Low Milk Supply? A Tale of Two Mothers  

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Once upon a time, there were two pregnant friends. The friends were so excited about having children together. I will call one friend FA as in Friend A one FB as in Friend B. J Of course, I am rooting for FA and FB to have wonderful pregnancies, births and breastfeeding outcomes that they feel empowered and successful with. They are also hoping for the same.

Both FA and FB were planning on having a child. They both were very educated women and planned on doing more education while pregnant. They both had ideas on what it would be like to have children. They were both very happy about having new babies in their lives. They had watched friends have babies and they felt strongly on how they could do things similar or different from their friends.

FA and FB started out with the same OB/GYN. At about 20 weeks, their OB gave them a “gift bag” which included marketing pamphlets from many sales companies for formula, diaper, clothing and more.  Most of the “information” was lacking or misleading and was mainly passed out by the OB because they wanted something free to hand out and not because the staff had actually screened the flyers. 

FA decided she would get more information and so she read many books on pregnancy. She had over 6 books on pregnancy on her nightstand! She was so excited to learn more about what was going on in her body. She went regularly to her OB and felt comfortable there.

FB decided she would get more information and so she asked a friend who was a midwife what books she might suggest. She decided to read the book The Healthy Pregnancy Book and then do some more research. She then decided she would read a few books on birth since she was half way through her pregnancy. FB decided to read books that leaned towards empowering birth and to leave her options open. She knew that the OB practice she attended had a high rate of surgical birth but maybe that was because they had a Level 3 NICU so they had more complicated cases. She decided to ask them at her next appointment. She was also happy with her practice but thought she’d start interviewing Birth Centers and Midwives and maybe even hire a Doula.

It came time to take hospital tours. FA and FB went together to the classes. One of the hospital classes was on breastfeeding. The nurse who had taken a Baby Friendly course told them that breastfeeding was important. This was a short introduction to breastfeeding. FA and FB talked about breastfeeding after the class. FA and FB were both excited and a little worried about how that would go. FA decided she would try to breastfeed and see how it went when baby was born. FB decided she would try to breastfeed so she bought Breastfeeding Made Simple and went to the library to look for a few more books on breastfeeding. She made sure to look up the authors and make sure that they were Internationally Board Certified Lactation Consultants so that she could trust that the information in the books was accurate and not just opinion. She started to keep a list of the local IBCLCs in case she needed them when the time came and decided she would start looking for breastfeeding support groups in her area. She found both a local La Leche League and Breastfeeding USA group and she decided to ask FA to join her at one of the meetings. FB did attend one or two meetings and started to make a few new friends. Some of them were nursing toddlers, which she felt was a little different than her goals but they assured to her “take what works for her and leave the rest”. FA felt support groups were more something she’d consider going to if there turned out to be a problem and kept the flyer FB gave her.  

FA and FB had due dates that were only two weeks apart. The OB where FA went told her that her baby was “measuring big” so they would have to induce if she went past 37 weeks. She knew the importance of going the full forty weeks but also figured that her OB knew what he was talking about and trusted him. FB was due before FA but her Midwife told her there was a range of “normal” that was from 38 to 42 weeks and that as long as everyone was doing well, they would watch and wait. Both friends had vaginal deliveries. Both friends were very happy with the outcomes even though neither of them would have liked the way the other’s birth occurred. Both babies were born healthy and strong and started out nursing well. 

FA had her baby and was told by the night nurse that she shouldn’t let her baby use her as a pacifier. She was told to time her nursing sessions per side to 10 minutes even though adults don’t time their own meals. FA nursed every 3 hours in the hospital, timing from the start of one feeding to the next and made sure to switch sides after 10 minutes. Her mom came to visit and was worried she wasn’t making much milk yet so suggested that they give baby a bottle of formula. FA was worried about her baby and if she was making enough milk. Her baby was crying or sleeping in between the 3 hours and FA was very tired, especially on the second night. FA asked if the baby could go to the nursery so she could rest.

FB had her baby and reminded the nurse that she wanted to have skin-to-skin time and nurse in the first hour after birth. Her nurse told her not to let her use her as a pacifier but she reminded her nurse that since colostrum comes in tiny amounts and baby’s tummies are so small, her baby needed to nurse. Anyway, she didn’t mind comforting her baby this way and she knew her baby was having a lot of changes to deal with, just as she was. FB nursed on and off as baby would and when she noticed time go by, she stirred baby to nurse and snuggle. Her mom came to visit but since she attended one of the breastfeeding support meetings with her, she knew that the best way to be supportive would be to offer help with positioning or to call the hospital LC on staff if she had concerns. The hospital was a Baby Friendly one so they educated families on rooming in and FB kept her baby in the basinet next to her so she could get rest.

FA went home with her baby. She posted her “baby stats” on social media and everyone was excited for her. She tried to keep to the schedule she started in the hospital but sometimes it was harder than others, especially with so many visitors. In a few weeks she started going out more and getting together with some of her friends from her organizations and clubs. Of course, everyone asked her if her baby was sleeping through the night yet. Sometimes she told them no and other times she lied because she felt like she was doing something wrong. A few of her friends were following a sleep training book and they added her to their facebook group so that she could start learning about how to follow the program. She read about how hard it was for these moms to hear their baby scream and cry at night but how it was the right thing for their babies because they would be more disciplined and independent. She felt in her gut that babies under a year were really not meant to be independent yet but they all seemed to be more experienced than she was so she started to let her baby cry if it was dark out and nurse in the daylight.

