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Thread: Dwindling Supply

  1. #1
    Join Date
    Apr 2013
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    West Virginia
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    Unhappy Dwindling Supply

    Hi all. My son just turned 4 months old on the 10th of this month. I had been noticing some issues with my supply for about 2 weeks when I contacted my lactation consultant. She had me pump in between a morning feeing to try to assess the situation. I could only pump 2 oz between both breasts. She suggested that I start pumping after each breastfeeding session, with 100 min a day being the goal. She believed that my supply issues were coming from the low-dose birth control I was prescribed 6 weeks postpartum. My doctor told me that it was ok to take, but she said that she sees a lot of women have issues with their supply when taking it. I wish I would have asked her about it in the first place! Anyway, so I began pumping Wednesday (it is now Fri.) To be honest, reaching the 100 minute goal has been rough. I did 85 min on Wed, 102 min on Thurs, and have only gotten in 76 minutes today. The most I can get in a session is 2 oz. The least I have gotten is less than 0.5 oz. I have had to use 1 supplement formula bottle a day (which kills me) of about 2 oz. I am also trying to drink 3 cups of Mother's Milk tea a day. The last dose of the birth control I took was Tuesday night. I feel like it should be completely out of my system soon, but I have not really noticed an increase yet.

    Anyways, to sum it all up, I am completely devastated by all of this. I want to breastfeed my son exclusively. Does anyone have any suggestions of anything more I could be doing?

    I want to add that my son is being finicky now at the breast. He will latch on and off numerous times throughout the feedings. I have been trying to offer both breasts at each session, so long as he is cooperating. I am also bottle feeding him everything I am able to pump...... which he guzzles down.

    The pumping is making my nipples quite sore, but I am just pushing forward. It is exhausting every day. I feel like I am nearing the breaking point.

  2. #2
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    Jun 2009
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    Default Re: Dwindling Supply

    Ok, I just want to be clear. So I have several questions. Sorry!

    What was happening that made you concerned about your milk production so you contacted your LC in the first place?

    Did you see your LC for a one on one appt? Did she watch baby latch and nurse? Take a history? (or is this someone you have been seeing for previous issues?) Was a before and after nursing weight check done?

    If you did not see your LC, was Low milk production diagnosed by your LC from how much milk you expressed at one pumping session? Or was there some other evidence of low production-like baby losing weight or not gaining, not wetting diapers?

    You were told to pump 100 minutes a day? In what configuration? I have never heard of pumping being suggested in this manner-usually, mom is told to pump such and such times a day. Not that that is necessarily better or easier, I just worry you are pumping too long each session and hurting yourself. I really think it might not be helpful to over exhaust yourself trying to pump this much.

    Did a pediatrician or doctor see your baby and tell you your baby needed supplements?

    Did your LC suggest alternatives to bottles? Paced bottle feeding? Was your baby getting bottles prior to this?

    Prior to contacting your LC, how many times a 24 hour day did your baby nurse?

    Pumping should not be hurting you. Does your LC know this is happening? I strongly suggest, get your pump checked out and make sure the flanges are sized correctly. As a stopgap, you can try a little olive oil in the flanges if you are experiencing nipple rubbing when pumping. & pump at a lower setting.
    Last edited by @llli*lllmeg; November 15th, 2013 at 10:35 PM.

  3. #3
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    Default Re: Dwindling Supply

    The most I can get in a session is 2 oz. The least I have gotten is less than 0.5 oz.
    Did you know that .5 to 2 ounces is considered normal output per session when a mother is pumping as well as nursing?

  4. #4
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    Oct 2009
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    Default Re: Dwindling Supply

    Have you considered that your baby may be fussy at breast because the pump is removing milk from you that he wanted to nurse? When a baby does a good job at milk removal I personally see no point in pumping. Why not just nurse more often? Let him get the milk and get rid of bottles. Bottles can affect baby's latch and give them flow preference as well. I would be very very careful using them and contact the LC with the questions Meg brought up ASAP. I feel like you are making more problems for yourself than you started with.
    Nursed my sweet daughter 3 years, 3 mos.

