Breastfeeding: A Year In Review

As a breastfeeding mother who has had a breast reduction I had a challenging road.  Despite the setback of a reduction, I was able to exclusively breastfeed my son for six months and am still breastfeeding him now at one year. Perhaps my story can give some hope to other moms hoping to breastfeed after a reduction. 

Part I: Pregnancy

A year ago I was very, very pregnant.  We were eagerly awaiting the arrival of our little monkey – wondering if he was a boy or a girl and wondering which of the names we liked would suit him.  My feet were massively swollen.  I was drinking a LOT of chocolate milk.  I was also agonizing over whether or not I’d be able to breastfeed my baby.  

I wanted to, very much.  My mom breastfed me and my three siblings.  Jb’s mom breastfed her and her four brothers.  I strongly believe that breastmilk is the best choice for babies and mom – and we didn’t have a lot of room in our budget for the added expense of formula.

But I had a breast reduction about a decade ago and there was no way to know what kind of success I’d have nursing my baby.  I researched breastfeeding after a reduction extensively (BFAR.org is a great place to start) and found there are a range of experiences out there – enough to give me hope, but no guarantees.   There are so many variables: the type of surgery, your age, how much time has passed, your body’s capacity for healing (recanalization and reinnervation).   There were suggestions and strategies for boosting supply once the baby arrived , but while pregnant all I could do was wait and see.  

I thought about it everyday.  I had dreams almost every night about breastfeeding – or nightmares about not being able to.  I was prepared for a wide possibility of scenarios from not getting a single drop to being able to feed my baby without supplementation - but knew that most likely I’d only be able to produce a small amount of milk and would likely need to supplement with formula.  I researched galactagogues and nursing supplementers like the Medela SNS and Lact-Aid.  I braced myself for the worst, hoped for the best, read everything I could get my hands on and waited.     

Pt. II: The Early Weeks

Once my perfect little baby joined us earthside we had our first nursing session within an hour of his birth.  I didn’t know if my body would produce, but I was ready to give it my best shot.  Despite the reduction, I was set up for success in every way:

• I was full of information.  My doula training and reading requirements had laid a good foundation of information on breastfeeding and upon becoming pregnant I upped my information consumption considerably.
• I had an incredible support system: I worked in a community of doulas, midwives, and IBCLCs.  I had family who had breastfed and friends who were currently nursing babies or toddlers. 
• The Midwife Center (where Leo was born) and the pediatrician we chose were very pro-breastfeeding and non-alarmist.
• I had an awesome natural birth and enjoyed skin to skin time with Leo right after his birth.
• My partner was completely on board for breastfeeding our baby.  She supported me 100% and picked up a lot of the other work so that I could focus on nursing.
• I was enrolled in WIC which sent a Lactation Consultant to my home twice a week for those first weeks and also loaned me a hospital grade pump at no charge.  (This would have been completely unaffordable for our family without WIC.)

I was so hopeful as I put him to the breast for the first time and visualized him getting all the nourishment he needed.  Within three hours I had my first blister.  

The weeks that followed are a blur – but I remember them being really, really hard.  My poor nipples were torn apart, I was sleep deprived, I screamed into a pillow every time he latched, the first few times I tried to nurse in public I had a small panic attack, it seemed like he wanted to nurse every minute of every day, and his weight gain was slow.  For someone who was educated about breastfeeding and had so many resources available to me, I couldn’t believe how vulnerable I still was to worry and doubt.

I worried I wasn’t making enough milk, I worried if I pumped rather than nursed  I’d interfere with establishing whatever supply I was capable of, I worried that my lean and long little baby was hungry…  There was plenty to worry about.  I cried.  Oh, how I cried.  The hormones coursing through my system certainly weren’t on my side.  Three a.m. through sunrise was the hardest time, when I would open the cabinet and stare at those cans of formula that the formula company had delivered to my door the week of my due date.  Without all the support I had around me I certainly would have given up.

At around the one month mark things started to change.  I began using a nipple shield (despite my concerns about nipple confusion) which let my nipples heal, I got a prescription for All Purpose Nipple Ointment, Leo’s latch improved, his weight was catching up and I had a couple successful nursing sessions in a public setting.  It wasn’t quite smooth sailing, but there was a light at the end of the tunnel. 

Pt. III: Happily Ever After

 

By two months we were off the nipple shield completely and nursing was no longer something I dreaded.  The sleepless nights, worry, pain, and doubt were fading.  I mean, we still had a baby so there was still sleeplessness, worry and doubt – but it wasn’t due to breastfeeding anymore.  I was free to focus all my nervous mama energy elsewhere.

Things got better and better and soon I was realizing how nice it was that I didn’t have to think about packing bottles and formula each time we left the house and that I barely had to wake up for those night time feedings – since we co-sleep I just had to roll over to nurse him back to sleep.  

As things fell into place and Leo and I developed a happy and easy nursing relationship I made sure to do several things:

• Thank everyone in my pediatrician’s office and at the midwife center.  They really empowered me to keep at it when my supply was working so hard to establish itself.  There is a world of difference between hearing “Well, your baby is not gaining as quickly as we’d like to see, but let’s have him come in for regular weigh-ins and see how he progresses.  I wouldn’t worry, though, look how energetic he is and how bright his eyes are.” versus “Your baby has not gained enough weight.  It looks like you aren’t making enough milk, have you considered supplementing?” 
• Write a letter to WIC thanking them for offering breastfeeding support through their program.  I know that without the lactation consultant who came to my home and was knowledgeable and encouraging I would have thrown in the towel.  One morning in particular – she single-handedly brought me back from the edge.   
• Nurse in public.  Leo has nursed in restaurants, rest stops, parks, museums, stores and concerts.  I remember how inept and self conscious I felt that first time I attempted to feed him out of the house.  I went home and googled images of women nursing in public – "do they pull their shirts up or down?"  Now that I’ve figured out what works for us, I use it – and hope some new mama is encouraged.

Leo turns one in a few short days.  For the first six months of his life he was exclusively breastfed.  He is now developing a love for solid foods, but is still nursing regularly.  I’m so grateful I have been able to nurse him for a whole year and don’t see an immediate end in sight for our nursing relationship.  It has been such a joy.  From the newborn snorty rooting, to the feeling of his little hand rubbing my arm, to seeing his eyes rolling back in his head when he latches on, to his current acrobatics (last night he was nursing while standing on one foot and somehow running the toes of his other foot through my hair…) – it has been such a special part of my life and I’m so glad I stuck it out during those tough early weeks.