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Belated Breastfeeding Woes

Nov14

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Hi Amy! You are the shiz and your kids are ungodly cute.

When I think of the myriad of topics I’ve written to you about, I think I must look like some kind of lunatic. Probably because I am! Anyway.

We just had our 3rd boy in August, an adorable little ball of awesome. I went on maternity leave and he and I were having the best breastfeeding experience I’ve had thus far. No supplementing necessary – the boy didn’t even have a bottle of breastmilk until he was over a month. I felt really good about this. I went back to work a couple weeks ago and we were moving along just fine still with me pumping twice a day at work and nursing at night. I’d send him to daycare with 8 oz of breastmilk and 8 oz of formula and that was working out quite nicely. Since then we’ve hit a couple minor speed bumps.

He still gets up once or twice a night and started getting really lazy about nursing at night. He latches, gets annoyed that it’s not fast and instantly gratifying, pulls off, latches again. We plowed through it, but what used to take 10-15 minutes with both of dozing in bed during it now takes an hour and we’re both wide awake, and then he’s harder to get back down. So, you know, I’m exhausted. Then, this past weekend, I got strep. I was apparently allowed to nurse on the antibiotics but I got a virus on top of it and was so congested that I really couldn’t get by without cold medicine that I could NOT nurse on. And you know, I felt so crappy that I got really lazy about pumping. So I just..didn’t, really.

I kind of thought on Monday or Tuesday that I’d give it up for dead..switch solely to formula and pat myself on the back that we did so well for this long anyway. But I don’t feel good about that. Not out of any societal guilt or whatever…I was just enjoying it, and it made me slow down a bit and really enjoy this guy. So I want to keep doing it, but I’m really struggling with getting my supply back up.

A bunch of probably unnecessary background info – my husband and I both work full time, and both go to school. I’m wrapping my last semester at community with online classes so I’m not out of the house much outside work, but come January I start Penn and will be out at least two nights a week. Our oldest has a lot of sports commitments so that’s a lot of running around. All in all, we’re busy. I have a job that deals with a lot of time sensitive projects so I can’t always stick to a really rigid pumping schedule, but I do have a double electric pump and a lockable office that I can duck into 2-3 times a day. I also have a small manual pump that I could theoretically duck into the bathroom with for a couple minutes to help boost things. I take so much fenugreek that I smell like IHOP. I notice that if I skive off on pumping sessions during the day, I see a big dip in my ability to nurse effectively at night.

I’ve got my sights set on a year – so I’m basically looking for your best and most practical advice to keep up my supply with such an insane schedule.

Thanks!!
Kate

Ah, supply problems. My old nemesis. WE MEET AGAIN.

After struggling with chronic low supply with Noah, I overcompensated in the beginning with Ezra (pumping, herbal supplements, the whole shebang) and ended up with oversupply. At which point I too got a little cocky and overconfident and started slacking on pumping sometimes, if I missed an in-person feeding. Then the biting started. Oy, that kid and the biting. He was chomping down on me practically every feeding. So I would pull him off and halt the feeding and after a few days of this I started swapping out an afternoon feeding with a bottle just to have a little respite from the Teeth Of Doom. Did I then head upstairs to pump in the meantime? No. No I did not, because BORING.

And then I was shocked when, after a week or so of this, I didn’t have nearly as much milk as I needed anymore. Whoops. And also: DUH.

So I had to basically go back to the drawing board and my assortment of newborn-days supply boosters:

1) More Milk Plus. Personally, I’ve never had much luck with just using fenugreek alone. Motherlove’s MMP is a supplement that contains fenugreek AND fennel seed AND blessed thistle AND nettle. You can get it as a capsule or liquid, and it works quite well WITHOUT making you smell like you sweat maple syrup. (There is also the prescription option of domperidome, which can be very difficult to obtain in some states and has to be ordered internationally from online pharmacies and oh my lands. I’ve heard it works quite well, but have never personally felt like dealing with the hassle.)

2) Mother’s Milk Tea. Basically the same stuff as MMP, plus anise and coriander. I liked using both because I could never manage to remember to take the full recommend dosage of either thing — MMP has you popping capsules four times a day and the tea instructions recommend five cups a day. Crazy! By having both options on hand I felt more confident that I was getting the full effect. I usually made a cup of tea in the morning and at night using two teabags per cup. Then if I could remember to pop a capsule a couple times in between, I was good. (And oh, if you can’t stand the taste [I'm not a big fan, though I don't really love herbal teas in general], you can double-brew it along with a teabag of something you like better.)

3) Nurse first, pump second. On days that you realize you may not have pumped often enough, or when you’ve got those extra busy nights away from your baby, you can potentially make up for it by pumping for 10 extra minutes after an in-person feeding with baby. Even if you are not actually producing a single drop, your body should eventually realize that you’re telling it to produce more milk.

4) Nurse naked. Lots of skin to skin. Bring baby to bed with you for night feedings and keep him there. Ditch the stroller or bucket carseat whenever possible while out with him and carry him in a carrier against your chest. Your body is more likely to get back into the rhythm of milk production if you keep him close to your boobs even when he’s not eating. Hormones are crazy weird like that.

5) Low-flow nipples. On the bottles, that is, not your boobs. Since you’re describing impatience with the flow and let-down at the breast, make sure he’s working to get milk from the bottle. Bump him back a level on the nipples — go all the way down to preemie if you have to. (Though daycare providers can get impatient with long feedings and might try to dissuade you from sending in slower nipples — Noah’s did, back in the day — but just tell them it’s a temporary measure to save breastfeeding, and once he’s nursing more contentedly you’ll move him back up. Maybe. Heh.)