  5. #5
    Join Date
    May 2006
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    Default Re: Dwindling Supply

    Are you still taking the birth control pills- I assume you mean the progestin-only minipill? If so, another form of birth control is probably a good idea, and we're happy to make recommendations if you're interested.
    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!"

  6. #6
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    Default Re: Dwindling Supply

    You sound exhausted and you said 'near the breaking point' OK so can you call your LC this weekend or email and tell her how you are feeling and that this is not working? If it's wearing you down that much I would highly encourage you to ditch the pump unless your baby isn't nursing often at all or goes a very long stretch. Pumping shouldn't hurt but even when it doesn't it can still make a person worn down and miserable. I had to do a ton of it for my babies but when they learned how to remove milk well I stopped and no decrease to my supply resulted.
    Nursed my sweet daughter 3 years, 3 mos.

  7. #7
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    Default Re: Dwindling Supply

    Quote Originally Posted by @llli*mommal View Post
    Are you still taking the birth control pills- I assume you mean the progestin-only minipill? If so, another form of birth control is probably a good idea, and we're happy to make recommendations if you're interested.
    She said she quit a few days ago.
    Nursed my sweet daughter 3 years, 3 mos.

  8. #8
    Join Date
    Apr 2013
    Location
    West Virginia
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    Default Re: Dwindling Supply

    Wow. Thank you all so much for your responses, I apologize for not writing back more quickly!

    To answer your questions (I'm just gonna go through the posts and answer them all):

    I was first concerned about my milk supply because my baby was increasingly fussy and much more needy than usual. I thought that perhaps it could also be teething, but was wanted to check with my LC because he is 4 months old. I am also a first time mom so I have no other children to compare too or anything else to go off of. He was especially fussy at night (after 8 or 9 pm) He did not want to sleep, or really do anything much besides cry. We tried everything. Tried to just get through it for a couple of days and see if it would get better.....It got worse. He also started crying right after eating, as soon as he would be done he would start - which made me think maybe he was still hungry? Not sure - I would try to feed him more and he would get frustrated and then I would just stop.

    I did NOT actually see my LC. We were corresponding via e-mail. I have seen her in person in the past, but not over this issue.

    She was concerned about low supply AFTER I told her about getting 2 oz, so yes, after the pumping session, not anything else. I was a little concerned about a decrease in WET diapers, but it was not a huge decrease, and I do not believe I even mentioned it to her. His urine is still very clear, not dark colored, so I figured it was ok. He poops about once a day, which I also believe is ok.

    She told me to pump 100 minutes a day, after nursing him, to stimulate my supply. I honestly do not know about his weight, he has not been back to his pediatrician since 2 months. His next appointment is coming up on Monday. She did not really give me any configuration for the 100 minutes. I have been trying to just do 15 minute sessions after he nurses.

    The pediatrician will see him Monday. I gave him a supplement because I was so concerned - I told my LC about it afterwards and she encouraged me to not beat myself up about it, but to continue to pump as much as I can.

    She did not suggest any alternatives to bottle feeding. I am not familiar with paced-bottle feeding. He was not getting any bottles prior to this. I was actually quite surprised that he even took it.

    Prior to contacting my LC, he would average about 9 nursing sessions a day, sometimes more, sometimes less.

    I think perhaps setting the pump a little lower may be beneficial. I am not in any extreme pain, but they are a bit sore from pumping so much and nursing.

    I actually did NOT know that the output I have been getting was considered normal, my LC's suggestions made me think it was low.

    Thanks for the validation about the bottle-feeding and flow issues. I was actually thinking the same thing. I really am starting to consider just stopping with the pump or slowing it down a lot.

    I have completely stopped the birth control, and yes it was the progestin only that I had been on. I am certainly open to suggestions of safe birth control options, I was thinking we would need to be using condoms for birth control, because I did not really know of any other non-hormonal options.

