Friday, February 8, 2013

It was the breast of times, it was the worst of times


We took Magpie to the pediatrician yesterday. She continues on her track, tenth percentile, steady as she goes. Her head and length are both 40th percentile. The pedi agreed her muscle tone is "at the high end of normal" and said an eval with a physical therapist would not be a bad idea, so I will be pursuing that soon.  Everything else checked out just fine with her - she is rolling from front to back and back to front, holding up her head pretty well, "tripoding," reaching for things, cooing, following us with her eyes and head.

On the home front, though, things have been a bit rough. I had a mild case of mastitis last week. I talked to one of my doctors about it and they suggested an ultrasound was in order, because five bouts of mastitis in three months - all in one breast - is a lot of mastitis. So I got that and luckily there was nothing major, but it did show that some of my ducts on the affected (infected?) breast are "knuckled," and basically go in one direction and then bend backward the other way, offering, the radiologist said, lots of opportunity for kinks and clots. So boo. The other breast has nice ducts that flow like rivers toward the nipple.

not me
As though to drive home the point that my left breast is doomed, I promptly got another clogged duct later that day (Tuesday) and by that night, I'd developed mastitis again. Yup, that's six times now in three months. This time's infection came with a raging 103.8 degree fever. Fortunately my mom was here visiting and took care of Magpie for the day I was completely out of commission, but yowza. Adding insult to injury I'd developed some kind of GI issue (food poisoning? mild gastroenteritis?) and was holding my painful belly and yeching Tuesday night. The next morning I was too afraid to eat to even take an ibuprofen, and so delayed the antibiotics, etc., until that afternoon, despite the growing fever. So it is now the wee hours of Friday morning as I'm typing this, and I'm feeling better today. The breast is sore but not exquisitely so like Wednesday. Half of it is still beet red and hot to the touch. The skin now feels like it is a different texture from my other skin - somehow this infection, or the heat of it?, has affected that as well.

So I'm pretty much at my breaking point. I think I'm going to have to wean off of this breast or risk ongoing, escalating illness. To say I am sad about this doesn't even begin to cover it. Providing the food the Magpie has needed to eat has been a singular joy for me and has felt so vitally important.

So I told the pedi all this and that I didn't think I would make enough milk without the left breast and she handed me a package of formula. Hypoallergenic formula since major allergies, asthma, and eczema run in both Will's and my families, but still formula.

I took it.

Sheepishly, unhappily, I took it.

And I thought I would be ok with it, I really did, but the more I thought about it, the less ok I felt. Right after Magpie was born, when my milk was slow to come in, I looked into human donor milk. It is available, but it is ghastly expensive ($5 per ounce). So I had ruled it out and haven't considered it since. But today I thought...well, wait a minute...I'd just need to top off with the donor milk hopefully...and we've gotten to three months, so getting to four months is only 16 days away...getting to six months 60ish days after that, but way closer than it was before. So I am looking into it.

I'm also looking into milk sharing programs. I'm much less comfortable with this, but it's also significantly cheaper (approximately $1-$2 per ounce). The worry there is that the donor would have some undisclosed medication they are taking that could harm Magpie or that they are infected with an illness they could pass along (HIV, syphilis, HTLV, Hepatitis, etc.). I would ask for testing (and pay for it) if I were going to work with someone, but they could still engage in some risky behavior after that and get infected, and well...it makes me nervous. The cost however, has me considering that if I could find someone I felt comfortable with, it could be a way to eek out the next two and a half months of exclusive breastfeeding I had been so hoping for for Ms. Magpie.

It's tough. Will is not on my side with this. He thinks I should have stopped pumping and fed formula long ago and he is not inclined to be very supportive about it now. And I feel just as strongly that breast milk is important if there's any way I can provide it, and if I can't, well, so be it, but that it's worth looking into all of the possibilities to see what we might be able to come up with. I keep thinking that this is such a short period of time, two and a half more months!, that could help Magpie out for a lifetime. How can I not look at every option to offer her what is the normal and most appropriate food for babies? Thank God for formula - it is a life saver. But the fact that it is more convenient or cheaper is not compelling to me.

My strong desire for continuing with breast milk is based on my understanding of the policy statement published by the American Academy of Pediatrics in March 2012. Will reads it entirely differently than I do, but I thought they presented some cogent, data-driven arguments about the short and long-term health benefits of a minimum of four...and even better six....months of exclusive breast milk (breast milk via breast would be, by far, more superior healthwise, but alas, that is not to be.)

So I'm wrestling with recovering from illness and with some marital discord around this feeding issue (I know I probably sound crazy regarding it - Will certainly thinks so). But the girl is growing and time is passing. Tomorrow is another day. Let the left-sided weaning begin.

Mo

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57 comments:

  1. The skin now feels like it is a different texture from my other skin - somehow this infection, or the heat of it?, has affected that as well.

    I think it's the heat; I don't know for sure, but I believe the heat quite literally burns the skin sort of like a sunburn. At least, with mine, once the mastitis subsided and the redness faded, that portion of the skin then flaked and peeled just like a sunburn.

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  2. I realize you don't really want to hear from someone who agrees with Will, but I wanted to tell you, it's ok to suppliment with or even totally switch to formula.
    The thing Magpie needs the most is a healthy mama.

    Me, I was unable to breastfeed. My nipples are not hooked up to breast tissue. In my daughter's first 6 weeks, I managed to get a grand total of 1/8th of a teaspoon of milk from one nipple. (My daughter hated it.)
    The pressure to breastfeed made me feel guilty and contributed to my PPD. But I had to accept reality. In my daughter's case, breast was not best.
    She was formula fed. And now, she is a happy, healthy, almost 3yo.

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  3. Are you able to build up supply enough in one breast to feed her exclusively from one? I have two children who were exclusively bf for 6 months- and weaned at 18 months- and both were fed only from 1 breast. (long story).

