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Thread: Low milk supply?

  1. #1

    Default Low milk supply?

    Hey all! I had to reach out with some concerns I'm having. I am worried that I am having issues with diminished supply and was hoping I could get some help.

    I have not had a chance to visit with a lactation consultant since the hospital and I don't think my insurance covers one.

    My DD is 10 weeks old. Up until this week breast feeding has been well but this week has been rough.

    She will eat fine at the breast at night and first thing in the morning, but during the day there are times when she will eat at both breasts then scream and cry like she is starving to death. I finally broke down and gave her some expressed breast milk from a bottle. She gobbles up one or two ounces and then finally seemed satisfied.

    She doesn't do this at every feeding, just a few times a day. Three days ago she needed one bottle in the afternoon. Two days ago it was one bottle in the morning and one in the afternoon. Yesterday it was one in the morning. Today it was one this morning.

    I had the Mirena IUD installed at my 6 week appointment. I know this can cause supply issues but I didn't see any trouble until this week.

    She uses a pacifier during the day and to sleep sometimes. We hadn't started bottles yet but were planning on it since I go back to work in four weeks.

    She's also been drooling a lot lately and I am wondering if she is teething. Her lower gums seem swollen.

    At this point I am not sure what to do. I am terrified my supply is going down. I used to be really engorged in the morning after her long sleep, but i am not as engorged in the morning lately.

    I've been drinking fenugreek tea. I can't eat oatmeal because it gives DD gas. What should I do? I still have some breast milk frozen that I can supplement with, but I don't have a lot.

    My apologies for the wall of text. I am very worried and appreciate any help. Thanks!

  2. #2
    Join Date
    Jun 2009
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    5,760

    Default Re: Low milk supply?

    Hi!

    Many moms think their supply is going down when they experience normal breast changes and/or baby seems fussy after nursing or wanting to nurse more frequently. Usually, this is entirely a false alarm.

    So, breasts feeling less full-normal at this age
    baby fussy after nursing-may mean something, may not
    baby gobbling bottle-usually has no meaning as far as milk production is concerned

    A baby only needs supplementation (possibly) if baby is not gaining normally when nursing a normal amount. So, I suggest, lets try to figure out if there really is a low production issue and then tackle the fussy baby question.

    How is babies weight gain-overall, and esp. what was the gain between the last two appts, and when were they?

    How many times in 24 hours does baby typically nurse?

    If you are pumping, How often do you pump and how much milk do you get when you pump?

    Do you nurse baby pretty much whenever baby cues, or on any type of schedule?

    How long is the 'long sleep' and when did baby start long sleeps?

    Does baby sleep with a pacifier? And why/in what circumstances do you use the paci during the day?

    Does baby sleep swaddled?

    Does baby sleep in a separate room from you?

  3. #3

    Default Re: Low milk supply?

    Thanks for your reply! Hope I can answer your questions.

    Babies weight gain: appointment on July 7: 8.4 pounds Appointment on August 19: 11 pounds

    Nursings per 24 hours: between 6 and 9.

    When I pumped I would get 2-3 ounces between both breasts. I haven't pumped in a while.

    I try and nurse on demand. She throws confusing cues lately, acting hungry but won't eat.

    Long sleep is between 5 and 7 hours (usually 6.5-7). She started sleeping long around the 5th of August.

    She sometimes falls asleep with the pacifier. She doesn't always nurse to sleep and gets frustrated when she wants to suck and gets milk instead. It's used during the day to calm her down sometimes. We have had serious issues with gas and reflux so it helps when she isn't feeling well.

    Baby sleeps swaddled but always manages to get her arms out.

    She sleeps in our room, but not in our bed.


    My largest concern is that she becomes frantic at the breast. She seems starving but refuses to latch. I usually give her the paci in these situations to help her calm down and have resorted to bottles twice. It is difficult for me to tell if my breasts are empty. I rarely feel letdown too.

    Thanks!

  4. #4
    Join Date
    May 2006
    Posts
    21,267

    Default Re: Low milk supply?

    This does not sound like a supply issue. Baby is gaining well- 3 lbs in just over a month! She's nursing a normal amount- most babies require at least 8 nursing sessions per day in order to get their needs met, so I'd encourage a couple more feedings on those days when she's nursing less. Your pump amounts were great. Baby is sleeping a very long stretch at night, which also points to normal intake- babies who aren't getting enough to eat generally cannot sleep that long (though, just for the record, plenty of babies who are being fed abundantly also don't sleep more than an hour or two at a time!).

    As long as baby is wetting/pooping enough and gaining weight normally, there's no reason to worry about whether or not your breasts feel full or empty, or whether or not you can feel letdowns. Fullness is actually something a mom experiences only when she's making too much milk. When supply and demand have adjusted to be well-matched, a mom will rarely if ever feel full. Not all moms feel letdown- I nursed my kids for a total of 6 years, and never once experienced a letdown sensation!

    Being frantic at the breast, and sometimes refusing the breast is a really frustrating- and normal- baby behavior. Why babies do it... . Sometimes they are just cranky. Sometimes they want to suck but not to eat. Sometimes they are too frantic to remember that latching on and sucking will solve their hunger problem. Some things you can do:
    - Try offering the breast before your baby escalates into frantic crying. Some babies are "0 to 60" types who go from calm to crying in a heartbeat, but if you have a baby who is a little more calm, maybe fussing for a while before crying, try to nurse her in that hungry but not frantic phase.
    - If baby is refusing the breast, try offering your clean pinky finger for her to suck on, with nail held down towards her tongue so that it will not damage the soft tissue of the palate. A few moments of sucking on a finger may calm her enough to enable a repeat latch attemot, and remind her that the key to getting her hunger problem solved is to suck.
    - Don't resort to the bottle unless baby is getting dehydrated. Teaching the baby that she can get her needs met with a bottle if she just fusses enough is one way that nursing goes south on a lot of moms.

    Try not to take this behavior personally, and also try to remember that fussiness is not always about feeding. Sometimes the baby really isn't hungry, and is just cranky. Crankiness/fussiness/colic actually tends to peak right in the 3 week-3 month window, so think of yourself as being in the heart of it right now. Some things to try for fussy phases:
    - Calm house. Lights, TV, and stereo down, or preferably off.
    - White noise. Vacuum or dryer sounds, radio static, etc.
    - Closeness. Cuddle baby close in a sling or hold her skin-to-skin so she can hear your calming heartbeat and breathing.
    - Motion. Out her in a swing, bounce her on an exercise ball, rock in a rocker, take her for a stroller ride, etc.
    - Give her a warm bath.
    - Go outside into the fresh air.

    A lot of baby fussiness can be short-circuited by changing the baby's sensory input. Nothing will work for long, so keep changing it up!
    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
    Join Date
    Jun 2009
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    5,760

    Default Re: Low milk supply?

    Thanks for answering our questions! I agree with mommal, I am not seeing any indication of a low milk production issue. Your baby has excellent weight gain. You pumped a normal to high normal amount when you did pump. Not feeling a "letdown" means nothing, many mothers have no letdown sensation. I wonder if you may have had some overproduction early on, and now that production has regulated to more normal levels, it feels really different and is alarming you. This is pretty common.

    The only thing I would suggest is that 9 times a day is normal but nursing 6 times a day is a little low. 8 or more times per 24 hours would be typical at this age. Obviously it has not hurt anything, as your baby has gained so well indicating baby gets plenty of milk. But nursing more often may help with fussiness, for many reasons. Also btw, it is fine for baby to nurse one side at a time if that is what baby prefers.

    It never hurts to offer the breast at any cue, or even just because you feel like nursing yourself!

    Baby sleeping close to you allows for less possibility of missed cues. So room sharing is a great idea if you prefer not to bedshare. Overuse of pacifier and swaddling may cause a baby to sleep though normal cues so that is why I asked about that.

