Where's my milk gone - DS refusing formula and my milk is getting less and less

[kittypower]

I don't know what's happened but suddenly my milk is getting less and less, It started on Sunday when I found I was getting less (no change in the amount of feeding or anything) and so for the last three days I have been expressing every feed and then carrying on for a bit even though my boob is dry to to and encourage my boobs to make more, but i seem to getting less each day rather than more. I'm drinking lots of water, eating etc....What can be wrong? Also my DS is refusing to take formula unless I have mixed it with my milk.

XX

Your HV's advice dates from the 1970s. If she is not 70 years old she has no excuse. If your baby is feeding efficiently and having wet and dirty nappies, he is fine. Normal baby growth does not follow those silly lines in the books. Stay away from the HV for a bit if she is issuing silly advice! Or just smile and back away quietly.

Kittypower, the absolute BEST way to increase your milk supply is to exclusively breast feed. mixed feeding is the surest way to reduce your supply... if you actually WANT to mixed feed, it is fine, and your baby will do fine from it, but if you want to just breast feed, the supplementary feeding will effect your milk supply...

The reason being the science behind it...
The action of your baby sucking on the breast stimulates the milk production. It triggers a physiological response, in that your brain ( specifically the pituitary gland) 'picks up' the message, and releases a hormone called Oxytocin which is responsible for the let down of your milk and then the increase in your milk production. pumping will just not produce the same response...

Once your milk supply is in and you have established feeding, your breast fill and your baby gets more efficient at feeding. this can take anything from 8 to 12 weeks to be truly truly established in this way. What i mean by this is, that up until this time, you may well feel very full breasts, followed by 'deflated' empty breast post feed. After this time, you dont notice the full feeling any more, well not so much. it still happens from time to time. I'm still feeding my DD and she is 9 months now. I cannot remember the last time i felt full with milk.. We had a really tough start to her feeding, and the ONLY way to get it established was to keep trying and to keep offering her the breast.

Your HV is basing her 130mls on a baby of your baby's age and weight. Its not appropriate to a b/f baby. It can be well applied to formula fed babies. and I suspect that maybe she meant when you fee the formula or expressed milk, that this is the amount your baby ought to be taking.

There is NO way to measure how much your baby gets from BF. NO way at all. expressing does NOT reflect this in anyway. As your baby will take differing amounts at each feed.

THe best way to know if your baby is getting enough is, as others have said... make sure your baby is weeing plenty ( at least 6 wet nappies a day) and that they are also pooing. THough, again, it is not uncommnon for a bf baby to not poo every day.

SO, little check list here:

1. Latching on, sucking AND swallowing at each feed.
2. Wanting to feed reguarly ( in bf babies as young as yours, it may even be every hour to hour and half, this again doe not mean they are not getting enough BUT, they can go up to 4 hours too at this age and still be healthy.. although i've not met a BF baby yet who does go this long
3. plenty of wet nappies
4. poo in nappies
5. fontanel is not depressed/ sunken in too much ( a sign of dehydration)

those are the simplest basic points to make sure of. If all those are a tick, then you are doing fine

my qualification for this advise?
Firstly,i'm a breast feeding mum, who had many probs in the early days and now have been successfully doing it for 9 months...
secondly i worked as a neonatal nurse and a adult nurse prior to being a mummy.
Before i qualified as a nurse, worked as a midwifery assistant in a very busy maternity unit and specialised in breast feeding.

though trust me, having the knowledge and applying it to your own baby is a VERY different story!! SO my main qualification for giving you this advise is that i've been there, done it and got the t-shirt myself ;)

SORRY for such a long post, but i felt it important to make sure you could understand the actual process and have a simple little check list... I truly hope this helps

oh, and YES YES and YES to the REALXATION and plenty of choccies...

you do need to drink plenty, but this is not to produce more milk, just to stop you becoming dehydrated from feeding. Any big loss of fluid form our bodies causes dehydration and 'milk loss' constitutes the same

good luck with it..

i dont want to confuse or contradict what i've saidm and i'm not going to but... if you do want your baby to take bottles at all, so dad, or another person can feed from time to time, just offer a small bottle in the evening, followed by a breast feed ( however small) when your production is usually less anyway. but ONLY if you want to be using bottles. most babies after 12 weeks will not happily go back to the bottle having been exclusively bf... not an issue if bf is all you want to do, but can be a problem if you need to get back to work etc... but i do stress... only do this if you want to or need to. NOT because you have to see how much they are getting.. i'm only telling you this as i could not for love nor money get my Dd to take a bottle when i needed her too due to medication i was on, when she was 13 weeks. the medication was ditched in the end! lol

PS... sorry, i promise I will stop now, but just re read my post and looked terribly arrogant... didnt mean to! I only put down what my 'qualification' for such advice was in case you wondered if it was accurate or true etc.. and how i could give you the advise. just to re stress, most of it was through doing it myself..