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  4. Obviously you are an intelligent person who is more than capable of making a good decision, but I'm going to chime in with my two cents anyway. I have two little girls who were breastfed and formula fed for different lengths of time. Both are healthy, sweet, intelligent and loving little girls. Whether you fed your daughter breast milk or formula she is going to be okay. You may not. I personally think that the breastfeeding movement has gone so far, and done such a disservice to mothers in the process. You deserve to be enjoying these first few months with your daughter, not suffering through six bouts of mastitis. That's not good for anyone. Obviously I don't have any vested interest in what you do, I just wanted to add one voice saying that your daughter is going to thrive whether you choose to give her formula or breast milk. I'm sure you know that logically, but maybe it won't hurt to hear it one more time.

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  5. Hey, Mo. I've read all your posts on this subject and know how committed you are to nursing. Tiny Boy didn't have a drop of formula until 11 mo. LG, on the other hand, moved part time at 7 mo and full time at 10 mo, due to extreme allergy situation.

    That said: knowing your commitment to breastfeeding, I'd say figure out a way to supplement her--whether banked milk or formula, your call--and pump maybe once a day to give her your milk IF there's a chance she'll be able to nurse from the breast at some point (otherwise pumping is probably more hassle than it's worth). I've enjoyed feeding an older baby much more than I thought, and it's doing something to undo the damage of forcibly weaning LG... just an alternative.

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  6. I wish things could be different for you with breastfeeding but you need to know your efforts have been heroic. You need to know this. You are a good Mom. You have already gone to the ends of the Earth for this baby. I wish I still lived in NY because I would help you (and I would provide the bloodwork to set your mind at ease). Take care.

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  7. I felt exactly the same way you did in the beginning when we were having such a rough go of it. And then again 6 months later when we were dealing with no weight gain and recurrent plugged ducts on one side--although thankfully no mastitis. I just couldn't stop and give him formula. I heard all the logical arguments about me being a better mom if I was healthy, that my baby would be perfectly fine and healthy with formula, but I just couldn't wrap my brain around it. It felt like an epic fail on my part, so I get how you feel about it. My DH was supportive, but he wanted me to quit as well. I just kept telling myself that I wasn't going to quit on a bad day and regret it later. Hugs to you. I know it isn't easy, but in the end you will make the right decision for both of you.

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  8. So sorry, this has got to be so unbelievably stressful. I remember the first few months breastfeeding was the number one thing on my mind--after a few hiccups at first I got lucky and we were able to have a mostly stress free bf relationship (still going at almost 14 months). You are such a good Momma, whatever you decide to do she will be fine! I think donor milk is an idea...also hopefully at some point your one breast can make enough? And obviously a little formula won't hurt her--but having everyone tell you that over and over again probably makes you want to scream. Unless it is your baby and your breasts no one else can understand (to a point Will is included in this...men can't understand the biological and hormonal drive for mothers to keep providing breast milk). Do what you think is best.

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  9. FWIW, I was a successful one-sided nurser. My left-side quit because of recurrent plugged ducts. You will want to pump more frequently on the right side to stimulate supply there. A manual one-handed pump (Aveda has a great one; Avent is also good), can let you get in a few quick minutes of pumping in between sessions with the big pump.

    Also (IMO), hypoallergenic formula is a much, much lower risk than getting milk from an informal donor. (How could you forgive yourself if she got hepatitis?) I've always seen breastmilk as dose-response -- the more, the better, but there is no *harm* in topping off with formula.

    Your DH doesn't want to see you suffer. You could explain that for now, quitting would be more suffering than continuing (but maybe promise to reassess that line each week?)

    That's great that she's meeting all her milestones. Yay! Good luck!

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  10. I nursed one sided too after the first month or so with both of my kids. I don't know why but I could never make more than 1-2 oz at a time from my right side and that soon dwindled despite taking all sorts of measures. The other side made loads of milk. I looked pretty wonky and strange for a while but it was worth it to nurse exclusively for the relative,y short time involved.

    I hope you find a solution that works for you.

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  11. Both my kids started with formula supplements when I went back to work.

    I cannot pump enough milk at work to get a full supply for the time I'm away. The pump just does not do it for my breasts.

    With my first, I freaked out that I couldn't make enough. I talked with the lactation consultant, went on fenugreek, etc.

    Then I had an epiphany that I could just supplement.

    Problem solved.

    If you supplement with formula, Magpie will be still be benefitting from your breast milk, and you can sock the $1-5 into a college savings account.

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  12. I actually have more or less the same issue- one breast which is prone to chronic mastitis, plugged ducts, and an incredible pain. After trying about, oh, five different antibiotics, I'm now on cephalexin until I wean (I've had this round since June so far). With the first kid this also happened- I was in so much pain I'd be laying in bed feeding him and just crying my eyes out while my spouse said "You know, you could wean him and that would be OKAY."

    If you feel it's best for you to just wean, great! Formula is fantastic and WAY better than mastitis! I really truly hope you feel better and you can stop reading this comment now.

    There's a doctor here who specializes in recurrent mastitis and breastfeeding pain; I've seen her about ten times now! What I ended up doing is having a breastmilk culture taken for antibiotic susceptibility, and then treating both me (fluconazole 200 mg/d for a month) and the baby (nystatin 2x/day for a month) for thrush, and also antibiotics. She uses dicloxacillin, augmentin, azithromycin, sulfameth/trimeth... I'm on cephalexin now because macrolides give me true migraines. The doc's name is Eglash and she's published a few papers about it if you're interested.

    Again, if formula is a better/easier choice for you and Magpie, I am not in ANY way criticizing this. I just wanted to say I had a similar (and similarly VERY painful) experience and there was a pharmaceutical solution.

