Please help me have a happier breastfeeding experience this time!

[Zana]

I'm about 5mths along with this pregnancy. I know this is early but I would like to be better prepared this time around.

The background: I was all set (naively) to breastfeed DS for at least a year. So despite knowing about latch issues and other problems it never actually occured to me that my milk supply would be a problem (why do the books never mention that :( ). Sure enough DS not only didnt latch (we had the shield, the feeder, and 3 lactation consultants) but my milk only came in after 11 days and that too in a trickle (we tried fenugreek, all sorts of broths, even non-alcoholic beer!). After about 6 weeks of supplementing and constant pumping (I was attached to that double hospital grade pump we rented almost continuously), I was exhausted and miserable and all the LC could finally offer was Domperidome as an option. Quite frankly I burst out crying at that and was so depressed that we decided not to extend the trauma and moved onto formula.

Well, now that #2 is on her way, I'd really like to research it and make some decisions that wont catch me blindsided (especially since I wont be battling the first-time mom issues!).My OB has said that since they are aware of the problem they will work with the LCs at the hospital to see moniter everything but that medication might the way to go (she suggested Reglan - Thank you Kristen for your timely post!).

I guess I was wondering a few things.

1. Anyone with BTDT experience. i.e. poor supply with baby#1, does that mean I may not have these issues the second time?

2. What can I do before the delivery?

3. Any reccomended do's or dont's for after delivery?

4. Are Domperidome and Reglan the only 2 medications reccomended? Do side-effects like depression only affect the mom, does it affect the baby in anyway? If I take the medication is it a continuous thing or does the milk come in and I can get off it.

4. Any good websites/book for supply issues would be great!

Sorry this got so long, but any help would be appreciated.

[MMEand1]

I don't really have any advice for you as our problems were of a different nature. It is good that you know ahead of time what to watch out for and give the LC's a heads up before problems have time to arise. I wish you the best of luck this time around. Just know that the problems you may have had with #1 does not mean that you will automatically be cursed with them this time around! Good luck to you and here's to a happy/healthy last few months of PG!
Mariah P.

[overcome]

Here is a phenomenal web site

http://www.kellymom.com

Good luck! I admire you for being up for trying again when your first experience was difficult. You never know...this time it could be totally different!

((HUGS))

[proggoddess]

I didn't have a poor supply with DD, but I definitely couldn't keep up with her when I went back to work. So we supplemented with formula. I also took fenugreek and ate my bowl of oatmeal every day. With her, my milk came in on day 5 and she is a tall, skinny toddler.

This time with DS, my milk came in on day 2. (I was still in the hospital and I was surprised I had to put on my nursing bra right away.) I now have an oversupply problem. DS was gassy and would pull off frequently because the letdown was so fast. I pump plenty for DS to drink while I am at work and I squirrel away several bags of excess milk each week. DS is a chubby baby.

All I can say is every time is different. Give nursing another try, but be prepared for a repeat, just in case.

[dowlinal]

I was in your shoes a few months ago. I had major supply problems with my first baby and did a ton of research while I was pregnant with my second. I'll try and answer all of your questions.

1. Anyone with BTDT experience. i.e. poor supply with baby#1, does that mean I may not have these issues the second time?
You honestly won't know until the second baby arrives. I'm not phrasing this correclty but with each subsequent pregnancy more glandular tissue is created. So some mother's are able to produce more milk in subsequent pregnancies and therefore don't have the same supply issues.

For me, with this second pregnancy I've learned that despite my large breast size I have insufficient glandular tissue and needed to supplement my second daughter as well. Fortunately I found a great LC and a LLL group who worked with me to keep me going. I was able to build up my supply to the point now where I am exclusively breastfeeding although my daughter does eat some solids to continue to gain an appropraite amount of weight.

2. What can I do before the delivery?
Get a good support team in place. Find your local LLL group and attend a few meetings so that you feel comfortable there. Find a LC who's philosophy meshes with yours. For me, I was not willing to pump around the clock this time. I did it with my first, had little results, and ended up misreable. My LC understood this and worked to help me create a plan that worked for me and my family.

