Happy Mothers Breastfed Babies
Page 2 of 2 FirstFirst 12
Results 11 to 19 of 19

Thread: Another "please help": low milk supply & risk of over-supply

  1. #11
    Join Date
    Jun 2009
    Posts
    10,739

    Default Re: Another "please help": low milk supply & risk of over-su

    She was weighed today and since 2 weeks, she has gained 0.63 pounds.
    since she was 2 weeks old she gained a little over half a pound? or do you mean in the last 2 weeks? Also you can report in metric if that comes more natural to you. I can convert it as long as I understand what type of unit you are using. Also, to me, .63 pounds would be about 10 ounces. Am I understanding what you meant by .63 pounds correctly?

  2. #12
    Join Date
    Aug 2017
    Posts
    26

    Default Re: Another "please help": low milk supply & risk of over-su

    Quote Originally Posted by @llli*maddieb View Post
    since she was 2 weeks old she gained a little over half a pound? or do you mean in the last 2 weeks? Also you can report in metric if that comes more natural to you. I can convert it as long as I understand what type of unit you are using. Also, to me, .63 pounds would be about 10 ounces. Am I understanding what you meant by .63 pounds correctly?
    She gained 0.29kgs - I actually don't know what it is in ounces. Yes, in the last two weeks. Sorry it was unclear.

  3. #13
    Join Date
    Aug 2017
    Posts
    26

    Default Re: Another "please help": low milk supply & risk of over-su

    Quote Originally Posted by @llli*maddieb View Post
    Hi again. I get it that you are thinking baby cannot nurse properly...but you really do not know if that is the case, it is at this point a suspicion, unless I am misunderstanding something here. And this is actually a very common suspicion that is often unfounded, and when a baby has been bottle fed and/or mom is pumping, the vast differences between pumping and bottles v. nursing at the breast tend to increase this suspicion. The concern that baby is not getting enough to eat at the breast, whether due to low production or some other issue, is one of the most common reasons moms stop nursing. But in fact often baby is transferring milk just fine and there is no problem with production, or when there is any issue, it is much more minor and more easily addressed than mom thinks.

    Here is how you tell a baby is getting enough to eat. Weight gain, accurately measured, is all the info you need. If a baby is gaining normally exclusively breastfed, there is almost certainly no problem. (Unless nursing hurts mom, that is the other main problem when it comes to breastfeeding.) You do not have to see an IBCLC to get properly done weight checks. Properly done weight checks means:

    Checks are done on the same digital, professional grade infant scale. It has to be the SAME SCALE each time, and if the scale is recalibrated between weight checks, you need to know that.
    Baby is naked or in a dry diaper
    Check is done carefully by someone who has the patience and knowledge to accurately weigh a squirmy baby.
    Number on scale is checked and rechecked and if something seems odd (like weight loss recorded in a 4 week old) the baby is weighed again and the scale checked out.
    Any math conversion is checked and rechecked.
    Weight checks are a reasonable time apart. Since babies do not gain exactly the same each day, but rather in fits and starts, the longer time elapse between two checks the more overall accurate your check will be. But of course when there is a concern baby is not getting enough, checks may need to be more often...just be sure to remember that gain in fits and starts is normal and try to look big picture.
    Conversions math is checked and rechecked

    The other way to measure how well a baby nurses is to do before and after nursing weight checks. What you want to see is that baby can transfer 2 ounces or more over about 20-30 minutes with baby nursing both sides in that time. That is the rule of thumb for indicating normal transfer when this type of check is done. The problem with before and after nursing checks is 1) you need to use a very accurate scale and know how to use it to do them properly and 2) sometimes baby is perfectly capable of getting enough milk but just not that hungry or for some other reason not nursing well when the check is done. So it really helps to have several of these done, unless of course your result is very good the first time.

    Have you tried adopting a more laid back nursing position? You leaning back (as little or as much as you like, but not flat on your back) and baby kind of on top of you? This often helps with "slippage"
    As far as holding baby's head, it is true that applying pressure on the back of baby's head can cause baby to reflexively push back into your hand or arm or whatever, and consequently this causes baby to pull away from the nipple and can cause baby to have a shallow latch or to pull on the nipple or to pop off. But in my experience it often does help to prop baby's head a bit with a hand or arm or whatever, maybe without pressing on the back if that is causing a problem. breastfeeding positioning is not about following the rules but about playing around and finding what works for you.
    Well this is only a problem if baby is not getting enough to eat because baby is sleeping too much and nursing too little. It is normal for baby to fall asleep when nursing.
    If you think baby is falling asleep because baby is shutting down because they are not getting enough milk, there are many ways to "rev baby up"- Breast compressions may help (search jack newman breast compressions) you can try stroking baby, pumping hand or foot, jiggling baby's chin, etc.
    Thank you MaddieB!

