Relactation Stats: July 4-December 2006

The table above is a condensed look at my relactation efforts. I started out pumping drops, as you can see, and have achieved close to 8 oz. a day this past month.

In another post, I will explain my use of prescription and herbal galactagogues and how I think they have helped my supply. I will also tell Justin's side of the story, drinking the milk and what his lab values show.

I will explain why I suspect that the domperidone is largely responsible for the amount of milk I have been able to achieve and that pumping, while important in building the supply, has not been as important in maintaining it. Otherwise, there should have been a decrease in the amount of milk I have produced as the number of pumpings in a 24 hour period have been reduced. Amazingly, the amount has staid the same, even though I started with 6-8 pumping sessions in 24 hours, and for the past 2 months, I have pumped only twice a day. Once at 6 AM and the other between 6 and 9 PM. Did I mention that I believe in miracles?

I would not recommend that mothers who are pumping to build or maintain a supply of breastmilk for their infant, use these statistics for their own situation! Except to be encouraged that if they follow the protocols I referenced in a previous blog, they should get favorable results. I prayed for 8 oz. of milk a day (don't ask me why), and that seems to be what my body is comfortable giving up. So, my results may be entirely different than someone else who follows a similar protocol. There are many factors that can influence an individual's ability to make milk. No two individuals and their circumstances are alike, so different results can and should be expected.

If you are interested in seeing my story in published form, please visit: http://www.withinreachwa.org/forprof/BCW/documents/breastfeedingwinter2006.pdf

July 3, 2006: I Begin Again

There is a reason why my journal ends with June 8, 2006 and picks up again on July 3, 2006. While I was pumping those 4 days in June I was also communicating with other lactation professionals about my plans to relactate. I found the website: www.asklenore.com. I began reading her information on Newman-Goldfarb protocols for Induced Lactation: The Guide for Maximizing Milk Supply and discoverd she had a "Menopause Protocol". I was not only intrigued by this, I was facinated to think I might be able to relactate at the age of 50. I realized I wanted to do this right, and knew I would need the understanding and knowledge of people who had gone before me. So, I emailed Lenore and she graciously replied that I could indeed expect to get a milk supply if I followed some of the rules she had laid out in her protocols.
What Lenore suggested is that I stop pumping. She said that without any preparation it is like "dry-heaving on an empty stomach." Indeed. I had already noticed that. She said I should start taking 10 mg domperidone 3 times a day and a birth control pill (she recommended Ortho 1/35). I had never taken birth control pills prior to this, so this was all new territory for me. The birth control pill, Lenore said, was to wake up my breast tissue that had been dormant for the past 6 years. I breastfed our 3rd son until he was 5 years old, so I stopped lactating altogether in 2000. I was to take the pill for 30 days straight with no interruptions, then quit taking it and start pumping. I was to continue taking the domperidone. Adding any other galactagogues was entirely up to me.

So, on July 3, 2006, I began my journey in earnest. I ended up taking the birth control pill for only 21 days because I had noted that I was already beginning to leak milk and I couldn't contain my excitement any more than a kid on Christmas Day! What follows is my journal entries for July 3, 2006. After that, I will be putting up fewer details and only what I consider to be pertinent information. For those wishing to learn more about the galactagogues or other details that may not be listed, feel free to email me privately or pose a question on the blog so others can learn too!

July 3, 2006 12:06-12:26

1. 3 ml pale white/yellowish tint. First pumping after 21 days protocol of Ortho 1/35 and Domperidone 20 mg. qid.
2. Symphony breastpump, let-down phase 6 notches, pumping phase 9 notches.
3. I sat up in my bed to pump. I did not massage my breasts prior to or during this pumping session.
4. I took 20 mg. domperidone. I also had taken 2- 620mg capsules of Fenugreek and 2-390 mg. capsules of Blessed Thistle at 10:00 PM before bedtime.

July 3, 2006 0307-0327

1. Just under 3 ml yellow/tan colored milk.
2. Symphony breastpump, let-down phase 6 notches, pumping phase 9 notches.
3. I massaged my breasts for 1-2 minutes prior to pumping. Once again, I am pumping, sitting up in bed.

