Thursday, March 21, 2013

No milk

This is the breastfeeding post, as you might have gathered from the title.

Breastfeeding my baby is what I really hoped to do. I know the benefits for both mom and baby. And it just sounded so darn convenient compared to formula feeding. I also went in knowing that it wouldn't be the end of the world if Gummy needed to be formula fed. This baby would be fed and loved, no matter what.

I had worries all along about whether I could breastfeed or not. The same issues that have caused my infertility would possibly (probably?) make it impossible for me to breastfeed. As a teenager, puberty sort of passed me by, and my breasts never really developed fully (and I never menstruated without meds, and never ovulated ever. Hence, the last 4 years). I worried that milk glands had not been fully formed and so wouldn't produce milk. Also, I worried that because my HPG axis (hypothalamic-pituitary-gonadal axis) is screwed, and that the pituitary is responsible for releasing prolactin, I would simply not make any prolactin (I felt confident that my body could make oxytocin, you know, since I have close relationships with other humans).

You would think that 1) hypothetically nonexistent milk glands and 2) a potentially missing essential lactation hormone would be enough to put sticks in the wheels of mama who wants to breastfeed. But no. There were more sticks.

Breastfeeding started off with a bang. And by bang, I do mean flourish...and pain (oh, my nipples paid for this in blood). Gummy was nicknamed 'the barracuda' by different nurses at the hospital. Her latch was ferocious. I was over the moon to see colostrum. I could hardly believe my eyes. My body might be able to do this after all. My confidence took a hit when we had a 16-hour cluster feeding session in hospital (hospitalization #1 - the birth) where Gummy grew increasingly distressed, and ended in her spending a few hours in the nursery being given formula while I wept in my hospital bed. We did start supplementing at the breast with a narrow feeding tube after this, and it seemed to be a good solution until the time when My Milk Would Come In.*

And then I was separated from my baby for 24 hours when she was 5 days old (hospitalization #2).

And then I had a massive postpartum hemorrhage because of retained products of pregnancy (hospitalization #3). As far as one's milk not coming in, the retained products is a usual suspect. Placental bits left in the uterus tell your HPG (well, the H and the P mostly) that you are still pregnant, so there is no need to lactate: placenta's feeding your fetus (except that your fetus is now a baby, and she is crying to be fed). I spent about 36 hours neither feeding nor pumping during that ordeal, and then resumed pumping on Sunday and putting Gummy to the breast on Monday.

We had a good chat with the lactation consultant on the day of discharged from #3, and much help from or dear friend who is a midwife with a special interest in breastfeeding. I left with a plan to help my body calm down from all the stress, recuperate from the physical strain, and help promote lactation while balancing the need for rest. The lactation consultant felt that while I may never be able to feed my baby 100% breast milk, there was a good chance that we could get back on the breastfeeding train. I went home and was pumping, breastfeeding with the tube, taking the herbal supplements, and spending lots of time skin to skin with my baby. I wasn't putting my expectations too high, but I was going to give this a good shot.

Sigh.

I have no milk. It's not that I have very little milk, or insufficient milk, or that my baby is now used to living large with formula and is turning her nose up at the breast because of the bird-sized portions. No. I have absolutely no milk.

Trying to guess at the why is a circular exercise (see above). There are so many factors that could explain it, not to mention the interaction between all the factors.

I went to see my family doctor yesterday and we talked about the possibility of meds (dom.perido.ne - I think it isn't prescribed in the US, but it is prescribed commonly for lactation problems in Canada). There are risks in term of this medication (although those risks have been cogently downplayed by breastfeeding advocates - see this website for more info). My family doc was reluctant to prescribe it to me at first, but then changed her mind. She gave me the prescription, but said I had to go for an EKG first.

And that's kind of where I hit my breaking point. I didn't go get the EKG and didn't fill the prescription. Instead, I went home and pondered this some more. And talked to Mr. A. This is starting to feel ridiculous. And the risks to my health now scare me more after the postpartum circus. And what tells me that this drug is going to make me lactate at all. How much more work do I put into this before I surrender completely, and just embrace my baby's formula-fed double chin and tell myself that she will build her immunity through exposure?

That's about when the GUILT hits me, and the nagging voice inside (the superego?) tells me I should move heaven and earth to try and breastfeed her.

And then I develop an overwhelming urge to take a nap. Because, you know, we've already moved heaven and earth just to have her. 
 

