Here's the story. I'm pretty discouraged by now, so I'm not too confident that you folks can help, but let's try again.

Marguerite was born at 35 weeks, and because she was small and had bad jaundice, I was encouraged by nurses and the pediatrician to give her supplementary bottles from the start. The general practitioner to whom I switched shortly after said the same thing. So she has been taking breast & bottle ever since birth. Things went surprisingly well, considering it all, while I was at home.

When she was 3 months old, however, I had to go back to work. She was by then nursing every 3 hours during the day and sleeping through the night. I bought myself a Pump & Style (Medela) and thought pumping would improve (in fact, I had rented a pump and had been practicing for 1 month). I have my own office, so interruptions are not a problem. I pump either twice or three times a day - I try to be consistent, but sometimes it's impossible to take the time off (most days it's 3 times).

I have been at this for 3 months now. IN my lucky days I bring home no more than 4 ounces. I have tried everything: I drink tons of water, take Blessed Thistle and Marshmallow twice a day (2 tablets of BT and 1 of M twice daily), try to relax, took to the office a hot pad. I also look at pictures of the baby and try to imagine her nursing. It doesn't seem to make any difference whatsoever.

The suggestions I receive or read are stressing me out even more - for instance, I read a book that suggested that I breastfeed during the night (please - I work very hard - I need to sleep too! I can't imagine convincing a baby who has been sleeping through the night since 2 months to now start waking up to eat!!!!). Another suggestion I've had was to pump after she goes to sleep. I try to, pretty much falling asleep on the pump, and it's the most frustrating experience - for 15 minutes absolutely NOTHING comes out.

I feel that I failed somehow, and hearing everyone talk about the wonders of breastfeeding makes me feel even worse. I'm about to give up trying to increase production and just give her whatever I have. At least at home - at night and in the morning - the production doesn't appear to be too bad. My milk, however, never leaks, and I don't really feel the let down.

Are there any suggestions that would not involve starting to wake my baby up at 3 in the morning? Forgive my discouragement, but sometimes I think my body just refuses to produce milk! In fact, that's what the nurses say in the ob office - everywhere I turn, someone from the medical profession tells me to give up. (does this sound familiar?)

Incidentally, here's the only bright side to this story: Marguerite is doing great, has never had a sick day in her life, and manages somehow to avoid all the colds that her father - and even I - have caught these 6 months. But, she has been taking about 8 ounces of formula a day, plus solids. I only manage to send to the daycare 4 ounces of my own milk, and that's not enough to keep her fed.

THANKS!




 

Dear Chris,

I always love a good breastfeeding challenge, so the fact that you're not too confident that we can help you is not a hindrance to me! While I would love to see you be able to build up your supply, I also realize that that may not happen (although I think it can). More important to me is that you see that what you are doing right now has merit and is beneficial to the health of your baby and you!

I loved the last paragraph of your letter and want you to think about what you said, "Marguerite is doing great, has never had a sick day in her life, and manages somehow to avoid all the colds that her father--and even I--have caught these 6 months..."   The "somehow" is very easy--It's the breastmilk! And even though you aren't making enough right now to avoid supplementing, you can see that in terms of protecting the baby, it's certainly enough! One thing we know about breastmilk is that, as the baby weans and the mother's supply goes down, the antibodies become more concentrated in the milk. So even a little milk is beneficial! I am constantly saddened to hear women giving up breastfeeding because they think it's not worth it anymore since they can't get a full supply. I often tell moms, "If I could only get a teaspoon of milk out, I would be feeding it to my baby! " I have been studying about breastmilk and breastfeeding for 15 years now, and I am convinced that even a teaspoon a day is beneficial. Your last paragraph says it all! What I want you to realize is that, it may not be the way you had pictured it or the way you would like it to be ideally, but what you are doing is working! You have a healthy happy thriving baby--and you can be sure that the breastfeeding is playing a big role. I hear constantly from women that, as soon as they weaned, that is when their babies started getting sick. Many of these women have been down to only 1 or 2 feedings a day prior to weaning, so we aren't talking about a lot of milk.

