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The Non-Joys of Breastfeeding, Part Three: SUPPLY PROBLEMS

Jul14

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Photo by blmurch

Yes. ProblemS. Plural problems. After suffering through chronic low supply with my first baby, I ended up with oversupply this time around. And while I would definitely choose the latter over the former if I had to, I must say that neither condition is particularly fun.


BREASTMILK LOW SUPPLY

Let’s start off with low supply, so those of you who suffer(ed) from it can skeedaddle before we get to the oversupply section, because I’m sure you want to stab us in the boobs with a fork, like oooohhhhh I make too MUCH milk, isn’t that AWFUL wah wah wah. I know you want to stab us in the boobs with a fork because that is PRECISELY what I wanted to do every time I heard someone talk about her leaking breasts and her war chest of frozen milk and there I was with my sad little A-cups and two ounces of milk that took me three days to pump.

If you’re here looking for magical supply cures, I doubt I have anything you haven’t heard of before. Fenugreek, Mother’s Milk Tea, More Milk Plus, brewer’s yeast, Guinness, Domperidome, Reglan, pumping. I tried pretty much everything. My baby did not gain enough weight on my milk alone. He was always hungry after nursing. I went back to work and pumped and pumped and pumped for nothing and after two months of that I simply had nothing left.

Here’s something though, that maybe nobody had told you, or at least put out there as a suggestion. It might not be *your* fault. Anger at our bodies’ apparent “failure” to provide enough sustenance for our babies seems to be a common thing among sufferers of low supply. I felt terrible. Clearly, my body let my son down. I tried to remind myself that he was so big (9 pounds, 15 ounces) and that maybe that had something to with it — there was no gradual ramping up with him, he just wanted milk and a ton of it. But then I would blame my body again, this time for growing a baby too big for me to nurse.

As Noah has grown and his many many special little quirks and needs have been evaluated and classified and defined, it finally dawned on me that he simply wasn’t a strong sucker. He learned to latch just fine, but he couldn’t suck very well. He’s had a ton of issues with his oral motor skills, from poor muscle control/tone to hypersensitivity, and after the 20th occupational therapist inquired about his feeding patterns as a baby, I realized that it might not just have been that he preferred bottles with a fast flow nipple, and that his constant nursing strikes weren’t because there wasn’t enough milk — he simply couldn’t suck hard enough to get that milk, thus he got frustrated and refused to empty my breast. And thus my body took it as a signal to stop making so much milk. I tried to artificially increase my supply, but since I could NEVER seem to get anything while pumping, I simply assumed Noah was like…DRINKING the milk I managed to produce. He wasn’t. He’d nurse for a few minutes and then pull off and cry when his mouth muscles bothered him, and I’d curse my boobs once more and then oblige him with eight ounces of formula and a Level 3 nipple.

Now, goodness, I don’t want anyone reading this to think: I had low supply! My baby must have developmental problems too! OMG! I’m not saying that at all. I did have physical reasons for being predisposed to low supply (I have a lot of scar tissue from a botched cyst aspiration on one side), but it didn’t happen this time. I’ve read that sometimes damaged ducts will heal themselves with subsequent pregnancies and lactations, but still. The difference was like night and day. And I’m pretty sure that the different BABY had something to do with it. It was a weirdly healing realization for me, so if you’re still angry at your gimpy boobs and their weak attempt at lactation, maybe you can cut yourself some slack too. Blame your baby, that good-for-nothing freeloader. Get a job, baby!

BREASTMILK OVERSUPPLY
I was so terrified of a repeat low supply performance that I packed a bottle of fenugreek supplements in my hospital bag. As soon as I was cleared for liquids after my c-section, Jason started making me cups of Mother’s Milk Tea. I rented the hospital-grade pump at Ezra’s first doctor’s visit and asked for a battle plan for maximum milk production. I continued with the herbal supplements and added in a ton of pumping — 10 minutes, both sides, after every daytime feeding. (And there were a lot of feedings.) I continued this craziness for an entire month, essentially tricking my body into thinking I had twins, or even triplets.

And oh, it worked. It worked too well. I made SO MUCH MILK. I could fill breastmilk storage bags in minutes on the pump. My breasts swelled to D cups. The sound of a sink faucet or even the briefest passing thought of Ezra’s face triggered a WICKED letdown reflex that tingled and ached. I stuck cabbage leaves in my bra and woke up at night in puddles of breastmilk.