July 3, 2006 0607-0627

1. Just under 2 ml tan colored milk.
2. Symphony pump, settings as above-6 and 9.
3. Massaged breasts for 1-2 minutes prior to pumping.
4. Took 2 Fenugreek, 2 Blessed Thistle, 2 Domperidone.

July 3, 2006 0911-0929

1. 4 ml from left breast, drops from right breast.
2. Symphony pump, settings 6 and 9.
3. I have developed cracks at the base of both nipples. There is fresh blood there. Ouch! And also, so what!

July 3, 2006 1204-1224

1. 1 ml pinkish milk
2. Symphony pump, settings 4 and 7. Too painful on higher settings.
3. I am feeling guilty. I am pumping in our office at work and Denise is out on the floor doing all the work!
4. Domperidone 20 mg.

July 3, 2006 1513-1533

1. 1 ml tan colored milk
2. Symphony pump, settings 5 and 8.
3. Pumping in our office. Switched to 30 mm shields to see if less torture for my damaged nipples.
4. Took 2 Fenugreek and 2 Blessed Thistle.

July 3, 2006 1813-1833

1. Drops only, did not save.
2. Symphony 5 and 8. In our office, end of day, writing a pump order for a patient.
3. Took 20 mg. domperidone.

July 3, 2006 2109-2130

1. 2 ml
2. Symphony 4 and 7, tired and in bed. Relaxed. Using 30 mm shields and much more comfortable than 24 mm shields.

Stats for the Day:

159 minutes pumping time

16 ml fluid pumped

80 mg Domperidone

3720 mg Fenugreek

2340 mg Blessed Thistle

Relactating: Day by Day

From my journal:

5:40 PM Monday June 5, 2006-- Medela Symphony breastpump, Let-down phase (7 notches), Pumping phase (5 notches). Right breast only until 6:00 PM, then Left breast, same settings until 6:20 PM.

I have called my breasts back into service. Justin, 17 years, has recently been diagnosed with ulcerative colitis. I believe if my milk protected him the 1st time around it can also heal him now. This is an incredible sensation! Rusty pipe droplets at the tips of both nipples this 1st session.

8:55 PM Monday June 5, 2006--Medela Symphony breastpump, Let-down phase (6 notches), Pumping phase (4 notches). Both breasts at the same time until 9:15

I am having 5-7 let-downs as I pump. This is not only going to be good for Justin--it is going to be a rewarding journey for me. I know I can do this. My body is telling me so. More rusty pipe drops, some yellow as well.

12:00 AM Tuesday June 6, 2006--Medela Symphony breastpump, Let-down phase (5 notches), Pumping phase (4 notches). Both breasts at the same time until 12:35 AM

More rusty pipe and even a drop into the shield on my right breast.

3:05 AM Tuesday June 6, 2006--Medela Symphony breastpump, Let-down phase (7 notches), Pumping phase (4 notches). Both breasts at the same time until 3:35 AM

I am really tired at this pumping but want to keep going. I will do everything in my power to see Justin's gut healed. So far his spirits are good but he is not crazy about the idea of drinking his mother's milk! More rusty pipe.

6:15 AM Tuesday June 6, 2006--Medela Symphony breastpump, Let-down phase (6 notches), Pumping phase (4 notches). Both breasts at the same time until 6:35 AM

Dripping into the shield this time. One drop on right, 0 drops on left. Rusty pipe and some yellow.

0944-1005 Tuesday June 6, 2006--Medela Symphony breastpump, Let-down phase (7 notches), Pumping phase (5 notches). Both breasts at the same time.

This one I am anxious to get over with so not having the familiar 5-7 let-downs per pumping session. There is a technician in the house putting in our cupboards, so I am in Justin's bedroom sitting on the floor. Usually I pump either in bed or in the living room. Still rusty pipe colored but a drop in both shields. Nipples feel tender.

7:00-7:20 PM Wednesday June 7, 2006--Medela Symphony breastpump.

Took to work today. Pumped at 0930, 1245, 1545. 20 minutes each time. Am now getting some dripping down into the shields from both breasts. Resembles caramel topping and is very thick and sticky. I have been rinsing the shields with small amounts of plain tap water and collecting with a 10 ml eccentric tip syringe. Then I place this in a ziploc bag and put it in the refrigerator. Justin will have 8 syringes partially filled to add to a milkshake tonight. This probably represents no more than 2-3 ml rusty pipe milk. I am also noticing less let-downs per session. Maybe the novelty has worn off. Suction settings are now comfortable at 8-9 notches in the let-down phase and up to 12 (out of 16) in the pumping phase. But I have to notch it up gradually. Is it my imagination or is this pumping whiter and thinner? I will have to remember to wipe the shields dry.

