Confidence and Milk together

I just had a moment. 

Context: These past few days I have been feeling like I have more milk. The very rare and random occasions where my little boy feeds with no supplement are becoming a little less rare. 

Loving those beads lately!
There was one feed on a very full train up to Mount Rigi last weekend, where I'd have to disturb my sleeping toddler, my comfortable baby and about four other people in order to get my supplement bottle, so I just tried to keep taking deep breaths, using my hypnobirthing techniques, and I wanted to see how we'd go. We did fine! No supplement required. The fact that my toddler was asleep and I could focus solely on this little one here probably helped... 
The magic boob-only feed 
Yesterday, he needed only about 50ml. I feel as if he could have taken more if I kept offering supplement, but I didn't and tried to believe in my milk production for the first time since week two. I got anxious every time he cried, though, presuming he was famished, but it was usually more so that he had dropped a toy (we are at that phase now!). 

So far today, he hasn't had any. And it is 5.52pm. I'm tipping milk down the drain (blasphemy! Gah!) because I get it ready and then it isn't required. I am feeding him perhaps every 90 minutes, both day and night, right now, so I must admit I am pretty exhausted, but wowsers. 

So I just had a little moment. He was screaming his little guts out, which he never does (Okay, unless he is in the car. Then he plays 'cry it out' just for fun.). I had been feeding him very often all day long. I have been feeding him both to sleep and upon waking for each of his naps today, rather than just putting him in the carrier until he falls asleep, just because I feel like it. Because he isn't on his Mama, his sleeps haven't been longer than 20minutes all day. 

Then came the screaming. I was so anxious that he was hungry. And I really swore that I would not let my baby go hungry. So I had a bottle ready, and then I braced myself, put him in the carrier and started pacing. Maaaybe he was just tired again... much earlier than usual... but maybe? And I started singing. Usually I sing him a song that I made up in the hospital on that one awful sleepless, heart wrenching night where we paced the halls all night long: 'Little Harvey, my little Harvey, who you gonna be, my little Harvey? Maybe you'll be a ...' etc. But this time, for some random reason, I started the chant that we do at the beginning of yoga: 'Ong namo guru dev namo'. Only after singing this perhaps forty times did I realise that I was singing 'I bow to the infinite wisdom in me'. And then, just at that realisation, he fell asleep. 

Singing as he falls asleep

How beautiful is that? I trusted that infinite wisdom inside of me that he was not hungry, and he wasn't. 

Yay for slowly building my confidence along with my milk! 
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WHY don't I have enough milk?!

Why don't I make enough milk for my baby?

WHY DON'T I MAKE ENOUGH MILK FOR MY BABY?! Yes I am screaming. I am over it. I am so over it. Five months of this. Three years of this. I am OVER IT.

Enough with the photos already, Mama.


I am not 'over' our version of breastfeeding. I am not done. I am not ready to give a bottle. I am OVER not having enough milk. Can't I just bloody MAKE MORE MILK ALREADY!

There is no placenta stuck in me.

There is no thyroid hormone imbalance.

There is no prolactin issue.

There is no latch issue.

There is no tongue tie.

There is no lack of skin-to-skin contact.

There is no lack of patience.

There is no lack of love.

There is enough breast tissue.

There are enough calories.

There is enough water.

I still feed him every 2-3 hours, usually, with one 4 hour break in the night, though sometimes all night continuously. And each feed takes at least 45 minutes, often more. That is enough stimulation, surely.

So. Is it really just my mind? Really? But when I have my weeks where I am chilled out and accepting and happy, my milk supply doesn't drastically increase. Why not?

I'd love to do a personality profile on all mothers with unexplained low supply. Are we all overachieving, anxious perfectionists? Can somebody who doesn't have two small children please do a dissertation on this?

This is why using the SNS is sometimes very complicated.
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Increasing my dosage?

So whose advice do you take? The midwife who you have literally trusted with your life and the lives of your children, who is also a newly qualified lactation consultant, whose word has always been absolute gospel and who seems to see right into your heart and bring out the most vulnerable sides of yourself that you had really never known to exist before? Or perhaps the most internationally renowned lactation consultacy team on the planet, who knows very little of my story, who has never met my family or seen me breastfeeding, but who is the absolute go-to for lactation issues?

I spoke with Anja, my midwife, about my domperidone usage. She has always admitted to me that she has very little experience with it and is not the greatest source of knowledge when it comes to that area. She even guaranteed that I know infinitely more about it than she does, because I am a bit of a research junkie, and have read from such a wide variety of both reliable (ie scientific journals and government bodies) and unreliable (ie forums and blogs) sources. She says that she is excited at the prospect of me perhaps becoming a lactation consultant one day, and she can refer people to me for low-milk-supply issues and domperidone advice. That's a cool idea...
Lacking photos for this post!
So here's my sweetness, 14 weeks.

