All I ever wanted

You guys. I have something important to tell you. Baby Brother is now 8 months old. And I am still nursing him.

To be clear, when I say that I am still nursing him, I mean that I am feeding him actual breastmilk directly from my actual body, with no intervening technology.

I KNOW!!!!!!

When BB was born, as I wrote here, I was very clear that I wanted to do what I could to breastfeed but that I wouldn't go to any crazy lengths. And I was lucky in that he was one of those newborns I previously thought existed only in myth, who, when held on my naked chest, would literally worm his way down to a nipple and latch on hiimself. Hell, he even tried doing it to my (fully clothed) husband.

That's not to say it was easy. I remember about two weeks in I was weeping with exhaustion and frustration and probably pain, too, and saying to my husband that I was so tempted to just quit. And he looked at me and said, "This is all you ever wanted."

OK. Not ALL I ever wanted, certainly--I want lots of things--but breastfeeding my baby was high up on the list. So I stuck with it, and told myself I just had to get to three weeks and then I would let myself quit. Then four weeks. Then six weeks. Then I figured I'd breastfeed until I went back to work, at 14 weeks. Then it was going so well (minus a hiccup when he went a whole day refusing to nurse from the left breast--what the hell???) that I thought I could surely make it to 18 weeks, which is how old Bat Girl was when she had her last drops of breastmilk--because after all, shouldn't the baby who nursed get at least as much breastmilk as the baby who refused?

And here I am. When I started it was a wild fantasy to think I could still be nursing at 6 months, and now I'm seriously considering hanging on until a year. A YEAR!

BB still gets lots of formula, of course. Based on the occasional pumping I've done at home and the pumping I do at work, I probably peaked at around 12 ounces a day, same as the maximum I ever made for BG--but this time with just a baby and some fenugreek (which I stopped taking months ago), no domperidone or insane pumping. He is a huge eater so he actually gets more formula than BG did at the same age.

But he loves nursing. And I surprised myself by how much I love it too. I loved the lazy mornings crashed out on the couch when he was a couple months old, dozing and nursing on and off for hours, his soft small weight curled around me like a comma. I still love the cozy late nights and early mornings snuggled together. I love how his eyes roll back in his head as he latches on, and how he pops off to look up and me and smile.

I said right from the beginning that I didn't care how much or how little breast milk he got, as long as he got it directly from the boob. Maintaining a breastfeeding relationship was more important to me than maximizing breastmilk intake. I'm glad I defined that right from the start (and would highly recommend that anyone embarking on breastfeeding knowing she might have difficulties look into her heart and think about which, if she had to, she would choose). It helped make the decisions clearer every step of the way.

And indeed, although I do pump twice a day at work, when I am home BB gets 100% of his breastmilk directly from me. For a while I was pumping right before bed to help keep my supply up, as well as for my own comfort because BB was sleeping from 8 pm to 5 am most nights. But then the 4-month sleep regression hit and he was waking up a lot, and I got out of the habit of pumping, and now the fancy hospital-grade pump I've been renting since August has been sitting unused for two months and I really should return it and stop paying the $60/month. (My old Pump In Style died a sudden, whimpering death when BB was a couple weeks old and I was too superstitious not to have a pump in the house, so I ran out and got the rental--a Medela Symphony which is AWESOME AND THE BEST PUMP EVER. I was really glad to have it when BB ended up in the hospital for a week with viral meningitis at 3 weeks old--OMG I really have not updated here in forever--and I needed to pump to keep up my supply when I ran home to shower and spend a few hours with BG every day.)

ANYWAY.

Really, from the perspective of this blog and its raison d'etre, I do have everything I ever wanted. Two beautiful, healthy children. A successful breastfeeding relationship. (Outside my reproductive life, my marriage is actually better than ever and my job...well, okay, my job isn't so great but you can't have it all, right?)

So I've decided it's time to make official what my lack of posting had rendered basically all but said and done. That is, I think this blog's time has come.

I will leave the whole blog up as long as the Google empire allows me the free server space, because I want to leave a trail of breadcrumbs (as Moxie puts it) for those who come after, my sisters of the fucked-up uteri, my fellow PCOSers, my kindred spirits in the world of IF and breastfeeding woes. But I don't think I will be posting here anymore.

