Milk drying up? Help please!

[Ef22]

I have a nearly 5 month old who is exclusively breastfed but I’m worried my milk is drying up since going back to work part time 2 weeks ago.

I’ve built up a supply so he has expressed milk when I am working and I’m trying to pump at our usual feed times but I can’t always do it as much as I feed at home.

Over the past few days he’s been nursing for really short bursts (5-10 mins) then seems frustrated and cries a bit when I try and get him back on - initially I thought he’d just got quicker at feeding but then today I’ve offered him a bottle with expressed milk after he came off and he’s drunk loads (150 ml ish after nursing). I’ve been trying to cluster feed to boost supply but it just feels like I’ve not got much & I’ve tried pumping between feeds too but am only getting 30-40ml.

Im really worried he’s hungry & that I should start combi feeding (as my stock would run out if I topped up all the time) but also know the only way to boost supply is to get him to nurse , I’m just so worried he’s not getting enough & I can’t force him to keep at it for longer.

Any advice at all would be amazing!!

I was told to drink full sugar lemonade . I fed 5 sons for a year each one for 18 months . I used to give them a bottle a lunch time ready for when I went back to work . But otherwise they were breast fed . I think they get alot in 5 to 10 minutes I'm sure some expert will be on soon who can verify that . Keep going you're doing great I'm sure .

Hi @Ef22 I can totally understand how stressful this must be for you and it's so hard to trust that baby is getting enough. Sounds like there's lots of factors at play here so there's lots to think about.

If you're nursing baby when you're with them, your milk is absolutely not drying up. Remember, even if what the pump is removing is not a full feed, babies are far more effective than a pump at extracting milk. Pumps really tell us nothing about how much a directly breastfed baby is extracting themselves.

Also, most babies when offered a bottle will drink it. That doesn't always mean they're hungry. Worth thinking about how much expressed milk baby is getting while you're at work. Breastmilk is totally different to formula and adapts to meet baby's nutritional needs. So a 1 month old baby and a 6 month old baby would have the same volume of breastmilk but the nutritional content would differ. It's generally accepted that they need around 120ml per feed while away from mum. See this website here for info.

Also, in order for this to work well the care giver really must be pace feeding the bottle while you're at work. Does it feel like baby is frustrated at the breast? It could be that a bottle preference is beginning and, to resolve it, whoever is bottle feeding needs to make sure baby is having to work at the bottle as much as they do at the breast. If baby is having very easy access to more milk than is needed they may start to expect it as it will stretch their stomach.

In terms of your supply, the main thing to think about is that it works on supply and demand. So your body will make enough milk for baby as long as baby (or a pump) is removing the milk from your breast. I know this is really difficult at work but in order to maintain your supply you will need to get into a routine if you can. Your body is really clever though and it will know that baby will be removing milk when you're not at work and so that milk supply shouldn't be affected as long as baby is still nursing effectively when you're not at work.

In terms of you expressing between feeds, getting 30-40ml out when you're also nursing baby is great! The people pumping whole feeds after a nursing session have massive over supplies which can come with a whole range of issues. As long as you're removing milk when you're working (and remember baby is way better than the pump so it's not an accurate indication of supply) really you shouldn't need a big freezer stash of milk and should be able to pump while at work and use that milk for the next day's feeds. Power pumping (pump for 20mins, break for 10, pump for 10 mins, break for 10mins, pump for 10mins - takes an hour) is a tiring but useful way to boost supply for many people.

The short bursts could be because of frustration or that supply is dipping because of less milk removal but it could also be that baby is looking for the closeness to you after the brief separation while you work and it isn't about the milk. It's really hard to know.

It would help to get a feeding assessment at your local breastfeeding support group and also chat things through with the National Breastfeeding Helpline.

To up your supply you need to eat lots if fat (buttery sandwiches, yoghurts etc), oats and sugar, plus drink lots of water, and let him suck as much as possible even if nothings coming out.

Hope you’re ok. I know the return to work must have been very hard and that will have affected you on a physical as well as emotional level.

