Low Supply & High Guilt: How to Deal With Your Milk Drying Up

Dear Amy,

I’ve been reading Amalah for years — pre-Noah (your first child). I remember you posting one day that you had quit breastfeeding, including pictures of all the pump parts / accessories that you were throwing away. At the time, this was meaningless to me because I had no children. Fast forward to me with a 2 month old. I am back at work, pumping and supplementing, and oh! the angst and guilt and tears.

I always struggled with low supply. I have plenty in the mornings, it dwindles in the afternoon, and by the evening I had a seriously pissed newborn nursing hungrily for 2 hours at a time, sleeping for 30 minutes, repeat until dawn. After 3-4 (hazy memory) nights of this, I ORDERED my DH to make a bottle of formula. I cried as she gulped down 3 ounces and fell happily asleep. It was clear to me that my baby was hungry.

Undaunted, I went to see a LC (lactation consultant). I WOULD NOT FAIL. She basically told me that I had low supply BECAUSE I supplemented and that I was just lazy and not wanting to stay up to nurse my child. She ordered me to nurse and co-sleep (which I’m not ok with). I went to see another LC, and she ordered me on herbs, etc. I’ve done the herbs, Guinness, extra calorie diet, oatmeal, pumping after feeding, 64 ounces of water, etc. No change. The only thing I haven’t tried is Reglan, but I’m a bit afraid of the side effects.

Now my beautiful daughter is in daycare and I’m pumping. She gets somewhere around 60-70% of her calories from me, 30-40% from formula. The formula amount keeps creeping up. The milk: she’s going to dry up.

I am OVERWHELMED with guilt and grief and angst and everything else about this. DH is the oldest of four and his mother BF all of them for a year, no problem. My mother BF me for 5 months, no problem. The guilt is multiplied by a thousand because I feel like getting those antibodies is so much more important with her in daycare (not to mention the run-of-the-mill daycare guilt).

Why do my boobs suck? How do I let go and get over this? DH is tired of me crying over it. I am tired of me crying over it.

Help,

Drying Up

A Story About Nursing — and Quitting

(Totally random aside! Why do I always feel compelled to start columns with some kind of phonetic non-word expression? Like I just typed “ay yi yi,” which I’m not sure I’ve ever actually said out loud, but it’s like a compulsion here. Anyway. Moving on.)

First, a little personal backstory for those who may not know my own breastfeeding history — my first son, Noah, was gigantic (9 lbs, 15oz), my milk took over a week to come in, and it was always a tenuous, inadequate supply thanks to some botched cyst aspirations and scar tissue. We supplemented occasionally from the get-go thanks to a SUPER AWESOME HAPPY diagnosis of “failure to thrive” because Noah lost way, waaaaay too much weight in that first hazy week — my time of “exclusively” breastfeeding probably totaled a whopping month. Maybe. Probably not all in one consecutive chunk of days, either. I too did everything the lactation consultants recommended, but I always struggled to keep up with Noah’s appetite.

I went back to work full-time when Noah was 12 weeks old. I’d pumped and pumped and pumped in preparation, hoping to fill just a FEW of the dozens and dozens of breast milk storage bags I’d cluelessly bought while pregnant. Noah drank my entire pumped supply on his FIRST DAY of daycare. It was a pathetic game of catch-up after that. I probably got a bottle’s worth of milk from the pump every three days or so. I tried leaving work at lunchtime to actually nurse, but that soon became undoable and unrealistic. We resumed nursing on demand at home, but it soon became clear that Noah was only interested in nursing when he wanted comfort — when he was hungry, he wanted that damn bottle. And who could blame him? He needed FOOD. Serious FOOD.

After about two months of this, I was right where Drying Up was. The more I relied on the pump, the longer Noah slept at night without eating, the less milk I had. Finally, one morning I put him to the boob and he pulled off in a righteous fury. Nothing there. Not a drop. He never, ever latched again. I kept pumping for a couple days, upped the fenugreek, just in case it wasn’t really and truly The End, but it was. Five-and-a-half months. Two weeks under my worst-case scenario goal of six months, a pathetically far cry from the year that I really wanted.

