Low Supply- Depressed and Lack of Support

[@llli*joyxbabe]

Without typing a novel, I will try to explain my situation.

DS was born at 6 lb 6 oz, at first ped visit 3 days later was 6 lb 0 oz and the next week was 5 lb 13 oz. Was told by Dr to supplement. Went to a LC (not by ped recommendation, of course) and wasn't that concerned since most babies lose a portion of their birth weight, and I did get fluids at delivery. We did a couple of weighted feedings and she said that he had a great latch, but was only getting about half an ounce. In both instances, he had eaten about an hour beforehand so I am not sure if these were great examples. I went back to LC at two weeks and he had only gone back to 6 lb 0 oz. She told me to supplement, so I have been giving him between 4-6 oz per day. It kills me, but he was 7 lb 3 oz at his 3 week weight check.

I have been trying desperately to up my supply so that I can cut out these supplements. This includes fenugreek, placenta pills, increased water intake, pumping MANY times per day, as well as feeding every 2 hours at least. This is, of course exhausting and depressing.

I recently found out that DH has been giving the baby formula behind my back. I feel devastated even more so that I already was, since I thought things were getting better because WE were doing better... not because dad was sneaking bottles. Breastfeeding has been a constant fight since we brought DS home and I think the stress and tension is an additional reason that I am having supply issues.

Other things:

-He is having sufficient wet/dirty diapers
-Mustard/Seedy poos
-He does NOT seem content after feedings often, and cluster feeds at night (which I have tried to explain is normal but DH has been sneaking bottles when I am in the shower... which makes me feel that I can't even shower now)
-I have a Medela Symphony and pump after every feeding, and sometimes in between.


Please help me.

[@llli*mommal]

Welcome to the forum and congratulations on the new baby! I am sorry your nursing journey has been such a hard one so far, but I think there's every reason to think that you can get things back on track.

Some questions for you:
- How does nursing feel? Forget about how the latch looks, and tell us what it feels like on the inside.
- Is baby sleepy at the breast? Does he quickly transition from active sucking to sleepy, shallow sucking?
- Are you on any form of hormonal contraception?
- How does pumping feel?
- What sort of pump output are you getting?
- Any family or personal history of thyroid conditions or PCOS?
- How was the birth? Did you have any of the following: large volume of blood loss/postpartum hemorrhage, retained placenta, manual placenta extraction?

[@llli*djs.mom]

I am so made at your DH. The fact that he has yellow seedy mustardy poops even though he is being supplemented and and someone is trying to sabatoge your relationship means the MAJORITY of his nutrition IS coming from breastmilk though! So that is good! See KellyMom for how to wean from supplements completely. http://kellymom.com/bf/got-milk/basi...rease-formula/ Shower during the day with the baby in the bouncy chair.

[@llli*joyxbabe]

- How does nursing feel? Forget about how the latch looks, and tell us what it feels like on the inside. -It often starts well but can get rather shallow
- Is baby sleepy at the breast? Does he quickly transition from active sucking to sleepy, shallow sucking? -Yes he is sleepy, and gets shallow quickly. Sometimes I can't tell if he's sucking or just pacifying.
- Are you on any form of hormonal contraception? -No
- How does pumping feel? -Pumping feels fine, it doesn't hurt or cause discomfort
- What sort of pump output are you getting? -Lately, I have been getting 1-2 oz on average, sometimes less in the evenings and sometimes more in the mornings
- Any family or personal history of thyroid conditions or PCOS? -My mom and sister both have hypothyroidism but I was tested during pregnancy and found no thyroid issues
- How was the birth? Did you have any of the following: large volume of blood loss/postpartum hemorrhage, retained placenta, manual placenta extraction? -No


It is good to know that he is getting most of his nutrition from me. :-) I expected to see his poos change after supplementing but they've looked the same.

I might add that I have to go back to work in two weeks and feel that I am doomed if I don't have a good supply established before that.

[@llli*mommal]

Thanks for answering those questions! Based on your answers, it seems like there are a couple of things you want to check into. The first is your baby's sleepiness. Sleepy babies sometimes have trouble with weight gain because they fall asleep before taking in enough milk. And then the fact that they're not taking in enough milk can contribute to their sleepiness. So I'd do some/all of the following:
- Breast compressions
- Keep the baby cool; a cool baby is often more alert. When it's time to nurse, strip him down to a diaper or onesie, and keep a fan blowing in the room where you nurse ( but not directly on the baby).
- Annoy him; an annoyed baby is a more alert baby. Tickle the soles of his feet and rub agains the grain of his hair using your hand or a cool damp washrag.
- Try switch nursing. Whenever the baby seems to be dozing off, take him off the breast, burp him, and switch him to the other side. Continue to switch him until he will no longer wake. (note: switch nursing is great for supply.)
- Keep the lights dim; new babies sometimes close their eyes in response to bright light.

