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Thread: Small Breasts, Low Supply, Feeling Lost

  1. #1

    Default Small Breasts, Low Supply, Feeling Lost

    I gave birth to my second child less than a week ago, and I began the breastfeeding process with so much optimism. THIS time would be different, I thought. But so far, it's the same sad story.

    With my first child, I breastfed like crazy for the first three days. He seemed to be hungry constantly. I couldn't tell if he was getting anything, but I trusted it was working. Meanwhile, his skin got papery thin, he broke out in a rash, and he seemed listless. The midwife came to check on us, took one look at his weight loss and the crystals in his urine (a sign of dehydration), and said he wasn't getting enough milk. She sent my husband out for formula and we fed him. In a few days, his skin cleared up and he seemed actually alive. I struggled with intense feelings of guilt and depression for letting my son suffer like this, and I never really bounced back in the breastfeeding department. Despite working with a lactation consultant, taking supplements, and pumping, I never got enough of a supply to feed my son solely from the breast. After 6 months, I stopped breastfeeding altogether.

    Though my first son turned out wonderfully, and I am glad I could use formula to see him through, I wanted to give my second son what I thought he deserved, an all-breastmilk diet. But sure enough, when my milk came in a couple days ago, everything went back to how it was before. His skin was getting rashy, he seemed hungry 24/7, and I couldn't even tell if he was getting anything. After 12 hours with no wet/dirty diapers, my husband ran to the store at 3 in the morning and got formula. I was relieved to see him doing better, but now I'm at a crossroads.

    I don't want the use of formula to destroy my milk supply. I still want to breastfeed. But I have NEVER been able to get much from pumping (we're talking a quarter of an ounce per session, if that). Plus, it leaves my nipple swollen and sore. Since I am so small-chested (when my breasts are full of milk, they are a large A cup, that's how small I am!), I don't know if I can ever get the pump to work for me. But right now, my breasts are hard and engorged (maybe milk? maybe edema?) and my son's nursing is not getting them fully emptied. His latch seems good, we use the laidback position for maximum suction, and I still breastfeed during every session in addition to the formula, but I'm worried if we're truly emptying the milk in my breasts, it will just further dwindle my supply. I don't want my son to starve because of my own need to make this work at all costs, but I don't want to lose my window to establish a good supply, which I think I lost with my first son, and never caught back up.

    I'm meeting with a lactation consultant tomorrow, but I feel the issue is so complicated, with so many factors, and I don't know what to focus on first. I have my pump (little to no help), Mother's Milk tea and Motherlove tincture on the way (thanks, Amazon.com), and my son, who is trying, the little champ. But every time I look at that measly .25 oz of breastmilk in the pump bottle, I just want to cry.

    What do I do? Where to I begin and how do I up my supply and make this right before it's too late??
    Last edited by @llli*littleblueowl; November 17th, 2013 at 11:35 PM.

  2. #2
    Join Date
    May 2006
    Posts
    21,249

    Default Re: Small Breasts, Low Supply, Feeling Lost

    Welcome to the forum and congratulations on the new baby!

    The first thing I want to reassure you about is breast size. Breast size is a terrible predictor of milk supply, because the size of the breast is more influenced by the amount of fatty tissue in the breast than the amount of glandular (milk-producing) tissue. Small breasts are lean breasts, large breasts are fatty breasts. The amount of glandular tissue doesn't necessarily differ that much between the 2 types of breasts.

    If you're a large A-cup when you're feeling full, and you're currently feeling hard and engorged, that implies that you actually have sufficient milk. Remember that the amount of milk a week-old baby needs at a feeding is around 1-2 oz- put that amount in a bottle and you'll realize how little volume it represents.