9:50-10:10 PM Wednesday June 7--Medela Symphony breastpump, let-down phase (9 notches), pumping phase (15 notches). 5 total let-downs

Barely a drop this pumping but white in appearance. Did not save it. Gave Justin all 8-10 ml syringes to use in his milkshake. He accepted it without complaint.

12:35-12:55 AM Thursday June 8--Medela Symphony breastpump, let-down phase (5 notches), pumping phase (6 notches).

Nipples are really sore. Got only light moisture both nipple tips. Don't be discouraged!

Justin, Then and Now

Before I begin to publish my relactation statistics, I thought I would show off my son with a couple of pictures. The first was when he was less than 24 hours old. The second was taken just this past week on Thanksgiving Day. It is a reminder to me of how thankful I am for my family, and the gift of life and health that I am allowed to give and receive, both then and now. Human milk is awesome!

Relactating

Mothers never stop thinking of ways to help their children. It doesn't matter how old the child is or what the problem is. So, when Justin received his diagnosis of Crohn's disease, I began to wonder if there was anything I could do to fix it. Quite frankly, I was petrified. I know that Crohn's is not something you have for a while and then get over it. It is a lifelong sentence. According to what I am currently reading, it can ravage major body systems and affect almost every aspect of family, life and work. Not a diagnosis to be taken lightly. I of course began to pray fervently for healing. Not just a lessening of the symptoms, not just a temporary reprieve. I wanted the Crohn's to be gone. Now, I am not into thinking that God needs my help to do his healing. And I don't make it a habit to try to tell Him how to do His job. But I did at least try to think of ways this healing might possibly come about. Being a lactation consultant, I have learned what a marvelous food human milk is for babies. It is unparalleled in its composition and in its capacity for providing protection against diseases of all kinds. The foundation that is laid in the early weeks of exclusive breastfeeding is so important for lifelong health. There is research that clearly backs this. I don't know why Justin has Crohn's since I breastfed him exclusively for 6 months and with complementary foods until he was 2-1/2 years. God has His own reasons. He also believes in second chances. Would he give Justin a second chance? Could it work the second time around? At first, I thought of donor human milk as a possibility. After all, Crohn's is a disease of the GI and human milk has anti-inflammatory properties. It would soothe his gut. But where do I get donor milk? Whose milk can I trust? There are milk banks, but they want $3.75 an ounce. Who can afford that? Then I began to wonder if I could relactate and be the donor myself. The more I thought of it, the more it made sense. My DNA is already imprinted on every cell in Justin's body. His body would recognize my milk as an old friend. And unlike donated milk from the milk bank, my milk would be raw and the immunities and antibodies intact. I am the perfect donor! But would I be able to relactate? In my enthusiasm, I began pumping with our Medela Symphony breastpump that we have in our lactation office. I was surprised to see a drop of fluid at the nipple when I turned the pump on. I kept this up every three hours for the next 4 days and each time was able to pull drops of colostrum-like liquid to the tips of my nipples. Not much, but a start. My nipples began to feel raw, much like they did in the early days of breastfeeding each of my three sons. I began using a little Lansinoh nipple ointment and triple antibiotic ointment. Both of these seemed to help a lot. I also had to experiment with flange size to get the right fit as I discovered that the 24 mm size shield was too small and caused irritation on the sides of my nipples from rubbing along the funnel of the flange during pumping. I also began inquiring of other lactation professionals if they had any pointers for me and my relactation efforts. One LC pointed out her set of relactation and induced lactation protocols which I thought very appropriately titled, "Menopause Protocol." I am 50 years old, and while I still have some periods, I feel that I am not far from complete cessation. I asked this LC for her advice. She suggested that I stop pumping and begin taking Ortho 1/35 for 28 days along with 10-20 mg. Domperidone, 3 times a day. She said this was necessary to "wake up" the breast tissue that had been involuted for the past 6 years. At the end of the 28 days I was to stop taking the Ortho 1/35, keep taking the Domperidone and resume pumping every 3 hours. I got through 21 days of the birth control pills that my doctor prescribed and my excitement couldn't be contained. My breasts were beginning to be fuller and were leaking milk. So I began pumping on July 5, 2006, every 3 hours for 20 minutes. Once again, I was on my way to making milk for my baby! Next post will give some of the nitty gritty on the galactagogues I have taken, the amounts I have pumped and am pumping and Justin's response to drinking the milk!

