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Thread: Milk Production Down? Or Something Else?

  1. #1
    Join Date
    Jan 2012
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    Default Milk Production Down? Or Something Else?

    Hi I have been breastfeeding my 11 week old from a few days after birth, with minimal formula after the first few weeks (one bottle a day). I initially took fenugreek seeds as a supplement and then switched to red raspberry leaf tea a few weeks ago after I heard that fenugreek can cause stomach problems in some infants, which my baby has a lot of (though not GERD). With both supplements, I have reduced and increased dosages when it seemed like I was tending towards over production.
    However, since last week i have begun to feel my production has dropped. My baby is nursing for MUCH less time each time (though I am told it can be she is more efficient now) at about 5-15 minutes max mostly and sometimes also will drink an ounce or two of formula soon after feeding. My nanny believes she is not getting enough milk from me as she grows.
    I do pump once a day when we always feed her formula at bedtime, and I pump about 4 ounces but I have noted that the pumping has gotten slower and longer. I did try to up the pumping strength but abandoned that when I thought it had made my milk blister come back (if interested, please see separate thread on "Help needed - nipple and breast pain" for details)
    She feeds for much less time also at night now, and I am wondering whether she really needs the two sessions in the middle of the night or this is just habit for her at this stage? Any thoughts on that would be welcome.
    I am loathe to spend another big sum of money for an LC visit to just weigh the baby before and after feeding - I do have a baby scale with an error of 10 mg that I am considering using.

    I am concerned that my milk production is actually falling. I am consistently under-rested since the beginning but I figure that is par for the course. I am starting full time work in four weeks and am quite disturbed at the uncertainty on whether I will be able to feed my baby mostly or we'll eventually migrate to a LOT of formula.

    Any suggestions and thoughts would be highly appreciated! Do people typically have issues at 3 months or is this unusual?

    thanks

  2. #2
    Join Date
    Mar 2006
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    10,440

    Default Re: Milk Production Down? Or Something E

    A few questions:

    What kind of pump do you have? Is it new? Have you changed any membranes, etc?
    Why are you giving formula after a nursing?
    How are her wets and poops,
    How has her weight gain been?

    It is normal for your supply to regulate, which is why it is harder to get milk out with a pump.

    In your shoes, knowing its almost time to go back to work, I would consider:
    Going back on fenugreek
    Nursing more

    As far as pumping at work, if you are pumping every 2-3 hours until you stop seeing milk drops, plus a few minutes, you should be OK. This is usually at least 15 minutes. 20 is better for your supply.

    I would NOT drop the night time nursing. Those are GOOD for your supply.

    I wonder if your nanny is making you doubt yourself. Is she more used to formula fed babies?
    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!

  3. #3
    Join Date
    May 2006
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    20,852

    Default Re: Milk Production Down? Or Something E

    with the PP. I just want to add that most babies will take a bottle even if they have just nursed. Babies like to suck, and they will suck on the bottle if nothing else is offered. Since the bottle always delivers the same flow of milk regardless of whether the baby is sucking for food or for comfort, a baby who has recently eaten his fill at the breast will often still take an oz or two from a bottle.
    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!"

  4. #4
    Join Date
    Jul 2010
    Location
    New York
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    Default Re: Milk Production Down? Or Something E

    Dear mom2000,
    The most reliable method for increasing your milk supply is to nurse your baby w/o keeping to a schedule. As long as you are nursing your baby 10-12 times over a 24 hour period your
    milk supply will remain bountiful. It is normal for our breasts to regulate their milk production and not "fill-up" in between feeds.
    I can relate to your apprehension over calling a lactation consultant. I think your milk production will respond positively the more frequently you nurse.
    DD#1 July 1986 VB
    DD#2 April 1988 c/sec
    DS#3 April 1990 VBAC
    DS#4 June 1993 VB
    and suprise!
    DD#5 April 2001 c/sec
    BTDT scars and stretchmarks,: wrinkles and grey hair

  5. #5
    Join Date
    Jan 2012
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    Default Re: Milk Production Down? Or Something E

    Thank you for the quick responses to all three of you!

    I am nursing far fewer than 10-12 times a day - in the 12 hrs at night my baby nurses twice (at 6 hrs and 9 hrs or so) and during the day I manage 2-3 sessions before she sleeps for 2-3 hrs hrs in the afternoon and one after when she wakes up. That makes about 6-7 times max. From my prior conversations with other moms, I hadn't gotten the sense that fewer feedings were bad if the baby was ok (weight gain is good, as are the diapers). I will try and increase the number of sessions.

    On the other questions, she has been gaining weight at an ounce a day, and we havent had trouble with the peeing and pooping. My pump is the Medela one and worked well initially. I have cleaned the pipes and membranes worrying about the pumping efficiency but that hasnt had any effect so far as I can see.

    Thank you again - its a relief to hear of these comments. Will keep the advice in mind for pumping when I am back at work as well.

  6. #6
    Join Date
    Mar 2006
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    Default Re: Milk Production Down? Or Something E

    You may need to replace the white membranes. Most moms who pump a lot at work replace them at least once a month.

    Make sure you have the right size of horns. That can impact your supply when you are partially dependent on a pump.

    6 nursings a day is adequate for some moms, but not all. If you are low, nurse or pump more. Pumping can take a week or so to rebuild your supply, so nursing is faster and easier
    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!

  7. #7
    Join Date
    Jan 2012
    Posts
    18

    Default Re: Milk Production Down? Or Something E

    Thanks again! I switched out the membranes yesterday (though I noted they are in the chain of pumping after the milk comes out and makes its way to the bottle) and will be changing the pipes as well today.

