Supply help! :(

My daughter is combi-fed because while I was EBFing her she lost a lot of weight at first and wasn't putting it back on like she should have. So, under the advice of the midwives and health visitors I supplemented.


I realise now that it may not have been what I should have done. I want my daughter to be EBF, but I don't know how to fix this.

I've tried things to up my supply, but I end up giving her a bottle because she gets so frustrated with me   I've tried fenugreek, which didn't make much difference. I also don't respond well to pumping; I get about 1oz from both boobs after like an hour and a half, when there's more in there.. (I have an electric, and a manual.. same story with both, and they're different brands of pump too).

I just wonder if there's something else I haven't tried? I normally nurse her then give her a bottle afterwards. I mean I've tried nursing her longer, see if she'll settle, but she gets so upset when she isn't getting enough and she's still hungry. Like I could maybe nurse, top-up with a little formula, nurse some more? Nurse when she wants a paci? I'm so lost with this  

TIA!

I had issues at first I would have my LO nurse at first then bottle then nurse again. Nurse at every chance you get and your body will produce more. I also ate oatmeal they say it can help increase your supply

Quoting Kismet:" I had issues at first I would have my LO nurse at first then bottle then nurse again. Nurse at every ... [snip!] ... Nurse at every chance you get and your body will produce more. I also ate oatmeal they say it can help increase your supply"

Ooh I didn't know about oatmeal, I'll give it a try, thanks!

I posted this to another momma a few days ago regarding low supply - but read through it. PLEASE list the baby's age - when you started to supplement - what her weights were - if she had good diaper output (4-6 wets a day & at least 1 poop) & ANY other info you got. I will be back to check to see if that helps you understand what is happening a bit more....



If you keep using formula your supply won't ever catch up. I KNOW that sounds backwards as all get out - but it's true.

Nursing is optimal obviously for milk supply. This is true for the following reasons:
Part 1 - When you nurse the baby uses it's jaw to do compressions that stimulate ducts that rest behind the areola. Those ducts send signals to the pituitary gland to elevate your prolactin levels. Prolactin is the hormone responsible for regulating milk supply. Most women REQUIRE a minimum of 8 nursing sessions per day (12 or more is optimal) to establish & maintain early milk supply.

Part 2 - formula (according to research done via ultrasound to watch the stomach empty) takes on average twice as long as breastmilk to digest. breastmilk contains predigestive enzymes. So it breaks down easily with very little digestive effort for the baby. Every time baby is fed formula, baby is obviously not on the breast (so less prolactin stimulation) and then baby takes longer to cue to eat again, so further stimulation is delayed.

Part 3 - a baby that is having problems with latching is a baby that should NOT be offered abottle. Ther ear ealternative feeding options (Such as up feeding or syringe feeds) that can be used if breastfeeding is not possible. However, once you introduce a bottle nipple - you essential make it harder for baby to learn a proper latch because a bottle nipple is absolutely NOT like a breast nipple even *if* the bottle is labelled "breastfeeding friend;y". There is no such thing as a "breastfeeding friendly" bottle. There are only bottle styles that breastfed babies are more likely to be willing to accept. NO bottle reduces or eliminates nipple confusion or the forming of nipple preference. Nipple preference is also further complicated because breastfeeding requires suckling until letdown occurs. Bottlefeeding is a constant flow. Giving bottles makes a baby more likely to give up quickly when latched because baby believes "it's not working" because there is no flow.

Sooooo onto what you CAN do.

It would help to know if you *want* to exclusively breastfeed & have just gotten off to a rough start or if you are wanting to do mix feeding for some reason. Just be aware that continuing to mix feed this early on (regardless of "why" it is going on) is not a way to maintain supply & giving you advice on herbal remedies is like telling you that you can keep skipping sleep & live on caffeine pills and coffee instead. Herbs can help short term, but you eventually will still loose supply if you stay as is. You can take a bunch of galactogogues if you want to but if you aren't giving your body the right biological & physical signals, you will dry up eventually, regardless.

So if you want to EBF - then you have to get off supplements. Easier said than done? yes & no.

If you want supply up you must nurse or pump for no less than 10-15 mins every 2 hrs during the day & every 3 at night. Nursing is always preferable to pumping of course & is a far betters stimualtion. You shoudl pick up a supplemental nurser system. it is a tube with syringe you pu tmilk into, tape to the nipple & slowly drip feed while babie sis suckling ot keep baby interested until letdwon starts. You can also opt to try pumping until letdown starts & then quick latch baby on so baby can start to associate suckling with getting satisfied.

