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Thread: Help! Milk supply dropping fast after going back to work

  1. #1
    Join Date
    Dec 2014
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    16

    Default Help! Milk supply dropping fast after going back to work

    My baby will be 4 months next week and it has been a long, hard journey. I have been back at work now for 3 weeks and my supply is dipping precipitously. I have a history of low milk supply (my older one was supplemented 50-60% with formula). For this guy, I have been trying so hard and have made it this far without supplementing (I did see a lactation consultant when he was a few weeks old). He is tiny (born 6 lbs 11 oz)and has consistently been in the 7th-9th percentile. I was just about making enough and would usually have 5-10 oz. to freeze at the end of every week, however as of this past week, that has changed in a big way. Every day this week has been worse than the previous day. Specific changes that could have caused it: 1) He stopped wanting to nurse on the right side which used to actually be my better side, but where the letdown is very slow. And the production in the right dropped a lot. Even though I have been putting him on it first, he always comes within a couple of minutes. 2) About 2 weeks ago, I stopped waking up in the middle of the night to feed him as it was getting impossible to function at work. He usually sleeps from 10 pm – 3 am, and then wakes up at 6 am. I nurse him until 10 pm, and then stay up till midnight, pump and go to bed leaving my husband with a bottle. I would then sleep from 12 am – 6 am. However given the drop, this weekend, I have stopped doing that and woke up at 3 am to feed him; but because my flow is so slow, he has been nursing for long stretches (3-4:30 am, and again from 6-7:30 am). And yet when I pumped this morning at 9 a.m., I only got 3 oz. Prior to this week, every morning for the first pump I would get 5-6 oz, and 3-4 oz after that consistently with every pump through the day. As of today, I am now only getting 2.5 oz when I pump every 3 hours, even if I haven’t nursed him. I have been putting him to the breast as often as possible, but outside of the middle of the night, he unlatches really quickly on the right side, and will stay on for about 5-10 minutes on the left. I do currently rent and use a hospital-grade pump (Medela Symphony), and have been taking both fenugreek and Malungay (3 pills, 3x per day). I don’t have my period yet, and I know that is sometimes suggested as a reason for a sudden drop. In terms of baby’s weight gain, it has dropped since I went back to work (he is now at the 5th percentile). He has about 6 wet diapers and 1 dirty diaper per day. I have a frozen stash of about 60 oz, and at this rate of production, he will eat it all in about 10 days. So it is a sad time; I wanted to have him exclusively on breastmilk until 6 months, and this time I really thought we would make it. I fear my breastfeeding journey is coming to an end. I have a fairly high-pressure job, and I definitely can’t nurse + pump after every 2 hours (as I have been doing this weekend). As a last resort, I plan to order Domperidone to see if that will help. I apologize – I know this was a long post, but I would be so grateful for any help or advice as I feel like I have taken this as far as I can.

  2. #2
    Join Date
    Nov 2014
    Location
    Colorado
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    54

    Default Re: Help! Milk supply dropping fast after going back to work

    Stress is a killer for milk supply! That one I've learned from anxious experience. I had a similar thing happen to me (though I don't have a history of low supply) - I had my production drop off rather suddenly by ~85%. The good news (which will hopefully help you worry less) is mine recovered.

    Can you afford to take a milk day? That's what my LLL leader recommended and I strongly advise it! I know it's easier said than done to be all Zen about it, but try to focus on "strengthening the connection with your child" rather than on "upping your supply." If you think about the let down, it won't happen (or didn't for me). Spend a day and let him nurse and/or nuzzle as much as he will for the full 24 hour period, emphasizing skin-to-skin too. If he isn't interested, pump for a short episode of something (e.g. Friends is ~30 min long).

    Can you set aside pump appointments at work? I think my supply dropped because I was getting too lax about how long I'd wait to pump. I put 30-min appointments in my calendar every 3 hours now. It's hard to do with a busy job - I can attest to that! - but I was torn up at the thought of not being able to feed my kid. So I have to go in to work a little earlier, but I won't negotiate on "pumping on time;" for me it's not worth the trade-off.

