Weight Loss

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Sunday, November 21, 2010

Breastfeeding and Losing Weight---or Not

Well, I haven't posted much here because I've been trying to keep this a little more WLS-appropriate, and I don't have much WLS stuff to post right now. Losing weight isn't really my plan at the moment. But that's not to say I wouldn't like to, it just doesn't seem to be happening, and I'd rather make sure I can produce milk.

I did learn, rather interestingly, that breastfeeding does NOT actually help most people lose weight, as is popularly said. I'll try to find the particular study, but I recently read that on average, women who are nursing actually gain a few pounds versus those who formula feed their babies. This is presumed to be because elevated levels of prolactin, the hormone that causes lactation, also increases appetite--presumably because lactation requires more calories.

This is significant to me because I am taking domperidone to increase my prolactin levels and thus increase my milk supply. My weight has levelled off, but I gained back some weight after getting very close to pre-pregnancy weight. I knew that this could happen, but it does bug me a tiny bit.

As I have discussed elsewhere on this blog, I had breast reduction surgery in 2001 (long before my lap band). I was told at the time that I wouldn't be able to breastfeed, and I was okay with that at the time. I was recently divorced, and although I wanted children, it didn't seem like it would happen anytime soon, if ever. But when I got pregnant I started researching, and discovered that a lot of women who have had the same surgery have been able to breastfeed at least somewhat. I read everything I could about the subject and was very hopeful that it could work for me. The fact that it had been 9 years since that surgery was a plus in my favor. But there is no way to know until you try.

Just like giving birth, nothing with breastfeeding has happened exactly the way I envisioned it. My daughter did nurse very soon after birth, and was placed on my skin immediately after birth, and stayed there for the first 2 hours. She nursed exclusively until the day after we got her home, when she started seeming a lot more lethargic and jaundiced. We brought her to her pediatrician that day, and she had lost quite a bit of weight from her birth weight--almost a pound. Sometimes a large weight loss can be attributed to the fact that birth weight is falsely elevated by IV fluids given to mom during labor--but in our case, I arrived at the hospital and Lucy was born 15 minutes later. There was no time for an IV, so this obviously couldn't have been the case. And if she wasn't obviously symptomatic, we might have been able to let her nurse a little more without intervention, but she was too sleepy to nurse, and looked obviously dehydrated, so right there in the ped's office we gave her her first bottle of formula, which she gulped right down. (And I cried my eyes out, seeing how hungry she was. It was hard to feel that I couldn't provide what my baby needed.) It turned out that my surgery left only the inner most milk ducts intact, and that plus a large nipple meant that she was just not big or strong enough to compress enough to get much colostrom out.

I continued to try to nurse her as we gave her bottles, but over time she became less interested in the breast. We tried the non-bottle methods of supplementation, but we couldn't get any of them to work well for us. I started taking domperidone when she was about 4 days old, but it still took close to 2 weeks for my milk to come in. I've been pumping constantly since then, and now am making about 60-70% of the milk she takes in each day. Considering the surgery I had, and the fact that only the left breast produces enough to pump or nurse from, I feel pretty good about that, but I am still trying to get her to nurse more so I can pump less. I've been working with some great lactation consultants on this, and have a lot of support and information about it. I won't be able to really lose weight until I stop taking this medication, but as long as it doesn't increase anymore I think I'm probably okay with this.

This whole nursing/lactation deal has been very emotionally intense. I was much more invested in things going the way I envisioned than I realized, even though I knew intellectually that the chances were that it wouldn't go perfectly. I'm happy we are doing as well as we are, but it has been hard to let go of the high hopes I had of feeding her exclusively from my breast. Despite all of this, I'm not sorry I had the surgery. It gave me a much better quality of life, and enabled me to exercise so I could lose weight and keep it off. Whenever I decide I am done having children and lactating, I will probably need to have another reduction or lift, which I do want to do, but it is worth it. (I was a 38H preop, down to 38C post op. I ended up a 34D after losing weight, then was a 36DD during pregnancy, and now am a 34F. There will be a lot of sag when I am done nursing, and I will be pretty lopsided.) If I have another baby later, it should be easier to nurse, because breast tissue continues to develop as the first baby nurses, so the second usually has an easier time.

I don't know if this stayed more on-topic, but oh well. :) Lucy is doing great...getting big and sassy, and cuter by the day. We are having a great time together! Being a mommy is pretty fun so far.


Gen said...

I'm so glad you are doing what it takes to nurse your baby!

I did not have any problems, but I did nurse my 4 kids (including quite a bit of pumping when my kids were sick or I was working!) and it is just such a special, amazing bonding experience. In my opinion, it is worth all the trouble. And you are so smart, doing all the right things with the lactation consultant etc. to get the support you need.

Enjoy this, it really is over in the blink of an eye! And don't worry too much about your boobs. Mine are okay even after 4 babies and losing weight - not perfect, but good enough.

Gen said...

Forgot what I wanted to say - I absolutely did NOT lose weight in all my years of nursing, and it was frustrating. Everyone expects you to lose when you nurse, but not me! I was WAY hungrier and I think that hormonal thing is true - the prolactin or whatever increases hunger, at least for some of us lucky moms! I was never able to lose weight until I stopped nursing.

In your case, don't even think about it while you are focused on producing milk. Seriously, you have a job to do!