Ask a Mum who breastfeeds with insufficient supply!

[cabaretmum2b]

Hello everyone!

Sorry this is late - I was pretty busy today putting up my Christmas tree (YAY!) and babysitting my brothers. But now, here I am And, on the subject, here's bky, who's here to answer your questions

Hi, I'm Becky and I've been breastfeeding with insufficient supply (can't make enough breast milk) for 5 months. Ask away!

 

[moomoo]

Hi Becky! Nothing to ask but just wanted to say I went through the same thing and managed to BF my little man for 7 months!

Well done!

 

[mrsraggle]

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

 

[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

 

[kiwimama]

Was it tough to convince midwives etc, that you had low supply?

 

[discoclare]

Did you try anything to boost supply like doperamine (sp?) or fenugreek?

I didn't find out about fenugreek until I had already been BFing quite a while and wonder whether I should have used it at the beginning. Instead I tried to up my supply by pumping every second of the day that she wasn't on me (which wasn't many at the start!), which did work but was very exhausting. I'm wondering that if I have another baby and seem to have the same kind of issues whether I should try another method of supply increase.

 

[bky]

Was it tough to convince midwives etc, that you had low supply?

My midwives were a bit shitty about it actually. They told me at day 15 when LO had lost even more weight that I had to give formula, then they treated me either like I wasn't trying hard enough, or that it was just one of those things.
I pumped after feeds until 5-6 weeks trying to get my supply up and they kept treating me like I'd given up because I was supplementing, and wouldn't answer questions about formula. I kind of felt like they just wanted to tick the box that said 'baby gaining weight' and move on. It was a real shame because they were so great all through my, admittedly problem free until the end, pregnancy.
My HV nurse gave me the 3rd degree about why I was giving formula the first time I saw her, so much that I started crying. She's more supportive now, but still.
My Dr. has the opinion that it's just one of those things. I've been to see her 4 times asking for both general and more specific help and she's not willing to do anything because she doesn't think it will help. So, I'm hoping for a more supportive midwife next time (we pick our own, so I'll be interviewing carefully).
Few of my health professionals openly disbelieve me (though other people I've talked to do), but they haven't been eager to help me do anything about it because it's not an obvious fix. By that I mean, there's nothing obvious that was 'wrong'.

 

[bky]

Did you try anything to boost supply like doperamine (sp?) or fenugreek?

I didn't find out about fenugreek until I had already been BFing quite a while and wonder whether I should have used it at the beginning. Instead I tried to up my supply by pumping every second of the day that she wasn't on me (which wasn't many at the start!), which did work but was very exhausting. I'm wondering that if I have another baby and seem to have the same kind of issues whether I should try another method of supply increase.

I did use fenugreek from about 3ish weeks, though it didn't do anything much for me. I finally got my Dr. to give me a prescription for domperidone at 10 weeks (backed up with a letter from a lactation consultant), but sadly it seemingly messed with my milk ejection reflex so less milk was coming out (a rare result according to Dr Jack Newman). I had some increase from a tea with nettle, red clover, red raspberry, and blessed thistle in it.
I've also had ok results from fennel.
I've tried quite a few things. At some point I just kind of drew the line because there are loads of galactalogues out there and I only have half a supply. So basically I'm not likely to be able to get away from formula. As one of the lactation consultants I had said since what I'm doing works, just stick with it.
With the regimen I'm on now I've increased my supply somewhere between 3-5oz (100-150ml) per day from what it was around 7 weeks.

I now take a few blessed thistle capsules before bed as it seems to help maintain my ability to do all the night feeds without supplementation. I have fennel seeds in my oatmeal every day, drink 2-3L of fluids, avoid peppermint, sage and parsley.

I think you'd be less likely to have similar issues with baby #2 as each subsequent pregnancy/breast feeding develops your tissue, nerves and ducts. It seems anecdotally common for women with persistent insufficient supply (not related to milk removal problems, blood loss or treatable hormonal issues such as thyroid etc) issues to have a full supply by the 3rd child.

