I feel it important to impart all of the wisdom I procured over the most intense eight weeks of my life.

The eight weeks I spent trying to establish anything resembling a milk supply.

There’s a lot I need to type out here so I’ll try to make it as easy to read/scan as possible.

Before Vivi was born I read “The Nursing Mother’s Companion” by Kathleen Huggins and “The Breastfeeding Book” by Dr. Sears. From my limited experience with Addie I knew to have Lansinoh on hand and to use it with reckless abandon.

Much of the blame in an unsuccessful breastfeeding relationship is heaped upon the hospital and its staff. I am pleased to report that not only was the hospital I delivered at baby friendly, it was boob friendly too. Vivi was given to me as soon as she was out, and if it weren’t for some minor complications as a result of her being meconium stained she would have remained skin to skin with me for the next two hours. After she was suctioned and cleared by the doctor (which only took a few minutes) she was handed back to me where she remained skin to skin for the next two hours. No interruptions from doctors or nurses.

Just Vivi, Cody and me.

Throughout our three day stay at the hospital Vivi was only removed from my room by nurses three times in the middle of the night for weight checks and then brought back to me immediately. If Vivi was awake I was awake and she was in my arms. If she cried a boob was popped into her mouth. A IBCLC came into my room twice daily and there was a CLC on staff at all times. Never was formula mentioned or offered.

Her latch was superb.

Everything seemed perfect.

My advice for the hospital: No visitors if you can get away with it. The hospital is sacred time with your new baby and visitors throw a wrench in your new relationship. You cannot full focus on your baby if you have other people in the room. (To be fair Addie came in with my MIL twice a day and of course they came to see me.) Nothing makes me squirm more than seeing hospital rooms FULL of people just after a baby is born.

Be selfish. Be bossy. You’re the mom and the last thing a new mom needs is help holding the baby. What she needs is for you to make her family dinner and scrub the toilets.

Here’s where I get into what I wish I would have known/would have had on hand immediately upon coming home. (Amazon and Buy Buy Baby did a lot of next day shipping to my house.) My advice on gear? If you have any suspicions that you will have trouble establishing a milk supply (from PCOS for example) have everything on hand immediately, you can always return what you don’t use later.

