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  • Erin Stevens

Ounces


Breastfeeding is hard. I knew that before I was pregnant. I've told patients that forever. I didn't necessarily expect a beautiful and magical experience.


It is so hard.


I had to stop directly breastfeeding. I've been an exclusive pumper for the past 6 weeks or so. I keep trying not to measure my worth in ounces, but it's hard when I'm pumping so much love into each one.


Breastmilk is now a very complicated entity to me. It's symbolic of struggle, sacrifice, perceived failure, triumph, worry, joy, and a bond to my baby that only I will ever have. It's admittedly an obsession at this point that is a bit of a trauma response - every decision I've made in the last couple months about what to drink, eat, and do has been almost entirely based on how it will impact my breastmilk, my baby's feeding schedule, or my pumping schedule. I document every ounce pumped and every ounce she eats and am a sucker to buy anything to improve lactation or my pumping game because it makes me feel like I can control this beast. I still keep thinking of myself as a "just-enougher" despite the fact that today I bought a small chest freezer to store my stash of frozen milk so it stops taking over our normal freezer. I always have a lingering worry about things going wrong.


My experience with breastfeeding has so many parallels to our fertility struggle. My body's refusal to carry out a natural process appropriately brought a deep sense of personal failure with an all-consuming desire to fix it. That makes it sound all negative, but I'm also so proud of the hard work I've put into this and happy that I've been able to feed her breastmilk for three months with no current plan to stop in the near future. I am so blessed that my pregnancy was normal, my delivery was amazing, my postpartum physical recovery was easy, and my baby is healthy, happy, and beautiful. I've simply had these flanking issues with creating a baby and then feeding that baby. I would have loved if we had conceived easily naturally. Instead, I needed the help of medications. That doesn't reduce the quality of the pregnancy. That doesn't change the fact that we have a perfect baby who we love more than anything. I would have loved to breastfeed my baby for many more months. Instead, I'm now exclusively pumping to give her expressed breastmilk and putting her at the breast maybe once a day when she needs soothing rather than with a primary goal of feeding. She's still getting breastmilk, and we're both better off for the change away from trying to feed at the breast and pump to supplement every time she's hungry. I can be the best mommy for her *because* I stopped directly breastfeeding.


I've been using the Instagram account for my book to essentially photo blog about the not-so-sunny parts of my own postpartum experience. It's pretty much all about breastfeeding/pumping. I've compiled the relevant posts below. I'm not looking for advice, sympathy, or a pat on the back. It's therapeutic to write about it. I also share to normalize 1) talking about postpartum struggles, 2) talking about breastfeeding/pumping, and 3) every person feeding their baby in the way that works best for them.


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11/27/2020


Loooong post...


We went to our first peds appointment on postpartum day 3. Her exam was normal except for her weight. Every baby loses weight initially, but she was down slightly more than expected.


What I heard? Despite doing your very best, you're failing as a mother. You're not enough for her.


I could logically tell myself that she was born big (9#1oz) so had room to lose, her weight loss was barely out of range, she was going through diapers appropriately, she wasn't in distress, she was doing great otherwise. But emotions don't care about logic, and it's hard not to be sensitive about your self-worth when you're trying to sustain the life of a tiny human.


I was advised to pump after each feeding and then feed her whatever was produced after the subsequent #breastfeeding session. True milk doesn't come in for a few days after birth, and the initial stuff is a concentrated, nutrient-dense substance called #colostrum that's produced in small amounts. Sitting through a breastfeeding session and then taking another 15 minutes to pump out minimal fluid is disheartening. I cried many times that day and night. I felt defeated and worthless to my baby.


A friend who works with @lalecheleagueusa gave me encouragement and advice. I also had a virtual visit with a local #lactationconsultant.


My milk came in the following day and we worked on adjusting her latch. I was encouraged by hearing more swallowing sounds as she fed. She continued to go through diapers like a champ. She started spitting up, letting me know she was clearly getting enough. I stopped the pumping and supplementing because I knew it wasn't needed yet and wasn't helping my exhausted, hormonal self preserve any sanity.


Today we went back to the pediatrician, and her weight is going up well!


