What to do when you know/suspect you'll have to FF (xposted in BF challenges)

[Katico]

I posted this  first over in BF challenges but thought some of you ladies here  might have had similar challenges and have some wise words for me?

******************************

Ok, so.  I started BF DD (now 2yo) a few minutes after she was born.  At our 1 wk checkup we realized she had lost too much weight, was dehydrated and my supply was practically nothing.  I was well educated on BF, thought things were fine because she was alert and didn't cry, we had no pain, etc.  She wasn't dirtying her diapers enough, though...and I never experienced any of the things you're supposed to feel when your milk comes in.

Fast forward, two months later, after every support (LLL, wonderful doctor, midwife) and prescription and herb, and bedrest and non-stop pumping and supplementing at the breast, I still had almost no milk (literally only a couple of ounces a day) and she was almost 100% formula fed from the supplementation.  I was exhausted and so sad and finally decided to let it go.  It was an enormous challenge for me and left me to deal with a lot of guilt and redefining the mother I was going to be.  In the end, my DD is healthy and beautiful and whip smart and we are so close, I am at peace with what happened.

I'm 30 weeks pregnant with DD2 and I decided early in this pregnancy that unless there were obvious signs of breast change (I had almost none with DD), I would accept that I was likely not going to be able to BF this baby and I would not put myself through weeks/months of sleep deprivation and pain trying to make it work.  So far, there has been almost no change again, just like the first time.

But now I realize I'm kind of clueless about what to do at the hospital when she is born.  Has anyone out there been in this situation?  Did you put your baby to the breast for comfort? I feel really wierd about the idea of doing this, like it's too emotionally painful to go there...but I do seem to be producing a bit of colostrum already, so maybe I should, just for that and a bit of comfort?  When did you first feed them a bottle?  Did you grieve all over again even though it was expected?

And before anyone asks, there is no milk bank in our city...and even if there were, I feel like using it would just compound my feelings of inadequacy...selfish, I know.  

Sigh. 

[Grace and Granola]

Oh how I feel for you!  My story is practically identical to yours as far as first baby goes. When the second one came, I was determined to try again armed with the knowledge I had gleaned from the first child, but also mentally prepared for the high probability of needing to go to formula.  I think if I were to get pregnant I would still try.  After all, every baby is different and every pregnancy is different. I don't think I could just not at least try.  With the second baby I took reasonable measures, in my opinion.  I drank a lot of water, got lots of sleep, drank mother's milk tea, ate oatmeal and used Goat's Rue which was indicated for my situation.  And above all, I tried not to stress about it!  I made sure while in the hospital to closely monitor his diapers and weight and I actually did have more output than I had the first time.  Upon leaving the hospital, I was on a regimen of nursing for 10 minutes and following with a bottle formula.  I like this regimen.  I still got the bonding time with the nursing relationship, but I could relax because I knew my child was being fed enough.

It is a hard decision, but my advice would be to do what feels right for you.  And do NOT count it as a failure if you try and it doesn't work.  This is not a competition, it's about the relationship between you and your child.

Best luck to you!

[starling&diesel]

Hello, from another fellow low-supply mama!

My story:  DD latched on right away and nursed often, but kept losing weight.  Did the tube-and-syringe feeding with donor milk.  Herbs, herbs, herbs.  160 mg of domperidone a day.  Pumping (useless), pumping when all I wanted to do was hold and love up my baby.  Shame, shame, shame.  Tonnes of grief.  Overwhelming sense of failure. Finally resorted to a permanent fix of using a Lact-Aid at the breast supplemental system using a mix of donor milk and Nutramegen formula.  No bottles.  No articifial nipples.  No paci.  Introduced an open cup at four months, to have some options.  Used the Lact-Aid for over a year.  It's assumed that I have IGT (insufficient glandular tissue).  DD's latch was beautiful. 

My plan this time: 

No shame.

No guilt.

No sense of failure ... I will measure success based on my OWN story and experience.

And no effin' pump.  I am NOT doing that again.