REALLY sorry if it came across the wrong way, to anyone reading this.. feel a bit embarrassed now

susie - FWIW I didnt think you sounded arrogant at all. I always put on my Bf posts that i am just a mum and not an expert, so i thihk its helpful for the Op to see that lots of people posting here DO in fact have qualifications and lots of experince in thsi field

when you are a first time mum its easy to believe that your com midwife or HV is an expert.its only when you get down teh line a bit you realise that soem of thenm are wonderful and some knwo diddly sqat

also when you have been on mumsnet for a while, you get used to the endless posts from the first time mums who have been told a load of c* by their Hv. thats why moondog is so grumpy. its very upsetting to those who spend much of their lives promoting BF - to be undermined by one of the professions who shoudl be helping

With my first baby I was also told to supplement with formula and to use breast shields and a dummy. all because the comm MW coudlnt get the baby to latch on. Rather than sending soemone esle who actually knew what they were doing......sigh

my HV immediately said to top up, and it was her fault the thrush got so bad. She told me it was milk spots, even when I said, ARE YOU SURE IT@S NOT THRUSH????

Bloody useless.

Thanks for your help, You didn't come across as arrogant at all susie, very helpful. I have been just bf since your replies last night and haven't expressed anything today. DS is sleeping happily now so I'm guessing he did get enough!! It is very demoralising when I'm so tired and think I have got the breast feeding under control to be told by the HV that i'm not producing enough and he hasn't put on weight. So thanks for all your advice, i feel much better about it all now and off to BF!
X

Well done!

You also don't need to take your baby to be weighed every week (or even every month... or even at all... but little steps first ). If it's helping and giving you reassurance and making you happy then fine, but if it is bringing you into contact with a loony HV who reckons that one week's weight gain taken in isolation means anything much then it is neither helpful nor reassuring. Give yourself a few weeks off from getting him weighed, bf him loads and enjoy your time together.

Good for you.
But how was his weight gain before?? What percentile is he on[nosy]???

Although in my experience with my two daughters, a baby can be born at a particular place in the centile chart, and then spend the first four months regaining their natural post birth growth phase. Neither of my daughters EVER gained more than 2 oz a week, from birth. I was made paranoid by rather dim HV about the first one, especially since my oldest child, a boy, had grown at least 1/2 pound a week. By the third child, I was ready for the slow growth, had a wonderful rather than dim HV, who just asked: Are you worried about your baby's weight? When I said no, she said, Well she's prob fine then.

I'm glad i didnt come across that way.. but even happier to see you are feeling a bit more positive about what you are doing.

another thing i thought of this morning as i was feeding dd, has your baby been weighed on the same scales every time by the same person? scales and their users can vary SO much. infact, the determining factor in letting us go home when dd was born was her weight gain, as she was prem and so tiny. they weighed her and she had not put on anywhere near enough. I was mortified. I was sure she had been feeding better than ever.. i insisted she was weighed on the exact scales she had been before. I knew which they were. They did, and she had gained a huge amount! I knew i was right... ( no apology though )

not gaining weight for one week is not a good enough reason to interfere with and change what you are already doing. It IS demoralizing, it knocks all your confidence which is only beginning to grow as it is after only 7 weeks. sometimes health professionals just have no idea of the impact the smallest of comments can make.

Incidentally, of course should your baby start to seriously loose weight that is of concern, then you may have to rethink things a little but i see no need for this based on what you have told us

When you are so exhausted from feeding, lack of sleep and all the other things that come with having new born, these things can be even more magnified and seem more monumental.

Just tell yourself you are doing fine, because you are. trust YOUR instincts, don't let someone sway you otherwise. Its the best thing we have to go on, its how we have all evolved and adapted and survived. A mothers instincts are FAR too undervalued.

best of luck lovely, and DO post again, or PM me, or CAT me or whatever its called here! ANYTIME you want advise.. i'll always try to help you.

i didnt mean the weight loss is demoralizing, but that the comments made by HV are

stop taking him to get weighed so often and believe that if he is feeding regularly, settling after feeds and developing in the usual way then that's it...
I have 3 kids
one on 99.6 centile
one 0.4 centile
and one on the 50th centile

Guess what!
They all fed the same from me!

