One Breast is Enough

By Patricia G. Blomme
Issue 129 March/April 2005

Unilateral nursing mother

I have been blessed in my lifetime—I have had the pleasure of placing five children to my breast. That singular term, breast, is very accurate. Four of my children have benefited from my having nursed them to the best of my abilities as long as I could. 

My breastfeeding tale is fairly unremarkable compared to those of other breastfeeding mothers, who have tried and, with difficulty and lack of knowledge, eventually succeeded in fully nourishing their babies at their breasts. My situation is different—I am a unilateral nursing mother.

My story began 33 years ago, on a chilly November morning. I was six years old and had just finished letting the cat out. I turned around and saw that the stove was on. As I attempted to turn the stove off, my pajamas caught fire. I received third-degree burns that covered 30 percent of my body, including half of the front of my torso, and obliterated my right nipple.

When I was 25, I began looking into what I would have to do to be able to breastfeed. My plastic surgeon had told me that I could, but that I would have great pain and pressure in my right, burned breast, and that he had heard of no procedure by which that breast’s milk ducts could be opened to relieve the pressure.

A few years later, I saw another surgeon. She told me that the ducts could be surgically opened (no small feat!) when I began lactation. I would then have to keep expressing milk to keep the ducts open until the healing was complete. I would endure some pain, but I was elated to have found someone who would go the extra distance and at least try.

I continued my inquiries but found nothing about my particular situation in the medical and nursing texts I read over the years. Even during my initial training as a diploma nurse, education in lactation was greatly lacking. I was under the impression that a woman’s breasts worked together—the one friend I had who was a mother leaked from one breast when using the other. In my case, there was no place for this leak to go. But I badly wanted to nurse and decided to further investigate the milk-duct surgery. My baby, yet to be conceived, was worth it.

Before I could make an appointment with the plastic surgeon, I became pregnant with my first child and was directed to the lactation consultant who worked with my family physician’s medical group. Linda was great—right off the mark, she explained that there should be no problem with my ability to breastfeed; that it was only a matter of my desire to do so. I couldn’t believe my ears. I was told about all the changes my breasts would go through, and how they worked independently of each other. Then she talked about how fresh cabbage leaves could suppress lactation in my nonnursing right breast while I lactated with my left. Little did I know at that point how much help they would be. I left the appointment feeling confident that
I would be able to breastfeed my child.

I gave birth in the hospital, unmedicated, to a healthy 7-pound, 8-ounce baby boy. I received little support for breastfeeding from the nurses while in the hospital, but my new son, Paul, and I managed. We decided to go home the same day I gave birth. On my third day postpartum, I awoke to all the joys of having a pair of red-hot rockets sitting on my chest. I was glorified. Linda and another lactation consultant, Dr. Janette Hurley, helped me with their knowledge and encouragement during my first postpartum visit. By day seven, I was feeling less engorgement in my right breast. Because I was not using the breast and was applying cabbage leaves, that breast’s milk production was suppressed—and baby was happily nursing at the left one. One hot afternoon, I fell asleep with some nice cold cabbage leaves on my right breast, only to wake with the whole room smelling of cooked cabbage. Yuck.

I fed Paul for four and a half months. But I was always fearful of him not getting enough, and between breastfeeding, using expressed breastmilk, and infant-formula supplementation, he weaned from my breast to the easier method of feeding, the bottle. I was devastated and didn’t know how to get him back on the breast. Even going to my doctor didn’t help—she didn’t ask if I wanted to continue breastfeeding or tell me how to resume breastfeeding, nor did she ask if I wanted to talk with the lactation consultants. She simply assumed I didn’t want to breastfeed anymore. Little did she know that I would have jumped at the offer of speaking with the lactation consultant again and resuming breastfeeding. I felt like a complete failure, and I felt tremendous guilt. I continued to bottle-feed with formula and was pregnant again six weeks later. This second pregnancy filled a void and rekindled my desire to breastfeed.

The birth of my second child, Matthew, was completely different. It took place at home, with midwives, and this time I had a great deal of support. Having used a midwife for the homebirth, I had consistent help in the first hours to ensure that babe and I got off to a good start. And experience can be almost everything. I had even found a book that discussed exclusive unilateral feeding: The Nursing Mother’s Companion, by Kathleen Huggins (Harvard Common Press, 1999). Everything went well until I woke from my first postnatal nap. Matthew and I had fallen asleep while nursing, and I now had two small blisters on the tip of my nipple. From that point on I learned a new definition of pain.

My milk came in two days later, and I again experienced massive engorgement. Still, between that and the blisters, I wasn’t doing too badly, though latching on caused sharp but momentary pain. It wasn’t until about seven days later that I began to have increasingly steady breast pain, as mastitis settled into my feeding breast. For the next two or three days, until the infection settled down, I nursed with great trepidation—the whole process caused pain that brought tears to my eyes. But all during this time, Matthew contentedly nursed and slept at my huge, hot, swollen breast. My husband gave me all the support he knew how to give and took time off work so I could rest. I never once thought about supplementing with formula, knowing I could give my son all he needed from the one breast and that mastitis alone is not reason enough to stop nursing. Everything settled down within a week, and by the time Matthew was one month old, we were “dancing” together like old pros. He never had a bottle.

I nursed Matthew for his first five years, including the third, when I was pregnant again. To the amazement of everyone, I then nursed my newborn as well as her brother and continued to double-nurse them for a year and a half—both were late starters with solid foods. Matthew was exclusively nursed until he was almost a year old, and my daughter was interested in nothing but the breast until she was eight months old. I’m still amazed at my single breast’s ability to provide such massive amounts of milk during that time.

