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Thread: Low milk supply - need answers!

  1. #1

    Default Low milk supply - need answers!

    Hello all,

    My baby is 2.5 months old. I have been having low milk supply right from day 1. Whenever I mention this to any doctor, they simply shrug it off and say it is not possible. A mother is always able to produce enough milk for her child.

    After 2.5 months of intense struggle to feed my baby, I need some answers. Most doctors I have approached seem to go by theoretical knowledge. For any other ailments they have answers - but for low milk supply all they say is "you shud feed more frequently." or "maybe u are stressed" or "your food intake is not good enough". Believe me, there were phases when I was not stressed - but my milk supply was still low, I have been feeding every hour at times and my food intake has been pretty good. I have been eating all kinds of healthy foods like papayas, apricots, almonds, figs, sometimes fenugreek, spinach, oatmeal, etc. But somehow I find my supply fluctuates - I have no clue why! My baby does not put on weight when he is exclusively breastfed.

    If someone could just tell me that its ok for some mothers to produce lesser milk, I will be happy. I need someone to tell me that formula feeding is ok ad is not poison. I need someone to tell me that a lot of women give formula to their babies and I am not the only mother to do so.

    1) In the first month, my milk supply was very low. In the initial few days - one day I realised my baby was dehydrated and had not passed urine for a long time and had jaundice. Doctor asked me to start formula so that he starts passing urine.
    2) His weight gain was low too. So we started formula top-ups. He started gaining weight. After a certain point in time, doctor asked to slowly reduce formula top-ups.
    3) We reduced formula top-ups. At some point in time, he was on breast milk only. He would pass urine after every feed. He passed stools regularly and I took it as a positive sign. But in the next checkup we realized his weight gain had again dropped to 15 gms per day. He was not even in the 5 percentile on the growth chart.
    3) We started formula top-ups again as suggested by the doctor. Now he is gaining weight. When I asked my doctor can we attempt towards exclusive breastfeeding again, she said that he is very much used to formula now and we cannot stop it now or else he may again stop gaining weight.
    When I asked her what is the reason, she said that its probably stress that is causing poor milk supply and weight gain. (I was not stressed back then!!!) She asked me to get urine tests done for the baby to rule out any infections and all reports are normal.
    Another doctor suggested that probably my milk is not nutritious enough because of my food intake. Perhaps the fat levels in my milk are low and I need to eat for two people. I decided to give that a try and have been having a lot of fat-laden foods - but it is not helping.
    Since the past 3-4 days I have realized that my milk supply has dwindled down further and i have no clue why. When I express milk from both sides, I get only about 60-90 ml maximum.

    I just wanted to know what could be other possible reasons besides "stress" and "non-nutritious food". I have PCOS - although I conceived naturally. Could that be a reason?
    I get annoyed with doctors who quote from textbooks and say mother's milk is enough. I can see a real live example that proves that's not true! My baby cries for milk immediately after every feed!! Why don't they consider that. I feel awful.

    Fiona

  2. #2
    Join Date
    May 2006
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    24,794

    Default Re: Low milk supply - need answers!

    Welcome to the forum!

    The most common explanation for low supply is poor breastfeeding management. Things like not feeding the baby often enough, limiting the baby's time at the breast, unnecessarily supplementing with formula, scheduled feedings, allowing a baby who is not gaining well to sleep long stretches at night. Most women will make sufficient milk if they simply nurse their babies on demand because milk supply is governed by the frequency and completeness of milk removal from the breast. Want more milk? Nurse or pump more often.

    If breastfeeding management doesn't explain why a mom is struggling with supply, you have to consider the rarer causes. These would be things like the baby being unable or unwilling to nurse well, for example a tongue tie or reflux. Or the baby having some some sort of medical condition that would impact his ability to grow well on breastmilk (this would be VERY rare and the baby would likely have trouble growing on formula, as well). There can also be issues with the mom, including hormonal issues like PCOS, thyroid disfunction, and pregnancy, and physical ones like insufficient glandular tissue (extremely rare) or damage to the breast from trauma or surgery. A mom who is literally starving or severely dehydrated would also have trouble making milk.

