to get breast milk from her. I decided I wouldn't.  I wanted donated breast milk for my baby, but formula was working OK and I decided the time in the car in Southern California highway traffic was not worth it for me and my daughter.  Then another woman private messaged me saying she was in the area, had never donated before, didn't have any diseases, only had small amounts of alcohol after her infant daughter goes to bed for the longest stretch between feedings, and had some frozen breast milk that was about to expire and needed to be used.  Her message made me feel comfortable, and I messaged her back thanking her for her openness and explaining I had never accepted milk from a connection with a stranger on a website before.  We decided to meet for the first time at a mall near me, as she was going to the Hollister nurse-in.  

It felt kind of like a Craigslist sale, meeting this stranger to exchange goods, except without the financial component.  I texted her telling her to look for a woman wearing a sleeping baby in a baby carrier (me)- then she walked up wearing her daughter in a baby carrier as well - and with a large cooler full of frozen breast milk.  Her husband and older son were with her, but as we started talking breastfeeding and postpartum struggles they wandered away.  She sort of smiled and said her husband had wanted to come with her to meet this stranger from the internet.  We laughed and then I wondered: why the heck was I so willing to just go meet a stranger from the internet without anyone with me?!  Minutes after meeting her I'd felt comfortable.  She was a mama with plenty of breast milk who stored some up when her daughter was much younger - and as the frozen milk neared its expiration date, she didn't want it going to waste.  We are both moms who knew breast milk was best for our babies, and both moms doing our best to provide what we can.  We've stayed in touch, as she might have some more milk for us in the future as she easily pumps above and beyond her daughter's needs. Even if she doesn't, we are grateful for the gift she has given us.

Since then, I met another mom in a breastfeeding support group, also exclusively pumping and with more milk than her daughter needs.  After meeting her a few times and running into her in my neighborhood, she insisted she could begin providing us with fresh breast milk every couple of days.  I accepted. Once again, I felt comfortable as I knew she was doing the best she could for her baby and attending support groups for support.  Since then I've enjoyed meeting up with her for walks as we compared the struggles of new mama-hood.

I still sometimes have fears of my daughter contracting a communicable disease - or imagine the horror of a donor realizing she has something she didn't know she had - but have decided that the benefits outweigh the risks.  I'm not yet open with family about the fact that we're using donor milk.  Perhaps that's an indicator that I'm still not 100% OK with it, but mostly I think it's because I just don't want to have to defend our decision.  The heartbreak of low milk supply is something I've learned to speak rather matter of factly about -- but how we choose to feed our daughter is nobody’s business, but our own.  Who we choose to involve in that decision (for example: our pediatrician, our lactation consultant) is just that - our choice. Perhaps over time I'll be more open about the donor milk that is helping to nourish my daughter -- writing up our experience like this is a start!

Thanks to my breast milk, donated breast milk, and formula my daughter is thriving.  Thanks to donated breast milk I've gotten to know other moms in a new way and we've built a community I never even dreamed we'd have.  I am just so grateful for this gift other moms have given my daughter!

My Attempt to Trust My Milk Supply

Today, on the San Diego Breastfeeding Center blog, I'm honored to share Krystyn Brintle's memoir about her battle with Insufficient Glandular Tissue.  If you would like to submit your story as well, please email me at robinkaplan@sdbfc.com.  Thank you so much, Krystyn, for sharing your story with us!  Your story is truly inspirational!

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A Brief History of My Breastfeeding Journey (So Far) in Numbers:

32 - Number of weeks along in pregnancy when a midwife suggested I meet with an IBCLC to discuss potential breastfeeding complications

75 - Percentage of tissue found in my breasts after examination by IBCLC, compared to average woman

50/50 - Odds given that I would need to supplement

27 - Number of herb capsules (goat's rue, alfalfa and malunggay) I began taking daily after my initial consultation with the IBCLC

7 - Number of days my daughter spent in the NICU following my unplanned c-section, further jeopardizing our planned breastfeeding relationship

3 - Number of weeks it took for my daughter to gain back to her birth weight, necessitating an extra weight check with her doctor and hours of agonizing over whether my breasts were failing us both

12 1/4 - Pounds my daughter weighs as of this afternoon (13 weeks), which averages to her gaining about half an ounce a day – perfectly reasonable for a breastfed baby