*italics added to emphasize the mythical tone of this pronouncement. 

44 comments:

  1. I'm so sorry for your struggles. Breastfeeding was something that I too really wanted to make work, and we gave it our best shot. She always nursed great when the lactation consultant was present! Unfortunately, I couldn't afford to pay them to simply sit in my livingroom with me. I eventually reached a point (with both nursing and then later with pumping) where I realized that no amount of antibodies in breastmilk could ever make up for the unhappiness in both of us when we tried to nurse, and that having a happy mom and a happy baby was worth far more. If formula did that, I was going to be OK with that.

    The guilt comes and goes. What if we hadn't moved when she was 19 days old? What if I had tried hard? What if I had gritted my teeth and bore down through the pain? What if, what if, what if? But most of the time, I look at a fabulously healthy 16 month old and know in my heart of hearts, I did all right by her. I'm allowed to feel sad that things didn't turn out how I wanted, but I should also feel happy with how things turned out, too.

    Enjoy your nap!

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    1. thanks for sharing that, A. I really appreciate it.

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  2. Oh, yes. This whole thing makes so much sense to me. And I'm sorry, on top of everything else, that this has been an experience denied to you, especially after it seemed like it might actually work. I would start myself looking at the silver linings here....you'll probably sleep better, she won't bite your nipples as a toddler, you won't have to wear ridiculous bras with flaps. Yeah, I know.... those things are small compared to what you want. I'm sorry.

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    1. no, it actually helps to have you point out the silver linings. And it's easy to hear it from you, as opposed to say, someone for whom this whole bf thing went entirely swimmingly (does that even exist?) Thanks Gwinne.

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    2. Speaking of silver linings, you won't get mastitis! Or thrush! Or weird hormone-related rashes that last for two years! For example. Ahem.

      I found that breastfeeding was 'convenient' in that it was always there, and therefore, *I* was always there, or at least the pump was always there. I HATE PUMPING. Seriously hate. I don't know who it's convenient for: the baby? Certainly not the breastfeeding woman. It's certainly no more convenient than Amaz.on's automatic delivery service.

      I understand the disappointment - theoretically, if not in personal terms- and it does sound like the whole prolactin-related hormonal pathway bypassed you. Hmph. I think I remember reading that Melissa at Stirrup Queens also had very low prolactin and her milk, likewise, just never came in.

      And... the US allergists' professional society now thinks that early introduction of potential allergens might be beneficial! One of the much-touted supposed benefits of breastfeeding is always 'might reduce allergies' but frankly, allergies are so poorly understood that I am not surprised the AAAAI changes their mind every few years. So you might be helping Gummy have a lower chance of dairy/soy allergy! (Obviously children with bad reactions to dairy or soy formula or other foods are not included in this guideline.)

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    3. point well taken re: additional silver linings, Jenny. Hasn't been easy for you, despite breastfeeding.
      And yes, allergies seem to be poorly understood at this point (you, of all people would know). Does early exposure build immunity or destroy it (or somewhere in between?) I mean, they use to tell women NOT to eat peanut butter and lots of other things if they were breastfeeding for fear their babies would be made allergic. Now this doesn't seem to be the recommendation.

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  3. I am so sorry for all your struggles!
    At the end of the day, there are PLENTY of formula fed babies out there who are healthy and happy. They are being fed - that is the important thing. Don't beat yourself up. Gummy needs her mommy to be healthy and happy - that is SO important! And, as the commenter above noted all those silver linings (we have been dealing with a teething toddler nursing and all I can say is OUCH - it prompted weaning and believe me, my nipples sure are happy about that!)

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  4. I'm so sorry! :(

    Breast feeding did not go well for us. Boys didn't seem to want to latch. I was soooo overwhelmed. The boys were born at 36 weeks, and for whatever reason, my pro-breastfeeding hospital immediately had me give them a bottle. We tried breastfeeding while supplementing with a bottle. The lactation nurses suggested trying to feed them for 15 min and then finishing them with a bottle. Long story short: no breastfeeding for my babies; they never got it. I was able to pump, but it RAVAGED my nipples. Since I thought that the boys didn't need to have blood-tinged milk (I know, yuck), I only pumped 4 or 5 times a day (never enough at one time for a whole feeding), by 4 months I was down to once a day and then quit.

