Breastfeeding questions - low milk production edition
April 24, 2018 11:48 AM Subscribe
I'm pregnant with my second. Dealing with nipples that suck for latching and very low milk production almost certainly due to insufficient glandular tissue (tubular breasts). How do I provide as much breast milk to baby as possible, without driving myself nuts?
So, hi metafilter - I'm asking you guys instead of reddit or an LC or nurse or even reading a whole book on the subject because I trust you to be sensitive to these facts:
1. I'm not inventing these breastfeeding issues:
I have tubular breasts. Which means that I have low milk production. Also, my nipples don't seem firm up into a point very well, meaning that I have to use a nipple shield, which sucks. I prefer pumping, unless they've developed some new nipple shield technology in the last 8 years. With my first, I was prescribed domperidone and used a hospital grade pump as often as I could manage (every 3 to 6 hours, which is maybe not enough, but keep in mind I was also formula feeding, having to get baby back to sleep, dealing with infection). I still only produced between 2 and 4 ounces PER DAY. So I would save it all up from all the pumpings during the day and pour it in with the formula.
2. I am a little upset about the fact that I can't breastfeed exclusively.
3. Yes, I know the usual things you are supposed to know about breastfeeding, such as: drink enough water, get enough rest, reduce stress, breastfeed more frequently to increase supply, skin-to-skin as much as possible as soon after birth as possible.
Essentially, I will be formula feeding and supplementing with breast milk. I would really like to maximize my breast milk production if at all possible.
The most frustrating thing to me is people not believing me - I've had friends and a doctor basically say - that was last time and this time will be different. Yeah, um, I don't see how these anatomical issues can have magically resolved themselves between the last pregnancy and this one.
Basically, I'm looking to have some questions answered without being treated like I'm dumb, misinformed and not trying hard enough.
1. This time I should start the domperidone before giving birth, right? Does anyone know when?
2. If the baby's latch is not super effective, would it be better to start using the pump right during the first 12 hours? Should I maybe do both?
3. Can someone please explain why, if it's true that your milk doesn't come in for several days, you are still supposed to breastfeed like every 2-3 hours and watch that they baby doesn't lose too much weight...
4. Any advice for dealing with ignorant nurses who might try to tell me I shouldn't give the baby any formula?
5. What are the best, SANE things I can do to keep my production up?
Thanks so much. This topic stresses me out, if that's not utterly apparent.
So, hi metafilter - I'm asking you guys instead of reddit or an LC or nurse or even reading a whole book on the subject because I trust you to be sensitive to these facts:
1. I'm not inventing these breastfeeding issues:
I have tubular breasts. Which means that I have low milk production. Also, my nipples don't seem firm up into a point very well, meaning that I have to use a nipple shield, which sucks. I prefer pumping, unless they've developed some new nipple shield technology in the last 8 years. With my first, I was prescribed domperidone and used a hospital grade pump as often as I could manage (every 3 to 6 hours, which is maybe not enough, but keep in mind I was also formula feeding, having to get baby back to sleep, dealing with infection). I still only produced between 2 and 4 ounces PER DAY. So I would save it all up from all the pumpings during the day and pour it in with the formula.
2. I am a little upset about the fact that I can't breastfeed exclusively.
3. Yes, I know the usual things you are supposed to know about breastfeeding, such as: drink enough water, get enough rest, reduce stress, breastfeed more frequently to increase supply, skin-to-skin as much as possible as soon after birth as possible.
Essentially, I will be formula feeding and supplementing with breast milk. I would really like to maximize my breast milk production if at all possible.
The most frustrating thing to me is people not believing me - I've had friends and a doctor basically say - that was last time and this time will be different. Yeah, um, I don't see how these anatomical issues can have magically resolved themselves between the last pregnancy and this one.
Basically, I'm looking to have some questions answered without being treated like I'm dumb, misinformed and not trying hard enough.
1. This time I should start the domperidone before giving birth, right? Does anyone know when?
2. If the baby's latch is not super effective, would it be better to start using the pump right during the first 12 hours? Should I maybe do both?
3. Can someone please explain why, if it's true that your milk doesn't come in for several days, you are still supposed to breastfeed like every 2-3 hours and watch that they baby doesn't lose too much weight...
4. Any advice for dealing with ignorant nurses who might try to tell me I shouldn't give the baby any formula?
5. What are the best, SANE things I can do to keep my production up?
Thanks so much. This topic stresses me out, if that's not utterly apparent.
I can only really answer 3... before your milk really comes in, you should be producing colostrum, which is basically super-concentrated milk. IIRC, the baby needs something like 1 oz per day or even less at that stage.
I don't know answers to the rest, but as for keeping your sanity, one thing that's happened in the past 8 years is that research has begun to show that the benefits of breastfeeding have likely been overstated. I'm not saying you shouldn't give it your best shot, but mainly because it's important to you.
posted by Kriesa at 12:26 PM on April 24, 2018 [13 favorites]
I don't know answers to the rest, but as for keeping your sanity, one thing that's happened in the past 8 years is that research has begun to show that the benefits of breastfeeding have likely been overstated. I'm not saying you shouldn't give it your best shot, but mainly because it's important to you.
posted by Kriesa at 12:26 PM on April 24, 2018 [13 favorites]
It's a very stressful topic; it literally could be life or death for your baby. I'm a guy, so I'm not super knowledgeable about this stuff, but I can tell you some things that helped with my wife when her production was down.
If you can, work with a doula and/or a lactation consultant. The former was more helpful than the latter, in my experience. Our lactation consultant seemed a little... dim, and she didn't do anything to help my wife's production except tell us to buy a bunch of expensive stuff. Our doula, on the other hand, was very helpful. She suggested this power-pump thing that succeeded in increasing supply. I don't remember the details, but it was something like pumping for an uninterrupted hour two or three times a day, even if nothing is coming out. I guess the idea is to simulate increased demand with the idea that your body will respond by increasing supply. It sounds a little too cute, but it worked.
We ended up having to bottle-feed exclusively because of latch issues. There's a stigma about this for some reason, but it worked for us. After our daughter was diagnosed as failing to thrive at her one-month checkup, our pediatrician suggested exclusive bottle feeding, and our daughter shot up so that, since her six-month checkup, she has been in the 90th or above for both height and weight. As a side benefit, you don't have to worry about breastfeeding in public.
There's a lot of judgment around breastfeeding in general. People are unbelievably dogmatic that you MUST feed your child breast milk directly from your breast, or you are somehow a failure as a parent. This is BS. As our doula told us, the best way to feed your child is the way that your child will actually eat. If that means formula, so be it. Shortly after our daughter had her failure to thrive moment, algorithmic news sources decided that what I really wanted was to read stories about infants who died because they could not latch, or because their mothers could not produce enough milk. (It's shocking how many stories there are like this.) The common thread in all of them is that, even though it was obvious that the baby was not getting enough nutrition, the nurses' dogmatic suggestion was just to try harder rather than switch to forumula. Breastfeeding may be best, but I'd rather have a formula drinker who's actually alive.
That's the other reason I suggest a doula: they're there to advocate for you. If you come up against an asshole nurse, your doula can do the work of explaining the situation for you. When you've just given birth, you don't have the energy to explain everything and demand you get your way (and speaking from experience, your partner often won't have that energy, either). That's where the doula comes in. It's worth it.