    Is this your first baby? Have you friends or relatives who have breastfed, and/or are you able to get out to a mommy and me meetings or a (ideally) any LLL meetings? I cannot express how helpful it is to be around other breastfeeding mothers and their babies. Even experienced moms have doubts and concerns about what is normal and what is not, so it really helps to get out there and see other babies and how wide the range of normal behavior is!

    Please let us know-are our responses helpful? Do you have more concerns we are missing? Thanks.

  6. #6

    Default Re: Low milk supply?

    Yes, thank you for your replies. I am glad to hear it doesn't sound like a supply issue.

    My main concern is she is still having trouble eating. I'm suspecting teething. Let's look at today:

    She went to bed around 9:30 last night. She woke up this morning at 3:30 and nursed on both sides before falling asleep. She woke up again at 6:00 and ate, again on both sides. She went back to sleep until 7 and woke up. Since then she has been screaming and crying, won't take the breast. As soon as I try and put her on it, she freaks out. She'll take the pacifier a little bit, but even that is only working a little at a time.

    Finally got her to eat around 10 on one side for a little bit, and she fell asleep and is currently asleep. I'm attempting to pump now, but am not getting much.

    I have one friend who is currently breastfeeding, and she has been helpful (she was the one who mentioned the possibility of teething), but her babies (3) have never had issues like this. My mother in law helps a bit, but she had kids so long ago she doesn't remember.

    I haven't had a chance to go to any meetings. I live rurally and it's an hour drive to the nearest city (Spokane). I wouldn't mind attending, just need to find the time now.

    I've been thinking about consulting with a lactation consultant, but it doesn't look like my insurance covers it, so not sure what to do there.

  7. #7
    Join Date
    May 2006
    Posts
    21,267

    Default Re: Low milk supply?

    Call the LCs in your area, and ask them. They may be able to clarify the insurance situation, and even if they don't take insurance, it's possible that you will find someone who will help you for free, for a reduced fee, or who will agree to spread the fee out over a longer time period.

    Sounds like baby eats well during the night. Are you nursing in a different position during that time? Maybe side-lying instead of sitting up?
    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!"

  8. #8

    Default Re: Low milk supply?

    Usually in the rocking chair with the boppy. I've tried that during the day and no success.

  9. #9
    Join Date
    Jun 2009
    Posts
    5,760

    Default Re: Low milk supply?

    Hmmm. yes this does sound a little odd, it sounds almost like 'evening' colic except for the timing! is the fussyness/not wanting to nurse typically in the morning or can it happen any time?
    So you tried side lying during the day and that did not help?

    How reliant are you on the boppy? Nursing pillows can cause baby to be positioned awkwardly so they are not comfortable or able to get a good latch, especially as baby gets larger. They also tend to cause mom to hunch over baby, further decreasing room baby needs to get a nice comfortable, effective latch. (Plus this tends to make nursing uncomfortable for mom.)

    Have you tried other positions, like "laid back?" (Laid back would only mean you are leaning back a bit, you could still do it in the rocker, or on the couch etc. it does not mean you have to actually "lay" back. And baby can be in any position.-it's a very adjustable position.)

    You can use the pillow AND do laid back as well. But usually laid back eliminates the need for a pillow.

    Some positioning examples:

    General Tips with pictures on latch and different positioning ideas (includes side lying) http://www.llli.org/faq/positioning.html

    Laid back position http://www.llli.org/docs/00000000000...astfeeding.pdf

    Laid back video http://www.biologicalnurturing.com/video/bn3clip.html

    Here are two simple pictorials, you want the one on latch. Notice that the mother is in a “slightly” laid back position, looks like on a couch? This is a very “adjustable” position, play around to find how you and your baby are most comfortable. http://cwgenna.com/quickhelp.html

  10. #10

    Default Re: Low milk supply?

    It seems to be more in the morning, though it has occurred in the afternoon a few times.

    During the day I usually nurse laid back in the bed. Rarely in the rocker except for at night.

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