is this me not having enough milk?

[reastie]

we are having issues with settling my 3.5 mo dd in evenings which I'm wondering is (partly) due to if I have enough milk.

We had bf with one formula feed in the night until a couple of weeks ago when dd started sleeping through the night, since then, she's been a nightmare to get to bed and I often feel like she wants more milk than I have in evenings (effectively we have dropped the ff as she's sleeping through so I have to provide milk during the day/evening to compensate for it).

I cluster feed in the evening and we give a ff top up of a couple of fl oz or so at about 7 to try and help her. Last night, I did things differently as we tried no ff top up and saw how she went - she woke up screaming and only feeding would stop her. She fed from me both sides until it hurt and she kept trying to feed but coming off the boob and crying in a frustrated way so I gave her a bigger ff top up of about 80 - 100ml. After that - she was chirpy and happy like i've never seen her at that time of day - she even went in her cot looking happy and talking (as opposed to the usual screams straight away).

Have I just not got enough supply in the evenings? Can I up it or is this common? I'm wondering if I should regularly d a bigger top up at the 7pm feed now to catch the hunger before she gets really upset all evening as maybe this is the cause . Ohhh. so many questions, sorry, but you are all so knowledgable and helpful

Have you read this on Kellymom? It's very common. I think the risk with big top-ups is you are further reducing your milk supply.

interesting reading rita, although it says it should start getting better at 3 - 4 months when it's getting worse/starting like this here . It also says it's not milk supply that's the prob, but then she was so content after the ff last night I'm querying that. I can't put up with every evening like this on my own (Dh goes to bed early as up early with work so I have her on my own). That combined with having to get up at 5 every morning when she's hungry is really getting me down

Hi - I'm not sure about your supply, but a similar thing happened with my DD at about 3.5 months. I was determined not to give her formula, and soldiered on until I was a physical wreck by 4.5 months, when I introduced a 7oz formula feed in place of the last breast feed. She started sleeping again, and I just kept on breastfeeding, except for her final feed. She's 7 months now, and I am still going with the breastfeeding. I know it's not "perfect" breastfeeding, but at least she's still getting breastmilk. Personally, I'd give your DD a bit of formula again (I'll get flamed now!!) I have taken a lot of Rita Morgan's advice, though - Rita, what's your view? I wouldn't think one bottle should matter at this stage? Good luck.

Well its upto you really. Do you want to give her a regular ff say at 7pm or do you want to cut out the formula top up? If you want to do the ff obviously thats fine and if you want to cut out the formula top up have a read of this this on Kellymom. If you do decide to cut-out the formula I think it may take a few evenings to increase your supply.

It might also be worth talking how you are feeling and your options through with a local Bfing Counsellor or one of the Helplines.

The only other thing I can think of is it may be the 4 month sleep regression.

that link is really good jilted . this started at 3 months though so not sure re: regression (and also started when she started sleeping through the night ). I'm not adverse to a ff every day (only one max if i can help it though) as we've been doign this for ages. obv ideally I'd prefer not, but, if it's the only way i can get some sleep (and so function better and do more with dd in the day) i don't mind, i just feel so guilty if ever i feed it to her (it's ok if i'm asleep and dh does though ). Maybe tonight I'll try a feed at 7 and then a top up after but bigger than normal and see if it works. Maybe my munchkin is just eating more milk than before as she gets bigger and my body struggles to keep up

reastie don't ever think that you don't have enough milk. You've managed to get her this far haven't you . You have milk even if your boobs feel empty you will have milk.

Like Rita says though, the top ups will further reduce your supply. If you do want to give up on the top ups it will take a short while to get your supply back up in the evenings, and like I said, you are probably best talking all this through with a Bfing Cousellor so that you have some support while you are doing it.

If you really are doubting your supply though have a read of this.

