Please advise! Not producing enough milk...

[Bmore Mom]

Having read the good advice you have given others in the past, I would greatly appreciate your help with my problem.

My son will be 24 weeks this Wednesday. I breastfed him exclusively until he was 4 months, at which time I started pumping and he started to take expressed breastmilk in bottles b/c I went back to work.

Over the past few weeks, I have introduced solids to his diet (he showed all the signs that he was ready, and he really does delight in sitting in my lap at the table and eating with us).

My problem is that I can no longer keep up with my baby's nursing demands. In addition to nursing him in the morning, when I get home from work, and when he goes to sleep (although that, admittedly, is a very quick nursing session), he takes two 9 ounce bottles of expressed breakmilk during the day.

Despite pumping in the morning and twice during the day, I simply can't keep up with the demand. I use my EBM to mix with his rice cereal for dinner (so that's another 3-4 oz). Although I pump in the morning and twice during the day (for a total of about 18 oz, if I am lucky), I realized tonight that I have very little of my freezer stash leftover (I began pumping two months b/4 I went back to work to create this stash, thinking that it would last me a long time. Boy, was I wrong!).

I am at a loss as to what to do. I plan to keep nursing my son through his first year, but I am getting nervous that I won't be able to do so. I tried pumping more during the day, but that was like getting milk from a stone. No matter how much water I drink, my body will only produce but so much, it seems. As things stand now, I sometimes wonder if I am not producing enough for my son when I get home for work, b/c he often cries during that nursing as if he is frustrated (I have to switch him back and forth between breasts to get him satiated).

For some reason, I feel like I am failing him by having to introduce him to formula. I am also not sure how to do this. Should I start making his cereal with formula? I certainly don't want to reduce the amount of EBM I am giving him. When I run out of my freezer stash, I am going to have to make up the difference in EBM with formula. Is this okay to do (always have a formula/milk mix, that is)? If so, how do should I introduce the mix to him?

I know I am rambling a bit, but this is really weighing on my heart. I so desperately want to do what is best for my baby. I can't help but wonder if this wouldn't have happened if I had stayed home with him, but that just isn't an option.

I really appreciate your thoughts.

Thanks.

[C99]

Here's my advice: Fenugreek. Fenugreek. Fenugreek. And oatmeal. Take 3 capsules of fenugreek 3x day (9 capsulestotal). And eat oatmeal in the morning and oatmeal cookies. These are known ways to increase your milk supply. I've had good luck with them.

Also, I might mix the cereal with formula rather than EBM. It will save your stash for him to drink and also get him used to the taste of formula. In dire situations, I've added water to rice cereal before (w/ EBM too) with no ill effects.

HTH

[egoldber]

I agree with Caroline. Take fenugreek and start using formula for the cereal to save your stash. Make sure you nurse as much as you can at night and during the weekend. And also, try to relax. Breastfeeding is partly a mind game, and the more you stress about it, the harder it will be for you.

You may also want to think about changing the valves in your pump. They do wear out over time and that will impact your ability to pump.

You may also want to check out a Yahoo Group called PumpMoms. This is a huge list of women that are working and pumping. I'm sure they will have a ton of good advice for you.

And whatever happens, you are NOT failing your son! Good luck!

[stillplayswithbarbies]

I would mix the cereal with water, or just mix it with pureed fruit.

Here is some info about increasing your supply:

http://www.kellymom.com/bf/supply/low-supply.html

One thing you can try is pumping in the morning before baby gets up. This is what I do, and I usually get double the amount I get at later pumpings. I feed her right afterwards, and she still gets milk because the breasts keep making milk as long as the baby is suckling.

In any case, you don't have to stop breastfeeding. Even if he is only getting breastmilk in the morning, evenings, and on weekends, that is better than none at all.

Edited to add this:
What kind of pump do you have? The right pump, properly maintained, can make a big big difference in the amount of milk you get out.

...Karen
Jacob Nathaniel Feb 91
Logan Elizabeth Mar 03

[Bmore Mom]

Did you just give me a valid excuse to eat more cookies? :)

I appreciate everyone's comments. I've heard about fenugreek. Is this the herb in mother's milk tea? I drink that a couple of times a day. I didn't know oatmeal would help, too. I will try that.

As for pumping in the morning, I generally let him nurse off of one breast in the morning, and then pump off the other. Are you suggesting that I pump from both and then let him nurse from both? (He nurses from both breasts during all other feedings.) I can do that and he will still get enough milk? That's good to know - for some reason, I didn't think he would.

I will try mixing his cereal with formula starting tomorrow. Do you recommend any formula in particula? I have the samples the hospital gave me when I delivered, as well as the sample I got in the mail soon thereafter. I think they are the Lipil samples.

Thank you all again so much for your advice!

[jennifer13]

First you all, you should feel happy and proud that you exclusively bfd your son for 4 months! That's a wonderful accomplishment! You should be congratulated on your efforts, and supported in your desire to continue bfing. You are obviously a great mom and care about your baby very much.

I was in a similar situation, working, pumping, not being able to keep up my supply. So I began supplementing with formula (as do many of my working-mom friends) and it has worked out great. It's my feeling that any breast milk is better than none, and that it doesn't have to be an all-or-nothing thing for my baby to get the benefit.

I introduced formula by mixing with ebm (you will read things that say not to do this, only because if they only drink 1/2 the bottle then they are missing out on the ebm, but if your son is drinking a full bottle that probably won't be a problem). Whenever I have enough ebm, then I do that combo. If I don't then I make it a full bottle of formula. Now my daughter gets 3 feedings a day of ebm, and 2 of formula. On the weekends I nurse more. I have serious supply problems (surgery on one breast so only one is producing). You might be able to pump enough to do a formula/ebm mix with every feeding.

Some tips, for what they're worth: if there's a feeding which your son is generally less interested in, use formula (or a mix) for that. When giving formula bottles I try not to alternate so as not to give 2 bottles of 100% formula back to back. I've read that that's easier on the baby's digestion. And definitely consider using formula or water for the cereal!

I hope you can go easy on yourself- it will help your supply more than anything else. And remember that your baby has what's most important- a mom who loves him.

Best of luck to you!

Jennifer
Mom to Norah, 5/23/03

[hellokitty1]

Your story sounds like me. I EBF'ed before going back to work and now pump along the same schedule as you do. I managed to make a big freezer stash b4 going back to work but in the last month and a half, my supply seems to be leveling off and is not equal to what I need to pump. So I've been taking from the freezer but not putitng any in. Do that math and that tells me I'll be out of freezer stash soon. :(

It's so weird bc when I was pregnant, I knew I wanted to BF bc it was healthier for my baby and I told myself my goal was six months. And I thought I'd be very lucky if I made it to six months. Here it is six months and I'm still doing it and wnat to continue as long as I can. I can't even explain why but I just do. And I too, feel "bad" about needing to supplement.

Anyway, I've tried fenugreek and am stil taking it (2 capsules, 3 times/day) But for me personally, it has not helped much with increasing volume. You should definitely try it though. So I have had to face the issue of what I will do when I run out of freezer stash and cannot pump enough to keep up. I've decided that if it becomes necessary, I will supplement her daytime (weekday)bottles with formula. Yes, breast milk is superior to formula, but eating is superior to not eating so I try to tell myself not to feel guilty about needing to supplement and you shouldn't either. MY DD takes three 4.5 ounce bottles at daycare, so my plan is to still continue to pump the same and give her as many EBM bottles and only mix EBM and formula when necessary. You can mix the two (no safety issue) but you wanna make sure that the bottle that is mixed is the one that is most likely all finished.

What I plan to do is before I absolutely have to supplement, try mixed bottles while she is at daycare. I want to do go ahead and try it beforehand so I can see if she has any particular preferences or reactions to certain kinds of formula. I'm going to start out a bottle of 25-F/75-BM, then gradually shift to 50/50, then 75/25 and then for yucks see how she does with a whole bottle of formula. Once she's okay, then I won't really use it til I have to. But at least I'll know beforehand that she'll be okay with it.

As far as mixing cereal/solids with BM, I don't do it. For one, I was already worried about my supply that I didn't want to use it for solids. Also, DD is still nursing the same amount with solids so I figured she wouldn't be getting any less BM if I used water or formula in her solids. When I start to supplement with formula, I'll likely use it with her solids instead of water.

I hope this helps and I'd really like to know how things go with the supplementing/transition. Good luck!

