14 wo baby coming on and off breast- under supply? Time to stop?

[CarterGirl]

I've been mixed feeding DS since he was in hospital (was given formula to help in the second night before my milk came in - I knew nothing about BF. if I'd known what I do now...) Anyway all along I have been paranoid (or realistic) about lack of supply as I never had hugely swollen breasts or much leaking. And DS has often fed frequently.

With much determination (and expressing) I have kept going, even past the 6 week feeding frenzy (again, I knew very little about BF at that point- only found out later that this was a traditionally 'tough' period) - where I distinctly remember saying to my mum that I thought I'd come to the end of the road.

DS was born 6 lb 14.5 oz and regained his lost weight within a week. He has remained in the 25th percentile despite some pretty good early gains- he put on a lb one particularly good week! This however was probably largely FF. He used to drink reasonable amounts of formula. However, since his first set of injections (I just remember it being that week) he started to reject the bottle and only want BF. this was terrifying as the only reason I was supplementing was because I felt I didn't have enough! I then had to pretty much exclusively BF but with whatever formula we could persuade him to take alongside this- which might be around 2 x 220 ml a day. Some days he'd only take 20 or 40 ml though, which was pretty stressful.

With eating oats/ taking fenugreek (which I felt worked but stopped reluctantly as thought it was giving DS bad wind), fennel tea and getting through incipient mastitis and a bleb (still there but not so painful) I struggled on through the days where I thought I'd be stopping the next day (DS doing short and seemingly unsatisfactory feeds, my breasts going soft and 'empty-feeling' most of the time etc). In the weeks where I was lowest on getting any formula to DS his weight gain slowed to 2 and 3 ounces.

I dreaded the next potential growth spurt at 12 weeks but got through it and ironically 2 days ago felt as if was having my most successful time BFing yet- quick easy latches, fairly long feeds etc but then yesterday all day, and the evening before, he continually came on and off the breast- starting pretty much straight away. He would want to latch straight back on, and would often slurp the nipple back into his mouth. But he'd just take two more sucks then pull away again. I think the longest I could persuade him to feed was 30 mins but that was just after an evening bath when he was pretty sleepy- not sure how much was just sucking my nipple like a dummy. When I squeezed my nipple there did seem to be thin jets coming out (my 'streams' have always been incredibly thin) but maybe that's even less than usual? The previous successful days even saw any expressing sessions going up from 2-3 oz to 4 but yesterday when I tried it was right back down.
Has my supply finally bitten the dust?

NB in the growth spurt he was also not sleeping- up every 1.5 to 2 hours and feeding. I think this may have led to my final 'good' days as possibly boosted supply a bit? The past couple of nights he has finally done 8 pm to 4.30 am then up again at 5.30 or 6. Presumably the drop in night time feeds has been a killer to my supply? (even if it saved my sanity in terms of catching up on some sleep!)

Also - he has never done many dirty nappies. His max would be one a day and the average is every 2-3 days he'll do one. But he does plenty of wet ones.

Anyway- if you read all of this and made sense of it then thank you. And if I should stop do you have any advice on how to get him to take the bottles happily again? If he doesn't get any BF presumably he'll be hungry enough to just switch over?

I'll be very sad to stop BF, as although have had a bit of a love-hate relationship with it I think DS loves it and when it was going well I really enjoyed it. But it's been dark in the bad times. Plenty of tears.. But I guess 14 weeks is better than nothing. I would rather have stopped out of choice than just grind to a halt though. Has anyone else been in this position? - giving up from lack of supply?

Not an expert, just looking back nearly 12 yrs to when I BF...

Plenty of wet nappies is good and demonstrates they're feeding OK - assuming they're not drinking water, too, where else would the fluid come from? Babies don't always poo much (especially when FF).

The jets of milk are thin. More pinprick size than, umm, teapot spout!

Your breasts don't always fill and empty per se, unless there's a long time between feeds maybe. Milk is produced as your baby feeds, rather than being produced in advance.

Hopefully you'll have an expert along soon. :)

btw I don't think you need to be expressing, unless you're looking to freeze it or to let someone else feed your ds.

All sounds pretty normal to me. Dd3 is 6 weeks old and ebf, but my breasts never feel full and I only get drops of milk not jets if I squeeze so you sound fine

When did you last get him weighed - do you know what centile he's on now?

You sound like you are doing really great and worrying really disproportionately. Bf babies don't always poo loads - mine did, but my friend's only went once a week, they're all different. If he is having wet nappies and is gaining weight and not losing it, then you are doing fine, nothing else is cause for concern - boobs change, babies pull off etc. When dd would pull off I would change sides or wind her a bit, but do keep going! x

Thank you JennaiMarr, I appreciate your reply! Is that really right about milk being made as they feed? I'd love to believe so but how come when I express it comes to 'an end' (as it were)? And sometimes I'm more successful at expressing than other times- presumably because there's more milk stored in the breast at the better times? (you don't need to reply- am just wondering aloud really)

Glad to hear that about 'streams'! You read about women who have 'jets' shooting out who need to let it flow into a cup or muslin etc before feeding.. This has decidedly never been my problem..

