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Old 11-30-2011, 11:35 AM   #1
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Dr. says to add supplements, need advice

Just got back from my son's one month checkup. He's down from the 22nd percentile for weight to the 5th percent. He had been getting 1-2 ounces of formula a day as a supplement due to weight loss, but because of his continued low weight gain, his doctor wants me to offer 2 ounces at every feeding or more, if DS will take it.

He said not to pump after nursing because as long as my breasts are being emptied, they won't be making more milk, and that in order to make more milk, they need to have a break. (I'm nursing ALL THE TIME right now!) I kind of get what he's saying, but at the same time, I've read that the more you nurse/pump, the more milk you'll make, but clearly that hasn't been working for me so far. He said to nurse 1st on both sides, then give him a bottle and DS will still think it's the breast. (I have been feeding him with a dropper) I have tried an SNS and the thing makes a huge mess every time I use it (I've used it to give him about 3/4 ounce 3 times a day for a few weeks until the domperidone seemed to be increasing my milk supply) and it didn't seem to do anything to help my milk supply anyway. I have a low milk supply just like I did with my first DS. And no, I am not just assuming that based on my ridiculously low pumping output. (Usually about 5 or so mL from both breasts combined with the most ever being one ounce from both sides combined once when I pumped in the middle of the night.) I can tell when he's done with a feed that he is not satisfied by how he acts and also his diapers are never super wet.

I have tried every.single.thing. to increase my milk supply. . . every herb known to man, pumping more, pumping less, power pumping, nursing vacations, skin to skin, hospital grade pump, SNS, breast compressions while nursing, raglan, and now domperidone. The domperidone actually seems to be helping, just not enough. I'm afraid that if I start adding all these supplements my milk supply will never get where it needs to be, but I don't want my baby to starve either! I am not against adding more supplements if that's what my son needs to be healthy and not so hungry, but I want to balance it with nursing the best I can so as not to deplete the nutrients he's getting from me. He has to go back in one week for a weight check so any input you have would be great! Thanks so much for your help!

ETA: Birth weight 7 lb. 15 oz.
Going home weight 7 lb. 3 oz.
1 month weight 7 lb. 8 oz.

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Old 11-30-2011, 11:48 AM   #2
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1st of all your Dr is absolutely wrong about the way supply works! The more often the breasts are emptied the more milk you will make, when they get fuller milk production decreases. How much domperidone are you taking? How many wet and poopy diapers in a 24hr period? The diaper doesn't need to be "super wet". Do this: measure out half of 1/4 of a cup (1/8c), this is 1oz. Pour it into a diaper and feel how much it weighs, pour another oz in and feel how much that weighs. Do this until you reach 4-5oz. One pee equals 1 oz. So a diaper with 2-3ozs in it is actually 2-3 pees.

Also, are there any issues that you are aware of? PCOS, IGT, tubular or hypoplastic breasts?
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Old 11-30-2011, 12:03 PM   #3
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When my supply was low I used the SNS full to make sure my son always got all he wanted at the breast. They won't overeat with the SNS so fill it up and let him eat to his hearts content. After a few weeks we got good with the SNS so it was not nearly as cumbersome and messy. Using the SNS let me cut out pumping for a few days to give my body a break without further damaging my supply. The herbs and teas didn't help too much for me, but the SNS over time got us to a 100% supply. If you are struggling with the SNS feel free to PM me and I can share some tips!

Silly doctor! Boobies don't work like that!
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Old 11-30-2011, 12:12 PM   #4
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Re: Dr. says to add supplements, need advice

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Originally Posted by Connor View Post
1st of all your Dr is absolutely wrong about the way supply works! The more often the breasts are emptied the more milk you will make, when they get fuller milk production decreases. How much domperidone are you taking? How many wet and poopy diapers in a 24hr period? The diaper doesn't need to be "super wet". Do this: measure out half of 1/4 of a cup (1/8c), this is 1oz. Pour it into a diaper and feel how much it weighs, pour another oz in and feel how much that weighs. Do this until you reach 4-5oz. One pee equals 1 oz. So a diaper with 2-3ozs in it is actually 2-3 pees.