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  13. Nothing here but love and support in this challenging time. I agree with the other posters, I think that you can build up supply in one breast so that you wouldn't need that much donor breast milk if that's the way you decide to go.

    Wishing that I could help in some way! Sending love and assurances that you are an awesome Mom, however you resolve this. Also, just a nosey question-- are you still trying to get Magpie to try nursing about once a week? Perhaps after this 4th surgery there will be a way that she can nurse which is a *much* more fulfilling relationship for everyone.

    Hugs from here!

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  14. Hun, I'm with Will. Your pedi was fine with formula, that should tell you something. The risks of using an unscreened donor FAR outweigh any benefits (and also: yuck).

    Please supplement. Magpie will be fine.

    Also: wow, rolling/tripoding at 3 months! That's way early!

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  15. I'm with Will, too. My kids were both formula fed, as I had very little supply and cannot take supplements due to a heart conditions. They're both in day care, too, at ages 5 and almost 3. And, knock wood, they are way healthier and sick way less often than most of my friends' kids, including may who were breastfed to a year. This is not to say breast milk isn't great, because obviously it is, but there's a lot more that goes into a child's health in the short and long term than just breast milk.

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  16. It may be too out there for you, but there's a Facebook page on Human Milk for Human Babies where you could possibly find someone local to give you some pumped milk. It's going on trust but the pumper was presumably going to give the milk to their own baby at some point.

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  17. Just jumping in to say -- she will likely be fine on formula. But! I also nurse from one side and its enough. YMMV, of course, but if you choose to try that, it is possible.

    But supplementing with formula is a perfectly valid choice too! Take care!

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  18. FWIW (not much), my son was exclusively breastfed for 9 months (including several months of exclusive pumping and recurrent plugged ducts), supplemented with formula from 9 mos to 1 year, and not weaned completely until 15 months. Despite all that effort, he had chronic ear infections from 6 months to 9 months and ear tubes placed. After a year, one of ear tubes is coming out (apparently normal), and we've already been through another two ear infections. In the end, I loved nursing, and I can't wait to bf #2 (I hope she takes to it better than her brother did). But it's not the be all/end all/cure all.

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  19. I am enthusiastically pro-formula and was 100% confident that it was the right choice, not only for my (bright and extremely healthy) daughter, but also for me -- so, admittedly, I cannot at all relate to your belief that good things will happen if, and only if, she is breastfed. But might I propose an analogy:

    Imagine yourself, and Magpie, five years from now. You desperately want to provide all of her nutritional needs through foods that you prepare. Despite spending months preparing every leafy green known to man, and suffering many painful cuts and burns to your hands in your attempts to try different cooking methods, Magpie simply can't or won't eat it. Your pediatrician tells you that, despite your best efforts, she is iron deficient. He hands you a bottle of Flintstone vitamins.

    Would you get past your belief that a good mother could feed her child enough spinach and give her the vitamins to help her get what she needs for her growing body? OF COURSE you would. Would this be to Magpie's advantage? YES. Would anything bad happen because the thing she needed came from a bottle instead of from you? NO.

    GIVE HER THE FORMULA.

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  20. I agree, Mo. I've commented many times here previously that you're my hero. Your tenacity and grace are remarkable but even I have to say, it sounds like enough is enough. I'm a huge proponent of breastfeeding (breastfed my son for more than 2 years and hope to do the same when my daughter arrives) but I agree with the above poster; breast milk is not the be all and end all. I think my son was sicker with colds and ear infections than any other kid we knew. I'm not saying that the breast milk was not beneficial and nursing at the breast was a great comfort to him when he wasn't well but don't think of breast milk as this magic elixir that is going to mean the difference between a child who thrives and one who doesn't. Not to mention, is it worth passing 6 courses of antibiotics to the baby through your breast milk?
    You may find she will gain weight faster on formula too. My sister in law gave birth to a little boy with a VSD. He was on diuretics, which contributed to his failure to thrive weight-wise but children with VSD also need more calories. When she switched him to formula (I wish she had supplemented instead) he gained enormous amounts of weight.
    I think you really need to evaluate your reasons for taking this so far. Every study out there will tell you breast milk is better and no one is contesting that but part of me wonders if your long battle with infertility leaves you with a need to prove that you can do it (and I'm not criticising this as a reason either). To be honest, I'm not convinced that banked milk is soooo superior to formula, it certainly doesn't contain the antibodies in fresh milk. And honestly, there is not a human being on this earth whom I would trust as a source for fresh breast milk. Yuck.
    I hope you take it easy on yourself. How many years has it been since you've allowed yourself to unwind; it's as though you have had to conquer one challenge after the next. I think your idea to wean the one breast is a good one. But I really do think you should consider supplementing with formula, rather than the alternatives you mentioned.

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  21. I am very pro-breastfeeding IF it works for you. It worked wonders for us, but I know that's not always the case.

    Anonymous @ 10:04 makes a great point! I had never looked at it that way and wish I had that analogy when encouraging my friend to STOP breastfeeding due to recurrent mastitis 3 months ago. Mothers are too hard on themselves when it comes to breast feeding.

    Good luck!

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  22. I think you're being too hard on yourself Mo. I know you strongly believe in breast is best...but formula is not the end of the world. I had wanted to exclusively breastfeed Lexi when she was born...but she wouldn't latch. I pumped and gave her my milk for 2 months...but my supply waned and I switched to formula. Nothing bad happened to her. She rarely gets sick and she's a happy, healthy almost 4 year old!

    And one other thing I wanted to bring up to you given your history...please have IBC ruled out as some women with IBC are often misdiagnosed with mastitis.

    http://www.cancer.gov/cancertopics/factsheet/Sites-Types/IBC

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  23. Mo, please, let it go a little. Maybe righty will be able to supply enough, but if not, supplement. I've said before, I'm not convinced there's a significant benefit to EXCLUSIVELY feeding breast milk versus combo feeding. I suspect lactavists push for exclusivity because they fear the "slippery slope" of supplementing will lead to total weaning. Not true! And as others have said, it's not about "convenient or cheaper," IMO, donated milk does not have the safety standards as formula.