Give the stuff above a sporting try for a couple weeks — maybe a month? — and see if things bounce back for you. Good luck! And you know, even if you don’t ever get back to the days of nursing exclusively and continue to pump whenever you realistically can and nurse when it’s possible and supplement when it’s not, that’s sooooo okay too.

Photo credit: Thinkstock

About the author

Amalah

http://www.amalah.com
Amalah is a pseudonym of Amy Corbett Storch. She is the author of the Advice Smackdown and Bounce Back. You can follow Amy's daily mothering adventures at Amalah. Also, it's pronounced AIM-ah-lah.

If there is a question you would like answered on the Advice Smackdown, please submit it to amyadvice@gmail.com.

Amy also documented her second pregnancy (with Ezra) in our wildly popular Weekly Pregnancy Calendar, Zero to Forty.

Amy is mother to rising first-grader Noah, preschooler Ezra, and toddler Ike.


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8 Responses to “Belated Breastfeeding Woes”

  1. Cara Nov 14 at 9:17 pm Reply Reply

    Just a simple suggestion, but it warrants saying during the frenzy – take a few boxes of the mothers milk tea in to the office. I found I easily drank enough tea when it was sitting there on my desk. That and a big cup to remind me to drink water. Getting enough water after I went back to work required a new habit, and water is essential to my milk production.

  2. Jeannie Nov 14 at 11:00 pm Reply Reply

    I also work outside the home, and nursed my kids through toddlerhood, and am wondering … And I mean this question seriously and am not trying to seem like an arse … Is the OP *sure* there is a supply issue? Babies can have issues with nursing for all kinds of reasons, including *just because*. I went through similar things with my son when he was six months old, and after many trips to the doctor and an expensive lactation consultant, we eventually ruled out a supply issue entirely. So … Just saying its possible the baby has something else going on — developmental spurt? — and her supply is just fine even through the huge variety in timing of sessions (mine was!)

  3. Diane Nov 15 at 8:14 am Reply Reply

    I want to chime in (and echo Jeannie) that I had a son in July, and he went through something similar to this a few weeks ago. Are you familiar with the Wonder Weeks? Around this age, they start becoming more aware of the world yada yada, and they get less interested in nursing for a little while. My son had never even HAD a bottle, and he would still get mad that the milk wasn’t coming in quickly enough. Anyway, I just wanted you to know that some part of this might be developmental, and hopefully he’ll be more interested and efficient again soon. All three of my children went through this at the same age, and it was so frustrating. I’ll leave the supply upping advice to everyone else, but I wanted to offer some encouragement! Good luck.

  4. IrishCream Nov 15 at 10:24 am Reply Reply

    I don’t have any advice on the supply issue, but I do have a tip about what to do when you’re completely congested. I get a couple of sinus infections a year, and can’t breathe through my nose at all. Obviously you should check with your own doctor, but my doctor has said that medicated nasal spray is fine while pregnant/nursing. It works in two minutes, lasts for 12 hours, and will save your life (or at least feel that way). Oh, I heart Afrin when I’m sick.

  5. Cluelessx2 Nov 15 at 1:47 pm Reply Reply

    I distinctly remember a phase (at around 4 mOnths) when I had to lean over my son and dangle a boob in his mouth to get him to nurse.  It only lasted a week or two but man it was inconvenient!  I would try supply boosters but it may just be a weird baby phase.  One tip for getting in enough mothers milk tea- brew a lot and keep a pitcher of iced tea in the fridge so you can just grab it on the go.

  6. Courtney Nov 17 at 3:36 pm Reply Reply

    If the OP is concerned about her baby getting enough milk during the day, I would suggest pumping more often at work. I always had to pump 3x/day at work and usually another session after my son went to bed to keep up with his demand (I had supply issues as well due to small size/bad latch at first).

    Is it possible he’s not hungry at night, just looking for some comfort?

  7. camille Nov 17 at 4:32 pm Reply Reply

    16 oz of milk/formula sounds like an awful lot during an 8 hour day. I know anedotes aren’t data, but my tank of a son (95 percentile height and weight) takes ~8oz on most days (sometimes a little more), and he’s 8 months old (exclusively breastfed, plus negligable amounts of solids in the past 2 months). Kellymom has some great advice on how much baby needs, and how to prevent him from overfeeding when he’s away from mama.

    http://www.kellymom.com/bf/pumping/milkcalc.html

  8. Theresa Nov 27 at 9:09 am Reply Reply

    I can soo relate to this post. I was a lazy pumper on returning to grad school when my son was 13 weeks, but like the poster it was because I was so busy and it was hard to just stop and pump, and the supply issue took a while to become obvious. I planned on pumping twice a day (and I was gone roughly 9-5) but ended up just pumping once (and I kept pushing the pumping time farther and farther back). At first this wasn’t a problem and I would pump 7-9 ounces which was enough for him at the time, but after some colds, his 4 month sleep regression, and a couple of months of sleep deprivation I realized I was only getting about 5 ounces a day, and was rapidly depleting my freezer stash.

    Since then I’ve been pumping twice a day when I’m at school, taking more milk plus and mother’s milk tea, and I’m again pumping close to 10 ounces while I’m gone. I’m also vigilant about feeding my son as often as possible mornings and evenings (so I try to feed him right before I drop him off), and I’ll call his caregivers before I leave so that they know not to give him a bottle within an hour of me picking him up, and he eats between 6 and 12 ounces a day while I’m gone, with about 9/10 ounces being the average now. He nurses through the night so he’s definitely getting the other ~ 15-20 ounces he needs in a 24 hour period. 

    Anyway, you sound like you’re doing amazing in general, my gosh 3 kids and work and school, amazing, please don’t hesitate to take a night off sometime soon to catch up on sleep! I’m trying to plan such a night although the thought of not being near my baby through the night makes me nervous.

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