Also, are there any issues that you are aware of? PCOS, IGT, tubular or hypoplastic breasts?
He has about 6-7 wet diapers in a day, but I can definitely tell the difference between the wetness of the diapers that he has normally as compared to those after he has had an extra ounce of formula. He only poops once a week. The doctor checked, he's not constipated. I'll have to do the wetness test in a bit as I am nursing right now as I type. I am taking four Domperidone tablets three times a day right now. And I can tell an increase in my milk supply, but it's still not enough. It seems like I have more milk in the morning than later in the evening so I've been giving him the 1-2 ounces of formula in the evening when he seems hungrier. Usually an ounce around 5 or 6pm and then one more before bedtime.

I had been pumping at around 3 am to get an ounce of formula (this is when I make the most) to save to give him that evening in place of one of the extra formula supplements, but lately he just screams when DH takes him in the middle of the night so that hasn't been working so well. (I side-lying nurse him and he sleeps in our bed because he cries every time I put him down) I do my best to pump during the day, but he always wants to be held and nurses almost all the time when he's not sleeping, so it works better at nights and on the weekend when DH is home and can hold the baby for a bit. I've tried pumping one side while he nurses on the other to get milk to save for later in the day when he's the most hungry, but then he doesn't have enough milk for the feeding he is in the middle of. Plus I never get more than a few mL then anyway.

I don't have PCOS. I do have one breast that is slightly larger than the other, but when I asked the lactation consultant, she said she didn't think I have IGT. They might be somewhat tubular, but not enough that I could say for sure. They never used to feel full but now that I've started domperidone, I can tell a difference between when they are full and not full.
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Old 11-30-2011, 12:18 PM   #5
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Re: Dr. says to add supplements, need advice

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Originally Posted by jessnic View Post
When my supply was low I used the SNS full to make sure my son always got all he wanted at the breast. They won't overeat with the SNS so fill it up and let him eat to his hearts content. After a few weeks we got good with the SNS so it was not nearly as cumbersome and messy. Using the SNS let me cut out pumping for a few days to give my body a break without further damaging my supply. The herbs and teas didn't help too much for me, but the SNS over time got us to a 100% supply. If you are struggling with the SNS feel free to PM me and I can share some tips!

Silly doctor! Boobies don't work like that!
Thanks for the advice! The SNS that I used was a temporary one that I got from the hospital. It had the skinny tube attached to a 3/4 ounce syringe that you had to squeeze out manually. It eventually broke (the rubber part on the inside of the syringe kept sliding off so it wouldn't suck up the formula) and I never replaced it. I looked into getting a medela SNS but didn't read very good reviews on it and wasn't sure it was worth it and the Lact-aid ones use disposable bags which seem expensive. What kind of SNS did you use?
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Old 11-30-2011, 01:56 PM   #6
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Re: Dr. says to add supplements, need advice

Ditto to what's already been said and shame on your doctor for not knowing how supply and demand works! Good grief. If you have the energy to pump after every feeding do so, it WILL help your supply.
The only piece of advice I can give you is to look into getting some donor milk instead of using formula. I wish someone would have told me about donor milk when my DS was born since we struggle the first few weeks with low milk supply. Hang in there mama! Any amount of mama' milk is better than none
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Old 11-30-2011, 02:50 PM   #7
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Re: Dr. says to add supplements, need advice

