I recently met Nicole at a local doula gathering. When she shared her breastfeeding story with me, I was overwhelmed by emotion. I immediately asked her two things: 1-How will you work through this to help other women as a doula, and 2-Do you like to write? I am so grateful she generously poured her heart out to let others know how painful and confusing it can be to face the obstacle of not producing enough milk. I say it to moms everyday: We don't expect feeding our babies to be so hard. I have worked with many moms experiencing milk supply issues due to IGT, PCOS, breast reductions, and extreme blood loss during birth. Very often there is a deep sense of loss. Thank you to Nicole, for being vulnerable and honest -- I know it will help others. 

​"Your worth as a mother is not measured in ounces." This, this right here has been my solid ground -- my strength when I just can't seem to stop beating myself up for things I cannot control. Let's rewind a second, shall we?

Being a young mother is never easy, especially when you're the first of all of your friends to have a baby. You have no one to look to for advice or wisdom, it's just you and a new baby who won't stop screaming and nurses who are less than helpful. I was 19 when I gave birth to my greatest accomplishment and I was so proud, but what was I doing wrong? Why wasn't she latching? Sure, I knew breast is best, but as a first time mom, the crying was overwhelming and I just wanted her needs to be met. The night after she was born she got a bottle of formula because she had been crying non-stop and hadn't eaten because she hadn't ever latched for more than two minuets at a time. I was sad but I was just happy she wasn't screaming from hunger anymore. I had about 6 women give or take look at my breasts (or lack there of) and touch them, without permission at that, and no one had any advice for me -- so I went home, formula in tow and with no regrets.

At home I continued trying to pump, trying to latch her, and just trying to get a supply when I only had drops at a time. I tried a nipple shield, pumping religiously, teas, supplements, and I just gave up because I read some women just don't respond to a pump. Afterall, she was fed so she wasn't really going without, was she?

​I have since given birth again, 11 months ago to be exact. This time to my son and my second greatest accomplishment. Before I conceived him and during my pregnancy, I devoted HOURS to researching the best parenting practices, and that included breastfeeding. Breastfeeding: Natural. Normal. Tradition. Instinct. The reason the human race has survived for centuries. I learned that every woman should be able to breastfeed if she "tried" hard enough. I learned about proper latch, feeding on demand, skin-to-skin, the benefits of natural labor, tongue ties, lip ties, no pacifiers or bottles for a minimum of 6 weeks. The list is basically endless, I knew it all and I was confident. You can ask my doula, the one thing I wanted the most out of my birth plan was to be able to breastfeed, and my worst fear was not being able to breastfeed.

After 7 hours of labor I gave birth to my son, completely naturally. Yes! I did it! I was so proud of myself and immediately placed him to the breast. I remember looking at my doula and saying, "look, his mouth is big, he should latch nicely," and he did. He latched and we spent so much time nursing. We denied baths and took off that annoying hat they put on him -- everything was textbook. We went home after some time on the lights for jaundice.

​Did I mention everything was textbook? It was...until it wasn't. He constantly wanted to nurse, which is normal for babies. But then I noticed he wasn't peeing much anymore, and he wasn't satisfied after nursing for what felt like an eternity. I birthed him on Friday afternoon, and by Monday he had extremely chapped lips, yellow skin, yellow eyes and little urine output, but I was basically in denial. The next day he was admitted to PICU for jaundice and had to spend 24 hours on the lights. I HAD to start supplementing because my son was starving. I was starving him. My body was failing him. I cried and cried and cried. From 7 lbs 6 oz, to 6 lbs 3 oz and NO urine output. I did everything right, why was this happening to me? I was devastated, but despite my pain I kept at it. I met with an LC who gave me an SNS and and an abundance of advice that included "if things don't change in 1-2 weeks then you just might be one of the small percent of women who can't breastfeed."

Can't breastfeed, what? Some women can't produce milk, but why?

We went home the next day and he was thriving from being supplemented, but I hated myself -- hated the body that birthed two beautiful children. It's an awful feeling, a feeling that left a wound that is still as fresh as when it appeared. I kept at everything I had learned and I never got an increase in supply. Between both sides I couldn't even pump to cover the bottom of a bottle. Prescription drugs, water, clean diet -- NOTHING helped, but why?

IGT: insufficient glandular tissue. I found a great support group on Facebook that was my saving grace, they encircled me with comfort and understanding. There are markers for IGT and I realized that I had most of those markers. Buy why hadn't I heard of this before? All of the articles I read and people I talked to and I had never heard of it. All of the medical professionals that had seen me topless and I never heard a word spoken about it. Why aren't people trained to notice this, and why isn't this a more well-known issue?

This has been a long road and I'm still suffering. I can't feed or nurture my baby the way I was designed to. He's missing out on the best kind of milk his little body was designed to live off of. We did donor milk but it's hard to come by, honestly. He's now exclusively formula-fed and I hurt every time I wash or make a bottle.