I love the Lact-Aid system and will have it washed and ready to go from the moment I know the baby is coming.

I will have a prescription for domperidone in hand from 36 weeks so that I can fill it and have it at the ready for when the baby is born.

Start taking Mother's Milk tea in a couple of weeks.

Start with the fenugreek and blessed thistle and all the other herbs at 36 weeks.

Again, no pacis, no artificial nipples, no bottles. 

I still believe in the importance of at-the-breast supplementing, for all the bonding and nurturing time it provides, and for the fact that dd will get every single drop of milk that I can possibly produce. 

I was successful last time, by my own definition, and by the fact that dd (31 months) is still nursing several times a day.

Questions for you:

Was it ever determined why you didn't have enough supply?

Did you try domperidone?

Are you leaking anything this time yet?

Do you have a breast feeding friendly pediatrician?  (Mine was content to have dd on the 3rd percentile of the WHO breastfed baby chart.  I hear many peds are NOT okay with babes who are less that 50th percentile of the formula red baby chart.  Bah to that!)

Good luck!  And be kind to yourself!

(ps.  I'll go cut and past this in BF challenges too)

[Katico]

Originally Posted by starling&diesel 

Hello, from another fellow low-supply mama!

My story:  DD latched on right away and nursed often, but kept losing weight.  Did the tube-and-syringe feeding with donor milk.  Herbs, herbs, herbs.  160 mg of domperidone a day.  Pumping (useless), pumping when all I wanted to do was hold and love up my baby.  Shame, shame, shame.  Tonnes of grief.  Overwhelming sense of failure. 

This, this, this!!!!

Questions for you:

Was it ever determined why you didn't have enough supply? They assume IGT 

Did you try domperidone? Yep, right away and a high dose - it did nothing.  Also did Fenugreek and blessed thistle, oatmeal, bedrest, lots of liquids, pumping constantly, hot compresses and massage,  etc. 

Are you leaking anything this time yet? A tiny bit of colostrum, similar to the first time.  No change in size, no real tenderness.

Do you have a breast feeding friendly pediatrician?  My dr. is wonderful.  She is young and current and very pro-bf.  She spent some time working in Dr. Newman's practice.  She understood how important this was to me, to try everything I could, and was willing to try anything she knew of and do more research for new ideas.

I so admire your dedication to a.t.b.supp, starling&diesel....I found the lact-aid so awkward, especially in public.

Thank you ladies for your response.  It's just so nice to know you're not alone and that other people have experienced this....it was so embarassing to me for so long to bottle feed in public or to have friends surprised to see me bottle feeding and have to explain.  It actually makes me really angry now that there is such a stigma around FF'ing in our city (it is wonderful that this is such a pro bf'ing community, but...) Even when you explain what you went through, trying, there tends to be a response of "oh....right....hmm...", because after all, EVERYONE can bf if you just try hard enough, right?!?  Not.

I guess I'm realizing that this is still a bit of an emotional minefield for me and I need to do some more thinking on it!

(copied to BF Challenges post)

[dollyanna]

Originally Posted by Katico 

I so admire your dedication to a.t.b.supp, starling&diesel....I found the lact-aid so awkward, especially in public.

Thank you ladies for your response.  It's just so nice to know you're not alone and that other people have experienced this....it was so embarassing to me for so long to bottle feed in public or to have friends surprised to see me bottle feeding and have to explain.  It actually makes me really angry now that there is such a stigma around FF'ing in our city (it is wonderful that this is such a pro bf'ing community, but...) Even when you explain what you went through, trying, there tends to be a response of "oh....right....hmm...", because after all, EVERYONE can bf if you just try hard enough, right?!?  Not.

I guess I'm realizing that this is still a bit of an emotional minefield for me and I need to do some more thinking on it!

(copied to BF Challenges post)

Oh, I'm there with you, too.  I remember feeling so embarrassed about FFing that I avoided going out in public.  Ugh.  Will not let that control me this time.

