Trying to increase milk supply not working. HELP!!

[sharanb]

Hi,
I had a little girl nearly 12 weeks ago by emergency c-section. It took 7 days for my milk to come in and she has baby reflux so at the start she refused to stay on the breast. Now she is on medicine from the doctor and her reflux has been so much better. I would be able to breastfeed her completely if only I had enough milk. I have been pumping since she was born and putting her to the breast when possible but as I don't produce enough milk as soon as the flow stops she wriggles, fusses and comes off crying as she is still hungry at which point I have to give her a bottle as she is now taking 4oz and I nowhere near make that much.  I have been taking Fenugreek 4 tablets, 4 times a day which doesn't seem to be helping much.  I am quite a big girl so i am wondering if I should increase the number of tablets I take but then again I don't know how many is too many. I have spent many days pumping every 2 hours but nothing seems to be working to increase my milk.  I manage to pump about 1oz every 3 hours which is so little, but I get 3oz first thing in the morning.  Does anyone have any advice as I am considering stoping with the breastmilk as I can only express enough for 2 feeds a day. I feel like I am clutching on to breastfeeding as she is going to be my last child so I will never do it again.  I wasn't that great at breastfeeding with my first child either so I guess my body just isn't good at it :O(

If anyone has any advice at all that might help me then please let me know. I have asked my doctor if there is anything I can get on prescription to help but he said no (I'm in the UK). Maybe I should just stop 

[deb]

Most (and I mean "most," not all! doctors are useless when it comes to that stuff, at least in my experience. My insurance wouldn't even pay for a LC.

First off, remember that what you pump is not necessarily an indication of what your baby is getting. For that ounce you pump, more efficient actual nursing would get maybe 1-1/2 or 2 ounces, and for the 3-ounce pump nursing might well get 4 (or more? I'll let the BF experts chime in on that - it's been a long time for me! LOL).

Secondly, at 12 weeks you're probably hitting the 3-month growth spurt. Keep putting her on, nurse as much as you're able, and your body will get the message to make more! After she nurses, you can even pump for an extra few minutes; even if you get zero milk, your breasts are still getting the stimulation even if baby pops off in frustration.

Thirdly, are you drinking enough water? All the fenugreek and blessed thistle in the world won't do any good without water to make the milk with!

I would say give this routine a week so you have an end in sight if it doesn't seem to be improving, but those few days might be all it takes to work thru the growth spurt. the 3-month one is a HUGE one, and is when many BFing moms do end up stopping 'cause it doesn't seem like it WILL be enough - but it will be!

Edited to add: If you feel the need to supplement for those few days with formula to make sure your baby is getting enough, that's not necessarily bad. But if you do plan to keep BFing, make sure she's getting as much milk as possible from the breast first.

[opsmummy]

Hi

Big HUGS it is so stressfull if you think that your milk is not right!!

The amount of milk you get when you express is not always an indication of what your LO gets. When i express i only get one let down and i know when i feed DS that i get at least 2. Expressing one breast while you feed on the other is a good way to increase milk ( i have only tried this once it is a little fiddly). I used to express at the end of feeds and then inbetween as well. It took about a week but my milk supply really increased

I found that expressing was not a good way to tell how much DS was getting. He would only feed for 5 mins and i was always worrie dhe did not get enough. My rule of thumb is now, regardless of how long he feeds if he doesn't grumble between feeds and still last 4 hours he is getting enough.

Hope things improve for you

Becky

Oh!! i have also read about a tea called mother milk. Never tried it myself but have heard others talk about it.

[sharanb]

Well my rule at the moment is to offer her the breast when she is hungry and then top up with formula. I know that I dont make enough as when she comes off she takes another 4oz from the bottle and no matter how much I try she wont go back on and cries until she has the bottle. If she does go back on she chomps on me and wriggles and gets upset. I try to pump every 3 hours for 20 minutes on each side. I even let her suckle if she is just tired and let her fall asleep on me suckling as the way I see it she is still stimulating a little bit.  All I know is that what she does get from isn't enough to keep her going as she is still wanting more afterwards, also it is hard to get her on for every feed as I also have a 3 year old who is quite demanding. I'm not ready to give up yet but it is getting to me now.

[Rileysmum]

{{{hugs}}} 

It is really hard when you want to breastfeed and are having difficulties.  You have gotten some really great advice.     I don't know if this will help but here is what I did (my milk never came in very well, and my DS had reflux, so he would often refuse to BF, but we made it until he was 8 months with supplementation before I had to give up from a combination of reflux, teething, and distraction  :'().

I took fenugreek, usually 8 or 9 capsules a day.  A great link for information on fenugreek is: http://www.kellymom.com/herbal/milksupply/fenugreek.html#Safety (it lists recommended amounts, etc.)

Used mother's milk tea, but it never really helped me. 

