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Thread: im a little confused.

  1. #1

    Default im a little confused.

    Hello!
    My sweet little girl is just over 14 weeks old. Just before she turned 12 weeks, we began to have some issues. They came on quite suddenly and I was pretty worried. She went from nursing 15 minutes per side to less than 5 per side over night. She would always come away crying and seemingly unsatisfied, and I was not able to hand express even a drop after she was done.

    I knew that supply regulates around 12 weeks, but I did not know I would be left with so little so suddenly. I also knew of a growth spurt around this time, so I really wasn't sure what the problem was. I tried not to worry... but it was hard. She has always been in the 10th percentile or lower for both weight and height. She doesn't have much room for problems. I began nursing every 30 to 45 minutes. When she began to not even meet the minimum wet diapers, I panicked and started giving formula after breastfeeding. I only gave 2 ounces at a time as I knew it would only hurt my supply more.

    At the worst point she got 8 ounces of formula total in 24 hours. The last couple days she has only had 2 oz total. I am still nursing very frequently. I would have pumped but I can't even get an ounce total from both sides.

    So now we are almost off the formula. However, she does not seem to want to put any effort into eating. This is where I get confused. Sometimes she sucks me dry and still wants more. Other times she pulls off and refuses to try to take in the hindmilk. Her poop has been green for a week or so now. I know this indicates an oversupply but I really doubt this. I still feed very frequently and she often wants more than I have. I don't believe I have an overactive let down. We have never had a problem with her choking or having a hard time. I just don't get how sometimes she pulls off crying when I still have milk... and other times she pulls off crying because she wants more.

    I've tried breast compresssions. It seems to make her angry and doesn't really help. Any thoughts?

  2. #2
    Join Date
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    Default Re: im a little confused.

    Green poop can mean a variety of things, and if you don't have other signs of oversupply, it probably doesn't mean that.

    Have you seen a lactation consultant, preferably an IBCLC? I think it would be helpful to have someone who knows what they are doing WATCH you nurse, and potentially weigh your baby before and after a feeding, to give you some idea of how much milk they are transferring.

    It could be that your baby's latch is not ideal for transferring milk. This is something someone could see in person, but it's really hard to diagnose in this way. Or, it could be that you could increase your supply by pumping after feedings, taking galactagogues, etc. But it's hard for me to tell by your post.

    While it's not common, there are several medical conditions in a mom that can cause low supply. PCOS and thyroid problems are the most common. So if you're continuing to have issues (especially with diaper counts, which is concerning), you might want to look into getting your thyroid levels checked, etc.



    You can call me JoMo!

    Mom to baby boy Joe, born 5/4/09 and breastfed for more than two and a half years, and baby girl Maggie, born 7/9/12.

  3. #3
    Join Date
    Feb 2011
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    278

    Default Re: im a little confused.

    Is her poop green when you give formula? it could just be the iron in the formula, that's actually common.

    She may be beginning to favor the bottle (especially if you truly are having an issue with supply, but this can happen even without because they don't have to work as hard with the bottle). I would be concerned if her diaper count is not good though, in which case supplementing is necessary. What have you done to try and increase supply other than feeding frequently (which is a good idea, but have you tried fenugreek or other galactogogues?)
    Mama to five beautiful kids- 9, 8, 3, 2 and currently nursing our new baby girl born 1/20/2013


    "It should not be necessary to tell reasonably intelligent mammals to suckle and not dismember their neonates." ~Susan Blustein

  4. #4
    Join Date
    May 2006
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    21,175

    Default Re: im a little confused.

    Welcome! I'm sorry you've had such a difficult time with nursing. But what you describe sounds fixable, albeit confusing, and you're certainly not alone in struggling!

    The drop in supply you seem to have experienced at 12 weeks is puzzling. Generally all a mom needs to do in order to maintain milk supply is to nurse in demand. So usually when a mom who is nursing on demand panics about milk supply, she's overreacting to a normal adjustment in supply. Basically, the usual case is that a mom mistakes the transition from oversupply to normal supply for low supply. But your baby stopped making the minimum number of wet diapers, which implies that whatever was going on was real, and not just a misperception on your part. So that makes me wonder what might have been going on at that point. Some possibilities that could explain an abrupt reduction in supply:
    - Sick baby. If your baby had an ear infection or other illness, she might have nursed much less and that could explain both the low diaper output and drop in supply.
    - Going on a new form of hormonal contraception. Even some of the hormonal options that are promoted as being safe for breastfeeding (like the mini-pill or Mirena) seem to cause supply reduction for some moms.
    - Pregnancy. It seems unlikely at 12 weeks...?
    - Return of your menstrual cycle. Also unlikely at 12 weeks, but many moms experience a premenstrual drop in supply.
    - Thyroid problems. Both hypothyroidism and hyperthyroidism can cause issues with milk supply, and thyroid problems are apparently quite common but underdiagnosed in postpartum women.
    - Retained placenta. Can cause issues with milk supply, but it seems like this possibility would have shown up long before 12 weeks.
    - PCOS- said to cause supply issues for some moms.

