Trying to increase milk supply - how much longer do I keep going?

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My baby was born emcs and with early jaundice, so he was mostly formula fed at the start and as a result we've always had issues with milk supply as well as latching. Now 3 months on we're mixed feeding and I'm still trying my best to increase my milk supply. I've been on and off domperidone and trying to pump as frequently as I can, but I can only get 10-30 ml from both breasts each time, depending on when I last breastfed. It can be a struggle to get baby on the breast - he knows he gets more and faster from the bottle (we use Medela to make him work a bit harder for his formula) so he often cries and refuses after a few seconds on the breast. He's much more receptive during night feeds and just after naps when he's calmer. But it's hard to tell how much he is getting from me. After feeding him twice overnight, I think we've done well, only to find an hour later in the morning that he's starving and guzzling formula like he never had a night feed.

We've been to the infant feeding clinic, seen a feeding specialist provided by our children's clinic, been to breastfeeding cafes, hired hospital grade pumps, tried sns, read all the advice on Kellymom and I think I have exhausted all the advice that there is. At the moment, going by what we expect baby should be taking in, I think we're about 70:30 in favour of formula.

I'm making another push now with 30mg/day domperidone plus fenugreek, and offering the breast and pumping as much as I can. Things seemed to be improving slowly - he started latching a bit more willingly as he matured - until a couple weeks ago when baby started having reflux issues. We've seen a gp and started infant gaviscon, but it's made things so much harder - he'll only feed horizontally but cries on pain when I try to lie him down. (He's never liked reclining position, vertically or feeding on top of me - he can't latch and reverts to old behaviours of screaming and head banging in frustration.) I find myself carrying him in my arms or in a sling and soothing him almost constantly all day. He'll nap but for only 30 mins at a time. When I do have some respite, I'm too exhausted to do anything, and am only fitting in one pumping session a day now.

I desperately want to breastfeed more but the infant feeding team suggested kindly that I may have to readjust my expectations, do what I can, and to just enjoy my baby. He is healthy and putting on weight otherwise. My husband is supportive, makes me breastfeeding cakes, but he works all day. How much longer do I keep trying? I know it's an answer only I can give but I would love any more advice or support.

The one thing I didn't do was post on mumsnet about this - I didn't know about this infant feeding section sadly and I wish I'd posted sooner. (I think it's a bit tucked away - wouldn't it be more visible in the Being a Parent section?)

Also this:

The other thing is that if he isn't full then he won't nap/sleep

Explain this further. Do his eyes ping open when you put him down in a cot/pram? Again, normal, not underfed. Does he conk out on you then stay asleep? If so, let him sleep on you!

Hi OP, I had supply issues- dd had jaundice, lost more than 10% weight after 10 days no wet nappies at times. We started a 3 hr pumping cycle, where I would express, bring Dd to empty breasts to stimulate supply then top up with expressed milk which if it was less than 90ml (inevitably it was as I was just so exhausted) I would top up with formula. I also took fenugreek and ate truck loads of oats. It all helped but essentially I look back and realise I was very depressed at this point and I more or less don’t remember much else of dd’s first 6 months. I remember I was prescribed domperidone but by that point (maybe 6 weeks in) I just wanted to give up and switch to formula entirely. Well, then dd decided she only wanted to bf and we ended up bf’ing until a year and I gave up all the expressing as it seemed to work. I did keep up the fenugreek and stank of sweaty maple syrup boobs for a while.

I am waiting to give birth to second dc now and I know if I have just a bit of the supply issues I had last time I will switch to formula straight away. I feel so guilty about how little I enjoyed that time with dd and as it was mat leave, I will never get it back. For me fed is best BUT I know had anyone said this to me when I was going through everything with bf’ing and dd at the time I would have ignored it because I desperately wanted to bf and felt it defined me and my relationship with dd at the time. That’s bollocks and I know that now.

I don’t know how helpful this post is, but you’re not alone at least. Good luck.

I really do appreciate the advice. But I keep saying I am offering him my breasts, when he looks hungry and and when he hasn't - he may initially latch on and have a few sucks but he won't stay on. Then he'll cry and cry and won't stop until we give him a bottle. I have been assuming this means that it's not coming quickly enough for him.

Maybe low supply is not right - slow flow? When he's refused the nipples I have hand expressed to check there is milkn there and there is. At that point I might let my husband feed him while I pump, but as has been said, it doesn't get much milk out of me.

Just to add even when bf’ing was established that paranoid feeling of ‘has she had enough?’ Didn’t leave me so I would do crazy things like being her to the breast when she was asleep and I destroyed her napping and her and my night sleeping as a result which didn’t help my mental health either. If you are happy and enjoying what you’re doing and baby is being fed but if not I would address it and consider a change.

So stop with the bottles for a few days so he gets used to how much work he has to do to feed from the breast exclusively. Dark room, skin to skin, and white noise to calm him down enough to get him latched on. As long as you’re still offering a bottle, he’s going to want that as it’s less work, Medela teats notwithstanding.

ElphabaTheGreen, he won't go to sleep, he'll just get more and more cranky and cry and cry, but will be too upset to breastfeed - i can't seem to comfort him with breastfeeding unfortunately. So we give him a lot of formula and conks out.

If I catch him at the right time he will breastfeed to sleep for his naps, but this isn't very consistent. He usually breastfeeds half asleep overnight until he dozes off properly and detaches.

I had very similar problems but without the reflux. I stopped BF at 3 months. I was sad but I had done my best. Three days in a darkened room sounds like torture from mum and baby. Going cold turkey on formula sounds very risky.

Good luck whatever you decide

Have you tried skin-to-skin + dark room + white noise? I used to have to really stuff a boob into a screaming mouth several times over before they’d latch as well.

There is no other magic solution. If he’s still getting a bottle, the cycle will keep repeating.

Three days in a darkened room sounds like torture from mum and baby.

You don’t spend the entire time in the dark. Just when baby is unsettled - you’re re-creating the womb environment. Also - you set up a box set or MN on an iPad, and surround yourself with food. It’s bloody lovely when you’re too knackered to do anything else! It’s the way breastfeeding has been established (minus the technology) for millennia.

Going cold turkey on formula sounds very risky.

Not with a baby whose weight is fine and is producing wet/dirty nappies (according to the OP). If the baby had weight issues, of course it would be risky.

I agree with Elpha. He's crying for a bottle because it's his easy solution. If you cold turkey on the bottles and spend a few days at home topless and offering milk he will work it out.

Cheekyandfreaky thanks so much for sharing.

Also - awake time is only 45 minutes at his age. If he’s awake much longer than this, he will get furious and over tired and refuse breastfeeding. So offer him the breast when he is waking up, as you say he’ll take it then. Then clock-watch like mad and offer him the breast again 45 minutes later and he may well take the breast more easily as he hasn’t got to over-tired stage. He could then fall asleep on the breast. If so, stay put, let him sleep as long as he wants, then offer the breast again the second he stirs.

Cold turkey isn't risky if baby is putting on weight and has wet and dirty nappies.

Be kind to yourself OP.

I agree with other posters, it doesn't sound like low supply. I couldn't pump more than a few mls with DD1, but actually had tons of milk. I had no option but to breastfeed because she was allergic to formula With DD2, on one occasion when I wasn't allowed to feed her because of medical tests, I threw away 800mls of milk over the course of 24 hours. It was heart breaking. I had tons of milk and could have fed the whole street. Each person is different.

It is far easier for them to take a bottle, which is why your baby fusses at the breast. He has learned that if he fusses, you give him a bottle. There is nothing wrong with formula feeding. If this is what works for you, then go with it. You have done your best and sometimes it just doesn't work out. Disappointing, but baby is growing and thriving (velcro babies are very wearing!) so you have nothing to berate yourself for.

Thanks for the advice. I don't think I could go cold turkey on bottles completely, but I'll try to offer the breast, skin t of skin, dark room for longer before giving in.

I sympathise. We were in a similar situation at a similar age. My supply only fully established once we dropped the formula top ups (prescribed by the Dr after DD lost 12.7% of birth weight).

Top ups really meddle with the natural process of baby giving your body the message to make milk.

If I had my time again I wouldn't use any formula in the first place or if I absolutely had to I would wean off it within a week.

And I wouldn't express. Expressing is a time stealer. I only reduced to expressing once a day at 4 months and like a PP I look back and think what the fuck was I doing expressing every 3 hours when I should have been cuddling DD, feeding her directly more, sleeping, eating etc.

My advice would echo others: stop topping up and expressing. Dedicate a couple of days to skin to skin cuddles and lots of feeding.

I don’t have any advice, you’ve been given a lot by people who sound like they know what they’re talking about, but wanted to offer my sympathy as it reminds me so much if what I went through with my DS. He had a tongue tie, snipped at a week old but we never really mastered breastfeeding very well in my opinion. I did stick it out and mix fed him until 10 months when I stopped bfing altogether but honestly it was hard, upsetting and stressful. I never felt like I was good enough. I wish I’d not put so much pressure on myself. Currently pregnant with nr 2 and willing to give bfing a go but if it doesn’t go well then I know it’s ok to stop. I really made myself unhappy about it. Do what’s right for you.

Thanks all. We tried again this morning with some of the suggestions but it followed a familiar pattern of relentless hungry crying. We eventually gave in with a bottle, but stopped after 100ml and offered breast again, which he took briefly. In the future we might continue to try to offer a small bottle to calm the initial hunger pangs but try to help him finish on breast.

