need to supplement - help!

[sneakydee]

Hi, I've been lurking in this amazing community for some time, and this is my first post.

I have a 14 week old daughter. BFing started out amazingly, but when she was 3 weeks old I had to start supplementing her with formula due to supply and let-down issues. I was quite upset about this, but she was losing weight and I've since become comfortable with doing what I have to do to keep her happy and healthy. I'm on 160mg/day of Domperidone (plus fenugreek, blessed thistle, fennel, etc etc)to maintain what little supply I have.

I was supplementing her with a combination of the supplemental nursing system (the "tube at the boob") and the bottle, and she was doing well with both. 2 weeks ago, she suddenly started refusing ANY formula. As soon as she tastes it, either by tube, or bottle, or cup, she shuts down and refuses to drink anything else. Sometimes she'll even refuse my breast if she tastes formula through the SNS. I've tried EVERY formula under the sun in an attempt to find one she'll take. Why did she stop when she was doing so well?

She's hungry all the time, and feeding on me every hour, night and day. But she'd rather starve than have the formula, so she ends up screaming for 4-5 hours every night until she finally passes out.

I've seen dozens of LCs and been to Dr. Jack Newman's clinic 4 times, with nobody able to help. Does anyone have any ideas for how I can get her to take the formula again? I'm so physically and emotionally exhausted from all of this.

[Asparagus78]

Nurse, nurse, nurse! Unless there is a biological/medical reason you don't have enough milk, nursing around the clock will increase your supply. She will be frustrated, yes, but at the same time, don't all EBF babies go through that same frustration when they have a growth spurt and it takes a few days for your breasts to adjust and produce more?
Good luck!

[sneakydee]

Thanks Asparagus78 - I've been nursing around the clock for a long time now and it's becoming quite exhausting to not get any more than 20min sleep at a time, but I'll continue to do so (especially since I don't have a choice!).

I also purchased a PIS and have been trying to pump, but often I can't get anything (I presume because my daughter is taking what milk I have at her frequent feedings!)...will pumping, without any milk coming out, stimulate my breasts to make more milk or is it a waste of time?

[mrsfussypants]

Good for you for hanging in there!

I had a baby that required SNS supplementation. She didn't reject the formula like your baby, though, and was able to use the SNS for 13 months. I wonder if there is a formula or milk that doesn't taste so bad that can safely be used as an SNS supplement? What about pasteurized goat milk from the grocery store? [Seriously, I've heard of this, although I confess I've never done it and don't know much about it. Maybe somebody else here could weigh in.]

I tried pumping for awhile, it just exhausted me more -- more demands on my already taxed breasts. Never got more than an ounce, not enough really to supplement. You must be exhausted keeping up with it all.

Don't let anyone criticize your choice of using an SNS. Fact of the matter is for some women, they simply don't make enough and more nursing isn't going to increase the supply enough. It's not the norm, but it happens! Back in history, a woman in your situation would require a wetnurse for help; nowadays we have SNS. Nobody may criticize your choice of using it--it's YOUR baby and YOUR choice. (And for somebody without lactating breasts himself, Jack Newman is tops. He knows his business.)

Sorry this post is all over the place. Good luck.

[larzanna]

You could get breastmilk from a milk bank, or maybe you have some friends that could pump you some extra until you figure it out?

[PatioGardener]

I'd try donor milk if I were you. I'm not sure if the Newman Clinic would be able to help with finding donors - perhaps check out milkshare?

[mambera]

You know, I would actually view formula refusal as encouraging. A starving baby is unlikely to refuse food no matter how unpalatable. I would wonder whether your supply hasn't come up to within normal range, allowing her to be able to be picky about the supplement.

I think the suggestion for donor milk is a good one but I would also continue to keep close tabs on her weight. See how her curve looks while she is refusing formula. Things may not be as bad as you think.

(You probably have already heard this a bunch but I would minimize the bottles too. Reason being that you need to pump every time she has a bottle and pumping is horribly time-consuming, unpleasant, and less effective than the baby. I would do 100% SNS/Lact-Aid if you can.)

