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LFCA Latest Issue: Friday, September 25, 2009.

Latest Post on BlogHer: Parenting after Infertility.

My Status: Fed Josh's almonds to the squirrels. They needed them very badly.

Monday, October 01, 2007

A Couple of Paragraphs About My Boobs (Breastfeeding Mentioned)

Maybe I couldn't conceive on my own and maybe I couldn't get to term, but by fuck, I was going to breastfeed. When the babies were born, I wanted to get to the NICU immediately, not just to check out their adorable punim, but because I needed to get them on my breasts. Everyone knows that early breast milk is crucial for a full-term baby so imagine what I had convinced myself in my anxious little head in regards to my premature, underweight, IUGR babies. It was like my breasts were literally leaking the medication that would get them home and I wanted to shove my boob straight into their mouth AS SOON AS POSSIBLE.

Except that my breasts weren't really leaking anything. Strangely, I hadn't had any breast changes during the pregnancy. No sensitivity, no big boobage. My size C's stayed firmly size C's. I commented to my OB about this and he brushed it aside saying that many women experienced no breast changes. Which is probably true.

But then my milk didn't come in. My boobs never became "engorged." In fact, it was sort of like my boobs hadn't gotten the message at all that I was pregnant nor had given birth. I thought of my boobs like teenagers glued to a Sony Playstation who have blankly turned towards my voice with a glazed over expression. "What? You were pregnant? Dude...that is nasty."

But the breastfeeding consultants and books didn't find this a problem. Rest more! Pump more! Eat more! Drink more! This was the advice that kept coming around every time I set up a session with a consultant and mentioned that eight full pumpings as well as several sessions directly on the breast every day yielded at most one ounce--altogether. In other words, I could squeeze out a few cc's each session and if you poured all of them together into a vial, you could sometimes eek out an ounce that would go to one baby for one feed.

Books promised me that if I followed their instructions, I would easily be producing four ounces or more per feed. And I believed it because I wanted to believe it. Even though everything felt wrong just as it had with conception. I knew long before that first year was up that something felt "off" and I knew long before the blood work yielded no prolactin in my body that something just didn't feel right with breastfeeding. But I really wanted to breastfeed, so I kept with it for weeks, drinking the water, popping the Reglan, pumping with one of their dirty spit cloths under my nose. I was literally willing to try anything.

Breastfeeding for me was very similar to trying to conceive. The initial message when I expressed my fear that something was wrong was that I needed to give it time. I was told I need to relax. I was told I needed to focus on timing and drink more robitussin or green tea. I was told that a good vacation would bring me a baby. Then the blood work was taken and diagnoses were doled out: POF, LPD, MTHFR/PA1 4G/4G. Suddenly, there were identifiable problems and doctors stopped telling me to relax and started addressing the situation as if they had believed me all along when I said, "something just doesn't seem right."

Which made me realize that breastfeeding consultants are a lot like pilates instructors. They have a focused agenda. Pilates instructors are going to push a pilates routine with exercise being of utmost importance. They believe that almost everyone can do pilates as long as you really want to do it and you commit yourself to the exercises. If you're going to take a half-assed approach, you're going to get half-assed results. But if you make the commitment to doing pilates every single day and doing the exercises correctly, you are going to succeed and feel good and be aligned and whatever else you gain from pilates. Pilates instructors are never going to nod their head in agreement and say, "sedentary living and forgoing exercise to drink a latte and read a book is just as good as pilates."

Therefore, I cannot blame breastfeeding consultants when they have an agenda. Breastfeeding consultants do not believe that formula is just as good as breastmilk, therefore, I can hardly blame them when I went to them for instruction and had them berate me for giving my children formula (we had a breastfeeding consultant tell us we made a terrible choice by taking our children off IVs and giving them formula through an ng tube. She told us that this proved that we weren't committed to breastfeeding). I can blame them for telling me continuously that my lack of breastmilk was my own doing and that all women can breastfeed if they wish. Turns out, if you don't produce any prolactin, you can't. But no one told me to have blood work taken. Instead, it was something I had to push for with my OB at my 6 week appointment. And with the results, there was no apology at pushing my body and self-esteem through hell. There was simply a shrugging of the shoulders and a comment that this "sometimes happens to women who use Follistim during fertility treatments."