    Did I feel guilty? Oh yes. Did I cry? You betcha. Did the kids thrive on formula? Absolutely! They don't have immune issues. I could credit it to the little bit of milk that they got in the beginning. But I really don't think that is the answer. I think that they were just...OK. Formula is fine. Actually I was formula fed in the 1970s. I don't have immune issues.

    Dear Augusta, please be gentle with yourself. Allow yourself to grieve at the thought of not breastfeeding you daughter, but don't be consumed by it. In a few weeks you won't be so emotional about it; in a few months, you will hardly remember even trying; in a few years, no one will even ask you.

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    1. thank you for your very kind words, Brenda. And thank you for sharing your story. It's just such a BIG DEAL at this moment, and it really helps to read that yes, in a few weeks, months, and years, this won't even be a deal.

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  5. I am sorry. I can empathize, as I also really wanted to breastfeed and was unable to breastfeed my twins either. (Long story, but it was a combination of prematurity-related inability to latch, preeclampsia/mag, postpartum hemorrhage, and anatomical issues.)

    Our sons are 14 months old and very happy and healthy despite the lack of breast milk. I know it seems like a big deal now, but in the overall scheme of things, it will not.

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  6. I had been wondering how the hospitalizations had effected BF'ing, not even knowing the other issues. :( I'm so sorry!

    Just to repeat what others have said and to encourage you, you need to make the decision to do what's best for the whole family - including you!! And if that means allowing your body to heal and simply enjoying your baby without the BF'ing/pumping stress, then do it!

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    1. I appreciate your supportive comment, dspence. Yes, enjoying my baby and motherhood is the whole point, isn't it.

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  7. Breastfeeding did also not go very well for us. One little girl latched like a pro (they also nicknamed her a 'baracuda') but our other little girl had some jaundice and didn't latch well. Plus it seemed to be so much work she would almost immediately go to sleep. I was definitely not prepared for the exhaustion either. So after a couple weeks of fighting to breastfeed and pump...I through in the towel for my sanity. I understand the guilt and upset/depressed feelings in that respect. But formula is not the end of the world and if it takes stress off you (medical risks and everything else) then no guilt for it. Our girls have been healthy and happy and developed great little immune systems on their own (hardly ever sick).

    But definitely be easy on yourself. You have been through so much and done so much to get Gummy here. That and the love you have makes you a great mom...not all the little technicalities. It happens pretty often (at least in my circle of friends) that illness or complications just don't make it possible to breastfeed. There is nothing you could have done differently and Gummy will do great and flourish just the same. Don't get down on yourself and don't allow anyone else to make you feel less either. You are doing so great mommy :)

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    1. Thank you for sharing some of your story and for your very supportive encouragements, Michelle.

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  8. Hugs to you. Great big ones. I am writing you an email right now. xo

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    1. thanks for the hugs. I will reply by email :)

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  9. OK, so I'm one of those lucky people that anyone with issues in the department wants to vomit when talking to. Breastfeeding was easy and plentiful for me the first time around.

    BUT, my mother didn't breastfeed my brother or me - not for one day. No colostrum, nothing. She remembers that they gave her pills to dry her milk up in the hospital after have us.

    And here's the thing. My son is thriving and healthy at almost 2. But guess what? I'm 41 and I am healthy and thriving (but for pregnancy related sickess of late!) and have been my entire life. So is my brother. Neither my brother or I have had any significant health issues. Oh ... and my husband has 2 siblings. He and his sister weren't breastfed either but his younger brother was. Guess who has the most health issues of the 3 of them - that's right - the breastfed brother.

    So... all of this to say that we (read: nurses, midwives, lactation consultants and general know it all assholes) need to stop being so hard on mommy's who want to, try really hard, and can't or - to those that just decide not to!

    Your journey has been long, exhausted and hard fought Augusta. Enjoy this time - your beautiful Gummy daughter will be just fine whether fed with formula or breast milk. You know why? Because she's got the best parents she could ever have dreamed of!

    xoxo

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    1. Let me just add (so I don't get yelled at) that I don't think ALL nurses, midwives and lactation consultants are assholes at all ... but the push I had to breastfeed was from these folks. I don't mean to generalize.

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    2. Thanks Lisa. Yes, so many of us were formula fed in the 70s/early 80s. It's just the way it was. And it isn't the case that we are a generation of very sick people.
      Thank you for your supportive words, on this post and always. You are so kind, dear woman.

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  10. Just wanted to chime in. Please do not beat yourself up over this!! It's totally normal to feel guilty, but do not. I had my son nine years ago. We also attempted breastfeeding. I was able to give him colostrum, but then he had trouble latching on and would keep falling asleep. It ended up being so much easier to give him formula. I did manage to pump for a little bit (maybe two weeks), but I'd say the majority of his diet was formula. Because he was bottle-fed it gave everyone a chance to feed and bond with him, and let me tell you, it made me a much happier mom for it. Those first few weeks are killer, and you've already been through SO much. You deserve to enjoy this time without having this stress you out.

    I can tell you that my son has no allergies and is extremely healthy -- hardly ever gets sick. He's a thriving elementary school student who is a whiz in math and is an extremely fast reader. He has thrived and has not suffered for is all-formula diet.

    You're doing great, momma!! Enjoy that Gummy!

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    1. Thank you so much for your comment, Danielle. I appreciate it so much. Thanks for sharing your experiences with your son. He sounds awesome! (like his mom)

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  11. Please don't feel bad for using formula--- you tried and no milk is no milk. I would be leary of using meds to try to force your body to make milk given your medical history. My little one never latched on and so got mostly formula ( I did pump which super sucked). He is a very healthy non-obese 2 yo now with a robust immune system.

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    1. Thanks so much, NL. Weighing the risks and benefits told me that taking the meds was a risk I didn't really want to take, especially with not a lot of hope for success. Thanks for telling me about your experiences. Immunity and obesity are indeed my two most significant concerns with not breastfeeding.

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  12. I feel like others have eloquently expressed everything I'd want to say (It's hard to let go of this experience, it's unfair that you couldn't do this thing you'd hoped to do, I hope the sting will fade, I believe it will, be kind to yourself, it's okay to say "enough's enough" and, by the way, any casual reader will surely agree, ENOUGH IS ENOUGH! let alone those of us who have been with you through your previous heaven and earth moving) that it gives me space to say something else entirely: I WAS JUST READING A PAPER ABOUT PROLACTIN! (A paper suggesting [with no evidence, alas] that sad music causes a release in prolactin, hence our enjoyment of it.)

    Ahem. Much love to you as you work through this.

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    1. your comment made me imagine what it would mean if sadness was entirely dependent on prolactin. I would not have the ability to feel sad. A blessing or a curse? It's a moot exercise, since you know, prolactin makes people leak milk, not tears.
      Thank you for your comment, dearest Bunny.

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  13. I greatly commend you for realizing that enough is enough and making the incredibly sensible decision to formula-feed. May you both be happy and healthy.

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    1. Thank you so much for your supportive comment.

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  14. I am over the moon that Gummy is healthy. And I experienced barely a fraction of this and wanted to give up entirely. You are a powerful mama bear and this little one has you to hold, protect and feed her even if it isn't through those barracuda jaws. Even that brief bit where your body did it's job is really amazing. I am so proud of you. I would not trade the worry of gaining weight and breastfeeding. Plump gummy is a happy warm thought.

    Thinking of you tons.

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    1. Misfit, thank you so much for your immense support. Thank you for saying that you are proud of me. It means a lot.

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  15. Augusta, you've been through a ton. I have to say I admire you for knowing when to say when (a particular weakness of mine). You DID already move heaven and earth to have your girl, and there's no reason you need to move heaven and earth banging your head against the wall trying to breastfeed her. She is well fed and will be a happy and healthy girl. thinking of you, fondly. and wish this silly breastfeeding thing didn't have to be so darn tough (and btw, WHY isn't it more widely known how tough it is for so many of us?!)

    Mo

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    1. I must admit that reading about your determination to breastfeed Magpie despite the mountains of challenges you faced was inspiring. I thought of you in some of the dark moments and it helped me persist.
      Thank you for your very supportive comment, Mo.

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  16. Dearest Augusta - I am so late to this show, but I still have to back up and say Congrats!!! (about gummy) And, I'm so sorry!!! (about the hospital visits)

    I had no idea how emotionally taxing the whole breastfeeding thing would be. I swear so much has taken me off guard, how little I could predict how I would feel about things, how hard certain aspects would be. I'm so overjoyed to have these problems and the good, oh the good, makes it worth it a million times over. But shit, some of it is just hard :).

