Is it time to give up? (low milk supply mama)

[germin8]

I just saw the LC (my DD is 4 months next week) to see how much DD is getting from breast while on Medela SNS (large tube). The LC says I've done everything under the sun and I have done a lot of research that I could be more educated than some LCs out there. She also says my breasts are normal, so she rules out Insufficient Glandular Tissue (IGT).

We came to the conclusion that there are 5 more things I can try (out of the ~100 I already tried, hehe). They are:

1. See an herbalist to ask about Maca and hormone balance. Ideas?
2. Oxytocin prescribed, but it is very expensive. She is checking cost. Anyone try it?
3. Alfalfa
4. Larger flanges/cones. B/c the one I used w/ Ameda is bigger than my current one. It could get more ducts. Anyone heard of this?
5. Switch from domperidone to Shatavari. How shall I do this?

At my request, we weighed the SNS w/ milk before and SNS w/o milk after DD ate. And, we weighed DD before feeding and after. DD only took... 10 grams from me. *sigh* They say that is 10mL, but I called to get the final numbers. I will repost them here. Came home and pumped for 20 minutes to get 22mL from left breast and 9mL from right breast (which is the one DD fed from). Why couldn't DD get the 9mL too?

ETA:
DD weight before: 5435g (11lbs 15.8oz)
DD weight after: 5535g
SNS empty weight: 35g
SNS w/ milk: 125g

I confirmed with LC that I have a slow let down. How do you fix that? Which could explain why my supply dips after I slow down pumping... i.e. let down is too slow to maintain supply b/c DD can't suckle it out in the time that she's at breast.

She kept emphasizing how great I have been doing (yadda yadda yadda) and how I've done more than what many mother's would want to do (who give up as early as 2 wks)... yadda yadda yadda. Ok, *yeay* for me, but that didn't solve anything.

When I pumped a lot more frequently the first 6 weeks, my supply was good... but not 100%. I slowed down pumping to 2-3 pumps a day (supply dipped) and have restarted pumping 5-8 times a day 2.5 weeks ago. I'm not where I was at 6 weeks...

Other than the above, LC pretty much gave up on me, it seems.

I don't know what I will do next...

[ShwarmaQueen]

Did she check your DC for tongue tie or palate issues? These can cause transfer difficulties.

How is she gaining?

[germin8]

Well, when I had a decent supply (at about 6-8wks), my 3-5 AM supply was good. And, she would suckle that out very well... and swallow very well. So, there was no question about transfer. Could there be one now?

She weighed ~6.5 lbs at birth and almost 4 months later DD is 12 lbs (my DH & I are thin).

ETA: Come to think of it, DD used to get about an ounce from me and two ounces from SNS. Now, she gets 3 ounces from SNS which explains why she only got 10g (10mL) today! Yikes! How did THAT happen.

[AislinCarys]

Do you feed from the breast only first, and then add the SNS?

I'm asking because I had trouble with slow let-down, and when we used the SNS I used to put it on last, after switch-nursing for 45 min to an hour. Because my impatient baby would have just sucked down the extra milk in the SNS. The specialist ped later told us to start cutting down on the extra milk by about 25-50 ml a week after starting Domp., to give the Domp. a chance to work.

[ILoveMyBabyBird]

have your hormones been checked are they in normal range? How about thyroid issues?

For slow milk ejection I've read that fennel, and red raspberry are good for it, among other herbs.

Really when you do so much work trying to solve your breastfeeding problems, you do become quite the expert, that's why i may not even see a LC when i have my baby, I already know what i need to do to build the best supply.

And as far as IGT, it is hard to say, I remember reading an article that some women's breasts appear normal but yet, had less Glandular tissue.

Bottom line, don't beat yourself up mama, many of us have been there and know it is a very lonely place trying to give your baby the best food and not being able to. But even a low supply is still beneficial to your baby.

[germin8]

Originally Posted by AislinCarys

Do you feed from the breast only first, and then add the SNS?

Wow, 45minutes to an hour is a very long time. I don't think my DD would be able to take that. She would just fuss & cry. I'm going to try to bottle feed one meal and breast feed & pump the next meal... to see what happens.

Originally Posted by ILoveMyBabyBird

have your hormones been checked are they in normal range? How about thyroid issues?

...Bottom line, don't beat yourself up mama, many of us have been there and know it is a very lonely place trying to give your baby the best food and not being able to. But even a low supply is still beneficial to your baby.

Yes. I had my prolactin levels checked and they off-the-charts b/c of the domperidone. So, I am slowly weaning... such that my supply is not affected. My dosage kept increasing to hopefully increase my supply and it didn't. So, I want to go back to the "minimum" I can handle.

