Baby doesn't seem to be getting enough milk - advice, please

[@llli*hlc12]

My little girl is about 5 1/2 weeks old now and we have had issue after issue with breastfeeding! We had terrible latching issues while in the hospital. The lactation consultant at the hospital thought she might have a tongue-tie. Because she had caused so much damage to my nipples and they were both bleeding, the lc advised me to allow them to heal for a few days and, instead, give her bottles of expressed milk. After getting home, I went to see another lactation consultant -- she thought that my little girl just needed some time and practice. We have been working at it for weeks now, but there seems to be a new problem everyday! So frustrated! So initially, serious latching issues -- she has gotten better but I still don't think she latches 100% correct. Since then, I have experienced weeks and weeks of her cluster feeding in the evening for hours. She fusses and never seems satisfied. She pulls off of the breast repeatedly and bats at me. Eventually she goes to sleep but I am worried she isn't getting enough milk. I have also had several plugged ducts in each breast (I'd estimate 5 to 6 in each one). She has enough wet and poopy diapers each day but her weight gain isn't real good. By her second week she had gained two ounces above her birth weight (but I had given her mainly bottles up to that point); since then, she gained around 6 ounces one week, nothing at all the next week and then maybe 2 1/2 to 3 ounces this last week. I am worried about her weight gain. I went to see the lactation consultant again who picked up right away that my little girl likes to piddle around at the breast. She nurses for about 45 min to an hour every time but doesn't constantly suck. She dozes off or just "nibbles" here and there. You have to constantly nudge her to suck. But, if I take her off, she gets upset and wants back on. So back on she goes and then she'll suck for awhile and the whole cycle starts back over. I honestly can't get anything done other than feed her and, even then, I don't think she's getting enough! She still nurses around the clock, which also makes me think she isn't getting enough milk.

So I am wondering -- is it milk supply? A slow let-down issue? Slow flow? I am taking fenugreek now and have been working my butt off if I do say so myself but I just feel like things aren't getting better! When I went to see my lactation consultant this last time she said I didn't have real full breasts (of milk) and said it's hard to tell if I don't have real full breasts because of the way she eats or if she doesn't eat well because I don't have real full breasts. Also, my lc weighed her to determine how much milk she took in during the 45 minute nursing session -- a little less than 2 ounces. My lc said most babies her age should be taking in around 3 ounces. AND, I had to really really work during those 45 minutes to even get her to eat that much! She just takes forever, and loves to be on the breast!

So, I am thinking about giving her an ounce of expressed milk after a few nursing sessions just to make sure she's getting enough milk. Any thoughts on that? ( I also struggle with pumping . . . let down isn't real good, but I can usually manage to get an ounce or two each time. Weird because I pumped fine in the beginning when I was expressing milk to give her in a bottle). Any suggestions on how to make my baby nurse better? It's so frustrating for me because I have to go back to work at 12 weeks and I really want to enjoy this time with her. Right now, though, I feel like it's an all-day struggle every day and stressful! Any advice or insight would be much appreciated!

[@llli*phi]

You might want to consult a pediatric ENT about tongue tie if no one has adequately followed up on that.

[@llli*esthervegan]

I know how frustrating it feels to be nursing around the clock and not have adequate weight gain. Your instincts are right, your little one should be gaining weight and it is not considered an optimal feed if your baby transfers less than 2 ounces of milk during a 20+ minute nursing session.
Your milk supply is dependent on your daughter's ability to suckle adequately.
If your daughter does not have a deep and lustful latch, then hand expressing and/or pumping might be in order.
You can supplement nursing sessions with expressed breastmilk.
I had to hold and support my breasts for the entire feed for all my kids, for the entire duration of their nursing lives.

[@llli*lilpats-mama]

I had some similar issues when my LO was your age! It was so difficult, and caused frustration, tears, self-doubt, etc.! I could never tell if my LO wasn't taking enough out which caused slow weight gain and hurt my supply, or if my supply was too low for my LO to take enough out. It became this circular chicken-and-egg problem and I'm not sure a solid answer was ever reached. Maybe it was a combo of things. I do know that after meeting with an awesome LC things started to improve, slowly but surely, and I hope things get better for you. I remember some advice from my LC that I've shared elsewhere on the boards. I started taking fenugreek, alfalfa AND blessed thistle capsules (sold at Sprouts - number of capsules per instructions on the bottles - I took 3x/day).

I also had repeated problems with painful plugged ducts (some women just do, apparently) and my acupuncturist recommended taking this brand of lecithin capsules: http://www.amazon.com/dp/B00013Z1QE/...B1_cs_sce_dp_1 . It worked WONDERS! I still take them twice a day (1x/morning & night) and they have kept the duct problems at bay. I started getting cavalier about not taking them about a month ago, and lo and behold the problems came back, so I went back on them for now. I also drank chamomile tea to help with inflammation.

