Thursday, June 3, 2010

It Takes a Village

A week ago, I opened Facebook and saw, at the top of my newsfeed:

At the very moment that I read those words, I was pumping milk for our friend MommyA's two-month-old daughter, BabyJ.

But let me begin at the beginning, in MommyA's own words.
I had breast reduction surgery in January 2006, at the age of 31. I did so knowing it was risky that I might not be able to nurse, but I also wasn't in a position where I was sure I would ever have children.

When I finally did become pregnant, I spent most of the time stressing over whether or not I would be able to nurse. I didn't get much support from heath-care providers about my likelihood of nursing. One nurse at my OB's office told me she "couldn't remember" if women who'd had BR could usually nurse. She said it in such a way I figured she meant that she did remember that they usually COULDN'T.

My nurse when I was in labor told me that I would almost definitely have to supplement, if I could nurse at all. Um, that was not very helpful information at the time, especially since I was having a very difficult labor!
During MommyA's pregnancy, I happened upon a blog review of a book called Defining your Own Success: Breastfeeding After Breast Reduction Surgery, and immediately thought of MommyA. I sent her an email saying, "I don't know if you're planning to breastfeed, and if you want me to just back off, that's fine, but I thought you might be interested in this."

She bought the book (Twice actually - as the first one was stolen from her doorstep as soon as Amazon delivered it! I'll bet that jerk was in for a disappointment.) and read it, and when I visited her and BabyJ in the hospital, it was sitting on the tray beside her bed.

Of course, I also put her in touch with DoulaK, She actually would have liked to have hired her as her birth doula, but because her own baby was due just two months later, that didn't work out, but they were in contact, and I relayed a several messages back and forth.

(As it turns out, BabyJ was almost two weeks late, and DoulaK's son BabyK was a couple of weeks early, so they're almost exactly a month apart.)

When BabyJ finally did arrive, other being a little sleepy and not wanting to nurse alot the first day, they seemed to get off to a pretty good start with breastfeeding, which was just amazing considering not only her breast reduction, but also the fact that she'd had a c-section, which can often lead to breastfeeding difficulties.

When BabyJ went to her pediatrician a few days later, she'd lost more weight than he liked, so she had to return for a weight check at just shy of three weeks old.

That was the day after our Easter party, and when BabyJ nursed through most of the party, I told MommyA that "She knows she has a test tomorrow, so she's cramming for it!"

She had gained a couple of ounces, which made her doctor happy, and he said he didn't need to see her again until her two-month checkup.

In the meantime, MommyA was pumping to build up a supply for when she returned to work, but wasn't getting much output.

Of course, babies are much more efficient than breastpumps, and BabyJ was peeing, pooping and happy, and her onesies were getting too short - all of which are good signs.

At two-month checkup, she was "perfectly healthy," but only up a pound from her low weight.

The doctor, of course, wants me to "switch" to formula. But, I'm going to keep pumping and nurse when I know I have milk.
Unfortunately, I only have enough milk in the freezer to last through Thursday. I have already worked on supplementing with straight formula. She also does fine with formula as well as breast milk.

Unless pumping while I'm at work improves my production by leaps and bounds, I will probably be mixing breast milk and formula bottles.
I have been taking fenugreek and blessed thistle for almost 3 weeks, but I don't see alot of improvement so far. I also let BabyJ nurse as long as she wants as much as I can, but again, I am not really able to sustain her anymore.
According to my breast-reduction book, a lot of women who've had the surgery have far less success than I have, so I'm really, really trying to be OK with doing what I have to do. I just hope to continue to pump for a long time, and also hope that BabyJ will continue to want to nurse after getting bottles all day long while I'm at work.
Of the 20 ounces that MommyA brought over on Tuesday (her first day with us), BabyJ took 17 ounces, and based on that and what MommyA pumped at work that day, it was clear that we weren't going to have enough for the week.

I remember how grateful I was to our friend AnotherK, who gave us several ounces of milk when we had to go to the Children's Hospital of BigCity when she was eleven days old and not nursing. (She is a surrogate and was pumping for a baby a month older than Peeper.)

We ended up not needing it, but it brought immeasurably peace of mind just knowing that we had it and no matter how little I pumped that day, Peeper would not be getting any formula.

I hoped that I could do the same for MommyA and BabyJ, so at the Wednesday morning drop-off, I offered to pump in hopes of helping to making up the difference.
I was a little nervous about how MommyA might react to the suggestion, but it turns out she'd been wanting to ask, but not sure she should.

I was able to get two or three ounces over the course of the day, and we had even some left over, but by then, she'd blown through vA's freezer stash, and we weren't even close to having enough milk on hand for the next day.

As you can imagine, I'd been in touch with DoulaK about this, getting advice for MommyA on increasing her supply and her pumping output, and when she found out on Thursday morning that we were probably a bit short, she texted me to say that she had "a couple of ounces" in her freezer, and could bring it over.

She brought ten ounces, and despite BabyJ taking 22 ounces that day, again we had a bit leftover.

DoulaK brought over some more on Friday and even more today. MommyA's gotten a little more at work each day, and I've gotten a couple of ounces each day. So far, we've had enough and tomorrow is looking promising. She's not had a drop of formula the whole time!

MommyA received a shipment of domperidone on Tuesday, and we hope that will help to increase her supply to the point that she can pump enough to keep up with BabyJ on her own, but in the meantime, we'll do all we can to make sure this little girl gets the breastmilk that she needs.

As for me, I have to say that this is doing wonders for my relationship with the breast pump.

(Which is now chanting, "Filling the hole, filling the hole!")

