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Thread: Still struggling with milk supply 3 months PP.

  1. #1

    Default Still struggling with milk supply 3 months PP.

    Here is a little about my story...
    My little girl born 2 weeks early at 6lbs 12oz. Took her 4 weeks to get back to birth weight, so at 3 weeks PP my LC had me start supplementing with EBM. We concluded it must be a milk supply issue because breastfeeding management was good. I have been taking domperidone, fenugreek, blessed thistle, brewers yeast, oatmeal, alfalfa, More Milk Special Blend, teas, cookies and still haven't been able to really noticeably increase my supply. She continues to have slow weight gain, but is meeting all milestones. All investigations have come back normal, so we don't believe there is a medical problem to her weight gain.

    I have been discussing with my LC about possible insufficient glandular tissue, my breasts have always been small, but also didn't increase very much in size during pregnancy or PP. I never really got engorged, only felt "fuller" on day 4 PP. I just got a prescription for Metformin, to see if that might help with glandular development and milk supply. Has anyone tried this? What has your response been? How long should I wait to notice an increase? Thanks!

  2. #2
    Join Date
    May 2006
    Posts
    24,794

    Default Re: Still struggling with milk supply 3 months PP.

    Welcome to the forum! It would help to know a bit more about what is going on with breastfeeding, so although I hate to answer questions with more questions, bear with me!

    - Can you tell us some more about your baby's birth- for example, were you induced, did you have IV fluids, did you have a large volume blood loss, did you have problems with the placenta, did you have any medications, did you have a c-section?
    - Can you give us a complete weight history for your baby, including birth weight, lowest known weight, and weight at each checkup?
    - How often does your baby nurse in a 24 hour period?
    - How does nursing feel?
    - How does pumping feel?
    - What make and model of pump are you using?
    - Are you using any form of hormonal contraception?
    - You've been supplementing with EBM- has it been hard for you to get enough milk for the required supplements?

  3. #3

    Default Re: Still struggling with milk supply 3 months PP.

    -I had a natural vaginal birth, no IV, no medications, placenta delivered intact, with average blood loss.
    -birth weight 6.12, lowest known was 6.6 3 days PP, 1 week 6.7, 2 weeks 6.8, 3 weeks 6.10. So at 3 weeks we started supplementing and she gained 6 oz., the next week with little supplementing she gained nothing. So back to supplementing and she has gained an average of 3 oz/week. current weight is 9.1
    -nurses usually 10 times in 24hr. i feed her on demand at least every 2 hrs during the day and on demand at night (3-5 hr stretches)
    -no latch issues, nursing is comfortable
    -i have the medela freestyle pump, pumping is fairly comfortable. i got back and forth between 21 and 24 mm flanges. i think the 24s are too big because of the amount of areola in the tube, but i seem to have more output with them.
    -no hormonal contraception
    -i usually pump 3-4 oz/day after feeds, i do have donor milk as well if i don't pump enough

    We have done weighted feeds for the last month at a breastfeeding clinic, she has taken 2oz each time. She tends to fall asleep often, i do breast compressions to try to keep her eating and empty my breasts.

  4. #4

    Default Re: Still struggling with milk supply 3 months PP.

    still waiting for a response if you have any advice...

  5. #5
    Join Date
    May 2006
    Posts
    24,794

    Default Re: Still struggling with milk supply 3 months PP.

    Sorry for the slow response! I'm glad you bumped your thread.

    I'm a bit over your situation. On the one hand, it sounds like you are doing everything right- your baby is nursing at a nice frequency, she's nursing at night, nursing is comfortable, you're using a fairly good pump, you're not using hormonal contraception, and yet the baby isn't gaining as fast as one would like and when there's no supplementing the baby doesn't seem to gain well at all. Confusing! Nevertheless, there are a few things that stick out from your post.

    First, the pump. The freestyle is a decent pump, but in your shoes I think I would want to bump up to a hospital grade pump. The difference in yield can be significant.

    Second, pumping itself. You're pumping 3-4 times a day, which is great. But when you want to boost supply, you want to pump as many times as possible. If you can squeeze some more sessions into what is surely a very busy day, I think you will be rewarded.

    Third, the baby is sleepy at the breast. She was a bit early and early babies tend to be sleepy. It's possible that the slow gain is a result of her just being too dozy to take in sufficient calories. So keep on trying to get her to wake up a bit.

    Have you had any bloodwork to see if you have issues which might contribute to low supply? PCOS, thyroid problems- those can cause issues with milk production.

  6. #6

    Default Re: Still struggling with milk supply 3 months PP.

    I have had a little bloodwork, thyroid is normal, HBA1C is normal, but we are treating me like a possible insulin resistance and/or PCOS person anyway based on some symptoms. i have been taking the metformin for almost 3 weeks, with maybe very slight improvement in supply, but still unable to nurse exclusively. I did have the Medela Symphony rental pump for a few weeks before I got the Freestyle, and at the time I didn't have any more output from it, but that was still early on in this journey, so maybe it might work better now. I am trying to squeeze in a few more pump sessions....just challenging with the feed-bottlefeed/SNS-pump routine!

  7. #7
    Join Date
    May 2006
    Posts
    24,794

    Default Re: Still struggling with milk supply 3 months PP.

    Believe me, I know exactly how challenging it can be!!! It's not something I would want to ever have to do again and I always feel like a jerk for suggesting more pumping to a mom who is already doing the supplementing/pumping/nursing thing. I really wish there were some better alternative to more work.

    Did anyone ever check you for a fragment of retained placenta? It seems like a long shot at 3 months postpartum, but maybe you at least want to talk about it with your doc?

  8. #8

    Default Re: Still struggling with milk supply 3 months PP.

    We thought about the retained placenta, but my lochia stopped at 5 weeks. I also randomly had a volunteer ultrasound at work for physicians practice about 1 month PP, which showed my uterus was almost back to normal size and looked normal, so I don't think that would be an issue.

    I'm starting to feel like this is just the way its going to be. She is 4 months old tomorrow, and I'm starting to accept that this might be our nursing relationship. Not at all what I wanted, but I guess better than nothing. I wonder if anyone has had any improvements after 4 months, or if most people have given up trying to increase their supply by now.

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