Have I lost my supply?

[brokenboobs]

DD is 4 months old and has been EBF from birth. She's held at about the 50th centile for weight until the last month when she's seemed very fussy and dropped to the 25th. I have had my period every month since giving birth and it seems to make her very fussy and my supply seems to dip lower. This week I started my period again and she's acting very hungry and getting hardly any wet nappies. I've tried giving formula but she's point blank refusing the bottle. I'm at a complete loss as to what to do and getting very worried.

All could be normal - fussiness sometimes happens before a period but supply should not drop without picking up v quickly. A drop to 25th from 50th is within normal. Babies normally take less time at the breast as they get older.

What does your Hv say?

Lack of wet nappies - babies wee less often as they get older (when newborn they wee all the time). So again could be normal.

What do you reckon, OP?

I think something is wrong....I've had two wet nappies in 24 hours. That's just not right. I've missed the HV clinic for the week but have booked a visit from the lactation consultant on Monday. She just won't take a bottle but I'm assuming she will or I hope she will if she gets hungry enough.

If you think she is dehydrated, then you can't wait till Monday. She needs to be seen today.

She'd have other symptoms, too, though.

Hope all is well.

I've started giving her little syringes full of water just to make sure she isn't dehydrated. She was more unsettled than she's ever been last night. Do you think I should go to the GP? I can't imagine they'd want to see more or do anything.

A friend of mine had a baby that was on the 2nd percentile and they were worried about how nuch she was getting from the breast. The HV actually weighed the baby immediately before and after feeds so they could see how many ounces the baby had had. They determined from that, it wasnt a supply problem. Obviously you'd need the proper scales for it though.

Do you have a Health Visitor you can call? I would try and go and see your GP today as I personally wouldn't want to leave it over the weekend.

The GP will want to see her. You should get a same day appointment

Tik Tok is right - possible deydration needs to be checked out ASAP

I'd take her to the Gp with those symptoms

Also try giving her syringes of formula

GP will be able to tell if she is dehydrated. If she really is, she needs to be hydrated with medical advice.

Dehydrated babies are lethargic and obviously poorly, so it's prob not that.

But you do need a medical opinion on this - not an Internet forum :)

Prob best not to give her syringes - at least not without doc's appro.

GP and HV asap OP, its worth getting it checked and if she is getting dehydrated then Monday is too far away. For your own peace of mind and babies best, when in doubt - get checked out.

She will be fine, but better to be safe! xx

In the meantime check her anterior fontanelle, if she is dehydrated you will feel a noticeable dip xx

Definitely go and get her checked out please!
But from a supply point of view if you're giving her formula and water then your supply will drop because of those missing feeds. I would just keep putting her on the breast as much as possible, say every hour, then hopefully even if she's feeding only a little she'll still be getting enough cause she's feeding often! Fussiness is normal around the time you get your period as your milk is supposed to taste a little different in some cases but coupled with only 2 wet nappies then I would definitely get her checked though!

She's not had any formula at all because she is refusing it. I've given maybe 3ml of water just because I was worried last night. I'll take her to the GP but they are just going to think I'm hysterical. She isn't lethargic and her fontenelle (sp?) is fine. I just don't understand. My supply was fine and she and I were chugging right along with breastfeeding. I don't know where I've gone wrong.

I'm sure they won't feel your hysterical. IMO they are more than happy to check out any concerns with children, especially babies.
FWIW I'd take mine in the same situation and I'm not one for bothering DRs.
I hope they are able to put your mind at rest and offer some suggestions

broken, everything you have described here is on the normal spectrum. It is normal for babies to drop a centile space. It is normal for them to go through fewer nappies as they urinate less often as they grow - the wee comes out in larger amounts less frequently. It is normal for them to have fussy periods - and to take less time on the breast and object if their mothers keep insisting on longer or more frequent feeds. Fussing around the time a period is due is normal, too.

However, if you feel there is cause for concern, then none of that means you should not see the doctor. Worrying you will be thought of as 'hysterical' is not a reason to leave a possibly ill baby several days before seeking medical help - no one will think you are hysterical, and even if they did, what's more important.....your daughter's health and your peace of mind, or what the doctor might think?

Hi Op hope you get on ok at the GP. They won't think you are hysterical. I think most GP's are happy to see babies when there are any worries, even if you can't put your finger on what's going on.

Fussiness at this age can be pretty normal - in fact both my dd's went through fussy periods at different points. It isn't always anything to worry about although I did always worry! Who doesn't?!

Just stick with it, offer feeds but don't force the breast. Try different positions, different locations - quiet rooms etc.

Baby was slightly dehydrated but not enough to warrant rehydrating her apparently. Two wet nappies isn't enough though and GP reckons I no longer have enough for her. How did this happen? I feed on demand and offer even if she's not giving hunger cues but it's been a while. She's not my first and I never had this issue before. GP reckons to stop offering breast and syringe in formula and keep offering it in a bottle.

It's good your baby is not unwell.

Losing supply never just happens - there is always a physiological reason connected with the baby not feeding often enough, or use of formula, or the baby not removing milk effectively.

None of this applies to a healthy baby beyond newborn, who has been feeding and growing well for some months.

Your GP may not understand BF very well. Nothing of what you have said here indicates you have insufficient milk. Did the GP offer any explanation?

Have you got a local BF specialist midwife or health visitor? A breastfeeding counsellor?

I think it would help to have a good session with someone face to face who can observe a feed, take a history, and work out what to do now.

You can also put a cotton wool ball inside your baby's nappy to see if she is seeing more often than you think. Today's super absorbent nappies don't always give you an accurate idea.

