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Low supply - What helped you?

post #1 of 105
Thread Starter 
I am struggling with low supply. My 2 and a half week baby is still pretty far from his birth weight. Currently I am supplementing with donor milk and nursing and pumping every two hours during the day and every 3 hours at night to try to boost my supply. I am also taking herbal tinctures, using clary sage essential oil, drinking Guiness, and eating alfalfa sprouts and oatmeal. For other moms who have struggled with low supply, what are the things that helped you the most?
post #2 of 105
Honestly, Domperidone is the only thing that really, really worked for me. Not that I have ever had a full supply either, but it's the only thing that made it worth it to keep going.

There is a really long thread about the medication somewhere around here...

I just started using a Lact-aid supplemental nursing system as well. It gives baby practice, gives stimulation at the breast while supplementing, and because it does all that, it makes me not feel so bad if I skip pumping session because of life getting in the way, you know?
post #3 of 105

I made a lot of Barley water.  Lactation cookies and brewer's yeast also helped.

post #4 of 105

I completely agree with GISDiva! Domperidone is the way to go with low supply. Also, adding some Fenugreek to your herbal regimen would help some. It looks like you have a lot of your bases covered with the SNS and other things. Good job! Do you have a Private Practice IBLC who is seeing you regularly and weighing the baby and sending weights to your Ped?

 

Do you know the genesis of your low supply? If you have PCOS or Insulin Resistance a drug called Metformin (Glucophage) is like the Water of Lourdes for PCOS or IR caused low milk supply. I've seen supply pop up to normal in just a few doses. If that is the case, you would need to see a good endocrinologist (or maybe your OB if he or she knows enough about PCOS and the resulting insulin problems it can cause in some women, and its effect on milk supply.)

 

Keep up the good work, and if it is Insulin Resistance see a good endo for help. You need a prescription for Domperidone from a doctor to be filled at a Compounding pharmacy (the formula companies have successfully lobbied to KEEP Domperidone OFF the US Pharmacopeia for the time being.... for obvious reasons.) It has to be compounded but it is worth every grain and every dollar. Metformin for IR is a RX drug that is commonly used for IR and PCOS. You will probably need a Glucose Tolerance Test, in addition to an exam and regular visits with the endo MD. If it's something else, let me know and I can see what I can find about it. Sometimes low supply doesn't have a readily discovered etiology, but I always send Mamas to an Endocrinologist as the chance of them having PCOS or IR is high. (Especially if you had a difficult time conceiving, have problems with keeping weight off, most of your weight is around your middle,  you may have acne, excessive body or facial hair, or you may have skin tags, and there are a number of other symptoms. Of course, you could have PCOS or IR and NOT have any of these symptoms. It's a syndrome so it's complicated. But, an Endocrinologist will help you discover if this is the problem.

 

Good luck and Blessings. :goodvibes 

post #5 of 105
Domperidone and supplementing with the Lact-Aid supplementer. I never got a full supply, but I don't need bottles.
post #6 of 105
Thread Starter 
My MW is providing newborn care for my son so we aren't currently seeing a pedi. My MW loaned us a scale, so we are closely monitoring my son. He has steadily been gaining weight since we began supplementing with donor milk. I am a little hesitant to go to a pedi right now because I think they would be opposed to us getting milk through mom-to-mom milk sharing (milk bank milk is almost impossible for us to get here) and I think they would push us to supplement with formula.

I had seen a WIC IBCLC and she suggested the pumping and supplementing regimen we were already doing, but was pushing formula supplementation very hard and was pretty anti-MW and using scare tactics to try to get us to see a pedi, so I stopped going to her.

My dad offered to pay for a private practice IBCLC recommended by my MW. I spoke to her Thursday and she suggested seeing an ENT. So Friday we saw one and he diagnosed my son with tongue tie and clipped it. Nursing seems less painful though it isn't pain free; however, I am pumping so much that some of the nipple soreness may just be due to that.

We don't exactly know what is causing the low supply. Obviously, the tongue tie may have been a factor. Also, at 2 weeks post partum I passed a piece of amniotic sac that I had retained which was probably also a factor. The new IBCLC thought it was but also thought that by now (a week later) my supply should have seen more of an improvement.

It is interesting you bring up PCOS because an OB once diagnosed me with it. I didn't really believe her because I had always had regular periods, tend to maintain a healthy weight if I am eating well and getting exercise, and honestly couldn't see the cysts she claimed to see on the Ovarian US at all. I felt like she was just trying to push BC pills on me. And I had no trouble conceiving, my pregnancy was actually unplanned while (TMI) my DH and I were using the pull-out method with him never failing to pull out on time.