I have since became a birth doula, and I almost feel hypocritical about it. How can I offer breastfeeding support to women when I can't breastfeed myself?

I'm healing and I've come to be a huge lactivist. Just because I wasn't and couldn't be successful doesn't mean I don't know the dos and don'ts of breastfeeding, and it doesn't mean that I won't run in to someone who will struggle like I did (and still do).

My heart hurts often and I still cry a lot, but I am healing. I need to start loving my body again. My first step to forgiving the things I can't control is writing this in hopes that more people will understand this kind of terrible struggle. It may not be a big deal to some, formula vs. breast, but to others, it's extremely difficult to accept.

And that's what I have learned to accept.

I used to weigh myself weekly at the midwifery office in Chico, CA where I worked. I could pinpoint reasons I might weigh less or more. For example: fully dressed and Danskoed, I would weigh almost 5 pounds more -- my Danskos alone were about a pound! Despite what I could manipulate on my own, including drinking a ton of water, or peeing a ton of water, there was one other way my weight could change. This office had two scales. One was digital, and that's where I saw the precision of ounces. The other scale was the old, slide-over-the-doo-hickeys one -- you know, the tap-tap-tap-balance kind? The two scales rarely matched exactly, leaving a discrepancy of two-ish ounces lost somewhere in the hallway between bathrooms. 

This sweet little one was born at 35 weeks, 6 days, weighing 5 pounds, 13 ounces. His mom is a doula in Bakersfield, CA -- and a friend. Late preterm babies aren't new to her, but solely breastfeeding is. She has been so proud to nurse him, and even prouder to pump for him. He had to stay under the bili lights for jaundice treatment, and since his official discharge, he has been monitored by his doctor through repeat visits for weight and lab checks. 

From a Friday to a Monday, he gained 2.4 ounces, checked on the same scale. Great news for a baby at 7 days, who in there somewhere had lost 9% of his birthweight, right? (Mom also had 3 bags of IV fluids during labor.)

On Wednesday, he had only gained .5 of an ounce, and Mom was devastated. "Was it the same scale?" I asked. She replied: "Same office, different scale." I was surprised they didn't want to verify his weight with the other scale, and this mom didn't think to ask in her postpartum haze as her roller coaster dropped down...very fast.

The doctor asked, "Are you able to pump?" Mom responded with a hearty yes, she had almost 50 ounces in her freezer by now. The doctor then looked at her chart and said "Hmmm, let me go get you some formula. Give him an ounce to an ounce and a half after every feeding." The doctor sent this mother away with a bag filled with formula. 

We had more time, the mom and I, to troubleshoot. The first thing we looked at was his output, and he was having 7-8 wet diapers, and 7-8 poop blow-outs in 24 hours -- his stool had been yellow since day 4. Even with jaundice at play, I shared the ABM Protocol for Jaundice, which states "Breastfeeding infants should not be supplemented with water, glucose water, or formula," and that supplements offered, if needed, should be "expressed breastmilk, banked human milk, or formula (in that order of preference)..." I suggested she read that document and arm herself with what the AAP's own breastfeeding specialists have agreed is best practice, so she could ask, why is her baby different than the norm? Why is the doctor suggesting formula versus breastmilk?

All along, I encouraged this mama meet with an IBCLC, and I wondered why her pediatrician wasn't suggesting the same? Mom was making arrangements to do just that. Mom was so worried, the evening of the "weight loss," she offered the baby a bit of formula -- and he threw it up. Reaffirmed by this response, she supplemented him with an ounce of her own breastmilk after each feed.

At the next 24 hour weigh-in, back on the same scale that showed the original gain of 2.4 ounces, guess who was up three ounces in weight? As the nurse brought Mom and Baby to the exam room, they passed by the other scale. Mom asked if they could weigh him there? The nurse agreed. Suddenly he was 2 ounces less in weight! Mom came unglued and her Mama Bear claws started to emerge. The nurse showed a doctor, and the doctor tried to explain it away...this Mama was not having it! She demanded a new doctor! The new doctor apologized profusely as Mom told her everything they had experienced, including being sent home with formula and no further breastmilk or breastfeeding information/clarification. This new doctor was understanding and agreed things weren't handled well. 

So there you have it -- 2 ounces to me could be the difference between taking my keys out of my pocket or not. But for a new baby, pre-term and being watched closely (not closely enough?), 2 ounces is huge! The importance of sticking with the same scale cannot be underestimated when looking for true accuracy. It was one of the first questions I asked this mom, and it proved to be the point of contention. I am so proud of her -- she is pushing upstream against society, her doctor's suggestion of formula, and even her own doubts and past history, to listen to her gut and provide the best to her baby.

​Way to go, Mama!