The second thing I would urge you to check into is your thyroid level. About 5% of women come down with something called postpartum thyroiditis, which can include both a hyprthyroid and hypothyroid phase, or just skip straight to a hypothyroid phase. Women with personal or family histories of thyroid problems are more likely to have postpartum thyroiditis and are probably more likely to become permanently hypo. And having low thyroid function can have a negative impact on milk supply. The fact that youhad normal function during pregnancy doesn't rule out a problem at this point.

Other than that, it sounds like you're doing really well and doing just what you should be! Your pumping output sounds pretty good for a mom who is also nursing, and as Djs.mom said, the fact that your LO is having yellow seedy poops is a good indication that you are giving baby most of his nutrition from breastmilk. If he was getting a lot of his nutrition from formula, his poops would likely be pasty, olive green, and super-stinky.

[@llli*krystine]

I agree with the waking baby up ideas that Mommal suggested. We would tickle my baby's toes, use a cool wash cloth on her. Also my IBCLC told me to not let her sleep more than 3 hrs at night and to wake her up to nurse - not every baby will need that but mine was also very sleepy and acted like a premature baby although she was full term. We switch nursed, too. It sounds like you are doing many things right. You might also try brown rice and oatmeal to help your milk supply.

[@llli*sonogirl]

Would your DH be open to learning about what is and isn't normal BF behavior? I had a lot of well meaning family members worried about my supply because of my daughter's cluster feeding early on, but once I showed them information about why it is normal, and why it helps supply, they were really supportive!

[@llli*maddieb]

You are doing everything you can to bring your milk supply up. But is it TOO much? All that milk won't help if you are die from exhaustion.

I was talking to a friend who is a wonderful IBCLC today, and she was talking about the importance of sceduling follow up appointments or phone calls in order to 'tweak' plans as needed. So you might want to see if your IBCLC can do that for you again. Here is what I wonder-
Do you need to pump after EVERY nursing session? If it was a good session and baby was not given any supplements, especially?
Is the problem low supply or poor transfer? (or both) If it's poor transfer, what else can be done about that?
What is the plan for weaning off the supplements?
I think you are saying your baby gained 19 ounces in one week? From 6 lbs even, to 7lbs 3 ounces, between week 2 and week 3? So, that is more than twice the average of one ounce a day, and quite possibly, would indicate overfeeding (with bottles-you cannot overfeed at the breast.) Right?

As far as going back to work-don;t feel doomed. A lot can happen in two weeks, and of course you cna keep on working on this after back at work if needed. That said, it certainly would not hurt to try to push your return back a bit, which is a bit on the early side even if all was going great. or go back part time at first, or something.

[@llli*joyxbabe]

Thanks ladies, your input is very helpful.

Today, DS was suckling to fill his mouth with milk but was failing to swallow, causing milk to leak out of his mouth and down my side. This probably further confirms the sleepy baby thoughts.

I think that there were 10 days in between the weight checks (Friday- the Second Monday) so it was over a pound and half per day. I am definitely willing to guess that he may be over-fed, especially since DH was giving an extra ~3 ounces per day.

My biggest concern here is that his tummy has stretched and that is why he is being fussier..? Yesterday, I fed him 1 oz of EBM, jumped in the shower, DH gave him 3 oz of formula , and I fed him again directly after I got out. This was probably at least 5 oz within 1/2 hr so his tummy is probably grossly expanded. It was very hard to get him to feel content today, and I am wondering if this is why.

I am not sure what my weaning plan is. The Kellymom article sounds great, but will baby fuss more/ act like he is starving if I don't give him more?

DH's older children from a previous marriage were EFF, and he is in favor of formula because that is what is easy and comfortable for him. I have overheard him discussing that our baby looks "sickly" or "unhealthy", and he often discredits research because of his personal experiences. I've accepted that he is not going to be the "rock" that I need, per se, but going behind my back was crossing the line.

[@llli*mommal]

Weaning from formula supplements can be a fussy time. Let's say your baby is accustomed to 2 oz of formula after a nursing session, but you only give him one, and then offer the breast again. He's going to be fussy because he didn't get her usual amount of formula AND because the feeding isn't going the way he expects. Babies are real creatures of habit!

I am really sorry your DH went behind your back. If he's having trouble accepting the "No extra formula while mommy is in the shower" rule from you, maybe send him here? We'd be happy to try to talk sense to him.