Breastfeeding help needed from some experienced Mamas

[Puppmom]

Ladies who EBF, I need some help. Our son is 4.5 months old and we have a bit of an issue with his nursing schedule. He is getting BM exclusively now – two bottles while I’m at work and I nurse the rest of the time (usually 3 feedings per day). Over the past few weekends, I’ve noticed a weird pattern developing. He nurses 7 or 8 times to his normal 5 feedings. Three of these come between 5pm and 11pm (and he even woke up during the night once - oh, the horror!). Last night, for example, he nursed at 4:00, 5:30, 7:00, 9:00 and 11:00 after nursing at 7:30 am, 11:30am and 2:30pm which is his normal daytime schedule). My best guess as to why this is happening is that he’s become very distractable. As a result, he’s on and off the breast during his daytime feedings (and stops as soon as he doesn’t feel really hungry) then realizes he’s starved and eats like a mad man at night. I let him nurse until he empties me then we offer the bottle. This is exhausting (thank goodness it’s only been on the weekends!) and my boobs get sore from nursing so often. I don’t think this is an issue with the bottle because he can easily see the world around him and start and stop as often as he wants without affecting the flow. If I were physically nursing all the time, I think my body would adapt but, since this is only happening on the weekends, I can’t keep up and we’ve had to supplement with pumped milk in the evenings. I’m worried this will eventually catch up with me and impact my supply.

Any advice? Do you think it's because he's distractable? Do I pump on the weekends too during the day and give bottles? Is there a way to build my supply at nighttime? I have enough milk just not at the right times. I’ve tried covering him when he nurses and nursing in a quiet place and he’s still on and off. He’s teething (we think) – could this be a factor? Should we start solids?

I would REALLY like to nurse as long as possible and am afraid that my supply is going to suffer. Is this just a phase? Or is this kiddo going to be distracted from now on?

Any help or insight would be greatly appreciated! This nursing thing is new to me so don’t be afraid to tell me anything to basic. I won’t be insulted!

ETA - I forgot to mention he's very fussy at the breast at night. I think the slow let down and the low nighttime supply are frustrating him.

 

[packrat]

Not sure how much help I'll be but I'll sure try! The more you take away, your body will work to replace. So, pumping more often will not only keep a good supply in the freezer, but will encourage your body to work to replace it. When I knew it was about time for my kids to nurse, I pumped an oz or two of each side, enough so that the tingly let down feeling was gone, and then went in to nurse. By the time the kids were done, I knew there couldn't possibly be any left. I chugged water like a mad woman. Even between nursing times, say if I knew it would be a few hours yet, I'd pump a little bit, or a lot, depending on how long it would be before a feeding. Then they're getting right at the hind milk when they begin the feeding.

London was a good eater, and was only distracted during 2 certain commercials. I always sat and read or watched tv with her. Trapper wouldn't eat if I was doing something else. He liked the focus on him, so most of the time (until he was quite a bit older) I nursed in his room with the door shut or partially shut. Maybe your little guy needs a more quiet environment? Also, when my kids were adjusting their sleep patterns or going thru a growth spurt, they spent some time messing w/their nursing schedule, so maybe your boy is doing the same thing? Maybe he just wants some extra time with mom?

 

[Dreamer_D]

As a comparison, I was on maternity leave still when my son was that age and he BF every 2.5 hours during the day and 3-4 times at night And this represented and increase in frequency from 3mo old. So I actually think your sone is quite normal, as I am pretty sure my son's eating habits were also quite normal for an EBF baby. Your son is actually a little abnormal because he is sleeping through the night

One possiblility is that he is trying to increase you supply when you are with him -- he may be getting more ounzes of milk when apart in the bottle then when you are together. Going back to work early is really hard for BFing, and one reason is that pumping is just not the same as BFing directly. My own milk did not last very long after I weaned my son at night and day feedings became less common (he was 12 months). As I said, the "natural" pattern of BFing at 4 months old would would be feeding around the clock 24 hours every 2-3 hours, the pattern you are in might not be close enough to that for your supply to keep up, and after a couple months of the augmented pattern, it is starting to show in your supply on the weekend. One way to fix this, if it is the issue, is to pump more often in the day, every 2-3 hours at least. Also, introduce a night feed as those feeds are really important to the production of milk as your body produces a lot of prolactin at night. That would take a lot of dedication but it would work. You might also offer the breast more often in the daytime. Drink lots of water and within a couple days your supply will increase the meet the new demand. You should not need to offer a bottle after a breast feed (most likely it is not needed now).