Ate oatmeal (loads and loads of oatmeal  ).  Not the instant kind, but the "real" oatmeal.

I don't know if you would be willing to get one, but a lactation aid helped me tons.  Your LO will still be Bfing, so your breasts get the stimulation they need, but can still be supplemented with formula.
http://www.kellymom.com/newman/05lactation_aid.html 
I personally used the Medela Supplemental Nursing System. http://www.medelabreastfeedingus.com/products/breastfeeding-devices/51/supplemental-nursing-system-sns

I also pumped as often as possible (I even got up at night for a few nights to pump at night, as I have heard that prolactin levels are higher at night.  Really came to regret missing out on that sleep though. )

I don't know if they would have one in your area, but my local La Leche League leader was very supportive and helpful.  In our area they have support meetings once or twice a month.  If you become a member, you also receive a magazine that has lots of great stories and support (but you have to pay to be a member :'().  http://www.llli.org/

Also, if you are able, I would also recommend using a lactation consultant.  They will be able to give you lots of ideas, and just double check that some of your problems aren't caused by your letdown or latch.  I didn't use one, because I didn't know there was one in my area until too late.

Lastly, I recommend the book "The Breastfeeding Mother's Guide to Making More Milk"  by Diana West and Lisa Marasco, which could help you identify a cause as to why you may not be making enough milk, and lists some additional ways to help increase supply, such as other galactogogues besides fenugreek.  There were a couple of other books I read as well, but I can't remember what they were now....

Hope that some of this helps you, and isn't just too much information for you.   

[nossi]

I would also highly recommend getting a lactation consultant (preferably one that a friend can recommend).  I live in the US and found a medical doctor who is also a lactation consultant.  Her visit cost US $250 but I have out of network insurance which covered 80% of that cost (so it only cost me $50 in the end).  I'm not sure how it works in the UK, but I'm guessing insurance would cover an LC, since your health care system is much more generous than ours.  A highly skilled LC should know exactly what to do.  Generally pumping after feedings and taking herbs are standard pieces of advice (I've had really good luck with Mother's Milk Plus extract).  It could be though, that you're having trouble because you didn't get off to a good start and it's tough to increase supply when that happens.  But if you give it a shot with an LC, at least you'll know that you did all you could.  As someone who had an extremely difficult time breastfeeding for the first 2 months, I have to tell you that once it starts going well, it can be a wonderful experience.  But if it ends up not working for you, have compassion for yourself and do not feel bad.  You seem to be trying really hard!!  I hope things go well for you.

[lilalley]

I am in the same boat.  I produce almost exactly what you do and my DD is the same age.  I in the last two weeks I have also gone back to work.  Another backwards step for BF.  I have been searching the posts for help too. I have resorted to co-sleeping s she can suck her way all night long as I sleep.  Although I usually still need to supplement once during the night when she get too squirmy.  Hang in there we can do this.  Every drop of it is a blessing for LO.

[sharanb]

Thank you all so much for your wonderful advice. I have been trying to get it right for many weeks now and have spent half of my life lately on the internet trying to find something that will work. I have found that alot of people were just like put your baby to your breast and feed her and stop pumping and supplementing, as they didn't seem to understand that when you have problems it's not that simple. Thank you so much for being understanding. I'm going to keep on trying for a few weeks more and see what happens. At the moment I think that being able to get enough breastmilk for 2 feeds a day is better than none so I am glad she is getting that.

How much water should I be drinking a day? I'm not a great water drinker, is there anything else that is good to drink and do some drinks makes things worse such as Tea, fizzy drinks etc?

[deb]

Definitely nothing with caffeine, so watch the tea and make sure it's decaf or herbal. You may also want to go easy on dairy. Really, water is THE best thing - if you can get yourself to drink an 8-ounce glass 3 times in the morning, 3 more in the afternoon, and anothe glass or two in the evening, that'd be good - tell yourself it's medicine, and it really is, especially for something like this! (Plus it costs less than anything else you can get! Try adding a bit of lemon juice to it for flavor if you like?

[A pair of Charlies]

Hi there

So sorry that you're having such a rough time. It will get better.

Okay. A couple of issues here I think. First up, supply; I've detailed a load of stuff down below and some links that might help. Secondly, supply and demand. Thirdly, human nature even in babies.

So. Supply and demand. Breasts usually work on a clear supply and demand basis producing milk. At first, your breasts store loads of milk and you're lugging milk around with you all day long. They're being super prepared. But as time goes on, they move towards producing on demand. So the hefty milk bags diminish as they produce more and more on demand. Now, I don't know if there is a 'time' when this happens but I know of it happening usually from 6 months onwards. Just preparing you for the changes in that full feeling. Aunt Flo also dents supply a little in many cases, when she returns.

