An extremely complicated breastfeeding situation...

RawAlmond · February 2012

Hello All! Im just going to tell my breastfeeding experience to lead up to this very important and controversial questing so please bare with me!

I am the mother to a 5 year old and a 3 week (today!) old girls. I have had struggling with breastfeeding both of my children. I managed to breastfeed my older daughter for 3 months. I got what all this time i considered horrible advice from a postpartum doula I had that at 11 days old - with my daughter rapidly loosing weight and not having enough BM's - That I "should just give her formula" I had just turned 20 years old, I was a single mom and I didnt have the all natural labor that I wanted and I CRIED my eyes out feeding her formula the first time! After that - I never built my supply - I would breastfeed - feed pumped breast milk - then go on to supplement with formula - and then pump - all in time to shortly after repeat the cycle again. I felt like I was constantly feeding my child and after about 3 months was so far behind in building any kind of supply and so frustrated I gave up.

Moving on to now my baby daughter is 3 weeks old today. I had a wonderful all natural nearly pain free birth with the support of my boyfriend and family. However at 4 days old shortly after coming home from the hospital the BMs stopped and the wet diapers slowed to a measly 3 a day - staying clay colored until she was 8 days old. From 4-7 days old this continued, no BM with the reddish brown urine. I had taken her to the Dr twice in that first week because of this and because of being down to 7lbs after having been born 8.5lbs. I was constantly breastfeeding - i spent three days only leaving the bed to go to the bathroom in skin to skin contact with my baby feeding her ever 1.5 hours, setting my alarm through the night to wake up and feed her (and making my 5 year old hate me!). She was latching on and suckling, however would fall asleep frequently and fast. I tried the constant skin to skin, the wet compresses, blowing on her, playing with her feet - and no matter what I did (and sometimes still do) she will be at the breast for a half hour and only suckle for what seems to me 5-10minutes. Finally at the 6th day I started to pump, only being able to get 1/2 ounce between both breasts during one pumping. My family doctor told me this is not enough. We were both concerned with the lack of BM, wet clear diapers and the weight loss - so at a week old I fed her formula. This time i didnt cry, it really sucked but I was more scared for my baby. I talked to LLL and SEVERAL LCs - two from the WIC office - two from the hospital where she was born and they all said it had gotten to the point where the formula supplementing is what I had to do. I figured it would be okay for a week or two and I would just build up my supply.

And thats not happening.

Over the past two weeks I..

have a hand pump I bring out with me and I pump in the backseat of the car if I do happen to stay out of the house more then 2 hours. I had an Ameda pump and style and currently have the medela symphony the LC said as a final resort it would be worth it to try a hospital grade pump.

I take Feugreek and Blessed Thistle three pills three times a day as well as mothers milk tea and some drops from the homeopathic store that have the blessed thistle and nettle etc...

I try to pump every hour if I can - with a boyfriend who works, and the baby and my 5 year old to take care of this doesnt always happen.

I was told this time around to try the "end at the breast' technique where I feed my baby 1-2ounces of pumped milk or formula if i dont have any, and then to feed on both breasts 2 times for as long as possible.

I am currently living the same hell I did with my older daughter and feeding! I am extremely frustrated and have recently felt like giving up. I know even if i can only get sometimes an ounce in one pumping if i am lucky it is better then nothing for my baby. I enjoy breastfeeding her even with the problems we have - and when I feel like giving up my very supportive boyfriend and father have pushed me to do what i need to do - eat well, stay hydrated, pump, drive me to where i need to go, and sit in over crowded waiting rooms while I speak for sometimes hours to these LCs! But im LOOSING IT! These 5 years I always contributed my issues to breastfeeding to the fentanoyl I got in my last labor, or that horrible formula advice but now, I am not so sure....

I do have PCOS, High Testosterone lvls - I always have - I gain wight and loose weight yoyoing all my life - I have Diverticulosis - have been told on and off that I have metabolic syndrome - then i loose weight and don't have it anymore - Was told my 5 year old was a blessing and that I "got lucky" and would need help conceiving later in life...

It took me two weeks to conceive my second daughter and 2 months to conceive my first.