Ultimately I would have spent every minute pumping to supplement if it meant helping my baby. I would have added or switched to formula if it was what was best for her. Her needs are my priority, and any preconceived plans or expectations don't matter now. That's a tough adjustment for an anxious Type A planner, but I can do hard things for her.


12/4/2020


We went back to the pediatrician yesterday for follow-up. To recap, my little one was born not so little, lost a bit too much weight at her first peds appointment, gained appropriately by the time of follow-up a week ago. She should have been about back to birth weight yesterday. ⁣

Instead, she had lost some weight again. ⁣

She is peeing and pooping more than enough.⁣

She has no signs of dehydration.⁣

She had a normal exam otherwise. ⁣

She is not unhealthy. ⁣

And yet. ⁣

I feel like a horrible mother who's been starving my child. ⁣

The pediatrician recommended going back to pumping after each #breastfeeding session and then giving her whatever is produced via bottle after the subsequent session, which I had done for just a day after her first peds appointment until my milk came in. I'm scheduled to see a #lactationconsultant in person (I previously had essentially a virtual visit with a friend who works with @lalecheleagueusa and then a virtual visit with a consultant in the community) at the peds office in a few days.⁣

I know in my brain this is not my fault. This is certainly not her fault. Neither of us is choosing to create a problem. The only thing in the world that I want is ensuring her wellbeing. ⁣

My heart, though, has a dissenting opinion. My heart is full of self-blame. My heart is hurting. ⁣

We are going to keep working and doing whatever it takes to ensure she stays healthy and safe. I'm going to try to listen to my brain as much as possible in the meantime.


12/5/2020


Well, it happened. ⁣

I cried over spilled milk.⁣

And that's all I have to say about that. ⁣

12/8/2020



I've been pumping like crazy to supplement after feeds. While disassembling the pump parts for washing last evening, I ripped this duckbill valve. I immediately broke down. It just felt like I couldn't catch a break, like when I'd figured out somewhat of a plan, another setback arose. I felt so defeated.


I couldn't even initially think about the fact that it was 6 pm and Target was still open so we could easily replace the part. Putting things into appropriate perspective and thinking logically is difficult in the face of emotions.


We picked up two from Target and ordered six from Amazon, so this particular issue shouldn't cause me to lose my sh*t for a while.


12/10/2020


I don't have a #pumpingbra (yet...it should be arriving in one of the many packages of things I order when up in the middle of the night), so for now I'm using this high tech hair binder trick to keep the pump in place so my hands can be free while pumping forever.


12/12/2020


I'm a slave to my #breastpump at this point, spending a large part of my day sitting on the couch being a dairy cow. Hubs gave me an early Christmas present, and reading its 700 pages as I sit will probably be a more worthwhile distraction from measuring my worth in ounces than watching ER reruns and home improvement shows while endlessly scrolling through social media.


12/14/2020


A #galactogogue is a substance that may increase #breastmilk supply. (It's also just a fun word to say.) Oats, flaxseed, nuts, garlic, chickpeas, barley, hops, red raspberry leaf, fennel, and fenugreek are just some purported galactogogues. And by the time our #breastfeeding adventure is done, I'm sure I will have tried them all.


12/16/2020


At the beginning of last week, I was pumping 1 oz of #breastmilk or less during most sessions. This meant that while #breastfeeding my little one every 2-3 hours, I was trying to pump twice between most times she was at the breast to ensure I had 2 oz ready to supplement after the subsequent feed. Giving her a minimum of 15 minutes each time at the breast and spending 25-30 minutes pumping each time...well, you do the math on the rigors of that schedule. I was struggling to try to keep up and get some amount of sleep.


When I'd seen the #lactationconsultant at our pediatrics office, pumping and trying to supplement 2 oz of something (breastmilk +/- formula) after a majority of feeds was really her only recommendation. She looked at my baby's latch on one side for half a second and said latching was fine. She told me she wasn't sure what the issue was and asked if I had any idea as an #obgyn. She didn't give any tips on breastfeeding or #breastpumping more effectively or talk about ways to increase supply. She told me most of the patients she sees with a low supply are never able to increase it.


