Size Matters: Breastfeeding

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Senior Year of High School (I am on the left)

For as long as I can remember, and in everything I have read, the size of your breast does not matter in regards to breastfeeding. While I agree with the scientific backing that it is all about how much and what kind of breast tissue, I disagree that size plays absolutely no role. As a mom with extremely small breasts (I was a AA prior to getting pregnant and didn’t even fill out those bras, and I am now just an A and I am exclusively breastfeeding my 4 month old). While I am sure women with large breasts have their own trials and tribulations with breastfeeding, I obviously cannot speak for them. What I can speak on, is how having small breastfeeding plays a significant role in my breastfeeding journey.

 

Anatomy

When Evie was born, the nurses were quick to help me to get started breastfeeding. I had done my reading and knew that I wanted to see a lactation consultant prior to leaving the hospital to ensure that I got the right latch, was holding baby correctly, blah blah blah. The nurse I had during my delivery was quick to assure me I had the “perfect” anatomy for breastfeeding (my nipples weren’t flat or inverted, etc.). However, when Genevieve attempted to suck she struggled. Her tongue would push out rather than pulling in as a result of sucking her thumb in utero. Consequently, we had to do some suck training, and breastfeeding was off to a rocky start.

Furthermore, an issue with the anatomy of small breasts, requires you to hold your baby much higher in order to reach the breast. This might not seem like that much of an issue- but when you have a small, fragile newborn who needs body support to make sure their body is completely “in line” and in addition neck support to guide them to latch correctly, your arms quickly tire of hoisting them up and onto your boob. Especially after you are dead exhausted from labor!! You are encouraged to sit bolt upright to ensure good posture and avoid the pain from hunching while feeding your baby. They explain to bring the baby to the breast, not the breast to the baby, but when your boob is flat to your chest, your core muscles shot from pushing out a child, and your arms unaccustomed to holding said baby for hours on end, that is a huge feat to overcome.

Genevieve-37

Gadgets & Gizmos

Now, you might be thinking why not just use a nursing pillow to raise your baby? Duh. Hmm.. not so much when you have small boobs. In theory, breastfeeding or nursing pillows seem like they can solve world hunger with this issue. However, for me the luck was not in my favor. I bought the ever-popular-boppy pillow, in hopes of making nursing a breeze. I brought it with to the hospital and it let me down. The “U” shape fit snuggly around my postpartum waistline, but sank all the way to my hips. So, my average-7lb-child laid towards my belly button rather than right at my breast. Stacking a pillow underneath was not helpful because then she just rolled into the “U” and angled away from my boob. It was useless.

The lactation consultant immediately advised against the boppy, and recommended the my brestfriend pillow instead. She said the firmer, wider pillow would be helpful in not only propping up my baby’s head, but would also avoid her sinking in. When we left the hospital, Tyler immediately went out and bought the pillow. Boy was in a change!! It was much better in holding Evie’s body in line, and made nursing so much easier. However, the cons were that I could not really do the football hold, and because of my smaller tits, the pillow was still too low for Evie to reach my boob. I had to stack another pillow underneath in order to avoid not having to hold her up the entire 45 minute nursing session.

Pumping

So, now that my milk has come in my boobs did not grow in size. They were still only a full A- maybe a B- cup. I wanted to start pumping so I could have tons of milk in storage if I returned to work. I purchased the Spectra S2 after researching what pump was the quietest, most baby-like, and painless and the Spectra S2 had been ahead of the others by a landslide. Let me tell you- pumping has never hurt! I don’t know how many moms have said they hate pumping because it hurts, and I am so thankful I have never had that issue. Is it fun? No. Is it 100% comfortable? No. Is it manageable? Yes. I don’t dread pumping. The pump itself doesn’t hurt my boobs, pinch my nipples, or anything like that. (Make sure you have the proper flange size if your pump is hurting, and experiment with different suck cycles). However, having small breasts makes pumping a challenge. Why?

