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Overcoming low supply/ineffective suck

1762 Views 7 Replies 4 Participants Last post by  williamsmommy2002
Greetings Y'all,

I'm looking for help from moms who have overcome low supply/ineffective suck issues.

My son is about six weeks old, and my supply dropped dramatically around 8-9 days postpartum because he was not sucking effectively, and it was hard to get him awake or keep him awake for feedings. He'd suck for an hour and only get a little bit of milk. We had his frenulum clipped at 5 days, then the LC noticed that his palate was high, and he wasn't maintaining good suction. The ped said that palate was not too high from a clinical standpoint although it might be high enough to affect breastfeeding. Then the LCs recommended an occupational therapist because they had helped us all they could. The occupational therapist thought his chin was recessed and that might be causing the pain on my nipples. Sometimes it seems like he's thrusting out with his tongue and clamping down on breast with his gums--which hurts and prevents him from getting any milk. I've recovered some of my supply, but he's still not getting milk effectively from my breast. Every time I think he's got the hang of it and relax--pump less and nurse more, my supply seems to drop a bit.

From the supply side, I've been taking Domperidone (20 mg 4x/day) until last week when I started weaning back to 3x a day. Fenugreek & blessed thistle 3 caps 3x/day and Traditional Medicinals Mother's Milk Tea. Also, I've been drinking lots of water, eating a heaping bowl of oatmeal every day and pumping. I'm pumping 6x a day most days with an Avent Isis. I'm also trying a Whittlestone Breast Expresser but am so far unimpressed. I had the hospital grade Lactina, but I get more milk and better letdowns with the Isis. Just wish Avent would make a double electric--my hands are worn out, and it takes so long to do one side at a time!

I've got enough milk back that I haven't supplemented formula in almost two weeks, but I still don't feel like my breasts are filling up as fast as they should. On a few occasions, I've felt fullness or engorgement, but often after several hours there seems to be little milk. When ds #1 was this age, a few hours would get me overflowing breasts...The LCs think my son might get the hang of suckling more effectively if I managed to get a really robust supply going...

I think the most important thing is probably to keep the stimulation going with lots of pumping.

Anyway, it's all been pretty stressful, and I have weepy periods and optimistic periods. I'm looking for stories of how you overcame similar issues, whether or not youever got back to just nursing without supplements and pumping, and how long did it take. Also, anyone have data on serum prolactin levels and domperidone? I inferred from a post on Dr. Hale's forum that if your prolactin levels arehigh enough, domperidone isn't indicated/likely to help. Anyone know what amount is high enough?

Wombat, how did you get from low supply to oversupply? Oversupply sounds pretty nice about now...

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I did it! My oldest DD was tongue-tied, but I couldn't find a doc to clip her tongue. By the time I sought professional help, I had no milk supply left at all. I pumped and pumped and pumped, and finally got my supply to meet her needs, but she still couldn't nurse effectively or stimulate a good supply.
We'd have good days and bad days, but eventually the good days started coming more and more often, and at about three months, she quit taking supplemental bottles altogether.

Yes, it was very hard work. Probably the hardest I've ever worked for anything in my life, but it was so worth it!

Here's my breastfeeding story:
If you have any specific questions, please feel free to ask me anything, anytime! I found the support at MOBI to be invaluable. Without the wonderful ladies there, I don't think I could have kept trying as long as i did to make nursing work.
Wow sounds like you have some great professionals working with you. They really sound like they know their stuff. It's funny you mention recessed chin because mine is a bit recessed and so is dd's. I've never heard that mentioned before, I wonder if that was also an issue in our case. Learn something new everyday around here!

Sounds like you're really on top of this - just a matter of plodding on and waiting for supply to build up and your ds to overcome his latching difficulties. Just a matter of time...

Re the Isis - I did hear of a mom buying 2 of them and using both at the same time.

Re getting from undersupply to oversupply - I pumped after nearly every nursing session - 8-10 times in 24 hours. Although when I had a bad weepy day, sometimes it'd only be 6 times. And I started taking about 6g of fenugreek a day ~ 12-15 capsules.

