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Low supply and slow weight gain


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#1 Tigridia

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Posted 26 July 2011 - 12:24 PM

We are having ongoing issues with low supply and really slow weight gain. Astrid is 5 weeks old tomorrow and we are still 65g short of birth weight. She initially lost 14% of her body weight in the first 6 days as my milk never came in properly and she fed poorly after a vacuum assisted delivery that left her with a very sore head and neck.

To try and combat the low supply problem I've been on fenugreek and motillium and have been eating lactation cookies. I've also had several accupuncture sessions to try and boost supply. I'm also seeing a private lactation consultant. I had probable retained placenta and an endometrial infection so they also think that affected/is affecting my supply.

Astrid had a tongue tie (which was picked up by the LC) and couldn't suck properly so that was fixed then we took her to an osteopath to try and fix the head/neck tightness that wasn't helping with the sucking.

I am expressing after every feed (double pumping) but never get more than 10ml. I think I"m a bad expresser though as there is more milk than that there. I just can't get it. As a result we don't have enough EBM to top her up with so have to give formula top ups. We were initially doing this with a syringe (finger feeding) but eventually moved to a bottle as she was taking 2 hours to feed. Last week we moved to a supply line (supplemental nursing system) so she gets her top up as she is feeding from me.

We still have really slow feeds. At least an hour on the breast per feed and sometimes longer but she is a slow sucker and I can't cut her off when I'm trying to build supply.

Has anyone else out there had a similar history? Did you manage to perservere? I really want to get to fully BFing at some point. Also, any other suggestions of what I can do to help the situation?
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#2 Magnolia

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Posted 26 July 2011 - 01:03 PM

Hi Tig, I was exactly in your situations, but sadly never got to exclusively BF. sad.gif

You sound like you are doing all you humanly can. Only thing I ask is what sort of pump are you using? I hired an electric one from the hospital and it was really good. Also are you expressing for about 2 mins after your flow has finished? Sometimes you can have multiple let downs. You can also try breast compression. I'm sure your LC has given you all this advice though.

Be sure to get enough sleep too as the hormone responsible for supply (I can't remember the name) is produced while you sleep.

Best of luck xox I hope you will be successful. smile.gif

#3 Malibustaci

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Posted 26 July 2011 - 01:29 PM

We too had similar problems and J used to take an hour to feed plus both EBM and formula top ups. J took about four weeks to get back to his birth weight also. I generally had enough milk during the day but would run out towards the end which was when we would give a formula top, then would express before bed and use this milk throughout the day as top up when needed.

At the time I would feel guilty about giving formula, but looking back now I really feel proud I BF for as long as I did and even if I had to give formula top ups - making sure my lil man's belly was full was and IS the most important thing.

Due to the struggles at the start my goal was to get to 12 weeks - I actually BF for 19! So was very happy - I chose to stop at that point as I was returning back to work.


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#4 Bel_000

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Posted 26 July 2011 - 01:35 PM

Hey there

I had a similar issue when my son was 12 weeks. He became really unsettled in the afternoon, screaming from what we later found out was hunger. (we just thought our dream run of a good placid baby was ending). My GP is a lac consultant and kept a really close eye on him (weighing him twice a week) and he was loosing weight.

I found the fenugreek worked well, I was also on the motilium/cookies and acupuncture. I was basically just feeding feeding feeding for hours on end. It's exhausting and time consuming but I really wanted to make it work.

Im not certain exactly WHEN it all started working. I know I started solids earlier than I wanted to (4 months instead of 6 even though they recommend that now I think?) but it did improve. I have just last week finished feeding and my son is 15 months.

I don't really have any advice (you sound like you're doing as much as you really can) but just wanted to say I was in a similar position and it worked for me. Increasing water consumption is a must to (probably the first thing you tried but I found in winter it's hard to keep drinking as much as you should). Oats are also supposed to help - so try porridge for b/fast as well.

Also, 10mls you are expressing is 10 more mls your body has to make. That's what my doc used to say to me.

Good luck - keep at it if you are determined to make it work. You are doing a great job perservering. :-)

#5 Monica

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Posted 26 July 2011 - 02:10 PM

No advice but just wanted to say you are a champion for doing all that you are. I know that desire to want to fully BF and how much it consumes you.