I can’t remember when Matthew came to the breast for the last time; he weaned himself so gradually. All I remember was noticing that it had been more than a week since he’d nursed; after that, he never did again—no big deal for him, but a tad melancholy for mom. My daughter nursed until she was three and a half, at which point I had to encourage her to wean—another circumstance had arisen that sent me back to the lactation consultant and the plastic surgeon.

Just before Christmas 2002, I found myself pregnant again, even as my daughter continued nursing as contentedly as ever. When the pregnancy was 13 weeks along, we discovered to our surprise that I was carrying two babies. I continued to nurse my daughter, for I saw no reason to wean her. However, questions regarding the nursing of twins began to surface; I again consulted Linda, the lactation consultant, as well as my new MD, regarding the possibility of milk-duct surgery for my right breast. Though I was willing to explore this possibility, I was completely reassured by Linda’s first words on seeing me: “Well, we know you’ll have no problems feeding these two with one breast.”

We both knew that I have an abundant milk supply, that a single breast that had been more than enough for one baby would do just fine for two. My MD had a great chuckle at my circumstances. Since the birth of my first child (which she had attended as the practice’s on-call MD), I had been walking the road to full empowerment as a mother and, primarily, as a woman. She had been watching from the sidelines as I made my journey, offering advice that I didn’t always understand. When the subject was breastfeeding, however, I always knew that no matter what the challenge, I could meet it and overcome it. The prospect of twins, however, made me think twice.

I then consulted the surgeon, and the news was not good. There was a less than 10 percent chance that the milk ducts could be opened and become functional. The same situation was presented as before: I would have to have surgery immediately postpartum, after which I would have an open wound that I would have to keep open in order to lactate—if the wound closed, the tissue would heal and seal up again. But as long as the wound was open, I would face the likelihood of multiple breast infections.

I gave up the idea right there and then. I had needed to investigate the possibility; now, having done so, I was able to close a chapter in my life and feel a sense of completion.

Meanwhile, my daughter had continued to nurse. Now I was 34 weeks pregnant, and her suckling was beginning to trigger strong contractions. I did not want to birth preemie twins, so weaning it had to be. I was not unhappy about it—it was time, and the suckling was not as soothing to me as it was to my daughter. So at the age of three and a half, with my encouragement, she weaned—we did it together, very gently, switching to just booby cuddles. We have been happy ever since.

The twins were born, at home, at a healthy 39-plus weeks and in record time—after 40 minutes of active labor. They weighed 6 pounds, 7 ounces and 6 pounds, 12 ounces, and they were born hungry.

Thus far, I have believed in my ability to produce enough milk for them. I had a postpartum visit with my lactation consultant at ten days, by which time each girl had gained 10 ounces over her birth weight. We corrected a few habits I had formed from nursing older children for three years and chatted a bit about what feeding twins is like. The one thing Linda made sure I understood was to not entertain self-defeating thoughts. I wanted to know right away if my milk supply would be enough or if I would ever need to supplement, but she told me to cross that bridge when I came to it. For now, I should just feed them and be happy—simple as that.

I have refused to go to bottles and supplementation because supply has equaled demand—my body has been producing copious amounts of milk from the single breast. The girls can nurse one after the other, and I can then draw still more milk from the breast with a pump. My confidence in this ability of my body has done wonders for me. I cosleep with the girls, and all three of us sleep incredibly well. If you asked how many times a day the girls nurse, I couldn’t tell you. If you asked who nursed last, I probably could tell you—they nurse often.

My overactive milk-ejection reflex (OAMER) could drown my babies with their first gulps after latching. Amazingly enough, this same reflex has allowed me to nurse the twins with great efficiency. Each baby can be on and off the boob in less than ten minutes and be fully fed. After a quick burp, I offer the breast again. Many times I’ll be nursing one baby while her sister waits her turn. I nurse the first baby until she’s sated, then attend to the second baby. Usually I sit cross-legged, one baby propped in the folds of my legs, the other at the breast. I keep switching them until both girls are fully fed and ready to sleep. I keep thinking how much more time I would have on my hands if I had two breasts to nurse with.

I have been thrilled with my girls. So has the rest of my world. I love the attention they get and how my family is evolving. Nursing two babies unilaterally is not that complicated—following my instincts and their cues makes it easy. The time spent with a baby at breast takes a good portion of my day, but what makes this rhythm easiest is following an attachment style of parenting. In other words, there are no schedules—the girls set their own pace. Sometimes their hungry bellies overlap, but that’s nothing that cuddling won’t soothe as one waits her turn.

There is no magic to nursing two babies from one breast. I’m confident in my ability to ensure that these babies grow well. I’ve never followed any feeding schedule and see no reason to start now—I just feed whoever’s hungry. I watch to see what comes out in the diaper and if they’re gaining weight—two simple tasks. My girls rarely cry; if they do, it’s for a reason that’s easily remedied. Neither has had colic, something I believe we have avoided by the type of parenting we practice and by providing only breastmilk. The biggest challenge to having twins was finding the amount of support I needed, especially in the first few weeks of the girls’ lives. Without support from my husband, like-minded moms, my lactation consultants, and the homebirth community, I’m sure I would have faced greater challenges than I did.

I’m pleased that I can provide my babies with the best, knowing that my body was designed for this and proving to the world that, given the chance, my body can work wonders.

Patricia G. Blomme lives with her family in the foothills of the Canadian Rocky Mountains.

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