The thing, though, is that she spoke mainly about what an amazing start to life my little boy has had, and that I shouldn't get so caught up in needing to continue indefinitely. He is three and a half months and could potentially start solids in two weeks (though I have always been a fan of waiting as long as necessary until they start to want to eat my food – for my big boy, that was five months and one week) and then he perhaps won't need as much milk. She said that there is no need to continue taking this drug until he is one year old, and that he will probably always want to come to the breast for comfort, as we have that well established. She said that I need to let it go a little, and that we have already achieved so much more than any of us had ever expected, considering that I was at the point where I was not really even going to try to breastfeed again, after my last experience. She suggested that I wait one or two weeks until I feel ready, and then I slowly begin to lessen my domperidone usage.

This is the first time that I have spoken to her where I felt a little defensive. And that has really made me think. A lot. Usually, what Anja says goes. She is my guru and I trust her instincts implicitly. I do, however, feel as if I also know her very well now. I know that she is a big believer in anthroposophic medicine, and is perhaps as alternative as they come. I was originally surprised when she mentioned domperidone to me, as I would never have expected her to suggest a pharmaceutical medicine. She knows, though, that I have tried everything else.

She originally suggested that I take 60mg a day for eight days and then wean off. None of my research ever mentioned anything like this. Women take it for the duration of their breastfeeding time, for months on end. And they appear to take anywhere between 90 and 140mg. So for the past seven weeks I have been self-medicating, tentatively, taking the 60mg.

So yesterday I wrote an email to Dr Jack Newman, telling him a little about our situation, with the domperidone, the donor milk and the SNS. Did he think I should increase my dose? Or should I see how we go with solids?

His reply, though I am not permitted to copy and paste, is that of course I should increase my dosage, and that I should take it as long as I want to breastfeed. I can occasionally try to reduce one of the nine tablets and see if that affects my supply, and if it does then go back up.

So now I am met with my original dilemma, that great oxymoron: How do I feel about medicating to breastfeed? Apparently okay for the moment. So here is another situation where I am learning more about myself through all this breastfeeding business, having to decide what is important to me and why. I've decided to try 90mg for a while – let's say ten days – no higher, and see what it does.

I wonder how my midwife will take it.
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Considering the Pros and Cons

I fluctuate so dramatically and rapidly with how I feel about our current feeding situation, at four months. One day I absolutely love it and am so so happy that we can do what we are doing, and the next day I am just over it. I suppose there will come a time in future where that 'just over it' feeling will dominate, and then we'll see where we go from there.


Pros:

  • I have never had to get out of bed at night to console a baby. We spend many hours in the night attached to each other and he gets what he needs both physically and emotionally from me. The difference between being able to do this and spending so many early hours trying to get a screaming first baby to sleep is just mind boggling. 
  • When he is sick or unsettled for any reason, I can bring him to my breast and he feels better. Again, no inconsolable screaming. 
  • I am experiencing such a special bond with my boy, him staring at me, me staring at him, stroking his hair as he falls asleep
  • He's getting my milk, but to be honest, it isn't really about that. That is what I am coming to understand. If there was some kind of feeding issue where I had to feed my boy only my expressed milk in a bottle (because in this imaginary world I'd be able to pump everything he needs), I would still be sad. It isn't about the milk, though that obviously plays a role. 
  • This sounds stupid, I realise, but I like the fact that I am feeding my boy in a way that women have fed children since humans have existed. In the same way that I like that my births were unmedicated and allowed me some kind of primal connection to all births that women have had to endure throughout time. 

Feeding is a team game sometimes!

Cons:

  • It still takes so long. Around 40 minutes, usually. Sometimes longer. Every 2-3 hours -- that is, from the start of one feed to the start of the next. My big boy is really good throughout it all, but of course that isn't always easy, and he can't always be a superstar toddler. 
  • I am always second guessing myself, never sure if he has had enough (but does this change if you bottle feed?). Sometimes I think he is done, and then half an hour or forty minutes later he is hungry again, which makes me a little lacking in confidence when it comes to going out or planning our day. I would love to avoid having to feed in the playground at minus two degrees.
  • The SNS bottle is fickle. Sometimes I want to throw it very hard against a wall and then jump on it repeatedly, but then I know that I wouldn't be able to breastfeed at all if it weren't for that. 


More pros than cons, still. I suppose, in the back of my brain, I had always thought that my supply would be continuing to increase. That is what the SNS is for. That is what the domperidone is for, and all the other things I am doing and taking. But I'm not pumping. I need a bit of a reality check and I need to accept that this is really it. This is as good as we will get. I won't ever be able to sustain this bubba on my milk alone. Though, wait! I did when he was sick! So there's a big tick!

In the hospital, the nurse who attempted to give him a bottle seemed astounded that I was using such a 'complicated' system to feed my boy, particularly as a second child. If he was the first, I'd have times and focus to be able to work at this... it made me reflect on how this has affected my first boy, and if this is somehow unfair on him. I really don't think so, I haven't been neglecting him through all this, but it has made me think.

My big boy gazing with love at his brother
Seems that my kiddliwinks are getting better, but I am not. To be boring, all the pain that is in my jaw, teeth, ear and face in general makes me presume I have a sinus infection. My toddler really wanted to dance this morning, so much that it was a bit of a dance-by-force scenario involving him throwing himself repeatedly at my body so that I would have no choice but to wiggle... And his ever-dancing daddy is away for work for a week, so he just has me. Bummer. So this post is probably a bit grumpy.

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