Single side feeds and other issues

[MackMum]

I've got a couple of questions. First is that I would like to go back to single side feeds, to give me the option of being able to give my LO the other side if he's still hungry. I did managed to do this a couple of times before he was about 9wo. I got engorged and then one side was enough to satisfy him. But we only managed to keep this up for about half to one week before he started creeping onto the other side for longer and longer .

I boosted my supply a bit a week ago, and got pretty full again, but my LO has been such a fussy feeder that he went through a spell of not taking much during the day and tanking up bigtime during his nighttime feed. Also I didn't feel like I had managed to produce enough on one side to satisfy him even though I felt pretty engorged.

So, I'm wondering how best to get back to single side feeding and how to keep it going. Any suggestions?

Also, I've noticed that my right boob seems to consistently produce significantly less than my left. How can I boost production on that side?

And my supply noticably diminishes quite a bit as the day goes by. I've taken to pumping leftover milk in the morning to top him up by bottle at bedtime. Is there a way to increse supply in the evenings without that meaning I get too full overnight?

[First Time Mom]

From my understanding supply=demand so I would stick with offering both sides at each feed otherwise the breast is going a long time without a signal of needing to replenish the milk supply. A feeling of "fullness" doesn't mean lots of milk, it means more foremilk so when you feel empty in the evening you actually have less foremilk but still enough hindmilk.

If you are bfing and pumping in the morning your breasts are receiving a signal that they need to produce that much, if you are offering the bottle of ebm at night and not bfing then you are not going to "make" more milk in the evening. If you offer the top up by bottle I would pump at that time if you want your supply increased in the evening. Not sure if you cluster feed or df but that's a good way of tanking him up as well.

The best way to increase supply is to nurse more often or longer. It's normal for one side to sometimes feel like it has more, if it does then los will nurse longer at that side and stimulate the need for more at that side. In the past when my dd favoured my right side I would put her back on the left when she was done to nurse a while longer to stimulate the left.


If your lo is fussy from a slow letdown perhaps pump initially to get the flow going. Otherwise I find it helpful to feed in a quiet area with no distractions and when possible, laying down as I find my dd nurses the best then.

[MackMum]

Thanks for the quick reply!

My problem is that DS doesn't usually like to nurse when there isn't much left, so he doesn't stay on long enough to stimulate more milk. He starts repeatedly bobbing on and off till my nipples get too sore. (he's a generally fussy eater - plus we have reflux issues).

That's very interesting to know that the engorged feeling is usually mostly foremilk! So how do you boost hindmilk production too so that you end up with a 'well balanced meal' but more of it? Can you?

I top up DS by feeding him at 6pm and then again at 7pm. I've been pumping the 6pm feed and feeding it to DS by bottle (to teach him to take bottle too - it's early days and it's still a battle  ) After his bath I top him up at 7pm, feeding him the expressed morning milk, sometimes mixed with formula if I didn't get much in the morning. I do this cos he usually takes 150ml (eventually) by bottle whereas I can only pump a max of 90ml (over both boobs), and that's at about 7:30pm (after I've put LO to bed) so that's given my boobs an extra half hour to fill up again after the 6pm feed. I'm hoping that by pumping that bedtime feed I'll be able to increase my supply at that time of night.

In the morning when I've pumped and fed by bottle instead of bf (to see how much I had) I could get about 200ml - the 6pm feed is usually a max of 120ml so that's a significant reduction! And there's usually about 20-40ml less on the right, regardless of which one I pump first. So according to what you said, I should pump the right after each feed to try and boost supply on that side (since LO won't usually stay on after he's started scraping the bottom)?

[Samuel's mum]

I would have to agree with the previous poster:

From my understanding supply=demand so I would stick with offering both sides at each feed

Although Tracy advocates single-sided feeding to start off (which I did happily), even she assumes most people will move to double-sided. In the first book on p.116 she says it usually happens by the time the baby is around 12lbs. If a mother has any concerns about supply then the LLL would be very adamant that double-sided feeding is best (actually they are fans of it for everyone). I would say your LO has naturally shown he is ready to move to 2 -sided.

