Trying to boost supply, finding it hard, can you help please?

[smk84]

Ds is almost 19weeks. He is gaining weight but very slowly, and is dropping down the centiles, currently struggling to track 0.4. For 3days we have been giving a formula bottle in the evening, but the rest of the day ds doesn't seem satisfied (and he hasnt for a long time). For example, he will feed both sides, then want to latch again, but often goes on a doesn't get any and comes off frustrated. I am trying to persist, but it's really hard when he's wriggling around and moaning. So I have decided to have a babymoon ,lots of skin to skin etc. because he won't stay on for a third or 4th side, I am going to double pump after he feeds. The thing is I have just tried that, and once I had fished pumping, he wanted to feed again, then went on and got frustrated and came off. If you we're me would you carry on doing this? I am not convinced that ds can maintain a good supply and thought pumping would help him out. I have really sore nipples and pumping doesn't hurt but feeding does i think because he keeps slipping off. I have tried 10 mg domperidone 3times a day but it didn't make any difference. The other trouble we have is that the only sleep he often has during the day is on the boob, and so I can't pump while he sleeps.
Also, It has been taking him almost 5 mins to get the milk to let down at times today. Is that normal?
Thanks for reading yet another of my rambling posts...

Are you eating enough? I didn't have enough milk because I was so busy I skipped loads of meals. Only realised when I went out with some friends for fish and chips and chocolate cake then realised how much milk came in the next day!

Fenugreek and milk thistle are also supposed to help.

Has your DS been checked for tongue tie? Even if there isn't obviously one there, there can be a posterior one that will still affect feeding. Sounds similar to my baby - he struggled to extract enough milk and my supply dropped. Tie found, cut, and my supply is increasing again, happy baby after feeds too. Worth a try finding someone qualified to check it (not MW/HV as they often don't know what they're really looking for).

Have you been to see a lactation consultant? It was one of those that sorted our tongue tie out, but she also gave us some really good advice for bf afterwards :). I had decided I just wanted my baby to put on weight and had almost given up on bf, but now we're slowly increasing the bf and reducing the formula which is more than I'd thought we'd manage!!

If your nipples are sore and you are worried about your supply, you need some good RL support. Is there a Local BFC you could ring or a bfing support group you could go too?

As for the let down, some women hardly ever even feel it by 19 weeks, its no indication of low supply in itself.

If you are worried that he doesn't get enough during the day, then nothing stops you offering a formula bottle after the feed. You keep pumping and store in fridge, this expressed milk can be used next time to top up after a feed instead of formula feed. In this way you can increase your milk production and rest assured that he gets enough.

I did this with one of my children for a while and it worked a treat as he bf (in addition to other food obviously) until he was nearly four in the end. So don't worry if people say topping up with formula means it is the end of bf, this is not true as long as you keep offering and express as well.

Fenugreek really helped me.

I'm also at 19 weeks and my baby sometimes does the same. I think for mine it is digestive discomfort. When she had diarrhoea she pooed ever feed. I think feeding kick starts the digestive system so that it often makes them wriggly and uncomfortable.
But then mine is gaining weight steadily so it's easier not to worry.

correct me if I'm wrong. your the lady who's baby had a tongue tie cut at 4 Weeks?

has it been checked to see if it's reattached? this can happen. I'd get it checked.

has he become like this since having the bottle. as you know it's much easier for them to get milk out of a bottle and if he is really having problems at the breast. them supplementing another way mite be a good idea. have you Hurd of supplemental nursing systems? this could be a good option for you, it's a small capillary tube you attach to the breast or it can be used as a finger feeder by another carer.

My HV got my GP to prescribe me domperidone to help with low milk supply - made a massive difference (had already tried the natural remedies which didn't seem to have much effect). Some GPS can be reluctant to prescribe - HV sent them a bundle of research and they prescribed straight away.

I had this twice. The first time, from about 3 weeks old, DS was either sleeping on me, crying or feeding and he feed for about an hour at a time with maybe a half hour gap. He dropped through the centiles and became a bit skinny. The only time he was awake and contented was after his one bottle of formula. Eventually a doc told us to give him a bottle after every feed, and he changed overnight into a happy, healthy baby. He was about 10 weeks then. I challenge people who say you just need to keep feeding because we were all so unhappy before bottles and I really did feel like I'd tried everything.

