Saturday, October 10, 2009

The things I've done

My milk first came in on August 14th, my 30th birthday. I felt like Mother Earth herself. I thought having milk would solve all my problems—Will’s latch would stop hurting, he would stop crying, and life would be happy again. But none of this happened. Will persisted in crying relentlessly, inconsolably, all times of the day and night. And his latch continued to hurt just as bad as it had in the hospital whenever I wasn’t in the lactation consultant’s office. I had plugged duct after plugged duct. The crying never ended.

I’m not sure when it was—when Will was 2, maybe 3 weeks old? He only gained 4.5 ounces that week. Not dangerously low, but enough that the lactation consultant told me that she thought I had a low milk supply. It hit me like a ton of bricks. Here I was, nursing the baby for hours at a time, at least 12 times a day; in fact, I was doing little else besides nursing. I couldn’t believe that his weight gain was so low after all that nursing. But what I didn’t know was that most of the time he was “nursing,” he wasn’t really nursing. I didn’t know there was such a thing as “non-nutritive sucking” and that he was doing it. I didn’t know what it sounded like when babies swallowed and that if I didn’t hear that noise, he wasn’t getting any milk.

All of us have gone to extraordinary efforts to increase my milk. Will is now 8-1/2 weeks old and we’re far from in the clear. I’ll be honest, my life has pretty much been a nightmare during this whole time.

We tried the simple things first:

  • Skin to skin contact—didn’t help.
  • Breast compression—got more milk into him but didn’t increase my supply.
  • Eating oatmeal—did nothing. I still eat oatmeal every day though, just in case.
  • Eating alfalfa—nothing.
  • Mother’s Milk Tea—nothing.
  • Pumping after feedings—I really think this only made things worse. In theory, if the breast is more frequently emptied, that should signal your body to produce more milk. But I feel like it did the opposite for me. I’d feed him, pump, and then when I fed him again (often with very little break in between), a lot of times I’d be completely dried up—not a single drop of milk in me. I’d have to give him the pumped milk, and it became a vicious, vicious cycle. Plus, all this was hard to do, practically speaking. He took forever to eat—often 45 minutes or more, what with all his non-nutritive sucking. When I finally decided the feeding bout was over and took him off, he would cry inconsolably. I could try to calm him down, or I could pump. Most of the time I ended up pumping while listening to him scream. And as soon as I was done, he wanted to eat.
  • Power pumping—the same as pumping. In this technique, you pump 10 minutes on, 10 minutes off for an hour, and you do that several times a day. It was virtually impossible to do when I was home alone with him, as I often was.

We tried all kinds of different galactogogues:

  • Fenugreek—the lactation consultant put me on this. It didn’t do very much. When you’re taking fenugreek, it’s supposed to make you smell like maple syrup (fenugreek is what they use to flavor artificial syrup). I took as many as 12 pills a day, and I never smelled like syrup, and I never noticed much of an increase in my milk or a decrease in Will’s hungry cries.
  • Blessed thistle—sometimes fenugreek works best in combination with blessed thistle. We tried this. Nothing.
  • Goat’s rue—this may have helped a tad, but the package instructions say not to drink anything 20 minutes prior to and 20 minutes after taking it. And you’re supposed to take it 4 times a day. Try doing this and also getting the 90+ ounces of water you’re supposed to have while nursing, all the while taking care of a screaming baby. Not good.
  • More Milk Special Blend tincture—the lactation consultant didn’t know I tried this, but I was really desperate. It might have worked had I taken it for weeks, but it had goat’s rue in it and I had the same problems as above.
  • Domperidone—This is actually a drug for acid reflux (or some type of gastrointestinal problem) and I believe it is not technically FDA approved as a galactogue. I’m not really sure what the deal is. But one of the side effects of this drug is to increase your prolactin levels, which in turn increase milk production. The problem is that insurance companies do not cover it, and it is very expensive—around $1 per pill. I took 9 pills a day. Plus, you can only get it from certain compounding pharmacies. I had to go to the St. Joseph Apothocary, which sounded very medieval, but ended up not being very medieval at all.