    Much love, hon. Hope you feel better soon.

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  24. I have to side with Will on this one. At this point in your journey, I just don't see any benefits that could possibly outweigh the strife this is causing for you and your family. I do think Will should have some say in this...I doubt he enjoys seeing his wife and daughter struggle. And maybe he sees things just a little clearer since he's not the one who has been so sick. At the risk of coming off harsh, it's starting to sound like the breastfeeding propaganda has won it's battle with you.

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  25. I'm so sorry you have to go through this. I wish there was an easy answer. I had one bought of mastitis with a high fever and that was enough for me. I can't even imagine 6! Your dedication to this is amazing.

    I wish there was an easier way for you. I have to agree with some of the other commenters. Try with the one side and see if your production increases. As for donated milk, I couldn't risk not knowing so I would shell out the extra money. However, when my milk ran out, I switched to formula and my daughter seems to be just fine. She's healthy and growing.

    It's a very personal choice and you have to do what is right for you. Good luck! And sending you healing thoughts!

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  26. I meant to add for what it's worth I found it very hard to give up breast feeding each time, not sure if due to hormones, breast filling and the urge for the milk to flow, who knows. But once I stopped those feelings disappeared and it really wasn't a big deal. It's possible you are stuck in that really difficult spot and things will be a lot easier if/ when you do stop. Not saying you should, just wanted to raise it. My kids are of course fine from formula feeding post breast feeding.

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  27. mo, i am normally right on page with you, but i have to offer my differeing opinion here-
    come on!! formula is fine! are you kidding me? it is actually offensive to those of us who may choose to supplement or exclusively use formula, what you are saying. you are so far deep, you can't see the forest for the trees. you have had an infection from this, 6 times now, in which you couldn't care for your baby at all. THAT is better than your pediatrician recommended allergy-free formula supplemntation? come on now.

    i know you want to do it. and you are doing it. let your one breast provide some breastmilk- great job mama! and then the other choice is really yours to make... pay thru the roof for screened donor milk, take a huge risk for the unscreened stuff (really? really?!), or just use the frickin' formula. you have been very, very, very attached to this and i do not believe it is a healthy rumination.

    for me, i say, just use the frickin' formula. SO MANY HEALTHY KIDS arer raised on formula. they are not inferior morons because their mom's didn't give them some or all of their nutrition from breast milk.

    i am sorry if i sound harsh. magpie is healthy, growing, hitting her milestones. you, on the otherhand, are suffering and sick with infections and emotional self-flagulation over this breast milk issue.

    you are a great mama, mo. that is the bottom line, so, i know you will do what is best for you and magpie... even if it is different than this little rant of mine ;)

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  28. Mo,

    While I completely understand where you are coming from, I think you are being entirely too tough on yourself. I am a NICU nurse and am expecting my 1st baby in August. It is also my desire to exclusively breastfeed my baby for as long as possible. But if for some reason or another I am physically unable to do so, I know in my educated heart that formula is okay too. Magpie is so lucky to have had only breastmilk for this long, I seriously doubt her IQ will be any higher or her health will be any better if she only gets breastmilk and not a breastmilk/formula combo for the next few months. You could be surprised, your "healthy" breast may pick up the work load if you wean yourself from the other, the formula supplementation could help boost Magpie's weight a bit, and so on. Formula is not the worst thing in the world. However, I feel very strongly about giving babies milk from other mothers that doesn't come from the milk bank, where the donors have been screened (as though they are donating blood) and the milk has been pasteurized. Would you give Magpie a blood transfusion straight from someone you know vs blood from the hospital's blood bank? There is no difference unfortunately and you could be exposing her unnecessarily. And I agree with an above poster, Will is her father and should be able to weigh in on the situation as well.

    Good luck on whatever route you decide upon!

    -B

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  29. Magpie is your and Will's daughter and no matter what anyone says here, you have to do what is best for you and your family...and only you can decide what that will be.

    I'm not here to try to convince you that formula will be okay. I can tell you that my daughter (who was adopted at birth) has been formula fed from day 1 and at almost a year is thriving with milestones and has yet to be sick.

    It's always hard to read these kinds of posts and the comments where some breast feeding mamas equate formula to some kind of junk food crap. "...but it's still formula." When I read these kinds of things, I can't help but feel judged in a backhanded sort of way. Of course I wish you well and hope that you find a solution that fits, but in the same breath ask you to consider not condemning formula in a way that makes those who must use it inferior.

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  30. Ugh, sorry you are going through this. I feel like you should be exempt from all major baby care difficuluties! Sending a hug.

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  31. I read all blogs lately on my phone but I charged up my computer just so I could write you a comment because my heart truly goes out to you.

    With my firstborn I had my own BF issues though not quite so severe even remotely. I wept with guilt at wanting to quit BF because my mother breastfed me and I saw the effects in my life as in being a very healthy baby, child, adult [so far, knock on wood]. I explained this to my mom as my reason for continuing breastfeeding despite the pain and hell I was experiencing and she told me her dirty secret "but Aisha, I formula fed you."

    Mo, I'm just one anecdote but there are millions of people walking around also formula fed like me who turned out just fine. My own doctor shared his story of having been fed condescned milk, sugar and a dollop of vitamins mixed in as his formula and well, he's a doctor!

    I didn't have the issues you are experiencing and I did breastfeed my son and I am 100% pro breastfeeding however formula is not acid, it is not poison. Giving her formula does not doom her to be on the bad side of the stats. Just because she's formula fed doesn't mean she'll GET diabetes, obesity, etc etc. She will be fine.