Hi @Ef22
Hope you and babe are well!
Just wondering what happened after you posted this message?
I’m currently in the same situation re fussiness, short feeds, falling asleep quickly during feeds, etc. Basically everything you’ve described. I’ve also just been told my baby has dropped a centile (to 2%) he had already dropped to 9% because of late diagnosed tongue tie, he was born at 25%.
It feels like my supply has dipped, I never feel as ‘full’ as I used to, even a week ago. Not sure if drying up has been caused by the hot weather, or that I stopped pumping extra about a month ago (I figured 3 months was a good run and I was sick of the constant soreness!).
We have a few bottles in the freezer and are using these to supplement but my main query really is whether you were able to pump up your supply again? Or whether you ended up combi feeding?
Thanks for any help you can give xx

@LL1991 just wanted to come back to you on this. Sounds like you and baby have been through a lot together - it definitely isn't easy and you're doing really well. Is there a reason you feel like your milk has dried up? For most women, our bodies make as much milk as baby needs based on supply and demand. If baby is removing milk it signals to our bodies that we need to make more. From what you've said it sounds like it might be an issue with baby effectively removing milk. I'd really recommend you seeking support either from a breastfeeding support group near you or from an IBCLC. They'll be able to do a full feeding assessment and establish whether there are any issues with baby's latch and provide really good advice on next steps.

There are very few people who have supply issues that aren't a result of milk not being removed effectively. It can be totally normal at around 12 weeks (which I think you said baby is) to feel less "full" as supply regulates. However, in your case with baby not gaining weight as we'd hope to see I'd really recommend seeking further support from lactation experts.

Keep us posted on how you get on.

@LL1991 the advice you've been given is excellent. I was just wondering if LO's TT has been divided?

@SiouxsieSiouxStiletto
Hi, yes TT cut that first bank holiday weekend in May, he was about 8 weeks old. Was diagnosed at 4 weeks and we waited for NHS apt but kept getting cancelled due to Drs strikes so got a private midwife out, she came within hours of being messaged and diagnosed and snipped for £150 - best money I’ve ever spent! Straight away he started sticking his tongue out and wiggling it while smiling which is never even clicked he should be doing!

For context:

Honestly breastfeeding has been very tough and so I really thought it couldn’t get any worse!

To start with my milk came in day 2 and with a vengance! They got me pumping because baby was very sleepy and wouldn’t stay awake for longer than a few minutes. But I had so much milk that for every 60ml he was bottled/cup fed I was pumping 170ml! We were such a mismatched pair - he wouldn’t feed effectively and needed cup feeding (husband was brilliant and took this) and I was there pumping 3x more than he needed. I was put on a schedule (feed Al, pump and then rest) every 3 hours and the whole thing left me about an hour to sleep or eat or whatever I needed to do - horrific! Paediatricians sent us home with a chart of how much milk he needed each day for the first few days we were home and I was lent a hospital pump to keep on top of my supply so I didn’t get mastitis.

When we did feed at the breast (when he woke up a bit) his latch was terrible and really painful. I persevered for three weeks before I broke down and bought nipple shields. The lady on the specialist feeding team was against me using shields but I couldn’t deal with the pain anymore and just needed to try something! It really was a case of her trying to push a personal opinion on me but at that point I was honestly about to stop and didn’t want to so no harm in trying.

We’ve not looked back since I bought the shields - he goes on so easily and I don’t have the pain anymore. I have tried to wean him off the shields since his tongue tie has been cut, but we’ve been unsuccessful. He still seems to struggle with the latch and just ends up screaming while my nipple is right there in his mouth! It’s not the end of the world for me to use them, they are fiddly and life would certainly be easier without them but I’m just thankful that I found the thing that let me carry on.

I carried on pumping once home as I had to to be comfortable and I built up quite the freezer stash, I stopped pumping about a month ago. My last pump was right before we got in the car to drive to Cornwall and then while we were in Cornwall I bf but also gave him the occasional bottle here and there (if we were out for lunch or dinner at a particularly swanky restaurant). I wasn’t pumping to replace those bottle feeds which I didn’t think would hurt but now I’m wondering if that was the beginning of a slow decline…

@Mumsneat
Baby is 16 weeks old tomorrow. I’ve had lots of help from different people, a Hv who is meant to be the queen of breastfeeding, the specialist infant feeding team at the hospital, the private midwife who snipped his tie, and done lots of research with the main names, La Leche, etc. I’m reluctant to go to the breastfeeding help group at my local centre as honestly I’ve already spoken to the woman who runs it and she was less than useless. Spoke to her last week after he was weighed and I asked about adding in formula to help him gain weight and she just went on a tangent about not pushing me to do anything - I was honestly asking for her professional opinion and whether she thought it would help with weight gain and she couldn’t say and wouldn’t say incase I decided to give up bf!

