Sudden decrease in supply... need help!

[@llli*NCtraumaRN]

My daughter is almost 4 months old. I've had no problems breastfeeding until this last week. I noticed while pumping that I was getting less. I used to get at least 3 oz from the left breast and 5+ from the right during one pumping session (20 minutes). Now, especially friday and this weekend, I'm getting about 1/2 oz from the left and about 1 - 1 1/2 from the right. I'm pumping 20 minutes at a time, just as I have this whole time. I've tried increaseing the number of times I pump and it doesn't seem to make a difference. I'm worrying that my daughter is even getting enough when I put her to the breast now. All weekend she's been more fussy, she seems to get frusterated at the breast, pulls away and arches her back. I just ordered some Fenugreek because I read it may help, but it won't arrive until Tuesday. What else can I do? I'm not ready to be done breastfeeding! I had some heavy bleeding at the end of the week before last leading into the first of last week, so I guess my period has returned. Is that what's caused this??? Can your supply recover??? What can I do?

[@llli*auderey]

Hi mama,

There's a couple things you're talking about. First, pumping. You were an overachiever before; it is much more normal to get about 2 oz from a pump. Remember your supply regulates - often around this time - so you are now closer to producing what your baby needs, rather than way too much. That's not much good news for a pumping mom who wants to get the most milk! You might try experimenting with the length of time you're pumping (I got a second letdown around 23 mins), but please also tell us what pump you're using, how often, is the pump used and have you replaced membranes, and any other pumping details you can think of. Increasing supply by pumping takes a long time - at least a week often - so increasing the number of times will usually work but you won't see results right away.

Second, your daughter nursing. When does she nurse and when does she take a bottle? Count her wet diapers; if she has 6-8 in 24 hours, she is getting enough. Again, remember your supply is regulating, so you might not feel full or spray or leak if you used to. She is still getting enough. Fussy might just be normal. When, exactly, does she get frustrated? At latch on? After 5 minutes?

And yes, your period can reduce your supply temporarily. It will come right back up if you let her nurse nurse nurse.

And she is not done breastfeeding, at 4 months! For sure. This is just a tiny bump in the road. Don't panic!

Fenugreek is great; so is eating oatmeal; but you also have to just drain the breast, preferably through nursing, as much as possible.

Hang in there!

[@llli*browncow]

I know for some women their supply decreases with their cycle. I know you said you just had your period return but is there any possibility you could be pregnant? Pregnancy killed my supply really early on.

[@llli*NCtraumaRN]

@auderey - wow! I had no idea I was an overachiever before Good to know.

I purchased a new Medela Pump In Style Advanced Double Electric Breast Pump - The Metro Bag just before I had my daughter in January of this year. My schedule was like this: Breastfeed daughter at 7AM, pump both breasts from 10:30 AM - 10:50 AM, pump both breasts from 2 PM - 2:20 PM, breast feed daughter at 5:30 PM, breastfeed daughter at 8:30 PM. She'd usually sleep all night, but sometimes she would awake between 3 AM and 4 AM to breastfeed. Since the decrease, I've added a pump both breasts at 12:30 AM. I have to work, and even switched jobs so that I could pump because providing my daughter with the best (breastmilk) was so important to me. I have replacement membranes, but I've not noticed any damage to them when I'm cleaning them between uses.

Her daily wet diapers are within the normal range so far. I guess my wory is that she is getting two bottles of breastmilk at daycare each day (4.5 oz each), so she would still have normal diaper output, wouldn't she? I have noticed over the past week that she's not wetting her diaper at night. She'll get changed after bath and before last feeding at 8 PM and go until 6 AM without wetting. She used to be very wet when she woke up. When she gets frustrated at the breast, it usually goes like this: she'll nurse for about 2-3 minutes, then start pulling away and coming back to the breast, followed by aggitation and fussiness every 30 seconds or so. That all leads to full on crying and arching her back away from the breast.

I called a local la leche league leader on Monday (after my midnight cry and plea for help here) and since then have followed her advice: I'm taking 3 capsules of 610 mg Fenugreek 3 times a day, I'm eating oatmeal every morning, and I'm putting my daughter to the breast everytime she wants to suck (instead of using a pacifier, which she rarely takes). Thing I'm noticing now is that she is keeping the breast empty, or so it seems to me. Then, when it is actually time for her to eat (and she usually acts starved), she gets frustrated because there's just not much there for her.

@browncow - I guess there's always a possibility of pregnancy, although I doubt it in our situation. Our daughter was concieved through fertility treatments because I don't ovulate, even though I have regular periods. It took over three years to concieve and carry to term. That being said, I have read this past week that infertilty can change after having a baby, so who knows. I will also add that my husband and I have had sex only 2 times since the birth of our daughter. I would be willing to take a test to check for the possibility of pregnany, but doubt that is an issue here. I will also add that it's interesting you say that because the LLL leader I spoke to on Monday said the heaviness of this bleeding nearly two weeks ago sounded more to her like a miscarriage. I've had several during the course of our fertility treatments, and this didn't really seem like ones I've had before. Then again, we were observing basil body temps, ovulation signs, bloodwork and ultrasounds during those times, so we knew we were pregnant and then miscarrying in those situations.