 

[Try Rocking]

I went through the same thing and I want to say how great you are doing! It isn't an easy thing to keep up doing, so good job

I breast fed with a tube going in her mouth from a bottle of formula so she kept my breast milk coming in as much as it ever would, I took domperidone, blessed thistle and fenugreek, not to mention pumping like crazy.

I'm sorry you had so much trouble with the people that were supposed to be there to help you.

 

[~Mummy~]

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?

 

[kiwimama]

Was it tough to convince midwives etc, that you had low supply?

My midwives were a bit shitty about it actually. They told me at day 15 when LO had lost even more weight that I had to give formula, then they treated me either like I wasn't trying hard enough, or that it was just one of those things.
I pumped after feeds until 5-6 weeks trying to get my supply up and they kept treating me like I'd given up because I was supplementing, and wouldn't answer questions about formula. I kind of felt like they just wanted to tick the box that said 'baby gaining weight' and move on. It was a real shame because they were so great all through my, admittedly problem free until the end, pregnancy.
My HV nurse gave me the 3rd degree about why I was giving formula the first time I saw her, so much that I started crying. She's more supportive now, but still.
My Dr. has the opinion that it's just one of those things. I've been to see her 4 times asking for both general and more specific help and she's not willing to do anything because she doesn't think it will help. So, I'm hoping for a more supportive midwife next time (we pick our own, so I'll be interviewing carefully).
Few of my health professionals openly disbelieve me (though other people I've talked to do), but they haven't been eager to help me do anything about it because it's not an obvious fix. By that I mean, there's nothing obvious that was 'wrong'.

I found that bfing is pushed too much here. I got a huge telling off from my plunket nurse when I went to see her and had told her I'd finally given up bfing after weeks and weeks of incredible stress and resentment from me towards Ella. I was also refused all help whenever I asked about formula etc.
My friend featured on Campbell Live about the pressure to bf. Basically she had had a breast reduction years ago and her milk would just not come out. She wasn't allowed to feed her baby formula, the midwives just continued to push the baby on the breast where she got nothing. Baby finally got her first feed at 3 days old when they went home and got a tin of formula on the way home...
You sound as though you do your absolute best to ensure Lucy gets the goodness of bm as well as thriving by supplementing as she needs it. It's not great you weren't given the support you needed when the issue of supply first came up.

 

[bky]

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)...

 

[bky]

Was it tough to convince midwives etc, that you had low supply?

My midwives were a bit shitty about it actually. They told me at day 15 when LO had lost even more weight that I had to give formula, then they treated me either like I wasn't trying hard enough, or that it was just one of those things.
I pumped after feeds until 5-6 weeks trying to get my supply up and they kept treating me like I'd given up because I was supplementing, and wouldn't answer questions about formula. I kind of felt like they just wanted to tick the box that said 'baby gaining weight' and move on. It was a real shame because they were so great all through my, admittedly problem free until the end, pregnancy.
My HV nurse gave me the 3rd degree about why I was giving formula the first time I saw her, so much that I started crying. She's more supportive now, but still.
My Dr. has the opinion that it's just one of those things. I've been to see her 4 times asking for both general and more specific help and she's not willing to do anything because she doesn't think it will help. So, I'm hoping for a more supportive midwife next time (we pick our own, so I'll be interviewing carefully).
Few of my health professionals openly disbelieve me (though other people I've talked to do), but they haven't been eager to help me do anything about it because it's not an obvious fix. By that I mean, there's nothing obvious that was 'wrong'.

I found that bfing is pushed too much here. I got a huge telling off from my plunket nurse when I went to see her and had told her I'd finally given up bfing after weeks and weeks of incredible stress and resentment from me towards Ella. I was also refused all help whenever I asked about formula etc.
My friend featured on Campbell Live about the pressure to bf. Basically she had had a breast reduction years ago and her milk would just not come out. She wasn't allowed to feed her baby formula, the midwives just continued to push the baby on the breast where she got nothing. Baby finally got her first feed at 3 days old when they went home and got a tin of formula on the way home...
You sound as though you do your absolute best to ensure Lucy gets the goodness of bm as well as thriving by supplementing as she needs it. It's not great you weren't given the support you needed when the issue of supply first came up.

