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Thread: Options for increasing supply? I've tried a lot already...

  1. #1
    Join Date
    Jun 2010
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    10

    Default Options for increasing supply? I've tried a lot already...

    Hi all,

    I have been working for six weeks to increase my supply. My son is 8 weeks old and we are breast feeding around 12 times per day. About 3 times per day he finishes both breasts and then starts to frantically kick, punch, cry, and bob his head on and off the nipple. If we try to calm him with walking, jiggling, swaddling, changing, etc, he continues rooting and violently sucking his fist.

    I should point out that he was slow to gain weight early on. He was born at 6 lb 14 oz and didn't regain his birth weight until week 3. Maybe he is just playing catch up?

    Because of our early BFing challenges, I have been seeing a lactation consultant for six weeks. We have tried pumping after feeding, massaging my breasts during feeding, fenugreek, more milk plus, and now I am on domperidone. After one week I haven't noticed much difference. The doctor that prescribed the domperidone now suggested shatavari. But I noticed on a random website that you are not supposed to take both domperidone and shatavari? Has anyone heard why or know if this is true?

    In the meantime, I have been supplementing with formula because he is definitely still hungry. This is also based on the LC's recommendation. He is asking for about 10 oz per day. We started supplementing at week 2 because he was too lethargic to eat. Half the time I use a syringe with feeding tube, and the other half I use a bottle (now with the Kassing method).

    I am hoping you all will have some suggestions on how to proceed!!

    thanks so much,

    T&J

    I'm pasting his weight history below, for more context:

    All naked weights

    Birth (17 April): 6 lb 14 oz

    3 days (20 April): 6 lb 4 oz

    2 weeks (3 May): 6 lb 7 oz

    2.5 weeks (6 May): 6 lb 10 oz
    started taking fenugreek at 5.4 g per day

    3 weeks (10 May): 6 lb 15 oz
    LC recommended supplement as needed

    4 weeks (14 May): 7 lb 4 oz
    LC recommended 4-6 oz supplement per day

    5 weeks (21 May): 7 lb 9 oz
    LC recommended Kassing method for bottle feeding, supplement 4-6 oz/day

    6 weeks (27 May): 7 lb 15 oz
    LC recommended supplement as needed if he is still hungry
    Also suggested I see director of lactation program about domperidone and possible thyroid issues

    7 weeks (3 June): 8 lb 12 oz on different scale
    prescribed domperidone at 20 mg for 2x per day

    8 weeks (11 June): 9 lb 9 oz
    raised domperidone to 20 mg for 3x per day and suggested shatavari at 2-3 g per day

  2. #2
    Join Date
    Jun 2008
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    Landof2toddlers, Oregon
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    3,113

    Default Re: Options for increasing supply? I've tried a lot already...

    That is a tough place to be. I am going to ask some questions first so I don't suggest a bunch of stuff you have already tried.

    How many wet and dirty diapers are you getting a day?
    When your LC did the weight-feed-weigh thing how many ounces did your baby get?
    Can you give us a general idea of how you feed the baby, in terms of times of day and when you supplement etc?
    Have you tried power pumping? (pump for 10 minutes, rest for 10, pump for 10 etc for an hour?) If you did how much did you pump?
    When you pump after nursing do you get anything
    Have you tried nursing-supplementing-nursing (start and finish at breast)
    How is your baby's suck now? And his latch?

    Sorry, I have never ever heard of shatavari.

    I just did some quick calcs on kellymomand your LO is certainly gaining very well these days (the average for a breastfed baby is 5-7oz/week during the first 17 weeks) - I might be willing to try back slowly off the formula to see how it went (and very carefully watching the number of wet diapers so you can ramp back up if necessary). You might be pleasantly surprised by how your supply has increased with the dom
    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.

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

  3. #3
    Join Date
    Jan 2009
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    5,883

    Default Re: Options for increasing supply? I've tried a lot already...

    Good input from pp.

    www.drjacknewman.com has a protocol for domperidone and he lists the starting dose at 30mg three times a day.

  4. #4
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    Jan 2009
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    lookingforchange!!
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    Default Re: Options for increasing supply? I've tried a lot already...

