low milk supply

[Madigan]

Help please! How do I improve my milk supply?

I have been BF my newborn for 1 week now - 4 hourly feeds. She always needs a formula top-up afterwards (at least 30 mls). I express after each feed and there is barely any milk left. My milk came in late (day 5-6; I hasd a c-section and that may by why): now on day 8, and the situation is not improving. I never feel like my breasts are "full" and she is not satisfied after a feed.

Please please can anyone help? I really want to stick at breastfeeding, but am becoming demoralised about it ............

I would offer her the breast much more often than once every 4 hours - try 2 hourly for a couple of days.

The baby feeding will stimulate the supply, but 4 hourly is not enough at this stage.

Encourage her to feed, and drop the top ups, as they will hinder your supply too.

I'm sure if you drop the top ups and feed her really regularly for a few days, your supply will increase.

I know it's scary dropping the top ups, but your boobs work on a supply and demand basis, and if her appetite is being met by the top ups, she will never demand enough from your boobs!!

Good Luck and hang on in there - things will be a lot better in a few days.

Madigan, can you give us more details? How heavy was your baby when she was born? Has she been weighed recently? does she have plenty of wet and dirty nappies a day? Is the 4 hourly gap between feeds set by her or are you spacing them out for her?

Try not to worry, there are lots of people on here who will be able to help and support you .

new baby needs feeding much more than every 4 hours. are you timing feeds? have you tried putting her back to the breast rather than giving her the formula?

Firstly, a newborn should be feeding at least every 3 hrs (or 8 to 12 feeds per 24 hrs). 3 hrs means from the start of one feed to the start of the next.

There is no need to express at this stage unless your baby is not able to latch.

Your breasts do not have to feel 'full' to have milk. You will have milk and the best way to stimulate your body to have more milk is to feed your baby as often as possible. If she is not satisfied after a feed, put her back on the other side, even if she has had that one before.

I think it is important for you to talk to one of the bf helplines. ABM (Association of Breastfeeding Mothers) is open tonight till 10.30 pm (the one that stays open latest).

Please give them a ring as there are other important questions which a trained breastfeeding counsellor may want to ask you.

Hello

the 4 hours is set by her really, and the other problem is that shefalls asleep on my breast all the time, so I spend the whole of her feeding time poking and prodding her to stay awake.

She weighed 8 lbs and 4 oz at birth, which then dropped to 7 lbs 7 oz and is now back up to 7lbs 14 oz (as of Wednesday - bet she is at least 8lbs now). She has plenty of dirty/wet nappies.

I have a maternity nurse and have been relying on her a lot ... will ask about 2 hourly feeds to see what she says ... have to say that it makes sense to me to feed her more often ............

Completely agree with Jojay, feed more often to stimulate supply and drop the formula top ups as giving formula will only reduce your milk supply.
Also eating oats is thought to help with milk production, porridge or those nice oat bics will do (cant remember their name)! Have a look at Kellymom site for loads of good advice/info
www.kellymom.com/bf/supply/milkproduction.html
GOod luck

is your maternity nurse trained or experienced in bf? has she explained to you that a one week old bf baby should basically be at the breast pretty much the majority of the times...feed feed feed...

at least every 3 hrs but dont be surprised if she wants feeding after 2 hrs.

here are some hunger cues which will tell you that your baby wants a feed. best to offer her a feed before she gets too agitated or is crying.

Personally I wouldnt wait to see what the maternity nurse says about feeding - she your baby, but every 4 hours is nowhere near enough in the early days, every 2 hours is much more like it and will stimulate your supplt.

keep going you will regret giving up to soon.i tried feeding my first for 4 days and when he was taken into hospital and given formula i felt in a way i had let him down.i was also only able to express less then enough to cover the floor of the bottom of a milk bottle in 12 hours. i felt awfull. my second child i gave up after 24 hours but he was then diagonised with heart problems and couldn't feed.he was tube feed but i wish i could of expressed for him but i was so tied and worried i couldn't produce hardly anything.my wish is that i had had the support to hold in there. good luck and keep trying but don't kill yourself.a happy child is that of one with a happy mummy.enjoy her and don't stress

then here is a link for a sleepy baby so you will have to do the waking rather than waiting for hunger cues.

