Sudden Severe drop in Milk Supply (especially in the AM)

[mama2JTK]

Hi All,

I've had a sudden and severe drop in my milk supply, to the tune of 25% in 3 days and I have no idea what is causing this.  Worse yet, no idea how to get it back.  And yes, I know it truly is a drop in my supply based on the before/after weights that I take with my son for each feed (but that is whole other story). 

My son and I have had breastfeeding challenges all along... long stroy short, I finally built a full supply after 4.5 months of nursing 8-10 times a day while using an SNS and pumping after each feeding, that along with taking every hearbal supplement under the sun (fenugreek, blessed thistle, fennel, goats rue, marshmallow root, milk thistle, Vitanica lactaion blend) as well as Domperidone and weekly visits to the acupuncturist.  For my son's part, he had a frenotomy at 10 weeks as well as frequents visits to the physical/occupational therapist and osteopath for cranial adjustments.  There's more to our story but I'll spare all the details. 

About 2.5 weeks ago, we decided to take the plunge and lay off the SNS/pumping and just see what my son could do on his own at the breast and aided by the trusty scale for before and after weights, we knew that our experiment was smashing success.  By about 4 days into it he was taking more on his own at the breast than he previously had take at the breast plus whatever i pumped through the SNS.  THen he started taking in a bit less, but i wasnt worried as I knew he was still getting enough in the day... but then all of a sudden BAM - i had very very little milk in the AM for him (previously that is when my breast were most full for him) and through out the day he is just taking in very little.  I've never had a sensation for let-down so i cant be certain but he's defintley not staying at the breast very long and is not having many swallows. 

Its so frustrating that after all that time to build up my supply and get him ready to eat at the breast on his own, it seems like it is gone in a matter of days and really there was no change prior that i can think of that would cause this. 

I've now resumed the pump/SNS regimen and this stinks.  I've talked to 3 differenct IBCLCs and we are all scratching our heads.  I'm not sure if it could be period or pregnancy, but I havent had any cervical mucus so i doubt that.  I was drinking lots of raspberry leaf tea thinking that would help with let down, but have since read that some herbalist think that it can cause a drop in supply after prolonged use (I was drinking about 3 cups a day for a month... not sure if that qualifies as prolonged use or not... but I've stopped either way). Also my son has had thrush a few times (doesnt seemed too bothered by it though) and now I am being treated for it, although I am not having the severe pain that I know many moms have, just kind of an itchy red ring around my nipples.

Seriously... anyone have any ideas about what may be going on here.  And since I am sure someone will ask, i've been using the scale so religiously is 1)make sure that he is taking in enough (he's notorious for not acting hungry and really only eats when offered the breast) and 2) to monitor my supply as it was building up and then in hopes of weaning off some of the supplementation/medication.

This is just heartbreaking to me... i hope we get it figured out.

Thanks in advance.

[Megan73]

I'm on the nursing/supplementing with the Lact-Aid/pumping treadmill with my second nursling, so big hugs to you. It is SUCH a grind.

Here's what I suspect is happening: People say babies are more efficient than pumps but I'm convinced it's not always true. I think some babies (whether it's because of tongue tie, a weak suck, getting used to bottles or even a supplementer) can extract milk when the flow is strong but give up when it slows. When you stopped pumping, your breasts were fuller for a while and your little one got enough milk. Then the "extra" milk stopped being there because you weren't pumping and now he has trouble with the slower flow. I've had it explained to me that a breast is like a balloon full of water. When it's full, water streams out of a hole but it just trickles out when the balloon is mostly empty.

With domperidone I'm currently pumping as much after feeds as I'm supplementing during feeds, which is great because I have been able to eliminate all but the odd ounce or two of formula. But I know I can't give up pumping until my three-week-old is efficient enough to transfer that milk. He's had a TT released and is gaining and growing well so I'm fervently hoping he'll get more efficient and I'll be able to drop the pumping. Nursing/supplementing/pumping an average of 10 times a day (although I try to keep the whole routine to one hour) is sucking the life right out of me and I'm neglecting my poor two-year-old.

[mama2JTK]

Hi Megan,

Thanks for the reply and its great to know that I am not the only one.  When people hear about what it takes to feed my little tyke, they gasp and ask why we dont just give him formula.  Sigh.

Anyway, I totally get what you are saying about my supply adjusting down, but the thing that doesnt add up for me is that about a week into us cutting off the pump/SNS he was taking in more on his own that I was ever able to produce before (with nursing and pumping), so his nursing more actually got my supply up at its highest... then it trended down a little bit which I thought no big deal, but then all of a sudden the floor just fell out from underneath us.  And one of the stanger things is that its my morning supply which was typically the highest.

And since i posted the original question, he's started being very fussy whereas he was never fussy before... seriously he was practically born with a smile on his face - I'm lucky, i know :)  But most startling for me is that in the last day and half he is mostly refusing to nurse at all.  If i even lay him down next to me he arches his back and tries to get away (gee thanks, Judah!).  He'll really only nurse right before he takes a nap or during the night - but he's not removing much.  At this point I am pumping more than he is able to remove on his own... which is saying something because I have about the worlds slowest let down to the pump.  I have a feeling that the "nurse strike" has to do with him possibly teething, but the sharp supply drop was before that so I am still stumped there

[Megan73]

I'm lucky - I have yet to have anyone ask me why I bother. But it really eats away at me that it seems to be so hard for me to nurse. I  just try to remember that despite the rough start and the fact I always needed the Lact-Aid, dom and a bit of formula to nurse DS1, he nursed happily well into toddlerhood. So hang in there, mama!

Thanks for providing more info but I'm afraid I'm stumped, too. I'm struck by you saying your little one never cues to feed - DS1 was the same way and I've always wondered why. I doubt it's your fertility returning because most women find the dom keeps it at bay. Have you tried upping the dom? Dr. Newman puts some women on as much as 120 and 160 mg a day.

The good news is that pumping is protecting your supply and the SNS is keeping your little one at the breast while you figure out what happened and if this is a strike or something else. I know how awful it is to have your babe refuse the breast when you've worked so hard at nursing but I suspect it will pass. I'm sorry I can't be of more help but please feel free to PM me if you want to vent. You're doing everything right and I'm sorry it's not an easier road for either of us.