Breastfeeding

How serious are my supply issues?

I have spent the past few hours reading stories of people's success building supply and relactating, but when I see the "starting" amounts, the amounts people describe as being "supply problems" I start to despair.

My baby is 2.5 weeks. I saw an LC on Wednesday who said I had suppressed lactation, and put me on More Milk Plus supplements, a rigid pumping schedule, and I rented a Medela symphony double electric. On Friday, I was feeling pretty good because my suply was steadily increasing from 3 ml a breast per pump to 10 ml per breast per pump.

My pediatrician, still concerned about my daughter's weight gain (she never lost more than 10% of her birth weight but hasn't put on any weight yet) said we needed to start supplementing with formula, but I was to keep pumping to see if my supply improved and feed her everything I pumped. Today, I'm doing about 3/4 ounce on each breast per pump.

Friday night, I spoke to the LC again, who was all gloom and doom this time. She said all my pumping/fenugreek/oatmeal was "too little too late". This is a registered lactation consultant who came highly recommended. So the fact that *she's* so pessimistic about my chances is really bumming me out! Even my pedi seems more optimistic? Everyone is already telling me I've failed and I didn't even know I had a problem until Tuesday!

My friend watched me pump the other day and remarked on how I'm "dripping, not squirting" and says that when she pumps, she has a stream of milk coming out. The people I see on here complaining about supply are getting 3-4 oz per pump. 

Am I just kidding myself? Did anyone else here go from "dripping" to "streaming?" Has anyone else been counting their output in mls and then in ounces? 

Someone give me some good news. I'm ready to cry. 

Re: How serious are my supply issues?

  • I dont have much advice, but I would find a new LC.  When I started pumping to increase my supply for a freezer stash, it took about a week for me to see results with increased supply.  But I would honestly find a new LC first and do not give up.
  • i have had low supply issues since the beginning and i am still bf'ing, so don't despair! i've had to supplement until around the time we started solids (my supply has gotten better). some people don't respond to a pump (like me). you're so early on.  just keep baby to the breast as much as possible. and remember, it doesn't have to be all or nothing.  you're doing a great job, mama!
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  • image alliwalton:
    I dont have much advice, but I would find a new LC.  When I started pumping to increase my supply for a freezer stash, it took about a week for me to see results with increased supply.  But I would honestly find a new LC first and do not give up.

    She's the "gold standard" of LCs in town. She's the name that everyone recommended. I think it's why I'm so frustrated. 

    When you were hoping to see results, what were you starting with? 

  • image americanada:
    i have had low supply issues since the beginning and i am still bf'ing, so don't despair! i've had to supplement until around the time we started solids (my supply has gotten better). some people don't respond to a pump (like me). you're so early on.  just keep baby to the breast as much as possible. and remember, it doesn't have to be all or nothing.  you're doing a great job, mama!

    Thank you. I don't know if I'm responding to a pump or not. I don't know if I'm not responding to HER. I mean, if she isn't gaining weight, chances are she's not getting her nutrients, right? The LC did a weighed feeding, and she wasn't getting much. 

  • image Allie30:

    image alliwalton:
    I dont have much advice, but I would find a new LC.  When I started pumping to increase my supply for a freezer stash, it took about a week for me to see results with increased supply.  But I would honestly find a new LC first and do not give up.

    She's the "gold standard" of LCs in town. She's the name that everyone recommended. I think it's why I'm so frustrated. 

    When you were hoping to see results, what were you starting with? 

    I'm sure you can find a more positive LC if you are in the DC area - there have to be lots of options.  Sorry, but I just don't buy her "too little, too late" - your LO is only 2 weeks old!!!

    It's VERY normal to get next to nothing when pumping in the first few weeks.  Part of it is training your body to respond to the pump and part of it is that your supply is still building.

    How often are you nursing?  How long does LO nurse?

    The fact that she hasn't dropped weight is good.  Some babies haven't made birth weight yet by her age so I think you are still in the range of acceptable.  How are her diapers?  Is she super sleepy at the breast?

    Your best bet is to increase time at the breast and get as much skin to skin contact as you can.  And find a new LC!!  You need positive encouragement - and she sounds like someone with little bedside manner.

  • image Allie30:

    image americanada:
    i have had low supply issues since the beginning and i am still bf'ing, so don't despair! i've had to supplement until around the time we started solids (my supply has gotten better). some people don't respond to a pump (like me). you're so early on.  just keep baby to the breast as much as possible. and remember, it doesn't have to be all or nothing.  you're doing a great job, mama!

    Thank you. I don't know if I'm responding to a pump or not. I don't know if I'm not responding to HER. I mean, if she isn't gaining weight, chances are she's not getting her nutrients, right? The LC did a weighed feeding, and she wasn't getting much. 

    that's how it was for us, too. do all you can to get your supply up. oatmeal every day helps me.  not instant though. you have to do what you have to do to keep you both healthy and sane, so don't beat yourself up over the choices you make for your family.

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  • image ncbelle:
    One other thing - is she having you pump on top of nursing or instead of nursing?

    the LC was having me pump after nursing and feed the pumped milk to her with a syringe. The pedi, after a day and a half of this, said she wanted me to pump instead of nursing to see how much I got. when i did that, i got .5 oz. (i'm now at 1 oz). she then prescrbed a weekend of pumping evry 3 hrs, feeding her what i pumped, then supplementing the difference with formula. i called the lc, who told me if i did this, my baby would refuse the breast, and to try to prevent this, i was to "comfort nurse her between pumping sessions, but that this remedy was probably "too little too late".

    i just feel like everyone except my pedi is telling me to give up! at 2 weeks!

  • OMG I thought I was having issues and now I'm really worried - I barely get an ounce out of each breast. What is a typical output amount?
  • image Allie30:

    image ncbelle:
    One other thing - is she having you pump on top of nursing or instead of nursing?

    the LC was having me pump after nursing and feed the pumped milk to her with a syringe. The pedi, after a day and a half of this, said she wanted me to pump instead of nursing to see how much I got. when i did that, i got .5 oz. (i'm now at 1 oz). she then prescrbed a weekend of pumping evry 3 hrs, feeding her what i pumped, then supplementing the difference with formula. i called the lc, who told me if i did this, my baby would refuse the breast, and to try to prevent this, i was to "comfort nurse her between pumping sessions, but that this remedy was probably "too little too late".

    i just feel like everyone except my pedi is telling me to give up! at 2 weeks!

    I feel ya! It's frustrating. But I'm getting the opposite pressure from everyone to keep going and tough it out. It's not that I don't want to anyway but I feel like even if I wanted to quit all my friends and family would totally judge me!!! 

  • image Allie30:

    image ncbelle:
    One other thing - is she having you pump on top of nursing or instead of nursing?

    the LC was having me pump after nursing and feed the pumped milk to her with a syringe. The pedi, after a day and a half of this, said she wanted me to pump instead of nursing to see how much I got. when i did that, i got .5 oz. (i'm now at 1 oz). she then prescrbed a weekend of pumping evry 3 hrs, feeding her what i pumped, then supplementing the difference with formula. i called the lc, who told me if i did this, my baby would refuse the breast, and to try to prevent this, i was to "comfort nurse her between pumping sessions, but that this remedy was probably "too little too late".

    i just feel like everyone except my pedi is telling me to give up! at 2 weeks!

    Really honestly seriously ;-)  an ounce is normal at this stage.  I do agree that just pumping and not nursing is a bad idea.  Pumping every 3 hours is also bad - it really would need to be every two if you were only pumping.

    What I would do is nurse often - like every 2 hours (that means if you start at 8, you start again at 10 even if baby nurses an hour) around the clock (you can go more like 3 at night if she's sleeping).  Wake her to eat.  Work to keep her awake while she's eating.  If you pump, pump after she nurses, not before (so right after) - even if nothing comes out, you are still telling your body to make more so keep at it.  I personally wouldn't do that every session or you'll go nuts though.  Focus your energy on getting her on the breast.  If you do supplement, use a dropper at the breast so she doesn't get lazy and start to only want bottles.

    Get skin to skin time as much as you can.  Get a comfy spot and camp out there with baby all day.  Eat lots and drink tons.  Have someone take care of everything else for you.  Do this for a few days and I bet things will pick up for you.

    And definitely get a new LC - no LC worth her credentials would basically tell you to give up at 2 weeks when it sounds like you are having VERY typical beginners' issues!

  • It is not too late, it is possible to turn this around!

    I am looking at my pumping outputs for the 24 hours (for jaundice) we had to give formula at 2w4d....looks like it was between 1 and 1.5 oz every 2.5 hours. That was with the Freestyle. I switched to the Symphony after that was pumping about 30 minutes after a feeding as was getting about the same, but after a couple days started to see an increase to 2 - 2.5 oz.

    I never had a "good" weighted feeding, the best was 1.5 at the pediatricians office, then it was .5oz the next day at the LC (after the 24 hour formula bit). However, I would nurse, then give DS what I'd pumped. Luckily, going into it I had about 25 oz of frozen BM in the freezer, and we stretched that so I never gave formula after the 24 period. I weighed DS every few days to make sure he continued to gain, and he did.

    I remember feeling so hopeless during that time, wishing that I "start over." Not to mention like a failure. My LC wasn't as pessimistic as your, but she didn't give me that much hope. But I just kept at it and I did start seeing an increase in my pumping output...nothing major, but enough to keep me going. And as I mentioned yesterday, DS is great now. He's doubled his weight since that time!

  • relax

    take a step back

    how much was baby able to take in at the breast when the LC did a pre and post nursing weigh in?

     

    I wouldn't pump instead of offering the breast if at all possible,  I would pump after every nursing session for at least 20 minutes after the milk stops spraying/dripping/squirting

     UNLESS baby is wearing themselves out with nursing and burning too many calories.  this is the case with a small baby, premature baby, or a baby with tongue tie or other issue that makes them unable to effectively take in milk at the breast.

     

    However, with use of a supplemental nursing system, baby could get all feedings at the breast, and get any necessary supplementation.

     

    consider reading around at kellymom.com and click on a bunch of the links on here

    http://www.kellymom.com/bf/supply/low-supply.html

     

    AmyG*

    I don't type posts; I type novels.

    I don't get tags, sorry.

  • At 2 weeks my LO had lost past his 10% and I was told to supplement. At that point I never saw "sprays." I believe my milk came in late and then the supplementing did not help with establishing it whatsoever.

    After about a month whenever I pumped I got 3/4 oz total (both breasts put together) and saw a small spray from each breast. At 2 months I did a weighed feeding and Skylar got 2 oz total. After that, when I pumped I saw spraying at the beginning and partway through.

    The most I've EVER pumped was 3 oz after about 3 hours in between feedings. I don't pump often anymore because it began to wear me out.

    I've come to conclude that I make almost 1 oz every hour. I still supplement with formula. No matter what I do I just don't make enough for Sky. To this day he still nurses every 2 hours and wakes up often at night. He is growing very well.

    I have tried everything besides an SNS system (formula goes through tubes that are attached to the bewbies so when your LO sucks they get your milk plus some formula. Staying on the breast longer/the extra stimulation is supposed to help and is especially good for women who don't respond well to the pump.)

    Through all of this, I am proud to say that I've been BF for 6 months despite having a low supply and having to supplement.

    In your case, I think it's WAY too early to be making assumptions.

    What did the LC think of your LOs latch? Is/was your LO jaundiced or sleepy?

    HANG IN THERE! 

  • Let me see if i can start at the beginning.  Probably first is to find a lactation consultant who is willing to work with you and support you.  some are better than others at encouraging moms  some are good at latching, some are good at pumping tips, and some are good at how to nurse a newborn or an older baby, but not every LC is good at all parts of the breastfeeding puzzle.  If you can't get with another LC for some reason, call around to find an LLL leader to at least give you advice and support.

    It would be nice to know exactly baby's weight at birth, whether you were induced, or had any issues with retaining fluids or lots of IV fluids.

    and to know baby's lowest weight since giving birth.  some babies tend to take closer to 3 weeks to regain their birthweight, and it may not have anything to do with your supply, could be a latch issue, could be supply, could be that baby is small and burning a lot of calories (high metabolism)

    AmyG*

    I don't type posts; I type novels.

    I don't get tags, sorry.

  • You're only 2.5 weeks out.  You have plenty of hope!  I'm 10 weeks out and my pediatrician, midwives, and LCs still have hope for me!  I have low supply and started supplementing at 24oz/day (my baby was at birth weight at 4 weeks, 6 weeks only 2.5 oz above) and I'm down to only 12oz/day (baby is 3 pounds above birth weight now!).  

    I've struggled with this from the beginning and if I could go back and do it all over again I would have told myself to just relax and believe in myself.  

    Having to supplement so your baby can THRIVE does NOT make you a failure!   You are a success because you're not giving up and doing everything you can for your baby.

  • So you need to do another pre and post nursing session weigh in and see how much baby is transferring at the breast.  one time of doing this doesn't really give you a picture of what baby can get at the breast, since the amount of milk will vary depending on time of day.  ideally a check first thing in the morning will give you your best picture--as that is when prolactin is highest and your milk supply is usually best for the day.

     

    a supplemental nursing system would be ideal to have baby nursing at the breast, and getting supplements at the tsame time.  they are not easy to work with, basically a bottle hung upside down between your breasts, and then small tubing comes out of the nipple, and are taped to the edge of your nipple.  baby latches on to the nipple and gets the small tubing at the same time in their mouth. when they suck they get your breastmilk, they get supplement and they stimulate your body to make more milk all at the same time.  you would follow every nursing session with a pumping session for 20 minutes after the milk stops flowing/squirting/dripping to signal your body to make more milk. 

     

    repeat this every 2 hours during the day.  If you can't deal with it at night, then at night pump every 3-4 hours and have your dh give baby supplement with a breastfeeding friendly device. that would be a syringe, eye dropper, cup, medicine spoon with a hollow handle, or if you use a bottle use a slow flow nipple. 

    Realize that the human breast makes about 25 oz a day.  baby takes in about 1 oz per hour.  when your milk first comes in, you make less than 5 cc/ml of colostrum.  this increases closer to 15 ml of colostrum and then goes up from there.  most breastfed babies take in about 2 oz every 2 hours by the time they are about a couple weeks old.

     

    if you don't give enough supplements baby may not gain enough weight to have enough strength to effectively nurse so you get into a catch 22 round and round in a circle thing.  but if you give too much supplement, baby doesn't want to nurse because they are too full and they don't bring in a good supply of milk.

     

     

    AmyG*

    I don't type posts; I type novels.

    I don't get tags, sorry.

  • you also need to be evaluated for reasons for low supply.

    thyroid issues are common post partum and effect milk.

    retained placenta

    hormonal imbalances

    and severe anemia

     

    baby needs to be evaluated for latch, low muscle tone, high palate and tongue tie issues.  are your nipples sore?

     

    AmyG*

    I don't type posts; I type novels.

    I don't get tags, sorry.

  • The supplemental nursing system is ideal, but we never did it. We got Dr. Brown's bottles with the Preemie nipple. Thankfully, DS didn't have a problem going back and forth between the boob and the bottle.

    Also, do try to stay optimistic. There is a mind-component to BF'ing. Hopefully your family is able to support you, if not, surround yourself with people that will!

  • i took forever to "squirt" and when i pumped i only got 1/2 - 1 oz total (and sometimes that was only pumping) with a hospital grade pump. I had lots more problems (it took 13 days for my milk to "come in" and it was still too low) I ended up having a retained placeta that caused all my problems. Find out a 6 wk appt.

    Find a new LC.

    Also massageing while pumping helped me a ton, i still have to massage every time i pump (once/day) to get the milk out. http://newborns.stanford.edu/Breastfeeding/MaxProduction.html

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  • I don't know where you're at in DC, but I'm in the Northern VA area and see a great LC in the Ashburn area.  Her name is Carolyn, though all of the LCs in the office seem great.  They are at Inova Loudoun Hospital.  The number is (703) 858-8911.  Good luck.  :)
  • Hmmm.  I didn't have supply issues, but my DD didn't hit/surpass her birth weight until 3 wks & we didn't have to supplement w/ formula.  Are you BFing or just pumping?  
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  • image AmyG*:

    Let me see if i can start at the beginning.  Probably first is to find a lactation consultant who is willing to work with you and support you.  some are better than others at encouraging moms  some are good at latching, some are good at pumping tips, and some are good at how to nurse a newborn or an older baby, but not every LC is good at all parts of the breastfeeding puzzle.  If you can't get with another LC for some reason, call around to find an LLL leader to at least give you advice and support.

    It would be nice to know exactly baby's weight at birth, whether you were induced, or had any issues with retaining fluids or lots of IV fluids.

    and to know baby's lowest weight since giving birth.  some babies tend to take closer to 3 weeks to regain their birthweight, and it may not have anything to do with your supply, could be a latch issue, could be supply, could be that baby is small and burning a lot of calories (high metabolism)

    Thanks, Amy, unfortunately, this LC is the "gold standard" in town. When I called around for recs (including the LLL), this was who everyone recommended. She's not telling me to give up, but she's telling me that there's little hope.

    She did examine the baby's latch and etc. and that seemed to be fine. She said she had a very strong suck. She was born at 7lb 6 oz and was 6 lb 12 oz by day 4. On day 7, she was 6 lbs 15 oz and so I thought I was on the upswing. I didn't weigh her again until day 14, when we discovered she was back down to 6 12, where she's been ever since, despite spending all day every day this week breastfeeding. 

    The weighed feeding was .4 oz. That was on day 15. The LC doesn't know if it was one particular factor that led to my suppressed lactation. She is jaundiced and she's always falling asleep on the breast, but nothing I try (undressing her, tickling her, blowing on her, coughing) keeps her up for more than a second or two.

    I was induced with cervadil (she was post-dates), and had an epidural but she went to the breast right away after birth and we got in half an hour of breastfeeding with skin to skin contact before they washed her or anything. We're skin to skin all the time except when I'm pumping and need both hands to do it (I tried to pump with her on the other breast and it didn't work.) I'm also on fenugreek and my OB wants to put me on Reglan but I'm scared of the side effects because I already feel so tired, irritable,a nd depressed.

    The LC tells me that 3 weeks is the "limit" and that it's really hard to fix problems after that, that maybe she could have helped me at day 5, but not at day 15. But I didn't know there was a problem until day  14. My milk came IN at day 5!

    As you all suggested, I tried pumping after breastfeeding all night tonight (we also supplemented). I still came up with one oz each time. I have no idea what that means. If i get one oz. whether or not she feeds at the breast beforehand, does that mean she's getting ZERO food when she sucks on her own? The pedi thinks that breastfeeding alone won't keep my supply up, and I'm going to have to be a pumper.

    How will I ever know if she's getting enough on the breast and when I can reduce the supplements?

    I'm not sure how it's possible to do this on a two hour schedule.  If she feeds for 50-60 minutes (which she does), and then I pump, even if I try to pump both breasts at once (which is really hard), that takes about 30 minutes, and then to try to pump for 20 minutes AFTER the milk stops dripping (it starts and stops, but never stops for 20 minutes altogether) then that gives me maybe 10 minutes to wash everything, go to the bathroom, get something to drink, eat, sleep -- I don't know how that's possible. Breastfeeding makes me so tired. I fall asleep all the time. I have no idea how i'm supposed to eat. There's a bowl of soup sitting ont eh stove for me over an hour but if i put her down she starts crying, even if we feed her formula. My husband and my mother can't stop her crying either. The only thing that stops her is my breast, and she falls asleep on it right away and doesn't suck.

    I feel like this is all I've thought about or done for the last week. I've done everything I'm supposed to (except for oatmeal -- I tried and it made me gag, but I'm eating other whole-oat products) and drinking a ton and skin-to-skin and pumping and nursing and my nipples are KILLING me (though I no longer have the bleb or the cracking that I did earlier this week when I was just breastfeeding -- the pump seems to have rounded out my nipple again and sucked out the bleb)... I just feel like I'm out of options.

    Should i call LLL again? Is that appropriate on Sundays? 

  • image MrsCAA:

    i took forever to "squirt" and when i pumped i only got 1/2 - 1 oz total (and sometimes that was only pumping) with a hospital grade pump. I had lots more problems (it took 13 days for my milk to "come in" and it was still too low) I ended up having a retained placeta that caused all my problems. Find out a 6 wk appt.

    Find a new LC.

    Also massageing while pumping helped me a ton, i still have to massage every time i pump (once/day) to get the milk out. http://newborns.stanford.edu/Breastfeeding/MaxProduction.html

    Thank you for this video. It was very helpful and I'll try out the methods!

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