Where to go with this now?

[aamia]

Had initial feeding problems due to tongue tie. That's left me with an insufficient supply, and baby needing top-ups. Supply has gradually increased since the tongue tie was cut 5 days ago - I now get more if I pump (just under 60ml total if double pump where I used to get 30ml total), but have to leave it 4 hours or so between feeds/pumps or there's just hardly anything there. I know that because pump gets about 10ml out, and if baby feeds that often he doesn't feed for long before giving up, and doesn't swallow much. So we've been on ff then bf then ff etc. Recently he's started drinking the formula too fast, and then throwing up. This is better if I bf first as he's less hungry, even if there's not much in the boobs.

Obviously I'd like to up the supply as much as poss. Baby is 3 weeks old. Am I better bf at each feed and topping up after, or sticking with ff then bf then ff etc and perhaps trying to reduce the gaps between until I'm bf every 3 hours or so? Baby can't feed on demand as he doesn't 'demand' enough so I have to offer something every 2 hours at least so he doesn't drop weight. He is gaining well on the current regime and is now finally heavier than his birth weight.

Hello aamia. Sorry you've had a tough start.

The way to increase your supply is to stimulate your breasts as much as possible. The best way to do this is to feed your baby. The amount you can pump is not necessarily an indication of how much is available- your baby will be more efficient than a pump. Your breasts are never empty- someone explained it to me as saying they are like rivers not ponds. Sometimes the flow is slower but it's still there.

It's also possible that your baby is not feeding long before giving up because he is so used to the bottle now and finds it easier- so again it's not necessarily because there is no milk there. Would you consider offering top ups by cup rather than bottle? It may not interfere with bfing as much.

I would try putting him to the breast first at every feed. I would offer both breasts, maybe more than once, every feed. 'Switch feeding' can increase supply. I would offer breast as often as possible. Could you try offering smaller top ups (gradually) so he gets hungry sooner? Many mums find their supply is better at certain times of day, perhaps try reducing top ups at that time?

Can you spend some time just holding him skin to skin and letting him look for breast whenever he wants it? It sounds as though he was sleepy and not demanding enough initially- now he's a little older he might be better at this.

Finally, can you get some RL support? I'm a peer supporter and my area offers a BF support group most days. I think it might really help you to get some support and reassurance from someone who knows their stuff.

You are doing amazingly so far, it sounds as though you and your son have had a lot to cope with. Good luck.

Hi aamia. You need to speak to somebody who knows about tongue tie. Have you thought about contacting milk matters?