I fully, fully expect that I won't produce enough this time.  No significant breast changes to speak of with this pregnancy, either.  Last time (my first baby) it was just such a shock. I totally didn't see all the signs that my baby was hungry, because everything I'd read convinced me if I just tried harder everything would work.  Sigh.  I'm just hoping that at least knowing ahead of time that I'll be more mentally prepared.  I was a mess last time!

I still plan to try, but within reason.  I can't spend every waking moment with my nipples attached to a baby or a machine.  I am uncertain about whether I will do dom this time.  It is a pain to get in the US and I feel a little uncomfortable taking it.  I have been taking alfalfa throughout the pregnancy. I'm planning on adding goat's rue & shatavari, doing oatmeal, etc. I'll try the lact-aid (had an SNS last time). I'm also planning to try metformin to see if that helps (I have PCOS & that is supposed to help).

I'm also unsure what I'll do in the hospital... Do I take formula with me & use the lact-aid there? 

Katico you might want to read through this thread on IGT & 2nd time mamas -- I got some good info there http://www.mothering.com/community/forum/thread/1252021/igt-and-second-time-mamas

(x-posting)

[starling&diesel]

Originally Posted by Katico 

I so admire your dedication to a.t.b.supp, starling&diesel....I found the lact-aid so awkward, especially in public.

Thank you ladies for your response.  It's just so nice to know you're not alone and that other people have experienced this....it was so embarassing to me for so long to bottle feed in public or to have friends surprised to see me bottle feeding and have to explain.  It actually makes me really angry now that there is such a stigma around FF'ing in our city (it is wonderful that this is such a pro bf'ing community, but...) Even when you explain what you went through, trying, there tends to be a response of "oh....right....hmm...", because after all, EVERYONE can bf if you just try hard enough, right?!?  Not.

I guess I'm realizing that this is still a bit of an emotional minefield for me and I need to do some more thinking on it!

(copied to BF Challenges post)

(xposted)

Total emotional minefield, eh?  My breastfeeding failure has been the one most devastating experience of parenting thus far.  Hands down.

Had you not mentioned that you did not have milk bank in your city, I would've guessed that you were in Vancouver ... and more specifically, here in East Van with me!  I can honestly say the part of my stunning 'commitment' to the LA at the breast supplementing is partly due to the over-powering judgement from mamas who nurse easily and cannot understand what my problem is. 

The social shaming is razor sharp and totally gets under your skin.  It's so horrible. 

That said, I have fallen in love with the Lact-Aid system and thank the universe for it on a regular basis. 

It makes NIP an even pleasant experience!

[mambera]

Originally Posted by Katico 

Ok, so.  I started BF DD (now 2yo) a few minutes after she was born.  At our 1 wk checkup we realized she had lost too much weight, was dehydrated and my supply was practically nothing.  I was well educated on BF, thought things were fine because she was alert and didn't cry, we had no pain, etc.  She wasn't dirtying her diapers enough, though...and I never experienced any of the things you're supposed to feel when your milk comes in.

Fast forward, two months later, after every support (LLL, wonderful doctor, midwife) and prescription and herb, and bedrest and non-stop pumping and supplementing at the breast, I still had almost no milk (literally only a couple of ounces a day) and she was almost 100% formula fed from the supplementation.  I was exhausted and so sad and finally decided to let it go.  It was an enormous challenge for me and left me to deal with a lot of guilt and redefining the mother I was going to be.  In the end, my DD is healthy and beautiful and whip smart and we are so close, I am at peace with what happened.

I'm 30 weeks pregnant with DD2 and I decided early in this pregnancy that unless there were obvious signs of breast change (I had almost none with DD), I would accept that I was likely not going to be able to BF this baby and I would not put myself through weeks/months of sleep deprivation and pain trying to make it work.  So far, there has been almost no change again, just like the first time.

But now I realize I'm kind of clueless about what to do at the hospital when she is born.  Has anyone out there been in this situation?  Did you put your baby to the breast for comfort? I feel really wierd about the idea of doing this, like it's too emotionally painful to go there...but I do seem to be producing a bit of colostrum already, so maybe I should, just for that and a bit of comfort?  When did you first feed them a bottle?  Did you grieve all over again even though it was expected?

