Low Supply?

[babymakesthree]

I think I have a low supply. My DD is not gaining weight very well. Born at 8 lb, 5 days later at 7 lb 11 oz, at 12 days she was 7 lb 15 oz and at 24 days she was 8 lb 2 oz. That means that in 12 days she only gained 3 oz. We have been EBF and I have had an LC come to the house and have tried any/all tricks I can think of. Breast compression, pumping between feedings (I have gotten 1/2 oz a day when I pump), try to make sure she has a good latch every time, putting her to the breast whenever she shows any interest at all in it (have done this since birth) I just started taking motherlove more milk tincture yesterday but I have been drinking mothers milk traditional medicines tea since birth. I am seriously considering getting some domperidon... : I am very frustrated because BF was one of the things I was looking the most forward to as a new mother but I feel inadequate and I feel like she is not getting enough. She is bright eyed and pooping 2/3 times a day but her wet diapers are about 5 or 6 a day. She seems to get very frustrated at the breast starting in the afternoon through til she goes to sleep at 11 or so. And I also can't pump more than a few drops when I pump in the afternoon. The 1/2 oz I pump is all in the morning. AHHHH I don't want to supplement but obviously my DD eating and being healthy is more important. How do I supplement so my supply doesn't drop even more?? Please help wise mommas!!! I am wanting to do the best I can for her..
Amber

[puppeteermom]

Hi Mama Amber,

You are doing a great job -- please remember that! I'll have to let others weigh in who have more knowledge about weight-gain and all that jazz. It's great that she now weighs more than she did at birth! And now she is almost a month old now , right? How much does she weigh now? Is your pediatrician at all concerned?

A lot of women have let-down issues at the pump. Don't be discouraged by the low amount you are pumping at each session. There was an interesting post someone made not too long ago about pumping output...remember that pumps are never as efficient as babies! It's a lot of work, but it does get better. It sounds like she is alert, pooping and peeing -- these are fabulous things!

I had horrible supply issues. At my peak, I only produced 8 ounces a day! I found out I had something called breast hypoplasia or insufficient glandular tissue. I don't think you have to worry about this degree of low supply at all.

IF (and I don't think you do, but I'll let others weigh in) you do have a low supply and need to supplement, using an SNS (Supplemental Nursing System) or a Lact-Aid will keep your daughter at the breast even while you are supplementing. HOWEVER, this should only be used when you are absolutely sure that your daughter is not getting enough and there is cause for concern. I'm not sure that you need to take drastic measures at this time.

The amount of poops is encouraging! Remember that everyone grows a little bit differently. Suggestions if you need supplements: Fenugreek and Alfalfa, but check into any adverse things first. These are in the Motherlove tincture, so you should be good to go. You may increase your supply so much that you have an oversupply, too. (Not that it sounds like you would mind that a bit .)

Kudos to you for caring so much to look into stuff. Naked time in bed (nursing holiday) with lots of skin to skin can help. A great website to check out is www.kellymom.com.

Keep us posted on your progress and just keep doing what you are doing!

Hugs,
Heidi

[babymakesthree]

Thank you for taking the time to help and the Heidi! She will be 4 weeks old tomorrow and as of Tues the 28th she was 8 lb 2 oz. We have another appt on Wed the 6th to check her weight again and since she looks healthy and is active we are just sorta playing it as we go and watching her closely. She is alert and smiley a lot of the time and fusses in the evening but as long as she is at the breast it's not inconsolable, she just fusses and pops on and off for hours some nights. It makes me think she is frustrated but maybe she is just fussy in the evening? I am totally attached to her by the boob for sometimes hours on end and at least half the day so I sit on the couch for half the day and we lay in bed the other half. I don't know if this has anything to do with her slow weight gain but DH has always been on the thin side/hard to gain so maybe she got this from Dad? In his early 20's he was 5'10" and 120 now is 165#. BTW I would love to have an oversupply..
Amber
P.S. Congrats on your impending little one!!!

[Shanana]

It's been so long now that I don't remember the weight gain "guidelines" ... but I seem to recall it being acceptable for it to take several weeks even to return to birth weight. If that's the case, then your dd is doing just great, as she has exceeded her birth weight in less than two weeks!

