I want to breastfeed, but my milk is disappearing. I’m looking up stuff about what to do and am totally overwhelmed by citeless sites that assert a whole hell of a lot without anything to back them up. I am seeking scientifically verified information and/or advice. Please don’t give me unsupported assertions, even if those assertions come from reasonable sources.
Examples of an unsupported assertions I see reiterated everywhere, but never supported with evidence:
[ul]
[li]Breastmilk supply fluctuates to meet baby’s demand.[/li][li]Pacifier use decreases time baby spends sucking at the breast and therefore decreases supply.[/li][/ul]
It’s not that I don’t think these assertions COULD be true, just that I can’t evaluate them meaningfully without evidence.
How exactly do I re-stimulate production? My kid is on a direct-nursing strike, so I have to do this with pumping until he relents. But I’m pumping every 2 - 3 hours and getting almost nothing.
More details on my own situation in bullet points 'cause kid is fussy.
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[li]4-month-old son – healthy! woot![/li][li]41-year-old mother (me)[/li][li]want to breastfeed exclusively[/li][li]had cancer; fetus exposed to chemo during 1st/2nd trimesters[/li][li]major health consequence expected for baby = low birthweight[/li][li]delivery induced due to worries about Intra-Uterine Growth Restriction[/li][li]then emergency C-section due to prolapsed cord[/li][li]baby 6 lbs, 9 oz at birth[/li][li]hospital super-duper pro-breastfeeding but advised supplementing anyway due to slow weight recovery in first week[/li][li]kid went from 5th percentile in size at birth to 50th at 2 months (don’t know current %ile)[/li][li]continued supplementing for various reasons; guessing baby got about 1/5 of calories from formula until recently[/li][li]have good quality (not hospital grade) Medela breast pump (“Pump in Style”)[/li][li]until recently, usually got a couple of ounces when pumping – more first thing in AM, less as day went on[/li][li]in last 2 or 3 weeks, baby’s been taking more and more formula[/li][li]in last 2 or 3 weeks, get less and less when pumping – now 10 - 45ml[/li][li]in last few days, baby gets pissed off when I offer breast (still likes breastmilk from bottle, though)[/li][li]stupit formula got recalled, no longer available as powder locally, have to buy as premix or switch brands :mad: and don’t want to do formula anyway![/li]not thrilled about fenugreek; most people think it makes you smell like maple but my nose gets “rotting garlic”[/ul]
You might find some helpful information on a Google search of “inducing lactation”-these women are starting with a breast that has not been exposed to pregnancy hormones, and providing enough stimulation of the breast to cause milk production to start.
Maybe your husband would be willing to provide a little extra nipple stimulation.
I can’t provide you with science. I just know from experience that a baby who gets a bottle gets lazy. The breast is more work for them, so they will fuss because they want it easier, and you give in. And the pump doesn’t stimulate some women enough to keep up production if the baby isn’t doing any of the work. He won’t relent if he knows he’s going to win by getting the bottle when he fusses. And when a baby increases his demand, even if he is exclusively on the breast, it takes a few days for supply to catch up (drink your water at every feeding!) so there will be some crankiness even for an exclusively breastfed baby.
Aah, the first of a lifetime of battle of wills between you and your son! enjoy!
I nursed my daughter for almost 2 years. I occasionally had supply issues and other moms gave me these suggestions. They worked for me–I hope they work for you…
1 - Drink lots of water! If you are the least bit dehydrated, it’ll screw around with your production.
2 - Previous posters had it right. supply = demand. I worked full time and pumped at work 3x daily. When I noticed a drop in supply, I’d take a day off from work and “super-nurse”. Stay home and basically nurse the baby as much as s/he will nurse, all day…like every 30 minutes, if possible. This will signal your body to start producing more milk.
3 - Eat oatmeal (this one worked for a while but stopped working–maybe it’ll give you the boost you need until your body starts producing more milk). Either oatmeal for breakfast or homemade oatmeal cookies. Something about oatmeal stimulates production.
