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Discussion Starter #1
There's been discussion in another thread about low supply & the reasons for it, and it made me wonder ...<br><br>
How do you know if you have low supply or supply problems? What's the tip-off?<br><br>
And who decides if it's a supply problem, the mother or the doctor or the lactation consultant? And if it's a doctor, is it an OB/GYN or is it a pediatrician involved in the decision and treatment?<br><br>
And what sort of things can you do about it *before* starting to supplement with formula or whatever else (which supplementation itself is most certainly going to cause more supply problems)?
 

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Discussion Starter #2
So no response to this thread yet <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/headscratch.gif" style="border:0px solid;" title="headscratch"> ...<br><br><br><br><br><br>
But I saw elsewhere a comment about diapers in a just-born-newborn not being wet for a day.<br><br>
You know, my DD didn't wet a diaper, nor did DS#2, in the hospital. They passed that gross meconium stuff (man, is it gross) but I didn't see anything wet. They also lost weight in the hospital. Left the hospital weighing almost two pounds less, each of them.<br><br>
I didn't say a word to anyone, figuring how much weight or pish could colostrum inspire?<br><br>
And on top of that, I was tandem nursing, and nursed the older sibling while in the hospital, and didn't want anyone to tell me to stop ... and it did occur to me that if I said anything about the dry diapers, they might do just that.<br><br>
And it seems to be that supplementing from day one ... even if it's just dropperfuls of formula or water ... <i>is going to decrease supply</i>, whatever that supply may be ... because from day one all they're nursing is dropperfuls of colostrum.<br><br><br><br><br><br><br>
Oh, and no, I don't think I endangered my babies by not mentioning dry diapers to anyone. They were passing that other stuff out the back, and they were nursing, and all other things seemed normal ... so that was a judgment call.<br><br><br><br><br>
So again I ask, how does anyone know they have a low supply?<br><br><br><br><br><br><br>
(I truly don't remember with DS#1. Not that it was so long ago, but I was so nervous that I just have no clue what anyone said or did about diapers except for showing me how to change them ... <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/ROTFLMAO.gif" style="border:0px solid;" title="rotflmao"> ... though I do remember that he also was almost two pounds less in weight, and that upset us, but the pediatrician told us that was 100 percent normal.)
 

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Discussion Starter #3
Am having my own private thread, I guess ... :LOL<br><br><br><br><br>
Anyway ... just feel the need to clarify that I am not not not attacking or challenging anyone who has low supply or supply issues. Not at all. And I don't doubt or question any of anyone's choices.<br><br>
Plain and simple, I'm just interested in how the decision was arrived at, and when interventions began ...
 

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checking in because I'm curious...
 

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me too...<br><br>
had to laugh at ur 'own private thread ' comment.lol
 

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<div style="margin:20px;margin-top:5px;">
<div class="smallfont" style="margin-bottom:2px;">Quote:</div>
<table border="0" cellpadding="6" cellspacing="0" width="99%"><tr><td class="alt2" style="border:1px inset;">But I saw elsewhere a comment about diapers in a just-born-newborn not being wet for a day.</td>
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ummm, i guess that was me. just to be clear, the whole stiry is that <i>that</i> comment was about my 2nd dd... given my history of low supply, it was a concern.<br><br>
here's <a href="http://mothering.com/discussions/showthread.php?s=&threadid=101528" target="_blank">my thread</a> on what's up with me now.<br><br>
here's <a href="http://mothering.com/discussions/showthread.php?s=&threadid=88005" target="_blank">Lisa_Lynn's</a>
 

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:LOL at your thread w/ yourself...nak or would have replied sooner<br><br>
nak<br><br>
I have never had low supply issues, but I have had a dr tell me I needed to use formula (for toddler ds when he was a baby due to medical problems that were causing him to not gain weight)....I decided to seek advice from other drs instead and did have to pump exclusively for 4 months (when he was 2 months until he was 6 months), but then we were able to go back to nursing.<br><br>
With baby ds, he lost over a lb before leaving the hospital, but has gained continually since and is now somewhere between 25 and 30 lbs at 8 months <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/jaw.gif" style="border:0px solid;" title="dropjaw"><br><br>
 

