Low supply problems

kateitho

    I never thought about not breast feeding, but now, our little guy is 12 days old, and I'm still not making enough milk.  I've never felt engorged, and only leaked a few times.  The pediatrician has us supplementing 1.5 oz goat's milk after every BF. I am currently taking Milk Rich with goat's rue and fenugreek 3 times a day, and I'm waiting on my domperidone to arrive in the mail.  My OB recommended the domperidone, but since there's nowhere to get it in our small town, she told me to just order it from Canada, which we did.  I am feeding him whenever he shows hunger cues, which is almost constantly during the day, and every 2 1/2 to 3 hours at night.   I tried pumping between feedings, but they're not spaced out enough, and I end up with less than an ounce, and very sore nipples.  Is there anything else I could be doing?!?   I'm getting so frustrated and defeated!

fsumom

Please hang in there.  If your supply is really low, Fenugreek and oatmeal are a couple of things that may help your supply along with staying hydrated!  Also, plenty of skin to skin contact and a lot of nursing!  I'd also recommend going to any breastfeeding support groups in your area so you can ask questions and do weighed feedings so you can make sure your LO is actually transferring any milk.  I highly recommend you seek the help of a IBLCE as soon as possible!  GL.

Eena1242

I have never posted on this board before, but I just went through this, so I thought I would offer my advice.

It's a lot of work, but instead of pumping in between feedings, maybe try hand expressing. It's harder to save the milk but will stimulate your nipple a lot more gentle than a pump.

We were told to supplement at first too, and after I got done nursing I would do some hand expressions onto a plastic spoon and feed that to him before I gave him the supplement. It really helped get us off the supplements quickly. Good luck to you!

ETA: make sure you're eating enough and drinking enough too. Now that I'm able to pump regularly, I can tell that these really affect how much I'm able to pump. My LC said a nursing mom needs 500 more calories daily. That's quite a bit!

mommatotwo2

The other posters have given great advice, so I just wanted to chime in primarily that i agree the goats milk doesn't sound nutritionally complete for such a young baby and I too have never heard that advice.

I also second what everyone else suggested: nurse and/or pump on demand and very often, make sure you are eating and drinking plenty and resting when you can. Let everything else go right now, don't worry about housework, visitors, etc.

Also, its definitely not a bad idea to be checked for retained placenta as @casey78‌ suggested, that can be the culprit.

It's also important to keep in mind that lack of engorgement and leaking do not necessarily mean you have a supply problem. The important thing is that baby is having plenty of wet diapers and is gaining weight.

Best of luck to you!

kateitho

    We've seen the lactation consultant at the hospital 3 times so far, and go back again tomorrow.  The reason we are using goat's milk with an infant vitamin is that I have a very severe coconut allergy that results in anaphylaxis.  Coconut oil is the 3rd or 4th ingredient in formulas, including the soy and sensitives.  It's not because I'm against formula, it's just that formula essentially makes me allergic to my baby.  In our small town, the hospital will only do donor milk for inpatients, and I don't know anyone who is currently nursing.

ETA: I'll ask my OB about the possibility of retained placenta, but my uterus completely prolapsed twice after delivery, so I would think she would have been able to see/ deal with it then.... I don't know though.

kateitho

I guess we actually go back today.... I was up nursing and didn't realize that it's already morning until I saw the sun coming up. lol

mommatotwo2

I see, that does complicate things. That's extremely unfortunate that all formulas contain coconut.

Panaceia

I have never posted on here but thought my experience might help. My milk took over a month to come in properly. We used a lactation aid. Basically you take a feeding tube (you can order these online or get them from your LC or local hospital or medical supply store) tape one end to your nipple with medical tape (don't put the tape on your nipple. ..tape it higher up on your breast so the end sits at your nipple) and put the other end in the bottle you are using to supplement with. When baby latches and nurses he/she will get both your milk from your nipple as well as the supplement through the tube. That way you are being stimulated throughout the entire nursing session and in fact will alleviate your need to pump. I was also on domperidone for just over a month. I did pump for 40 minutes about 3 times a day for the first 6 weeks but my LC said it wasn't needed. When milk started coming in more readily baby would just spit out the tube when nursing. We stopped the domperidone and switched over to supplementing one 4oz bottle a day rather than using the tube at about 2 months when my milk came in more and slowly got rid of that. My LO is now 7 months old and no supplementation needed. Ask your LC about assisted lactation. It is used a lot here in Canada and has been a life saver for me and quite a few friends of mine.

Hang in there and the milk will come in eventually.

kateitho

Thank you so much @ Panaceia .  

****I was exhausted when I wrote my initial post, so here's some clarification on what's going on.  

    Our routine right now is nursing both sides on demand every time he shows hunger cues, which is about every hour and a half.  Then every other nursing we nurse both sides, then the supplement, then relatch on each side for as long as he's willing to play along.  I've been baby wearing and trying to do skin to skin at every feeding, especially when we supplement.  My pediatrician, LC, and OB seem to all be on the same page with our plan.  We even had a conference call between everyone and the head of NICU about his feeding plan.  We're going in today, so I can see both LC's at the same time to talk about the possibility of IGT, which they don't diagnose at the hospital without both LC's being in agreement...

kateitho

    My baby lost 12% of his birth weight, and only gained 2 oz in the past week.   `We did a weighed feed today at the hospital LC's, and he only gained 21g after feeding 20 minutes on each side.   

she said his latch looks good, but he's still only swallowing about every 10 sucks. I also received and IGT diagnosis.  They called my OB, and I should be able to pick up domperidone on Wednesday from the compounding pharmacy.

kateitho

Insufficient Glandular Tissue: I've never had any breast changes before or during pregnancy, and only very minimal changes after, widely spaced breasts, and I have a luteal phase defect which can also come into play...

RosyGlow

@kateitho please have your baby checked for tongue tie. It can really mess with weight gain, supply, and more! I also really hope you can supplement with a Hazel Baker type SNS. It may really help! Hang in there. The domperidone really helped me, but it was slow progress. You are feeding the baby and if you can stick with it, I really believe your supply will come around. It took me from 8 days until the baby was four weeks old to be ready to drop the supplement completely, and I slowly weaned it down from baby's week 2-4 of life. Hang in there, Mama!!

RosyGlow

@kateitho I did the schedule @AmyG*‌ is recommending, and it worked slowly but surely. Please don't give up. My breasts have a wide space, too, blah blah...I'm EBFing my baby just fine since four weeks of age when we dropped the supplement. You WILL get there. It might feel like a battle but you can do it!

kateitho

Thanks for the support ladies.  I got a hand pump yesterday that has a smaller flange than my electric. It is much gentler, and doesn't make me hurt afterwards, so we're trying to get on the ball with pumping after every feeding.  My double electric Avent is too big and pulls quite a bit of areola into the flange which makes my breasts too tender to comfortable nurse afterwards.  I'm hoping that between this and the domperidone, we're going to make it over the hump in the next week or few...

kateitho

I managed to get a Medela Pump in Style, which has a smaller flange than the Avent.  I've been pumping for 20 minutes after every feeding, and taking 30mg of domperidone 3x a day since Tuesday at dinner.  I actually managed to pump a WHOLE OUNCE this morning!!!  And yea, I've only been able to pump about a 1/4 oz at a time since, but this was a HUGE accomplishment, and it's helping me feel like we might be able to make this work!  

kateitho

Thanks @AmyG !  We go back to lactation today, so hopefully we've made some progress!