    Here's what doesn't effect supply: stress and eating the "wrong" foods. Stress can make it more difficult for a mom to let down her milk, but it doesn't spontaneously cause low supply. And a poor diet isn't good for you, but as long as you are adequately nourished it doesn't really matter what you are eating. Your body will create good milk even if you eat nothing but junk food and soda- not that you should!

    So, at this point, what do you do? I would suggest the following:
    - See a lactation consultant, preferably an IBCLC, for hands-on help with your baby's latch, with pumping, and for an assessment of your baby's ability to transfer milk when he's at the breast.
    - Make sure your doctor is following proper weighing procedure. Babies should always be weighed in the nude, using the same scale as last time.
    - Nurse as much as possible. A newborn brings his mom's milk in by nursing around 10-12 times a day, and after the newborn period most babies need a bare minimum of 8 feedings per day to get their needs met. If your baby is nursing less than 8x per day, try to bring him up to that.
    - Don't let your baby sleep long stretches at night. If he is sleeping swaddled or with a pacifier, take those away as they can extend the baby's sleep stretches, and you want your baby to wake up and nurse!
    - See your own family doctor and discuss your own health, with special focus on the PCOS, prolactin levels, and thyroid function (particularly if you have a family or personal history of thyroid problems).
    - Pump frequently, using a high quality double electric pump with correctly sized shields. There's no reason to supplement with formula if you can produce enough milk to fill the bottles. And if you can fill all your baby's supplemental bottles with your own milk, you'll know that you have enough milk to transition to exclusive breastfeeding. The fact that you can express 60-90 ml at a time suggests that you actually have the potential to produce sufficient milk, as the average feeding for a nursing baby is just 60-120 ml (2-4 oz).

    If you do all that and your baby still can't gain weight from nursing alone, that's okay. No reason to feel awful about something that may be beyond your control. Okay?

  3. #3
    Join Date
    Mar 2014
    Location
    Central FL
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    1,575

    Default Re: Low milk supply - need answers!

    Hi fionashrek,
    My baby is 11 weeks now and I have had some intense struggles too. Been posting here since 10 days old, long thread if you want to read to not feel so alone.
    http://forums.llli.org/showthread.ph...te-milk-supply

    Anyway, how does breastfeeding feel?
    When you pump are you doing it right after feeding?
    As Mommal says!
    To be able to pump 60-90 ml is actually a really good amount to be able to pump.
    Definitely try to see a Lactation Consultant and check for things like tongue/lip ties and positioning that may be hindering milk transfer or even hurting your supply.
    To increase supply make sure you are feeding often, including at night and pump right after nursing as often as you can (this signals your body to make more milk.)
    Once you are pumping as much as you need to supplement, you know your milk supply is good enough.
    Also, topping up with bottles can be detrimental to breast feeding if the bottles are not given in a breastfeeding supportive way. Babies can develop a flow preference for bottles that don't require them to work for their milk and they may stop eating at the breast long before they drain it much and then just wait or even cry for the bottle.

    Also, if you do need to use some formula to supplement, don't beat yourself up, you are still giving a great start with the breast milk you are providing. Look into the causes that may be hindering your breastfeeding relationship and do what you can, it doesn't have to be all or nothing. It isn't your fault. And Drs who tell you simply to relax are just not able/willing to figure out what is going on or how to fix it and it's time to look for answers elsewhere.
    Last edited by @llli*tclynx; May 28th, 2014 at 08:51 AM.

  4. #4

    Default Re: Low milk supply - need answers!

    We had to supplement for a few weeks too due to weight issues. Do everything mommal says, especially see an LC and your own doctor. Nurse, nurse, and then nurse some more. When my DS was having weight issues, I made sure never to supplement too close to bed time or overnight so that he would wake up at regular intervals of 2 to 3 hours. Nurse for comfort, nurse to sleep, nurse before you go to the grocery store etc... It will reinforce that you are where to go for food and comfort, not the bottle. At 2.5 months, baby is still new to eating in intervals instead of having a mainline 24/7. Watch for those wet diapers. Also, not all babies gain weight the same and percentiles are not necessarily an indication of health. My DS just pulled up into the 10th percentile at 4 months and the only thing the doc was looking for was a general progression upwards in his growth curve. He didn't care about the number. I think if you follow some of the suggestions from posts above, you and baby will be pros in a few weeks.

