Pls help-starving 6 month old and serious supply issue.Apologies,this is LONG!.

[Jusser]

Really hoping someone can help me here, I am desperate !  Having posted both on the naps board and the solid food and weaning board, I am now realising my LO's sleep/wind problems are related to the BF.  We have enjoyed 6 months of BF, complemented by 1 formula bottle from 4 months and solid food from 5 months.  I have a very hungry baby !  Here is the problem.  My LO is not settling for naps due to excessive wind and/or waking after 30 minutes needing to be burped (after maybe 30 minutes of winding him before putting him down).  At night it can take an hour and a half for him to finally settle down having put him down and picked him up several times to burp him.  The reason I posted on the naps and the solid food boards was because I thought he had some kind of intolerance to either my breastmilk or the solids, but now I am realising, hopefully not too late, that he is taking too much foremilk. In the last week or so he will only feed when the milk is flowing fast, i..e the first 5 minutes, then he breaks off and starts messing, blowing bubbles etc. I would switch him to the other side in the hope that once he has taken the foremilk from the other side he may stay on or switch back once he is almost full.  However a lot of the time he will only feed for 5 minutes each side.  I was taking it that he was satisfied (he wouldn't be crying but he is an Angel and doesn't really cry much) and carrying on with the routine, trying to put him down for a nap after 2 hours or so.  At nap time he would scrunch up on me and fuss and cry and I assumed it was just wind, but even after winding and knowing he is tired he would still fuss.  It is only recently that I have realised he is actually hungry again, so I feed him again but it still doesn't seem to satisfy him.  In the last 2 days I have tried to increase my supply by pumping an hour after each feed but I literally get less than 1/2 an ounce.  I think because he has only been taking foremilk and not staying on for the hind milk, my supply has really dwindled and also too much foremilk has caused his excessive wind.  Also he is getting hungry again really quickly because he is not getting the hindmilk.  Yesterday I HAD to give him a bottle of formula in the day and eventually he settled for his nap.  This morning the same, I first tried settling him at 9.30 and after putting him down and picking him up several times I pumped (got less than 1/2 ounce) and gave him 6 oz of formula which he guzzled down.  He is now sleeping. 
My main problem now is how do I increase my supply?  Feeding on demand doesn't work because LO won't stay on long enough to stimulate.  Even if I pump an hour after feeds how do I get him to feed for longer when he does feed?  I feel like it is a vicious circle - I know supplementing bottles can interfere with breastmilk supply, but only if your LO will actually BF properly and for long enough.  To get into a routine it would be very tempting to wean him to formula but I really DO NOT want to do this.  Our BF relationship has survived me being in hospital for 4 days when LO was about 3.5 months - despite everyone assuming I would give up, and I feel very strongly that BF is the best milk for him and really want to continue until he is a year old.  But can I ? .  It is the worst feeling in the world that you don't have enough milk to feed your baby.
Sorry this is so long, hopefully there are some BF pros out there who will have some ideas for me....
Tks

[MelissaS]

Oh my gosh!!!! You poor person - I almost cried when I read this email as it brought sooooo many memories back for me when David was young.

I still get guilty pangs every now and then remembering when he was young - I also did not realise his crying and lack of sleep was all hunger related. I was breastfeeding (still am) and always received comments that David was smaller than a lot of other babies. I was demand feeding (as I received lots of pressure this was the way to go) I also tried EASY. But in the end the ESAE ended up working for us and built up my supply with approx gap of 3 hrs apart. We still had to really up the solids as well (things like yoghurts and porridge) to help fill his little tummy up.

One more thing I just remembered - when I was demand feeding (probably about 6-7 times in 24hrs) my breasts became REALLY REALLY sore and felt empty for days and David was not satisfied at all. I found not breast feeding for one day (just formula) worked in getting my supply back up then I went onto the ESAE I mention above and that seemed to work.

He is perfectly happy now and we have a great relationship breastfeeding only 2-3 times in 24hrs now, solids and also full cream milk.

I hope you don't mind me writing to show a huge amount of support for you but don't feel I am able to give advice as I am not sure if I would be able to help with supply, I just found if I left longer gaps between breast feeds my supply really filled up.

