Low milk supply/hungry babe

[MaryMarg]

I am an extended BFing, baby-wearing, co-sleeping mom who nursed my first two for around 2 years (weaned themselves).  I had hyperlactation with both.  They were preemies and I was advised to pump and pump by lactation to ensure adequate milk.  I did, but had problems with repeated engorgement and with #2, with mastitis/blocked ducts.  BG #3 is 5 months old and has always been small (a 35 weeker, too).  MD has been fine with her low weight/percentiles, but she has fallen off the chart in the last 6 weeks.  She has plenty of wet diapers each day.  Poops infrequently, which is strange compared to my other two but seems to be her own pattern. I did not pump much with her, due to lack of time and not wanting to have repeats of previous problems.  Lots of stress in my world, as husband took and out-of-town job when baby was 4 weeks and we put our house on the market, not expecting it to sell quickly.  It sold in 9 days and created a wild ride for me with childcare, packing, and finding a new place to live.  The new place didn't work out and we had to move in with my parents who do not support any natural childcare practices, including BFing.  I'd be lying if I said I get much sleep and I eat, but not as much as I should.  I do drink lots of water.  These are factors that I cannot change much right now.  We will be moving in 3 weeks to our new home but I'm fearful it'll be too late to make a difference.

Going to get her weighed at BF support group tomorrow to see what her intake is but, honestly, I dread it.  Now that I have stepped back and seen what is happening, I realize she isn't getting enough.  I have tried some herbal supplementation, some homeopathic remedies, and am now pumping after EVERY FEED (which time-wise with 2 older is a complete challenge).  I get nothing when I pump, which I kind of expected post-feeding, but also haven't seen a big jump in my supply during feeds.  Lactation stated if this doesn't improve supply after 72 hours, I may have lost my milk.  I am so devastated as my 72 hours is nearing and I have still had to supplement with frozen milk over the last few days. 

I will continue supplementing with the small amount of milk I have frozen and try not to regret not pumping.  If I do have to start formula, can anyone tell me what kind they use?  I have no idea how this works and all my BF books are packed up!  Any others had low supply that came back later after pumping etc?  Any other suggestions are greatly appreciated--TIA.  I need some encouragement here.

[nyakanyasko]

Wow, you have a lot going on!! One thing to try, is if you aren't getting much at the pump after feeds, you could hand express instead. There is a new theory that both colostrum and hindmilk are more viscous than the milk at the beginning of a feed, and may not come out as well for the pump. I'm also wondering, since you have two older children, how old your pump is? They are actually supposedly only designed to last for about a year, so they can still seem like they work, but be getting less efficient over time. You could see if you can rent a hospital grade one for a few weeks and see if that makes any difference.

Another idea is, if you can have your baby go back and forth between your breasts a few times each feeding...this can help stimulate your supply, if she is willing to do it, and is better than any pump anyway. You could also try adding compressions during feeding and pumping. http://www.nbci.ca/index.php?option=com_content&view=article&id=8:breast-compression&catid=5:information&Itemid=17

And lastly, it sounds like you are going though a lot right now!! Please try to be gentle with yourself! You are a wonderful mother and all three of your children are lucky to have you working so hard to help them through this transition in your family's life!

[MaryMarg]

Thanks for these ideas!  I have worked for the compression and am switching multiple times between breasts at feedings as well.  And just today I went and got a hospital-grade pump in case my old medela is tired from the extra milk the others had!  Also went to the support group and weighed BG before and after a feed and she only took in 2 oz.  I feel, sadly, that this might be accurate.  Will continue to pump each day but now will also give her a bottle of froz breastmilk after feeds if she still seems hungry.  Hard for me.  Thanks for the encouragement!

[APToddlerMama]

I had a 35 weeker too and did the crazy pumping thing as well (including mastitis and all those issues).  I understand your hesitation with pumping but think that is great you're working it in despite so much stress and change.  One thing that helped me was waiting an hour after DS nursed, and then pumping.  You may want to try that.  Honestly it took me about a month to get my supply up.  Has your DD been evaluated for tongue tie or anything?  Another thing you may want to check out. 

[homemademom]

2 oz is not bad! I mean, yes, you want more, but at least it means you're making milk. How often are you offering the breast? Are you still taking herbs?  Don't lose hope! Chances are good you can get your supply back up. I'm glad you got a hospital grade pump.  Also, has your baby been checked for tongue tie to make sure that physically there are no impediments? Posterior tongue ties are very hard to diagnose so call around to the IBCLCs near you to find someone with expertise. Good luck.