So stubborn me took to the crazy pumping schedule and started consuming every #galactagogue I could think of. I continued to try to improve latching. Instead of passing our baby off to Dad for the supplementary bottle feed, I would hold her and bottle feed her while pumping to try to increase my oxytocin response. This can be tricky but has been worlds easier now that I have #pumpingbras.


Being ahead of the game with potentially enough breastmilk ready to supplement for the whole day feels amazing. This amount would be nothing to many lactaters, but I'm going to take this as a win for now. It doesn't mean things will be easy now, but it makes me very hopeful.


12/26/2020


A bag of #breastmilk was apparently not sealed completely. It's amazing that 3.5 oz doesn't feel like much when it's freshly pumped but looks like a lot when it's spilled. Our fridge is getting a deep clean that it probably needed anyway. ⁣

With my supply issues, losing any amount of milk feels pretty crummy. This is like working hard, cashing a paycheck, and then having a few large bills fall out of your pocket. Are you going to survive? Yes. Does it really suck that it happened? Also yes. Are you going to think angrily about it even though there's nothing you can do about it? Definitely yes as well. ⁣


12/29/2020


Just need to say how wild it is that my body made this.


12/29/2020


I'm going to say it.


The f word.


Formula.


When you're #pregnant or #postpartum, you're inundated with messaging about how #breastisbest. There are some ways in which that's true, but it doesn't apply to every situation for every postpartum person or every baby.


You know when breast is definitely not best? If baby can't or won't eat from a breast.


We first started using formula 3 weeks ago. We'd met with the #lactationconsultant at the pediatrician's office who advised supplementing 2 oz of something any time our little one would take a bottle after #breastfeeding. I started spending an insane amount of my day pumping. It was doable short-term but would never have been sustainable and was not good for my mental health or sleep. Even so, I wasn't always making enough milk. I gave 1 oz formula on a couple of occasions. The first time I gave any, even though I know it's healthy and fine, I felt terrible given the stigma surrounding #formulafeeding. I gave it to her, though, wanting to meet the goal of feeding her enough so she would gain weight.


She did, although less than desired. She was otherwise healthy, so our pediatrician said she just might be pokey at gaining weight.


A couple of weeks ago, I started operating under the assumption that she's getting nothing or close to it with breastfeeding most of the time. I'm not sure why that's the case, but it seems to be true. I started giving her more in each bottle and began giving her formula for two feedings every day.


At our last two check-ins with the pediatrician (we're regulars there), she has gained weight appropriately, even more than expected at her appointment today. I'm so relieved and happy that she's healthy and on the right track, and that we were able to achieve that with the benefits of both breastmilk and formula. We would absolutely not be in this position without formula.


Depending on how my milk supply fares (it's slowly increasing!), I may or may not continue to give formula on a regular basis. We will figure out the right balance to keep her fed and healthy. Whatever that is is what's best.


12/30/2020


Holy. Moly.


To this point, I've been using a very good personal electric #breastpump that is touted as hospital-grade. My insurance covered most of it, but I paid an upgrade fee. The last #lactationconsultant I talked to (the fourth one for those keeping track) recommended I try an actual hospital-grade pump to "leave no stone unturned". Hospital-grade pumps are rented and reused, with any piece that comes into contact with the #breastmilk purchased as a personal kit. This one arrived yesterday, and I used it for the first time this morning.


Let me just say...heck yes.


With first use, I collected 50% more milk than my previous *best* pumping session.


I'm elated on the one hand. On the other hand, I'm kicking myself for not trying this a month ago. If these results are consistent, I would have a nice freezer stash by now, and my anxious, always-be-way-too-prepared-for-the-rainiest-of-days self would be sitting pretty.


C'est la vie. Going to stick with the happy feelings.


1/13/2021


I posted previously that I did my first #postpartumworkout day 11. I've been going for a couple walks each week and doing the occasional impromptu plank or set of squats (and, you know, toning my arms by carrying a growing baby around), but today on #postpartum day 53, I finally did my second workout. ⁣

I've been afraid of exercise. ⁣

I hesitate to say this next thing because I don't want to make anyone think negatively about their own experience, so I preface it by saying it is absolutely not normal and should not be an expectation. ⁣

My body was essentially back to normal by postpartum day 5. I don't weigh myself, but I could fit into all of my clothes and looked normal. Before I hit two weeks I wore a dress for family photos that before pregnancy I'd had to squeeze into and worry about sitting down. ⁣

I didn't try to do that. I was, again, not exercising. I was eating everything. ⁣

While I felt happy and lucky for that initially, as we struggled with little one's feeding and weight gain, I had to wonder if this rapid weight loss on my part was a contributor to my low #breastmilk supply. I didn't want to exercise and worsen that.