    I'd also really really caution you against the milk donor programs. The risks for those outweigh the benefits from what I've researched. My husband works at the CDC and when we looked into it, people very strongly stated it was not a good idea, not to mention, studies on the benefits of breastmilk are regarding the benefits of one's own mother providing ones own milk formulated specificially or one's own child. The benefits of donor milk is not documented well enoug but the risks are obvious enough.

    It's your choice at the end of the day, but your daughter deserves a healthy mom. This is more important than how you feed her.

    Good luck, thinking of you.

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  32. I just wanted to send you a hug. Be extra kind to yourself if you can. I'm glad you have your Mama by your side.

    The decision you and Will make, whatever it is will be the right one.

    I'm hoping for some rest and good health for you as you enjoy your new precious girl.

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  33. I don't think I've ever commented though I've been reading and admiring you for years - I just had to weigh in.

    The SINGLE most important factor affecting a baby's health and well-being is the health of the mother. You have had SIX infections that have at times left you feverish and unable to care for your child, who is having problems gaining weight.

    GIVE HER SOME FORMULA!

    I have two children. The first was a tiny little guy who only filled out and hit his physical milestones after I started supplementing at six months - I am still bothered by the thought that he may have been hugry or that I may have been inhibiting his physical progress because if my stubborn insistence that breast is best.

    After six years of fertility treatments and heartache I finally had number two and was determiend to BF for a year. Well he was hospitalized with respiratory issues at 4 weeks and couldn't latch. He had issues for 4 months during which I pumped but then finally gave it up because I was falling apart.

    I felt so sad because I had spent six long years dreaming of bfing again but once I let it go I could focus on other things.

    Today they are 7 and 13 months and happy, healthy and thriving. There are so many decisions you make as a mother. BF is just one and it seems you are so far into the trees you can't see the forest.

    Please give yourself and your daughter a break and do what's necessary to ensure best heath for your whole family.

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  34. I EBFd my second son, did everything I was supposed to do, but he has life threatening egg and dairy allergies. If it's going to be it's going to be. My first son had formula when he was a newborn and is fit and healthy. I had no issues breastfeeding at all and loved it, it was important to me. But it's not worth it to make yourself so sick. You are also potentially giving magpie small doses of antibiotics via your breast milk which has been linked to asthma too. You really have to do what's right for you today and not worry too much about what will happen in the future, you do your best and some of this stuff is beyond our control. Gosh being a mum is hard. I know it's that hardest thing I've ever done.

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  35. Hi, Do what you think is best.
    The followong blog and fb page has helped me:
    http://www.fearlessformulafeeder.com/

    Good luck with whatever you and Will decide.

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  36. My son exclusively nursed from my right breast. Its a matter of supply and demand.... I guess it could be different since you are pumping..... But if you get her tongue thing fixed and she could nurse it would help your supply.....

    And really don't beat yourself up. You have gone overboard trying to nurse. If its not meant to be its not. She will be fine if you use formula. Many of us never nursed and we are fine (me me me!!) Magpie will be fine with formula.... You are an awesome mom.....

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  37. You can make your own formula. There's some recipe in the book, Nourishing Traditions by Sally Fallon. You can use Raw Milk or Broth but you might feel better about giving natural formula than the man made stuff. Here's a link anyway.
    http://www.realmilk.com/how-to/recipes-for-whole-foods-baby-formula/

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  38. Props to you for continuing nursing!! I very much admire you, with all you've been through. If it's any consolation, at 5 months my daughter decided she would NOT nurse on my right breast. Refused. I saw three doctors and a lactation consultant and we never did find out the cause. So, from 5 months to 13 months she nursed on my left side exclusively. (we did not introduce solids until 6 months and even then she was not that interested.) The right breast eventually dried up and we continued on, mostly because I believed in it, loved the bond, and she hated the bottle. In fact, she never did take a bottle or formula. And we got along all right.

    You do what feels right to you. There are a million ways to accomplish a full baby's tummy and all of them can be the right choice.

    {{hugs}}

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  39. There is a post on The Fearless Formula Feeder today that you should go look at. Puts things in perspective. Good luck to you and Magpie!

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  40. Oh Mo,
    This is such a hard thing... Let me tell you a story. LIke you, I have had years of infertility, a few failed attempts at IVF and finally I was blessed with my first DD. I was determined to BF exclusively. For three months I braved the pain, the PPD, the latching issues and one (only one) mastitis incident. Finally, somehow, I managed to get through the tough times and do it. I was so happy!!! Then when she was around 6 months of age, both me and my DH decided that it would be wise to give it another try at IVF. We really wanted a second child and god knew how long it would take me to get pregnant again.... So with a VERY VERY heavy heart, lots of crying and self doubt I decided to quit BFing and give that first injection. I will never forget that day. That morning, I was BFing my daughter in our bed knowing fully well, that once that BF session was over, I had to go downstairs and give the first Lupron injection, thus ending any nutrition she would get from me. There was nothing wrong with my supply at that point, there was nothing wrong with her latching, there was nothing wrong with our BFing relationship. It was just DH's and my desire to add to our family.
    I can't even tell you how difficult that decision and IVF round were. For MONTHS, I hated myself for having given her formula. Actually, because of all my emotional issues with giving her formula, I ended up throwing up almost every time I would attempt to feed her formula (talk about some crazy things going on with me at that time)... I was convinced that breast is best.
    But, here she is, at almost 4.5 years old, having had 6 full months of formula, and you would NEVER had known she was formula fed. She's healthy, smart and an amazing little girl. :)
    On the other hand, my second DD, who ended up being exclusively breast fed for 17 months, ended up with an RSV infection that landed her in the hospital for 7 nights, needed a surgery for a separate issue (giving us another 2 nights at the hospital) and since then, has ongoing asthma issues.
    Bottom line, it really doesn't matter how you feed your little one. As long as you are healthy (both physically and mentally) and she's healthy, that's all that really matters!