Concerning your milk supply--the two most important factors to building up a good supply are (1) frequency of stimulation to the breast, and (2) getting enough rest and avoiding stress. Let's take them one at a time:

(1) Frequency of stimulation. The more often the breasts are stimulated, the more milk there will be. So in order to build up milk supply you have to stimulate the breasts often. It does not matter at all if nothing is coming out--it is the stimulation that gets the hormones flowing. Double pumping (which I hope you are doing) helps even more to accomplish this--even though you cut your pumping time in half.

If you can get yourself on a two-hour schedule (or as close as possible) while you are awake, that is the ideal. 10-15 minutes of double pumping is how long--again it doesn't matter that nothing is coming out. By the way, looking at a picture of your baby may not necessarily be the best thing for you to do. When a woman is having problems with supply, taking her mind off what she is doing can be even more beneficial sometimes--reading a book, watching TV, or just closing your eyes and resting. 

(2) Getting enough rest and avoiding stress. Because rest is so important, I never encourage women to pump frequently through the night. However, during the time that you are trying to build up your supply it can be extremely helpful to pump at least once during the night. That is because going all through the night without stimulation to the breasts will cause your hormone levels to fall. The stress of not having enough milk and trying constantly to build up your supply can actually decrease it even more. It is similar to a mother who is trying to get pregnant, gives up, decides to adopt, and all of the sudden she's pregnant. I have seen this quite a number of times. So anything you can do to relax is a good thing. This is one of the reasons I would like to to accept the fact that what you are doing for your baby is valuable.

Being a morning person, I also rarely encourage people to pump after the baby goes to sleep. However, if you can do that just while you are trying to build up your supply, again it can be helpful. Your supply will be at it's lowest point of the day, so you wouldn't really expect to get any milk. Again, it's the stimulation that is important. Drinking "tons of water" will not help milk supply. It only produces more urine. In fact, drinking more than you are thirsty for can actually decrease supply since, in a "waterlogged" body, the hormones are going to be more diluted.

Blessed Thistle is good, but I'm wondering if you have tried Fenugreek. 2-3 capsules with each meal has been shown to help increase supply for about 80% of women. You can take this along with the blessed thistle.  Good luck to you. I truly hope what I have said is helpful and gives you some peace.

Cher Sealy, RN, BSN, IBCLC, LLLL





Later Reply From Chris:

Dear Cher,

Thank you so much for your help. You wouldn't believe (or maybe you would) the amount of negative info I've received all along. I had a tough beginning ... maybe even a little tougher than I told you. The pediatrician who first saw my daughter told me that she could have Down's Syndrome. She was, fortunately, wrong. But due to that misdiagnosis, as you can imagine, the first 2 weeks were incredibly tough. The only possible explanation is that, somehow, she didn't recognize a different ethnicity (I'm Brazilian) and ordered the tests without even asking about my heritage (which includes Portuguese, Spanish, and South American Indian). After that I had very painful and countless clogged ducts and even more painful blisters all the time.

During this saga I heard from my GP and the OB/GYN's nurses, and my mother, and every single soul around me... why are you doing this to yourself? Why don't you stop? And then, when the supply problems started it was... maybe your body is not meant to make milk... some women are like that... just accept it. My boss was not incredibly supportive either, and I had some unnamed colleague complain to him about the "unfairness" of my taking time off to pump (I simply use the hour I have for lunch and have a 5-min sandwich, but that of course doesn't move anyone).

Well, I'll start trying again. I hadn't stopped breastfeeding, but I had stopped, in utter frustration, to try to pump after she went to sleep, or more often during the day. I'll also try the Fenugreek. To look at Maggie does make it worth while. I'll let you know how it goes. Thanks again a LOT for your support. You have no idea how much it meant.

Sincerely,

Cris Wildermuth
Lima, OH





 

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