My ds2 dropped a significant amount of weight the first weeks and we had to supplement. I actually gave him mostly formula and pumped while he drank the formula and froze it for later. Then, when he started to gain back and the ped gave the ok to cut down on the supplementals, I started giving him the milk that I had froze (since it had more antibodies, etc and I could be sure how much he was getting) and still pumped. Now he's drinking right from the breast, my supply is HUGE and I've got some frozen milk saved for when I need to rely on sitters.
The most important thing is to relax. The let-down won't happen unless you're relaxed enough for the ducts to open fully. I know it's hard. I found that reading a book while pumping/bfing my ds2 helped me not focus so much on what was going on and my body just naturally responded to him then.
Hope this helps!
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Old 11-30-2011, 04:26 PM   #8
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Quote:
Originally Posted by katiekat1032

Thanks for the advice! The SNS that I used was a temporary one that I got from the hospital. It had the skinny tube attached to a 3/4 ounce syringe that you had to squeeze out manually. It eventually broke (the rubber part on the inside of the syringe kept sliding off so it wouldn't suck up the formula) and I never replaced it. I looked into getting a medela SNS but didn't read very good reviews on it and wasn't sure it was worth it and the Lact-aid ones use disposable bags which seem expensive. What kind of SNS did you use?
I use the medela SNS with the 5 oz bottle. They sell a temporary one that is a 2 oz bottle that is not very good. The medela long term SNS is great once you get used to it. I know because I had supply issues if my son is fussy at feedings I am always concerned he is not getting what he wants or needs, so we use the SNS so I know he will get what he needs without a bottle. I got my SNS from a mama on here, so you might want to see if someone has another one.
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Old 11-30-2011, 05:40 PM   #9
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Re: Dr. says to add supplements, need advice

Quote:
Originally Posted by jessnic View Post
I use the medela SNS with the 5 oz bottle. They sell a temporary one that is a 2 oz bottle that is not very good. The medela long term SNS is great once you get used to it. I know because I had supply issues if my son is fussy at feedings I am always concerned he is not getting what he wants or needs, so we use the SNS so I know he will get what he needs without a bottle. I got my SNS from a mama on here, so you might want to see if someone has another one.
When you use the SNS, do you nurse for a while on each side first before adding the SNS or do you use it right away?
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Old 11-30-2011, 05:40 PM   #10
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Re: Dr. says to add supplements, need advice

I'm so sorry you are having such a hard time Can I offer a suggestion? You mentioned that you are supplementing in the evening because that's when your supply seems the lowest. I understand your logic, but something important to know is that the hormone, Prolactin, which is responsible for regulating milk production, is at its peak during the evening hours. ( Prolactin levels "follow a circadian rhythm: levels during the night (sleep) are higher than during the day.") That is when your supply is most sensitive to stimulation to increase production. Babies take advantage of this and nurse more frequently in the evening and night hours to make the most of this productive time. When you give your LO the supplement, do you notice him not nursing for a couple hours? The break is nice, but it won't actually help your supply, unfortunately. I'd encourage you to try to just nurse in the evenings and try to supplement mid-day or early-early afternoon to prep LO with the energy to do his marathon nursing in the evening. That will have the greatest benefits for your supply.

Here is a link with more info from kellymom.com - http://www.kellymom.com/bf/supply/milkproduction.html

And like pp have said, your doctor was dead wrong on milk production... I wish I had a dollar for every time a "well meaning" doctor gave crappy breastfeeding advice... I'd be a very rich lady.

This explains why his advice is wrong: http://www.kellymom.com/bf/supply/milkproduction.html#supply

And these two links have some really helpful info on low supply -

http://www.kellymom.com/bf/supply/


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


I'm not saying you're wrong about your baby fussing b/c your supply is low, but *sometimes* there are other reasons. Once you are already concerned about low supply, its easy, and totally understandable to look for those signs. This offers some alternative suggestions, just in case it helps at all: Based on your baby's weight gain, I'd say you might have a bit of a low supply, but I really think it can be overcome and I do believe you can exclusively breastfeed. I really do. Sometimes it just takes a few little "tricks" and things can drastically improve and get back on track. You are doing a great job trying everything you can and I hope you know that your efforts are so worth it and your baby is so blessed to have such a wonderful Mommy!

Hang in there - don't get too discouraged! You can do this!
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