There's no true evidence of association between exercise and decreased milk production, but some people do report this, and with my every thought and action centered around my ability to produce milk, I couldn't shake the thought. I worried that if I exercised, my body wouldn't be able to support milk-making. ⁣

Avoiding exercise is, of course, problematic. Exercise has countless benefits for physical and mental health. In fact, it may *improve* milk supply for some people by reducing stress and improving mood. ⁣

So I'm back at it. Slowly. Because valuing myself is important too. ⁣

1/15/2021


When you have to squeeze in time on the treadmill around your baby's needs...


1/17/2021


I'm essentially a just-enougher when it comes to pumping. I usually produce a couple ounces more than the little one needs each day, but with the small amounts of milk lost with transferring containers or from what she can't get out of the bottle adding up over the day, often I don't actually have anything left to save. This means I'm pretty consistently anxious about the exact amount I'm able to pump each time and what might impact it.


This morning, I randomly pumped over twice as much as my average session - much more than I've ever pumped in one sitting before. AND I HAVE NO IDEA WHY IT HAPPENED. So if you'll excuse me, I'll be replicating my every move over the last 24 hours every day for the foreseeable future.


1/21/2021


You can't know you need a #breastfeeding/#breastpumping cover covered in boobs until you know it exists.


1/23/2021


As I start thinking about going back to work, one of the big things on my mind (other than that I'm going to cry all day every day until I return to her) is how I'm going to make sure to pump enough. I've worked too hard on building and maintaining a supply to this point for it to fall apart. I do have pumping breaks worked into my daily schedule, but as an OB/Gyn, I have to think about the potential for getting behind in the office or being called to the hospital or having surgeries scheduled in the mornings.


Luckily, we live in the future and technology is amazing. I decided to splurge on a wearable pump (so yes, right now I have three pumps). For those not into the pumping scene, wearable pumps are devices inserted into the bra that allow for completely untethered pumping. Hopefully this means I'll be able to pump on my commute or while actually working if needed. Bonus: you leave people wondering if you got giant breast implants.


I joined a @willowpump (the brand I chose - a couple others are out there) Facebook group in advance, which let me know that there's often a transitional period, and it's recommended to use it at least twice a day for a couple of weeks and empty with a traditional pump right afterwards while the body adjusts to the different type of suction with this pump. That means it's a little extra work again for a while (oh joy) but that hopefully eventually it can work just as well as a traditional pump. If it never does, at least I'll know I'm getting some output in lieu of the alternative of not pumping at all.


1/27/2021


On this #worldpumpingday, I used my @willowpump while riding in a car for the first time (verdict - easier than using a non-wearable pump in the car). Not only did I have one of my best pumps in the few days I've been using it, but I transferred the milk to a mason jar in the dark without spilling a drop! Winner winner.


2/3/2021


I feel like I can't have normal adult conversations because as this account would suggest, one of my big areas of interest currently is making milk, and highlights from my day include, "I pumped the most I ever have in one sitting before!"


2/9/2021


If you're #exclusivelypumping or #breastpumping/#chestpumping is simply a big part of your feeding routine and you're on the fence about a #wearablepump, I'd recommend it! I've had mine for a couple of weeks now. I originally bought it with returning to work in mind, but it is SO NICE to just pop the pumps in and then play with my baby instead of being tethered to one spot. Since I'm able to engage with her, I just let the pumps run until they automatically pause instead of worrying about the time.


As I'd read about in advance, originally my output was lower as my body adjusted, but it has been increasing. Today I had excellent output - more than I've ever seen with any pump at this time of the day. This one session may be a fluke, but I'm very happy so far and feel encouraged about our #breastmilk journey as I think about going back to work next week!


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I think we still have a lot left to our breastmilk journey. If not, I'm at peace with knowing I've done my best for my baby.

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