Then again it might be comfort nursing. What happens if you offer a paci instead of a bottle? It is a myth that if you offer a bottle and they drink they are hungry. Most babies will drink/eat whenever and whatever, especially bottles which just pour in their mouths sans effort.

Have you seen a lactation consulant?

 

[Dreamer_D]

Any advice? Do you think it's because he's distractable? Does not sound like it, seems normalDo I pump on the weekends too during the day and give bottles? I would pump on weekends for the supply if you want, not for milk for him. Nursing is much better for increasing your supply no worries. If you want to pump to increas supply, do it *after* he nurses for another 10 minutes. But I think it is not necessary. His frequent nursing will do the trick.Is there a way to build my supply at nighttime? Yes, Nurse him at night all the time, not only weekends. Your body and his will get in sync and you will have milk when he wants it but it needs to be consistent. Have you tried cluster feeding (this is what he is doing at night as you descibe) during the week? It is actually normal btw to have less milk at night, it is related to your hormones I have enough milk just not at the right times. That is because you presently pump -- which tells your body to make milk -- at the wrong time too I bet if you nurse him frequently in the evenings dueign the work week your supply will increase I’ve tried covering him when he nurses and nursing in a quiet place and he’s still on and off. He’s teething (we think) – could this be a factor? Oh yes, and it could be why he is nursing so much. It might be for comfort not nutrition -- this is highly likely. Try giving him a dose of tylenol and see what happens? They basically teeth for the next, oh, two years so get used to it Should we start solids? Absolutely not. It is not needed. The WHO and other health organizations say no solids until 6 months. It will not help with sleeping anyways, that is a myth too.

I would REALLY like to nurse as long as possible and am afraid that my supply is going to suffer. Is this just a phase? Or is this kiddo going to be distracted from now on? As they get older they "wake up" more and don't focus as much. That is normal. They also becomevery efficient nursers. I think that that age Hunter could drain both sides in about 10 minutes. It is normal.

.

One other thing I did not mention, when nursing switch sides every 5-10 minutes to keep him interested. When waiting for letdown, which would also frustrate hunter, I would switch back and forth, back and forth until it happened. Kept him more focused and interested. Impatience with letdown also does nto indicate you have not enough milk. It is normal for babies that age.

And one last thing, what is his demeanor like? I have seen a baby hungry because he is not getting enough milk -- crying crazy wild inconsolable and crying to be fed 2 minutes after coming off the breast. If this is not your son, then most likely it is not a supply issue.

 

[Puppmom]

Packrat, thanks! I'm definitely going to try to pump more often. This week and next should be light at work so I'm going to shoot for every two hours to boost my supply. I won't get much work done but hey, this is important! On a regular basis though, I'm only able to pump twice.

DD, so you think it's possible that he doesn't need the bottle? I honestly never thought of that. Here's what happens - I nurse him to sleep then he wakes about 1.5-2 hours later wailing. He can't be consoled - we thought it was teething so we tried orajel and it didn't work. The first time he did this, it didn't even occur to us that he was hungry. I know it sounds stupid but, for two months now, he had been eating at about 7pm and not again until 6:30am. Anyway, when he wakes, I nurse him. He's fussy almost the whole time he's nursing and I offer him both breasts twice. Once I'm *empty* (or at least I'm assuming so), he's still crying. So, we try consoling him with the paci, rocking, shooshing etc with no results. If anything, he gets more worked up. We offer the bottle - at first just a couple of ounces - but got all the way up to 7 ounces last night before he would settle and sleep.