Thank you, I needed to hear that. This news has made me sick to my stomach and given me a headache. I'm not one to get headaches. And, I am surprised how this news has affected my health... so unusual for me.

I may just switch to pumping every 3-4 hours during the day and early morning and bottle feed 100%... but, that's just what I say now b/c I'm tired.

[cristeen]

I just wanted to give you a , mama. I know this ie really hard, emotionally.

I higlHy recommend having her latch checked by someone who knows what they're looking for. My guy's tie wasn't diagnosed until he was 6 wks and i just happened to see the right person.

I would recommend backing down on the tube size. Something supplementers need to know is that the babe learns how to use that tube like a straw because it's easier than nursing. Make it more difficult for her. I also suggest doing like the pp recommended, nurse first and then add the tubing. I would also nurse her without the sns while the lc watches, to be sure her latch isnt sloppy. With my guy, his latch deteriorated when he figured out the straw, until he was getting nothing from me. And i didnt realize it until far too late.

But just to give you a little encouragement, we nursed w a supplementer Almost exclusively until 7 mos w donor milk. And then until 9 mos at least once a day when he gave up nursing entirely (he refuses the tubing).

[ILoveMyBabyBird]

hey,

I've been doing some preliminary research on iodine deficiency=low supply, thought maybe you may want to read it as well, it could be another possible area for you to explore.

here's a thread with some links you may want to read in your spare time.

http://www.mothering.com/discussions...4#post15949614
post number 41

[germin8]

Originally Posted by cristeen

...I higlHy recommend having her latch checked by someone who knows what they're looking for....
I would recommend backing down on the tube size. Something supplementers need to know is that the babe learns how to use that tube like a straw because it's easier than nursing. Make it more difficult for her. I also suggest doing like the pp recommended, nurse first and then add the tubing. I would also nurse her without the sns while the lc watches, to be sure her latch isnt sloppy. With my guy, his latch deteriorated when he figured out the straw, until he was getting nothing from me. And i didnt realize it until far too late.

But just to give you a little encouragement, we nursed w a supplementer Almost exclusively until 7 mos w donor milk. And then until 9 mos at least once a day when he gave up nursing entirely (he refuses the tubing).

These are all great tips. Wow, I can't believe this LC didn't give this advice!!! You all are brilliant. I feel like I need a new LC since it didn't sound like the current LC could help me any more.

I just switched to the level 2 (from #4) tube, and she did well. I may try level #1 in a few days. BTW, at 4/5A last night, she nursed just at breast and fell back to sleep. I could hear her suckling and swallowing away at each breast. I am guessing she may have had less than an ounce, judging by what I pumped afterward. Yeay, I haven't been able to nurse at 3-5A with breast alone since she was about 2 months old (she's almost 4 m). I hope this continues.

Originally Posted by ILoveMyBabyBird

...I've been doing some preliminary research on iodine deficiency=low supply, thought maybe you may want to read it as well, it could be another possible area for you to explore.
...

Hmmmm. I don't think I have an iodine deficiency. I do use sea salt and eat other foods with regular salt. It should be enough.


I feel better now. Thank you for your advice; it is encouraging! I won't give up... yet. But, I won't stress about it either. I feel better.

[germin8]

UPDATE: I SNS fed my DD with the #2 tube (medium) again. I did so on the right breast and pumped afterward. I got about 1 mL from the right breast... and 30 mL (1oz) from the left. YEAY. That makes me think the the #2 tube allows her to suckle more at my breast and get those 30mL of my milk that would have been there had I only pumped.

And, just tonight (midnight) she woke up to nurse. She nursed on both sides... heard her swallowing away... and then fell back to sleep before my DH got back with an SNS filled w/ warm milk. YEAY!

My supply is not 100%, but this is progress! Thanks for not letting me give up.

[sattygirl99]

I would say regardless, don't give up... breastfeeding is more than your full supply!! I used a supplementer for 9 months with DD... And I will nurse as long as I have to this time with one if it means being ale to BF.

YAY for a good transfer!!

[Chloe 777]

Originally Posted by germin8

UPDATE: I SNS fed my DD with the #2 tube (medium) again. I did so on the right breast and pumped afterward. I got about 1 mL from the right breast... and 30 mL (1oz) from the left. YEAY. That makes me think the the #2 tube allows her to suckle more at my breast and get those 30mL of my milk that would have been there had I only pumped.

And, just tonight (midnight) she woke up to nurse. She nursed on both sides... heard her swallowing away... and then fell back to sleep before my DH got back with an SNS filled w/ warm milk. YEAY!

My supply is not 100%, but this is progress! Thanks for not letting me give up.

Way to go both of you!!