I have gotten so much out of this space over the last 7.5 years--a place to vent and cry, the love and support of a community that has followed me into the IRL world--and I only hope that I have given back, in some small way.

If you're reading this and you're at the beginning of your journey, I hope my story gives you some hope. And remember, you're not alone. You're never alone.

Baby Brother is HERE!

Baby brother arrived on Tuesday, some time between 11 am and noon (we didn't really pay attention; I guess I'll find out the exact time when I get his birth certificate), weighing a whopping 7 lb 12 oz. He is healthy and gorgeous and delicious. My OB pulled out one leg first and the first thing she commented on was the chunkiness of his thighs. He also has very delectable cheeks.

My recovery from this c-section has been incredibly easier than the last time. I think it's because (1) I didn't have ANY systemic narcotics--no PCA pump (at my current hospital they don't do that anymore for cesareans--there's a long-acting narcotic in the spinal which just affects your lower half, and then when that wears off you get an NSAID in your IV for a day or so and then only oral meds thereafter), no Percocet, just some Tylenol 3 for the first day or two after surgery and then ibuprofen afterward. Without the heavy-duty narcotics I didn't have any nausea or grogginess, and I felt emotionally more stable too. (2) I got up and moved around as much as possible--last time I barely left my bed for the first 3 days and it really took a toll on my overall mobility and healing. (3) I ate and drank like crazy--I was eating a full meal of solid foods 6 hours after my surgery, where last time I was supposed to be on clear fluids only for the first 24 hours and I barely touched those because I was so nauseated and emotionally wrung out. I forced myself to eat the terrible hospital food and I downed food from home and takeout on top of that, and I drank pitchers and pitchers of water. (4) I went home a day earlier--it makes such a difference to sleep in your own bed.

I got to go home after 3 days because we made the decision to be proactive about supplementing Baby Brother with formula. He was nursing great--latched on in the recovery room like a pro, sucked like a champ--but on his second day he stopped pooping and the pediatrician agreed that given the family history of severe jaundice, it made sense to proactively supplement. They also tested his bili level earlier than normal, and while it did get a bit high, it never reached the levels that Bat Girl's did, so we were able to get away without treating him as long as we promised to keep supplementing at home so that he would keep pooping out the bilirubin.

I did shed some tears over the supplementing at first, and over my breast pump when I decided to break it out at home. But my milk came in a full day earlier than it did with Bat Girl (again, I think because of everything I did above), and stronger. It's still clearly very scanty, based on the output of the few pumping sessions I've put in, but I get engorged and Baby Brother latches and sucks well at every feeding. We give him a bottle of formula afterward and he's fine with both.

And I made a decision: No herbs, no meds, and most of all no crazy pumping. I don't care how little breast milk Baby Brother gets as long as he's getting it mostly from the breast. I've pumped once every evening before bed (and gotten just a few CCs each time) just so I can get away with sleeping through one nighttime feeding (though I've been waking up painfully engorged so that luxury might have to stop), but I will NOT pump just to build supply. The baby takes what he takes from the breast and that's fine with me. I hate that pump and I won't be chained to it again. This time I have a baby who DOES actually nurse and I'm going to enjoy that as much as I can.

Now if you'll excuse me, I'm going to go nibble on some baby cheeks.

32 weeks

Not much new to report on the pregnancy front, thank goodness. After much agonizing, I realized that the fact that I was hoping Baby Brother would remain breech, thus taking the to-VBAC-or-not-to-VBAC decision out of my hands, was telling in and of itself. So at my 30-week appointment, I told my OB that I wanted an elective c-section...and she said that given the baby's still-breech position, chances are it would have been out of my hands anyway. We can't actually schedule the surgery yet, since the hospital doesn't open up the OR schedule until 6 weeks in advance, but it's looking like July 24 is the day. (My doctor does scheduled surgeries on Tuesdays, and wants to get me to 39 weeks but not past 40.)

