Help me advise a new teen mom on possible low milk supply issues?

[MotherBhaer]

Hi there,

I will be visiting a new 19yo mama of a 4 week old little girl in a few days (she's a friend of my SIL, and I've kind of been her advisor in crunchy parenting stuff during her pregnancy), and want to be prepared to help. She is breastfeeding her babe, and that seems to be important to her, but she thinks she has supply problems because her daughter is not gaining weight well. She's been offering formula after each nursing session, to make sure dd is getting enough.

So I need help with the following questions:
--Are there other reasons for slow weight gain, besides low supply?
--If it is low supply, what are some things she can do to increase it?
--What would you advise re:formula? I'm worried it's going to damage her supply further if she continues to supplement.

TIA for your help!

[Heba]

How great that you are able to support this mama!

Low milk transfer is far more likely than low supply (although primary low supply is of course possible).  The kicker is that poor milk transfer becomes low supply, as the body isn't getting signals to make milk.

I'd double check latch and active feeding, talk her through typical feeding patterns in a day (ensure she can recognise hunger cues and is not waiting for baby to cry, for example, and is feeding on cue - also setting no time limits on a feeding), is keeping baby close to her day and night so she is able to respond to baby's hunger cues.  Also talk through why she feels she had low supply; could it perhaps have been a growth spurt, or normal evening cluster feeding which had her worried?

Making sure she knows about signs of sufficient breastmilk intake might help boost her confidence (e.g. nappy output - although after a few weeks poop is no longer a reliable sign - but soaking wet nappies still are).

It's likely that her supply will already have taken a hit if she's been offering formula for more than a few days; Jack Newman has some good suggestions here: http://www.drjacknewman.com/help/Protocol%20to%20Increase%20Breastmilk%20Intake.asp .Lots of skin-to-skin, co-sleeping if mum is open to it and will be following safe bed-sharing guidelines, and nurse nurse nurse!

Finally, if latch/suck seem less than optimal, or if tongue-tie seems possible, a referral to a GOOD breastfeeding counsellor or an IBCLC may really help.  Sometimes mums need help in accessing the support available.

Just some thoughts...all the best!  Would love to hear how you, she and the babe get on.

xx

[Heba]

Oh, sorry, I see you've already mentioned why she felt that she needed to supplement (low weight gain).  Ignore any irrelevant bits in my earlier post :).  You might want to double check that the slowing in weight gain has been confirmed by more than one weighing.  It is possible for one measurement to be "off" due to using different scales, time of day, weighing before/after a feed, wet/dry nappy, or even user error.  Also remember that weight gain should be measured from the lowest point (typically a few days after birth).  If however there is a pattern of low weight gain over the four weeks, then intervention may well have been warranted and unfortunately in many cases formula is the only thing a mum or health professionals know how to do :(.

[sosurreal09]

I would definately advise her not to do the formula b/c that will make her supply drop.

[ewe+lamb]

Originally Posted by sosurreal09 

I would definately advise her not to do the formula b/c that will make her supply drop.