My mother-in-law also bought my wife some lactation cookies. I guess they include an enzyme that stimulates milk production. I don't think they actually worked, but I tried a bite, and they tasted good, so it wouldn't hurt.
posted by kevinbelt at 12:37 PM on April 24, 2018 [1 favorite]
If you can, work with a doula and/or a lactation consultant. The former was more helpful than the latter, in my experience. Our lactation consultant seemed a little... dim, and she didn't do anything to help my wife's production except tell us to buy a bunch of expensive stuff. Our doula, on the other hand, was very helpful. She suggested this power-pump thing that succeeded in increasing supply. I don't remember the details, but it was something like pumping for an uninterrupted hour two or three times a day, even if nothing is coming out. I guess the idea is to simulate increased demand with the idea that your body will respond by increasing supply. It sounds a little too cute, but it worked.
We ended up having to bottle-feed exclusively because of latch issues. There's a stigma about this for some reason, but it worked for us. After our daughter was diagnosed as failing to thrive at her one-month checkup, our pediatrician suggested exclusive bottle feeding, and our daughter shot up so that, since her six-month checkup, she has been in the 90th or above for both height and weight. As a side benefit, you don't have to worry about breastfeeding in public.
There's a lot of judgment around breastfeeding in general. People are unbelievably dogmatic that you MUST feed your child breast milk directly from your breast, or you are somehow a failure as a parent. This is BS. As our doula told us, the best way to feed your child is the way that your child will actually eat. If that means formula, so be it. Shortly after our daughter had her failure to thrive moment, algorithmic news sources decided that what I really wanted was to read stories about infants who died because they could not latch, or because their mothers could not produce enough milk. (It's shocking how many stories there are like this.) The common thread in all of them is that, even though it was obvious that the baby was not getting enough nutrition, the nurses' dogmatic suggestion was just to try harder rather than switch to forumula. Breastfeeding may be best, but I'd rather have a formula drinker who's actually alive.
That's the other reason I suggest a doula: they're there to advocate for you. If you come up against an asshole nurse, your doula can do the work of explaining the situation for you. When you've just given birth, you don't have the energy to explain everything and demand you get your way (and speaking from experience, your partner often won't have that energy, either). That's where the doula comes in. It's worth it.
My mother-in-law also bought my wife some lactation cookies. I guess they include an enzyme that stimulates milk production. I don't think they actually worked, but I tried a bite, and they tasted good, so it wouldn't hurt.
posted by kevinbelt at 12:37 PM on April 24, 2018 [1 favorite]
I will leave answering your questions regarding milk production and how to maximize that to folks who know the subject better. I'm here just to say that I, too, was diagnosed with IGT by an LC with my first baby, and that I'm also thinking about how I want things to go with my second baby (due in July). I completely believe you, and get how hard this can be!
What I did last time: after discovering the IGT (after a scary 10 days of watching my newborn fail to gain weight as we tried to primarily BF and supplement only a bit per my now-fired ped's recs), I decided, with my LC's support, to pump for as long as I felt it worthwhile & not taking away from time with my baby or my own much-needed self-care. I also put my baby to the breast for about 5-10 minutes per boob to let him get what he could. After about a month, I ceased both pumping & breastfeeding, and I felt happy about that decision, especially based on what research I had done on the value of breastfeeding vs. formula-feeding (tl;dr: research shows that breastfeeding doesn't have many benefits over formula-feeding, and basically none that continue past infanthood; please PM me if you'd like more data).
What I plan to do this time: I will start supplementing right away in the hospital, after putting baby to breast for a few minutes on each side (longer on the side with the more-productive boob). My understanding is that milk-gland tissue can increase with each pregnancy due to pregnancy hormones, but given how low my production was last go-around (1 - 3 ounces a day), I'm not expecting to be able to exclusively breastfeed by any means. I do want to give my newborn a good shot at getting some colostrum, though, and whatever milk I can. My hospital has an LC come around, so I'll ask her for pointers on how to best keep up what little supply I have without stressing over it and/or spending time that I'd rather spend on recovering from childbirth (a mother's health matters too!) or just hanging out with my baby. I'm not planning on doing any significant pumping this time, because I don't feel like that's a worthwhile time investment for me (it totally could be for you, though - you should take whatever path feels best to you!). And then when the breastfeeding relationship peters out, which I'm sure it will, I'll be an exclusively formula-feeding parent who will be very happy to share the feeding responsibilities with my partner.
This is hard, and there's a lot of judging and shame and guilt that happens around breastfeeding & formula feeding. Please take care of yourself. If no one on the green has answers to your questions, I highly recommend finding an LC who has significant experience with IGT to help you find answers. If you can't find one local to you, PM me and I'll hunt up the LC who helped me when I got panic-y at the ten day mark about how my newborn wasn't thriving - she drove 3 hours to help us, had had IGT herself, and was all sorts of amazing.
posted by Jaclyn at 12:39 PM on April 24, 2018 [5 favorites]
What I did last time: after discovering the IGT (after a scary 10 days of watching my newborn fail to gain weight as we tried to primarily BF and supplement only a bit per my now-fired ped's recs), I decided, with my LC's support, to pump for as long as I felt it worthwhile & not taking away from time with my baby or my own much-needed self-care. I also put my baby to the breast for about 5-10 minutes per boob to let him get what he could. After about a month, I ceased both pumping & breastfeeding, and I felt happy about that decision, especially based on what research I had done on the value of breastfeeding vs. formula-feeding (tl;dr: research shows that breastfeeding doesn't have many benefits over formula-feeding, and basically none that continue past infanthood; please PM me if you'd like more data).
What I plan to do this time: I will start supplementing right away in the hospital, after putting baby to breast for a few minutes on each side (longer on the side with the more-productive boob). My understanding is that milk-gland tissue can increase with each pregnancy due to pregnancy hormones, but given how low my production was last go-around (1 - 3 ounces a day), I'm not expecting to be able to exclusively breastfeed by any means. I do want to give my newborn a good shot at getting some colostrum, though, and whatever milk I can. My hospital has an LC come around, so I'll ask her for pointers on how to best keep up what little supply I have without stressing over it and/or spending time that I'd rather spend on recovering from childbirth (a mother's health matters too!) or just hanging out with my baby. I'm not planning on doing any significant pumping this time, because I don't feel like that's a worthwhile time investment for me (it totally could be for you, though - you should take whatever path feels best to you!). And then when the breastfeeding relationship peters out, which I'm sure it will, I'll be an exclusively formula-feeding parent who will be very happy to share the feeding responsibilities with my partner.
This is hard, and there's a lot of judging and shame and guilt that happens around breastfeeding & formula feeding. Please take care of yourself. If no one on the green has answers to your questions, I highly recommend finding an LC who has significant experience with IGT to help you find answers. If you can't find one local to you, PM me and I'll hunt up the LC who helped me when I got panic-y at the ten day mark about how my newborn wasn't thriving - she drove 3 hours to help us, had had IGT herself, and was all sorts of amazing.
posted by Jaclyn at 12:39 PM on April 24, 2018 [5 favorites]
Oh, and my birth plan will mention that I have IGT and that we will be supplementing from the start. Hopefully nurses & doctors in the hospital will read that and not be annoying about trying to get me to breastfeed, but if they aren't, I have zero issues shutting that shit down. If you don't think you'll be comfortable dealing with that (which is totally okay - you'll have just given birth!), please find someone who can run interference for you - your partner, a doula, a trusted friend or family member! No one should judge you for the choices you make in ensuring your baby is well-fed!
posted by Jaclyn at 12:51 PM on April 24, 2018
posted by Jaclyn at 12:51 PM on April 24, 2018
It seems that everyone has very strong opinions about breastfeeding so doing research online can be challenging. Here are a couple things that might help though.
