Let's talk about the "B" word

I notice that when you become a mother, there are two questions that people are likely to ask you:


1. Are you breastfeeding?

2. Is your baby sleeping well at night?


In today's post, I am going to tackle the first question and share my breastfeeding experience with you.


This is certainly not a topic that is easy to discuss given that I don't even feel comfortable talking about it with my close friends. What is my motivation in taking this bold step?


Well, I believe I am not alone in suffering from lactation failure. Apparently, at least 5% of women have medical conditions that make breastfeeding extremely difficult or impossible.


I feel that I need to speak up and raise the awareness that there are mothers who are not able to breastfeed their babies totally despite their best intentions and utmost efforts. Support should be given to them, not harsh judgments or patronizing words.


One day, I had a meltdown of sort at the hospital and the pediatrician on duty shared with me that she too couldn't breastfeed her child. That comforted and helped me feel less alienated. I am grateful to her and hope to pay it forward. If you're a mom who desires to breastfeed your baby but can't, I write this with you in mind, dear sister.


My position on breastfeeding

To begin I like to state my position upfront that I am pro-breastfeeding. I believe that "breast is best". Thus, I hoped with all my might that I could give my daughter "the best". At the same time, I do not believe that "formula is poison" either since I grew up perfectly fine and I was a formula-fed baby.


I believe that breastfeeding is not for everyone as I have friends who faced great challenges in breastfeeding their babies and they ended up beating themselves up and suffered greatly. Given my background as a mental health professional, I know that maternal mental health is very important because a stressed out and depressed mother is not good for the baby.


Consequently, I told myself when I was pregnant that I would give my best shot and should I fail, I would accept it gracefully.


The reality

Despite having this firm belief, the truth is I beat myself up, felt like a failure, inadequate and ashamed that I couldn't produce sufficient milk for my daughter. More so since she is a preterm baby and would strongly  benefit from breast milk. It seems as though I am hardwired to feel this way because I remember feeling super frustrated with myself for beating myself up like that.


My circumstance

The circumstance surrounding the birth of my baby was far from ideal. First, she was born at 32 weeks and I didn't even get to see her when she was born, much less to place her at my breast for her to nurse. Also, she was not able to suckle then. I started pumping several hours after her birth and followed a schedule to the best of my ability. Unfortunately, my own health crises interrupted the schedule as my blood pressure skyrocketted two days after her birth.


Instead of resting and focusing on recovering from the surgery, I was also under tremendous amount of stress and shock as I confronted the reality and implication of my daughter's prematurity. We didn't have much support as none of our family members could come and help out. This resulted in me not eating and resting very well.


After I was discharged from the hospital, we shuttled back and forth from the hospital and home and I could barely keep up with the pumping schedule. Exhausted, I did my best. I tried different types of schedule as well starting with the three-hourly pumping, cluster and power pumping. Nothing worked. When Olivia was ready to suckle, I placed her at the breast but because of the low volume, she got frustrated quickly.

Enter the galactogues

As a guideline for milk production, I was told that milk usually comes in after five days and that after seven days, the estimated amount is about 300 to 500 ml. In my case, after eight days, I only produced a grand total of 2.6 ml (after 7-8 sessions of 20 minute pumping).


Using a syringe, I collected my milk drop by drop. I started with a 1-ml syringe and went up to 5 ml and eventually used the bottle. I couldn't use the bottle initially because the amount was so meager that I felt super demoralised and depressed.


Also, I was using the hospital-grade pump that I rented and I hand-expressed after I have pumped. Each pumping session lasted me about 40 minutes when I was done. One lactation consultant actually told me that I worked too hard when she found out.


I started taking galactogues after a week to help increase the supply. Every morning I had oatmeal for breakfast, drank copious amount of water and lactation tea. The nanny made lots of nutritious soups that have worked for many mothers she knew. She asked me each day if I had more milk and I had to disappoint her each time.