    (Also, I just drank a coke and had a giant burrito for lunch and I have a friend who seriously produces like a dairy cow and drinks star bucks frappacinos everyday. Not the greatest food choices but certainly not hurting our milk supplies)

    And always, if you feel you have tried everything you can do, and still feel it's not happening, then you are not a bad mom for giving formula. Never feel judged. You are a wonderful mom just for reaching out and trying to make it work.

  5. #5

    Default Re: Low milk supply - need answers!

    I have pcos and have trouble with my milk too. The nurses and the lactation consultant said some woman with PCOS have trouble producing enough milk if they produce at all. And not to stress if I have to supplement. Any BF at all is good. So that is how I look at it. However it is exhausting having to bf, sup and pump all the time. I would rather have a good supply. My next baby I am going to pump right away in an attempt to get supply up.

    They gave me the 3 step to produce more.

    1st BF and switch sides until baby gets too fussy. I hand express to see if I have any milk left.
    2nd sup
    3rd pump. And pump for at least 5 min after last milk.

    That is the 3 step... but I added
    4th Power pump once at night and once in the morning. This is 10 min on 10 min off for an hour.
    5th oatmeal
    6th extra food extra fluids. I force fluids. And I drink at least 100+ fluid oz...

    But I still only get anywhere from 10ml-1.5oz per pump during the day And have to supplement at least 4oz formula per feeding cycle. And once a day after her long sleep at night I am engorged and need no sup bottle and get about 3 oz pump.

    My point is... You are not alone *hugs*. There are others in the some situation.

  6. #6
    Join Date
    Mar 2014
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    Default Re: Low milk supply - need answers!

    Quote Originally Posted by @llli*mariahpoo View Post
    6th extra food extra fluids. I force fluids. And I drink at least 100+ fluid oz...

    But I still only get anywhere from 10ml-1.5oz per pump during the day And have to supplement at least 4oz formula per feeding cycle. And once a day after her long sleep at night I am engorged and need no sup bottle and get about 3 oz pump.

    My point is... You are not alone *hugs*. There are others in the some situation.
    Forcing fluids isn't necessarily good. You should drink to thirst unless there is something keeping you from experiencing thirst naturally.

    Pumping after breastfeeding you are not likely to get very much unless you have extreme oversupply or baby isn't able to extract the milk.

    When you say you need to supplement 4 oz per feeding cycle, does that mean each feeding? Breastfed babies usually only take between 1-4 oz total per feeding (this is why mothers and babies need to nurse so often, at least 8-12 times a day.)

    Sounds like there may be some issues with milk transfer and not entirely supply related.

    I'm only a few ounces shy of being able to exclusively breastfeed (I have enough milk but baby has some transfer issues so I supplement with expressed milk) and when I pump after a feeding during my Max supply time I'm lucky to get 1 oz combined total. During low supply afternoon hours I'm probably lucky to get 10ml. Pump output isn't necessarily a good indicator of supply.
    Last edited by @llli*tclynx; May 28th, 2014 at 05:53 PM.

  7. #7
    Join Date
    Jun 2009
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    10,754

    Default Re: Low milk supply - need answers!

    HI I think you have gotten lots of good info from everyone.

    Your post demonstrates again that doctors are unfortunately not always the best source for assistance and information about breastfeeding issues. I do not know where you live, but in the US, the normal breastfeeding experience, what is in human milk, and how to help mothers with breastfeeding issues is not taught in medical schools or is an elective if it is taught. Of course there are doctors who know a great deal about breastfeeding because they have made a point to study these areas. But these are the exception, not the rule.

    I do also want to point out that the current thinking is that the link between PCOS and low milk production is tenuous. Some moms with PCOS have enough or even overproduce. So even if a mom has PCOS, that may or may not explain low milk production. I just want to throw that out there.

    a good resource for further information about all aspects of low milk production is the book "The Breastfeeding Mothers Guide to Making More Milk."

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