Facing many challenges, looking for support (*long*)

[@llli*adasmom]

Hello, just looking for some support and advice if anyone can help me. My DD is 8 months old and nursing has been a real challenge lately. Here's a laundry list of battles I'm currently facing:

-When LO is teething, she doesn't want to nurse
-She's extremely distractable, no matter what I do (dark, quiet room, etc.)
-She sometimes does not want to nurse on the left side (my supply has always been lower on that side)
-I've been experiencing a very slow let down lately (anywhere from 2-4 minutes). LO is NOT patient! I was just pumping until let-down, then letting LO nurse and that somtimes works...
-I've noticed an abrupt drop in my supply over the past week. Pump output is much lower that it was (even with the Medela Symphony pump available to me at work). I'm getting maybe half an ounce to one ounce total each session.
-Nursing sessions have been getting much shorter, and maybe this is the cause for dip in supply? She only eats for a couple minutes on each side. Or is she just more efficient now that she's older?

Over the last week I've caught a cold and started on 50mg Zoloft for PPD. Not sure if illness or the medication could be causing a supply issue, or simply the fact that DD isn't nursing for longer than a couple minutes at a time.

LO is healthy, meeting milestones, seems to be gaining appropriately (we are supplementing with formula through all this while I attempt to maintain/improve my supply). She eats solids 3 times a day and loves it. She either nurses or gets a bottle about 5-6 times a day; is sleeping through the night.

I am taking fenugreek and have been taking blessed thistle although I just ran out and need to get some more. Also have been trying fennel for slow letdown, can't really tell if that's helping.

I am getting really frustrated by all these compounding factors that are making it next to impossible to nurse. I'm getting really tempted to just say to hell with it and start the weaning process, but if there's a way through it I would like to stick with it. Sorry for the long, drawn-out post. If anyone can speak to any of the problems I'm facing, I sure would appreciate it. Thanks!

[@llli*karrieperry]

Sounds like you're handling a lot of challenges right now! That's awesome that you're willing to work through it, though.

The only one that I could give any advice on is the slow letdown. I have a very strong letdown, but now it's taking about the same amount of time to kick in, usually 2 minutes. For a while it was taking much longer (like 5 min when it used to take 30 sec) and baby was getting impatient, although now 2 min doesn't bother her. I looked at this: http://kellymom.com/bf/got-milk/supply-worries/letdown/, and tried the nursing cue thing. I have a little sound machine that I turn on every time we nurse, to the same raindrops sound. That seems to help, also doing something relaxing right before, like a few sips of tea. My letdown actually hurts, but I notice if I'm not stressed it doesn't hurt as much. I know that when you're worried about the nursing session in general it doesn't help letdown, I have that problem too, but I try to just close my eyes and take myself out of the situation a little bit.

It seems the more relaxed I am and not thinking about it, the faster it happens. Also, maybe a distraction for you, like reading/email/something so you're not thinking about it?

[@llli*andie613]

I definitely can relate to a distractable baby--my LO is 9.5 months and we have to nurse in his room where it is quiet and dark. Nursing down for naps is the easiest because he is tired, but last night when I tried to nurse him to sleep he thought it was funnier to hit me in the face. Sometimes when he is not nursing down for a nap or bedtime or overnight, I try to give him something to hold while he nurses, like a bib with a tage (he loves tags for whatever reason), a stuffed animal positioned to my side where he can touch it, or wearing a sweater that has buttons he can hold onto. Often its a battle! If your LO is gaining weight well and eating solids well, just try to nurse as much as possible, but sometimes baby will just be "done."

As to the supply--you mention that she sleeps through the night. I know this is not what you want to hear, but adding an overnight feed will help with supply. Can you wake around 2 am or so and try a "dream feed" for her? I've heard that the hormones responsible for increasing milk production peak overnight, so adding a night-time feed should help boost supply. It may be worth sacrificing some sleep.

[@llli*bfwmomof3]

Hi mama, I have a couple thoughts in addition to the good suggestions from previous posters.

First, 5-6 nursing session per 24 hours is low. Most babies this age are still nursing at least 8 times per 24 hours, and often more than that. So that would be my first thought about why your supply is low. My second thought is that with the decreased frequency of nursing and the sleeping through the night, you are about to get your period, which can often cause an abrupt decrease in supply. Third, I'm worried that the formula supplementation may be exacerbating things. If a mother feeds on demand, if there is a hormonal supply dip, for example, baby will nurse more to up your supply. But if you're giving her formula, she won't do that. So the formula is counteracting your ability to increase your supply. How much formula are you giving right now? Are you pumping when giving formula? Because if not your supply will dip for sure. I agree with andie613's advice to feed (or pump, but feeding is easier) at night while trying to get your supply back up. It's really normal for babies this age to be distractible and a lot of them make up for distractible nursing during the day with increased nursing at night. But it it sounds like by giving formula baby is getting satiated and not having that urge to nurse at night. Also, though it's great that she's enthuasiastic about solids, you want to make sure solids are not replacing breastfeeding before the age of one. So make sure you nurse (or give EBM) before solids.

I'm not aware of zoloft causing supply issues, however if you have medication-related questions you might want to contact InfantRisk: http://www.infantrisk.com/
A cold could have some impact if you are getting dehydrated or overly exhausted but I think that would be a minor contributor. If possible, this weekend try to spend as much skin-to-skin time as baby, get some rest, stay hydrated and just nurse, nurse, nurse as much as possible. The solution to supply problems is always to nurse (or pump) more! It's all supply and demand. Sounds like you are going through a lot right now, hope you feel better soon.

[@llli*adasmom]

Thanks for your thoughts.

I will consider doing the dream feed. Even though she STTN from about 7p-7a, I still try to pump before I go to bed. I've missed a few nights of this though since I've been sick so maybe my supply is just adjusting to that.

Also, as far as the solids go, she really loves it, but I'll try and hold back. And, I'm embarrassed to admit this but I think I might have created a problem by sometimes mixing in formula with the solids (and a sippy cup of water for fluids) thinking that it would make up for the not nursing. Now I realize that was a dumb idea. I'll stop doing that immediately and see if that helps her create more of an appetite for nursing.

I am pumping each time we use formula. The more I think about it though over the past week I've had this bad cold and haven't been eating as much as I normally do. I'm going to try and bump up my calorie intake and just offer to nurse as often as I can this weekend. Even if she only latches on for a minute I'm guessing that's better than nothing?

ETA: also, another possible factor: I'm not the only one who's had a cold. LO has also had a cold and has been having a stuffy nose, sneezing, etc. I try to keep her nose clear but I guess a cold could still maybe affect her appetite and willingness to nurse? Eh, so many different things going on all at once, it's hard to pin the problem down...

[@llli*diymom]

Ok, so thee is a lot I can suggest...the first is a nursing vacation. Only nurse, don't offer solids, no other fluids, and within a day her appetite will soar. By the next day your supply should start to rebound with extra fluids on your part and a healthy eating regimen. Think oatmeal for breakfast, lots of veggies...fruit. I know this works because I was sick, my son was sick, teething and distractable and my supply dropped too. He was a healthy weight and I had a free weekend since I was sick and so was he... I stayed home and nursed all day for two days while taking motherlove more milk plus and drinking mothers milk tea... my supply rebounded and my son did a great job for the FIRST TIME draining the breast. He learned to really work at nursing instead of waiting for supplementation. If i were you, I would also decrease the solids...3 meals a day is excessive for a baby under a year unless you are almost weaned which shouldnt happen before a year either. My son is a greedy little pig when it comes to food...he'll eat until he falls into a food coma. It really interfered. With my nursing for a bit when I was letting him have as much as he wanted amount wise with the solids. I cut back to 2-3 oz a meal for the solids and only allowed those meals after a nursing session. I do a breakfast and a dinner and it works well. After the meals I do a quickie nurse and he is totally fine with the new arrangement. I never add formula and I give whole foods with lots of finer like fruit and veggies, no empty or processed calories. Food is really not important right now and it interferes with nursing quite often leading to early weaning.

So I encourage you to try motherlove more milk plus tincture and do a nursing vacation ti retrain your little one to nurse for all its worth. Also I agree with the Pps, you should add a night time pump or feed. My son slept through 2 nights in a row and my supply was effected. I would try a few quick nursing sessions whenever you have 5 minutes too... I started doing that recently and my distractable son thinks its fun to snack when he is having playtime. He comes crawling over spends a few minutes on each side and then goes back to playing. So offer more if you have any opportunity, cut back food and supplementation as neither can compare to the nutrients and quality of your milk.

You are doing so well keeping up with bfing, you can continue with just a few adjustments. Great job!

[@llli*adasmom]

Great suggestions--I have two days off this week on Wed. and Thurs. and I might try a nursing vacation then. The only problem is, DD is really resisting nursing completely. I think she is teething and so I think part of it's that, but also my really horribly slow letdown and milk flow frustrate her. I can't get her to latch on for more than a few seconds at a time before she pulls away and cries. Any advice on what to do with this?

[@llli*amysmom]

I have 3 girls. So DD2 and DD3 have never been able to have quiet time when they hit the distractible nursing phase. For us, we just roll with it. She nurses, she nurses. She doesn't, she doesn't. I just make sure that I was available when she wanted to. It makes for more spaced out nursing, sometimes when she finally would, it would be 2-3 short sessions.

I would stop with any other fluids (formula, water or otherwise). You want her to come to you for thirst and hunger.

For solids, are you spoon feeding? You might want to look into Baby Led Solids or Baby Led Weaning. This approach gives them finger foods that they feed themselves. It emphasizes their discovery of foods (which is all that solids are before 1 year). It's just about experimentation. Sometimes spoon feeding encourages more food intake than they need or really want. It's more about the interaction and their getting food is just a byproduct of it. So I'd back off on that too.

For teething I would suggest getting some Camilia (homeopathic teething drops). I use it when I need to take the edge off. If that doesn't work, I will give tylenol. A snack you can offer is mango in a mesh feeder. The cold on their gums with the natural sugars seems to help to take the edge off as well.

Your supply will probably to better once you stop giving the water / formula. Nursing is much more efficient than pumping, so try to physically nurse as often as possible. If you're physically there, try. Even if she only nurses for a minute or two, she'll come back.

Try to relax. Take the pressure off yourself and try to 'go with the flow'. In general, if you roll with it, it tends to work it's way out.

[@llli*adasmom]

*Update*

I've been pumping later at night for the past couple nights and last night nursed DD when I got home from work around midnight. Woke up to nice firm, full breasts (first day that's happened in a while). Today was the first day of our supposed "nursing vacation." It actually went really well, much to my surprise. I think we got in about 6 or 7 successful nursing sessions. I gave her some solids for dinner, nursed her again before bedtime at 7pm. A few minutes after I put her down she started screaming...she seemed to be acting frantically hungry and wouldn't nurse. So, out came the formula. On the plus side, she only ate about 2 ounces. And I'm planning on doing a dream-feed of sorts around midnight. Really hoping we're on the right track!

[@llli*amysmom]

Sounds like a great start to getting back on track! Try to make sure that if you do give her formula due to her refusal to nurse, that you still pump. If she wants food, you need to signal to your body to produce at that time.

So you know, at around 8 months my girls would go through this as well. For them it seemed like the only thing that would settle them was pacing the floor and holding them diagonally across my body, tummy to tummy. No idea why, but it happened often. It lasted about 6 weeks. It also tended to be when my husband would have to hold them to go to sleep. I call it the sleepy hold (they basically lounge back on him). Sometimes it's not about food, it's more of a development stage where they just can't seem to settle.

Sometimes it wouldn't work and I'd need to take them back, but the 20 minutes or so was enough for them to calm down and reconsider nursing. Please rest assured that while it's tough, it does sound normal. Best of luck Momma!