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Thread: PPD, Low Supply, and Supplimenting

  1. #1
    Join Date
    Mar 2009
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    12

    Unhappy PPD, Low Supply, and Supplimenting

    I'm pretty distraught. I'm pretty sure I've had PPD (at least mildly), and now with current events, I think it's gotten worse.

    So, I went to see a lactation specialist Wednesday. My poor baby had lost 15% of her birthweight and wasn't gaining yet- she's 3 weeks old. She was born at 9lbs. 10 oz. The birth was induced (42 weeks) but otherwise unmedicated. Pitocin was only used during the last few hours of labor, and I was taken off of it (due to my arm swelling like a balloon) almost immediately afterward.

    The weight loss went this far because other than the weight loss, she is a happy alert baby who looks healthy- just getting thin. The only real problem was that she was nursing around the clock (though her habits were changing daily), and wasn't always swallowing. My supply was all over the place- I had no measurments, I'm going off of a feeling of fullness and how much she swallowed.

    At the consult, I managed to give her a half oz. after 10 min on each breast. Then I pumped a half oz. after 10 min on each breast.

    The Specialist said that I should be giving her 3 oz. every 3 hours with her size/age. She said that she didn't like it, but she thought I should suppliment. I nearly cried right there. She offered to give Anaka (my baby) some formula right then, and gave DH and I some time alone to talk it over.

    DH is VERY supportive. We both agreed that this wasn't what we wanted, but we needed our baby to be healthy. We decided to go ahead and get her some formula at the clinic to make sure she would take a bottle in the first place (she's rejected pacifiers outright).

    Anaka took the bottle just fine, but after getting 2 oz. of formula, she spit most of it back up. She gave us a good burp, and then spent the next 2 hours quietly alert, or asleep. This was totally out of character for her. It hurt, but I was hopeful.

    The plan is/was every 3 hours to feed her on the breast, 10 min each breast, then give her some formula (work my way up to 3oz. since her tummy is too small right now). Then pump 10 min. each breast. I am to give her the expressed milk before I give her the formula. The idea is to up my supply, while making sure Anaka is still taking in enough calories. Eventually I would cut out the formula entirely.

    The problem so far is that I am not able to stick to this plan so well. Anaka will not be sated for 3 hours. It only took 2 till she was fussing and rooting after the consult. It went downhill from there.

    She wasn't keeping down 2 oz. and was showing signs of hunger every hour. I decided that we'd just feed her on demand still, and spread out the formula. So when she started rooting and fussing, I'd put her to the breast. Then I'd try and give her a half oz. of formula at a time to try and reduce the spitting up.

    The result that is killing me is that I seem to be producing less and less milk when I pump. I know, it's only been a little over 24 hours, but I'm freaking out. The upside, that I am hopeful about, is that Anaka seems to be swallowing a lot more (and consistantly) at the breast...

    It breaks my heart every time I give her a bottle. It's gotten to where sometimes I have to hand her off to DH to feed because I can't take it.

    Any recommendations would be welcomed. I feel like friends are encouraging me to give up, and all their "it's ok" isn't helping at all because they're all pro formula. The lactation specialist was very complimentary, but it wasn't much comfort to me. My baby is doing everything she's suppossed to- good latch, good signalling that she's hungry. She even prefers my milk to the formula so far... I don't want to ruin any of that, but my body just isn't working with us as well as I'd like.

    I'm sorry this post is so long... I'm just really having a hard time. I really just want to enjoy my baby and feeding her.

  2. #2

    Default Re: PPD, Low Supply, and Supplimenting

    Hi

    I am experiencing the same problem. My baby wasn't gaining weight, and the health visitor advised to start top-ups with formula milk. Since then she gained weight and seems to be calmer. However, she spends less time on the breast (max 5-10 mins and then gets very irritated), which affects my already poor milk supply. But I am determined to give her as much as I have, so I continue to express milk and mix it with the formula. I am having well balanced diet and drink plenty of liquids, but it doesn't make my milk supply better.

    It is very depressing, as I never wanted to bottle feed, but the baby's health is more important.

    Is it worth visiting a lactation consultant?

  3. #3
    Join Date
    Jun 2008
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    Landof2toddlers, Oregon
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    3,113

    Default Re: PPD, Low Supply, and Supplimenting

    Mama

    I am so sorry that that is where you are right now. I have been in exactly the same place you are and it sucks... But I have some advice too.