    For a week after you start trying to fix this (if it's been a week in the making), just try to accept whatever you get from pumping. Don't get down on yourself because it's only an ounce or two (I was getting 1/2 ounce per session at the worst of it). Just accept it as what your body is presently producing. Drink plenty of fluids, enjoy a show or a puzzle while you pump, and spend plenty of time loving on that kid of yours; the body has an amazing ability to respond

  3. #3
    Join Date
    Dec 2014
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    16

    Default Re: Help! Milk supply dropping fast after going back to work

    Thank you so much for responding - just hearing that you went through something similar gives me hope. Exactly what all worked for you? I assume you took the nursing day over the weekend? It doesn't help that we live in the Northeast where the winter is hitting us hard, in an old drafty home where we have challenges cranking up the heat. Even with a space heater nearby he screams for every diaper change and a bath because it's so cold, so skin to skin is a bit harder to do, but I will try this tomorrow night. I have been pumping every 2 hours this weekend (except for a 3.5 hour stretch at night), but no improvement so far. In fact it's getting worse, and this is in spite of using the hospital-grade pump. I will stick with the pumping, but if you have any other tips to share of what worked to change things for you, I would be so grateful.

  4. #4
    Join Date
    Apr 2014
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    688

    Default Re: Help! Milk supply dropping fast after going back to work

    I think Dandelions covered most things but are the flanges fitting well and have the membranes etc been recently changed on the pump? Women often change flange size as time goes on.

    Also if shows don't work when pumping for you. I found a slide show of photos if her on my phone really helped! Other mums use scents e.g. baby clothes or baby toiletries help too

  5. #5
    Join Date
    Nov 2014
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    Colorado
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    Default Re: Help! Milk supply dropping fast after going back to work

    I actually took the milk day on a Wednesday -- called in sick. I think my milk had been declining for 4-6 days at that point, and I panicked a bit. Here's what I did:
    • Drank plenty of fluids
    • I made Oatmeal Chocolate Chip lactation cookies (recipe here: http://www.bellybelly.com.au/breastf...s#.VNmBZPnF8-A). (Two batches over a week's time.) We also made sure we were eating healthy/enough -- home cooking, whole grains, etc.
    • I set my alarm for 2 hours after every feeding or pumping session during that Wed. I tried to nurse when it went off, and pumped for 15-30 minutes if my son wasn't interested. I'd dress him down to a diaper and cuddle under a blanket. The key is to not be hard on yourself, even if you pump nothing -- your objective is to tell your body more milk is needed, rather than to obtain said milk. I also spent time snuggling in between the 2 hours, but made sure to just like clockwork, send that "more milk" signal.
    • Aside: I definitely understand the cold house issues... maybe try nursing lying down in bed with covers (just make sure you don't fall asleep or that the covers are sufficiently anchored), taking a warm shower together, or unzipping/buttoning his sleeper so you're chest-to-chest, but he's otherwise covered?
    • I played Sudoku or watched TV during pumping sessions. Usually photos will work for me - like bsua65 suggested - but I was so stressed out that I would end up thinking about the implications if my milk completely dried up, with my son only 4.5 months. TV was much better for just getting my mind off of it --- whatever does the same for you is great!
    • I let him nurse as long and as often as he wanted to that night (we bed share so this is easier for us than some), and subsequent nights.
    • Thursday and Friday at work I made absolutely sure to pump every 2-3 hours, regardless of how much I got, how full I felt, etc.
    • During these days my son also only ate the milk I had from the previous day(s). As long as you're feeding on demand and let your son nurse as long as needed when you are home, he should be fine (I'm assuming here you can muster together an ounce or two for every few hours.) My son would normally drink 12-15 oz while I was away and I think I only managed to get 6 or 7 together for Thursday. If you decide to dig into the freezer stash, I'd try to nurse him first, if you can. I don't think a pump can be nearly as effective as a baby in signalling the body to produce more.

