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Thread: Undersupply.

  1. #1
    Join Date
    Aug 2013
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    14

    Default Undersupply.

    Well, it looks like I'm back here again. I had posted a week ago because I was put on Micronor (the minipill... which I have since then stopped) and got my first pp period and felt like my supply had dropped. At the same time, my latch needed fixing so I went and saw a lactation consultant to fix baby's latch. Baby was still gaining weight so my undersupply concerns weren't really considered valid at the time.

    This week baby had his 2 month appointment... and he weighed 9 pounds even... 5 ounces less than he did the week before. He's no longer a percentile for weight... dropped right off the charts.

    I don't know what to do. I'm taking 5 capsules of fenugreek 3-4 times a day (can anyone say pancake sweat!?), on motherlove more milk plus special blend (1-2 pills four times a day), drinking lactation tea and eating oatmeal every morning and often making lactation cookies with brewer's yeast. I'm pumping between feedings, feeding baby on demand (every 1.5-3 hours, except he JUST started STTN four nights ago) and as long as he's wants to eat, offering both breasts... and have been doing this for two weeks now.

    Starting halfway through this week I feel like my supply might've gone up a little bit... not a lot, and mainly just in the mornings. I can pump a little more than I used to... I've been able to put 4 feedings into the freezer, which I'm desperately needing because I start school and work in the next two weeks.

    Baby is acting well, is a super alert baby and shows no signs of malaise, fatigue or malnutrition... and despite his weight loss his length and head circumference continues to increase. If I didn't know baby's weight, I would've never guessed there was a problem. The doctor will see us back in 2 weeks to do a weight recheck, and said that as long as I feel my supply is coming back he's not too concerned about the weightloss. If he is still losing weight in two weeks he is going to recommend using formula supplementation.

    So I guess my question is 2 fold.

    1) What the heck am I doing wrong that baby is losing weight? How can I fix this actual honest-to-god undersupply problem?

    2) At what point do I cave to formula? I'm not going to starve my baby, but I am so wanting to succeed at breastfeeding that I don't know if I'm going to know when it's time to give in.

    I don't know... I'm just getting really stressed about this and it's not helping my situation.

  2. #2
    Join Date
    Jun 2009
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    5,629

    Default Re: Undersupply.

    Hi I am so sorry you are having this stress. No mom needs this!

    First off, please know that if your baby requires supplements beyond what milk you are able to make, temporarily or permanently, that is not giving in, nor need that be the end of breastfeeding. Many mothers with low production or who are working on re-lactating, or who have adopted babies so who are working on inducing lactation, breastfeed while also supplementing with 1)milk bank purchased breastmilk, 2)donated breastmilk or 3)formula. Breastfeeding need not be all or nothing and the research is very clear that ANY breastmilk is way better, health-outcome wise, than none, And any nursing at the breast is way better, health outcome wise, than none. So please know that you have many many options even when you have low production and indeed do need to supplement.

    But no one here can tell you when to supplement. Supplementing a breastfed baby is a medical intervention that should only be done when it is needed, medically. That is something you would have to discuss with your pediatrician and your IBCLC. We can certainly give you ideas on HOW to supplement so it is less negatively impactful on nursing.

    Second-was this weight loss from weight checks taken a week apart on the same scale? Does it jibe with the baby you see before you that baby has lost a substantial amount of weight in a week? Was baby ill? Dehydrated? Is baby still pooping, wetting, normally? My point is, the first thing I would rule out before driving yourself nuts with this is scale error. Scale error, either due to different scales being used or due scale or to human error is real. It happens. I have personally seen it happen. And it can dramatically skew weight check results.

    When did you see the IBCLC? Just a week ago? Did you do a before and after nursing weight check? I do not understand how milk production could plummet that dramatically in a week, especially since you went OFF the pill. Yes production MAY dip at around the point you get your period. But enough for a baby who was doing ok before to LOSE a third of a pound in a week? it’s just odd.

    There is research on which galactagogues work best in specific situations Not all moms benefit from fenugreek but may do better with something else. You can learn more about this yourself from the book Making More Milk and at www.kellymom.com and your IBCLC should also be able to guide you.


    If a breastfed baby is losing weight or not gaining normally, here are the possibilities:

    Baby is not nursing often enough or long enough
    Baby is unable to transfer milk effectively when nursing
    Mom has low milk production
    Baby has an undetected medical issue that has nothing to do with breastfeeding, for example, a heart problem or nutritional deficiency.
    Some combination of the above.

  3. #3
    Join Date
    Aug 2013
    Posts
    14

    Default Re: Undersupply.

    I guess that is a thought. He was weighed twice, two different scales two weeks ago, both saying 9lbs5oz. This past week was yet another scale saying 9lbs0oz. A whole 1/3 of a pound discrepancy though? Especially since he should be gaining weight?

    Baby does looks bigger to me.... I was excited to see his weight at the doctors office because he's been looking bigger and just recently started to get much more of a personality ("talking" to me with his coos, smiling more often, trying to laugh). No illnesses that I have detected (and I do check his temperature whenever I have any doubts of his health). Now that I think of it, he has been increasingly fussy lately, which I thought was normal for his age group... but feeding him hasn't been helping him calm down. I feel like nursing him doesn't leave him satisfied... especially in the afternoons/evenings. He's been pooping 1-2 times a week... usually a dark yellow/tan color, but peeing like a champ.

    I saw the IBCLC two weeks ago when I first noticed my supply dropping off. I was also having extreme pain with feeding at the time (now fixed with a latch alteration) and had been pumping for a day before I saw her. Baby was able to get 2 oz from me in the nursing session (my first time nursing him in about 38 hours).

