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Thread: Low supply...

  1. #1
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    Default Low supply...

    My dd is going through her 6 week spurt. I was wondering what I should do considering that I think I have much lower supply than I thought. (She wouldn't breastfeed after getting a bottle most of the day, so I nursed her upright and it worked. When I did she was at the right breast nursing perfectly for about 1 minute, the other about 10 seconds [this after about 1.5 hours after feeding/pumping].) Should I take the risk of nursing her constantly? Or should I bottlefeed and risk not being able to pump? I just bought an SNS, but can and will try the finger feeder I got before.

    Also, when I do get a lot of milk, it always seems to be in one place (upper right corner on the left breast, for instance) and I get TONS of blocked milk ducts in both breasts, and have a recurring blocked pore on the right side.

    Update: 40 minutes after nursing her I pumped for ~10 minutes (I didn't time it) and got ~1/2 oz on left, ~1/4 oz on right (current average for right). Could it be because she left some milk in the breast? Should I have gotten this output in better time for it to count as the rough amount in my breasts?
    Last edited by @llli*forecastofrain; July 22nd, 2013 at 04:12 PM. Reason: Update.

  2. #2
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    Default Re: Low supply...

    Can you explain why you suspect you have "lower supply than you thought?" Plugs MAY suggest milk is not being removed effectively enough or often enough.

    So, these are the "rules" when dealing with a breastfeeding issues:

    1) Feed the baby
    2) Protect milk production
    3) Keep the breasts a welcoming, happy place for baby
    4) get help

    How, exactly, a mother does these things can vary quite a bit, of course. Why would letting baby nurse as much as baby will "risk" her going hungry? Cannot you also supplement as needed? And if baby needs a bottle, how does that prevent you from being able to pump?

    I understand there is the very large issue of time and mamma exhaustion and fitting everything in, and you will have to figure out what works for YOU, "schedule wise." But many moms who are not making enough milk to exclusively nurse and are trying to build production do manage to nurse, pump and supplement.

    Update: 40 minutes after nursing her I pumped for ~10 minutes (I didn't time it) and got ~1/2 oz on left, ~1/4 oz on right (current average for right). Could it be because she left some milk in the breast? Should I have gotten this output in better time for it to count as the rough amount in my breasts?
    I am not sure what you are asking here. A lactating breast is always making milk, so it is normal for a mom to be able to pump something even after a baby has nursed very well.

  3. #3
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    Default Re: Low supply...

    Plugs MAY suggest milk is not being removed effectively enough or often enough.
    That could be. I was also wondering if I might have thrush. A few questions: Do SNSs and fenugreek really work to build supply and keep it maintained? Is it really possible to lose supply in a few days? And if I ebf and she falls asleep without getting enough, isn't it time to supplement?
    Last edited by @llli*forecastofrain; July 22nd, 2013 at 05:44 PM.

  4. #4
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    Default Re: Low supply...

    SNSs and fenugreek can help. For some moms, they are all that is needed. For others, more is required. I will say that herbs and SNSs are not nearly as effective at increasing supply as frequent and complete emptying of the breast using either baby or pump.

    You can lose a lot of supply in a short time, if you're one of those moms whose body responds that quickly. But most of the time when a mom feels like she has lost supply, she's mistaking a normal adjustment to supply for low supply. LLLMeg's question about why you think supply is low is really important- if you can tell us exactly what is making you think there's a problem, we can either reassure you that it's normal or suggest specific steps to fix it.

    If you EBF and baby falls asleep, that's a good indication that no supplement is required. It's rare for a baby to fall asleep when still really hungry! If you're in doubt about baby's intake, watch her diapers: good diaper output = normal milk intake.
    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!"

  5. #5
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    Default Re: Low supply...

