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Thread: low milk supply - have to supplement with formula

  1. #21
    Join Date
    Jun 2009
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    5,252

    Default Re: low milk supply - have to supplement with formula

    This was 3 oz in how many days? Sorry, I can't figure it out from your posts
    I think it was one week?
    Were you able to add additional nursing sessions as we suggested? Still supplementing 2 ounces total per day during that time?

    When I pump at my fullest I get 2 oz total at most which I believe tells me that I'm not making enough
    but two ounces is a normal sized feeding for a baby this age. A baby this age needs about 25 ounces of breastmilk a day, some a little more. They usually get this by nursing at least 10 times a day. It varies, in part because normal milk production varies.

    So a normal sized feeding is about 2 ounces, sometimes more, sometimes less. Plus you are still nursing at least 8 times a day-yes? And pumps are often not as good as baby at extracting milk. So how much do you expect to be able to pump?

    I think it is time to go back to your IBCLC or consider seeing another one. Breastfeeding needs to be seriously re-assessed so you can get clarity on what is happening so the underlying issue can be addressed. I am disturbed that everyone including your IBCLC is throwing formula at the problem as if that will solve the underlying issue. But it will not. Maybe you do have low production, and that can be addressed various ways. But from what you said about your IBCLC appt, there also may be an issue with your baby's ability to transfer milk. And sometimes. slow weight gain has nothing to do with what or how much baby is fed.
    You may need to supplement, it happens. Much better from a health standpoint to give baby needed supplements along with breastfeeding than to not breastfeed at all. But it should be a supplement. Not almost an entire feeding. You DO make milk. Enough to keep your baby alive and to grow, although slowly. So that is very close to 'enough.'
    This is kind of urgent because you are on your way to no more breastfeeding, which I assume you do not want. If baby is supplemented 1.5 to 2 ounces every time you feed your baby, that is what-10 - 16 ounces per day? That is a lot, almost half to over a half of what your baby needs total. Your baby is getting close to being entirely formula fed, almost certainly unnecessarily.

    When your baby fusses after getting the bottle, have you tried offering the breast again? Anyone suggest the 'finish at the breast' method of supplementing to you?

  2. #22
    Join Date
    May 2013
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    15

    Default Re: low milk supply - have to supplement with formula

    Well since i cant determine how much she is receiving, i give her 1.5oz the four midday feedings after bf. I only get 1.5oz when pumping at my fullest, and when i bf on demand i certainly dont have that. I only get full after 2-3 of no feeding. My concern is that when i only bf, she isnt always fussy, which leads me to believe that maybe i dont need to give her formula, but then sometimes i bf and she wants more but there isnt another letdown, so she gets frustrated and there's no milk. I'm trying to pump after her 10/11am feeding just to stimulate, but after I weigh her tomorrow I think I'm going to have to give her less formula. The overactive letdown is so quick that that is how I know that there isn't a ton of milk. I'm making an appt to meet with the LC.
    When she does take the formula however, she is satisfied and calm "milk drunk" for an hour, takes a nap, wakes up and we start again. Without the formula she is never "milk drunk" - NEVER.

    Yes, I'm still offering/giving the breast on demand. But I also know that she could sometimes suck harder, but doesn't. And when she stops feeling the flow of milk, she stops sucking (sometimes) because it seems like there is no more. I am frustrated and feel like I'm not sure what else to do. When I think about the 25 oz she should be getting a day (I'm SURE i can't make that because I don't get the 2-3 hour rest to produce 2oz a nursing session - which probably makes up for the little weight gain).

  3. #23
    Join Date
    May 2013
    Location
    Oregon
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    111

    Default Re: low milk supply - have to supplement with formula

    Quick question: couldn't you also try supplementing with pumped milk? You could even put it in the fridge for a few hours so that the hindmilk seperates from the foremilk and scoop off the "cream", and give al or mostly cream after the feeding , replacing the formula. Correct me if I'm wrong but it's better to supplement with our own milk, which has way more good fat than formula. Just a thought.

  4. #24
    Join Date
    May 2013
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    15

    Default Re: low milk supply - have to supplement with formula

    i could scoop off the hind milk, but then what do i do with the rest of the milk and how much is sufficient?

  5. #25
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    Jun 2009
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    Default Re: low milk supply - have to supplement with formula

    I'm SURE i can't make that because I don't get the 2-3 hour rest to produce 2oz a nursing session - which probably makes up for the little weight gain).
    Has someone told you that you have to feel "full" in order to have milk in your breasts for you baby to get? This is not true!

    This is very important. So I am going to bold it: Even if you do not make enough milk overall, the most effective way to approach that problem is to remove milk from the breasts very frequently. Whether by pump or by nursing, or both, it is frequent milk removal that will allow a mother to have normal milk production in the first place, and frequent milk removal is the first step to increasing milk production when it is low.

    Galactagogues help some mothers, but they must be used along with frequent milk removal. The last thing you want to do if you have suspected low production is to wait until your breasts feel full to nurse or pump.

    Certainly you can supplement with your own milk instead of formula. Or supplement with your expressed milk as much has you have, and then formula as needed. I assumed you were already doing this. Yes you could scoop of the fatty milk only and give your baby that, but I sincerely doubt that is needed. Just supplement with all your expressed milk. The issue is not that there is something wrong with your milk, but that there may not be enough of it, or baby maybe cannot get enough of it from the breast.

    Yes, I'm still offering/giving the breast on demand. But I also know that she could sometimes suck harder, but doesn't. And when she stops feeling the flow of milk, she stops sucking (sometimes) because it seems like there is no more.
    do you switch sides at this point? Try breast compressions? Take a little break and bring baby back to the breast shortly?

