Thursday, July 19, 2018

Troubleshooting Breastfeeding & Increasing Supply

Greetings faithful blog readers,

I'll start out today's post with a major disclaimer: I'm NOT a pediatrician or a certified lactation consultant. I have literally no training or background in either field! If you want to speak to a certified lactation consultant, you can find one here or ask your child's pediatrician for local resources. These are just a few helpful approaches that worked for me and may be of help to you too. File under: things I wish I had known!

Tip 1: Reduce Your Stress & Remember Breastfeeding Isn't "All or Nothing"
In the beginning, breastfeeding was very stressful, and I think the stress (combined with sleep deprivation) contributed to my supply issues. I was under the impression that if I used any formula or bottle, breastfeeding would be permanently sabotaged; meanwhile, my child was dropping in the weight percentile, and I even rushed her to the ER the day after we were discharged fearing that she was dehydrated (she was, mildly). We supplemented with my pumped milk and formula up until week 6 (about 20-30% of her diet was formula, the rest breastmilk), and it did not equal the end of breastfeeding. She has been exclusively breastfed since the start of week 6 and is now 15 weeks old. She never had nipple confusion or lost interest in breastfeeding. I always breastfed her first before offering supplement, and I made sure to keep pumping (more on that in a minute). I also have a friend that uses donor breastmilk, and Human Milk 4 Human Babies is a great resource to check out. I also know people that have been exclusive pumpers.

Tip 2: Come Up With a System For Tracking 
I was so sleep deprived at the beginning that I really did have confusion about how many diapers we were going through. Next time, I will use an app or simply use one small plastic bag per day to put them in to keep track. This is really helpful at allowing you to identify if there is a true supply problem. I also wish I'd invested in this scale to track how much she was eating. Next time!

Tip 3: You Shouldn't Be Suffering
Everyone told me to expect a little pain when adjusting to breastfeeding. I was honestly in a lot of pain and didn't want to admit it. We probably had some early latch issues. I asked the pediatrician for a nipple shield, and it made a huge difference in my comfort level. Also, Willa went from screaming in frustration and taking forever to latch to immediately latching. At about 6 weeks old, she simply weaned herself off of using them, and by then, my nipples were fully healed.

Tip 4: Pump, Pump, Pump (But Don't Make My Mistakes!) 
My friend Laura advised me that young babies sometimes "suck at sucking" (pun intended). I absolutely feel this was the root of my supply problems. She couldn't get enough, so I wasn't making enough, and she was hungry. The pump helped us break this cycle, but in the beginning, I had no idea what I was doing with pumping.

  • I would pump one breast at a time for five minutes. Double pumping is much more efficient, and a pumping session is generally 15-20 minutes.
  • I was using the incorrect flange size. I thought I needed larger flanges, and in reality, I needed smaller ones. It truly is the size of your nipple (not the size of your breast) that matters here. Here is a quick sizing guide. If you are hurting after pumping, something is wrong. 
  • I didn't know how often to pump. During week 5, my SIL Annie helped me get to a breastfeeding support group at the hospital, and they advised that I try triple feeding. I did this faithfully for 3 weeks pumping after each feeding for about 10-15 minutes (yes, it was exhausting and feeding/pumping was what I spent most of my time doing). When we started, Willa was eating about 50 ounces a week of pumped milk (everything else from the breast), but as time went on, she needed less supplementation (36 ounces one week, 26 ounces the next, and then she stopped needing supplementation). We knew that she was still gaining thanks to weight checks. Finally, after pumping more than 360 ounces, I could start a freezer supply, cut back on pumping sessions, and reclaim my life! I dropped pumping sessions gradually...waiting 5-7 days between dropping a session. I went from 6-7 pumps a day to 1 over the course of about 6 weeks. I am now only pumping 3-4 ounces a day in just 11-15 minutes and have about 200 ounces frozen. I'd like to stop pumping soon and just enjoy the rest of the summer. I'll resume pumping once I start back to work in the fall. 
  • Final pumping mistake: once Willa stopped getting supplemented pumped milk, I realized that pumping to "empty" was no longer helpful. She would take forever at the next feeding. Now, I cut off pumping at 11-17 minutes depending on the day. I don't pump until I feel totally empty, and her subsequent feeding is faster and leaves me feeling confident she got enough nutrition. 
Tip #5: Supplements For You CAN Help 
I was super skeptical about supplements, but I really had success with these things: 
Fenugreek-I take about 6 capsules a day OR drink Mother's Milk Tea 
Legendairy Milk Products: Cash Cow (usually use 6 capsules a day) and Lactivist (usually use 1-2 drops a day). 

Tip #6: Your Diet Can Make a Difference 
Oatmeal, brewer's yeast, and flaxseed are supposed to help. I would put those in smoothies and in lactation cookies and eat those. (Oatmeal is quite a regular breakfast around here). For me, I also found that adding a little meat to my diet helped. Also, drink a lot of water. I don't diet (in fact, I love a nightly bowl of ice cream) and have heard friends say dieting causes their supply to crash. I try to maintain a healthy diet (lots of fruits and veggies) and eat foods with calcium (yogurt and cottage cheese are two of my favorite sources). When you start working out again, make sure that you are getting enough to eat. 

Tip #7: You Need Support 
I can't say this one enough! You need support at home! Brendan has done so much to help us make breastfeeding work. He cleans pump parts, he makes me lunch so I can eat while feeding her, he brings me all the things I can't get up and get myself since I'm feeding her (water, my phone, my book). Other great support systems are our families (who, like us, are always excited about weight gains) and the hospital breastfeeding support group. The first time I felt like breastfeeding was not a test I was failing was when I walked into that room at 5 weeks. Thank goodness my SIL could help me get there the first time. Seeing the amount Willa eats increase each visit really increased my confidence that everything is okay; plus, the support group was free. Another great system of support is your friends who have recently been through it. Note the word recently in italics. I think many women forget how hard the beginning was once they have some distance. Find your friends that recently struggled, vent, and let them walk you through it. You CAN do it!

Tip #8: You May Feel Like Quitting
Most people I've talked to, and this applies to me as well, felt like quitting in the beginning. It's just hard. You are really tired. You don't know what you're doing, and it's super stressful if your milk is slow to come in and you have to supplement. The first time a lactation consultant told me "it gets easier," I thought she was just telling me what I wanted to hear, but it really is true. It does get easier. The baby eats less frequently, eats faster, and stops waking up in the middle of the night. They get better at latching and it stops hurting. You become confident and that stress that they aren't getting enough goes away. It actually does become convenient once you no longer need to supplement. I feel really glad that I stuck with it because it truly is a special part of our relationship, but I remember how hard it was in the beginning. 

Additionally, we live in a country that, despite recent efforts, still isn't very conducive to supporting breastfeeding. Women have absurdly short maternity leaves and that probably accounts for why even though 79.2% of women start out breastfeeding, only 18.8% of babies are being exclusively breastfed at 6 months (Texas has an even lower rate than the national average). Many women feel guilty when they struggle, but they are doing absolutely everything they can and the support just isn't there.  

Tip #9: Repeat After Me 
You are a good mom--No matter what ends up happening with breastfeeding. Toss your guilt to the curb and know that your baby will love you no matter what. 

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