Sometime in the last week, I hit a wall. Between the sudden heat here in Big City, and my increasing size (I'm already at the weight I was when Bat Girl was born, and based on photographic evidence have a much bigger belly), I'm suddenly exhausted, achy, short of breath, slow-moving, waddling...just physically spent. I remember feeling DONE in the last month or two of pregnancy with BG, but the one advantage of being on bed rest was that I didn't have to haul my ass to work, or try to bathe a 5-year-old, or ever stand up for more than a minute. Luckily the contractions are still erratic, though I do have a lot of pelvic pressure, so I'm trying to hydrate and stay off my feet as much as possible.

The big news is that we are moving! A larger (3-bedroom) apartment opened up in our building, and with a little cash passed to the building super to grease the wheels, it looks like it's ours. The only hitch is that we won't be able to move in until June 30...3 weeks before this baby comes. My husband is basically handling the entire move solo, since I will be next to useless. The good thing about moving one floor down is that we don't even really need to pack--just pile things into carts and dollies and wheel them into the elevator, though we'll have to get some help with the larger pieces of furniture. We're using part of our tax refund to buy a sofabed--the first new couch I've ever owned in my adult life. I slipped down the rabbit hole for a little while researching flame retardants etc. but since I don't have $7000 to spend I'm just throwing up my hands and buying something from a chain store and will maybe throw an organic cotton slipcover on it to make myself feel better (and to protect the couch from baby fluids, in case you were wondering about the wisdom of acquiring a new couch and a new baby at the same time).

Last week I took my old breast pump in to be inspected at the local embarrassingly-named everything-lactation store. (Side note: Why must all things breastfeeding-related be so terribly named?) For $10, they examine all the parts, tell you what needs to be replaced, and even use a little pressure gauge to make sure your pump is still sucking adequately. Despite its history of hard use, my pump was deemed to be in excellent working condition, and all the parts ready for action, down to the little teensy membranes. I had some PTBD(TM) flashbacks when I heard the wheeze of the motor, I must admit. The milk lady recommended that if I needed help establishing supply, I should rent a hospital-grade pump to start with...not sure if I will, but I'll consider it.

I'm going into the whole breastfeeding thing with no expectations, basically. I'd like to give Baby Brother some breastmilk, but I'm not willing to kill myself over it. No domperidone, probably no herbs, and definitely no pumping around the clock. I'll pump to help establish supply, but if baby won't take it straight from the tap I really don't want to be attached to the pump all day long. So I'm pricing out formula too, and we'll have it on hand before we even head to the hospital. No torturing myself, that's my vow.

NOW they tell me

Crawling out from under my rock to share this:

Breast Pump Not Best Way to Succeed at Breast Feeding

Talk amongst yourselves. I'll be back soon.

Take this survey

Thomas Hale (yes, that Thomas Hale) is conducting a survey of women who used (or are using) domperidone or Reglan to build milk supply while breastfeeding. Take it now! (PS I'm so glad I blogged my breastfeeding struggles, because I would never have remembered all the details about when and how much and how long without this record.)

For my PTBD peeps

And anyone else who's interested, from the April 2009 issue of The Atlantic:

The Case Against Breastfeeding
"In certain overachieving circles, breast-feeding is no longer a choice—it’s a no-exceptions requirement, the ultimate badge of responsible parenting. Yet the actual health benefits of breast-feeding are surprisingly thin, far thinner than most popular literature indicates. Is breast-feeding right for every family? Or is it this generation’s vacuum cleaner—an instrument of misery that mostly just keeps women down?"

Interesting to chew on, no matter what your opinions and experience of breastfeeding. (Link via The Juggle.)

Hey, did you hear formula is POISON?

Ah, yes, something else to feel guilty about: Apparently Similac Organic formula is noticeably sweeter than other formulas because it's made with--gasp--sugar!

With the exception of a few weeks worth of Similac Advance at the beginning of her life, and of course four months of half breastmilk, half formula, Similac Organic was the only thing Bat Girl drank for the first year of her life. And seriously? This article alarms me not one little bit. Really, I fail to see the problem here.

I may not be a "professional taster," but in my experience breastmilk is far sweeter than ANY formula, SO included. So the idea that adding sugar to formula instead of lactose or corn syrup is going to make your kid overeat or give them an insatiable taste for sweet things seems bogus to me. One mother is quoted as saying, "[S]ugar is a concern for us--that’s why we started her on vegetables rather than fruits, so she wouldn’t get used to the sweet taste first." Too late--your baby was BORN with a taste for sweet, and the commandment to start on veggies instead of fruits is outdated and not based on real science.