Can I just question an assumption you have:

given my boobs an extra half hour to fill up again after the 6pm feed

Boobs actually don't fill up as you describe nor do they store the milk from feed to feed. The milk is manufactured during the feed - a very small initial amount is held in the ducts but it really isn't much (and was recently discovered to be even less than we had previously thought - research done by Peter Hartmann in Aus. in 2005).

If the milk was held in the breasts as many imagine then breast size would be a much bigger factor in successful breastfeeding.  Some engorgement is caused by the milk ducts becoming distended but this is a small amount of what your baby will actually take in during the feed. Many women experience no engorgement at all between feeds. If breasts did 'fill up' then the blanket advice given by medical professionals in the 1970s (certainly in the UK) of everyone starting on 4 hr cycle for newborns wouldn't have had the devastating effect that it did on people's supply and ability to breastfeed.

Breasts are all about supply and demand and what's been demanding of them previously as the pp said. Your breasts are accustomed to manufacturing less later in the day because that's what has been asked of them but also because that's the way pretty much everyone's supply works. It's why cluster feeding in the evening is a natural pattern for very young babies. It explains why after a good night's sleep our supply is back up - breasts flag as the day goes on!

I'm hoping that by pumping that bedtime feed I'll be able to increase my supply at that time of night.

You are right to think that by increasing demand you can adjust your supply but a pump isn't exact in reproducing the baby's milking action (the wave like motion on the underside of the nipple) so it doesn't do the job exactly and not everyone is able to solve the problem of the evening supply dip.

I've been pumping the 6pm feed and feeding it to DS by bottle (to teach him to take bottle too - it's early days and it's still a battle  )

If your evening supply is an area of concern then I think it might make more sense for you to try to move your pumping earlier in the day and having as much natural feeding later on (i.e. with his milking action.)

I know this is all extra hard for you because you are concerned about his bobbing on and off which doesn't make things easy but his feeding is still more effective than a pump - you could always offer the breast first and then top up with what you've expressed earlier (which you would need to do initially anyway if you did make the move)!

I should also mention that you are getting a lot when you pump !! 200ml is a heck of a lot.  It's not uncommon for mums to find that pumping output does decrease as their babies get older and their breasts are more intelligent/ used to baby's milking action. Some mega-pumpers have no change but some people do settle down at around 2-4oz especially around the 3/4 months mark.

It's very normal to have slightly different supply in each breast - infact it's rare to have exactly the same. You could certainly try and pump more on the right after a feed.

I've said a lot of different things there - In summary!!!:
Certainly pump to increase supply but also understand the 'importance' of natural feeding to regulate supply.
You're normal with regards to the evening dip and uneven boobs.
I would stick with double-sided rather than attempt to revert back.
Do ask someone about the bobbing if you do feel it's really making a difference to life (I know I'm a nag)
Have you found someone to help with the reflux?

It sounds as though you are working so so hard to make this a success. I know your LO will reap the benefits even if some days feel tough. I do think your first stop is trying to get to the root of his bobbing and then the supply questions may fall into place.

[MackMum]

Bother! my reply disappeared. Nevermind, I was saying thankyou very much for all those useful facts. I'm so pleased to hear that double-sided is the norm after a certain age, I've lent my book to a friend and could only remember Tracy talking about single side feeds. So, I'm very happy to stick with double sided.

I was assuming that it takes time to 'refil' the boobs cos I'm sure I'd read somewhere that within 1hr of a feed you've produced half the amount you had available at the last feed (assuming you're feeding 3hrly). Also I'd noticed that if I pumped after a feed, I'd have to wait a good 2hrs before I had the same amount available that I had at the previous feed (if I'd pumped instead of nursed). I also thought that cos I seem to get one main letdown, at the begining of the feed, where the bulk of the milk is available- as if it had all been sitting in the ducts waiting to be let out (it's quite intense and verging on uncomfortable when I letdown). then the flow slows more and more. If DS stays on (rare) for over 10-15mins after the flow has slowed right down (ditto if I pump that long) then there;s sometimes another small and short letdown but it's not much, then back to next to nothing - I can hear this happening with DS's swallowing patterns too.

