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Thread: HELP! Increasing milk supply!

  1. #1

    Default HELP! Increasing milk supply!

    My lo is 3 weeks, i was breastfeeding her since the moment she was thrown into my arms however last weekend, I came down with a fever and my ob had me go to the ER to get checked and sure enough i wad sepsis. I was hospitalized for two nights and was away from my baby for almost 3 whole days. I wasn't pumping just bf on demand, so my baby had to go on formula!! Which broke my heart! The hospital had me pump and dump the whole time i was there because i got a CT with contrast but I wasn't consistent( i mainly slept)She currently is still on formula because her doctor wants to me to be off my antibiotics because my doctors do not know where my infection came from. I have been pumping and dumping every 1-3 hours or sometimes before and after i gives her a bottle. But only get about 24 oz a day. I feel like that is low because she's getting 4 oz of formula every 2 hours. How can I increase my milk supply?!? I want her back on only BF! I don't want to give up! I need advice! Any help will do!!

  2. #2
    Join Date
    May 2006
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    24,794

    Default Re: HELP! Increasing milk supply!

    I think the first thing to do is to contact Infant Risk, http://www.infantrisk.com, and to discuss the medications you are on. It is quite possible that you can breastfeed despite being on antibiotics; many doctors do not know when breastfeeding and medication use are compatible, and therefore give overcautious direction about pumping and dumping. I also suggest posting the names of the medication(s) you are taking here on the forum; one of the LLL leaders has access to Hales Medications & Mother's Milk and can check for you.

    On average, exclusively breastfed babies eat about 20-30 oz per day of milk. 24 oz of pump output is therefore not low. It's just about average. The baby's formula intake, 4 oz every 2 hours, is probably excessive at this point if you go by the rule of thumb that a baby should get about 2.5 oz of formula per lb of body weight. And most 3 week-old breastfed babies should not get 4 oz bottles, because intake at the breast is typically 2-4 oz. Offering 4 oz every time baby eats is therefore probably somewhat excessive.

    Tips for keeping the baby breastfed wile figuring out the situation with the antibiotics:
    - Look at paced feeding videos on YourTube. Everyone thinks they know how to bottlefeed, and few of us do. (I count myself in this number, as I am someone who once fed my 2 week-old baby 7 oz, which she promptly threw up.)
    - Consider retaining at least one nursing session per day while the antibiotic situation gets sorted. Even if high exposure to this antibiotic is not compatible with breastfeeding, you may be able to nurse once a day or when the breast is very thoroughly pumped out. Getting the baby to proactive her latching and sucking skills at the breast can help her retain those skills for the future.

    When it comes to maintaining milk supply, here is what I would do:
    - Pump frequently. Your current pump frequency is EXCELLENT! So keep it up if you can. But also do not beat yourself up if there are days when you cannot pump that frequently. Anything you can do is terrific.
    - Use the right pump. An exclusively pumping mom should have a top-of-the-line double electric pump with correctly sized shields. If possible, she should probably use a hospital-grade rental pump.

    Does anyone know where the infection originated? I assume this is birth-related, maybe something from an IV or from the fact that most births involve a lot of people sticking their hands in you. But if the original infection site is in the breast, that would be significant in terms of what we suggest WRT breastfeeding.

  3. #3
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    Jun 2009
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    Default Re: HELP! Increasing milk supply!

    24 ounces per day is actually a normal amount to be pumping as that would be enough for many (if not all) 3 week olds. If your baby is being given 4 ounces every 2 hours around the clock, baby is eating 48 ounces a day and is being grossly overfed.

    If I were you, the first thing I would do is make very sure all this pump and dumping of your milk is needed. Is it really unsafe for your baby to nurse? I honestly do not know anything about sepsis and breastfeeding, but to me it sounds like the doctors are only GUESSING it is possibly a problem for baby to nurse. I am very sorry to say that doctors are often the worst, most unreliable and ill-informed sources of information about breastfeeding. So I would NOT trust their word for it. Is there a board certified lactation consultant at this hospital or a breastfeeding clinic? Anyone you can get breastfeeding supportive information from? Just so you know, mom taking antibiotics is NOT usually a reason baby cannot nurse.

    If indeed you cannot simply immediately start nursing again, here is what I suggest.
    Get baby gradually (but quickly) down to reasonable amount of formula. No more than 30-35 ounces a day should be AMPLE. At this age especially, a baby will want to eat very frequently in very small amounts. This is easy and natural at the breast, but with bottles, baby cannot control the flow and also expects to suckle for a longish time, So baby will keep sucking until it is all gone, way past satiation of any hunger, which is why special steps must be taken to avoid over feeding. Feeding baby every two hours is fine if that is what baby wants, but bottles should be 1-3 ounces at a time, (normally the amount varies feeding to feeding.) 4 ounces at once is simply more than a 3 week old needs.

    I would suggest at this point, consider tossing the bottles and cup feed, with a small open cup, because the realities of cup feeding safety help keep those meals the right size and pace. But if you want to stick with bottles, everyone who gives baby bottles must learn how to do paced bottle feeding. This is a technique that has many components the most important being how baby and bottle are positioned and that caregiver makes sure there are built in pauses to the feeding.

    It is vital baby stops being overfed and baby's formula is given in a breastfeeding supportive way. When this is not done, it leads to breast refusal.

