difficult to feed and slow weight gain also, low milk supply??? please help

[avera1]

Hi,

I wonder if anyone can help me...

My baby is 4 months old, exclusively breastfeeding but I m finding it more and more difficult to get her to feed.  On an average day I she feeds at 7 or 8, at 12, at 6, at 10 0r 11, then again at 2.  I am also finding it harder and harder to keep her on the breast, a usual feed for her lasts 4 to 5 minutes (it generally takes nearly one minute of nursing before the let down occurs) I try to offer her the otherside when she stops but generally she is not interested, she'll other fall asleep or started to look around.

I also feel that my milk supply is dwindling, I have been trying to offer her more feeds and expressing to increase demand but it has not seem to have helped.  When expressing I only manages to express 20mls at a time, and only a few drops if I express after a feed.

Babe also have slow weight gain, she was 10lb11oz at birth and is only 14lb6oz at 4 month old.

My periods has also reappear since baby was 2 months old....is this mean that babe is not feeding enough??? my milk supply seems to be a lot less a week before and during my period and increases again when my period is finished, but does not seem to return to the quantity the month before...Is any of this connected???

I am so worried can anyone help???

[Mrs Coops]

Hi
I'm no expert but she was a big baby at birth, perhaps her slow gain is to do with how big she was at birth? Maybe she doesn't need to build herself up like other babies? How much does she gain on average each week/month? Perhaps she is getting all she needs in just a few minutes nursing? There are a lot of women out there (me included) that used to spend up to an hour feeding!! Is your health visitor worried about her weight? More importantly is she happy and thriving?  Because if she is I wouldn't be too concerned.

As for the not interested thing I think that is definitely an age thing, my LO has been an absolute nightmare to nurse sine the 4/5 month mark as she is just sooooo interested in the world around her, the slightest little noise and she's off to have a peek. If there are a lot of people around I had to take her into a quiet bedroom to nurse. My days of watching TV while feeding her ended ages ago!

I'm afraid I can't help you with the supply/ period issue as mine haven't returned yet and I'm not sure what happens in that department, I'm sure someone more knowledgeable will be along soon to offer help/ advice!

x x x

[Canwi]

Have a peek at this thread.  It has some info that will answer a good portion of the questions you have.  http://babywhispererforums.com/index.php?topic=65905.0

Your supply can dip with your period starting.  Some notice a dip in supply like you do, others don't notice it at all.  When your period returns is not an indicator of your LO not feeding enough.  There are other factors to consider.
http://www.breastfeed-essentials.com/menstruation.html has some good info about this, as does http://www.kellymom.com/bf/normal/fertility.html

I wonder if your LO is just hitting that "what's going on in the world?" stage and wants to look around rather than focusing on feeding.  Try feeding in a dark/dim quiet room and see if that helps too.

[clh]

In addition to the pp's (previous posters), I would add that you're doing what looks to be a more-than-4-hour-EASY routine.  There are only 1-2 stretches when there are only 4 hr between feeds; the rest are more spaced out than that.  I'd try to make it no more than 4 hr between feeds, although I do know how distractable they are at that age. 

That said, I just took a look at the WHO (World Health Org) weight-for-age charts.  She started out & is remaining well above the 97th percentile, so I think she's gaining just fine.  Here's the chart:  http://www.who.int/childgrowth/standards/cht_wfa_girls_p_0_6.pdf

The other thing is that pumping is NOT an indicator of your supply.  It does NOT indicate how much supply you have or how much your lo (little one) is taking in.  It only indicates how well you respond to a pump at any given session.  There are hormonal things that happen between mom/baby that cannot happen between mom/plastic pump parts.  I know it's hard to wrap your head around, but it's the truth.  Some moms, even with oversupply, can hardly pump anything because they don't respond wellto the pump.  Personally, I always struggled to pump enough for ds1 (first dear son), but when I nursed from the breast, he always had plenty.

The 3 things that you need to ask to determine your supply are:
1) Is baby happy & content when she comes off (i.e. not rooting for more)?
2) Are there enough wet diapers?
3) Is baby gaining?  (see a couple paragraphs above... if your weights are correct, then it looks OK)
If the answers are all YES, then you're doing fine. 

[avera1]

Hi, thank you for your replies,

clh, I had a look at the WHO weight for age chart, at birth dd was way above the 97th centile and she is now just above the 50th centile.  She seems to be happy and content after a feed, does not root anymore, actually, she doesn't normally ask for a feed, but I just offer it to her if I think it's been a while since she last fed.  However, I find that whenever I do this she seems to be less interested on feeding, but if I leave her until she is requesting a feed it could be 6 to 9 hours between feeds (I only notices this when I went out shopping for the day, I went for frequent pit stop to feed her, but she's never interested and only feed when I get back home if she doesn't fall asleep due to what seems like sheer exhaustion).

With regards to her nappy, I change her nappy about 5 times a day, they are wet, but not soaked.

I was a little worried but was still happy to Carry on just observing for the next 2-3 weeks, but then my doctor called me at home out of the blue and asked me to get her reweighed and she'd only gained 2oz that weeks and promptly referred me for an urgent appointment with the consultant. However the consultant was not concern and discharged us.  Now I am just really confused at when I should be worried and when not to.

To me things feels like it's in a slope downwards but I don't know if that is a concern or not. I feel that my milk supply has lessened since the appointment and I don't know how else to try to increase it. I tried getting her to nurse more often, tried expressing, I don't know what else to do. I tried doing the EASY plan but she refused to feed when she's awake, preferring to feed just before she falls asleep, and she would go hours until I give in and feed her before she falls asleep again.  Thinking about it, I am not really sure if she is satisfied with the feed cos she would just fall asleep and I am not able to wake her up for more feed.  Is this mean that she's had enough feed???

