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04liquidS 07-21-2011 07:15 AM

What would you do? Super low supply and NICU baby
Owen was born by c-section 8 days ago. He was 9lbs 9oz so they checked his blood sugar and it was very low (25). I did not have gestational diabetes but I do have insulin resistance due to PCOS. After several hours of trying to raise his sugar by nursing and then syringe feeding formula, he was taken to the NICU for IV dextrose. He ended up refusing to eat enough so he got an NG tube and was put on continuous feedings through it in addition to the IV to keep his sugars stable. He is now weaned off the IV and NG tube and we are working hard to make sure he takes formula by mouth. I have Polycystic Ovary Syndrome and I had a segmental (partial) mastectomy on my right breast a year ago due to a Fibroadenoma (a large benign mass). I produce less on the right side because of this. I pump every 2-3 hours for 20 minutes and I get less than 5 ml of milk. Hand expressing doesn't work any better. I try to nurse him every 3 hours during the day (NICU has scheduled feedings). Sometimes he latches on and does ok for 10 or 15 minutes but mostly he is too sleepy and won't stay latched well even with the nipple shield. I'm taking More Milk Special Blend and drinking Mother's Milk Tea. I also started Metformin on Monday since I have PCOS and it could possibly help with my supply by getting my hormones back in order (I was on it until I was 10 weeks pregnant and the midwives wouldn't let me continue it). So far I haven't noticed any increase. I've considered Domperidone but I don't quite understand how people get it and I'm wondering if it would do much for me considering my low supply is really really really low. I don't think I want to keep all this (pumping, supplements, etc) up just to get 2 or 3 ml of milk.
Another option I'm considering is to give him formula and as much donor milk as possible. My sister offered to pump for him. She has an oversupply and a 1 year old that isn't nursing as often anymore. I know there are a few groups for milk sharing too.
I'm hoping you mamas can give some opinions and advice. Thank you.

PerfectFifth 07-21-2011 08:13 AM

Re: What would you do? Super low supply and NICU baby
Wow, did we have the same baby?? DS weighed the same at birth, had the same blood sugar problem. I think I posted on another thread of yours, because we had a very, very similar situation. Big :hugs: for you, because I know how stressful this is.

Anyways, I think a big hurdle is those scheduled feedings. I have no idea why hospitals do that when it's been documented to cause poor weight gain and milk supply issues. For preemies, I can understand, but healthy, full-term babies with willing mamas? That really makes me :headscratch:. To this day, DS rarely goes 3 hours between feedings!

Don't be discouraged about getting 5 mil per pumping. After 10 months of breastfeeding, I'm lucky to get 1 mil when I pump! The real gauge of milk supply is whether your baby is gaining weight and making plenty of wet/dirty diapers. That being said, I'd continue to pump every 2-3 hours, and once you get Owen home, he can feed as often as he wants and set your supply. Keep an eye on his weight, and if he doesn't gain well, then you might have a low supply. Just be ready-- my DS was in the NICU for 12 days, and once he came home, he was nursing AROUND THE CLOCK for about a week. I think he had to get used to digesting smaller amounts of milk sooner (instead of getting force-fed ginormous amounts of milk spaced apart-- oh yes, we had the feeding tube, too), and I think he just really craved his mommy's touch. :(

And of course, I'd get in touch with an LC or La Leche League leader, especially considering the medication aspect. Some LLL leaders specialize in NICU situations, so that's definitely worth checking out.

Good luck, and hang in there! :hugs:

Wanderlust 07-21-2011 09:42 AM

Re: What would you do? Super low supply and NICU baby
big hugs. I have PCOS and it was an uphill battle to get my supply established. I noticed that day we brought home our boys from the NICU, I did get a little spike in my supply- I think it's because it's hard to totally relax in the NICU environment. I always felt rushed and a bit agitated while pumping there.

I had to start pumping more often in the beginning and when the boys went through growth spurts. I would try to pump every 1.5 hours during the day and every 3 hours during the night until my supply reached where I wanted it to be and then did the every 3 hours during the day.

I did fine until they hit 4 months- I just couldn't keep up with them no matter how much I pumped. The military doctors wouldn't prescribe me domperidone even though their lactation consultant recommended it for me. I ended up buying through the online pharmacy that other mamas ordered theirs from (not sure if I'm allowed to post the site here). It really did help me make it through to 1 year even though I did have to supplement with maybe a can or two of formula a month.

Other than that, no advice. That's very sweet your sister will pump for you- that is such an awesome gift

04liquidS 07-21-2011 09:51 AM

Re: What would you do? Super low supply and NICU baby
I should mention that I don't think it's just an issue with the pump not being as efficient as a baby. My breasts aren't any heavier, fuller, engorged or anything.

jenmm 07-21-2011 11:00 AM

Re: What would you do? Super low supply and NICU baby
No advice, just wanted to offer you good luck and some hugs. :hugs:

BooneNicuMama 07-21-2011 11:31 AM

Re: What would you do? Super low supply and NICU baby
I haven't had the same situation, per say. But is your LO still in the NICU? If so it makes keeping your supply a near impossibility for us mamas without alot of outside issues ( let alone the extra factors your working with :hugs:). Both my littles were in the NICU for 93/50 days. Have you asked the NICU doctors or your OBGYN for a script for the medicine to help your supply? My NICU dr. wrote my script for my Reglan, and that rocketed my supply up for a few weeks, which is better then nothing. Especially to a little in the NICU.

I'd snuggle your little when you can't nurse, and then try pumping right after. The company from baby helps some. And don't get too down. Once you have the little home, they'll help bring your supply to where it should be. The little one works so much better then the pump. It was too late with my first, cause my supply was to the point that pumping I got nothing by the time she came home.... but with my second it was around where your's is now. I managed to nurse her for three more months once she got home before my supply wasn't cutting it. Just gotta have hope and hang in their mama :hugs:

And like another mama said, I'd check into a LC.

tuhraycee 07-22-2011 03:39 PM

Wow sounds like you're dealing with a lot! I wouldn't stress too much about bf'ing if it turns out to be something that is becoming a huge worry. Donated milk from your sis sounds wonderful - that's great he can have that as an option!

kocho 07-22-2011 09:59 PM

Re: What would you do? Super low supply and NICU baby
((HUGS)) Mama!! Will they let you do kangaroo care?? That additional skin to skin contact really helps with BF and keeping a premies. I know pumping is a pain in the butt. But when you do pump, try power pumping every time. Pump five minutes, rest a minute, pump five, rest one, pump five. It only ads a minute to the pump time, but the start/stop start/stop helps to increase your supply.

isabelsmummy 07-26-2011 11:32 PM

Re: What would you do? Super low supply and NICU baby
I've never been in your situation but I agree that every 3hr feeding is totally not helping. For now, I would keep up the pumping/nursing until he gets home and *then* really work on it. It sounds like you have plenty of options if it doesn't work, but at this point, you've still not really had a chance to nurse normally.
Not everyone gets engorged. I get huge and sore but another friends breasts didn't change in the slightest and she nursed way longer than me.

pix1114 07-27-2011 09:16 AM

Re: What would you do? Super low supply and NICU baby
Sounds awesome that your sister is willing to donate! I also have PCOS and it took while to get my supply up. I took More Milk Special Blend (taste horrible, but I mixed it in cran-grape to cover the taste and put it in a little shotglass). It worked wonders. I only did that for awhile to get my supply up and then drank tons of water. Once my son learned to suck more it all balanced out. We also had to supplement with formula a little each day too. Good luck mama!

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