I do have a bifurcated nipple on one side and have serious problems emptying the breast but I get just as much milk as i do out of the other breast, it seems to be more uncomfortable then anything else - no matter how much I pump I get a let down and then the milk just drips out - if i take the pump off I am able to hand express forever and can never fully empty this side.

So here is my question after writing this book of a story - after having one of the LCs ask me about my hormones and if i had PCOS - it got me thinking that maybe my problems breastfeeding hadn't been the formula all this time but maybe it was just me. I have milk - so i should be able to make enough right? But maybe Its my out of whack hormones that are stopping it. I have been researching all weekend and came across the talk of Domperidone. I understand that since 2004 its not FDA approved and that the American Academy of Pediatrics does in fact recommend it for aid in breastfeeding. I am under the impression that if I can in fact obtain a Rx for it in the US there are a few scattered pharmacies in the country that will fill the prescription. If I cant get the Rx - if i decide to try it - I know that i can obtain it from Europe or Mexico (kind of freaks me out...)

Has anyone used Domperidone?

Did it work, How did you obtain it? If you obtained it out of the country I would really like to know the best method as to how?

Has anyone else had any other issues like mine with the PCOS and breastfeeding or feeding with a bifurcated nipple?

Any advice or input anyone has I would love to and need to hear it, I have maternity leave for 12 weeks and 3 of it is gone. I have an appointment on Wednesday afternoon with my family physician to talk to him about my concerns with hormones and breastfeeding and the idea of Domperidone. I am running out of time - as i read that it can take 2-4 weeks to work - and i will most likely have to obtain it from out of the country if i want to try it. Any input or advice, i would love to hear it and thank you!

LadyAph · February 2012

First of all: TAKE A DEEP BREATH. Your daughters will get much more benefit from a sane and happy mother than a stressed mother.

I can commiserate with the low supply. Although my milk "came in" at 4 days - I didn't have enough supply. Because of a postpartum hemorrhage, my son was given formula from day one which certainly didn't help.

Anyway, my first suggestion is to get a Supplemental Nursing System (SNS) (assuming the LCs haven't already suggested it). It can be a pain but it allows you to supplement formula or expressed milk while breastfeeding. This means your body will get the suckling/stimulation it needs to tell it to make milk and the baby can regulate how much she's eating. Plus it should decrease the amount of time you spend nursing - it cut my time from over an hour to just over 20.

Second, stop pumping so much! It sounds like it's stressing you out and I was told by my LC that pumping too much can actually be detrimental because it gives the body confusing signals. I posted a few days ago about pumping after feeding for at least 5 minutes past empty - I got a reply with a link to information on how to hand express. Hand expression + pumping (with massage) is actually the best way to empty your breasts...see if you can find the link.

I also tried taking fenugreek, blessed thistle, mother's milk tea - the works, without much results. I haven't tried Dom but I've seen posts on here about getting it online. Otherwise, I think it needs to be compounded by a specialty pharmacy and I have no idea how much that would cost.

Lastly, I just want to say that ANY amount of breast milk is great. I have spent the last 6 weeks trying to come to terms with the fact that I have to supplement with formula. It sucks because I fully intended to BF for at least 1 year. I've gone through a grieving process because, in my mind, I lost something really important to me. It's ok to grieve but I also realize that I didn't fail. I'm feeding my son - the only way to fail is if I fail to feed him.

Being sort of in your shoes, I now pump + hand express after (just about) every feeding and supplement formula with the SNS. My son is getting SOME breastmilk everyday, and I'm ok with that.

I admire you because you're committed to BF, even in the face of problems. That's something not everyone can understand, however it does not define you. You can still share a BF relationship with your daughter through an SNS even if it's not necessarily with your milk.

tokenhoser · February 2012

First of all: what a great mom you are. You're trying so hard. No baby could ask for anything more.

It does sound like you're working against some physical challenges. I live in Canada, and here my doctor would happily prescribe me Dom if I thought I needed it. It's really not that scary of a drug - it tends to be better tolerated than Reglan, which US docs still prescribe. If it feels like that's the last-ditch "i want to have tried everything", then try it. If you post with Domperidone in the title, other people have bought it online. It's much cheaper to order overseas, as well.