    At this point, if your baby is producing adequate wet and poopy diapers I think you can safely wean off formula. The green poops are unlikely to be a sign of oversupply. I'd guess they are a sign of your baby's mixed diet: formula can turn poop a kind of greyish-green color. However, a baby who is not taking in enough milk can also produce green poops, so I think I'd want to talk to a lactation consultant about your experience and maybe rent a professional grade scale. If you do a few days worth of weigh-feed-weigh tests, you can gain a highly accurate picture of your baby's milk intake. (One weigh-feed-weigh test at the LC's office is not enough- milk intake can vary a lot from feeding to feeding.)

    Your baby's behavior at the breast actually sounds pretty normal. Sometimes a baby will nurse you pretty dry yet still want more. Short feedings are normal- after a certain point, babies become efficient nursers and can get all the milk they need in just 5-10 minutes at the breast. It's not necessary for a baby to stay on the breast for a long time in order to "get the hindmilk"- there's really no such thing as hindmilk and foremilk. There's just milk- low-fat and refreshing at the beginning of the feeding, increasingly creamy as the feeding progresses.
    Coolest thing my big girl said recently: "How can you tell the world is moving when you are standing on it?"
    Coolest thing my little girl sang recently: "I love dat one-two pupples!"

  5. #5

    Default Re: im a little confused.

    Her diaper count is okay now. Nothing impressive, but she's over the minimum daily amount... I have been slowly trying to reduce the formula with good results. I only wanted to use it to get through the rough patch. She nurses great at night when she is half asleep. I did worry about her having a preference for the bottle but she starting doing this about 5 days before I actually broke down and gave one to her...

    Her poop is green even with the formula... but i don't think she gets enough formula for it to affect that... yesterday it seemed halfway between green and Orange, but today it was back to green. It is not foamy!

    We are doing much better now than we were a couple weeks ago. But its just a bit frustrating and confusing when one session she refuses to empty a side and the next she is crying for more.

    Prior to this we nursed every 2 hours. Every 45 minutes now gets us by. I can't afford to see a lc... we did have problems with latch in the first weeks but it seems okay now. I don't have pain anyway...

    I did recently start taking fenugreek but... I started taking just 1 in the mornings. Then I quit because I thought I was going to have to give up bf at the lowest point. Then I got a new resolve and started it again but I'm very inconsistent with it. I just plain forget. My schedule has been all messed up with my son being on break from school. Once things are back to normal ill probably be better about it...

  6. #6
    Join Date
    Mar 2010
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    Default Re: im a little confused.

    Quote Originally Posted by @llli*coldnote View Post
    Prior to this we nursed every 2 hours. Every 45 minutes now gets us by. I can't afford to see a lc... we did have problems with latch in the first weeks but it seems okay now. I don't have pain anyway...

    I did recently start taking fenugreek but... I started taking just 1 in the mornings. Then I quit because I thought I was going to have to give up bf at the lowest point. Then I got a new resolve and started it again but I'm very inconsistent with it. I just plain forget. My schedule has been all messed up with my son being on break from school. Once things are back to normal ill probably be better about it...
    I just wanted to say, I was like you and didn't think I could afford to see a LC, but when I thought about the cost of formula for a year, I realized I could afford to see a LC. Formula is EXPENSIVE. Way more expensive than a couple trips to a lactation consultant.

    If you truly can't afford a lactation consultant, what about contacting your local LLL leader? They are often very knowledgeable and helpful.

    Most people find that only much larger doses of fenugreek are helpful for supply. Hopefully someone will stop by who knows more about that, as I am one of the few people who can't tolerate fenugreek at all, so I don't know the proper dosage.


    You can call me JoMo!

    Mom to baby boy Joe, born 5/4/09 and breastfed for more than two and a half years, and baby girl Maggie, born 7/9/12.

  7. #7
    Join Date
    Feb 2011
    Posts
    278

    Default Re: im a little confused.

    I would definitely contact your local LLL. also my insurance covered my lactation consultant visit. Another thing I would do is see your doctor about the possibility of postpartum thyroid issues. In general women with pcos and retained placenta tend to have low supply from the beginning. You're nursing very frequently for her to barely be getting enough.

    I had amazing results with domperidone, and only needed it a couple of weeks in the beginning. But fenugreek- yeah you need 6-9 capsules a day depending on what dosage your pills are. If you don't smell like maple syrup you're not taking enough.
    Mama to five beautiful kids- 9, 8, 3, 2 and currently nursing our new baby girl born 1/20/2013


    "It should not be necessary to tell reasonably intelligent mammals to suckle and not dismember their neonates." ~Susan Blustein

  8. #8
    Join Date
    Mar 2006
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    10,440

    Default Re: im a little confused.

    Regarding fenugreek, I take 2 capsules 3-4 times a day when I need a bit of a boost. 1 a day isn't enough.
    Susan
    Mama to my all-natural boys: Ian, 9-4-04, 11.5 lbs; Colton, 11-7-06, 9 lbs, in the water; Logan, 12-8-08, 9 lbs; Gavin, 1-18-11, 9 lbs; and an angel 1-15-06
    18+ months and for Gavin, born with an incomplete cleft lip and incomplete posterior cleft palate
    Sealed for time and eternity, 7-7-93
    Always babywearing, cosleeping and cloth diapering. Living with oppositional defiant disorder and ADHD. Ask me about cloth diapering and sewing your own diapers!

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