The hardest job there is

If you told me during my pregnancy that I would have to do a triple feed program on my baby, a) I would have had zero idea what you were referring to, and b) I’d probably respond with something ignorant like, “but I’m planning to breastfeed!” I didn’t realize that “combo feeding,” or breastfeeding *and* formula feeding, was a thing; I just thought you chose one path or the other. I had no idea that “exclusive pumpers” or moms who pump milk and feed it to their babies via a bottle was a thing. I always just thought people pumped milk for their babies when they could not physically be there (as in, they’re going back to work). I didn’t know that “breastfeeding” referred to both nursing *as well as* bottle feeding breast milk. I really didn’t know much about any of this stuff at all despite having taken an online breastfeeding course from a reputable source, as well as reading endless articles and blogs on breastfeeding. I thought “latch” was the key to ensuring breastfeeding success; I had no idea what poor milk transfer meant. I had no idea that inadequate milk removal, either via a baby’s sucking or a breast pump, could torpedo your milk supply, nor did I fully understand the “supply and demand” process that a new mom’s milk supply would be determined by.

I really didn’t understand any of this, and I’m scrambling to read and learn more about it all now, which may be too late to recover my milk supply. I have no idea. But I guess that’s what it means to be a mom: always doubting yourself, always feeling like you’re failing or that you are inadequate, always feeling like you can do more. There are social media memes for pumping moms, saying that you shouldn’t measure your love in ounces (of milk), but somehow, that’s how I’m feeling about myself and my crappy output via this breast pump I feel like I am a slave to.

The job of a mother never ends; it doesn’t end when you shut down your computer for the day or close out Slack or put your phone on silent. It literally goes on 24 hours a day with no break. It feels like the little “me” time I have is in the shower, massaging or stretching my arms and hands, and even looking out the window to take deep breaths and remind myself that I’m doing the best job I can despite the little sleep I am getting. I hate pumping, but pumping is the only way I can ensure my baby gets breast milk, so the pumping journey continues.

postpartum care package from San Francisco

A few days after giving birth to Kaia, my aunt messaged to say that she was putting together a care package of dried ingredients to send to me. This was so that I could make the ji jiu tang, or chicken wine soup that is a well known and popular Chinese postpartum soup. She said that I likely didn’t have time to go down to Chinatown to buy all the ingredients, so she wanted to save me some time and effort and send them over. She obviously could not send over the chicken or the Chinese rice wine, but she sent all the dried ingredients: dried shiitake mushrooms, wood ear mushrooms, lily buds, and Chinese red dates. In addition to these, she also sent some chocolate, a random bag of dried lentils (that my mom apparently asked her to pack me… don’t ask), and a carefully double bagged ziplock bag of thinly sliced ginger soaked in Chinese sweet black vinegar. She messaged and called several times to let me know how sorry she was that she couldn’t be here in person to make this as well as other Chinese postpartum dishes for me, but she hoped that I could make the soup myself with the ingredients she sent. “Don’t forget the ginger!” she said. Ginger, if you didn’t already know, is in pretty much EVERY Chinese postpartum dish. The black vinegar-soaked ginger is in place of the Chinese black vinegar/pork knuckle soup that is a well known Cantonese postpartum dish that moms or grandmas will make for their female family members after giving birth. She told me to eat a few pieces of the soaked ginger each day to help my body recover.

Other than the chicken, the only thing I needed to run out and buy was rice wine, so I went to a local wine shop to pick some up. Unfortunately, they didn’t have Chinese wine and only had Japanese rice wine, so I got a bottle of that (after texting my aunt to confirm this wouldn’t change the flavor or essence), soaked all the dried ingredients to rehydrate them, and dumped them into my Dutch oven to prepare. She was right: it really was easy to prepare and didn’t need too much precision. And when the soup was simmering over the stove, a very familiar savory, warming scent wafted through the apartment, and I realized that I’d had this soup many times growing up. When I took a taste of it, it was like I was immediately transported home into my grandma’s kitchen: she made some of the most delicious Chinese soups, many of which required hours and hours of simmering chicken and pork bones down to nothing. I immediately felt comforted and knew I would enjoy every spoonful of this. Chris enjoyed the soup, as well.

