A Tricky Situation

[roseola]

DD just turned 6 months; she has been STTN for a while.  She had been waking 2-3 times a night previously, and on the advice of our baby nurse I pumped a bottle one night instead of BF’ing and she drank 8.5oz. The baby nurse said what might be happening was by the end of the day my supply was not enough to get her through the night. But knowing that she had such a hearty meal, the nurse believed if she woke she was not hungry.

Since then I have been BF’ing her before bed and then giving her a bottle of expressed milk. She was taking less and less. It went from 6oz to 3.5-4.5oz every night (plus a BF). She STTN almost every night.

She just got over RSV and a subsequent ear infection, finished her Abx 2 days ago. She lost weight during her illness, which is typical, but has now increased her bottle intake at night probably to catch up on her weight. Well I am unable to keep up with expressed milk. I have a store in the freezer that is about a month away from being finished because I take about 3oz from it daily.

I am trying to figure out a plan when my stored milk runs out and I cannot offer such quantities of EBF every night.

I feel like my options are:

1) start feeding her in the night again if she wakes (ahhhh!!!!!)

2) give a few ounces of formula at night - this really, really doesn’t sit well with me and I’m not sure it is a real option for me, but I know it is an option.

3) ***Increase my supply – this is my ideal of course! I’m using a hospital grade pump (through insurance thanks to Obamacare), today I started to increase my water intake, I’m thinking of Fenugreek but really know nothing about it.

Any other ways to increase supply? Should I go back to feeds every 3 hours? Change position? I always feed lying on my side. She seems to give up sucking as soon as it becomes harder work.

What would you do?

TIA!!

[Erin M]

As far as increasing supply, you might check and make sure that your calcium intake is ok -- that can make a difference - as well as making a conscious effort to drink and eat enough at the end of the day. 

As for the waking, my first inclination would be to drop the bedtime bottle and see what happens -- it's quite possible that she might sleep, or she just might wake once during the night (all of mine were doing a dream feed or a dream feed plus a night feed at that age) which might not be fun since you've gotten used to her sleeping through, but one feed might be doable.  If she wakes multiple times then I'd probably look at other causes as well. 

[Saskmom]

I found the fenugreek did work to increase supply, I still didnt have enough to keep up with lo but it probdbly doubled my supply rather quickly

[roseola]

Erin - I would drop the bottle, but I'm worried about her recent weight loss and if she's trying to catch up right now.

Saskmom - did you use a recommended brand?  What form does it come in?

Thanks!!

[Lewa2]

Hi Nini, I breast and bottle fed DS1 for 7 months, so you can definitely mix feed! I also gave DD the odd bottle of formula if I felt she needed it (or I needed a break). If it is in addition to your normal bf'ing (to catch up the weight loss) , I wouldn't think it would be a problem. Kellymom website has great ideas about supply boosting as well.

[malenka]

Nini, DD had RSV as well and lost half a pound will her illness. Since she's been sick, her sleep has been terrible and in the past week or so, she's been waking every 2 hours. Sometimes I manage to resettle her (gas trouble, paci, etc) but most often, I've had to feed her. I think she was trying to regain her lost weight. The past couple of nights, she's only woken once in addition to her "dreamfeed" (which she's also waking for), so I'm guessing that when she's back up with her weight, that feed will gradually drop off as well.

All this to say, I would have patience for a week or so and feed her at night if she's waking for it. After such an illness, she's probably just catching up. Once her weight is back up, I bet her NWs will gradually drop off and she'll go back to STTN.

During the day, I would keep the feeds spaced out to encourage her to take a proper feed instead of snacking. With DD, I was trying to feed her more often to help her gain back her weight, but I think it was backfiring on me as she wasn't eating well at the feeds and was waking a lot at night. I think I was basically encouraging her to "snack" around the clock. The past couple of days I've done the opposite and pushed her out to 4 hours for the most part (we've never gone that long between feeds before) and she's been eating better during the day, and waking less at night.

[roseola]

That's the thing Meredith, she hasn't been waking at night, and I attribute that , probably incorrectly, to the bottle I give after her BT feed.  I have been decreasing the amount in the bedtime, after BF, bottle. Last night was less than 4oz and STTN. I'm going to decrease gradually to zero. I'm trying breast compression too, and I think I will try fenugreek because I find it really helpful to have milk stored so on occasionI can skip a feed. I'm also making sure I take my daily calcium and drink water. We go back to doctor in about 3 weeks for the flu booster and to check her weight, which of course I am stressing about, but I'm a stresser!

[lauradj]

I take fenugreek and I noticed a huge difference right away, I was back up to what I used to be literally within 12 hours.  However, as a PP mentioned, it hasn't been enough for me and I do now have to give a bottle of formula at DS' second to last feed of the night before BT.  I do that because his weight keeps dropping and because he was getting fussy at his last feed of the night because there wasn't enough milk after the first cluster feed 1.5 earlier...does that make sense? 
As my sister said, you do what you have to do to make sure your baby is healthy and that's all that matters.  If you need to give one bottle of formula, so be it.   

[Saskmom]

I can't remember the brand I used, but it was in pill form. I went slightly above the recommended dose

[roseola]

I should have know while I was writing she STTN, that she wouldn't STTN!

DD woke up last night and I was going to feed her, but I had had some wine and my BM tested + on the alcohol test strips. I was in the process of defrosting a bottle and she fell back asleep. She wasn't awake much longer than 30 min total. This makes me think she wasn't waking from hunger, maybe just a random NW....FX!!