Constant/Long Nursing sessions mean low supply?

[Maurine]

I can't believe I was asking if I should wean off Domperidone only a few weeks ago!  My 6 week old is still gaining weight well, but for the past week or so has been almost constantly nursing, and for long periods.  I am doubting my supply!  I think I am getting him what he needs, but only because he is constantly on the breast.  For instance, we might nurse at 12:00, 1:00, 1:45, 2:15, 3:15, 4:45 etc...for 30+ minutes.  He does sleep for 2-3 hour stretches at night, which is a life-saver.  But during the day, he cries with hunger a lot until he's put back on the breast.  He doesn't get more than a few minutes of let-down (sucking and swallowing).  Normal?  Supply issues?  Should I increase my Domperidone dose (I am on 80mg)?

I thought it was a growth spurt, but it's been going on for 7 days now.  He is also on Zantac for reflux...

Thanks!!

Edited by Maurine - 8/31/11 at 5:20pm

[homemademom]

I would assume it was a supply issue. I've been in that situation (had low supply, on dom, etc.) but ours was also related to tongue tie.  Ds would nurse for long periods, really frequently, but still be hungry. Before his second tongue tie procedure (the one that really fixed things, including my supply) I had to give him about 6 ounces a day, but the difference in his overall happiness was huge with just that small amount (my supply seemed lower during the day; he nursed all night with no problem). Dom worked for me to a point but More Milk Special Blend by Motherlove helped even more. I bough it from amazon.com. 

[Maurine]

Thanks for the reply.  It's such a catch-22 isn't it?  That's what I am stuck on...if I start supplementing (I have maybe a week's worth of extra frozen breast milk but after that I would need to use formula)--that will effect my supply and it will decrease, right?  If I don't supplement and hang in there, maybe it will increase it?  But it's been more than a week now and nothing has changed it seems. 

And then I read about how many babies nurse frequently or almost all the time until they are 8, 9, 10 weeks.  And I think maybe we're in that category. 

But seriously, I am thinking about starting to supplement.  I am just so confused over what to do!

(Oh, and I am taking Dom 80 mg a day, More Milk Special Blend, and extra Goat's Rue thrown in there...I have PCOS.)

[homemademom]

I would always nurse first, and really, really make sure that he got in a good nursing session before offering the bottle. Some days he took a little less, some a little more, but it was constant over several months, so I don't think it diminished the supply I had at the time.

I really think the supplement-supply killer is because people slowly offer more supplement than they really should. Maybe it's a convenience thing, or a freedom thing (being able to easily leave baby with another caregiver), a tiredness thing (who wants to pump in the middle of the night?!) or whatever (not slamming moms that do any of these things, because I get the temptation), but if you keep a tight hold on it and don't skimp on nursing and pumping, I think it can be done.

Good luck, mama. Go with your gut! 

[foreverinbluejeans]

If your baby is gaining at least 4 ounces a week it probably isn't a supply issue. Human babies are supposed to breastfeed "all the time." Babies have tummies about the size of their fist and they need to eat small amounts frequently. If your baby is having "reflux" then it may be important to nurse on only one breast a feeding so your baby doesn't get too much milk. You may have an over supply problem or your baby may be getting too much of the low fat milk milk that comes at the beginning of a feeding and not enough high fat milk that comes from nursing long periods on one breast.

You might want to read about laid-back breastfeeding. There is a section in the newest Womanly Art of Breastfeeding or you can go to google and type in "laid-back breastfeeding." The epidemic of reflux problems that infants have had in the last 20 or so years may be because of how women have become so strict about positioning, latch, and following rules about breastfeeding. Laid-back breastfeeding is based on the notion that if the mother get in a comfortable laid back position and just let the baby have a chance human babies actually know how to breastfeed (vs learned skill). Positions and rules may be causing the reflux. When my children were babies 25 plus years ago reflux was very rare and babies weren't medicated until they were older and unless it was the last resort.

Wearing your baby in a carrier or sling can help with spitting up (reflux).

[Maurine]

The good thing is that I think the reflux has improved.  He is gaining about 7 ounces a week or sometimes more, so I think I am getting enough milk into him...it's just a huge effort of nursing nearly all the time...  (sigh)  Perhaps I am just not cut out for constant nursing.  A friend thinks I might simply have lower reserves of milk than other people, hence the need to nurse really often.  I am hoping things will get easier as I am considering formula at some point (to allow him to feel more satiated and go for a little longer between feedings).

[homemademom]

If his weight gain is decent, I would try to stick it out with ebf for another 6 wks. So much improves at that 3 month mark. Your baby may be nursing more efficiently, you may be producing better, and you might find that everything just works out.  I've nursed 4 other babies before my low supply baby, so I know that constant nursing can be normal for small infants. But another thing to consider is his latch. I know you have low supply/pcos, but if his latch isn't the best (for whatever reason; I'm most familiar with posterior tongue tie), he won't give enough stimulation to the breast to produce more.  It might be worth getting evaluated by an experienced LC.  Also, if you're interested in donor milk so you don't have to use formula, there's a group on facebook called Human milk 4 human babies that you could contact.  Good luck.