    First, know that that amount of weight loss is not unusual in a very large (especially induced babies). I assume you had an IV for a while - that basically pumps their birth weight to more than it was supposed to be - so when they do the weight loss it also looks like more than it was "supposed" to be.

    Secondly, your supply may be better than you experienced at the LC. Supply ebbs and flows throughout the day. You may have been at the LC at the exact wrong time of day for you.

    Thirdly, you can increase your supply. Did the LC say anything about your baby's latch, provided that is good the following should help:
    • Do not go longer than 2 hours between feeding (you can up this to 3 hrs during the night if you baby stays happy). But other than as a maximum gap do not watch the clock. Watch your baby - she will tell you if she is hungry (most brestfed babies cannot go more than 1.5 hours without eating when there are as young as yours). Your baby's suck is the best thing to induce supply.
    • Try taking large amounts of fenugreek (you can get it in capsule format from health stores etc),you can also get mother's milk tea, blessed thistle and a few other herbs. These are natural galactalogues and can have an amazing effect for a lot of women.
    • Eat oatmeal a couple of times a day (seriously - it sounds like nothing but there are moms who find this is enough all by itself)
    • pump every.single.time you give your baby formula (this was the hardest for me but if your breasts aren't getting stimulation from the baby they need to get it from the pump) - it is totally worth investing in a good double electric pump (if you will be going back to work you might as well buy one otherwise I would advise renting a superduper hospital grade pump from the hospital or LC.
    • Rest when your baby naps. And if your baby isn't sleeping (mine wasn't) have someone take the baby out for long walks a couple of times a day and you should get as much sleep as you can, because your body probably needs to recharge.
    • Try not to stress too much and make sure you take advantage of all the support you have. Stress can be a supply killer and it is a vicious circle when you get stressed, supply goes down then you stress about your supply. I know that from first hand experience. Know that for most women supply pops right back up when they get the help they need (and for the very unlucky few where that doesn't happen you can still have a successful nursing relationship - even if it is not what you wanted and has to be supplemented with formula).
    • Enjoy your baby, get skin to skin as much as possible. Spend the day in bed with your baby you topless and the baby in just a diaper don't get up except to go to the bathroom and change diapers. Read, sing, watch movies - just hangout. This can encourage the baby to suck and your body to produce more - the power of pheremones.

    FWIW I think your LC is an ass - 3 hours is far too much between feedings. You have great instincts and are doing everything you can for your baby. And you may be pumping less because your baby is taking more of your supply. If the baby is very efficient you will basically not be able to pump anything - so maybe things are getting better.

    ETA: go see your ob/mw - they can screen you for PPD (it might just be baby blues and stress over supply). PPD is 100% treatable and you don't have to suffer. You will be a better mom if you get treated (if you have it) and it will seriously help your nursing relationship.
    Last edited by @llli*durhamgrrl; August 9th, 2009 at 09:13 AM. Reason: forgot OP mentioned PPD
    proud but exhausted working mammy to two high needs babies

    • my surprise baby: the one and only D-Man born 3 weeks late (5/5/08) at 9 lbs 14 oz and 21.5 inches, and
    • the shock H-Girl born about a week late (10/7/09) at 8lbs 15oz and 20.75 inches.


    If I am here I am covered in baby (probably two) and fighting for control of the keyboard.

    Family beds are awesome

    Wondering if you have PPD? Take the screening and see your doctor. You deserve to feel better.

  4. #4
    Join Date
    Jun 2008
    Location
    Landof2toddlers, Oregon
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    3,113

    Default Re: PPD, Low Supply, and Supplimenting

    Quote Originally Posted by @llli*little.star View Post
    Is it worth visiting a lactation consultant?
    Make sure the LC is an International Board Certified Lactation Consultant (IBCLC). If you have a new mom's group try asking the leader or you can check with your hospital or birth center or ob/midwife.

    Also try and contact your local LLL leader, they can give you lots of advice and do some of the things the LC would do - like check latch.
    proud but exhausted working mammy to two high needs babies

    • my surprise baby: the one and only D-Man born 3 weeks late (5/5/08) at 9 lbs 14 oz and 21.5 inches, and
    • the shock H-Girl born about a week late (10/7/09) at 8lbs 15oz and 20.75 inches.


    If I am here I am covered in baby (probably two) and fighting for control of the keyboard.

    Family beds are awesome

    Wondering if you have PPD? Take the screening and see your doctor. You deserve to feel better.

