Trying to increase milk supply - how much longer do I keep going?

[MenorcaSunrise]

My baby was born emcs and with early jaundice, so he was mostly formula fed at the start and as a result we've always had issues with milk supply as well as latching. Now 3 months on we're mixed feeding and I'm still trying my best to increase my milk supply. I've been on and off domperidone and trying to pump as frequently as I can, but I can only get 10-30 ml from both breasts each time, depending on when I last breastfed. It can be a struggle to get baby on the breast - he knows he gets more and faster from the bottle (we use Medela to make him work a bit harder for his formula) so he often cries and refuses after a few seconds on the breast. He's much more receptive during night feeds and just after naps when he's calmer. But it's hard to tell how much he is getting from me. After feeding him twice overnight, I think we've done well, only to find an hour later in the morning that he's starving and guzzling formula like he never had a night feed.

We've been to the infant feeding clinic, seen a feeding specialist provided by our children's clinic, been to breastfeeding cafes, hired hospital grade pumps, tried sns, read all the advice on Kellymom and I think I have exhausted all the advice that there is. At the moment, going by what we expect baby should be taking in, I think we're about 70:30 in favour of formula.

I'm making another push now with 30mg/day domperidone plus fenugreek, and offering the breast and pumping as much as I can. Things seemed to be improving slowly - he started latching a bit more willingly as he matured - until a couple weeks ago when baby started having reflux issues. We've seen a gp and started infant gaviscon, but it's made things so much harder - he'll only feed horizontally but cries on pain when I try to lie him down. (He's never liked reclining position, vertically or feeding on top of me - he can't latch and reverts to old behaviours of screaming and head banging in frustration.) I find myself carrying him in my arms or in a sling and soothing him almost constantly all day. He'll nap but for only 30 mins at a time. When I do have some respite, I'm too exhausted to do anything, and am only fitting in one pumping session a day now.

I desperately want to breastfeed more but the infant feeding team suggested kindly that I may have to readjust my expectations, do what I can, and to just enjoy my baby. He is healthy and putting on weight otherwise. My husband is supportive, makes me breastfeeding cakes, but he works all day. How much longer do I keep trying? I know it's an answer only I can give but I would love any more advice or support.

The one thing I didn't do was post on mumsnet about this - I didn't know about this infant feeding section sadly and I wish I'd posted sooner. (I think it's a bit tucked away - wouldn't it be more visible in the Being a Parent section?)

[Changerofname987654321]

You have done so well to breast feed for so long.

I gave up at 7 weeks after having similarish issues. Have you had little one checked for tongue and lip ties? Go back to GP and ask for rantitadine rather than gaviscon as it is better/easier for breast feeding.

I felt emotionally much better when I have up breast feeding but I needed therapy to deal with decision.

[MenorcaSunrise]

When i first found this section there was a thread that gave such excellent advice with an example of a detailed plan on how and when to pump to increase supply and how to fit it with breastfeeding. I wish I'd read that sooner - I wasn't told anything other than to pump every 3 hours.

[MenorcaSunrise]

I think the various consultants we've spoken to have watched is feed and looked out for it, but I don't recall anyone actually opening my baby's mouth to take a l look.

Baby does feed well at night - latch feels good. He's just more impatient during the day when he's awake. Suppementary feeding should have helped with that but he often choked on the tube, even though it was barely past my nipple and in the corner of his mouth.

[MenorcaSunrise]

Thanks for the recommendation of ranitidine. It's on special order and on the way.

[MenorcaSunrise]

I know formula is not bad. But I look at his little face and I just want to give him the best. It breaks my heart a bit when I go to baby classes and all the mums get their breasts out and I'm usually the only one with a bottle. No one's judging me, but it makes me quite sad. My friends told me it's more important for baby that I'm happy rather than stressing out about formula. And I don't think I'm stressing exactly, just a bit mournful and tired from trying with very little to show for it.

