Caloric needs and milk supply

[@llli*lily.mama]

I've been watching my caloric intake since the New Year to try to lose the last of the baby weight. My daughter is 5 months old and exclusively BF.

My problem is that I haven't been able to pump nearly enough recently for when I'm away at work. I was at work from 1-8:30 last night (I teach at a university and have odd teaching hours) and pumped 7 oz over three pumpings, but she consumed 12oz while I was gone. A month ago on this schedule I would have pumped 9oz while away.

So my question really is about caloric intake. I'm not on a "diet" per se, but I've limited my calories to between 1800 and 2000 a day (usually 2000) and am trying to eat whole and healthy foods. I never ate junk to begin with. Could eating 1800 cal a day harm milk supply? I workout, but not strenuously or even very regularly these days. 1800 calories doesn't seem restrictive enough to mess with supply, but I definitely seem to be getting less. Any thoughts?

[@llli*mammi]

I found this in the reousrce section of this website

Gradual weight loss of about one pound per week, while consuming about 1500 to 1800 calories per day, will help you to feel good and have the energy you need to care for your baby. The composition of your milk really does not vary much with your diet. (Mothers in famine conditions can produce milk that is nutritionally perfect for their babies.) However, your health may suffer if too many of your own reserves are used to provide milk. It takes a lot of energy to care for your baby so be sure to take care of yourself by "eating to hunger" and "drinking to thirst."

source http://www.llli.org/faq/diet.html

Hunger-- Inadequate caloric intake results in feeling weak, tired, and drained. When a mother feels this way, taking care of a baby is very difficult, and these very real feelings can result in lowered milk supply and inhibited milk ejection (letdown) reflex. The Subcommittee on Nutrition during Lactation advises breastfeeding mothers to take in 1500-1800 calories per day.

source http://www.llli.org/faq/lowcarb.html

[@llli*bfwmomof3]

It's possible that cutting calories is affecting your milk supply (the 1500-1800 calorie number seems low to me - I'm pretty sure I eat significantly more than that!), but I guess the question is whether something else could be affecting your supply/pump output. Any new medications, especially hormonal birth control? Could you be pregnant? Has your period returned? Could you be having a problem with your pump? Some mothers find they need to change the replaceable parts of the pump, and in some cases the motor itself can wear down - what kind of pump are you using? Is this the first use for the pump, or has it been used before? Your pumping frequency sounds good; how long are you pumping for? Are you doing hand compressions?

[@llli*mammi]

yeah, I had wanted to add last night that 1500 to 1800 seems low to me (but my son woke up and I had to go).

I am also not that certain whether it is calories alone.

[@llli*lily.mama]

No new meds, I can't be pregnant, and I'm on the non-hormonal IUD. I'm using a hospital grade Medela Symphony at home (it's a rental) and an old Medela PISA at work. While I'm out and about, I use a Medela Harmony. The pumping stats are low across the board. At the beginning of January, I was getting 2.5 oz from one breast first thing in the morning with the Symphony and now I get 1.5oz. I just started drinking Mother's aid tea, eating lactation cookies, and pumping after every feeding in hopes of boosting supply. I do compressions when pumping and usually empty both breasts relatively quickly (in under 10 minutes). I've tried waiting for a second letdown, but it never happens. I have plenty of energy and my weight loss has been moderate and gradual (about a pound a week). I do think I just started ovulating again, since I've been feeling moodier and recently saw an increase in CM, but I don't know if ovulation alone can affect supply like that. Are there other things I could be missing? The Medela PISA is definitely really old, but since I'm having problems pumping with three different pumps, it doesn't seem to be related to pump. Baby is growing and healthy as far as I can tell, and continues at exactly the 50% percentile for weight and is wetting diapers normally, so it seems to be a pumping problem, though she eats so much when I'm away that maybe she's not getting enough when I'm there....

