About the
time I took Will for his two month check up, I was starting to get a feeling
something wasn't quite right. He had gone from sleeping and settling really
reliably, to being very restless throughout the day. By this stage we were down
to one night feed, then waking about 5am for his first morning feed. Will had
gone from really happy and settled to really... not. One of the things they
tell you to look for is enough wet and dirty nappies. He was over the line, but
not by a lot. I felt like he was looking a bit lean. He had been measuring up
around the 85th percentile, so he had always been quite chubby. He was
certainly growing, but he was a stretched out string bean. I had mentioned it
at his last check up, but they weren't concerned, particularly as he was still
sleeping through.
Then he
stopped settling at night. I'd give him his feed, put him to bed and half an
hour later he'd be awake, hungry again. I'd give him a top up and he'd go to
sleep and stay asleep until morning. I'd been hand expressing and storing the
milk in the freezer. Over a week these top ups went from 60ml to 120ml and I
was convinced I wasn't imagining things.
We went
off to see the lactation nurse I'd seen while we were in hospital still. She
listened to me and my list of things that weren't quite right, yet weren't
glaringly wrong either. Guess what? In the two weeks since our last check up,
Will had gone from 85th percentile, to 15th! He had actually lost weight!
It took
her about 2 minutes to work out the problem. When I was discharged, my
medications had all been checked for safety during breastfeeding. What hadn't
been checked, was the long term effects. It turns out ditropan (oxybutynin)
suppresses breast milk supply when it's used for prolonged periods. My happy baby
was grumpy because he was starving.
Side
note for those of you who don't have SCI- a para of my level has a reflex
bladder. That means that when my bladder fills to about 200ml, instead of
stretching like most peoples, it just empties right away. Ditropan allows my
bladder to relax and stretch as normal. This means I don't have to spend my
whole day racing to the toilet and I have far, far less bladder leakage issues!
Since I
kind of need my ditropan, we had to find another solution. More drugs! I was
prescribed domperidone, which is an anti-nausea medication with the happy side
effect of stimulating the pituitary gland, responsible for milk production. I
started on 30mg a day, and could increase (up to 60mg) or decrease to see how
much I needed. It turns out 30mg is about right. It starts to kick in within a
couple of days and settles after a week or so. So in the meantime, my starving
baby got to have a go at some formula. Within days Will was settled and happy
again.
 |
| Skinny baby gets a top up! |
When I
went to get my script renewed, I had the doctor weigh Will to see if we were
making any progress. He had put back on the weight he had lost, meaning, at 12
weeks old, he now weighed the same as he had at 6 weeks! But at least we were
on the right track!
The other
way to increase milk supply, is to increase demand. So, after every feed, I was
also expressing. At first it was only 20 or 30ml, but that quickly increased as
the domperidone began to work. Will was sleeping overnight, but I didn't want
my body to know that, so for a good month or so, I was getting up overnight to
express. I'd express before bed then get up about 2am and again about
5am.
There are
dozens of pumps on the market to help with this. I tried several, manual and
electric before I gave up and just went back to hand expressing. I just found
for me it was much more effective. I do really have to make sure I don't let my
hands get dry though, because I will give myself sores.
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