  • Making More Milk by Diana West. Read it. Before you give birth. It’s a wonderful book.
  • Pump – You can rent or you can own. Whether you rent or own be sure the brand you choose is WHO compliant (Medela is not WHO compliant, you can learn more here.) I used a Hygeia pump, their online support is amazing, specifically on twitter through @hygeiakate. Another important element to pumping is being sure that you have the right size of flanges (the funnel looking things that your boobs go in.) More than half of nursing mothers need a larger size shield than expected. Either have multiple sizes on hand or get fit by a IBCLC. Your nipples will write you thank you notes for the next fifteen years.
  • Nursing Bras – I wore Nummies 24/7. They’re wonderful. The end.
  • Carriers – At some point you’re going to want to get up. Or leave the house. The best way to remind your body that there is a baby that it is supposed to be making milk for is to wear the baby. I used a Sleepywrap (MobyWrap) the most. Since it’s basically one enormous piece of fabric I could get away without wearing a shirt under it, thus furthering the whole skin to skin thing. An easier carrier to maneuver and one that isn’t quite as hot is a Mei Tai, but be warned, if you go skin to skin in a Mei Tai, keep the blinds closed.
  • Hands Free Pumping Bra – When I first saw a picture ofย  a hands free pumping bra while I was still pregnant I was SHOCKED! and APPALLED! at how ridiculous they looked. I now own two and have no idea how I went three weeks without one. You can pump and do your makeup at the same time! You can pump and read a book at the same time! You can pump and twitter at the SAME TIME. YOU CAN PUMP AND EAT AT THE SAME TIME. When you’re pumping six to eight times a day for 10-20 minute stretches? You’re going to want one of these.
  • Nursing Pillow – I had a Boppy. Then I used a My Breast Friend pillow at the hospital. Boppy what? I got over my not buying things with stupid names and bought a My Breast Friend pillow and never looked back. That thing is the cat’s MEOW. My breast friend INDEED.
  • A bottle/glass/jug/jar/trough of water in every corner of your house. A NURSING MOTHER’S THIRST KNOWS NO BOUNDS. If you were to spread 20 glasses of water throughout your house each morning you will have sought them out and drank them all by dinnertime. SERIOUSLY.
  • Supplements – Fenugreek will make you smell like syrup. It works for a lot of people. It’s pretty cheap and easy to find. More Milk Plus has fenugreek in it, does not make you smell as bad and can be ordered for pretty cheap on Amazon. Goat’s Rue is much harder to find, will not make you smell like anything and is easiest to find on Amazon. Brewer’s Yeast made me feel like an enormous painful fart. Milkmaid Tea tastes like hot artichoke water and works for some people as well. Domperidone is the holy grail of lactation drugs. While it is not FDA approved in the USA it can be obtained somewhat easily for a price. Compounding pharmacy, that’s all I can really say about that.
  • SNS (Supplemental Nurser Systems) – I started out with a syringe and small feeding tube taped to my boob. Then I moved onto the Lact-Aid, or as I called it, the feed bag. Y’all, these things are not for sissies. A pain to clean, a pain to assemble and a pain to attach…BUT…it works SO WELL. It allows you to pretend for one tiny moment that you are actually satiating your baby with your your own body. You will get better at it. If it weren’t such a huge investment in both time and money I would have kept using it on occasion, but it just wasn’t realistic. If there were ever a chance at me establishing a milk supply it would have been thanks to the Lact-Aid. DouLaLa has more information on the Lact-Aid including a video on how to use it properly. (A Lact-Aid will also takeย  three part feeding (nurse, supplement, pump) down to a two part feeding, which is super nice.)
  • Other Things I TriedOatmeal. I ate it three times a day. While I never made any more milk, I am now the poster child of low cholesterol. Dark beer, specifically Guinness. Works for some, I am not some. Hypno Lactation. Again, works for some. I am not some.
  • Kindle – So it technically has nothing to do with milk supply. But you’re going to be attached to either a baby or a pump a lot. Being able to read with one hand is pretty much the best thing ever. I have the cover with the built in light so I could read in the middle of the night AND see what was going on down in the defunct milk factories at the same time. Win. Book suggestions? Bittersweet by Shauna Niequist and Bossypants by Tina Fey, although the latter will probably cause you to laugh so hard you will shake your boob right out of your baby’s mouth.

If there ever is a third time (which let’s be honest, have you seen the babies we produce?) I will be taking all of my own advice as well as doing more hand expression while still in the hospital. It’s pretty much the only thing I didn’t do simply because I found out about the benefits too late. (I do however have to say that I became a MASTER at hand expression. In the final weeks, nursing with the Lact-Aid and then following up with hand expression instead of pumping seemed to get out the most of what little was in there.)

There is endless advice available on the Internet and in hundreds of books…it’s overwhelming really. Every situation is so much different, this is mine and this is the post I wish I could have read before having Vivi.

Breastfeeding is wonderful and magical. If I can make it easier for one more mom out there? Then everything I went through is doubly worth it.

(While no one asked me to mention any of the products listed above, I must thank Earth Mama Angel Baby, Alison from Nummies Bras, Hygeia (especially Kate), Amy, Pumpease and Annie for virtually holding my hand and talking me off ledges through my experience.)



  1. What a helpful post, Casey! I too wish I could have read this before my first and my second while we’re at it.

    I never had a huge milk supply. For my second it was just “barely” enough. Never ever to create a stash, really.

    I tried many of these things. But I think the thing that surprised me the most was the info about Medela. I just went and read that post. It all makes sense after reading it but everyone is always saying that Medela is the best breast pump! And I don’t think Babies R Us sells Hygeia do they? I just got an up close look at Hygeia at BlogHer and I was amazed. It is awesome!

  2. wow. huge flashback. i had a hard time with milk supply and tried almost every one of those things. domperidone was the bomb. i’m proud that with all the trouble, my kid got about 75% breast milk over her first year (we did have to supplement with formula a bit), and she nursed until her third birthday.

    i would add that a lactation consultant can also be helpful. i had someone come to my house a couple of times after we were home from the hospital – then again, we were living in manhattan where everything is delivered. ๐Ÿ™‚

    great useful post. i hope it helps some other people.

