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Low supply and slow weight gain


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#16 hearts_in_asia

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Posted 27 July 2011 - 07:24 PM

Most of your situation I can't comment on but I can say a couple of things.

You'll never get everything out by expressing, a baby is much more efficent than a pump, so try not to stress too much about the actual 'amount' that comes out as your babe will be getting more than that from you. Milk is also made as your babe is nursing, it's not just a case of 'breast fills up between feeds and is emptied by them.'

Slow feeds I wouldn't worry about at all yet. Emi used to take minimum 45 minutes, sometimes over an hour, and she fed about every 2 hours for the first three months or so. I spent a LOT of time sitting on the couch with her! When she was around 3.5-4 months old she sped up to 5-10 minutes for a feed, I couldn't believe how much faster she was, it was a different world!

And finally a :hug: for you, we had to finger-feed Emi for a fortnight at the beginning because she couldn't latch, it was horrendous. My biggest piece of advice is to persist. Honestly, I had a horrible, horrible time for months. I won't lie, there were dozens of times I could have given up (although I never had a supply problem, just lots of other things), but you know, just one more day, I can't give up yet. Now Emi is 17 months old and I'm still breastfeeding her. Just hang in there, and even if you have to combination feed forever that's quite OK too.

And make sure you're getting lots of water too, it's amazing what a difference that can make to supply.
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#17 VictoriaK

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Posted 27 July 2011 - 09:03 PM

this is exactly what happened to me and ironically my mum. We can/could both breastfeed fine with bubs on but expressing was a nightmare. Both times i expressed with my babies, i only got a good fill the day my milk came in, once it settled down, i went to only being able to express 20ml total per feed and that was expressing for 1/2 hour. I had a supply issue with Aidan from 3 months and ended up having to can it at 4 months due to no weight gain in a month. Basically it ended with me crying and him crying at every feed. I understand your need to fight on, i felt the same both times (Chloe never latched from day 1) but do whats right for you. Give it all you have (and it definately looks like you are) but if it doesnt work out, dont stress, honestly, i have raised both of mine on formula and they are both fine. In fact Chloe has only just had her first bout of illness at 10 months and there are fully BF babies oin my MG that have been sick numerous times already. At the end of the day my mantra is happy mum=happy baby regardless of how they receive their milk.
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#18 Decembergirl

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Posted 27 July 2011 - 10:52 PM

Nic I'm no expert, so take this with a large grain of salt, but have you tried expressing first, rather than after feeding Astrid? I've been thinking about this quite a bit of late, and maybe you'd get more if you expressed first? This could be a win/win as you'd be pumping off some of the fore milk, meaning the first thing Astrid would get would be the fatter, heavier hind milk, and you might be able to get more out of your fuller breasts, leaving Astrid (who's always going to be more efficient than a breast pump) to really drain them. Just a thought (and probably something you've already done!).

Also, I wanted to give you a massive hug. You're doing an amazing job, any way you look at it. smile.gif
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#19 Tigridia

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Posted 28 July 2011 - 12:32 PM

Thanks for all the replies, it's nice to know other people have had similar issues and have managed to get through it. Most people I know have had not many problems BF or have moved to formula fairly early when they have had issues (which I totally understand, it's harder than you think it will be to do all this extra stuff with a newborn).

Marisa, yep I'm on a lot of fenugreek. I think I'm taking a min of 6g a day but I've heard of people taking more. I might consider upping it again. I'm also adding it a lot of my food! The swapping boobs more frequently might be a good idea. I know I get most of my flow in the first few minutes but want the stimulation so going back an forth might work. Using the supply line though it's a pain getting her to attach but I might try it and see how it works. Yep, no dummy and I let her comfort suck if she wants to.

