Ask a Mum who breastfeeds with insufficient supply!

[bky]

Thanks for this 'ask a mum'

bky, you appear extremely well informed and it's been a real eye opener to read your replies so far. I'm really sorry your MWs etc seem so brutal about providing you with support - whatever direction that may take you in.

My question is... what would advice would you give to someone during one of the growth spurts who is anxious that they have supply issues?

Love you to you and your baby x

To anyone worrying that their baby isn't getting enough I'd say weight gain and output are the only real ways of telling if your baby is getting enough. Perfectly well fed babies will happily take a bottle and drink some of it down because babies are programmed to want easy food. it's really hard because as mothers we really want our children to be fed, warm and happy.
I'd also say, give the frequent feeding a few days. I never had a normal growth spurt as such, but they aren't supposed to last forever. My baby hit the 7-10 day growth spurt and was (I'm really not exaggerating) on my boob upwards of 18 hours a day for 10 days in a row. Since I knew about growth spurts and cluster feeding I kept thinking, oh this will end, though in the back of my mind I was wondering how we ever survived as a species because the at breast time went on so long.
So if you are worried get your baby weighed first.

I'm completely self taught on all this because I didn't have any help early on. Before I ran into this problem I certainly believed that not making enough milk was very rare and was more a result of outside circumstances (not feeding on demand, early supplementation etc). Unfortunately, around 4-5% of mothers in developed countries (and the rate is rising) will have insufficient milk, though up to 15% of breastfeeding mothers will have issues with low supply. I still vaguely hope that it was the emergency c-section that did this to us, though I gave birth in a baby friendly hospital, so no formula, bottles or pacifiers given, we were never separated, I recovered really well and she was on the boob within 2 hours of being born. My milk arrived (as it were) on day 3 even.

I kind of fell into it. I tried to increase my supply for so long I got past the bleeding, cracked nipple stage and then didn't see why I should give up completely because I had a latching baby and some milk.

 

[bky]

i just wanted to say well done. i gave up bfing my ds when my supply went down at 6 mo and have regretted it to this day.

I'm really lucky in a lot of ways in that, although I can't exclusively breastfeed, I have so far been able to set and meet alternate breastfeeding goals and have a different kind of breastfeeding success. I don't think I could honestly say to anyone having similar issues to stick with it. I do want people to know it's possible, but after that it's up to them. I sometimes feel if I'd made a clean break and gone 100% FF I wouldn't have a lot of the sadness that I do. But I also think that if/when I'm in this situation again I'd be happy to have what we have now. Though if I get a non-latching baby I'd pack it in much sooner. I know my limits and I hate pumping while my baby cries.

 

[a_c]

Just want to say what a good thread & what an achievement. I nearly gave up bf at 8 days, so much pain, ridiculosly painful letdown & a stressed baby who just screamed to be latched on. We now combi feed, one feed breast one bottle. I think my supply is slowly decreasing but is still good for a full on 15 min feed & as she put on 11 oz last week it's obviously working. I am assuming some breast milk is better than none for as long as this is working for us - am I right to continue on that premise?

 

[melorablack]

When and how did you realise that your supply was low?
Was it only based on your baby's weight or was there any other signs?

It was mainly the weight, though she didn't really poo much at first either which is a warning sign of inadequate intake. It was marked down to her having gone in the womb, and twice, massively, right after she was born. She didn't go again until 5+ days old.
Since she was overdue and a c-section baby she was overhydrated, so she peed enough in hospital to not worry anyone.

I can look back now and see that I had some signs that should have been investigated: I never really got engorged when my milk came in at 3 days pp (I just noticed it turned color), my baby was eating for 18+ hours per day for 8-10 days in a row (and losing weight), never settling or being satisfied (or sleeping!) etc. All of those individually may or may not indicate a problem, but each should be cause for further investigation. The bottom line is weight loss though.