    I hope you figure out what's the best thing for you and your family. Maybe, just one side BF would be perfect, maybe a combo of BF and formula, maybe straight formula. Whatever works best for all of you.

    I am not taking sides, I was just sharing my personal experience....

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  41. I have this theory that the hormones of some nursing mamas (myself included) make us hardwired to hate the thought of giving our babies formula. It doesn't matter if changing to formula (or supplementing with formula) might be the better choice, we can't stand the thought of anything but breast milk for our babies.

    Of course, previous posters have already reminded you of the truth of the matter, that Magpie will be fine if you have to supplement, and in fact may do even better, since you will be healthy. But that doesn't change the fact that your hormones are screaming at you that it just isn't so!

    I didn't struggle with BFing, but I did struggle with weaning, when it was time to start TTC again, and put it off for 6 months longer than I'd originally planned. Those 6 months might be the reason I'm having to go to donor egg for number 2...but hormones are powerful things. As you're deciding on what to do now, be sure to listen to your head, and not just your heart.

    (((hugs)))

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  42. I haven't read the other comments.

    I don't mean to alarm you, know (basically) nothing about it, and see (I didn't read comments but I did search) that someone has already posted. But it was just this week that Mel at Stirrup Queens posted about Susan Niebur's death from IBC a year ago, and her (Susan's) page on it is I think worth your reviewing (and talking to your doctor about?): http://toddlerplanet.wordpress.com/inflammatory-breast-cancer/ .

    I trust that you don't have IBC, but ... please ... get checked if you don't feel what you've already had done has ruled out this possibility.

    As for the BFing, I was never an exclusive BFer despite my efforts/desire to do so and honestly found it very frustrating that there's really no evidence (at least not that I could find) about BFing as part, but not all, of an infant's feeding. The comparisons all seem to be between EBF and EFF, and ... it's frustrating. My hope as a non-exclusive BFer was (and is) that providing all the BF you can (I could) and supplementing with formula beyond that still conveys most of the goodness of BFing, but the data just aren't there (that I could find) to tell us. Still, for what it's worth, if you can continue to BF but avoid the mastitis, even if you can't provide all of what Miss Magpie needs, surely she'll still benefit (antibodies and such) from your milk?

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  43. Hi, I've never commented before, but I have followed you for years. I had trouble nursing my first and ended up pumping every three hours for a year, in addition to nursing. Looking back on it with perspective, it was serious insanity. I was SO FIXATED on supplying my milk that I have some pretty overall unhappy memories of that year. I, too, did what you are doing right now mentally... only fifteen more days until x month... only thirty days until x month... I pesevered, and I have to say, if I could do it all again, I would have given formula. I even took domperidone, which no one has mentioned. It is allowed in Canada but outlawed here. Fenugreek did NOTHING for me, but domperidone kept my production up to maintain my crazy that year. I ordered it online, and it is so expensive. However, it tripled my production.
    Please take a look at this, though. I feel the breastfeeding movement (and I am part of it) has gone too far.
    http://www.theatlantic.com/magazine/archive/2009/04/the-case-against-breast-feeding/307311/

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  44. Hi Mo, I've been reading you for at least a couple years now but this is my first time commenting, I suppose this is the first time I had anything potentially helpful to add! I just brought my son home from the NICU a week and a half ago and there was a question as to whether or not I was going to be able to breastfeed him. I asked the neonatologists whether or not banked breast milk was an option for us and they told me that honestly there was no point - the main benefit of banked breast milk is for babies that have digestion issues and need something "gentler" than formula. They said because banked breast milk is pasteurized that pretty much negates any of the benefits of the live antibodies so they would not recommend it in my son's case.

    As so many others have said you are seriously such an amazing mommy and I can understand how difficult it is to let go of something like EBF when it is what you had in your mind as something you wanted to do for your baby. You've done your very best and I really doubt that supplementing with formula at this point will harm her or deny her any sort of advantage. I can't imagine sticking with BF-ing after all you've gone through and when your little girl is older she is going to appreciate all the pain and sacrifice it took for you to give her your milk all these months.

    I know it probably doesn't mean much coming from a complete stranger but please don't beat yourself up over this! You are a great mom and Magpie is going to grow up to be a strong, beautiful, intelligent woman whether you give her some formula now or not.

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  45. I wish the big man up the the sky would cut you some slack! I am so sorry to hear that the mastitis is chronic. I think the one-sided breastfeeding can work for some people and there is absolutely nothing wrong with formula. You've gotten Magpie through the critical stages with exclusively breastfeeding even at great cost to your own health and sanity. I hope that you can feel good about what you have accomplished and not beat yourself up if you end up supplementing with formula. Most kids in the US are on exclusive formula at 3 months. I know this has got to be so hard and I pray that you will not be too hard on yourself - you're an amazing mother - this fact is not contingent on breastfeeding or not!

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  46. The skin changes could also be caused by cellulitis, so please have it checked out if you are not feeling better soon or if the antibiotics do not seen to be working.

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  47. I was very fortunate that I had a straightforward experience breastfeeding my (IVF/only)child for the first three 2-3 months of her life. She gained weight and I was lucky enough not to suffer any major pain or discomfort. BUT, then the disease activity of my arthritis, which had improved during my pregnancy, started up again with a vengeance. I became unable to walk, to lift her and to carry her safely. I needed someone with me 100% of the time to be able to physically care for her safely. I began to see the confusion in her eyes when she could tell that I could tell that she needed picking up, but I didn't (couldn't) respond.

    For me, I painfully came to the conclusion that the EMOTIONAL cost to my baby of my reasons for continuing to breastfeed (supported by all my reading of the research evidence of course) was too high a price for her to pay. From 3.5 months (I can remember the hour and date of our last feed) I resumed my meds, which were incompatible with breastfeeding, bought what I had researched to be the best formula I could, and offered my daughter a mum with way more physical and emotional energy to be available to her.