4 - Take Fenugreek capsules. You can get it at just about any grocery store in the vitamin aisle. It won’t harm the baby. Beware–you’ll start to smell like maple syrup!
5 - If you’re pumping, make sure you’re using a good hospital-grade pump. Weaker pumps won’t stimulate your breasts as well and your production can suffer. I ended up renting a really great pump for next to nothing. It helped tremendously.
There’s a drug called domperidone (an antacid) that can up your flow of milk. It’s legal in Canada, but not FDA approved in the US. Some doctors will write a prescription for it and you can get it made at a compounding pharmacy. I personally didn’t use it, but I read a lot of accounts and was told by people who did use it/prescribe it that it was effective.
Another thing to try is a different “cone” for your pump - boobs are not one-size-fits-all, of course, and there are a bunch of different inserts and whatnot you could try. I had the same pump you have and it worked pretty well, but I had much better relative success with a Lansinoh hand pump (relative = obviously, I didn’t get quite as much with the hand pump, if only because my hand got tired, but let-down was easier and it was a LOT more comfortable).
I took fenugreek as well, when my supply dipped, and it worked. I HATED the smell, but it was worth it at the time.
On parenting boards, I’ve also heard of a drug called Domperidone that might not be available in the U.S., but apparently has fantastic results. My own kid is clamoring for attention right now, though, so I don’t have any more info for you than that!
Blessed Thistle (also known as Milk Thistle) also works for milk production, especially in combination with the Fenugreek. The liquid More Milk Plus supplement was the best, though, as was Mother’s Milk Tea (I drank three cups of that a day religiously while breastfeeding, as I always tended toward low supply). But four months is right when your kiddo starts interacting with the world, and feedings become dull for them. They get a little pissy when they’re feeding during the day, and cut them shorter so they can look around some more. Many breastfed babies who sleep through the night stop doing so for about a month when they’re 4 months old, because they cut their daytime feedings short.
Oh, and you’ll want to replace your pump parts every three months (valves and flanges, not necessarily tubing). My supply would always go up after I replaced mine.
I’m going to agree with the people saying to try a different pump or pump parts. I had very active milk production and I still had problems pumping.
And if it comes down to it, don’t feel too bad if it turns out you can’t continue breast feeding.
I have no cites to offer, but I had a robust and hungry baby keeping up demand and I still never could get anything out of the pump. It was exhausting and made me feel less than successful.
Because I couldn’t make the pumping work I did supplement with bottled formula from the start and it didn’t make her lazy or less happy to nurse when she could (as some people warn).
Try a new pump or switch up the attachment. Try scheduling the nursing for a little while so he gets used to nursing at certain times, that could make it easier to get him into the groove, then increase the length or frequency until you can build back up to breast milk only.
This issue can really do a number on your confidence as a mom. My only contribution here is that probably it’s not you, so go easy on yourself, give it time, and congratulations on making it through what sounds like a difficult pregnancy.
I’m kinda off topic here and chiming in with what may or may not be a welcome opinion so I do apologise in advance…
For our first kid, my wife had problems with breast feeding - daughter was about 50% breast fed for the first three months or so then supply “dried up”…whether this was due to laziness, mummy, diet lacking or whatever I don’t know.
Currently on baby two, who is coming to three months now. She is about 50-60% breast - suckles 3-4 times a day, as mummy supply does’t seem to be enough. And we are not particularly willing to see baby go hungry until mummy supply catches up.
My thoughts would be not to get too hung up on exclusively breast milk, if it works for you great, if not meh, you won’t do baby any damage by bottle feeding. It IS easier on mummy, and also it DOES give daddy a chance to bond with baby (not that breast milk can’t be expressed for daddy to bottle feed, but well, you know - that just makes more work for mummy :)).
Basically I guess what I am trying to say is that (IMHO) it is better to bottle feed, ensure that baby gets enough milk and have a (relatively) relaxed mummy than to breast feed exclusively if it means that mummy is going to be stressing over producing enough milk
I don’t know how much scientific evidence you will find here, but lots of us will have good ideas to try. Here’s mine FWIW:
Have you called LLL? That would be my first step.
