Thursday, January 7, 2010

Pumping and Breastfeeding Class

First I must say thank you for your kind words, encouragement, and suggestions. It means a lot to me to have all of your support. I'm still pumping away every 2-3 hours and all I can say is thank goodness for Medela Hydrogel Pads--they are like a cool piece of heaven on my sore nipples! I emailed Lenore, the woman who pioneered the lactation induction protocol that I'm using with Dr. Newman, and she made me feel better about how things are progressing. Here's what she had to say:

"As for your current impending arrival, you have done all the right things. Inducing a milk supply proceeds quite differently from lactation following a birth. The reason for this is that we can only approximate some of the hormones involved during pregnancy and we're missing a big one....human placental lactogen which is only present during pregnancy. We approach inducing lactation as a two phase process. The hormones can only do so much in phase 1 which is developing the milk making structures. Phase 2 is building the milk supply. To do that it is vitally important that you pump at least 8 times per 24 hours for about 20-30 minutes each time. According to research out of Australia, frequency of milk expression is more important than duration. We typically suggest fenugreek and blessed thistle along with domperidone once you stop the birth control pill and begin pumping. It generally takes about a week for the birth control pill to leave your system. It suppresses milk production while building the breast tissue. Once the milk starts flowing, it tends to build and build. Keep up the great work and your supply should build and build."

I felt much better after reading Lenore's response as she induced lactation herself and has worked with many others who've done it. At least I now know that my response isn't atypical and that I'm on track. I'm adding the herbs this weekend (after I get them) and plan to increase my dom dose to 3 tablets 4x/day (thanks for the suggestion Saffy!). Even without these changes I have already experienced an increase in milk production at each pumping. Last week I just had droplets forming on my nipples that didn't drip into the bottles, but this week I get a few mL that drip into the bottles with each pumping. I'm getting at least 2oz a day from my 8 pumpings. At this point I only pump once in the night around 1:30am, but then sleep until 5:30am and don't pump again until 6:30am. In about 2 weeks I plan to add a 3:30am pumping. I have to pump around 6:30am because I need to leave my house no later than 7:10am to get to school to start teaching at 7:35am. I can't pump again until 11:25am, so I want to have that morning pump as close to 7am as possible.

On Tuesday night J and I attended a breastfeeding class. I was nervous about going. The thought of sitting in a room full of pregnant women isn't the most appealing situation for me (thanks infertility!). It doesn't help that I'm obviously not pregnant and would get some funny looks. As I expected I did get a few stares despite arriving late and sitting in the back. We had to go around the room to introduce ourselves by stating our name(s), EDD, and gender of the baby(ies). I said "I'm Niki. This is my husband J. We are expecting twins via my cousin, our surrogate." I was so flustered that I forgot to mention the genders, so J added "boys ... the twins are boys". I'm sure that everyone in the room was curious why I was at a breastfeeding class (except the teacher ... she was thrilled that I was there), but no one asked. Instead they tried to steal curious looks at me. Nothing like feeling like a complete anomaly.

I thought the class was informational, but J couldn't help himself. He whispered jokes to me throughout the whole class. His favorite, that he's stil saying, is "Niki, can I get time at breast?" The teacher kept referring to "time at breast", so J couldn't help himself. Yep, I'm married to a man who often acts like a teenager. I appreciated J keeping the mood light, which he always does, but I felt bad for giggling. Although he's a jokester, J did take the class seriously and learned a lot. I think the stats they presented will help J to be even more supportive of my efforts.

We signed up for a newborn care class that meets next week. I think I'll be less uncomfortable at this class than I was at the breastfeeding class.


Tina said...

Great Job! I knew you could do it...Im glad you had J with you and you might be suprised at what those people were really thinking :) My guess is wow how cool that her cousin is helping them become a family and even cooler that she is going to breastfeed her own children...:) Keep up the great work your boys will love you for it..

Lost in Space said...

Good for you Niki!

LOL at J. My husband's motto is "Funny in the 4th grade, funny now." I totally get you!

Kelly said...

I second the fenugreek! Heard lots of good things about it! I can't imagine how you must have felt at the breastfeeding class. It's like you don't want to stand out but you don't feel you need to explain either. Sorry things cannot be the way we want them. This does suck in so many ways! LOL at J though for making you laugh. I just cannot wait for your boys to arrive!

Anonymous said...

Amazing job!!! So happy to hear your supply is building!

J sounds like my DH - thank god for him keeping it light for me at times!

Expectant Duck said...

We are signed up for an infant first aid class and I am excited and nervous about going there and being obviously belly less - would you recommend going to the bfing class or will my books surfice?!

I am so glad that the bfing is going well!!!

Anonymous said...

I LOVE that you're doing this. You will love that you're doing this when you nurse your babies. :) I'm sure the people in class were in awe of you and thought you were fantastic.

