Did i just kill my entire milk supply???

[Cupcakejamlover]

I have birth to my first baby 10 days ago. I had a huge over supply of milk caused by over pumping in the first few days since baby was away from me for medical reasons. I suffered from alot of pain, engorgement and lumps in my breast it was extremely painful. I’m talking producing around 200ml of milk from one pumping session without even feeling that relieved after, never fully emptying my breasts because they told me that would stimulate more production. The midwives, doctors and lactation consultants all gave me different advice as in how to handle the situation, some people said just leave it alone, some people said pump it out, some people said just massage it etc, so i was left home extremely confused without a plan. I googled how to relieve engorgement where i came across savoy cabbage helping, and it said you could do it 2-3x a day for 20 minutes but not more than that because it could dry up your milk. I have only done it twice, a day apart, for around 30 minutes since i did not want to risk losing milk, i just wanted some relief. I now have extremely jiggly boobs, they are even softer than from where i was pregnant. They went from being rock hard to being saggy grandma jiggly boobs!! I’m very worried that i could have killed my milk supply? I’m still able to pump and he’s still feeding on my breasts however i’ve always had to top him up with bottles regardless of what happened so i’m not sure if he’s feeding properly from my breast. I’m now able to pump around 50ml from both breasts after having him latched on for around 30 mins potentially eating (not sure if he only used me as a pacifier). I’ve read somewhere that it could be my body adjusting to the demand but to me its a huge drop in two days so i’m worried it gets even worse and i lose all my milk? What should i do? Any advice helps!!

If you just keep feeding on demand, your body should up production as needed, just as it does any time the baby has a growth spurt. You don't need to monitor your boobs - you just monitor nappy output and baby behaviour.

However this assumes that baby is extracting milk effectively - what was the reason you had to top up with bottles despite oversupply?

Keep feeding on demand and your boobs should sort themselves out, being rock hard means too much milk so sounds like they are just getting used to what your baby needs.

Try not to worry, drink plenty and then some more and eat well and you should be on the right track.

I would be concerned that you were ‘drying off’ (sorry for the horrible terminology) but as you’re now feeding your baby regularly you should be able to stimulate your supply again. Besides, 50ml, although it sounds small, is fine for a new newborn in one feed. Just keep an eye on the baby’s nappies to ensure he’s taking it in. For future reference, if the baby isn’t feeding from you and you’re only pumping then it’s important to pump several times through the day/night to keep up supply initially. Though on a side note, it is actually possible to regain milk supply after drying off but it’s hard work.

@bunglebee baby was born with a lung infection so had to be tube fed for a while, which we had to come off slowly by topping him up with expressed milk because he never seemed to be full without topping up with bottle. I’m assuming my breasts were too hard for him to suckle on, and it was already exhausting for him to eat since he got so used to just finding his milk in the stomach via tube without having to work for it. The problem is he is jaundiced and has it quite high, so its very important for him to eat well and at the moment i’m not sure he’s eating enough from my breast alone so i always end up offering a bottle just to double check if he takes it, which most times he does end up eating another 20-30ml from the bottle.

He is eating quite well at the moment, he suckles on the breast (hopefully effectively eating) for around 30 minutes and then falls asleep, but we then wake him up to offer bottle which he ends up eating 20-30 ml from, and i pump after to make sure my supply stays up if he’s not eating enough from me, but now i’m worried i’m messing up my supply again by all the feeding then pumping?? How do i know he’s eating enough from my breast if he always ends up eating the bottle easily? I always try to burp him, switch sides, tickle his ears to make him feed as much as possible on the breast before he sleeps, so by the time i offer the bottle i always assume he’s full and ready to sleep, but he always surprises me by eating another 30 ml sometimes even more from the bottle after all the feeding, burping, tickling etc we’ve done to make sure he ate as much as possible before fully going to sleep and then offering the bottle...

That he takes a bottle afterwards doesn't really mean anything. It's a fairly small amount and a newborn will automatically suck whatever gets put to their mouth, which with a bottle means they end up with a mouthful of milk. That's why bottle-fed babies can be overfed - they can't control the flow like they can with the breast.

I can understand your concern, but unless you've been medically advised to top up, if baby seems content/sleepy after a feed they should be OK. They'll let you know when they're hungry again.

I assume you've already been advised to get baby as much sunlight as possible, keep basket by window etc

Remember sucking is a baby's primary reflex. They don't just suck to feed, they suck for comfort, to fall asleep, to relax their muscles so they can poo/fart...

I really think you can just drop the bottle topups. Watch baby as they feed and you should see swallowing (their ear will move). Usually they will suck intensely until they trigger letdown, then they suck-swallow-suck-swallow, then as the flow slows down again it's more suck-suck-swallow, then they may suck faster again to trigger another letdown if they want more.

I would feed on demand offering both sides each time. If your baby is wetting nappies then you can assume your milk supply is ok and has just been adjusting to the baby’s demand. Remember that breast fed babies poo much less often than formula fed as there is very little waste product from breast milk. Fewer poos doesn’t mean they are not eating enough but there should be plenty of wet nappies!

Mine drank tiny amounts at that stage so if your boobs have stopped producing 200ml plus each feed then it seems they are making what baby is drinking even if they don’t feel like balloons anymore!

If you want to drop the top ups I would phone your HV and just check that not offering the top ups won’t have an adverse affect on his jaundice. If she says it’s fine I’d either go cold Turkey on all top ups and see how it goes, your milk will increase as he feeds more often or for longer from you. Or you could only offer top ups at night (entirely strategic as formula fills babies up quickly which makes them sleep longer/without sucking to sleep on the breast) — you may as well get more sleep if you can.

I would phase out the bottles - it’s going to be very hard for you to regulate your supply if you’re bottle feeding as well as breast. If your baby is gaining weight and has plenty of wet nappies, your supply is fine and he does need top ups. If you can go back to feeding on demand your supply should soon match up with your baby’s needs.

*doesn’t need top ups!

Why not offer breast again when he wakes up, instead of a bottle? It's not uncommon for young babies to basically only sleep and feed. Try dropping the top ups, and offer breast again at wake up. This will stimulate your supply. You'll know if he is getting enough at the breast if he is content after feeding, and pooing and weeing regularly. If he's not then you'll know there may be an issue with milk transfer.

'Boobs are factories, not warehouses' is the best advice I was given. You make milk in response to your baby suckling. So when you feed him and he sleeps, you haven't now run out of milk and need to give him a bottle on wake up. Just offer breast again if you're concerned he might need more. Newborn stage I just offered breast whenever they were grouchy which could end up being quite frequently, but it lessens as they get older. I used to feed, they'd sleep for half an hour, then wake and grandparents would want a hold, only for them to get grouchy five mins later and everyone look at me like I was mad when I'd say oh he needs a feed. It's not big gaps like bottle feeding

Finally, not being hard and engorged isn't a sign of not enough milk, but of oversupply settling. In my experience you'll generally only become engorged if baby goes a bit longer than normal for whatever reason. The natural state of breastfeeding isn't going to be hard, uncomfortable and engorged. It's funny they can feel totally normal and there still be plenty of milk as like I said, factory not warehouse. Every time you use a bottle rather than breast is one less time you are signalling to your body how much milk to make.

I think this could be useful for you: themilkmeg.com/im-on-empty-i-need-more-milk-maybe/