The point of breastfeeding the first couple days is to get the baby colostrum and stimulate your supply. The point is not volume. I believe up to 10% weight loss is considered acceptable. The way I look at it is that being born is tough and there are a lot of new things to deal with (like breathing). Eating just isn’t super high on the priority list at first. That’s not scientific but might help frame things.
A good resource for breastfeeding topics is Kelly Mom. If you haven’t seen it before it’s worth looking at.
Finally, if latching is a problem consider a tongue tie as a possibility. You don’t mention it in your post but it can cause trouble latching.
posted by unix at 12:51 PM on April 24, 2018 [2 favorites]
The point of breastfeeding the first couple days is to get the baby colostrum and stimulate your supply. The point is not volume. I believe up to 10% weight loss is considered acceptable. The way I look at it is that being born is tough and there are a lot of new things to deal with (like breathing). Eating just isn’t super high on the priority list at first. That’s not scientific but might help frame things.
A good resource for breastfeeding topics is Kelly Mom. If you haven’t seen it before it’s worth looking at.
Finally, if latching is a problem consider a tongue tie as a possibility. You don’t mention it in your post but it can cause trouble latching.
posted by unix at 12:51 PM on April 24, 2018 [2 favorites]
First, congratulations on your upcoming baby. :)
So sorry you're going through this and finding it so stressful.
I have a friend with a congenital lack of glandular breast tissue who chose not to breastfeed her second child at all and went straight to pumping supplemented with formula. She did what Mariemma suggests, but she also asked to speak with the nurse supervisor to request that her doctor's note be added to her chart and that the nursing staff be briefed as well. This allowed her to explain her situation to the person in charge and request that the staff not harass her on the subject. It let her refuse to be required to constantly explain herself to them.
If a nurse / lactation consultant then said anything to her during her stay in the hospital, she would ask them to read her chart and come back to speak with her when they were fully aware of her medical history and condition. A rebuke was implied: the nurse should already know her medical needs before she entered the room to speak with her.
She said it didn't always work, but it did make things easier.
Good luck. I hope you find the answers you need.
posted by zarq at 12:56 PM on April 24, 2018 [7 favorites]
So sorry you're going through this and finding it so stressful.
I have a friend with a congenital lack of glandular breast tissue who chose not to breastfeed her second child at all and went straight to pumping supplemented with formula. She did what Mariemma suggests, but she also asked to speak with the nurse supervisor to request that her doctor's note be added to her chart and that the nursing staff be briefed as well. This allowed her to explain her situation to the person in charge and request that the staff not harass her on the subject. It let her refuse to be required to constantly explain herself to them.
If a nurse / lactation consultant then said anything to her during her stay in the hospital, she would ask them to read her chart and come back to speak with her when they were fully aware of her medical history and condition. A rebuke was implied: the nurse should already know her medical needs before she entered the room to speak with her.
She said it didn't always work, but it did make things easier.
Good luck. I hope you find the answers you need.
posted by zarq at 12:56 PM on April 24, 2018 [7 favorites]
How much domperidone did you take? The recommended dosage can go up a lot higher according to some docs. I won't recommend it personally (I am not a Dr) but used Dr. Newman's max dosage to get up to 18 oz from about 5 per day.
posted by decathexis at 12:59 PM on April 24, 2018
posted by decathexis at 12:59 PM on April 24, 2018
Can someone please explain why, if it's true that your milk doesn't come in for several days, you are still supposed to breastfeed like every 2-3 hours - the 1st production is a different product, not considered milk. It's an academic distinction. Breastfeed often because newborns can't hold much and to stimulate milk production.
Spend some time on the bed with your baby, letting the baby suck as much as possible, no nipple shields. Nipple stimulation promotes milk production. If possible, spend some baby time this way daily.
Weigh the baby and pay attention to diapers so you know baby is getting enough.
Yogi tea - Womans nursing support - may help a bit.
Nursing is good nutrition, good for you and your baby, and many women enjoy it once the painful adjustment phase is done, but if it doesn't work out, you and your baby still get to be happy and healthy and will still bond.
Absolutely have it put in your chart, and ask the nurses to be supportive and not critical. This is a medical issue that is keeping you from doing what you really want to do. Criticizing would be unkind.
Congratulations!
posted by theora55 at 1:14 PM on April 24, 2018 [2 favorites]
Spend some time on the bed with your baby, letting the baby suck as much as possible, no nipple shields. Nipple stimulation promotes milk production. If possible, spend some baby time this way daily.
Weigh the baby and pay attention to diapers so you know baby is getting enough.
Yogi tea - Womans nursing support - may help a bit.
Nursing is good nutrition, good for you and your baby, and many women enjoy it once the painful adjustment phase is done, but if it doesn't work out, you and your baby still get to be happy and healthy and will still bond.
Absolutely have it put in your chart, and ask the nurses to be supportive and not critical. This is a medical issue that is keeping you from doing what you really want to do. Criticizing would be unkind.
Congratulations!
posted by theora55 at 1:14 PM on April 24, 2018 [2 favorites]
Hon, I mean this as kindly and empathically as you can imagine: YOU DO NOT NEED TO BREASTFEED. You do not need to do a million things to keep your supply. You don't have to be wracked with guilt and inadequacy for your low supply. Your baby will thrive on your love, your care, your touch, formula, and exactly as much breastmilk as you can give without causing yourself all the stress and pain. There are no experts in this world who can pick out the breastfed vs. the formula-fed from a lineup of kindergarteners with any degree of accuracy whatsoever based on the children's IQ metrics, immune system measurements, or any other data. In first world countries given a basic minimum std of living, formula vs. breast milk has NO measurable effects past the age of about two. This is not a controversial claim!
In your name, and in the names of moms like us everywhere, I swear I am going to torch every chapter of La Leche League one day for perpetrating this massive guilt trip on new mothers. But until I do, my wish for you is simply this: enjoy your baby. Snatch as many good moments during the babyhood as you possibly can. Second time around can be such a blessing.... Allow yourself to ease into it. You are enough. <3
posted by MiraK at 1:43 PM on April 24, 2018 [30 favorites]
In your name, and in the names of moms like us everywhere, I swear I am going to torch every chapter of La Leche League one day for perpetrating this massive guilt trip on new mothers. But until I do, my wish for you is simply this: enjoy your baby. Snatch as many good moments during the babyhood as you possibly can. Second time around can be such a blessing.... Allow yourself to ease into it. You are enough. <3
posted by MiraK at 1:43 PM on April 24, 2018 [30 favorites]
As a two-time mom who had a surgical breast reduction prior to breastfeeding, I feel you.
Talk to your doctor about Domperidone, but I can't find any research that shows it is effective prior to milk coming in.
If you're having trouble getting that latch started after birth, ask for help! At one point, a nurse literally shoved my nipple into the babies mouth for me. Pumping is really only a good idea if you absolutely can't get the baby to latch. Nursing during that first few days helps establish your milk supply and is really important going forward. I was told by my LC that it is better to nurse with a shield than to pump at this stage.
Babies are actually expected to lose 7-10% of their birth weight in the first week. Once you feel your milk come in, you can visit the pediatrician or an LC and they can weigh the baby before and after nursing to give you a good idea how much milk you're producing. I produced barely anything the first time, but had much better luck the second go around.