Low supply totally sucks! Forewarned is forearmed though!  It makes sense to me for the babe to get colostrum and whatever milk you produce, then follow with supplementation (bottle or breast your choice).  I think it is common for low-supply mamas to make more milk the second time around (not necessarily a full supply but definitely more than the first time).

If you are open to the idea of ATB supplementing I would bring the Lact-Aid to the hospital because there may be an LC there who can help you get started with it.  If you don't want to deal with the supplementer (I never did) then I think Grace and Granola's plan sounds good, 10 min at breast followed by bottle supplementation.

For me, with this baby I am going to just be way more on top of the monitoring.  Like you, I didn't realize anything was wrong at first... I started off in sposies and couldn't really tell how much fluid output she was producing in those, nor did I realize how important that was to track.  She had 1 BM per day and as far as I knew that was OK, didn't know it was supposed to be 5+.  

This time around I am armed with a baby scale and a whole lot more knowledge about what could go wrong and what to do if it does.
 

Also I am NOT going to spend all my spare time pumping... it didn't do a spot of good for my supply last time, all it did was deprive the baby of time she needed to be held and snuggled.

Also, in case you haven't read it, I found the book "A Mother's Guide to Making More Milk" incredibly informative and useful.  Good luck, and #1 rule is enjoy the baby!

[AlexisT]

I also had severe low supply with DD. I suspect it may be IGT but I had so much else go wrong that there's no way to be sure (preeclampsia, 37 week delivery, >1L blood loss, jaundiced baby, NICU nurses who did not allow BFing while baby was under bili lights...)

This time, I am NOT pumping long term, I will NOT drive myself nuts with special feeders, and I will not down every supplement on the planet. I made myself sleep deprived, miserable, and just didn't enjoy my baby until she was 6 weeks old and I gave up. I'll give it my best shot. If it doesn't work, I've had one baby thrive on formula and I can do it again. Better to have a bottle nursed baby and a happy mama than to make us both miserable again.

I was in the hospital last week for high BP and met the LC, who was very nice, so I know I'll definitely get better support this time.

[Katico]

Originally Posted by AlexisT 

This time, I am NOT pumping long term, I will NOT drive myself nuts with special feeders, and I will not down every supplement on the planet. I made myself sleep deprived, miserable, and just didn't enjoy my baby until she was 6 weeks old and I gave up. I'll give it my best shot. If it doesn't work, I've had one baby thrive on formula and I can do it again. Better to have a bottle nursed baby and a happy mama than to make us both miserable again.

This is exactly how I have been feeling.  But then that guilt sneaks up.  When we quit the first time, I did so knowing we had tried everything and had stuck it out as long as I could before I had to prioritize my emotional/mental health and enjoy my baby!  But I still feel like I should have tried "harder" or longer

I feel like...If I tried it again and did it all again and  managed to get a bit higher supply the second time....this baby might be what, 95% formula fed instead of 99% like DD was? And as for bonding....we bonded immediately and tightly...but I doubt it had anything to do with the breastfeeding, given I was a crazy, sobbing woman with a pump attached to her night and day. It was the crazy love I had for her, and the bottle nursing, and all the other AP things we COULD do that made that happen.  And at nearly 2.5 yo, she is still as close and in tune with me as (or in most cases, more than) any ebf/extendedbf child I know.  So is it even worth it, knowing that I will not make enough supply to come close to meeting her needs, no matter how much effort I put in?

I know this sounds defeatist, and I so appreciate the encouragement from PP...this is just the other side of the "I should do everything I can again" coin that keeps getting tossed around in my head.

[Katico]

Thank you so much everyone for your replies - I think what I am going to do is talk to my dr. at my next appointment, see about starting dom. immediately, bf'ing and supplementing at the hospital and going from there.  I think if there is no real sign of milk coming in after the first week I will ff exclusively and be glad for whatever colostrum she got in that week.