Supply and Demand
Beryt Nisenson
Houston TX USA
From: NEW BEGINNINGS, Vol. 20 No. 3, May-June 2003, p. 91
Before Josh was born, I
could have taken or left breastfeeding. I knew it was the best thing
for my baby, but I didn't really like the idea of being the only one
who could feed him. I also didn't imagine the physical sensation to
be anything I'd want any part of.
Then came Joshua Rush. After
a long, extremely empowering, natural labor, I cradled his tiny, wet,
warm little body in my arms and my doula helped put him to my breast.
Everything changed while watching him nurse. I was hooked.
The first week was a total
blur. Josh seemed to have enough dirty diapers and his color was normal.
At home, he seemed to be breastfeeding all the time, but I knew that
this was normal. I never actually felt my milk come in or any kind of
engorgement, but my doula said that this was okay. Josh was happy and
so was I.
In the second week, Josh
became more demanding. He nursed sometimes for 45 minutes on each side,
and would fall asleep at the breast. When I'd take him off the breast,
he would cry hysterically. He never seemed satisfied after nursing.
Since I couldn't nurse all the time because I needed to sleep and eat
myself, my husband, mother, or stepfather would carry him around in
the sling as he cried, until he finally fell asleep.
After three or four days
of constant crying, my mother, a registered nurse, told me that she
was afraid he wasn't getting enough milk. She convinced me to call the
pediatrician, whose nurse promptly told me that he had gas and was using
me as a pacifier. I was to limit his nursing to 20 minutes on each side
and give Mylicon in between. I was exhausted, so that sounded like a
fantastic solution. Within a few hours on that schedule, he slept more
and cried less. Eureka! That was the answer! I could have kissed that
nurse.
But after about 24 hours,
Josh was lethargic. He was sleeping almost all the time, and stopped
crying at diaper changes. He was even quiet while we bathed him. Something
was wrong. The next day we took him in to the pediatrician's office.
He was 13 days old and weighed eight ounces less than his birth weight.
The doctor asked me to breastfeed him for 10 minutes on each side, and
we weighed him afterwards to see how much milk he had gotten. He had
not gained even an ounce.
I could see the concern in
the pediatrician's eyes as he gave my husband a bottle of formula. I
cried as I watched Josh struggle with the artificial nipple, and finally
begin to drink the formula. He guzzled the contents in minutes. He was
so very hungry. I felt confused, discouraged, and defeated, yet somehow
determined. Over the next two weeks, I met with a La Leche League Leader
and the hospital's lactation consultant, talked to friends, and read
as much as I could get my hands on. Most advised me to just nurse as
often as possible, and said that the increased demand would bring up
my supply. This didn't work.
I tried a different strategy
every few days, pumping every couple of hours, herbal supplements, or
staying in bed all day nursing. Nothing seemed to help. Even my mother,
(who had breastfed me) and my husband were suggesting that Josh was
doing fine and gaining weight on the formula supplements, so maybe I
should just give it up.
At four weeks postpartum,
I was about to give up hope. As a last resort, I called a lactation
consultant who had been too busy to meet with me when I had called two
weeks earlier. We met, and after a thorough consultation, she asked
me to commit to following her advice for 12 days. If it didn't work,
then I would know for sure that I couldn't breastfeed exclusively. I
agreed.
I carefully followed her
plan. First, she adjusted my latch-on technique ever so slightly. She
advised me at each feeding to nurse Josh, then pump for 15 minutes to
thoroughly drain my breasts, and feed him the pumped milk or a formula
supplement. I also began taking Domperidone, a drug that is not marketed
in the United States, so I had to purchase it at a special compounding
pharmacy. It's an acid reflux medicine with the fortunate side effect
of increasing serum prolactin, which can help with milk supply. I was,
of course, very nervous about taking any kind of drug while breastfeeding,
but I read everything I could and made a decision to try it.
To make matters worse, Josh
and I both had thrush, so nursing and pumping were both very painful.
At times, it was all I could do to pump and feed the milk back to him
in a bottle. Eventually, with a regimen that included antifungals, washing
bras in hot water, and boiling bottle nipples, we were both cured and
he was breastfeeding again.
My days were filled with
breastfeeding, pumping, bottle-feeding, and sterilizing pump pieces
and bottles. Talking on the phone every few days to a new person who
had succeeded at the same challenge was essential to keep me going.
I was pumping at least eight times a day on top of everything else that
needs to be done with a new baby. It had become incredibly important
to me. The pumping just became part of my daily routine, somehow manageable.
By feeding back all of the
milk I pumped, I was able to tell that I was eight to 10 ounces short
of meeting Josh's nutritional needs, a little under half of his daily
requirement at that time. But I saw improvement within one week, and
each day I was feeding him more and more human milk. In three weeks
I was feeding him all of my milk! What a day that was, when I looked
at my logs and saw that all of his nutrition was coming from me!
The next task was to get
Josh to take all of the milk on his own, which was easier said than
done because he was used to being fed a bottle after breastfeeding.
While I continued the frequent pumping, we spent the next three weeks
giving him less and less in his supplement bottles. The consultant called
it "giving the responsibility back to the baby." Though this
was a scary process, I eventually began to see that when I gave him
a smaller bottle after nursing, he would come back to the breast sooner.
Eventually, I was nursing more and bottle-feeding and pumping less.
By the time Josh was two months old, we were exclusively breastfeeding.
For a while, I still pumped
after one or two feedings a day. But without the "luggage"
of bottles every time we went out and without pumping after every feeding,
I was finally able to understand why everyone said breastfeeding was
so much easier! I could relax and just nurse my baby. And when I took
him to his four-month checkup and he had jumped from the 15th to the
30th weight percentile, I felt so incredibly proud that the increase
was all from my milk! He was thriving.
I began to wean myself slowly
from the Domperidone and was off it about two months later. To my surprise,
there was never a decrease in my supply. My body had learned how to
produce the right amount of milk on its own.
Now, Josh is an active, curious,
happily nursing 15-month-old. And I am a champion of breastfeeding,
often found recounting my story to pregnant friends so that they'll
do whatever it takes to establish their milk supply from the beginning.
I'm also a strong proponent of La Leche League since I received such
incredible support and information from my local Leader and the many
friends I've made at LLL Group meetings.
If there's one thing I've
learned about my personality, it's that I appreciate things more when
I have to work for them. I sometimes curse myself for that trait, but
other times I look back at my experience and wonder, would I have chosen
extended breastfeeding? Would I appreciate nursing as much as I do now
had I not faced such challenges? I cherish every nursing moment, knowing
that had I not worked so hard, we would not share such an incredibly
special connection.
Last updated Tuesday, October 24, 2006 by njb.
Page last edited Sun Oct 14 09:29:43 UTC 2007.
