How soon after birth should I supplement? (IGT)

[Taryn237]

I have PCOS and IGT, I had a ceasarean with my son, he was losing a lot of weight, started supplementing at 2 weeks but it took him a long time to get
back to his birth weight. I ended up producing 10-12 oz. a day for him and supplemented the rest with formula from an SNS.

This pregnancy I'm taking Metformin and herbs to try to increase my supply.
I have 300 oz. breastmilk in my deep freeze from a friend and milkshare if I need it. I'm hoping to have an exclusively bf baby between me and donor milk.

How long should I wait for my milk to come in?

How will I know when I need to start supplementing?

(I'm having a VBAC so without being pumped full of fluid and drugs I
hope it will come in quickly.)

[momongeon]

Originally Posted by Taryn237

I have PCOS and IGT, I had a ceasarean with my son, he was losing a lot of weight, started supplementing at 2 weeks but it took him a long time to get
back to his birth weight. I ended up producing 10-12 oz. a day for him and supplemented the rest with formula from an SNS.

This pregnancy I'm taking Metformin and herbs to try to increase my supply.
I have 300 oz. breastmilk in my deep freeze from a friend and milkshare if I need it. I'm hoping to have an exclusively bf baby between me and donor milk.

How long should I wait for my milk to come in?

How will I know when I need to start supplementing?

(I'm having a VBAC so without being pumped full of fluid and drugs I
hope it will come in quickly.)

It should take any where from 2 to 5 days depending on the details of your birth. My advice is to put baby to breast with every cue. Sleep with the baby close to you and stay skin to skin as much as possible until your milk comes in. If you feel like it is taking too long for your milk to come in or if the baby is losing too much weight you can try to pump in between feeds.

You will know if the baby is getting enough by the amount of wet diapers he/she has. Day one (the day after delivery) they should have 1 wet diaper and every subsequent day they should have one more than the day before until about day six. They can get there faster if your milk comes in sooner. If the baby is peeing six to eight times a day it is safe to assume he/she is getting enough. Many docs will use 10 % as the weight loss limit befroe starting to supplement. It really depends on how conservative they are. Here they are pretty conservative.

It is great that you have so much stored milk. If the baby is not peeing enough or gaining enough weight (usually they like to see .5-1oz a day) despite every effort to increase your supply I would definitely start supplementing as early as necessary. The rule of thumb is not to supplement until 2wks or so to insure adequate milk supply. This may not be the rule you should follow b/c your situation is different. You are already armed with experience. That is half the battle. GL

[justthinkn]

I would work with a LC from day 3-5 to assess weight gain/loss, and weekly thereafter. I would also have your SNS ready to go, just in case. This is me, anyway - next time, baby will not go hungry - I'll supplement at the breast and pump, but baby will not go hungry!

All the best wishes.

[thepeach80]

I'm trying to remember. I know Evan got his first bottle the day we came home (so 2 das), that night b/c he had been bfing well and often, but had brick dust in his diaper which meant dehydration so I felt better giving him a bottle to help. I would just watch that first week and see how it's going. Ilana did great the first few wks w/ no supplementation so I continued and she was basically FTT by the time the DR told me I should try and supplement at 4 mos. I felt awful b/c I thought I was doing good that time.

Were you on metformin your last pgcy? Do you think it's helped at all so far, can you tell a difference? What herbs are you trying? I'm really hoping to jumpstart things this time BEFORE baby comes in hopes of having a good supply.

[Taryn237]

Originally Posted by thepeach80

Were you on metformin your last pgcy? Do you think it's helped at all so far, can you tell a difference? What herbs are you trying? I'm really hoping to jumpstart things this time BEFORE baby comes in hopes of having a good supply.

With DS I took Met for the 1st trimester. Now I'm planning on taking it until 36 weeks and then starting a Goat's Rue tincture (there are very few studies on Met throughout pregnancy but it has been shown to contribute to jaundice which is why stopping at 36 weeks is advised).

I just started taking alfalfa, nettles, dandelion root, and red clover. You take one for a week and then switch to the next, and repeat. So you are only taking one at a time. I am not a tea fan so I've been taking the herbs in capsule form. They are pretty cheap from vitacost.com ($3 a bottle). I have not been able to find oat-straw. Once I hit 38 weeks I think I will take alfalfa every day and alternate the rest.