Right now, your babe is satisfying hunger with milk that your body / breasts have no clue about. But a hungry babe needs feeding. So for now, perhaps continue to supplement with formula after feeds AND express as well say an hour after the feed or before the next feed. OR take a baby honeymoon and put her back to the breast 20mins or an hour later (you decide the time on how she seems), then again if she fusses - pretty much like feeding a newborn. Why? Over a day or 2 this sends a very clear message to your body to produce more milk. Once the milk ups in quantity, adjust the feeding frequency gradually moving yourself back to the EASY she's content with. It's tough going initially, but my body got the hint pretty darn quick.

With the expressing, stick to a clear routine and remember that you're trying to mimic your babe. Pump even if empty - just a few mins unless painful or uncomfortable. Switch pumping can really help.

Human nature. Babies love to suck. And sucking on a bottle is generally easy easy milk as they don't have to work to hard for it. I'd consider getting teats on the bottles that are closer to how the breast supplies milk - the ones that make babes work hard for it. I do wonder if she finds the breast to slow, to stop and start, to difficult in comparison to the easy life of a bottle. There's a SNS (supplmental nursing system) that enables you to breast feed your baby from a bottle with a little pipe thingumy. That might help get her working on the breast more. RileysMum has included a link to this in her post. I've never used one but it's recommended here lots.

Try breast compressions: http://babywhispererforums.com/index.php?topic=88759.0
And maybe review latch, try teething meds (gel) before a feed to see if that helps, try a lactation consultant (http://babywhispererforums.com/index.php?topic=63599.0)

Other info that might help:
 * http://babywhispererforums.com/index.php?topic=94121.0
 * http://babywhispererforums.com/index.php?topic=63603.0
 * http://babywhispererforums.com/index.php?topic=65905.0

And be patient with her. Trouble shoot to see if there's anything else that might be making her wriggley and uncomfortable... wants to look around, needs to poo, uncomfortable (too hot, too cold), not enough sleep / not rested, sore gums (teeth can hurt long before you see any signs)... and so on.

So. Back to the start: increasing supply:
Things that you can do to increase your supply:

*First and foremost - your lo!  Nothing will stimulate your supply like your baby so key here is to nurse, nurse, and nurse some more

*Skin to skin contact - as much as you can - strip yourself off - strip lo off and climb into bed.  Play, cuddle, nurse etc.  Spend the whole day in bed if you can.  Failing that, make sure the house is nice and warm and strip your lo off and yourself and just play like that all day.  Bathing together etc...  This will increase teh level of oxytocin (one of the primary milk producing hormones) and therefore help a LOT

*switch nursing: when lo has finished with the first side, offer the second.  When done with the second, offer the first.  When finished with the first for a second time, offer the second again.  This will normally stimulate a further let down with each switch and tells your body to make more milk.

*Pumping directly after the feed preferably for at least 15 mins per side although anything is better than nothing.  You can also "switch pump" which is basically going back and forth between the breasts when the milk stops coming...

Things you can consume to help:

*Fenugreek, Blessed Thistle, Mothers Milk Tea & Brewers Yeast are all things you can buy at your local health food store that can be really great for helping to boost supply.  With the fenugreek, it's arguably the most effective but unless you are smelling like savoury maple syrup (and I mean everything - your urine, your sweat, you!), you're not taking enough haha! Follow the dosage instructions for the size of pill you are taking - they vary!

*Oatmeal/porridge.  This can be great for some - I personally notice a difference with this   When I've been low in the past, I've had it for breakfast and for lunch - you can also eat tons of flapjack or oatmeal cookies ~~~ porridge is great for me: porridge, milk, cinnamon, pinch of ground cloves, drop of vanilla essense and fresh berries - really helps my supply everyday. Also, oatmilk available from healthfood stores and some UK supermarkets - even do chocolate flavour!

*make sure you're getting plenty of water - this really can be a major factor for many! In those early months (up to 6 months or so), I'd drank a large glass of water or milk during / or with each BF. All other drinks during the day I saw as drinks / hydration for me. Drink drink drink. But avoid caffinated, fizzy, nutritionally empty drinks - you're drinking for 2!!

*make sure you're eating properly - well balanced diet, with enough calories, enough dairy fats and health fats (such as are found in seeds and nuts etc). Up until 9 months or so, I ate an awful lot. I viewed main meals as nutrition for me, and then additional meals and snacks as feeding the boy...so I'd have breakfast and then toast an hour or so later... lots of healthy, carby nutritious snacks all day. It helped me make sure I was taking on enough to feed us both.

Whichever methods you choose to try to increase your supply, make it a consistent part of your routine for at least 3 days. You should see results within 3 days, but we're all different so give it at least 3 days CONSISTENT effort. Once your supply is up, maintain that level with regular feeds to your LO and improvements to fluid and food intake.

Hope this helps. Let me know what you think and how you get on?

Charlotte