    That is all very helpful

    Have you tried adopting a more laid back nursing position? You leaning back (as little or as much as you like, but not flat on your back) and baby kind of on top of you? This often helps with "slippage"
    Yes, she cannot seem to get the milk out - I used to think it was because she couldn't "grasp" the skin as it's too soft. But maybe it is an anatomical issue.

    I am just done BF and she finished unhappy and crying, I am now pumping because without it I'm worried supply will drop. Pumping immediately yields me milk but she can't. I'm at my wit's end, she won't take the bottle either and rather be hungry. I am thinking she probably does have lip and tongue tie, I really didn't want her to undergo laser for it but I may have to at this rate.

    Re: weight gain, I agree. What I am seeing is her lose her momentum of weight gain. I can also go to a breastfeeding clinic where they will weigh her before and after eating..

    Thanks again...maddieb...
    Last edited by @llli*lllkaren; August 26th, 2017 at 09:57 AM. Reason: added quote tags for clarity

  4. #14
    Join Date
    Jun 2009
    Posts
    10,739

    Default Re: Another "please help": low milk supply & risk of over-su

    Yes, she cannot seem to get the milk out - I used to think it was because she couldn't "grasp" the skin as it's too soft. But maybe it is an anatomical issue.
    I would suggest adjusting the position- how much you lean, and how exactly baby is positioned. The nice thing about laid back (and really most nursing positions) is that there are endless variations to experiment with.

    I am just done BF and she finished unhappy and crying,
    So she started crying while nursing, came off the breast, and refused to latch again? I am trying to understand what you mean by she was finished.

    .29 kg is a slightly over 10 ounces. This would be normal gain for 2 weeks because it would average out to 5 ounces a week, and while that is on the low end of normal gain rate, it is still normal gain, as normal average gain in the newborn period (2 weeks to 3 months) is 5-8 ounces per week.

    In the previous 2 weeks while supplemented, iirc, your baby gained 3 pounds. This is three times normal gain. There is no way that would be a sustainable weight gain rate. Of course it reduced and reduced substantially. Also because baby was gaining so fast when supplemented, it makes sense gain would slow down this much so things "even out" with overall gain.

    Weight gain happens in fits and starts and the most accurate way to measure gain is to step back and look at the big picture. At this point it is hard for you to do this because you are comparing time periods of supplementing to time periods of not supplementing, and that is confusing the issue.

    Weight gain rate also slows down over time. The first 3 months generally speaking baby gains much faster than the next 3 and it keeps gradually reducing.

    You believe your baby is not doing well extracting milk and I believe you. However your baby's gain would indicate that while there may be a problem in this area, it is probably a fairly minor one that just may require a few simple adjustments to fix. Adjustments might include using breast compressions, encouraging baby to nurse more often, too nurse longer, and getting in person help to ascertain if baby really is having an issue extracting milk and why, and what strategies might help.

  5. #15
    Join Date
    Aug 2017
    Posts
    26

    Default Re: Another "please help": low milk supply & risk of over-su

    Quote Originally Posted by @llli*maddieb View Post
    I would suggest adjusting the position- how much you lean, and how exactly baby is positioned. The nice thing about laid back (and really most nursing positions) is that there are endless variations to experiment with.

    So she started crying while nursing, came off the breast, and refused to latch again? I am trying to understand what you mean by she was finished.

    .29 kg is a slightly over 10 ounces. This would be normal gain for 2 weeks because it would average out to 5 ounces a week, and while that is on the low end of normal gain rate, it is still normal gain, as normal average gain in the newborn period (2 weeks to 3 months) is 5-8 ounces per week.

    In the previous 2 weeks while supplemented, iirc, your baby gained 3 pounds. This is three times normal gain. There is no way that would be a sustainable weight gain rate. Of course it reduced and reduced substantially. Also because baby was gaining so fast when supplemented, it makes sense gain would slow down this much so things "even out" with overall gain.

    Weight gain happens in fits and starts and the most accurate way to measure gain is to step back and look at the big picture. At this point it is hard for you to do this because you are comparing time periods of supplementing to time periods of not supplementing, and that is confusing the issue.

    Weight gain rate also slows down over time. The first 3 months generally speaking baby gains much faster than the next 3 and it keeps gradually reducing.

    You believe your baby is not doing well extracting milk and I believe you. However your baby's gain would indicate that while there may be a problem in this area, it is probably a fairly minor one that just may require a few simple adjustments to fix. Adjustments might include using breast compressions, encouraging baby to nurse more often, too nurse longer, and getting in person help to ascertain if baby really is having an issue extracting milk and why, and what strategies might help.
    By finished I meant that I unlatched her and put her to bed. She was not happy with this. Usually I like to respect her and let her come off herself (although that is rare except at night when my breasts are engorged/hard/full)

    Thank you Maddie I have an appointment now (with your support) to see an IBCLC on Friday now. I also experimented today with laid back - it was a relief as I am so intensely exhausted after the last few days and had a strong headache.

