Breastfeeding woes

It took me a while to decide if I was going to write about my breastfeeding struggles–the topic is more intimate than I usually cover–but the more I research the condition I have and read stories about other women with a similar diagnosis, the more awareness I want to bring to women in a similar situation.

Sam was born at 6am in an unmedicated birth, and by 6:30am, with the help of an L&D nurse, he was latched on and enjoying colostrum. I worked with a number of nurses during our two days at the hospital to make sure his latch was deep and he was getting what he needed, and was taught how to pump in order to stimulate my milk supply to come in.

Sam was born on a Wednesday, and we were discharged on a Friday with orders to see a pediatrician on Saturday about his mild jaundice. By then he hadn’t peed a lot, so they encouraged us to supplement with formula, just until my milk came in, which everyone said would be “any day now.”

My milk (sort of) came in on Sunday, although it wasn’t the engorged, bursting-at-the-seams feeling I’d been expecting based on my friends’ anecdotes … More like the colostrum just came in thinner and whiter, and about doubled in quantity.

For the next few days, Sam was happily nursing … But not gaining enough weight, according to the pediatrician. And then his nursing became more urgent–he was nursing for longer, but ending less satisfied. There were a few days that he would nurse for 2-3 hours (he nursed for a whole Packers game), which left my body sore and chapped and tired, and he would still be asking for more.

I called in for support–my local LLL leader, the public health department nurse, the hospital nurses, and of course many Google searches–and kept getting new information about how to latch to help increase supply. The underlying message was always to keep letting him nurse on demand, and that my milk supply would increase to meet his demand.

Eventually, after an exhausting Thanksgiving that left me snapping at family members and crying over my delicious turkey dinner, I went back to the hospital to see the lactation consultant, Karen–we’d talked on the phone a few times, but due to severe weather and holiday visitors, I hadn’t been able to visit until Sam was almost 3 weeks old.

Karen helped me latch even better, weighed Sam before and after he ate, and asked lots of questions about my family history and pregnancy. Then she gave me the bad news: I have insufficient glandular tissue (IGT), which means I can’t produce enough milk for Sam’s voracious appetite. We estimated, based on Sam’s weight change in office, that I produce about 4-6oz/day, and he needs 20oz to gain weight.

I’ve always wanted to breastfeed–I’d read the books, taken the class, heck when I worked in public health I even wrote about how important it is–and it never occurred to me that I might not be able to exclusively breastfeed.

So understandably, I was shocked and devastated. I felt betrayed by my body–this was something I wanted to experience with my son, I wanted to meet his needs “the natural way,” I even hoped to overproduce and donate extra pumped milk to a donor bank. Knowing that my breasts had failed me, that they couldn’t perform the one task that they were designed to do, was a painful realization.

Karen showed me how to use a supplemental nutrition system (SNS) to simulate breastfeeding with formula (which I didn’t love, but I understand why some women want to experience this), and also taught me how to give Sam a bottle. I cried the whole feeding, but I also watched Sam’s face, which had been red from hunger crying, start to calm. His shoulders de-tensed, his muscles relaxed, and he leaned into me, exhausted and happy.
Sam & I had both cried the whole way to the hospital, and on the way home, Sam finally slept soundly and I started to realize: “If this is what I have to do to feed my baby, this is what I’ll do. It may not be what I planned, but it’s what he needs.”

I hesitate to admit this because I know how important breastfeeding is to many women, but once I learned that I wouldn’t be able to supply all Sam’s nutrition needs, it was like a weight was lifted from my shoulders. If I hadn’t gotten this diagnosis–and many women with IGT don’t have lactation consultants who are familiar with this relatively rare condition, so I was incredibly lucky to have an answer so early in my quest for knowledge–I was prepared to call my obstetrician’s office to discuss counseling for postpartum depression, because I’d been feeling so overwhelmed by Sam’s need and my painful breasts that it sometimes felt like the room was closing in on me.

Instead, I’ve been able to adjust to this new plan the best way I know how: education. I’ve read books, medical journal articles, and blogs about formula feeding (not nearly as detrimental as the media would have you believe), increasing milk production in challenging situations (including certain herbs and supplements that I’ve started taking), and even explored possible causes (sometimes insulin resistance during puberty can impact the creation of breast tissue). I’ve empowered myself with knowledge about my condition and am trying to mitigate our circumstances and continue to have a breastfeeding relationship with Sam, even if it’s not enough to feed him exclusively.

