Lactation, Lactation, Lactation

An Account of my Breastfeeding Journey, for Moms who need a Boost
Yishan Lam | November 2020, Singapore

Photo by OFFVICES.COM

At 4–5 months post-partum I wanted to recount the ways and means I tried to make more milk for my firstborn. As someone who hasn’t yet gotten to exclusively breastfeed, some combination of these actions taken have gotten me from, so the spreadsheet says, 40–50ml pumping output plus 5–6 hours of direct feeding per day in the first 2 weeks, to currently 200–300ml pumping output plus 3–4 hours direct feeding per day.

Breastfeeding can be a harrowing, exhausting experience and an inexact science. My methods made up an experimentation journey in spurts; it wouldn’t be sustainable to do all of them simultaneously or for a long time. But insofar as these were things I did, maybe other parents might like to try them as well.

1. Get educated, get support

• My friend KL pointed me in the direction of Making More Milk: The Breastfeeding Guide to Increasing Your Milk Production by Lisa Marasco, which I read off the National Library Board app. God knows how many articles I read on low milk supply, but I found this to be a thorough, educational and practical read.
• When I reached the fourth week postpartum without a significant bump in output, I pushed myself out of my circuit breaker shell to see a lactation consultant. I saw Fonnie from Thomson Parentcraft (whom I took prenatal classes from before they were cancelled, because Covid-19) who tare-weighed baby to derive my nursing output, observed her latching and my pumping techniques, and taught me suck training exercises. Whilst my paed advised me to manage my expectations as I feared I’d reached a local maximum, she gave hope and a line of support to believe in the increase!

2. Enrol the family

• Being a lower supply mom especially exacts a physical and emotional cost on not just the feeder but everyone at home who has to help wash bottles and pump parts, carry the baby, etc… I have my husband and mom to thank for X getting maximum nutrition benefits I could offer her, with such outsize efforts to yield what might seem precious little milk.
• I needed to assuage my guilt that breastfeeding and pumping are one major inconvenience to all (plus water bill damage) and focus on the host of benefits it delivers, immunologically and psychically for your child. I tried to set daily formula quotas, cited the WHO’s recommendation to feed to year 2 if possible and made it clear to everyone the aspiration was to reduce the formula amount slowly. It was tough whenever baby’s coercive cries came on, in which case ‘fed’ was not only best but necessary.

3. The body is a temple

• It’s annoying to be told that sleep and rest aid lactation when there is a baby in need of constant attention, when her sleep times are the only time you can get other things done, or there are other stressors at play. But the 4–5 hours of sleep I got before my overnight pump at 4–6am indeed built up the quantity for the day, given prolactin levels are highest at night.
• Post-yoga, working out or a long walk, I’d also often feel fuller earlier, from the increased blood circulation; perhaps serotonin release? Meditation and visualisation of your child’s face, people recommend, did not create marked improvement for me, but can be both enjoyable habits.

4. Hydration and warmth

• Forums and internet literature are divided on how useful drinking copious amounts of water is to increase milk supply — it certainly forced me to the toilet more often, when I was already time-starved! What seemed to work though was to down a large glass of warm to hot water before or during my pump, so as to encourage let down.
• I also bought a Lansinoh hot or cold compress purpose-built for moms; I’d warm it up in the microwave and use it before a pump sans its polyester cover which was not moisture-wicking. This gave mixed results; I ended up using it to warm a sprained ankle (from getting back to running too soon post-partum) and inside my bottle kit as a heat pack keeping milk warm!

5. Register demand

• Breastfeeding is ultimately a demand-and-supply game, where it’s been said the only efficacious action is to keep emptying one’s breasts as often as possible, thoroughly. A number of things helps towards optimising milk removal, from pumping equipment to frequency and technique.
• As the forums all read, breast compressions and massage help greatly towards creating volume, even if it means you can’t be hands-free to multitask! I would step into the shower prior to a pumping session, for the heat and to prime the pump as it were.
• My friend G got me a Hakaa silicon milk remover to collect letdown on the other side when breastfeeding baby, which saves time for the pumping session to follow. You get better suction by flipping the lid back and then squeezing the vessel to create a stronger vacuum — how you apply it matters. I was not too religious about this however, as side-feeding was the usual way for me to calm baby down and let her focus when she was frustrated by the slow milk flow, which makes it hard to let gravity help using this method.
• In the first few weeks especially I would power pump for 1.5–2 hours with the Spectra S1 in the wee hours at 3–4am, when chances of interruption were least; in the roughly 20min pump, 10 min rest, 10min pump, 10 min rest, 10min pump cycle. This was so as to register demand, and also to yield as much as possible for the morning, as my strategy was to delay feeding formula as late as possible in the day.

