Drop in supply - any chance of it improving again

[FrogLover]

Hi everyone,

my DS is just over 4 months old. I started back at work in September and have been expressing milk to leave for him during the day.

Before I went back to work, he was fed on demand and usually slept through from 10pm to 7am.

After 2 days back at work, he started waking up to feed at around 4am and we settled into a vague routine of:
6.30 am - I wake up and express 150 - 180 ml
7.30 am - he wakes up and feeds for roughly 30 min
1pm - express 150 - 180ml
4pm - express 150 - 180 ml
7pm - I get home, he feeds for 30 min
9 pm - he feeds until he falls asleep (usually about 30 min)
10pm - express 150 - 180 ml

To begin with, he would feed more or less on demand and the 4 pots of milk that I left usually weren't enough so my DH (who has taken parental leave) would usually end up giving him a bottle of formula in addition to my milk. Over the last couple of weeks, he has settled himself into feeding with me at 8am, then 240ml at 12, 240ml at 4pm and finally a bedtime feed and a 4am feed with me. He's also started eating small amounts of pureed vegetables at lunchtime.

The problem is that my milk supply has been progressively decreasing over the last two weeks. It all started when we went away for the weekend. DS slept very badly and I was up all night for 3 nights in a row (on the last night, he woke every 90 minutes - a distinct improvement on the two previous nights) then straight back to work for a week, followed by another weekend with visitors at home and so not much rest. By the end of last week, I was so tired that I was forgetting words and, to top it all off, I was so busy at work that I didn't have time to express during the day so I had to try to catch up while at home but I struggled to express even half of what I would usually manage.

Over the weekend, DS fed for hours at a time but I ended up having to give him a bottle when he was screaming his head off due to hunger. All notions of routine went out of the window.

I took a day off work yesterday and got plenty of rest over the weekend and feel almost human again now so I hoped that my supply would improve. All was fine this morning - I expressed 150 ml before DS's morning feed but this lunchtime, it took me over 45 minutes to obtain a measely 50ml of milk, despite the fact that I had drunk a litre of cold fennel tea during the course of the morning.

I know that supply can drop off once you go back to work but I really hoped that this drop would be temporary and would resolve itself once I wasn't so tired.

Does anyone know if drops in supply can be temporary? Any tips on how to improve my supply?

Thanks in advance

There's a supplement you can take to boost supply. Fenugreek. I started taking it when I went back to work to boost my pumping output (it worked so well I actually got engorged!).

Also check out the advice on the Kellymom website for boosting pumping output.

I'm not an expert op but I don't think stress and tiredness affect milk supply, as horrid as they are for you. I suspect it's missing the expressing that's caused the drop in supply so increasing feeds and pumping more would help. Increasing milk removed is the only way I know of (except some medication) to increase supply. Can you fit another feed and pump in at all??

CityDweller thanks for the fenugreek tip off. I'll have a look for it at my local chemist.

NickyEds I remember the midwife telling my that tiredness was one of the main causes of drop in supply, which I why I assumed that was why my supply had dropped. Interesting to know that it may not be the case.
I don't think an extra feed is possible as I leave home at 8.30am and don't get back until 7pm at the earliest - poor little DS might burst if I try and make him feed even more.
Extra pumping at work is delicate because of the job I do. The law over here entitles me to take up to one hour every day to express milk but I'm supposed to make that time up, which would mean coming in earlier or leaving later, both of which would mean even less time at home with DS so I'd rather avoid it them. Luckily, I have a job with goals to be met rather than hours to be filled so, as long as everything is running smoothly and I'm delivering what needs to be delivered, nobody really bothers to check what time I'm at my desk. That being said, I'm pretty much at the limit of the amount of time I can take and still get everything else done and weeks like last week show me how easy it is for the whole situation to get thrown off kilter. Maybe I'm just going to have to come to terms with the idea that my original goal of him having my milk until 6 months just isn't realistic in my situation.

Like I said I'm no expert so maybe your mw is right but I can't help but think that if tiredness really hindered milk production the human race would have been scuppered a long time ago!!!

Have you tried LLL or the nct bf helplines? The nct one in particular was very helpful to me when I was having supply problems with ds. All of their suggestions revolved around increasing milk removal to increase supply though. Sorry op-it must be very hard expressing at work. Try doing a mn search for advice for exclusive expressing-although you're bf too there might be some good ideas??

