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Thread: Help increasing my supply while supplementing

  1. #1

    Default Help increasing my supply while supplementing

    Hi All
    There are several posts online but I am very confused and wanted to see if someone can guide me specific to my case.

    I had C-section 6 weeks back and my LO was born 7Lbs and 14oz. My milk came in late and by the time we got discharged from the hospital my LO weighed only 7lbs. Due to the immense weight loss Dr recommended to supplement but I was hesitating to do so, so I didnt do it until her first Dr apt. 8 days after her birth she had lost 14oz and gained 4oz. But since Dr insisted we started supplementing as needed. On most days we would feed her at night when she became extremely cranky. Average she took on most days is around 2-4oz and the max she has is 6 oz.

    I am not sure how to gauge my milk supply. I have done power pumping for past 3 days and try to pump after feeding. Since I am alone with the baby during the day I give her formula bottle too, so by the time i get to pump its ~1hr from when i fed her. I typically would pump ~20-30ml combined from both breasts after an hr of the nursing session. Is that too low? My baby becomes cranky at night and keeps crying, unlatches and gets fussy while feeding..that is when i feed her formula..I want to eventually move away from formula and try to increase my supply. How do i start to do that? i am stay home mom so i will whatever it takes to incrase my supply but dont want to hamper her growth if that doesnt happen. Please help!!

  2. #2
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    Default Re: Help increasing my supply while supplementing

    How old is your baby now? Is your doctor generally knowledgable and supportive of breastfeeding?

    Would your little one nurse more frequently if you offered more frequently? When you supplement, do you give the supplement by bottle? Do you currently use pacifiers? How many times would you say that baby nurses during a typical 24 hours? Have you had a professional watch you and babe nurse to see if there is a good latch and a good milk transfer?

    These are some questions that came to mind, that might help with coming up with some ideas.

    You are doing a great job for your little one! I wanted to offer too that sometimes babies can just be grouchy in the evenings, not necessarily caused by hunger. This isn't to say that this is what's going on with your baby, and it isn't to say they don't have a reason, just that sometimes that reason may not be apparent to us. My baby has been growing along a normal curve, a generally really joyful little one, and still even at 6 months that 6-9pm range can be the fussiest.

  3. #3
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    Default Re: Help increasing my supply while supplementing

    Good questions above, More info will help us give you more guidance. It does not sound as if you are supplementing all that much at this point. This is good news for getting back to exclusive breastfeeding rapidly.

    Is baby's weight gain normalizing?

    C-sections, like any surgery, are a huge shock to the system. I know because I have had three. How is your health? Are you off all heavy pain meds? Drinking to thirst, eating ok? have you ruled out retained placenta?

    Have you tried switch nursing (encouraging baby to nurse both sides each session) and breast compressions? Is baby nursing at least 10 times per 24 hour day?

    What have output (poops) been like? Yes, weight gain is the best way to tell if a baby is getting enough. But weight checks can be wrong! Birth weights can also be 'inflated' for many reasons. So when supplementing due to slow gain, it is very very important to have regular ACCURATE weight checks. This means: All checks done on the Same accurate digital infant scale while baby is naked or in a dry diaper ONLY. Having weight checks too frequently may be misleading, as babies do not normally gain exactly the same each day. Once ever one or two weeks would probably be ok.

    Once weight gain normalizes, you can talk to the doctor about weaning off the supplements.

    How much you pump is NEVER an accurate measure of how much you make. All it can tell you accurately is the minimum amount of milk that is in the breasts at the time you pump. This is not nearly enough information to make assumptions about milk production. Many mothers do not produce well for even the best pumps. Many mothers are not using the right pump or the pump is not fitted correctly.

    But even so, still a mom really must pump whenever baby is supplemented. (Not always at the exact same time, but reasonably close to it if you can manage it-within an hour or two is fine, and if baby wants to nurse again and you miss a pump session, that is ok to- As long as baby is capable of extracting milk, usually best to fit pumping sessions in around nursing, not the other way around) .) You do not pump to see how much milk you make, but to extract as much milk is possible and give the breasts stimulation they may not be getting due to baby being supplemented. Thios is needed to keep milk production normal when baby is getting supplements. Also if the problem is low milk production (it may not be) then the pumping should help increase milk production.