  5. #5
    Join Date
    Mar 2009
    Posts
    12

    Default Re: PPD, Low Supply, and Supplimenting

    First off, we're doing a lot better. Thank you for the advice. Sorry I have taken so long to respond, I had a weekend essentially alone with the baby, so we had a "nurse-in."

    Here is the news-

    1) About the 3 hour mark:

    I didn't go that long except at night. She sleeps VERY well at night, in fact maybe a little TOO well. I'm going to have to start sitting up to feed at night because baby and I will sleep through a feeding, and she'll wake up quite hungry and upset later.

    We did about 1 to 1.5 hours between feedings, and feedings typically lasted 45min to an hour. DH was gone, so pumping was pretty much out- I let Annie (baby) do it for me . So it was 10 min on each breast, then a few ounces of formula (she'll take 1-2.5 ounces at a time depending) and then back on the breast as long as she wanted. Between these there were burp-breaks and a little bit of "face time" to get her more alert.

    I think having Anaka do the "pumping" was the big difference. I'd like to build up some stored milk so I can get out a little more, but I'll just take it slowly.

    Typically she'd fall asleep in my arms, head rested on my breast (she's adorable) but I couldn't put her down longer than a bathroom break before she was crying again. So I think I pumped maybe 4 times, all weekend. Something to work on.

    2. Supply Issue and Pumping:

    Things are looking up! I managed 3/4 of an ounce at the follow-up appointment and that was just with Anaka "fooling around" and not getting a good feed. She loves to BF and pretty much suckled a bit, then hugged my breast while checking out the room. I don't think she was even on a full 5 minutes- so my milk is flowing a lot better.

    When I DID get to pump (DH came home) I managed to pump nearly an ounce from just one breast (10 min)- I am feeling a LOT better. So far I haven't had to up the amount of formula she's taking, my milk is taking care of that.

    3. Weight Gain/Loss:

    Anaka gained 11oz. in the 5 days we were given! The LC called her a little over-achiever and was pleased with my methods of feeding- actually she was happy with our modified schedule before she even weighed Annie.

    I think there may have been a slight misunderstanding- she wanted Annie to get 3 oz. within 3 hours. The feeding method (breast, bottle, then pump) was mostly a guideline to get me going.

    4. Oatmeal and Fenugreek:

    I have yet to try this- I will. I want to cut out the formula entirely.

    5. Something Nice:

    The LC did give us a manual pump, some bottles, and some formula all for free our first visit, and then this visit we were given a whole case of formula. This was welcomed since DH and I are unemployeed. I don't think she's formula-happy, since she is supporting my goal to cut out the formula entirely. Also, they don't sell any formula at their little store, only BFing supplies.

  6. #6
    Join Date
    Jan 2009
    Posts
    5,883

    Default Re: PPD, Low Supply, and Supplimenting

    I have a lot to as having had a hard time early on but I'm on my phone and it's dinner time so I need to come back.

    First, rent a hospital grade pump or invest in a pump in style advanced or ameda purely yours. A double electric pump. If you need to keep pumping. You are pumping a great amount for a MANUAL. I can't pump with one at all.

    Second, set am alarm clock at night for every three hours. It's imperative with a slow gaining baby to get calories in her every three hours at night.

    Third, you as doing an awesome job and have very good instincts. I don't think your body is failing you at all. I think you guys are just off to a slower start. However, it is worth having your OB check you out for thyroid problems that could contribute to low milk supply.

  7. #7
    Join Date
    Mar 2009
    Posts
    12

    Default Re: PPD, Low Supply, and Supplimenting

    Ugh... took so long to respond because I've been trying to use my little breaks to get things done around the house. We also had a new roommate move in (to replace the one that moved out)

    I haven't been able to consistantly pump at all this past week, and DH keeps pushing to get out of the house Either by himself, or all of us. I think he might be dealing with a little depression as well. He's very supportive, and a real partner (he's cuddling DD right now so I can be on the computer)... but he doesn't always understand, or have the same priorities I do.

    ANYWAY - yeah, I should buy/rent an electric pump. I've looked into it, and boy are some of them pricey! I need to get on WIC, they have pump rentals too. It's just rough getting out of the house, especially when DH keeps wanting to add more outings. I don't feel comfortable BFing in public yet. I'm working on it, but it still makes me uncomfortable... mostly because I feel like I'm making everybody else uncomfortable.

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