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Thread: 2 months, finally getting better! But q's about supply

  1. #1
    Join Date
    Jun 2012
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    Default 2 months, finally getting better! But q's about supply

    I'm not sure if this should go here, in the pumping section, or the too much milk section, so please move it if it is in the wrong place

    Toby is 2 months old today and breastfeeding has been an uphill struggle, but thanks to perseverance and the support of people around me (including this forum), we are finally getting there. I am posting this as a separate thread as I have some specific questions, but the full story is here:

    http://forums.llli.org/showthread.ph...gue-tie-*LONG*

    Anyway, now that I appear to be managing to exclusively BF (hooray!), I am having some issues with my supply. I have been using a double hospital grade pump for about 2 or 3 weeks (was using a personal electric pump before that but was advised to get something more powerful) as well as taking fenugreek to ensure I had enough milk. I was advised that if I was exclusively pumping and bottle feeding, I should double pump 8-10 times a day for a total of 120 minutes. I managed this most days, but I was also trying to BF Toby, so wasn't truly EPing.

    After seeing the lactation consultant yesterday, Toby has only had a bottle twice and I have been BFing the rest of the time. I think I may have developed a bit of oversupply. I have a small stash in the freezer (around 500-600 ml) and since yesterday my breasts have become very engorged, and I had to pump yesterday evening and this evening to relieve the pressure. Toby seems to only need one breast each feed, so the other one doesn't get 'emptied', whereas when I was pumping I would 'empty' both. This is leaving one breast fuller than the other, so by the time he next comes to feed 2 or 3 hours later, I am bursting!

    He seems to cope well with a full breast, but I am concerned I am getting some lumps and am a bit worried about developing mastitis. Also, I know a full breast means he gets a lot of the foremilk, and I am concerned he may not be getting enough of the high calorie stuff, though no green frothy poops so far.

    I'm not sure what to do regarding the pumping and fenugreek. I know I should pump each time he has a bottle to ensure I keep my supply, is this also the case if (as I suspect) I have a bit of oversupply? Is it enough to pump once a day or should I increase it (or not pump at all)? Should I continue with the fenugreek?

    I understand these early weeks are very important in establishing supply and I don't want my milk to dry up so am scared to stop the fenugreek and pumping (especially as his latch still isn't great) but I don't want to create a massive oversupply either.

    Any advice most welcome

  2. #2
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    Default Re: 2 months, finally getting better! But q's about supply

    For the lumps, massage your breasts firmly (it may hurt quite a bit if there are plugs) the nurse in various positions. That I'll clear any plugs and reduce your risk of mastitis.

    Don't worry about foremilk/hindmilk. There isn't a true distinction, just a gradual change in milk composition throughout the feed. OS babies tend to pack on lots of weight and thrive even if they are getting mostly foremilk, because of the sheer volume of milk that they get because of the OS (all of your milk has fats in it).

    I would still pump every time your baby has a bottle, but only pump what he drinks. If you can nurse exclusively, it's a lot easier. Just nurse frequently, on demand, and your supply with regulate.
    K. Sophia - Mama to my little lactivore, the amazing Mr. X (11/10).

  3. #3
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    Default Re: 2 months, finally getting better! But q's about supply

    Slowly start backing down on the pumping unless you have skipped a feeding. And yes, only pump what he drank. This may mean a few days of full breasts, but it will even out. Don't just stop pumping though, unless he is nursing great

    The foremilk/hindmilk thing is really only a problem for a mom with a huge OS. I am one of them. When I was pumping 12 times a day, I could pump 15 minutes or longer before I saw any fatty milk, but I was pumping 80 oz a day.

    You may be able to start backing down on the fenugreek too. Try going to twice a day, or drop one capsule out of each dose.
    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!

  4. #4
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    Default Re: 2 months, finally getting better! But q's about supply

    Excellent advice from the PPs. I don't have anything to add except that I am thrilled to read that things are going so much better for you!
    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: 2 months, finally getting better! But q's about supply

    My wife says thanks to everyone who's commented and helped a lot so far. She's in the shower and asked me to type this for her. Thanks again!

    At the moment, she's breast feeding only and taking two doses of Fenugreek a day (which seems to genuinely increase milk production.)

    Baby Toby is being checked on Friday, but my wife is worried at the moment that she's giving him enough milk, with breast feeds only. His latching is improving (sometimes) but he seems to want food more regularly now (sometimes every hour instead of every 2 or so). He often feeds for a bit, then drops off or starts smiling or grizzling and cries for food again fairly quickly.

    My wife is trying to express less, so she can exclusively breast feed at last. She expressed twice yesterday and once today.