I've heard things like that before I actually got my first encouragement from a Plunket lactation consultant. By that time I'd already figured out on my own how to maximise my supply (and I found out later I'd reinvented the wheel as to the best ways to supplement without losing breast milk etc), but she was really encouraging and not at all afraid to talk about formula use. At that point I was pretty afraid to ask for more help because my MW's had me convinced I had done something wrong.
I think one of the biggest problems I had was that my midwives totally dropped the ball. I expressed concern that my milk was in (had changed color) but that I wasn't engorged really (oh, well your milk isn't really in then), that my breasts hadn't grown much etc. Then they didn't refer me to an outside lactation consultant because they were lactation consultants (not good ones!), didn't help me rent a hospital grade pump, the list goes on. It's probably something I would have picked up on earlier if I'd had a more difficult pregnancy. They checked latch multiple times, and checked for tongue tie, but after that threw up their hands.

One question I'll have for future midwives is if they believe in low supply, and what they would do for someone struggling to make milk.

 

[Cocobelle]

Well done for making it work for you both and thank you for sharing your experiences.

This week my HV has diagnosed me as having a very low supply, something I have suspected for a little while now as I never felt my milk come in, I never get hard boobs (even in the morning), they never leak and Georgie is on them all day long, often getting quite cross with my boobs. My boobs are slightly bigger now (they never changed size in pregnancy but now are about a large B cup size) but they are always soft to the touch. He was wetting and pooing, which I thought meant that at least something was getting in him, but when the HV checked what I thought was a large poo, she said it was lacking the substance of a well fed babies poo.

Georgie is 5 weeks now, was born weighing 6lb 3oz and now only weighs 6lb 7oz, he has dropped off the percentile charts now and bless him, he is a skinny little thing. I am lucky in that my HV is brilliant and very supportive and I am seeing a lactation specialist who is helping all she can. Today has shown me how to feed using a tube as I am now supplementing with formula 4 times a day (2oz each time). Tomorrow I am seeing my doctor to see if they will prescribe Domperidone.

I am taking Fenugreek (and will get some blessed thistle capsules capsules next time I am in town) and have hired a hospital grade pump but have decided to stop pumping for now as it was seriously stressing me out. For one, I usually only get about 5-10 minute breaks when George is not on me in one way or another so spending that precious time (when I could be showering or just doing a bit of tidying up) sitting with a pump on me was driving me nuts. It doesn't seem to have helped my supply and nothing came out with the 'power pump' anyway!

Amazingly, night time feeds are great, we co-sleep and both get a good nights sleep, which is one of the reasons why I am so determined not to give up on BF as I could not be bothered with bottles at 3am!

Obviously I am hoping to be able to increase my supply well enough to eventually exclusively BF but if not, it gives me hope to see that others have successfully combined the two.

Jo x

 

[PepsiChic]

just wanted to say, im in the same boat. I just started supplementing with formula when depsite my best efforts my low supply was causing my LO's weight to drop. I tried everything, pumping every 2 hours, non-alcoholic beer, guinness, fenugreek, blessed thistle and constant nursing but with no luck.

i noticed my supply was going down when he started to feed every 2 hours, hardly pooed, started waking more during the night (he used to sleep through) and then when pumping i only got 2oz whereas before id get 4-6oz and he only put on 1lb in 2 months, and then dropped another 1lb 8oz in a week and a half.

its been almost 2 weeks with formula top-ups and my LO's weight not only reached what it was at his last drs app 3 weeks ago, but added an extra pound on!

im still feeling guilty about not exclusively breastfeeding, did you feel guilty too? when, if ever, did you stop feeling that way?

 

[bky]

I'd recommend the book 'The Breastfeeding Mother's Guide to Making More Milk' to anyone who has low supply. It has a lot on finding the cause of your low supply and information on galactalogues and other milk increasing techniques including dosages etc. It also has a good section on dealing with the emotional fallout.

im still feeling guilty about not exclusively breastfeeding, did you feel guilty too? when, if ever, did you stop feeling that way?