    For pumping as your only means of milk removal, you want to best pump you can afford. It must be a double sided electric, it should ideally be a rented hospital grade pump. If your doctors are telling you to pump and dump, then they should absolutely be providing you with the means to do so without harming production. And that means a hospital grade pump if at all possible.
    Make sure your pump flanges fit you properly.
    Make sure pumping is comfortable for you (as possible) it should not hurt to pump.
    Try to pump at least 8 times a day on average. 10 would be better, but you also do not want to exhaust yourself. If you have a bad day and only pump 6 times, no worries, try to pump at least 8-10 times the next.

    Many moms find adding hand expression or breast compressions to pumping helpful in extracting more milk.

    Article: Bottle feeding Breastfed baby: http://www.llli.org/docs/00000000000...astfedbaby.pdf

    Videos:
    Paced bottle feeding: Doll:https://www.youtube.com/watch?v=UH4T70OSzGs
    Newborn: https://www.youtube.com/watch?v=ykdFuEOIdeE


    Video- Cup feeding newborn: http://www.breastfeedinginc.ca/conte...me=vid-cupfeed
    Last edited by @llli*maddieb; July 16th, 2016 at 11:27 AM.

  4. #4

    Default Re: HELP! Increasing milk supply!

    Thank you for the response. I am currently on Cephalexin(500mg) and Clindamycin HCL(300mg) every 6 hours for 7 days. I have about three more days to go.
    I did go out a rent a pump the one they have at the hospital.
    My own doctor told me it was fine to breastfeed while using these medications, but when i went to my baby's follow up appointment(she didn't gain her birth weight by the two week mark so we had to go back)i told him that she was on formula and I explained to him what went on he was the one who told me to wait.
    I believe my infection was birth related, i had a pelvic exam done and they found tenderness and a foul smell, they ask what i was doing and i said nothing i had no pain no burning and i didn't notice the smell..I've been on my butt since i got home from the hospital. They believe it could have been that i did bleed out a lot after I delivered and i was also GB strep positive, i also went over 24 hours with my water broken. I did tear and got 7 stitches down there but it wasn't infected so it was something inside my body.
    And it was not breasts related i had no lumps or redness.

    I watched those paced feeding videos! Wow I didn't know! Thanks for those!
    I also thought four ounces was too much but 2 ounces was not doing it for her. At first i was doing 2 oz every hour to an hour and a half But she would get fussy so i gave her 4 and it keeps her happy for 2-3 hours sometimes. Her birth weight was 8lbs 3oz. She was a big baby. When we left the hospital she was down 7lbs 13 oz. and by her 2 week mark she was 8lbs 2oz, her doctor still wanted her to come back in a week which was this week and she was up to 9lbs 6oz. When we went she had only been on formula for about three days I don't know if she gained that much weight because of the few days she was on formula or because she was finally nursing right.
    I just want her back on my boob lol
    I miss the bonding, and i want the best for her!

  5. #5
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    Default Re: HELP! Increasing milk supply!

    Pretty sure both those meds are okay for nursing. I know plenty of people take Cephalexin and nurse, Clindamycin I wasn't sure about so I googled. Looks like the only negative consequence for the baby is possible disturbance of gut flora and consequent diarrhea. But that's a possible side effect, not even a probable one. I would call Infant Risk or your local LLL leader right away and get the definitive answer. Because the longer a young baby is on bottles only, the less likely it is that she will go back to the breast.

  6. #6

    Default Re: HELP! Increasing milk supply!

    My Ob told me it was good to nurse while taking them but my lo's doctor asked for me to wait. I waited long enough, i began to nurse her again and last night she refused the bottle. But now i feel like i might have upset her stomach with going back and forth from formula to bm because she was fussy and grunting all night from 2am-7am. I tried everything, she fell asleep on my boob and woke up at 10 hungry. I will bf her all day today to see if she's happier but i hope I'm not too late with my milk supply, I didn't pump as much yesterday because I settled on leaving her on formula.

  7. #7
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    Default Re: HELP! Increasing milk supply!

    Quote Originally Posted by @llli*saenzb View Post
    My Ob told me it was good to nurse while taking them but my lo's doctor asked for me to wait.
    THIS is why Infant Risk exists. One of these docs had no idea what he/she was taking about!

    But now i feel like i might have upset her stomach with going back and forth from formula to bm because she was fussy and grunting all night from 2am-7am. I tried everything, she fell asleep on my boob and woke up at 10 hungry.
    It's a myth that switching back and forth between formula and breastmilk upsets the baby's tummy. I think the formula companies invented that one to convince moms that once you start formula, there's no safe way back from it. If anything, it's formula that is more "upsetting" to a baby's stomach- after all, babies are meant to digest human milk, not a cocktail of cow's milk and corn syrup and other additives. Best thing you can do is to give baby a few days to readjust, be patient with her. She will reestablish a more topical rhthym in time.

    I will bf her all day today to see if she's happier but i hope I'm not too late with my milk supply, I didn't pump as much yesterday because I settled on leaving her on formula.
    Don't worry, a single day of decreased pumping will not kill your supply. And even if a day of decreased pumping did damage your supply, the baby should rapidly get it back to where she needs it to be by nursing frequently.

    How are YOU doing, mama? You had a pretty major health issue. Are you feeling okay? Getting enough rest, and enough help?

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