Low Supply...when do you throw in the towel???

[@llli*scadiets]

I am 19 days pp and still do not have enough milk to feed my little one. I feel like I have done everything and it is really upsetting me that I cannot feed my baby. He lost 14% of his birth weight when we were in the hospital so we had to start supplementing with formula. He was 7 pounds 4 ounces at birth. Baby will be 3 weeks old on Sunday. I had a c-section which I know can make it more difficult to breast feed. We saw a lactation consultant in the hospital and this week and both have said he is latching fine and the technique is fine, my supply is just not coming in. We thought he was getting enough milk so the pediatrician told us to start weaning him off formula, but then he only gained an ounce that week so we are back on formula. He is now 7 pounds 1 ounce, he has still not gained his birth weight back. I am letting him latch for 10-15 minutes every 2-3 hours, then giving him 2-3 ounces of formula to get his weight up and then I pump for 15 minutes. I am eating oatmeal every morning, drinking a ton of fluids, trying to get as much sleep as possible and even drinking a beer at night to try to get my supply in. Needless to say feeding are taking about an hour or more and I am exhausted and feeling like at some point I just have to come to grips with the fact that I do not have a big enough supply to feed my baby. That might be best for me mentally and for my bonding with the baby. I am open to any suggestions. The LC weighed baby before the feeding and after and he only took about a quarter of an ounce in 15 minutes. Any advice would be greatly appreciated.

[@llli*djs.mom]

Well, it' supply and demand. So if you want to make more you need more stimulation and less formula. I understand that baby not gaining can be stressful. And based on what is going on with weight your weaning off supplements should be a slow one not an overnight one. But understand how formula works and effects supply so that you can adjust your schedule. So every time you use formula you throw off your cues by at least 2fold. Because if your baby truly needs another 2-3oz after a feeding(which I really doubt)and you give it in formula instead of flipping breasts then your body thinks after that 10-15minutes of feeding that your body has made enough because it's not getting the cue to keep making it. And then it takes much longer for formula to digest because it's not nearly as absorbable. So Instead of getting your next cue at the 1-2 hour point your next cue isn't going to come for 3-4hours. Which is longer than you would go if you were EBF. So that's the first issue. So every feeding even if you are going to supplement, should begin and END at the breast. And in the middle I would cut WAY back on the AMOUNT you are supplementing and here's why.
An exclusively breastfed baby needs between 24-32 oz of breastmilk in a 24hour period of time. Based on your post you are giving your child that much in formula supplements alone! So there is no way your body is getting anywhere CLOSE to the cues it needs. AND a bottle fed baby doesn't self regulate the way a breastfed baby does. They HAVE to drink. Because the nipple is constantly dripping into their mouth. So just because a baby drinks 2-3oz after nursing doesn't mean the baby NEEDS that much or is hungry.
The normal amount that you should be breastfeeding at this point is AT LEAST 12times a day. So AT LEAST 12 times in a 24hour period the baby needs to be brought to your breast. That is the MINIMUM. More is BETTER. Especially if you are trying to get your supply up. So begin at the breast. Supplement with an oz, then bring the baby back to the breast. So that your breast get the number of ques they need to make more milk. Feeds often will take an hour that is also normal. But you should spend as much time as possible in that hour at the breast. Especially since nipple preference is a real concern. Not you haven't said that your baby has any problem going from bottle to breast and I hope that that is the case, but you definitely WANT your baby to be willing to do the work and associate doing the work with the reward of milk.
Often what happens is that babies reject the breast right after letdown because they don't want to do the work because they know they can eat food another way. You DON'T want that to happen. So begin at the breast and end at the breast so your baby is willing to do the work AND so your baby associates the Full or Done feeling with your breast rather than the bottle. Cutting back the supplements and getting MORE breast stimulation is the only way to get your supply to increase. HTH!

[@llli*aprilsmagic]

I have worked with a couple moms who did this. Did everything possible and just could not make enough milk. One quit entirely. One gives a bottle and then tops off with nursing for the connection and oral development. Been doing that for almost a year.

Have you considered herbs or medications to see if that helps?

[@llli*mommal]

Welcome to the forum and congratulations on the new baby! I'm sorry you've had a tough time nursing him thus far. But if you can hang in there, it's going to get much better. I know lots of moms go into breastfeeding expecting an ideal, natural bonding experience, and feel totally crushed when they don't get it. But don't feel like you're alone or like you're doing something wrong: many, many women struggle during the early weeks of breastfeeding and it doesn't affect their ability to bond with their children any more than having a c-section affects your ability to love and bond with your baby.

The PP is very correct that the absolute best way to increase supply is to increase stimulation to the breast. If the baby won't do it, you need to use the pump to do it. What sort of pump are you using? In your shoes, I would want to use a hospital-grade rental with correctly sized shields to ensure maximum stimulation. I'd also want to be taking fenugreek and blessed thistle, and eating oatmeal (all herbal remedies which can increase supply), and I would talk to my midwife or doctor about taking one of the prescription drugs which can increase milk supply (Reglan or Domperidone, depending on where you live).

The finish at the breast technique referenced by the PP is an excellent suggestion. I'd give an oz of formula, and then nurse, and then offer another oz (if your ink the baby needs it), and then conclude with more nursing, followed by some pumping with that hospital-grade pump. An exhausting regime, to be sure, but NOW is the time to put in the hard work, because NOW is the time when you have the most chance of success.

I'd also suggest going to see another LC, preferably an IBCLC, for more hands-on help. In particular, I'd want to see your baby checked for tongue tie, and for you to have assistance with a rental pump (if yo don't have one already), and also rental scale. When I had difficulties with supply, I used a rental scale to do weigh-feed-weigh records after every feeding. This was really useful, because one weigh-feed-weigh test tells you very little: a baby may have a much better or much worse than average feed at the LC's office. The more data you have, the better chance you have of knowing when and how much to supplement. If your baby takes in 2 oz at the breast, no supplement necessary! If he takes in 1/2 an oz, then it's time to make a bottle.

I also recommend going to see your doc and seeing if there is any organic explanation for your difficulties. Thyroid problems, retained placenta, PCOS, previous breast surgeries or injuries- those can explain low supply and some of those issues are treatable!