and in my opinion, if your maternity nurse is advising you that a newborn bf baby can go 4 hrs between feeds, then she doesn't know enough about breastfeeding. I would fire her.

don't panic. your baby is less than 10% below her birth weight. but do something sooner rather than later to drop the formula top ups otherwise, she will become a fully formula fed baby.

the amount you can express doesn't show what amount you are producing, it only shows the amount the pump can get out of you. a pump is a fairly crude version of how a baby suckles the breast.

Agree with ruddynorah, expressing is a poor reflection of the amount of milk you produce, plus its a hassle. Easier to drop the expressing for now and just feed your DD more often.

Madigan,

My ds was a very sleepy baby too, and I had to wkae him all the time to feed - he would go hours if I didn't.

I'll probably get shot down in flames for this, but in the absence of a better idea at the time, I started following the Gina ford routines, seeing as he didn't seem to want to 'demand' any feeds at all.

The routine at that age dictates that you feed a minimum of 3 hourly, sometimes even more frequently, and I certainly never had a problem with my supply.

The routines aren't for everyone, but like you, i was a first time mum with no experience, and a baby who didn't seem to know what he wanted either ( except to sleep......) Following her routines gave me the confidence that I needed, to know that i was meeting his basic needs.

When he was about 10 weeks old, he started to want to do his own thing, so we dropped the routines, and our own pattern evolved.

So we didn't do it for long, but I feel it reaaly set us on the right track at the beginning.

Good Luck!!

I always found that carrying DD in a sling would really increase my supply and she seemed more keen to feed. Its also really nice for both of you.

I knocked expressing on the head. Its so much more trouble than its worth, especially at this stage. I only manage to express if DD has slept for most of the night and then I feel engorged in the morning. It really doesn't represent what DD is actually getting when she feeds.

Stick with it and give bf counsellor a call, they are really helpfull.

first of all dont panic - i know easier said than done

I agree with everyone saying dont top up it does sound like your baby is doing well gaining weight and wet/dirty nappies.

There is no need to express just yet I am sure it is tempting especially if you have a full time maternity nurse so you can get some rest at night. have a word with your mat nurse and explain that you wish to fully breastfeed (if thats what you want) and that you want to be brought the baby every 3 hours max.

I had worries when my lo was born 11 wks ago about my supply but if you persevere with putting her to the breast your supply will get better, you can also take feugreek as a supplement for your supply I recently started taking it and my supply is much better now.

If your LO is falling asleep on the boob its not un-common I had to take my DS off and on and constantly tickle him to encourage him to stay awake during feeding. I spoke with a BF councellor and she said strip the babe down to nappy when feeding as this will encourage the bub to stay awake also tickle their earlobes and talk to them to keep them awake, a laborious task but worth it. It does work, she also said do this for the first 20 mins of a feed as that way you will know they have taken a good amount on board.

It is very early days yet your supply is still coming in and your LO is getting used to the world dont worry if they are sleepy often babies are for the first couple of weeks its their way of dealing with being out in the world.

Good luck and keep at it you are doing a brilliant job.

forgot to give ABM's number
08444 122 949

sorry.... was sure i did.

Madigan, have you tried stripping her off before a feed so she isn't quite so warm and snuggly? I had a very sleepy baby too and it was so tricky keeping him awake long enough to feed.

I agree with the others that you need to feed more often. As you are lucky enough to have the maternity nurse there you could spend a few days just feeding as much as possible, literally every time she stirs as feeding more often is the best way you will reliably increase your supply.

I'm going to be a bit rude here and ask about your maternity nurse. Does she have any specific training with bfing? If she doesn't, I would ring one of the bf helplines and talk it all through with a trained bf councillor. Some maternity nurses have outdated or poorly informed ideas about bfing that will be more detrimental to your feeding. I would hazard a guess that she isn't particularly knowledgable by the way she isn't encouraging you to feed more often than 4 hourly.

