Breastfeeding: My sad story and a glimmer of hope!

Science says breast is best and science is right.  Science would also have you believe that every woman can breast feed. In that regard, they would be wrong.  In 99.9% of the time that is indeed the case, but sometimes, just sometimes a woman can have a physiological problem that can prevent her from being able to fully feed her child. Sometimes this can be self-induced such as the case with breast reduction surgery, but other times there can be no known cause.  I fall into the second category.

May 7, 2004

When my daughter was born in 2004 there was no question in my mind that I would breastfeed.  I wanted to give my daughter the best start in life and what better way to do it.  It never occurred to me I would have difficulties that couldn't be overcome.  I had a drug-free natural birth with a nurse midwife in a hospital in Michigan. For the most part it was a wonderful experience and baby went straight to the breast.  They told me right away that she had jaundice but encouraged me to breastfeed.  On her second day she was bright yellow and had to go under blue billirubin lights. The pediatrician wanted me to supplement to try and get the jaundice out of her system and recommended I do so with an SNS so as not to delay or upset my milk coming in.  Several days later my milk had not "come in" in the way I'd read about. No engorgement, pain, leaking... nothing.  I had a visit with a lactation consultant who examined me and knew immediately something was wrong.  She said I had underdeveloped breasts and not enough gland tissue.  She recommended herbs and domperidone to help with my supply.  Unfortunately this whole time Ella was losing weight and the jaundice was not improving.  My father-in-law came to visit immediately after she was born (never make that mistake friends) and he made me uncomfortable feeding so after just two weeks I gave up.  It was a sad day, but being in the US at the time I knew I had to be back in work in four weeks and convinced myself it was for the best.

Roll on 18 months later and my second daughter Ciara was born, this time in Ireland. Again a natural unmedicated birth.  It was to be a homebirth, but the midwife was not able to attend at the last minute so we had to go to the hospital. It was perfect and the midwife was wonderful allowing plenty of skin-to-skin and immediate feeding.  I had also had nine months to prepare and try and address the problems I had with Ella.  I worked with my GP ahead of time and was officially diagnosed with breast hypoplasia and insufficient glandular tissue.  An ultrasound confirmed that I had minimal gland tissue and as a result could not produce a full supply.  This time I was going to try pumping after feeds and add more herbs (fennugreek, blessed thistle to name a few) and a high dose of domperidone (motilium, 90mg 3x day).  None of this actually helped with my supply as far as I noticed which in hindsight makes sense as if the tissue is not there no amount of galactagogues are going to help.  I breastfed Ciara for just over nine months using the SNS to supplement but she continued to comfort nurse even though there was nothing there for about a year.  I would have liked to go longer but she was ready to move on.  Another sad day.

During both my experiences I met lots of people who tried to help whether doctors, lactation consultants or La Leche League leaders and enthusiastic members.  Most meant well, but generally made things worse by telling me everyone could breastfeed and I was obviously doing something wrong when clearly baby was latched perfectly and I was continually attached to a baby or pump.  Six years later there is a lot more known about my condition, but I have yet to find anyone else in Ireland with my problem.  Breastfeeding is atrocious here, most women get very little help and give up within days or weeks.  It makes me so sad to think of all the women and babies out there that were perfectly capable of having a wonderful nursing relationship and full supply who did not do so because no one showed them how or helped them when they encountered more common difficulties.  When you've pumped for 18 hours straight and are staring at a sum total of half an ounce, you would literally kill to have functional boobs albeit ones with mastitis, inflamed nipples or oversupply.

The good news is that this condition does improve slightly with each pregnancy as more tissue is formed.  Women with less severe hypoplasia can even go on to have a full or almost full supply in subsequent pregnancies.  There is much more known about the condition and many books and groups that help.  MOBI (Mothers Overcoming Breastfeeding Issues) has been an incredible resource for me as have two books.

The Breastfeeding Mother's Guide to Making More Milk is an incredible resource for anyone with supply issues be it something like my IGT, breast surgery, PCOS or something baby related such as tongue tie.  There is lots of research on physical, herbal and medical solutions to many of the problems mothers and babies may encounter.

Mother Food: A Breastfeeding Diet Guide with Lactogenic Foods and Herbs for a Mom and Baby's Best Health is the second book which is a riveting read regardless of issues you may have.  It's a fascinating insight into breastfeeding throughout time and investigates both modern and historical antidotes for various issues and essential outcomes.  It's a great book for anyone breastfeeding who wants to ensure their milk is the best it can be.

Both books offer suggestions for women with chronic supply issues before and after baby is born which has helped me immensely in preparing for this pregnancy knowing the issues I will face.  My IGT plan of action is as follows:

• Pre-natal natural progesterone supplement to 38 weeks
• Pre-natal supplement of Go-Lacta, Goat's Rue, Alfalfa
• Pre-natal nutritional supplements including prenatal vitamin, Omega 3,6 oils, Evening Primrose Oil, Calcium and Floradix Iron Supplement
• Pregnancy Tea
• Expression of colostrum from 34 weeks to collect and freeze for baby and encourage supply
• Gentlebirth Hypnobirthing and the breastfeeding hypnosis track after birth
• Home waterbirth with no interventions, immediate skin-to-skin and nursing.
• Frequent on demand nursing with breast compression
• Supplement donor milk* using SNS, as necessary
• Post-natal nutritional supplements as above, increasing iron if required
• Herbal supplements of Shatavari, Leptaden, fenugreek, More Milk Special Blend and Blessed Thistle.
• Prescription supplement of high dose domperidone (motilium)
• Pumping after feeds.

* I was lucky enough to find some very understanding, kind and generous women to offer me donor milk through Human Milk for Human Babies. I am so incredibly touched that these women would help someone in my situation and I am blessed that I will be able to feed my son the best I can in my circumstances and avoid formula. 

Our wee man!

So that's the plan and my story.  Little Boy Blue is due any day now and I hope that it will improve this time .  I would love to hear from other Irish Mama's who have IGT, I know I can't be alone! I would also ask lactation consultants, LLL leaders, Doulas, PHNs and midwives to read up on the condition as it can be extremely disheartening to be told you are doing something wrong when in fact you are doing everything and then some right, but baby is still not thriving.  

I've listed some other excellent breastfeeding resources below:

Dr. Jack Newman's Website - Renowned Canadian breastfeeding expert. Lots of articles, videos and research here. A fantastic resource for new Moms. 

Kellymom - A wonderful resrouce by mothers for mothers. 

La Leche League - The breastfeeding advocates. Information on local meetings, a useful forum and tons of great handouts and pamphlets.

Human Milk for Human Babies - Find donor milk or donate milk to mothers and babies in need.

MOBI - Mothers Overcoming Breastfeeding Issues: great articles, fantastic email support group and links to various books and suppliers.

Breastfeeding Mums Ireland - A facebook group for breastfeeding mothers.

Friends of Breastfeeding - An Irish group promoting breastfeeding and lactivism.