I thought it was about time that I wrote a pregnancy post with an update about how breastfeeding Andrew is going and my thoughts on how it might go once baby is here. In early pregnancy, I wrote about my thoughts on nursling (self-)weaning. I then wrote a sort of update at 21 weeks, but I hadn’t come to any firm conclusion about how or when I would initiate weaning if Andrew didn’t self-wean. I guess I was trying to leave it as long as possible, to see if Andrew would self-wean, even if right at the last minute. Well he’s still going strong (as strong as he has been for the past 6 months), and feeding for about 20 minutes first thing in the morning and about 20 minutes last thing before bed, plus the occasional feed in the day if he’s upset or grumpy for some reason (for example, teething).
I’ve been reading the book Adventures in Tandem Nursing on and off for a while, so I now have lots of info about breastfeeding a toddler in pregnancy and once the new baby is born. This has been very helpful, but since I know that we’re a special case, given my hypoplasia (insufficient glandular (milk-making) breast tissue), I wasn’t sure that all of the info was completely applicable to us, because it doesn’t specifically mention mums with hypoplasia. So I decided that the best thing would be to get some expert advice, more than is available in books.
Andrew reading up on tandem feeding with the book Adventures in Tandem Nursing 
I spoke to the leaders at my local La Leche League (LLL) group where we’ve been going since Andrew was just a few weeks old. They have been an amazing support to us, and I knew they would do everything they could to help us with this situation too. One leader in particular was very helpful. As we talked and she helped to unravel my thoughts by asking me specific questions about what I was thinking, I came to the conclusion that I wasn’t against tandem feeding in itself, but what was stopping me from thinking it was possible for us was my hypoplasia and the memory of awful supply issues that I had when Andrew was a baby. (If you’ve not read from the beginning of our breastfeeding journey, you can find it here.) I realised that IF supply wasn’t an issue (a big IF) then I’d have no hesitation in tandem feeding both Andrew and baby – I was up for that. But of course, like I said, it’s a big IF, because it’s likely that supply will be an issue again with baby. My concern would be that Andrew, although he’d help make more milk by feeding (the more he takes the more I make), would also take milk, and I wouldn’t want him to take what would be better drunk by the newborn.
My helpful LLL leader understood what I was telling her, and agreed that it’s an unusual situation to be in – there can’t be many mums out there who have hypolasia and are considering tandem feeding, or are actually tandem feeding. She recognised that our unusual situation went beyond what she had personally read as part of her LLL leader training and experienced with other mums through her role as an LLL leader. So she offered to post our question to the online national forum of LLL leaders, to see if anyone else had experienced a similar situation, either themselves as a breastfeeding mum, or from other mums they had met through their role as leader. What was our question though? Essentially it boiled down to: Is it possible to tandem feed with hypoplasia?
Within a couple of weeks, I had three very helpful leads as a result of my leader’s post to the national leader forum. One was from a mum who hadn’t had supply issues herself, but who had recently been to a conference for lactation consultants (people whose job it is to support breastfeeding mums), where there had been a paper on insufficient glandular tissue and possible ways of helping increase supply. The main focus of her emails to me was on herbs that act as galactologues (substances that help increase milk supply in breastfeeding mums). She gave me some links to resources on these, including those that are apparently safe to use in pregnancy, because relatively few of them are. I’m not entirely convinced about taking herbs in pregnancy, because Andrew is still feeding now and helping to keep my supply going, and the herbs are pretty expensive to keep taking every day over extended periods. As money will be even tighter once I leave work, I have to weigh up all the pros and cons of dealing with supply issues.
Another email correspondence I had was (indirectly via my LLL leader) with Diana West, author of The Breastfeeding Mother’s Guide to Making More Milk. She’s done some research herself into insufficient glandular tissue, and, as you can tell from the title of the book she wrote, is an expert on supply issues in general. Nothing like going straight to the top lady for advice! Her reply was very to the point: in her opinion it is possible for a mum with hypoplasia to tandem feed, though she would need to take some steps to make sure she is making as much milk as possible, such as taking herbs, expressing and using an at-breast supplementer if supplements are needed for the newborn – all the stuff you can read about in her book, which was relevant to me as a first-time mum breastfeeding just one child; the toddler would also help to boost supply. She said there was no reason that I couldn’t be treated like any other tandem-feeding mum and any other mum with low supply, in terms of the support that my LLL leaders could give me. That was encouraging!
