Addendum to postpartum body woes: Part 3

June 10, 2014
Sorry, I didn’t mean for this to turn into a multipart series.  It just . . . happened.  Here’s a short summary:

1) Realized that I was not only not losing weight, but gaining it (slowly) postpartum.  Not thrilled with this.  Tired of feeling frumpy/uncomfortable.

2) Decided to track intake using an app for a few days, with goal of just being more reasonable with eating.  (Literally, a few days – today was day 4).

3) According to app, while being more reasonable I was eating 1800-2000 calories/day and not feeling particularly ravenous.  Continuing moderate level of exercise (~3 mi run every other day or so, a 40-minute barre3 workout at home on Sunday).

4) Already feeling better about myself, UNTIL . . .

5) Milk supply tanking.*
I know that’s what this is for, but I wasn’t ready to have to dive in so soon . . .

There were signs all weekend, but I chose to ignore them.  Then, when faced with the pump today, it became clear that there was a noticeable difference in my output.  We’re talking a ~20-30% drop, which might not sound significant, but oh — it so is.  It’s the difference between putting ounces in the freezer and taking them out.  It’s also the difference between a happy, content baby and one that seems to be always on the verge of a hunger-induced meltdown.  The whole issue reminds me way too much of my TTC experience (pre-Annabel), and it’s not a great feeling.  I’m experiencing a combination of guilt (for caring what I look like . . .) and anger (at my body for being so #(*&$@ oversensitive to these things). 

So the right thing to do is . . . what?  Add back extra calories (Josh says: DARK BEER) and try to get my supply back up, while resigning myself to just not feeling ‘normal’ for another few months (because it is so temporary)?  Stop worrying so much about providing 100% breastmilk and keep the promises I made to myself earlier about NOT getting obsessive (too late)?  One friend wrote in an email: “what stresses you out more?  the few extra lbs or the keeping up with C?  for me, the pumping and milk supply stress would make me nuts, so i’d rather diet, feel good about my body, and give my kid some formula, but it’s up to you.  does that make sense?  i know you’ll probably stress out more if you’re restricting and then having to worry why C was fussy and whether you should have eaten an extra helping of almonds etc.  that sounds miserable, for one.”

I’m more likely to go with the extra calorie approach, but I did appreciate this fresh (and rather liberated, in a way) view.  I am happy to have the perspective that a) these are all such disgustingly first world problems that it’s ridiculous and b) it won’t matter in 9 months.  But today, I’m still feeling a little annoyed about it all.

and I hate that there is anything at all stressful associated with this wonderful baby
* Two other variables: I’m getting over a mild respiratory virus, AND I didn’t pump in the AM on Saturday or Sunday mornings like I usually do.  One friend (a lactation consultant AND pediatrician) suggested that maybe it was actually the lack of extra pumping that slowed down my output.  I’d love that to be the answer, but I’m just not entirely convinced.

On the upside, the rest of our weekend was wonderful.  We went to the beach — Annabel was scared of the waves, which was a little sad — and then Cameron had his first dip in the pool.  Lots of great family time and beautiful moments. 
we’ll try again soon.


  • Reply oldmdgirl March 10, 2019 at 7:14 pm

    I agree with your lactation consultant. You dropped a pumping session. For me, dropping one pump would lead to a drop in production for me in about 2 days which…. sounds about right.

    I also like your friend’s approach — Really Sarah, the only way you can go wrong here is by stressing yourself out about the decision. Anything you choose is right. Make yourself happy, whichever path you decide!

    • Reply theSHUbox March 10, 2019 at 7:15 pm

      yeah, i actually kind of like the friend’s approach too. also, i realized 300(ish) oz in the freezer = 5 oz supplement per day x 60 days, which gets me ALMOST to 6 months. and it’s much more arbitrary than i’m making it out to be. breastfeeding doesn’t have to be all or nothing.

  • Reply jengalry March 10, 2019 at 7:14 pm

    I second OMDG on both counts, but especially on the pumping piece. I remember figuring out a few months into my pumping career (so at about 6 months, maybe?) that my body’s response to the pump was very dependent on being conditioned to a pumping schedule — I was never one of those women who got more output on Monday after being with my baby all weekend and lower by Friday; Fridays were when I got my highest output because my body had learned through the week that it needed to make milk at those specific times, whereas we were on a much looser schedule on the weekends. Never mind holidays or time off with a sick baby who I was nursing as much as I could for hydration — pumping was an absolute mess when getting back to the office.

    I think especially since you *have* been operating at a surplus, not having the pumping sessions that basically created demand for more than C was consuming over the weekend would be a ready explanation for why it didn’t produce as much today. I bet after a couple of days of normal pumping schedule (maybe going an extra minute or two when you’re done, if your schedule can handle that) it gets right back to what it was doing before.

