Breastfeeding and IGT: A Doula's Journey

National Breastfeeding Awareness Month is coming to a close

And with it brings various emotions for different people. Some people celebrate another year of successfully breastfeeding their child, some reminisce about those special times spent with their little ones in the past, some people honor the donor or donors in their life who make it possible for them to nourish their child with human milk even if it's not their own, and for some of us, this time can also be a reminder of a relationship we have grieved or are still grieving to this day. 

There are many reasons why a person may have difficulties breastfeeding; for it being the most natural thing in earth, it can certainly be a challenge at times. There can be issues with baby's latch for one reason or another, our own anatomy can occasionally present challenges, and sometimes we simply do not produce enough milk to nourish our babies. Low supply can be associated to a number of issues ranging from thyroid disorders to hormonal issues, and for me personally and others like me, a diagnosis of Insufficient Glandular Tissue. 

“Preserving the ‘every woman can nurse’ myth contributes to perpetuating a simplistic view of lactation and does a disservice to the small percentage of women with primary causes of unsuccessful lactation.”

Glandular tissue is responsible for milk production and forms during adolescence and pregnancy. In some cases, a person's breasts may have developed fatty tissue, but did not form glandular tissue, resulting in low milk production. IGT can be attributed to various circumstances presented in life far before pregnancy and even child bearing years. Some of these include delayed or interrupted menstruation, hormonal disorders, use of hormonal birth control during puberty, and a high BMI during puberty. Studies indicate that IGT affects approximately 5% of lactating people, however it is grossly under researched. According to this study, lactation failure could even be hereditary. Or maybe it isn't and those women just had unrelated issues.

That's the point; we hardly know much at all about the root of why lactation failure occurs. It goes on to add: "These cases are presented to emphasize that primary causes of lactation failure do exist and to alert clinicians to the historical and physical findings suggestive of inadequate glandular tissue as an etiology of previously unexplained lactation failure. Preserving the "every woman can nurse" myth contributes to perpetuating a simplistic view of lactation and does a disservice to the small percentage of women with primary causes of unsuccessful lactation."

THANK YOU, KIND SCIENTIST. 

Breastfeeding comes in all forms and variations, and my personal breastfeeding journey has a little bit of everything. I had no idea that I would have complications breastfeeding; I had never heard of IGT and had no reason to believe my breastfeeding journey would be anything but typical

After my son was born, he cried A LOT. His was a constant cycle of nursing, crying, and sleeping due to sheer exhaustion for the first several days. Nursing was not comfortable for me at all, but I, like so many other people, assumed it was just a matter of "getting used to it." We had a postpartum appointment with our midwives about two weeks after my son was born and discovered that my son hadn't gained any weight. Despite almost constantly nursing, despite our complete lack of sleep, despite my being incredibly sore and raw - he hadn't gained even an ounce.

The realization that he was always crying because he was so hungry absolutely broke my heart.

Upon further examination, my midwives were fairly convinced that my son had a tongue tie, which contributed directly to the pain I felt. I was referred to an amazing IBCLC who diagnosed my son with both a lip and a tongue tie and began discussing our options for increasing my supply to counteract the poor latch we'd been dealing with thus far. My son's ties were revised and I tried everything under the sun to increase my supply; fenugreek, goat's rue, a ridiculous amount of lactation cookies, massage, pumping, constant skin to skin, you name it. Nothing worked. I became discouraged and depressed. I still nursed him at every feeding even though when my milk attempted to let down, it felt like razor blades coursing through my breasts. Based on the challenges I was still facing along with my own history of irregular menstruation, my IBCLC made the diagnosis of Insufficient Glandular Tissue.

“I poured what milk I could pump into the large mixing bowl full of goat’s milk and nutritional goodness that I had to thank for keeping my son alive, and it was like pouring drops into an ocean.”

Although breastfeeding was monumentally important to me, at the end of the day, I just needed my son to have enough food. We made the decision to supplement with a homemade goat's milk formula, which I can't say enough good things about. It was a huge peace of mind to know exactly what my son was eating, and it provided the necessary nutrients he needed to thrive. And that he did. He gained weight, he was happy, his digestive system was on track, and he was highly alert and sharp as a tack. We maintained our breastfeeding relationship for a bit longer as I nursed him along with an SNS, or supplemental nursing system, in order to both supplement him with the goat's milk and retain our bond to help boost my own supply.

Unfortunately, between the IGT and the lip/tongue ties, my supply had completely tanked. I still tried to pump and a 30 minute session would produce amounts too minuscule to even measure. I poured what milk I could pump into the large mixing bowl full of goat's milk and nutritional goodness that I had to thank for keeping my son alive, and it was like pouring drops into an ocean. But at least I knew in my heart that I gave him everything I could. 

For me personally, it became too great a disappointment to continue the attempt. My son was full and happy, and I needed to reconcile my own emotions, so I made the decision to exclusively bottle feed.

This of course didn't stop the inevitable questions we all face as new mothers; you know the ones I'm referring to, the ones that aren't anyone else's business even under the best circumstances - "How's the baby sleeping?" "Did you have a natural birth?" "Are you breastfeeding?"

Ok: 1) who the hell has a newborn that sleeps on a regular schedule right off the bat? 2) all births are natural so get outta my face with that, and 3) no, I'm not breastfeeding and that makes me sadder than I ever thought possible so thanks for bringing it up. I grieved. Hard. I still do. But, with my grief came recognition, not only for the privilege of other viable options, but of a community of people who face the same hardships I do. While IGT itself is rare, low production is not. It is a struggle so many people face for one reason or another and if you're currently struggling, no matter what your reason is, please know that you are not alone. 

My heart is so happy for each of you who have had a successful breastfeeding relationship with your little ones, and my heart grieves with those of you who have not.

Each breastfeeding journey is different, and none is more valid or meaningful than the other. As parents, it is our responsibility to do our best with what circumstances we have available to us, and those circumstances vary for every family. Do the very best that you can for your children every day, and find your peace knowing that much is true. 

- Rachael