    I just want to clarify a couple things, for lurkers...
    Fenugreek is ONE type of herbal galactagogue. (Foods, herbs or medications that increase milk production are called galctagogues.) It happens to be a popular one that many mothers respond to at high enough doses, but others do not. Luckily, there are other types of galactagogues, and some mothers respond better to those, or to a blend.

    An SNS (supplemental nursing system) allows baby to get any needed supplements of expressed breastmilk or formula at the breast. (There is another brand as well, called the LactAid that many moms prefer, and some mothers make a homemade version.)

    This device, also known as a lactation aid, is not going to increase milk production on its own... Why it may help is it can keep baby nursing AT THE BREAST more, and, especially if baby is latching and sucking well, this stimulation and, most importantly, possible additional milk removal from the breast while baby nurses wiht the lactation aid, will help milk production to some extent. Also important, a lactation aid allows baby to be supplemented without bottles, which is 1) a possible time saver (very important in such cases as I discussed above) and 2) avoids the risks of breast refusal inherent in supplementation with bottles.

    But as mommal points out, the single most important step to increasing milk production is to remove milk from the breasts effectively and frequently. Usually babies do this best, but sometimes a mom needs to pump instead or, do both. Frequently means, at least 8 times a day or more. Effectively means, gets most of the milk out of the breast that is there at a time.

    EDIT: Which interventions will work best in a particular situation depends on individual factors such as the reason for any low production and if baby is able to suckle frequently and effectively.
    Last edited by @llli*lllmeg; July 22nd, 2013 at 08:42 PM. Reason: clarifying

  6. #6
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    Default Re: Low supply...

    Quote Originally Posted by @llli*mommal View Post
    LLLMeg's question about why you think supply is low is really important- if you can tell us exactly what is making you think there's a problem, we can either reassure you that it's normal or suggest specific steps to fix it.
    Sorry, I didn't see that question.

    1. Mostly it was the fact that her head only grew 1cm since birth (5 week measurement). She's grown 2.5" (last check) since birth, though.
    2. She falls asleep frequently at the breast (which I saw in a video on how to use an SNS that young babies fall asleep when the milk stops flowing, but will perk up and continue eating when supplemented at the breast). When I wake her up she'll lunge for the breast.
    3. Her pee diapers were there, I would pinch her skin (lightly) and it would go back to how it was, her softspot could be felt but not really seen... but she had poo that came out like toothpaste and only happened about twice a week since birth.
    4. She only gained about 4oz a week (one time 3oz), and ever since being supplemented she's now getting chub, which she never had before.
    5. I strongly believe she has an upper lip tie that should be cut, but the ped said it wasn't an issue. The doctor just really freaked me out and told me two appointments ago that I should seriously consider supplementation because I could hurt her brain. Then last week I found out her head had only grown 1cm.
    6. She only actively sucks for a few minutes, then falls asleep... or actively sucks, whines, then starts lightly sucking until she sleeps.
    7. At night during fussy/cluster time she nurses, sleeps, nurses, sleeps until she passes out... but I feel like I don't produce enough because her cluster feeding lasts for 8+ hours (is it normal for it to last that long?). Last night she kept waking up hungry and was hungry continuously today. I've been ebfing her through her cluster feeds the past three nights and only maybe one or two oz of formula for the past two days, so I don't know if it's her body catching up to hunger or her 6 wk growth spurt.


    [/quote]If you EBF and baby falls asleep, that's a good indication that no supplement is required. It's rare for a baby to fall asleep when still really hungry! If you're in doubt about baby's intake, watch her diapers: good diaper output = normal milk intake.[/QUOTE]
    That might be, and usually is (and was a good number of times the past few days), but during her witching hours (and all day today) she'll sleep for ~10 minutes and then wake up eating her hands.
    Last edited by @llli*forecastofrain; July 22nd, 2013 at 09:47 PM.

  7. #7
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    Default Re: Low supply...