You won't need to give the baby formula while in the hospital if you are going to try to breastfeed, but no nurse should give you crap if you end up using formula. In that case, you have every right to make a complaint and request a different nurse.
Things that helped me keep production up- A Spectra breast pump with properly sized flanges. Reminding myself that my first supplemented and still turned out ok. Co-sleeping and letting my sweet baby nurse to her heart's content while I slept.
Congrats! You're gonna do amazing no matter what you do!
posted by galvanized unicorn at 1:51 PM on April 24, 2018
Talk to your doctor about Domperidone, but I can't find any research that shows it is effective prior to milk coming in.
If you're having trouble getting that latch started after birth, ask for help! At one point, a nurse literally shoved my nipple into the babies mouth for me. Pumping is really only a good idea if you absolutely can't get the baby to latch. Nursing during that first few days helps establish your milk supply and is really important going forward. I was told by my LC that it is better to nurse with a shield than to pump at this stage.
Babies are actually expected to lose 7-10% of their birth weight in the first week. Once you feel your milk come in, you can visit the pediatrician or an LC and they can weigh the baby before and after nursing to give you a good idea how much milk you're producing. I produced barely anything the first time, but had much better luck the second go around.
You won't need to give the baby formula while in the hospital if you are going to try to breastfeed, but no nurse should give you crap if you end up using formula. In that case, you have every right to make a complaint and request a different nurse.
Things that helped me keep production up- A Spectra breast pump with properly sized flanges. Reminding myself that my first supplemented and still turned out ok. Co-sleeping and letting my sweet baby nurse to her heart's content while I slept.
Congrats! You're gonna do amazing no matter what you do!
posted by galvanized unicorn at 1:51 PM on April 24, 2018
I used a lactation supplement called LactationAid that was a combination of various herbal supplements. It increased my production about 25%.
I laid in a good supply of TV shows to watch during my midnight pumping sessions. Come to think of it I still haven’t finished watching Angel.
I had supply/latching problems the first time around to the extent that I exclusively pumped and supplements with formula for about six months. The second time around things were indeed much easier - just magically the boobs made more milk for no reason I could see. So perhaps things will be a little easier for you this time around. It still hurt like a bitch for the first couple of weeks though.
There’s a video online about massaging while pumping that’s pretty impressive. It does increase output a lot.
Congratulations and best wishes, enjoy your baby!
posted by bq at 2:00 PM on April 24, 2018 [2 favorites]
I laid in a good supply of TV shows to watch during my midnight pumping sessions. Come to think of it I still haven’t finished watching Angel.
I had supply/latching problems the first time around to the extent that I exclusively pumped and supplements with formula for about six months. The second time around things were indeed much easier - just magically the boobs made more milk for no reason I could see. So perhaps things will be a little easier for you this time around. It still hurt like a bitch for the first couple of weeks though.
There’s a video online about massaging while pumping that’s pretty impressive. It does increase output a lot.
Congratulations and best wishes, enjoy your baby!
posted by bq at 2:00 PM on April 24, 2018 [2 favorites]
I can only answer the question about the nurses. I chose to formula feed my second right at the hospital and the amount of grief I got for it from the nurses was unbelievable. Pediatrician and all the OBs were super supportive (“do what’s best for you, baby will be great regardless!”) but the nurses were absolute shits.
The advice I would give would be for your partner to be clearly and firmly on board with your plan and ready to dish it out to the nurses on your behalf. My husband, poor soul, mistakenly thought that I would find it patronizing for him to intercede on my behalf when the nurses got pushy. Normally that would totally be the case because I can handle it but three hours post-partum? Nope.
So get them briefed, work on a script, and have them run interference if you encounter a pushy, judgy nurse. Because fuck pushy judgy nurses.
posted by lydhre at 2:02 PM on April 24, 2018 [1 favorite]
The advice I would give would be for your partner to be clearly and firmly on board with your plan and ready to dish it out to the nurses on your behalf. My husband, poor soul, mistakenly thought that I would find it patronizing for him to intercede on my behalf when the nurses got pushy. Normally that would totally be the case because I can handle it but three hours post-partum? Nope.
So get them briefed, work on a script, and have them run interference if you encounter a pushy, judgy nurse. Because fuck pushy judgy nurses.
posted by lydhre at 2:02 PM on April 24, 2018 [1 favorite]
Pumping sucks. Baby will get out more milk plus bonding. If there is any way you can get in some baby on boob time, I say you go that way. Meet with a lactation specialist to discuss. Don't pump. Pumping sucks and will never get your supply up. I could see the first six weeks effort of pumping and then give up! You can quit pumping. And you should.
posted by Kalmya at 2:02 PM on April 24, 2018
posted by Kalmya at 2:02 PM on April 24, 2018
Also, I pumped exclusively with my first because I hated breastfeeding and it was fine. If you want to pump to supplement you should! If you don’t you shouldn’t! It’s all good as long as you’re happy and baby is fed.
posted by lydhre at 2:04 PM on April 24, 2018
posted by lydhre at 2:04 PM on April 24, 2018
Generally speaking, babies are significantly more effective at removing milk than a pump. If I had a low supply but wanted to breastfeed, I would feed the baby directly (with nipple shields if needed) and then give the baby a bottle of formula immediately after. I wouldn’t pump at all because pumping takes a lot of time that I would rather spend with the baby / sleeping / staring at a wall.
In terms of sane things to increase supply in addition to the domperidone, I’d make sure to stay hydrated and eat enough food (no dieting), but that’s it. Your mental health is way more important than making a few extra ounces of milk.
I also want to echo the point that you don’t need to breastfeed. If you want to breastfeed and it works for you to both nurse and supplement with formula, great! If it ends up being too stressful and you switch to just formula - great! I breastfed my daughter and it was the right choice for us, but the health benefits are pretty marginal (assuming access to clean water and formula, which you have).
posted by insectosaurus at 2:07 PM on April 24, 2018 [2 favorites]
In terms of sane things to increase supply in addition to the domperidone, I’d make sure to stay hydrated and eat enough food (no dieting), but that’s it. Your mental health is way more important than making a few extra ounces of milk.
I also want to echo the point that you don’t need to breastfeed. If you want to breastfeed and it works for you to both nurse and supplement with formula, great! If it ends up being too stressful and you switch to just formula - great! I breastfed my daughter and it was the right choice for us, but the health benefits are pretty marginal (assuming access to clean water and formula, which you have).
posted by insectosaurus at 2:07 PM on April 24, 2018 [2 favorites]
This is folk medicine, and I pass it on as anecdotal and harmless, but eating oatmeal and fenugreek are both supposed to be good for production. As is hoppy beer, but that depends on your comfort with drinking while nursing (I did, but I understand lots of people wouldn’t.)
And what everyone else said about nursing being optional. The benefits of breastmilk over formula made with clean water and so on are tiny; the benefits to the baby of you not being miserable are huge.
posted by LizardBreath at 2:25 PM on April 24, 2018 [1 favorite]
And what everyone else said about nursing being optional. The benefits of breastmilk over formula made with clean water and so on are tiny; the benefits to the baby of you not being miserable are huge.
posted by LizardBreath at 2:25 PM on April 24, 2018 [1 favorite]
Response by poster: Pumping..will never get your supply up.
