Help! breastmilk drying up fast (a long read)

[Lucy123]

..well at least I think my breastmilk is drying up.

Dd is 16 weeks old and up until last week fed very well (4 meals a day with "snacks" before each nap), although she did have a very occasional bottle of formula when things were tricky like when I had to go out. She sleeps through the night too from about 9.30pm to 8.30/9am (yes I know this is very lucky - was a bit worried it was too much but I need my sleep so didn't let it get to me).

Anyway last week we went to Granada to go house hunting. On the way, the car broke down and we had a couple of hours of major stress finding a breakdown truck (don't have insurance) and then trying to find a garage that would fix our 12 year old English Landrover. Cue lots of sucking air in through teeth and shaking heads. We couldn't miss our house appointment so we ended up leaving the car and hiring one and going straight to Granada.

This resulted in poor dd's routine being totally thrown. I fed her a bottle of formula in the car (didn't want to get her out of her car seat to breastfeed - ended up doing this on the way back anyway though) and she had only had 3 meals by bedtime. Lots of screaming and feeding in the restaurant later, she went to sleep at about midnight. Her routine was pretty much out of whack the following day too (and she had another bottle of formula). I was, of course, rather stressed.

Since we've been back things just haven't fallen back into place. The first day I spent about 3 hours feeding her in the afternoon and it was very tricky to get her to sleep. Yesterday and the day before at several feeds she just flatly refused my breastmilk, but screamed until I got her a bottle. On some occasions I noticed that there didn't actually appear to be any milk, although once or twice I could get a good squirt out of the breast she'd refused. I also tried several feeding positions each time, including lying down, which has always worked before. Because I also managed to express far more than usual last night (but that's not saying much). Finally she woke up at 7am yesterday morning, in the middle of the night last night and at 6am this morning.

So my question is this: is it possible that the formula plus the stress have significantly reduced my milk supply over only a few days? Why would she suddenly start refusing breast milk at the times when there is some? Is there anything I can do, or to avoid stress all round should I just give up and move to formula? If I did do that is there any reason why I can't keep, say, the breakfast feed (which has been the best through these days)? Would solids help? Argggh!

[Philippat]

I had this trouble when dd was ill and kept puking on my breast milk, but not on formula. After a few days of expressing rather than feeding my supply definitely diminished.

Even if the stress and change of routine has reduced your supply, it builds up again fairly quickly. Don't go over to formula or introduce solids unless you really really don't want to exclusively breastfeed anymore (if you don't, well fair enough, don't feel guilty about it).

Over the next few days you just need to take it easy, forget all about your routine and just put her to the breast often (even if you don't think she's hugely hungry). If she needs more milk, she'll wake up at night, but that'll help your supply build up too. Try not to give in and give a bottle because she's probably finding that easier to get the milk out than the breast, but if you absolutely must, try and make it EBM rather than formula so you keep you milk up. If she yells and refuses the breast, distract her and then try again a short while later (I always found a darkened room helps).

Fengeek is supposed to help if you can bear the taste and I know Mears has posted about a drug you can buy over the counter that boosts your supply.

In a few days time, it'll all be back to normal and you can go back to routine again. It may take a week but shouldn't take much longer.

If you then want to change a feed over to formula, your supply should adapt to that fairly well, but it's best to just let your supply build up again first.

[SoupDragon]

this is the drug Mears mentioned "For women who truly do not have enough milk then Domperidone can be prescribed/bought over the counter - increasing milk production."

Stress can cause a temporary drop in supply and this coupled with the "missed" feeds may be the problem. Stress, I believe, also affects your let down reflex and this may be why your DD screams - she sucks and nothing happens. This makes you more stressed which affects the let down reflex.... get the picture?

Try to relax when feeding. A quiet, dark room, a comfy chair, quiet relaxing music, lavender aromatherapy oil in a burner... and keep feeding. This will build up the supply again over a few days - the longest I've had it take after a bout of illness (mine!) is 4 days. When DS2 stopped feeding because of the heat it only took 2-3 days to build back up again.

I agree with Philippat - use EBM instead of formula in the bottle. If DD won't feed, express at the feed time so you have a bottle for next time.

RE solids, current WHO guidelines recommend introducing solids not before 6 months for breastfed babies.

[pupuce]

Lucy 123 - I think if you can persevere you should. IMO this is not a reason to start solid.... but why don't you call a BF counsellor for some 1 to 1 suggestion ???
There are loads of reasons why this may be happening at least a counsellor can walk you through them and together you can see what is the best way forward !!!

GOOD LUCK

[tiktok]

Lucy, the breastmilk supply is pretty robust and flexible. It does not just 'disappear' with a few days of not feeding very often, once it has become well established.

That's not to say it is not affected by this. BTW, the stress is not an issue - fear and pain can affect let down, and some people let down more easily when relaxed, but overall stress has no affect on quantity. There is research on this, and it makes no sense in terms of teleology (the way evolution has caused us to adapt and improve our bodily functioning over millennia) for stress to reduce quantity.

However, your baby has fed for a while on 4 feeds a day, which may not be often enough (at this stage) to be robust enough to withstand further gaps - but that does not mean it is gone forever, no way !

Feeding more often will restore it, and that means offering your baby lots of chances to feed at the breast, maybe when she is sleepy and relaxed, and forgets there has been an 'issue' about it. Keep her close day and night - literally close, skin to skin with you if you can at least some of the time, and she will return to the breast and your milk will whoosh back.

She is young for solids. Giving formula and solids at this point will make your supply worse. No, I don't think you would be able to keep the breakfast feed going indefinitely. People do continue bf on one feed a day but this is almost always after many months and later years, of bf.