I've recently been feeling less guilty, but I won't lie; it's still not entirely gone. Up until 15 weeks I cried over it and thought about stopping every single day. Because at 6 weeks I pretty much realized I wasn't ever going to have a full supply I then bought the SNS system and have been using it for all top ups since 8 weeks. Mainly as I could no longer handle the pumping after feeds, and I thought, 'hey this way I can kill two birds with one stone!' Seriously, breastfeed, bottlefeed, pump will kick your ass. At 15 weeks I was preparing to put her in daycare and we had no idea how many bottles she would take in a day so we had a day with my husband feeding her bottles and no breast feeds so we could have an idea of how many bottles to send along.
That day was really horrible, because she wanted my boobs for naps and comfort. The good thing that came out of that is that I no longer think about stopping every day because I realized she doesn't care if the boob has a tube attached to it or not, or even if it's a bottle instead of a boob (ok, she loves my boobs, but someone else giving her a bottle is fine as long as she gets boobies at the end of the day). That even though I inadvertantly starved her early on she still trusts me to make sure she's ok.
Guilt means you care.
I find with breastfeeding guilt that it's more about regret though. 'If I'd only known this it would have been better, If I'd only done that...' I mean, you didn't maliciously make a choice, you did the best you could at the time, and maybe next time you'll do something different.

 

[bky]

Well done for making it work for you both and thank you for sharing your experiences.

This week my HV has diagnosed me as having a very low supply, something I have suspected for a little while now as I never felt my milk come in, I never get hard boobs (even in the morning), they never leak and Georgie is on them all day long, often getting quite cross with my boobs. My boobs are slightly bigger now (they never changed size in pregnancy but now are about a large B cup size) but they are always soft to the touch. He was wetting and pooing, which I thought meant that at least something was getting in him, but when the HV checked what I thought was a large poo, she said it was lacking the substance of a well fed babies poo.

Georgie is 5 weeks now, was born weighing 6lb 3oz and now only weighs 6lb 7oz, he has dropped off the percentile charts now and bless him, he is a skinny little thing. I am lucky in that my HV is brilliant and very supportive and I am seeing a lactation specialist who is helping all she can. Today has shown me how to feed using a tube as I am now supplementing with formula 4 times a day (2oz each time). Tomorrow I am seeing my doctor to see if they will prescribe Domperidone.

I am taking Fenugreek (and will get some blessed thistle capsules capsules next time I am in town) and have hired a hospital grade pump but have decided to stop pumping for now as it was seriously stressing me out. For one, I usually only get about 5-10 minute breaks when George is not on me in one way or another so spending that precious time (when I could be showering or just doing a bit of tidying up) sitting with a pump on me was driving me nuts. It doesn't seem to have helped my supply and nothing came out with the 'power pump' anyway!

Amazingly, night time feeds are great, we co-sleep and both get a good nights sleep, which is one of the reasons why I am so determined not to give up on BF as I could not be bothered with bottles at 3am!

Obviously I am hoping to be able to increase my supply well enough to eventually exclusively BF but if not, it gives me hope to see that others have successfully combined the two.

Jo x

The pumping will really do you in. I think pumping to increase low supply isn't going to help much beyond 4-6 weeks anyhow. I was always torn because I have a baby who wants to be held all the time, so it was often a choice of pump while she cries, or hold her. Pump while she's asleep or sleep myself. Not really good choices. I have to do a lot of breast compression to get much out and my midwives always treated me like I was making excuses when I said I couldn't pump and feed or even pump while holding her. For awhile there I was feeding her 18 hours a day, so there was no time for anything. I need 2 hands for feeding, I need 2 hands for pumping and I don't have 4 hands!

Good luck with the extra supplements and the domperdione.

 

[venusrockstar]

Good on ya! I dealt with supply issues in the beginning also, and once the lactation consultant narrowed it down to that I started on Fenugreek and I've had no problems since. I've been exclusively BF'ing for 5 months this coming Friday and haven't had to give formula. It's a huge accomplishment for me since I struggled so much and was in tears in the beginning.

 

[Seraphim]

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

 

[nada87]

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.