No milk

This is the breastfeeding post, as you might have gathered from the title.

Breastfeeding my baby is what I really hoped to do. I know the benefits for both mom and baby. And it just sounded so darn convenient compared to formula feeding. I also went in knowing that it wouldn't be the end of the world if Gummy needed to be formula fed. This baby would be fed and loved, no matter what.

I had worries all along about whether I could breastfeed or not. The same issues that have caused my infertility would possibly (probably?) make it impossible for me to breastfeed. As a teenager, puberty sort of passed me by, and my breasts never really developed fully (and I never menstruated without meds, and never ovulated ever. Hence, the last 4 years). I worried that milk glands had not been fully formed and so wouldn't produce milk. Also, I worried that because my HPG axis (hypothalamic-pituitary-gonadal axis) is screwed, and that the pituitary is responsible for releasing prolactin, I would simply not make any prolactin (I felt confident that my body could make oxytocin, you know, since I have close relationships with other humans).

You would think that 1) hypothetically nonexistent milk glands and 2) a potentially missing essential lactation hormone would be enough to put sticks in the wheels of mama who wants to breastfeed. But no. There were more sticks.

Breastfeeding started off with a bang. And by bang, I do mean flourish...and pain (oh, my nipples paid for this in blood). Gummy was nicknamed 'the barracuda' by different nurses at the hospital. Her latch was ferocious. I was over the moon to see colostrum. I could hardly believe my eyes. My body might be able to do this after all. My confidence took a hit when we had a 16-hour cluster feeding session in hospital (hospitalization #1 - the birth) where Gummy grew increasingly distressed, and ended in her spending a few hours in the nursery being given formula while I wept in my hospital bed. We did start supplementing at the breast with a narrow feeding tube after this, and it seemed to be a good solution until the time when My Milk Would Come In.*

And then I was separated from my baby for 24 hours when she was 5 days old (hospitalization #2).

And then I had a massive postpartum hemorrhage because of retained products of pregnancy (hospitalization #3). As far as one's milk not coming in, the retained products is a usual suspect. Placental bits left in the uterus tell your HPG (well, the H and the P mostly) that you are still pregnant, so there is no need to lactate: placenta's feeding your fetus (except that your fetus is now a baby, and she is crying to be fed). I spent about 36 hours neither feeding nor pumping during that ordeal, and then resumed pumping on Sunday and putting Gummy to the breast on Monday.

We had a good chat with the lactation consultant on the day of discharged from #3, and much help from or dear friend who is a midwife with a special interest in breastfeeding. I left with a plan to help my body calm down from all the stress, recuperate from the physical strain, and help promote lactation while balancing the need for rest. The lactation consultant felt that while I may never be able to feed my baby 100% breast milk, there was a good chance that we could get back on the breastfeeding train. I went home and was pumping, breastfeeding with the tube, taking the herbal supplements, and spending lots of time skin to skin with my baby. I wasn't putting my expectations too high, but I was going to give this a good shot.

Sigh.

I have no milk. It's not that I have very little milk, or insufficient milk, or that my baby is now used to living large with formula and is turning her nose up at the breast because of the bird-sized portions. No. I have absolutely no milk.

Trying to guess at the why is a circular exercise (see above). There are so many factors that could explain it, not to mention the interaction between all the factors.

I went to see my family doctor yesterday and we talked about the possibility of meds (dom.perido.ne - I think it isn't prescribed in the US, but it is prescribed commonly for lactation problems in Canada). There are risks in term of this medication (although those risks have been cogently downplayed by breastfeeding advocates - see this website for more info). My family doc was reluctant to prescribe it to me at first, but then changed her mind. She gave me the prescription, but said I had to go for an EKG first.

And that's kind of where I hit my breaking point. I didn't go get the EKG and didn't fill the prescription. Instead, I went home and pondered this some more. And talked to Mr. A. This is starting to feel ridiculous. And the risks to my health now scare me more after the postpartum circus. And what tells me that this drug is going to make me lactate at all. How much more work do I put into this before I surrender completely, and just embrace my baby's formula-fed double chin and tell myself that she will build her immunity through exposure?

That's about when the GUILT hits me, and the nagging voice inside (the superego?) tells me I should move heaven and earth to try and breastfeed her.

And then I develop an overwhelming urge to take a nap. Because, you know, we've already moved heaven and earth just to have her. 
 

*italics added to emphasize the mythical tone of this pronouncement.