Our first child, a girl, was born in December 2006. We felt prepared for exclusive breastfeeding. I had read La Leche League's 'Womanly Art of Breastfeeding' from cover to cover and felt passionate about breastfeeding and confident that I would be prepared for whatever challenges I encoutered in the first weeks. My partner and I attended a breastfeeding class at our birth centre as well.
I now know that I experienced warning signs of Insufficent Glandular Tissue prior to the birth.
1. My breasts did not change in appearance or size during the pregnancy.
2. My breasts had also changed very slightly if at all during puberty. I now think that this was quite remarkable, and my first symptom of having insufficient glandular tissue.
Our daughter was born in Indiana, in December 2006, after a glorious, unmedicated, uncomplicated birth in the birth centre area of our local hospital. Here are the symptoms of Insufficient Glandular Tissue that we experienced after the birth:
1. No evidence of “milk coming in” besides a change in the colour of the milk.
No engorgement ever, no increase in flow, no feelings of a letdown reflex
during any feedings.
2. An Insatiable Baby. Beginning the first night after the birth, our daughter wanted to nurse almost non-stop.
She would nurse until she fell asleep exhausted, then sleep for 15 minutes
and wake up starving again. Her hunger kept her awake. Until we increased
the formula supplementation when she was a few weeks old, she was probably getting a total of about 4 hours of sleep over
a 24-hour period if I added up all her sleep periods during the day and night.
3. Only 1 wet diaper a day. Her wet diapers contained “brick dust” which is an indication of dehydration. Note: This was in cloth diapers, in which the slightest wetness could be detected.
4. No dirty diapers. She did not poop for the entire first week, and only did after we gave her a wax suppository.
5. No swallowing sounds when she nursed. I only realized this in retrospect. I did not recognize what a swallowing sound was until I began supplementation.
Four days after her birth the home visit nurse came over and we found that our 7 lb 2 oz baby had dropped to 6 lbs, 3 oz. (she would later drop to 6 lbs). We started to supplement her with formula, 2 oz (60 mL) at a time a few times a day. These are some of the things we did in an attempt to increase my supply.
1. I always breastfed prior to supplementing.
2. Supplementation was not done through a bottle (to prevent nipple confusion) but though a cup or syringe, or later, the SNS (tube formula feeding via sucking on the nipple so as to stimulate milk production).
3. I took Fenugreek tablets, and a few weeks later started Domperidone as well.
4. I used Jack Newman's Breast Compression method. I also had an e-mail exchange with Mr. Newman which was unhelpful.
5. I pumped between feedings with a rented hospital grade electric pump but would barely get enough milk to even cover the bottom of the bottle. I was told by the many lactation consultants I saw that pumping was not a good indicator of milk supply so I did not see this as a warning sign.
6. I had many, many sessions with lactation consulants at my local hospital.
The true wake up call for me was when our daughter was 2.5 weeks old.
I rented a baby scale so that I could weigh the baby before and after a feeding and determine exactly how much milk she was receiving.
The very first time I used the scale, I nursed for 45 minutes. When I put her on the scale after the feeding, it did not register even a 0.1 oz change in weight. Her weight DID NOT CHANGE, meaning she had less than 0.1 oz (3 ml) of breastmilk in that feeding. I was heartbroken and felt extremely guilty that all this time I was starving my child (she was later labelled “Failure To Thrive”). I repeated the weighings after many, many feedings over the next 2 weeks, with the maximum change of all being 0.3 oz at a time when she probably needed about 3 oz per feeding.
I immediately began to increase the supplementation we gave her. I continued to breastfeed prior to each supplementation for the next 5 months, holding out some small hope that my milk supply would increase (I had heard that domperidone takes some time to kick in). After ramping up the supplementation she weighed 7 lbs by the time she was 1 month old, almost back up to her birth weight.
Our son was born at home in Canada when our daughter was 18 months old. I began formula supplementation immediately and had an entirely different experience mothering him in the early weeks of his life. It was a much more blissful experience and I did not have any guilt regarding the formula supplementation. I found with him as with my daughter that after 5 months I no longer breastfed prior to every formula feeding as it became a frustrating experience for the babies, and I then limited breastfeedings to when my child was sleepy but not hungry.
UPDATE FEBRUARY 2011: Our third child was born in Canada in August 2010. After reading Making More Milk I decided to try breastfeeding at the END of each formula feeding,
against the advice of my midwives and other experts. I found this to be the best decision for me.
Another difference this time is that I switched from the SNS to the bottle at only 2.5 days as I found it too hard (especially overnight) with 2 other small children to take care of, with night wakings of their own. This probably had some effect on my supply, but I chose sanity.
Now at almost 6 months he is still an avid breastfeeder, longer than the other two were. I think my supply is better than the previous times, although I am sure he is still getting at least 95% formula.
His breastfeeding sessions were no longer frantic, and we were both able to enjoy them. There were times when I miscalculated how much of the bottle to give him, and then he was too full to breastfeed, but those lessened as time went on and I understood his signals.
UPDATE MAY 2011: My third child is still breastfeeding at most feedings at 9 months old, and is more interested in breastfeeding at this age than the other two were.