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Discussion Starter #8
Thanks for the links, bananasmom ...<br><br><img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/hug.gif" style="border:0px solid;" title="hug"><br><br>
& wishing you & your little one lots of luck & light ...<br><br><br><br><br>
If you don't mind me asking, when did you know about the supply situation with your first? And how did you know?<br><br>
And if you don't want to reply further, I'll stop nudging, I promise ... <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/smile.gif" style="border:0px solid;" title="smile">
 

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My pediatrician said the wet diapers thing wasn't neccessarily the key sign, rather just check the baby's skin to make sure he's hydrated (pinch a little skin and make sure it bounces back a certain way - evidently the skin of a dehydrated person is very distinctive)<br><br>
My babe wasn't back to his birthweight till 5 weeks after he was born. He lost 10% or so and then was just putting it back an ounce at a time, very slowly. So I kept have Dr's appts and eventually lactation consultant appts.<br><br>
Of course I did assume my supply was low, I was a new confused mama, didn't feel let-down, didn't hear swallowing. But now I'm not so sure it ever *was* low. I think maybe everything was normal and some babies just take that long to get back to birthweight. Of course you have to be vigilant and follow the situation closely -- and the baby has to gain, not continue to lose --but my son was healthy and my supply probably did increase quite a bit- but IMO it was enough, all he needed, even in the first few weeks. At the time I didn't think so, of course.<br><br>
I have to give him credit, my ped. did not push me to supplement, even with such slow weight gain. He was reassuring and great. I really appreciated that. And he's not some young New Age doc - he's pushing 60 yet was informed enough to support breastfeeding to that extent.<br><br>
Anyway - just to say that supply issues are often a matter of perception, for sure.
 

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Oh one more thing. merpk, you're asking how does one know.<br><br>
I did feel that milk was just not coming outbut how would a new mom know what that feels like?). You read in Nursing Mother's Companion, et al that you hear swallowing, see the baby's jaws and temples moving and see a pause after babe opens his mouth in the sucking motion.<br><br>
also I remember reading that the baby will sink into blissful satiety with milk possibly dripping out of its mouth. That was so far from my experience. Oh, and that your breasts leak milk - didn't happen to me, and it doesn't have to happen for enough milk to be there. But it's hard when everyone is talking about breast pads and waking up soaked from milk<br><br>
When you don't see any of those signals and there's no gain, one jumps to conclusions.<br><br>
I think even a lot of lactation consultants don't know that those things don't all have to be present. My son went on to gain well and was exclusively breastfed for 9 months. I"m positive that most women would have gotten the advice or decided to supplement, which would have adversely affected their supply and confirmed their worst suspicions.
 

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NAK<br><br>
A IBCLC at kaiser checked ds's weight on day 3. He had lost 13% of his weight (she said they didn't like to see over 10% of a loss), & was jaundaced (which she said was from not enough liquids). I also had a "feeling", my milk never came in, ds would nurse for 7 hours straight and would still scream bloody murder. He also stopped peeing very much at all. It was all of those things combined.<br><br>
At first the supplementing via the SNS was "just until my milk came in". Well, it never did. I was never engorged, never even "full" feeling (until one night when ds slept for 6 hours within the last month, after I stopped supplementing).<br><br>
What was a catalyst in getting him off the supplements (esp the SNS) was feeling like I was useless and couldn't even get him through one feeding with just my milk. I started not using the SNS at night and mornings. Ds would just stay latched on all night, and I was ok w/ that & could sleep. Then my mornings we could go for 2 hours, then 4, then on and on until he was only getting supplemented @ night, just an ounce or two at a time.<br><br>
I think nursing all night was really what got us to 100% breastfeeding. But anyways you didn't ask for all of this, but I just had to share my whole story I guess! :LOL
 

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<div style="margin:20px;margin-top:5px;">
<div class="smallfont" style="margin-bottom:2px;">Quote:</div>
<table border="0" cellpadding="6" cellspacing="0" width="99%"><tr><td class="alt2" style="border:1px inset;">If you don't mind me asking, when did you know about the supply situation with your first?</td>
</tr></table></div>
day 4. i was a first timer, and just nursed around the clock. she cried every second off my breast, which drove me nuts, but i just kept nursing. it was the dehydration (and urate in her diaper) that got things rolloing the other way.
 

