not enough milk?

[fishie]

ds is now 9 weeks and is barely putting on weight. lots of trouble establishing bf, terrible nipple problems etc, all now (i thought) fixed. birthweight 3.5kilo, now 4 kilos (or 1lb gain) and he is THIN. i've tried changing position, feeding marathons, no change.

each feed usually 5 mins of big gulping then nibbling / gulps for 15 mins or so each side. am currently feeding every 2-3 hours all day and 2/3 times at night. and he's sucking away all evening to calm the colic - or is that screams of starvation? nothing spare to express. he's been feeding more often overnight and this morning, hopefully is trying to build up supply. but milk not building up between feeds so he is also really hungry and won't nap which isn't helping.

gp and hv sympathetic but not given any practical advice - waiting to see if improves over next week or so. baby otherwise fine, smiling, 4/5 sopping wet nappies daily, big poos every other day. but he just doesn't seem to be getting enough to eat. really don't want to supplement but don't know what else to do.

bf as much as poss in morning - i was told milk is richest then (even if it means waking him up). dont worry about being able to express. i never managed any and i bf for four months. sorry cant be more help but hth

Hi, fishie. You need to see someone who knows what they are looking for and get your positioning and attachment checked...this can make a difference. Call one of the bf helplines, and/or visit a bf support group.

There is no difference in the milk quality in the mornings (sorry, gg, don't know where you got that from ) so it doesn't matter when you do it, as long as it is often and effective. I can't say if 2-3 hours is enough, in fact - some babies need more than that.

You do need proper observation, though. Sometimes, when bf is hard to establish early on, problems with supply arise later, but they can be improved with the right help.

If he is not good at getting it out maybe your body isn't producing that much milk. Maybe you could try fenugreek capsules (get from a health food shop) - over a few days that can boost milk supply.

Get someone to check out the latch. Don't bother epressing. Does he seem hungry ? (apart from in the evening - lots of babies get fractious then).

Maybe he is just growing his brain and will start on his body in a few weeks - babies to grow in fits and starts.

Give him time - as long as he is not losing weight.

Babies often get more proficient at breastfeeding as they get bigger.

what I meant was maybe he isn't giving enough stimulation to up milk supply.

thanks for advice. yes, baby deffo hungry. tiktok, i've seen bfc a couple of times, we both thought latch much improved. although, it can't really be anything else wrong can it? will call her and ask to come round again. she suggested domperidone last time i spoke to her but gp never heard of this and said don't.

Sorry to anyone who's sick of hearing it!

Fennel tea is excellent for boosting supply, honestly.

Metoclopramide is another anti emetic (like domeridone) which is sometimes prescribed to help supply. It was prescribed to me, I wouldn't recommend it because although it does give supply a boost, everything has to be going perfectly (positioning, regular feeding, etc) to sustain the raised quantity of milk otherwise it can mean taking it on and off for a long period (not recommended at all).

I felt that though it did boost my supply after I took it, my production failed further between times.

Priority is definitely getting to the root of the problem (positioning?), then going from there.

(But, in the meantime.....fennel tea!! )

If he's weeing and pooing lots, maybe things will improve soon? Can you spend time lying in bed with him and just feeding him whenever he likes (as in, all the time if he wants), particularly at times when he's fractious?

hello nqc. yup have tried feedathons in bed, bfc has visited, positioning and latch is ok. i suspect have suppressed production by taking him off too soon to avoid agonies when nipples were bad

have now got domperidone, will see. bit dear at 40p a pill - can i get it cheaper? and is fennel tea from health food shop?

Hi fishie. Sympathies from me. DS is 6 weeks old and we are having similar struggles, though I do top up with formula. Started domperidone about a week ago. It has helped. Nothing dramatic, but a bit better.

Pumping, even if nothing comes out (as long as you don't make your nipples sore) can help stimulate more production, as it tells your body the baby wants more.

I've always found making sure I'm eating well and resting well makes a difference, although I'm told it doesn't really. Makes me better able to cope I guess?

There must be some good web info on domperidone out there, so you can convince your GP to give a prescription? That would be the cheapest of all.

If you can avoid giving formula, please do, as it doesn't help you make more milk. Your baby is gaining weight, and will no doubt start to gain faster. Cosleeping could help you feed in the night without tiring yourself out so much, if it suits you.

Some domperidone info

Hi Fishie. I had exactly the same problem with DS (now 2.2yo). He fed every 2 hours day and night. BFC visited often. No probs with positioning or latching. I tried pumping (had no pain, sometimes I got a bit out, but usually very small amt, and somethimes nothing). I pumped till I felt like a milk cow - but no difference to DS's fussiness. I thought he was hungry. Everyone said don't suppliment (and I really didn't want to). Found that a dummy did help settle his colic (didn't want to give a dummy either, but it really helped him, and he refused it after a few weeks when his colic settled). At 6 weeks, I started giving a bottle top up after the two feeds when he seemed the most fractious (evenings). He settled immediately and went 4 hours without a feed for the first time. He continued to feed often in the day (2 -3 hourly), and settled into sleeping 6 to 8 hours a night within a couple of days. I believe that topping up saved my sanity. It gave me the rest I needed to produce more milk. He was happier and so was I. I continued to BF with top up after two of the BFs each day. I didn't top up the day time feeds because he seemed more settled. He BF 95% (and bottle 5%) until 7 months (when he had bad flu and had problems breathing when feeding). At that point transition to bottle was easy and hassle free. Other than this flu he was very healthy (and has remained so).

Everyone said, don't worry if he is putting on weight and weeing and pooing. But I just FELT that he was hungry (but was not too confident about my instinct as a first time mum) - he certainly was more unhappy than I thought he should be even if tired/grumpy. Once I tried the top ups, I believe that I had been right about him being hungry because the change in him was miraculous and instant.

I had hoped to BF for longer, and would have if he hadn't decided to refuse the BF when ill. I had also hoped to do exclusive BF, but that just did not work for me.

Everyone is different, and you need to do what is right for you and your bubs. I know everyone gives dire warnings about not topping up, but I was honestly a nervous wreck from sleep deprivation after 6 weeks of feeding every two hours day and night. Exhaustion was probably affecting my supply anyway. Although topping up would not have been my first choice, it worked well for us. If you've tried everything else, then I'd suggest trying a bit of topping up (even if only short term to give yourself some rest). Of course if some of the other remedies work for you (and I hope they will) then you can always drop the top up after a couple of days. Certainly topping up did not seem to decrease my milk supply as the expressing seemed to produce the same amount of milk as before, and DS was as settled in the daytime as he had ever been (but still feeding frequently).

Baby no 2 is due in September, and I hope to exclusively BF, and will try fennel tea in the hopes of not having to top up (no one suggested this to me when I was BF - thanks Mners). But I will trust my instinct if I think baby is hungry and top up with bottle. After all, if it is not hunger, then topping up should not make any difference to the baby (in which case you can try once, and then not do it again), but if topping up settles them as it did for my DS then you just have to go with your instinct.

Good luck!!

I'm glad topping up worked well for you, KiwiKate, and I'm glad you were able to bf for so long.

But I do feel obliged to point out that topping up is not risk-free. Often babies who are given formula topups start refusing the breast (and at an earlier age than 7 months). Also, some of the benefits of breastfeeding, for mother and baby, are reduced by giving formula.

the funny thing is he sleeps pretty well at night - although is co-sleeping which must help. just during the day/evening is feedfeedfeed.

will see if domperidone and fennel tea works - weigh in is tuesday, if no improvement will have to supplement i think, he is far too slender to continue as we are.

Thanks for that NQC. I guess each person just has to do what works for them. I do wish I hadn't had to top up, but it was the only thing that worked for us.

Good luck Fishie. I'm really hoping that the fennel tea or domp get you right.

Keep us posted please

On the subject of tea: in Germany you can get 'breastfeeding tea' (you can get a tea for everything here, from nerves to intestines ) which contains fennel, aniseed, caraway and fenugreek, which is supposed to be a top combination for milk supply. If anybody wants some, CAT me and I am more than happy to send a packet of 20 teabags over for you to try. (No, I don't sell it! I just want to do something to help for once rather than always being helped and giving nothing back but a )

yippee! 170g gain not sure whether domperidone, feedathons, fennel tea or all three - so long as it continues i can experiment a bit.

berolina that's really kind of you, but hopefully i won't need it. is it nicer than plain fennel tea? (which i don't mind) - could add fenugreek to my cuppa.

fishie that's great news! carry on with the feedathons. because if the domperidone has increaxed your supply then you need to sustain that... is he feeding well?
let him feed for as long as he wants every time...
hope things carry on going well

Fishie, congrats on improved weight gain. Hopefully, you don't need any more top tips but I'm sharing now I've read this far anyway

Breastfeeding new mothers sometimes forget how tired they are and need to REST to give themselves a chance to produce plentiful milk supply. I don't mean there's much you can do about sleep being broken, but just slow down a bit and plan less to do each day if you can.

Second tip - you need to eat enough - preferably highly nutritious, health snacks but I found cakes to be essential too