Is this true? If so, why not?
posted by kitcat at 2:56 PM on April 24, 2018
Is this true? If so, why not?
posted by kitcat at 2:56 PM on April 24, 2018
Response by poster: Just to clear - because the reasons to pump, as I see them, are:
- You can see if you are producing anything or not. Don't try to tell me that's trivial if you don't know what it's like to produce less than an ounce of milk per feeding/pumping. I've been to the LC and done the - feed the baby and weigh her after thing. It came up less than an ounce when she was about 3 weeks old. I can't weigh the baby on a scale with that kind of sensitivity after every feeding - they have those in institutions, not homes. Plus, that would be crazy-making.
- It's hella easier than trying to breastfeed with a nipple shield.
- Precisely to get supply up. You can do it whenever, for as long as you want, as often as you want. I think I mostly tried to breastfeed my daughter first and pump after, but I think eventually breastfeeding was so frustrating and doing both so time-consuming that I gave up and began pumping exclusively.
posted by kitcat at 3:08 PM on April 24, 2018 [1 favorite]
- You can see if you are producing anything or not. Don't try to tell me that's trivial if you don't know what it's like to produce less than an ounce of milk per feeding/pumping. I've been to the LC and done the - feed the baby and weigh her after thing. It came up less than an ounce when she was about 3 weeks old. I can't weigh the baby on a scale with that kind of sensitivity after every feeding - they have those in institutions, not homes. Plus, that would be crazy-making.
- It's hella easier than trying to breastfeed with a nipple shield.
- Precisely to get supply up. You can do it whenever, for as long as you want, as often as you want. I think I mostly tried to breastfeed my daughter first and pump after, but I think eventually breastfeeding was so frustrating and doing both so time-consuming that I gave up and began pumping exclusively.
posted by kitcat at 3:08 PM on April 24, 2018 [1 favorite]
It's not true, and it doesn't need to suck either. It's absolutely possible for people to feed their children through exclusively pumping.
I forgot to mention hands-free bras, although I hope if you did exclusive pumping last time that's covered. If not, buy some extra cheap sports bras and cut holes in the nipples.
posted by bq at 3:12 PM on April 24, 2018
I forgot to mention hands-free bras, although I hope if you did exclusive pumping last time that's covered. If not, buy some extra cheap sports bras and cut holes in the nipples.
posted by bq at 3:12 PM on April 24, 2018
The most frustrating thing to me is people not believing me - I've had friends and a doctor basically say - that was last time and this time will be different. Yeah, um, I don't see how these anatomical issues can have magically resolved themselves between the last pregnancy and this one.
From what I know, with your second all of the milk ducts that you used to breastfeed last time around are ready to produce milk and possibly, if your child has a good latch and breastfeeds vigorously, more than you produced last time around. Oversupplies are more common with second babies, for example.
3. Can someone please explain why, if it's true that your milk doesn't come in for several days, you are still supposed to breastfeed like every 2-3 hours and watch that they baby doesn't lose too much weight...
Colostrum is awesome. I stumbled across this in my early breastfeeding days, stressing the importance of giving colostrum to baby calves. Emptying your breasts of colostrum helps signal to make more milk. It also helps to contract your uterus and is good for postpartum healing. With a newborn, rather than touching a pump, I'd do breast compressions to ensure that my boobs were empty after every feeding. Generally, massaging your breasts, breast compressions, and hand expressing are one of the best ways to up supply and women taught breast compressions and hand expressing in the hospital have better long term breastfeeding success.
The last thing I'd mention isn't just not dieting. I would eat, like, a lot more. I had an oversupply, and I essentially ate like a teenage boy during my first year of breastfeeding. I could not be trusted with cookies. I had a friend who was told she had low supply with her first; one day, in the depths of postpartum depression, she ate a handful of candybars and suddenly made a lot more milk. She decided to indulge in higher calorie meals with her second and didn't have any supply problems.
posted by PhoBWanKenobi at 3:38 PM on April 24, 2018 [2 favorites]
From what I know, with your second all of the milk ducts that you used to breastfeed last time around are ready to produce milk and possibly, if your child has a good latch and breastfeeds vigorously, more than you produced last time around. Oversupplies are more common with second babies, for example.
3. Can someone please explain why, if it's true that your milk doesn't come in for several days, you are still supposed to breastfeed like every 2-3 hours and watch that they baby doesn't lose too much weight...
Colostrum is awesome. I stumbled across this in my early breastfeeding days, stressing the importance of giving colostrum to baby calves. Emptying your breasts of colostrum helps signal to make more milk. It also helps to contract your uterus and is good for postpartum healing. With a newborn, rather than touching a pump, I'd do breast compressions to ensure that my boobs were empty after every feeding. Generally, massaging your breasts, breast compressions, and hand expressing are one of the best ways to up supply and women taught breast compressions and hand expressing in the hospital have better long term breastfeeding success.
The last thing I'd mention isn't just not dieting. I would eat, like, a lot more. I had an oversupply, and I essentially ate like a teenage boy during my first year of breastfeeding. I could not be trusted with cookies. I had a friend who was told she had low supply with her first; one day, in the depths of postpartum depression, she ate a handful of candybars and suddenly made a lot more milk. She decided to indulge in higher calorie meals with her second and didn't have any supply problems.
posted by PhoBWanKenobi at 3:38 PM on April 24, 2018 [2 favorites]
Honestly, get some whole fenugreek, make a strong tea and sip it throughout the day. Start with a very small amount because it works insanely well and can make you very uncomfortable if your baby can't keep up with the additional production. Keep in mind it will also make your sweat smell like artificial maple syrup. I don't know if it works that well for everyone, but it's inexpensive and easy to try, and I was completely amazed at the results myself.
posted by OnefortheLast at 3:41 PM on April 24, 2018 [1 favorite]
posted by OnefortheLast at 3:41 PM on April 24, 2018 [1 favorite]
Also, you might read up on Las dos. Women in some cultures mixed feed from the start and it is not generally thought of as a sign of failure. Our cultural attitudes around exclusive breastfeeding make "success' much more difficult to achieve.
posted by PhoBWanKenobi at 3:42 PM on April 24, 2018 [1 favorite]
posted by PhoBWanKenobi at 3:42 PM on April 24, 2018 [1 favorite]
#2 If pumps are ineffective for you (as they are with a lot of women), make sure to try hand expression before giving up. I could never trigger my let-down reflex with a pump or get more than a half oz of milk that way, but could get an easy 6-8oz with hand expression in minimum time.
#3 Yes to all who answered why colostrum is important, but also breastfeeding before your milk comes in will also signal to your body how frequently your baby feeds and for how long, so it will know how much milk to make when it comes in.
#4 Your body, your choice. So nod and smile, then discard any "well meaning" advice that doesn't apply to you. It's a never ending phenomena when you become a mother to receive endless unsolicited advice, so learn early how to mentally block it out to maintain your sanity.
posted by OnefortheLast at 3:51 PM on April 24, 2018 [1 favorite]
#3 Yes to all who answered why colostrum is important, but also breastfeeding before your milk comes in will also signal to your body how frequently your baby feeds and for how long, so it will know how much milk to make when it comes in.
#4 Your body, your choice. So nod and smile, then discard any "well meaning" advice that doesn't apply to you. It's a never ending phenomena when you become a mother to receive endless unsolicited advice, so learn early how to mentally block it out to maintain your sanity.
posted by OnefortheLast at 3:51 PM on April 24, 2018 [1 favorite]
Re. #4
The phrases:
"Oh, really? I didn't know that! Thank you."