FB went home with her baby. She covered all the clocks and changed the message on her answering machine so that it said that she’d call back when she could. She also put the “baby stats” on the machine and on her facebook page and everyone was excited for her. When people came by, she kept visits short and only really let them come after week of babymoon time. She had a diaper log for a few days and when she saw that her baby had nice mustardy yellow stools 3 or 4 times each day, she stopped logging them and realized she was learning her baby’s nursing and sleeping cues. It was rough at first but when she felt she had questions she turned to the reputable breastfeeding sites and organizations she knew in the area. She had requested to join a facebook group that was connected with breastfeeding and she learned who there were the trained counselors and who was not. She had learned that her baby needed to nurse at least a dozen times in 24 hours, day or night. She remembered that when she was pregnant, her baby would kick a lot around 3 am. It was funny how now at 3 am her baby was most active and seemed to get the most milk at 3 am!

FA and FB were both so tired! It is amazing how little sleep new parents can run on. 

FA was really getting depressed and overwhelmed. She was up a lot at night with her crying baby. She had now moved her into her own crib down the hall and it was hard to wake up and then fall back asleep so many times each night. She talked to her doctor and started going for walks daily with FB. She started supplementing with formula because she wasn’t sure if the medication she was considering was “safe” while breastfeeding.

FB was tired so she made sure to set up a nursing station for herself with water and healthy snacks so that she got more calories. She was up a lot nursing her baby when she stirred. She knew that the AAP recommends keeping baby close to prevent SIDS and that it is important for baby to hear you so that they wake often. She had the crib next to her bed so that she could nurse and then go right back to sleep.   She was starting to feel a little depressed and overwhelmed so she talked to her doctor. She started taking walks daily with FA. She considered taking medication, which she looked up with her Mommy Meds app. 

Both FA and FB are now nursing babies who are 4 months old. Four months seems to be a really active and alert time. So many changes are happening.

FA has gone to the pediatrician and the doctor is worried that baby is falling out of their percentile on the growth chart. FA has been swaddling at night and she has finally gotten her baby to sleep through the night. She is disappointed that she isn’t making enough milk and feels it is something to do with her body. She nurses her baby 6-8 times in the day, every 3 or 4 hours. Maybe she will start taking fenugreek pills and pumping more? The doctor recommends rice cereal and suggests adding more formula. FA remembers that flyer FB gave her so she calls one of the numbers. She isn’t sure about what to do and is certain that she has low milk supply issues and that something is wrong with her baby or her. Can she relactate?

FB has gone to the pediatrician. Her doctor says that the baby is too low on the growth chart percentile but she remembers that her baby has always been on that range and that her baby is growing in both length and weight so she is discusses this with her the pediatrician and asks to see the WHO Growth charts they have been using. She knows from reading The Womanly Art of Breastfeeding that babies tend to have growth rates that slow at this time. She nurses her baby about 10 times in 24 hours, sometimes less but usually more. She also knows that the AAP suggests waiting 6 months for solids and so when the doctor suggests she start purees, she asks about waiting that out and starts reading about Baby Led Weaning and Baby Led Solids.

Both FA and FB are moms of 6 month old babies now.

At 6 months, FA has completely weaned her baby and is very proud of herself for making it this far. She had a lot of obstacles in her way. Her baby is doing great on the jars of solids and formula she is using now. FA is happy for the most part and starting to feel like she is bonding with her baby more and more each day. However, she believes her body didn’t make enough milk and she is unsure if she will breastfeed again or not.

At 6 months, FB is starting the weaning process by introducing new solids. So far her baby has tried avocado and squash. Her baby loves to lick her apples too! She always nurses before introducing any solid because she wants to make sure her baby gets the good stuff first. Food is really fun so far and it is funny how it comes out in chunks sometimes!   She is proud of herself for making it this far. She is considering changing her goals now to a year, maybe more? If she ever has another baby, she is thinking this can really be something she will do again.

IF you have gotten this far, you know the following… Both of these mothers love their babies dearly. Both of these mothers are smart and capable. In this case, both of these mothers’ bodies had capability of making a full milk supplies when their babies were born. Both of these mothers could nurse for any length and any goal they chose because their bodies work just fine. Both of these mothers read books. Both of these moms reached out. Both of these moms had health care teams. Both of these moms looked forward to being mothers. Both of these mothers are happy that they nursed for their goal. Both of these mothers should be proud of getting as far as they have. Both of these mothers can be experts when it comes to their own children. Both of these mothers will gain confidence in their parenting abilities but it will happen at different rates and has happened more so for FB than FA. Both of these mothers tried very hard and did their very best and don’t deserve judgment. One of these mothers educated herself on natural biology of babies. One of these mothers felt really empowered in her choices.

One of these mothers is getting more rest and making more milk.

 

 

This entry was posted in Body Awareness, Breastfeeding, Child Development, Cue Feeding, IBCLC, Logs, Medications, Milk Supply, Newborn, Nighttime, Parenting Books, Pumping, Solids, stools, Weaning and tagged . Bookmark the permalink.

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