Another thing you mentioned is going back to work. I'm wondering if this is a factor because MIL gives him 7 ounces two times during the day. At first, we had her giving him 6 ounces. That somehow crept up to 7 ounces (we put our foot down when she started logging "7 plus" in our daily journal and said no more than 7 ounces.). So...maybe he's not getting that from me when he nurses during the day? I get about that when I pump at work so I'm not sure. But that would explain the more frequent nursing on the weekends.

Thanks again for your advice guys. I've made it much futher than I thought I would and want to continue so I don't want to inadvertently sabotage my efforts by doing something *wrong*. I haven't seen an LC since the hospital when N was a newborn but maybe it's time to pull out that phone number!

ETA - Dreamer, to answer your last question - he's very laid back usually but when he's waking recently, he's pretty much freaking out. Wailing, tears, crying until his voice is raspy. It seriously makes me sick to my stomach to hear him so upset.

 

[swimmer]

Exactly to DD's last point. How is he telling you that you "aren't making enough?" If he has enough (4ish) wet diapers a day and seems vibrant and happy, then you are giving him enough. If he is lethargic, cranky, and listless, then you aren't making enough. Kellymom says that about 5% of women don't make enough milk and at 4 months you would know already... Milk changes over time, I'm sure you see that when it is in the bottle. Hydrate and you should be making the perfect concoction for your dude. I have seen one baby who is ebf with a mom who is not making enough, he feeds for 2 mins and then blinks and sits waiting for 10 min to nurse for 2 mins, he is lethargic, has 1 wet diaper a day, and does not look healthy. You do not have that baby.

Mostly, damn girl! you are doing great! and his sleep is magnificent for a tiny person! My 7month old ebf dude ate at about the same schedule at 4 months, I'm looking back at my log now, and it was around then that I cut him off from boob after midnight and DH went in to pat him to sleep, but he still wakes up sometimes 2xs a night now even now that he is getting 4 boob sessions plus 4oz of bm in addition to a banana, half an avocado and 4ozs squash or other veggie. So food is, as DD says not always the key to good sleep. Yes, our MILs disagree, but they also had us in the backseat of cars with no belts....

Mine also used to wake up pissed when he sleept through the night (or mostly) I think its a self soothing thing, or lack thereof. The "I AM SO HUNGRY THAT I CANNOT NURSE!" stage was incredibly upsetting for me, but he seems to have moved on, and I just consoled myself looking at his ripply thighs knowing that he could actually get through the night and not starve to death.

Do see an LC if you can, I still call mine up with questions, DD and Kellymom are great, but a pro coming over and telling you how awesome and perfect your baby is, how you have gotten him so far with your body is just amazing and they know all the tricks. You have one or two more months of exclusively bfing, treasure it! food is a pain to prepare and store, the boob is just so easy now after going through everything to get to this point. You are in a great place and your baby is thriving, just keep on going and know your body makes the perfect food for your little man.

Oh, and remember, they still clusterfeed when going through a growth spurt. Good luck and keep up the excellent work.

 

[Dreamer_D]

Yes, swimmer is right, call the LC for sure!

The night time thing is interesting. I don't really have an answer. The fact that a full bottle makes him happy does not mean that was the problem, KWIM? Like aspirin for a headache does not mean that a lack of asperin was causing the heachache. A really full belly is a soporific for most people/babies and will knock them out.

I EBF and after the first week when my milk did not come in, I never used a bottle to supplement. Hunter would not take it and I hated pumping. So for us it was not an option. Sometimes he was a maniac like you describe, sometimes not, but since he was fat and making lots of wet diapers we just assured ourselves it was not a "supply issue" -- that is a very modern term and I think more common with pumping etc. As Swimmer says, most women do not have a supply issue. Heck, you do not have a supply issue since you are able to produce that much milk for the pump! Your son will be extracting even more that that from you, baby mouths are way more effective than pumps. Sometimes babies just want to nurse for an hour, and if he has teething pain that could be it for sure. Is he content to nurse longer than it takes to empty you, or does he pull off and on an off and on once you are empty?

Anyways, if you have an LC give em a call and see what they say. LCs are not all created equal, but you can assess her feedback critcally I am sure.