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    1. A friend of mine here in Pleasantville gave me 2 pieces of advice when she learned that I was pregnant: 1) don't listen to people's advice and 2) read up on breastfeeding and newborn care instead of spending all your time reading about labor. She added that while breastfeeding seems so intuitive (breast + baby = breastfeeding...SOUNDS SIMPLE BUT IS NOT). Yeah, I see what she means now.

      thanks for your comment, lovely Mrs. Brightside. And yes, these problems are really wonderful problems to have compared to stressing about injections and vaginal ultrasounds.

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  17. Thinking of you my dear friend. I've had some guilt over not being fortunate to breastfeed Q. With his unexpected arrival, there just wasn't a chance. But I know that he is growing and thriving, and while there are so many that feel strongly against formula, it is working for my little miracle. I was so worried about bonding, but I am pretty sure we've crossed that line. My heart aches when I think about how much guilt there is placed on those who are unable to breastfeed for whatever reason. I wish we could all just respect one another and allow us to make the decisions that are right for our children. Sorry I'm on a soapbox. This has been something weighing heavy on my heart lately. But to quote a good friend- I LOVE that parenting issues are the challenges you are facing now. ;) Much love my friend...

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    1. yes, these are good problems to have ;-)
      I can't tell you how glad I am that we are both on the other side, my friend. I hope everyone who reads this and is suffering from infertility joins us in this magnificent place of parenthood.

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  18. BreastFeeding is tough. I'm sorry it is not working out the way you wanted. LMI was supplemented with formula ad exclusively formula fed for the first while, but having our bodies not do what they are supposed to is the worst part. Hang in there!

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    1. yes, it feels hard to once again face the fact that my body can't do something that many women's do. But the most important thing is that I have a daughter.

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  19. Breastfeeding (or the attempts at it) was the hardest thing I've ever tried to do in my life. I was totally unprepared for the physical challenges, the unbelievably heart wrenching misery when it didn't work (which was the norm), the horrific guilt number I could do on myself, the endless advice/suggestions/two cents and hands on mauling from everyone around me, the anguish of a crying baby (or in my case - 2) at my breasts which inevitably led to me being in tears as well, etc......

    It was wretched. On a few rare occasions one or more of the three of us got a brief handle on the situation. I thought once that happened I would have the "aha moment", angels would sing, the skies would clear and I would be experiencing the BLISS OF BREASTFEEDING. Um - not so much. It was never, ever easy. It was never enough (we supplemented from day one). It was never joyous. It was consistently the most challenging, upsetting, hard thing I have ever tried to do. It was hard on the babies. It was hard on my husband (and permanently changed his previously idealized view of the womanly art...). It was difficult socially - people seemed to think they could just hang around and watch me try. Mothers in law seemed to think it was ok to talk w/ all their friends about my breastfeeding challenges. Pumping took over my life. I was a slave to the cause. My nipples bled (which is truly horrifying). I had pain. I leaked embarrassingly on occasion. And on and on....

    I put myself through this for months, despite virtually everyone I know in my generation (including myself), having been exclusively formula fed and being as healthy and allergy free as one could hope to be.

    Everyone in my house was happier when the babies were bottle fed. Everyone slept better, felt better, thrived more happily when I finally gave up. The importance of the mother being ok in order for the family to be ok was made very very clear. The babies today (at 18 mths) are healthy, allergy free, thriving, and completely hearty wonderful creatures. I am thankful to have the emotional anguish of breastfeeding well in my past.

    I share all of this just to say that you are doing a fantastic job, despite all the many hurdles you had to leap to get to this day. Your beautiful girl will thrive. The breastfeeding guilt and torment will fade in time and all will be well.

    I am sorry it was so hard for you and things haven't gone as you would have wished. But the most important thing is that you and your daughter are healthy and that you are there for her.

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    1. thank you for sharing your story with me, ebg. And thank you so much for your support. It's not easy to make all these decisions, and it helps to have the support of such an amazing community.

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  20. Oh Augusta. The things you had to go through to have Gummy here with you. Moving heaven and earth, indeed. And now this, it is just not fair. But, as you said, she will be fed and loved no matter what. Hang in there.

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    1. thank you so much for your comment. Yes, above all, my girl is fed and loved and thriving. That is so much more important than breast versus bottle. Thank you for your comment.

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  21. I gave myself shingles trying to produce enough milk for Leah. I thought I would die when I started to supplement.

    How absurd, I now think. But it took me a second baby to get here. I can relate to what you are feeling a little bit. My heart goes out to you.

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