In 2001, I was a first-time parent finding out just how difficult and stressful it can be to do something as seemingly simple as feeding a hungry baby. I have an engineering background, and back then was a very Type-A personality, so I of course did a tremendous amount of research about birth and breastfeeding. Having done all the research, I understood that breastfeeding would give my daughter the best start possible, yet none of the books I had read, nor the classes I had taken, prepared me for the reality of trying to get my baby to latch and feed successfully.
I had a wonderful midwife who supported me through a difficult and long labor and delivered a healthy 8 lb. 3 oz. baby girl in a water birth. The labor and delivery had exhausted me, but I was so thankful to hold my sweet daughter in my arms. Unfortunately, nursing was extremely painful from the very first latch, and it only took about 24 hours before my nipples looked more like hamburger than anything else.
The midwife had a lactation nurse who tried to help with positioning, but no matter what I did, latch was still extremely painful. I felt lucky that my baby was a “good baby” who wanted to sleep all the time and did not feed frequently — latch was so painful, that I dreaded her feedings. Unfortunately, I did not know back then that it was her being such a good sleeper was NOT a good sign. At her first pediatrician’s visit, she had lost more than 12% of her birth weight and the pediatrician informed me that I was “starving my baby,” and just needed to give her formula — I was devastated and felt like a horrible mother. I called the midwife’s office to ask for advice, and they told me that the problem was that I was not putting the baby to the breast often enough. Since we were getting conflicting recommendations, we decided to try both. We tried to nurse the baby every 2 hours as suggested by the midwife and started supplementing with formula after each feeding as the pediatrician recommended
The next day, my husband called the lactation support line at one of the local hospitals, and they suggested that I should “triple feed” – in other words, nurse/pump/supplement at every feeding.. Once I started pumping, I soon found that I had very low supply, producing less than 10 ml of breast milk in 30 minutes of pumping. My baby was sleepy and did not nurse well because she wasn’t getting any milk from me! I felt so defeated – the pediatrician was right – I was starving my baby.
Once my daughter started getting some food then she wanted to feed all the time! She would nurse for an hour or more, then I would pump for 30 minutes while my husband gave her bottle. After her bottle, she would fuss and cry and end up vomiting what seemed like the whole feeding. It was exhausting. I would just finish nursing and pumping and then she would want to feed again. When she was not at the breast, she was fussy, and when she was, she seemed to just fall asleep.
We then tried calling Le Leche League, and the leader we spoke to on the phone told us that our baby was “lazy,” and that was why she didn’t feed well, and that I just needed to have her at the breast more often, wake her up and make her mad. We tried this for a few days, but quickly found that it just made everyone miserable. The whole process of feeding/pumping/supplementing/settling the baby too 2+ hours. I could not get more than a short 20 to 30-minute nap before having to start the whole process over again. And most of what my baby was getting was formula.
We saw our pediatrician again at two weeks and the baby had regained her birth weight, but I knew that this was only because she was getting so much formula. The pediatrician told us that some babies and mothers just cannot breastfeed and that I should just give up and just give the baby formula. I was disheartened, but also angry at the lack of support. Surely there was a “reason” my baby did not nurse well; I just was not seeing the right person who could figure it out.
We called the hospital support line again, and the lactation consultant there suggested that I come to their group meeting. At the meeting, the lactation consultant said that she thought the problem was probably flat nipples and suggested that I use a nipple shield. My baby would still nurse for an hour, but at least with the nipple shield, I was not in excruciating pain and my nipples had a chance to heal. I attended the group meetings for a few weeks before someone recommended that I see a Private Practice IBCLC.