It is very common to not get very much while pumping. I think I was lucky to get 1/2-1 oz when I started pumping (dd was several months old at the time).

Originally Posted by babymakesthree

She seems to get very frustrated at the breast starting in the afternoon through til she goes to sleep at 11 or so.

This is the traditional "witching" hour for newborns, and your dd is still very young. My dd fussed all evening and late into the night, and cried through all her feedings at that age. It turns out she had an oral aversion due to deep suctioning done at birth (heavy meconium staining). I don't know if that might apply to you or not (you can read more about our experiences here). Even if you don't think that's the case, it is very normal for babies to be fussy at this time of night. I would guess that your supply is just fine!

[Erinok]

I had a similar prob. my son was born 9lbs 2oz, but went down to 8lbs by the time we left the hospital. we put off supplementing for a month, and had to go for weely appointments b/c my dr. was concerned. he was nursing constantly it seemed, the appropriate ammount of dirty diapers. I tried pumping and produced VERY little. after a month when he was still not at his birthweight we began supplementing. I know how you feel, I was so looking forward to nursing and I felt like I was doing something wrong. What I tried to do to keep my milk up was to pump as much as possible. he's a year old and he still nurses, but only 1x a day (at night) but that is also b/c i'm pregnant again. I'm really hoping I can avoid the formula all together with this next baby. good luck

[2 in August]

First of all hugs for you. This is so hard to have to deal with. You sound like you are doing a great job though! The fact that your baby is pooping/peeing enough and gaining wt is very encouraging. Don't worry about pumping output (I know, very cliche). But I could barely pump a 1/2oz with a hospital pump, but I would put ds back to the breast and he would suck and swallow, so the milk was there, just not coming out.

The night-time fussiness is hard to deal with but actually very common. Your baby could also be going through a growing spurt which could be causing the nurse-a-thon behavior.

If you can at all avoid it, don't supplement. It is a very slippery slope. If you have to, try a sns or lactaid. I do have to supplement. My ds was born at 6lb 14oz and dropped to 6lb 7oz and stayed there for weeks. It was only after I started giving him tiny bits of formula that he gained wt. But it took us several tries and weeks of a screaming baby to find a formula that didn't upset his stomach. When we first started it was only 2oz a day, spread out in 1/2oz increments during the day. Now we are up to 8-12oz a day. I'm thankful that it still is low, but this is why I say it is a slippery slope.

Follow your instincts. If your baby is acting in an age appropriate way, getting bigger, happy and healthy, things are probably ok. Don't let anybody force you to do something you don't want to do. My ped said that he would diagnose my ds as Failure to Thrive and have him switch to all formula if he didn't start gaining more weight. He also said I'd have an 8lb 4mo. Well, unless he was going to come live with me and physically fight me, I was not giving up nursing and my little guy is a 10lb 4mo, thank you very much!

[MaryJaneLouise]

Another for you!

Here's the guidelines for weight gain and diagnosing a low supply, plus info on herbs & domperidone:

http://www.kellymom.com/babyconcerns...ight-gain.html


Low Supply

http://www.kellymom.com/bf/supply/low-supply.html

Herbs

http://www.kellymom.com/herbal/milks...actagogue.html

Domperidone

http://www.kellymom.com/health/meds/...actagogue.html

Give the motherlove tincture a few days to work. I hope that will do it for you. Keep in touch, it's good you are keeping on top of this without worrying excessively

[babymakesthree]

Thank you ladies! Well this morning we are laying in bed, her in her diaper and me in my undies for as much skin to skin as I can get and nursing whenever she will take the breast. She is laying in my lap smiling at me and squirming as I type.
"Keep in touch, it's good you are keeping on top of this without worrying excessively" . MaryJaneLouise, I am TRYING not to worry excessively!! It is hard though. 2 in August, I am trying to not supplement, but I will do it :. I tell myself she will get as much breast milk as I can give her then if she needs some formula to grow and be healthy I will do it for her and not obsess about it to much. What can you do, she has to eat! I keep telling myself to breathe and relax that the stress does nothing for my milk supply.
Shanana, on your story! I am so sorry you and your baby had to go through that nightmare. Awen was born at home and bulb suctioned a bit as she was coming out of me so I don't think that is the case with her. She is SO happy to be at the breast, she fusses if she doesn't get it.
Erinok, still BF at a year ... I keep telling myself that we will get that far and all this will be in the past and she will be healthy and growing. It is just so hard to know what to do as a new mom and not obsess but still do everything that I can to make sure she is well taken care of.
I will keep you posted as I know more and we weigh her again this coming week. :
Amber

