Should I quit?

[@llli*pokey7878]

I have a 9 week old daughter that was born 6 weeks early. Due to her being born early she was unable to breastfeed at the beginning, she was too weak. My milk supply was quite good and I pumped a lot but as time went on it started to decrease. Now she is strong enough to breastfeed but I feel like she is not getting enough because my milk production has dropped so much. I want nothing more than to breastfeed. What can I do to increase my milk supply and to make sure that she is getting enough food? I have tried fenugreek and blessed thistle but it doesn't seem to work. Is it time for me to accept defeat and quit?

[@llli*mommal]

Welcome to the forum! Please don't get discouraged- it's definitely possible to make more milk and to get baby to nurse more effectively.

Some questions for you:
- Can you tell us why you feel like your milk supply is insufficient?
- How many times a day do you nurse, and how many times a day do you pump?
- When you pump, how much milk do you get?
- What sort of pump are you using?
- How does nursing feel? (How the baby's latch feels is infinitely more important than how it looks.)
- What is baby's behavior like at the breast? Is she sleepy, does she fuss?
- Are you taking any hormonal contraception?

[@llli*pokey7878]

I feel it is insufficient because when I do pump I only get about two ounces after 30 minutes. She never seems satisfied after nursing and sometimes I end up giving her a bottle afterwards. Sometimes she nurses for an hour and isn't satisfied. Quite often When I think she is finished and I try to burp her she screams and fusses. I usually nurse her 4 to 5 times a day and she gets a bottle 2 to 3 times. I pump whenever she gets a bottle. I'm using the Medela Freestyle pump. I'm not really sure what the latch should feel like but usually it feels fine to me. Very rarely do I feel any pain like I hear a lot of people complain about. Lately she sounds like she loses suction with almost every suck but she seems to be doing that with the bottle too. When she is at the breast she is usually just calm or sleepy. I am not taking any contraception.

[@llli*mommal]

Thanks for answering those questions! Based on your answers, I think you are doing better than you think, and I also think there are some areas that could be improved.

It's wonderful that baby is nursing- you are so much better off than a mom whose baby will not latch! But you need to nurse a lot more than 4-5 times a day. Most newborns nurse 10-12 times per day, at a minimum. All that nursing is highly stimulating to milk supply and also gives the baby a lot of chances to improve her nursing skills. So the first thing I suggest is that you immediately start nursing at least twice as much as you currently are.

Another thing you have going for you is milk output. 2 oz with the pump is pretty good, especially when you consider that babies tend to empty the breast better than the pump! New babies often take just 2 oz at a feeding when they're nursing, though they may take much more from the bottle due to the mechanics of bottle-feeding (when a baby sucks on the bottle, she must swallow or she will choke, so swallowing will continue even after the baby has stopped sucking actively for food and is sucking lazily for comfort).

I think that it's very ikely that all you need to do is to nurse more, even if that means havng the baby almost constantly latched on for a few days. But if you want to pump up supply, you can always do that by pumping more and using a better pump. The Freestyle isn't meant for a mom who is really relying on the pump to maintain/increase supply. So I'd talk to a lactation consultant, preferably an IBCLC, about renting a high-quality hospital grade pump.

Fussy behavior, extremely long feedings- those are par for the course with new babies. One problem may be that the baby has been bottle-feeding since birth, and bottles are familiar to her. She expects one at the conclusion of every nursing session, so she fusses even after a decent meal. But I'd love to have you see an IBCLC for some in-person help with the baby's latch. It's great that nursing doesn't hurt, but baby shouldn't be losing suction when she feeds. Not with every suck, anyway.

Tips for waking a sleepy baby:
- Keep her cool. When it's time to nurse, strip her down to a diaper or onesie, and keep a fan blowing in the room (not directly on baby)
- Annoy her. Tickle the soles of her feet or rub agains the grain of her hair using your hand or a cool damp washrag.
- Keep the lights dim. New babies often close their eyes in response to bright lights.
- Use breast compressions to speed the flow of milk to the baby.
- Try switch nursing. When the baby's sucking slows and she seems to be drifting off to sleep, take her off the breast, burp her, and switch her to the other breast. Repeat the process until baby will no longer wake. Switch nursing is great for supply!

Another technique which may be helpful to you is "finish at the breast". With FATB, you offer the baby a small supplement (1 oz or less) using the bottle, and then switch her to the breast after the bottle is drained and baby's hunger is less desperate. This can result in a long period of comfortable nursing, and baby may be so full at the conclusion of the feeding that she will forget to fuss for a bottle.

You're doing really well! A lot better than you think. So just keep up the good work!

[@llli*pokey7878]

Thank you for the advice. I will look into renting a better pump. Now my question is: how do I get her to nurse more often? if she doesn't "ask" for food or doesn't want it when I offer it, how do I get her up to 10-12 times a day? So far in the last 22 hours she has had two 3.5 oz bottles one 1 oz bottle and five times nursing.

[@llli*djs.mom]

You can begin by nursing her in her sleep. Most babies will instincitvely nurse in their sleep. So dream feed her.

[@llli*mommal]

Just try your best to wake her up, put her near the bare breast, try to get her to latch. Even very sleepy babies will often nurse in their sleep.