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Low supply with baby number 2 - is it possible to get this to work?

(11 Posts)
thaliablogs Sat 11-Jul-09 12:28:40

I had DS1 last Thursday (2nd) with a c-section. My DD is 21 months. I had a very difficult time bfeeding her - my milk never came in and I only built a decent supply by demon pumping and lots of domperidone. Even so she was never completely fed at the breast, and needed top ups at almost all feeds until she started solids. I know she had a suck issue, I just didn't know how much of our joint issue was her and how much was my supply. Our difficulties with feeding caused me a lot of grief and took a long time to get over.

DS started off as a great little nurser, he was on the breast within 45 mins of delivery, nursed for 2 hours, and I gave him unfettered access for the next three days despite the midwives telling me he was feeding too much. My milk came in, such as it was, overnight on Saturday, although my breasts didn't get engorged or anything, they did get lumpy and hot and the milk I could hand express changed colour (never had anything like this with DD). On Sunday he started sucking less well. I could see his latch was poor and my nipples were already shredded, but whatever I did I couldn't get him to take a decent mouthful of boob. Then he got jaundice, which eventually required 18 hours under lights overnight on Tuesday, and bottles had to be used so they could measure the volume he was getting. I was able to pump all he needed bar 10mls, which I felt pretty good about. They weighed him and he'd lost weight to day 3 as normal, but had stayed flat after that so I thought that was a good sign things were turning a corner.

They sprung us from the hospital on Weds lunchtime, and I thought he was doing ok, but I was concerned enough to get a lactation consultant in on Thursday evening. By then he was having a top up after every feed, but only about 20-45 mls, and all expressed milk so not too bad. I was depressed to be pumping again but thought we should be able to fix this quickly as i seemed to have enough milk, he just wasn't getting it out of the boob well.

The lactation consultant was great - the first really well informed one I've seen. She told me to start the domperidone as I didn't have enough flow to keep Junior interested on the boob - there was very little 'productive sucking' when he was on the boob, and none at all if I wasn't doing breast compressions. So I started. She also suggested to start using an SNS rather than bottles as he was clearly developing a preference. So I struggled through thursday night trying to use the bloody SNS, which he kept spitting out, or milk would spill out of his mouth because I hadnt got the tube positioned right. By the end of the night I was using it to finger feed at least some of the supplement. Latching was still crap, and involved lots of screaming and pulling off constantly. That's continued through the last 24 hours, and last night the 2 feeds involved up to 90 mls of supplementing, meaning that for this morning's feed I had to finally supplement with formula as I was out of breastmilk.

And I weighed him and although it's the first time on our home scales and I know consistency in measurement is important here, he's lost weight since he was weighed on day 5.

I am angry and sad and not sure what to do. Because I'm trying to ensure he's fed very regularly - that was one of my many mistakes with DD - and because the whole feeding process is taking about 2 hours by the time he's latched on and off lots of times, fallen asleep on the boob, had his nappy changed twice, I've pumped and finger fed until he's happy to settle etc., I have pretty much no time in between feeds to do anything, and I'm only getting about 3-4 hours of sleep. Which means very little time with DD, which I hate.

Until some time last night I had the sense that this could really work if I tried hard enough. I thought I had more milk than I did this time last time, and he had started off being such a good feeder. I'm sure it's theoretically possible to make this work, and I remember last time by about 4 months how happy I was that I'd persevered with breastfeeding, but I'm not sure it's worth trying that hard. I cannot do what I did with DD, it's not fair to her. So I dunno. It's all a bit crap really.

Not really sure what I'm looking for but thanks for reading so far. I won't quit today, I'm clear on that. Tomorrow I'm less sure about. After that I'm not sure how to manage the grief that this bfeeding relationship yet again hasn't worked.

EldonAve Sat 11-Jul-09 12:36:48

Why are you pumping and supplementing?
Why not just feed him yourself?

thaliablogs Sat 11-Jul-09 12:55:51

he is going on the breast at all feeds but i can barely see any productive sucking. He is still hungry after over an hour on both breasts (he's starting to refuse the lower production boob actually). The SNS allows me to give him breast milk at the boob if I can get it working, at a faster flow than my boobs can provide. Even with this he needs more top up at the end of the feed. And yes I've tried just swapping him back and forth, he's still hungry after literally hours of this, and doesn't suck well anyway.