Just do what is right for your family and as long as you feel you can, keep going but it's alright if you don't.

wub.gif
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#6 Tigridia

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Posted 26 July 2011 - 02:24 PM

QUOTE(Carolyn @ Jul 26 2011, 01:03 PM) View Post



You sound like you are doing all you humanly can. Only thing I ask is what sort of pump are you using? I hired an electric one from the hospital and it was really good. Also are you expressing for about 2 mins after your flow has finished? Sometimes you can have multiple let downs. You can also try breast compression. I'm sure your LC has given you all this advice though.

Be sure to get enough sleep too as the hormone responsible for supply (I can't remember the name) is produced while you sleep.




Carolyn, I am using a double hospital grade pump which I hired. Originally I was pumping for 15 mins (based on what I was advised) which would get me about the 10ml. Then my LC suggested 5 min power pumps (with breast compression) and I still get the 10ml in 5 mins. I seem to have a let down and get the few mls then it pretty much slows downs to a couple of drops so I'm not sure if I just don't have much after the inital let down. I know when Astrid sucks I can still here swallowing well into the feed and can hand express a few drops after she has fed for quite awhile so I think she is getting more out of me but the pump is not good at getting it. Not sure what to do about that!

Oh the sleep thing is hard but i am trying. I know when I don't sleep I get no milk. We were readmitted back to hospital for 24 hours due to weight loss and I was feeding for 2.5 hours out of every 3 and didn't sleep for 30 hours and had virtually no milk so am trying really hard to get some rest. It's so hard though!!

QUOTE(Malibustaci @ Jul 26 2011, 01:29 PM) View Post

We too had similar problems and J used to take an hour to feed plus both EBM and formula top ups. J took about four weeks to get back to his birth weight also. I generally had enough milk during the day but would run out towards the end which was when we would give a formula top, then would express before bed and use this milk throughout the day as top up when needed.

At the time I would feel guilty about giving formula, but looking back now I really feel proud I BF for as long as I did and even if I had to give formula top ups - making sure my lil man's belly was full was and IS the most important thing.

Due to the struggles at the start my goal was to get to 12 weeks - I actually BF for 19! So was very happy - I chose to stop at that point as I was returning back to work.


I'm so glad to hear you made it to 19 weeks. We are well over the hour with the top ups too (an hour on the breast plus top ups makes for long feeds). I was initially devastated about the formula but I don't have much choice as she would starve without it. If I can cut it down as time goes on I'll try but I'm working on the theory that some breast milk is better than none.

QUOTE(Bel_000 @ Jul 26 2011, 01:35 PM) View Post



I found the fenugreek worked well, I was also on the motilium/cookies and acupuncture. I was basically just feeding feeding feeding for hours on end. It's exhausting and time consuming but I really wanted to make it work.

Im not certain exactly WHEN it all started working. I know I started solids earlier than I wanted to (4 months instead of 6 even though they recommend that now I think?) but it did improve. I have just last week finished feeding and my son is 15 months.

I don't really have any advice (you sound like you're doing as much as you really can) but just wanted to say I was in a similar position and it worked for me. Increasing water consumption is a must to (probably the first thing you tried but I found in winter it's hard to keep drinking as much as you should). Oats are also supposed to help - so try porridge for b/fast as well.

Also, 10mls you are expressing is 10 more mls your body has to make. That's what my doc used to say to me.




Did you find the accupuncture helped? I think it helped me a bit but it's hard to know. I might keep going with it as it can't hurt. It's just hard to get someone to look after the baby for the 2 hours it takes me to get to acupuncture and back and I can't really take her with me while I'm being poked with needles.

To get to 15 months is awesome! I had also thought that if I could get to the solids stage I might be able to have enough milk to keep her going.

Good point about the 10ml. It's disheartening when you see so little in the express bottles but now I collect it over a day or two and it's almost enough for a full feed which makes me feel like I'm really getting somewhere when her dad can give her an EBM feed when I rest.

QUOTE(Monica @ Jul 26 2011, 02:10 PM) View Post

No advice but just wanted to say you are a champion for doing all that you are. I know that desire to want to fully BF and how much it consumes you.

Just do what is right for your family and as long as you feel you can, keep going but it's alright if you don't.

wub.gif


Thanks Monica! I don't even know why it matters to me so much but I know so many people have told me to give up but I just can't until I exhaust all options. I guess I'm just fairly pig headed and really want to at least partially breast feed if I can.
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#7 Monica

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Posted 26 July 2011 - 02:51 PM

Mummy guilt is why it matters, and some people out there that berate you if you 'give up'
Pfft to them.

Keep doing what you are doing for as long as you can and know that you have the full support of all of us here.

Astrid is very lucky to have you as her Mummy.
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#8 goodgirl

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Posted 26 July 2011 - 03:16 PM

Hey Nic, you really are doing a fabulous job so don't feel like you're being anything but a wonderful mummy to Astrid. wub.gif

My supply seems to be a bit eratic so I can go from oversupply one week to undersupply another. I'm not sure what dose of fenugreek you're taking but a friend of mine who had low supply found it was only when she took 15 tablets a day (5 tablets, 3 times a day - 1000mg each tablet) that her milk supply really kicked in. By comparison I was only taking 2 a day and only for a couple of days at a time. It might be worth upping the dose to see if that helps.

Also, when I was trying to build up my night time supply, I would sit and pump on empty boobs for hours. I figured even though I wasn't getting any milk out, the additional stimulation would help get things moving. You obvioulsy need to weigh this up with the need to sleep/rest when you can.

Allowing Astrid to comfort suck you rather than a dummy would also help a bit but I assume you're not using a dummy and doing this anyway?

Do you switch back and forth between breasts when feeding? I know the general rule is to do one breast and then offer the second if required but I believe switching every 5-10 minutes (so each breast is offered 4-5 times each feed) can help too.

I know you have an LC but have you called teh ABA and asked them for any other tips?

Gee breastfeeding is hard isn't it? I'm 4 months in and still have problems (although not the same as yours). Oops, gotta go, crying baby wants my attention...

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#9 stars87

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Posted 26 July 2011 - 03:44 PM

Hi, I am sorry you are having such a hard time, I can relate, your story sounds very very similar to mine with my first child and also we had a few issues with my second.

I still don't think my milk ever really came in properly with my first, never felt full, never leaked. I was on Motillium and tried lactation cookies. The Motilium did help a little, I certainly noticed once I tried to go off it that I had almost nothing at all.

Our daughter was very very slow to gain weight too, we were doing 45mins plus on the breast, then formula top ups and then I would express for another 20/30 minutes. It certainly all took its toll but I was very stubborn about it, and would not give up no matter what anyone told me. Unfortunately I never got to exclusively BF, and had to give up BF totally at 11 weeks when the little milk I had vanished and she got so frustrated she refused to take the breast anymore no matter what I tried sad.gif

FWIW though, while her weight was an issue, it turns out she is also just meant to be little. She is three next month and is still tiny (10.5 kg), it's just how she is but of course at the time we didn't know that.

I totally understand your drive to continue breastfeeding and aim for doing it exclusively, it is such a wonderful thing to be able to do and I felt exactly the same. Can I just say though, just keep a bit of an eye about how you are feeling about it all, and that you are getting plently of time to enjoy your child as well. I know this is just my experience and you may well be feeling differently, but I know I was so stubborn about feeding and committed to the schedule of feeds and stressed about her poor weight gain no matter what I did that I really feel like I missed those first three months of her life, and in hindsight I only realised how much once I gave it up sad.gif They are only newborn for so long, and you don't get that back, and I do really think I sacrificed bonding and spending time enjoying my baby because I was so determined to breastfeed.

Just a though but I really hope things turn around for you, but no matter what you are doing a truly amazing job, don't forget that



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#10 mrsmac05

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Posted 26 July 2011 - 04:36 PM

Hi Tig

My DD was a terrible feeder and also lost about 15% of her body weight in her first 5 days. I was on motillium and tried many other things, unfortunately I just had very little in the way of supply and the lack of sleep didn't help me to produce any further. As it turned out we had some other issues as well which led to our feeding problems such as silent reflux and stomach tenderness from this. If you are seeing a paediatrician keep talking to them about the fact that she is taking a long time to feed.

I know that the advice I was given will go against the grain a little but as far as taking care of yourself it is very sound. Here goes:

Set yourself a time limit for baby to be on the breast. For us it was 30 mins/ 15mins per side then express and top up with ebm or formula whichever you are able to get more of or the baby will take.

Don't let yourself keep feeding for more than 1 hour as a newborn will be too tired at the end to efficiently take anything from you and will just continue to comfort suck which doesn't actually help to increase supply.

DD would fall asleep during feeding so tickling her feet or taking off all her clothes to keep her awake was another thing I was told about.

Like I said that advice will probably go against what a lot of others have been told but this is what we were given both whilst in the hospital and outside. In the end though our DD had some significant issues with Silent reflux and stomach aches from that and the only way to feed her was to sit her upright. I went off the motillium at 8 weeks and had completely dried up by 12. I hope that you have better luck than we did but definitely get her checked out for any health problems as well just in case.

#11 Miss Em

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Posted 26 July 2011 - 04:48 PM

My story is nearly identical to yours even down to the tongue tie. 4 months on I am still breastfeeding with formula tops and I intend to do this for as long as I can.

The only other thing I can suggest you try is the Mummy Shake - http://www.themummyshake.com - I have one mid morning and I have found it helps with my supply in the afternoon. I also wanted to add that as Astrid gets older her feeing time will reduce. This certainly helps when you are expressing and doing formula top ups.

#12 Magnolia

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Posted 26 July 2011 - 05:39 PM

You're right Tig, any amount that Astrid is getting is a huge bonus, even if you're having to supplement with some formula she's still getting the benefits of BM. I was like you, I so desperately wanted to BF and hopefully you will be able to, but be sure to look after yourself in the process.

I used a combination of fenugreek and blessed thistle. I noticed you didn't metion that herb? Might be worth a go if you're looking at anything/everything to help. But make sure it's blessed thistle, not milk thistle, that's something else entirely.

Also, under the guidance of my LC, my motillium was upped to 2 tablets 4x a day. But that's something for you to discuss with your doctor. It didn't make much difference to me, but it can in some people.

Have a look into Jack Newman's advice. I emailed them for advice and got a response. Maybe see what they say? According to my LC, he's one of the worlds leading experts on BFing.

#13 *Simone*

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Posted 26 July 2011 - 07:48 PM

QUOTE(stars87 @ Jul 26 2011, 03:44 PM) View Post

I totally understand your drive to continue breastfeeding and aim for doing it exclusively, it is such a wonderful thing to be able to do and I felt exactly the same. Can I just say though, just keep a bit of an eye about how you are feeling about it all, and that you are getting plently of time to enjoy your child as well. I know this is just my experience and you may well be feeling differently, but I know I was so stubborn about feeding and committed to the schedule of feeds and stressed about her poor weight gain no matter what I did that I really feel like I missed those first three months of her life, and in hindsight I only realised how much once I gave it up sad.gif They are only newborn for so long, and you don't get that back, and I do really think I sacrificed bonding and spending time enjoying my baby because I was so determined to breastfeed.


This.

I fell into the same trap, and can barely remember enjoying my son for the first 6 weeks as it seemed all I was doing was trying to feed, expressing, sterilising etc etc.
It was that actually that prompted me at 6 weeks to start switching over to formula slowly, as I didn't want to miss any more time than I had already.

Unfortunately breastfeeding (or exclusively BFing) will not work for absolutely everyone, and I had to accept that I was one of those cases. If you can breastfeed but also need formula top-ups it isn't the end of the world (I know how it can feel like it is but it's not). What is most important that your baby gets the nutrition she needs whether it comes from breastmilk or formula.

#14 Bel_000

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Posted 26 July 2011 - 08:20 PM

I will come back to reply properly later but I also drank 'weleda' nursing tea which you can get from health food shops.

#15 stars87

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Posted 27 July 2011 - 01:22 PM

Further to what mrsmac is saying too, putting time limits on feeds etc might be a good way to make sure you are resting enough as well. We have recently gone back to our paed with low weight gain with our son and he said to only do 5-10 mins on each breast as they get 90% of the milk they are going to in the first seven minutes, and long feeds can sap underweight babies of the little energy they do have, which leads to less effective feeding and turns into a cycle with more weight loss. We then had to top him up. Obviously with trying to increase supply sucking will benefit but might be something to consider as well. Of course your situation and set up may be different but I thought it was interesting.
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