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Milk production
I had every intention of breast feeding but it hasn't worked out - although I am still trying but my daughter (6 weeks) is basically formula fed and just has very small amounts of breast milk every day. I really want to increase the amount of breast milk she gets but my problem is that I don't think I am producing anywhere near enough milk for her, which results in her getting frustrated at every attempt at breastfeeding or me spending hours and hours every day expressing (and this is becoming less realistic as she spends less time asleep during the day and requires more and more of my time).
Since her birth I haven't experienced leakage from my breasts or ever felt a 'let-down' sensation while feeding and when expressing I vary rarely produce a significant amount of milk (usually only enough drops to just cover the bottom of the storage pot). I know that breast milk is produced on a supply and demand basis, but even when I express frequently throughout the day the supply doesn't seem to increase. Does this mean that my milk supply has reached it's maximum and this is the most I can hope for or is there anything else I can do to help increase the supply?
Any advice would be much appreciated.
K.x
Since her birth I haven't experienced leakage from my breasts or ever felt a 'let-down' sensation while feeding and when expressing I vary rarely produce a significant amount of milk (usually only enough drops to just cover the bottom of the storage pot). I know that breast milk is produced on a supply and demand basis, but even when I express frequently throughout the day the supply doesn't seem to increase. Does this mean that my milk supply has reached it's maximum and this is the most I can hope for or is there anything else I can do to help increase the supply?
Any advice would be much appreciated.
K.x
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Replies
In the topic Mixed Feelings (below posted by renri) Mrs Setters has put some tips on for increasing supply.
HTH
H x
First of all congratulations on your daughter, and well done for continuing to try to breastfeed under trying circumstances.
Lots fo questions for you!
First of all, a nosy question but do you suffer from any known ongoing health conditions - PCOS, diabetes, thyroid problems?
Secondly, talk me through your 'feeding day'. How often do you put yhour baby to the breast, how many times do you express (and when in relation to feed), are you topping up with formula at every feed time, and how is your daughter fed (bottle, cup, syringe etc and if bottles, what brand?). Are you feeding to a routine or schedule, or following her lead, and how often is she demanding feeds? How much formula does she have per feed/day?
How do you feel she is expressing her frustration, what makes you think she is hungry? What does she do? How well is she latching on and feeding, how long does she feed for, and does she take both breasts at a feed before being topped up?
One thing is that feeling of fullness/leaking; feeling a let down, and amount expressed either by hand or pump are NOT indicators of supply. You can work to increase your supply, and these things may not change! Some women don't ever feel fullness or let down, and some just don't 'express' well, even if they are producing ample milk for their baby's needs.
There are things you can take, both herbal and pharmaceutical, to boost supply, but other natural things you can do are eating plenty of oatmeal - try having porridge for breakfast daily - and staying well nourished and hydrated. If you are thirsty you are already dehydrated, and whilst pushing fluids to excess won't increase an ample milk supply, dehydration can definitely negatively impact your milk production.
I try breastfeeding at every feed (which is roughly every 3 hours at the mo) except the 4am feed as my husband does this feed (his daddy & daughter time!). She struggles to latch effectively, often not opening her mouth wide enough. When she does latch on, she will often suck for only a minute or two before pulling herself off the breast. We keep trying this for about 20mins (more or less depending on her temperament at the time) and try both breasts before resorting to the bottle.
If my husband is around, he will then do the bottle feed whilst I express, and if he is at work then I express once she has had her feed (if she is asleep or settled - otherwise I don't get the time to do it). We use the Tommee Tippee Closer to Nature bottles as they said that these made it easier for babies to switch between bottle and breast.
We are feeding on demand and she has a formula top up at every feed - usually between 90ml and 120ml per feed and she usually feeds roughly every 3 hours (although last week she had a growth spurt and it went up to about 150ml per feed but she has gone back to usual amounts now)
When she is attempting unsuccessfully she shows her frustration in a number of ways: her latching becomes less successful than normal, she takes herself off the breast more frequently and then eventually refuses to re-latch (pushing her head away from the breast and screaming).
I have tried breastfeeding before she shows signs that she is hungry, at the first signs of hunger and when she is really hungry and has waited for a while (this last one was at HV's suggestion and I felt so mean doing it that it only lasted a couple of feeds!).
