Very worried re my milk supply - any way of testing/telling how good it is?

[Caz10]

DD is 9wks old and we've had lots of concern over her weight gain, advised to top up, blah blah long story...I also had very painful nipples caused by poor P&A...

anyway due to all of the above problems I've had loads of bf-ing help. The advisor at the hospital put me on domperidone, although she and the advisor from the BFN both agreed they didn't think my supply was an issue. However I really feel like i am not producing enough for various reasons:

• dd's poor weight gain
• i can only pump 2oz MAX
• boobs only ever seem full 1st thing in the morning when dd has slept 5/6hrs
• i NEVER feel let down, no idea when milk is flowing or not, and never leak
• friends tell tales of jets of milk flying out etc...i get nothing at all, even when i try to hand express

dd fed every 2 hrs or so for the 1st few weeks...i am now feeding her no less than every 3hrs in the day, and she's currently sleeping 12- 6ish after cluster feeding from 5pm...anyway, point being i think i feed her enough to stimulate/build supply?

but her poor weight gain especially makes me think she's not getting enough. she takes an hour to feed, takes both sides. she often falls asleep or gets fussy at the breast, which makes me think she's fed up with not getting enough.

is there any way of assessing/confirming that i have enough milk?

PS I'm worried that lack of night feeds are damaging my supply but the sleep is helping me cope so much better, and when i was waking dd in the night to feed, the feeds were so useless it was a waste of effort, she barely fed and i spent the whole time trying to keep her awake

sorry, it's me again. I don't think there is any way of confirming how much milk you have but all the things you have listed don't matter. None of them are an indication that you don't have enough milk
In fact, aside from the weight gain (i have fat babies lol) the same are true for me, every single one.

I honestly think that some babies are just slow gainers. but do talk to the BFC again if you're worried about her feeding

you sound very similar to me, i get same amount when expressing, have had lots of probs and am currently mix feeding, trying to get back to full time bf, my ds also doesn't feed in the night, sleeps 12-8!Ds also has poor eight gain and i don't leak. Bumping for you as interested in any advice that comes along

Message withdrawn

Caz....really sorry you are still having these issues to worry about.

There is no way to test supply - and even if there was, it's intake that matters more than supply

I don't know if you are feeding enough to build up and maintain a supply from what you say - none of what you say is definitive.

If she is sleeping 12-6, then that's a 7 hour gap (assuming you have started to feed at about 11.00) - and I hear what you say about her response to night feeds not being good, but that's a long gap.

Babies who sleep next to mum usually feed more in the night - is this a possibility for you?

(waves to fingerwoman)
agree with fingerwoman, she is obv v wise
can you try cosleeping and dreamfeeding if you want to fit in an extra feed without it being too tiring?
re hand expressing, have you been shown how to do it? tried straight after a feed? not that I think it is important for milk supply but just thought it might make you feel better if you were able to express a bit //www.kellymom.com/bf/pumping/bf-links-pumps.html#manual//
I'm also sure someone has pointed you in the direction of these pages but just in case //www.kellymom.com/babyconcerns/growth/weight-gain_increase.html// I'd really recommend co sleeping and also breast massage/compression during feeds

oops my links didn't work, will try again after reading instructions properly this time
www.kellymom.com/babyconcerns/growth/weight-gain_increase.html

Hi Caz, I shall steer clear of the weight gain issue, as I'm no expert . But I've been bf-ing ds for 16 weeks now and not once have I felt a let down or felt the milk "rushing down" or had jets spurting or any of the rather dramatic-sounding things like that I've heard other women talk of. When I'm pumping I only know milk is flowing by constantly checking the bottle! I've no idea how common it is not to feel any let down at all - anyone? - but I'm sure that this doesn't mean that there is a problem with your supply. The lack of fullness or leaking I also wouldn't worry about; I think this is quite common once your body's got used to producing the right amount of milk, AFAIK. And lots of people will tell you that a baby is much more efficient than any pump at getting milk out, so don't assume that there's only 2oz in there!

I never felt a let down reflex nor leaked, and the only way I could express at all was when I was feeding the baby on the other side at the same time. My dd used to suck for ages, which I think was much more a comfort thing rather than the fact she was not getting enough milk & also feed loads in the evening, so that's not uncommon. I'm not sure why she's not gaining weight, but I think it's a vicious circle in that if you give her bottles to top up she'll need less breast milk & you'll produce less etc.