And the worst was what it did to poor Ezra. He would gag and choke every time he latched on. He’d slow down at the end of the meal to sleep and the milk wouldn’t stop coming and he’d cough and cry. His stomach was upset and he spat up a lot. His diapers were full of brown and greenish sludge instead of the healthy mustard yellow breastmilk poops.

Sure, I could pump a ton of milk for grown-up dates nights…but I had to spend the majority of those grown-up date nights with my arms across my chest to stop the aching and the leaking. Sexy!

My lactation consultant assured me that it would regulate out eventually on its own. And it did — about a month later than all the books and breastfeeding said it would. She also told me to latch Ezra on while lying on my back, or at least leaning as far back as possible, to keep the milk from forcibly shooting down into his throat.

By the time my oversupply settled down, however, I’d gotten so USED to the sensation of engorgement and that crazy letdown reflex that I started to worry about low supply all over again. My boobs aren’t rock hard! I’m not leaking anymore! Quick, I need some fenugreek! It wasn’t low supply, but I seriously thought it was. Turns out I was simply this crazy thing called “normal,” where my boobs make exactly the amount of milk my baby wants to drink, no more, no less. Without the oversupply, I can’t really pump much, just like last time. When Ezra got his teeth and started biting me with some terrifying regularity, I swapped out one or two feedings a day with formula and BAM, that was pretty much the end of those feedings. Just like last time when I went back to work.

But every morning I wake up 10 minutes before Ezra wakes up. There’s no alarm or noise on the baby monitor — I just know. I just feel it. If I’m away from him at night, I don’t have to look at a clock to know exactly when it’s 8:15 pm and that somewhere my baby is settling down with his last bit of milk for the day. Not too much, not too little, but just right.

If you landed here but are still pregnant, visit Amalah’s Pregnancy Weekly. You won’t regret it.

 

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About the author

Amalah

http://www.amalah.com
Amalah is a pseudonym of Amy Corbett Storch. She is the author of the Advice Smackdown and Bounce Back. You can follow Amy's daily mothering adventures at Amalah. Also, it's pronounced AIM-ah-lah.

If there is a question you would like answered on the Advice Smackdown, please submit it to amyadvice@gmail.com.

Amy also documented her second pregnancy (with Ezra) in our wildly popular Weekly Pregnancy Calendar, Zero to Forty.

Amy is mother to rising first-grader Noah, preschooler Ezra, and toddler Ike.


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10 Responses to “The Non-Joys of Breastfeeding, Part Three: SUPPLY PROBLEMS”

  1. rscott Jul 14 at 12:36 pm Reply Reply

    I am having low supply problems with my second baby right now. It is better than the first, but still kind of pathetic. With medication and breastfeeding tea, I can supply about a third of the milk my daughter needs at six months, and have enough to nurse her back to sleep if she wakes up in the night (which makes it all worth it!)
    I also got a lot more help at the start this time. With my son, the nurses at the hospital didn’t know what a good latch was and I had to go to a pediatrician in another county to find one that would even let me try nursing longer than the first 5 days.
    Now I am in Canada. My midwife’s receptionist was a lactation consultant and public health nurses will come to your house to help you learn to breastfeed. Getting help right away made a big difference and it just helps me feel like I did everything that I could and it is not my fault.