If you choose to nurse or pump less than 8 times a day, then you can try the herbs & continue to offer breastmilk for as long as you have it to offer, but you can expect a slow steady decline. Moms with well established supplies can have a bit more flexibility in these options, but new moms generally don't. A few moms can seem to maintain supply even though they "break the rules" and a few will not have supply despite doing nothing "wrong" - but most (and likely you & I fall into this middle ground of the 90+%) will loose supply if mix feeding 1 week post partum unless you make a big effort to get off the supplements.

Also keep in mind there are growth spurts at about 7-12 days old, 3 weeks old, 6 weeks old, 3 months & every 3 months after. During those times all babies act like bottomless pits & that your supply is trashed. You just nurse through it & all that extra stimulation tells your body to step up, it takes a few days, bu tit doe s& then you are back on track. Supplementing during growth spurt times is the worst kind of self sabotage, as it interferes with the dance your body & baby are supposed to do to help your body know how much milk it should be making to satisfy your baby. In the 1st 4 weeks those growth spurts trigger increases in actual volume of milk made. Then somewhere around a month you usually top out around 25 oz a day give or take & after that your body doesn't make more milk, it makes thicker & denser milk through each growth spurt. This gets a lot of moms messed up in supply too - because they *think* their baby should get equal ounces of breastmilk as they would formula & that is NOT true. Formula is the same day 1 through day 365. So the only way to increase calories, vitamins & fats is to increase volume. Breasmtilk become denser & denser. So the average breastfed baby does NOT increase volume intake from 1 month through at least 6 months of age. Instead the milk keeps changing ot meet their changing need.s So if a baby is used to a formual bottle with 6 ounces - it is hard to convince that baby tha tit only needs 3 oz of breasmtilk - so then mom is supplementing mor e& more & more.

That is why they call it the slippery slope - it is a very slippery & confusing slope to step out onto & if a momma really wants to nurse, I recommend she get a lactation consultant or contact La Leche League ASAP. You can call them for free 24/7 at 1-877-4-la-leche & they WILL help you.

AND PLEASE MOMMA - realize NONE of hat I said is taking your inventory or assessing any judgements - I am ONLY trying to help you be fully informed so YOU can decide what you want to do with full knowledge of what it will or won't mean either way.

Best wishes & congratulations!

Quoting justanothamotha:" I posted this to another momma a few days ago regarding low supply - but read through it. PLEASE list ... [snip!] ... decide what you want to do with full knowledge of what it will or won't mean either way. Best wishes & congratulations!"

Thanks for the post. A lot of what you've mentioned I've already read, and a lot of things I didn't know! But nowhere have I been able to find advice on what to do to fix it when I'm in this deep...

My daughter will be 9 weeks on tuesday, she was born big at 9lbs 7oz and lost I think it was around 10% body weight. She was slow to catch up (I don't have her notes with me atm!) and she was still hungry after every feed when I had nothing left, and she'd come off and cry. Though I realise now, she may have just wanted to pacify or cluster feed. BUT everyone was pressuring me to give her a bottle, telling me she was hungry, and I felt like hell, but I did. I didn't know better at the time, and I was so stressed and unsupported. She was I think 3 days old when I first offered formula, and she only had a little tiny bit, less than 1oz, but it settled her.
She wasn't (and still isn't) pooping every day, but she was wetting enough not to concern the midwives/doctors, I was changing her often. I still change her between 6-8 times a day, but I also don't like leaving her if I suspect she might be a bit wet, so the nappies aren't always that saturated.

I think what you said about her thinking the boobie 'isn't working' is very true for her because she will latch, suck a little, and come off and whine.

Her latch seems to be okay, when she's properly feeding. I was told by the lactation consultant and health visitor that it looked right.

The volume of formula she has isn't huge. She's a 'little and often' feeder, 2.5oz-3oz will fill her. But it seems like I don't have that much breastmilk as often as she wants it.

She's nursing about 3-4 times in the day and 2-3 times at night... so I should be doing it more. Okay, I had no idea   at night when it seems I have more milk, she will nurse and sleep, and not need a supplement, a lot of the time. So that gives me some hope we can get this fixed.

The herbal remedies haven't really worked, so they're not an issue anyway.

I never felt engorged when my milk 'came in', and I've never felt a 'let down' sensation that I've read about. Soooo I'm clueless as to that as well.

Quoting נєz:" Thanks for the post. A lot of what you've mentioned I've already read, and a lot of things I didn't ... [snip!] ... when my milk 'came in', and I've never felt a 'let down' sensation that I've read about. Soooo I'm clueless as to that as well."

Okay - firs toff - NO room for "woulds coulda shoulda - it's all water under the bridge.....so do NOT beat yourself up or whatever.

So...hang in there...so I can address things you mentioned...
Yes - if baby acts like a bottomless pit - welcome to early nursing.   You are right, even though she DID settle after an ounce of formula, that isn't proof that was what she needed. That freaking out at the breast is what stimulates milk production - but again, we know this already...so moving on.