And
"Oh, really? I'll have to try that. Thank you."
Used interchangeably, ad nauseum, are all I've ever used for 15 years with no issue whatsoever. It's an effective way to cut off an advice-giver mid-lecture, makes them feel respected heard and useful so they stop with no hard feelings, and is a good way to remind yourself that everyone has a different opinion on how to parent, but the only way that matters is what works for you personally. Don't get caught in the trap of feeling like you are required to defend your choices or change them to please others. Parenting is hard enough as is.
posted by OnefortheLast at 4:24 PM on April 24, 2018 [2 favorites]
The phrases:
"Oh, really? I didn't know that! Thank you."
And
"Oh, really? I'll have to try that. Thank you."
Used interchangeably, ad nauseum, are all I've ever used for 15 years with no issue whatsoever. It's an effective way to cut off an advice-giver mid-lecture, makes them feel respected heard and useful so they stop with no hard feelings, and is a good way to remind yourself that everyone has a different opinion on how to parent, but the only way that matters is what works for you personally. Don't get caught in the trap of feeling like you are required to defend your choices or change them to please others. Parenting is hard enough as is.
posted by OnefortheLast at 4:24 PM on April 24, 2018 [2 favorites]
To keep your supply up: make sure, to the best you can, to take care of yourself.
When my supply dropped, my pediatrician asked me how much I was sleeping and if anything stressed me out recently. (Answer: in-laws were visiting) She emphasizes to me each appointment to get at least 6 hours of sleep, eat, and drink water. (Also this Mother’s Milk tea) After that appointment I took a looong nap and downed a delicious burger and tons of tea. I ignored my in laws and cuddled my baby. My supply started up again a day or so later
posted by inevitability at 5:11 PM on April 24, 2018
When my supply dropped, my pediatrician asked me how much I was sleeping and if anything stressed me out recently. (Answer: in-laws were visiting) She emphasizes to me each appointment to get at least 6 hours of sleep, eat, and drink water. (Also this Mother’s Milk tea) After that appointment I took a looong nap and downed a delicious burger and tons of tea. I ignored my in laws and cuddled my baby. My supply started up again a day or so later
posted by inevitability at 5:11 PM on April 24, 2018
Oatmeal seemed to improve my milk output.
Fenugreek worked for a while, but then it screwed up my thyroid and I had to stop taking it. (It also made me smell like maple syrup, which was annoying.) I've read it can also affect blood clotting and blood sugar levels. This page has some info about various health effects.
Best wishes on your pregnancy!
posted by belladonna at 5:33 PM on April 24, 2018 [1 favorite]
Fenugreek worked for a while, but then it screwed up my thyroid and I had to stop taking it. (It also made me smell like maple syrup, which was annoying.) I've read it can also affect blood clotting and blood sugar levels. This page has some info about various health effects.
Best wishes on your pregnancy!
posted by belladonna at 5:33 PM on April 24, 2018 [1 favorite]
I saw a doctor who specializes in breast feeding (in Vancouver, if you're here google Vancouver breastfeeding clinic). The doctor was amazing. One of my twins was failing to thrive, and I ended up bottle feeding him and breastfeeding feeding the other. Which is.. not uncommon. After several months, we figured out nursing, and I switched.
My issue was a baby issue: he had a jaw problem and couldn't suck, so different. But the doctor was so much better than all the doulas and lactation consultants who tried to help. So my advice: my bottle fed kid is just as bonded to me as the breastfed one. The doctor helped, but she was the one who switched him to bottles. Get help, but if it doesn't work, your baby will be fine. And if you can find a breastfeeding specializing doctor? Go see her now, before baby comes.
posted by Valancy Rachel at 5:42 PM on April 24, 2018
My issue was a baby issue: he had a jaw problem and couldn't suck, so different. But the doctor was so much better than all the doulas and lactation consultants who tried to help. So my advice: my bottle fed kid is just as bonded to me as the breastfed one. The doctor helped, but she was the one who switched him to bottles. Get help, but if it doesn't work, your baby will be fine. And if you can find a breastfeeding specializing doctor? Go see her now, before baby comes.
posted by Valancy Rachel at 5:42 PM on April 24, 2018
it literally could be life or death for your baby
No, it cannot be anything like that in the first world with a safe water supply, Jesus H. If you don't produce enough milk (and so! many! women! don't) you supplement, as you know, as you're already planning. You're fine.
(I had supply issues. It was awful. The time spent with the crazy lactation woman who taped tubes to my nipples was one of the low points of my life. I wish I had consumed a LOT less pernicious "breast is best" nonsense. Breast is fine, formula is fine, additional stress for a new mom is very bad.)
A not-horrible thing to try is "lactation cookies" with ground flaxseed. Will they work? Who knows, but cookies are very nice for new moms.
posted by fingersandtoes at 6:04 PM on April 24, 2018 [12 favorites]
No, it cannot be anything like that in the first world with a safe water supply, Jesus H. If you don't produce enough milk (and so! many! women! don't) you supplement, as you know, as you're already planning. You're fine.
(I had supply issues. It was awful. The time spent with the crazy lactation woman who taped tubes to my nipples was one of the low points of my life. I wish I had consumed a LOT less pernicious "breast is best" nonsense. Breast is fine, formula is fine, additional stress for a new mom is very bad.)
A not-horrible thing to try is "lactation cookies" with ground flaxseed. Will they work? Who knows, but cookies are very nice for new moms.
posted by fingersandtoes at 6:04 PM on April 24, 2018 [12 favorites]
Try to rent a hospital grade pump like Medela Symphony. Way way better at getting milk supply up. I used three different ones and that was the best.
Also, I had a ton of milk with my first and just right at adequate for my second. I get that your breasts may have less tissue, but it was just.......different with my second. Milk came in differently, nursing felt different....the time frames between nursing were different. Just all around not the same.
posted by aetg at 6:50 PM on April 24, 2018
Also, I had a ton of milk with my first and just right at adequate for my second. I get that your breasts may have less tissue, but it was just.......different with my second. Milk came in differently, nursing felt different....the time frames between nursing were different. Just all around not the same.
posted by aetg at 6:50 PM on April 24, 2018
I bf and pumped for 2 kids. Pumping never empties the breast as much as a baby can, which is why it doesn't keep your supply up as much as breastfeeding does. That doesn't mean it's worthless. I had the best success with a hospital grade pump. I also got better supply by pumping before I nursed the baby (circle back to: baby extracts milk more efficiently than the pump. So the pump gets the "easy to get" milk, baby then gets the rest).
You might look into going to some LLL meetings now, to find practitioners that specialize in your condition. There will absolutely be women there who believe you, have heard of or have had your condition, and who will offer advice based on their experience.
Get in some local breastfeeding FB groups for more advice/resources.
Finally, I'll offer you this idea: for my second, he had a bad latch and nursing / supply was a lot more difficult than with my first. Despite oatmeal, fenugreek, pumping, nursing staycations, etc etc etc. He has an allergy to cow's milk so formula wasn't a good option for us. We ended up getting donated breastmilk. There are two groups that foster peer-to-peer milk sharing: Human Milk for Human Babies, and Eats on Feets. In my area they are active on FB. A lot of people have trouble getting past the "ick" factor, but I met all of my donors in person, and they were just regular moms who had oversupply and a passion for breastfeeding and infant nutrition. It was a HUGE relief to me when I only pumped 2oz in 24hrs to know that I had extra donated milk in the freezer. It's an option to keep in the back of your mind. I'm happy to answer questions about the specifics of how it works via memail.
posted by vignettist at 7:26 PM on April 24, 2018 [1 favorite]
You might look into going to some LLL meetings now, to find practitioners that specialize in your condition. There will absolutely be women there who believe you, have heard of or have had your condition, and who will offer advice based on their experience.