I'm not sure you want an oversupply. I like your LCs term "robust" supply, that sounds healthier - more conducive to ds improving his latch and less painful for you without being engorged. If baby has a poor latch and can get by with it because mom has an oversupply, it doesn't encourage baby to improve his latch, kwim? More info here:

I found it took me a few weeks to really get used to a pump. I had a Medela Classic first then I bought an Ameda Purely Yours. Pumping regularly seemed to be the most helpful for me. And those nighttime or early morning pumping sessions were the most productive - your prolactin should be higher then. Now my dd is 17 mo and I have tried to pump once or twice to make up a bottle for her when I leave her with dh and I can't pump more than 1-2 oz these days! It's like my body has gotten out of the habit.
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Thanks Y'all for the good advice and support.

It was a terribly difficult day. I got up at 5:30, couldn't wake my son to feed so I started pumping. He woke up and wanted to nurse, so I quit pumping and nursed him in bed from 5:30 until about 7:30. I wept when I put him on the scale (I rented a Baby Weigh), and he'd only gotten a half ounce. I was so upset that I hadn't pumped to empty my breasts and stimulate my supply since two extra hours is such a long time, and the baby clearly did neither.

But it's so overwhelmingly counter intuitive to let the baby cry while pumping. But that's what I did later in morning--it was so hard, but boosting my supply is so important. I also stepped up my use of the Lact-Aid today. Still, it seemed like most of the day was nurse a baby, pump, put the toddler in time out, nurse a baby, pump, put the toddler in time out. Finally the toddler got mad and slammed a toy parachutist into the baby. I lost it and spanked him. The diaper cover took the hit, and I know it didn't really hurt him, but it shocked us both. I don't believe in spanking. I'm grateful that that's all I did when I lost control, but still very sorry and ashamed. It's scary how well it worked though. He calmed down, somehow it seemed to dissapate a lot of the negative energy and we both settled in for a cuddly nap while the baby slept. I've forgiven myself, but I don't want to go there again...

I'm wondering if I need anti-depressants to help cope with this. I know a lot of the depression I'm feeling is situational. This nursing situation is not normal; it is extremely difficult. Still, I have a history of depression and the last thing I need is to have a major depressive episode. For the moment, I'm going to take it day by day and see what happens.

Wombat thanks for the latch encouragement and links. I got some good ideas that seemed to help there. This afternoon and evening, I tried several things together that I'd tried separately before and seemed to get better results.

I'm also accepting that it may be a long haul. It's not going to resolve itself in a few more days. I've got to be diligent about pumping and about using the Lact-Aid. How long did it take y'all?

I think what spiraled our day out of control this morning is that he never really got full, so he wanted to nurse all morning. I got a long enough break to shower and get a diaper bag ready to go out, then he started nursing again and we never got out of the house...

On top of all that, I'm large and was hoping to take advantage of breastfeeding to lose a little weight. Now, I'm terrified that any reduction in the amount of calories I take in will affect my supply. I'd like a few nice nursing clothes and they are so hard to find in plus sizes. I searched for hours, finally found one dress and when it came, I looked like an elephant in it...

I struggled with whether or not to give the baby a bottle so I could spend some time with my toddler, but felt like giving him a bottle is just putting off the day when he can get milk out of my breast effectively. Still, somehow, tomorrow, I've got to get the baby full long enough to spend some time with my big guy.

Wish me luck,
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I was there with my ds. He had a poor suck and wouldn't empty the breast. We couldn't find a "real" reason for it. Around 4 months his suck got better and by 5 months he could completely empty the breast and wouldn't need get any supplementation. I know how hard it is and I only had one at the time. Really what helped me was to nurse and them pump all the time. It takes a lot of time but luckily I had help. I also had one long pumping session a day while my ds napped. I would do it at the same time everyday and it really helped my supply.

I was also depressed about the situation. I finally had to relax and realise that I was doing the best I could. I also had to deal with the weight thing also. I gained weight while nursing because if I started to lose, my supply would dwindle. I know it's easy for me to say now but the only way I made it through was to understand that this was just going to be a short time in my child's life and I was going to do the best I could while enjoying it as much as I could. I let go of the weight issue and realised I had the rest of my life to lose the weight, right now I was going to do what was best for my baby.

I have to say that what you are doing is great. This was one of the most difficult things I have been through in my life. Being on the other end of it now, I feel like I have done such a great thing for my child. He is now 19 months and still nurses like a fiend.
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Sorry to hear about your bad day. I remember them very well and I only had my dd to deal with.

