Life in the Baby Lane: Chapter Nine

Milk It

They say you never stop learning. You know the adage, “You learn something new every day.” You’ve also probably heard that “life with a baby/kids/a preteen/teenager/college student/insert other phase of life here is never boring.”

Both of those seem to be true in my life. Recently, I’ve been doing a lot of learning, and of course it all has to do with babies. Every breastfeeding mother knows that feeding her baby is driven by the basic concept of economics: demand drives supply. Okay, so maybe that’s not entirely accurate as far as economics goes, but I never did like that class.

I’ve mentioned in previous posts how extremely fortunate I am to have gotten a top-of-the-line double electric breast pump for FREE from Husband’s cousin. This has been a life-saver both while traveling and now that I am back at work. Since I can’t feed Little Miss every time she needs to eat during the day, I pump at work for two reasons: 1) To keep my supply up, and 2) so Husband has milk to use in bottles for Little Miss during the day.

One thing I never realized before now is that working mothers tend to struggle to keep their supply up – even while pumping regularly. As the lactation consultant said, even the best pumps can’t extract milk as effectively as a baby.

A woman’s body knows when it needs to produce milk and when it doesn’t. (Which is why you start lactating as soon as the baby is born, and why you stop lactating when you stop nursing.) It also knows how much it needs to produce: As much as you tell it it needs to.

Since going back to work, the daily number of feedings at the breast Little Miss receives has dropped from somewhere around eight down to around five. While this may not seem like a big deal, it really is.

A couple of weeks ago I started noticing that when I pumped at work, the amount I got was significantly lower than when I’d first returned to work at the beginning of November. Whereas in the beginning I could pump around 9-10 ounces over the course of the day, now I was lucky to get 4 ounces. When Little Miss’ bottle meal is usually between 3 and 4 ounces (times two), pumping four ounces a day meant she was going to go hungry.

And she did.

Little Miss has always been on the thin side. She was born long and thin, and the doctor pointed out that she’s staying on that curve. She was in the 50th percentile for weight and the 80th for length for the first three months of her life.

When I weighed her the week of her four-month birthday I discovered she’d gained only a few ounces in the last month. She’d also recently stopped sleeping through the night. It was as though we’d reverted back to the first two weeks when, as a newborn, her stomach was too small to hold enough to tide her over through the night.

At her four-month checkup the doctor said she’d dropped into the 18th percentile for length…and the 15th for weight. My baby is tiny. And she’s not growing as quickly as you’d expect her to. Though the doctor wasn’t yet concerned, he did seem a bit hesitant to tell me she was perfect. He told us we’d see what happened at her six-month checkup.

Then, over the last week, Little Miss started acting extremely fussy while nursing. She’d squirm and kick and grunt and stretch and frown and whimper instead of calmly sucking away as she’d been doing for the last 3 1/2 months of her life. At first I thought she was just gassy or tired, but it happened too frequently to be that. Finally, I realized she was frustrated. She was sucking as much as she could, but not enough food was coming out.

All of this information combined led me to believe that my milk supply was dwindling, but I didn’t know why and I didn’t know how to fix it.

Squelching the panic in me that I was starving my child, I quickly emailed the lactation consultant for help. She emailed me back with encouragement, telling me this was absolutely normal for a working mom. While intended to make me feel better (and it did, a little), it also increased a little bit the guilt I feel for not being able to be a stay-at-home mom as I’ve always wanted to be.

The easiest way to fix this, she said, was to quit work, stay at home, and nurse Little Miss exclusively. She said this with a smile, tongue-in-cheek, knowing my situation.

In all seriousness, to increase milk supply and make sure Little Miss is getting the nutrients she needs, the nurse gave me the following advice:

  • Whenever I CAN nurse, I shouldn’t watch the clock at all. I should just let her go, even if I don’t think she’s getting any milk anymore. The more stimulation it has, the more my body understands, “Oh, she needs more.” The down side to this is that this also means that babies don’t often sleep for long periods through the night until the milk supply is high again. And that’s a good thing as far as milk production is concerned.
  • Although Little Miss used to be able to go 3 hours at a time between feedings, now that I’m not nursing as often during the day and when she does nurse she’s getting less, more frequent feedings will also help my body understand it needs to produce more milk. Now I feed her every 1 1/2 – 2 hours as I’m rebuilding my supply.
  • Increasing the number of pumping sessions each day can also be a trigger to my body to kick into gear.
  • A “Nurse-In” over a weekend can do wonders for milk supply: Staying home as much as possible, hyper-hydrating myself, and resting (staying in bed longer, lounging instead of working), all while feeding Little Miss frequently and for as long as possible.
  • Use “galactagogues.” (I love this word!) It’s a term referring to herbs/foods/drinks that encourage your body to produce more milk. Some of the ones she referred to are: Fenugreek & Blessed Thistle, old-fashioned slow-cook oatmeal and even a small amount of beer or brewers yeast twice a day.
  • Avoid known “milk-suppressants:” Caffeine, birth control containing estrogen and over-the-counter decongestants (i.e. Sudafed and Benadryl). She said it’s also possible that empty-calorie foods can slow milk production.

Though it’s not back to where it should be yet, things are looking up. I am pumping four times a day instead of just twice, and am feeding Little Miss more frequently when I’m home. This means that I’m actually producing 6-8 ounces of milk a day, which is just enough to make bottles for her. I plan on trying the nurse-in thing this weekend, too.

The lactation consultant also said that she has begun to feel that the medical professionals of the world have started having exceedingly high standards for how fat a baby needs to be to be considered “healthy.” She has nothing to base that on except her experience as a nurse with mothers and babies, and she didn’t state it as fact, just as a theory and personal opinion. She encouraged me to research healthy weight gain in babies – “Just one more thing to look at in your spare time,” she said with a smile.

So while I’m not panicking now, I came awfully close in the last couple of days when I knew Little Miss wasn’t getting enough to eat, and the stash of pre-pumped milk in the freezer was completely used.

I realize there are other things she can eat, such as formula or watered down rice cereal (at four months some doctors will okay this for certain babies). But I’ve always been of the “strictly breastmilk” mind, and don’t want to give in on this as well as having to work when I don’t want to be.

Knowing there are things I can do to fix this problem is very encouraging to me, and I’ve already noticed a difference. True, it’s annoying to have to pump every two hours at work (get out the pump, set it up, plug it in, pump, unplug it, put the milk into storage, rinse off the pump parts, put everything away….only to do it all again in less than two hours). And I know that this Sunday when I go to “the big city” for some shopping it’s going to be frustrating to have to stop every 90-120 minutes to nurse Little Miss again. But in all honesty, it’s completely worth it.

I mentioned in my other blog about breastfeeding that it made me feel good to know that my little girl is getting personalized food – a formula that’s made specifically for her and is the best possible combination of nutrients for her own little body. That still stands. I know what I’m doing is the best possible option for Little Miss. And that makes all the difference in being inconvenienced during the day. What does it matter? In 8 months she’ll practically be feeding herself. I’m learning to appreciate every single stage of this whole parenting thing. But…that’s a topic for another blog.

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