[Vegan Princess]

I too want to encourage you to stick with it. I supplemented with a lactaid until DD was 15 months. I probably made about 1/2 her supply before solid foods and 2/3 once she was eating. But then we gave up the lactaid and kept nursing bare until we just weaned at almost 21 months, last week. She was a total boobahollic and didn't care how much milk she got - she loved the closeness with mama. So even if you have to supplement, you are still getting some of the greatest benefits just by keeping at it!

Also, re: switching from dpd to shat....I wouldn't reccomend it at this point! I weaned off of DPD when DD was a year old and weaned onto shat at the same time. Not only did it not make up for the supply drop, I think it inhibited my let down. DD actually started swallowing more once I dropped the shat.

Cindy

[sattygirl99]

cindy - did you wean from the shat or just drop it all together? I'm wondering if it's inhibiting my letdown as well... It seems to take longer to letdown now...

[Vegan Princess]

Sattygirl: I just dropped it all at once when my bottle ran out. I've heard you can cycle it - 5 days on, 2 days off. I didn't try it though. Maybe you should try that before stopping it?

Cindy

[GoBecGo]

I know it's been asked but i don't know if you meant you had it checked - did you get your thyroid levels checked? I had hyper-then-hypo-thyroidism after DD1 (post-partum thyroiditis but then it turned out i'd had hashi's for several years and my entire pregnancy undx) and i had dwindling supply and more and more delayed let-down from 3 months and ended up weaning at 7. I tried WAY less hard than you though (i was less crunchy, newly single, depressed, stressed and ill). This time, properly medicated, i have enough of a supply that i'm able to feed my baby AND donate 7oz/day (from one pumping) to a friend. It's really worth having checked if you haven't already.

[germin8]

Thank you for the reply, GoBecGo. My thyroid (TSH) levels were tested at my regular annual checkup (postpartum), and they were within normal range. Sometimes, I wish it were something... so we would then have something to fix! ...and have milk! :S

[BethHH]

Yes!  I can't exclusively breastfeed, but my daughter loves nursing all the same.  I love it even more.  It was a hard road and I beat myself up a lot along the way, but in the past couple of months I've grown into our rhythm.  Don't give up yet!

One thing that helped us a lot was to put the pump away.  I let her do the work because she likes it and she is much more efficient at it.  When we are at home, I offer the breast every hour or two.  (When we're out, it depends on when we are sitting down.)  With pumping, I resented the time away from my regular life.

I hope you find what works best for you and your little one, whatever that may be.
 

Originally Posted by Vegan Princess 

I too want to encourage you to stick with it. I supplemented with a lactaid until DD was 15 months. I probably made about 1/2 her supply before solid foods and 2/3 once she was eating. But then we gave up the lactaid and kept nursing bare until we just weaned at almost 21 months, last week. She was a total boobahollic and didn't care how much milk she got - she loved the closeness with mama. So even if you have to supplement, you are still getting some of the greatest benefits just by keeping at it!

[AustinMom]

I haven't read all the replies, but I will say this.  We are only 7 weeks out, so kuddos to you for keeping going!!!  We did the SNS for a while, and we did the weight checks before and after every feed to see how much she gained to track out supply.  Once we quit the SNS, as I found it a huge pain, we went to just pumping while feeding (with a sports bra turned into a pumping bra) we tracked that, and turns out we got TWICE as much milk pumping as we did with the SNS.  That's including the SNS pumpings after feeding.  So basically, if we fed with the SNS, and them pumped after, and totaled how much she got at the feed and our pumps worth after the feed, it would only be half as much as if we would have just pumped.  WEIRD I know!  So, we're just pumping now.  I am taking Shatavari as it's big on oxytocin release and that's what it's studied for, but I'm also taking Domperidone, so I'd say don't worry about weening off the Dom before starting the shatavari.  Do both.  I also have a pretty low supply. And when we did weight checks she wasn't getting more than 10-15 ML each feed.  Pumping I'd get total an ounce, then it's graduallly built up to now 2-3 ounces each pumping.  I'd try this before you quite BFing all together.  It's worth a shot at least.  And you won't have to worry about supply dwindling, as you can pump when you feed anyway, even through growth spurts. 

Much Love to YOU!!!

[germin8]

AustinMom, thanks for your entry.  I too get more pumping than from the SNS so I am exclusively pumping these days.  I didn't know Shatavari was big on oxytocin.  That was what I think I needed...to help with let down.  Oh well; I plan to stop pumping at 5 or 6 months... which is soon.  So, I'm not sure it's worth trying Shatavari now.

I'm still hanging in there... by a thread.  But, life has improved now that I've been pumping only every 4 hours.