    This did not instantly fix things. We got through Friday & breathed a sigh of relief because we were at the weekend and at least I could be home to feed him as often as needed. By Monday, however, things were definitely improving -- I was able to pump enough over the weekend to leave 12 oz for the day on Monday, and things continued to improve.

    I'm pretty much back to normal now (~2 weeks later), but I am militant about drinking enough, spending quality time snuggling the kiddo & leaving the stress of the day at the door, and never going more than 4 hours without pumping during the day. I sometimes get a lot when I pump, but sometimes I'll only get a little, because e.g. it's more important for me to pump at 8 even though I fed him at 7, because I have a long meeting at 9am.

    My issue didn't happen to be a pump issue -- I am pretty good at hand expressing and I still couldn't get anything -- but it's definitely good to eliminate that as an issue. Your son may have hungry periods for a day or two, but your body will continue producing milk the whole time he's nursing, so as long as he can nurse uninterrupted, he will be able to catch up.

    Sorry for the length I wanted you to have all the details you might be looking for. Feel free to let me know if you have more questions. I suggest contacting your local LLL leader as well, though -- it can be really comforting to just have someone in your camp who can give you advice & reassure you. Oh! And the diapers are key... if he's still making the normal amount of diapers (I think it's ~5+ well-soaked diapers, or equivalent - your LLL leader or pediatrician can probably confirm), you can be sure he's getting enough to eat.
    Last edited by @llli*dandelions; February 9th, 2015 at 10:33 PM.

  6. #6
    Join Date
    Dec 2014
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    16

    Default Re: Help! Milk supply dropping fast after going back to work

    Hi there, just wanted to provide an update. Thanks so much, Dandelions and bsua65. We made it through the slump and are still going strong! The thing that seems to have worked is resuming night nursing. I did pump a little more frequently, but that is the one big change I made, and it seems to have made the difference. It is hard because my milk flow tends to be quite slow, so baby doesn't get much in one session, and so he wakes up 2-3x per night to nurse. So I am not exactly at the top of my game the next day at work - we do cosleep but I simply can't sleep while he nurses, so I only sleep 3-4 hours per night in total (and not at a stretch). I wish I was able to sleep for 6 hours at night, and not have it affect my supply. But on the other hand, by night nursing, I am at least able to make as much milk as he drinks, so I plan to do it for as long as I can. He is still small (7th percentile), but he doesn't seem to be hungry, and I always have at least a little leftover milk every day. Thanks again for the support!

  7. #7
    Join Date
    Oct 2012
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    2,578

    Default Re: Help! Milk supply dropping fast after going back to work

    Can you go to bed earlier in the evening? Let nonessential things slide? That helped me when I was at that stage.

    I also have a high-pressure job and I was not at the top of my game either during my (three) babies' infancies. I was also really, really tired. My youngest is 3 now (and still nursing, by the way!) and although I still have nights of interrupted sleep because she decides to sleep on TOP of me rather than next to me overall I am much less tired and more productive. I guess I want to say that although it's really, really hard when you are going through it to try to balance taking care of an infant and doing well at your job, and it feels like forever, you WILL eventually be less exhausted. (And honestly, you'd be tired if you were formula-feeding baby too.) And, in my opinion, having learned to balance all that I am actually all the more capable now. I used to shrug it off when people called me a "super woman" but I think the truth in it is that once you figure out how to balance all those conflicting priorities and get the sh*t done that needs to get done, whether at home or at work, you can do anything! Hang in there, it's awesome that you were able to get your supply back up!

  8. #8
    Join Date
    Nov 2011
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    85

    Default Re: Help! Milk supply dropping fast after going back to work

    You need to take a "milk day" or two, or three, whatever you are able.

    This means taking off from work and just nursing baby directly the whole day. It is very hard to increase your supply while pumping at work. Do it at home with your baby.

    As I say often to friends, there is no easy substitute for direct breastfeeding when supply is low. True story.

    I just had the stomach bug and my pumping output at work decreased by 5 oz. I took off for 3 days, now I am actually up an ounce from what it was before. No stress, no pump, no pills, just baby and me.

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