    Thank you all SO MUCH. Many of the concerns you brought up were concerns that I also have. Perhaps I will just give myself a trial run of ditching the pump for the day and see how it goes.

  9. #9
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    Jun 2009
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    Default Re: Dwindling Supply

    OK, I think it is very possible you were alarmed over nothing, really.

    There is a phenomenon that happens at around 3 and 4 months of age, it is normal, and it has noting to do with milk production being inadequate.

    Part of it is that weight gain rate typically slows, sometime quite a bit, after about age 3 months. This gain slow down is often more pronounced in breastfed babies and is thus entirely normal. (Because breastfeeding is the biologically normal way to feed a baby.) Baby is still gaining weight quickly of course, but often less than the very rapid gain of about 2 lbs a month typical prior to 3 months.

    The other thing moms notice is that baby gets more efficient at the breast and nurses for a shorter amt of time each time. Often moms think this means baby is not getting enough.

    The other is that baby starts nursing 'weird.' -often something like what you are describing-baby is fussy, maybe wants to nurse more often, cues but then does not nurse, pulls off, etc-the exact behavior varies baby to baby. Probably this is at least in part due to distractions as he is able to see and respond to much more outer world stimuli. But it certainly could also be related to discomfort from teething. Teeth can erupt any time (some infants are even born with teeth!) and the discomfort of teething is there long before teeth eruption is visible. It could also be due to the flow of the milk being less forceful-which is NOT to say, there is less or not enough milk.

    The other is that mom starts feeling 'not full' or as if she 'has no milk'

    All of the above is 100% normal and NOT, alone, an indication of low milk production or any breastfeeding issue at all!

    It is very common for moms to take these normal changes and think it means a problem. So common, in fact, that it is written about extensively in breastfeeding literature.

    This is written about in the kellymom article I will link below -read the section on how to tell if you have low milk production very carefully. I am also including her article on what to expect when pumping.

    For more info, see the book The Womanly Art of Breastfeeding (2010) the section 'four month fussies'
    and the book My Child Won't Eat (2012) the section 'crisis at three months of age.'

    This is not to say you did not have an adverse reaction to the minipill. It is certainly possible. If so, going off the pill and letting/encouraging baby to nurse lots may well solve the issue without pumping or galactagogues. Those things will not hurt, except that the pumping is hurting you, not good at all, and even if it were not, the pumping is exhausting you and interfering in your enjoyment of your baby. I just do not think the evidence of low production is strong enough to warrant all this pumping and supplementing without more evidence.

    Supplementing, even with your own milk, when it is not needed, is potentially very harmful to milk production and the breastfeeding relationship and should be avoided. EDIT: (This does not mean you should beat yourself up about it, of course- you are understandably worried, and a couple days of supplements are probably not a problem at all, except in the amount it undermined your confidence to see baby 'suck down a bottle" which in reality means nothing.) It just means, these actions have potential consequences that mothers are too often not really told about.

    If supplementing is needed because baby cannot gain normally without it, it can be done in a less impactful way than bottles or with paced bottle feeding. If, after visiting your child's doctor, you thing supplementing is needed, please let us know and we can direct you to those techniques. I don’t want to get into it yet because this post is already long and I think probably the best thing to do would be to stop supplementing at all for now. But if you want that info now, just let me know.

    9 times a day is normal nursing frequency. But it never hurts nor does it indicate an issue if baby will or wants to nurse more often than that.
    Last edited by @llli*lllmeg; November 16th, 2013 at 01:26 PM. Reason: bold section added

  10. #10
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    Jun 2009
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    Default Re: Dwindling Supply

    http://kellymom.com/bf/got-milk/supp...es/low-supply/ esp the top section on how to tell if you have low milk production

    http://kellymom.com/bf/got-milk/supp...ping_decrease/

    see the part about what is normal when pumping

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