Oh and don't feel guilty if you give her a bottle, lots of people do it. Different things work for different families and if you wanted you could try topping her up with expressed milk or collecting milk in shells if you leak.

reastie- I'm just wondering if your milk supply has dropped - in conjunction with her sleeping through.

If you previously only gave her ff in the night (I'm assuming here) then maybe the gap between feeds was just too long and your breasts weren't getting the stimulation they needed. Especially as prolactin levels, the milk producing hormone are higher in the night.

Just a thought however.

Agree with JJJ that how you proceed depends on what you're happiest with and that speaking to a bfc on the helpline might be beneficial.

Breastfeeding works on a supply and demand basis so offering top ups of formula can lead to reduced supply and increased top ups etc etc.
I had the same issues in the evening with my 5 mo. I used to express milk early in the mornings when supply was plenty and then feed her the expressed breastmilk from a bottle in the evenings if she needed it. Just a thought.
I was really worried at the time and wanting to introduce and evening bottle of formula and my health visitor told me to stop beating myself up and give my body time to adjust to the increased demand. she also told me to take a couple of pj days with my baby, plenty of skin to skin contact and plenty to eat and drink. Good luck with whatever you choose.

its entirely up to you. if you want to carry on breastfeeding exclusively, you just have to feed her on demand, offering 3 or 4 sides, and wait for your supply to catch up. or you can offer her the top up. some women find this a slippery slope to more top ups, and by six months they are ffing, some find this to be more than fine, and carry on for months/years. its highly unlikely that you don't have enough milk at this stage.

you can try galactagogues (milk increasers) - fennel tea, fenugreek, blessed thistle. some women have found chamomile, nettle and raspberry leaf work too. try drinking quite a bit of it apparently...

fwiw i fed my DS and there were phases where he woke up after an hour for more milk?! i just fed him as it was easier that way (even though it felt like there wasn't any) and my supply just adjusted - he was quite the chunky monkey so he was obviously getting some. its when you want to start controlling the whole thing that it becomes more difficult as some boobs and babies don't like being controlled.

good luck, hth x

Wow Yes where did you get a HV like that from? Where do I put my order in?

Don't ask me Olivetti I'm no expert I did start doing a formula dreamfeed at about 4 months, but it wasn't in response to a supply issue iyswim - I would just worry that using formula to make up for a drop in supply would compound things.

but we have been doing a night ff for nearly 3 months and ff top ups since 2 weeks (we stopped the top ups at about a month until last week or so when she dropped night ff) and so far so good on bfing

ff top ups from early can cause trouble like this at around this time . i suppose if you are happy trying to feed her from you as much as possible - 3 or 4 sides if poss to see if you can get some more milk in her that way - some women find they have more let downs that way as while she is on one side, the other is busy manufacturing iyswim. meanwhile you could try the galactagogues to up your supply - some find it works. try the babymoon idea - get into bed to up your supply. if its milk she wants, its milk you need to make . is there anything else wrong do you think? teeth? sleep regression?

you might have to deal with a few episodes while your supply catches up?

really peanut - it's common to have trouble at this time if I've been combination feeding? I'm feeling really :( tonight as we're having another terrible night with dd refusing to settle. I've given her 2 top ups of ff this evening - 80ml each time :( just didn't know what else to do and it did the trick of settling her at that moment but I'm getting completely paranoid about my supply now and that I might be diminishing it

Try slings, pushing the pram, going out in the car, giving her to anyone else to try to settle... Do remember that not settling isn't always about needing more milk, even if it does help.

