Zero milk supply after returning to work, in tears trying to fix it. Help!

[Seyamom]

My baby is 4.5 months old. exclusively breastfed so far. This past Wednesday 1/2, I went back to work. My work schedule is 3 days a week. She goes to day care right out side my office so I can go feed her 2 times a day. Last week she was in day care for two days between 9-3pm and I fed at 9, 11 and 1pm during day care hours.

Now here's my problem. Since last week my milk supply is next to nothing. I have a scale at home and I weigh her before and after feeds. She used to take in 5-6 oz at a time. Now we are lucky if she can get 2 oz. most of the time it's just 1oz. I've been feeding her very frequently and pumping a lot. But so far it doesn't seem to help. attached is my schedule from yesterday and so far today. as you can see it looks like my milk supply is getting lower.
She's had normal amount of wet diapers and two dirty diapers yesterday. She came home with a cold from day care (on her second day) this past friday) But she seems to be doing fine now.

I'm in tears trying to fix this supply issue. I've had fenugreek but that gave me and the baby diarrhea but didn't change the milk supply. so I stopped. She seems very unhappy after the feeds. But won't take the bottle. I have about 80 oz of milk in the freezer that i can dip into.
Any advice? What am I doing wrong? How can I get my supply back up? or is it gone for ever and should i train her better on the bottle and turn to formula? not being able to breastfeed is breaking my heart. Please help.

[Fiver]

*hugs* Sounds like you're doing all the right things.  Are you eating/sleeping/drinking enough with being back at work?  Any stress isn't going to help either.

If it was me, I'd look more at wet/dirty nappies and her general demeanour and stop using the scales.  It sounds like they are what has made you think that your milk supply is particularly low (which is actually may not be).

Also illnesses can reduce milk intake, so it may be that she just needs to work on taking a bit more now that she's better.

Looking at your attachment, you seem to be feeding very frequently.  Is she asking for milk at those stages, do you think?  Could you maybe be misreading her cues?  Do you think she could go for more than 1.5 - 2 hours without a feed so she might take more?

[Seyamom]

Fiver..thank you so much for the quick reply. I am feeding frequently now hoping that increased demand will increase the milk supply. I used to feed her every 2.5 hours. But She can't go that long now because she only takes in 1oz most of the time. When she's at the breast she sucks nicely for few minutes and I can hear her swallow. Then she sucks but no swallowing, then she gets upset. Pulls off the breast, sometimes bites. when i offer the breast back to her she takes it happily again but few suckings and she gets upset. her behavior plus the scale make me think i'm low on milk. also i used to be able to pump 4oz after feeding her. now it's just few drops or 1oz the most. Also past week she's only gained half an ounce in weight. her average weekly weight gain is 6oz.
I am eating right, drinking a lot. maybe could use more sleep. very much stressed out because of this supply issue. Her 4 month well visit ( a bit late) is coming up on friday. maybe i can discuss my options with the doctor. but i do not want to go to formula...i wanted to breast feed so badly. now she's pretty much going hungry...

[Fiver]

Have you tried some Breast compression to keep her interested when the flow of milk slows?  Around 4m it is pretty common for LOs to get more distracted and fussy when feeding as the way your body is producing milk has changed and they are beginning to work out that there is a world around them that they want to look at and explore.

Have you tried hand expressing (Instructions on how to express by hand.  It can be a bit tricky at first, but some mums find they can express more by hand than by the pump because of the skin to skin contact and because it milks the breast (in the same way a baby does when they feed) instead of just sucking (which is what the pump does).  A great combination is hand expressing and pumping together so you get both actions that LO performs at the breast.

Do you think that's worth a go for a couple of days to see how you go?

[Seyamom]

I'm already doing the breast compression. But hand expressing is something new to me. Will give it a try. Do you think this is something temporary? Is it normal to see a low supply for a while andthen pick it up? Do you think separation from the baby is drying up the milk? Anything I can do to help in that area while at work? I appreciate your time and advice.

[Fiver]

I truly don't think being away from your little lady is drying up your milk, especially if she's feed as often as she is right now.  What is normal is to see fluctuations in amounts of weight gained.  The centile charts give a warped impression of how babies gain weight, especially BF ones.  They'll often have a steep gain, followed by a slower gain/plateau and then another bigger leap.