    My daughter continued to be in good health (now with two years of pre-school and school under her belt she has never been off sick). Before I stopped breastfeeding, her percentile weight began to decline - I'm sure the physical toll of my pain and the stress of the situation was impacting on my milk production. I hated seeing her weight drop and I felt that this could compromise her health more than the change in milk source, when it came to her resilience and strength to battle any illnesses. I also hated the thought of her being hungry, and questioned the nutritional value of milk produced when I was in such a state of pain and stress.

    I trained and work as a Child & Adolescent Psychotherapist, and take seriously the idea that a baby takes in so much more than physical sustainance when they feed. When I bottle fed my daughter I followed the advice of a wonderful senior colleague, to place her next to my naked skin, and snuggle her tight, just as if we were breast feeding; I tried to give her the chance to drink in the love and attention of a mum who wasn't compromised by pain or confusion.

    I don't know what would have happened if I had continued to breastfeed, and whilst at the time, the relative ease of early breastfeeding made it hard to give up, with hindsight it probably also made it easier to work out my feelings about it and (especially after the trauma and feelings of failure of infertility), to be able to let it go.

    I hope you can find some peace in whatever decision you make about this very personal matter. You have given Magpie so much already, under very difficult circumstances for you both. I wish you all hope and peace as you journey onwards x

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  48. I tried breastfeeding for ten days while the twins were still in the hospital. VERY LITTLE milk ever came in. Very little colostrum. And I have flat nipples, which apparently is a problem. We tried a ton of things... and I was trying to feed TWO (4.6lb & 6.4), who were already being supplemented with formula BEFORE I was even out of recovery.

    I cried and talked with loads of lactation consultants. And finally I was crying in the nursery and the pediatric nurse was just like, "sometimes our bodies are just assholes to us. Yours was with the infertility, and so often women who struggled with infertility also struggle with breastfeeding."

    And so, I went to formula.

    Coincidentally, I resent anyone who is judgy about not breastfeeding.

    Do what's right for you!

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  49. I admittedly did not read all the previous comments so this may have already been mentioned. I understand that you'reuncomfortable with donor milk, however, we have been using it with my now almost 2.5yr son since he was about 3mon old. Most of it we have gotten through Human milk 4 Human Babies, from donors who were mostly strangers. Baby E is as healthy as anyone could be (our older son ahs had 3 bouts of strep in the last several months and E hasn't gotten it once). I understand your heistation with using donor milk, however, what I've (and hubby) come to is this - these are mamas who are feeding their own babies this milk. They've all had recent testing during pregnancy which would have identified any kind of diesase/infection. That said, there was one donor who I felt off about, so we didn't use her milk. We have used the milk of over 30 different mamas to date. I'm ridiculous grateful for donor milk. I read the research and could fine any instances of a baby being infected by donor milk either. Good luck finding a solution that you feel good about :) Parenting is hard!

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  50. WOW - I'd love to give an opinion here, but it looks like you've already received a boatload. But in reading the previous comments, what really strikes me is how many people have taken the time to comment because they CARE so much about you and Will and lil' Magpie!! How awesome is that?? So much support out there for you!!

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  51. Yikes, Mo. Sorry, but I 100% agree with Will on this. And no offense...but you ARE starting to sound a bit crazy with your breast milk obsession. I can promise you that you aren't doing Magpie any favors by being sick and stressed over this all the time. And you've literally been unable to care for her at time?? USE THE FORMULA!!!

    Also, I have to agree with an Anonymous poster who said that you are really sort of making anyone who has ever used formula feel like you think they are an abusive parent. Formula was invented to save the lives of babies who could not breast feed. It wasn't created to murder babies for crying out loud. I'm also quite confident that mothers who give formula love their children just as much as mothers who breast feed. Everyone does what is best for themselves and their children. Which brings me to the point of this: at this point breast feeding does not seem to be what's best for you or Magpie, or Will. USE THE FORMULA!

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  52. I am the Anon poster from yesterday morning with the vitamins analogy. I've been surprised how much this issue/discussion has stuck with me, and how, frankly, my annoyance has grown. Mo, while I can obviously appreciate that you are so far in it that you don't see/mean the implications you are making about formula feeding, I'm happy to see some other commenters pointing it out. (Slow cap in particular for Carrie @ 3:48 p.m. -- you said it exactly right.)

    What EXACTLY are all of these terrible, scary, no-good, very bad things that so many of you believe will happen to a baby upon having formula touch her lips, and that will render her forever identifiable as a (insert shameful whispery voice here) "formula-fed baby?" This is a real mystery to me....

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  53. Im delurking to say: use.the.formula!!!!!!

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  54. Wow, I'm amazed how opinionated people are on this subject. I do think this is something each person may feel differently about for different reasons and you need to make the decision, along with Will, that you and your family can live with. I hope the one breast weaning idea works - I'm sorry the ducts in that breast are not aligned in the best way. Sounds like you're not alone in having one breast be more productive than the other. Anyway, sending lots of support to you.

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  55. Mo,

    Will is right. I hope and trust that he's not being a jerk about it, but he's right. Breastfeeding is legitimately hard in the first few weeks, but I firmly believe that after those weeks mothers should exclusively breastfeed ONLY if it's working well for them, without undue stress on the mother. For you and Magpie, it's been a nightmare. Ergo, exclusive breastfeeding is not the healthy choice for you and your baby.

    I'm a big fan of breastfeeding, but I really do wonder if we as women have bought into a kind of psychosis around the whole "breast is best" idea where we fixate on it as THE signifier of real, genuine, natural, effortless motherhood. The anxiety and justification and tying ourselves up in knots over how much we did or didn't breastfeed is SO, SO out of proportion to the actually scientifically proven benefits of breastmilk, which when you really look at them aren't really that robust. (A good, honest public health assessment might find that for new mothers in your situation the costs -- stress, fatigue, infections -- outweigh the benefits).