Which is a long rambling to get to why I've been waiting for a book like Andi Silverman's Mama Knows Breast for a while. One evening while the kids were still in the NICU, we went down to a local bookstore and sat down with every breastfeeding book, searching for answers. And the answers I found were the same blameist ideology that fuels unsuccessful conception until infertility is diagnosed--if it isn't working, it must be your fault. There must be something you're not doing or that you are doing that is getting in the way of conception. If you'd just lose weight/gain weight/relax/exercise it would happen.

Which is why Andi Silverman's breastfeeding book is different. It is written not by a breastfeeding consultant or a La Leche League spokesperson, but by a mother who wanted to pass on whatever knowledge she gleaned from her own experience to other mothers who might be struggling with breastfeeding. She doesn't have that La Leche League agenda and even--gasp!--talks about formula and throws it out there as an option. As she states on page 36, "You're the only one who has to feed your baby, and you'll choose what works best for you." Thank you, Andi.

The book is a breastfeeding book so it goes through breastfeeding instructions as well as ways to troubleshoot. But the difference between this book and others is that I didn't walk away feeling like shit about myself. She found the perfect tone. Even in her long list of true-and-false questions about breastfeeding, she leaves open the possibility that breastfeeding may not work for everyone and the overriding message is "give it a try" instead of "breast is best and you are a terrible mother if you're giving your child sub-par nutrition" (an actual message I received from an actual person).

Why do I care about a breastfeeding book? Because if I ever get pregnant again, in the third trimester, I was told that they could try to replace the missing prolactin (is this true? Who knows since that OB also told me that he could get me pregnant without treatments this time around). And yes, if it's possible, I want to try breastfeeding again. I'll admit this here--I don't even think it's for that baby. I think it's for me--for conquering something in regards to conception, delivery, and feeding. I want to succeed at breastfeeding.

And this is the book I'm going to use. Because if it isn't working, I want a friend to be on the page, giving a sympathetic smile and saying, "at least you tried." Not a lactation consultant who will tsk tsk me and say, "no prolactin? Not a problem." Which is not to say that every breastfeeding consultant is like this and I'm sure this post will cause a slew of people writing to tell me all about how breast is best and how they're sorry I had a bad experience but they know a great consultant or resource I can use next time.

And this post is not meant to freak you out if you are currently pregnant after treatments, but it should be a heads up to start with blood work to check that all is kosher if your milk doesn't come in. This was my experience with breastfeeding and it wrecked havoc with my self-esteem. So next time, I'm sticking with Andi Silverman's book and tossing out the other agenda-laden breastfeeding guides. Boobs, beware! I've conquered my ovaries and I've conquered my uterus. I'm coming for you next. I mean...after I get knocked up...


Samantha said...

Having never been in a position to breastfeed, I have never thought about it in that light before - that efforts that don't work could end up feeling like failed IF treatments all over again. That you would be berated for trying your best to be a good mom even though your body let you down. I'm so sorry you had to go through all of that.

Anonymous said...

I'm putting this book on my Amazon list immediately. I've just heard so many stories of women having difficulty with breastfeeding, specifically with milk issues, that I've been worried that I might not be able to myself, assuming everything continues to go swimmingly.

nancy said...

COOL. Thanks for posting this. I was able to breastfeed after a rocky start and would love to have this kind of book to be able to advice to other girls or use myself if necessary.

I have so much to type here about this whole subject. I won't go into it, but I will say that I think many women think the problem they are having IS the "end-all" problem with them being able to breastfeed and give up too soon. You are the prime example of someone who really, could not breastfeed, but kept trying. Too bad the former is true and consultants/docs are used to it and they treat everyone like it. It's kind of like the emergency room doctor who is wary of anyone in pain, thinking they are probably a drug seeker.

Anonymous said...

I think the comparison of IF and breastfeeding is very valid. One of my friends (who got PG accidentally but had gestational diabetes and unsuccessful breastfeeding) has said so many things that echo my own infertility experience. There's a strong sense in both conditions of not being a REAL woman.

battynurse said...

