Not enough milk production - dad writing on mum's behalf

[rrt]

My wife is having trouble in producing enough milk for our 3 week old DS. From the beginning, he was given formula by the midwife in the hospital as my wife was having trouble feeding him (latch was bad). Things got worse when her nipples were in real pain, and so to ensure the baby was fed, was given more formula. Wife was in so much pain with feeding from her nipples, but didn't give up and soldiered on.

In the last 10 days, breast feeding has improved and it appeared that there was less need for the formula. However, yesterday he cried for ages not happy with her milk and wanting formula - having thought that he was almost off the formula, he then drank about 90ml in one go (loads compared to the 30-60 he had previously been drinking).
What to do to increase her supply?
Wife is trying to stay calm and unstressed (difficult she reminds me), has tried to stay in bed as much as possible, and eats well as well as getting a good amount of liquid.
What is a sensible way to move from her milk+formula all the way to just her milk. She is happy to put the work in, just that she is not apparently producing enough to make him happy!
ps. yes, sorry for this not being dadsnet, but wife really would like some help!

Sorry, nurseyjo, I am going to have to ask you yet again to stop posting non-evidence based advice. Alternatively please direct me to the research that shows a healthy, well-balanced diet can improve supply, and that being active decreases it?

Of course mothers should look after themselves and take time to feed often, eat well and drink according to thirst, so they are comfortable and nourished, and try to enjoy life without stress or fatigue. But only one of those 'items' will help with supply, and that's the frequent feeding.

Nothing wrong with trying the herb teas, you are right. But in this situation, full breastfeeding is probably not gonna work with formula supplements of 30-60 ml - that's the cricial factor.

I have had occasion to bring your approach up before, as you know, and I know you don't take well to criticism, so I have no hope at all this will change your behaviour. You use your previous experience as a maternity nurse to give spurious authority to your advice, and I think this is wrong. I do think there should be a warning symbol on your posts, somehow, so people are wary about what you say

How lovely your dw has such a caring and supportive hubby . I really hope ahe manages to up her supply, with all your support I'm sure she will .

I have to agree with tiktok there on frequency of feeding. I have breastfed 5 babies so far and am awaiting the arrival of number 6 now, late as usual.
I was often flumoxed as to how I managed to feed the babies despite running around like a blue arsed fly pretty well immediately post birth. Snacking on whatever scraps I could and resting?? yeah right and I too think the answer must be frequency of feeding. Whenever they cried I fed/ let them suckle and they fed quickly and efficiently.And weight gain was fab. I'm no technical expert nor to I have a list of research and statistics at my disposal, but it makes sense to me.

If her nipples are still painful then it does sound like the latch isnt quite right still....or it could be that she has thrush. Difficult to tell from your message...is the pain just when she is feeding or does it continue after feeds? HVs & MWs are not always experts in bfing & so it pays to get some expert opinion on this so I would keep trying the LLL helpline or similar. Especially as you say you arent sure what to do next. These are all the bfing helplines:

National Childbirth Trust: 0870 444 8708 (8am-10pm)
La Leche League: 020 7242 1278 (24 hours)
Breastfeeding Network: 0870 900 8787 (9.30am-9.30pm)
Association of Breastfeeding Mothers: 0870 401 7711

All of them train their own volunteers (some for several years depending on the organisation) so you are guarranteed to get through to someone who has very good bfing knowledge. Of course there are good bfcs and bad bfcs so if you arent sarisfied with the help they offer its worth getting 2nd & third opinions (either with the same organisation or with a different one). Its also worth keeping in mind that these numbers are manned by volunteers in their own homes with families of their own...so sometimes it can be hard to get through to someone....its very worth keeping trying though.

You could try calling a bfc direct. This page has the numbers of active LLL leaders in england & there are quite a few in London. I remember having problems in the early days with DS & spending a good morning phoning every bfc number I had until I got through to somone....I can tell you from personal experience that it is definately worth it!

I don't think rrt is going to come back here....that happens sometimes, when people post and then disappear FOR EVER!

He only posted yesterday - what makes you say that tiktok.....

Whoops, sorry.....I missed his update!

