I'm totally new to this forum, I was recommended to come here by someone on another forum because of how knowledgeable you all are over here, and I am so desperate for advice and encouragement right now!! I sat and cried through the "low supply" thread, because I think that may be my issue again, but I have some other questions as well...

I'll spare the long details, but my ds is 2.5 years and was never a good nurser; I definitely had low supply and ended up pumping after every feeding, supplementing with formula etc. until he was 5 months old and the whole schedule along with working FT plus my Mom having medical issues became too much and I quit.

Now dd is 4 weeks old, and while things are better, they're not great; she was jaundiced and back in the hosp for bili lights (as was my son) and I had to supplement her during that time, but she was gaining weight so well as of a week ago with bf and supplementing only on demand (i.e. after I'd nurse for an hour + and she still acted like she was starving, so 1-2 oz 3-4x/day) I tried going without the supplement... In a six day period with supplements "on demand" she gained nine ounces... in the last week of bf only she gained only one ounce.

I'm extremely sad and discouraged because I FELT things were going so much better. This girl is happy, alert, and very content; she does get a little fussy in the evenings but I think that's normal? I nurse her WHENEVER POSSIBLE, even when she's not asking for it, I put her on the boob. I learned my lesson with #1, and I figure the more she nurses (even if just for comfort), the better stimulation and thus supply etc. Here's the thing; she'll get on, suck and I hear her gulping, then she will often just stop and hang out there, sometimes doing nothing, sometimes, just very softing sucking, but I don't think she's *drinking*. I can hand express milk or do breast compressions to get her going again, but when that milk is gone she stops. If I take her off the breast she's looking for more, so she obviously wants to eat more... Here's another mistake I've made: (and another reason I thought things were going great!) she sleeps so well at night! Initially I'd wake her every 3 hours to feed, but in the last week as she's over birth weight finally I let her sleep when she went 6.5 hours!! Now - if she's not getting what she needs, why would she sleep that long? (BTW, now I'm waking her up at night again.)

I do not want to have to get the pump back out if I can help it. I'm willing to nurse her 24-7, but she just doesn't do it! My LC was not very encouraging today, she said by one month babies usually have the nursing/sucking down, and if she's not keeping up with that she didn't really have anything to offer me, unless I wanted to try the SNS again.

Note: on some occasions dd will nurse well...it just depends, but is frustrating when I know there's milk in there and she won't get it out, then I worry about my supply if I'm not being emptied.

BTW, I'm taking Lactation Blend, drinking Mother's Milk Tea and water by the gallons, eating as much as I can including a higher fat diet... I was taking fenugreek prior to the lactation blend, but as fenugreek is in the "blend" I just took that... I think I'll try taking them together, think that's ok?

It is very possible that I do have low supply as I definitely did with ds, but now I'm confused and think too that it just may be that she is not very efficient at getting the milk out. When pumping a week and a half ago before I stopped if she hadn't just eaten I'd get just about 2 oz total (at least 1.5 each a.m.) which I think is pretty good!? In the evenings however my breasts feel very empty, I feel like there's nothing there for her.

Is it possible she's still "getting the hang of it?" Is it possible I weaned too quickly? If you think that's possible, should I give her some supplement once-twice a day for now? I hesitate, because then I KNOW she won't nurse as often. I just don't know what else to do... I feel exactly like someone said in another thread, trapped in my house, not able to do things with my older ds because I can't stray far without my pump and if dd is even remotely willing to go on the boob I want her there... does this sound like low supply or a baby/nursing issue, maybe both?

And - why would she be so content if she's not getting what she needs?

Oh - she is wetting, but I question if her diapers are wet enough, and her stools are definitely less in number and amount compared to last week with the supplements, she probably gets 2 small yellow stools/day.

This is depressing. PLEASE help me! Sorry this post is so scatter-brained.

Just want to add: I do realize that yes, at least she gained an OUNCE and didn't lose and that it is still very early, but I am still so emotional over how things went last time with ds - I want to correct this NOW before it's too late if that is at all possible. I'm also so afraid she won't gain by next Monday and the ped will make me go back to supplementing (which could very well happen regardless.)

:Hug You sound stressed.

I'll try to post more later when I have more time. Can you see a different LC? They are not all the same, and not all are competent :( Can you also meet with a LLL leader, sometimes they have more insight than some LCs.

If you really think this is a "suck issue", ask your LC (old or new) if a referral to an occupation therapist or speech therapist will be helpful.

Keep up the breast compressions, wake her up at night to feed, try the shatavari herb and/or domepridone if you think it a supply and not a suck / transfer issue.

:hug This sounds very stressful, and you are trying so hard! TBH, the first thing I would do is consult a different LC - I didn't realize I was having supply issues until DD was 4 weeks old, and my LC did a LOT more than shrug and mutter "maybe an SNS"! That's so unhelpful!!

Re: the weight. An average rate of gain is 4-7 oz./week, so yeah, gaining 1 oz. this last week and all the other indicators you mentioned - basically, you feeling like she's still hungry after an hour of nursing - does make it sound like baby is not getting enough milk.

I agree with everything PP said... And wanted to add that while I understand your feelings about the pump, if you think baby is not emptying your breasts, it will be MUCH better for your supply if you pump, and probably better for baby's growth while you work on a longer-term solution.

I do know the pain of nursing sessions that can go on for hours because baby is still hungry and then having to pump afterwards anyway! An LC expert in low supply told me that as long as I fed often, like every 2 hours, I could limit time at breast to 30-45m and then pump, so that the whole feeding routine only took 45m-1hr total. This really helped me prevent burnout! (ETA: Not that I was on a schedule, but that I really tried to give DD a full enough tummy that we could both have a little time and energy for something other than nursing - like sleep!)

There are also different ways to offer supplement. I have used the SNS for 10+ months, and it saved my breastfeeding relationship, so I'm a fan! I gave enough supplement and used a tube wide enough that DD could finish eating in 30-45m. But bottles used carefully can work, too. If baby is too hungry to suck effectively, you could offer a small amount of supplement BEFORE nursing (At least 0.5-1 oz LESS than you usually offer at the end of nursing, to make sure she's hungry enough to nurse still). One additional benefit to that strategy is that baby experiences satisfaction and fullness at the breast rather than bottle. Of course, supplementing at the end can work, too.

:Hug You sound stressed.

I'll try to post more later when I have more time. Can you see a different LC? They are not all the same, and not all are competent :( Can you also meet with a LLL leader, sometimes they have more insight than some LCs.

If you really think this is a "suck issue", ask your LC (old or new) if a referral to an occupation therapist or speech therapist will be helpful.

Keep up the breast compressions, wake her up at night to feed, try the shatavari herb and/or domepridone if you think it a supply and not a suck / transfer issue.

:yeah:

My lo is 7 weeks and we're struggling through the same thing. I think a new lactation consultant is definitely in order! Mine is encouraging even when she doesn't have a new trick up her sleeve!

I'm on the domperidone and it has done wonders for my supply. We're currently weaning her from 4oz/day of supplement to 3 oz/day and we're going to see how her weight gain goes. I think the supplementing helped tremendously as she needed the weight to make her a more efficient nurser.

Also- we saw a chiropractor who used craniosacral therapy to help improve her sucking. I saw it change with my own eyes and it improved her efficiency remarkably.

Good luck mama!

Erin - I was kind of thinking the same thing, that the supplementing would help make her stronger and thus a better nurser, and that definitely helped in the beginning. I'm really wondering if maybe I weaned her too quickly, she probably needs some supplement still. I think I was in such a hurry to get off of it because of my history with my son, and I just figured that if I nursed and nursed and nursed her she would stimulate the milk needed and all would be good.

I'm really not sure if it is a "suck" issue; She sucks nicely when she sucks, but she just STOPS, even when I KNOW she should be hungry. She'll stop and just sit there...but if I take her away from the breast she goes crazy. Put her back on and she'll suck for 15 sec or so then stops... (this all usually happens after approx 3-5 minutes of "good" nursing.) And it could still be my supply... I feel so confused at this point! I felt so prepared coming into the birth of this baby with my experience and all that I'd read since, etc. and I feel so new at this all over again.

I don't know where to find another LC...I know there are a couple LC's at our hospital that do it part time but are technically OT's, but what do I do, call and ask to speak with someone other than the one who's been helping me? I feel really funny doing that, I don't want to make the LC feel bad... Is there someplace else I can find one? Even just someone to talk to on the phone would help, because I don't know where else I'd find one locally.

What city / part of the country do you live in? maybe someone could recommend a new LC

Grand Forks, North Dakota!

If there is a children's hospital anywhere near you, I would try to see their LC and their occupational therapist. Perhaps they could both see you on the same day, if you have to travel. Those folks should be more versed in dealing with helping the baby do what she needs to do!

I had both issues, neither of which ever got fixed. One of the things I wished we had done different is keep going with the supplements longer, while still being careful to pump and keep my supply going of course. When my milk finally came in, we all thought, OK, everything's swell, baby will get my supply up. One week later, baby gained zero ounces and we were back on supplements anyway. I think if we had kept going, baby would have gotten stronger sooner.

I'm not trying to be discouraging, just wanted to share what didn't work for us. You're already pumping more ounces than I do now sometimes, keep up the good work!!

I'm sorry you're having such a stressful experience.

I'm a low supply mama with late milk onset who has had to deal with supplemental feedings with all three children. First time destroyed my supply and our nursing relationship. Next two times we got off supplements and EBFed. It worked somewhat like a growth spurt does in non-challenged nursing relationships. Baby fusses, wet dipe and stool count might take a temporary dip, weight gain stalls while your body bumps up it's supply to the "new normal" etc. I had to learn not to pull out more supplements every time baby fussed. It's a fine line. And much easier to walk if you're being advised by a good lactation professional or LLL leader.

I doubt the answer here would've been more or earlier supplements. IMO, for most mamas, earlier and/or more frequent supplementation only leads to continued low supply issues. Especially if the supps aren't at the breast.

Are you using an SNS? That would be a good first step.

But most importantly, find someone other than that LC to help you.

And consider some chiro and/or craniosacral adjustments for your baby. That can be really helpful with latching issues.

I'll pm you some North Dakota contact info....

Strength and major milk vibes to you!

I had to pump after every feed and use the SNS for 6.5 weeks in the early days when ds would not regain his birth weight. I had the supply, he just wasn't transferring milk well. It took him 6.5 weeks to get the hang of things. I never let him go more than 3 hours at night. I used a cold wet wash cloth to keep him going. :o

And consider some chiro and/or craniosacral adjustments for your baby. That can be really helpful with latching issues.

:yeah: I agree with the CST for some latching issues. Also consider a tongue-tie that would make milk transfer more difficult. Sometimes they are hard to spot, especially if not 'classic'.

:hug best wishes for better milk transfer!