His latch also sometimes caused me real pain and we had to work on it for many weeks. He was checked by a specialist for tongue-tie and that apparently wasn't the issue. I tried to be patient, diligent and consistent (and gentle, obviously!) in encouraging a good latch because I noticed it would lessen the pain over a day's nursing and slowly things started to get better until he had no latch problems at all by a few months. The LC watched him latch on and saw that he could do it most times but would sometimes lose positioning. And he often did flutter sucking rather than swallows in the beginning.

You could also try giving your LO expressed milk via french tube (connected to syringe bottle) at the breast. The LLL book "Womanly Art of Breastfeeding" has info on this, and/or your LC should be able to tell you how to do this. I have to say it is a PITA but it did seem to help with my LO's weight gain to supplement this way for a little while in the early weeks. And it's apparently better to keep them on the breast stimulating milk production rather than switching over to bottle, if possible. When we did start using a bottle, we used low-flow nipples. My LC recommended First Years Breastflow bottles, size 1 nipples. The advice I've heard is that any time you give a bottle, you should pump so that your supply doesn't take a hit.

I hope this helps! I wish it wasn't so hard for some of us mamas in the beginning ... but you WILL get through it!

[@llli*lilpats-mama]

I had some similar issues when my LO was your age! It was so difficult, and caused frustration, tears, self-doubt, etc.! I could never tell if my LO wasn't taking enough out which caused slow weight gain and hurt my supply, or if my supply was too low for my LO to take enough out. It became this circular chicken-and-egg problem and I'm not sure a solid answer was ever reached. Maybe it was a combo of things. I do know that after meeting with an awesome LC things started to improve, slowly but surely, and I hope things get better for you. I remember some advice from my LC that I've shared elsewhere on the boards. I started taking fenugreek, alfalfa AND blessed thistle capsules (sold at Sprouts - number of capsules per instructions on the bottles - I took 3x/day).

I also had repeated problems with painful plugged ducts (some women just do, apparently) and my acupuncturist recommended taking this brand of lecithin capsules: http://www.amazon.com/dp/B00013Z1QE/...B1_cs_sce_dp_1 . It worked WONDERS! I still take them twice a day (1x/morning & night) and they have kept the duct problems at bay. I started getting cavalier about not taking them about a month ago, and lo and behold the problems came back, so I went back on them for now. I also drank chamomile tea to help with inflammation.

His latch also sometimes caused me real pain and we had to work on it for many weeks. He was checked by a specialist for tongue-tie and that apparently wasn't the issue. I tried to be patient, diligent and consistent (and gentle, obviously!) in encouraging a good latch because I noticed it would lessen the pain over a day's nursing and slowly things started to get better until he had no latch problems at all by a few months. The LC watched him latch on and saw that he could do it most times but would sometimes lose positioning. And he often did flutter sucking rather than swallows in the beginning.

You could also try giving your LO expressed milk via french tube (connected to syringe bottle) at the breast. The LLL book "Womanly Art of Breastfeeding" has info on this, and/or your LC should be able to tell you how to do this. I have to say it is a PITA but it did seem to help with my LO's weight gain to supplement this way for a little while in the early weeks. And it's apparently better to keep them on the breast stimulating milk production rather than switching over to bottle, if possible. When we did start using a bottle, we used low-flow nipples. My LC recommended First Years Breastflow bottles, size 1 nipples. The advice I've heard is that any time you give a bottle, you should pump so that your supply doesn't take a hit.

I hope this helps! I wish it wasn't so hard for some of us mamas in the beginning ... but you WILL get through it!

And I meant to say from the beginning - you are obviously working so hard and doing an AMAZING job for your LO!

[@llli*mrsjenks]

First of all.... CONGRATS ON THE NEW BUNDLE!!!!!

I know this is very exciting and overwhelming. But trust me---Your doing an excellent JOB!!

My sweet Bella is 5 weeks old too. My journey to this exclusive breastfeeding has been a HELLISH one! If anybody knows your frustration---I DO!!


My sweet one didnt latch or nurse the first 36 hours of her life. She slept the entire time. Her birthweight was 6pds 14 oz. And yes you guessed it, she lost major weight. I was pumping and and cup feeding. I was doing all I could to wake her and make her eat. It wasn't working. She didn't have any interest in the breast of formula. The nursing staff gave me looks like "You should give this thing up" They were testing my babies Glucose levels and her weight everyday because she wasn't interested and they thought her sugar levels were low. My baby went from 6:14 at birth to 6:9 that afternoon to 6:6 that next morning to 6:4 at discharge.

I was just like you, trying so hard to feed my baby. I tried to introduced her to the breast and I was in so much pain. Her no latch turned into shallow latch and my nipples turned into raw meat! I was crying and gripping the seat when It was time to eat. I cried when she was ready to eat. We had to supplement, visit a feeding specialist,see the LC and have constant visits to the Pediatrician. I was at wits end. I finally visited the LC and she latched on perfectly. That was LAST WEEK. She has been on the breast consistently for just a week. I will tell you what has worked for me.