In my family, food is basically a love language, but I suppose that’s like most Asian families. Most of the time, they won’t tell you that they love you or care about you, but you know they care about you when they ask if you’ve eaten (then constantly add food to your plate until you are stuffed to the brim), and when they remember your favorite foods and ensure you have them when you come over to their home (or order them when out at a restaurant). You also know they love you when they prepare delicious, nourishing soups like this one for you, or when they so painstakingly soak hand cut and peeled ginger for hours for you and have it Priority-Mail shipped to get to you ASAP after giving birth, or when they insist that you have this soup for yourself and apologize endlessly for not being there in person to nourish you themselves in your delicate postpartum state. I felt so loved when I received the care package from my aunt, and I made sure to send her photos to get her seal of approval once I finished making the soup, as well.

“Smart girl!” she texted me back. “The soup looks very good! Now I’m going to make a big pot of it to eat, too!”

The blame game with milk supply and demand

After five days of the triple feed program, we went back to the doctor’s office for the RN/lactation consultant to check the baby’s weight to see that it was working, and the good news was that it was working; she was finally gaining weight and getting on track. So the RN suggested we continue the triple feed until her one month appointment on January 10th, much to my disgust and exhaustion. We also did a weighted feed to see how much milk was being transferred when she breast fed for 10 minutes on each breast and found that she only transferred 1 ounce. So, the good news is she IS getting milk from my breasts; the bad news is that it’s not enough for her to be exclusively breast fed. This crushed me, as this was my hope and goal.

The RN observed part of the feed and just came to the conclusion that I was the problem because I probably had low milk supply, which kind of pissed me off and immediately sparked my desire to get a second or third opinion. Both my experiences with international board certified lactation consultants (IBCLCs) in person at the hospital and here at the pediatrician’s office felt terrible; I was not being given the full lactation consultant experience and instead I was getting blamed without the full picture. At the hospital, all the LC did was listen for a swallow and check latch. Here, she didn’t give me the full hour I was supposed to be given despite charging my health insurance $275 for the stupid visit. She didn’t bother asking me about my pump settings or flange fit; she never discussed anything about me, which is supposed to be the focus of an LC visit.

I spoke with two other lactation consultants about her conclusion, and they both thought it was flawed: since milk supply is all about supply and demand, if the demand is not there, meaning the milk removal is not effectively happening by an efficiently feeding baby, then my body doesn’t get the signal to make more milk because I am not properly being emptied. So it’s a bit of a chicken and egg situation, but having an inefficiently eating baby makes the supply worse. And though she suggested that I take supplements like fenugreek and I will try it, I realized after chatting with these other LCs that the only way I was going to ensure my baby would get breast milk and that my supply would continue and/or go up is if I continued to pump milk. I may just need to increase my pumping and even attempt to be one of those “exclusive pumpers,” or EPs, even if I am an under supplier due to nearly three weeks of inefficient and poor milk transfer. I would still attempt to nurse, but the main way Kaia will get my breast milk is via a bottle of pumped milk. I just need to find ways to increase my milk supply, whether that is via power pumping or some other ways to further stimulate my nipples.

I would never have imagined I’d become a 7-8-time-per-day pumper, or wannabe exclusive pumper. But I did not choose this path for myself; it chose me. I still wish I had a proper IBCLC experience, and the closest I got to that was the Cleo IBCLC I spoke with, who was unfortunately virtual only. But she actually made me feel seen and heard, and she even called me a couple times when I was getting anxious and about to have a breastfeeding melt down. I never thought that my breastfeeding journey could feel so lonely and isolating, not to mention make me feel so inadequate as a mother. I’m trying my best, but my best is not enough to fully 100 percent nourish my own baby, and it just hurts.

Unanticipated postpartum pain

It’s been almost three weeks since I gave birth to Kaia and came home with her. In that time, while I was anticipating postpartum pain such as uterus contractions during breastfeeding, difficulties peeing and pooping given my postpartum pelvic floor, and related vaginal burning and itching given the stitches I got, one thing I was not actively thinking about was the re-emergence of my carpal/cubital tunnel pain, or pain in my thumbs.