17,453,519 - Number of times I've doubted my supply, or number of hours spent searching the Internet for info re: IGT, hypoplastic breasts or signs your baby is getting enough milk

0 - Number of times I will ever judge a mom who gives her baby formula, because I know now that there are extenuating circumstances beyond our control that can make the dream of EBF impossible

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With my borderline PCOS diagnosis and lifelong struggle with weight, my biggest concern in pregnancy was eating healthy and exercising enough to prevent gestational diabetes. Breastfeeding complications
were simply not on my radar - my older sister is still nursing my three-and-a-half-year-old nephew - until my 32-week appointment. I mentioned that I thought I was leaking a little colostrum; the midwife did a brief examination and suggested that, considering the PCOS issue, I meet with an IBCLC to discuss any potential hurdles. I made the appointment, not entirely clear about what these hurdles might be. Sure, my breasts hadn't changed during pregnancy - but I convinced myself that was because milk comes in after birth. After a physical examination, Ellen (the IBCLC) explained that there was a term for what I had always considered my unsightly breasts - I had breast hypoplasia. She went on to estimate I had about 75% of the expected breast tissue and that the "plumbing" involved in making my milk did not extend fully through my breasts and into my chest. She gave me 50/50 odds that I'd need to supplement. We went through a list of various foods and supplements to help increase supply; she explained no research had shown that prenatal use of galactagogues affects milk, but that it couldn't hurt to try. At least it felt like I was trying to help my girl, buying all the expensive herbs and choking them down three times a day.

After an unplanned c-section, my daughter was taken to the NICU for meconium aspiration. She was placed under an oxygen hood and was unable to nurse for the first 24 hours. I had read about the difficulties a c-section could pose in terms of breastfeeding; adding to that the intense stress of her condition, in addition to my IGT, I feared breastfeeding was not in the cards for us.

We worked hard to establish our nursing relationship while she was in the NICU, requesting help from the IBCLCs on staff for nearly every feeding. We supplemented with donor milk while waiting for my milk to come in, were introduced to the stressful world of pre- and post-feeding weighs - but by time she was discharged, she was relying solely on me and my breasts for her nourishment.

I scheduled LC appointments weekly. We did pre- and post-feeding weighs and determined she was getting two ounces when she nursed on both sides. When she hadn't gained her birth weight back by two weeks, I began to fear the worst: the odds weren't in my favor, and I'd have to figure out the SNS I'd requested in the hospital "just in case." My daughter's pediatrician requested we return the following week for a weight check, and she also requested I nurse the baby every two hours (instead of letting her sleep for longer stretches like I had been).

The stress of the situation really took its toll. I couldn't keep food down, I wouldn't allow myself to go to sleep for fear of missing a feeding. My midwife diagnosed PPD and told me I needed to allow myself to be okay with my husband handling a feeding so that I could get four continuous hours of sleep each day. When pumping wasn't netting enough, and when I felt my sanity slipping away due to the stress, I caved and bought a can of formula. Over the course of a weekend, my daughter had four formula bottles. And I felt like a failure.

But I also really slept for the first time since she was born. I relaxed a little, knowing she was eating even if my body wasn't producing her food. I started accepting the idea that breastfeeding didn’t have to be an all-or-nothing proposition.

When we went back to her doctor for the weight check, she had gained back to her birth weight plus an extra ounce. Knowing that all but four feedings of that weight gain came from me was the proudest moment in my young motherhood. We had our third - and final - LC appointment the following day, where the scale showed she took 78 mL of milk (and promptly refluxed 18 mL back). Ellen told me I could start weaning off the herbs and that, somehow, I was the exception to the IGT rule.

My lovely Liv has not had another formula bottle. Despite her extreme refluxing, she's gaining appropriately and is in the 50th percentile for weight - right where she should be. After everything I've been through, I've found that I am a lot less judgmental when I see mothers feeding their babies formula.  There are plenty of reasons why a mom might have to supplement, or maybe the stress of trying to breastfeed was too much - now that I've been there myself, I've come to understand that moms are just trying to do the best they can.

I'm only 13 weeks in, and my IGT story has a happier ending than most, but I can honestly say I'm incredibly proud of how I've handled what was an obstacle-laden path to breastfeeding and am so proud of the other mamas out there who are doing the same!