[karika]

I would take this as the child knows what is not good for her body. She (for some reason, whatever it is) believes the formula is not food (neither do I, but I have never been in this situation). I am always very interested in hearing about low supply since I have never experienced it (except in growth spurts). I see you have seen a 'breastfeeding guru' as someone mentioned, so not too sure what else hasn't been brought up. This is my feeling for what to say to this... my suggestions, coming from my place of experiential ignorance, yet with intuitive help I hope. Are you holding the baby constantly, in arms or sling as much as possible, never leaving her for more than 10 minutes in another's arms? (it will stimulate milk to keep her in your arms all the time) Are you sleeping with the baby? Do you stay topless and keep the baby's naked skin against yours? Are you feeling letdowns when you nurse? how many in a feeding? Do you allow the baby to stay latched on until she comes off on her own, never timing feedings? Do you use a pacifier (if so, ditch it to return to your nipple for stimulation)? Are you drinking at least 32 oz of water a day? Are you eating organic fresh fruits and veggies (raw or steamed). Are you eating enough calories and good fats (avocados great for this)? Are you avoiding all caffeine (will work against milk production) and preservatives and GMO, prescription and OTC drugs, chemicals in your body care and dairy? I would say to get into a bed with baby, have someone bring you food and drink. Stay naked together and nurse at will. If you are not feeling a letdown, it may be anxiety. In the older days, the women would tell you to drink half a beer to help relax to let down. I think it is easier to have a hit or two of cannabis, anything that relaxes you to help let down occur (it will not harm the baby, but be sure another is around (awake) to make sure sleeping happens safely since you are so exhausted). Milk production is regulated by the number of letdowns you have, so during a 40 min feeding session, you may have 3 letdowns. I know I have many and have good supply. I second the recommendation to get donor milk while you work on yours, or I have seen people suggest raw goat's milk from a local farmer that doesn't feed them GMO grains or a soy based feed, grass fed is what is acceptable). But refusing the chemical laden formula is probably a good thing, however we have to get some nutrition in there somehow... I know the comment about the bottles may have hit you wrong, but once you begin supplementing, you begin weaning... your breasts will not be adequately stimulated and will shut down production. Check all the threads in breastfeeding challenges for help also. I am hoping ya'll work it out....

[Katica]

I`m sorry, it must be exhausting to be nursing that much. My first baby was nursing around the clock and it was REALLY TIRING.
I agree with the previous suggestions and posters. I`m not sure what caused her to reject the formula. Maybe, it upset her tummy somehow. She might like the donor milk through the SNS though.
Are you keeping an eye on the output? How many times does she pee/poop per day? What goes in has to come out and 4-6 wet dipes/ day should mean that she is hydrated enough. The poop frequency varies for breastfeed babies.
I hope you get it figured out. Meanwhile, take every opportunity to rest, drink plenty and eat well. Put her in a sling or other carrier and go for a walk outside. My son slept well in the sling and I got some fresh air.
Hope that helps some.

[georgia]

Originally Posted by sneakydee

I've seen dozens of LCs and been to Dr. Jack Newman's clinic 4 times, with nobody able to help. Does anyone have any ideas for how I can get her to take the formula again? I'm so physically and emotionally exhausted from all of this.

I would highly recommend continuing to turn to trained professionals for help getting your baby to eat. I think we can all empathize with how hard it is with a new baby, esp. when there are difficulties. Here is a LLL link that might be useful: http://www.llli.org/NB/NBsupplementing.html Good luck and please make sure to surround yourself with "in real life" support as much as possible!

[sneakydee]

Thanks for all of the support! Her BMs and urine output seem to be fine, and I'm going to take her in this week to weigh her. It seems like she's just barely getting by on my milk supply, but maybe I'm overreacting a bit, which is easy to do when one hasn't slept for 3 months!

The idea of using donor milk makes me a bit nervous, as we don't have any kind of screening program here in Ontario. I know that some undesirable things can pass into the breast milk (HIV, medications) but I'm not very educated on the issue. I'd also like to look further into the idea of using goat's milk as I'm not sure whether a young baby's digestive system could handle it (though they probably couldn't handle formula any better).

My diet is fairly good (well balanced vegetarian with minimal dairy, organic as much as possible within my budget, minimal caffeine). Other than oatmeal, are there other foods that are said to increase milk production?

My letdown issue is another thing - I have loads of trouble getting it, despite relaxation techniques, some beer/wine, nipple stimulation, etc. Anyone have any other tips?

Spending a lot of time in bed with her is another good idea; I'll go back to trying that again.

Thanks again everyone for the replies.