  2. Cindy Jul 14 at 12:51 pm Reply Reply

    I’m sitting here at lunch at a sub place(sales job) away from my 5.5 month old, and LOVED LOVED LOVED this post — then went back to the post about weaning Noah (http://www.alphamom.com/smackdown/2008/08/low_supply_high_guilt_how_to_d.php#more) and my eyes welled up.
    I don’t know why this topic seems to hit home so much with me. I’ve had a relatively easy time of breast feeding (with my now 3 y.o. daughter, as well as my son)… but …. we moms put so much pressure on ourselves, especially with regard to feeding our child. EVERYONE wants to do what’s best for their child (and WHOLE FAMILY)– and it’s important to realize that the situation that is best for you and your child may not be what is best for others.
    Anyway, with regard to a “low supply” you make a great point about the fact that there may also be something else going on there — one of my girlfriends was dedicated to breastfeeding her daughter (now 3 months old) — and had a ton of problems. Fussy Baby, pulling off, screaming … she thought that it was a low supply issue, and then the pedi pointed out due to this -and some other symptoms that I’m not listing just because I’m not entirely sure of what they are and I HATE inaccurate medical information on the Web- that it was probably a MILK allergy! Now granted, supposedly my friend could have cut EVERYTHING w/ Milk protein out of her diet, but for her that would have been extremely difficult, especially while getting used to being the Mommy of a newborn.
    Bottom line — the basics are a great place to start, but keep in mind that sometimes it is something a little more odd and you may have to dig a bit deeper — and try not to have huge MOMMY GUILT about whatever your decisions are.
    Well, time to go to the car and pump, because my day is not stressful enough! ha ha!!
    P.S. – thanks for the mastitis article — makes me realize I may have actually had it when I was away for the weekend w/ my daughter — no pain (luckily), but had a RAGING fever of 104.5 (and I usually run low) for about 24 – 48 hours w/ just general I FEEL AWFUL symptoms. Thank God I kept going with feeding her (after a call to the local hospital was NO help!) otherwise I’d have probably given up
    P.P.S. I would LOVE to see a pumping article! That’s a whole set of “non-Joys” in itself!!

  3. Lisa Lee Jul 14 at 1:33 pm Reply Reply

    Hi Amy,
    I don’t know if you are still nursing, but if you do I can recommend the Boston Billow nursing pillow since it is excellent for C-section moms.
    Lisa.

  4. Summer Jul 14 at 1:40 pm Reply Reply

    Terrific blog. Breastfeeding is a real bitch in my opinion. I love being able to feed my little girl, but I was convinced I wasn’t making enough for her for the first 6 weeks. I, too, tried everything. I think another big part of breastfeeding that they don’t tell you about is to trust your body. Cursing at it never seemed to help like I had hoped!

  5. Arwen Jul 14 at 4:58 pm Reply Reply

    Thanks for talking about oversupply too, Amy! I’ve read about a million posts on the topic of how to boost your supply, and I have sympathy for people with low supply (and NEVER complain about my huge supply in front of them) it’s also true that having oversupply can be a burden. I can’t count the number of times I’ve woken up in the middle of night having soaked through the bath towels I put in bed with me to catch the extra milk. It can be really frustrating (not to mention extra-laundry-making!) to have an oversupply problem.
    For other moms with a natural oversupply like mine, I want to recommend kellymom.com for tips on reducing supply. I practiced their suggestion for “block nursing” this time around with baby #2 and it has made a huge difference! I honestly wonder if part of my first baby’s colic might have been caused by her getting too much foremilk because my supply was too big. My current baby (6mos) is much happier.

  6. Della Jul 14 at 11:00 pm Reply Reply

    My letdown was freaky – it was so forceful, I could literally stand 18 inches from the bed and shoot my husband with it. (bwahahahaha!!)
    But all that foremilk (and I imagine a lot of air swallowed along with the fire hose milk) resulted in terrible gas and chronic diarrhea (like, the consistency of stage 1 peaches, LIQUID, frequently green) for months.
    (Side note, the doctor never actually saw this runny poop and tried to tell me that all baby poop is soft. We DID sometimes have the properly seedy, soft but technically solid newborn poops, which gave me a basis for comparison. Dumb doctor, LISTEN to the mommy! just because he’s my first baby doesn’t mean I’m ignorant!)
    It was also frustrating to continually have leaking boobs.
    I found out about block feeding (where you feed only one one side until that side is EMPTY, even if that means multiple feedings in a row, before switching to the other side. If you have too much discomfort on the other side, you express by hand JUST ENOUGH that it isn’t killing you.). It made a huge difference in my comfort level, in the insane squirty milk, and in the baby’s gas problem. (That and Mylicon, which we didn’t find out about until he was almost 3 months old.)
    One unfortunate side effect of the oversupply and having to block feed was being afraid to pump. If I pumped, I knew it could rev my breasts back up. So I didn’t pump, and I didn’t have any spare milk for other people to feed to the baby. :(

  7. Thank you for suggesting the idea that your baby might have been the one who needed help. Our 4th baby was the worst at nursing. I knew what I was doing, but he was so lazy. I learned about breast compression and it saved our nursing experience. It’s a way of helping pump more milk into your baby’s mouth as he drinks so he’ll wake up a little and fight for it. If anyone wants to learn, just google “breast compression”.