Krystyn Brintle

Breastfeeding with Hypoplasia

Today, on the San Diego Breastfeeding Center blog, I'm honored to share Fakiha Khan's memoir about her battle with Insufficient Glandular Tissue.  If you would like to submit your story as well, please email me at robinkaplan@sdbfc.com.  Thank you so much, Fakiha, for sharing your story with us!  It's stories like yours that make me want to be the best mom I can be! 

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When my son was born 2 and 1/2 years ago, I wanted nothing more than to be able to breastfeed him.  He was in the NICU for a week after he was born, and I really did not get to nurse him until he was a week old.  By that point, he had trouble latching on, and my milk just was not coming in.  For the next five weeks, I did what I could.  I tried to nurse him every hour and a half, I pumped, I took herbs, and I finally went to see a lactation consultant. 

I will never forget how shocked she was that my son transferred only 1/2 an ounce at the age of five weeks.  Other than telling me to continue pumping with a hospital grade pump, the consultant had no other ideas of why I was not producing milk.  She kept saying to me - it is the most natural thing to produce milk.  It's all about demand and supply.  If you keep putting him on your breast, the milk will come. Well, I kept trying, and after weeks of emotional torture and physical discomfort, I finally gave up.  I was producing an ounce of milk from both breasts at that point.  And, giving up was not easy.  I felt like a complete failure, like I could not do the thing that is supposed to be so natural. 

I got a second chance when my daughter was born two months ago.  I figured that, with my son, I just didn't get started on nursing quickly enough.  This time, I decided to be proactive even before the baby was born.  I talked to people and a lactation consultant prior to giving birth.  This consultant suggested that I might have a physiological problem such as hypoplasia, but I would not know until I got checked out.  I didn't get a chance to do so before I gave birth, but I went into the birth with hope of doing better this time. 

When the baby was born, I immediately put her on my chest and I nursed her within a half hour of birth; I kept her with me nonstop, nursing her whenever I could.  But, within the first two days, it was clear that I was not even making enough colostrum.  I had to give her some formula.  My fuller colostrum finally came in at day 3 and the milk first came in on day 5.  But, despite nursing every hour and a half, the baby was still fussing and clearly unsatisfied. 

Those old feelings of frustration and failure came rushing back to me.  I kept thinking, this is supposed to be so natural.  Every mammal mother makes milk for her child, yet, I can't feed my baby who is trying so hard to get out a few drops of milk from me.  All of the instructions from the breastfeeding class kept repeating in my head.  I kept thinking, maybe today I will suddenly make the milk my baby needs, maybe today.   

Before giving up, I went to see my doctor to find out if I had hypoplasia.  The doctor told me that hypoplasia was not possible, as I did not have the physical signs (tubular breasts that are set far apart) and because I was making some milk even if it was only an ounce at a time.  So, I thought, ok, there has to be something I can do.  So, I did some research and found out about fenugreek.  I began taking that, and immediately I got a boost in my milk supply.  But, then within a week, it started going back down again.  At this point, I was ready to scream, but before giving up, I decided to consult another lactation consultant.

As it happened to be, this consultant specialized in low milk supply.  She finally told me what I had been suspecting - I have insufficient glandular tissue.  The consultant suggested a number of herbs and medication, all of which I tried.  Again, my milk supply went up very quickly, but now after 3 weeks, I see it going back down again.  I still don't know if any of the medications or herbs (which I understand work by increasing hormone levels) really work with insufficient glandular tissue.  Can they create tissue where none exists?  No one can seem to answer this question for me. 

Now, I continue pumping during the day, saving the little bit of milk I made (about an ounce and half), and mixing it with formula.  I nurse when I can and regularly throughout the night.  But, I have resolved myself to the fact that I will not be able to exclusively rely on breast milk.  It's a very sad realization, and I wish I had a solution, something to fix this problem, or even a bit more information.  Alas, I do the only thing I can and, in the process, laugh at myself when I am proudly toting home the four-ounces of breast milk I take home after pumping 3 to 4 times at work.  To a regular breastfeeding mom, four ounces is probably how much she produces in one feeding.  For me, it's a day-long effort, and at the end of the day, I carry it home with the same pride as if I had just discovered gold!