And what about the argument that sucrose causes tooth decay? Well, first of all, a kid needs to have TEETH to have tooth decay. Second, so does lactose or corn syrup or ANY kind of sugar--it's why you're supposed to brush your kid's teeth after they have a cup of milk at bedtime. Is it possible that sucrose is not the healthiest form of sugar available? Sure. I'll even concede that there may be unknown differences in the way sucrose is metabolized versus other sugars that could be deleterious to health. But, you know, once you make the decision to poison your baby with formula, does it really matter? (HA!)

No, seriously though, for me, if this article had come out when Bat Girl was still drinking formula, I would not have switched. Organic is more important to me than what kind of sugar is in the stuff. And SO comes in ready-to-feed form, which other organic formulas do not, and I am really, really lazy. And based on my highly scientific sampling of babies (n=1), SO has not caused any problems. Bat Girl generally had no more than 24 ounces of formula a day when it was her sole source of nutrition. She drank a little more (around 30 ounces/day) when she was nearing 10-11 months, but that was a signal to us that we needed to step up her solids consumption. She has consistently fallen around the 50th percentile for height and around the 25th percentile for weight. She eats all kinds of vegetables, including broccoli, spinach, and peas. She had no problem switching from formula to cow's milk, and when I gave her (sweet!) apple juice for the first time this weekend she spat it out. She is super healthy and active and suffers no apparent ill effects from her year drinking pure evil.

But if you need a good Monday morning dose of rage, check out the comments on the article. There's the usual "breast is best," "down with the evil formula conglomerates," followed by the backlash by women who couldn't breastfeed, followed by the backlash-backlash from people claiming that women who can't breastfeed are RILLY RILLY RARE and everyone else is just a lazy selfish bitch, etc. Awesome! My favorite comment is #56, which I quote in part especially for you, my IF homies: "One thing we forget is that there is much more to breastfeeding than the milk itself. Breastfeeding is to breastmilk as making a baby the usual way is to in vitro fertilization. Feeding a baby breastmilk in a bottle is just not the same thing as breastfeeding." The best/worst part is that that commenter? Jack Newman, whose handouts I used extensively during my own breastfeeding battles. Ain't that just a kick in the pants?

PTBD sufferers, unite

So as I think I've mentioned here before, I buy super pricey organic formula for Bat Girl. Just a personal preference, though I sure will be glad when we can start transitioning to cow's milk in a few weeks. Anyway, since we go through the stuff like crazy, I order it by the case online (btw, if anyone ever needs a discount code, let me know!). Today the UPS man brought what I hope may be our very last shipment of formula--box torn, so the contents were clearly visible. I answered the door with Bat Girl in my arms, so he very kindly hauled the heavy box into our foyer for me.

(I should preface this by saying that we are quite fond of our UPS man--we know him by name and are very friendly with him.)

"Now, if you were breastfeeding, I wouldn't have to carry these heavy boxes of formula all the time," he joked to me.

Huh? But OK, fine, I replied in the same tone: "Believe me, I'd much rather be breastfeeding and not spending the money on this stuff."

"Eh, you moms today, you try for a few days and then give up and go to formula."

WTF?!? Not quite believing that I am defending my inability to breastfeed to my UPS delivery man, I say, "Well, I tried really hard."

"Oh, sure, I went through that with all three of my kids, we got the pump and everything, but then you know what? After a couple of days, formula." He says this very knowingly, like, yeah, my wife pussed out like you, too.

Still not quite believing I am having this conversation, I say, "Well, I tried to breastfeed her for four months, but we had to give up, it was too hard."

"For you or for her?" he asks.

"For both of us," I say, which is the only way I can sum up four months of low supply, bad latch, breast refusal, and pumping problems without just printing out my whole damn blog and handing it to him.

Then he looks me up and down and says, "Yeah, I figured." OH NO HE DIDN'T! Did my UPS man just LOOK AT MY BOOBS and basically call me flatchested and unable to sustain human life?!???

For the record, this is the FIRST person ever to say anything the slightest bit critical about my not breastfeeding. The UPS man. Damn.