It makes sense that your ulnar nerve via your cubital tunnel and your median nerve via your carpal tunnel would be aggravated with a newborn at home: You will always be picking up and putting down and holding your baby, and you need those nerves to do those actions. In addition, if you are hand expressing breast milk, as I do in preparation for pumping milk with my breast pump, you may end up with sore thumbs at the base of your palm from that repetitive motion. So any constant, repetitive motion using any nerve or limb will inevitably act up as a result, especially if you are like me and had previously battled carpal/cubital tunnel problems. I actually had my carpal/cubital tunnel pain under control since March/April 2020, so right around the time of the embryo transfer. I achieved that via doing more voice-to-text, getting a more ergonomic setup for my work station, and resting and icing my hands/elbows more. But towards the end of pregnancy, I realized the pain was coming back again, likely due to pregnancy hormones (pregnancy carpal tunnel is really a thing, and for many women, it lasts even past their 4th trimester!). And now with the demands of caring for Kaia, the pain and burning are flaring up again, whether it’s from cradling her, bottle feeding her, or doing breast compressions during pumping and hand expression. I have less time to ice and pretty much no time to rest at all. I try to ice sometimes while I pump. When I am not caring for her or pumping, I am cleaning things up or cooking because I refuse to eat all delivery/takeout food, nor do I want nasty living spaces.

Chris suggested I look into a better PT or medical help than last time, but I honestly don’t think it will help: the number 1 thing you need with issues like this is REST. And that’s pretty much impossible. They also tell you to stop doing the activities that aggravate it, but that’s also unrealistic: what, I’m not supposed to care for my baby or pump milk for her…?!

Poops and pees

Oftentimes when people who have never been parents think about the dreads of having a baby, they immediately think of how gross and unpleasant it would be to do diaper changes. While initially it does sound pleasant and obviously messy, when you do become a parent, you quickly realize that diaper changes are just an everyday reality of well, being a parent to an infant, and that it’s just a practical obvious thing that just needs to get done. In addition to that, sometimes, especially when your baby’s poops and pees are lagging, as a parent you can get very excited to finally see that long awaited poop or pee diaper.

To track growth and how much a baby is consuming, assuming they are not exclusively formula fed, if they are breast fed, the only way to fully understand (or as close as possible) what they are consuming is to see their “output,” in other words, their poops and pees. Your baby’s pediatrician will always ask the same questions at the beginning of every visit: are they formula or breast fed? If combo fed, what is the approximate ratio of formula to breast milk? What number of poop and pee diapers have we seen on average?

Breast milk diapers will have lots of pee, and the poop will always be a mustard-seedy texture and color. Funnily enough, breast fed baby diapers don’t have a very strong odor, either. I still remember when we saw Kaia’s first poopy diaper post meconium and how excited I was to see that it was mustard seedy, meaning that in fact, my milk HAD come in and she was actually consuming milk through my breasts. In subsequent diaper changes, when she has been backed up and constipated, I have gotten excited and well, even admired her poopy diapers when they finally came… after 2-3 days of waiting. Chris thought this was so weird that he told our night nurse about this, who found this all at once cute, funny, and strange.

So, want to track your baby’s progress outside of using a scale? Keep a log of their poops and pees. Everyone will expect you to do this.

Hands-free bra for hands-on pumping…? Come again?

I was gifted two pumping/nursing bras off the baby registry that I really didn’t think I’d be using until I went back to work, which is when I was hoping to use my breast pump regularly. I certainly didn’t imagine having to use my breast pump as soon as I left the hospital, so alas, I’ve been getting acquainted with my Spectra S1 pump settings and the two different pumping bras I have.

The Spectra S1 is considered a hospital-grade breast pump, with the addition of a battery, which means I do not have to be stuck to a wall or outlet every time I pump (health insurance doesn’t think you should be mobile while you pump, though, and so I had to pay a $75 co-pay just for the addition of the stupid battery). However, while it’s a very popular and respected breast pump, it’s basically a mini bowling ball in that it’s round and you really need to be careful when walking around with it. I have managed to make oatmeal, measure ingredients and formula, cut fruit and vegetables, and even brush my teeth with it hooked up. But you really need to be SUPER careful that you don’t knock it over or even worse, spill all your milk, which is literally like liquid gold. My night nurse told me that there’s a big black market for breast milk, and on average, people are charging $18 per oz (30 ml) for breast milk!!

