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Thread: Low milk supply- need help to increase- nursing twins

  1. #1

    Default Low milk supply- need help to increase- nursing twins

    New here- my twins are 6months old. They have fed like champs since day 1. Ive always had enough milk up until about 3 months. We had a very stressful move and I think I was dealing with some PPD also during that time and at their 4 month appointment they had fell WAY off the curve and has gained almost nothing since their 2 month appt. I thought everything was going well but apparently it hadn't been for a month or so. They are happy & healthy, meeting milestones, not cranky. They were however not satisfied all the time after feedings which should've been my first clue that they weren't getting enough. I started working with a great LC, and we had weekly weigh ins for one month. In that time they gained on average 1oz per week. So not great. we did some weighed feedings at different times and they were only taking in about 2-2.25 ozs per feeding per baby. That was feeding every 2 1/2 hrs. So not much.
    I have done EVERYTHING I can think of to increase supply and nothing has worked. I have tried....
    *Fenugreek, blessed thistle, more mothers milk plus, goats rue, shatavari, moringa, oatmeal, flaxseed meal, brewers yeast, more water, more food, Gatorade. DOmperidone.
    I have nurse more and more and more. I took a nursing "vacation" lately (which was kinda hard to manage with both babies) for a whole day and nursed pretty much the whole time, that did nothing. I started power pumping every night for 2 hours for 2 weeks, still nothing. I have tried pumping after almost every feeding and never get a let down after feeds. I do breast compressions while nursing to try and remove the most milk. NOTHING is helping. On average I nurse probably 9-10times per day. They still wake up twice at night so I nurse around the clock.
    So after them not gaining weight and becoming increasingly hungry, I started supplementing with donor milk. I know my supply is probably suffering because of this but I had too. They weren't gaining and now are slightly behind in development because of it. (IMO) THey are 6months and while they roll everywhere they are no where near sitting on their own. THey LOOK very very healthy and are really happy babies. So I supplement about 6-7oz/day per baby. usually 1.5oz after a feeding here and there. I tried the lactaid and it got too difficult to do with tandem nursing. So im using a bottle.
    Now my DS has decided he doesn't want to drink for more than 5 minutes because he wants a bottle. So he doesn't drain my breast which is leading to more supply problems. I try and let DD (my power sucker) finish off his side to get the milk out but sometimes that doesn't happen. Which is why I started pumping after nursing to get all the milk out.

    Im just so frustrated. I feel like NOTHING I have done has made any difference in my supply. I want to go back to EBF'ing but they weren't and arent' gaining weight when I don't supplement. What else can I try???
    I have plenty of milk at night. THey seem very satisfied and I can tell I have way more at night. So im just supplementing during the day.

    Suggestions? What am I doing wrong??? Please help. Im sorry this got SO long.......

  2. #2
    Join Date
    Jun 2009
    Posts
    5,898

    Default Re: Low milk supply- need help to increase- nursing twins

    I know my supply is probably suffering because of this but I had too.
    I would question this. If you are nursing at every opportunity, pumoping etc, etc, and only supplementing AS NEEDED, that is not going to harm milk production. Especailly not at 6 months of age.

    Where supplementing harms milk production is when babies are over supplemented- supplemented more than they need or when it is not needed at all. Then babies get filled up with the supplement so they are not stimulating the breast/removing milk as needed for good production. If you are producing as much milk as you possibly can, and it is not enough, supplementing is appropriate. The trick is to be careful about how much, how and when to give supplements so as to not interfere (or interfere as little as possible) with breastfeeding.

    But I also have to question how you can have enough milk some of the time and not all of the time. I mean, yes, it is normal for milk production to go up and down over the course of the day. That happens with all mothers. But nevertheless, baby gets enough milk overall because there IS enough milk overall. If you have more milk at night, what about encouraging babies to nurse more often at night?

    Also when did weight gain become an issue? Breastfed babies often tend to level off sharply in gain rate after the first few months.

    My daughter was a roller, not a crawler, which was different than my older two kids. IIRC She was not sitting up on her own or even beginning to crawl at 6 months. She could sit up when I plopped her on her bottom-you know, she stayed up. But she could not get herself into that position. She is 14 months old now and running, climbing, scaring the living you know what out of me, at an age the older two were only beginning to take steps. Is your pediatrician concerned about your two babies’ development?

    Also what about adding solid foods into the mix instead of/or as well as formula?

  3. #3

    Default Re: Low milk supply- need help to increase- nursing twins

    thanks for the reply. I guess I just assume that because everything you read says that extra milk will hurt your supply. but I am not oversupplmenting. only enough for them to be satisfied and gain appropriately.
    Weight gain became an issue at their 4month apt but likely it started around 3months. At their 2month apt the were great for weight and height. Small, but gained well.
    at the 4mnth apt, they had fell WAY off the curve and im not sure how much they had gained but it was NOT much. THey were then in the 1 & 2 percentile for weight and 10th for height. I know they slow down growing around that time, but when we did weekly weight checks one week they gained 1oz each, next week nothing, week after, less than 1oz. Then I started supplementing with donor breastmilk from a friend. 5-6 ozs per day per baby and I brought them back in the next week and they had gained 6 & 8 ozs in one week!!
    as far as having enough milk at night, I know people naturally have more milk at night because of prolactin levels being higher, they do nurse at least twice at night. Which is great and all but I get maybe 4-5hrs of sleep per night if that. I try and tandem nurse at night also, but otherwise I just throw who ever is awake in bed with me and nurse laying down. Then we both drift off to sleep until the next baby wakes up an hour later usually.

    We just started solids about 2 weeks ago. Its not going that great. DD is doing pretty good except she sucks off the spoon which causes everything to go everywhere! DS still has a little bit of the tongue reflex thing goin on as a lot of it still comes back out right away. I was going to switch to baby led weaning after about a month or so. I am mixing in some coconut oil or olive oil into their baby food for some added calories. I probably could maybe get away with adding in MORE solids instead of donor milk but what do I do then about them not being satisfied after a feeding?? depending on what feeding it is, they scream after they are done nursing or getting no more out. and they don't always settle down unless I give them a little extra.

    If I sit them on their butts they just tip over. they in my opinion aren't even close to sitting up. they roll everywhere and can pretty much scoot themselves around the living room floor but If I try and sit them up, they just tip right over. we are practicing, but no such luck so far. At their 4mth apt the pediatrician wasn't concerned because at that time they were not behind at all. But I don't have their 6mth apt for 2more weeks (ped is hard to get into)
    LC says they are doing great and thinks if I could get them to eat a little more solids we could get them to continue to gain without supplementing all the time. She was borderline on if I should supplement or not. They weren't gaining and yet they looked great, had some fat on their little legs and wrists and don't look like they are starved but yet babies should gain weight too. They cant stay 12lbs forever!!!
    I just think my supply regulated when it was down at 3months and since then we have been struggling to keep nursing and nothing I do is helping to increase it.

  4. #4
    Join Date
    Jun 2009
    Posts
    5,898

    Default Re: Low milk supply- need help to increase- nursing twins

    Yes I understand, of course supplementing CAN harm production. You are right. But if it is needed and not taking the place of breastfeeding’s at the breast, it is not going to effect things too badly. Of course the recommendation is to pump when babies are supplemented, but you can only do what you can do as far as that goes.

    You seem very certain that your babies require more calories than you are able to provide at the breast, and you are the mom and know best! In my opinion, babies who have rolls of fat and are happy are probably fine even if they are gaining erratically and very slowly, but that is only my layperson's opinion from afar. Of course, your babies cannot stay 12 pounds forever and they won't! Try to remember that small does not equal unhealthy or malnourished. Growth rate is one thing, it does naturally fluctuate but I do understand why you were concerned about a very slow rate of gain. But overall size is a different matter. There is nothing inherently unhealthier about a baby on the 1st % on a chart than a baby on the 50th or the 100th. I do presume your doctor is using the 2005 (?) WHO charts -those are the only charts based on breastfed babies.

    So again, as long as you are supplementing, I would only suggest continue to be very careful about how much you supplement. Babies do not require more breastmilk as they grow-for example, A 7 month old does not meed more than a 3 month old. So if you are not seeing the amounts they need to be supplemented growing, that is a good sign your milk production is holding it's own. If you see it growing, be aware of that. It is very, very easy to oversupplement.

    You could also consider supplementing with a lactation aid rather than a bottle. Or at least make sure bottles are given in a breastfeeding supportive way as in: http://www.llli.org/docs/00000000000...astfedbaby.pdf

    and that you are letting babies "finish at the breast" at least some feedings, so babies keep associating the breast with satiety and comfort.

    So you have worked with an LC- Did she ever do a before and after nursing weight check to see if babies are able to transfer milk properly?

    Why do you say solids are not "going great"? Many babies are not really ready for solids at this age. If a baby is still tongue thrusting solids out, that baby is probably not really ready for solids. I would suggest, wait a few weeks and try again. I think baby led solids is great, I have been doing that with my baby and really like it.

    Dr. Sears’ The Baby Book development chart says starting to sit on their own occurs between 6 and 9 months, and that crawling typically starts then as well-sometime between 6 and 9 months. Your babies’ gross motor (rolling, scooting) truly sounds entirely normal to me. There is a wide range of normal for all this developmental stuff.

    As far as increasing production, did you discuss with your LC a medication option such as Reglan or Domperidone?

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