There are some other signs that I could have been prone to issues, such as breast shape which can indicate a lack of glandular tissue, but those aren't investigated often.
There are a variety of reasons for low supply that fall into baby problems and mum problems. Baby problems usually involve latching and milk removal issues (various forms of tongue/lip tie, palate issues, muscle issues etc), where mum problems can range from traumatic labours/excessive blood loss, to thyroid issues, postpartum or otherwise, to hormonal imbalances (PCOS for instance or cortisol imbalance), and lack of glandular tissue development (either in puberty or during pregnancy).
Mine are somewhee on the mum side of the equation, though I'm not sure exactly what (or if it's just one thing even)...

I'm so glad I saw this thread. I think I had supply issues and I know you replied to my thread, but reading your story has helped me understand some more. Thank you!

 

[hajis-sweetie]

I had big issues after delivery, having given myself the equiv of whiplash. I couldn't move my head or neck, had terrible head/neck ache. I couldn't look down to see baby so this made BF nigh on impossible. I gave up BF on day 7 and although at the time I needed to to help my sanity (I was in so much pain) I have been upset ever since. As a result my supply dwindled. Oh and baby had tongue tie so latch was poor, I had sore sore sore nipples which were lipstick shaped after feeding. Looking back there were a lot of factors which contributed to the issues i'm having now. I could go on forever (loss of blood in delivery, rubbish post natal midwives, unhelpful lactation consultant, neck to name a few).
I am trying to relactate as I have never given up hope, I am on Fenugreek and DOmperidone. When pumping/hand expressing I can now get up to 3/4 ounce at a time, whereas when I began it was a drop from each nipple. Baby has gone on strike though and won't latch. She isn't putting up such a fight now, this started a couple of weeks ago and she'll now be put into position and licks around a bit. Oh and her tongue tie was cut last Fri.

After my rambling, my question is has your baby ever been on strike and how was it resolved? I read you are using a supplementer at the breast, which we were sucessfully using until her strike and even that wasn't good enough!

 

[bky]

Just want to say what a good thread & what an achievement. I nearly gave up bf at 8 days, so much pain, ridiculosly painful letdown & a stressed baby who just screamed to be latched on. We now combi feed, one feed breast one bottle. I think my supply is slowly decreasing but is still good for a full on 15 min feed & as she put on 11 oz last week it's obviously working. I am assuming some breast milk is better than none for as long as this is working for us - am I right to continue on that premise?

Yes. As little as 50ml (2oz) of breast milk per day imparts quite a lot of helpful immunities. Unfortunately there are very few studies done on this and all are in relation to weaning.

https://www.kellymom.com/bf/weaning/weaning-partial.html

https://milkmatters.org.uk/2010/11/18/mixing-bottle-and-breast-it-doesnt-have-to-be-all-or-nothing/

 

[bky]

I had big issues after delivery, having given myself the equiv of whiplash. I couldn't move my head or neck, had terrible head/neck ache. I couldn't look down to see baby so this made BF nigh on impossible. I gave up BF on day 7 and although at the time I needed to to help my sanity (I was in so much pain) I have been upset ever since. As a result my supply dwindled. Oh and baby had tongue tie so latch was poor, I had sore sore sore nipples which were lipstick shaped after feeding. Looking back there were a lot of factors which contributed to the issues i'm having now. I could go on forever (loss of blood in delivery, rubbish post natal midwives, unhelpful lactation consultant, neck to name a few).
I am trying to relactate as I have never given up hope, I am on Fenugreek and DOmperidone. When pumping/hand expressing I can now get up to 3/4 ounce at a time, whereas when I began it was a drop from each nipple. Baby has gone on strike though and won't latch. She isn't putting up such a fight now, this started a couple of weeks ago and she'll now be put into position and licks around a bit. Oh and her tongue tie was cut last Fri.

After my rambling, my question is has your baby ever been on strike and how was it resolved? I read you are using a supplementer at the breast, which we were sucessfully using until her strike and even that wasn't good enough!

