Still struggling to BF - supply issue. Help please!

[mummyjah]

Dear all,

I am back on this board as am still struggling to BF a now-19 day old DC4. He had jaundice and was sleepy, lost a lot of weight, had low blood sugar in the first three/four days post-birth so didn't get BF established. He's now fine and wants to feed (alert for a lot of the time) BUT I now have practically no milk left. I never felt my milk come in with him and have never felt full. I can only express very little and it's going down by the day. I am pretty sure that I have a supply problem. I am desperate as am determined to BF him (BF the other three DCs for two years, no problems). I have ended up in the cycle of expressing during the day/after feeds, to try and get some milk into him, but has this killed off my supply? He wants the food - happy to bottle feed but now cries on the breast because there must be nothing there for him (this is my instinct about why he cries). It's getting less by the day. He's been checked for TT, latching, etc.. All fine (and I would agree with that as I can tell that he wants food, I just have very little for him). Last week, he put on 180 grammes and was back up to his birthweight (just over) by day 16 but that was with a torturous regime of feeding + expressing which we certainly can't sustain. Can anyone recommend anything at all , and mostly, ways to increase my supply quickly? With DC 1, who also had jaundice, I increased my supply by pumping but this time things aren't happening. I'm trying fenugreek today - I have tried feed fests, skin-to-skin, lying down with baby all day and night, etc.. Any advice gratefully received as am really sad about this.

[JiltedJohnsJulie]

mummy this must be heartbreaking for you. Assume you've seen ths article on low supply. Taking Fenugreek does sound like a good idea.

Could it be that he is fussing at the breast because its just easier to get the milk from the bottle?

As for the expressing, although it can knock your confidence if you don't get much its no reflection on your supply. Don't forget that your baby will be much more efficient at getting the milk out than you ever will.

Have you seen a BFC? What does she say?

[featherblue]

I feel for you. I am in the same boat with my now 9-wk old and am completely heartbroken about it. We had tongue tie, but I truly feel our problems were mostly my supply, though that could've been caused by the tt. my thread.

I'm now at the point where I feel my supply has definitely improved, but my baby has a clear bottle preference and cries every time I put her to the breast (which I do before every top up). It's heartbreaking, and I believe she will refuse completely soon. So my only advice is to use a SNS to supplement if you plan to continue the breast/topping up/expressing regime. I wish I had, as now I can't get her to finish the milk that is there.

To improve my supply I take domperidone, fenugreek and an iron pill (read somewhere that low iron can interfere with milk production). Also, can you ask your GP for a blood test for underactive thyroid? It can very much affect milk production. I think my underactive thyroid contributed, though it is under control with medication.

It's been a pretty horrific 9 weeks, and I really feel for you. I think it's been worth it, but I do not have 3 other children I need to look after. People will tell you that there's no such thing as low supply, but you've breastfed 3 others and I'm sure know when the baby is getting milk or not. I can tell a clear difference at night (the only time my breasts feel remotely full) when she's swallowing milk than during the day when she's not.

I hope this is not discouraging you. I have managed to mix feed for 9 weeks, which I should be proud of. And some wonderfully supportive mumsnetters from my thread have been successful for much longer. It is possible.

[lilham]

I also think the problem might be he's used to the bottle, and find the breast different. (hence you have ebf babies refusing bottles in reverse). Milk is completely supply and demand. The baby is better at getting milk out than a pump. For example i need to pump 2-3 times to get one feed in bottle. Without him sucking properly I think that's why you don't feel the milk coming in.

Have you rung one of the bf hotlines? Or went to see a bf counsellor? Your situation must be fairly common.

[mummyjah]

Thanks everyone for your responses. It is a desperately sad situation. I have no idea what went wrong and keep on trying to piece the early days together to see if I can find the cause (and thus fix it - no luck as yet!). I've seen a bf counsellor - latch fine, no tongue tie. When I saw her, he latched on well and fed well, but that was when my supply was greater. Everyone was happy with my feeding at the hospital. I've rang helplines, etc..He was born in good condition and quite big so no issues there. Do I need to take domperidone and fenugreek together or should I start off on one and start taking both if just the one supplement is not working?

[Albrecht]

My instinct would be that you need to see someone, not to observe one feed, but to talk through and make a plan of how to get back to bf, if that is what you want. I'd try a helpline again or you can search for a local support group here

As I understand it drugs alone will not majorly increase your supply if the baby is not stimulating your breasts to increase. Have you looked at a SNS as featherblue suggests? I've read you can make your own if its difficult to get hold of.

I'm not sure that looking for a cause is necessarily going to provide you with a solution. I think you have to start with where you are today rather than what you did or didn't do in the past. Good luck.

[featherblue]

You can take both together, and as time is so important here, I would. I'm sure you're doing switch feeding and breast compressions? And just pump pump pump, as well as trying to get him to spend as much time on the breast as possible. I wish I had offered slightly less supplement than she needed and just kept putting her back to the breast when hungry. Feel that may have helped us.

I really hope it turns around for you!!

[violetwellies]

I had horrendous problems feeding a breast refuser, after he was bottle fed for his first feeds - my medical situation plus dp not fighting hcp to get him on a cup.
I am now ebf, and have been since 6 weeks, with top ups of expressed milk.
I didn't give him a bottle after every feed.
Would feed, pump feed again, then top up after next feed. I cut out night top ups first, was effectively feeding or pumping round the clock for several weeks.
My idea was to wean him off the bottle, used nipple shields to con him into thinking he had a bottle :) then had to wean off the shields. Didn't use them for every feed for long - it just seemed like it.
Took fenugreek & blessed thistle ate a lactogenic diet.
Am still off caffeine & citrus but am mostly back to normal now & have no bottles, no nipple shields & no herbs to remember. It was all bloody hard work. :)

[devonshiredumpling]

this sounds silly but if you express more at night and make sure you do than it does increase your supply it is a pain but if you get up during the night it increases your prolactin levels and fools your body into thinking that all of a sudden your baby needs more milk hopes this helps