Cannot increase milk supply! Just need some support...

[@llli*iris.8181]

This will be long. I'm having issues with being able to make enough milk for my daughter. I've been trying many things and none of them seem to work and that is just so frustrating! Some background: this is my second daughter but I've been having the same issues with my first. When I started nursing my oldest I've had horrible nipple pain for over 2 months, which resulted in very minimal supplementation with formula while I got a hang of pumping. Very soon we were able to exclusively bf. Even in the early days, when my milk first came in, I wasn't able to pump very much even when replacing a feeding so I started fenugreek, blessed thistle, tea, more milk plus, domperidone, pumping after feeding, pumping between feedings and none of these made a noticeable difference. My daughter was gaining weight, albeit slowly, so I just kept doing the best I could. When I went back to work after 12 weeks I was able to pump 4 oz in the morning and 3 in the afternoon. I've been coming home to nurse during lunch and nursed as much as possible when I was home with her. Soon I had to start supplementing because she wanted more volume and I simply could not keep up.

Fast forward to this day and I'm having exact same issues, only now my baby isn't gaining very well at all. She's only gained 6 oz in a whole month! (From 2 to 3 months) and she's suppose to gain around 5oz per week... LC said to nurse her for longer, which is exactly what I did over the weekend, nursed her longer (40 min on average) and more often, every 1.5-2 hours. Today in the morning I pumped and was only able to get 3 oz, which is not unusual. I've also been taking more milk plus special blend for about 5 days now. She eats 2 times at daycare if I'm able to come and nurse her on my lunch hour, otherwise it's 3 times. I nurse her twice in the morning and 3 times after work before bed. She sleeps 8-9 hours at night.

LCs keep telling me that I'm doing everything right. Then why am I not able to keep up and provide enough so that my baby gains weight better? Although I try to keep things in perspective it's extremely difficult not to feel like a failure I just don't get it. If it is what it is I'll make my peace with it, but I guess I need to go through a grieving process of sorts, especially as yet another study came out in July that establishes a strong correlation between months of exclusive bfing and IQ. I'm not sure if I'm looking for advice or words of understanding and support, but either will be much appreciated . Sorry it is soooo long.

[@llli*mommal]

The first thing that jumps out at me is that your baby is a "good" sleeper. Sometimes good sleepers gain poorly because they spend too much time sleeping when they should be waking to nurse. Are you doing anything at night which might lead to longer sleep stretches? I'm thinking of things like using a pacifier or a swing at night, or having your baby sleep swaddled. If you are using those sleep-extending techniques, it may help to take them away. If not, you might need to set an alarm and wake your baby and feed her during her long sleep stretch.

How much milk is baby taking at daycare?

And are you using any form of hormonal contraception- including the minipill or Mirena IUD- that could be putting a damper on your supply?

[@llli*iris.8181]

Thanks for replying! Yes, middle of the night feeding seems to be my last option, if not for boosting my supply but to give her extra ounces. I do swaddle her but she doesn't really need pacifiers or any other soothers. I'm going to try waking up at night and feeding her but, honestly, I'm not sure ill last long before I either collapse or go mental on one of the family members, lol! Unfortunately, I'm one of those people who really needs sleep in order to stay functional with a demanding full time job, a 3 year-old and a baby. I wake up at 5:30 am and nurse, then nurse again at 7 before I go to work. Baby goes to bed at 9 and I do at 10.

I'm on a mini pill but don't think going off would make much difference because I wasn't on it for as long as I nursed my first daughter and I had the same issues with her.

[@llli*iris.8181]

Oh, and she takes 3.5 per feeding at daycare but I've asked that she be given 4.

[@llli*mommal]

Where does your baby sleep? In her own crib in her own room, in a crib in your room, in your bed? If you're not co-sleeping- that is, sharing a room or maybe even a bed- with your baby already, it might help to do so. Babies who sleep with mom sometimes rouse more often, and nursing them is less disruptive because the baby is right there. No need to do much more than latch baby on and drift back to sleep. Taking away the swaddling and tweaking your sleeping arrangement might be enough to result in baby getting plenty of extra calories.

I would also consider switching contraceptives. The minipill is not supposed to cause supply issues- but there's at least good anecdotal evidence that for some moms, the minipill can cause problems with supply. The way I figure it, the worst thing that happens is that you use a nonhormonal method (e.g. condoms, sponge, diaphragm) for a month. If your supply improves, then you know the minipill was an issue for you. If it doesn't, then you can feel free to start using it again. All you lose to the experiment is a month.

