Why isn't my supply increasing?!?!

[CapitalChick]

Argh!! I'm having such issues with BFing...Need help!
Background: My daughter was born, had lots of health issues, I wasn't allowed to hold or nurse my daughter for 3 days, and nurses in hospital forgot to offer me a breastpump for first 3 days (I was too overwhelmed to think of it myself). As a result, on day 3.5, when I could finally nurse her, there was nothing, and we've had MAJOR supply issues ever since...

I've met with lactation consultants (LCs), who've recommended pumping between feedings (8-12 times per day), which I find totally exhausting and I think almost made me severely depressed. I also only get between 2 tblsp and 1.5 oz (which is so good and rare it makes me dance...pitiful) when I pump...The only times I ever got 1.5 oz was 1.5 hours AFTER a feed...If I pump right after a feed, I only get drops.

The LCs have said that I need to supplement my daughter until my supply is up. If you were with me for a feeding, you'd see why. My poor baby is SO hungry after taking both breasts, so we've been offering her 2 oz of formula after each feeding (each feed takes an excruciating 1 hour, by the way). The LCs also said that I should try reducing the formula amount by 10cc every 2 days and see if my daughter is still satisfied, which would indicate an increase in milk. I have not been able to reduce the amount. I'm clearly NOT producing enough...not even close.

Also, my early morning feeds (3-4 am) are usually excellent in terms of supply...my daughter gulps and gulps for a few minutes on each side. But then the day and evening feeds are just terrible! I strain to hear swallowing and barely hear anything...I'm not sure anything is coming out, no matter how hard I compress my breasts.

I am taking domperidome (the drug to induce lactation), as well as fenugreek tablets and blessed thistle, 3 times per day each.

My daughter is now 4 weeks old, and I'm beginning to think that this just isn't going to work out!...I mean, if I haven't been able to increase my supply by now, this just isn't going to happen, is it?

I often feel guilty because I KNOW I could be doing more to increase my supply. I could do more pumping during the day (I only pump about once a day now), I could put my daughter to the breast 50 times a day if I really wanted to, etc. But I think that my mental health suffers when I do all of that. I really get depressed when I'm stuck with a breast pump or when I nurse and nurse all day long and see no improvement...especially since each feed takes SO long.

I need help....any suggestions, really...

 

[Mervs Mum]

Not sure what else to sugest honey. If you dont feel you can keep putting her on and pumping and you top up, you'll find it's a vicious cycle.

The best time to pump is between 1am and 4am -thats when your prolactin levels are highest which is why you have loads then.

I'm sat her pumping and when I was in a good pumping routine I could get 9oz - now I dont pump as often I'm down to 3 or 4 max in 30 mins. When I started I'd jump up and down for a single oz!

Feeding took at least an hour in my early days too - It's draining but it will come right.

I suppose what I'm saying is that what you are describing doesnt sound unusual but when it's you in the thick of it it's overwhelming.

If you really feel you are suffering mentally doing more pumping etc then dont - there's no point ending up depressed honey.

Sorry I couldnt be more help

 

[Mervs Mum]

How are things hun?

 

[CapitalChick]

Meh....so so...not so great today. Mia was up a lot last night, which meant I didn't get much sleep....which means bad milk supply today. I commited myself to spending three days at home this week (today, tomorrow and the following day) and doing nothing but working on my milk supply. I pumped twice today between feeds (and plan to pump twice more before bed tonight). I put Mia to the breast whenever she wanted, but really...it was rough because very little was coming out and she'd quickly get frustrated because she was hungry.

Then, a friend of mine came for a visit. Her son was born one hour before Mia and they were the same weight...He's SO SO much bigger than her now and I'm concerned about her weight gain more than ever. I feel like a TOTAL moron because of, what I believe to be, our errors related to supplementing. I'm embarassed to even admit this...but here it goes: When she was newborn and in the hospital (ie. 1-7 days old), the nurses said to supplement her with 2 oz of formula after each feed. Now she's 1 month old...and we're still giving her 2 oz after each feed. And here we are, like total idiots, going "I wonder why she's acting hungry after the supplement". DUH!!!!

