I was diagnosed with PCOS at 13 years old. I had always struggled with my weight and at 20 years old, I had gastric bypass surgery. I was six months post-op, 100 pounds down, and I wanted a baby. I had my A1C, DHEA-S, and testosterone levels checked and all of them came back looking great. I was the healthiest I had ever been – I even started having regular periods (so regular that I knew what day it would start and what day it would end).

The first month I started tracking my ovulation and got a positive, we got pregnant. My pregnancy wasn't the easiest. I had severe morning sickness from five weeks until the day I gave birth. I dealt with perinatal depression and anxiety. And at the 20-week anatomy scan, we found a mass on our baby's lung. I had weekly and then biweekly ultrasounds for the remainder of my pregnancy, met with a pediatric surgeon, and the neonatal team. For the most part, I had to do everything alone because of the COVID restrictions. The mass did end up shrinking until it wasn’t visible via ultrasound any more towards the last month of my pregnancy.

I wanted a natural birth; I would've even given birth in a birth center or at home, but my husband and I just felt more comfortable in a hospital with the NICU given the circumstances. Around 36 weeks, my doctor started trying talk me into having an induction. Of course, given my hope for a natural birth, I was against that. At my 39-week appointment, I was two cm dilated and 60 percent effaced. I came home and did all the things to encourage my body to go into labor.

Around 3 a.m. the next morning, I woke up with severe back pain but was so tired I went back to sleep. Around 9 a.m., the contractions started. I was having inconsistent contractions about every 20 minutes all morning. By 1 p.m., they were five minutes apart so my husband and I headed to the hospital. We were admitted at 5 p.m. at 4cm dilated and 80% effaced. I labored the rest of that evening and all night with no change (and no sleep). By 8 a.m., I was absolutely exhausted; my doctor talked me into letting her break my water and give me Cytotec. Minutes after my water was broken, the contractions were on top of each other and I couldn't handle it. I went for two hours with no change and opted for the epidural. The rest of my labor was uneventful.

By 3:30 p.m., I was 10 cm and fully engaged. By then the epidural had worn off almost all the way. I was waiting for a little over an hour and the urge to push never came. Baby's heart rate was dropping so they told me I had to push. After pushing for nearly two hours, using the vacuum, and sustaining a severe tear, our baby boy was born at 6:31 p.m. He had the cord around his neck and I lost over double the amount of blood expected with a vaginal delivery.

I didn't get to hold my baby for the first two hours of his life. His first latch was painful, but the nurses provided no help with it. They all just said it looked good. A lactation consultant came to help. She told me baby had lost eight ounces in the hospital, which was a normal amount.

At home, it was really hard. Baby didn’t want to do anything except nurse. My nipples were torn up and he wasn't having hardly any wet and dirty diapers. He had his first doctor appointment at five days old and he had lost just under a pound. I was told to see a lactation consultant and start triple feeding. I cried and cried and cried. I felt worthless. Useless. I felt like a terrible mother.

The lactation consultant told me I wouldn't be able to exclusively breastfeed because my breasts are too small and too spaced out. When my son was a week old, we started using a supplemental nursing system. I dealt with postpartum depression for a couple of weeks while I battled the feelings of insufficiency. I just wanted to be enough for my baby. After much research and not giving up, I found an amazing group on Facebook (the IGT and Low Milk Supply Support Group) and dove into the mystery of low milk supply. I came to find out that there can be many underlying causes to chronic low milk supply and I was battling many of them: PCOS, blood loss, anemia, low vitamin D, hormone imbalances, insulin resistance, IGT.

Baby is nearly five months old now and we're doing better. I have come to terms with my low milk supply and we exclusively nurse with a DIY SNS. I'm an advocate for low milk supply. I'm battling trying to find and treat my underlying issues so I can optimize my supply for the next baby.

How old was your baby when you realized you had low milk supply? What concerns led you to learn this?

Baby was five days old. I had suspected he wasn't getting enough breastmilk from me because he wasn't having sufficient wet and dirty diapers.

What were some of your goals when you first started your breastfeeding journey? How did these goals shift throughout the time you were lactating?

My main goal was to exclusively breastfeed until baby was a year old and continue to comfort nurse for as long as baby wants. Fortunately, I'm still able to fulfill that latter goal, but I obviously cannot exclusively breastfeed. Instead, I will hopefully use the SNS until baby is a year old.

What advice were you given, if any, to increase your supply? By whom?

I was told to triple feed, take fenugreek, drink a dark beer, take supplements, take Reglan, drink Body Armor. There's probably more but I can't remember it all.

Did you feel supported by your medical providers? Why or why not?

Yes and no. I felt like they all knew how painful it was for me but I don't think any of them were prepared to support me long term.

What is one thing that you wish someone would have told you when you began your low milk supply journey?

Honestly, I had all the support in the world from my husband. He said all the right things. If there's something I wish people would tell mothers more, it's that it's okay to put your mental health before your wants.

Is there any support from people other than medical providers (e.g. lactation consultants, family, friends, peers) that you wish you had gotten during your low supply journey?

I wish more people realized how painful it was for me not to exclusively breastfeed. My husband was the best, but after he went back to work I was severely lonely and that's where other friends and family members could've helped me.

Did you feel prepared for the possibility of low milk supply? Why or why not?

No. I didn't get ANY information about it at all. In fact, I was told low milk supply wasn't possible. I was 100% under the impression that every woman with functional breasts could breastfeed.

What is one thing that you would like all medical and lactation professionals to know about chronic low milk supply?

I would like all medical and lactation professionals to know that low milk supply can be a symptom of an underlying health condition. I want it to be routine for mothers to get blood work done (full blood panel, micronutrients, prolactin, hormones, etc.) during pregnancy and after, ESPECIALLY if the mother presents with low milk supply or has a history of it.

In one sentence, why does low milk supply matter to you?

Low milk supply matters to me because there's an underlying cause that needs to be addressed for me to be at optimal health and provide as much as I can to my babies.

What is one thing about your low milk supply experience that makes you proud?

I will forever be proud of myself for overcoming postpartum depression and the perseverance I have to continue to breastfeed despite what others may think.