Give Up the Guilt

I wish I could tell you, Drying Up, that quitting/weaning/whatever-it-was was some fabulously freeing experience for me — oh! I could be free of the guilt and enjoy my baby! — and I guess there was that side of it. I really did believe I’d done everything I could, but that my baby and my body had made the decision for me and it made little sense to fight it. I also was extremely conflicted about being back at work. So that didn’t help the creeping thoughts of “if I’d just been able to stay home with him this never would have happened!”

But. Hell. That’s life. We do the very best we can for our children given our own unique circumstances. Like you! Back to work after two months? My God, I commend you for even being able to navigate a hallway without smacking headfirst into walls, much less keeping up with pumping and multiple LCs and all of the rest.

Mamas with temperamental supplies like ours…well, the pump just doesn’t cut it sometimes. (I’m assuming you’re still on a hospital-grade rental, and not a hand pump or other small, less-powerful travel/portable kind.) Our babies are more efficient at getting the milk out, and our bodies respond best to the sight and feel and smell of that little downy head rooting around down there. Not so much with the cold plastic of a goddamned milking machine, no matter how many photos we stare at or little hats we smell while trying to pump. The stress we feel over the lack of significant output doesn’t help either.

Again, this isn’t FAILURE on anybody’s part. It’s just life. Modern life in this country, with terribly short maternity leaves and hectic schedules and SO MUCH PRESSURE from ourselves and society to do it all and to do it all perfectly.

60-70% breastmilk? That’s OUTSTANDING. That’s a lot of antibodies there. Antibodies that she’ll have long after you’re done nursing. Seriously. Forget what that ratio might be in a week or two weeks or a month. Accept a standing ovation for what you’re doing right now.

(And for the record, Noah had two ear infections while in daycare — one before and one after we weaned. He’s had exactly one more ever since. He’s been on antibiotics once. The only other medication he ever takes is a week or two of Zyrtec in the spring. He kicked a speech delay roundly in the ass and is, I AM SORRY, unbelievably smart and healthy and awesome. I dare anyone to find a mother and son who are more closely bonded, pea-in-a-pod style, than we are. And hey! He’s pretty nuts about his Dada, who also got to feed him a lot of the time, as well.)

You’re Doing Enough (I Promise)

I’m totally just rambling here, I know. Obviously I don’t have some awesome solution to offer you. Maybe try the Reglan (I never did — my LCs finally admitted that my breasts were probably working at full capacity, what with the duct damage, and never really recommended prescriptions). Maybe try a different pump. Maybe just hang on as long as you can, doing exactly what you’re doing, knowing each day is a blessing but that all good things must come to an end.

In the “non-maybe” category — STOP comparing yourself to your mom or MIL or that self-righteous twit in your playgroup who never had any problems exclusively nursing her triplets until they were in the second grade but still clucks her tongue at bottle-feeders. STOP looking at this as a pass/fail exercise. STOP feeling guilty. (Note that I’m not saying you need to stop feeling disappointment or sadness — those are natural when something that’s important to you doesn’t work out as planned. But GUILT. The feeling like this is your fault or that you’re letting your daughter down when you are clearly kicking your own ass repeatedly trying to make it work…no. Stop that. Easier said than done, but…stopthat.)

I think, towards the end of our breastfeeding time, the only time Noah really WANTED to nurse was right when we got home at night. His daycare providers were lovely, wonderful women who were just crazy for him. His needs were met, his days were stimulated and fun, and yet he would divebomb for my shirt the minute we got home and settled in on the couch. I kept up this feeding as long as I could, and it was the reason I was most distraught that morning when I realized I was finally, completely bone-dry.

So that night, we came home. We settled down on the couch. I’d pumped several times that day and didn’t produce a drop. I was terrified Noah would try to latch and get angry again. But…he didn’t. He knew. But he also didn’t howl for a bottle or wriggle away from me. He curled up against my chest and sighed and sucked his thumb. I rubbed his head and cheeks and stroked his body the way I’d done while feeding him, and he looked up at me and smiled around his thumb, just like he’d done while nursing.

And I knew everything was okay. I’d done enough. This was enough. For both of us.

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