I doubt I will be able to solve the problem of the eveing supply dip - I've tried for weeks to pump after the bedtime feed to stimulate more but it doesn't seem to do much, and I can't ger DS to stay on long enough to stimulate more. So for the moment I'm trying to get him to stay on longer for each of his daytime feeds so that he won't want so much at bedtime and will (hopefully) go for longer stretches at night again. People have suggested swapping back and forth between boobs, but unfortunately once DS has come off one side, he's very hard to put back on it again for that feed 

I have been doing all I can to work out this bobbing on and off. Sometimes it's cos he's trying to do a poo, sometimes I wonder if it's his guts spasaming a bit, sometimes it's distraction, sometimes I think the reflux probably has an effect, and sometimes he's just had enough - so between any of those, and sometimes a combination, it's very hard to figure out the problem !! Anyway, I'm happy to keep persevering cos when a feed goes nicely it's really enjoyable for both of us 

[magda1461]

Just a quick question, is your fluid intake adequate. I found that I had to drink plenty of water throughout the day so that my milk was sufficient, as between wk6-7 LO was eating every 2hrs...
I found that the key was drag her out to 3 -3.5hrs after each feed to ensure my breasts increased milk supply, and then LO only ate one side, and nuzzled other, so I expressed that breast, increasing the supply and alternated boobs after each feed!
NOw my 9wk eats only 1 breast every 3 -3.5hrs, and is full, so i ensure i pump the other out, also remember you can combine the milk after each pump even if its a small amount, and top him up for the lsat night feed.

[Samuel's mum]

You certainly have milk waiting in the ducts - but it's just nothing like the 'full amount' of the feed.
Flow certainly slows down but that's partly because the hindmilk moves much more slowly due to its high fat content and the fact its literally thicker.

There's some good stuff to read here:
http://www.kellymom.com/bf/supply/milkproduction-faq.html#refillmyth

Some of the stuff on this site about milk production gets very technical though.

I think the main reason to dispute the 'filling up' theory is incase people don't appreciate that increased demand = improved supply. The absolute last thing you want is a new mum feeding less or even supplementing in the belief that will help her supply increase or build up. I did once read someone on this site using formula to "let her boobs fill up"!!!!!!!!!!!!

However it doesn't sound like you are anywhere near doing this so just keep on feedin' 

Apologies if I focus too much on the technical - boobs are fascinating!

[MackMum]

I'm a very technical person too so thankyou for all that info! I always like to know the reason behind things and how things work - you're right, boobs are quite fascinating things! In fact I'm really astounded and proud of what my body has shown me it can do through all this pregnancy and child rearing experience.

I do have to work at keeping my fluid intake up - I try but I easily forget so it's probably not as good as it should be. It's winter in NZ at the moment so I never feel like drinking heaps of water - tend to want hot chocolates etc instead 

Don't worry - I certainly didn't think that feeding less would increase supply! Just in the past couple of days all that pumping has paid off and my general supply seems to be meeting DS's needs better - he's feeding less at night (he's gone 10hrs at night for the past 2 nights) and eating better during the day  so things are looking up.

Thankyou very much for your help - I'm off to read the technical stuff now 

[Samuel's mum]

Just in the past couple of days all that pumping has paid off and my general supply seems to be meeting DS's needs better - he's feeding less at night (he's gone 10hrs at night for the past 2 nights) and eating better during the day   so things are looking up.

Fantastic news!!!

Mmmm. Hot chocolate. How about a really big one! We've been in 34 degree heat over here! What happened to the rainy London thing!

[MackMum]

Just read all that info on the Kellymom site - fascinating! Lots of questions have been answered from fat content to how breast regulate supply - by far the most interesting article on breast feeding I've read. Thankyou!