    Whenever there is a breastfeeding issue that requires intervention, such as pumping and/or supplementation, I strongly urge a mom to get breastfeeding assessed and professional assistance from an IBCLC (International Board Certified Lactation Consultant) if at all possible. If that is not possible, what other hands on assistance is in your area?

    Be aware of how baby is being supplemented. Using a lactation aid (at the breast supplementer) for supplementation is something to look into seriously, particularly if supplementation is going to be more longer term. Since baby is not getting all that much, you might want to consider if cup feeding might be less impactful than bottles. Bottles should be small amounts at a time and given in a breastfeeding supportive way. Supplements in bottles or cup can be given before, after, or "during" a nursing session.

    Frequent effective milk removal is usually all that is needed to have a normal milk production. If that is not doing it in your case, there are many galactagogues (Foods, Herbs, and/or meds) to consider.

    Try to get your information from accurate and recent evidence based sources. I suggest:

    Books: Making More Milk and The Womanly Art of Breastfeeding (8th edition)
    Websites: here and www.kellymom.com
    Jack Newman has good info on alternative feeding methods as well as many aspects of breastfeeding. Look at his info on breast compression as well.
    Last edited by @llli*maddieb; September 9th, 2014 at 04:02 PM.

  4. #4

    Default Re: Help increasing my supply while supplementing

    Thank you for the replies!! Good luck Erin with your baby 
    The baby will be 6 weeks tomorrow. My Dr is supportive of breastfeeding but not at the expense of baby’s health and I feel the same way. I have been tremendously depressed supplementing and feeling not being able to provide for my child but have made peace that her health is of upmost importance hence started supplementing. Ya she does nurse frequently if I do so, but when I hand express there isnt any milk coming making me feel as though I am making her loose calories by making her suck and she isnt getting any nutrition…is that false thinking? Or should I let her nurse as long as she wants and keep switching breasts when she gets frustrated with one?



    Is baby's weight gain normalizing?
    Ya, her weight is now progressing in the right trend..she is gaining ~1oz a day after supplementing

    How is your health? Are you off all heavy pain meds? Drinking to thirst, eating ok? have you ruled out retained placenta?
    I have been doing well, in the beginning got infection was on antibiotics at the hospital and later when I got discharged…not sure about retained placenta? No complications during delivery

    Have you tried switch nursing (encouraging baby to nurse both sides each session) and breast compressions? Is baby nursing at least 10 times per 24 hour day?
    My baby is a big eater , so she does nurse on both sides each feeding..she does around ~10-12 sessions in a day…I haven’t tried breast compression, should I do this while nursing?

    What have output (poops) been like?
    She has been pooping and peeing well, even when I didn’t supplement she was ok….but now with supplements she is gaining more weight each weigh in at the Dr’s..we do use the same scale

    Once weight gain normalizes, you can talk to the doctor about weaning off the supplements.

    I use Medela pump in style pump..i also rented medical grade pump for a week but then returned it for cost reason. I will try to pump after each feeding, I do pump when supplementing….but now she sleeps 3-4 hrs at night, should I pump at night too every 2 hrs? to get more milk and store what I extract? How long should I do this for?

    I did see a lactation consultant and she said that latch is good but my breast seem small to her and she said may be I have less milk ducts…she asked if I developed later than people in my school and I said yes..and she suspected that was the reason for low milk supply..given this info, do you think that my milk supply will never increase whatever I might try, as my body isnt equipped with right things to produce more milk?
    I have been taking fenugreek seeds by water and taking milkplus drops.