What a hag that lactation consultant was. I can't believe she said that to you and it's truly an awful thing to say. I'm sorry that had to happen.

Anonymous said...

I had similar problems with my twins and if it weren't for one particular LC, I don't think I ever would have been successful. The difference with her was she was completely supportive of my efforts and tried everything she could think of to get my milk to come in but also said if you have to give them formula, do it, it's not the end of the world. We did supplement for about ten days and luckily my milk finally came in.

LJ said...

I've actually bookmarked this post so that I come back to it some day. You're the best...

Baby Step said...

Thanks for this post. It just seems so unfair...IFers struggle to get pregnant and then they are put through the ringer if breastfeeding isn't easily done...I agree, that lactation consultant was a BEE-ATCH.

Anonymous said...

I breastfed my son for 5 months and then pumped exclusively for another 7 months. I am a huge proponent for breastfeeding.

That said, I would never NEVER make someone feel bad because they couldn't or because they chose not to breastfeed. If someone asks, I do encourage them to give it a try. I agree that all moms (unless there is a medical issue) should try, but if you can't, you can't. And "can't" can be a physical, emotional or mental reason.

A friend of mine couldn't breastfeed her second daughter because she had SEVERE PPD with her first daughter that was aggravated by the breastfeeding hormones. Yeah, she could have put herself and her family through hell to b/f, but she wisely decided that she'd rather enjoy her 2nd child's first year and be a good mother, rather than just an out of it milk supplier.

I think everyone should give it a try, but if you can't or decide it's just not right for your family, there is NOTHING wrong with that. You have to do what's right for you. The breast isn't always best, the choice you make for you and yours is the best.

The Boob Nazis can kiss my behind.

Anonymous said...

Hi everyone...I'm the author. I just did a quick search for prolactin on one of the best breastfeeding websites. Go to and type in "prolactin" into the search bar. You'll get tons of information. --Andi

SMiLeD said...

thank you for writing this, your timing is impeccable, I just had a total nervous breakdown today when after breastfeeding my twins for the zillionth time today they still acted hungry, apparently I can't produce enough to satisfy them. I so want to throw in the towel, and at this point it's probably better for my sanity just to give them formula but have been feeling like such a failure, I failed at getting pg and damnit I was going to succeed at being the perfect mom giving them the perfect breastmilk. I may just read that book before I throw in the towel!

Meghan said...

I too am bookmarking this post for whenever I need it. Loved the "boobs beware" comment!

Bea said...

Them's fightin' words.

Very good points, well made.


Barb said...

Loved the post and I've never had babies! Pretty cool if you got the author to comment. ;-)

lltanderson said...

this is awesome info. amazing info. should i be lucky enough to get pregnant again, i will use this info (i'm buying the book now in high hopes i get to use it). i also pumped 8 to 10 times a day for 6 weeks and never got more than 4 ounces in 24 hours. i also didn't have any breast changes t/o pregnancy. i, too, got weird looks, derisive snorts, and generally unhelpful comments when i tried to explain why i was bottle feeding my daughter. my LCs also kept telling me to relax (and in my case, recover from a hellacious birth that included a severe post partum hemmorahge). oh, the list goes on. no one ever tested me for the presence or absence of prolactin, though one group of LCs did tell me to come see them during pregnancy should i ever be pregnant again, but they didn't elaborate, and i didn't ask...i just wanted to run out of their office so i could go have a really good cry about turning in my hospital grade breast pump in defeat. now i know. THANK YOU! THANK YOU! THANK YOU!

electriclady said...

Wait...Follistim use is connected to prolactin deficiency?

...Damn. I wish I'd known that. It does explain why domperidone (which increases prolactin) was such a huge help for me.

I was lucky enough to consult LCs who knew that PCOS can be associated with supply problems. I also had very little breast changes in pregnancy and my milk took forever to come in. My daughter never really took to the breast and I fought my way from pumping 2 oz/day to eventually around 10 oz/day max. I hung in there until baby was 4 months old but once I was back at work fulltime I just couldn't keep it up.

Your use of the word "conquer" is interesting--I think my attitude toward breastfeeding was similar to my attitude toward infertility--that I was going to WIN, dammit, and I would NOT let this thing kick my ass. Except in the end it kind of did. Honestly, one of the big reasons I'm not sure I want another kid is that I can't face going through all that again.

mandolyn said...