Get in some local breastfeeding FB groups for more advice/resources.
Finally, I'll offer you this idea: for my second, he had a bad latch and nursing / supply was a lot more difficult than with my first. Despite oatmeal, fenugreek, pumping, nursing staycations, etc etc etc. He has an allergy to cow's milk so formula wasn't a good option for us. We ended up getting donated breastmilk. There are two groups that foster peer-to-peer milk sharing: Human Milk for Human Babies, and Eats on Feets. In my area they are active on FB. A lot of people have trouble getting past the "ick" factor, but I met all of my donors in person, and they were just regular moms who had oversupply and a passion for breastfeeding and infant nutrition. It was a HUGE relief to me when I only pumped 2oz in 24hrs to know that I had extra donated milk in the freezer. It's an option to keep in the back of your mind. I'm happy to answer questions about the specifics of how it works via memail.
posted by vignettist at 7:26 PM on April 24, 2018 [1 favorite]
I'll take a swing at the increasing production question. I can just tell you from my own experience that pumping was only good for getting rid of excess milk - it never increased my milk production. I was able to increase my milk production by increasing baby feeding even if I was totally out of milk. The feeding process (and being close to the baby) resulted (usually by the next day) in an increase in supply. Pumping didn't do jack. And also, it sucks (no pun intended...)
If I was going to make a suggestion based on not knowing you or your circumstances at all (so loads of grains of salt), you may consider trying to breastfeed regularly for a few minutes even if there is no/little milk then switching to the bottle anytime the baby is ready to eat. If you make up the bottle first knowing that's your plan, then the switch from boob to bottle can be pretty seamless.
posted by Toddles at 8:14 PM on April 24, 2018
If I was going to make a suggestion based on not knowing you or your circumstances at all (so loads of grains of salt), you may consider trying to breastfeed regularly for a few minutes even if there is no/little milk then switching to the bottle anytime the baby is ready to eat. If you make up the bottle first knowing that's your plan, then the switch from boob to bottle can be pretty seamless.
posted by Toddles at 8:14 PM on April 24, 2018
I’m pumping while writing this! I didn’t thoroughly read all the answers above but it looks like you got some good advice.
For number 5, a few things that seemed to boost my supply when I was trying to boost it were eating more calories (especially red meat), drinking more water and yellow Gatorade, and getting more sleep (haha, I know, but when I managed it, it really made a big difference). I also had my wonderful MIL make me lots of these lactation cookies - no idea if they helped but they were delicious and a filling snack and I figured they couldn’t hurt.
You may already know this from pumping last time, but I also found a good pump (I’m using a Spectra), a hands-free pumping bra, and hands-on pumping/breast compressions to help my output a lot. And, this is contrary to most advice, but my daily output was better when I did fewer longer pumps than more shorter ones. I think I just have slow flow boobs. Don’t be afraid to experiment with schedules, etc.
I also wanted to add two tangential things.
1. If you’re giving your child milk from your breasts, no matter the volume or the method, you are breastfeeding. It counts! Even if it’s 15 ml a day. I exclusively pumped for awhile and also gave a mix of formula and breastmilk from the start, and had to remind myself of this frequently. Don’t ever feel like it doesn’t count or isn’t good enough.
2. Breastfeeding has been suuuuuuper emotionally charged and all over the place for me as we dealt with various configurations and issues and etc. I thought it would be a straightforward thing that I could approach with cold logic. Hahahaha no. So it’s okay to feel stressed about this topic, or sad if you can’t breastfeed if it’s important to you, etc. It’s hard! If you want to chat with someone who’s on the same rollercoaster but a little farther down the track, send me a PM.
Most of all, congrats on the upcoming kiddo!
posted by bananacabana at 9:36 PM on April 24, 2018
For number 5, a few things that seemed to boost my supply when I was trying to boost it were eating more calories (especially red meat), drinking more water and yellow Gatorade, and getting more sleep (haha, I know, but when I managed it, it really made a big difference). I also had my wonderful MIL make me lots of these lactation cookies - no idea if they helped but they were delicious and a filling snack and I figured they couldn’t hurt.
You may already know this from pumping last time, but I also found a good pump (I’m using a Spectra), a hands-free pumping bra, and hands-on pumping/breast compressions to help my output a lot. And, this is contrary to most advice, but my daily output was better when I did fewer longer pumps than more shorter ones. I think I just have slow flow boobs. Don’t be afraid to experiment with schedules, etc.
I also wanted to add two tangential things.
1. If you’re giving your child milk from your breasts, no matter the volume or the method, you are breastfeeding. It counts! Even if it’s 15 ml a day. I exclusively pumped for awhile and also gave a mix of formula and breastmilk from the start, and had to remind myself of this frequently. Don’t ever feel like it doesn’t count or isn’t good enough.
2. Breastfeeding has been suuuuuuper emotionally charged and all over the place for me as we dealt with various configurations and issues and etc. I thought it would be a straightforward thing that I could approach with cold logic. Hahahaha no. So it’s okay to feel stressed about this topic, or sad if you can’t breastfeed if it’s important to you, etc. It’s hard! If you want to chat with someone who’s on the same rollercoaster but a little farther down the track, send me a PM.
Most of all, congrats on the upcoming kiddo!
posted by bananacabana at 9:36 PM on April 24, 2018
If you have tubular breasts and had that small an output from both pumping and weighted feeds, it seems like having breastmilk be a large percentage of the baby's intake is just not possible for you. Physically, it just can't happen! There's no shame in that. Like people have said, there's a chance your supply will be a bit higher this time around, but in your shoes I might wonder whether it's worth it to extraordinary measures to get a small increase in milk. (eg, is it worth it to take an off-label drug and pump six times a day to get four ounces instead of 2?) In studies comparing siblings, most of the benefit of breastfeeding disappears. And it's unclear whether all of the benefits of breastfeeding apply to expressed breast milk in a bottle. So if the benefit is unclear, the amount of milk is small, and it's in a bottle anyway, you have to weigh out how much grief it is worth to you.
You have a physiological reason for lower milk production, not a behavioral one... if you didn't end up breastfeeding your first because you had trouble latching and your supply dropped, and then people weren't supportive and you switched to formula, I'd say try to do xyz things differently this time. But this is body-based. Like you said, it's not just a question of drinking more water. Even Kellymom, breastfeeding-is-always-possible propagandist extraordinaire, talks about how it's not usually possible to exclusively breastfeed with tubular breasts. I know this is a crazy sensitive subject and hopefully nothing in my phrasing or suggestions is hurtful to you! If so I apologize.
In your shoes, I'd focus on putting the baby to breast every few hours to stimulate production (with a shield if you prefer). This would also give the baby the benefit of snuggles and skin-to-skin-- which is one of the factors I've heard put forward as being behind some of the potential differences in breastfed kids, versus anything in the actual milk. But I'd feed almost the full formula recommendation for a baby of whatever age your baby is from day one, through either a bottle or an SNS for more stimulation and snuggles.