  8. Cecily T Jul 15 at 11:07 am Reply Reply

    Just want to point out, as I have before, that a lot of milk supply messages are governed in the first 6 weeks by post-partum hormones.
    I had a crazy oversupply as well (like my daughter only nursed one side with some left over, and I pumped the other side for months). Yes, yes, I was one of those gals w/ gallons of milk in the fridge.
    But! I was also terrified to pump off any of the milk which was making my boobs so painfully full because I was afraid that it would make my body make more. I leveled off around 4.5 months (yes, a month or two after all the books said). Next baby, I’m pumping whenever it hurts, because it really sucks to be awake and have to pump b/c your boobs hurt too much to sleep and the BABY is sleeping! That was the worst.

  9. Karen Jul 15 at 3:49 pm Reply Reply

    Hi Amy. I had a common problem of great supply with sudden drop-off. I think my body was just over it. I work(ed) full-time (and at the time was running around in the news business) and would pump all hours to be sure my son had enough to get him through the day at daycare. He was also a big baby, 9.2 at birth and never looked back. Suddenly at 7 months – the pump wasn’t working. Each day I saw my supply go from 6 ounces at a session to 5.5 to 5.25 and eventually to 2-3 ounces. I NEEDED 6 ounces each session plus extra sessions to get by! I became insane. I was pumping after feedings, taking fenugreek, drinking tea. Once day I was pumping at work and looked down to see a pink bottle attached to the pump. I was bleeding because I was pumping so hard. Finally, it occured to me that supplementing was going to have to be ok. I cried and cried like I had done something awful to my son. I blame the people around me who were pushing me to continue when it wasn’t what was best for any of us. I am glad it happened though, because I will not give away free samples of formula next time. I will supplement from day 1 if necessary and I will not blame myself for anything I simply can not do. It is ok and I am ok with it.
    Thanks for these posts.

  10. qwyneth Jul 18 at 2:26 am Reply Reply

    Oh my lord I know so much about pumping up supply. I had a breast reduction and bought both the BFAR book and Making More Milk and rented a hospital grade pump 2 weeks before I gave birth. I was totally prepared! And then my baby was born and he fell asleep and pulled off screaming and sucked only for comfort and lost 10% of his birth weight within TWO DAYS. I tried a zillion different latch methods and breastfeeding holds and ended up having to pump after every feed and syringe feed it to him plus supplement. And FOUR different People Who Should Know (including the hospital lactation consultants) were totally stumped by how he completely sucked at sucking, after HOURS of trying to get him latched and sucking.
    And then I hired an independent lactation consultant who stuck her fingers in his mouth and watched him latch and told me that it was entirely not my fault, that he was lousy at sucking. And I cried. A lot.
    This most miraculous LC has actually worked with an oral-motor specialist on this. (She also said something about a ramping up study, possibly related to oral-motor issues later on, but I was still floating on the It’s-Not-My-Fault cloud and missed the details.) Basically she was seeing these tough cases, people who weren’t helped by other LCs, who were latching their babies fine but their babies weren’t able to get at the milk. She got the specialist to devise oral-motor exercises and put the babies on Haberman nipples (dripless nipples used for cleft palate babies, truly incredible things) to try and strengthen the babies’ sucks. The hope was that after 4-6 weeks you could get the babies back to breastfeeding.
    Now, it didn’t work for me. Griffin was a big baby who very quickly pushed for larger feeds and we kind of forgot to do the exercises half the time. Also I misinterpreted her instructions and didn’t try him at the breast at all for about three or four weeks, which made him grumpy when I tried later. AND, between my reduction and the exclusive pumping, I never managed more than 20 ounces or so, even with supplements. But I believe it’s worked for other women in the moms group she runs.
    Anyway, Amy, you are completely correct. It’s not always the mom’s fault. Didi, the Most Fabulous LC in the Land of which I speak, theorizes that these weak suck babies would have been those babies that failed to thrive and were sickly in years past. If you’re interested in looking more into it, possibly for a column, I can put you in charge with the LC. She’s based up in Baltimore and runs a moms group (for younger and older babies) on Friday mornings/early afternoons.
    Oh! And if you do write a pumping column, you should include instructions for the do-it-yourself handsfree pumping bra. Buy a cheap bra at Walmart (I chose a nursing bra but others have done sports) and cut slits at the nipples. Voila! Handsfree pumping bra at less than half the price.

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