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Thread: Trouble getting enough supply to EBF

  1. #11
    Join Date
    Oct 2012
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    Default Re: Trouble getting enough supply to EBF

    I definitely think there's a point of diminishing returns when it comes to this type of pumping. Utter exhaustion can be really counterproductive. It sounds like you have come up with a schedule that is very doable for you, which is great. Keep us posted!

  2. #12
    Join Date
    Apr 2014
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    16

    Default Re: Trouble getting enough supply to EBF

    Well I went and met with the lactation doctor today. She agreed that I am doing absolutely everything that I can be doing.

    She did go ahead and weigh Kaiden before and after a feeding. I have been able to get him to take 1.5oz at most feedings now as long as I keep him on for about 20 minutes on each side, and as long as he is awake. A week or so ago, he was getting .5oz at the breast, and I was able to get him to start taking 1.0 oz, but had to keep him on for about 40 minutes. Within just a couple days he was taking that ounce much faster and rarely gets less anymore. So I'm hoping we're looking at the same thing with the 1.5oz. At the appointment we let Kaiden eat for 20 minutes each side and he did get 1.5oz again. As a side note, I wonder how much of this is a problem of him just being an inefficient feeder, and as he gets stronger, will this lead to major improvement.

    She wasn't very promising that the hospital grade pump is going to do much more than the pump that I already had, but says it doesn't hurt. She did encourage me to increase the pumping schedule again as much as I can, but making sure I'm still getting enough sleep. So while I'm awake, I'm going to try to pump after each feeding as much as possible. And I might also pump at night, with leaving one feeding with no pumping to get a longer stretch of sleep. I do feel refreshed after the break the last couple of days.

    One interesting thing she mentioned was to try to pump as quickly after finishing breastfeeding as possible. I just don't know how to make that happen unless my husband is home to take the baby when I'm done and bottle feed him, but it's something I'll work on.

    My husband just noticed that the baby is smelling like syrup after being next to me for breastfeeding, so I guess I'm finally seeing the smell from the Fenugreek. The doctor told me that Fenugreek works within 4-5 days if it's going to work at all. However if the smell is any sign of whether it's working, I would think it just started.

    We discussed the use of Reglan. She was very hesitant to prescribe it with my already taking Zoloft for some postpartum blues. She would have if I really pushed for it, but this was already a concern of mine and after hearing her opinion, I decided not to go with it. She said that she doesn't see the most amazing results with Reglan, so it's a big risk to take for likely a small return. I really want to be careful not to cross the line here, from being dedicated to being self destructive.

    Now she did have great things to say about Domperidone. She agrees the side effects are low, and except for the IV dosage, very safe. She said that the results from it are also better. However, Children's Hospital doesn't allow her to prescribe it. It would be a matter of having to find a doctor who would be willing to prescribe it at a compounding hospital. Or go the route of ordering from Canada/off shore pharmacy, which I don't even know the first place to start of what is trustworthy. I'm open to opinions on this.

    The main thing we discussed is the reality of the situation. She wanted to be as realistic as possible with me, allow me the option to stop if I wanted, and to be encouraging. I thought she walked that line very nicely. She agrees that we still seem to be on the upswing. As long as we're on the upswing, and I am willing to continue, she encouraged us to keep trying. She said if after a few weeks we're just not seeing any improvement at all, she might have a different suggestion, but for now, she encourages us to keep going.

    So... in the end I didn't leave with much more than I came in with, but I do feel good for going. I would have always questioned if not going to see the lactation doctor was leaving out something more to try. And it was good to talk through everything to make sure we're on that right track.

  3. #13
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    Oct 2012
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    Default Re: Trouble getting enough supply to EBF

    Wow, that sounds wonderful! I wish all moms had such a great resource. That's great Kaiden is taking 1.5 oz in a feed now, hopefully that trend will continue.

    When I was pumping to build up my stash of milk for work, if baby was not asleep I would put her in a bouncy chair facing me and bounce her with my foot while I was pumping, while also looking at her, maybe singing or talking to her. This seemed to keep her reasonably content while I was pumping. I'm sure this would not work for every baby but perhaps worth a shot if you have a bouncy seat.

    I don't know anything about ordering Dom from Canada. If you don't get good replies to this thread about that, maybe start a new thread with that specific question. I know there are at least a few moms around here who have been on domperidone.

    Whatever ends up happening, you are nursing your baby and I think there is no reason to think that you will not be able to continue nursing your baby for as long as mutually desired. Keep up the great work!

  4. #14
    Join Date
    Mar 2014
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    Central FL
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    Default Re: Trouble getting enough supply to EBF

    I know I've read that the Fenugreek isn't likely to have much effect until you get the maple syrup smell.

    To save you some time between nursing and supplementing to make pumping easier, you might look into using an at the breast lactation aid type supplemental nursing system. It means you could provide the supplement at the same time as you are nursing and then you don't have the step of bottle feeding between the nursing and pumping.