Believe me, there's nothing I'd like to do more than what you suggest. That I can't do it is the source of huge pain for me.

AitchTwoOh Sat 11-Jul-09 13:18:54

sounds really tough, thalia. i was in pretty much the same situation as you, although i never managed to fully conquer my supply issues with dd1. so i was very determined to do it with dd2, and then she was prem, which was a pita.
still, she was a good wee trier, more assertive on the breast it seemed to me than her sister was. we persevered with the pumping and the topping up etc for five months, before i let the bfing wind down. i know what you mean about wanting to be fair to both of them wrt bfing, but also wanting to be fair wrt your time. it's really difficult.
if you're not going to give up today, good. take it one day at a time, you'll know when you can't do it any more if things don't improve. in the meantime can you fully concentrate on all those things they say, skin to skin, babymooning etc, and take dd into bed with you?(we have a tv in our bedroom so that dd1 could watch cbeebies and get a cuddle of sorts while i fed. it became like a gross picnic area, our bed, but at least i had time to read dd1 stories etc).

one day at a time, have a look at jack newman's website for the clips, and good luck. you know that if you can get through these early days you'll be happy that you did. (and as someone with a three year old and a nearly one year old i can tell you i really wish that the exc bfing had worked out so that i wouldn't be faffing about with bottles all teh time. for the brief few weeks of exc bfing i had, the liberation was wonderful.) smile

tiktok Sat 11-Jul-09 15:00:18

thalia

It sounds like the LC you saw was very good - interventionist for the right reasons, and clued up. The current issue is you have seen an upsetting weight on your home scales....what sort of scales are these? Not bathroom ones, surely? Whatever....you are right, consistency in scales makes a difference and I think you might be helped by

* contacting the LC an asking what to do

* getting a decent, accurate weight

Both possibly hard to do on a Saturday...but without these steps you are floundering and not even knowing if youshould be worried or not.

thaliablogs Sat 11-Jul-09 16:47:20

Thanks so much to both of you.

The scales I am using are proper baby weighing ones, I got them with DD because diff ppl kept weighing her and I wanted to be able to check how she was doing without going to the HV. But still it's the first time Ive used them for DS so don't know how they differ from hospital ones - basically weight is flat since day 5 and today is day 9 so not disastrous but not great. (30 grams less but clearly cant go to that level of accuracy w diff scales).

I have sent a text to the LC to see if she can contact us tomorrow, I know she is working today and can't answer the phone.

Current feed is worse, he is refusing both breasts. Instead of developing a nipple preference he's developing a finger feeding preference!

Thanks again

AitchTwoOh Sat 11-Jul-09 17:16:47

hang in there, thalia. smile

verylittlecarrot Sat 11-Jul-09 21:28:55

Sorry for your tough time thalia - keep hanging in there. Some suggestions to try:
Have you tried biological nurturing / breast crawl to try to get a better latch?
I found that "more milk plus" actually had a more tangible and rapid effect on my supply than domperidone did, which was surprising, as one is a proven medication and the other is basically a devilish pond slime suspension designed to test the strongest iron stomach. Still, I actually felt and saw the supply increase within 24 / 48 hours with MM+ which was encouraging.
Are you able to co-sleep and night feed lying down? I found that my dd took in a lot of her feeds through the night, and even if she wasn't actively sucking, she'd be latched on, and I'd get random let downs every now and then which would deliver milk to her in her sleep.

The very best of luck.

AitchTwoOh Sat 11-Jul-09 21:58:51

oh YES, i'd forgotten about more milk plus. DISGUSTING but it really works. and i took shitloads of fenugreek on top of it. my nails were LOVELY, it's good for those too.

thaliablogs Sun 12-Jul-09 23:07:23

I'm taking more milk special blend - the one that's supposed to help build glandular tissue as I seem to have very little in the left breast in particular.

Today was a bit better. Had one feed where he did some productive sucking without the supplement for about 5 mins. NOt amazing but better. Also getting better at not letting feeds take 2 hours so am spending a bit more time w DD which helps.

Next step is coming to terms with the fact things are not miraculously better this time, and I am never going to have an easy time feeding my babies. Will work on that!

Thanks again for help

Has anyone tried alfalfa and/or psylium to build supply?

AitchTwoOh Tue 14-Jul-09 16:10:50

yep, it's a bummer. i had such high hopes for dd2. how's it gone today?

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