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Breastfeeding and the Tyranny of the Scales

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Most mothers will gleefully tell you horror stories about birth. Anything from how many hours/days they were in labour to how they pooped in front of the doctor (or 10 doctors) and had their girl parts torn asunder. But nobody tells you, or at least nobody told me, how difficult breastfeeding can be.

Babies lose up to 10% of their birth weight in the days following birth, before the mother's milk comes in. This is usually from 3 days or so after the birth. More in the case of a cesarean section. They're supposed to gain all this weight back again by the end of their second week. Let's just stop and think about that for a second. Veronika was born 3250g. When we left the hospital on day 5 she was 3040, and my milk came in the next day. That means she had 8 or 9 days to gain 210g. The World Health Organisation recommends a minimum weight gain of 125g per week. See the first problem here? At any rate, she reached 2 weeks without regaining her birth weight, and at our daily weigh ins with our midwife, she started to express concern that Veronika was not gaining weight fast enough. She reached her birth weight again one day before 3 weeks. Ok, slow weight gain but nothing serious. Especially considering how small I am.

At this point I should mention the way the daily weigh ins were conducted. The midwife came at different times each day and the weighing didn't happen at the same time in relation to feeding. So one day she might weigh the baby right after I fed her, and the next day would weigh her right before I fed her, and then she would exclaim that the weight was stagnating and we would have to start supplementing and go to the pediatrician because there could be something wrong. At any rate, she said, I might not have enough milk, or the baby might not be strong enough to get it and if I really wouldn't start supplementing, then the only way forward was the following routine:

Before feeding, do a hot compress for 5 minutes, then pump for 5 minutes to stimulate letdown (make the milk start flowing), then feed the baby from that side. Then pump for 5 minutes after she'd fed on that side, then swap sides and repeat. Then feed the baby the milk I pumped. Every 2 hours including all night feeds. No matter that the baby is screaming to be fed while I'm going through the first stages of the routine. Maybe if I did this I would have enough and Veronika would put on enough weight.

Remember this is a few weeks after a pretty rough birth (33 hours labour and then a cesarean section), getting very little sleep and going out of my mind worrying that I couldn't feed my baby. One night after this routine I went to the toilet and looked down to see blood flowing out of my cesarean section incision. Oh, said the midwife, but try to relax because a lot of the trouble you're having is probably caused by stress.

Martin and my mother were both telling me to throw away the scales, and stop listening to the midwife because we had a happy healthy baby and how I wish now that I had the confidence to have listened to them. After about 2.5 months of making myself completely crazy, convinced I had a chronically low milk supply and trying everything I could think of, find in a book, or read on the internet, I decided that I was being selfish to keep trying like this, and I was doing it for the wrong reasons (stubborn refusal to admit failure rather than doing what was best for Veronika), I stopped taking all the crazy medication, stopped timing each breastfeed and decided that if we had to supplement, then we had to supplement. That night when Veronika woke up to feed I had more milk than ever before.

Veronika is now almost 5 months old, and we're still supplementing, and I've come to terms with it. I no longer feel when I give her a bottle that I'm feeding her poison. I feed her as much as I can and if it's not enough she gets a bottle. We started off with about 100ml extra a day and she's up to maybe 250ml extra a day now, so she's still getting the majority from me, and we're both much happier. I still occasionally meet a well meaning mother (MILS I believe is the nomenclature) who asks me if I tried x or y, or maybe if I had just done z I would have solved all my problems, but I can now ignore it.

For the record, here's a list of the things I tried (in no particular order)

- Fenugreek
- Blessed Thistle
- Domperidone
- Thyroid Hormones
- Feeding every hour
- Pumping before, and after feeding
- Pumping between feeds
- Pumping in the shower
- Feeding in the bath
- Taking 3 days off to have a breastfeeding "holiday" and do nothing but feeding
- Breastmilk tea
- Malt coffee
- Malt beer
- Wheat beer
- Breastfeeding massage oil
- Hot compresses
- Cold compresses
- Acupuncture
- Oats in various forms
- Green papaya

I'm pretty convinced that I don't have any fundamental reason for low supply, other than getting off to a really bad start. I'm writing this in the hope that some new mother who is being terrorised by daily weigh ins reads it, and does what I didn't have the courage to do - throw out the scales and instead look at your baby.

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