[alegna]

Did you have an IV during birth? If so, her birthweight was inflated.

I would say keep doing what you're doing a bit longer, work with an IBCLC and/or LLL leader.

good luck!

-Angela

[MaryJaneLouise]

Originally Posted by babymakesthree

I will keep you posted as I know more and we weigh her again this coming week. :
Amber

for your hard work! I know how hard it can be, I had to supplement at least 1/2 the calories my twins received in their first year.

Just as a clarification, I don't think anybody here is telling you NOT to supplement, if you have to. Many of us are low-supply here and have had to use SNS to supplement, when necessarry.

Don't be afraid of domperidone, I've been on it for over a year and it has really helped my supply. I've bumped the FAQ so look for it please.

If you do have to supplement, please look into donor milk? Much less dangerous than formula. Here are some links with possible leads. Also ladies in your local LLL might be able to help.

Donations:

http://www.breastmilkdonations.com/index.html

http://milkshare.birthingforlife.com/

[babymakesthree]

Originally Posted by alegna

Did you have an IV during birth? If so, her birthweight was inflated.

I would say keep doing what you're doing a bit longer, work with an IBCLC and/or LLL leader.

good luck!

-Angela

No IV. Homebirth with no interventions. (Although I got a shot of pitocin after her birth to control bleeding but that in no way affected DD)

[mamaverdi]

When thinking supplement, first think human milk....first your own, and then someone else's, and then donor milk, and then milk banked milk.

Another thing to think about is do you eat anything that decreases milk supply? Parsley, sage, peppermint, even spearmint. Some of these things can reduce milk supply.

Third, I like the LactAid better than the SNS.

Fourth, do you have LLL to contact in your area? www.lalecheleague.org

And finally, domerperidone compounded works really really well for many mothers.

[2 in August]

Originally Posted by babymakesthree

2 in August, I am trying to not supplement, but I will do it :. I tell myself she will get as much breast milk as I can give her then if she needs some formula to grow and be healthy I will do it for her and not obsess about it to much. What can you do, she has to eat! I keep telling myself to breathe and relax that the stress does nothing for my milk supply.

I am soo sorry if I made you feel bad. That is the last thing I wanted to do. I wasn't saying not to feed your baby. You are right, she needs to eat and grow. A wise momma here told me "First of all, feed the baby." It is my mantra everytime I start to get down on myself for not being able to fully bf my ds. I was just trying to say that if she is eating good, but going through the fussy night stage, don't think that you have to supplement. Also, that not every baby has to be the biggest baby (not saying you feel this way, but I know I got/get a lot of pressure from everyone from his ped to little old ladies in the grocery store about him being small). I give my baby formula every couple of hours (after almost every nursing session). If I don't, he doesn't grow. That's why he's so small now, because I held out as long as I could before giving him formula. But he is very alert, smiling, happy, starting to roll over, stands up only holding onto my thumbs for balance, etc so even though he is small, he is totally normal. It is a rollercoaster for me. I hate every drop of formula that goes in his mouth and yet I am grateful for it because who knows how sickly he might be if he only had to depend on my low milk supply. Again, I am deeply sorry for making you upset, please accept my apology.

[mamaverdi]

"First, Feed the Baby" comes from Linda Smith. She is a famous and WONDERFUL and : IBCLC.