I'm not sure what the cause of the low supply is, but I feel like there are a lot of factors. I just started taking fenugreek and blessed thistle today, so we will see if that has an impact. We have an appt with the new IBCLC on Monday, so hopefully she will shed some new light on the situation. So far, everything I'm doing has had little impact on my supply. I'm pumping about 6 oz every 24 hours and my son seems to be nursing about 4 oz every 24 hours. Fortunately he has gained almost 10 oz in 5 days with the donor milk and is now only 8 oz shy of his birth weight.
post #7 of 105
I am so glad you have access to extra milk. I wish I had those connections, but instead have been using formula.
post #8 of 105
Thread Starter 
I got the donated milk by posting to my state's Eats on Feets and Human Milk 4 Human Babies Facebook pages. I was surprised at the responses I got. I also just reached out to friends and got some smaller donations. Eats on Feets webpage has an article called the 4 Pillars of Milk Sharing that goes over the kinds of questions to ask potential donors.
post #9 of 105

I got my milk supply up for my 3rd by using a baby scale for weighed feedings. I would weigh him before and after and then based on what he took, supplement with around an oz of formula while I pumped with a rented hospital grade pump for 10 minutes each side. After about 2 weeks, I was up to what he needed according to the ped (2 oz every 3 hours) and was able to discontinue the supplements (I think he was around 3-4 weeks old). He never had another drop of formula. I didn't do that routine with #4 and just nursed and nursed and nursed, but in hindsight it wasn't as effective and I struggled with low supply his whole first year. I was just so determined to not use formula at all with him, but I think I was more successful when I did use it looking back. 

post #10 of 105
Quote:
Originally Posted by lilmamita View Post

My MW is providing newborn care for my son so we aren't currently seeing a pedi. My MW loaned us a scale, so we are closely monitoring my son. He has steadily been gaining weight since we began supplementing with donor milk. I am a little hesitant to go to a pedi right now because I think they would be opposed to us getting milk through mom-to-mom milk sharing (milk bank milk is almost impossible for us to get here) and I think they would push us to supplement with formula.

I had seen a WIC IBCLC and she suggested the pumping and supplementing regimen we were already doing, but was pushing formula supplementation very hard and was pretty anti-MW and using scare tactics to try to get us to see a pedi, so I stopped going to her.

My dad offered to pay for a private practice IBCLC recommended by my MW. I spoke to her Thursday and she suggested seeing an ENT. So Friday we saw one and he diagnosed my son with tongue tie and clipped it. Nursing seems less painful though it isn't pain free; however, I am pumping so much that some of the nipple soreness may just be due to that.

We don't exactly know what is causing the low supply. Obviously, the tongue tie may have been a factor. Also, at 2 weeks post partum I passed a piece of amniotic sac that I had retained which was probably also a factor. The new IBCLC thought it was but also thought that by now (a week later) my supply should have seen more of an improvement.

It is interesting you bring up PCOS because an OB once diagnosed me with it. I didn't really believe her because I had always had regular periods, tend to maintain a healthy weight if I am eating well and getting exercise, and honestly couldn't see the cysts she claimed to see on the Ovarian US at all. I felt like she was just trying to push BC pills on me. And I had no trouble conceiving, my pregnancy was actually unplanned while (TMI) my DH and I were using the pull-out method with him never failing to pull out on time.

I'm not sure what the cause of the low supply is, but I feel like there are a lot of factors. I just started taking fenugreek and blessed thistle today, so we will see if that has an impact. We have an appt with the new IBCLC on Monday, so hopefully she will shed some new light on the situation. So far, everything I'm doing has had little impact on my supply. I'm pumping about 6 oz every 24 hours and my son seems to be nursing about 4 oz every 24 hours. Fortunately he has gained almost 10 oz in 5 days with the donor milk and is now only 8 oz shy of his birth weight.


You may never know why, but PCOS is always one of the keys to the puzzle. It's a syndrome not a "disease" so one can have all or only one or two of the symptoms. Some women with PCOS have no problem conceiving, that alone doesn't rule out the diagnosis. Ultrasounds are VERY hard to read, I've worked in Health Care for more than 20 years and I can't read them well at all. I leave that up to the people who do it every day. I'm not surprised you couldn't see the problem with your ovaries, your doctor sees thousands of ultrasounds before she was able to spot problems, so not being able to read the ultrasound as well as a trained professional is normal. My guess is there may be some PCOS going on here. Have you ever had a full 5 hour glucose tolerance test? Might be a good idea, eventually. Also, as I said, the meds they use for Insulin Resistance and PCOS can help some women make tons of milk IF they suffer from these conditions.

 

Did you SEE the LC or just talk to her? You do need to be seen, I hope she was planning on seeing you for a needed follow up after the TT snip. These aren't issues than should be expected to be handled over the phone. You need to see her in person, have her do a complete history, a complete exam of you and the baby and set up a treatment plan!

