I am posting this here so that anyone intrested may see it. I don't think it would help other people as much if pre-surgery and LCs/LLL leaders etc can't see information like this. I originally wrote this as a handout when I was invited to speak to a group of LCs in my area about being BFAR. She was about 8 months then.

My daughter was born at home weighing 7lbs 4oz. She had trouble gaining weight for nearly the first year even with formula supplementation....

The first week
Right after she was born I tried to nurse her, but neither of us knew how. She just kinda licked and the midwives told me this was normal. I had trouble getting her to latch on that first day. When the midwives stoped by for her one day check they showed me another way to latch. My milk came in when she was 50 hours old. That whole day nurseing was much easier. That night she fed for about 30 min on one side while the other side got engorged. After we both slept for 4 or 5 hours. When we awoke I couldnt get her to latch on. I figured it was because now both sides were engorged. I tried to pump a little to make them a bit softer and easier for her, but it still didnt really work. I had two hand pumps, an Isis, and a manual Medela. The only milk she got was by using a dropper to feed her the little milk I did pump. The next day, my midwife came back for her 3 day check. She suggested to try the football hold so my baby couldnt kick me and hurt my engorged breasts. It helped with the kicking, but she still had trouble latching. The midwife gave me the number of a lactation consultant. I called and managed to get an appointment for the next day. (which was awesome because we didnt know what to do and would have had to get some formula from the store without any help until Monday which was thier next free appointment) That night was horrible. She couldn't eat at all. The next day I was so happy to go the the LC, Alison. She did managed to get my daughter latched on, but she said that the engorgement combined with the tightness of my skin from my surgery made it very hard for my daughter to latch on. She had lost about a lb since birth. Alison put us on a scedual of attempting to nurse, iceing, and pumping (we rented a Symphony). If she couldn't nurse then we had to finger feed her at least 1.5oz. If we had pumped milk then we used that first, and supplemented with organic soy formula (Baby's Only). We had to do this every two hours. It was very tireing. At some point she started latching on. I was too tired to remember when that was.

The first month
When she was eating for hours at a time and was gaining less then an oz a day Alison suggested that we only nurse for 40 min or so, then "top her off" with the finger feeder, she suggested that this may be up to 6oz of formula a day. We did that for maybe 2 days, never getting to the 6oz (perhaps 3 or 4). Then I managed to pump some milk while she was being finger fed and I gave her that twice in one day (no formula), neither time did she finish what was in the feeder. The next day we had another appointment with Alison and we didnt use the finger feeder at all before the appointment (Alison wasn't happy about that). She had gained 5oz in 4 days. We tried to just nurse, with no supplement. In 4 days she lost .5oz. Not good. We started to use the finger feeder like an sns. 2oz 3 times a day. She finally started to gain weight and was at 7lbs 6oz at one month old. Finally over her birth weight.

2-4 months
After 6 weeks she was gaining well and Alison didn't see a need to contiune to see us. Over the phone she reccomended that I try herbs or maybe dom to help my supply, but didnt go into details. I started taking fenugreek pills and drinking mothers milk tea. But its hard to make tea with a baby in the other hand so I didnt always get as much as I should have. So, I ordered some of Motherloves More Milk Special Blend. It tastes terrible, but was easier to take then the tea, which I still tried to take. My daughter useually didn't finish her supplement so I figured that I was making more milk. She avraged about 4oz a day.
At some point my finger feeder had gotten a slit in the tubeing. The timeing worked well because she was starting to take all 4oz in one sitting and the finger feeder only holds 2oz and it was getting to be a pain to refill it. I ordered the delux kit from Lact-Aid. The thick organic soy powder didnt go through the strainer AT ALL, so I didnt use it.

I didn't like that I didn't know how much she weighed. I had no idea how she was doing. Was I making enough? Was she getting enough to eat? Fortunantly my midwives have a scale that anyone can come in and use. I started weighing her weekly at 3 months old. She didn't seem to be gaining much, but I didn't really know what to do.