    So if you have sufficient milk, why did the baby suddenly seem starving and stop producing wet/poopy diapers? My guess is that what happened is that your milk came in, and all of a sudden baby was having a difficult time getting the milk out. This often happens during the initial engorgement phase of milk production. The shape of the breast changes when it's full, making it difficult for the baby to latch and extract milk. If I'm right, here's what you do about the problem:
    - Try to soften the breast by getting some milk out before latching the baby on. If pumping works, great. If not, use hand-expression or reverse pressure softening (see http://kellymom.com/bf/concerns/moth...oft_cotterman/).
    - Work on the baby's latch. Experiment with different positions and see the LC.
    - Make sure the baby isn't tongue-tied. Ties often run in families, and if your first had a tongue tie that made nursing difficult, it could explain both the problems you had the first time around and the ones you're having now. The LC and/or pediatrician should be able to detect ties.
    - Keep the milk moving. The more milk you remove, the more you make. The fact that pumping hurts you and leaves you swollen and sore suggests that you may be using the wrong pump or the wrong size of shields, so make sure you bring your pump to the LC and have her watch you pump. If a different pump or different shields don't help, work with hand expression- some moms have much better luck with that than with the pump.
    - If you must continue to bottle-feed, do it in a breastfeeding-supportive way. When it's time to use the bottle, cuddle him close to your bare chest and tickle the baby's lips with the bottle until he opens wide. That way he'll associate eating with being at the breast and won't learn a sloppy latch from having the bottle slipped into a half-open mouth. Offer appropriate amounts of formula or expressed milk- maybe as little as 1 oz at a time. Pause the feeding frequently and switch baby from side to side to get him used to the normal rhythm of breastfeeding. And conclude every feeding with unlimited time at the breast- the more baby associates being at the breast with feeling full and comfortable, the more likely he will be to want to continue nursing.
    - Consider renting a professional scale. What you're going through right now may be more of a crisis of confidence than a crisis of milk supply. With a scale, you can do before and after feeding weights, and by subtracting the before from the after you can determine exactly how much milk baby got while nursing, and therefore know whether or not you need to supplement. The LC should do a weigh-feed-weigh test at her office (if she doesn't, demand one), which will give you a one-time snapshot of your baby's ability to transfer milk. If you want better data, take a scale home with you.
    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!"

  3. #3
    Join Date
    May 2013
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    Oregon
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    Default Re: Small Breasts, Low Supply, Feeling Lost

    Agree with the PP
    Every baby and situation is different and there is still hope!

  4. #4

    Default Re: Small Breasts, Low Supply, Feeling Lost

    I got an update from the LC, who I talked to at length, and did a pre-/post-nursing weigh with. I have IGT/hypoplasia, which I've suspected for a while. My breasts never really developed, and they didn't really change during pregnancy. My story is the same as so many mothers with IGT. I tried everything to feed my first baby, and I could never make enough, despite endless pumping, herbs, drugs, etc. This time, instead of torturing myself with an impossible pumping schedule and blaming my low production on my failure to "do enough," I'm going to try to stay positive and focus on making what milk I can, so that my baby gets the benefits of breastmilk, but still gets the remaining nutrition he needs from formula. So far, it has made the road much easier for us. Although I struggle with feelings of inadequacy, I know that this issue is not my fault, and I'm doing the best I can. At least I do have milk and feel the letdown, which is more than a lot of moms with IGT. I consider myself lucky that I can bond with my son over breastfeeding, and it's OK that he needs something beyond that. I'm just glad to know I'm not alone!

  5. #5
    Join Date
    May 2006
    Posts
    21,249

    Default Re: Small Breasts, Low Supply, Feeling Lost

    Of course you're not alone, mama! A lot of women, with IGT and without, struggle to produce enough. I totally agree that if IGT is to blame for your difficulties, there's not much you can do about it, and there's no shame in not putting yourself through the pumping/herbs/drugs rigamarole. However, I do wonder what might happen if you did. My understanding is that IGT is a difficult diagnosis to make- it can't be based on production, or breast size/shape, or past experiences alone. And while it sounds like you have a combination of those 3 factors which is very suggestive of IGT, there's still a chance that the diagnosis is wrong. So if it were me, I might give it my all for a few weeks, and see if something changes.

    Please don't take the above as a criticism, as it's not intended that way. I guess I always like to err on the side of caution when it comes to accepting that producing enough is impossible.
    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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