stars - I have the same problem, my breasts never feel that full and I don't really leak. She may just be small or a slow gainer so I'm trying not to get too stressed out about the weight. Both hubby and I are tall and well built so I'd be surprised if she is petite but stranger things have happened!
You are right about not letting it get to much and trying to enjoy the newborn stage. I've been so busy with feeding, expressing, topping up, sterilising then settling it seems like a job. I'm trying to not overdo it and cut myself some slack but it's harder than I imagined it was going to be. Certainly not a lot of fun and it makes you wish the days away so I need to stop thinking like that and try and enjoy the newborn bit while there is still time.

mrsmac - sounds like we have similar babies. Astrid definitely is a very sleepy feeder. We try to keep her awake but most of the time even stripping her doesn't help and I end up pulling her off and giving her a couple of minutes to wake up and realise she is still hungry. I agree that 1hr plus is a long time for a feed and a few people have said to shorten them but it's hard to know what is a good time when she still wants to feed off me (all be it very slowly).

Miss Em, glad to hear you are still going well after a similar start! Thanks for the link, I'll go check it out.

Carolyn, blessed thistle is the one thing I haven't tried so I will go get some. I'm on 9 xmotillium a day and certainly that is working better than when I was on 4! Luckily I have an authority script because a box lasts about 2.5 days at that dose smile.gif

Simone, you are right about finding it hard to enjoy or remember much of this stage. Its all such a blur of feeding at the moment. It's a good point and something I need to remember in when deciding enough is enough.

Just another question, has anyone else used a supply line? We are using one for feeds and was just wondering if anyone had any tips on attachment etc. I will speak to my LC again but I thought if anyone had anything useful to add it might help.








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#20 Tigridia

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Posted 28 July 2011 - 12:43 PM

It took me so long to type my 1 handed post that I missed some people!

Katie, good to know that Emi eventually got faster. I know a lot of babies Astrid's age are getting much faster already so to know it can take 3 or 4 months is good to know. I am spending so much time on the couch at the moment that there is a dent in it. Just going outside for 10 minutes and not feeding is bliss smile.gif I'm glad things got easier for you though and you are still BFing! I agree that finger feeding sucks. We did it for a couple of weeks and it is so slow trying to get 70 odd mls in every feed and poor hubby's finger was mangled from having it in her mouth several hours a day. The supply line had meant we don't have to worry about that so much now at least.
I do think most days that just one more day, or even one more feed is my goal. I do want to get to 6 months but that seems so far away at the moment but I can do a day at a time!

Victoria, I'm glad to hear someone else is a horrid expressor but had enough milk. It is disheartening when you get so little out but the fact that Astrid is gaining some weight means she is getting at least half her milk from me (based on the amt of formula we are giving) and it is more than 10ml a feed.

Kerry, that is something to try. I've expressed a couple of times closer to feed time (as she has slept longer and I needed to pump, esp over night when she does a longer block of sleep) and those times I get closer to 14-15ml as opposed to my usual 6-10ml so it definitely is more. Might try it sometimes and see if it helps.
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#21 Magnolia

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Posted 28 July 2011 - 01:53 PM

QUOTE(Tigridia @ Jul 28 2011, 01:02 PM) View Post


Just another question, has anyone else used a supply line? We are using one for feeds and was just wondering if anyone had any tips on attachment etc. I will speak to my LC again but I thought if anyone had anything useful to add it might help.


I did the supply line from about day 4 (before my milk had come in) till around a two months. It's pretty tricky to latch baby and get the line in at the same time, especially when he was a bit older and became aware of it. My best trick was to attach him first, then try and work the line in. It was easier to get it in on the side of his mouth. But sometimes it would end up under his gum, or there would be a kink in it so he wasn't sucking it down. You just have to persist. It's just one of those things that takes a lot of practice. smile.gif

#22 Myst

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Posted 31 July 2011 - 10:02 PM

Just wanted to say that I know how you feel - good job keeping at it because it is not easy.

I cannot help with the supply line because we never used one but I just wanted to give you some more hope by saying that we had similar issues to you. My DD didn't get back to her birth weight until almost 6 weeks and it was very stressful and we ended up back in hospital a few times but we persevered and now 10 months down the track we are still happily breastfeeding.

Honestly it was not easy. I had low supply, severe nipple thrush, a baby that was not strong enough to suck properly, couldn’t attach properly and TBH still has trouble at 10 months but it got easier. For the first 14 weeks of my DD’s life all I did was feed and express and I missed a lot of time with her and I cried a lot. Looking back, it was all worth it for me but you have to think about what it is worth to you. There is no shame in stopping if that is what is best for you both.

The only tip I have that has not been mentioned is to express on each side more than once. So start on one side and once you have had a letdown or two move to the other side and have a letdown then go back to the other side and just keep swapping. I always got more milk this way. Also just remember that it is not forever, your LO will eventually get to a point where you do not need to spend quite so much time on feeding. For us this was around 14 weeks which seemed like forever at the time but now looking back it doesn’t seem like such a long time.

Also like some of the others have mentioned, some babies are just slow gainers and there is nothing wrong with that. Don’t get too hung up on weight gain but look more at how content bubs is. My DD didn’t gain anything back for weeks and then was only gaining 20gms a week but she got there eventually. Now at 10 months she is a very healthy little girl but still only in the 25 percentile which is fine. She still does not eat or drink anywhere near what she should for her age but she is happy and content and that is how I judge how she is going.

Good luck and great job – you’re an amazing mummy to spend so much time on something that seems to come so easy to some and not others.

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#23 Tigridia

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Posted 29 August 2011 - 09:36 AM

I just thought I'd update.........

After another couple of weeks of very slow weight gain we had a 50g loss the other week so were admitted to QEII (residential hospital for feeding and sleep issues). They didn't have any brilliant ideas for us as we were already doing pretty much everything they normally suggest for feeding issues - herbs, motillium, expressing, supply line etc. We have started feeding skin to skin and are working on attachment which is still poor. I just have a baby that will not attach properly no matter how hard I try. She also has a very weak suck so we are hoping to get into a speech path to work on that.

We were told to increase her top ups and cut down the time at the breast to give her more nutrition in a shorter time to hopefully conserve energy and get her weight up. So now we are doing 30 min feeds with the supply line and then the rest of the top up in a bottle. We managed to get a 170g weight gain in 5 days and got off the 3rd percentile for weight and are now close to the 10th. They want her on the 25th so still aways to go.

My supply totally tanked while I was there (due to stress I suspect) and I was getting quite frustrated with the feeding. It's recovered a little now I"m home but I still have very low supply and really most of the nutrition is coming from formula and only a little from breast milk. I have decided to stop expressing as it was just taking up any time I had between feeds and settling. I was getting very little benefit from it. I've also decided to review the breastfeeding situation in a month and decide whether I will continue or not. I want to but at the moment it is a lot of hard work for very little benefit. I still think it's worth perervering for now though.
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#24 HayleyNZ

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Posted 29 August 2011 - 06:17 PM

Big hugs! Do not feel bad if you decide to stop breastfeeding. It sounds like you have done absolutely everything right and sometimes it just doesn't work out.


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#25 Amelia Jane

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Posted 29 August 2011 - 06:41 PM

Have you tried a nipple shield, Tig? I doubt anyone would ever suggest it to you as they are rumoured to reduce supply but if she doesn't attach properly, it would help with that which might then mean she sucks better, gets more milk out and then in turn boosts your supply.

Thinking of you guys, you are doing such an amazing job. xox
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#26 *Simone*

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Posted 30 August 2011 - 03:10 PM

QUOTE(Tigridia @ Aug 29 2011, 09:36 AM) View Post

I just have a baby that will not attach properly no matter how hard I try. .


(((HUGS))) We had this problem too and it is just so frustrating, I completely understand how you feel, AND I gave up on BFing as a result so much earlier than you and expressed full time until I moved to formula.

Don't let yourself feel bad for a second, you really have tried everything!

#27 Tigridia

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Posted 30 August 2011 - 05:26 PM

Thanks guys, I know I've tired everything but it still annoys me that I can't seem to get it right........ I hate that breastfeeding is supposed to be natural when it's so fiddly and difficult for so many people. I really do understand why people give it up as with only 1 or 2 issues it can become very hard to continue and it seems like I've had pretty much every issue under the sun.

Piper, interesting suggestion about the nipple shields. I actually have really big nipples (apparently, who knew? I certainly didn't till I tried to BF and have been told by several midwives, LCs that they are very big) so I think that is part of the problem. Astrid can't get a good latch. Plus she never opens her mouth widely or tilts her head back enough. Sigh.
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#28 Amelia Jane

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Posted 30 August 2011 - 07:31 PM

They may not (and to be totally honest, probably won't) work for you, but it might be worth a try before you give up completely. Not that I think you are giving up-I think you've done an amazing job to get as far as you have. I was ready to give up on day 5 and that was with only one problem.

I use the shields because of flat nipples and he latches on differently now. Instead of sort of rolling on from the side and the nipple rolling in to the top of his mouth, it's straight on from the front...I do think it'd be worth a try if the problem is that she can't open her mouth wide enough. Because there's no risk of damaging your nipple from poor attachment, it doesn't really matter if she doesn't get a big mouthful of areola, IYKWIM?

ETA: I hear you on it being fiddly and difficult! I really struggled with it and have no doubt I would have switched to formula if one of the midwives hadn't suggested the nipple shield. It would have broken my heart to do it but I think how freaking hard it can be is glossed over by the ABA and people like that. It may be natural but it's not easy.
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#29 Tigridia

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Posted 31 July 2012 - 10:19 AM

*UPDATE*

I just thought I should do an update. Astrid is now 13.5 months and we have just fully weaned from breastfeeding. I fed for the entire time with a supply line, but I made it, I breast fed her for 13 months!!

She is still a little on the smaller side. She was 8.9kg at 12 months (about 25th percentile) but this is a vast improvement from when she was below the 3rd percentile for all those weeks/months. She was born on the 90th percentile, so it was a dramatic drop in weight. I was told so many times just to give up, but I hung in there. It wasn't easy but gradually her latch got better and her suck stronger and she started drinking more and putting on weight. My supply was never great. Despite every herb under the sun and huge doses of motilium, expressing round the clock and breast compression with feeding, I never produced more than 50% of the breast milk she needed. As she went overnight without feeds and started dropping day feeds my supply dropped off a lot.

This meant I had to feed with the supply line the whole time. In the end I managed to feed in pubic with the line. We fed in airports, shopping centres, on a plane and during yoga classes. At first it was quite hard to feed in public with the supply line attached. It looked weird and required a lot of chest flashing to tape it in place. However, I did it, and some good came of it because a few women asked me about it and even said they felt more comfortable giving a supply line a go (it had been recommended to them) now they had seen someone managing one.

Every clinic appointment I went to, the nurses seemed surprised I was still feeding despite all the issues. Apparently, people normally don't last long with all the supply and attachment issues plus feeding with a line 100% of the time. I guess I"m just stubborn though, and wouldn't give in.

My goal was to get to 6 months. Once we made that I thought I could keep going for a bit, as she was gaining weight and starting to feed pretty well. Once it got close to 12 months I wanted to reach that milestone. In the end we made it to 13 months. We were down to 1 feed a day and my milk was pretty much gone. While she was still happy to feed from me, it was at the point where it was more for me than her. Plus, the last valve on the supply line broke. So we had our last feed a few days ago and she is now totally on cows milk/cups.

I do miss the feeds, but I'm glad we got 13 months of feeding. We had a few periods of breast refusal and biting but aside from the supply issues and attachment issues we had a pretty good feeding relationship. I hope that if I have another baby I can feed without all the dramas!
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#30 nephthys

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Posted 31 July 2012 - 12:09 PM

*applause* Very, very well done. smile.gif


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