At her 4 month appointment with her pediatrition she had only gained 5oz since her 2 month appointment. Her ped was concerned, but didn't know much about supply issues. I told him that I give her supplement and he suggested to increase the concentration of powder to water to make it 24 calories instead of 20 per oz. He wanted another weight check in two weeks. (he is very pro bfing and he didn't want to suggest to only use formula)

4-6 months
Two weeks after her 4 month appointment we had another weight check. She had gained over a pound (10lbs 13oz gained 1lb 3oz in 2 weeks). That was great. We scedualed another weight check for two weeks to see if the trend continued. So at the 5 month appointment when she had lost 2 oz (down to 10lbs 11oz) her pediatrition was worried and ordered some blood tests as well as a sweat test to rule out metabolic disorders. I let them do it. But I knew the problem was me.

We had another weight check a week later since my husband was comeing back from Iraq and I was leaving the state to be with him. (11lbs 2.5oz thats 7.5oz gain in one week!) Her doctor advised us to get a new pediatrtion in NY asap. I tried, but the only one near us (according to my insurence company anyway) was not intrested in weight checks and would not scedual an appointment until after her 6 month 'birthday'. I decided he would be of no help and ordered my own scale.

Since she was nearly 6 months old, and my husband was back (and all of that tubeing was becoming a HUGE hassle since she had learned how to grab things) we started giving her the supplement in a Nuby Sports Sipper. I got a Pump In Style and started pumping while my husband fed her.

months 6 and 7
We started her on solids just after 6 months. She was more then ready and loves bananna. But she doesn't get very much in her mouth.

There is no where in our area to buy the supplement that she eats so I had to buy extra before we moved. Unfortunatly since we had increased how much supplement she got after I moved (from 6oz to 8oz), what I had brought didn't last long. We ran out. I had ordered some online the week before, but it didn't arrive for over a month. I was very upset about that. Unfortunatly due to that she lost a few oz. I hated that, but what could I do?

On her 7 month 'birthday' she weighed 13lbs 1.25oz no diaper, just had 4oz supplement. We started giving her 8oz in her sippy and letting her pick how much she wanted at first. Normally she would take 5 or 6oz and then finish it off later. After a little while of that she started taking all 8oz in one sitting and then spitting it up a little while later so we broke it up into 2 4oz servings.

After we got back on track she started gaining well again. Then her weight gain started to slow down and she wasnt pooping as much so we increased her supplement to 10oz a day.

8 months
She gets 10oz of supplement a day now (6oz then 4oz). I pump .5-2oz a day, avraging about 1oz. I pump 1 or 2 times a day for about 10 mintues with my Pump In Style. As of Monday the 9th of October she weighs 14lbs 3oz.

She eats solids once a day. Useally 1/3 or 1/2 of a bananna or something similar.

She nurses at night as well as all day. She just doesn't nurse for as long as she did when she was younger.

The worst of it
The worst thing about being BFAR is that I chose to formula feed. I cant give her what she needs because of something I chose to do. When shes hungrey its my doing. She's small and didn't gain weight well because of me. It's all me.

Update:
She upped to 12oz of supplement a day and then refused to take it around 11 months. Probably because she was really getting into solids. As her 3rd birthday aproaches she still nurses to sleep most nights. Since I am pregnant I don't know how much milk she actually gets now, but she still seems to like her 'nilk'.

Notes
My daughter got Babys Only Organic Soy formula to supplement the milk she does get. Alison reccomended it. I later found out things about Babys Only that make me like it quite well. Things like thier position on breastfeeding (they only make "toddler" formula) and thier advertising practices. The website for them is: http://www.naturesone.com/index.php

My surgery was less then a year before we got pregnant. She was born almost exactly a year and a half after it. This was not much time for recanilization to occur. I was not planning on having children so soon or I would have waited.

She was born at home so I didnt have to worry about a hospital staff member sabatoging my efforts. My midwives were VERY pro bfing, but they were not knowledgable in helping me with being bfar. I also think I was lucky that she didn't have any other problems like being tounge tied or having a bad latch.

Thank you for sharing. It's all such a difficult experience. I'm glad you are sharing so others can be helped.

Yvonda