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Thread: Am I missing anything? I think I've tried it all...

  1. #1

    Default Am I missing anything? I think I've tried it all...

    Hello all,

    I am at my wit's end with trying to re-establish my milk supply, and I was hoping to get any ideas I may not have thought of yet. I'm 7 weeks postpartum now, and we've made some headway, but seem to be stuck now. I got a bad case of thrush before my milk even came in (due to the antibiotics during birth for Group B). I tried EVERYTHING for clearing that up, and finally was able to get rid of it about 3 weeks after giving birth. Once that was out of the way, I found out that candida was only part of the pain I was feeling; I was also having vasospasms/Reynaud's. Anyway, for the first 3 weeks, between the intense pain from thrush and vasospasms, I wasn't able to nurse or pump like I needed to be. I have low milk supply as a result (I've been working closely with an IBCLC who confirms this...baby only gained 1oz/week on breast alone). I have worked extremely hard to go from supplementing 1-2 oz after every feeding, to about 5-6 oz total per day. About 3-4 oz of that is expressed milk I pump. I'm trying so hard to be EBF, and I'm hoping there's something else I can try. I have tried:

    - nursing completely on demand, which is pretty much all day (with 10-20 min breaks here and there...but mostly just nursing)
    - fenugreek
    - oatmeal
    - More Milk Plus Special Blend
    - Mother's Milk Tea
    - pumping after nearly every feeding
    - hand expression after pumping (I get mere drops)
    - power pumping (10 min on/10 min off, for an hour)
    - "nursing vacations"
    - "finish the first breast first" nursing, as well as switch nursing
    - warm compresses before nursing and before/during pumping
    - breast compression during nursing/pumping
    - LOTS of water
    - drinking water only to thirst (lots of water seems to do better)
    - domperidone (just started on Monday)

    I'm not on any birth control. I don't drink any caffeine. I stopped postpartum bleeding at 3ish weeks, and then had spotting at 6 weeks - I then passed a marble sized piece of tissue I believe (it definitely wasn't a clot), and the spotting ended. I was thinking that meant I may possibly have retained placental fragments that were causing me to produce pregnancy hormones, but I took a home pregnancy test yesterday and that was negative. My daughter has a strong suck and good latch, is not tongue tied or anything. My breasts grew quite a bit during pregnancy as well as once I gave birth, so it's not IGT. She developed a bottle preference briefly when we were using Tommee Tippee and the flow was too fast, so we switched to Dr. Brown's premie nipples, and are doing paced bottle feeding. My flow is slow, which puts her to sleep, so nursing is a labor intensive activity, due to having to use constant breast compression, and having to thump/tickle/pick-up/relatch/etc just to keep her awake. I don't think she's ever come off the breast satisfied...she either comes off asleep, or awake and still hungry. During my LC appts., my highest intake measurement was 2.5 oz from both breasts combined, but 2 oz is typical. That's from 45ish minutes of nursing. After nursing, I generally pump. I can get about 15-20ml after feeding during the day (with 20-30 mins of pumping), and closer to 30ml after a nighttime feeding (may be due to her emptying less just because she's so sleepy during the night. Getting her to eat in the night is very difficult). My breasts never feel "full" unless I don't wake her up for her 1:30ish feeding, meaning I would have gone from 11pm to 5:30 or so without emptying. I don't make a habit of doing that though. When pumping, I have to have it on a high setting in order to express much at all...it ranges from "definitely uncomfortable" to "moderately painful" in order to get what I get. Anything less and I am logging pumpings of 5 or 10 ml. I have a Medela advanced double electric pump, and I don't notice a difference in output between this and the Symphony at my LC's office. Also, when pumping, I notice that my first let down comes fairly quickly, but the amount of time between let downs seems to be pretty long, and after the 15 seconds of milk coming out well, there's not even drops coming out until the next let down. Is that normal? I can see why my baby falls asleep at the breast though...I basically turn into a human pacifier during the time between let downs.

    Anyway, my current regimen is:
    - 2 capsules More Milk Plus Special Blend, 3x daily
    - 3 capsules fenugreek, 4x daily
    - 1 10mg capsule Niphedipine, 3x daily (for the vasospasms)
    - 3 10mg tabs Domperidone, 3x daily
    - large bowl of oatmeal daily
    - approx. 100 oz of water per day
    - pumping 5-6 times per day, in addition to near-constant nursing

    I apologize for the length of this post! I was just trying to cover everything. Is there anything I'm missing? Any thoughts on what to do at this point? I feel like at this point I'm playing a waiting game with the domperidone, and if that doesn't work, my EBF dream is shattered. I will definitely have to up the amount of formula she gets, because I can't stay at the pace I'm going with the nursing/pumping for too much longer.

    Also, any thoughts for helping my husband understand why this is such an emotional thing for me? That it's not just "giving her a few ounces of formula," it's "my body is insufficient for my baby's needs" and the whole inadequacy bit that follows. I'm reaching a definite breaking point emotionally, and while my husband is supportive, he's not understanding, if that makes sense.

    Thanks so much in advance!

    Holly

  2. #2
    Join Date
    Oct 2013
    Location
    Salt Lake City
    Posts
    1

    Default Re: Am I missing anything? I think I've tried it all...

    Holly,

    I am in the same boat. My LO is 15 weeks and I have had to supplement with formula from the time he was two weeks old. I am currently taking:

    Domperidone 10mg 3x daily
    Fenugreek 4 caps 3x daily
    Blessed Thistle 3 caps 3x daily
    Brewers Yeast 2 caps 3x daily
    Red Raspberry Leaf 2 caps 2x daily

    I have now ordered goats rue to add to the gamut. I sympathize with you on how frustrating it is to build a full milk supply (I have only been able to produce 17-18 oz a day from the beginning- now that I have returned to work I fear even that tiny amount is dwindling). I hope that some of the experts on here can help the both of us with this but in the end, I think we ought to take solace in the fact that we are doing everything we can to care for our babies. Don't get discouraged, take heart and keep trying. Some breast milk is better than none. You are not alone in your efforts. Natalie

  3. #3
    Join Date
    Oct 2009
    Posts
    2,584

    Default Re: Am I missing anything? I think I've tried it all...

    You should be pumping at the highest comfortable setting. You don't want to injure yourself. Also consider using an SNS or another at-breast supplementer. A few other ideas, what did the LC say about your baby's latch? A baby can nurse poorly all day and get nothing or nurse well and get something but nursing 20 hrs/day poorly isn't going to do anything for you or baby , as far as I know.

    Try to tell your husband how you feel. I told my husband it was a huge self esteem thing and it's a lot like, for me, infertility (we had IF and recurrent miscarriages) because a woman typically wants to bear children and take care of them and it's just part of mommy hood that even if it's not your fault is very hard not to take personally if you don't have enough milk. It's hard.

    Also recommend buying the book by Diana West - making more Milk.

    Retained placenta can definitely affect milk supply.
    Nursed my sweet daughter 3 years, 3 mos.

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