    OK I can't figure out how to put it better,-re my pp, Yes, a lactation aid WILL help increase milk production in the sense that a baby nursing at the breast, even while using an aid, also may (hopefully will) be stimulating letdown and removing milk from the breast. So I was wrong to say that using them will not increase milk production as of course sometimes they will. But not because there is something special about the device that increases production, but rather because it encourages baby to latch and nurse, and nurse perhaps longer and more effectively-that is what I was trying to say...? Sorry it is probably still as clear as mud. Going to sleep early tonight...

  8. #8
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    Default Re: Low supply...

    OK, but you know all this already-right? I am not seeing the new info that makes you think your production is lower than you thought previously?

    I forget, have you been able to see an IBCLC? Can you get a second opinion re: the lip tie?

    I cannot speak to how fast head circ should grow, I don't know. Yes, the fairly slow gain and infrequent poops do suggest baby may not have been getting enough milk overall. But whether this is DANGEROUSLY slow gain? I do not know. Average gain is about 6-8 ounces a week. So this is less, but not THAT much less.

    In any case, when it appears baby is unable to get enough milk via breastfeeding, from a medical standpoint, the protocol is (or should be) to help mom increase production and/or increase baby's ability to transfer milk effectively, whichever is needed, while supplementing if/as needed.

    IF your baby is not getting enough milk via breastfeeding, there is a reason. It may be low production. It may be poor transfer. It may be a combination of the two. And no matter what the reason, formula supplementation , (while possibly appropriate) will not do anything to SOLVE the underlying problem.

    NOT breastfeeding is a serious issue, health wise. So you deserve respect in your choice to breastfeed and the best possible help and support to keep breastfeeding from your hcp.

    This article from Jack Newman touches on what I am talking about .

    http://www.breastfeedinginc.ca/conte...ename=doc-HKHP
    Last edited by @llli*lllmeg; July 22nd, 2013 at 09:35 PM.

  9. #9
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    Default Re: Low supply...

    Some techniques for waking a sleepy baby:
    - Annoy her. Tickle the soles of her feet or rub against the grain of her hair using your hand or a cool damp washcloth.
    - Keep her cool. When it's time to nurse, strip her down to a diaper or onesie, and keep a fan blowing in the room where you nurse (but not directly on baby).
    - Keep the lights dim- new babies often close their eyes in response to bright light.
    - Do breast compressions to speed milk flow to the baby, particularly when sucking slows and she appears to be drifting off to sleep.
    - Try switch nursing. When suckling slows and baby seems to be falling asleep, take her off the breast, burp her or change her diaper, and then put her on the other side. Repeat the process until baby will no longer wake. In theory, switch nursing increases the amount of milk a baby takes at a feeding, and also teaches baby that the breast is a place where she needs to stay active, and keep nursing, because you're going to annoy her every time she tries to take a nap.

    Waking up within 10 minutes of nursing is pretty typical for a young baby, particularly if you're trying to put her down in between feedings.
    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!"

  10. #10
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    Default Re: Low supply...

    I am not seeing the new info that makes you think your production is lower than you thought previously?
    Well, I realized that my daughter was not emptying my breast because of a shallow latch (I took her off of a nipple shield she had been on since birth and didn't teach her the proper latch... my husband said not to try so soon). I taught her to latch properly the other day and she drained the breasts well... and after that I got hunger cues continuously until she was bawling. So, I don't really know how to go about this except that I bought a starter SNS and am breastfeeding her, then giving her whatever breastmilk I can in the SNS before formula. She still takes about 1-1.5oz formula a feeding. Which is very significant... but I'm trying to do "power pumping" sessions (10 minutes pumping, 10 minutes rest, repeat for an hour) while she sleeps. Does it sound like I'm doing the right thing? I'm doing the fenugreek (9-12 pills daily) and am trying the more milk plus (175lb dose), but I can't say that it's helped any yet.

    And is dom really not a good idea?
    Last edited by @llli*forecastofrain; July 26th, 2013 at 05:58 PM.
    - June 1, 2013

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