    Good q's from durhamgrrl -
    And what makes you think you have a shortage?
    My LO always seemed hungry but it was more his sucking reflexes...
    But let see some responses....


    We've made it 1 YEAR




    A newborn baby has only three demands. They are warmth in the arms of its mother, food from her breasts, and security in the knowledge of her presence. Breastfeeding satisfies all three. ~Grantly Dick-Read

    Stacey

    Married to DH since 2001
    Mommy to Mikki 2006
    Mommy to Xander 2008

  5. #5
    Join Date
    Jun 2010
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    10

    Default Re: Options for increasing supply? I've tried a lot already...

    How many wet and dirty diapers are you getting a day?

    15 wet and 1 poop (we use cloth)

    When your LC did the weight-feed-weigh thing how many ounces did your baby get?

    It varied from ~30 cc to 50 cc, total both breasts

    Can you give us a general idea of how you feed the baby, in terms of times of day and when you supplement etc?

    The last 24 hours we had 20 feedings at the breast. I count a feeding as finishing both left and right. About three times during the day he starts to do the "I can't get anymore" dance - kicking and punching and bobbing his head on and off the nipple, and eventually getting frantic and screaming. At night he seems to be fine. He sleeps only about 3 hrs at a stretch and a total of 12 hrs per day with naps. All I do these days is nurse!

    Have you tried power pumping? (pump for 10 minutes, rest for 10, pump for 10 etc for an hour?) If you did how much did you pump?

    No! Cool idea.... tho I can only manage 1-2 pumpings per day b/c he is always on me... But maybe I can do it during a long nap.

    When you pump after nursing do you get anything

    I have pumped after feeding and get ~15 cc total both breasts with rented Medela Symphony

    Have you tried nursing-supplementing-nursing (start and finish at breast)
    yes


    How is your baby's suck now? And his latch?

    Great suck and great latch (LC checked this). It seems like he can't get a let-down

    thanks!!

  6. #6
    Join Date
    Jun 2010
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    Default Re: Options for increasing supply? I've tried a lot already...

    Oh and I should mention that I use a syringe with feeding tube about half the time to supplement with formula. He has been getting 9-10 oz of formula per 24 hours over the past week. A few times he has demanded 4 oz at a sitting AFTER feeding at the breast!! This shocked both us and the LC. He does not spit up.

    Today I have tried walking him around and bouncing and soothing when he does his dance, and he does eventually calm down but is rooting and sucking my shoulder or his hand the whole time. We then sit down again to nurse and it seems a bit of milk has come back so he can get some. But many times he just will not be consoled and is displaying all the usual feeding cues.

    So... my instinct to avoid letting him "crying it out" has usurped my desire to avoid formula! If he is hungry, I want to feed him! It breaks my heart that he can't get what he needs from me.

  7. #7
    Join Date
    May 2006
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    Default Re: Options for increasing supply? I've tried a lot already...

    Good questions and suggestions from the PPs. I'd like to suggest a trip to your doc to check a couple things. First, your thyroid. Thyroid problems (both hypo thyroid and hyperthyroid) are common postpartum, and can affect supply. Second, talk to your doc about retained placenta- sometimes that can inhibit milk production.

    Until then, pump as much as possible. When I had supply issues, I pumped every 2 hours during the day and every 3 at night.
    Coolest thing my big girl said recently: "How can you tell the world is moving when you are standing on it?"
    Coolest thing my little girl sang recently: "I love dat one-two pupples!"

  8. #8
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    Default Re: Options for increasing supply? I've tried a lot already...

    Quote Originally Posted by @llli*quendi View Post
    How many wet and dirty diapers are you getting a day?
    15 wet and 1 poop (we use cloth)
    If you are getting 6-8 there is enough milk going in. Anything over and above is gravy. (I get panicy that they are not wet enough so I put 3 tablespoons of water in a diaper to know what they were supposed to be like. This is the best way to know things are going well when you add a galactologue or decide to reduce supplementing with formula.
    When your LC did the weight-feed-weigh thing how many ounces did your baby get?
    It varied from ~30 cc to 50 cc, total both breasts
    Yeah. That is about what I got. It is good to keep in min that bf babies need between 1 and 1.5 oz per hour (or thereabouts). If you are feeding veryfrequently (and you are) there is likely to be much less "on offer" every time baby nurses. Just like you can eat 3 large meals or a lot more little snacks.

    Can you give us a general idea of how you feed the baby, in terms of times of day and when you supplement etc?

    The last 24 hours we had 20 feedings at the breast. I count a feeding as finishing both left and right. About three times during the day he starts to do the "I can't get anymore" dance - kicking and punching and bobbing his head on and off the nipple, and eventually getting frantic and screaming. At night he seems to be fine. He sleeps only about 3 hrs at a stretch and a total of 12 hrs per day with naps. All I do these days is nurse!

    it is so hard at this point. But it will get better. Moms with no issues find it really tough in the first few months and you are doing way more than most. Sleep sounds well within the bounds of normal. Are the inconsolable times in the evening (or at regular times)? If it is the evening it could just be a form of colic/fussy evenings/clusterfeeding. If it is regular, it could be a time when your body hasn't been able to recharge enough. The hormones involved in milk production have cycles (so for most women their supply is highest in the early hours of the morning. Conversely there are down times.

    Have you tried power pumping? (pump for 10 minutes, rest for 10, pump for 10 etc for an hour?) If you did how much did you pump?

    No! Cool idea.... tho I can only manage 1-2 pumpings per day b/c he is always on me... But maybe I can do it during a long nap.
    my son never napped and it was impossible for me to pump after every nursing and still look after him, so this worked better for me too. And anything you do get can be used to supplement during the hungry times. But this is more for stimulation than anything.

    When you pump after nursing do you get anything
    I have pumped after feeding and get ~15 cc total both breasts with rented Medela Symphony
    This might seem like a bad thing, but it is actually good. It means you baby is nursing efficiently and not leaving a lot in the breast.

    Have you tried nursing-supplementing-nursing (start and finish at breast)
    yes
    Sometimes this helps with the nipple confusion and makes sure that all comfort nursing is done at the breast.

    How is your baby's suck now? And his latch?

    Great suck and great latch (LC checked this). Yay good signsIt seems like he can't get a let-down
    thanks!!
    here is some information on letdown. I highly recommend finding some stress relievers (I know there is a lot of stress for you right now). Some of my favourites were nursing in the bath - both my kids LOVE the water, and the skin-to-skin day in bed.

    Now, are you getting any support? Is your significant other home? Do you have family close by? Are you trying to cook and clean as well as baby care? Sometimes the best thing you can do is drop everything, make sure you have enough to eat and drink and snuggle with your baby. Read or watch tv while they nap if you can't manage to nap with them.

    Do you have a moby or sling so you can wear your baby. If you are nursing as much as you are it can be difficult to do anything other than sit in a chair and go crazy. The moby really helped me as DD could nurse anytime but I didn't have to be stuck.

    I know this is tough, but you are doing really well.
    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.

  9. #9
    Join Date
    Jul 2009
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    NE PA
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    Default Re: Options for increasing supply? I've tried a lot already...

    Just had one thought to add to all the PPs great info. After your LO has nursed on both breasts it is Ok to switch him back and forth as often as neccesary. So if you start on right then switch to left you can switch back to right again and back and forth as many times as neccessary. Your breasts are never totally empty and this back and forth will signal your breasts to make more milk. Good luck.
    Jessica

    Moma to DS1-the monkinroanie (3/09) and DS2-the sweet pumpkin (5/12)
    Strong Women- May we have the delight of knowing them, the courage to be them and the privilege of raising them.
    And yes I know my spelling terrible (is that spelled right? )

  10. #10
    Join Date
    Apr 2009
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    Default Re: Options for increasing supply? I've tried a lot already...

    Quote Originally Posted by @llli*rcsmom View Post
    Just had one thought to add to all the PPs great info. After your LO has nursed on both breasts it is Ok to switch him back and forth as often as neccesary. So if you start on right then switch to left you can switch back to right again and back and forth as many times as neccessary. Your breasts are never totally empty and this back and forth will signal your breasts to make more milk. Good luck.
    This is what I did A LOT in the early weeks of BF. If DD still seemed hungry after both breasts then I would just go back to the first breast again. Great advice from rcsmom! This will only tell your body to make more milk.

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