    Do you have the book Making More Milk? I strongly urge you to read or re-read it. I really think some clarity on why a breastfed baby might not gain well and what is typically recommended in such cases by lactation experts who have studied the issue will help you make a plan that will work best for you.

  6. #26
    Join Date
    May 2006
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    20,782

    Default Re: low milk supply - have to supplement with formula

    Quote Originally Posted by @llli*marissa.basch View Post
    i could scoop off the hind milk, but then what do i do with the rest of the milk and how much is sufficient?
    Making double-cream bottles is a good trick for a mom who needs to supplement due to infant growth concerns and who is also producing milk in excess of what her baby needs. If you're falling short on pump output, you don't want to do this- it's more important to use all your milk than to enrich your baby's diet with extra fat.

    If you get to a point where you must supplement and you're producing lots of extra milk, and you try the double-cream bottles, then you'll end up with some milk which is basically skim because all the fat has been removed. This is still useful milk, so you can save it in the freezer and use it to thin out baby's first solids if you take a purée-and-spoon approach.
    Coolest thing my big girl said recently: "How can you tell the world is moving when you are standing on it?"
    Coolest thing my little girl sang recently: "I love dat one-two pupples!"

  7. #27
    Join Date
    May 2013
    Location
    New Jersey
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    158

    Default Re: low milk supply - have to supplement with formula

    There is no way I could give the detailed and educated advice you are receiving but I may be able to provide you with a light at the end of the tunnel type of story?
    When Ellie was born she lost almost 20% of her birth weight. Due to a lack of help with breast feeding the doctors at the hospital had us supplement. I fed her for at least 15 min per side every two hours and gave her 2 oz of formula 2 x a day. Once home from the hospital I started pumping. I would not get much at first but after every feeding I pumped for 10 minutes on each side. By the time Ellie was about 3 weeks we were giving her a bottle of pumped milk about 3x a day and formula once a day (Never more than 2 oz at a time). By 5 weeks I was able to pump about 3 oz every morning after Ellie ate and another 4-6 oz through out the rest of the day. We also cut out all formula at this point but kept giving her BM bottles as top-offs, when I was going to be out for a few hours or when pumping in the car and giving a bottle was more convenient because of a longer car ride. Now, at almost 15 weeks she is still EBF. She takes bottles at daycare, nurses when I am home and is growing great. We have had our share of problems (mastitis and oversupply now, reflux, possible dairy allergy) and I am not thrilled I had to give her formula BUT after those feeding where we topped her off with formula was the only time I slept more than 45 min at a time so in the end it was well worth it.
    There may be a lot of issues for you to work out with supply problems, let down, etc. but we did this with trial and error (I did not know this website existed) and we have a great nursing relationship now.
    Im not saying any of this is what you should do (for all I know I did it all wrong) but you seem frustrated and I know when I am frustrated the information I need does not always help but knowing this too shall pass provides the little encouragement I need to keep going.
    Good luck!

  8. #28
    Join Date
    May 2013
    Posts
    15

    Default Re: low milk supply - have to supplement with formula

    Thank you for your story Elliemommy...it's always great to know that there are more ppl out there like me...

    I went and saw the LC today. Before feeding, my LO weighed 8.8 (which was quite disappointing), but then after BF and formula, weighed 8.14. The LC basically explained that sometimes while we increase our supply it sometimes just doesn't meet the demands of the baby - and I think that it is time for me to stop being so obsessive and just let it be.

    Obviously my baby needs some extra and it can't hurt to give it to her. I am reading Making More Milk, and just going to continue on my path. I'll update when I have one. I appreciate all of everyone's help and support.

  9. #29
    Join Date
    Jun 2009
    Posts
    5,252

    Default Re: low milk supply - have to supplement with formula

    OK, please forgive me if I have this wrong, but here is what I think you are saying.

    On 5/28 your baby weiged 8 lbs 7 ounces
    For the next 7 days, you nursed about 8 times a day and supplemented 2 ounces PER DAY(?)
    On 6/4 baby had gained 3 ounces to weigh 8 lbs 10 ounces
    You started supplementing 1.5-2 ounces per feeding, and still nursing-again, about 8 times a day(?)
    9 days later on June 13th your baby had LOST 2 ounces to weigh 8lbs, 8 ounces?

    Tell me what I have wrong here.

  10. #30
    Join Date
    Feb 2013
    Posts
    43

    Default Re: low milk supply - have to supplement with formula

    Hello . . . just thought I'd offer my two cents here. My LO is now 4.5 months old - but at her 2 week check - Dr. told me to supplement with formula because weight gain was not enough. Shallow latch . . . weak suck . . . not enough milk etc. I was devastated. I decided not to offer formula - but to pump. And pump . . . and pump. After every feeding I pumped as much as I could. Sometimes getting only an ounce (out of both combined) - and sometimes up to 4 ounces (both) . . . and I'd offer LO the bottle of pumped milk after nursing her. Her weight started to go up . . . and I managed to continue doing this until she was three months old. I'm happy to say we made it through that time - and now at 4.5 months . . . I don't pump unless I want to (which is next to never - other than to get milk for some home made *ice lollies*!) and LO is nursing strong and well!

    It's SO worth not giving up on! My supply increased and baby got stronger and more efficient at nursing. Keep going Mama and don't give up. You'll be SO happy you didn't!! Things will end up working out beautifully and that bonding between you and babes will get stronger and stronger!

    ((hugs))
    Life is Beautiful.

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