Mine had some breast refusal intermittently between weeks 5-7. At that point most of her top ups were still done via bottle. I would get frustrated because she would cry and I would cry so I'd just give her the bottle since I was trying to do breast then bottle every time. I'd try to set a goal of trying to latch her on for no more than 10 minutes at a time with the aim of getting 5 minutes of sucking in. Sometimes I could calm her down by giving her my pinky finger to suck and then she'd take the breast. Or I could hand express some into her mouth. If I could get her to latch on I kind of had to massage my boob constantly while she was feeding or she'd lose interest due to low flow (do this enough and flow improves over time). If we did that and she was still fussing around I'd give the bottle.
For a while there I felt like every breast feed was going to be our last.
She still refuses the plain boob sometimes now, but as all top ups done by me are done via the supplementer at least she's sucking on there. I don't give her bottles any more now as it just confuses her and makes her fussy at the breast. She gets bottles at daycare, but not from me.

When I started using the supplementer she learned to suck the tube, so I still have to control the latch carefully so she's on the boob and the tube rather than just sucking the milk out of the tube.
In your case, have you tried upping your tube size or changing the height of your milk bottle so the flow is faster? It might make a mess (use formula not your milk!), but if she's drinking fast enough she'll be distracted from what she's sucking on and learn to relax in that situation.

 

[hajis-sweetie]

Thanks bky.
I think we are already using the biggest tube, I will check though.
I think the SNS is a god send but is also a faff! I think this adds to the anxiety of whether she'll latch or not. She in turn then gets stressed.
Oh to think when I was pregnant I thought it would be plain sailing. I had no clue whatsoever!

Can I just say this thread is a really great and helpful idea. xx

 

[moomoo]

Hi! Just had a thought! Have you thought about what you would do when/if you choose
to have any more children?

Just Reading your story, mine was very similar. A LOT of feeding (sometimes for upto 10 hours in one sitting!) no dirty nappies (1 in 2 weeks!) and weight loss (over 10% which is heartbreaking when you've sat and fed for some huuuge amounts of time!!)

I'm really frightened of the same thing happening this time round. I
don't think I could put myself under the same pressure especially with a LO to look after!! Won't have the time to pump ect x

 

[Cocobelle]

I still vaguely hope that it was the emergency c-section that did this to us, though I gave birth in a baby friendly hospital, so no formula, bottles or pacifiers given, we were never separated, I recovered really well and she was on the boob within 2 hours of being born. My milk arrived (as it were) on day 3 even.

I wonder if there is any truth in this as I had an emergency section under GA, so it was about an hour and a half before I even woke up and saw my baby. Saying that, I was at a baby friendly hospital too and they actually let my husband wake me with our baby and they put him to the breast as I was coming round. We were never separated after that. I never did feel my milk come in though

I saw my doctor yesterday and luckily he agreed to give my a prescription for Donperidone. I shall start it today. I do have a tube to use for when we supplement with formula but as Georgie is on me ALL day long, I must admit, the chance to have a few minutes of hands free time while someone else feeds him is just too much to pass up on. I must start being stricter though as I don't want him to start refusing the breast. Luckily he loves to suckle on me and usually wants to come back on the breast after he has had a bottle, it must be a comfort thing.

 

[cissyhope]

iv only just found this thread! thank you so much its really good to read others going through similar experiences on now on domperidome,fenugreek and drinking fennel tea (when i can) dont understand why my supply is low i really suffered with sore nipples which would turn white 20 mins after id feed lo they thought i had thrush so took treatment for that. Feel better but still get sore any way i am supplementing with formula now and although i did cry when giving lo his first bottle,he has started to gain some proper weight.My problem now is i think he is getting lazy at my boob as he starts getting frustrated and even angry and crying but i know there is milk there??? as when i express after some comes out iv even got paranoid that he doesn't like my milk as he is more sick on it than blumming formula! what do u think girls? also i have seen improvement in my milk since taking domperidome but what happens when i finish taking them? im trying to pump as much as i can but its so hard with looking after my demanding lo xxx

 

[bky]

Hi! Just had a thought! Have you thought about what you would do when/if you choose
to have any more children?