 

You will need to see the LC again after the snip because a lot of babies don't "realize" they have been snipped and continue to have problems with tongue elevation and movement. The LC needs to see you again if the supply isn't increasing yet. I always do follow ups with TT snip clients. Always, It should be a matter of course.

 

You retained placenta? It took two weeks to pass the fragment? WHY didn't your midwives do a complete exam of the placenta after the birth? This isn't acceptable. Placentea need to be examined, preferably in a Pathology Lab to make sure not a single stitch is missing. It can cause problems, like preventing your progesterone levels from dropping properly after birth, it can take a while after the segment is passed, or it can be immediate, but if ALL the placental fragments have passed your progesterone levels will eventually drop. The thing is, it took two weeks to pass the fragment and all that time your progesterone was too high. Why was this missed? (I don't expect you to know, but I would have a few questions for your midwives..... ) Have you had an ultrasound and exam to make sure ALL of the placenta was passed? Was the fragment sent to a lab for examination? Retaining placenta is serious and should not go unexamined. It is NOT normal and can not only effect your milk supply but make you seriously ill. I'm a bit frustrated that no one caught this earlier.

 

No one expects you to have all the answers yourself, but taking advantage of good health care providers who know a lot about this situation is your best bet at making the best out of your supply challenges.


Edited by MaggieLC - 10/13/13 at 10:55am
post #11 of 105
Thread Starter 
MaggieLC - my MW did examine the placenta and I was actually transferred to the hospital after the birth for a D&C and they also gave me Pitocin. I am more frustrated and questioning how the OB who did the D&C at the hospital managed to leave fragments of the amniotic sac in after he did it.

The LC, recognizing our financial situation and the fact that we would likely only be able to afford one session which my dad offered to pay for, was nice enough to do a free phone consultation first, in which she suggested we go to the ENT before having our appt with her (since she would have likely suggested we go there after our 1st appt with her). So we are scheduled to see her on Monday. The LC I saw for free through WIC was not very good and just wanted us to supplement with formula. She had actually detected his Tongue tie but didn't follow up with us on what to do about it.
post #12 of 105
Quote:
Originally Posted by lilmamita View Post

MaggieLC - my MW did examine the placenta and I was actually transferred to the hospital after the birth for a D&C and they also gave me Pitocin. I am more frustrated and questioning how the OB who did the D&C at the hospital managed to leave fragments of the amniotic sac in after he did it.

The LC, recognizing our financial situation and the fact that we would likely only be able to afford one session which my dad offered to pay for, was nice enough to do a free phone consultation first, in which she suggested we go to the ENT before having our appt with her (since she would have likely suggested we go there after our 1st appt with her). So we are scheduled to see her on Monday. The LC I saw for free through WIC was not very good and just wanted us to supplement with formula. She had actually detected his Tongue tie but didn't follow up with us on what to do about it.


Wow, almost unheard of. I've never seen placental fragments after a D&C. Did you take the fragment to either your midwife or doctor to have a Path exam on it? If so, you certainly have evidence for a lawsuit on your hands. Leaving material behind after a D&C is serious medical malpractice. Women bleed to death!

 

I've once mistaken a couple of HUGE clots for placental material (and I've been trained to tell the difference) and I popped Mom and Baby into the car and right to the ER. The doctor did an immediate (and actually quite simple) test on the clots (which I saved in plastic jars, which she was excreting during a Doula shift, to take to the ER) and we found out, to my complete surprise was just chunky blood clots. No placental material at all.  It was years ago, and I didn't have as much experience as I have now, but, then, I would have sworn those clots were placental material. I now how to tell the difference, but always take a Mama who is passing clots or bleeding right to the ER and save the clots. I now know a simple medical procedure to tell the difference (the ER doc had me assist and showed me how to do the test even in a home enviroment,) now, but I always get Mom to the ER when there is any doubt. If she's bleeding, she needs to get Emergent Treatment.

 

I have also, like your LC, had plans with a client whom I knew the baby was TTed, and I also have scheduled our LC visit for after the snip. Seeing as there isn't a whole lot I can do while the frenulum is in place. The WIC LC (assuming she even was a Board Certified LC) didn't send you for a snip or follow up with you, you've been getting some terrible treatment. Find out if the "LC" at the WIC clinic is actually Board Certified and report her to the www.iblce.org. She isn't doing her job.

post #13 of 105
Thread Starter 
The WIC LC was board certified - at least it said IBCLC on her card. I just remember that when she looked at my son's tongue she was saying, "you do have a little forked tongue" but didn't say anything else to my husband or me and I was too frazzled to follow up at the time. Then when the new LC mentioned tongue tie on the phone, I remembered what the first one said and told her and she said we should take him to an ENT.