I do wish you the best of luck & really feel for you; although mine are quite big now, I still remember what a difficult time it was & how I constantly worried that I was doing it wrong.

Just to add some further reassurance, I've been bf'ing for 2 years now, and have never felt the let down.

I also got virtually nothing when expressing (and since dd wouldn't drink from a bottle gave up trying after a while).

Could you nap when dd does during the day, and wake to express during the night if direct feeding is unproductive?

thanks all

dalrymps i've read some of your post before and wondered if you were me! . how old is your lo now and how long has he been sleeping through?

trollydolly i get 2oz in total, expressing with an electric pump, 15-20mins each breast. I've tried different times of day etc and that is the max i can get, usually in the morning, but at the moment with various clinics etc for dd, dog needing walked etc etc i find i am mainly dashing for the shower then out of the door after the morning feed.

fingerwoman and everyone else with non leaky boobs!...glad to hear you say all that. bfc has always said she though P&A was more of an issue than supply, and now my nipples are much less painful and healing up, so I'm hoping latch is better and therefore dd is getting more milk.

morocco i've never been shown how to hand express but i've read all about it on kellymom etc so will give it another go - do you think i would get more? is it quicker?

tiktok i am not keen to cosleep due to my own sleep "issues" as it were...i am a VERY heavy sleeper at the best of times, which i think is linked to my having had severe post-viral fatigue/CFS previously. In the early weeks DH often had to wake me to tell me DD was stirring/crying. I know no-one does well on broken or too little sleep but i really feel bad from it, i was suffering dizzy spells and almost dropped dd one day, terrifying. been all checked out and am fine, no other health issues. i was so teary and feeling low, dh was sure i had pnd, as did the hv the 1st day after dd slept through i was like a new person, although i still need a nap in the day if DH happens to be home. anyway my point to all that was, having read the advice on safe co-sleeping i don't think i am a suitable candidate! dd is as close to my side of the bed as i can get her in her moses basket and i intend to keep her there or in her cot in our room for at least 6mths. Obviously if she WAKES for a feed I wake up, or get woken up, and feed her, but setting the alarm for 3am was awful. Is the idea of a dream-feed that dd feeds without waking? cos she doesn't seem able to do that.

DH and mum can't understand why i am stressing about dd sleeping, they just think we are lucky to have such a "good" baby.

she is getting weighed again in a week and a half, and the results of that might help me - if she's gained even while sleeping through i will feel more confident. she is definitely developing well, we see more alertness every day, she is babbling and smiling away. she is on the bottom centile, but am i right in thinking that as long as she gains along that line she is ok? dh and i are both small and i am pretty skinny!

oh meant to add, people always talk about their supply getting established - how would i know when this has happened?

yes, it doesn't matter what line she is on, if she is sticking to it (orthereabouts) then that is good.
it would be a problem if she suddenly dropped a long way, but there is always a little bit of give and take so as long as she is roughly following the line she will be fine.

with establishing supply, most people would say that your supply will generally be established by around 6 weeks. that is if you have been exclusively bf-ing and had no probs.
It's basically just used to mean when everything has settled down, you're producing what baby needs and you're no longer getting the whole engorgement thing that you get in the early days when your milk supply is getting itself regulated. In the early weeks things like not feeding often enough, missing feeds, giving supplements etc can all affect your milk supply easily because your body isn't yet used to how much milk to produce and can react quite quickly tyo changes. Later on when all is "established" you can do things like miss a feed here or there without it necessarily causing a problem
So, you wouldn't necessarily know it has happened- there are no particular signs. But if you're feeding her and she is happy, alert, gaining weight (even if that is slow) then I would say by now it's probably established.

lo is 15 weeks old now and has been sleeping through since about 12 weeks, before that he only woke once at night though at about 4am

did you find that his sleeping through coincided with weight loss dalrymps? DD only fed once in the night from quite early on, she's really only dropped one feed by sleeping through, as i used to feed 11/12ish, 3ish, then 6/7ish - now she just does without the 3am one. but her weight did dip when she started sleeping through, although it's back up now.
fingerwoman she's been ex-bf apart from the top-up weekend from hell for 9wks now. And in fact all of these top ups were after, not instead of, her normal feeds. My breasts are full in the mornings but thats it.
God I wish both she and I had a "milk out-milk-in" indicator somewhere!!