I think lots and lots of things are happening at once. 4 month sleep regressions, supply matching demand (always going to be harder to maintain a supply when relying on pumping anyway) and it's possible that the purees aren't helping. If he's filling up on veg, it's possible he's not taking the same volume of milk so the demand is different there, plus he could be struggling to digest the purees which might affect his sleep and behaviour too. He is a little on the young side for solids and it will quite possibly have a knock on effect on your milk supply. Can I ask if there's a reason why he's on solids already? Bear in mind I'm in the UK and use the WHO guidelines which recommend solids aren't given until around 6 months. It might be different where you are so I might come at it from a different angle to you.

Also bear in mind that your breasts aren't empty so if he's feeding for 45 minutes and then screaming and distressed, it's worth considering whether he's struggling with wind or discomfort in some way or whether he's not actually hungry at all.

There's so much going on here. What sort of breastfeeding support do you have where you are? It sounds like you've received some not so accurate information and not a lot of practical support and advice. Kellymom is brilliant as a starting point if the rl info isn't there atm.

showofhands, thank you so much for taking the time to reply. There is a lot happening and to be honest, I'm feeling a little overwhelmed. I don't really have any RL support (except DH, whose knowledge of boobs doesn't really extend beyond the recreational ).

I live in France, where the general approach to breastfeeding appears to be to try to feed for the first day but anything beyond that is Professional Martyrdom. I had some support from a freelance midwife that I was referred to due to some complications towards the end of my pregnancy and who I chose to see for the post-natal follow-up as she seemed to be the only vaguely reasonable person I encountered during the whole period but now that I've officially been discharged from post-natal care, I don't see her anymore. FWIW, she is the one who told me that fatigue had an effect on milk production. Staff at the hospital were neutral at best on breastfeeding, some were out and out discouraging and I opted out of the health visitor system after the first visit when the only "practical" advice I was given was to ask a friend to come over and take care of DS for a couple of hours a week so that I could go to the hairdressers/beauty salon. DS was 10 days old and I had not expressed any concerns about not getting time for myself/my split ends/my unwaxed legs.

DH has taken parental leave to take care of DS at home, so there's no childminder or nanny. My parents live in the UK and, for reasons I have discussed elsewhere on here, aren't really people I'd turn to for advice. DH's parents live about an hour away but DH isn't close to them and prefers to keep contact to a minimum. Also, my MIL didn't breastfeed any of her 3 children and didn't go back to work until DH was 2 so she wouldn't have much to say on this particular subject anyway.

We take DS to a drop-in centre to be weighed once a month and the women there are the ones who do the home visits. They have been urging me to stop breastfeeding since our first visit because according to them "DS might not grow enough" if he is only fed breastmilk. For the moment, his growth rate and size are spot on the average curve so I've told them that while this is the case, I will continue to breastfeed. My GP is pleasant enough but he is getting on a bit and it became clear early on in my pregnancy that he is not really up to date on matters regarding pregnancy and early infancy. When we realised that the information he was giving us about vaccinations was over 10 years out of date, we decided that DS wouldn't see him anymore and switched to a local pediatrician (which sounds extreme for someone used to the UK healthcare system but is quite normal over here). She is the one who recommended introducing solids. Current recommendations over here are to start introducing a couple of spoonfuls of vegetables at lunchtime from 4 months and fruit purée mid-afternoon from 5 months to reduce the risk of intolerancies, allergies and rejection. To be honest, I was sceptical but he really does seem to love his butternut squash. He only has about 1 tablespoon of purée per day and always follows it with a 240ml bottle so I don't think it is having too much of an effect on his appetite.

Wow, this has turned out to be a really long post. To sum up, DH and I are applying the 'stumble along and hope you don't cock it up too much' approach to parenting and would appreciate any advice people can give.

In the mean time, I've added a hefty pinch of fenugreek to my fennel tea (not as vile as I was expecting) and will check out Kellymom and see if LLL have a hotline for France (I looked at the French website yesterday and didn't find it very helpful in my situation but maybe if I can get someone on the phone it would be better).

Thanks to anyone who managed to read though this novel and get to the end.

Make sure that you are drinking enough fluids as that will effect supply. The more you feed the more you will increase supply. Try to make sure that if you are feeding every hour or so you put him back first on to the side you last fed him on and tgen change sides. Def contact ll they will help you. Take care

sorry you've had so little support for bf op.I thought it was crap here but it sounds truly dreadful.

What kind of pump are you using? My friend who exclusively expressed hired a hospital grade pump from the nct and said that it made a big difference.