Just Reading your story, mine was very similar. A LOT of feeding (sometimes for upto 10 hours in one sitting!) no dirty nappies (1 in 2 weeks!) and weight loss (over 10% which is heartbreaking when you've sat and fed for some huuuge amounts of time!!)

I'm really frightened of the same thing happening this time round. I
don't think I could put myself under the same pressure especially with a LO to look after!! Won't have the time to pump ect x

#2 (and 3!) are still in the planning stages, though we'll be TTC by the time Lucy is a year old as we'd planned to have 3 in fairly short succession.

I am also afraid that the same thing will happen again, but I hope to catch it earlier with test feed weights and closer monitoring.

So for my next pregnancy I'm hoping to find a supportive midwife. I've been toying with the idea of seeing an IBCLC (international board certified lactation consultant--basically the top kind of lactation consultant you can get). I called one up and talked to her, but since my Dr isn't very supportive in regards to ordering bloodwork etc I'll see the IBCLC once I'm under the care of someone supportive who will order blood tests or other medical help I may need. During my next pregnancy I'll be taking some herbs in the hope that it will aid my eventual milk output. There are other things that you can do based on the type of diagnosis you get, from progesterone shots to taking metformin.
I'll be happy if baby #2+ and I end up with something similar to what I have now. Using the SNS for several feeds per day etc. I don't feel (now that I'm so pro at using it ) that the SNS is significantly more difficult than breastfeeding plus bottles. In addition I only plan to pump for the first 3-4 weeks to increase supply.
However, if I end up with a non-latching baby #2+ I will pack it in early and go completely to bottles of formula because it's not fair to Lucy (and #2+) for me to be spending that much time pumping.

 

[bky]

iv only just found this thread! thank you so much its really good to read others going through similar experiences on now on domperidome,fenugreek and drinking fennel tea (when i can) dont understand why my supply is low i really suffered with sore nipples which would turn white 20 mins after id feed lo they thought i had thrush so took treatment for that. Feel better but still get sore any way i am supplementing with formula now and although i did cry when giving lo his first bottle,he has started to gain some proper weight.My problem now is i think he is getting lazy at my boob as he starts getting frustrated and even angry and crying but i know there is milk there??? as when i express after some comes out iv even got paranoid that he doesn't like my milk as he is more sick on it than blumming formula! what do u think girls? also i have seen improvement in my milk since taking domperidome but what happens when i finish taking them? im trying to pump as much as i can but its so hard with looking after my demanding lo xxx

That sounds a bit like nipple vasoplasm. Have you seen a lactation consultant?
They do get lazy at the boob if the bottle flow is faster, are you using the slowest flow teats? I'd also say do a lot of breast massage and compression to keep interest at the boob. The massage and compression helps speed up your milk flow.
If he's sick after feeds you might try keeping track of what you eat. I've had to cut out onions, garlic, broccoli, tomatoes, citrus and kiwifruit from my diet to keep my milk down better.

Have a google for Jack Newman + domperidone as he has some good information on using it and coming off.

 

[bky]

I still vaguely hope that it was the emergency c-section that did this to us, though I gave birth in a baby friendly hospital, so no formula, bottles or pacifiers given, we were never separated, I recovered really well and she was on the boob within 2 hours of being born. My milk arrived (as it were) on day 3 even.

I wonder if there is any truth in this as I had an emergency section under GA, so it was about an hour and a half before I even woke up and saw my baby. Saying that, I was at a baby friendly hospital too and they actually let my husband wake me with our baby and they put him to the breast as I was coming round. We were never separated after that. I never did feel my milk come in though

I saw my doctor yesterday and luckily he agreed to give my a prescription for Donperidone. I shall start it today. I do have a tube to use for when we supplement with formula but as Georgie is on me ALL day long, I must admit, the chance to have a few minutes of hands free time while someone else feeds him is just too much to pass up on. I must start being stricter though as I don't want him to start refusing the breast. Luckily he loves to suckle on me and usually wants to come back on the breast after he has had a bottle, it must be a comfort thing.