  3. You are a seriously awesome WOMAN!!!! Most would have given up way way way before trying all of these things. You rock! And that’s why I *heart* you and why I come back to read more day after day! ๐Ÿ™‚

  4. I wish I’d had this 7 years ago! I tried almost every thing on this list, too. And nada. And back then I felt like I was the only one in the world who knew how much I wanted this and how much and how hard I tried. Not being able to breastfeed was one of the hardest things for me to accept. (And still is, honestly. With each baby I told myself I wouldn’t get my hopes up. But I did. And it crushed me every time.)

  5. Love this list Casey. I have always been blessed with more than enough milk, but having trained to be a LLL Leader, I know a lot of the tips and tricks. I love hearing from a Mom firsthand though what worked, and what didn’t.
    Love you and your boobies and that DARLING baby girl.

  6. May I just says Yippee! For your comment about compounding pharmacies? It’s something one hardly ever hears about, and they’ve literally saved my life. Thank you Casey! ๐Ÿ™‚

  7. Great post! I think so many people try and give up because they don’t realize there are so many helpful products available. Granted, I had a super easy time nursing, so I don’t know what I would have done if I had had trouble, but I’d like to think I would have exhausted all options before giving up. I was certainly prepared. I read “The Complete Book of Breastfeeding” by Marvin Eiger before I gave birth the first time, and it made me all “I can do this, no matter what!” Which was exactly what I needed.

  8. Thank you so much for this. It will be bookmarked and used if I can get pregnant with baby number 2.

  9. I’m going to share this with every pregnant woman I know!! Thank you for sharing your experience ๐Ÿ™‚

    (And you’re right, you do make beautiful babies!)

  10. You have been through a lot. I feel your pain. I nursed by first two with relative ease but my third child had problems and we tried and tried and tried everything. The herbs, (liquid form…bleh), the pumping ALL THE TIME. The guilt. I even went as far as to give up and then RE LACTATE when she was in the hospital by taking regelan and pumping every hour around the clock. It still never really worked. I commend you for all that you tried and how hard you worked. It appears that vivi is perfect. I am sure she benefited greatly from what milk you were able to provide. I am also sure that she is doing just fine without breastfeeding because she has such a dedicated, loving mother.

  11. So helpful for those struggling moms with PCOS or anything really.

    And the part about being selfish is SOOOOOO right on. I never understand why people feel like they need to share them at that point… they’ve got their whole lives to get to know them. That time is YOUR time!

  12. All I can say is… I am bookmarking this. Thankyou. I know I will need it again and again starting like, yesterday.

  13. The Pumpease handsfree bra you mentioned is always at the top of my list of recs for nursing mothers, too! Such a godsend!

  14. I have no idea how I never had a pumpease. Especially because I exclusively pumped with my first. I managed to go hands free with some complicated bra maneuvering.

  15. I’m due with my first in about 6-7 weeks and I’m bookmarking your post right now! Hopefully it goes smoothly but now I have a go to if it doesn’t ๐Ÿ™‚ Thanks for posting!

  16. Can I ask a question? Feel free to ignore. This is more about me and my hopes for one more baby and less about you. However…you have PCOS too. So yeah, I’ll just ask now. Are you on Metformin? I’ve only know I had PCOS since February and my endocrinologist yesterday said something about if they put you back on it when the baby is born, it helps with milk production. So yeah…am just curious. ๐Ÿ™‚

    For what it’s worth, I couldn’t BF any of mine. Course I wasn’t being treated for PCOS then. So I really have no clue.

  17. I SO wish I could have known some of this information about a year ago…more specifically your nursing bras. A hands free pump? Shut up.

  18. Casey, I was doubly honoured to virtually hold your boob, er hand. ๐Ÿ™‚

    You are amazing.


  19. While a big part of me is, as usual, thankful for your honesty with your struggles with fertilty and breast feeding (I never knew there was a connection!) another part of me is just thankful I’ll probably never have to worry about any of this.

    But if I ever DO have a baby, I’m picking your brain about all of it.

  20. What a great post. My jaw is DROPPED at the info on Medela. I had no idea. If/when I have another baby, I will be ditching my Medela and getting a Hygeia pump, pronto. Thanks.

  21. Awesome post!!!

  22. I am so sorry you are going through this. I am also struggling to feed my son Julian. It is a nightmare sometes, but my daughter was also formula fed and she turned out great. We will both getthrough it.