[etsdtm99]

 2 oz isn't bad! and i have to disagree that you need more - if she could get 2 oz every time you nurse and you nursed every 2-3 hours why do you need more?   my now 3 yr old never took more than  2 oz at one of those weight checks (even at 9-10 mnths) - usually more like 1-1.5 and he only nursed every 3 hours and he did drop off dramatically on his growth curve between 6-12 months (but he wouldn't take any more milk or food if we forced it on him.)   plenty of wet diapers is a very good sign too   - i wouldn't panic yet - and i also would not get totally discouraged by that 72 hour rule - if women can relactate from NOTHING, surely you can make more milk since you've had other children and had a full milk supply before, your body knows how to do this!  i think the hospital grade pump is a great idea..

also, you could try putting out the pump for a 4-6 hour period and pumping for 5-10 mins every time you walk by/have time - at the end of the 4-6 hours, store the milk in the fridge and wash everything and start again - some moms find this easier and more effective than pumping after feedings.  also you can try power pumping, or pumping between feedings instead of right after.. 

check out diana west's book "making more milk" if you get a chance.  there are so many ideas in there it is hard to put it down..

[Evergreen23]

I second the recommendation for "Making More Milk." that book saved our nursing relationship! Have you had your iron checked/hormone panels run? I'm wondering if it might be a hormonal issue since your previous nursing experiences were so successful.

I had a low supply that came back when I fixed my problem with anemia by taking iron supplements, power pumping, eating a handful of almonds every day, and taking Motherlove more milk special blend 3x a day. Best of luck to you! <3

[MaryMarg]

Thanks for all the support!  We have closed on a new house today and will hopefully move in the next 10 days.  Maybe decreased stress then??  I have been pumping after every feed for a week now and power pumping for the last 3 days.  Trying to increase caloric intake.  Still minimal change in output, which has surprised me.  Taking fenugreek supplements and wondering if figuring out how to get domperidone is a good idea.  I do awaken in the morning with leaking breasts and somewhat engorged; that is when DD seems the most satiated.  If it would just continue like that all day.  She is fussing after a few feeds, wanting to eat more and I have given her a few bottles of breastmilk then.  The lactation group leader offered me the scale for the weekend and DD was taking anywhere from one ounce to 3.5 ounces from me.  She does not try very hard if the milk isn't spraying hard--throws her head back and fusses.  However, when I pump, I get very little milk.  She has gained weight since I've been supplementing with breastmilk bottles, closer to 3/4 ounce a day, which I would like her to gain.  She is such a content little thing, but seems so happy when she can gulp the available milk from the bottle.  It honestly makes me cry.  As an experienced BF mom, I know in my head this is shooting myself in the foot, but certainly want to remember "feed the child" first and foremost.  I struggle with knowing whether she really needs the supplements or not.  I guess I think she does based on sometimes limited milk intake (she wants more, but I cannot extract more from the breast) and her limited weight gain in the last month.  She likes to breastfeed, but mostly likes to feel full.  Doesn't seem to nurse emotionally like my 2nd did.  Still working on the pumping and hoping for change.  Keep the ideas coming; they are great!!  Many thanks!

[Megan73]

NAK
A couple of quick things - I'd try to get a SNS so you can supplement at the breast, heading off problems with flow preference. The routine would be nurse both sides "bare" with breast compressions then supplement with the pumped milk from the previous feed in the SNS then pump. Domperidone might do the trick if you can get it. Also, has she been checked for tongue tie?
Hang in there, mama. I hope things settle down for you soon!

[lian]

I am going through the exact same thing! Funny how whenever I need help there's always someone on here with the same problem.

We also just sold our house and just bought a new one, tonnes of stress associated with that!  Sooo hard to always have to keep our house spotless. But then about a week ago I got really sick, couldn't eat anything and was having really painful (crampy) blood diarrhea (sorry, TMI).  I ended up in the hospital over the weekend, finally got the issue diagnosed, and am back home now, feeling way better.  Baby stayed with me in the hospital (actually, they made us go home overnight cuz nurses were worried about germs, but that's another story).

My supply is basically non-existant right now. I always had massive oversupply, so I never bothered to build up a freezer stash. DD2 gets some milk when she nurses, but she definitely seems to want more. She doesn't seem to be having as many wet diapers as normal, but I don't really know because DH has been doing a lot of the diaper changes that I normally do.  She seems to be sleeping more than normal too.

So... I think I might need a good formula recommendation. My supply is not coming back quickly, and it needs to... it's been low for over a week now and seems to be dropping, even though I've been eating more and taking iron supplements. I really don't want to have to give her formula, but... baby needs to eat and I don't seem to have the milk.   She's 3 months old, btw.

It's so weird to be having this problem, because I am so used to dealing with trying to reduce my milk supply.