Are you using both breasts at each feed? I was advised to switch sides regularly during a feed by a bfc, particularly if the baby is sleepy as a new rush of milk will encourage her to start actively feeding again, rather than dozing.

can't really add much more than has already been said. Agree that every 4 hours is not enough and that you should stop expressing. Putting lo to breast more frequently will stimulate your supply. Eat and drink plenty yourself. It will get easier, please don't give up yet, it is worth it.

IS BABY GETTING ENOUGH? QUICK REFERENCE CARD

WEIGHT GAIN: 
If baby is gaining well on mom?s milk alone, then baby is getting enough. A 5-7% weight loss during the first 3-4 days after birth is normal. Baby should regain birth weight by 2 weeks. Once mom?s milk comes in, average weight gain is 6 oz/week. If these goals are not met, call your lactation consultant. More on weight gain. 

WET DIAPERS: 5 - 6+ sopping wet diapers per day (after 1st week). 
Expect one wet diaper on day one, increasing to 5-6 by one week. To feel what a sufficiently wet diaper is like, pour 3 tablespoons (45 mL) of water into a clean diaper (if baby wets more often, then the amount of urine per diaper may be less). Urine should be pale and mild smelling. 

DIRTY DIAPERS: 3 ? 4+ dirty diapers per day (after day 4). 
Stools should be yellow (no meconium) by day 5 and the size of a US quarter (2.5 cm) or larger. The normal stool of a breastfed baby is usually yellow and is loose (soft to watery, may be seedy or curdy). More on infant stooling. 

OTHER POSITIVE SIGNS: After a feeding, mom?s breast feels softer and baby seems reasonably content. Baby is alert, active and meeting developmental milestones. 

Is your Milk Supply really low? 

There are some things you can take to Increase your Milk Supply and these include Teas and Tictures

The Breastfeeding Network (BFN) - Supporter Line 0870 900 8787 - The service operates from 9.30am to 9.30pm every day of the year.

La Leche League Great Britain - 0845 120 2918

National Childbirth Trust - 0870 444 8708 - 9am to 6pm, seven days a week.

Association of Breastfeeding Mothers' - 0870 401 7711 - Open every day from 9.30am to 10.30pm

hi
hope you are still there.
if you can, go back to bed with your babe in the afternoon, or late morning, get someone to come in and take care of family, dinner etc.rest, rest, rest, drink plenty of water and eat sensibly.
strip you and babe, i agree, ski to skin, and throw this 4 hour business out of the window.
your breasts will produce more milk as your babe feeds more.
i am worried about introducing a bottle to "top up". can you give that up? and let your breasts top up?
feed babe on one breast per feed, making sure that babe is getting both "fore" and "hind" milk, and don't rush a feed. small babies have small tummies and cannot take a lot in one go, and a good feed may take anything from 20 mins to 1 hr, as your babe nods off, - b/feeding is tiring for a new baby- your breast will automatically produce more milk. after a snooze of 2 or 3 hours, try rubbing a little milk fromyour nipple onto babes lips to stimulate another feed, if youare worried babe is sleeping through a feed. your production will increase in 24-36 hours, don't time feeds, feed on demand, as often as babe wants, this really is very early days. i do agree 4 hours is too far apart. lie in bed and listen to the radio, or watch telly, and get to know your baby, you both have to learn how this b/feeding thing works for you.
good luck.
oh, and don't bath in anything too scented, let baby smell you and your milk, that should build up an appetite
x

sorry forgot-
check positioning
make sure babe is getting enough of a mouthful of breast,sometimes if babies nipple feed, rather than b/feed , they don't get a full and satisfying feed
x

Thank you for all this advice .....

am going to feed on demand all weekend, and try to forget formula, and see how we go ...

will look up all your links etc tomorrow - as right now I am dead on my feet, and due to feed again at 2am

but thank you for all advice, and any further advice would be vv welcome

xx

yeah, get your maternity nurse to cook, do laundry, tidy up and bring you cups of tea, juice, biscuits the remote etc. stay in bed and feed your baby.