I did find that breast refusal for us started around 5-6 weeks. Someone else giving a bottle shouldn't confuse him as much as you doing it though. Good luck! I think part of my success (such as it is) is having a baby that looooves the booby.

 

[Poppy7]

So do you exclusively breastfeed? Or do you top up with formula?

I can't make enough milk for her to gain weight so she gets between 350ml-400ml (12-14oz) formula per day. I actually feed via an at breast supplementer, so it sort of all comes from the boob

Well done you It's great that you are perservering. Is it the Medela SNS you use with the tube?

 

[Poppy7]

i really suffered with sore nipples which would turn white 20 mins after id feed lo

My friend also suffered with this for a short while. Sometimes it is called nipple blanching and can be due to Raynauds of the nipple (yes, this is possible!). Aparently when it happens trry applying warmth to the affected nipple/s as it is supposed to help to reduce the pain and bring the blood supply back in to the nipple.

Just a thought

 

[bky]

So do you exclusively breastfeed? Or do you top up with formula?

I can't make enough milk for her to gain weight so she gets between 350ml-400ml (12-14oz) formula per day. I actually feed via an at breast supplementer, so it sort of all comes from the boob

Well done you It's great that you are perservering. Is it the Medela SNS you use with the tube?

Yes it is.

Here is a picture in case anyone is wondering how it works:
https://beckymonster.files.wordpress.com/2010/09/dscn0825.jpg

 

[Poppy7]

So do you exclusively breastfeed? Or do you top up with formula?

I can't make enough milk for her to gain weight so she gets between 350ml-400ml (12-14oz) formula per day. I actually feed via an at breast supplementer, so it sort of all comes from the boob

Well done you It's great that you are perservering. Is it the Medela SNS you use with the tube?

Yes it is.

Here is a picture in case anyone is wondering how it works:
https://beckymonster.files.wordpress.com/2010/09/dscn0825.jpg

Fantastic! Such a great piece of kit! Thanks for sharing

 

[cissyhope]

iv only just found this thread! thank you so much its really good to read others going through similar experiences on now on domperidome,fenugreek and drinking fennel tea (when i can) dont understand why my supply is low i really suffered with sore nipples which would turn white 20 mins after id feed lo they thought i had thrush so took treatment for that. Feel better but still get sore any way i am supplementing with formula now and although i did cry when giving lo his first bottle,he has started to gain some proper weight.My problem now is i think he is getting lazy at my boob as he starts getting frustrated and even angry and crying but i know there is milk there??? as when i express after some comes out iv even got paranoid that he doesn't like my milk as he is more sick on it than blumming formula! what do u think girls? also i have seen improvement in my milk since taking domperidome but what happens when i finish taking them? im trying to pump as much as i can but its so hard with looking after my demanding lo xxx

That sounds a bit like nipple vasoplasm. Have you seen a lactation consultant?
They do get lazy at the boob if the bottle flow is faster, are you using the slowest flow teats? I'd also say do a lot of breast massage and compression to keep interest at the boob. The massage and compression helps speed up your milk flow.
If he's sick after feeds you might try keeping track of what you eat. I've had to cut out onions, garlic, broccoli, tomatoes, citrus and kiwifruit from my diet to keep my milk down better.

Have a google for Jack Newman + domperidone as he has some good information on using it and coming off.

thank you not sure on the teats? its only got one hole in? how did you know what foods to avoid? x

 

[cissyhope]

i really suffered with sore nipples which would turn white 20 mins after id feed lo

My friend also suffered with this for a short while. Sometimes it is called nipple blanching and can be due to Raynauds of the nipple (yes, this is possible!). Aparently when it happens trry applying warmth to the affected nipple/s as it is supposed to help to reduce the pain and bring the blood supply back in to the nipple.

Just a thought

thanks yes i was told it could be raynauds iv been putting a hot water bottle on after feeds