 

[swimmer]

That is so true! i was not impressed by the hospital lc, but the one a friend suggested who came to our house at 1wk was legendary. I hope you have a great one.

threadjack: DD, Hunter also refused the bottle? Can we form a stubborn little men club? Now that E is on real foods its fine, I just pour milk into everything, but the no bottle thing got really old for some time. hugs.

 

[Pandora II]

I ditto everything that Dreamer said - especially about it being normal for a 4 month-old to nurse every 2-3 hours around the clock.

I would also hazard a guess that he is going through a growth spurt and/or the teething is contributing.

Whenever Daisy is ill/teething/growth spurt she turns into a permanent fixture on my boob for a couple of days and then goes back to normal.

She's still feeding like a mad thing at 19 months including once or twice at night and 4+ times during the day - she'll drink water but won't touch cow's milk or formula anymore.

I have always worried that I didn't have enough milk - I had nothing till 2 weeks after she was born and it didn't come in properly till 5 weeks PP, so I did mixed formula/pumped milk/breast milk till then and EBF after that. I never got engorgement and not always the let-down feeling and they always felt on the soft side so I really worried that I didn't have enough. However at 6 months PP she was a well nourished, chubby little thing and that was just on what I had to give her.

The distraction thing is also common at 4 months - annoying when they turn their heads while still holding onto your nipple - they are very elastic I have discovered!

 

[cara]

Puppmom, you are ahead of me on the whole child growing thing, so I certainly don't have more experience than you, but FWIW it doesn't sound like you have a supply issue. Maybe your son had a growth spurt this weekend (okay, so temporarily you had a supply issue) or something else that made him want to eat more than usual, but it sounds like you are keeping up fine and your son is growing, etc.

Also, do you normally feed him both sides at a feeding or just one side? I am not convinced (says the woman back to work for 1 week thus far!) that I need to pump every 2-3 hrs. Like you, I want to EBF and do what I can to protect my supply, but also I need a pumping schedule that produces enough milk and allows me to get some work done during the day, so I *think* pumping 1-2 times during the work day will work. Right now that is getting me plenty of milk. Excess even. If I need to I can pump one side and feed on the other in the morning or evening, but I normally only offer one side to Silas and that is enough for a feeding at this age. So if he normally goes 2-3 hrs between feedings during the day, that is 4-6 hours between feedings for any one breast. Obviously I haven't made this work long term yet, but this is my plan. If I notice any issues with supply, I'll need to add in more pumping, but that may have to happen late at night. I'm just not sure I can make that many holes in my day to go pump somewhere while at work.

 

[Puppmom]

Swimmer, thanks for your encouragement. I really thought that 0-3 months would be the hard part (as far as nursing goes anyway!) but I was lucky enough to have minimal issues during that time. Now, more than ever, I feel like I have a hard time reading N’s signals which is why it’s so upsetting to me when I can’t console him. It’s no longer as simple as did he eat, did he poop, is he tired? I was really unsure about breastfeeding when I was pregnant and now I can’t imagine feeding him any other way! Maybe it’s cheesy, but I’m kind of proud of myself for being able to do it. I really didn’t think I could. Oh, and I do feel like the luckiest woman on the face of planet each night that he doesn’t wake up in the middle of the night!

Dreamer, thanks again. I’m going to call the LCs *warm line* tonight. I saw 3 different LCs while in the hospital and they were all fantastic so I’m confident I can get some good advice. To answer your question, he is happy to continue nursing once I’m empty sometimes – sort of using me as a paci – especially if he falls asleep. During these late evening feeds though he’s fussy and on and off the breast the whole time. The one thing I’m not sure the LCs will be able to advise me on is what do I do if he’s still crying after nursing and I can’t console him? Thanks for the info on solids too. At his 4 month appt the pedi said we *could* try rice cereal if we wanted. I asked if we could wait and he said absolutely but seem surprised because apparently most parents seem to be chomping at the bit to give their babies solids. I’m certainly in no rush but thought maybe this was an indication that he was ready.

