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One Mom’s Story– Trouble Conceiving, And Then Trouble Breastfeeding

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Pregnancy and breastfeeding are hard enough when everything goes according to plan. Sometimes, nature defies us and makes it even tougher. Mel, the blogger, behind Stirrup Queens, sent me this story about the trouble she had conceiving and breastfeeding. Here’s her story.
Maybe I couldn’t conceive on my own and maybe I couldn’t get to term, but come hell or high water, I was going to breastfeed. When the babies were born, I wanted to get to the NICU immediately, not just to check out their adorable punim (Yiddish for cutie faces!), but because I needed to get them on my breasts. Everyone knows that early breast milk is crucial for a full-term baby so imagine what I had convinced myself in my anxious little head in regards to my premature, underweight, IUGR (Intrauterine Growth Restriction) babies. It was like my breasts were literally leaking the medication that would get them home and I wanted to shove my boob straight into their mouth AS SOON AS POSSIBLE.
Except that my breasts weren’t really leaking anything. Strangely, I hadn’t had any breast changes during the pregnancy. No sensitivity, no big boobage. My size C’s stayed firmly size C’s. I commented to my OB about this and he brushed it aside saying that many women experienced no breast changes. Which is probably true.
But then my milk didn’t come in. My boobs never became “engorged.” In fact, it was sort of like my boobs hadn’t gotten the message at all that I was pregnant nor had given birth. I thought of my boobs like teenagers glued to a Sony Playstation who have blankly turned towards my voice with a glazed over expression. “What? You were pregnant? Dude…that is nasty.”
But the breastfeeding consultants and books didn’t find this a problem. Rest more! Pump more! Eat more! Drink more! This was the advice that kept coming around every time I set up a session with a consultant and mentioned that eight full pumpings as well as several sessions directly on the breast every day yielded at most one ounce–altogether. In other words, I could squeeze out a few cc’s each session and if you poured all of them together into a vial, you could sometimes eek out an ounce that would go to one baby for one feed.
Books promised me that if I followed their instructions, I would easily be producing four ounces or more per feed. And I believed it because I wanted to believe it. Even though everything felt wrong just as it had with conception. I knew long before that first year was up that something felt “off” and I knew long before the blood work yielded no prolactin in my body that something just didn’t feel right with breastfeeding. Beyond quantity, my breast milk didn’t really even look like the breast milk the other NICU mothers were proudly placing in their child’s bottle. One triplet mum confided in me that she had so much of this creamy goodness stored in the refrigerator that the nurses were telling her to pump and dump. The babies just couldn’t keep up with her overachieving breasts.
But I really wanted to breastfeed, so I kept with it for weeks, drinking the water, popping the Reglan they promised would increase milk production, pumping with one of the twin’s dirty spit cloths under my nose to stimulate the brain. I was literally willing to try anything.
Breastfeeding for me was very similar to trying to conceive. The initial message when I expressed my fear that something was wrong, conceptionwise, was that I needed to give it time. I was told I needed to relax. I was told that a good vacation would bring me a baby. Then the blood work was taken and diagnoses were doled out. Suddenly, there were identifiable problems and doctors stopped telling me to relax and started addressing the situation as if they had believed me all along when I said, “something just doesn’t seem right.”
Which made me realize that some breastfeeding consultants are a lot like pilates instructors. They have a focused agenda. Pilates instructors are going to push a pilates routine with exercise being of utmost importance. They believe that almost everyone can do pilates as long as you really want to do it and you commit yourself to the exercises. If you’re going to take a half-assed approach, you’re going to get half-assed results. But if you make the commitment to doing pilates every single day and doing the exercises correctly, you are going to succeed and feel good and be aligned and whatever else you gain from pilates. Pilates instructors are never going to nod their head in agreement and say, “sedentary living and forgoing exercise to drink a latte and read a book is just as good as pilates.”
Therefore, I cannot blame breastfeeding consultants when they have an agenda. Breastfeeding consultants do not believe that formula is just as good as breast milk, therefore, I can hardly blame them when I went to them for instruction and had them berate me for giving my children formula (we had a breastfeeding consultant tell us we made a terrible choice by taking our children off IVs and giving them formula through an nasogastric tube. She told us that this proved that we weren’t committed to breastfeeding).
But I can blame them for telling me continuously that my lack of breast milk was my own doing and that all women can breastfeed if they wish. Turns out, if you don’t produce any prolactin, you can’t. But no one told me to have blood work taken. Instead, it was something I had to push for with my OB at my 6 week appointment. And with the results, there was no apology at pushing my body and self-esteem through hell. There was simply a shrugging of the shoulders and a comment that this “sometimes happens to women who use Follistim during fertility treatments.”
Which is a long-winded way to say to breast feeding consultants, help your clients get a diagnosis. New mothers are insecure mothers, desperate to succeed at what we’re told is the most natural thing in the world. When you see issues cropping up—breasts that are never engorged, breasts that remain indifferent whether the mother is pumping or not, or simply the mother who says, “something isn’t right”—start with removing the blame from the woman and instead suggest some simple blood work to check prolactin levels prior to prescribing medication or superhuman pumping schedules. Be boob investigators. True breast advocates. And if everything checks out and no problem can be identified, run down the list of suggestions to increase supply: eat more/eat less/drink more/sleep more/stop exercising/relax.
The best day of my foray into breastfeeding came when I received my diagnosis at the endocrinologist. I walked out of her office crying, mourning that there was yet another womanly trait I couldn’t master. But also relieved that stopping the madness was the right decision. I was never going to be able to make breast milk and all of the suggestions consultants threw at me—from the 2 liters of daily water intake to the Reglan—were like drawing blood from a stone.
Most new mothers who start out trying to breastfeed truly want to succeed. Instead of admonishing those who quit, try sending the message that breastfeeding doesn’t work for everyone. We all have to make decisions that work best for our family and ourselves. And sometimes very real problems exist and the message that “breast is best” cannot trump the more useful adage: take care of yourself. Positive interactions could be the difference between the mother who tries again with her second child and the mother who swears off breast feeding forever.
For myself, I’m not giving up on the idea of somehow producing prolactin if I ever get pregnant again. Boobs, beware! I’ve conquered my ovaries and I’ve conquered my uterus. I’m coming for you next. I mean…after I get knocked up…

Notes from Andi: I inserted the links to other sites in this post. Additionally, the book “Medications and Mothers’ Milk (Thomas W. Hale, Ph.D.) has this to say about Follicle Stimulating Hormones, such as Follistim: “FSH…is very unlikely to enter milk or be orally bioavailable to an infant. However, it is not known if the administration of FSH, and the subsequent maternal changes in estrogen and progesterone, would alter the production of milk. It is likely, since the onset of pregnancy is commonly followed by a decrease in milk production in most mothers.” (page 379).
If you want information about different medications and breastfeeding, check out Dr. Thomas Hale’s book and website. Also, check out ToxNet/LactMed.
Finally, a final note about Reglan– it can cause depression, so be sure to talk to your doctor if you have a history or depression or experience any feelings of depression.
And for more information on increasing your milk supply, check out this post from lactation consultation Melissa Nagin on About.com.



One Response to “One Mom’s Story– Trouble Conceiving, And Then Trouble Breastfeeding”

Bravo to Mel for her courage and perseverance, and bravo to you for posting this story. Yet more proof that doctors need to receive a heckuva lot more training in lactation than they do now.

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