I also was terrified of getting depression again. I'd had it during the pregnancy, was on antidepressants the first trimester and was at high risk of PPD. Then a horrible birth experience, c/s, isolated new immigrant...blah blah blah - I was a textbook candidate for PPD and yet I didn't get it. I didn't enjoy the first few months dealing with all the nursing problems but as much as my life felt horrible, I knew it wasn't depression. I had bad days but I could pull myself out of it. It's just my feeling but I think the BF hormones protected me from PPD.

I just wanted to add: Because this sounds like a latch problem that your ds will need to grow out of and adjust to, don't feel like you're doing anything wrong by giving bottles or even skipping the occasional nursing session and just supplementing. I know what the books say and what the LCs say but they don't have to live with it for months (or the ones I knew didn't) - just do what you can to get through this period of time without sabotaging the nursing process too much.

If I was having a bad day (or couple of days sometimes), I'd just pump and supplement and even 'decided' to give up lots of times. Then when I felt better and more optimistic, I'd start nursing again. Also I'd do things like not bother nursing at night - it didn't seem worth spending all that time trying to get her latched on, to have her fall asleep on the breast after 5 mins and then not be able to supplement her cause she was too sleepy and then have her wake again in an hour cause she was still hungry. Dh would supplement her at night while I pumped. So I saved the 'latching lessons' for specific times when she was most alert. Otherwise I found there weren't enough hours in my day.

I remember DaryLLL's advice from here - 'the first rule of breastfeeding is to feed the baby'. And my dd's lowest weight was 5lb 5oz so it was important to get her weight up. One LC told me that with latch problems, babies often just get it at around 11 or 13lbs. So in this kinda situation, not supplementing can delay weight gain which can delay development which can delay them growing out of this difficulty.

We got to exclusive BF finally at 16 weeks. But I think we could have done it earlier - I'd just lost the confidence: At 6 weeks, the LC advised weaning off the bottles and exclusive nursing so I tried - but after a week she stopped gaining weight and pooping so LC advised supplementing again. I was really devastated after that. I think by about 12 weeks, dd could have done it. I remember at about 12 weeks thinking that dd was latching better and we needed to try weaning off the bottles again but it took me about 3-4 weeks to build the confidence up to try it again. Plus by that age, I was dealing with pretty strong bottle preference. (We were supplementing with the Avent bottle).

Oh poopy baby, gotta go...
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((((BIG HUGS))))
I so know that feeling! I almost cried reading about your bad day, because I know what that was like, and I only had one at the time!
Don't feel bad about giving your baby a bottle. Don't feel bad if you have to sup with formula sometimes, either. Giving myself permission to bottle-feed my DD lifted a huge weight off my shoulders, and in reducing the stress I was feeling I was able to pump more milk in less time. I also had to give myself permission to miss a pumping session every now and then, if there was something really important I needed to do (like take a shower at least once a week

Did you read my story? I finally had enough with the triple feedings, and not getting anything else done, and quit trying to nurse my baby every feeding. It really was futile. She wasn't getting any milk nursing, she wasn't stimulating supply, and she'd stay latched on for hours and hours at a time! I would still put her to the breast a couple times a day, and bottle feed her expressed breastmilk. I just had to prioritize, and decided that most important was that baby get breastmilk no matter what (she had issues with formula, long story... allergies... colic). In order for me to have the time to pump enough milk for her, I had to supplement with bottles (and *gasp* faster flowing nipples, since with slow-flow nipples she would take an hour or two to finish one bottle).
Finger feeding didn't work, she learned that the finger was for food and the breast was still just for comfort to her. Lact-Aid didn't work with my baby, either - she's spit out the nipple and somehow just suck the tube by itself instead. If something isn't working, try something else.

Some things that might help - since the Avent works so well for you, have you tried using two of them at the same time? Pumping one side while nursing the other? Using the Avent petal inserts in the Lactina horns?
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I just want to add we gave up on the sns early on. It was too frustrating and too much work. We just bottlefed after that. I would nurse for 10-15 mintutes and then he would get a bottle. Yes, we would even give a bottle without nursing first. I really had to let go how I thought things would be and just deal with them the way that they were. I also had to come to terms with giving formula. Once I let go of all of these things, it was easier. Just realise you are doing the best you can and go from there.
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