By Adrienne Harmel, CPNP

I wanted to share a little bit about how I came to develop a special interest in lactation support, and why helping families with feeding issues has become a focus for me.

Having worked in pediatrics since 2001, I knew the many benefits of breastfeeding for mom and baby, so when I gave birth to my daughter six years ago I was committed to succeeding, and my husband was committed to helping me. Like many other parents, we thought “it’s natural, so we will figure it out.” As we would learn, we were unprepared for the struggle that awaited our family.

We were fortunate that, other than jaundice that was treated with phototherapy, Lila was healthy and was able to start breastfeeding right after delivery. We did the things that are recommended: skin-to-skin immediately, nursed in the first hour after delivery, and she was in our room 24/7. We had a great first session in the delivery room, and then things went downhill. She entered the typical “sleepy stage” and also had jaundice, so it became increasingly difficult to get her to nurse. But we persevered. We started pumping after every attempt to nurse and syringe feeding her in the hospital, and continued that at home once we were discharged. My milk came in on day 4, and she was latching more consistently. At our initial peds visit after discharge she was doing ok, some weight loss but nothing unusual, and her jaundice had stabilized. So we went home and continued to nurse every 2-3 hours, having to wake her up for many feedings because she was still so sleepy.

We went back to the pediatric office for her next visit, assuming she had gotten back to her birth weight which is the norm, but she had gained NO weight. I was devastated and shocked. I had been nursing every 2-3 hours, she was voiding and stooling. My husband and I thought everything was going well. We were working with a lactation consultant (LC) at our pediatric practice and she determined that Lila was latching but then falling asleep at the breast, barely taking in any milk. And as a result, I almost lost all of my milk supply. What made it so difficult was that I had no idea it was happening.

We were still committed to succeeding, so we were told to go home and do what is called “triple feeding” which means nurse every 2-3 hours, then pump after every feed, and feed the pumped milk to Lila via bottle after every feeding at the breast. On the advice of my LC, I started taking fenugreek, and making double batches of lactation cookies. Lila didn’t love the bottle and she continued to be sleepy at the breast for a few weeks, so my LC told me to do breast massage the entire time she was nursing to keep her awake and feeding. I even had to wipe her down with cold baby wipes to keep her awake at the breast. Ever so slowly she started to gain weight and feed more vigorously. And my milk supply rebounded, perhaps not fully back to what it would have been, but it was enough. Even after her weight gain normalized, I still had to pump after 2-3 feedings per day in order to maintain my supply.

Then we did pretty well until it was time for me to go back to work. Once I started having to pump instead of nurse, my supply dropped again. The pump just didn’t seem to “agree” with me. I developed painful clogged ducts and a mild mastitis. So I went back to my LC, and we adjusted the pump settings a bit, and eventually I started using a hospital grade pump that was better than what I was using at home. By that time Lila was eating solid food, and we were able to get by with stored milk combined with what I was pumping on the days that I worked. But it was literally a constant source of stress…Am I making enough? What if she needs more than I can give her?? These feelings on top of the guilt I felt at leaving her to go back to work were very overwhelming. I was so worried about it not working that I think I lost out on some of the enjoyment that I should have felt while nursing my daughter.

In the end, we were able to continue to breastfeed until Lila was about 13 months old. It was a struggle, but we succeeded in large part due to the help and guidance of a very talented lactation consultant. Would I do it again? Absolutely. Do I have regrets? Yes. I will never regret my choice to do it, only that I was so preoccupied with failing that I was not able to spend more time just enjoying and appreciating the finite experience of breastfeeding.

So this is why I have developed this special focus within my practice as a PNP, and why I have such a passion for helping other families navigate this journey. As with many things in life, breastfeeding truly takes a village. I know that there were multiple times that I would have stopped, and in fact I would not have made it past the first month without the help of my LC. I want to be able to provide that guidance and support to other families. I want to be part of their “village.” I am dedicated to helping families not only provide the best nutrition possible for their growing babies, but also to feel the joy, and to love the process.