    Well... for the reasons of losing weight
    1) Baby is nursing super often. I can't even count how many feedings that he has in a 24 hour period because the end of one feeding and beginning of another is hard to tell since they can be so close together. For example, I just spent the past 1.5 hours putting him on, switching sides, burping him, switching sides, taking a 5 minute break, and starting over. This has been normal for us lately and it's super frustrating for both of us.
    2) Maybe. The lactation consultant mentioned that he has a short tongue (because I'm personally still convinced he has a posterior tongue tie like I have. But no medical professional agrees with me on this one yet, so I let it go.) She mentioned sending me to a lactation doctor to see if there could be anything done about his tongue if the position change in nursing didn't help the pain with nursing. However as for his latch, as far as I can tell, it's a picture perfect latch now with no pain and feels better than ever.

    So that leaves low milk production / medical issue. How would I even go about determining if baby has a health problem? He seems super healthy to me... He's a really cute baby by the way. Don't know if I've bragged about him yet. Should I wake him up in middle of the night to feed? I've really been enjoying finally getting sleep but if you think it'd help it's worth a try.

  4. #4
    Join Date
    Jun 2009
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    5,629

    Default Re: Undersupply.

    I guess that is a thought. He was weighed twice, two different scales two weeks ago, both saying 9lbs5oz. This past week was yet another scale saying 9lbs0oz. A whole 1/3 of a pound discrepancy though? Especially since he should be gaining weight?
    I personally know of an incident just this year (I mean, I personally know the mom) where her 2 week old baby was weighed twice in 24 hours on two different scales and the two checks indicated the (normal, breastfed baby) gained half a pound-again, in less than 24 hours. Obviously that is impossible but when the mom pointed that out, she was told to be happy because baby was gaining! But what if she had done the two checks in reverse order of scales? It would have looked as if baby lost half a pound (or close) in 24 hours! Going just by the weight, this healthy baby could have ended up in the ER on an IV! So yes, I know it seems impossible but I would say it may be remote but IS possible. I am not the only person who thinks this about scale error-Dr. Jack Newman writes about how scale error is rampant with newborns.

    If I had any concerns about my baby’s weight gain, here is what I would do as far as weight checks go. Weight checks MUST BE on the same digital infant scale, every time, with baby in a dry diaper or naked, with mom watching carefully to make sure there is no rush or error and with mom writing down the number and making sure it jibes with what the nurse or whoever records, and to be on the safe side, REPEAT the weight check immediately.

    Yes your baby should be gaining. I am not suggesting all is well. I am suggesting that if there IS a problem we do not really know how severe it is until weight checks are done on the same scale, other health factors (like output) are taken into account, and some before and after weight checks are
    done. This information will be important in determining how much your baby may need to be supplemented and if and for how long baby needs supplements. So it is really important it is accurate.

    How would I even go about determining if baby has a health problem?
    You don't. your babies doctor does.

    Should I wake him up in middle of the night to feed?
    how long is baby sleeping without nursing? Personally yes, if my baby was not gaining well and baby was sleeping longer than 3 or 4 hours at night I would wake baby to nurse or dreamfeed.

    No pacifier use, correct? No swaddling?

    How long has baby been pooping twice a week? Was it ever more frequent? Are the poops pretty big?

    She mentioned sending me to a lactation doctor to see if there could be anything done about his tongue if the position change in nursing didn't help the pain with nursing. However as for his latch, as far as I can tell, it's a picture perfect latch now with no pain and feels better than ever.
    Can you follow up with this?

    You saw an IBCLC 2 weeks ago and she was not alarmed about babies intake, I take it. an you say baby nurses frequently. So SOMETHING is not jibing here. So I strongly suggest you see your IBCLC again and yes, if your baby has a ptt treating it may help. At the very least, a "lactation doctor" is hopefully goingto be helpful in getting a second opinion (if you want one) about supplementing.
    Last edited by @llli*lllmeg; September 15th, 2013 at 05:57 PM.

  5. #5
    Join Date
    Aug 2013
    Posts
    14

    Default Re: Undersupply.

    Ugh this is going to be hard. My pediatrician's office has like 10-15 different scales. But I will try to get it on the same one next time. That is so crazy that they can differ so much... I never really considered that one and I'm glad you brought that up. I will be taking Dean to a mother's group on Tuesday and get him weighed on the same scale he was weighed on two weeks ago to get a little more accurate information about his weight.

    Baby is sleeping for 5-6 hours without nursing. Yes, he is swaddled. Is this bad? I don't know anything different?

    We use pacifiers but very scant... I use it to either calm him down before breast feeding, or to calm him down (say if I was in the grocery store) until I could get to a place to feed him. He doesn't really like his pacifier that much and is starting to not accept it anymore.... I'm hoping that this isn't a problem. He doesn't suck on it for anymore than a few minutes usually...

    Baby has been pooping once or twice a week since about 5 weeks. It's usually explosive that I have to clean whatever clothes/bedding/carseat he was in at the time. So yes, quite large. Or if it's two, it's two moderately big ones.

    I will call the IBCLC I saw tomorrow and see what she has to say.

    Thank you so much for taking the time to write such thoughtful answers, by the way. I never knew that breastfeeding was going difficult.

  6. #6
    Join Date
    May 2006
    Posts
    21,175

    Default Re: Undersupply.

    Swaddling can be a good thing, and it can be a bad thing. It's a good thing when a swaddle produces a longer sleep stretch in a healthy baby who is having no trouble gaining weight. It's a bad thing when it produces a long sleep stretch in a baby who needs to be waking up and eating.

    It's the same deal with the paci- if there are no problems with breastfeeding or weight gain, then the paci is a useful tool. But if the paci is causing a baby to nurse less than he should, it's a problem.
    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!"

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