[georgia]

That's great that her output is good Here's a milk production link, a galactagogue link and a great book on increasing production. Hang in there and keep the faith! You are not alone

[mambera]

Originally Posted by sneakydee

Thanks for all of the support! Her BMs and urine output seem to be fine, and I'm going to take her in this week to weigh her.

Yaaaay!

I have borderline low supply and my LO dropped off her growth curve early on. We had to supplement while I pumped like a madwoman. (If I knew then what I know now I would have bought a Lact-Aid.) The very day she stepped back on her weight curve, she started refusing formula. It was amazing.

(Unfortunately I had to go back to work after that and it was the kiss of death for EBF. I might have managed it had I been able to stay home but there was no way I was going to do it with a pump. I did manage to keep her at 80-90% breastmilk though, and she is still bfing fine at 10 mo.)

I felt the same as you about the donor milk btw. It didn't seem worth the risk for a few oz of formula a day. Whatever the shortcomings of formula, at least it is not going to give her HIV. Although I guess you could always scald it if you do end up needing to continue with the supplement.

Other than oatmeal, are there other foods that are said to increase milk production?

I've heard beer, barley, fenugreek, fennel, garlic, coffee, chickpeas, and more. There's a whole book about it ("Mother Food" by Hilary Jacobsen, which I found terribly written and not particularly helpful, but there it is.) There are teas and supplements galore. I've also heard to stay away from mint and sage.

Nothing I ate or drank ever made an iota of difference to my supply one way or the other. But I know others have had different experiences.

[ktgrok]

Just wanted to say that nursing every hour doesn't mean low supply....I have enough milk to donate the extra to a friend, and my baby is at the 99% percentile for weight, and she still nurses every hour AT LEAST during the day. Often times i nurse several times an hour. and in the evening she nurses for a couple hours straight for the most part. And sometimes she fusses and is frustrated. All of that is NORMAL!!!!!!!! I just really want to emphasize that, because the whole 'every 2-3 hours" thing is a load of crap, and I think it really sets women up to have low supply.

[Katica]

Yay for good output.
I hope you get some good news at the next weight check.
I have heard that pigs trotter soup is very good for low supply. I`ve only tried it once (not enough to make a difference) but some women swear by it.
hang in there

[cristeen]

Originally Posted by Asparagus78

Nurse, nurse, nurse! Unless there is a biological/medical reason you don't have enough milk, nursing around the clock will increase your supply.

Please be very careful giving this kind of advice. I've been nursing my little guy for 7 mos with a Lact-Aid, and at most I might make an oz or two a day at this point. It's just not true for everyone.

Originally Posted by sneakydee

The idea of using donor milk makes me a bit nervous, as we don't have any kind of screening program here in Ontario. I know that some undesirable things can pass into the breast milk (HIV, medications) but I'm not very educated on the issue. I'd also like to look further into the idea of using goat's milk as I'm not sure whether a young baby's digestive system could handle it (though they probably couldn't handle formula any better).

Donor milk can be scary, but if the other option is having her go hungry because she's refusing formula... We've been using donor milk for 6 mos now. You can request test results from the donors (you might have to pay for them), and there are detailed questionnaires available online that cover medication usage if you are so inclined. So far as I know, there is no "screening program" in the states, either. In fact, there's a significant stigma associated with donor milk.

As for goat's milk, it alone is not sufficient nutrition for a baby. You can find a recipe for making homemade formula on the WAPF website using goat's milk, but honestly it's a lot of work if she's only taking a little bit each day. I will warn you against discussing it on MDC though, I've gotten flamed for it several times.

HTH

[sneakydee]

We went to the doctor, and her weight is fine! The doctor's suggestion was to get her on a feeding schedule (every 2-3 hours)...advice I will be ignoring, since I think my baby knows best what she needs.

She still only gets milk for 1-2 minutes each feed (no matter how long she's on the breast) and is feeding every hour, but she's going a bit longer between feeds at night now, which is allowing me to get some rest.

I've now been able to get a little bit of milk by pumping, but I've got lipase issues with it (it "turns" after less than 12 hours in the fridge and if frozen...hurray for more challenges ) so I guess I'll need to find time for scalding the milk if I want to continue trying to pump.

I really appreciate the advice and support I've gotten here.

[Katica]

that`s wonderful news So, she was refusing the formula b/c she is getting enough bm. I tell you, these babies are very smart.
Keep up the feeding/pumping. I had lipase issues as well and it was very challenging. Scalding really does make a difference.
Keep up the good work and GO BABY