  • Reply Colleen March 10, 2019 at 7:14 pm

    So it may be very arbitrary but I COMPLETELY understand where you’re coming from with this and am actually facing a similar issue, well at least the supply part not necessarily the diet part, with my 11 week old. I’m currently going a little nuts (2 am feeds and then pumping session, etc) just so I can keep her EBF. I can’t figure out why I can’t just "let go" and be okay with formula, but right now, I just can’t 🙁 A couple of things my LC suggested which might help you too- I just had my thyroid levels checked and it turns out while "normal" for adults, they are too low for a nursing mom so I’m going to see an endo that’s familiar with this. I’m actually interested in your thoughts on this! And my LC recommend shatavari supplements and also motherlove special blend. Hope you find peace either way!!!

    • Reply theSHUbox March 10, 2019 at 7:15 pm

      yep, the whole ‘letting go’ thing – i can’t figure it out. is it because we’re so conditioned that ‘breast is best’ that we feel like failures for not giving 100% breast milk? especially those of us who work and feel like our ‘mothering’ is already being put into question ? that’s my hypothesis, and i DON’T like it and yet I still can’t bring myself to relax about it all.

      one thing that did help me is finally realizing (with annabel) that i could still breastfeed 2-3x/day and enjoy that relationship, but also supplement during the day and sort of get the best of both worlds. not sure why i can’t just do that sooner rather than later with C but i feel like I have to provide for them equally for some (arbitrary, unclear) reason.

  • Reply Cinda March 10, 2019 at 7:14 pm

    First-love your blog and your writing. Your love and your heart is for your family-your children reflect the love. I can tell from your words you are a compassionate M.D.- and that your pt’s. are lucky to have you for their children. You think through things with a passion. You need to relax and look at all your hand touches and feel good. I know from my nursing days and early little one days that is easy to see on paper harder to put into practice. Our firstborn is 30- I used to worry like you about the weight vs, the breast output. I continued to eat so my calories were in the 2100-2500 /day range. I as well ran… I sooo noticed around the 7-8 month mark ( when soft / table foods were introduced ) that the weight would fall off. I believe I slowly lost weight bit by bit until I weaned him at the 13 month mark. During this time my thoughts were that my body just wasn’t needing the calories and the body did’t need to do the output of milk as in his earlier days. These are short lived days-but while in them I know the feeling about the "extra weight". I as well believe that the more you nurse or pump the more the breast will produce. ( this worked for me). 3 children later…. I just finished my 3rd half and am in great health. Smallish frame-102 #. I hope maybe my words provided some thought /help. My mom always said– advice is something you can take of what you want, like eating fish….. One eats the meat and leaves the bones. With our children it is always learning and re-learning with their growth and ours and the adjustments, I think……

  • Reply Michelle March 10, 2019 at 7:14 pm

    I’ve admired your blog and your multitasking ability for a while. We’re a two-physician household and i am finishing up my Anesthesia residency with a nearly 2 year-old and thinking of adding another, so I love reading your stories on how you juggle this combo. From an outsider’s point-of-view, I think you and your husband are doing an amazing job!
    Breastfeeding-wise, have you ever tried oatmeal? While breastfeeding, whenever I had oatmeal, I would notice my supply increase. It was noticeable even in cup-size more than 6 months pp! Totally non-scientific and purely anecdotal but perhaps worth a shot?

  • Reply Ana March 10, 2019 at 7:14 pm

    Agree, if you weren’t super-hungry, I bet it was the lack of pumping and not the reduction in calories. Also dehydration can do it, and you were out a LOT this weekend in the heat. I thought I was dropped supply because of running itself, or calorie deficit due to running…turns out that when I drank enough water after the run I was better.
    Its so freaking confusing and annoying, isn’t it. I completely support working on only one thing that requires tracking and counting at a time.

  • Reply Sam March 10, 2019 at 7:14 pm

    I totally understand why you want to keep breastfeeding, I just went through it once …. made it to 1 year. My tricks which you may already be doing – showers before the morning pump (getting things going in the shower w/ your hand, if you know what I mean) AND bran (cereal, as in All-bran, with milk although I imagine other brands would work). Regarding the latter, on days when I did not eat bran, I would notice a serious drop in production. My son is a hungry little guy and the thought of not leaving him enough really got to me and caused me a great deal of stress. Your stash looks awesome- you are doing great! Thank you by the way for your help last year – I asked you a pregnancy or baby related question, I honestly can’t remember what it was but you were so sweet and helpful. Best of luck!!

  • Reply Sarah March 10, 2019 at 7:14 pm

    Sarah, did you notice any difference in your output /supply while taking fenugreek/blessed thistle with Anabel? Having similar supply issues/return to work woes at 11 weeks…thanks!!

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