    Thank you so much for the help (and for offering me a different, non-panicky perspective)

  6. #16
    Join Date
    Jun 2009
    Posts
    10,739

    Default Re: Another "please help": low milk supply & risk of over-su

    it was a relief as I am so intensely exhausted after the last few days and had a strong headache.
    Ugh that is the worst. Make sure you are staying well hydrated! very important. I hope the LC is helpful for you.

    She was not happy with this.
    Yes Many babies prefer to be held when sleeping at this age and do not appreciate being put down! This does not necessarily mean baby is still hungry, but even the non-hungry baby may want to nurse more. If you have some one else there to hold sleeping baby so you can get a break it may help.

  7. #17
    Join Date
    Aug 2017
    Posts
    26

    Default Re: Another "please help": low milk supply & risk of over-su

    Update...

    I went to see an LC. Very good one, and helpful. LO also clusterfed for a # of nights. LC recommended I reduce pumping and wean off gradually. And stick to 60 grams of domperidone.

    Since yesterday my supply seems good, esp as I stopped pumping (all together today) - but now ironically it feels like a lot of milk. Sometimes it drips from baby's mouth.

    She also cries a lot now, like it's too much.

    Q:

    1. Should I reduce domperidone?
    2. Is cold turkey not pumping stupid?
    I find not pumping now seems to mean more milk for baby but also clusterfeeding seemed to boost supply
    3. Baby is still nursing but is extremely stressed by the milk. She now clamps down more just at nipple section and I let her because maybe this way she controls milk better..

    Thanks,
    B.

  8. #18
    Join Date
    Jun 2009
    Posts
    10,739

    Default Re: Another "please help": low milk supply & risk of over-su

    Hi again! When under the care of the LC, I suggest always also ask LC your follow up questions. She is going to have the most complete understanding of what is going on plus we on here are not LCs.

    If you are finding that you now make more than enough milk, it seems that it would make sense to wean off the dom and the pumping. But with the dom I cannot tell you how to safely do that.

    Stopping pumping cold turkey may be a bad idea if you are finding yourself engorged or even just uncomfortable due to less milk removal. If baby is nursing as much as baby will and you are becoming engorged or uncomfortable, you can pump or hand express as needed to be comfortable, gradually reducing how much you do so. Just remember to only pump or express as often and as long as needed to be comfortable- not to "empty" the breasts.

    For fast letdown, Encourage baby to nurse frequently. try leaning back position with baby on top. Nursing one side at a time is probably fine if that is what baby prefers.
    If baby is having a hard time with fast flow after latching, take baby off, let the initial flow go into a cloth, and then relatch baby.

    Fast flow is usually related to mom making "too much" milk. Your body naturally wants to make enough, not too much. So, this is a self correcting problem in almost all circumstances. It just takes a little time.

  9. #19
    Join Date
    Aug 2017
    Posts
    26

    Default Re: Another "please help": low milk supply & risk of over-su

    Quote Originally Posted by @llli*maddieb View Post
    Hi again! When under the care of the LC, I suggest always also ask LC your follow up questions. She is going to have the most complete understanding of what is going on plus we on here are not LCs.

    If you are finding that you now make more than enough milk, it seems that it would make sense to wean off the dom and the pumping. But with the dom I cannot tell you how to safely do that.

    Stopping pumping cold turkey may be a bad idea if you are finding yourself engorged or even just uncomfortable due to less milk removal. If baby is nursing as much as baby will and you are becoming engorged or uncomfortable, you can pump or hand express as needed to be comfortable, gradually reducing how much you do so. Just remember to only pump or express as often and as long as needed to be comfortable- not to "empty" the breasts.

    For fast letdown, Encourage baby to nurse frequently. try leaning back position with baby on top. Nursing one side at a time is probably fine if that is what baby prefers.
    If baby is having a hard time with fast flow after latching, take baby off, let the initial flow go into a cloth, and then relatch baby.

    Fast flow is usually related to mom making "too much" milk. Your body naturally wants to make enough, not too much. So, this is a self correcting problem in almost all circumstances. It just takes a little time.
    Thank you so much Maddie!

    LC is on holidays for 3 weeks - but she left me with a plan.

    Today I am freaking out a bit as my supply (after a few days of not pumping and reducing dom) seems to have gone down instead. Anyway...I will see. You are right about taking time. I pray this time it will work out well so that baby is not hungry and I have a good supply for her.

    thank you again

Tags for this Thread

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •