Breast milk supply has just disappeared help!

[Lavender14]

My ds has just turned 4months old and has been ebf. Prior to this past fortnight I could have fed him all day and still expressed about 5 oz on one side and 3oz on the other no bother. He's been consistently on 50th centile for weight and 91st for height. However the last few weeks I've felt like my breasts haven't been as full, he's fussier when feeding and I didn't feel he'd gained as much as I'd want. Hv confirmed today that he's down to 9th centile and hasn't been gaining quickly enough. When I tried to pump today to encourage supply I've got less than 1oz out of one side and nothing from the other. I'm now totally panicking about why this would drop off so suddenly from what was previously an over supply when my diet hasn't changed. I started cezarette 3 months ago so not sure if it would be that and my job is at risk for redundancy so I'm extremely stressed about that. Ds also has a slight posterior tongue tie that the lc refused to cut saying it didn't need done but he's excessively won't windy and I can still hear him clicking the odd time when he feeds. He also dribbles a bit at one side and struggles to keep latched. Anyone any tips for rebuilding my supply? I've been having porridge oats for breakfast and we've been doing lots of skin to skin. I have worked so hard at this I'd be really devastated if this is the end of our journey I really wanted to get to at least 6 months. I have a really good freezer stash built up from the prior over supply - should I give him the odd bottle while I pump even though I'm not getting much? Or just keep putting him to breast instead? I've been trying to feed him hourly during the day. I hate the thought that he's hungry. Any advice would be so appreciated.

Also just to say I'm just using a wee hand pump, I found I never got much out of my electric pump for some reason.

Lots of women stop being able to express at some stages once the supply settles or when periods come back, but can still have enough for feeding. Is he still gaining weight ok?

My supply dropped after I had a health issue, and what worked was a 'babymoon' - spent a few days in bed and on the sofa feeding every time my baby wanted to, and watching box sets in between, was also surprisingly relaxing!

I'd also recommend trying your local la leche league/ breastfeeding support / HV if you have one to help with technique too.

Your supply should come back, but if your baby isn't gaining enough wait or there's any issues and you still want to breastfeed you can still mixed feed too. In the UK a lot of people see it as the beginning of the end, but in my home country it's quite common to do it for a long time, it can work. That said, don't jump to it right away, as it can make a supply issue worse - but also it's not so bad if needed. Good luck!

https://llli.org/breastfeeding-info/birth-control/ there’s some info here about the progesterone only pill. I recently emailed for advice on something else and got a detailed response - might be worth contacting them, perhaps including how soon after starting the pill you felt your supply dropped?

Like you I started the mini pill and had stress about the same time so when my milk supply dropped (about a week after starting it) I wasn’t sure of the cause. I stopped the pill and the stress was also resolved so not sure what helped, but I haven’t risked trying the pill again.

@Cantstaystuckforever he has gained in the last 10 weeks but dropped from 50th centile to 9th centile so the rate of his weight gain has slowed significantly which is a concern. I also don't know at what point in the last 10 weeks this happened, he's been in generally good form during the day (he's extremely colicky at night) so I wasn't getting the impression he was overly hungry until just this week.

@WhatDoIDoPls did you do anything additional to rebuild your supply or did it just increase naturally? I'm very tempted to stop the pill but worried it might bring on a period and more issues.

Your supply does settle down to match what the baby needs, and I found that your breasts don’t feel as full as at the beginning, although there is still enough milk. Have you tried doing a test weight? Weigh the baby before and after a feed so you can see how much milk they have taken.

@Lavender14 My supply came back without doing anything too methodical, but I was conscious of putting my baby to my breast frequently. Like you I do also have a lot of oats - overnight oats are a go to :) - and making sure I was well nourished / hydrated.

Even if you’ve been discharged formally, if there’s a community midwife unit you can call they might be more specialist in giving advice on this sort of thing than a GP? I’d also say the La Leche League rep got back to me same day.

When I was worried my baby was hungry right at the beginning before my supply was established I was told to offer the breast first every time and then a bottle as a top up - someone more knowledgeable might be able to say if this is a good idea or would slow your supply getting back up?

Ask the doctor for domperidone. It's an anti sickness drug but increases milk supply. I found the routine of pumping horrendous. There reccomend trying to pump every 2 hours for 10 mins to build your supply enough but I would also see about having the tongue tie done. I got reffered to the infant feeding team by a breastfeeding group and then onto NHS for posterior tongue tie. It didn't help us in the end sadly but it affected our bottle feeding too. Hope that helps

@Elisheva that's a good idea actually I'll give that a go.

@WhatDoIDoPls thanks so much I'll get in contact with them. I'm meeting a breastfeeding specialist from my hv's team next week but just want to do whatever I can before then to stop it getting worse.

It's likely you do actually have enough milk in your breasts and expressing just isn't as efficient any more. Babies are better at getting the milk out.

Tbh I don't hold too much stock in the graphs and meeting criteria. We are all different shapes and sizes. He could have just had a growth spurt that's thrown off the scale a bit. I wouldn't worry

And stay hydrated!

You'd surely need to have some highly accurate scales for this.
But this poster is right, your breasts do soften down.

@Cantstaystuckforever just wanted to say thanks we did all of your recommendations and my supply is back up and he's feeding brilliant again! Just had a long weekend on the sofa cluster feeding! Thanks for the advice to all who replied!

Op, glad you are back on track. I was going to say also that a baby moon is usually the answer. Feed as often as you can.

As an aside. I think the current trend for pumping is concerning. It used to be that women pumped as a when they needed to but now everyone is just stacking milk up in the fridge for no apparent reason. Ultimately that will lead to a drop in supply. Pumping isn’t breastfeeding. A pump will neither extract milk in the same way as a baby nor signal the body to make appropriately composed milk.
Everyone I’ve know who pumps as a matter of course quickly has a dwindling supply.

So glad you are both happily BF again but definitely don’t worry about pumping output. It means nothing.

There is so much wrong with this statement it's hard to know where to start.

Firstly, pumping is breastfeeding. Feeding your baby breastmilk from a bottle makes them a breastfed baby.

Secondly, it is entirely possible to establish, increase and maintain a full milk supply with a pump. How do I know? Because I pumped 1.5l of milk a day for my eldest when I couldn't latch him (covid baby, no support, turned to pumping). He thrived. I did this with a wireless, in-bra pump. When I wanted to wean I did it as slowly as I wanted, no issues with "dwindling" supply. Countless women breastfeed this way and succeed, particularly in the US where maternity leave allowance is crap - there are massive Facebook groups dedicated to it. Why you would pass harsh judgement on these women I have no idea - surely we want the breastfeeding rate to be higher?

Moreover, breastmilk is tailored to your baby whether it's straight from the source or from a bottle. You share germs with your baby every day, it's inevitable that your milk would be perfectly composed. The whole nipple backwash theory is literally just that, a theory.

OP please disregard the "information" from @Opine and carry on as you are, you're doing a great job!

@Kindofcrunchy you said it yourself. It’s bottle feeding with breast milk. If everyone did that and no longer put baby to breast or did so less often than pumping yes you would lose supply.
your single experience cannot cancel out that fact.

In the US it is common because, as you say, there is appalling maternity leave provisions. Their rates are as dire as the UK so factually it isn’t sustainable.

It is also fact that milk composition does not alter if baby is never at the breast. Be triggered by that all you like but that is the fact. Human milk is intended to be taken straight from the breast. It is fine to pump sometimes but there is a point of too much. If this is the only option it is of course better than nothing.

proof in the pudding is that OP BF her baby on demand around the clock and her supply is re-established. She doesn’t need to ignore me. Someone else told her to do this and it worked. Her problem was very likely the pumping.

And it’s very telling that you read my comments as ‘harsh judgements’ when I said absolutely nothing to indicate such.
I actually couldn’t care less how anyone feeds their baby.

I’ve fed my own babies and every time ran into problems. I have never been advised to pump. The opposite in fact. Every problem I’ve had as always been solved by putting baby to breast. Supply, latch, blocked ducts, mastitis.

Fenugreek seeds are amazing for breast milk supply, I would suggest looking for milk supply teas online or just boil some fenugreek seeds in water and drink as a tea. Tastes gross mind but amazing for the milk supply!

