Need some advice and support

[krispifsu]

My DS is 9 months old.  I have been struggling for the last few months to keep up with pumping enough to supply when I work in the office.  I typically nurse when he wakes up @ 7 and then pump as I'm getting ready around 7:30. I get about 2 ounces from the first pumping.  I then pump again around 11:00 and get about 3 oz.  I pump again around 2 and get around 2-3 oz.  I nurse when I get home at 4:30ish but I am typically so empty by the end of the day that I have to use some of the milk I pumped that day to fill him up at bedtime.  I am pumping about max 8 ounces each day and he drinks about 10-12 ounces while I am gone and I sometimes I have to use some of those 8 ounces I pumped to fill him up at the end of the day because I am so empty on the days I am away from DS.  So my freezer stash has been slowly diminishing and today his caregivers had to give him the very last frozen bag of BM.     

I only pumped 6 ounces today and am completely empty right now so I know I am not going to have enough milk for him tomorrow and there's nothing frozen to make up the difference.  I went to the store during my lunch break and picked up a container of formula.  I know it's not the end of the world to feed formula, but I am just really dispapointed that my supply isn't good enough.     I breastfed my daughter until she was 13 months and weaned to cow's milk without ever having formula and hoped to do the same for my son but that is clearly not going to happen. 

So I guess I am trying to figure out if I have to supplement with formula, what is the best way to do that.  Feed all of the breast milk that is available and then offer a bottle of formula? and how much do I give? or should I mix the breast milk and formula together?  Is it going to be hard for him to get used to the higher volumes of formula and then be satisfied with the smaller portions of BM?  or should I give a bottle of formula at bedtime and pump to save that milk for the next day? 

I've never done this before so feeling a bit like a new mom and very sad that I just couldn't keep my supply up.  I have been taking fenuugreek with limited results.  I know part of it is stress and not enough time and not nearly enough sleep but I just don't want supplementing with formula to make it even worse. I want to continue to nurse until at least a year - so I'm willing to do whatever I have to to get my supply back up.   

Right now I'm just feeling defeated.     I feel like I've worked so hard to keep up and keep up but it's just never enough. 

Ok but enough whining on my part - I'd really appreciate some advice to make sure that I'm not making my supply problems worse. 

[Erin M]

((hugs)) sweetie, it's so hard!
Something you might want to try is to pump after those 4:30 and BT feeds -- that might help stimulate your supply even more.  It's hard though, you have a lot working against you right now. 
When I went back to work when my dd2 was about 9 months, she refused any sort of bottle, cup, etc (breast milk formula, whatever, she'd only drink water) so she essentially weaned herself down to 3 feeds at that age.  That's something to think about as you might be working towards 3 feeds in the next few months and then you could concentrate on just pumping to top him up at the other feeds.
Will he let you feed him more often on the weekends to help stimulate your supply more?  Have a bit of a "nursing holiday", if you've ever heard the term.  Just let your baby nurse a whole lot over the weekend, more than he usually would.

Here's some links I found, if you haven't seen them already:
http://www.workandpump.com/supply.htm
http://www.kellymom.com/bf/pumping/pumping_decrease.html#increase

As for the formula, you could probably just give it to him -- I started my dd1 on formula around the 8 month mark and I just gave her a bottle of formula one day instead of bm and it was fine.  I hope it all works out well!

[juliabell]

*hugs* I have had low supply from day 1. Thanks to getting a cold in the hospital, which delayed my milk coming in, I have just been messed up from day 1. I worked really hard to be able to breastfeed in the first 6 months, and still always supplemented with formula. Honestly, I cried the first time I gave DS a bottle of formula by myself. I had to hold back tears when I did it at the lactation consultants office. It is HARD.

When DS started solids my supply tanked again. And it's still going down. He has a hard time nursing because he's super distractible and it takes forever to get a letdown. So that doesn't help. He's getting more supplements now than he did before.

I don't think that there is a magic method to giving BM or formula and in what order. I only pump once a day - at night when DS refuses to nurse at all. During the day, I nurse in the AM and after naps. Then he has a couple more ounces (or however much he wants) after nursing. At one of those times he'll get the BM supplement before the formula supplement. Sometimes I just freeze the milk so that when DH is watching the baby he can give him BM instead of formula. But really, there is no rhyme or reason!

Some other supplements I found helpful: More Milk Plus (by Motherlove), Chlorophyll with Papain, Brewer's Yeast, eating lots of oatmeal, drinking lots of water. No sage!

Another thing that made me feel a little better about giving formula was researching and finding one I felt comfortable with. We ended up with Earth's Best Organic formula. I figured if I have to give it to him, at least he can have organic.

Really, it will only take time for you to kind of come to terms with it. I still have my moments where I wish that I could have had the whole EBF thing and have it easy. On top of low supply I struggled with plugged ducts (which probably didn't help the supply!) Just know that you ARE a good mom - just by trying to find some help for the situation and being upset about it shows that. My LC told me that the ratio of BM to formula is not equal to the benefits. Like 50/50 of BM and formula doesn't mean they're only getting 50% of the benefit of BM. It's actually much higher than that. And ANY BM is great

Oh, another thought, is it possible you are getting your period? I know that can sometimes greatly diminish a supply when you're about to have it. Kellymom.com has info on it and how to battle it by taking Calcium and I think magnesium.

*hugs* again

[krispifsu]

Thank you both for the input.
 
Juliabell - like you, I struggled from day 1 with this baby. My daughter was a breeze to nurse - never had a supply issue once and she weaned like  a champ. But my son was slow to latch on and nurse right from birth and then I never got engouraged even when my milk first came in. It's like I've been playing catch-up all along. Then work and sleepless night for 9 months just took their effect I suppose. Plus I got a plugged duct when nursing my daughter the first go around and I swear that breast just never came back fully even this time.  I produce twice as much on the other side so one breast is having to make up for the other one lacking.   

I ended up giving him a small bottle of formula on Tuesday night so the first time he had formula wouldn't be with his caregivers.  He drank about 1 oz and then refused to take any more.   But it was enough that I was able to pump double time that night and the next morning that I set aside enough BM to feed him his two bottles on Wednesday while I was in the office. I was home with him today and let him nurse as much as he would and offered hardly any solids to keep him nursing hoping he would stimulate my supply.  He is at that really distracted age too but I managed to get 2 really good feeds in right before and right after naps. I wish I could pump one side while he is nursing first thing in the morning but I have no doubt he'd be all over the pump and not nurse at all! 

I am keeping my fingers crossed that the formula becomes a back-up and I can stash a little BM aside each day to just scrape by until the year mark.    

Erin - I did forget that he will be cutting down on how many feeds he gets soon so I am hoping that maybe he'll cut down to just one bottle while I am gone for the office and I can nurse right before I leave and the second I get home.   
 

[Erin M]

I wish I could pump one side while he is nursing first thing in the morning but I have no doubt he'd be all over the pump and not nurse at all!

Seriously, we are SO at the distracted age too and I can only imagine if I tried this. 

Good luck, you're doing a fabulous job!!!!