The lactation consultant came over on Tuesday afternoon, discussed the issues I’ve been experiencing, checked over both Zac and I, watched us feeding, offered suggestions for improvements in positions and worked out a plan of action for increasing supply whilst ensuring that Zac gets what he needs.
Sue said that she sees many women who have had breast reductions and that most end up feeding with a mix of breast milk and formula. Often there is greater nerve damage within the breast than anticipated, or scar tissue interferes with milk delivery or it could just be that the remaining breast tissue just doesn’t compensate for the removed tissue.
The first step though is to work at increasing my supply as much as possible over the next 2 weeks and then see where I stand a far as providing for Zac ‘s nutritional needs is concerned.
The current regime is:
Feed Zac with breast, expressed breast milk and finally formula, approximately 4 hourly (basically on demand feeding when Zac is hungry)
Use a supply line for feeding the expressed breast milk
Express for 10 minutes after each feed
Express for 5-10 minutes between feeds, so essentially expressing every 2 hours
Use just bottles (expressed milk and formula) for 1-2 night feeds.
Skin to skin wherever/whenever possible.
Drink fenugreek tea
Take herbs recommended by Chinese herbalist
Eat lots of protein, coconut, almonds and oats
It is now Monday, nearly a week since seeing Sue and I have not managed one whole 24 hour period of following the full routine. Zac’s feeds have been all over the place, sometimes 3 hourly, sometimes a break of up to 5 hours between feeds, often followed by two complete feeds back-to-back. In between feeds he often wants to be held during the day -he is a snuggly baby!- meaning that about half the time expressing doesn’t happen due to snuggles or due to me catching up on sleep while he’s sleeping. It’s a catch-22 situation: I need to get enough sleep for my body to produce the milk, and I need to express regularly to encourage greater milk production.
Expressing can happen when he’s happy to snuggle and suckle and leave me with a hand free. I told Sue how I was frustrated with having to express after every feed because I was missing out on the milk-drunk snuggles, which I adore. It was making the expressing a chore which I resented having to do because it interfered with my enjoyment of my beautiful baby boy. Sue completely understood and suggested that instead of double pumping with the machine, I pop Zac on one breast whilst pumping the other. That way I get the snuggles I want and still get the benefit of double pumping.
Haven’t had much luck with the supply line either. It is quite fiddly and a considerable amount of milk ends up running down Zac’s chin. It’s hard to persevere when every drop of breast milk is so precious. If I continue with the supply line, I think I will put the formula in it instead. If anyone has any tips for successfully getting the tube of the supply line into the mouth with successful latching, they would be appreciated!
I’m using the Tommee Tippee Closer to Nature bottles, in hope of minimising nipple confusion. Hard to tell if it’s working or not; sometimes Zac just won’t latch on properly and I can’t encourage him to open his mouth wider, but other times he latches on perfectly.
We’ve yet to work out feeding away from home. Yesterday I resorted to using bottled breast milk and formula to feed him when he just wouldn’t latch onto the breast no matter what I did. Perhaps I need to practice feeding on our kitchen chairs to mimic restaurant environs so Zac and I are familiar with whatever postural adjustments are required. Then again, it could just be self-consciousness when being watched by people who know better than I do how to breastfeed!
I really liked Sue and would recommend her to anyone. She had a beautiful manner with Zac, so gentle and calm, constantly reassuring him. A very different kettle of fish from the Maternal &Child Health nurse. Sue has directed me to “The Happiest Baby on the Block” and showed me a different way of swaddling which has been much better for Zac. I’ve half a mind to have her out again to show me her tricks and techniques for calming and settling babies.
Good to hear you’ve got help. I was never able to rigorously follow my lactation consultant’s regime, but my milk production improved nonetheless. I think choosing sleep is always a great option 🙂 I used bottles to feed Gully in public in the early weeks because I was too embarrassed about my fumbling about trying to breastfeed. *hugs*
My milk supply has definitely gone up, despite not following the plan to the letter and I’ve even experienced proper let-down a few times; notably soaking the front of my nightshirt 2 nights ago! There is also a very definite increase in amount I can express once I’ve got some Z’s under my belt, so sleep continues to be the best option for me.
I’m so relieved to hear of someone else using a bottle to feed in public whilst still feeling a bit unco with it all. We had the awkward situation yesterday of traveling to Yea for Zac to be christened and arriving at the church just as Zac was due a feed. I gave him some EBM in a bottle, but that wasn’t enough so he cried through the whole ceremony, after which I immediately gave him the formula as I didn’t feel comfortable or confident pulling out a breast in church -frustrating because if we could have finished feeding him before the ceremony, he would have been perfectly content and quiet, and because once filled up with formula, he went to sleep for the next hour or so. When he did wake, wanting the rest of his feed (the breast), I couldn’t get him latching properly. I left the restaurant we were at and sat in the car, but Zac fell asleep as soon as he latched on. rather than persevere, we chose to head home and hope Zac would stay asleep for the whole journey. He didn’t and I ended up giving him more formula to avoid the remaining 20 minutes being just crying. I felt so bad about the day’s feeding that when we got home I popped him on my breast and gave him as long as he wanted, something like 2 hours! Of course, once home, he latched on no problem and stayed awake and actively fed. The last two weekends have pretty much shown me that at the moment, Zac and I really need to be staying at home, just focusing on feeding and not trying to take it on the road to unfamiliar surroundings at this time.
Until Joshua was able to hold his own head quite well I took a cushion with me everywhere I went in order to accomplish the feeding out and about. I used to travel with not one but two nappy bags (with clothes, nappies, etc), quite a performance. I just could never quite manage the juggling of holding him with one arm and getting him latched on etc, having the cushion on my lap brought his head up to the right height to give me a bit more manouvrability. Over time it all gradually became easier as he got better head control, latched better, and his mouth got bigger. You’re on the right track, you’ll get there 🙂