    I am trying to nurse more frequently though now I have a new problem - my baby falls asleep at the breast or sometimes refuses to take the breast (this happens especially with my left breast, which has more milk). And in the process she is not getting enough from me, which then means she almost always wants a bottle before she will go into deep sleep (the sleep at the breast is over within a few minutes of putting her down). I am on the verge of simply moving to pumping and bottle feeding during the day when she does this. I think she just gives up sucking at the breast when she is sleepy (and she tends to get drowsy and relaxed anytime she is at the breast).

  8. #8
    Join Date
    Jun 2009
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    Default Re: Milk Production Down? Or Something E

    Why don't you stop giving her a bottle? And work on keeping her awake when she is nursing?
    Tracie

    Mommy to
    Lilah 10/08 nursed 25 months
    Beatrix 01/11 nursed 30 months

  9. #9
    Join Date
    Jun 2009
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    Default Re: Milk Production Down? Or Something E

    Breastfeeding and formula/bottle feeding are utterly different. So trying to make one set of rules work for the other is going to cause issues and confusion. You cannot overfeed a breastfed baby, but you can overfeed a formula fed baby and that is unhealthy due to the difficulty babies have digesting formula. So formula feedings do have to be measured and regulated, while a breastfed baby, while they are exclusively breastfed, usually need & will request 8 or more nursing sessions per 24 hour day, and best if these are given on baby's cues, not on a schedule. (Some babies' are OK with less, rarely.) Also, while babies need more and more formula as they grow in order to get enough nutrition, they do NOT need more and more breastmilk, because breastmilk changes in nutritional content as baby grows. So a 1 month old needs about the same amount of breastmilk as a 4 month old, and so on until baby is geting lots of their nutrition from solids. So it is incorrect that your baby needs more milk as baby grows. This is a common error.

    When a baby is cueing so infrequenlty, I first wonder if mom is missing some cues, especially the more subtle, early cues. If someone else is taking care of baby part of the day, you may be missing some of baby's cues. Same if you are sleeping remotely from your baby, which is why it is recommended that breastfeeding moms have baby in close proximity even at night. If you are nursing on a schedule, you may be nursing baby when baby is needing to sleep instead. This is why sleep training and meal scheduling often interferes with the normal course of breastfeeding. On the other hand, it is perfectly normal for baby to fall asleep at the breast, and many babies continue to nurse in their sleep, this is normal and expected. "comfort nurseing" is an integral and important part of nursing. Many babies, both formula and breastfed, wake shortly after being put down, and a light sleep pattern and frequently waking is normal at this age. I know you are tired, but health wise, it is not necessarily a good thing to put a baby into a very deep sleep state by feeding a bottle of formula at bedtime.

    Some babies seem to do fine on 'combo' feedings (breast and bottles) while others, especially if bottles are introduced very early, develop nipple/flow 'confusion' and that causes them have difficulty nursing or to refuse the breast. This is usually reversible, here are tips: http://www.kellymom.com/bf/concerns/...to-breast.html

    I think you have several options, of which exclusive pumping is one. Here are three I can think of:

    1)You can decide you are going to exclusively nurse, and do so, by working on cue feeding and nursing more frequently. If your supply has been impacted, you can work on that by nursing more, maybe pumping a bit, trying galactagogues. When you go back to work, you can pump and your baby can be given your milk while you are away. Only if necessary for baby’s health is formula supplementation needed. Baby acting hungry is not a good indicator that supplementation is necessary. Many moms fear they have low supply when they do not. This article has info on the real signs of low supply: http://www.kellymom.com/bf/supply/low-supply.html also, to avoid flow confusion, have you and your caregiver learn how to bottle feed the breastfed baby: http://www.llli.org/docs/00000000000...astfedbaby.pdf

    2) You can continue to routinely combo feed as you have been doing. Since this can cause issues such as breast refusal and low supply, and indeed does seem to be causing these issues, you can expect that your breastfeeding relationship may not last as long as if you exclusively nursed. But, until then, you and your baby will continue to get the benefits of nursing at the breast, those are physical and emotional benefits that go above and beyond the benefits of breastmilk.

    3) You can stop nursing and give your baby your pumped milk, perhaps by necessity in combo with formula. Since many moms find pumping & bottle feeding much more difficult than nursing, and it is also much harder to maintain a good milk supply this way, this may lead to your baby having breastmilk for the shortest amount of time. However, healthwise, this is of course much more healthy than going right to exclusively formula feeding now.

    If you choose number 1, you have the best chance of building and maintaining a good supply, and if it is not working for you, you could always stop that any time and switch to number 2 or 3. If, on the other hand, you choose number 2, and particularly number 3, it will become more and more difficult each day to change your mind and go back to nursing at the breast. I like to point this out because sometimes moms get frustrated or tired and make a decision today that they regret a few weeks later when it is difficult to reverse things because they have lost more supply or will have an even harder time bringing baby back to the breast.


    PS I wonder if baby refusing the best producing breast is actually due to forceful letdown, which can be caused by infrequent nursing. See this article for more: http://kellymom.com/bf/supply/fast-letdown.html
    Last edited by @llli*lllmeg; February 8th, 2012 at 07:00 PM. Reason: confusing typos

  10. #10
    Join Date
    Mar 2006
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    Default Re: Milk Production Down? Or Something E

    The little membranes flap open and closed, which causes microtears in the edges and decreases suction. That is why they are last in the chain

    Often, that is all you need to do to restore a pump to good working order as long as it is not nearing the end of its lifespan. A professional grade pump is meant for about 400 hours of use. The lighter pumps, meant for occasional pumping, won't even last that long. So if your pump is used or older, that could be a problem.
    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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