The amniotic sac tissue I passed was flushed down the toilet. It came out in a sitz bath and I just took a picture of it and sent it to my MW who said that is what it was. But I haven't been having much bleeding at all. All that being said, I'm not really interested in lawsuits or filing complaints, or really the past at all for that matter. I just want to get my supply up so my baby can have the best possible start.
post #14 of 105
I've been reading some about thyroid conditions popping up right after birth too, affecting milk supply. MaggieLC, do you have any insight on that as well? I am getting mine tested this week just for giggles, I would like to know the source of my low supply as well...

Also, Domperidone can be acquired from overseas via http://www.inhousepharmacy.biz/ . I have used them for both kids now and have had no issues.
post #15 of 105

Have those of you looking into causes heard of breast hypoplasia and/or insufficient glandular tissue as a cause? That's what I have, and if you look it up, it's pretty easy to self-diagnose, I think. 

post #16 of 105

Mother's Milk Special Blend gave me a nice boost.

 

Be careful with Domperidone if you suffer from depression/anxiety. My lactation specialist (30+ years experience) warned me not to take it and being the hard head I am, I went against her advice. My mental condition got so much worse, it was scary. I think it is fine for most people if they don't have mental health issues, certainly worlds better than Reglan, but it can be a trigger. Now mind you, if I actually NEEDED it to make enough milk I would probably endure the side effects but that's just me. My son is highly allergic to dairy and soy is just the worst, especially for boys--so I was willing to do anything necessary. Fortunately my issue was not a physiological problem but due to having a really bad start breastfeeding, thanks again to my anxiety. So lots of stimulation, skin to skin, and MMSB took care of it.

 

How are things going since your last post?

post #17 of 105
Fenugreek extract
Blessed thistle

I rely on them. Babe is 2.5mos.
post #18 of 105

PLEASE GO TO---www.Herblore.com.

 

Patty is a CERTIFIED Lactation consultant and she has wonderful articles about low milk production & the issues w/ Fenugreek like gas in Mom & Baby plus you MUST wean off Fenugreek b/c you reduce your supply more just stopping it.

I use her nursing tincture-3 droppers 2X day, blessed thistle- 3 droppers 2X a day, & add dropper of Goat's Rue & Fennel  2 to 3 times a day plus 2-4 Alfalfa capsules a day.

Staying in bed w/ my baby on my skin an entire weekend really helped get me kick-started b/c I had a milk gap after an emergency c-section. Getting your baby to nurse/ suckle as much as possible is really the best. Skin contact & wearing baby on skin helps so much. Daily walks for at least 20 mins seemed to help quite a bit once I could walk. Eating super healthy with lots of extra greens- grass fed milk, grass fed meats, lots of spinach, salads, veggies for me.

 

If you stay a low producer then your milk will start coming in super fatty i.e. less liquid more fat to provide the calories. I had so many issues w/ duct clogging so I take Organic NON GMO Lecithin 1200mg capsules- 2 capsules 2 x day to prevent issues but I took 3X a day when pain started. I also used Therma Care Neck heat wraps on the affected breast b/c the stay attached around the breast for at least 8 hrs and really stay warm too.

 

Also see Kellymom.com for more info on what hurts milk supply and more info about getting supply up when pumping like using the right sized breast flange. This site also lists drugs that are ok when sick etc.

 

When I supplemented I used ComoTomo baby bottles b/c they made my LO work for the milk. It took 20 minutes to suck out 3-4ounces of milk. I don't believe in the term "nipple confusion". I believe babies are smart so they want the ease and immediate satisfaction of getting their milk more quickly from the bottle; why work hard if you don't have to put in the effort? Most bottles feed in 5-10 minutes and then back to sleep for baby vs breastfeeding taking 20-30mins. When babies suck/ work as hard using a bottle then all the moms saw them not fussing when given the breast in my support group.

post #19 of 105

I had a really nice tea I drank all day, called "Stilltee" (breastfeeding tea). Aniseed, caraway and fennel. Two litres of that a day. Frequent, wholesome food helps, too, but most important I found for afternoon and evening supply was a long nap midday. Don't know if you baby naps well yet or someone could take baby for a bit so you can sleep? 

 

Sleep deprivation is terrible for supply.

post #20 of 105
Have any of you had a milk supply that increased after 4 months? I have had low milk supply and been supplementing with formula via the SNS for the last 3.75months, since my son was 2 weeks old. My milk seems to be dropping now, lower than it was. I don't understand how to make it better after this long, as I have been told by a few people that it stabilizes at about 12 weeks and often milk supply can go down after 3 months. Have any of you experienced anything different or know about it at all?
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