I also found an incredibly supportive private Facebook group filled with other women with IGT or low milk supplies. It has been a blessing to realize that I’m not going through this alone, that other moms have had to make similar realizations and decisions, and that I still have options about how to proceed.
I’ve briefly exploring finding donor milk to supplement Sam’s diet and ordering drugs that have helped many women to produce more milk … but at this time, I’m not comfortable with taking milk from strangers or with taking medications that aren’t FDA-approved without medical supervision. So right now, my decision is to stay positive and stick with formula, because it seems to be working, as Sam is happier and is quickly gaining the weight that he lost, and then some!

In the meantime, there are some silver linings to this tough diagnosis. Ben is able to help out more with preparing and feeding from bottles and Sam is sleeping better at night because formula takes longer to digest … both of which are things that help me sleep better, and help me be a better mom during the waking hours.

I share my story here for three reasons:

  1. I don’t want to explain endless times why Sam is drinking formula, and I’d rather not be judged for the decision to not exclusively breastfeed … even though the decision was out of my control, I know that there is an extreme bias against formula feeding moms (the perception is that they are being lazy or not trying hard enough) and I want to proactively explain myself, and encourage people to give the benefit of the doubt to other formula-feeding moms.
  2. As a new mom, plenty of people ask me about breastfeeding, because it’s an easy topic to chat about (right after sleeping and developmental milestones). I want people to understand that it can be a sensitive topic for me, especially among my friends who are able to exclusively breastfeeding.
    I’m happy to talk about my condition in an educational way, but would rather not hear any advice about how to increase my supply (yes, I’ve tried fenugreek and power pumping and lactation cookies, and I’m very glad they worked for you, but my case is different).
  3. I’d like to show a different side to the breastmilk/formula dichotomy–Sam is receiving both breastmilk and formula, and he is a happy, healthy kid. And in the end, that’s the most important result.

Thank you for reading (or skimming, anyway) this incredibly long post. As you can probably tell, this is something that has become very important to me in the past few weeks, and although it wasn’t easy to write this post, it’s helped me to process this information.

(Also: clip and send coupons for Enfamil. That sh*t is expensive!)


  1. Marie says

    I’m way late to comment, but just wanted to say thank you so much for sharing! So many moms have breastfeeding issues (we did!) and there are so many variables that you don’t know about until you live them. Even though our situations were different, I can totally identify with some of your thoughts and feelings. In the end (it took about 7 weeks), we’re now able to exclusively breastfeed, but it wouldn’t have happened without so much support and knowledge that we had to gain very quickly. Like you, I felt so lucky to have the support and a great lactation consultant! For us, it was a latch issue that led to a supply issue, and while in the midst of that, I had the same thought you did, that even though it wasn’t my plan, I was going to make sure she was fed and happy and if that means formula, that’s totally okay. Thank you for the post!

    • megcasebolt says

      Marie – no such thing as way too late! Sorry I didn’t see this earlier, so much spam I need to fix :)
      I am so amazed by the support given and knowledge shared by IBCLCs. I was a wreck–total snotty crying mess–and apologized to my LC for using all her tissues and being so emotional. She told me, “I only get concerned when moms AREN’T emotional. This is a tough subject for everyone, and if you’re here, you’re frustrated. I’ve gotten used to comforting while informing.” What a gift they have, to work with vulnerable new mamas and help them by whatever means possible!
      And so, so glad that your situation was resolved so positively!

  2. Wendy says

    Hey Meg!
    I just wanted to say “thank you” for being so open and willing to share about this topic. This is a great post for future moms to read. My sister had significant breastfeeding issues with her third child, even though she had had no problem with her previous two. Even though we hope our bodies will cooperate in every way to care for our babies, it’s good to keep in mind that some things aren’t up to us! And it sounds like you and Ben have found a great solution for Sam. I 100% agree that that is the most important piece. So nice job, Mama! Way to stay flexible and adjust to all the variables life presents. And way to share your experiences so other moms can be encouraged. Can’t wait to keep reading and see how Sam continues to grow and thrive.
    Love from Atlanta,

    • megcasebolt says

      Wendy – As one of my public health gurus, your support means a lot.
      I recently read an article where a mom complained that pregnant women, when asked if they were going to breastfeed, often responded, “I hope so,” instead of, “Yes of course.” Obviously that mama didn’t have any issues with her babies, but not everyone is so lucky … and thank you for sharing about your sister, who was successful with her first two before having difficulties. There are things that are out of our control, and unfortunately we have to learn to roll with the punches & adjust on the fly.
      Bet you’re not missing this snowstorm! Stay warm :)

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