    Myself, just a few weeks ago I could only pump a tiny bit in a day, Probably lucky to get an ounce a day. Now, I'm getting 4 ounces of pumped milk in a day. It takes patience, determination and a lot of help to get past such problems. You have made some great progress, hang in there a little while longer and see if it starts to get easier.

  5. #15
    Join Date
    Apr 2014
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    Default Re: Trouble getting enough supply to EBF

    I wanted to share my excitement... Kaiden just got 2 ounces from a feeding!

    Two weeks ago, he was getting .5 oz a feeding, with a single 1.0 oz feeding in the early morning.
    One week ago, he was up to 1oz feedings, with a single 1.5oz feeding in the early morning.
    This last couple days he has been getting 1.5oz feedings pretty continuously.
    Now today, he got a 2.0oz feeding in the early morning to go with those 1.5oz feedings! Maybe in the next week it will get to the point where he gets to 2.0oz feeding at most feedings.

    We're definitely increasing and it makes me so happy that I have stuck with this!!

  6. #16
    Join Date
    May 2006
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    Default Re: Trouble getting enough supply to EBF

    Awesome!
    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!"

  7. #17
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    Oct 2012
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    Default Re: Trouble getting enough supply to EBF

    Quote Originally Posted by @llli*erika2me View Post
    I wanted to share my excitement... Kaiden just got 2 ounces from a feeding!

    Two weeks ago, he was getting .5 oz a feeding, with a single 1.0 oz feeding in the early morning.
    One week ago, he was up to 1oz feedings, with a single 1.5oz feeding in the early morning.
    This last couple days he has been getting 1.5oz feedings pretty continuously.
    Now today, he got a 2.0oz feeding in the early morning to go with those 1.5oz feedings! Maybe in the next week it will get to the point where he gets to 2.0oz feeding at most feedings.

    We're definitely increasing and it makes me so happy that I have stuck with this!!
    That's wonderful!

  8. #18
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    Mar 2014
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    Central FL
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    Default Re: Trouble getting enough supply to EBF

    Good Job, keep up the good work, I know seeing results helps.

  9. #19
    Join Date
    Apr 2014
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    Default Re: Trouble getting enough supply to EBF

    Well my baby will be 8 weeks on Saturday and 2 months on Tuesday. At the beginning of the month I was only able to nurse/pump around 11 oz/day. As of this week, I'm able to nurse/pump around 17 oz/day. I'm definitely making progress! I would love to get to that 20oz mark since that would be in the "normal range" albeit at the low end.

    I ordered domperidone and have been taking the minimum dose for about 2 weeks (9 pills). I have more coming and should be here tomorrow, so I'm going to up the dose to see if I get more of a response to the medication (12 pills.) I read it can take 3-4 weeks to see a response to the medication and many people need to up the dose, as high as 16 pills. I am seeing an increase it's just slow, and could be from the domperidone, the fenugreek, the continued pumping, lactation cookies,... I could keep going!

    Monday I start back to work part time for a week and then full time the week after that. I work from home and my husband convinced his work to allow him to work from home half days to help with the baby while I am facilitating conference calls (generally only in the morning.) We're going to try to keep the baby home through 6 months if possible. This will allow me to continue the current routine which is:

    -weigh the baby
    -breastfeed
    -weigh the baby again to see how much he got
    -weigh the amount that I pumped last time
    -top off the bottle to get to a total of 85-88g between the nursing and pumping

    We will have to see if I can keep up this routine over night and still get enough sleep to function while working since I won't be able to nap during the day. I am thinking about skipping nursing overnight, solely pumping, and letting my husband give the baby a bottle. This way I am up for 15 minutes and back a sleep instead of 1-1.5 hours. The baby takes the bottle pretty quickly so it would probably be the same amount of time for my husband. We shall see. I'm going to continue the current routine for as long as I can since I am seeing results, just slowly.

    I also read that the AAP suggests that women who are not able to have enough supply for exclusive breastfeeding are recommended to start solid foods (bananas) around 4 months. That starting solids is a better alternative to formula. I thought this was interesting and means I'm halfway to not having to do formula any longer. Unless the domperidone works its magic before hand... What are your opinions on this?

  10. #20
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    Oct 2012
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    Default Re: Trouble getting enough supply to EBF

    Wow, fantastic progress!

    Re: overnight: I recall a mom with twins who was on here, she was doing a combination of nursing and pumping and she did exactly what you are proposing, ie pumping only at night and having husband feed babies. So that may work well. Babies usually do become more efficient at nursing as they get older, so at some point it may not take as long to go through the whole routine, and/or you may be able to switch to nursing only at night, but for now I think that sounds like it might work. Can I just say how fantastic it is that your husband and his workplace are so incredibly supportive?

    Re: bananas: hmmm, that's interesting, I had not heard that recommendation before. Usually I think of breastmilk or formula as the primary source of nutrition until age 1, with solids serving more of a role in baby learning new tastes, textures, and feeding skills, and studies have shown breastfeeding moms usually tend to wait longer for introduction of solids (ie until 6 months as opposed to 4). Bananas for example are mostly carbs without much protein or fat, so rather different nutritional content than breastmilk or formula. Something to discuss with your pediatrician or a nutritionist?

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