Combi feeding - keeping supply up for EBF

[Cutie18327]

Hi all, after some advice on how best to keep my supply up. DD is 15 days old, we had a decent birth but I lost a lot of blood (approx 1.5 litres), which from my research could have affected my milk supply. I breastfed exclusively for 2 weeks through all the pain and constant feeding but had problems with latching due to inverted nipples - she just wasn't getting enough sustenance which led to a 12% weight loss. Just as things were looking up with nipple shields, I ended up in hospital with an infection and my milk supply started dwindling again. I did try pumping in order to top up but could only get 25ml per session. So I am now topping up with 70ml of formula per 3 hour feed, but doing 30 mins of breast feeding first. I am trying to also pump but I am not getting a huge amount (max 30 ml) I am very wary of my milk supply diminishing even more, should I be trying to pump to incease supply? or just BF where possible before the formula?

I really want to go back to EBF so any guidance is appreciated. The breast feeding journey is by far the hardest, much harder than pregnancy and labour, but I am determined for my daughter to keep at it!

Sounds like you've had an awful start @Cutie18327 but congratulations on your lovely new DD.

I will put some links to some information below which might help but I really would encourage you to seek out some RL support.

See if there's a LLL Group near to you or a BFing Support Group, you could even go to both.

I'd also give one of the BFing Support Helplines a call this morning if you can. The earlier you call, the better chance you've got if speaking to someone.

Has she been assessed for Tongue Tie. If she's lost 12% it could be TT rather than your supply.

Increasing Low Supply from Kellymom is a useful article as well.

Have you been prescribed any iron or are you taking any? That might help you recover if you've lost a lot of blood. Even if it doesn't help with the supply it will help with tiredness and immunity

How are you getting on tonight @Cutie18327?

I exclusively pumped for my first for 15 months and pumping for my second at 11 months and still going. They both had tongue tie and I have large boobs and found it very very difficult to manage and besides they just weren’t feeding enough. Also haemorraged with first.
Pumping is all I can advise you on... you preferably need to use a hospital grade double pump like a spectra s1. You can hire them but they’re about £150 to buy.
If exclusively pumping you need to pump every 3 hours or 8 times in 24 hours with at least one pump between midnight and 5am as that is key to upping supply because of hormone levels. Keep that in mind even if breastfeeding it’s pretty constant!
You can do power pumping to up supply which is basically pumping on and off for an hour for one of those 8 pumps to mimic cluster feeding.
You need to pump past empty to tell your body to do more (20 minutes double pumping?). Eat and drink well I notice a massive difference in supply if I don’t.
I don’t really know how to combine pumping with breastfeeding but when my second would try with a nipple shield I would feed from one side with pillows and pump the other then finish the feed with the pumped milk top up. Unfortunately she would be feeding for 90 minutes on one side and still take 90ml of pumped milk. So just stuck with what I knew, feeding specialist was out of ideas, I clearly had an ok supply but she just wasn’t emptying me! It has been really hard mentally for me and pumping ended up meaning I could feed my babies the way I wanted so I know it’s tough.
Good luck!

@DominicRaabsTravelAgent thank you for the detailed response! I have been referred to a lactation consultant via my health visitor so am awaiting that appointment this week. I have been seen by numerous midwives but they all seem to say something different so I think some more specialist help will definitely make a difference.

I have been prescribed with iron tablets so I am taking those and my antibiotics have just finished so I have noticed a slight increase in supply (some leaking, more via hand expression, starting to feel engorged at times) since I stopped taking them. I am still persevering but the constant feeding 8 times a day and pumping 6/7 is definitely taking its toll on my body.

@lking679 that's interesting about the pumps. I didn't want to buy a double one initially so I only have a lansinoh electric but its single - I do find that it can be painful so I'm not sure how I would be able to cope with a double. I'm finding the same issue, there is always some milk left after my LO feeds, so she's just not emptying effectively. I will definitely try the power pumping, and I'm pumping around 6/7 times a day at the moment, with one of them being at 1am.

I pumped for DS1 for 9m and then BF DS2 for 3yrs. So a little experience of both.

If you're finding it painful then the pump flanges are the wrong size for you or you've got it on too high a setting. Single pumps just won't cut the mustard if you're pumping seriously.

Get yourself support like PP suggested. I wouldn't have made it there with DS2 if it wasn't for the weekly drop in group I found. The support of other women is critical.

I'd also recommend as much time as possible in bed with you topless and baby naked. Feed, nap, cuddle, watch tv. Bring food and drink up with you. Just baby being close and you being well rested will help.

You could also look at re-birthing - I didn't try it but my SIL did and it worked for her. More info here: www.gtabreastfeeding.ca/downloads/rebirthing.pdf

Most importantly though, having been both sides of the game, do whatever works for you and your family. In 12 months no one will care how baby was fed, and they'll be lobbing yoghurt and spag bol on the floor and at your walls. The scars will still be with you if you force yourself into something you can't do or don't enjoy. I wish someone had asked me what I was doing, pumping 7 times a day for 9 months. I wasn't in a good place but I couldn't see it at the time. Don't lose sight of your own happiness.

Is the Lactation Consultant also a [[https://www.tongue-tie.org.uk/find-a-practitioner/ tongue tie practitioner @Cutie18327?

@DominicRaabsTravelAgent luckily the lactation consultant did check and found a tongue tie so there is the source of the problems! (hopefully). I am hoping that once it gets cut DD will be much better at feeding. I've been loaned a double pump from the NHS to try and maintain/increase my supply in the meantime

My Dd2 tongue tie was cut but it didn’t improve her feeding. I gave her a couple of weeks after and she just wasn’t getting any better at feeding properly!

Just be warned it could take quite a while to see an improvement one revised and you might need a strategy in between!
Great about the double pump loan! Nhs less than interested in helping me when I had issues.