We tried feeding him again after 40 mins or so in a dark room but he became very distressed when I offered my breast, progressing to screaming and shoving me away. It brings me to tears that he'd rather scream in hunger rather than feed from me - he's pretty much done this since birth and I don't think I could let him go hungry. I won't give up and next time I might try another technique a midwife showed me and dribble milk over my nipples to encourage him to feed. I'll try sns again too as the issues are at least partly to do with him and not just supply.

I know people are questioning why I am sure fixated on having low supply - it's because the infant feeding team, breast feeding cafe, midwives all said I had to establish breast feeding in the first 2-3 weeks. They said I had a narrow window to establish pro lactin receptors to increase milk supply, after which it would be very difficult. Isn't this all likely? We had a difficult first few weeks because of the early jaundice, needing to push through as much fluid through him as possible, so we couldn't do a lot of breastfeeding and I wasn't very successful at expressing or pumping either. So I've assumed that I missed the window and have been struggling to increase my supply with domperidone instead.

In his second week, we were really struggling to find the time to both breastfeed (because of his latching issues) as well as pump every 3h. We spoke to a specialist at the breast feeding cafe who said that we had to make the early jaundice the priority and give him formula rather than struggle to latch him, pump 8-12 times a day to increase my supply, and we could fix the breastfeeding part later. But I could never pump very much, as I said, 10-30ml as most. So I wonder if I never gave myself a chance to maximise my supply.

As I suspected, your early advice was shite

You should never have been told to give formula for jaundice. That’s terribly outdated. Breastfed babies are more prone to jaundice, but you just keep feeding, put them into sunlight and feed some more. DS2 looked like one of the Simpsons for his first two weeks and I barely saw his eyes open. I kept him skin to skin and fed at the slightest yawn and he was fine.

It is also not too late to increase your supply. They’ve blinded you with science. But you do have to do what I’ve suggested without the bottle to get your (what sounds like a perfectly fine) supply up to EBFing level.

But it really doesn’t sound like you’re going to give up the bottles, so I think you just need to make peace with mixed feeding, breastfeed him when he fancies it and use the bottle when he doesn’t. Forget about pumping - I really don’t see the point in going to that hassle, TBH. Breastfeeding isn’t all or nothing - any breastmilk is better than none.

* progressing to screaming and shoving me away. It brings me to tears that he'd rather scream in hunger rather than feed from me*

Oh OP I feel your pain. Please try not to think of it in this way. You are a wonderful mother. You are doing your absolute best for him. He loves you. He is safe and warm and nourished and loved. That’s all that matters. He won’t remember these struggles.

We just had a successful breastfeed 😊 - he woke from his nap and when tried to offer a breast he cried for about 10 mins. I persisted by starting up his favourite song, dribbling breastmilk into his mouth, and standing and rocking him, waiting for gaps in the crying until I could pop my breast in. He stopped every time the music stopped and there were a couple more short crying spells, but he fed for at least 30 mins before he dozed off again. 😊 I'm really pleased, though I'm not sure how sustainable it is in the long run as my grip on him was not that comfortable, my arms wanted to drop off and I already have some back and shoulder pain. I'll have to experiment with a sling, and we'll see if we can try to go cold turkey, but it's a way forward. 😊

Thanks again to all for the advice and sharing your stories. We'll keep persisting, but only as long as we're both happy.

How lovely!
It sounds like you are trying OP and have had some terrible advice from professionals.
Did the standing hurt your arms? Once he is attached, try sitting down on a sofa. Cushions are your friend!
Plenty of water, oats and fenugreek for you. These will all help with your supply. Along with night feeds as this is when baby dials up food for the next day. At this age my evenings were spent on the sofa with my tits out! It doesn't last forever.

There is some questionable info and advice on this thread. OP I think it will help to go back to whoever you have found helpful in real life and have another go at developing a 'boost my baby's intake of breast milk programme'.

It is absolutely not a good idea to stop the formula. Not when prob more than half his intake is coming from it. This has to be done gradually. Long term supplementing with formula does impact on supply so I feel fairly sure your supply will need intense and prolonged boosting to replace the formula - no one ups their supply by 800 MLS in a couple of days and in the meantime the baby goes hungry. Not a good plan.

OP you may well restore full bf with a plan you work out but it has to be consistent and workable. Find that helpful real life person and go for it :)

Drinking more fluids is irrelevant btw. Nothing wrong with drinking more but it's hardly crucial.

Good luck :)

Dermymc, yes all his weight was pulling down on my arms. I did try to sit but he started whimpering every time! He generally prefers us to hold him standing rather than sitting - I don't know how he knows the difference!