Pooping every day is something that applies to babies under 4 weeks & pooping less than 1 per day under 4 weeks of age *can be* indicative of poor milk transfer. However, your baby is past there & pooping once a week is fine at this point.

If you can nurse all night without supplements - you can get off supplements. Period. No doubt in my mind.

Here goes on more info - to help get you there  

The average nursing baby take sin ONLY 25 oz per day. That's it. We overdo ounces with breastmilk because we confuse it with formula. Formula has the same nutritional profile per ounce every single day. breastmilk changes in volume only up to about 4 week s& then it stay pretty stable....from there on out, each growth spurt triggers changes in density of the milk. So you make the same ounces, just more nutritionally packed. If you think a bit it, it makes total sense otherwise our boobies would need carts to roll them around. So this is NOT as insurmountable as you think - you only need to get yourself up to about 25 oz & your pretty golden momma. That is TOTALLY doable.

You can call around to home medical supply places & see if you can get a hold of a supplemental nurser. Medela sells one, but I got one at the hospital that is basically a feed tube with a syringe on the end. You tape it to the breast & drip feed while she is latched. It keeps her interested & helps reduce the supplements WHILE giving you stimulation.

As far as herbs I didn't have great luck either I did find Mothers Milk Tea was decent for me, bu tbetter for me were lactation cookies.http://www.food.com/recipe/oatmeal-chocolate-chip-lactation-cookies-by-noel-trujillo-192346
Make sure you do get the brewers yeast & flax seed though - that is what helps boost that oatmeal.

You get off them the way you got on - you unsupplement. Keep cutting it down. She will fuss - that is part of inspiring her to nurse. She won't nurse if you don't let her be a little hungry. Don't starve her of course, but you can cut out one FULL supplement & let her work it out with your boobies...for real. She will come to peace with it as you supply responds in a few days time. If you can get a supplemental nurser, even easier...you let it drip a little here & there, just enough to keep her working.

And do not worry that you don't feel letdown - not everyone does. Count your blessings - for ages in the early months mine always feels like a horrible titty twister. I thought I might skip that with my younger one as I was still nursing the older one & had long since lost the sensation of letdown, but apparently birth is a like a "reset" and I got to enjoy ti all over again.   Lucky me.
if you can't tell when letdown occurs watch the way she drinks - you will see rapid suckling right up to letdown & then slower deep draws & swallowing. It really is a predictable pattern.

Hope that helps momma. For real though - this is not as far gone as you think, You can get back to the boobies full time if you really want that, It takes some patience with the process though. The main reason night feeds are SO important is that prolactin peaks at night - so the more nursing you can do at that time, the better....and interestingly it peaks whether you are awake all night or sleep - it is just part of your bio rhythm. ;)

Quoting justanothamotha:" Okay - firs toff - NO room for "woulds coulda shoulda - it's all water under the bridge.....so do NOT ... [snip!] ... the better....and interestingly it peaks whether you are awake all night or sleep - it is just part of your bio rhythm. ;)"

Thank you so much for the help and support  
I'm hoping so badly I can fix this.. I have always wanted her to be EBF and it would feel like a miracle if we can achieve that!

<blockquote><b>Quoting justanothamotha:</b>" Okay - firs toff - NO room for "woulds coulda shoulda - it's all water under the bridge.....so do NOT ... [snip!] ... the better....and interestingly it peaks whether you are awake all night or sleep - it is just part of your bio rhythm. ;)"</blockquote>

You have awesome information , just sayin!

No problem! Keep posting & I will do my best to help you trouble shoot.

Quoting *~Stella's Momma~*:" <blockquote><b>Quoting justanothamotha:</b>" Okay - firs toff - NO room for "woulds ... [snip!] ... all night or sleep - it is just part of your bio rhythm. ;)"</blockquote> You have awesome information , just sayin!"

I have about 20 books. I am a boob nerd.  

And thanks. Glad it helps someone besides me.  

Well I've had her on the boob for about an hour comfort nursing   And now she's fast asleep, lol.

Quoting נєz:" Well I've had her on the boob for about an hour comfort nursing   And now she's fast asleep, lol."

You're on the right track momma! One feed at a time you'll get there.

<blockquote><b>Quoting נєz:</b>" Well I've had her on the boob for about an hour comfort nursing   And now she's fast asleep, lol."</blockquote>

Good job, momma! Hang in there, you can do it!

And I'm a boob nerd too, I LOVE breast feeding and I want every woman to have the same opportunity I did. I volunteer with my lactation consultant so I can learn more and I love helping mommas fix their problems. It's an awesome feeling.