I am sure you will receive lots of support and responses - I would be VERY interested to hear different ideas because of the similar situation I went through.

HUGE HUGS TO YOU!!!!!!!!!

[squeaky's mum]

Hello,

Firstly I think you are doing a fantastic thing for your lo in trying to see this through. I also experienced major problems with bf and can understand the conflict between giving formula or not.

I have a couple of thoughts, although I am not an expert.

As your lo is now 6 months old would it better to focus on increasing the amount of solids in his diet and making the breast milk his secondary source of nutrition? This should help address his hunger and mean increasing your milk supply is not so much of an issue. Once my lo start eating 3 meals a day her daytime bf decreased dramatically. Now (she is 7.5 months) we only have proper bf on waking, going to bed and dream feed and I fully intend to continue feeding on waking and going to bed for as long as she wants it. I also offer her breast after each meal, but she rarely wants more than 2-3 minutes. The rest of the time she drinks water through the day.

If increasing the amount of solids works, I hope that the stress of bf is taken away from you and lo as he is less hungry. Bf can then become much more of a bonding/relaxing time for the both of you and hopefully the length of time he feeds increases as he makes the transition from feeding for nutrition and calories to feeding for comfort and winding down.

I am sorry I cannot be more help. I really wish you the best and think you have done so much already by bf until 6 months.

Good luck

Claire

[Samuel's mum]

Hello. I'm so sorry you are having a difficult time.

My first thought is that he has become impatient with the slower milk flow that happens when the foremilk has gone and it becomes thicker and fattier. If you are using bottles this isn't uncommon. I would experiment with a slower nipple on the bottle so things are more 'even' and he realises it may be worth working for milk. The bottlefeeding board may give you some more tips about bottles teats.
This is something else that struck me - YOU MUST'NT take pumping yield as an indication of supply. Honestly. You've probably heard this in other places and it really is true. Have a look at this link about milk supply.
http://www.kellymom.com/bf/supply/low-supply.html

Finally I really would urge you to get advice from a trained breastfeeding counsellor or lactation consultant. On this board we all mean well and it can be a fantastic resource but most of us are not trained professionals. Speaking to someone need not cost money other than the cost of a phonecall. There are links at the top of the board and you could also speak to a La Leche League volunteer in your area or not too far away.

http://www.lalecheleague.org/leaderinfo.html

I really would urge you to do this as the decisions you make in the next few days will affect whether you are able to breastfeed in the future. I don't mean to sound like a drama queen here! With your obvious dedication these problems can be fixed. I wish all the best with moving into the future with a happy solid food eater and milk drinker. Your baby is very lucky to have had a persevering mummy for these past 6 months. Good Luck.
P.S I've also sent you a PM.

[daisymelan]

{{{{{{hugs}}}}}}

You sound like you are working very hard at giving the best to your lo. 

As mentioned earlier, pumping isnt' a true mark of how much you are actually producing. 

The simple things like drinking lots of water and getting plenty of rest will help you as I'm sure you realize. 

I don't have much advice, just wanted to offer my support and tell you that you are doing a wonderful job. 

Again, {{{{{hugs}}}}}

Editted to add:  At your los age, bfing should still be the #1 source of nutrition. 

[The Vern]

My lo is about 6 weeks old and as I have been having low supply issues since her birth, my lactation consultation recommended the following: 
3 capsules, 3 times per day of Fenugreek
3 capsules, 3 times per day of Blessed Thistle

My M.D. also prescribed Domperidone (Canada), which is actually a drug to increase intestine motility, but has as a side effect to increase the hormone prolactin.  This drug has been deemed perfectly safe for infants and mother.  I started taking the drug at 2 weeks and saw good results within 2 weeks. Now I get total from both breasts about 2 oz each time I pump, in 10 minutes. Not great, but considering I got less than 1/2 oz combined at first, I'm happy with it. (my supply issue is due to having had a breast reduction 15 yrs ago btw).

I was also told to try to pump immediately after you have bf you lo to provide additional/longer stimulation, as well as what you are doing, in between feeds. It's a lot of work, and kudos to you for wanting to keep at it. 

Don't know if this info will help you but at least  you can start a discussion with you L.C. and/or M.D.

Good luck.