The second time with dd, I thought things were going better to start, then she started doing the same, but was never quite as miserable, at around 3 months. It coincided with me having mastitis and thrush and I phoned Nct helplines for help. I took fenugreek, relaxed and hand expressed after every feed - I found I could do this more easily than pumping (i did it into unsterilised bottles if she was asleep on me and threw it away) and easily got the hang of it. It went on for about 2 weeks - long enough for me to start to panic, but the single most useful thing anyone said to me was that she was working to increase my supply and may already have done most of the hard work. About two days after I was told this, she started sleeping again and feeding only every 3 hours and has since gained weight beautifully.

I hope these experiences help you.

Another vote for fenugreek and also fennel, they are galactogogues, ie herbs that increase milk production.

Thank you everyone. Yes miggril we did have tt snipped at 4 weeks, saw lactation consultant who said she didn't think any further work would help. I have been wondering about the bottle, but this behaviour started long before we started giving it so I don't think it's that. We do have a sns from when I had ds1, not sure if I could use that one?
I have tried domperidone but wondering I I should take more than 30mg a day?
Baby bouncer I don't get anything out if I hand express after a feed. Having said that I don't know if I am doing it right! That's a great idea though.
Jjj unfortunately m rl support is no great, nice people but no one has been able to help much so far. The LC we saw suggested compressions, seeing osteopath and trying dairy free, none of which have helped so far.
Thank you so much for sharing your experiences, it really helps.

If I were you, and I'm saying this only because you ask, no I wouldn't carry on. I don't think it's worth the stress & I've noticed you post alot in this topic with worries around feeding.

I would switch to formula and try & express some breastmilk so baby is still having as much as you can express.

That is what I would do in your shoes. You've got to do what is best for you & baby.

You can rent the type of breast pumps they use in hospitals, they are much better than ordinary breast pumps. You can contact your local hospital, otherwise John Bell and Croydon (or something like that, a big pharmacy in Wigmore Street in London) might be able to advise you.

I would agree with an earlier poster and say maternal has a huge impact. My dd dropped from 7:15 to 6:05 in one week. Midwife recommended a McDonald's, trifle, thick milkshakes, cream based sauces and fish and chips. After a feast the quantity of milk was unbelievable the next day. She gained four ounces in five days. So eating more might be something you could start straight away and see what happens. I was reluctant to try this at first as it seemed a bit ridiculous, but it really worked!

Maternal diet I should say

Sorry smk, didn't spot that you'd already tried domperidone. I can't remember grams and have thrown away the packets, but I was in two tabs four times a day (ie 8 tabs but speak to a doctor, obv, before you up your dose!). Also good idea from someone on hospital grade breast pump - I rented one direct from Medela. And on the last post - yes, worth considering - you sound miserable. I had to give up bf at 3.5 months with my first (poor supply, poor weight gain etc - also rubbish HV and Gp support which makes me realise how lucky I am this time round) - my daughter and I never looked back. I stopped stressing and she started putting on weight at rate of knots. And I finally got some sleep. It might be worth it.

material diet has vertualy no impact on supply unless you where on a starvation diet. The only impact it will have is you not feeling great. fluid intact does have some I impact but you have to be careful not to take to much fluids a it actually has the opersit effect and reduces supply.

I suppose I can only write from my own experience and maternal diet had a HUGE impact on my milk supply.

Thank you again everyone. I had a feeling that 3 domp tablets a day wasn't enough, but that's what it said on the packet. I have done a bit of reading and it seems that this amount is prob not enough. I need to ring gp and hope that they are ok about allowing a higher dose. Plus I am on setraline for anxiety so I need to know if its ok to take them together. I am going to investigate fenugreek too. My diet isn't too bad really. Must be eating enough because I am not losing weight as quickly as I did with ds1 and had to stop bf hi at 4 weeks. I am seriously considering stopping, but with ds1 stopping made me worse so its a tough decision.