Despite having a hands-free pumping bra and using it while pumping, it’s kind of ridiculous to think that a best practice of pumping is to actually be “hands on” — so to do breast compressions while you are actually using the breast pump to pump milk. Multiple studies have been done about this that have shown that doing breast compressions while pumping (meaning squeezing/pushing on your breasts) will increase your output and ensure that you are actually draining your breasts properly, which then signals to your body to make more milk and will also prevent clogged ducts. And logically, this makes sense: during nursing, a baby is not only sucking the milk out, but she’s gently compressing your breasts to push the milk out, as well. Even the most sophisticated breast pump is only capable of the sucking part of that combination, sadly. So, the only way to do this is with a hands-free pumping bra so that you don’t need to hold the flanges in place where your nipples are. But.. if you think about it, doesn’t that seem counterintuitive: I got a hands-free pumping bra so that I can.. do HANDS ON breast compressions?? You see all these ads for pumping bras showing women at their computers typing away or reading a book leisurely while a machine pumps out their milk, but if you are actually draining effectively, that’s not really how the picture should look.

You would think that at this point in time, we would have come up with better solutions or technology for this, and that there would be more science than art around nursing and breastfeeding. What a journey, and I’m only at the beginning of it…


It’s Christmas day today and Chris’s 40th birthday. One year ago today, it was just the two of us in our New York City apartment, not drinking alcohol in preparation to begin our IVF cycle a few days later. I had a lot of uncertainty then, yet I was filled with hope that IVF would get us one step closer to starting the family I’d been dreaming about for over two years. I had no idea then how IVF would turn out, and yet, one year later, here we are with the greatest gift I’ve ever received: my little baby Kaia (jam). It has been 15 days of a total lack of sleep and self care, 15 days of breastfeeding tears, anxiety around her weight increasing, and being uncertain if I was really doing my best as her mama. Yet at the same time, it’s also been 15 days of the most love I’ve ever experienced, both for my baby Kaia and my Chris. I have never been more grateful to be alive and here to raise my little daughter, nor have I ever been more grateful to have Chris as my life partner, who has been a rock through IVF, pregnancy, and now raising our daughter together. He has kept calm and cool through all my worries and tears this whole time. I have never felt more sure of myself in choosing him as my favorite human than in the days since Kaia has arrived. I can’t wait to see what life brings us a year from today in the future as a family of three.

Postpartum boob life

I always imagined that postpartum home life would mean a lot of my boobs sticking out all the time, but I never really thought much about how that would actually feel. Why would I have my breasts out all the time, you ask? Well, if you are nursing and/or pumping milk, your breasts and your nipples are going to be sorer than sore, and they will need to be aired out to prevent any cracking or additional discomfort. In between feeds and pumps, I try to air my nipples out as much as possible, which means I am either walking around topless or with my nursing tanks half down. But I’m cold sensitive, and even with the heat on, I need to at least have a hoodie on to keep the rest of me warm. When you’ve either got your nipples constantly being suckled on by a teeny tiny human, while also in between feeds having a breast pump suck milk out of your breasts at a hospital-grade rate, your breasts in the postpartum period are in for the workout of their life! And yes, this DOES burn calories whether you are nursing or pumping – wee!

I’m lucky so far in that I haven’t experienced cracked nipples, and given multiple lactation consultants and nurses have complimented Kaia on her “perfect” and “beautiful” latch, I haven’t really hurt at all, so I’m thankful for that. Occasionally, though, when she is finished eating on the breast, she will try to chew my nipple at the end as sort of a “send off,” which is not particularly nice. It’s a chew in a “twist” kind of fashion, and boy, is it NOT pleasant AT ALL. But I love nursing her; I love the closeness I feel to her, I love being able to stroke her hair and head and feel her warmth against me. I love the smell of her coming off of me, her mouth covered in my breast milk. I love the fact that my body is able (well, sort of, given the weight gain issue) to nourish my little baby. I’m hell bent on making sure that she has as much breast milk as possible, so if it cannot be directly from my breasts, I’m trying to pump as much milk as possible.