    Once again thanks a lot for the info 

  5. #5
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    Default Re: Help increasing my supply while supplementing

    No rational person is supportive of breastfeeding 'at the expense of baby’s health.' I understand your frustration and sadness, but please know there is nothing wrong with giving your baby supplements when she was/is not gaining normally exclusively breastfed. Of course her health is of utmost importance. Unfortunately, the fact is it is very common for babies to be given supplements unnecessarily at the expense of their health, or given temporarily needed supplements without mom getting the information and support she needs to address any breastfeeding issues and wean off the supplements. Those scenarios are much more common than for a baby to not be given supplements when needed. No one has questioned the wisdom of giving supplemental formula when needed.

    So weight gain is normal. Excellent!

    making me feel as though I am making her loose calories by making her suck and she isnt getting any nutrition
    Obviously she is getting plenty of nutrition. I am understanding correctly that your baby is being supplementing only about 4-6 ounces a day??? This is not going to keep a newborn alive, much less encourage normal gain. If that is all baby is being supplemented, you must be making a good amount of milk for baby to be gaining well now.

    If your baby can be "Made" to nurse, she is a very rare breed. This is basically impossible. Allowing/gently encouraging a baby to nurse as long and as often as they wish is very important for normal breastfeeding. Yes it is a myth that this will lead to calories being burned and poor gain. If you are truly not making milk, your baby would have to be completely supplemented-25 to 30 ounces a day or more.

    not sure about retained placenta?
    retained placenta can cause issues with milk production. There are other symptoms as well, I do suggest ask your OB.

    My baby is a big eater , so she does nurse on both sides each feeding..she does around ~10-12 sessions in a day…I haven’t tried breast compression, should I do this while nursing?
    Excellent. Yes breast compression is done while nursing (and pumping if you like) here is info: http://www.breastfeedinginc.ca/conte...agename=doc-BC

    I use Medela pump in style pump..i also rented medical grade pump for a week but then returned it for cost reason.
    This is fine as long as the medela is fitted well and working ok for you?

    I will try to pump after each feeding, I do pump when supplementing
    How often you need to pump depends on how much of a shortfall there is- how much & how often baby is supplemented. I am not suggesting you need to pump after every nursing session, this may not be needed at all. I suspect it is not. The less supplements baby needs, the less mom needs to pump.

    but now she sleeps 3-4 hrs at night, should I pump at night too every 2 hrs? to get more milk and store what I extract? How long should I do this for?
    I would not suggest pumping during this time. Instead I suggest, get some sleep yourself. A three to four hour break from pumping or nursing each day is totally fine as long as baby and pump are extracting milk enough times the rest of the day.

    I did see a lactation consultant and she said that latch is good but my breast seem small to her and she said may be I have less milk ducts…she asked if I developed later than people in my school and I said yes..and she suspected that was the reason for low milk supply..given this info, do you think that my milk supply will never increase whatever I might try, as my body isnt equipped with right things to produce more milk?
    There are so many other possible reasons your milk production was late coming in and babies gain was initially slow, primarily, the trauma and issues that occur with a C-section birth. Again, you are only supplementing a small amount, unless I am very confused- this does not sound like you have some preexisting condition that will make it impossible for you to increase your milk production. Breast 'look" and your history as far as development is one piece of information, but it does not necessarily mean anything about how milk production will go. I am not even convinced your milk production is not perfectly normal right now! Again, what I am hearing is baby is gaining normally with a very small amount of supplementation. If I have that wrong I am sorry. I again suggest talking to your doctor about weaning off the supplements, which will in turn increase your babies nursing at the breast. If this is done slowly and with regular weight checks, it can be done safely.

    And even when there ARE preexisting conditions that effect milk production, that does not mean a mom can 'never' increase her milk production.

    Your baby lost a lot of weight initially, and then at 8 days was starting to gain it back. Right? This indicates a delay in mature milk production, not all that uncommon after a c-section. But it does not necessarily mean a mom is always going to have low milk production- This happened to me with my first baby, also a c-section, and I ended up having overproduction.

    When was breastfeeding assessed by the IBCLC? When was the last time you discussed all this with your baby's doctor? What was going on at age one or two weeks does not necessarily correlate with the situation at 6 weeks.