Helping to fatten up sweet little BabyJ is such a more positive reason to be pumping than Peeper "rejecting" me as a newborn or, later, being unable to nurse because of her surgery.

I don't have to do this; I want to, and that makes all the difference in the world.

Also, there's no way I can repay everyone who helped me and Peeper, so maybe this is a way I can "pay it forward."

Disclaimers and more information:

If you purchase the book through the Amazon affiliate link above, I will earn 5% of the price.

Information on increasing low milk supply
La Leche League

Information on informal milk sharing, cross nursing and wet nursing:
La Leche League's official position
Links from

A great discussion about crossnursing, or at least the urge to do so:
Have You Ever Wanted to Nurse Somebody Else's Baby - Breastfeeding Moms Unite


  1. There is, of course, one small flaw in that "pay it forward" logic: DoulaK, one of the ones I owe the most, has already given BabyJ a whole lot more milk than I have!

    And, she's had to drive an hour to deliver it, has pumped around nursing her one month old and caring for her four older children, and her milk is probably a lot better for BabyJ than mine is, being made for a newborn.

    I am amazed at the effort she's gone to, for a woman she's only met briefly (while visiting me and newborn Peeper in the hospital).

  2. I'm sure you've probably read on KellyMom that a breastfed baby only needs about 1 ounce of milk per hour. So if MommyA is gone 8 hours, that should only be about 10 oz or so, give or take. The fact that the baby is taking 22 oz in such a short period may mean that maybe you're overfeeding. Not judging, but from everything I've read, this is VERY typical with care givers of breastfed babies. It's one of the main reasons moms can never keep up with the pumping once they return to work. Would it be possible to try some of the feeding techniques (like paced feedings) on Kelly Mom to see if the baby will eat a little bit less during the day and still be satisfied? Is the baby using a pacifier? My son never had a pacifier and he would drink 3 6 or 8 oz of breast milk a day plus a couple bottles of formula. Of course I could not keep up with that and eventually just started hand expressing for comfort during the day and allowing him to have formula at daycare and nurse with me at home. I'll never be 100% sure whether or not he really needed to eat that much, but I wish I would have gotten daycare to try some alternative feeding techniques before throwing in the towel.

  3. *That should be he would drink three 6 or 8 ounce bottles of breast milk plus formula a day.

  4. Hi, Elita!

    I am doing paced feeding, but I'd not heard the 1 oz/hour guideline. That's good to know.

    She's with us for about 10 hours / day, and mom nurses her at drop-off and pick-up.

    The 22 oz day was an outlier. Other than that, she's taken 17 - 17.5 each day. Except this Tuesday, when she was with someone else and took 14.5, then yesterday with us, took 20.5. Averaging out to.... Lol - Pretty good at math for such a little person :-)

    She does take a pacifier and I generally try that first, to see if she's just looking to suck, before feeding her.

    She might well be satisfied with a little less, but given her slow weight-gain, and the fact that mom's supply concerns may mean that she's not getting as much as we'd like to think when she's at home and nursing, it feels a little safer right now to err the side of more milk.

    Speaking of that - We are all looking forward to her weight check next Friday to see how much she's gained!

  5. Gotcha, I understand the concerns. I think most moms (like myself) feel the same way, better to overfeed than worry you are underfeeding. I am glad you are able to provide some milk for her and the baby, too. I wish I had had someone to give me some extra milk!

  6. What a great thing you are doing! I found your blog through kellymom probably a year ago and have been reading daily! I love seeing what Peeper is up to, as she is just a month older than my girl!

    It sounds to me like BabyJ might be overfed a little as well. When Devin was first in daycare at 10 weeks old, for 9 hours at a time, being nursed right before I took her and as soon as I picked her up, she got a 3-4 oz BM bottle every 3 hours and was just fine. She never got more than 3 bottles a day during that time she was away from me. So it sounds like Baby J is getting twice that amount! Even at 12 months old when she was still getting 3 bottles a day during that time, I never gave her more than 4 oz of milk at a time and she lasted 3 hours easily as opposed to 2 hours if she was with me and taking from the breast. And as you said in your post, the milk changes with the age of your child unlike formula which has to be increased with age.

    I may be completely misreading and that 22 oz was for the entire day, and not just the time you had her. :) Please ignore if that is the care. Either way, cudos to you and Doula K for helping Baby J!

  7. Alhough it is possible that she could be satisfied with a little less, I think that given that the slow weight gain issue is probably "real" in this case, rather than just a quirk of how this particular baby grows, I would vote for getting as much milk into her as she will take for the time being.

  8. Well, after discussing it with MommyA and DoulaK and making a point today of offering binky first, and carefully pacing the bottles (holding her upright and bottle horizontal to slow flow, waiting for her to latch it rather than sticking in mouth, pausing every few sucks, bigger break every ounce or so) we've decided that she really is asking for that much.

    She's spitting out the binky and trying to latch on my arm, crying until I offer the bottle again, then practically reaching out to grab it.

    I wonder if the 1 ounce/hour rule of thumb is for a baby who's reverse cycling - not taking much in the day, but nursing actively at night when at home with mommy?

    MommyA says that BabyJ is sleeping pretty long stretches and not nursing a lot in the night, and we don't know how her supply concerns might be playing out when she's actually nursing, so I'm thinking maybe she's getting a bigger proportion of her intake from the bottles during the day.

    So, for now, we will continue to pace the bottles and be mindful of the possibility of overfeeding, but err on the side of more calories in, at least until we see some little chubber thighs going on.

    I do appreciate all the info on it, though, because it's not something that had crossed my mind.

    I really had no idea how much to expect her to take, so I wasn't sure if the 17-ounce range was a lot or a little.


What say you?