Breastfeeding After Reduction: One Year In

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The summer before 10th grade in high school, I got a breast reduction. The thought of how the surgery would affect my ability to breastfeed at some point in the probably distant future did not even cross my mind.  At 15, I was a 44E, after the surgery, I was down to a 38B (and by the time I graduated high school, I had increased to a 38C).  I was happy to be rid of back pain, and of bra straps digging into my shoulders.  I could run the bases in softball without feeling ridiculous.

All went well for the next 17 years, and then I became pregnant. I read several pregnancy books and most said the same thing, supplementing with formula is often necessary because BFAR (BreastFeeding After Reduction) moms usually don’t have full milk supplies. I decided that I would try, since that’s what’s best for the baby, but that it would be okay if it didn’t work. I mentally prepared for any eventuality and even bought a set of bottles, figuring it likely that I’d need to supplement.

The big day came and Oliver was born. The birth was so difficult, that when they put him on my chest immediately afterwards, I just patted him and told them to take him to get cleaned up. After his bath, I got my second wind and felt up to breastfeeding and that seemed to go well. We went home two days later and for the first week, things seemed to be super. Oliver was a sleepy baby, but he’d latch on and nurse for a few minutes before drifting off to sleep while still happily attached to the breast. He’d wake up after half an hour, nurse a little more, then drift back off to sleep. I’d sit on the sofa for much of the day and night, nursing him and watching DVDs of Sex and The City. Then the midwife came.

After she weighed Oliver, we found out that he’d lost weight. Babies often lose some weight after they’re born, but regain it within the first week. At a week old, Oliver was at 10% under his birth weight. My husband was dispatched immediately to the nearest drug store to pick up formula. I stood in the kitchen crying while various emotions washed over me. Confusion, guilt, sadness. I remember hugging Oliver to me and feeling like I had let him down. I had thought things were going well and I had been wrong.

Thus began the difficult part of our breastfeeding relationship. Going in, I had been prepared to fail, but since he was there, some super strong mommy instincts had kicked in and I knew I had to make this breastfeeding thing work. I was a mom on a mission. The midwife said that Oliver’s lazy sucking was not stimulating my milk supply to increase. She seemed unconcerned about the reduction surgery, she just told me to keep him awake, keep his nursing sessions to under 20 minutes per breast, and drink nursing tea. I read on the internet about using a breast pump to build milk supply, so we rented a Medela Symphony. Feeding would start with Oliver on my breast, 20 minutes per side, then my husband would give him a bottle of formula, while I pumped for another 20 minutes per breast. I’d have about an hour break, and this would start over again.

Keeping him awake was impossible. I tried all the tricks, BFing him in his diaper, tickling his feet or neck, blowing in his face, etc. Those things all work now, but as a newborn, nothing would wake him when he was tired. We kept going with BFing, bottlefeeding, then pumping for the first six weeks, and things slowly improved. I seemed to be providing about 60% of the liquid he needed, we’d supplement with two bottles of 90mL each during the day.

At first I had thought that I wouldn’t need a book on breastfeeding, I’d just know what to do and if I didn’t, the midwife was there. But now I was at my wit’s end. I made a sobbing phone call to the nearest English-speaking LLL Leader, and she tried, but was anything but helpful. I got on Amazon and read through the reviews, picked the breastfeeding book that sounded best for me, Breastfeeding Made Simple: Seven Natural Laws for Nursing Mothers. This book was a godsend! First, it gave me the courage to listen to my heart. It said the advice to limit him to 20 minutes per breast was baloney, and we went back to what my instincts had told me to do, allow him to feed as long as he wanted. Second, it suggested the book Defining Your Own Success: Breastfeeding After Reduction Surgery, which I order immediately. From this book, I learned of BFAR.org. There was a whole organization for mothers like me!

I started taking the herb Fenugreek (Bockshornklee in German) and got some Shatavari powder, both are herbal galactagogues (substances known to increase milk production). I immediately discovered that Shatavari powder tastes disgusting (imagine drinking beach sand). I tried and tried, but ended up throwing my expensive 500 gram container away and ordering capsules. When I went to the US in December, I ordered a 6 month supply of Motherlove’s More Milk Special Blend, and took that instead of the Fenugreek capsules since it contains Fenugreek (Motherlove offers worldwide shipping - the website says to email for quotes).

I had also planned to wait until Oliver was 6 months old before starting solids, but he was grabbing food off our plates at 4 months, and I figured that solids would just be replacing formula, so why not try. He gobbled down baby food like it was going out of style. As his appetite increased, we decreased the formula feedings down to one bottle of 90mL, which he didn’t always finish.

After a few weeks on the Shatavari and More Milk Special Blend, we were able to do away completely with formula and it has been pretty smooth sailing ever since. He bites every once in a while, and one of those bites once led to a clogged duct. I hand-expressed to help clear the blockage, since it hurt too much for him to nurse, and was surprised at the quantity of milk I produced (about 100mL). It was so much greater than those days in the beginning when I struggled to pump 30mL from both breasts combined.

We have no plans to stop nursing anytime soon. The little guy loves the boobies too much, and I worked too hard to build up my supply. As soon as my supply was built up, he completely rejected bottles. He also stopped taking a pacifier around 6 months and stopped sucking his thumb around 9 months. I allow him to comfort nurse because I know it will help my supply. When he was sick recently and wouldn’t eat solids, the sound of him drinking gulp after gulp after gulp from my breast would sometimes bring me to tears. I worked so hard and really feel I’ve accomplished something good. I know not everyone could do what I’ve done and I’m proud of that.

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Tagged as: bfar, Books, Breastfeeding, Fenugreek. LLL, galactagogues, Motherlove, Shatavari, Websites