It's possible that cutting calories is affecting your milk supply (the 1500-1800 calorie number seems low to me - I'm pretty sure I eat significantly more than that!), but I guess the question is whether something else could be affecting your supply/pump output. Any new medications, especially hormonal birth control? Could you be pregnant? Has your period returned? Could you be having a problem with your pump? Some mothers find they need to change the replaceable parts of the pump, and in some cases the motor itself can wear down - what kind of pump are you using? Is this the first use for the pump, or has it been used before? Your pumping frequency sounds good; how long are you pumping for? Are you doing hand compressions?

[@llli*bfwmomof3]

Okay, that's helpful information. I agree, since it's not pump-dependent it seems less likely related to the pump (unless all three are failing simultaneously! which seems unlikely). Some mothers do notice a drop in supply starting with ovulation and continuing a few days past the start of their period. So that could definitely be an explanation. Some moms find taking a calcium/magnesium supplement helps. Or eating oatmeal. Of course, the best way to increase supply is to increase demand by either nursing or pumping more.
With regards to how much baby should be eating while apart from you, the rule of thumb is 1 - 1.5 ounces/hour. So 12 ounces over 7.5 hours is too much. Has she always taken in this much, or is it a new thing? What size bottles is she drinking? One approach would be to cut back by an ounce but leave an ounce topper just in case. For example, if she normally drinks a 4 oz bottle, try leaving a 3 oz bottle with a separate 1 ounce topper. That way, she drinks the 3 oz, and the extra effort of getting the additional ounce ready may give enough time for her caregiver to realize that she's actually had enough. It's just so easy for the baby to drink from the bottle that if the 4 oz are all in there to begin with, she'll drink it whether she really needs it or not. As you point out, that not only makes it hard for you to keep up in terms of getting her enough for the day, but also decreases the amount that she nurses when she's with you, because she's full from earlier.
Your 1 pound/week weight loss is perfect and the kind of pace that's usually advised for weight loss. So I agree, I think that's less likely to be the culprit.

ETA: One way to increase pumping is to try to pump for longer even if you're "pumping dry." 10 minutes is what I think of as a bare minimum 15-20 minutes is more typical, and some moms need longer.

[@llli*lily.mama]

Thanks, your reply is really helpful. I pump straight into the Medela bottles, which range from 2.5 to 6 oz. I almost never have more than about 3.5 oz in a bottle, and there are usually quite a few "toppers" in there as well. I'm going to try to keep an eye on whether there's a difference in terms of caregiver (my husband vs. the nanny, for example), since sometimes I think my husband throws food at any fussiness.

I'll also give the dry pumping a try. I didn't realize there was any benefit to continuing pumping after the breast is emptied, so that might help. I'm hoping that if I continue pumping religiously on my off days I can get enough of a buffer to cover the deficit on days I work. I also am trying to add in more skin to skin and babywearing on the weekends. We'll see if any of that helps. Thanks very much for all the suggestions! This has been a frustrating process, but I'm committed to avoiding supplementing as long as she's healthy and growing.

[@llli*bfwmomof3]

Do you feel like there's a difference in what you get between the Symphony and the PISA? In theory the Symphony should be a "better" pump so I'm wondering whether it might be worth having that one at work and the PISA at home? I don't know, just a thought. With regards to pumping dry, another suggestion I've seen is to hook yourself up to the pump after LO goes to bed and just leave it on for an extended stretch while watching tv or hanging out with DH. Lots of skin-to-skin/babywearing time with your LO on the weekends is a great idea too. I hope you start seeing that supply pick up sometime soon!

[@llli*lily.mama]

Thanks for the reply. I keep the Symphony at home since I pump at home every morning and every evening and sometimes in between. I'm only in my office three days a week, usually only for about five hours at a stretch. The other times, I'm writing and at a coffeeshop or something where I use the Harmony. I decided I use the pump most at home, so I keep the most efficient pump there.

As for supply issues, things have gotten much better. We introduced some solids last week, which can help take the edge off a little, and my supply has also gone up in the meantime. I now get about 1-2 oz an hour and that, coupled with an early morning pumping, usually gets me enough to break even or even have a little surplus. I'm not sure what the controlling factor was, but between mother's tea, increasing caloric intake, and pumping more, we're in good shape. Thanks for all the support!

[@llli*bfwmomof3]

Glad to hear it, thanks for the update!