I have noticed my breasts are a little fuller when taking the herbs and I'm producing colostrum now but I don't really remember much about them from DS so I can't tell if it will be different this time or not.

From http://www.mobimotherhood.org/MM/article-herbal1.aspx :

Herbs to promote health and glandular tissue during pregnancy
The herbs recommended for pregnancy are selected for their wealth of vitamins and minerals, their vitamin K and their folic acid. Some support the mother's liver and kidneys. Others may maximize the development of glandular tissue.

Take the herbs listed below regularly, starting at mid-pregnancy when the breasts begin preparing for lactation. These herbs can be mixed together (“Combinations”) or alternated as single teas (“Singles”) every one or two weeks. Taking “singles” prevents the body from becoming insensitive to an herb, or from getting too much of any one herb, and is preferred by some herbalists. If you prefer combinations of two or three herbs, alternate these every few weeks.

alfalfa leaf • dandelion leaf • nettle • oat-straw • red clover

Infusions for pregnant women

Infuse one ounce or two handfuls of the herbal mixture in a quart jar for several hours or over night.
Warm each cup and sweeten with a natural sweetener if desired before drinking.
To avoid developing an over-supply of milk, reduce your intake of these herbs —especially alfalfa—about two weeks before your due date unless you have a history of low milk supply with a younger baby, or have good reason to suspect that you will have low milk supply.

If you drink red raspberry leaf tea in addition to this program, introduce it slowly (see MOBI Herbal section on red raspberry tea).

[thepeach80]

Do you have GD or any signs of insulin resistance? I'm starting to show signs and am curious as to what my DR will say about my #s on Monday. I was taking my #s instead of drinking that nasty drink. Most of the herbs that are generally given for low supply carry a warning for diabetics. Maybe I should start a whole post on this and see what people say.

[Taryn237]

I don't think I have GD but I just took the test on Thurs., no results yet. I didn't have it with DS. I just had to drink OJ so it wasn't bad.

[thepeach80]

I've never had problems w/ the other kids too, surprise for me! I'll ask on the GD thread and see what others say. Good luck on your VBAC, it was the best decision ever for us! We're working on VBAC #3 this time.

[katheek77]

There was a small study that showed that a hospital-grade pump, used or ten minutes after every feeding, was shown to significantly increase milk production by the end of the first month in women with IGT. It might be worth a shot to have one rented for the first month at least.

[Cory]

Taryn I am due in mid-feb and we are attempting a vbac too! I also have IGT. Thank you so much for posting the info about those herbs. I have been meaning to start alfalfa and now I am going to make sure that I get some this week. I would like to try the other herbs as well. I have never heard of taking herbs on a rotation. I've always just taken everything at once. I'll have to look into that more.

As far as when to start supplenenting I think the advice you've had is pretty good. With my ds I didn't know about my low milk until he was a week old and he had already lost a ton of weight by then. With dd (who was my c/s baby) I supplemented at 2 days old. I did that because she had been nursing constantly since birth and was starting to act like my ds did when he was dehydrated. I used a syrenge with her because I had learned a bit since ds and I was really trying to get my milk up. After a week or two she was nursing and then getting a bottle at every feeding.

With this kiddo I am trying to do better. I have a Lact-aid this time for supplementing. I am going to take Goat's Rue and Shatavari in my last trimester, as well as after baby is born. Going to add some alfalfa and maybe some of those other herbs you mentioned soon. I am also going to take Fenugreek and Blessed thistle after baby comes (making my own tinctures). And I bought a baby scale so I can weigh baby and hopefully judge better when to start supplementing.

I don't know if anyone can say at what age you should start supplementing. My understanding is that most IGT mamas have more milk with each kiddo. I had more with dd than with ds (not sure how much i made with either of them). A gal I used to know who had IGT had about 3/4 of an ounce each feeding with her first, but her third she was able to EBF for the first 3 months! (she weighed her third every day and watched his diapers and every thing very closely.)

I guess my advice would be to look into renting or buying a baby scale and watching baby's weight closely. And keep on with all the other things you're doing. Good job mama!

P.S. Can you tell me what brand and dosage of the Alfalfa, nettles, etc. you are taking?