Since Friday afternoon I’ve been pumping after every feed (except last 2 of the day as he’s straight to sleep and so am I!) and already seeing a difference, I feel fuller quicker, getting the tingles back when he hasn’t fed for a while and (bonus) I’m able to feed him the bottle I’ve pumped right before bed and he’s back to sleeping 6+ hours where he was waking after 3 hours all last week 😵
La Leche suggests this as a way to up supply so I’ll stick with it for a few more days and see.
I’ve noticed what I pump is basically just cream with a thin layer of water at the bottom so I think he’s not been getting the good stuff which is why I’m keen to feed it to him same day to make sure he’s not missing out and dropping more weight.
I’ve just never experienced the fussiness, he goes on, sucks a bit then starts throwing his head around, arches his back away over time, starts crying mid way through. I’ve stopped to burp, rock, sing, change nappies and nothing seems to be the issue hence I wondered if it’s me and he’s not getting enough. He does seems to be happier yesterday particularly. But he does still move his head from side to side while feeding which is so annoying as the shield comes off with him and I’m having to replace the shield every couple of minutes!

I definitely don’t think he’s been effective at removing milk for the last 2 weeks and I called the HV to report this, they had him weighed hence I know he’s dropped weight. His sucking has slowed down and is a much smaller movement - more like how a baby sucks for comfort when he’s gone to sleep on the boob! This along with the fussiness means I’m just wrestling a baby 12 times a day and getting increasingly frustrated again!

I had Gestational Diabetes and breastfeeding lowers the risk of type 2 for both me and baby so that gives you an idea of why I’m so determined to continue.

Sorry for the essay - this really has been a rollercoaster for us! Thanks again x

Have a look for lactation cookie recipes made with brewers yeast and oats. I used to have sheets one but the website doesn't exist anymore. (Not made from breast milk as my friend thought, but to boost supply.)

Avoid mint teas and milk thistle which can have a negative effect on supply and keep up your liquids as you need extra water anyway and it's so muggy at the mo.'

Plenty of calories and skin to skin around work.

Stress can also have a negative effect on supply so try not to panic (I know I know - telling me not to stress doesn't calm me down either.)

Xx

Fenugreek tablets really helped me

Ooh fenugreek was one of the ingredients in my lactation cookies.

New poster - I'd make sure you're very hydrated, well fed and then boob boob boob baby. Sixteen weeks means you're hitting the major leap and things will be haywire for a couple of weeks. Go through the usual settling checklist and on and off boob. Everything will be fine.

Thank @booksandbrooks & @clarepetal
both lactation cookies and fenugreek had been mentioned by my HV previously in passing conversation but I’d forgotten about them - I’ll have a look now.

@Flittingaboutagain funny you mention the leap, it hadn’t even occurred to me that it could be the 4 month ‘regression’… I’m a little slow at spotting the leaps and by time I’ve joined the dots we are normally well into them! Hopefully this means we don’t have long to go 🤞🏻🤞🏻
can anyone answer whether the fussiness goes away post 4 month leap??

I called as lactation consultant from the La Leche website today and she was very helpful. She also thinks we are starting the ‘regression’ - in inverted commas as she said that wasn’t the right word for it! She was also pissed that the children’s centre had booked to have him re-weighed in 2 weeks but not given me any advice on what to do in the meantime. I asked what I should be doing differently to help him gain weight in the meantime and they said ‘nothing, just keep doing what you are doing’. I mentioned that I’d raised the idea of adding in formula to help him gain weight but that the lady at the children’s centre wasn’t keen. this really peed off the lady from La Leche as she said if I kept doing nothing and his weight had dropped further they would have then asked me to feed him formula anyway!
I definitely think I’m doing the right thing pumping after each feed and bottling him that a couple of times a day - he’s been much more chipper the last 2 days. I’ll keep it up and fingers crossed this is temporary and over soon!

Thanks again xx

It's a progression. So afterwards things will settle into a new rhythm yes and baby will have loads of new skills. Basically just keep doing what you want to and survive it! It's very temporary in the grand scheme of things. But pumping isn't necessary, by all means it's fine if it's giving you some peace, but baby hopping on and off the boob, fussing, shouting and punching the boob etc is perfectly normal and happens every leap with most breastfed babies. It doesn't mean you have a hungry baby, just they don't like having to put in ANY effort when they're fussing through a leap, which causes many mums to question supply and add formula or panic pump. I'm tandem feeding two at the moment. I've been there. Keep at it!

I think this is true. I used to try breast compressions and that seemed to help. DD, who was always a super quick feeder, learnt very early to do them herself and used to milk me like a bloody cow!