I received an email the other day from a former FFF Friday poster who is expecting her second child in a few weeks. She’s already made the decision to formula feed from the start, due to her own (extremely valid, not that it should matter) personal reasons. She made a completely informed, well-considered decision about what was best for her family, and I am incredibly proud of her for that.
Anyway, she’s understandably concerned about the drying-up process; no one really addresses this anymore, considering all the focus is on breastfeeding. The consensus seems to be that if you have decided to formula feed, you’re on your own. (This has actually been on my mind a great deal lately, and in the next few months I will be working on the FFF Guide to Formula Feeding, so that there’s at least some info out there that doesn’t come from a formula company, or is drenched in punitive sarcasm à la Dr. Sears’s webpage on formula feeding.) This mom writes that she would “like to go into the hospital/postpartum period knowing what to expect, like how bad is it, how long does it last, what helps, what doesn’t. I mean google breastfeeding tips and you get millions of sites chock full of advice, google dealing with engorgement when not bfing and you get brow beaten and chastised. Don’t I deserve to know what to expect when I’m making the best choice for my daughter and myself?”
Yes, sweetie, you do. You abso-freaking-lutely do.
I was so worried about engorgement and the drying-up process when I had Fearlette, that it almost made me want to skip trying to breastfeed altogether. I worried that by engaging in some nursing, it would make my milk come in faster and at a higher volume than if I went straight to the bottle. I felt there was nothing I’d be able to do to stop the pain and discomfort of engorgement, and coupled with normal postpartum pain and my personal history of PPD, this seemed like a daunting prospect.
I’ll admit that I investigated ordering lactation suppressing drugs from overseas. These drugs, which can dry a woman up in one fell swoop – pain free – used to be readily available in the United States and Canada. They were administered by injection in the hospital, or prescribed by physicians and taken orally in pill form. I’ve heard horror stories of women in my mother’s generation being injected with these drugs without consent, so that they attempted to breastfeed and found themselves dry as a bone. Scary stuff, and totally disgusting on a myriad of levels. But that isn’t the reason that these drugs were eventually taken off the market. Apparently, they were causing rare but serious (and sometimes fatal) side effects. Enduring a few days of discomfort for the sake of avoiding death? Perfectly rational, if you ask me.
However, there are other medications that have been put on the market which – at least as far as anyone knows – are safer. In other countries, these are still perfectly legal, and even in the US, doctors speak in hushed tones about giving women who’ve suffered late-term or infant losses these drugs, as a show of sympathy (because really, does a mother going through that kind of pain need to be constantly reminded of the baby she could have been nursing, or deal with the physical pain of engorgement?). It seems unfortunate – and a bit odd- that the FDA has yet to approve cabergoline for the use of lactation suppression; it is perfectly legal to use this drug for hyperprolactinemic disorders; the FDA states that their reasoning for not allowing its usage as a lactation suppressant is because “bromocriptine, another dopamine agonist for this purpose, has been associated with cases of hypertension, stroke, and seizures.” Well, yes. But that’s a different drug. Even within one family of pharmaceuticals, different medications can vary dramatically. Zoloft and Prozac, for instance, are both SSRI’s, and yet Zoloft metabolizes differently in breastmilk and is the “recommended” anti-depressant for nursing women.
Until the FDA changes its mind, though, we are stuck with “natural” remedies for drying up milk. I honestly felt like cabbage in the bra worked wonders when I weaned off the pump with Fearless Child, but metastudies have found that this remedy works no better than a placebo. There is a pumping protocol that is supposed to help (designed for women recovering from the loss of a baby, unfortunately), but I haven’t heard anything about the efficacy of this remedy.
In my experience, however, the engorgement I felt with Fearlette was NOTHING like it was when I had a full milk supply going and abruptly weaned FC. It could have been because I’m one of those women who doesn’t get much milk until day 5 or so, and by that point, I’d already begun weaning her onto the bottle; I know some second-time moms whose milk came in like gangbusters within hours of delivery, so I imagine the engorgement would be much worse. Regardless, I do suspect that if you aren’t attempting to establish a supply or completely feed a newborn from your breasts, the drying-up process won’t be as difficult. Meaning that women who intend to formula feed from the start probably won’t have too much pain from engorgement. I had one day of hell – Day 5 – when it hurt to hold Fearlette, and I was too engorged to even think about dragging out the pump (for the record, pumping to relieve engorgement might be a good idea on paper, but you try getting those suckers into the flanges when they are rock-hard balloons of burning agony. Yeah. Good luck.) but after that, it really wasn’t so bad.
That said, it won’t be the same for everyone, so here are my tips for drying up your milk without too many tears (or ruined shirts):
1.As soon as you have decided to not breastfeed or stop breastfeeding, start wearing the tightest sports bra you can, at all hours of the day and night. I wore two, for extra support.
2. When you shower, face away from the stream: hot water will induce milk supply, plus it hurts like a you-know-what if you’re already engorged and sensitive.
3. This one is terrible, but on the day your milk comes in, when your child starts to cry, hand them off to your partner and leave the room. You’ll feel like Mommy Dearest, but I’m telling you – your body will have a biological response, and you’ll be in pain. And then you’ll start crying, and then both of you will be crying, and that will just be sad. It’s one day, and you can hold your baby at all other times – just let someone else handle the hunger cries for 24 hours.
4. If your OB was kind enough to give you a few pain pills for postpartum discomfort (c-section mamas, this is a given for you – most of you probably got a few weeks worth of Vicodin as a parting gift from the maternity ward), save a few. When engorgement starts, take them. Every 4 hours, as indicated. There is no shame in letting a narcotic sweep you into sweet oblivion until the engorgement is gone.
5. Drink No More Milk Tea. It’s tasty, and I really do think it works. At the very least, it probably has some sort of placebo effect, and everyone likes a nice cup of herbal tea, right?
6. Another product I liked were these little ice packs you can put in your bra. They were super soothing and the ice helps relieve engorgement.
7. Don’t be surprised if you still feel a let-down sensation for a few weeks after drying up. It happens, and it’s normal. Some women take longer than others to completely dry up, so be patient, and keep wearing that sports bra. It will pass, eventually.
I’d love to open this up for discussion, since it’s a topic that is seldom addressed. If you chose to formula feed from the start, did you experience much engorgement? When did your milk come in, and how painful was it? Any tips for women going through the same thing?