I think that's all your questions answered and I really appreciate you taking the time to try and help.
Thanks again
K.x
I should probably point out that I am an enthusiastic amateur but I'm NOT a qualified breastfeeding counsellor. If you've not sought the help of a good one I would advise you ring the postnatal ward of your local hospital and ask if there is an infant feeding, lactation or breastfeeding specialist that could come to see you, as nothing really compares to in-person help and observation.
I'll also say that 4 weeks ago, I was exactly where you are now, and my DS is now entirely breastfed apart from one bottle of formula in the evenings, which we are weaning him off slowly. You CAN do it, as can your DD, it just takes infinite calm patience to get there. Just wanted to give you a bit of hope!
It sounds to me like there are 2 things going on - your DD has been slow to learn to latch and feed effectively; and also due to the bottles has developed flow preference. Absolutely what we went through.
As to what you can try - lots of things. I wouldn't recommend trying them all at once, but see what ones might work for you and give them a go. If they don't work, you're free to discard the idea and try something else.
We started with the CTN bottles, and recently made a switch to Breastflow bottles, and his effectiveness at the breast has increased dramatically. They take some getting used to, and he hated them at first because they aren't as *easy* as the CTN - but it's that ease that has created a problem, with most bottles the baby doesn't have to work for the milk, it just glugs down. This creates flow preference - they COULD get milk out of the breast but they fail to see why they should make the effort when bottles are easier. The Breastflow bottle seems to make them work for the milk, and certainly helped us. If you want to try them I'd suggest getting just one to see if your DD will tolerate it. Then when you want more, try the baby section in TK Maxx, they are less than half the price if you can find them in stock.
My other magic tool has been a Medela Supplemental Nursing System. They look bizarre, they can be hellishly fiddly if you aren't used to them, but they provide a way of your baby getting the top up whilst at the breast. This can forestall the fussing which starts when they realise that milk isn't going to glug freely down their throat, and as long as she has a halfway decent latch she will start getting supplement out of the tube immediately. Giving supplement at the breast acheives the very best kind of breast stimulation - that from a baby, rather than a pump - and will help to build your supply as part of that magic feedback loop that governs supply and demand. It also helps the baby to learn that nursing at the breast will bring milk - they learn to trust breastfeeding. Having the baby at the breast feeding and getting satisfaction will also help YOU trust breastfeeding again, because problems like these can really shake your confidence in it. I've used my supplementer on two babies and I think it's a great bit of kit, but again it's obviously up to you whether you want to shell out on one to try.
There's the option of just keeping on keeping on - some babies just take longer than others to 'get it' and yet one day just magically latch on and feed as if the preceding weeks of hell were all in your head. This is what my DS did, little bugger! If you do keep trying, I would advise you to ignore your HV and never try to 'starve' her into feeding - she will be too frantic and distressed to latch effectively. It's not that she WON'T feed properly, she CAN'T, for whatever reason, so I'd stick with trying her at the breast as soon as you start observing hunger cues but before she's crying for food. Take her away from the breast and offer the bottle as soon as she shows any distress - all this will help prevent creating an aversion to the breast. Try again next feed.
There's a really interesting method of supplementation here that you might want to have a crack at if you're going to carry on trying without a supplementer:
http://www.lowmilksupply.org/finishatthebreast.shtml
We did some feeds in this manner and I think it did help him find the comfort side of breastfeeding, because even after his evening bottle I now have to latch him onto the breast for him to go to sleep! You could also try sating her hunger with maybe 1oz of formula, then trying to feed her at the breast, then finish off the rest of the bottle afterwards. See what works for you.
There are always nipple shields - but if you're already worried about supply they aren't going to help matters. If you do use them, it's essential to pump afterwards, letting the pump run on for 5 minutes after the last drops of milk have come out, to stimulate your breasts - nipple shields can reduced stimulation and interfere with the supply/demand process.
Sorry if this is a bit incoherent, I'm quite tired and and just randomly chucking out ideas as they enter my head! I will think on and see if I can come up with anything else that might help.
In the meantime these might be both helpful and comforting - tink-a-belle these are the links I was telling you about too:
http://www.kellymom.com/bf/concerns/baby/back-to-breast.html
http://www.normalfed.com/Help/babyget.html