*****

Before I got pregnant with Bat Girl, my husband and I always assumed we would have at least two children, assuming we could get pregnant (though we were open to adoption as well). Then came the, shall we say, less-than-ideal pregnancy, followed by postpartum misery, breastfeeding hell, a year of sleepless nights, a depleted bank account, a sex life shot to hell (ah yes, I promised to post about that too--all in good time, my dears), etc. etc. etc....

Anyone who spends five minutes reading my blog or talking to me in person knows that my daughter is the light of my life and a source of unbelievable joy. I do not regret anything I went through to have her. But having a baby has been hard, that's just the truth. Neither my husband nor I are ready to dive back in to the newborn phase again, nor do we feel, now that we're parents, that someone is missing from our family. (That was the advice a friend of mine was given when debating whether or not to have another: Do you feel like there's still someone missing from your family? In her case, the answer was yes.) That's assuming we could even afford it, which at this point--yes, technically we could afford another child, people have two kids on less money than I make all the time, but it would mean squeezing every remaining drop of luxury out of our lives, like vacations and books and cable TV and other things I am not willing to give up. (Not to mention the fact that to minimize the chances of conceiving multiples, in the future we would go straight to IVF with single embryo transfer, so factor in the cost of that, too.)

All of those things are valid reasons not to have another child, as is the fear of landing on bedrest again, only this time with a toddler to care for. But the truth is, the biggest reason I don't want to have another is that secretly, I am terrified of facing breastfeeding again. As I've mentioned before, I think I have a case of post-traumatic breastfeeding disorder (tm Eva. The thought of having to go through all of that--the low supply (because let's face it, even though anecdotally people get a better supply with each pregnancy, if I was only able to get to 11 ounces a day with serious pharmaceutical intervention, I'm unlikely to ever have a full supply), the struggling with latch, the tanking self esteem, and oh god, the pumping, the endless pumping--it makes my stomach clench up.

Now, a smart person would do as Pru does and say, to hell with the whole thing, why torture yourself like that again? Why I cannot be rational like this, I don't know. I suppose I am just stubborn enough to want to have another go at hurling myself headfirst into a brick wall. But I am rational enough to assiduously refill my birth control pill prescription every month. Because I cannot do that again. I. can. not.

Pump-a-palooza

At last, here's my big post of links and info on pumping, breastfeeding, low supply, and breastfeeding with PCOS. I've been working on this for...well, Blogger tells me I started this post on 6/2/07, so for six months now. I'm finally motivated to get it up after the latest rash of beloved bloggers writing about their breastfeeding woes.

Even though I had read blogs (like Julie's) of other women who exclusive pumped (or EP'ed, as it is jauntily referred to online), I didn't really comprehend that EPing, or even half pumping half nursing, was possible until I did it myself, and then I had a hard time finding information on it. Skip to the end of this post if you just want links to other pumping moms, but I've collected here as much as I can think of on pumping and supply. I added the bulk of these links when I was fresh from pumping hell, months ago, so it should be pretty thorough despite my now being a happy formula-feeding mom (yes, you do eventually make peace with the evil formula!).

General info
Start with Julie's excellent pumping tips post--read the whole post and all the comments for tons of great info. Most useful tips for me:
• Get multiple collection kits (horns, valves, bottles, the whole rig) to save yourself from having to wash in between pumping sessions. Throw it all in the dishwasher once a day (if you have four or more sets, plus the bottles and nipples you're using to feed with, you should have no problem filling up the dishwasher every day) and don't mess around with sterilizers--the dishwasher gets plenty hot and steamy and you don't need another piece of equipment to worry about.
• Use the same rig for more than one pumping session. I'd go up to six hours (2-4 pumps) pumping into one set of bottles, leaving the whole thing out at room temperature between sessions (both my local LC and a lactation MD told me this was OK). Of course this only works if you don't fill up the bottles each pump--but this was never a danger for me.
• Olive oil on the horns or on your areolae/breasts (my PIS horns covered nearly all of my tiny breasts, so I lubed up the whole breast) improves suction and minimizes irritation. This is important--after three months of pumping 8-12 times a day, I started getting a boob rash from the constant friction.