6. Hardware

• I had to experiment, like many moms, with finding the right flange size, going through 25, 24, 23, 21 before landing on 23mm. A costly affair, but it affects yield and comfort.
• As the kind Hegen customer service specialists taught me, a manual pump can be an effective remover, allowing a deep expression and calibration. It’s a handy tool especially on the go. When I’m in the car, I get in the back seat (next to baby) where it is more discreet and pump with my available hand, so there is a stash by the time we are home. Waste no minutes!

7. Timing & technique

• It’s still a bit of a dark art, what creates yield on any given day. Sometimes a 5–6hr sleep stretch would yield more in the morning, sometimes if I didn’t pump it every other hour I would see my yield dip for the day. It’s all about observation and calibration. To give myself a good safety buffer not to dip, I would try to keep to a pumping rhythm of 2–3 hours, working through calls, or in the car. Even a 10 min pump is better than not at all!
• Pumping as the last thing before bed often helped me to yield more in the morning, telling the body to produce. Tiring, but good to empty out the system!

8. “Eating for two”: saving the fun part for last

• It’s amazing that a mother’s body supplies nutrition to her newborn, giving impetus to eat well. To me it was an interesting way to work with the body’s invisible chemistry, trying various adjustments to my daily intake.
• Supplements & Aids: I made my way through Legendairy’s Liquid Gold, Lechita and Pump Princess, Fenugreek pills bought off Amazon US, Swisse’s Breastfeeding Support from Watsons and Mother Knows Best via Pupsik. My aunts got me ground fenugreek from an organic store, meant to be more potent, coming from the shoots. Also good for skin, hair, cholesterol and other properties aunties love! Domperidone, prescribed by my paed for 1 month, didn’t make a perceptible difference for me.
• Food-based galactagogues: my mom-in-law, aunts and sister-in-law all made me the trad green (unripe) papaya with fish soup at various times during the first few weeks, which together with a large meal, I felt would boost my supply the next morning. I had fatty cod and salmon at least once a week, which is great for the fish oils as well. Omega-3s, baby. Other days, I’d make niku jaga (the Japanese housewife favourite Cooking with Dog has not one but 2 episodes dedicated to this!) for iron-rich beef.
• Oats, they say, aid lactation, so every fortnight I’d make a batch of Eleven Madison Park’s granola recipe — as published in the NYT, making for a nice breakfast or small gift for friends coming over or who’ve been a blessing to us. The restaurant used to give every guest a pack to go home with — so it was a way to replicate Michelin star hospitality! Stopped short of adding brewers yeast, which messed too much with the flavour for my liking. I would add dried apricots, which are supposed galactagogues, and as I like stone fruit. Also tried Milkingcowsg’s readymade bircher muesli which was gifted to us, hashtag support local!
• Fruit: Lactation made me order my very first durian e-commerce purchase, coinciding with the season. Apparently SOP with Thai moms, as also a filling, nutrient-rich flavour bomb!
• Fennel: Ingested in raw and cooked bulb form with tomatoes and balsamic, but I never was a big fan of the licorice flavour profile. Also applied fennel oil onto lymph nodes under arms; not sure efficacy; one is meant to do that also in moderation.
• Beverages: Speaking of brewer’s yeast, much better in beer form, and alcohol-free. I went through the e-commerce options for zero alcohol beer I could find, Suntory, Lotte, Veltins, and would literally BYOB to friend’s houses to teetotal whilst feeling part of the fun. Other beverages tried were coconut for the hydration, soy milk, and milk for the calcium and protein. It takes milk to make milk?

So viola, the ways and means attempted! Was it worth the time, cost and effort? I’d rather say that it’s been a learning journey that I could afford to go on, in an active search for knowledge, like all other classes of knowledge worth having : ) It was also a real check-your-privilege moment, reading about moms in other geographies or circumstances unable to feed, even if nature endows us with this capability fairly evenly. Hoping still that compiling these bits here helps moms who want to expand options and ideas.

What’s left is to thank cows, supply chains and manufacturing, with this classic Sesame Street segment I recall drinking from a bottle on a tilam mattress to, sleepy with milk:

Brings back mammaries?

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