Pandora, thanks, I think you’re right that some if it may be for comfort. During the day, when N is ready to nurse, he’ll fuss but not scream. At night, he wails! I think I’m better at reading his signals during the day. At night, it’s like he goes from zero to sixty in moments.

Cara, I definitely agree that I don’t have a low supply. I have a freezer stash to prove it! I just wish I had it when he wanted it, KWIM? I pump 10 ounces in the morning AFTER he nurses. If only my milk was that plentiful at night. Pumping 2 times per day is plenty for what he needs while I’m away but I won’t be able to keep up if we keep supplementing him.

ETA - Cara, in the morning, I feed on one side but all other feedings are on both sides.

 

[fieryred33143]

Pupp, I mentioned before to you that when I went to work S switched her schedule. She only took the bottle limited amounts of time during the day and would not get off of me from the moment I got home. Perhaps have MIL offer 5-6oz 3-4 times while he's with her?

Also wanted to mention that a lot of moms talk about the 4 month wakeful. I believe kellymom has a little blurb on it as well. That's right around the age where they get curious and don't eat as effectively because they are distracted. When you feed him, try in a quiet room with everything off. Worth a shot.

And a ditto to seeing LC!

 

[Pandora II]

A lot of people seem to have more milk in the morning than the evening - I was always the other way round...

Where is RPS when we need her - she's an LC IIRC.

 

[Dreamer_D]

Swimmer He would not take a bottle, but then when he started daycare at 10mo he took it like a champ! haha, The bigger issue was that I could not pump. I was never one of those women where milk just flowed out in abundance it seems, like Pandora my breasts did not engorge and always felt soft. But I EBF a nice fat baby for 6 months so it must have been ample for him! have you tried a cup?

Cara I found that it took about 2-3 weeks for my supply to drop when feeding habits changed, so watch for that since you ahve just gone back to work.

Pupp I will be curious to see what the LC says. Yanno, the fact is sometimes our kiddos cry a lot and there is not much we can do to help them but try to cover the basics and then console them as best we can. Hunter's teething pain is always worse at night. Your LO may also be realizing that he likes having mummy around. A lot of changes happen at that age. If you have a large supply of milk stashed, then I see no harm is doping him up with it at that late night feed if it helps Just nurse him first and your supply should not change much I would think. I don't know what you did to help your LO sleep through the night, if anything, but as he gets older you may have to try some new techniques too. Though it seems like this is a feeding issue, it may not be, it could be somethng else entirely! That is the thing about BF and babies in general -- the boob solves many ills so don't assume his desire to feed or fussiness is about food or hunger at all.

 

[Dreamer_D]

Oh, and one other thing, at that age I was feeding Hunter when he woke and again when he went down for his naps in the day, and he took 3 naps, so that means 8 feeds per 12 hour "day". I think having grandma give more bottles with less milk is a great idea.

 

[ljmorgan]

I want to echo everyone about fewer ounces in his bottles. The "rule" (not an exact science obviously, feed your baby what he needs) is 1-1.5 oz per hour for a breastfed baby. My son is a chunky 21 lb 7mo kiddo and never takes more than 5 oz in a bottle while I'm away at work -- usually a little bit is left too. He is offered a bottle every 3 hours (sooner if he seems hungry) while I'm at work, to mimic the schedule that I nurse him on the days that we're together. He might be annoyed while nursing if he's not getting his usual 7 oz all at once.

 

[Puppmom]

Dreamer, I'll definitely post after talking to the LC. I left a message and they try to call back in 24 hours. I think I'll survive until then.