Hang in there. Even if, for whatever reason, you have to keep supplementing, any amount of breastmilk has it's benefits. You don't have to quit altogether if you don't want to.

jandy09 · February 2012

I agree with PP'er, try to calm down. Stress can factor in on your supply issues. Next, put away the pump. I didn't respond to the pump for the first month. It really caused me some unnecessary stress in the beginning. I now work FT and have never had to supplement with formula.

Unfortunately, introducing a bottle this early can cause nipple confusion and cause your LO to get lazy at the breast. If it is possible, but away the bottles and only offer the breast and offer it VERY often. A supplemental feeding device may be necessary until BFing becomes better established. At 3 weeks old, your LO could need to eat more than every 1.5 hours during the day. Comfort nursing actually helps your supply (more so than pumping). If you feel like your breasts are hanging out all day, then you are doing it right.

Have you tried taking a relaxing bath with your LO? The warmth and skin to skin will help with your let down. Hand expressing before offering LO the breast will also help your let down. Make sure your shoulders are completely relaxed and maintain a comfortable position while breastfeeding.

For your nipples, have you tried the Medela Soft Shells for Inverted Nipples? I used these for the first month. They help your LO get a better latch and allow your nipples to air dry between nursing sessions. They also stimulated my breasts to create more milk.

Lastly, galactagogue cookies really helped my supply. Just google a recipe for them. I still eat homeade granola every morning.

GL mama!

yellowtulips80 · February 2012

have you tried eating oatmeal? I tried all those herbs with my first and none of them worked. But strangely oatmeal seems to help me. I absolutely hate oatmeal. It makes me want to gag eating it but I do it anyway twice a day.

I feel your pain. I also have had a lot of issues with BF.

alliapistor · February 2012

PCOS can affect breast tissue development and milk production. I would talk to your gyno or RE. Are you taking met? I've heard that it can help with supply issues in PCOS (but there is some controversy on whether it is safe).

www.soulcysters.com and the message boards on that site have a lot of helpful information and women.

https://www.breastfeeding.com/reading_room/pcos.html

nfrtny · February 2012

I don't have much else to say besides agreeing with what PPs have already said. Drink lots of water. Have you tried products from motherlove.com? Are you trying to nurse on both sides in one session? LO needs to stay on one side to get to the fatty hindmilk.

Also, I started pumping at 5 weeks, per the pedi's recommendation. She said to wait, because I didn't need the extra stress. I was only pumping an ounce at a time when I started. Pumping is really really difficult. And in my opinion, hand pumps suck.

I think you should feel great about what you're doing and trying to give your baby the best thing possible. Some women don't even care to try, and you're doing everything you can. Please don't beat yourself up over this, you sound like a fantastic mother and your children are so lucky to have you! Good luck mama!

miller4285 · February 2012

My gyno prescribes metformin for PCOS mothers with breastfeeding issues. She feels it is safe. I don't have PCOS, but have had issues with supply for the first time ever (this is my 4th child, and she points out I am not as young as I used to be). I have been on Reglan for 3 months, now. Without it...or if I miss doses too many time, I end up with very little milk.

This is the first time I have had to make the hard decision to supplement (she only get s formula once the BM bottles are gone AND only if I am at work). I go through only 2 cans per month....but I felt horrible. I made TOO MUCH milk with all my other kids!

I finally realized what matters is that I BF when I am with her, I pump at work...and formula bottle NEVER are given in place of a BF session nor have I decreased my pumping schedule. So she gets the benefits of every drop I can manage to give her.

RawAlmond · February 2012

I have tried oatmeal and all the other foods that the LC told me would help produce milk like yams, carrots, spinage, kale - so i broke down yesterday and after some researching bought the Domperidone.

It should be here in a week - so we will see what happens. I am running out of time to build this supply being that the weeks go by fast on maternity leave - not to mention she is starting to go through a growth spirt and eating more and I feel as though i will never be able to catch up.

Hope it works!

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