Other great general resources:
• Pumpmoms yahoo group (there is also an exclusive pumpers group but I never got around to joining that one)
• Jo's post on PCOS and breastfeeding problems
• Breastfeeding with PCOS
• Kellymom, of course
• Eva has tons of pumping and low supply links on her sidebar, so rather than rip those off her I'll just link to her here.
• The Lactivist has a bunch of good links and advice too.

How I pumped
It took me a couple of months to find the right groove with this--I was pumping on too high suction at first, and after I gave up on breastfeeding and went to exclusive pumping it took me a few days to figure out I should pump a lot longer to completely empty the breast. (My lactation MD advised me to pump just 5 minutes at a time, which worked great because I had such speedy letdown that most of the milk came out in 2-3 minutes. It also helped me stick with pumping when I was ready to give up--there's a big difference between 5 and 15 minutes 8x a day! But when I stopped feeding direct from the tap and wasn't getting the additional stimulation of my daughter nursing, I needed to pump longer to make sure I was getting all the milk out.)

Here's how I was doing it at the end: I started the pump (Pump in Style Advanced) on minimum speed/suction, then slowly turned it up (you want the lowest suction that will give good milk yield--you have to experiment. NOT the highest suction you can tolerate--you don't want to be in constant discomfort). I'd hit the button to switch to expression mode as soon as milk was dripping from both breasts--for me, with my ridiculously fast letdown, that was after about 30 seconds. After about 5 minutes, the milk would start slowing down. When it slowed to a slow drip, I'd start massaging toward the nipple to get more out. At about the 10 minute mark, I could usually get a second letdown with a combination of massage and "pumping" the cones (pressing them into my breasts, then releasing, a few times). Other women I know put the cones on asymmetrically (not exactly centered on the nipple) and get good yield by moving the cones around the nipple so as to stimulate different milk ducts. I stopped at the 15 minute mark or a minute or two past when the milk stopped dripping. (Pumping for longer than 15-20 minutes at a time is generally not recommended, though I have a friend who had extremely slow letdown and so swore by 40-minute pumping sessions.)

How often to pump?
Standard advice is to pump every few hours, or as often as a baby would nurse. If you are trying to increase or establish supply, some great advice I read is that instead of thinking "I have to pump every 2-3 hours," you should think, "I have to pump 8-10 times a day." Then just try to squeeze those 8-10 pumps in however you can--if it means you go 6 hours between pumps (because you're sleeping! hallelujah!) and then pump three times in the next 6 hours, that's fine. The important thing is to get in at least 8 pumping sessions a day, and you're much more likely to do that if you just get them in however instead of worrying about spacing them evenly. That said, it's also important to maintain your sanity, and if that means you pump fewer than 6 times a day, but you're able to enjoy your baby more, then that's what you should do.

Power pumping
"Power pumping" is frequent pumping aimed at stimulating your supply, much like a baby cluster feeding during a growth spurt will cause your production to increase to meet the increased demand. There are a number of ways of doing this--one method is to pump for 10 minutes, break for 10 minutes, pump for 10 minutes, and continue for I think an hour or two (not sure--I never did it this way). Another method is to pump for five minutes every hour for 24 hours. An easier method is to spend one day just pumping whenever you have a spare moment--leave the pump set up and throw the horns on every chance you get, for however long you can, whether it's been 10 minutes or 2 hours since your last pump. Got 15 minutes when the baby's napping? Pump. Got 2 minutes before your visitors arrive? Pump! You'll squeeze in tons of little sessions, just like a fussy cluster-feeding baby would do.

The way I power pumped was simply to insert an extra pumping session between my normal daytime sessions. This worked out to pumping every 90 minutes or so during waking hours (I was not insane enough to try to power pump at night), for a total of roughly 12 sessions in 24 hours. At 3 weeks postpartum, I started power pumping for two days, then taking one day off (regular 6-8x/day), then two days on, one day off. I did this for I think one or two weeks to jumpstart my supply, along with herbs (see below). Then I cut back to power pumping twice a week, then after another month or so I just did it once a week. When I went back to work I stopped power pumping altogether, because who has that kind of time? (I also knew at that point I was getting ready to quit.)

