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Eleven years before the birth of my daughter, I had a breast reduction. At the time, I believed it was the best thing I’d ever done and my surgeon’s warnings of possible problems with breastfeeding in future seemed quite distant and irrelevant – besides I was never breastfed and being relieved of huge, uncomfortable breasts was more important to me.

Once pregnant, I started learning about the numerous benefits of breastfeeding and was quite distraught at the prospect of not being able to give my child the best start in life due my earlier decision of “vanity.” There were varying reports regarding my chances at successful breastfeeding. I had heard of some obstetricians telling their patients that breast reductions lead to mastitis and that even attempting to breastfeed would be risking infection. The plastic surgeon who performed my reduction said I had a good chance since a number of years had passed since my operation, while a lactation consultant thought I would have no problem. Since I was producing colostrum and able to express a few drops during pregnancy, I was hopeful.

The birth was a glorious (albeit painful!) event and my beautiful baby, Mila, was put to the breast immediately where she happily suckled away (almost constantly). My milk came in on the 3rd day, and although I never felt engorged and didn’t leak a drop, I was still optimistic about my ability to provide all the nourishment my child needed.

Her weight gain was slow and by 6 weeks, I had to face the fact that my breasts were not producing the goods. After many tears (mine and hers), we had to start supplementing.

Thankfully, I had come across a picture of a breastfeeding device in an American parenting book, which was designed to assist adoptive mothers who wanted to breastfeed. I researched it on the internet and eventually tracked down the local Medela agent who sold me one of these “Supplemental Nursing Systems” (SNS).

Had it not been for the SNS, I would have had to give Mila a bottle. This works against the breastfeeding process as the breasts receive less stimulation and therefore produce less milk. Since I was not producing sufficient amounts anyway, it would probably have meant that I would dry up completely. The added risk of nipple confusion could also mean the beginning of the end of my breastfeeding career.

The SNS works by supplying the baby with additional milk (either expressed milk or formula) through a small feeding tube which is inserted into the baby’s mouth while she feeds at the breast. In effect, it creates a cocktail of your breast milk and the supplementary feed. Since the baby is still suckling at the breast, the breasts are continuously being stimulated to produce more milk and it therefore assists in keeping the breastfeeding going rather than counteracting it. (Some adoptive mothers using the device were actually able to stimulate their breasts into producing milk even though they were never pregnant and did not give birth!)

Once I started supplementing, Mila gained 300 grams per week and slept peacefully for up to 6 hours at a time (to my relief). I happily nursed with the SNS for months and had to answer many questions from curious onlookers – no-one I encountered had ever seen such a device before. Once I started speaking openly about my situation I realised how many other women silently struggle with insufficient milk supplies (whether they had had reductions or not). Many women seem to abandon their breastfeeding attempts in favour of the bottle because they are uncertain of the amount of breast milk their babies are getting or if their babies are even slightly lower on the growth chart than their formula fed friends. For most people, the choice has been either breast or bottle – with supplementing usually being a short step on the way to bottle feeding.

In addition to using the SNS, I also tried every conceivable remedy to increase my milk supply – from homeopathic remedies, lactation teas, alfalfa sprouts and fenugreek seeds to berry juice, syrups and even milk stout. (Eglinol being the only thing I didn’t try.) Although all these probably contributed to keeping my milk supply up, I found that expressing with a hospital strength breast pump for approximately an hour a day helped tremendously. From only being able to express 25 ml per breast in a 50 minute session, I went to expressing 120 ml from a single breast in one 15 minute session! Being able to measure the output of “liquid gold” also provided the motivation to keep going.

Mila is now 6 months old and I am happy to report that I am still breastfeeding successfully and only supplementing approximately 150 ml per day. (I used the SNS and breast pump for about 4 months – until Mila went onto solids.) I managed to overcome my feelings of not being a ‘perfect’ mother and find comfort in being ‘good enough’.

With all the focus on BREAST IS BEST, it’s easy to feel guilty and inadequate when you are not able to nurse successfully. Thanks to clever inventions like the SNS (and of course, loving and supportive husbands, friends and family), a constructive compromise can be found.

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