    I think when our babies are born -- particularly our first-born babies -- we love the idea that we alone are providing all their nourishment. It feels like a continuation of pregnancy, where everything they eat comes from your body. And it's really, really hard to let go of that. I didn't want my son to have reflux medicine as a newborn -- because it didn't come from me. Which was kind of crazy, but that was how it felt to me at the time.

    And I'm embarrassed to admit this, but when it was time to start solids, I didn't want to do that either because I was so fixated on the idea of my breastmilk being his only nourishment. Which is an indication that my thinking on the subject was a little warped, because, dude -- he was six months old. It was time for solids! It is FINE for your baby to receive food that isn't from you.

    Here's the thing: Formula is awesome. Think of all the mothers throughout human history who would have given anything they owned for a nutritionally balanced, safe, clean, palatable alternative to breastmilk to feed their babies. Think of all the mothers alive today who have no choice but to feed their babies sugar water from dirty wells. We are so, so lucky to have formula and yet we vilify the companies who make it because people on blogs tell us that "breast is best." Breastmilk is not magic. It won't make your daughter smart and pretty and get her into Princeton. Her genes and your parenting will do that... or they won't. Breastmilk is a food for infants with some upsides and some downsides. I'll repeat: Breastmilk is not magic. Formula is not poison.

    My advice to you is to run, don't walk, to the drugstore and get some regular formula. (It's worth trying regular first because hypoallergenic is expensive and tastes yucky and you don't want her to reject it because that's just going to cause more angst for you.) Continue to pump what you can, and supplement with the formula. You may have to mix it in the breastmilk to get her to take it at first -- not because it's not wonderful, perfectly healthy food for her, but because it's not what she's used to.

    And in six months, a year, two years, a decade -- you'll look back and say, "Breastfeeding was hard, but I did it, and I pumped, and later we supplemented a bit with formula because one of my breasts was a bit wonky, but everything turned out fine." And you'll feel some pride, and some guilt, and some defensiveness, and some uncertainty about whether you did the right thing -- which is to say that it will be EXACTLY like every other part of parenting.

    I apologize for this rambling comment. I'm so thrilled for you and Will, and I'm sad that the breastfeeding issue is darkening what should be a wonderful time for you both.

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  56. Mo: I pumped for 14 months for my preemie twins, only one of whom would (occasionally) nurse, so I understand where you're coming from, completely. My babies didn't have to deal with the same types of family histories that Magpie does, but they were still early, and had a nasty family history of ear infections on my side which did seem to be staved off by breastfeeding. I don't regret pumping for the length of time that I did, even though I didn't produce enough to feed them without formula supplementation.

    Now, I can and have told countless friends that their babies will be just fine on formula, sometimes comforting ones who are crying and/or upset about the prospect. And I believe it. Fervently and passionately -- I'm a big FFF fan. For *everyone else's* babies. But for my babies? Somehow, my babies were different. My babies NEEDED my milk, NEEDED. I don't have a blog, so I didn't post anything, but I felt that way. I couldn't get and stay pregnant the old-fashioned way, I couldn't keep my babies from needing extra care, but by golly, I could provide them with breast milk. I hated having to give them formula. Because my babies were clearly of a different species from everyone else's babies. Or something.

    Men and women have a few fundamental differences -- one of them being that men don't make milk for their offspring. Will's parenting of Magpie has never and will never involve producing milk for her -- he's never quite going to get the way you feel about breastfeeding. But. You have been through major surgery following an extended trial of labor, and since then you have 1) not gotten one full night of sleep and 2) have been using your own bodily resources to manufacture breast milk. And I can tell you that all that is affecting your thinking on this. I'm sorry if this sounds condescending, but while Will may not be at 100% clarity of mind, he's a lot closer to it than you are right now. I know this, because I WAS you. My husband didn't argue with me in the same way about pumping, but I wasn't getting debilitating mastitis.

    To quote one of my favorite pieces on infant feeding: You have to feed the baby you have. To which I'd have: You have to feed that baby with the mama she has. You obviously have a powerful will -- Magpie exists because of that will! But even those of us with powerful wills have to adapt and redirect at times.

    I am so sorry that this is not easy for you -- given everything you've been through, having to suffer through this seems even more unfair that usual. I'm not telling you to quit pumping altogether. I am, however, offering you obnoxious advice -- to whit, that the best thing for you to do is to stop pumping on the mastitis-prone side, and supplement with formula. If you're like me, you'll feel better using hypoallergenic formula because, well, it's the most expensive, or close to that. More advice, as per Fearless Formula Feeder: Use distilled water, not tap water. Adhere to the rules on the formula packaging about how long formula can be used after being left out. Etc.

    Magpie will be fine. She will be exactly the person she is meant to be. She has devoted parents with significant emotional and physical resources and a loving extended family. She is an extremely fortunate baby. And one day in the not too distant future -- probably when Magpie is running around with other kids in her kindergarten class and you realize that you have no earthly way of telling which of those kids got formula and which did not -- the infant feeding thing will seem like a very, very small part of the overall process of parenting.

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  57. Mo,
    I am dealing with multiple blocked ducts and now mastitis on the left side too. Ugh. I can't even imagine how difficult having mastitis so many times has been for you. I had been taking fenugreek for low supply and I have had to stop that because of the blocked ducts and mastitis. I wonder if my ducts on that side are wonky too. I can't very well wean him from that side because he won't take a bottle (not even expressed breast milk, and I can't pump much)and he is little (around 10th percentile for weight). He is 8 months old now and eating more solids so I hope he will be okay with less milk. I just wanted to say I understand and I admire your efforts. You are a breastmilk hero!

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