Also, www.BFAR.org is a great source of info even if you haven't had a breast reduction. Diana West is fabulous and she is completely approachable via e-mail. She has a new book on increasing supply that should be out any day. I can't wait to read it.

3. Any reccomended do's or dont's for after delivery?

For me, one of the most important things that I did trust my instincts this time around. With my first, she had become lethargic before I realized that she had a problem. This time, a soon as Sabrina wasn't making enought wet dipes I started cup feeding her about an ounce supplement after each nursing session. It kept her alert and able to nurse.

Another thing that I did was rent a medela scale for the first few weeks. This allowed me to see exactly how much milk I was producing. I started a course of regalan about 5 days after Sabrina was born and the scale helped me see that regalan didn't work for me.

Also, I had c-sections both times and did not get to nurse my first immediately. This time I demanded that my baby be brought to me in recovery to be nursed and that she not be bathed before I nursed her. Maybe it's just a coincidence but my first was a reluctant nurser while Sabrina is a nursing champ.


4. Are Domperidome and Reglan the only 2 medications reccomended? Do side-effects like depression only affect the mom, does it affect the baby in anyway? If I take the medication is it a continuous thing or does the milk come in and I can get off it.

These are the only two that I know of. I could not get a doctor to write me a prescription for domperidome so I took regalan. Fortunately I didn't have any side effects from it. The course that I was prescribed had me take the drug 3x per day for 2 weeks and then taper off of it. I believe that most woman are able to taper off without a major decrease in their supplies.

There are also alot of herbal remedies. I took fenugreek and blessed thistle and go some results but not the huge improvement that a lot of woman see. Based on Diana West's reccomendations about a month a go I started taking Goat's Rue. I take in as part of a tincture called more milk special blend and I am pretty sure this stuff is the magic cure for me. I've had an amazing increase in supply. Here is the link http://www.motherlove.com/product_more_milk_special.php

4. Any good websites/book for supply issues would be great!
Like I said before www.bfar.org is great and I would definitely by Diana West's new book once it is released.

I hope this helps. It has been a struggle, but I am really proud that I am about to reach the 6 month mark. What has helped me tremendouly is not focusing on needing to exclusively breastfeed to be successfull but instead beleiving that breasting at all is a success. LMK if I can answer any more questions for you.

[DrSally]

Wow, you went through a lot! Good for you for your determination to try again. I had supply issues the first time too and was panicked. I can only imagine what you felt. My milk didn't come in until the end of the fourth day, and my baby was big and late, so he was awake and hungry by the end of day 2. The nurses at the hospital were disturbed by his cries (as was I) and pushed formula but weren't much help with the BF. I was so determined, but eventually he became jaundiced and lethargic, so we went to formula to get the jaundice out and then slowly transitioned to exclusive BF (without the pressure of feeling he was starving).

Everyone I've asked has said that your milk is more likely to come sooner the second time around--whether it's physiological or psychological (more confidence) who knows; it's prob both. I do agree with the others, though, that just like every preg is different, every nursing situation will be different. Just b/c you had a hard time the first time, doesn't mean the second will be the same. Interestingly, after my appointment with an amazing lactation consultant, I went home and saw the first "drips" of milk come out while pumping (I've never been so relieved)! The LC said she believed my milk was already in, but my DS was so frantic for food that he was getting in his own way and not latching on correctly and removing it effectively. I think the help I received was huge in helping me to relax and facilitate the let down process. In the future, if I have this problem again, I will definitely be pumping in the hospital to supplement baby's sucking. I also agree with the other posts--to surround yourself with a lot of support ahead of time. I love the kellymom.com website too.

Good luck and keep us posted!

Oh, and I also had severe postpartum hemmhoraging a week after giving birth. The LC said that a retained piece of placenta would definitely cause issues with milk coming in.