Beyond the Bottle

"You will feel fulfilled when you do the impossible for someone else"

Breastfeeding is the normal and natural way to feed a baby. However, this does not mean it does not come without problems or complications. For the majority of women, most problems can be easily solved with the the support and advise from La Leche League or a Lactation Consultant (LC). The more extreme cases should seek for the advanced expertise of an International Board Certified Lactation Consultant (IBCLC). Luckily, we have an amazing MD, IBCLC, Dr. Punger, right here on the Treasure Coast. She has had clients visit her throughout the State of Florida and even come as far as New York!

When the common issues of flat/inverted nipples, thrush, poor/improper latch, over-supply/under-supply and tongue-tie/lip-tie are quickly solved, breastfeeding can resume to normal. But what if you don't have those "easy to solve" problems? What if you so desperately want to nurse your child, but your body just does not make enough milk, or release the milk?

I want to share two beautiful stories from friends, Ivalee and Veronica, whose courage and perseverance to nurse their children is felt through their words. Both uses a Supplemental Nursing System (SNS), which is a small bag that holds formula or doner milk and has a very thin tube that attaches to the bag on one end and attaches next to the nipple on the other. This allows the mother to still nurse her baby, as the baby will get milk from the SNS tube, and maybe some of the mother's own milk coming out also. Mother can either maintain or build back up her supply (no matter how small amount it might be) while still providing warmth, bonding, love and those amazing immunologic properties of breastmilk.

Ivalee: "I am a mom who uses a supplemental nurser (SNS) with my child. For the second time now I cannot provide nearly enough to sustain my children. I had to hospitalize my first son at 6 days old for fear that he was failure to thrive. I had to give him formula the very day that it was publicly announced that babies were dying from melamine in the formula. That was so heartbreaking and difficult, along with knowing that my body was just broken and couldn't do something so natural as nursing my child. I don't match a single marker for why I may have hypoplastic breasts but, alas, there I was. At the moment I couldn't even think straight and wasn't even thinking of donor milk. I talked it over with my husband later and he wasn't comfortable enough with the process so we, reluctantly, settled with formula. Thankfully we have two beautiful, healthy boys who survived formula. If I get to have another child and have the same issues I'm sure to push the issue more. I've lived and learned so much through this process. I just wish I had more information on the alternate breastfeeding options ahead of time.

Ivalee using the SNS, baby at 6 months

With my second I did a weigh, nurse, weigh at the local hospital and in 45 minutes my son only got something like .15 of an ounce and he was about 11 weeks old. Luckily I had a wonderful lactation consultant who directed me to Dr. Punger. She has been amazing and when I suggested an ultrasound to check the function of my ducts she was immediately on board. We did some full and empty ultrasounds against the wishes of the local radiology group where the tech made it clear in painfully nasty tone that my breasts "just don't look like lactating breasts and I should just go ahead and stop." Ever have someone fuel your fire like that? How very tiring it can be to use an SNS and then still pump after every feeding for something like 2 days just to collect enough breastmilk to give your baby 2 ounces. I did this for well over a year before returning my rented "beast of a pump", the Medela Classic, because it was supposed to pull the most milk while pumping. I'm happy to say that I'm currently nursing a 22 month old on demand during the day (probably more as comfort because he does eat/drink solids) and once at the end of the evening with the supplemental nurser.

I have been able to supplement with an SNS and keep him at the breast for almost 23 months so far and for that I am forever grateful! Every chance we get to nurse is a gift that HE gives to me at this point. Try to remember that even though your previous experience doesn't fit the picture that you thought it might, that doesn't mean that it isn't success. Our little ones help give us experiences that make us better people and allow us to help others as well. I know that sharing is my outlet for dealing with the loss of the experience that I had dreamed of that didn't come true. So far I've been able to help a handful of girls hang on to a nursing relationship that wasn't quite the same as mine but using an SNS helped them to keep their baby at the breast while they built back up their supply and worked on getting baby to latch properly. I am very involved in my local LLL. For new moms, it can be confusing to see me use the SNS. I don't want women to think right off the bat that it can be that hard or near impossible but I also wish that I had been prepared more the first time around for the possibility of it. I can say, I'm happily still producing at this stage but probably only drops. I'll take it though. Every single drop counts."

"Success is not final, failure is not fatal: it is the courage to continue that counts." - Winston Churchill