Anyway, when my friend told me that her son drinks 6-7 oz at a feed, I kind of freaked and thought "I'm starving my baby!!". After the next feed, she was clearly still hungry after her supplement, so I gave her another two oz. of formula (for a total of 4 oz.). As soon as the bottle was done, she was so content and fast asleep. It's clearly what she needed.

 

[Mervs Mum]

Is this other baby formula fed? ff he is then I'm not suprised he's taking more - the more he eats the bigger his tiny tummy stretches and the more it need to fill it next time. You really shouldnt be comparing them like for like anyway. Your baby has a different mother, father, grandparents and therefore totally different genetics. We live in a formula feeding culture and the formula companies want it that way. I have no idea how many oz my baby takes during her feeds - it's not relevant. Before formula no one did. You sound very down and negative about it. I think it then becomes a cycle. Lack of sleep and wont affect your supply. Topping up with formula will. If you are happy supplimenting then you need to make peace with that and just go with it! IT's not all or nothing - it's what works for YOU. If you want to exclusively BF you then there's probably some rough times ahead - it's all about what you want for you and your baby - only you can decide and you need to be comfortable with it to really make it work for you.
I topped up from about day 4 I think - I got to day 10 and it was clear it was a slippery slope. It was getting to be a bit more top up and a bit more. Fortunately a couple of things happened. I topped up so much she projectile vomited across the room and I was so scared I decided there and then that I wanted to stop. The other thing was that I remembered how much I wanted to do it - to BF her exclusively. So I went to a consultant and she went through what I was doing. Basically apart from the top ups I was doing everything right - I just need to keep doing it and most of all to believe in myself - believe it would happen. Remember when you were TTC. It's like the more you dont think it will the less like it is to happen. This is the same.

 

[marley2580]

I agree with Mervs Mum, you need to decide which way you want to go. If it's with topping up and formula then go for it. But if you want to continue with BFing then it's going to be a hard few days for you.

Personally, if you decide on BFing, I would suggest dropping the pumping altogether and taking your baby to bed with you for the next day or two. The baby is better at getting the milk out than the pump is, so this should help your supply. Instead of topping up after every feed, offer the breast every time she is hungry. If at any point you need a wee break then by all means offer some formula, but try to keep it to a minimum.

Oh, and if you take her to bed with you, you should be able to catch up on some sleep at the same time, which will also help your supply.

Good luck with whatever you decide is right for you.

 

[lillysmum]

sorry i can't think what to suggest other than getting Mia to latch on every hour to try and get the milk coming in rather than pumping between feeds, as ths is what naturally happens when babies go through growth spurts and need to increase the milk supply. topping mia up with some formula so she's not going without but gradually decreasing the amount as your milk comes in.

 

[cupcake]

i recommend trying different pumps, with an eletric i get barely anthing with the medela manual i get much more! i know lots of ppl who have said that different pumps do different things for them. i would say you are doing the best you can, if your supply is not increasing and its driving you crazy and your daughter is not gaining the weight she needs, i would just put her to hte breast each feed and then give her the top up. Her health and yours are most important. You really sound like you have done your best hun x

 

[CapitalChick]

Everyone,
Thanks a bunch for all your support and advice. Here's the situation. Yesterday I began a three-day "nursing vacation", in which I promised I wouldn't leave the house for three days and would commit myself to working on my supply and see what happens.

Yesterday (day 1), I nursed a ton, pumped twice, continued with my medication, and only supplemented the baby when absolutely necessary (it was quite obvious when it was required...moreso in the evening). Anyway, I didn't sleep well last night, so I expected that my supply would be lousy today, but our first morning feed (10am), was actually great! Of course, I don't know how much milk the baby got, but she was actually drinking at the breast for a good ten minutes on each side. Like...actually drinking and swallowing for a full ten minutes. That's UNHEARD of for us! I was thrilled. She didn't have that "stoned" full look after the feeding, but she also clearly did not require a supplement. I was so happy! She went down for a nap after the feed and, as I expected, she got up within an hour (as opposed to 2.5 hour naps she's used to) to feed again. I figured this would happen because she didn't get a supplement....But that's totally OK...at least she just drank from me, right?!