    Article on weaning off supplements: http://kellymom.com/bf/got-milk/basi...rease-formula/
    Last edited by @llli*maddieb; September 9th, 2014 at 06:14 PM.

  6. #6
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    Default Re: Help increasing my supply while supplementing

    to find an IBCLC
    http://www.ilca.org/i4a/pages/index.cfm?pageid=3901

    Definitely look into using a lactation aid to supplement right at the breast if you are supplementing more than a few ounces a day, it will give you more stimulation at the breast and take out one step of the whole feed/supplement/pump treadmill that can be really hard to cope with long term. If you are pumping after many feedings, you will probably want to keep the pump parts in the fridge or a cooler with ice pack so that you are not having to wash them every time. The real trick is figuring out how to handle it all while also dealing with a newborn and recovering from pregnancy/birth yourself. Add massage and breast compressions and some hand expression to your pumping routine to help increase milk extraction. You may find that if you are only needing to supplement 4-6 oz that you will soon be able to use expressed breastmilk to do the supplementing and once you are able to pump enough to fill that supplementing need, you will likely be able to quickly wean off the supplements and the pumping.

    There are some foods that can help increase milk production, things like Barley and oatmeal

  7. #7

    Default Re: Help increasing my supply while supplementing

    thanks all for reply.

    Yes she is only taking 2-8oz a day supplement, depending on the day. I have been pumping after a few feedings to increase my supply as you all suggested. Sometimes i only pump a few droplets post feeding her.

    Yesterday she was so cranky at night that she kept crying and wont even latch but when i offered bottle she immediately took it. Do infants do this when they are too used to bottle? I think she does this when my flow is low.

  8. #8

    Default Re: Help increasing my supply while supplementing

    @llli*maddieb you are awesome and reading this makes me feel so much better

  9. #9
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    Default Re: Help increasing my supply while supplementing

    Quote Originally Posted by @llli*tomiaditi View Post
    thanks all for reply.

    Yes she is only taking 2-8oz a day supplement, depending on the day. I have been pumping after a few feedings to increase my supply as you all suggested. Sometimes i only pump a few droplets post feeding her.
    Is that between 2 and 8 oz total supplement per day or are you saying 2, 8 oz bottles? Hopefully you mean between 2-8 oz total per day. Hopefully you are only offering very small top ups (like 1 oz at a time)

    Yesterday she was so cranky at night that she kept crying and wont even latch but when i offered bottle she immediately took it. Do infants do this when they are too used to bottle? I think she does this when my flow is low.
    YES, babies can get a "flow preference" since bottles tend to be very EASY, they get flow immediately, they don't have to suck till let down happens and the milk tends to just flow so all they have to do is swallow. I've experienced the fussy pulling off constantly barely even latching and then crying that nothing is flowing. Or latching on hard, even clamping down and then using arms to push against me like he is trying to pull the milk out with brute force, stretching my nipple way out in the process. All these can be signs to impatience because a baby has gotten used to immediate flow from a bottle.

    I found it helped me to use the SNS or other lactation aid and limit or stop bottles to break this habit. Sometimes it might help to express a little before latching baby on so that there is a more immediate milk flow, perhaps even leave some drops on the nipple.

    Of course in the evenings, babys are often fussy and sometimes it has very little to do with hunger.

    Sometimes it may also help to give baby a little bit by bottle to take the edge off the hunger and then put baby to the breast when she might be a bit more patient and then also more likely to associate the "full" feeling with nursing at the breast. Or you might nurse for a bit, give a bit by bottle and then finish at the breast.

    When pumping after nursing, it isn't really about how much you get out, your are doing the pumping and nipple stimulation to tell your body there is MORE DEMAND. So pumping only a few drops and then pumping for another 5 minutes with nothing coming out can help tell your body "hay there is a hungry baby here we need to make more milk!!!!!" And even if you can't pump for a time after all milk stops flowing, that is ok, as often as you can pump for even 5-10 minutes after feeding the more your body should get the clue. Make sure pumping doesn't hurt but that you feel stimulation in your nipples and if the pump doesn't stimulate the nipples well, do some of that by hand after pumping.

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