I might still check out that book. It sounds like something I could handle. And I totally should have had my blood checked...

My pathetic A's stayed A's. I never was engorged. I would have starved my baby if I hadn't caved (while sobbing uncontrollably) and given my baby formula. I realize that I'm lucky to be producing anything at all, but it's still incredibly frustrating. I make between 1 and 2 ounces a day, but I still offer it to her. I figure if she'll still have me, I'll still offer.

And it is about her. Mostly. I know that even one ounce can probably do some good, right? The process seems to soothe her (as long as there is a bottle waiting), but I know that a lot of it is for me. I'm still trying desperately to feel like a "real" woman.

And I do hate the question that I always seem to get from people when they watch me mix up a bottle of formula. "So you don't breastfeed?" I usually say, "I supplement." and let them think whatever they will. But what I think is, "Can't rely on my body to keep a baby alive on it's own, okay? Thanks for the reminder."

Amanda said...

My mother suffered through infertility then suffered through low milk production with me and my twin brother. I can still hear the sorrow in her voice if she talks about it. She felt she was not "enough" because she could not provide for her babies.

On the other hand my sister flat out refused to breastfeed her second child. She attempted with her first child, but was adamant about not doing it with her second. She received many nasty comments from people regarding her decision, even though she never told anyone why she wouldn't breastfeed.

It's amazing how many different views there are on breastfeeding and how judgemental people can be about it.

I hope and pray that you're able to breastfeed when the time comes!

KLTTX said...

I had a similar experience. When my son was born at 31 weeks, I wanted nothing more than to bf him. I knew that breast milk was best - especially for preemies. My milk never came in and I got all of the same - more sleep, more water, blah blah blah. I pumped every two hours for 10 weeks and still only got enough milk for one feed for the whole day. I beat myself up about it for a long time - I couldn't get pregnant, then I couldn't go to term, now I couldn't breast feed. I felt like a tremendous failure as a mom. Once I switched to formula, I enjoyed being a mom so much more. If I ever get pg again, I will not fret about it. If my milk does not come it, I am not going to kill myself about it. Obviously with the adoption route, its not even an option. I will enjoy my new baby from day one without having to worry about my milk. Thanks for posting.

Anonymous said...

Hi guys...Andi, here again. If anyone ever wants to do a guest post over at my blog, that would be really cool. Contact me through my blog, I'm always looking for people's stories to share. Also, if you ever need information about how certain medicines affect breastfeeding, there are two great resources. The first is a book by Thomas Hale, "Medications and Mother's Milk." He has a website, The second resource is a website Once you're at the site, click on LactMed.

Tina / Anxious Changer said...

I love this post. I never wanted to BF - and didn't with my DS. Surprisingly, I never had the consultants knocking down my door at the hospital afterwards (I think my pediatrician made it clear not to bother us). It was the best choice for us - and we bonded immediately because there was no blame put on me for "not performing."

With so many women I know IRL who have had children in the past 3 years - and how many of those women actually BF for more than a couple of weeks (being about 3 mommies total) - I tend to wonder what the statistics really are.

I am all for what is best for the baby - no matter the method. A fed baby is a happy baby in my book.

Aurelia said...

I meant to come back to this post and just have. Mel....that LC was a hag!

I've met many who were encouraging and kind and basically were just trying to undo all the damage that formula companies and nasty MILs inflict on women when the public constantly badgers us to give up breastfeeding.

But those LCs who were crappy to you weren't following medical guidelines when they didn't test you, and frankly, yes American women don't have easy access to domperidone, even though it has been proven safe, so you are all at an even greater disadvantage.

The person who might know the most about your prolactin issues is Dr.Jack Newman. Google him, his website pops up and he answers emails. Between him and Motherisk, they can help you figure how to get your prolactin going.

And if not---a breast milk donation network just might exist where you are. I know women who have done it for moms who have had mastectomies or were undergoing chemo or radiation.

Anonymous said...

Mel, I've come back to this post a couple of times to add something but I have to much to say and never enough time.


Yup. I know.