So yeah, I get why a lot of moms postpartum don’t want that many visitors over in the several weeks or even months post birth. How can you have visitors over if you constantly have your nipples sticking out everywhere? You need to prioritize comfort postpartum, and having your nipples covered would be uncomfortable. And if you don’t take care of your nipples and breasts, your nipples will be pissed at you and give you all kinds of issues, ranging from thrush (fungal infection on nipple that also affects the baby) to blebs (milk blisters) to the worst of the worst — mastitis (clogged milk ducts that go untreated and result in inflammation and breast infection requiring antibiotics – NOOOO).

So word from the wise: take care of your boobs.

Triple feed plan

I was devastated at Kaia’s doctor’s appointment today when we found out that she still wasn’t gaining weight. I was so upset that I started crying and immediately just thought something was wrong with my breast milk. My breast milk is poisoning my baby! I thought in my head. What the hell was wrong?

The RN/lactation consultant suspected that there were one of two problems that needed to be pinpointed: either I had low milk supply or the baby had a weak suck. Weak suck would mean poor milk transfer, which means that she wasn’t getting enough to eat, which would also mean that not enough milk was getting removed from my breasts to signal to my body to produce more milk. So it’s a bit of a chicken and egg situation. As a result, she strongly suggested we give her a higher fat formula as a supplement and start a triple feed plan: Every three hours, I would nurse her, then Chris would bottle feed her my expressed milk or formula, and then I would pump for 20 minutes. I get two nursing breaks and two pumping breaks, but this was definitely an intensive feeding plan. The idea behind this is 1) to get the baby eating and gaining enough weight to be on track, and 2) to get my breasts stimulated enough to produce enough milk for baby to consume.

It’s a plan I had no idea existed before, but it was stressful and so disappointing to hear that we needed to do this, at least until her next appointment a few days after Christmas. I thought about how intense and agonizing this would be if I didn’t have Chris or a night nurse or really any support, and how isolated I would feel. I always knew breastfeeding would be a journey, but I had no idea that it would be this time-intensive and completely out of my control. I always thought that if she latched properly, then it would all go well. I mean, that’s what all the breastfeeding articles and the breastfeeding class I took emphasized. No one told me about poor milk transfer or a weak suck and how that could be a potential problem, so I felt completely unprepared for this and thrown off guard. Why was I not aware of this before with all my research?? And I felt enraged thinking about this lack of emphasis as we left the doctor’s office. This is postpartum life. This is an introduction to motherhood for me.

Cleaning the humidifier

If you live in New York City, chances are high that your living space has dry, dry air. This is especially problematic in the winter time, when you will likely have your heater on constantly, only exacerbating the dryness in your apartment. When I started living with Chris, my nose was so dry in the morning that he suggested I whip out the humidifier he had. Humidifiers in general are beasts because the average one will require constant cleaning of the base and the tank — usually once a week. And it’s not like it’s easy: there are usually tiny crevices all over the damn thing that you can’t get with a regular sponge or cleaning brush; you will actually need to take out Q-Tips — that’s right — Q-TIPS! That’s how small these spaces and nooks are. Plus, the filter cartridge will need to be replaced every 3-6 months depending on the manufacturer.

In a life pre-baby, Chris never, even once, cleaned our humidifier. I had to clean the frickin’ thing myself, adding vinegar to the base, cleaning it with a toothbrush, and cleaning the crevices of the tank with a Q-tip, once a week every week during the winter time. I always soaked the base with white vinegar for a few hours each weekend. It was always something I dreaded. However, now with a baby, her nostrils are very tiny and given she is a winter baby, a humidifier was definitely a must in our dry apartment. And so we whipped out the humidifier for her specifically. And what ended up happening? For the first time in over ten years together, my husband is actually cleaning the humidifier and being extremely meticulous. He can’t properly clean greasy dishes to this day, yet HE took out Q-Tips on his OWN to clean this tank! I was completely shocked when I saw him do it for the first time and all subsequent times, as I just assumed this was something I’d have to do.

Well, I guess it’s true what they say: men really do change once a baby is in the picture, some for the worse, and some, like my Chris, for the better. 🙂