Call one of the breastfeeding lines for more info: 0870 444 8708 is the NCT one.

HTH.

[bundle]

lucy, one incredibly simple tip a breastfeeding counsellor gave me when I was having problems was a reminder to drink loads of water, especially with it being so humid at the moment you need it to keep things going (if you want to continue). hth (I bf for 23 mths after a very difficult start, 3 bouts mastitis in 10 wks...the difficulties made me more bloody minded, I think!)

[mears]

Lucy123 - have faith - you have not lost your milk. You have had a rough trot over the past few days and that can interefere with your confidence. Put the bottles away and feed as much as possible to get your baby used to being back to the breast. Try and remain relaxed . Your milk supply has been well established and your feeding will settle back to a normal pattern.
It is unlikely that you would need Domperidone at this stage.

[Lucy123]

thanks all. Felt much better yestrday, tried harder and already i seem to have far more milk (so much in fact that when I continued the frequent feeding this morning she ate too much and chucked a fair amount back up again). Phew!

[SoupDragon]

[tiktok]

Brilliant, Lucy - your are a text book case demo'ing just how robust the milk supply really is

[Lucy123]

I've just had to read this thread again for reassurance. After more or less re-establishing my milk supply, we moved house. As we work from home this was a very very big deal and I was needed to help with the move and with dealing with all the cliet emergencies that came up while we were in the process. Unfortunately dd had become difficult to feed again and after much heart searching i decided to put her permanently on two bottles a day (yes, Mears I know I shouldn't, but I simply didn't have the time). The final push came with a dirty look from my home-help and a "she was hungry" after I gave in and let her give her a small bottle.

Turns out though that you shouldn't do this and the last week has been hell, with dd screaming the house down, not taking her naps properly etc. The absolute worst came yesterday when I ran out of formula and had to buy some Nestle (wouldn't normally!) added-bifidus stuff from a small shop. I would have been better off letting her go hungry - the poor little thing had terrible wind and really frequent, runny, yoghurty poos.

Sorry, I just had to share that.

Anyway I'm now back to square one, only we've been on mostly bottle for a week so i think I have substantially less milk this time. I've kept up the morning feed, though it's been shorter every day, and given odd short feeds through the day. Also been expressing once a day, but I always was a bit rubbish at that.

I feel very silly - the restoring-milk screaming was nothing like this and I think I should give it another try. I've been keeping her close and feeding her at pretty much every opportunity (but also giving her a small bottle here and there so she doesn't starve: she fed for about an hour and a half this afternoon and then gulped down a 120ml bottle when I finally gave it to her.). I simply don't know what to do now. We're still very busy, but I would rather continue to breast feed. Unfortunately she will never ever feed sitting up now (only lying down) so going out with her is out of the question. Will it get better or have I gone too far this time?

[mears]

Lucy123,

You can still retrieve breastfeeding so don't panic. If she takes a bottle sitting up she will take the breast. You're confidence is just knocked. As you know yourself, the more you feed, the more milk you make. As she is mainly on bottles what you could do is breastfeed first and if you feel she is still hungry give her a bottle but reduce the amount of formula you offer each day. If you have time you could express inbetween to increase your supply if she settles for longer spells after the formula feeds. By reducing the amounts of formula given she will need more breastfeeds to increase your milk supply.
Remember also that babies who have had a decent breastfeed will still wolf down formula straight after because it is different.
Think what you can be like yourself after a huge meal. One minute you are stuffed but when pudding appears you can manage to scoff that too.
Mabe tiktok can offer more advice.

[tiktok]

Agree with mears....it's the frequency with which you feed that will help restore your milk, just as you did it lst time : )

So reducing the formula amounts will ensure she will not go too long between feeds.

Wolfing down bottles is no indication whatsoever of whether a baby actually 'needed' the formula....remember that the teat is a super-stimulus to the baby's swallowing reflex, and babies who like to suck will often just sit there and swallow away : )

Your confidence is fragile - stress and pressure have probably made you more sensitive to the look the home help gave you. What would she know about your baby, and what your choices are??? Read the thread again and just hang on in there!

[Temples]

How soon does the frequent feeding result in increased milk production? Is it hours? A day? A few days?

[SoupDragon]

Mears, Tiktok, what do you feel about the use of hrebal remedies like Fennel Tea and Milk Thistle to increase supply? Do you think they actually work?

[mears]

As with all things, if they do not do any harm and you THINK they work, they probably will. Not sure if any scientific basis.
Frequent feeding should see a response in 36-48 hours on average. Everyone is different - could be 2-3 days.

[tiktok]

I don't know of anything you could call good evidence for herbal remedies, but a lot of people have observed they seem to help.
They are not a substitute for frequent, effective feeding though - that's what makes the milk. I think it's a shame when women are told the reason they may have a problem with supply is due to not eatng/not drinking/not resting/being too stressed....tosh!! It's down to frequency and effectiveness. Diet and so on may have a slightly marginal effect in a few people, I suppose, but no more than that.

As for time span - it varies. Some people notice an effect straight away, certainly in less than a day. Others may need a few days of consistent, extra feeding.

[Eulalia]

Yes tiktok I've never drank a lot more, even when we went to Spain recently and it was very hot. Also there seems to be a myth about giving a baby water which just fills them up with useless liquid. After all breast milk is mostly water! My baby is 6 months old next week and has never had a drink of water in her life. I second that also about feeding often, just a few minutes every hour or so or even more often. Sometimes dd pops on and off every few minutes if I am just sitting in the evening.

[alux]

thanks for this thread. I'm walking in these shoes with dd at the moment. A stressful weekend for both of us going 2.5 hrs away to a christening and staying away from her familiar surroundings. Hoping to re-build my milk supply.