Hi there,

Haven't had time to read all the posts so sorry if I am going over things again.

I have bf both ds. I never felt let-down etc and was worried about poor weight gain especially in ds2 who had Downs.

All I want to say is keep trying and don't let the scales worry you too much. As long as baby is putting on weight, no matter how little, try not to worry. (Easier said than done I know!)

Ds1 is now nearly 5 and a big stapping boy, giving me cheek as I type! Something about a missing toy! Ds1 is early 18mths and causing more havoc than ds1 ever did.

Try and relax.

Sorry, should be strapping!

i suppose it did kind of coincide with him sleeping through yes, never thought of that, hope it starts to go back up soon then

Hello Peeps, have just discovered MN and have been reading all the posts with great interest! I volunteer at a Breastfeeding peer support group and have learnt a ton of stuff from our "lactation consultant" (who should be given a sainthood because she is a godsend!! ) One of the things I have discovered is that all the growth charts in the red books are based on formula fed babies, which put on weight at a completely different rate to BF babes. If your chart does not say "Breastfed from birth" at the top, the odds on your baby hitting all the right centiles are slim. Not all HVs and MWs have cottoned on to this! Some PCTs (but not all) have BF from birth charts available on request, and HVs can re-plot your babies weight gain onto a new chart. It makes a helluva difference! We've had some seriously worried Mums who have been hassled by their HVs to switch to formula or combined feeds because their babies do not appear to be gaining weight at the required rate. It's demoralising and makes you feel inadequate and it sucks! (no pun intended!) Just the simple solution of having the correct chart can make all the difference!

Have you checked for tongue tie in your DD?

It's quite common and that would be a good reason why your nipples are sore - if her tongue wasn't taking the nipple far enough back in her nouth.

I would seriously get her checked as the op for it (a simple snip at that age) would correct the prob.Obviously your supply would be affected if she wasn't drawing in enough milk and not stimulating you to make more.

Nizmat, see my post about the charts on the other thread

here.

Am a bit worried about your course - are they telling you that breastfed babies put on weight in a completely different way from formula fed babies? This is incorrect - the charts only really diverge noticeably from about six months on, and in the early weeks, breastfed babies are slightly heavier....Caz's 9 week old would look even lighter on a breastfed chart.

Problem is not the chart, but the interpretation of it.

tiktok i have been told the same thing as nizmat is saying by my bfc as well! so it seems to be a common misconception even amongst the experts!

thanks pta for sharing your story, and glad it has a happy ending!

lucie she apparently has a "very minor" tongue tie - that was GP's opinion at her 6wk check, bfc couldn't see evidence of one at all. GP said she wouldn't do anything with it anyway.

fingerwoman i think my supply should be established by now - she's had formula topups but they've never replaced a bf always come after. however in my paranoid state of mind i am just not sure! boobs are full in the morning after a longer gap between feeds but only then.

god i was sick of getting her weighed before, now we've been given longer between weighings i am just finding myself wishing I knew how much she weighed!!

Caz, if you or anyone else wants to read about the charts in use in the UK, then there is a pdf you can download from here which tells you everything you need to know and probably more

The charts we use in the UK, almost everywhere and in every clinic, are called 'UK90' and the pdf tells you the data sets where they come from.

More crucially, though, they are not very different - at first - from a 'breastfed' chart. You can get 'breastfed' charts from the web (there is a link to the WHO charts somewhere in the archives) and these can be compared. No one should be telling a mother of a young, slow-gaining baby that things would be better if her baby was plotted on a different chart - if anything, the slow-gaining bf will look lighter.

The real difference is seen later. Which organisation was the bfc from who told you the UK charts were 'bottle fed babies' - did she suggest your baby should be plotted on a different chart??

hi tiktok it was someone from BFN - to be fair she wasn't the main advisor, but someone undergoing training with them. it's certainly not the 1st time i've heard it said though. she said that some health authorities are now using different charts in their "red books" depending on how the baby is being fed.

thanks for the link, i am interested in reading up on this when i feel a bit less frazzled!

She wasn't a breastfeeding counsellor, then, Caz.....and if she was training she might have been doing BfN's 'mother supporter' level which is peer supporter level....nothing wrong with that, but it may mean someone who doesn't yet know what she doesn;'t know, if you get me

yes - some places do include different charts.

It doesn't necessarily make their bf support any better, though