Piffle talks sense, I only ever took the girls to the necessary appointments accept when DD1 dropped off the chart, but your ds is fine. 1 week of no weight gain is not a problem. It is easy to obsess, try not to, sounds like you are doing really well.

Thanks for your messages, I have stopped worrying about the HV and stopped expressing, ditched the formula top ups and just been BF today and DS seems very happy....Phew it all looks better again. DS has been feeding every 2-3 hours but I think that's fine isn't it?

Before all this happened he was on the 50 centile line on the graph and then last week he dropped to the 25 centile line, this is what caused all the nightmare with HV saying needs top ups etc. 25 centile is still fine though isn't it?

Hi Susie, not sure how to send you personal message from mumsnet (it's probably really obvious but can't see it right now!) I was going to ask your advice on another couple of things!

XX

It is fine. It will all settle down, and she will increase again. I think you are more likely to have success exclusively bf than a bit of both, as that way, seh wsa not getting a 'full' feed from either...

If you are happy with her nappies and she is not too lethargic and she seems as well as usual, then relax a bit. 2-3 hour feeing is fantastic for a bf baby. i dont think we went as long as 3 hours until nearly 12 weeks!

keep it up. of course, if she appears to be less alert, not weeing etc. then have her checked again, but its not neccessary to weigh every week. it just panics all conceearned should you have had a slightly productive week than usual... your baby will soon tell you if she is hungry

25 centile is absolutely fine. My baby went from the 25th to the 50th to the 75th and back down again - babies don't gain weight in a linear fashion and I really think that the HV encouraging people to go and get their babies weighed weekly is a fabulous way to make new mums paranoid

susiecutie's advice is great - if you can tick all those boxes, your DS is doing just fine. Oh and click on the little envelope in the top right next to her name to CAT her

ps I have no qualifications, just another bfing mum

Kittypower just mail me lovely, anytime

susie brett at mac dot com ( of course taking out all the spaces... )

oh god, i just noticed... sorry for calling your He a She!

And if it looks as though he isn't getting enough and his weight gain is a problem then there is no earthly reason the HV should be telling you to top up when you could just bf more often.

just replied to you kittypower

25th centile is ABSOLUTELY fine! (thinks back to her own 9th and 2nd centilers). Those charts are an abomination, truly. They just measured and weighed a whole load of kids without bothering to enquire how they were fed etc, then drew lines at the half way mark, the quarter way, the three quarter way, etc etc. They are actually utterly meaningless for any individual child's growth pattern. Gauging your baby's overall well-being and state of health by mother's eye is way more effective at detecting problems than the charts. Also it gives the medical staff something concrete to focus and a way to record whatever tenuous information they wish to record.

The WHO has charts somewhere on its site of charts drawn up for fully breast fed babies with mothers in optimum nutritional conditions (ie not under or over nourished) from babies and mothers all over the world. These are supposed to be a lot more representative of the fully breast fed infant's growth pattern than the ones in the red book. I'll see if I can track them down. They're a bit of a bugger to find though.

Get so mad about the crap advice given by so-called medical professionals. In my time as a Mum I have had:

• "He's got an ear infection, here are some anti-biotics": it was a virus and when I got a 2nd opinion they were the wrong anti-biotics anyway;
• "He's got a throat infection, here are some anti-biotics. $400, please" (we were in the States); it was another virus, and there was nothing wrong with his throat;
• "He's allergic to mosquitoes, don't let him eat bananas"; he isn't allergic to mosquitoes as the hives were coming up B4 the mozzie bites, and bananas are FINE;
• "You've got mastitis, so don't let him feed from that side"; just plain WRONG
• "He's got diarrhea, you'll have to stop breastfeeding"; no comment...

I have got to the stage where I listen to the medical "expert", think about the advice, check it out on the internet incl. MN then take my own decision. A bit dangerous, I know, but I have had SO MUCH stupid "advice" that I can no longer put my trust in any one professional.

When I had a very big baby, I still got disapproval from the hv about feeding. Once I said he went 6 or 7 hours one night between feeds (he was a few weeks old by then) and she said that big babies need feeding more frequently! As if I'm going to wake him up to forcefeed in the middle of the night.