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Here's my experience for what it's worth:<br><br>
Everyone (LCs, midwife, ped, OB doc, nurses) told me I *had* to supplement in the hospital. Why did they do this? Did my dd lose tons of weight? Did she not wet or poop on any dipes?<br><br>
No, she just was 10 lbs, 9oz.<br><br>
She was latching great, she was pooping and peeing like a champ, and she lost 10% but that put her at 9lbs14oz at 5 days old! Still, everybody told me I had to supplement, so we did so we could go home from the hospital, and I truly believe it screwed her up. She slept lots and we had to wake her to nurse, but when we stopped supplementing (as soon as we got home), she started nursing more. Go figure.<br><br>
I was told I had low supply when she was a week old and had stayed the same weight that she left the hospital at by this horrible, insensitive, yucky, ped. And that I immediately *had* to supplement, or else. How horrible for a new mom to hear. I cried and cried.<br><br>
DD didn't gain any weight (nor did she lose any) for a month. Finally, my new, wonderful ped, who was monitoring her closely and prounouncing her healthy in all other ways, told me to give her a few oz of EBM (or formula if I couldn't pump enough) a day to get her over the edge, and to keep nursing all the time. She finally gained her birth weight back at 6 weeks old (but remember, her birth weight was really high).<br><br>
My ped and I figured out that since I had IV fluid for 50 hours or so before she was born, and then more pushed in (C-section), she was grossly bloated by water retention. So he was fine with her not gaining, as long as all the other criteria were there. Yes, it was horrible, yes, we had to weigh her every five seconds, but it was not the insane crisis that my first (nasty) ped made it out to be. I have no doubt that if I hadn't called LLL crying and they gave me the name of the other ped, I would be a mom who was ff because my ped had no clue about bf babies.<br><br>
I'm still angry about the first ped, and dh occasionally urges me to write them a letter, but I don't think it would do any good. But I do get sick to my stomach whenever I think of him whipping out a bunch of formula from the back, instantly, because my week-old baby "only" weighed nearly 10 pounds.
 

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Discussion Starter #14
Lisa_Lynn, I did ask for it. Thanks. <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/smile.gif" style="border:0px solid;" title="smile"><br><br>
And thanks for the explanations, too, bananasmom & everyone else.<br><br><br><br><br><br>
Agreeing about a lot of folks thinking that if they don't have all the signs that "The Womanly Art of BF'g" talks about, then they must not be successfully BF'g.<br><br><br><br><br>
It's all a lot of confusion and mixed signals in some cases, I think.<br><br>
Nursing constantly is a common theme in newborn life, though, and I've known women who thought it meant they weren't producing enough milk to satisfy the baby ... DS#1 was like that. I'd be in one place for 3, 4, even 5 hour stretches, and when putting him down just to get the circulation going and go to the bathroom, he would absolutely scream. At bedtime he latched on, and didn't de-latch till the sun came up (though he was like that for two whole years, truth be told ... & how we found an opportunity to bring DD into the world we still don't know <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/ROTFLMAO.gif" style="border:0px solid;" title="rotflmao">)<br><br>
It's all confusing to me, because I have known several women who insisted they couldn't nurse ... one being the mother of my new nephew ... and in each case it just seemed like their situations weren't so different than mine, but their doctors were. Which is why this disturbs me and has me nudging y'all with this thread.<br><br><br><br><br>
There is one woman I know who tried desperately and couldn't nurse at all and was absolutely heartbroken ... but she won't discuss it, so I can't post the details.
 
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