I tried different brands of lactation tea that have received wonderful testimonies of their effectiveness. I was hopeful. After finishing three to four packets of tea, my milk supply did increase but the amount was barely sufficient. The volume increased to 20-30 ml for the entire day. I also finished two bottles of fenugreek and started on several courses of domperidone. The latter did help to increase the supply and I am still taking them today.


I don't know of anyone who won't be demoralised when she looked at the amount produced on the left picture. I couldn't help but cried. It's even worse when I accidentally spilled whatever little amount that I had collected. I had several incidents of meltdown that were related to breast milk and my poor husband became the punching bag. It was ugly.


Still I persist. Instead of pumping 7-8 times, I reduced the number to 6 because I noticed that regardless of the frequency that I pumped, the amount was comparable. I knew then that my problem has a primary cause as it has not responded well to any of the interventions. Still I persist.


On day 90, I was getting more milk (relative to what I had in the beginning) but they were still in the 60-80 ml range in total. That's the amount that I feed my baby everyday, which is about 10 percent of her total feed right now. Hence, I always maintain that my breast milk is the supplement to the formula.


I remember vividly the look of shock and horror on my OBGYN's face when i told her that I only managed to produce 1 ounce of milk after 6 weeks. She breathed easier when I said Olivia is on formula as well.


I am grateful that my daughter has formula to drink. Had she depended on my breast milk alone, she would have starved to death. Some may think that I set myself up for failure when I started Olivia on formula. But what other choices do I have when I only had drops of milk in the first few weeks?


Lessons learned

I am still pumping today and it's day 103. Looking back, I am glad that I gave breastfeeding a shot and lasted this long. I have set a date to return the breast pump and I may or may not continue with a hand pump or hand expression. I don't know yet. I am just gonna take one day at a time for now.


This entire episode taught me important lessons. As a high achiever, I always believe in working hard to achieve my goals. I worked hard in this case, yet the outcome is not within my control. It was most humbling. Related to this lesson is that I should not always focus on the quantity. Most lactation consultants have reminded me that whatever amount that I can give to my daughter is better than none.


I am also raised to believe in efficiency. What I was doing was completely inefficient. Imagine spending 25 minutes to produce 10-15 ml of milk each time. That's only half an ounce. I struggled with this a lot and wondered if I could have used my time better. I decided that it was not a waste of time. Here's an encouraging quote from a book I read:


"It is not about how much milk you were able to produce or how long you were able to breastfeed. It is about the commitment you made to give your baby the best start in life and the tremendous effort you put into pursuing that goal."


Because of the indoctrination that breast is best, I lose the perspective that motherhood is much bigger than feeding your child breast milk. While it is true that the bonding derived from breastfeeding is incomparable, I can still bond with my child in many ways. What is of greater importance is that I have the capacity in my heart and head to provide, care, love and respect her. To do that effectively I need to take care of my own wellbeing. No one can do that for me.


I only found out about lactation failure and the condition called Hypoplasia or Insufficient Glandular Tissue recently, which I suspect is what I have. Truthfully, it gave me much relief. It's weird that none of the lactation consultants mentioned this to me. Perhaps they didn't want it to be a discouragement to new mothers.


Given that this condition affects only a minority of women, there is a lack of awareness and knowledge about it. I presume mothers who have successfully breastfed their babies would not be aware of this condition. To mothers who believe that all women can breastfeed, I feel the need to assert that it is not true. When this is the only truth that one preaches, it isolates those who have been afflicted.


Finally, I learn to appreciate my body and give thanks for it. Initially, I felt like my boobs have failed me. But on hindsight, I realise that my breasts and entire body have supported me through this ordeal and I need be grateful. I have subjected my breasts to all sorts of painful  manipulation. Also, they did provide some valuable milk for me to offer to my daughter. I am reminded to appreciate and take better care of my body.


In part two of this post, I like to share some of the coping strategies that have helped me. Please do stay tuned for it.


Please share this post with anyone you know who may be struggling with this issue. Sharing is caring. Spread kindness and understanding, not judgment and criticism to all mothers, whether they breastfeed or not.


Relevant book/article: