Chronically low milk supply all but dried up in week 12

[Yika]

I've had a hard time bf from the start - milk never came in and I had to supplement from the start; I soon tried to revert to EBM but baby had not regained birthweight after 2 weeks so I carried on mixed feeding.

Since then I've been topping up daily with an average (lately) of around 150-250 ml, sometimes less, and constantly trying to build supply to get to a point where I can EBF.

Suddenly, at 12 weeks, DD is much more dissatisfied at the breast than normal (virtually every daytime feed now lasts just a few minutes; nighttime is fine and the first one or two of the day are usually OK too) and needs more bottle top-ups. When I try to express to compensate I can see that my meagre supply has dried up, as the amount I can express at any one time has dramatically diminished (by a half to two thirds).

I don't know what can have caused the change. It happened quite suddenly when we arrived in England from the continent for the Christmas holidays.

I had been hoping to use the holidays for one last effort to revert to EBF before resigning myself to mixed feeding for ever after, but it seems the opposite is happening!

Any ideas/advice?

[TruthSweet]

When you say you had to supplement from the start as your milk didn't come in - do you mean you started supplementing from day 7 or do you mean from day 1?. The usual time frame for milk to 'come in' is 3-5 days post birth - this means the colostrum being produced from birth is changed to completely mature milk by approx day 15 with a surge in supply at around day 3-5, with timings up to day 7 being considered late but within bounds of 'normal'.

You have done amazingly well to keep trying to provide bm for your DD, it doesn't sound like you have have much support though. Has anyone explained that amount of milk expressed doesn't equal amount of milk available to baby?

What things have you tried to up your supply?

Have you tried biological nurturing?

Co-bathing to encourage DD to feed/feel happy being close to you/breasts?

Used any herbal/medicines/foods to increase supply? E.g. fenugreek/brewers' yeast/fennel/calcium & magnesium supplements/domperidone/oats - not suggesting that any/all may work for you (or indeed anyone) - it can be a bit hit and miss finding something that works with your body

Expressing post-feed to increase stimulation to breasts?

Giving supplemental feeds by cup or syringe? This won't up your supply but may make bfing seem preferable to the cup/syringe.

Could you try one of the UK bfing helplines (NCT/La Leche League/Assoc. of BreastFeeding Mothers/Breastfeeding Network) if you are in the UK for any length of time?

Good luck and I hope others post with lots more help for you.

[MumNWLondon]

My DS1 only ever had quick feeds. He was a snacker, prefered more frequent shorter feeds. You may well have less as your LOs appetite has increased thus decreasing the amount you can easily express.

[AngelsfromtherealmsofgloryDog]

I would guess the sudden change could be the 12 week growth spurt. Short feeds and fussing are very common.

The amount you can express bears no relation to the amount of milk available to your baby - babies are much better at getting out milk than a pump is. The amount you can express can go down with time as your supply becomes better adjusted to what your LO needs.

When you say she needs more bottle top ups, how do you know she needs more? Babies often want to feed very frequently during growth spurts - they're trying to increase your supply. Keeping offering the breast is really important, or your supply won't keep pace with what she needs, so she'll need more bottle top ups.

Kellymom has good info on growth spurts. There's also info on increasing supply here.

I'd also recommend a call to one of the bf helplines to get some real-life help.

Babies do get faster at feeding with time too.

Good luck. :)

[Yika]

Hi there,

I started supplementing on about day 3 I think as the baby was screaming the place down all night. It was obvious it was hunger as it immediately stopped as soon as she got some formula inside her. I never noticed my milk come in - I think it built up gradually from about 5 days but I've never managed to get through a whole day without topping up.

Initially I used a supplemental feeding system for a few days but it was clear that the problem was not with the baby latching on - she is always quite happy to feed at the breast as long as there is milk (e.g. at night, first thing in the morning) or if she is sleepy and wants some comfort (even if offered a bottle).

In the first month I used a supplement available in Belgium where I live combining all kinds of galactogens such as calcium, magnesium, fenugreek, ... (can't remember the rest) and also took fenugreek (and also drank brown beer which is recommended in Belgium!).

I had advice from an NCT BF consultant on improving the latch and frequency of feeding, which I increased. I have expressed post-meal and 'power-pumped' in the evenings.

I think it may be partially due to a growth spurt but I'm still sure that my own supply has dipped. I am aware that expressing is not a true reflection of what the baby gets - but I'm still puzzled that whereas a couple of weeks ago I could get 40-60 ml in 10 mins of expressing I am now getting only 20-30 and even then it's pretty laborious.

I realise that with top-ups my own supply can't keep pace with the baby and that's why I express to compensate - but no matter what I do I just can't seem to bring my supply up to a sufficient level.

Sigh. Perhaps I'll try once more with a RL consultant.

thanks for the kellymom links - it's a great site and I wish I'd found it in the first week or so!

I think I probably have to just accept though that I have chronically low supply. At least the baby still gets most milk from me - I would say about two thirds to three quarters most days.

Thanks for the support!

[organiccarrotcake]

It's definately a classic growth spurt time and it can really feel like your own supply has gone down but trust your body - it can do this if you just keep letting your baby feed and suckle.

I would definately see a RL consultant again but I think you need to have more confidence in your body to do this. Having a newborn crying like you describe is not unusual and many people top up then, in the first days, see their baby settle and immediately think their supply is low whereas actually it's just the normal mechanism of the baby needing the drive to keep on suckling to get the milk coming in.

You won't necessarily feel your milk coming in at the beginning. While some people feel engorged and a definate change, others feel nothing or very little and are still making enough milk.

The change in expressing is absolutely normal if extremely annoying. I could express 6oz or so easily enough and around the 3-4 month stage I started to struggle to get 2-3 oz.

You are working so hard to EBF and as you're so committed it seems that it would be a really good thing to see a RL BFC and see if you can work out a way to wean off the formula.

Keep it up - you'll get there :)