Help with poor supply, please!

[ShortsAndWellies]

DSis has a lovely DS who is now 6+2 weeks. He had an undiagnosed tongue tie, eventually snipped at 3 weeks, but still isn't gaining weight - well he is, but has dropped through a centile, so while he is gaining, it is slow, and not what DSis had hoped after the tongue tie being fixed.

The pros - DSis is taking fenugreek, is offering whenever her DS is awake, switching breasts, plenty of rest and skin to skin.

The cons - DSis is using shields as before tongue tie was topping up with formula and her DS is now refusing to feed directly. DSis is very anxious and topping up after feeds. DSis can't see milk in the shileds sometimes after feeding.

I have seen her DS feed (via Skype lol as they are in Germany) and he doesn't seem to get a proper closed latch, can't see his botom lip flat and out. However, she has been seen by paeds, HV equivalent and a (very good) bf counsellor, who seem to think he is latching fine.

DSis is worried as he isn't following on the charts. Her DS is alert, sleeps fine, but feeding does seem to be less efficient than I would expect and for the amount she is feeding, I would expect her DS to be gaining more weight.

I am reiterating just offering lots and lots, but DSis has lost confidence, and because she often feels she has no milk left and her DS is struggling to get enough milk, she is convinced she doesn't have enough milk and needs to top up. Help!!

Maybe her DS is growing right for him, but she is worried he is getting used to getting not enough milk. How can sh tell whether he is just a slow grower or whether there really is a problem??

Sorry this is so long, but any advice welcome

Oh I struggled so much with my first child. Kellymom is fantastic, this link is about nipple shields and may be helpful: kellymom.com/bf/concerns/child/wean-shield/

And this link is how to tell if your supply is low and what to do about it, if you click on the writing in blue it goes to further information on each subject: kellymom.com/bf/got-milk/supply-worries/low-supply/

I think the above is probably far more helpful than my musings on what helped me, as kellymom is evidence based.

I also used kellymom.
And expressed a lot - often just by hand into a sterilised bottle to top up, but sometimes just into the sink or a pot and poured away (especially at night).
And did compressions - also on kellymom site.

KellyMom is fantastic tell her to have a look on their site. She could hire a breast pump, if she speaks to her insurer they'll be able to tell her about it. In Belgium you can hire a hospital grade one from the pharmacy for about Eur5 a week. Expressing will help her to increase her supply.

I tried More Milk and they helped a little bit. You can find other More Milk products on Amazon for free delivery to Europe if you spend over £25.

Also, the heights and growth charts are based on formula fed babies so if he's at the smaller end of the chart it's not a total disaster.

MamaBrussells - charts have not been as you describe for a long time now. This is certainly the case in Europe, too.

Charts are only one indicator of a baby's well-being and they should be used in the context of the 'whole' baby :)

OP you ask how you can tell the diff. between a baby who is not getting sufficient, and a baby who is just naturally a slow gainer. A good HCP should be able to judge but basically it's like this:

• a baby who loses weight may not be getting enough
• a baby who consistently moves down the charts beyond two or more centile lines may not be getting enough
• a baby whose appearance also gives cause for concern - skinny; pinched face with 'worried' look - may not be getting enough
• a baby who is often miserable may not be getting enough
• a baby who sleeps a lot may not be getting enough

This is very basic and general. If your sis is topping up then she may need some support to reduce the top ups (full bf does not have a chance to get going with too much formula) and she deffo needs to work out ways of ditching the shields, unless the shield is a very good fit (and this is rare) so it does not interfere with the baby's attachment to the breast.

It sounds as if your sis is still not out of the woods, but that her baby is basically healthy - can she speak to someone else about the bf for another opinion?

Cheers tiktok!

Did wonder about that after I'd written it!