There is also lots of information in this FAQ -  "I'm worried I may have a low milk supply"

[Seyamom]

Thank you. I tried hand expressing today. Some milk came out in the beginning. But then nothing after a minute or so. I kept going for almost 10 minutes. although nothing came out. Thought I probably did it right since some milk came out in the beginning. Hopefully things will get back to normal... I'm not ready to give up on breast feeding.

[amayzie]

Hugs hon!! Remember too that pumping 'on empty'- or expressing when there's no milk comig out is great for milk supply also. So don't get disheartened when you are getting nothing as you are still stimulating production...

[eva026]

Could your period maybe be coming back?
I see a huge dip in supply a while before it comes, the first time freaked me out too. Now that I know it happens every month I am able to supplement with my freezer stash.
Also when my milk supply was "established" I saw a pretty big dip and saved myself with fenugreek, I still have to take it 3x a day. You say it gave you the runs but maybe there are some other things you can take, like teas. Give oatmeal a try too.

[Seyamom]

Thank you guys for the kind words. So I was feeding and pumping entire day yesterday. Spoon fed the baby with milk from the freezer at bed time. She wouldn't take the bottle. She was so hungry, it made me cry. This morning she woke me up at 3:30 for a feed and my breasts were full! not engorged but much fuller than they've been in a week. I was thrilled I had to wake my husband up to show him. Fed the baby, I could hear her swallowing happily. She went back to sleep with a belly full of milk. What a feeling! I'm sure I don't have to tell you how it feels to know your baby had enough and happy. Then I pumped  for 10 min (nothing came out for the last 5 min) and I got 4.5 oz from both breasts. Then I hand expressed for 5 min, very little came out.
I don't know what fixed the problem. I had a big dinner last night ( I was going around thinking maybe I don't get enough calories and that's the problem here) maybe it was the extra calories at dinner? All the pumping and feedings? I had butternut squash, has anyone experienced that butternut sq increase milk supply? Maybe it was that? I don't know, but what ever it is I'm one happy mama now! We'll see how tomorrow goes.
few questions:
So..when the period comes back there's low supply for those few days every month? Then it goes back up again?
When you pump, does the timing matter? I mean if you pump at 10 pm does that signal the body to make more milk at 10 pm at night or just increase the overall milk supply?
I know too much of anything is bad for you, but has anyone had any side effects from eating too much butternut squash?

It's 5:15 am, maybe I should go to bed now while the baby is sleeping... thanks ladies..

[Fiver]

I would suspect, if anything, the increased feeding and pumping (and maybe the good dinner too!) made the big difference rather than what you had particularly

You might find this link http://kellymom.com/pregnancy/bf-prep/milkproduction/ interesting to see how your body is producing milk now.

Regarding AF (your period), it does seem to affect milk supply in some mums, usually a few days before and into the first couple of days of the new cycle (you might find this useful too http://www.motherandchildhealth.com/Breastfeeding/Becky/menstruation.html).  However this is not something that every BF mum notices.

[amayzie]

Awesome!! The hard work has paid off!!

[Seyamom]

That,s what I thought too. But i,'m low again. How can it go up and down like this-.  Fed the baby she got 2 oz and pumped 15 min later, I got 0.25 oz. Don't get this. Breast feeding is hard...

[Fiver]

I think sometimes we can obsess about how much/little LO is consuming rather than trusting that our bodies can sustain our LOs as that is what it is made to do.

Because there are lot of mums around us bottle feeding who can see exactly how much their baby is consuming, we get tied up in knots about them eating a certain amount with lots of 'they should be doing this or that'.  BF isn't like that.  You can't see how much they're getting and they alone choose how much milk they need to consume.

Have you thought about weighing a wet nappy instead of baby?  Some HCPs will recommend that if there seem to be issues with how LO is feeding.  You'd probably need to change LO before a feed, weigh a dry nappy and then wait for a period of time afterwards (possibly until before the next feed), weigh wet nappy and deduct the difference.

FWIW, I had a BIG wobble around 4m about how much milk I was producing.  I have an IRL friend who is a BF counsellor who constantly reassured me that I had enough milk and was doing a grand job.  DD is now just over 2yo and we are still doing a single BT BF.  My milk was and is good enough and plentiful enough for my little girl and so is yours.  You CAN do this.

[Seyamom]

Thank you so much for the encouraging words. I'll try to relax and let her decide how much she wants to eat. Will continue to pump until her cold is gone and she's able to suck better . Gotta admit I HATE pumping.