Supply Concerns, Bottle Feeding + WOHM

[1stTimeMama4-4-10]

Sorry this is kind of long. DD is almost 6m and ebf, though I do pump at work and DH, who is a SAHD, feeds her while I am at work. I've never had supply problems until now. Here is the schedule:

Wake around 7:45 get ready for work, nurse for 15min before I leave around 8:30, baby back to sleep as soon as I nurse her. Pump once at 11AM, I get between 4-6oz from each breast. Go home around 12:30 to nurse, which she sometimes does, sometimes doesn't. Back to work and occasionally will pump again, but I rarely get more than 1 1/2oz from each breast, so it's not really worth it.

Back home at 5ish and nurse on demand the rest of the evening. We co-sleep and DD wakes between 2-5 times per night to nurse. She nurses A TON at night (which is totally fine by me as I still get plenty of sleep), and wake to start over.

DD wakes around 10, and is fed on demand. She usually takes 10-14oz total from the bottle spread out over the course of the day. Until this week, I've always pumped enough the day before to feed her fresh milk the next day. I have about 30 bags of 6oz stored up just in case. Until this week, we've never needed them, now I'm concerned that we will need to start tapping into our stash.

Here's my issue: lately when DD is very tired, she doesn't want to nurse but she WILL take the bottle. When that happens, I don't know whether it is because I don't have any milk or whether she just doesn't want to work for it. When she won't nurse, I try to pump more but frequently I can't get more than an ounce or two between both breasts (which leads me to believe that my breasts don't have much milk). This has been happening more and more the last two weeks or so and so she has been drinking more and more from the bottle. I've been pumping a bit less (10oz rather than 14oz) and feeling empty more frequently.

So what gives? Do I have something to worry about here? My main fear is that I will be pumping less and less and she will be wanting more and more from the bottle. Then she won't want to nurse because there is no milk but I can't pump because I'm not making enough, and the less she nurses means I make less, which leads to a spiral effect where I have to supplement with formula which will further decrease my supply and I will have to wean years before I want to.

How do I stop this spiral before it starts? Assuming she won't nurse, how do I make sure my supply doesn't dwindle. Any advice anyone has would be greatly appreciated.

[Eligracey]

You say when she's tired she refuses to nurse but will take a bottle--any chance she associates nursing with sleep and is trying to fight sleep? We had some bad sleep fighting around 6 mo. Is she crying from hunger but still won't nurse? If she's tired and just fussy but not out and out crying I might try rocking her to sleep and seeing if she doesn't really need the bottle at all. She might wake up happy, well-rested and ready to nurse.

Also, it sounds like you're only pumping once and nursing once between 7:45 and 5PM? I would definitely need at least one more pumping session to get enough EBM for my kid at that age. Even if you only get 2 ounces, that's still stimulating your supply. Don't not pump just because you don't get much.

Hang in there, mama--there were always weeks at a time where I was sure he was getting less interested or my supply was going down, and twice I was almost positive we'd have to supplement but we never did. Babies are so fickle--it's quite possible that next week she'll decide she hates the bottle and only wants nursing.

[1stTimeMama4-4-10]

Yeah, after writing this I realized that I need to be more careful about pumping at least twice. I will start that next week, it's been hard because my job doesn't always allow for it, but I will just have to work harder to make sure it happens. Hopefully that will help. And there have been times I think she was really hungry and refusing the breast, but those times are also when she is very tired and I think she definitely associates nursing with sleep.

[lunarlady]

Did you switch to a faster flow nipple? BF babies should stay on a slow (newborn flow) nipple or else they can get lazy and start preferring the bottle. You really do want her nursing when you are there, not taking bottles while you try to pump. If you switched, switch back.

I started my DD1 on some thin cereal made with around seven months of age because I was having supply problems. She wouldn't take much, but it did help slightly. Good luck!

[1stTimeMama4-4-10]

Originally Posted by lunarlady

You really do want her nursing when you are there, not taking bottles while you try to pump.

This is my problem - I REALLY want her to nurse when I am here, but sometimes she refuses. She then can escalate into a full scale freak out and will accept a bottle but not the breast - if I know she is really really hungry, I just cave and give her the bottle because it calms her down. I HATE to do that though and it breaks my heart a little, but if she's starving and won't nurse, I feel like I have no other choice. I should say that she's in 97% for height and weight, and not having any growth problems whatsoever. She's still on newborn nipples, but I'm thinking I may want to switch to something even slower, we have been using Dr. Browns glass bottles, which I really like, but I think the milk flow might be too fast even with the newborn nipple.

[crystal_buffaloe]

We had bought Dr. Brown's before DD was born. After we introduced a bottle, and it did not go well at first (she choked and gagged a lot), we figured out that the advent nipples that came with my breastpump had a slower flow than the newborn Dr. Brown's. So we're using the 4 bottles and 2 nipples that came with the breastpump instead of the dozen nipples/bottles I got as a shower gift.

Could you ask your DH to work with her so that she's more likely to nurse when you're home for lunch? If she won't nurse while you're home for lunch, could you do hands-free pumping while you eat?

I agree with the PP that you should try to be consistent about pumping at work in the afternoon. Even if you're not getting much, having a letdown protects supply, and if you pump at the same time each day, it should signal to your body to produce more at that time.