Hi, rrt....I am glad you have sourced some help. You can't really tell how much milk is being produced by assessing whether the breasts are full or not.

Can't imagine why NCT would recommend a nipple shield....best way to help sore nipples is to use some stuff on them alongside getting the positioning and attachment right, but maybe the person you spoke to explored the drawbacks of shields with you.Very occasionally, the benefits outweigh the drawbacks.

Hope things continue to go better and sorry I thought you had disappeared ;)

rrt - I have googled and found that they run a clinic on Tuesdays and Thursdays. The Kings clinic became a bit famous for the expert support of a woman called Claire Kedves, I think...don't know if it is still so renowned. Check this link and call them? But you are probably out of the catchment area. here

tiktok - that sounded very ominous for a moment!

I wondered myself about the curse of mumsnet

Nipple shields helped me when the pain was really bad - I might not have got past it had I not used them for a while. Agree, though, that the ultimate aim is to be able to feed pain-free without nipple shields (am sure that is what your wife is aiming for rrt!)

Might hand-expressing be worth a go? (if the pain is really bad?)

A bf counsellor suggested I try hand-expressing for a bit and I could have cried with relief (in fact, I probably did!). Unfortunately for me, I was never able to express much but everyone is different.

Nipple shields are often really bad for supply. I wouldn't recommend them casually.

Depending on where you are in North London, the BFN may have a good support group for you - see some post codes of groups here - click on the location to find out where the drop in is.

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nipple shields were my salvation... best thing and helped me continue - actually without them, i would have given up a long time ago. used them for two weeks, then weaned ds off them.

You could always try posting at www.iwantmymum.com for advice- there are lots of BFC there - at least one usually on-line at some point in the day.

hi
just wanted to say that you should get someone to check for tongue tie as this is a common cause of painful nipples and difficulty latching and breastfeeding.

Just a though

Tiktok, you have a very sanctimonious tone and the use of the smiley emoticon at the end of your long admonition didn't make you come across any friendlier.

nurseryjo,
i have bf two children and would agree 100% with your advice
so there tiktok.

nurse, nurse, nurse, eat oats as this will naturally help increase supply and check out this site

Isn't the point that resting, eating well and drinking plenty will help the mother, by keeping her energy levels up but the only thing that will actually boost the milk supply is regular feeding by the baby?

I've just managed to successfully establish bf with my 3rd dc, after ffing the first 2. When dc3 was birn I had 3 children under 3 so I do not have a second to myself and resting, eating well and drinking plenty are nice ideas but not always possible. Yet I've managed it, women have successfully bf through wars, famines and having large families, so yes, it will help rrt's wife to feel better but it won't make much impact on her milk supply.

Please don't turn this into a row, rrt has come on here for help and doesn't need petty squabbling. Personally, I have valued all the advice tiktok gave to me personally when I was struggling with bf, and in a lot of her posts when I've been through the bf archives looking for help. I know she is exceptionally well qualified to give the advice she does and I can understand how frustrating it must be to have common misconceptions about breastfeeding come up again and again. Hence the tone of her post. I am guessing she is also human, as well as being a bf guru, so maybe she's having a bad day too?

Please can we get this thread back to what it should be, which is supporting rrt and his wife and making sure that she becomes an established bfer.

RRT, fwiw, you sound like a lovely dh and I'm sure with your support and all the advice you're getting on here you'll all be fine. I'm 12 weeks in and have just got the point where it's all fallen into place and it's working brilliantly - you'll get there too!

As you can see, it can often take many different approaches...
Sore nipples? Kamillosan worked brilliantly for me, and wandering around with nipples exposed (in private of course...)Also rubbing in a wee bit of breast milk at the end of each feed.
Supply? I found dd went in peaks and troughs and I always put it down to a growth spurt. Then the onus wasn't on me 'failing' but just that dd needed a bit more so my supply would have to have time to increase. Then I tried to rest more, drink lots, eat really well and just spend as long as poss cuddling/staring at dd. It took about 6-8 weeks before I felt we were on an even keel. I stopped b/f at nearly 18 months, so it must have worked!
HTH. You sound like a lovely supportive husband btw