Anyway, the next feed was ok, but not as great as the first one. She did need a supplement after the feed, but I used the Medela SNS (gravity feeder) to give it to her, so at least I got stimulated while she took the supplement. Now she's down for a nap. I thought I'd pump, but I was tired and needed to relax and eat, so that's what I did. I'd like to pump twice today, just like yesterday.

I hope that three days of this will really help my supply. I'll keep you all posted.

Oh..and the other things I'm doing are:
-Continuing to take domperidome, fenugreek and blessed thistle
- Drinking one large can of guiness beer per day (YUCK!!!!...I just tell myself to take it like medicine...just don't think about it...just swallow).
-Eating oatmeal for breakfast

 

[Mervs Mum]

WOW!!!!

Amazing start AND you already sound much more positive!!

You are doing EVERYTHING right too honey - awesome.

Soooo.....a pumping tip...when you pump have a favourite picture of Mia to look at - one that makes you go all Dont look at the pump or the bottle - look at the picture and think squishy baby thoughts - it will help I promise. Dont be tempted to look at how much you've got.

Great job using the feeder for suppliments - definately a great idea. Make sure when you can you strip her and you of as many clothes as possible - it cant be underestimated how much skin to skin contact helps supply.

She WILL sleep less between feeds BUT that's not because you're not giving her enough - its because the BM is much quicker to digest than the heavier formula so try to see it as a good thing IYKWIM.

WELL DONE WELL DONE WELL DONE!!!

 

[CapitalChick]

Thanks MervsMum! You really are a breastfeeding cheerleader!

 

[Mervs Mum]

If only I still looked like a cheerleader!!!! My hubby would be pleased.....

 

[CapitalChick]

LOL....You should see my tummy...oh the stretchmarks...yikes. My hubby just shrugs and says "It's great....you got 'em for a good cause". Bless him.

 

[Mervs Mum]

I hear ya sista!!! I call them my battle scars.....they were worth the war though!

 

[Michy]

Which pump you using hun?

 

[CapitalChick]

I'm using a Medela Symphony pump...hospital grade. Provided to me, free of charge, by a government program in my city...Thank Goodness...I could not afford a $2500 breast pump!!!

 

[Mervs Mum]

OMG!!! LOOK AT THAT BEEEEEEEAUTIFUL GIRL!!!!!

She's a dot! x

 

[Michy]

Same as mine!

I have a tip for you then, you know when it first starts it has a fast sucking action? Well when I was trying to increase my supply I would stop the pump after 4 mins and start it again so that you get 2 mins of fast sucking and then 2 mins of slow sucking.

For me that helped me get a second/third and sometimes fourth let down which mean more milk came out which in turn will increase your production further.

Also I found the most difficult part of pumping was the bloody sterilising! You don't need to wash and sterilise your pump parts every time you use them just pop them at the back of your fridge in a sealed container. Knowing this really helped me pump more.

Well done hun you are doing sooo well. xx

 

[Michy]

OMG your daughter is amazing

 

[CapitalChick]

LOL...thanks ladies. That's one of my favorite pictures of her. She's such a smooshy cutie pie... sigh...

Anyway, I just wanted to ask a question about the pumping: Today I pumped for 15 mins and was squeezing and compressing for most of it. i got very little out, and then for the last 5 mins, nothing was coming out at all, no matter how much I compressed. While I was pumping, the baby started crying, so as soon as I turned off the pump, I put her to the breast and she started drinking. Not much, but there were definite swallows going on...So why didn't it come out with the pump. Does this mean there's no point for me to pump? Or should I continue?

Also, another question...do you find you have less milk as the day goes on? I find my supply is highest in the morning, then dips a little, then is better again mid day, and then gets progressively worse as the day goes on. By night time, I'm pretty much dry. Anyone else??