[sntm]

another option is add a pumping session before bed -- probably the last thing you want to do at that hour but your body makes the most milk overnight so that way you will be primed.

i agree with using something other than EBM for solids -- unless he always takes every bite, then some may be wasted.

the switching back and forth at night is fine -- we do that too. he may be cranky because it is the end of the day or he missed you or he is preteething, so it may have nothing to do with supply. jack takes 3 6-oz bottles at daycare and I know how that can be hard to keep up with -- I was lucky enough to be a good pumper (God's way of making up for the early BF problems) and I still worry some days.

regardless, you are doing an awesome job! 4 months of breastmilk is better than half the mothers in the nation, and even if you end up supplementing, you are still giving him great nutrition. don't look at any of it like you are a failure. do the best you can.

one other thing to keep in mind is with holidays coming up you (hopefully) will have some time off and can nurse more at home to build your supply.


shannon
not-even-pregnant-yet-overachiever
trying-to-conceive :)
PREGNANT! EDD 6/9/03
mama to Jack 6/6/03

[Jen in Chicago]

I am experiencing the same thing you are. At 21 weeks my pumping sessions are not going well. With advise of many of you I replaced my values and membranes on my PIS over the weekend. I this will help. I HATE pumping so much. It is such a stressful thing to me. No matter what I do to distract myself, I find myself staring at the bottles praying for 4.5 oz each 2 x per day.

Friday after crying to DH I decided I can't stress myself out like this anymore. I have a healthy son (with a cold) who is 21 weeks old. My goal is 6 months for breastfeeding exclusively (or close to it, 4 oz of formula a day on occassion.) After that I want to do am and pm for a while, without pumping.

Getting away from my desk during the day and low production when pumping allowed me to decide to go to pumping 1x per day, unless I am engorged (wouldn't that be nice right now) and need to do it another time. My work environment is supportive, but I work with a team of 20 something single men mostly, and I hate being the 30+ year old mom having to slip away AGAIN to that secret room in the back hall. I already don't work the hours they do later in the day and feel guilt for that (my day starts at 7:30 theirs starts at 9.)

Sorry to go on and on. Bottomline, don't stress yourself out! I did it and have cried enough for the 2 of us! DS will be living off of what I pump and my freezer supply, and occassional formula. I will get some fenugreek (the tea I could not handle the taste of) sometime soon (hard to get to a store when I want to spend all of my free time with DS.)

I do use EMB or formula for the rice cereal. I use the rest of the bottle that daycare seems to start at the end of the day that is still good (can't waste my LIQUID GOLD) or that odd amount that does not fit in a bottle. If that fails, formula.

As for formula, we have tried all of the samples we received (and still have more to get.) Jude has taken all of them without problems. My favorite is Carnation b/c it dissolves easier than the rest by far. Got to love the price of it too!

[stillplayswithbarbies]

yes, you can pump from both and then feed from both. I do this with my baby 3 days a week, and I don't notice any difference in the way she eats on the days I pump versus the days I don't pump.

check the expiration dates on those formula samples, they may be expired.

...Karen
Jacob Nathaniel Feb 91
Logan Elizabeth Mar 03

[stillplayswithbarbies]

> No matter what I do to distract
>myself, I find myself staring at the bottles praying for 4.5
>oz each 2 x per day.
>


Don't watch the bottles! read a magazine, surf the boards (reading this board helps me get more when I am pumping because it makes me think about feeding my baby), or just tilt your head back and close your eyes.

try not to watch the bottles, and when you do look, you will be surprised at how much is there.

...Karen
Jacob Nathaniel Feb 91
Logan Elizabeth Mar 03

[peanut4us]

Fenugreek is different than the mother's milk tea. I've seen it at grocery stores (it is a little hard to find) in capsule form. Defintately get some. It works and quickly.

[lfp2n]

I am in a similar situation.My baby has one bottle a day at daycare and I pump once a day at work.My pumping is variable occasionally I get too much but sometimes not enough,I have no freezer stash,I've never been a 'big' producer and I also need milk for cereal. When I went back to work I was pumping all times of day trying to get enough for the bottle and store some up for future solids, mainly when I was feeding her, I was pumping on the other side, as I really felt like a failure if I had to give her formula.

I suddenly realised that it really sucked that not only was I not with her for several hours a day while she was at daycare, but to make it worse when we were together I was jumping out of bed ruining our cozy morning feeding sessions to get the pump, juggling her and the pump which is hard as she likes to switch sides...etc etc. Anyway she's 7 months now and I want to breastfeed til shes at least a year but I just decided that I'm going to enjoy all of all my time with her by only pumping at work and not while I'm with her, if I have to make up a few oz of formula here or there, and use formula for solids I think I have rationalized it to myself that that is OK. So I don't think you should feel like you are failing him. Hope it helps

lucy and Olivia (3/27/03)