After a full week on Domperidone, I noticed nothing. In desperation, I went back to the lactation consultant and she said it might take 3 weeks or more to notice a change. She said I might be one of the 5% of women who actually cannot breastfeed, and we might need to redefine success. That I would need to stop feeling like I was a failure if I had to give him formula and could not exclusively breastfeed.

But I’m Melissa. I don’t redefine success. Life would be much easier if I could do that, but I just don’t know how to. They prescribed me anti-depressants I guess so that I would just give up and give him formula and not hurl myself off a bridge as a result.

I have not given him formula. Not one drop. He’s gained a good amount of weight every time except that one appointment, and it has all been on my milk—whether pumped or from the breast. But it's killing me. Every night I think, this is one more small victory, one more day that he hasn’t had formula. Every morning, I wonder if this will be the day when I break.

After two to three weeks on the Domperidone, I finally felt like I had more milk. Not exactly as much as I should have, but enough that I finally felt like some of his crying might not be a result of hunger pangs. Around this time I also started drinking almond milk, after my yoga teacher recommended it. She’s from Israel, and she said that is what women do there to increase their milk supply, but I haven’t found any information about it. When we went back to the lactation consultant (also a pediatric nurse practitioner), she said two things. First, he had characteristic signs of acid reflux (crying after feeding, etc), so she would put him on Zantac. Second, he also had signs (green, foamy poo) of being intolerant to dairy products (i.e., the cheese and sour cream in my diet), so I would have to stop eating anything containing milk protein. Fine, consider it done. I was vegan before, I’ll be vegan again. I could be a vegan in my sleep. Especially if it would stop him from crying.

And yet.

The crying persists. Zantac did nothing. After 2 weeks, I went back yesterday and they put him on Prevacid, which is super expensive. Still waiting for results. Going off dairy products could take up to 3 weeks for any noticeable improvement. So I’ve got a week left to see if that helped. After my milk supply seemed stable for a while, I also began trying to slowly wean myself off the Domperidone... from 9 pills a day to 8 and so on. By the time I got down to 6, it seemed like maybe there wasn't so much milk as before, but I tried to convince myself that it was just my imagination. At his appointment yesterday, Will had gained enough weight, but it was less than before. The lactation consultant said that it didn't seem like a good idea for me to go off the Domperidone yet. She wrote me a prescription for another 10 days (back to the apothecary I go) and suggested that I look into ordering some from Canada to save money. It might be that I have to take it the whole time I nurse.

So...

The latest verdict on Will's persistent crying is: colic. Great. I don’t even believe in colic, and now he has it. Anthropologically speaking, babies of non-western societies do not suffer from colic. Their mothers wear them in a sling as they go foraging through the forest or savanna, and the babies nurse on demand and don’t cry relentlessly. I thought if I held him all the time, and wore him in the Baby Bjorn, and nursed him, that everything would be okay. But it’s not.

He’s sleeping at the moment. There are a million things I should be doing while the house is quiet, but for some reason I felt like I should write this. Thanks for reading.

4 comments:

Anonymous said...

Hang in there dearie, this too shall pass!!!!! This is the HARDEST job you will ever have, but OHHHHHHH, the rewards are WONDERFUL!!! and the bestest thing is, WILLIAM will not remember any of this nightmare!!!! Give yourself some slack, call a friend, have a COOKIE, take a nap... whatever helps..... luv you, mama

Maria said...

Hey, Melissa. I just wanted you to know that I was thinking about you and the rest of your family! I'm SO impressed by your strength and creativity in dealing with these issues......Good luck!

gutzville said...

Power pumping sounds fun, and here we were regular pumping like a ... Chump. Anyway glad to hear Will is healthy and continues to put on weight.

amypfan said...

So good to get to see you and meet Will today. He looks like a tough little guy to me- tough like his mama. You are doing a great job!