Seeing should be weeing 😀

What is making you think your supply has dropped, is it just the lack of nappies, or anything else? There is a normal switch at around 3 or 4 months where you're moving from hormonal based post birth overenthusiastic supply to demand based, tailored supply. This means that you'll stop getting bigger, full-feeling breasts between feeds - it's normal for them to feel soft all of the time - and you might stop leaking. Women are not often told about this, and it can be mistaken for low supply. Sometimes the baby gets frustrated at the slower flow of milk because when your breasts are engorged, the milk can almost gush out very fast especially at the start of a feed, so to simulate the faster flow, you can try doing breast compressions which means squeezing/pressing the breast as she's latched to increase the speed of the flow.

At four months babies often become fussy at the breast, too. This is often due to them becoming more aware of their surroundings and suddenly looking around is much more interesting than trying to take a feed. Many babies also begin to wake more at night at this age too, sometimes thought of as a sleep "regression" and seem to switch to a pattern of more frequent smaller feeds, which can be a pain if they've been going longer, and baffling if you were expecting feeds to consistently spread out! You can help this by choosing boring, unstimulating places to feed or perhaps (if your baby will tolerate it) using a nursing cover to block out distractions. You can also frequently switch sides which can help keep them interested and feeding for longer. It's fine to feed from each side more than once per feed.

Lastly teething can be an issue at this age. You could try feeling along her gums for any hard lumps which could indicate imminent teeth or try the granules you can buy or teething gels just before a feed. Just be careful not to give too much of the gels near the back of the mouth. If she's pulling off the breast and crying then it can indicate pain in the gums, but it's all a bit of a guessing game.

FWIW, GPs do not have any breastfeeding-specific training. They can recognise important issues such as dehydration in newborns but I would not (personally) rely upon a GP's advice about breastfeeding itself. If your supply is low, then the best solution would be to use methods which are shown to increase supply such as switch feeding (frequent switching of sides), frequent nursing, skin to skin and possibly also added pumping sessions and/or use of galactogogues. Less frequent feeds and offering more formula are ways to reduce supply, not increase it, although top ups are sometimes necessary. Whatever you decide to do over the weekend though, any effects on your supply should be fixable, so focus on getting food into her however you can best manage. Certainly I wouldn't withhold feeds from her in an attempt to get her to take the bottle, that seems likely to exacerbate the problem, especially if you know she'll at least take something from the breast.

(Sorry, the site went down as I was trying to post, so I might have missed some posts!)

You can rescue your supply (if this is what you want? ) You sound really upset. I think it's so unfair when a woman who has worked so hard at Bfing doesn't get to stop it on her own terms. You have given your LO the best start and done so amazingly well. you should be damn proud.

Now, you may decide that it is time, and just focus on just getting the LO to take some formula and give yourself a break, but if you do choose to give BFing another go, there are things you can do, and I'm sorry (but not surprised) that your GP didn't suggest them to you.

first things first- you haven't been taking any cold and flu remedies, have you? My friend had ONE lemsip and nearly lost her entire supply. Decongestants are designed to dry up mucous (which is, kind of, what milk is!) AVOID. I'm sure you will also be aware that the combined pill is a no-go too.

Secondly, if you want to have a bash at getting your supply back, you can do lots of skin to skin and maybe try power pumping (be careful though- I ended up with a sodding oversupply after just 3 days of doing this.) www.lansinoh.com/en/help-advice/power-pumping-what-is-it-is-it-for-me

It was gushing out of just like it had been when my milk came in. My DS thought Christmas had come early

Some people have had really good results using fenugreek (defo most effective when combined with increased BFing/pumping).
Jack Newman swears by Motilium (domperidone). It isn't available without prescription in this country, and sadly GPs are not licensed in the UK to prescribe it for milk supply reasons alone. It is a shame, as it works.

I am sure you know all this, but you should also drink loads of water and make sure you are rested and stress-free as poss (I KNOW- ridiculous suggestion when you're so upset and worried about this, SORRY.)
Good luck, and remember- you have done so amazingly to get to this point. You can try to keep going or not, but nothing will ever detract from that fact. Well done.

PS if LO won't take bottle, have you tried cup feeding? My DS was able to do it by 4m, although he eventually started taking a bottle of ebm not long after that.

^oh yes, what all the others said too. I convinced myself my supply had dipped and I started power pumping. As I said, it soon turned into an oversupply and I was engorged. Speaking to a lactation consultant, she highly doubts there was ever anything wrong with my supply at all. It just adjusts (sometimes quite dramatically) at some point between about 12 and 18 weeks, for the reasons Bertie states.

Also, a word of caution about centiles- the red book growth charts are quite misleading if you're plotting the development of a Bf baby, as so much of the data as to what constitutes an 'average' baby is based on data which is skewed by the abundance of ff babies (who tend to carry a little more chunk) vs bf ones. BF babies do occasionally slow in growth at times when FF babies are galloping on, as they are truly demand feb by a product which changes composition regularly, biologically and intuitively), as opposed to formula where the product doesn't change days to day or week to week. There is nothing to worry about if you drop a few lines on the chart, unless it is dramatic and prolonged (i.e. the baby stops growing.)

I echo tiktok's advice- before you stop BFing altogether and really DO lose your supply, why not try and get some proper BFing advice, either from local group, a lactation consultant, or one of the helplines- www.breastfeedingnetwork.org.uk/contact-us/helplines/

Sounds normal bar the mildly dehydrated.
Is baby suddenly more aware of the world & distracted? Or are you taking any meds? Or are you dehydrated yourself?

Snuggle up with your top off loads of skin to skin & frequent short feeds which babies do when boob is right in front of them. Make sure to offer both sides each feed.

Eat oats etc read kellymom & get some BF support NOT a GP who has had one afternoon about BF in their training.

Good luck