Supply seems lower, in a post partum depression rut

[annaconda]

Hi mamas.

I just got diagnosed with PPD and am seeing my therapist more often.  I'm definitely down in the dumps just about as bad as I've been in 5.5 months since lo has been born.  I have started medication.  I've been on that for a few weeks so I don't think it's the culprit.

My supply was fine last week - but this week I've noticed both of my pumping days it's not quite flowing like it used to.  I still nurse lo all the time when I'm with him.  It seems like he's gulping down quite nicely.  He has had a nasty cold, and has had slightly less wet diaper output than usual.  I thought it was dehydration from being sick but now I'm wondering.  I offered him the breast once an hour and he took it every time yesterday.  I thought he was just "nursing a lot" but now I'm thinking... did he have to nurse a lot to get what he usually gets in fewer sessions?

I have contacted my lactation consultants.  I really think everything is fine, but I'm concerned.  Could it be that my severe lack of sleep (ppd insomnia) and down in the dumpiness is affecting my supply?  It's already a source of major anxiety for me - having enough milk - and one of the triggers of my ppd.

I'm so torn.  I love bfing now but my anxiety about my supply is so bad that I am considering weaning for the benefit of everyone in my house.  I hate thinking that and am not actively planning it but I thought to myself today, if my milk really takes a hit, it would force me to wean and that's not the worst thing in the world.  

I could use some support I guess!  I'm hoping this is super temporary.  I really don't want to have to start pumping on my bfing days to build back up my supply... but I guess I would if I had to.

[Megan73]

I'm sorry you're dealing with this
I haven't had PPD but I've struggled - twice - with extreme anxiety about breastfeeding and low supply.
The first thing I'd do is make sure your anxiety is based on reality by doing a series of weighs on a good scale to see if he's gaining appropriately. Four to five ounces a week would be average from four to six months old. Two to four ounces a week is average from six to 12 months.
But even if he's not gaining enough, weaning is not your only option.
Domperidone might do the trick to improve your supply and doesn't have mood-related side effects.
I'm not sure if an older baby would accept an at-the-breast supplementer, but you could supplement with formula or donated breastmilk in a cup or start nutrient and calorie-dense solids such as egg yolk, avocado, sweet potato and meat if you're not planning to delay solids beyond six months. My preference with DS1 was to supplement with formula and go slow with solids but Dr. Jack Newman has been a proponent of "supplementing with solids" when baby just needs a little help to gain well.
One thing that helped me with both my babies was renting a baby scale so that I could reassure myself that they were gaining - and that if they weren't I could do something about it.
Edited by Megan73 - 11/9/11 at 12:37pm

[Mama2ChicknLil]

Oh mama my heart goes out to you! Please keep bfing, even of you really do have supply issues and need to supplement at done point. Think of it as your personal warrior in the fight against ppd! All of that oxytocin that gets released into your system while you bf is so important you help you battle this, and on a more simple note, both you and babe need and deserve that time for close hugging and skin to skin contact. In fact, I was at a training last year about bfing helping ppd symptoms correctly, pretty sure mothering had a great article about it too.

Good for you for exploring all of your options and working to deal with this, you are in my thoughts, and I have total faith you can handle this...good luck and happy bfing

Xoxo

[annaconda]

Thanks so much for the support mamas!

This morning I did pump five ounces which was a huge relief... both sides were flowing like normal even though I had a really rough night last night.  LO slept well in his crib... I woke up at midnight, dozed till 2, then was awake from then on.  Almost fell asleep at 4am, but that's when lo wakes up.  Vicious.  Really.  I'm such a mess with this insomnia... it started late July.

Megan73 - It is a huge anxiety for me about having enough milk and I'm so glad to hear that I'm not alone.  It's been a really tough road but I fought to EBF in the first few months of LO's life with the supplemental feeder, herbs, etc.  I do remember having my fears allayed in the lactation office when I saw that he nursed like normal and ate 3 oz (that was this summer).  The scale was very helpful.  Thankfully LO has definitely been on the curve consistently the whole of his life and we're scheduled to go in for a visit soon.  I will keep renting a baby scale in the back of my mind because that is definitely a solution to the anxiety.

Mama2 - Yes I do love the bfing when I'm with LO!  It is a wonderful snuggle/reassurance and it does make me feel so good to be near him.  I do fantasize about my time away from him and not dragging the pump and cooler around.  I yearn for that freedom, but really, I mostly yearn for sleep.  I am going to continue bfing.  The lactation consultant said yesterday that I'm doing everything I can and should, and she pointed out that I'm in no place to make any decisions right now - she said get yourself sorted out chemically and wait for a little bit to get your feet on the ground before making any long term decisions.

The thought of weaning makes me completely emotional and guilty and I wouldn't sacrifice the goodness of our time together for the ugh of the life of the pump and the 4am feedings.

I know that everything would be better if I could get some sleep!!!

My husband is definitely on the fence because I'm so horribly edgy and angry and down and moody when I'm off duty from the baby.  He would be fine if my bf drama was over because it has been drama from day 1.  Well... I did get to the doctor yesterday to tweak the medication and did speak with the lc and do have more therapy in the works so I hope this all evens out soon.

Thanks again.

[Mama2ChicknLil]

Congrats on 5 ounces!! That's a significant little stash!! Hers hoping it stays that way
5.5 months is a long time to struggle, both for you and dh. What I'm learning thigh is being a parent requires major sacrifices and will totally test your will power. Both of you (though dh more indirectly) are sacrificing for lo's safety and health, good for both of you.

I an sure ask of the measures you are taking will pay off, good luck!!

[Megan73]

I'm glad today is a better day! Be gentle with yourself...

[annaconda]

Happy to report things are good. I've gotten some sleep and my meds are balanced and I'm starting to feel better. Lo seems to be back to normal nursing, both sides, throughout the day. Phew!
I'm a yoga teacher and the lineage in which I study just released yoga therapy for depression. I did it today and it really made me feel good. I've now got my sites set on 1 year.

We are introducing solids too and that is going great. Lo loves applesauce and brown rice cereal so far.
Thanks for the support during this rough patch.

[Megan73]