You could be right to just stop expressing - sometimes DS wastes the milk because he doesn't want a bottle. I've done it to be able to see how much i'm producing but also to help boost my supply by ensuring milk is being removed if we give him a bottle or sometimes just after a feed to try and persuade my breast to make more milk! But it is a faff, and can be pretty dispiriting when I produce a tiny amount.

It's hard to relax as DS seems such a small mite- not a bouncing chubber. I'll be happier when am able to feed him some food too I think! Roll on 6 months.. (but then I feel guilty for wishing time away!)

Anyway, thanks for responding, I do appreciate it!

I tried expressing with my first two but found it really dispiriting I agree! Decided not to even try this time.

Thanks lilbreeze and Rightbuggerforit too!

Really reassuring to hear what you think.

DS was last weighed last Thurs - where he was 12 lb 3 oz (at 12 wks). And I'd thought he was 25th centile as he was on that when born but actually it looks as if he's tracking just under the line for 25th centile so is in the 9th.

Not sure I can cover every point you've raised but will try and reassure you on the bits that stick in my mind (on my phone and not easy to scroll up when replying)

what you're describing (pulling on and off) sounds very normal and is most likely your clever DS stimulating your let-down because he wants milk NOW

Expressing to 'see how much' you're producing is ineffective, you can never (or rarely) express anywhere near what a baby can get by breastfeeding. If you're doing it to see how much he's getting thats pretty pointless too if he's not taking a bottle. Its more work for you and could lead to oversupply (not nice, happened to me after a situation like you describe) - IME nothing beats just letting your baby get on with it

I know its easier said than done but try to stop worrying and just feed your baby whenever he wants to nurse for as long as he wants. This is coming from an obsessive worrier who had all the problems you're describing and more. So long as he is gaining weight and producing wet and the occasional dirty nappy you are doing brilliantly and doing everything right. Its hard to trust your body to provide but it nurtured him for 9ish months without you doing anything special didn't it?!

You are doing really well and I don't think this is the end for you just yet

It sounds like you (and your ds) are doing just fine but if you're concerned then you could try calling one of the bf helplines for advice - NCT or la Leche league both have helplines and may also have a bf counsellor nearby who you could see.

Also have a look at the kellymom website - loads of useful info on there. IMO (and I'm not an expert!) as long as your baby is gaining weight and not dropping through the centiles (eg 75th - 9th would be a concern, 25th to just below 25th sounds fine) and has plenty of wet nappies there isn't a cause for concern.. Also babies get more efficient at feeding so feeds get shorter, my 8wk old ds2 now rarely feeds
for more than 15mins at a time but is putting on weight fine. Also expressing I always found that I could never get much whereas both ds1 (ebf til 11mths and bf til 18mths) and now ds2 (ebf) don't have any problems getting plenty of milk.

In the nicest possible way I think you may be overthinking things here.

from reading your posts I think everything sounds fairly normal. In my experience expressing is not as effective at getting milk from the breast as a baby is. Your body does produce milk as the baby feeds. I am not sure there is a lack of supply if you can express some milk. I don't think the drop in night feeds will kill your supply either - it is a natural development that babies go longer between feeds as they get older. Your body continually adjusts your supply.

If you want to continue breast feeding then I would forget about expressing and using formula and just let your DS have breast milk whenever he wants it.

Also IME the few sucks and turning away was something my dcs did when they needed to burp or were not comfortable in some way. He may just be starting to play though . . .

I know you are worried about him not growing but he is still growing just slowly and there is some evidence that breastfed babies can be slower to gain.

I am sorry my reply is a little disjointed - I was just trying to answer some of your questions.

I just checked my red book and it looks as if your ds was just below the 25th centile at birth and is now halfway between the 25th and 9th.

Quoting from the text just before the growth charts, "it is unlikely that your baby's weight will exactly follow a single centile line, particularly in the first year. It is most likely to track within one centile space (ie. the gap between two centile lines).

So your baby is textbook

Thank you all so much for your replies! It is such a help. The friends I have who BF/ did BF were more of the 'over supply' types and so it's hard to compare. Same goes for my mum who says I clearly don't have masses of milk (she felt full all the time she says, and would be massaging her breasts in the bath to get rid of engorgement etc..).

It is entirely possible I'm over thinking it (thanks for saying so politely!) - I was pretty paranoid cautious when pregnant.. I've just found it hard faced with a baby who seems to have short feeds and not always seem very satisfied. And some pretty tough nights when he's had short feeds/ pulling off and still grizzling.. He can swipe and squirm at the breast too so it just seems he's not having a satisfactory time. So the constant pulling off just seemed the last straw!

I would call one of those helplines, thanks to poster who suggested it, but am deaf so would probably find it a bit tough (I do wear hearing aids and can call but it's hard on things like helplines. But perhaps will get mum or DP to call for me.

But for now am in Holiday House of Doom - mum has sick/ diarrhoea. Dad starting to feel grim.. DP and his father due in a day and they've only just recovered from a D&V bug DP's dad got on long haul flight over here! DS and I so far unscathed.. Fingers crossed we remain so! You can imagine how calm and rational me feels faced with PFB getting D&V when already thinking he is under-supplied and needs to put on weight.. sob

Thanks again!

Carter, those BF organisations are well established; I'm sure they can offer advice via email or textphone :)

Fingers crossed re the D&V - yuck!