Galactagogues
I had super low supply--I pumped maybe 0.25 oz. in 15 minutes the first day my milk came in, and after a week of nursing and pumping was up to maybe 3.5 oz/day. With a lot of effort, I was able to get my supply up to 10-11 oz/day. I used all of the following galactagogues (supply boosters), with varying success:

Foods (not sure how much they helped but I figured they couldn't hurt):
• Oatmeal (or oats in any form. I ate oatmeal every. damn. day. for sixteen weeks. Also granola, oatmeal cookies, etc. etc.)
• Almonds
• Sesame (PSA: Bear Naked Fruit & Nut Granola contains oats, almonds, and sesame seeds)
• Barley/barley malt (regular Ovaltine has barley malt, or drink beer!)
• Protein in general
• NO soy, which is suspected to decrease supply

Herbs
I took fenugreek and blessed thistle--taking them together is supposed to have better effects than either alone. 3 capsules of each 3x/day to start with, with immediate results, then 4 capsules 3x/day (on doctor's orders), with less obvious results. I tried taking the liquid tinctures for a while, as they're supposedly more effective, but they tasted horrible (suspended in grain alcohol!) and I actually smelled less mapley (which is a bad thing--you know you have an effective dose of fenugreek when you smell like maple syrup), so I switched back to capsules.

Domperidone
Domperidone is what kept me going--just when I was ready to give up (5 weeks in and only pumping 5-6 oz/day), domperidone doubled my supply, giving me the motivation to make it to the 4-month mark. I took 2 10mg tablets 4x/day, as directed by my lactation MD, who instructed me to take it for no more than 8 weeks, then slowly wean off (to prevent sudden dip in supply): 7 pills/day for 3 days, then 6 pills/day for 3 days, and so on. I ordered it from Inhouse Drugstore in New Zealand and felt like a badass outlaw (and also fretted that the meds would be seized by customs).

Metformin
Since I have PCOS, it was thought by the various experts I consulted that met might help increase supply--and that it might have helped me develop better milk ducts etc. had I remained on it during pregnancy. I was skeptical, because it never seemed to help me much in the ovulation department, but I was willing to try. I worked up to 1500mg/day (my TTC dose), overcoming the nausea etc., but I don't know how much of an effect it had, since I started it around the same time I started the herbs.

Other pumping babes
Finally, in the worst, darkest days, it helped me so much to know that so many women in blogland had been through pumping hell too. (Hmm, kind of like discovering infertility blogs for the first time?) So here, in no particular order, are just a few of the Internet ladies who have pumped, either exclusively or in combination with nursing:
Julie pumped for Charlie
Menita pumped for Polly
Pru pumped for P.
Blue pumped for Azure
Pumpmom pumped for two of her kids
Miss W. pumped for the lowercase
Cecily pumped for Tori
Alice pumped for Henry, and is hilarious about it
Momo pumped for B. (exclusive pumping for 6 months!)
Chris pumped for her twins (old blog with more pumping stuff may be taken down)
Aliza pumped for NG
Meg pumps for Jasper
Eva pumped for Baby (EP for 8 months!)
Rockmama pumped for the Prawn
Jennifer pumped for Elnora (EP for 14 months!)
Thalia is pumping for Pob
Kath is pumping for Banana

I'm sure there are tons more, so if you or someone you know has blogged about pumping, post it in the comments. Ditto if you know of any other great resources or some awesome advice I've forgotten.

Oh, and one more thing: If you are struggling with low supply or a baby who won't latch, you will feel like it is all your fault, that if you just worked a little harder, you should be able to fix it. (Probably because this is conventional wisdom among many lactivist types.) Please don't beat yourself up. I know that's easier said than done (anyone who reads my breastfeeding posts--Feb through June 07--will see I did plenty of self-flagellation), but really, all any of us can do is our best. Don't feel bad because someone else worked harder or pumped longer or did more or nursed until their baby went to college. As Moxie would say, you are the perfect mother for your baby, whether you breastfeed or not. There are no mothering awards given based on volume of breastmilk fed, and if giving your baby formula or pumping less or saying fuck it to the whole breastfeeding concept allows you to be the mother you need to be, then do it. Enjoy your baby. Don't let your boobs get in the way.