[cookiefiend]

Follow that detailed plan on how to pump every three hours. Give it a bash. Ultimately you decide when you want to give up. DD1 was finally free from formula top ups only a few weeks before she was six months (and about to start food). So it took ages, but by that time she was down to one top up a day.

Gradually reduce the formula and see if you can drop a top up here and there. Even if you have to increase the size of another feed, it feels good not to have to top up each time. I dropped the night Ines first so that she was waking during the night for a feed and I didn't need to get out of bed. I also started co sleeping with her which made it easier.

I never got more than 10-30ml expressing. But my supply did increase by pumping so DD1 got more.

It was suggested I give up too. Or st least stick with mix feeding. I didn't want to as I felt like a failure. In hindsight that was so stupid- she was loved and fed and getting the benefit of breastfeeding. However I am glad I did as it was right for me.

Do what suits you-!what you can cope with. You are doing so well and it is so hard. Focus on nigh time expressing (tiring as it is) and be more forgiving in the day so that you actually get out a bit.

What a huge ramble. I hope it is encouraging. Come back and let us know how you are doing-!younsound so much like me. I am currently feeding DD2 (almost 2) and DD1 still has breast milk at night. I worry my initial dedication to breastfeeding may mean I am the subject of some kind of channel 5 documentary one of these days!

Good luck- it can be done if that is what you want.

[cookiefiend]

Sorry- DD1 is 4.

[ElphabaTheGreen]

Back to basics...

What makes you think your supply is low?

Nothing of what you’ve said above is indicative of a low supply. An inability to pump much is not an indication of a low supply - it is an indication of how much you can pump which, for some women, is not much. They can still produce plenty to feed a baby directly from the breast. Also, a baby downing a bottle quickly is not a sign of a hungry under-fed baby - a baby is a captive audience on a bottle. They don’t have to work as hard to drain a bottle, so do it quickly and take more than they need.

The best thing you can do to increase supply is go to bed with your baby, skin to skin, and feed, feed, feed off both breasts, repeatedly. Don’t stop after the second side, go back to the first side and keep offering until baby conks out. Let baby sleep on you, skin to skin, then repeat.

[ElphabaTheGreen]

I find myself carrying him in my arms or in a sling and soothing him almost constantly all day. He'll nap but for only 30 mins at a time.

This is perfectly normal. Nothing to do with him being under-fed or you having a low supply.

[ElphabaTheGreen]

When I do have some respite, I'm too exhausted to do anything, and am only fitting in one pumping session a day now.

All the more reason to take yourself to bed, do as little as possible and feed like mad.

[MenorcaSunrise]

Thanks for the support from both of you, I do feel a bit better now. I'll give it another bash, as much as I can around the reflux issues. And I'll pump more often overnight - I found it so hard to do it when I'm half asleep!

[ElphabaTheGreen]

But why pump overnight? Breastfeed him when he wakes at night - far better than pumping.

[Bosabosa]

I would also add, make sure your fluid intake is high-lots of water, juice, tea etc- I always found an effect on supply if I hadn’t drunk much. Food too/make sure you are nourished- hard I know with a little one!! Good luck OP

[MenorcaSunrise]

I think I have low supply/slow flow, I guess partly on how much I can pump (5-10 ml on left, 15-20 ml on right) and it matches up with what I can breastfeed on each side. This morning, baby fed for a couple of minutes on left, then yanked off and started crying. I tried the left again, then the right and he stayed on for about 15 mins. I do offer him my breasts as much as possible, but he doesn't latch readily during the day when he's alert. We found by trial and error that humming and singing a particular song to him encouraged him to stop fussing and go onto the breast for a few seconds (it's so weird, like he's being hypnotized onto the nipple), but he'd be on and off, on and off, its quite frustrating. After a lot of this he starts crying, and it is impossible to get him on then.

[MenorcaSunrise]

I try to pump overnight after breastfeeding him to empty my breasts. He only feeds twice, usually 4 and 5am. I am a bit worried sometimes that I will pump and then he'll want to feed unexpectedly (more during the day) and I won't have enough for him.