Justin

Justin is our second son. He was born on May 25, 1989 in Minneapolis, MN. I breastfed him exclusively until he was about 6 months old and started adding some solids around that time. He didn't like the prepared baby foods so I gave him pureed table foods. Mostly, he just wanted to breastfeed, so that's what he did. We continued this lovely breastfeeding relationship until he was 2-1/2 years old at which time I began having Panic Attacks (an old friend of mine) and my doctor told me I would have to wean before resuming antidepressant therapy. Not knowing any better, I agreed. Justin was not thrilled about being cut off from the breast and it hurt me to see him consoling himself by sucking his thumb and twiddling his own nipple (he used to twiddle mine while nursing on the other!). That concluded our breastfeeding relationship.
Justin's health problems began to show up when he was all of 3 months old. He came down with his first cold and it developed into an ear infection. He was treated with antibiotics and it went away--only to return with the next cold and the next cold and the next cold. This went on for years and the antibiotics began to be less effective until only the most potent would take care of any acute infection. He was also put on maintenance antibiotics for every winter when he seemed to have the most trouble. When Justin was 6 years old, we consulted with an ENT doc who said his tonsils should go. Justin had spent the better part of a year having repeated strep-throat infections and ear infections. After he had his tonsils removed, the strep only returned occasionally, but Justin continued to have colds and sinus infections. He has been treated with Augmentin through the years because that seemed to be the only antibiotic that would clear up the current infection. This went on until Justin turned 16. Then the bloody diarrhea started. At first, I thought it was all related to the antibiotics wreaking havoc on his bowel. We tried switching antibiotics but the diarrhea prevailed. Then it would go away only to resume a few weeks later. We decided it was time for Justin to see another ENT to see if once and for all we could alleviate his sinus problems and hopefully his need for antibiotics would go away and so would the diarrhea. So, Justin had sinus surgery in December 2005. Of course he still needed antibiotics and of course the diarrhea seemed vicious while he was on them. But his sinuses did seem to improve somewhat. Then, in March, I got a call from Justin from school asking me to pick him up. He said he felt extremely tired and dizzy and he couldn't focus on his schoolwork. I brought him home and pulled down his lower eyelids and was shocked to see that there was very little bloodshot. That scared me. He was losing a significant amount of blood in his stools if he was showing signs of anemia. So I took him to the ER where they ran some tests to rule out parasites, among other possible GI diseases. This was not the first time we had seen Justin's doctors for the bloody diarrhea. In fact, he had an appointment to see a specialist at Children's Hospital in Seattle, but with this latest episode, I was afraid his electolytes were out of wack, so that is why he ended up in the ER. About the only thing they could tell us was that he did have a mild electolyte embalance and he did not have parasites, C. Difficile, or a number of other things. Then on his 17th birthday, he had a colonoscopy and endoscopy. The diagnosis came back as Crohn's disease. And that is where my story of relactation begins. But that is saved for the next post.

Welcome to My Blog!

Hi! I would like to welcome you to my blog. There is a reason for the title and if you keep coming back to hear my story, you will understand why. First, I am a mother of 3 sons, all breastfed. I am also a board certified lactation consultant and work in a hospital setting. Even though my sons are 20, 17, and 11, I am relactating for my 17 year old son who was diagnosed with Crohn's disease last May 25, 2006. I have pages and pages of written documentation of my journey through relactation that I will begin to post here. I will also be putting down Justin's perspective of being a 17-year old, drinking his mother's milk (again). Justin has not had any flare-up of his Crohn's since he began drinking my milk. I asked God for a miracle, and guess what! He answers prayer! I would love to hear from any of you who are interested in the topic of breastfeeding, lactation, Crohn's or any rabbit trail that might be created as a result of this blog. That's it for now.
Jane