I had a breast reduction years ago that made nursing a challenge. Domperidone saved the day. (I'm guessing they'll have you on the standard dose of 80-90 mg per day.... but hopefully they'll appreciate your situtation and give you more. Diana West says up to 120 per day... Dr Jack Newman says 160. I did the 160 for months. If the one giving you your Rx is conservative, don't be afraid to order more online if you're not getting the milk you want. Can take up to 6 weeks to get the dpd to really kick in.)

Fenugreek and Blessed Thistle are the old standbys for herbs... But there are some that people have better results with. Fenugreek can cause tummy upset for babies. And some of the other lesser knowns get more milk flowing, anyway. Here's a great site (Diana West) to check out if you already haven't.

I've been on all of those... Tinctures are better than dried herbs in capsules. (With regard to effectiveness -- NOT taste! lol.) Motherlove makes some great herbal cocktails. I took the one with Goat's Rue (builds mammary tissue.) One note, I still think they're recommending not to take shatavari and domperidone at the same time as they work much in the same way, might be overkill.

Anyway... sorry about the babbles. I'm just so excited for you guys. The boys will be here before you know it. Nursing will be a wonderful way to connect. Even if you don't build a full milk supply (I never did) I used an at-breast supplementor. (Loved my Medela SNS). Those things are a little fiddly at first, but save you a pile of time in the long run. You kill a few birds with one stone.

All the best!

Anonymous said...

Way to go Mommy!

And I have to laugh at J because he is sooo much like Matt! I can imagine if we ever got the two of them together it would be non-stop fart jokes and giggling at boobies. :)

Much love to you, keep on keepin' on know you are doing a great job!

Love, Becca

leikay2 said...

Just wanted to say keep up the great work!! It is a long hard process to induce lactation and I commend you for doing it!! I totally agree with the fenugreek!! I had to use it to keep up my supply and it worked GREAT!! The only negative thing ( if you can call it that) is it STINKS!! and will make your milk smell like maple syrup!! LOL I am sure by the time the boys arrive you will have established a wonderful supply!!

jill said...

Just wait until the twins are born and people see you with them and they say "You just had twins?! You look great!" and then all you have to say is "thank you" and smile! Those stares will make you feel good :)

goldenjag25 said...

Niki, it sounds like you are doing an awesome job!! When I was pumping I only got about 2-3oz each session so you are already on the right track, I had low supply. J cracks me up, totally something my DH did during the birth class! The newborn class is extremely helpful and I agree you won't feel as uncomfy in that one. Only a few more weeks until you meet those beautiful boys, I can't wait to see pictures.

James, Dawn and Family said...

way to go!!!!

E said...

I'm very impressed by your persistence! I had a low supply after returning to work with my first and the fenugreek worked wonders! I went from pumping 4 ounces to 14 in one night!

(Delurking to say how impressed I am!)

Ashley & Chris said...

Email me, I lost your email and i have a link to share with you :)

MyLifeMyWorld & Growing Families said...

Good for you for going, despite what others might think. Your doing everything in your power for your babies to come and that's what a great parent does.

I'm glad J was with you, the jokes I'm sure also helped ease some of the tension. My husband is like that too, men always have stuff like that on the brain.

You'll have fun at the newborn care class too! Good luck

Saffy said...

J cracked me up!!! ;) OK so I totally get that you might feel a bit weird being there sans a round belly, but if you've got a class like we had where you had to take along a soft toy (as a pretend baby, to practice positioning) then the other people in your class will be so busy feeling like dorks that you won't even be a consideration ;)

Go the domperidone. And go you, of course. I bet you feel like you've become to biggest clock watcher in the universe as you get that pumping underway. You're doing just fab!

Karma & Adam said...
This comment has been removed by the author.
Karma & Adam said...

Great job on the induction! I induced with my daughter and had similar results to you. By the time she arrived I was getting about 10-12oz per day - which was enough to feed her exclusively for the first week or so. Then we had to supplement, with BM my sister pumped for us. I breastfed, with added supplementation, until Addie was 8 months old. It was not easy, but we did it!
Two things that helped my milk supply after she was born (it never increased a ton, but these things helped): gatorade and oatmeal.
I didn't use the fenugreek - I was on 160mg/day of dom - the absolute max Dr. Newman could recommend. Still didn't have enough milk (common with induction) but at least I had the experience of BF.
Good luck to you - sounds like you're doing really well.

KRISTI said...

You are doing a great job! For what it is worth.... you are exactly on the same pace that I was when I induced lactation 3.5 years ago(A friend of mine carried my twin girls). Between the 4th - 6th week of pumping my milk supply really kicked in. I went on to breast feed / pump for 3 months after my twins were born without supplementing, then another 3 months w supplementing.

I am so impressed with your night time pumping! I only pumped once (before the babies came)between 10pm and 7:30am. But during the day at work I pumped every 2 hours in my office.

I just had to tell you that I'm impressed with your efforts. As far as the gawkers are concerned ... educate them! Most folks have no idea that women can induce lactation. :)

Good luck. I love reading your blog!