My husband ordered me a baby scale from EBAY. It was 40.00 but it was well spent. I weigh her before she eats and after she eats. I do a simple conversion and I am able to figure out what she does get from me.

I time her. If she has been on there for a few mins. and fall asleep I wake her because I know she hasn't gotten anything on that short amount of time. I wake her (undress her, change her, etc)

I nurse her as often as she wants. Even if she just ate 30 mins ago. I make sure she delatches herself.

PLEASE VISIT A LC as often and as much as you can. I regret not seeing her sooner. Now I LLLLLOOOVEVVVEEEE breastfeeding. Keep in mind I dreaded it just weeks ago!

You can do this! Your doing great already. I commend you for stepping up and seeking out help. She will be a butterball in NO time! LOL

[@llli*hlc12]

Thanks to those who responded! I have been trying to post this reply for the past few days but my little girl has been keeping me busy! I must say it is nice to hear that others have had a similar problem and were able to get through it successfully. I have my doubts. After reading some posts on here and breastfeeding books, I think the problem begins with my baby's latch. I have paid very close attention the past few days to how my nipples look when she comes off and they are slanted most times like a new tube of lipstick. I have also tried laid-back nursing to see if that would help with her latch. I noticed a horizontal crease most of the times when she came off. I think this indicates a bad latch. I am not sure what to do. I have not had any follow-up with respect to the tongue-tie because my lc said she didn't think that was the issue. She took a look at her tongue and watched her nurse. She felt that my baby can latch correctly. I am going to bring this up to her during my next visit and look into seeing a specialist. It couldn't hurt! As far as my milk supply, I am really really worried about it. I just feel like my breasts are soft almost all of the time now. I am nursing her on demand and trying to pump around 4 to 5 times a day (pumping after feeding is so hard with as much and as long as she nurses throughout the day). I am worried that her bad latch and inability to drain my breasts well are hurting my milk supply. I have been giving her an ounce of expressed milk about three times a day. And I just weighed her today -- about 4 ounces gained in the past week. I guess that means that milk supply isn't awful, right? And I am taking fenugreek every day (as well as that brand of Lecithin--it has helped tremendously!). I will look into taking those other supplements as well. Other than doing that, I just don't know what to do. I do not give up on things, but some days I am tempted, I must admit. My husband tries to be supportive but keeps saying things like "well, you are doing your best. If it doesn't work, it doesn't work. There is always formula." Most days I'm on the verge of tears (and some days I do give in and cry)! I feel so stressed which I know can also be bad for breastfeeding so I'm trying to keep that under control but, lately, I feel like the stress is winning. I want so badly for this to work well. Sigh. I just thought that it would have gotten better by now . . .

[@llli*lllmeg]

This was suggested above and I agree-it is important that your baby be assessed for tongue tie by someone who knows how to do that and will treat tongue tie. I know your LC says she thinks latch is fine, but from what you report it sounds like latch is NOT fine. How does she explain the poor weight gain? In the US at least, a LC may suspect tt but she is not a doctor and cannot make a diagnoses one way or another. There are several types of tongue tie and some-like posterior tongue tie-needs a specialist who is up on the current definitions of tougue tie to diagnose. TT is a huge barrier to breastfeeding and thus a serious health issue. Whether or not the issue IS tongue tie and you can get that corrected, it would help to see a board certified lactation consultant (IBCLC.) If you are happy with your LC that is fine, but if not, call around, and try to find someone experienced with tongue tie, poor milk transfer, low supply and latch issues in babies your babies age. Get references if you can.

Yes there is always formula, thank goodness. But it is far healthier for both both you and your baby, not to mention way cheaper, if you can breastfeed. Even after paying for a lactation consultants, pumps, etc, if needed, breastfeeding is in the end much, much cheaper than formula. And even if it turns out your supply never is quite enough, breastfeeding need not be all or nothing.

These books will help: Making More Milk and The Womanly Art of Breastfeeding (8th edition)

[@llli*hlc12]

My lc gave me the names of two different doctors that specialize in tongue ties. I think I will give one of them a call tomorrow. And no need to convince me that breastfeeding is better and cheaper -- I agree 100%!! That is why I am so upset! And also why I usually get really peeved at my husband when he even mentions formula. lol

[@llli*lllmeg]

Yeah I figured you want to nurse badly as you are obviously trying so hard. My convincing was for your husband! He is trying to help...maybe gently let him know his support for breastfeeding would be most helpful right now...

The Academy of Breastfeeding Medicine had a protocol for diagnosing and treating tt. Unfortuntely it is being revised and not currently on the website. But you could ask the doctor if he or she is familiar with the Academy or the protocols. http://www.bfmed.org/Resources/Protocols.aspx