To both my helpful mommies - Ugh! I'm just so frustrated, I can see how some mommies give up breastfeeding. I don't want to give up though. I really feel like this is best for our daughter. But at the same time, my frozen stash will only help make ends meet for so long. I need to get my supply back. Not only that, but it's breaking my heart to see my little girl so unhappy at my breast.

I'm going to try pumping for 30 minutes at a time instead of 20 for a few days and see if that helps.

Thank you for all of your help! Anything more, suggestions, anything, would be very much appreciated!

[@llli*auderey]

adding in the extra pump and extending to 30 mins will all help with your production, but it will take some time - a week or more is typical - so hang in there.

so - i think your LLLeader's advice was good to put her to the breast a lot - you should continue this - but does this mean that is IS nursing successfully most of the time? and only arches away occassionally? what happens if you switch sides when she fusses, even if it's only 2-3 mins?

and a couple other comments:
- 4.5 oz is a really big bottle. send 3 3oz bottles instead.
- i hope someone who knows more will comment on the not wetting from 8 pm to 6 am. that does not seem normal to me, but i don't know anything about it.
- you work 5 days and are home weekends?
keep at it!

[@llli*aprilsmagic]

Have your horns been sized? When some moms have pump horns that are incorrectly sized, their milk supply can take a hit.

And yes, double check on the pregnancy. It could have been a miscarriage, but after I lost a baby -- my milk supply was at zero when the baby died -- my supply came back up. Like the baby I was nursing at the time was gulping milk. However, now that I am cycling again, for the first time in years, my supply in general is not very good, no matter what I do. Try taking calcium and magnesium supplements.

You can also try some other herbs, such as blessed thistle, alfalfa and marshmallow. if you have access to a hospital grade pump, you could try it as well.

The book "Making More Milk" might be very helpful. Lots of ideas to try.

[@llli*NCtraumaRN]

@ auderey - See, that's what threw me, she's not nursing successfully most of the time. She arches away after just a minute or two and she continues until she's competely upset and in a full blown cry. If I switch sides when she fusses, even if it's only 2-3 mins, she starts over. I can hear her suck swallow, and she's content while soing that, but once her actual swallow stops, the arching of the back and fussing begins. The suck swallow is lasting about 1-2 minutes on the left and then about 5-6 minutes on the right. I will say though that I do think it's improving, even if just slightly over the past few days.

I started at 3 oz when adding the bottle, but she didn't seem like she was full. She was real fussy after just 3 oz, so we increased it. You think I should try going back to 3 oz every 3 hours? I just didn't want her to be hungry while I was away.

Yes, I work Mon-Fri 8AM - 5 PM, but this week I'm in a training, so it's 9 AM - 5 PM. My schedule will change a bit next week and she may actually have to be fed another bottle while in daycare

@ aprilsmagic - No, where would I go to get my horns sized? I never even concidered that, and it's probably an easy fix.

I took a pregnancy test yesterday, and it was negative. Also, I'm still taking a prenatal vitamin with DHA as recommended by my pediatrician. Should I add more mag and calcium? I'll definately check out the additional herbs and the book too! Thank you!

[@llli*aprilsmagic]

Maybe try giving her a little less more often. Or follow her cues. I bottlefed my fourth baby just like I would have fed a breatfed baby. Sometimes that means he would get 1 oz every hour, sometimes it is 4 oz every 2-4. It's his call, not mine.

You can have an IBCLC look, or, I'll go look up a link. Or just try the next size up. I ended up trying all the sizes and got o a 36 before it felt right, even though it looks really wrong. Like it looks way too big. But otherwise, it kind of hurt, and I didn't get as much milk as I could have out.

Keep working on this. She sounds like she really prefers a bottle to me. Or...could you have an overactive letdown? That can make some babes fuss when the milk suddenly starts flying out.

http://www.medelabreastfeedingus.com...d-breastshield

http://www.amedaonline.com/howtogetgofi.html with photos.

[@llli*auderey]

i'm with susan on this. also it is conceivable that if you're producing THAT much, she just gets enoug from one breast in 3 mins, then needs the other one and that's a full feed. babies have been known to drain a breast in under 5 mins, and if that combines with oversupply/oald that she's handling reasonably well - maybe she's just done?

[@llli*frangipanni]

hi, i just wanted to add that after i had my second ds my period was horrendous, i mean truely awful.. Turns out that pregnancy and childbirth can effect the thyroid which can affect milk production - or so my dr informed me.. Im now taking daily thyroxine to increase my thyroid levels and will have to do this for good now but it may be worth checking with your dr and having a blood test done to rule thyroid out?? just a thought