@Opine Not triggered, just correcting dangerous misinformation - which you appear to have an abundance of. Just because you don't have experience yourself of successfully breastfeeding with use of a pump, does not mean that it doesn't work well for others.

Also just going to reiterate that a baby fed breastmilk (tailored perfectly for them) via a bottle is still a breastfed baby, and not a "bottle fed baby". Let's not shame others for how they feed breastmilk, ok?

@Kindofcrunchy But you said yourself this was your solution to not being able to breastfeed directly from the breast. Is this not your own understanding that it is not how it is supposed to be done?
A permanently bottle fed baby is not breastfed. They are having breastmilk from a bottle so are bottle fed. Not formula fed but bottle fed. This isn’t my my definition but just fact. The ability to latch would be lost for a start. The mother’s hormone levels would differ etc. It is not the same and it is you who is perpetuating inaccurate information by saying it is. It can be what it is in its own right.

I’d be interested to know how long you pumped for. You don’t say. Anecdotally I have not come across anyone who has exclusively pumped for more than 6 months. Most much less.

No one is shaming anyone. Your anger is misdirected and it’s quite childish to use such inflammatory language because you feel a bit annoyed.
it isn’t about what worked for you personally.

Had you have had the help that you needed it definitely would not have included Pumping if your baby was full term, able to be with you and there were no medical reasoning against direct BF.
Breastfeeding is far more than milk in any case.

Op asked about upping supply not how to pump exclusively and she has her solution.

Op, sorry to derail your thread. I wasn’t in any way suggesting you should not pump if that’s what you choose to do.
Im glad you are back on track.

enjoy your lovely new baby

Sorry this is utter nonsense! It was pumping that helped me establish my milk supply after an incredibly bumpy start saw me having no option but to combi feed. DD is now 3 months old and we’ve been able to transition from nearly 60% formula fed at the beginning to now ebf all thanks to power pumping/regular pump sessions. My supply certainly hasn’t dwindled in this time!

I disagree that it’s completely wrong.

I’ve seen many women put on a regime of feeding, pumping, then topping up with the expressed milk.

effectively being told to pump instead of breastfeed to increase supply. When it will have the opposite effect as baby is at the breast less. It’s basically a visual reassurance that baby is getting milk.

pumping is an utter pita and feeding, pumping and topping up every few hours is completely unsustainable and I would not judge anyone for ditching the whole palaver and FF. it also doesn’t help with confidence if you can’t get much out with a pump.

pumping and topping up seems to be offered as a solution-so HCP are telling you to “do something” actively rather than just advising to feed more.

that’s not to say pumping alongside feeding to increase supply can’t work, depending on circumstances. But it seems to be the go to advice now and most HCP’s are recommending it without full understanding- like I said so they can offer an apparent fix. Most people I know like pp who have been told to feed/express/top up have experienced supply issues, either because baby isn’t feeding as much as they’re pumping instead, or psychologically because they aren’t getting much out with a pump.

That is wonderful news.
I only just read this and it's brilliant that you got helpful advice.
Extra suckling usually sorts supply issues. Breasts are brilliant!

I've seen mums almost losing their supply because pumping becomes a priority. The idea of 'accumulating' milk comes from an economics perspective, not a biological one.
One of my nieces had a dwindling supply until I advised her to 'put it in the baby, not the fridge'

I mean, I would say part of my issue is that I got over confident in my over supply and stopped pumping and hadn't done it in over a month. So I actually wish I'd kept that up. Everyone's experience is different - I have friends who have breastfed very successfully through exclusive pumping due to babies being in nicu and unable to latch. I imagine there is more to it than just mouth to nipple that stimulates milk and antibody production for example smelling and kissing baby is a huge part of it as well. I wish there was more research invested into this because its such powerful stuff. I also began pumping middle of the night during my 'babymoon' and first thing in the morning again while feeding hourly to two hourly. So the pumping for me definitely contributed to things rebuilding. I'd have been lost if I hadn't had a stash of expressed milk in the freezer as baby wouldn't latch at all for hours one day I was very glad I had it.