[babymakesthree]

Originally Posted by 2 in August

I am soo sorry if I made you feel bad. That is the last thing I wanted to do. I wasn't saying not to feed your baby. You are right, she needs to eat and grow. A wise momma here told me "First of all, feed the baby." It is my mantra everytime I start to get down on myself for not being able to fully bf my ds. I was just trying to say that if she is eating good, but going through the fussy night stage, don't think that you have to supplement. Also, that not every baby has to be the biggest baby (not saying you feel this way, but I know I got/get a lot of pressure from everyone from his ped to little old ladies in the grocery store about him being small). I give my baby formula every couple of hours (after almost every nursing session). If I don't, he doesn't grow. That's why he's so small now, because I held out as long as I could before giving him formula. But he is very alert, smiling, happy, starting to roll over, stands up only holding onto my thumbs for balance, etc so even though he is small, he is totally normal. It is a rollercoaster for me. I hate every drop of formula that goes in his mouth and yet I am grateful for it because who knows how sickly he might be if he only had to depend on my low milk supply. Again, I am deeply sorry for making you upset, please accept my apology.

2 in August you did not upset me and you don't need to apologize!!! If I came across snarky at all it was not meant toward you, it was at my situation. Goodness, I know you are only trying to help me and I would never be upset over that. I know you of all people can understand how frustrating it can be and I am sorry you thought you upset me. I know exactly how you feel about having mixed feelings about formula. If I need to use it then I am grateful that I have it available to make my DD grow and be healthy but I hate that I may not be able to give her everything she needs with my milk. I know she is getting all that she can from me and I am grateful to be able to BF her at all. I love it because I feel so close to her when she is at my breast. :
I know donor milk would be the best if we do need to supplement but I don't think my DH would go for that. (BTW next on my list to try is the domperidon if she isn't gaining when we go weigh her on Wednesday) And he would be doing all/most of the supplemental feedings because I don't want to be the one to give her a bottle. I am exactly the opposite of upset with you. I am in awe that you found what works for you and your DS and if I need to give formula then I am curious how you make things work and what you use. I am so glad he is hitting his milestones and is healthy and happy.
I know that not all babies need to be in the 90th percentile to be healthy but it is so hard when she only gained 3 oz in 12 days. She may take after my DH and have a hard time gaining weight so I am not ruling out yet that it may just be how she grows. I am keeping my fingers crossed and hoping that what I am doing so far is helping. I made DH smell my sweat last night because I am starting to smell like maple syrup from the fenugreek in the milk plus tincture I just wanted to really say thank you for caring about us and trying to help. I am not upset with you at all! Here are some pics of us on her birthday and today she is a month old YAY!
http://share.shutterfly.com/action/w...AZNGTlszcs2LiI

Peace and Love,
Amber

[MaryJaneLouise]

Oh Amber, what a sweet girl! Makes me baby-hungry all over again! : :

[babymakesthree]

Originally Posted by MaryJaneLouise

Oh Amber, what a sweet girl! Makes me baby-hungry all over again! : :

Thank you!!

[babymakesthree]

update

My DD is up to 8lb 4 oz now. That means in the last 8 days she gained 2 oz. Slow but steady.. She gains an oz every 4 days. I also have a milk donor and my DH is on board with it! So I think I am going to supplement a bit and pump even more to boost my own supply as much as I can. Everything I read says 4 oz a week is the low end of average for BF babies. How much should I supplement??? A few oz? How often?? Thanks!
Amber

[2 in August]

Oh Amber you don't know how relieved I am that you aren't upset with me. Your dd is sooo cute!

I use a Haberman feeder for his bottle. At first it was to improve his sucking, but I kept using it because I like that the milk/formula doesn't just run out. It has variable flow based on how I put it in his mouth. I started with just a half an oz. It's great that you can get donor milk. Now you don't have to worry about formula intolerances.

Keep us posted!

[babymakesthree]

Good News!

DD gained 5 ozs in 6 days!!!! OMG I can't begin to tell you all how relieved I am. She is up from 8 lb 4 oz on last Wednesday to 8 lb 9 oz today and she is 22 inches in length now up from 19.5 at birth. I am not sure why she was gaining so slowly but I am glad she had a growth spurt. And it was all me, I hadn't gotten any milk from my friend that was going to donate to us because she has been sick. So it looks like I don't need to supplement after all! I just need to keep doing what I am doing and take fenugreek and blessed thistle. :