low supply -OR- time for solids??

[bethann]

My 4 1/2 mo dd has been sleeping through the night from 7pm to 7 am (w/ df @11 some nights). The last two nights she has been waking 3 times each night (12:30, 2:30, 5:30) and is SO hungry. (I've been feeding her). My question is this: is she not getting enough milk during the day? I work 4 days a week and pump 3 times a day at work plus once at night- and have noticed a significant decrease in supply (almost half!). She has only done this when I've been able to bf her all day (at the sitter she gets full 8 oz bottles of ebm).  She'll empty me out on both sides and seems to still be hungry   -OR-   is it just time to introduce solids- like rice cereal?  She's on a perfect 4 hour schedule (according to BW). I don't mind waking with her, I'm just concerned that she's so hungry! And i don't want to introduce solids if she's not ready. 

(if this is the wrong place to post this, I appologize).

ps. I haven't been feeling too well lately, could this affect my supply?

thanks- beth

[rosie and joe's mummy]

trying to up the milk during the day is the first step. solids must be your last resort.

unfortunately once you express regularly you do end up losing supply, UNLESS you express more times than you would feed. i.e. if you're away from her for 3 feeds worth of time, you need to express 4 times.  this is because you cannot express as efficiently as she can feed, so in effect you're taking less millk at those "feeds" which will reduce your supply.

I've found many women get to this point and find their babies are very hungry. Partly it's due to growth and partly also it's when a lot of women go back to work. I think it's the reason why so many start solids early, and it's not necessarily the answer.

you need to make sure you are consistent with your dreamfeed, and possibly do it earlier than 11pm. I find that if i DF much after 10.30pm then Rosie seems more disturbed than if I do it at 10. I don't know why but it's true.  It's also worth trying to express as much as you can even on days when you are able to feed her all day, as that will also help up your supply, and you can use the extra EBM to fill her up at her dreamfeed.

the other thing is that since you've only recently gone back to work (I assume) she may be needing the comfort more than the milk? maybe try to have more interaction and cuddles with her when you can?? sometimes it's just that they are unsettled after mums go back to work that they do this. It can also be helpful if you send your DH in to give her a cuddle and try to settle her back to sleep first, before you go in there with a breast, as if it is just love she wants he will do just as well, if not better because he has no boobs to tempt her with.

[Samuel's mum]

I completely agree with the previous poster re-comfort as a possible reason and the benefits of extra expressing and with the comment that

solids must be your last resort.

What we often forget is how rich breastmilk is in calories compared to so many other foods:
breastmilk - an average of 22 calories per oz.
apple sauce: 13
rice cereal: 20
pears: 16
carrots: 7

It simply isn't the case that at your LO's age she will be able to absorb calories from her solid foods that are superior to breastmilk.

If you are exclusively breastfeeding (feel for those mums who would desperately wish to be in your position) there are good reasons to hang on and look at other ways to solve this problem - this is because of the way breastmilk coats the lining of the baby's 'open' intestinal wall  preventing the the passage of pathogens and allergens into the bloodstream. If you add solid food to this environment the coating is compromised. A baby's gut doesn't tend to 'close' until nearer 6 months.  The decision when to start solids is obviously a personal one that each family must take. Some people feel strongly that their babies are curious about food and want to begin, some people are advised by their doctors that they need to begin solids e.g in the case of reflux.

Feeling unwell and going back to work are all things that might have affected your supply. I would work on that first. Even if you did add solids at this age you would still need to ensure any potential supply problems are ironed out if you feel that is what it might be - solids for young babies is more about 'experience' and tastes than 'filling up'.

Is it also possible she may be going through a growth spurt or a new developmental stage? It is tricky to meet the needs of a growth spurt when you are working. I would try some extra pumping as suggested and perhaps consider taking a supplement that might help boost your pumping output e.g. fenugreek.

[bethann]

It could be the "cuddle" thing, however I've been at work now for nearly 2 months, and this is the first that she's ever done this- and she's done it on the days when I've been with her all day.  Could it be a growth spurt?  It's just so completely random!

this is because of the way breastmilk coats the lining of the baby's 'open' intestinal wall preventing the the passage of pathogens and allergens into the bloodstream. If you add solid food to this environment the coating is compromised. A baby's gut doesn't tend to 'close' until nearer 6 months.

(I didn't realize that! That's amazing!) so I guess I will wait as long as I can for the solids!

As far as the supply issue:

I have been quite stressed lately with working and many other variables in my life- could this be the cause? I'm also running around a ton for my job. It's very busy.  I've heard that being too active can lower your supply.  What tricks have you found in order to keep your supply at the proper level? (I haven't tried the fenugreek, but I suppose I should!)

thanks... beth

[jbepko]

Here are some thoughts on boosting supply issues-
http://www.kellymom.com/bf/pumping/pumping_decrease.html
And I think 8 oz bottles are probably too much milk- take a look
http://www.kellymom.com/bf/pumping/milkcalc.html#calculator

[Scate]

Hi Beth,

My dd did the same thing at about the same age and I started her on one bottle of formula a day which helped after a couple of days. I was also convinced my breastmilk supply was low, but she subsequently popped her first tooth a short while later. If you can bear it, try to battle it out before offering formula - not solids. If my theory is right, it could come right all on its own. And don't worry too much about the night feeds being habit forming - mine went back to sleeping through and is still an angel at 8 months.

I know how you feel, so good luck and whatever you decide, remember, you did what you thought best.

Cate

[bethann]

Well, she's down to one random waking a night. I truly think it was a supply issue, as my milk has miraculously come back and she seems much happier.  I just don't think I was drinking enough fluids or eating enough while I wasn't feeling well.  I've been trying to relax a bit more and eat more and drink tons of water, and I think that was enough to jump start my supply again.  I think I'll hold off on any formula or solids at this point.  I'd like to keep her ebf until 6 mo if that is at all possible.  (after learning about the changes anything other than bm can make to the ph levels of the little tummy). Thank-you though for all your replies. They were ever so helpful!  I think eventually she will go back to sleeping through the night....  I've just got to keep my supply in check.

thanks-
beth

[rosie and joe's mummy]

I'm glad it's all sorted out.

I think sometimes breastmilk production peaks and troughs, with so many factors involved it's only logical that it would.

as far as the night wakings go,

at the same age, rosie started waking at night again, having been through the night since 8 weeks. to be honest she didn't stop the night wakings until we started solids, but i wouldn't use that as a reason to start solids earlier, it's just one of those things, I think she was getting hungrier and waking for a feed, but as soon as we wree onto solids she went the whole night again.

I'm telling you this, not to encourage you to start solids, because I'm certainly not, but more to reassure you that if she doesn't go back to sleeping all the way through, it's probably not forever, as rosie seemed to go through a phase of it at the same age.