I am really sorry for all the questions...

[Erin (redstarfalling)]

Hi there - don't apologize for all the questions!   I'll try some of my own...

The consultant you saw - was it a lactation consultant?  Any chance you could get a second opinion from one in real life?  I'm not saying that there IS a problem, but at the least, it could be reassuring, and she might also have some suggestions.

What's your entire day look like - when she nurses (one or both sides), how much she's sleeping, and overnights? 

You said about 5 wet but not soaked diapers a day. What about poos?

FYI, my period came back at about 6 months old for both kids and I could always tell when it was coming because my supply dipped like CRAZY.  I tried to compensate a bit by drinking extra nursing tea at around that time, and later on I took fenugreek and blessed thistle.  I also found eating oatmeal helped.

[Canwi]

Another thought to ponder is that, according to DS2's gastrointestinal doc, it is about this age that kids start to "develop their genetic potential" with regards to their Body Mass Index (aka BMI) and where they will fit on the growth curve.
So she may be settling to where her genetic potential will leave her for the rest of her life.

[clh]

Canwi, I was thinking the same.  (avera1, you were right about percentiles.  I was looking at the wrong line for 4 months.  )  Maybe she was meant to be a 50th percentile person but came out big.  My boys were 8 lb 10 oz and 9 lb even, which was pretty high on the charts, but they came down to settle at lower percentiles. 

Thinking some more.  And Erin is right, don't apologize! 

[avera1]

Hi thanks for all your replies...

Erin, the consultant I went to see was my paediatrician consultant, my doctor referred her to them when she was crossing all those centiles he wasn't too concern at the time and neither was I as Dd seems to be content still between feeds...but not she's getting worse, she feeds for a shorter period of time and I am not able to do much house work anymore because she keeps crying if I leave her and she doesn't sleep as much and as preductable anymore...this seems to get me down somewhat as I am a lone mother and doesn't have any one that can help me when I have enough of being with her.

I tried putting her into a routine when she was 5 weeks old, she doesn't stick to it very well, but at least I know when I can have some me time and found that this was the time when she starts to gain less over a period of times...now all this is out of the window and I am offering her to nurse every two to three hours...although, I would say that she doesnt feed all those times, I would say that she feeds at 7, 12, 6, 10 and 2. do you think this is enough??? and with with regards of her sleep it has gotten worse now...she sleeps for 30 mins at 12.30 then another 30 mins at 3 or 4 pm. she would then falls asleep between 7-8, and wakes at 8.30. although sometime she shortens her naps to about 15-20 mins...

I found this by accident, can you give me an advice please...last night she was very frettfull and went to sleep around midnight, but probably had her last proper feed at 10-11pm ish, and her next feed was at 6.30am, she seems to be feeding much better at this time (she probably fed for about 7-8mins). I felt quite full at the time which I have not felt for about 2 months or so...

1. Do you think she's not nursing for a long period of time because she does not want to work for her feed???

It seems to me that she'd only feed up until my let down finishes, but she feeds longer when I am fuller

2. Is there any way for me to lengthen the let down period???

3. Is there any thing I can do to increase my milk??? (I tried offering her more, which doesn't work because she refuses the extra feeds, I tried expressing but this does not seem to increase the supply...Erin...does nursing tea, fenugreek and blessed thistle helps with increasing milk supply???when do you take it??and do you think it can work when I am not on my period??? I am trying to look for it but not finding much luck and I am due to go on holiday to asia, I am not sure if I would be able to find those there....which one do you find more effective???

Maybe in a way I dont mind her being small, I am just concern about when I should be worried and needs to seek medical assistant...She was weighed today....she is 14lb10oz now at 19 weeks, gaining only 4 oz in 2 weeks, and the health visitor had advised me to start weaning her is this a good idea???

With regards to her dirty nappy, she has one every 4-5 days...and not very much when she does have a dirty nappy...is this normal or is this mean that she is not getting enough milk???

Thanks for all your help guys....

Avera1

[Erin (redstarfalling)]

OK.  Well, first, at least she's GAINING and not losing, so that's a good sign.  You want to see closer to 4 oz per week rather than over a 2 week period, so, I think it could be 2 possibilities:
1. You have milk but she's not eating enough for some reason
2. You don't have quite enough milk

Either way, you would be best to try and find a lactation consultant in real life to help....Here are some places in real life that can help: http://babywhispererforums.com/index.php?topic=141609.0

Problems with her not wanting to eat enough....I'm not sure.  What about reflux? http://babywhispererforums.com/index.php?topic=654.0  Any of those things ring a bell?

To up your supply, fenugreek and blessed thistle can help - you need to take enough fenugreek so you start smelling like curry or maple syrup.  You usually take it several times a day. http://www.kellymom.com/herbal/milksupply/herbal_galactagogue.html  Here's some info.  Some mothers end up needing medication to help with supply, but again - you'd need some real life help (someone who actually knows about breastfeeding and that would probably NOT be someone who simply suggests weaning her right now....).

Dirty nappies can be tricky - some breastfed babies will go days without a poo, and then it's usually a really big one.  But the wet diapers should be really wet.

As for your other questions, she might not want to work after the letdown - do you do breast compression and switch sides back and forth?  It can sometimes trigger another letdown.  Drink lots of water, oatmeal can help to increase supply too.

Let me know how it goes and if you have other questions!