Lindsey, I didn't know that formula. During the day N eats at 6:30, between 10:30 and 11:30 and between 2:30 and 3:30. This seems to hold true whether he nurses or drinks the bottle (it's just the night that varies). If I use that formula, he should be getting closer to 6 ounces. MIL was supposed to be giving him 6 ounces and, over time, that turned into 7. I was okay with that because I was afraid that she might have to feed him a 3rd time otherwise. Since he only ate 5 times per day, that would mean I could only nurse twice. Then, she started pleading poor vision, and writing "7+" saying she can't see when she fills the bottle. I grilled her as to what exactly the "+" is and she fessed up that she was giving him 7.5 ounces saying he fussed after 7. He often fusses for a few moments after you take away the bottle so I told her no more 7+. She just didn't want her grandbaby to be sad. I can certainly sympathize! I'll definitely consider scaling him back to 6 ounces again. DH is off for the next two weeks so maybe he can try it while I'm at work. I'm guessing this is going to be some trial and error. Gosh, I wish I could be more laid back about it but I wound way too tight for that!

We've pretty much ruled out starting solids for now. He just doesn't seem ready.

 

[Puppmom]

A lot of people seem to have more milk in the morning than the evening - I was always the other way round...

Where is RPS when we need her - she's an LC IIRC.

Yes! Where is she? I would love to hear her take. She was so helpful.

 

[oobiecoo]

Exactly to DD's last point. How is he telling you that you "aren't making enough?" If he has enough (4ish) wet diapers a day and seems vibrant and happy, then you are giving him enough. If he is lethargic, cranky, and listless, then you aren't making enough. Kellymom says that about 5% of women don't make enough milk and at 4 months you would know already... Milk changes over time, I'm sure you see that when it is in the bottle. Hydrate and you should be making the perfect concoction for your dude. I have seen one baby who is ebf with a mom who is not making enough, he feeds for 2 mins and then blinks and sits waiting for 10 min to nurse for 2 mins, he is lethargic, has 1 wet diaper a day, and does not look healthy. You do not have that baby.

Mostly, damn girl! you are doing great! and his sleep is magnificent for a tiny person! My 7month old ebf dude ate at about the same schedule at 4 months, I'm looking back at my log now, and it was around then that I cut him off from boob after midnight and DH went in to pat him to sleep, but he still wakes up sometimes 2xs a night now even now that he is getting 4 boob sessions plus 4oz of bm in addition to a banana, half an avocado and 4ozs squash or other veggie. So food is, as DD says not always the key to good sleep. Yes, our MILs disagree, but they also had us in the backseat of cars with no belts....

Mine also used to wake up pissed when he sleept through the night (or mostly) I think its a self soothing thing, or lack thereof. The "I AM SO HUNGRY THAT I CANNOT NURSE!" stage was incredibly upsetting for me, but he seems to have moved on, and I just consoled myself looking at his ripply thighs knowing that he could actually get through the night and not starve to death.

Do see an LC if you can, I still call mine up with questions, DD and Kellymom are great, but a pro coming over and telling you how awesome and perfect your baby is, how you have gotten him so far with your body is just amazing and they know all the tricks. You have one or two more months of exclusively bfing, treasure it! food is a pain to prepare and store, the boob is just so easy now after going through everything to get to this point. You are in a great place and your baby is thriving, just keep on going and know your body makes the perfect food for your little man.

Oh, and remember, they still clusterfeed when going through a growth spurt. Good luck and keep up the excellent work.

I know that most moms don't have a supply issue... but my daughter had plenty of wet/dirty diapers and didn't seem any more cranky than alot of infants. Therefore, neither my LC or myself realized that my supply was low until we took her for a checkup and she wasn't gaining weight. So don't completely rule that out as a possibility PLEASE! To see exactly how much she was eating at each feeding, we rented a fancy scale from my LC and weighed her before and after each feeding. She really wasn't getting enough at most feedings. I tried to up my supply with supplements, pumping, etc but it didn't work. I eventually gave in and order Domperidone from overseas (without a script) since most docs won't prescribe it in the US and thats the only way to get it here. It has helped TREMENDOUSLY so that is always an option if you do find that your supply is lower than it should be.

 

[Dreamer_D]

I know that most moms don't have a supply issue... but my daughter had plenty of wet/dirty diapers and didn't seem any more cranky than alot of infants. Therefore, neither my LC or myself realized that my supply was low until we took her for a checkup and she wasn't gaining weight. So don't completely rule that out as a possibility PLEASE! To see exactly how much she was eating at each feeding, we rented a fancy scale from my LC and weighed her before and after each feeding. She really wasn't getting enough at most feedings. I tried to up my supply with supplements, pumping, etc but it didn't work. I eventually gave in and order Domperidone from overseas (without a script) since most docs won't prescribe it in the US and thats the only way to get it here. It has helped TREMENDOUSLY so that is always an option if you do find that your supply is lower than it should be.