But even more encouraging was to hear from an LLL leader who’s a mum who has personally experienced tandem feeding with hypoplasia. She gave it a go, and it worked out well for her and her children, who have a similar age gap to the one that Andrew and baby will have. She said that she definitely noticed that she had more milk with her second baby, though it’s hard to tell whether this is just the result of having a second child (generally mums have more milk with subsequent babies) or whether the breastfeeding toddler actually helped improve her supply even more than if she hadn’t have been feeding still. She also gave me some tips on herbs that she used, and told me that she always made sure that the newborn fed before the toddler did. Like us, she used a supplemental nursing system (SNS) in the early months for both babies, and she said that with her second baby she stopped using it a lot sooner than with her first, because her supply was better. She said that her toddler acted like her ‘breast pump’, by feeding after the newborn to remove even more milk from the breast so that more would be made for the next newborn feed. One thing that she highlighted, as I often do, is that breastfeeding is not just about food, and that the tandem feeding was a way for her children to bond with each other, and it helped her toddler through the transition of having a new baby in the family.
Bump looks big in this! I think it's because it's a flow-y top though, because I don't think I look so big in a more fitted top. Lots of people are telling me that I look very 'neat' or 'small' for over 30 weeks!
So my assumption that it’s not possible for us to give tandem feeding a go due to the hypoplasia and supply issue has turned out to be wrong. That’s not to say from what I’ve heard from these contacts that it would be easy, but I’m not one to avoid a challenge just because it sounds hard. I would never have continued to breastfeed Andrew if I wasn’t determined, despite how hard it was, to give him as much of my milk as possible, and in the end we’re still going now at 19 months. When I think about how much milk he’s had from me over those 19 months, I bet it’s not actually that far off what some babies get in 6 months of exclusive breastfeeding who are then weaned onto formula. Breastfeeding in early pregnancy was tough too, because I was so sick, but we’ve got through that and I’m feeling much better and glad that I was able to persevere in the hard times when I really didn’t feel like letting Andrew feed.
You can probably guess that my thoughts are now not so focussed on the necessity of weaning. My current thinking on breastfeeding is that I’m happy to let Andrew continue, if he wants to, and see where we end up. If he self-weans before baby arrives, that’s fine; there’s still plenty of time, given that weaning in pregnancy can be quite abrupt, and who knows what he’ll be like next week even if he’s going strong now. Or if he’s still feeding when baby arrives, that’s fine too. As he is pretty predictable in his feeding pattern (i.e. twice a day for main feeds and occasionally other small ones), it should be fairly easy to judge when to offer the newborn the breast before allowing Andrew to feed. If the newborn is anything like Andrew was, for which of course there is no guarantee, then he/she will feed most of the day on and off anyway, inter-dispersed with lots of activity and alertness; it would be harder if he/she is a sleepy baby, as I would then need to be more watchful as to when he/she needs to feed, especially in relation to Andrew. Or if Andrew decides to self-wean once the newborn is here – maybe because there’s less milk for him? – then that’s fine too. If breastfeeding helps him to accept the new baby and not feel jealous or like I’ve got less time for him, then I’m definitely up for tandem feeding as a means of meeting the needs of both my children.
It’s a nice feeling knowing that I have so much more info and support for breastfeeding already in place this time. At 31 weeks of pregnancy with Andrew, I had barely even thought about reading up on breastfeeding and was just getting round to booking my place at an antenatal breastfeeding workshop, which in the end was OK, but didn’t give me any info other than the textbook case, which of course we turned out not to be. I look back and wish I’d been more aware and able to get more info and support antenatally with Andrew, but it’s one of those things that is easy to say with hindsight, and Tom has reminded me that we did our best with the info and knowledge we had at the time, and that’s all we could do. At least this time we have been given another chance to learn from our first experience.
That’s all for now, except to say that this week saw Tom and I celebrate our 4th wedding anniversary. It’s amazing to think how much has happened in those four years, and I can’t believe that there are now nearly 4 of us instead of the 2 who started a journey together on our wedding day four years ago. Andrew is definitely a mixture of the 2 of us – I love looking at him and thinking of how he has bits from me and bits from Tom. I’m looking forward to discovering in what ways the new baby is another mixture of the two of us 
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