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Thread: Need serious help with supply issues-long...

  1. #1
    Join Date
    Oct 2012

    Default Need serious help with supply issues-long...

    is in need of some advice/suggestion. I has been dealing with an issue where I sees cyclical supply drops. I have some impact from my period but will also see it at other times throughout the month. Baby is 6.5 months old. I am thinking a big part of the issue is my work schedule as a nurse. I currently works two days[night shift] a week from 7p-7a. As a result I nurses baby normally on demand Monday-Thursday. Friday morning I nurses baby in morning then goes to sleep. As a result I dont not get a stimulation for approximately 4-5 hours until I wake up between 11am-12pm. I then ensures I get the minimum of 5 stimulations by either nursing or pumping throughout the remainder of the day. [and pumping overnight while at work friday and saturday nights] This cycle repeats Saturday and most of Sunday until I am reunited with baby in the afternoon. [sat going 5-6 hrs to sleep during day and sunday about 4 hrs]

    My biggest concern is that I noticed a big struggle/supply crash over night sunday into Monday. My pump output in the evening sessions were normal until Monday night. (I power pumps in the evenings, baby STTN). I worked all day monday to get baby to nurse 9 times (typically only get 5). I am approaching my period but this is the biggest change I have seen. [in fact just started lightly yesterday]

    I wonder if the culprit is how demand driven supply is at this stage in the game and the fact that I have 2-3 days a week where I have no stimulation for 5-6 hours. I have sought help everywhere and been recommended pumping after nursing to increase stimulation during the day, I been recommended not sleeping more than 4 hours (tough for me to go back to sleep), and to get in contact with her local IBCLC to ensure there isn't another factor contributing to this. I have some domperdione on hand about a week supply but not sure this is the right thing to do. [yet].

    I was hoping you could provide some additional insight, see if there was something im missing or not thinking of to help with this issue. I really appreciateany additional advice/suggestion you can offer.

    here are some weights:

    Also just to note I never had any supply issues with my son and never had to work at it this hard. I had my thyroid checked in December and it was normal....(for another reason not cause of this).

    Her birth weight was 8lbs 5oz. As of jan 5months old she was 15lbs even. I saw an LC yesterday and she was 15lbs 8.7oz at 6.5 months. She also did a weight transfer after a feed:

    so weight prior to feed was 7.20kg [15 lbs 8.7oz] after feed on right side only she wouldnt take left, was 7.24kg, [dont know pounds], but she also had pee in her diaper and LC said you have to take away for the pee, so technically she only transferred 1oz...and that was from the breast that she hadnt nursed off of since 730-8 the night prior
    LC didnt think it was a big deal though. she said she looks great, is gaining weight and happy.

    But, I am very concerned that this trend with my period is only going to cause more issues the farther we get out and I desperately want our nursing relationship to last. I value our nursing relationship as well and do NOT want it to have to end because I can't keep up my supply to meet her needs. I fear if things continue on this trend, in another month or two, I will be starting to dry up or not have enough for her. Yes, I have my stash [a big one too], but like I was telling my husband, I don't mind using that milk for her weekend bottles, or when we are out and shes drinking from a sippy, etc. but I dont want to have to feed her directly from that until she is a year old....I want to be able to still breastfeed her even if its just 3 times a day, and slowly slowly taper off after a year. My son nursed for 13.5 months and weaning was too quick for me actually. I want her to slowly trend down over a few months. She is my last baby so im not willing to just let it go, but I don't know how much more I can do honestly, to keep up my supply. if that makes sense.

    ps: not only am i concerned because of my breast changes, but i can tell when my supply is lower because baby has bare minimum wet diapers. like 4 or 5 a day and they are not sopping wet. i dont like that i have to watch so closely are her diaper output ..it makes me nervous that she isnt getting enough

    Its so bad this morning that DD cant even get milk out [no letdown no gulping, etc]. I always feel let down so I know when it happens. She last had a decent feeding at 7pm last night so thats over 12 hrs now. [prior to that yesterday she went from 1p-7pm without nursing...I had to pump at 530pm which was successfull after 5-7 mins and got 3.5oz out...after 4 hrs of her last nursing session....but then power pumped last night 10 on 10 off for an hr and no let down and got 1oz]. Im panicking b/c she cant get my milk to let down and I cant get it out for the pump either at times.

    Please help!!! I just talked with a LLL leader locally and I dont know who else to turn to for support.
    Last edited by @llli*jhowell; February 20th, 2013 at 07:33 AM.

  2. #2
    Join Date
    Jun 2008

    Default Re: Need serious help with supply issues-long...

    I'm having a hard time understanding what exactly the problem is. Is it that your baby isn't gaining weight like she should? Is the problem that you're not pumping enough? Is it that your baby is frustrated or refusing to nurse because of lack of milk? Maybe you could pin down two or three signs that you're concerned about.

    From what I can tell, you are stimulating enough to maintain a milk supply. Your milk supply might go down somewhat when you're at work, but your baby builds your supply back up Mon- Thu. This is okay!

    Stress is surely a reason why you wouldn't be letting down. Panicking feelings counteract the letdown reflex.

    I know, it's so easy to say, "Don't stress!" yet so hard to actually not stress!

    Here's the thing: If you have been lactating for 6.5 months, it would take quite a long, long time (or medications that are contraindicated for breastfeeding) to actually get your milk supply to dry up. A well-established milk supply can do pretty well for 5-6 hours of not nursing. Some six-month-olds go that long without nursing during the night or during the day and they do okay.

    I really think you're over-thinking this. I think if you nurse your baby and she still seems hungry, nurse again! And if she's still hungry, or if you can't seem to get a let-down, maybe she's ready for solids and she can eat some pears or avocado or something, then you could nurse her again.

    And you can always mix breastfeeding with other feeding methods (e.g. using up your stash in the freezer), then continue nursing as long as you both desire.

  3. #3
    Join Date
    Jun 2009

    Default Re: Need serious help with supply issues-long...

    I am not sure there is really a supply issue...but if there is, Here are some quick ideas. I am not sure if all will be relevant.

    Are you sure your pump is in good working order? Is it less than a year old? If not I would seriously consider if your pump is performing properly.

    Why are you pumping when you are with your baby? Typically babies are better at milk extraction than pumps, and typically nursing is more relaxing and pleasurable for mom (and baby) than pumping. Can you nurse when with baby, and only pump while at work? If what you can pump at work is not enough to feed your baby while you are next at work, is baby maybe being overfed by caregiver?

    Is this a new work schedule for you? Two overnight shifts a week while living daytime hours the rest of the time would tend to wreck havoc on your circadian rhythms. I would suspect the stress of this work schedule for harming supply more than a couple of days of 6 hour stretches. Not sure what can be done about that just throwing it out there.

    Are you able to eat properly over the weekends when on this shift work? Drinking enough water?

    Aside from work other factors can harm milk production. Some things that could contribute to low milk production issues in general are : mom going on birth control, Too fast introduction of solids, scheduling feeds/sleep training, overuse of pacifiers, unneeded bottles.

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