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.

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…?!

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.

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…