How is pumping going at work, this time around?

[@llli*iris.8181]

Baby sleeps in her own room in a crib. I've always been too freaked out to have our kids sleep in our bed. I know I won't get any sleep because I'll worry too much about accidentally covering her with a blanket or something. But I didn't swaddle her today so we'll see if she wakes up on her own or if I'll need to wake her up.

I'll go off the pill for a month to see if that makes a difference. The only thing that seemed to have made a difference is having oatmeal in the morning, which is the only time I can squeeze 4 oz, so I'm going to make sure I keep that up plus try having a little in the afternoon, maybe it'll make my afternoon pumping more productive. Today I was able to get only 3 oz in the am and 2.5 in the afternoon The most I can ever pump is 4 oz. More milk plus stuff doesn't seem to be working. That's the frustrating thing, all the things I try and I'm not where I need to be.

[@llli*sonogirl]

4 oz is excellent pumping output for one session! These sound like pretty normal pumping volumes to me. If you are coming up short for your milk needs during separations, can you add in another pumping session at work? Some moms need to pump more frequently than others in order to get the milk they need--I am one of them! I have also never, ever pumped more than 4 oz in a session, and those 4 oz sessions were rare ones.

Are you doing breast compressions while you pump? How long are your pumping sessions? What kind of pump are you using?

[@llli*mommal]

I totally get not wanting baby to sleep in your bed. But how about moving her crib in to your room? That way you're a little more conscious of her wake-ups, and getting up is not quite a disruptive.

They make co-sleeping cribs- the Arm's Reach is one- that can be sidecarred to your bed. That way baby is not in your bed, but is right next to you and you can roll over, nurse her, roll her back into her space, all without having to actually get up.

[@llli*lllmeg]

She eats 2 times at daycare if I'm able to come and nurse her on my lunch hour, otherwise it's 3 times. I nurse her twice in the morning and 3 times after work before bed. She sleeps 8-9 hours at night.

Generally speaking, over night feedings are not an option but a necessity for at least the first 6 months. Babies typically need to eat overnight or they may not gain appropriately and mothers might see a reduction in milk production. Long sleep stretches in the early months has been well established as a potential cause of poor weight gain and is one reason sleep training is so potentially harmful (I am not suggesting you are sleep training, but the result-long sleep stretches-is the same.)

Your history suggests that your potential milk production was/is possibly already on the low-normal side, so in that case, less frequent nursing and long stretches of not nursing are likely to add up to a big problem. Especially (but certainly not only) when mom is back at work, because it is often difficult to keep milk production appropriate when pumping instead of nursing a part of every day.

And some babies just need to nurse more often in order to get enough.

Swaddling is a sleep inducing technique, and it is argued by some experts that swaddling (like pacifiers) lead to a baby sleeping through normal hunger cues. So not swaddling baby may help baby wake on her own more often naturally. Sleeping in the same room as baby as suggested by the AAP may also help baby respond to your presence at night by waking more. This is a normal biological response. If not swaddling and/or sleeping in the same room as baby does not encourage a more normal wake pattern, I would certainly suggest start waking yourself and your baby at night to nurse. Some moms find they wake more easily and calmly if they wake 'natually' rather than with an alarm, so they drink a big glass of water before going to bed.

The frequency a baby needs to eat is dictated by biology. I understand you have a demanding job and two kids. This is not a unique situation. (I mean, of course every individual situation is unique, but plenty of breastfeeding mothers work and have more than one child.) And everyone needs 'enough' sleep to be functional. And yet, mothers of young babies do not typically get many hours of consecutive sleep because babies do not normally take that many hours of consecutive sleep. So, moms have to figure out workarounds. Co-sleeping/bedsharing as has been suggested, at least part of the night, if you are in a position to do so safely, (and the potential risks can, in most cases, be learned about and adjusted for.) is one way many breastfeeding* moms have found increased sleep. (*some experts warn it is not safe to bedshare if baby is formula fed.) But there are other ways to get more sleep. You could work on catching up with naps and/or lie-ins on weekends, the occasional evening nap, etc.

Babies are babies for a very short time. Sleep deprivation in the early months is a normal part of parenthood.