I had my breast reduction when I was 21. I was pleased to some extent with the results, but they were still a good size D and I was disappointed with that. I was told I would be made a C. I went back to the surgeon, and he agreed that they should be made smaller and offered follow up surgery (at no cost). I decided not to, with the thought that it may affect my ability to breastfeed even more than it had.
Two years later I became pregnant. I straight away set out to find out all the information I could to help me get off to the best start. My sister found the BFAR book on the internet for me, and I read it from cover to cover several times. I rang around to find a lactation consultant to talk to before having my baby, and I got shrugged off by several saying that there was no problem yet, and I would have to make an appointment when I’d had the baby and was having difficulties. Mind you, their waiting lists where five months long. I was really upset that I couldn’t find any help. Eventually my sister had been talking to a nurse who did lactation consulting. I made an appointment with her, and she seemed to really understand the issues for a BFAR mother. She gave me similar advice to the book, and was there for telephone consults after my baby was born.
I had Lara feeding within half an hour of having her. She latched on beautifully. I developed extremely sore nipples, which didn’t resolve till about 10 weeks. It was incredibly painful. I asked lots of midwives and nurses and they all said she was latched on well but my nipples would just need "time to adjust." [Diana's Note: This is absolutely incorrect. Nipples do not need time to adjust. Painful latching, particularly when it lasts as long as 10 weeks, indicates a possible problem with baby's tongue, usually tongue-tie, which may not always be the most obvious type (there are four types).]
In the hospital, I set my alarm every 2 ½ -3 hours to feed her. The midwives thought I was a bit pedantic, and said that I could just let her sleep for 6 hours if she wanted to. I was determined to build up my milk supply as much as I could so I ignored them. I asked for a breast pump after 3 or 4 days to help with my supply, and I felt once again they thought I was just getting worried about nothing. Lara lost 9 percent of her birth weight in three days, and had only put on 40g before leaving the hospital. I insisted that I wanted a prescription of domperidone, and reluctantly they gave it to me.
Coming home was terrible. Lara cried constantly day and night. I was so shell shocked and sleep deprived – I had no idea it was going to be that hard! I took an hour to feed her, and was trying to feed her every 2½ hours. On the occasion I could get her to sleep, I hated like anything having to wake her to feed. I tried expressing with an electric pump but could only get 5ml after 10 minutes at each breast. I soon gave up because there didn’t seem like much point.
She continued to make small weight gains. My child and youth health nurse said that some babies only put on small amounts of weight and that it was fine. I knew she wasn’t fine. Especially as she had fallen into the 50th percentile for her weight, and was born in the 90th. She was also in the 95th percentile for her height. I rang my consultant and she said to put off giving her formula as long as possible [Diana's Note: When a baby is showing clear signs of insufficient intake, supplementation is absolutely warranted. This mother's instincts were correct]. At six weeks she was putting on 100 grams a week on average (they say baby’s should put on 120-200g). She was still very unsettled and always cried after feeds. I started giving her 30ml after some feeds via syringe. She always gulped it down hungrily. It was so hard to know if she was crying because she was hungry, especially as the child and youth health nurse and paediatrician thought she had reflux as well.
I continued to take the domperidone three times a day, and took fenugreek capsules. I have no idea what sort of an effect these had on my supply. I ate cashews [Dianar's Note: cashews are not a known galactagogue] and tried to feed her after warm showers when possible to help with my let-downs. I never felt them but knew the milk flowed more freely when I was warm.
At six weeks she put on 300g. I was ecstatic. At seven weeks she didn’t put on anything. She was still crying and very unsettled. I started giving her 50 mls three times a day in the afternoon/evening. I gave it to her via syringe, but eventually swapped to the bottle when she didn’t seem to have any problems swapping between the breast and bottle. I felt very alone, as I felt stupid breast and bottle-feeding, so I never wanted to go anywhere so people wouldn’t know. I never told anyone I had the breast reduction, especially as I still had quite big boobs I felt dumb.
Eventually I insisted on a referral to a place where people get help with unsettled babies. They test weighed her (before and after feeds), and in a 24 hour period, I was supplying her with two thirds of what they worked out she needed. With the supplementation I had been giving her anyway, she was only missing about 90 ml a day. I doubled my dose of domperidone, and started line feeding after feeding without the line first. My supply definitely increased doing this.
Unfortunately, by this stage I was stressed to the maximum. I didn’t know how I was going to be able to keep up the line feeding at home. I was already feeling lonely and isolated, and there was no way I was going to go out in public with the line feeding. I was also worried I wouldn’t know how much to put in the line, and when I should increase it as she got older etc.
At nine weeks, I decided to swap completely to bottle-feeding. I was devastated. I definitely grieved over my inability to fully breastfeed. It wasn’t the nutritional value I cared about, but more that all Lara needed to survive was me. I continued to give breastfeeds in the morning and at night, but would still offer a full bottle afterwards. Funnily enough, my boobs had never felt so full before, even when my milk "came in" whilst in hospital. I cried nearly every time I thought about giving up breastfeeding for days. Lara drank about 400ml a day more than they said she needed, and still does, which means that she was probably pretty hungry.
It was definitely the best thing to go to bottle-feeding when we did. My stress levels went away almost completely, and when she cried I knew it wasn’t because I was starving her, so I could deal with it more easily. We are both so much happier now. I know I gave it my best, and don’t regret anything. I will try as hard again with my second baby, but would try and line feed to give her more formula earlier than I did with Lara. I also think that next time, I will continue to breastfeed her for longer (with top ups), so that with my third child hopefully my supply will be better.