Well, imagine this: you hold the breast flange up to your breast, and the pump pulls milk out and down into the bag/bottle. With larger breasts, they naturally “hang”- thus the nipple is naturally pointed downward so the pump flange is utilizing gravity to ensure the milk flows down into the collection unit. With smaller breasts, the flange is virtually held flush against your chest running vertical, rather than at a downward angle. Therefore, even though the milk still runs downward, milk tends to drip down the breast tissue breaking the seal of the flange, and running down my chest. Literally, I have to physically hunch or bend over to ensure milk goes into the pump, rather than pooling in the bottom of the flange. (Yes I have made sure to measure my nipple to make sure I have the correct fit, etc. etc.) This, as you can imagine makes pumping extremely uncomfortable, and also eliminates the opportunity to use a “hands free” pumping bra, since the flange would not be secure.

Attire

Another issue I have dealt with, is that nursing attire is incredible biased towards those with large bosoms. I understand that the majority of nursing mothers will have large breasts due to an abundant supply of milk. However, there should be resources for those with small breasts too! Nursing bras are all geared towards a C-cup or higher. The “sleep” nursing bras (which are not only hideous, but also can’t be worn underneath regular attire) usually run in sizes “Small, Med, Large” of which the small still dwarfs my chest and no one wants to wear a bra that bags underneath your clothing! There are nursing bras for 32B size- but HELLO, I AM A 32A HERE PEOPLE!

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This is a 32A Push-Up swimsuit

So how am I supposed to get nursing-friendly undergarments when there are virtually none (unless you spend upwards of $40 a bra!) for people my size? Hence, I purchased some target sports bras a size bigger than what I needed to make sure they were stretch enough to be pulled up. Even then- many women simply pull their breast out and over the fabric of their sports bra or bra to nurse. This works if your breast is large enough to “hook” the fabric underneath. With small boobs- there is nothing to hold that fabric down. Meaning with one hand you have to manage to support your baby, then in the other find a way to pull your shirt up, and at the same time pull down and hold the sports bra in order to leave access for your baby. This is not only damn near impossible, but also extremely difficult to be discreet in doing, making nursing in public out of the question.

Frequency of Nursing

While it is true that both large and small breasted lactating women produce the same amount of milk within a 24 hour period, the amount a breast can store at one particular time varies. Meaning, someone who may be a size F cup (yes I am not exaggerating here folks) can store perhaps 6oz per side, making a total of 12oz available for the baby or breast pump. Meanwhile, someone like myself may only be able to hold 3-4 oz per side, leaving only 6-8oz total. (Here is a great article that explains this concept) What that means is that my baby might have to nurse more often than say a baby of the same age from a mom with larger breasts.

The issue I have with this, is that larger breasted women may be able to fill their older babies up more, and thus nurse less frequently perhaps making outings a little more manageable. Although I cannot verify this, I know in my experiences that Genevieve will often need to nurse during an outing.

Nursing Positions

As I touched on before with the differences in nursing pillows, I was limited really to the cradle hold due to having to hoist my baby so high up in order to nurse. The football position was not really plausible with my new pillow, and prior to switching pillows it was very difficult to manage since I had to prop pillows behind me to support my posture (my core was so weak after delivery that holding myself upright without support for 45 minutes to nurse was exhausting!), to my sides for her body, and my front for her head. Laying down was also impossible early on due to my small breasts. As a newborn, Evie was too small to reach my nipple when laying on my side. This was because my breasts literally didn’t hang. So when I laid on my side, they were still 3-4 inches above bed level, and her mouth was at about 1 1/2-2 inches. That meant if I were to nurse side-lying, I would have to hold myself over her in a plank (you try some crazy things in sleep-deprivation mode to get your baby to stop crying!), or hold her up with my arm.

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It would be about two months until we were successful in side-lying nursing. I still had to angle my body towards her to get my boob to reach her mouth, but as she grew bigger it go easier and more comfortable. Now, at four months we greatly enjoy our side lying nursing and it is the only way I manage to get sleep since we bed-share around 2am when she wakes during the night for a feeding.

Overall

Genevieve_lowres-36.jpgI do not by an means want to make the assumption that women with medium-large breasts don’t have their own share of issues during breastfeeding! All I am saying is some issues I have had during my experience, and some ways to combat the issues to make life a little easier for my fell itty-bitty-titty members!

 

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