I did not even know what an IBCLC was at the time but was able to find one after searching online and made an appointment. After watching my baby feed, the IBCLC referred us to an Ear Nose and Throat Doctor (ENT) and a Speech Language Pathologist (SLP) to look for breathing problems and problems with her mouth. I felt vindicated, these were possible answers – and something we could work on. But the ENT said that everything was fine with the baby and did not see any problems. The SLP said the baby had low muscle tone, gave us exercises and had us come back weekly to see her. We decided to continue to work with the IBCLC and SLP, especially since it seemed like the SLP had found what was causing the feeding problem. They had us doing daily exercises with the baby, feeding with a Supplemental Nursing System and nipple shield, and taking herbal supplements to try to increase my supply. We even rented both a scale and a hospital-grade breast pump. But nothing seemed to solve the problems we were having. My daughter would still nurse for an hour, with an SNS, and could only transfer about 1 oz in a good feeding (I weighed her before and after EVERY feeding). Every feeding at the breast was followed with a supplemental bottle and pumping, and I felt like I could not leave the house with the baby.
At 12 weeks, I was still triple feeding, only producing about 8 oz of breastmilk every day, and I was almost out of maternity leave. I called the IBCLC to discuss options, but it seemed like there were none. I was told that I was past the point where I would be able to increase my milk supply, and that pumping alone would not maintain the meager milk supply that I did have. She hinted that maybe I had done enough and told me that it was OK if I wanted to give up and just formula feed. This was NOT what I wanted, at all.
So, I went back to work, determined to maintain what little milk supply I did have. I decided that continuing to try to feed my daughter at the breast when I was back to work was impossible, so even though I had been told it would not work, I focused on exclusively pumping. I pumped every 2-3 hours, trying to get in at least 8-10 sessions every day. I put my science and engineering background to work as I researched what impact milk supply and how a mother’s milk supply is established. I made a plan to work in increasing my milk supply. I power-pumped, I drank lactation tea, tried different herbal supplements, addressed underlying nutritional deficiencies and hormonal issues, and even took prescription medication to try to help increase my supply. After two long months, I finally got my milk supply up to where I was producing enough for my baby to have ONLY BREASTMILK. I was so happy to stop giving her formula, but it took 5 months to get there. Ironically, she only had one month of exclusive breastmilk before we started solids.
I continued to pump for her until she was 18 months old, still getting up at night (even when she was sleeping through the night) and pumping at least 8-10 times a day. At 18 months, I had enough frozen milk that she continued to have some breastmilk every day until she was 2. It is, to this day, one of my proudest accomplishments.
I now know that my daughter had an undiagnosed tongue tie and a submucous cleft palate. Luckily, her palate did not require surgery. Her tie was fixed when she was a teenager, because it was causing her to have sleep apnea, mouth breathing and orthodontic issues. Her tongue tie and palate were what caused all the difficulties — with nursing, reflux and colic, and even caused her to have sleeping difficulties as a toddler. I also know now that nutritional deficiencies, hormonal issues and my baby’s oral issues are what caused my milk supply to be low – but all these things were correctable, as I found out through my experience.
My breastfeeding journey with my daughter is what brought me to the Lactation field and my second child benefited from my newfound knowledge. With my son, I quickly overcame the early difficulties with latching him, and he transferred milk beautifully. I actually had oversupply with my son, which compensated for his tongue tie, so he gained well.
When I got pregnant with my third child, I was still nursing my second child. I nursed throughout the pregnancy and began tandem nursing once my last son was born. He was born with a classic tongue tie, but again my oversupply compensated for his restriction. We chose to have his tie revised when it became evident that it was causing a speech delay at about 15 months of age.
My breastfeeding journey was initially long, difficult and traumatic with my daughter, but joyous with my sons. Ultimately, when breastfeeding is not working, it can undermine a breastfeeding parent’s confidence in their ability to nurture their child. But when breastfeeding is not working, there is always a reason – and it is almost NEVER that the breastfeeding parent isn’t trying hard enough. I feel passionate about helping breastfeeding parents identify the root cause of the problems they are having, as that was what was missing with my daughter. I am so blessed to have found my calling in helping other breastfeeding parents navigate the sometimes-difficult waters of their breastfeeding journey
Annah, Ian and Evan
Suzanne and Annah