    We really hope the breast feeds only are enough for him. It's hard to tell if he wants to feed for comfort, or is genuinely hungry.

    Thanks again and it's really great to get the advice and support

  6. #6

    Default Re: 2 months, finally getting better! But q's about supply

    PS. My wife is the writer of this original post of course. Thanks!

  7. #7
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    Default Re: 2 months, finally getting better! But q's about supply

    She can feel free to nurse him for comfort as much as the baby would like. While you can over feed with a bottle, you cannot over feed at the breast. If she is concerned about milk intake, then she should offer the breast as often as the baby cues or even more often if it suits her.

    Congratulations on getting the baby to breastfeed. It is an amazing accomplishment!
    K. Sophia - Mama to my little lactivore, the amazing Mr. X (11/10).

  8. #8
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    Default Re: 2 months, finally getting better! But q's about supply

    Thanks phi Just wanted to add a couple of things:

    I am no longer engorged as Toby has been feeding a lot today, although I do get engorged at night, especially 2 nights ago when he slept for 5 1/2 hours!

    I am lacking a bit of confidence as I haven't pumped today (it was once yesterday and twice the day before) and Toby has been feeding a LOT but only seems satisfied for a little while before he wants feeding again. I know he is getting milk as although he doesn't always feed for long (as my husband mentioned), he has been feeding well for about a week - he takes rhythmic sucks, I can see/hear him swallow, and he softens my breast. So it all looks good, but because we have cut right back on the bottles (his last one was over 24 hours ago) and his latch still isn't perfect (though he isn't hurting me any more most of the time, so it must be improved) I am scared we are underfeeding him. Also, he has been quite fussy today and has been crying but we can't work out why, when I put him to the breast he has taken more but sometimes fallen asleep quickly.

    Apart from today he generally is alert and happy. He has had plenty of wet nappies and does at least one poop (usually a big one!) each day. I will have him weighed on Friday, to make sure he is gaining.

    Does it sound like we are doing ok, or should I offer him one or two bottles a day (and pump) to make sure he is getting enough? I really want to BF exclusively but don't want to starve him. Might today's behaviour be down to a growth spurt, rather than me not having enough milk?

  9. #9
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    Default Re: 2 months, finally getting better! But q's about supply

    It sounds like you are doing great!!!

    If diaper output and weight gain are good, then your baby is getting enough milk. Since he has a weight check in a few days, I would look at diapers until then - if it's coming out, it had to go in right?

    What you are describing sounds a lot like a growth spurt or a milestone coming up or teething or even just a crabby day - there are so many reasons for fussiness and non-stop nursing. If you have a sling, I would just tuck him in there and let him nurse non-stop. I've done just that on many occasions.
    K. Sophia - Mama to my little lactivore, the amazing Mr. X (11/10).

  10. #10
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    Default Re: 2 months, finally getting better! But q's about supply

    Thanks Phi.

    I am still feeling quite nervous about the whole thing. I don't know if I'm just more aware of his behaviour because I have stopped the bottles, but he seems more crabby the last 2 days (since I stopped pumping and giving him a bottle), and seems to want to feed more often. Today I am worried because his feeds have been very short but frequent, similar to yesterday. He has done two poops today and I noticed one of them was very runny (although I don't know if they are always like this - I noticed this one because he did it just after I took his nappy off!). Is it normal for his poop to be very runny at this age? Could it be something I ate (I did have some chilli), or something to do with my milk?

    I have also noticed that since I stopped pumping/bottle feeding and started exclusively breastfeeding, my breasts seem much softer and the only time they get a bit hard is at night. I'm hoping this is because he is feeding so often, but I am a bit worried that since I stopped pumping, my supply is going down. I think his latch is getting better because it no longer hurts to feed, but I just don't know.

    Finally, I don't know if I am imagining this but he looks thinner today. I'm having him weighed on Friday but am feeling very nervous in case he has lost weight - I would be so upset if this is the case.

    So - he is feeding a lot, some feeds he seems to drink more than others (though they are rarely longer than 10 minutes), he has pooped every day (twice today),plenty of wet nappies, he seems a little crabbier than usual (but I may be imagining this!), he is happy, alert and smiling at other times.

    Apart from the wet/poopy nappies and weight gain, is there any other way to tell if he is getting enough? If he wasn't getting enough, would he let me know by crying? He has been sucking his fingers/thumb quite a lot, but he does that anyway (e.g. if he is tired) so I can't tell if that is a hunger sign or not.

    Sorry for being so worried but this is a big deal to me! I will feel better when I get him weighed but until then, does everything still seem ok?

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