OObie how old was your daughter when this happened?

 

[Puppmom]

Oobie, I'm glad you were persistent and found something to help your supply! What an easy going baby you have - mine is laid back but man does he let me know when he's hungry! I certainly haven't ruled out much and am keeping an eye on my supply since I'm back at work and he gets a lot of his feeds from the bottle. My pumping output hasn't decreased which I'm taking as a good sign.

...so one thing I've learned with nursing is just when you think you have it figured out something goes bump. And just when you think you have a problem you get a break. Last night, N went to bed at 7. I nursed him to sleep but it was a *light* feed. He woke at 11 and nursed (happily!) and went back to sleep until 7 this morning.

I still want to hear what the LC has to say and still plan to *power pump* at work next week.

 

[Puppmom]

What's the deal with Domperidone and why won't the prescribe it in the US?

 

[oobiecoo]

I know that most moms don't have a supply issue... but my daughter had plenty of wet/dirty diapers and didn't seem any more cranky than alot of infants. Therefore, neither my LC or myself realized that my supply was low until we took her for a checkup and she wasn't gaining weight. So don't completely rule that out as a possibility PLEASE! To see exactly how much she was eating at each feeding, we rented a fancy scale from my LC and weighed her before and after each feeding. She really wasn't getting enough at most feedings. I tried to up my supply with supplements, pumping, etc but it didn't work. I eventually gave in and order Domperidone from overseas (without a script) since most docs won't prescribe it in the US and thats the only way to get it here. It has helped TREMENDOUSLY so that is always an option if you do find that your supply is lower than it should be.

OObie how old was your daughter when this happened?

She was about 2.5 months if I remember correctly.






Domperidone is an Australian competitor with American-made Reglan which is also used to increase milk production. I've heard that is why the FDA won't approve it... basically politics. The side affects with Domperidone are much less severe though. Its actually used for digestion or something like that and some docs will prescribe it for either of its uses but its hard to find those docs. And pharmacies have to compound it so you have to find one of the few who will do that. Its compounded from two FDA approved drugs though!

 

[Dreamer_D]

I think given PuppMoms LO's older age and large output on the pump it is pretty unlikely to be a supply issue, but I suppose it could happen at any time.

 

[Pandora II]

http://www.breastfeeding.com/all_about/all_about_domperidone.html

Here's a link from Jack Newman about domperidone.

My father was on the point of prescribing chlorpromazine (Largactil) for me but then my milk suddenly came in. He used to use it a lot on the island we were brought up on where babies could die without breastmilk as there wasn't formula available out there - apparently you'd have enough to feed half of Africa after a couple of doses! Looking at the data on that, domperidone and other meds like metoclopramide I would opt for the domperidone as the side-effect profile seems much better. Chlorpromazine, even at the very small dosage needed for lactation inducement, can be sedating - not what you want when you are already sleep-deprived!

In the UK domperidone is also sometimes used for women who want to breastfeed an adopted baby or one born through a surrogate and is I believe very successful.

 

[Puppmom]

Hi, all. I never did get a call back from the LC warmline...holidays, I guess. I called again this am so hopefully help is on it's way! N is consistently waking at night now which virtually eliminates the extra milk I pump in the morning. Also, he's often not hungry before I leave for work so I have to pump instead of nursing and I barely yield enough for his next feed. This also means he eats 3x while I'm at work instead of 2x.