Veronica and Elijah

Veronica had a breast reduction due to debilitating back pain. She remembers the doctor telling her she would not be able to breastfeed and feeling devastated, but at that point in her life she was not married or even thinking of children. Within months of her surgery, however, she met and fell in love with her husband-to be. She was determined to breastfeed their first child, Daniel. Although he latched on well, he was not gaining weight. Her breasts would fill up and become engorged, but there was no way for all the milk to get out. Eventually, Veronica had to bottle feed with formula. Daniel was fussy and cried alot; Veronica felt distant from her child. In preparation for their second child, Veronica started to research "breastfeeding after reduction" and learned about supplementing options. Sadly, she did not get to use it. Her daughter, Vivianna, had a traumatic birth, was born with brain damage and has to fed via a feeding tube. Finally, with her third baby, Elijah, Veronica was able to breastfeed with the SNS system. Elijah was receiving a little breastmilk directly along with home-made formula of all organic ingredients in the SNS. Veronica did use doner milk when she could. Between her 1st and 3rd child, Veronica learned about baby wearing and the bonding that it creates. She told me, "The kids are so different. Between the baby wearing and breastfeeding, it was a totally different experience." Elijah prefers the breast. He has always been a happy, smiling baby. Even though not much comes out at all, he loves to nurse, and prefers Mama. Veronica says he recognizes the difference of nursing for food and for comfort. He signs for the SNS when he is hungry, but will nurse without the SNS for comfort. (This proves exactly why breastfeeding goes beyond nourishment. And, when you "wean" a child off too quickly, or before they are ready, there are dramatic consequences. They nurse for comfort too!) Veronica rarely uses bottles. The SNS has different flow tubes for different ages, and is much more cost effective in the end compared to bottles. Plus, she is able to provide Elijah with the bonding and the small amount of precious breastmilk that does come out. "It IS a commitment. But, the benefits far outweigh the issues. Even with normal nursing, there are issues. But if you want that relationship, the rewards are priceless".

As Dr. Jack Newman states in his book, The Ultimate Breastfeeding Book Of Answers, "There are several methods of supplementing  that do not require the baby to receive an artificial nipple. The best is what I call a 'lactation aid' or a 'nursing supplementer'. This devise is best because: Babies learn to breastfeed by breastfeeding, Mothers learn to breastfeed by breastfeeding, the baby continues to get milk from mother's breast even while being supplemented, thereby increasing her milk supply, the baby will not reject the breast and there is more to breastfeeding then milk alone." The last reason is my favorite!

And then there are our Motherly Earth Angels, who selflessly donate their "liquid gold" to those mothers and babies in need. Their donations allow mothers that might have physical limitations, chronic low supply, birth trauma and even adoption to feed their babies with human milk through a SNS or bottle.

My good friend, Eugenie, shares her success story on how - and WHY - she donates her breastmilk to help other moms and babies:

"I always knew that I would breastfeed. It just made sense to me that it was the healthiest thing to do for my baby. When I got pregnant I tried to eat right for my growing baby. I ate things I didn’t like because I knew it was good for her brain, eyes, etc. I took every precaution to ensure that she was going to be perfect. When I was 22 weeks along, my sister-in-law had her baby 6 weeks early. I was so scared! I had nightmares for weeks. I was so emotional about her tiny baby struggling to stay alive that I could not even go to the hospital to visit. I was scared that it would happen to me too. I could not imagine my daughter coming that early, so every day after 34 weeks was a blessing to me. When anyone would ask me if I was ready for the baby to come I would say, 'No, she can cook as long as she needs.' She came at 40 weeks and 3 days. I was so relieved. She is perfect.

Eugenie and Gabriel

We started nursing right away. With the help of a lactation consultant, we were on our way with very few problems. From the first night my milk came in (at 3 am), I had so much extra milk. She would nurse on one side for a few minutes and then be full. The other side would leak a whole ounce while she was latched on. I had to pump just to release the pressure. I had so much extra milk; close to 75 oz in the freezer within a couple of weeks. I had no plans on going back to work and I knew that I would always be there to nurse my daughter when she needed me. I did a Google search online for milk donation. Out of the few I found, the one which stood out to me was Helping Hands Milk Bank. They collect milk for preemie babies who are younger than 36 weeks. I was moved because of what happened with my sister-in-law.

I applied online to be a donor. After I pre-qualified online, they mailed me a donor kit and emailed me some medical release forms for my doctor and pediatrician. The donor kit was a mouth swab, blood tubes, and a thermometer for the freezer. I had to qualify my freezer by emailing them my freezer temp. They scheduled someone to come to my house and take my blood. The mouth swab and blood sample are for a DNA match. It was a relatively easy process. The ladies were so nice and answered any questions I had. They did not provide a pump, but they do provide all the storage bags and a few other supplies too. When I have enough milk to send, I call them and request a cooler. They mail it to me with everything I need to send it back. There are 2 gel bricks that have to be frozen for 2 days. Once frozen, I call FedEx to come pick it up from my house. Helping Hands pays to have it overnighted back to them. I have donated more than 100 oz already.

I was a little concerned at first. It was easy to ship off half of what I had saved because I knew that it was extra. When I started to pump just to pump I was scared that I would pump and then there wouldn’t be any left for my daughter. There were times when she would nurse and nurse and there wouldn’t be any left to pump. I found that even the best pumps do not ‘get all the milk out’. I could pump a couple of ounces and she would always have whatever was left if she needed to nurse. I tried to offer her the other breast after she was done with the first but she never wanted it. It would just wake her up more and get milk all over both of us. After the first 3 months, her nursing/sleeping schedule stabilized and so did my pumping schedule. She is 8 months now and can go more than 2 hours without nursing so I am not worried about having 50 extra ounces on hand. I 'clean out' my freezer every 25 bags. If she does need some milk while she is with daddy, usually at night around bed time, we have no reservations about using what we have. Our baby comes first. Helping Hands makes sure that baby is getting everything she needs. They call about once a month to see how everything is going."