[MenorcaSunrise]

Thanks for the reminder about fluid intake Bosabosa, I'll go have another drink of water now!

[ElphabaTheGreen]

Nothing there says low supply to me at all. I think you’re anxious about how much he is getting - I do not think your supply is low. How long he feeds for means nothing, either. Some efficient babies can get a full feed in under five minutes. Some do need 15-20 minutes, or more.

I really think skin to skin for a few days (with no bottles at all) will make him happier on the breast and help you to feel more confident. You say his weight is good and he’s producing plenty of wet and dirty nappies. Those are the only indicators you need that he is getting enough.

[MenorcaSunrise]

ElphabaTheGreen, the carrying and soothing all day is a newish thing - I thought it might have to do with reflux as he cries when horizontal - this is exacerbating my feeding issues!

I have thought about trying to feed him vertically in a sling but I'm not too sure how. My nipples are lowish and he's a very big and long baby, so he'd have to be down to my knees or really curled up to get to my nipple.

[ElphabaTheGreen]

X-post.

You can’t ‘empty’ breasts - they’re factories, not warehouses! If you’ve just pumped and he wants a feed, your body will just produce milk directly from your blood stream. He will still get milk and your supply will only improve.

[ElphabaTheGreen]

The carrying and soothing is probably more to do with his age - he’s becoming more aware, so wants to know you’re there to protect him.

Both of mine were unputdownable Velcro-babies and never had reflux.

[ElphabaTheGreen]

PS Feeding in a sling is a bit of an advanced skill, and depends on your sling as well. I really only cracked it with no. 2 using a wrap sling.

Get thee to bed with baby!

[Wigeon]

I’m also confused as to why you think you have low supply. If you’ve read Kelly Mom, you’ll see that amount pumped is no indication of low supply. I got loads less when I pumped compared to what my babies seemed to be getting direct from the breast. Two feeds a night plus a hungry baby in the morning sounds completely normal for a 3 month old - actually quite good it’s only 2 night feeds!

Is he putting on weight normally? Why are you pumping rather than just giving him the breast as often as possible? The baby will stimulate your supply to meet what he needs. I would just stop beating yourself up about the amount you get when pumping and just feed!

A baby who wants to be carried all the time also sounds totally normal and nothing to do with supply / lack of.

[MenorcaSunrise]

ElphabaTheGreen, but we're mixed feeding him, he's happy and satisfied because he gets 600-800ml formula every day. I should be encouraged that it means he's getting a fair bit from breastfeeding too, but we haven't really been able to shift this formula quantity down. Even on a good day, when he appears to be breastfeeding relatively a lot, he gets more and more unsettled until the evening/late night when he cries and cries, and will only stop with 150-200 ml from a bottle, and we are back up to 800ml of formula. The other thing is that if he isn't full then he won't nap/sleep - he ends up overtired and crying, and won't breastfeed then either, but he will take a bottle. So we
just give him some formula so we can all get some rest. 😞

I have tried to reserve pumped milk for the evening, but plans have gone out the window recently because of the refluxing, but I'll try again now.

[ElphabaTheGreen]

Even on a good day, when he appears to be breastfeeding relatively a lot, he gets more and more unsettled until the evening/late night when he cries and cries

Again - completely normal. Both of mine were evening screamers until 10-12 weeks old. They wouldn’t take the breast either when they were like this until I went into a dark room, got skin to skin and blasted white noise into their ears.

If you’re happy mixed feeding, that’s fine, but you’re indicating you want to EBF, and you seem to have the idea that you have low supply when there are no indications of his from the information you’re giving.

[MenorcaSunrise]

He brings up a lot of digested milk, coughs when feeding, cries and seems to be in pain when we put him down (his legs keep straightening). We started carrying him vertically for 20-30 mins after each feed and this has helped a bit, he brought up less. This is why we think it's reflux, though I agree he is changing and maturing.