[Jusser]

Hi everyone, thanks so much for all your words of comfort and advice.  I am going to call a lactation consultant tomorrow, the reason I haven't done this already is because I felt LL would frown on my use of bottles ! Will also head to Health Food Shop for the Fenugreek and Blessed Thistle, I was going to do this today but since our routine is so haywire I ended up house-bound concentrating on naps/pumping etc.!  Samuel's mum it's funny that you mentioned changing the teat, I did this tonight, I put him on the newborn teat and he didn't take the full bottle - must have been too much like hard work - typical man  .  Daisymelan and Samuel's mum, I know what you say is true about pumping only being about 60% of what the baby would get, but when I was in hospital I was pumping at least 4 to 5 ounces a session and about 7 in the morning.  I really feel empty the last day or so, I know I am not producing as much as usual. Of course, anxiety doesn't help either so I have to try to relax about it.  Hopefully the combination of the supplements, plenty of water and the expressing between feeds (and I will keep him off the bottle during the day in the meantime) will help me along..... It's great to have everyone's hugs. thanks.

[Samuel's mum]

Great to hear you are getting sorted very soon. Good luck. I hope you are able to find a breastfeeding counsellor you can really connect with. You are obviously committed. Let us know how you get on!


Oh and here's something from kellymom about 'feeling full':


The feeling of fullness (sometimes even engorgement) that nursing mothers notice during the early weeks of breastfeeding is really not the norm at all, but means that mom's breasts haven't yet adjusted to the amount of milk that baby needs. At some point, typically around 6-12 weeks (if a mom has oversupply it may take longer), your milk supply will begin to regulate and your breasts will begin to feel less full, soft, or even empty. You may stop leaking, you may stop feeling let-down (or feel it less), and if you pump you may notice that you're not getting as much milk. This doesn't mean that milk supply has dropped, but that your body has figured out how much milk is being removed from the breast and is no longer making too much. This change may come about gradually or seem rather sudden. Many people are not aware that these breast changes are normal because so many mothers stop breastfeeding early on and never see this change (or mistakenly interpret this change as a sign that milk supply has dried up and wean because of this change).

[Engorgement] is caused by congestion and swelling of breast tissue as blood and other fluids begin to
acc umulate along with increased milk volume in the alveoli as milk production begins. It's not just about being 'full of milk'.

[jennas mommy]

My doctor gave me a prescription for REGLAN (I got the gerneric of it though) which is suppose to increase milk supply.  She also said that if you aren't getting extra calories, this will have an impact on your milk.

[deenz]

Also - if you have not been keeping up with the pumping, then that also has an impact on how much you can pump.  I think your body gets used to how the pump works if you keep up with it.  I know with dd1 I pumped in the beginning, and then stopped.  Then at 6m I wanted to pump again to get some bm to mix with cereal - I could not get more than a few drops!  And I know for sure she was getting much much more than that (dd1 was exclusively bf til introduction of solids at 6m, and she's still having 1 feed per day now at 24m).  I just couldn't get a let-down with the pump anymore.

Also at 6m, milk is still the most important food for baby, so they should be bf before solids, so that they don't just fill up on solids (at least that is the guideline here).

[Samuel's mum]

Hello all
After a little chat the moderators would like to add a comment to this thread. We would like to politely disagree with some posting above. Although it was written with the kindest intentions we feel it was potentially misleading.
"The Womanly Art of Breastfeeding" by La Leche League International says "The more the baby nurse effectively, the more milk there will be. Understanding this 'golden rule' of breastfeeding is the key to an abundant milk supply and a contented baby. Years ago, mothers were often told to wait four hours between feedings so that their breasts would 'fill up'. Many a mother and baby had a short-lived breastfeeding experience due to this well intentioned but erroneous advice. It is now well understood that milk is produced almost continuously, and that the more often and effectively the baby nurses, the more milk there will be. Thus, the mother of a baby who is nursing every two hourss will have a bountiful milk supply, while the mother who is trying to 'hold off' the baby and nurse only every four hours will have considerably less milk. Frequent and effective sucking at the breast signals the mother's body to produce a correspondingly increased amount of milk."

If you'd like any more information on this comment please contact one of the moderators or The La Leche League directly.
Thank you.