DH is home with him this week and we cut him back to 6oz per bottle feed. We're also trying to extend the feeds so N knows when he's full. The decrease to 6oz makes a lot of sense especially since he's nursing two more times per day than he was (he used to nurse/eat at 6:30am, 11:00am, 3:00pm, 5:30pm and bedtime. Now it's 4:30am, 9:00am, 12pm, 4pm, 6pm, bedtime and 11:30pm). We may try to get him back to 5.5oz. I'm upset with myself that I didn't address the fact that MIL gradually increased his volume from 6 to almost 7.5oz per feed. When she comes back on Monday, I will make it very clear to her that she needs to consult us before she gives him more as he shouldn't need it.

I'm hoping I can keep my head above water (or breastmilk! ) until we start solids in about a month although I'm not sure that'll help. Right now I'm not pumping enough while I'm away to supply all 3 feeds. I'm still pretty sure it's not a supply issue though. He's no longer fussy at the breast at night although still eating as frequently. Hopefully, cutting him back to 6oz will help but not getting that big am pump in and continuing to pump about 12oz at work still leaves me several ounces short each day. I do have my freezer stash so I guess I'll be dipping into that. I'm pretty beside myself actually and am seriously open to anything to get this right...even if I have to use a few weeks of vacation time to nurse exclusively to get back on track. DH is on warning that I may have to commit all of my time and energy to pumping and nursing leaving him responsible for taking care of everything else!

 

[phoenixgirl]

PuppMom, I was in the same situation with not pumping enough while at work. I was a teacher and could only pump at random times, like 10:30 and 12:30 on M,W,F, and 12:00 and 2:30 on T, Th. I don't think it's necessarily a supply issue. I think it's that babies take more from the bottle since it's there and it's so easy, and that your body does not respond to the pump the same way it does to your baby. I took clothing that smelled like my DD with me to work and looked at her picture to try to up my milk, in addition to drinking lots of water, taking fenugreek, eating oatmeal, drinking Guinness, etc. I never did try any of the heavier stuff. I would pump about an ounce per hour since the last feeding/pumping session, so I'd come home with maybe 6 or 7 ounces and need to pump an extra time at night after Claire went to bed. (At 4 months Claire was taking two or three 4 oz. bottles per day . . . I was always psyched when she'd only had two and bummed when she'd had three, which meant they'd had to go into the reserve stash which I had pumped while on maternity leave). She was also waking up an average of once per night to nurse, which I didn't fight on the theory that this meant I just had to pump less for the daytime.

Also, I don't think anyone has suggested the idea that the extra nursing could be about comfort/closeness when you are home. It's common for babies who STTN to stop doing so when mom returns to work. Maybe instead of waking up in the middle of the night, you're just having crazy nights/weekends?

 

[phoenixgirl]

Oh, and your story reminded me that I had a coworker whose mom just started giving the EBF baby formula when she still seemed hungry. Um, thanks, Mom. I guess grandmas think they know best!

 

[Puppmom]

Thanks for chiming in with your experience, Phoenixgirl. It really makes me feel good to know someone who made it to a year ( ) had similar issues.

I will defininitely try your suggestions. A friend of mine told me to look at pics of N so I did that today and I'm drinking a lot of water. I wish I could tell if N was nursing for comfort or nourishment. Last night we tried soothing him back to sleep and he was not having it! I don't mind the waking to feed him...I like the quiet time with him actually. I just miss that bonus 10oz I was pumping since he slept so long!

 

[turtledazzle]

Thanks for chiming in with your experience, Phoenixgirl. It really makes me feel good to know someone who made it to a year ( ) had similar issues.

I will defininitely try your suggestions. A friend of mine told me to look at pics of N so I did that today and I'm drinking a lot of water. I wish I could tell if N was nursing for comfort or nourishment. Last night we tried soothing him back to sleep and he was not having it! I don't mind the waking to feed him...I like the quiet time with him actually. I just miss that bonus 10oz I was pumping since he slept so long!

Pupp -- Sorry you're having issues. At night have you tried having only your husband go in to soothe N ... and if that doesn't work having your husband give him a bottle? I too wonder if he's just missing his mama. If your husband goes in alone that might help you figure it out. If he's wanting comfort I would think that he wouldn't take too many ounces from the bottle. Just a thought. Hope it gets better and the LC returns your call (I put a call in to my hospital's LC and they never called me back either ).a