As you were doing a FF until recently, your supply will need to adjust. It won't adjust if you keep adding in the formula again though.

oh reastie you can get back from this no doubt but adding formula short circuits the whole operation . she might sleep longer if she has formula and then your boobs aren't getting emptied and neither are they getting stimulation. you are quite right to be paranoid about your supply and that you might be diminishing it. simple - more formula, less breastmilk drunk from you, less breastmilk needed thinks your brain, less breastmilk made, and so on and so forth. like japhrimel says you can try other things too...

i'm sorry - yes formula top ups can cause trouble particularly when mums give them as night feeds which is common as the tired mum then gets to sleep. the problem is that night feeds are good for supply - i think prolactin levels are highest around 1-4am so if you can do a middle of the night feed that might help. and the tea/fenugreek might help?

but look, all is not lost! try cutting right back on the formula - someone posted a link to a kellymom page that will help you do this safely. can you get into bed with her when she won't settle and let her have unlimited access to the boob for a few days? co-sleep?

Not sure if its been mentioned but i was told the to make sure i did at least one big feed (using both sides) between midnight and 6am, as this is the key time for milk production and it helps your supply over the whole day. Also i think its been said but maybe try expressing in the morning when you have loads and using that to top up later on?
Good luck with whatever you decide :)

thanks. peanut my issue with lots of boob is my nipples are so sore at the min - I always had one sore side and one good side (but fed from both) as with feeding all the time it never quite has time to fully recover from one false move from dd iykwim (I'm as careful as i can with latch and take her off if she wiggles into a bad position but it's still done the damage by the time i do that). at the min i have 2 sore nipples from the other evening where she wouldn't stop suckling/feeding. i don't think i've got it in me to get her to feed all the time pain wise. maybe if i leave it until next week and see if it's improved then and in the mean time try to stop or at least reduce the formula. Thing is, I've never fed dd in the night (aside from late evening/early morning) since she was maybe a month old as i struggled so much managing to and i got so stressed and tired and anxious about it all that we did the ff at night which gave me sleep which in my logic meant i could have better milk in the day as i was rested and happier and calmer . I did find on kellymom something that made me feel a bit better - that i was worried as every morning my boobs used to be really engorged and painful and ready to feed and now they arn't so much and i panicked it was a supple thing but kellymom said this is common at this stage that they don't go so rock hard and are often soft.

reastie are you getting some RL help with your sore nipples?

It's normal to find your boobs feel a bit flat or "empty" in the evenings and more "full" in the mornings but if you're cluster feeding in the evenings (very common) then you are actually producing more milk in the evenings, not less. Milk isn't stored in your breasts. Any fullness you might feel, even though it is milk filling the ducts as a response to baby's cry, or because it's the time you usually feed your baby so your brain tells your body to start producing milk, it's not all the milk there is! If it were, your boobs would have to be HUGE to store enough! More milk is produced as soon as the baby starts to suckle - sometimes it take a few minutes but milk is always produced in response to the suckling of your baby, so you will not run out of milk, even if your breasts feel flatter at certain times of day.
This website is quite good:
www.babies.sutterhealth.org/breastfeeding/bf_production.html

jilted sore nipples arn't as bad as they were when i was first bfing and I go through phases of having no pain or discomfort, it's just it takes a while to heal up any irritation, so I don't think it's a massive issue, it's just painful/annoying when it does happen and doesn't usually happen on both sides together

thanks for that gourd much appreciated

Re: sore nips: Can you express from the worst side and feed only with the other till worst one has recovered, and then swap, to let the other side recover? You don't actually need two breasts to breastfeed, so it's perfectly possible to just feed with one if necessary. You might also try nipple shields - some people find they work and others don't, but they're not too expensive to buy, so might be worth a try if you haven't already.

As others have said, it's the ffing which is likely to reduce the supply. I know it might seem hard but with the help of a bf counsellor or just a bit of support from other mums at a breastfeeding group I'm sure you could get your supply going stronger. Keep feeding! Get all the help you can to enable you to do this. There's no point 'panicking' about your supply, it doesn't just diminish for no reason, it's a simple question of demand fuelling it.

Another good reason for going to a group/ speaking to a counsellor is to see if you need any help with getting the latch just right. I say this because of your sore nipples, and because if the latch isn't right it will affect what your baby is getting which will in turn affect supply.