Try pumping on one side while you nurse on the other, then switch. The combined stimulation should help increase your supply.
Take to your bed for the weekend. Take all of your clothing off, take everything off of baby except diaper and stay there for 2 - 3 days nursing completely on demand, no bottles.
Be thoughtful about your own intake, I second the oatmeal and the supplements others have suggested.
Good luck.
ETA get a nursing necklace! Google the phrase to see what it is. Like PP said 4 month olds sometimes are more interested in the world than the boob.
I don’t have any cites and I don’t have any babies, I just wanted to chime in with “breast is best… but healthy happy mama is better” - if breastfeeding isn’t working for you, for any reason, bottle is not failure. Your baby will not flunk out of fourth grade and end up riding the rails with hobos and eating pigeons and rats because breastfeeding didn’t work out for you. I know you know that, but, you know.
Zsofia, I totally agree, I nursed for a total of 3.5 years, but also both of my kids got a lot of formula too and really if nursing was so all-fired important we could point out on the street who was breastfed and who wasn’t. Just feed your kid something and everyone goes home happy.
When my supply crashed at four months, it was followed within days by the return of my period, I’m sorry to report. When that ended, my supply rebounded somewhat. But I had a massive oversupply in the early days, so I was able to use my stash instead of formula to supplement.
Get a massage. Being relaxed helps with letdown. I also found that pumping every three hours round the clock was counterproductive - being exhausted did a bigger number on my supply than the gain from the extra pumping sessions.
You might consider renting a hospital pump for a month or so while you work on getting the supply back up - it really does work better.
Try offering the breast when the baby is sleepy - you might get him to latch on even though he’s not getting a lot of milk, and thereby stimulate some more production. He is better at that than the pump.
Your supply isn’t hormonally driven anymore. It’s 100% supply and demand. If you nurse your baby as often as he wants, whenever he wants for as long as he wants, your supply will meet his needs - usually by the next day. Take a weekend nursing vacation like Hedda Rosa suggested.
Another issue may be that he’s going through a growth spurt. During growth spurts babies are super fussy and it can seem like they’re not getting enough milk when actually they’re just trying to pump up the milk production to meet their changing needs.
Ditch the bottles and pacifiers - a lot of breastfed babies don’t want to bother with the extra effort it takes to suckle milk from the breast if they know they’re getting a bottle later. The effort is worth it in the form of sinus, jaw and tooth development.
Latch baby on before he gets frustrated or is crying - just when he starts rooting. Or when he’s really tired.
Sleep with your baby if you don’t already and let him nurse all night long. You’ll fall inot that nice breastfeeding coma and sleep fantastically!
Talk to your Dr about galactagogues- Domperidone, Fennel, Mother’s Milk tea, Fenugreek, Nettle, Dill, Caffeine, Hops and Metoclopramide.
The medications are not antacids. Domperidone stimulates gastric motility and is often used for nausea and bloating. Metoclopramide is also a gut motility stimulant and is used as an anti-emetic. Both are effective at increasing supply, both are relatively safe, but your doc may have to issue them off licence and the have side effects.
Make sure you are sleeping enough- nothing kills your supply like exhaustion.
Check your diet- any new foods recently? Any new perfumes, soaps or laundry detergents?
Anything that might have changed the way your milk tastes or the way you smell might be putting your baby off nursing directly from the breast.
Make sure you masage your breasts regularly before and after you use the pump- it will help with letdown and make things more comfortable.
I’m in Canada, so I get domperidone from my kids’ pediatrician, and I can tell you, it makes all the difference. I also second the idea of the hospital grade pump. My kiddo has a pretty weak latch, and I found that pumping for 15-20 minutes after feeding really helped keep my milk supply consistent. Good luck!
Domperidone is not available in the US and you have to be very careful about it coming from Canada. It can be seized at the border if sent by mail. If you travel to a Canadian pharmacy for it, you need a script from a Canadian doctor.
My cousin in Calgary is currently using it for her daughter and it is working well for her.