I'd also do what people above have mentioned about putting your history in your chart. Based on your history, trying to exclusively breastfeed for the first 10 days seems dangerous. You should not put the baby to breast every 2-3 hours and wait for your milk to come in despite your past experience... the people who are saying that don't understand or don't believe you or are horribly misinformed! So many people have had breastfeeding issues due to poor advice or management, especially in the years before this big push for breastfeeding. But because so many people's problems are caused by behaviors that accidentally minimize production, a lot of people and providers assume that ALL NURSING PROBLEMS are caused by sub-optimal behaviors. And that's just not true!
Maybe reach out to this woman with questions, or recommendations for a lactation consultant in your area? IBCLC have a wealth of knowledge, but a strong bias towards as much breastmilk as possible at whatever cost, for obvious reasons. It seems like the ideal help would come from someone who is strong on the science of lactation (unlike a peer support group or La Leche League), but also doesn't have a super-strong breastfeeding at all costs mentality. Such people are hard to find though, alas.
Congratulations on your new arrival!
posted by sometamegazelle at 9:42 PM on April 24, 2018 [7 favorites]
You have a physiological reason for lower milk production, not a behavioral one... if you didn't end up breastfeeding your first because you had trouble latching and your supply dropped, and then people weren't supportive and you switched to formula, I'd say try to do xyz things differently this time. But this is body-based. Like you said, it's not just a question of drinking more water. Even Kellymom, breastfeeding-is-always-possible propagandist extraordinaire, talks about how it's not usually possible to exclusively breastfeed with tubular breasts. I know this is a crazy sensitive subject and hopefully nothing in my phrasing or suggestions is hurtful to you! If so I apologize.
In your shoes, I'd focus on putting the baby to breast every few hours to stimulate production (with a shield if you prefer). This would also give the baby the benefit of snuggles and skin-to-skin-- which is one of the factors I've heard put forward as being behind some of the potential differences in breastfed kids, versus anything in the actual milk. But I'd feed almost the full formula recommendation for a baby of whatever age your baby is from day one, through either a bottle or an SNS for more stimulation and snuggles.
I'd also do what people above have mentioned about putting your history in your chart. Based on your history, trying to exclusively breastfeed for the first 10 days seems dangerous. You should not put the baby to breast every 2-3 hours and wait for your milk to come in despite your past experience... the people who are saying that don't understand or don't believe you or are horribly misinformed! So many people have had breastfeeding issues due to poor advice or management, especially in the years before this big push for breastfeeding. But because so many people's problems are caused by behaviors that accidentally minimize production, a lot of people and providers assume that ALL NURSING PROBLEMS are caused by sub-optimal behaviors. And that's just not true!
Maybe reach out to this woman with questions, or recommendations for a lactation consultant in your area? IBCLC have a wealth of knowledge, but a strong bias towards as much breastmilk as possible at whatever cost, for obvious reasons. It seems like the ideal help would come from someone who is strong on the science of lactation (unlike a peer support group or La Leche League), but also doesn't have a super-strong breastfeeding at all costs mentality. Such people are hard to find though, alas.
Congratulations on your new arrival!
posted by sometamegazelle at 9:42 PM on April 24, 2018 [7 favorites]
I was thinking about this thread again and it brought up a memory from when my Lamaze class had its reunion about 6 weeks after the babies were all born. Everyone came, shared their birth stories, showed off their babies, etc. Most of the babies looked like the fat sweet healthy little bundles that they were. One baby, though, I'll never forget. The dad was this super Type A tech guy, obviously very smart and into optimizing everything. The mom was very quiet. The dad was very proud that his wife had been breastfeeding because of course breast is best. And... the baby looked like it was starving. The contrast between this little guy and the rest of the babies was terrible to see. Big, big eyes in a skinny little face, and so quiet. I heard the class teacher, a nurse, taking them aside after the class to tell them to get him seen immediately at the pediatrician and that they probably needed to supplement much more heavily than they had been. I don't know how they reacted; I hope they listened.
Not everyone can breastfeed. La Leche and those people will deny it, but if you ask around in your friend group you'll be surprised at how many are supplementing a lot; or just switching to formula. I'm not saying this to derail your question about how to get more milk. I'm just saying (1) my experience was that all those methods combined couldn't overcome my physical limitations and (2) if those limitations exist, it is a bad idea to fight them.
posted by fingersandtoes at 9:02 AM on April 25, 2018
Not everyone can breastfeed. La Leche and those people will deny it, but if you ask around in your friend group you'll be surprised at how many are supplementing a lot; or just switching to formula. I'm not saying this to derail your question about how to get more milk. I'm just saying (1) my experience was that all those methods combined couldn't overcome my physical limitations and (2) if those limitations exist, it is a bad idea to fight them.
posted by fingersandtoes at 9:02 AM on April 25, 2018
I just want to offer a little measure of hope. I had all kinds of problems with my first. Low supply was a big, big, big issue. Baby didn't gain weight, fell off the growth charts, etc. Ended up primarily formula fed by 14 weeks. It was awful. I still hate thinking about it. My very compassionate IBCLC had some speculation on my breast tissue, but she didn't send me to anyone for any definitive diagnoses, but I have some anatomical reasons that she speculated in part why I was having trouble (among many, many, many other things that weren't strictly breastfeeding related).
With my second, I was really worried about low supply again. So when she too was very low on the growth charts despite being a champion nurser, we were sent to a pediatric dietitian who gave us a recipe to put in her daycare bottles that upped the number of calories per oz in the bottle. She took one less bottle/day taking in the same calories. And nursed until she was four and a half! Not only that, but both my kids are just skinny lanky types with no fat on them. One eats everything in sight and one eat likes a tiny bird and there's a three year age difference and only a 4 lb weight difference. My husband and I just make small kids so all that fretting and running around early on still wouldn't have changed the ultimate outcome of my kids' body types.
I never responded to a pump. Not hospital grade, not normal grade. The most I ever got pumping was 12 oz total over three pumpings my first week back to work after my second child. As more weeks passed, that dwindled significantly until I was only getting 4 oz/day over 6 pumpings and at 10 months, I gave up pumping altogether. So even my champion nurser was mixed fed at daycare with whatever breastmilk I managed to pump and formula.
Where the hope comes in is that a) different baby will do different things and b) your body having done this before might do it better and easier this time, even if not as perfectly as you would like and c) for me it was easier to accept that the best I could do was enough with the second child. And your best will be enough, too.
posted by zizzle at 10:01 AM on April 25, 2018
With my second, I was really worried about low supply again. So when she too was very low on the growth charts despite being a champion nurser, we were sent to a pediatric dietitian who gave us a recipe to put in her daycare bottles that upped the number of calories per oz in the bottle. She took one less bottle/day taking in the same calories. And nursed until she was four and a half! Not only that, but both my kids are just skinny lanky types with no fat on them. One eats everything in sight and one eat likes a tiny bird and there's a three year age difference and only a 4 lb weight difference. My husband and I just make small kids so all that fretting and running around early on still wouldn't have changed the ultimate outcome of my kids' body types.
I never responded to a pump. Not hospital grade, not normal grade. The most I ever got pumping was 12 oz total over three pumpings my first week back to work after my second child. As more weeks passed, that dwindled significantly until I was only getting 4 oz/day over 6 pumpings and at 10 months, I gave up pumping altogether. So even my champion nurser was mixed fed at daycare with whatever breastmilk I managed to pump and formula.
Where the hope comes in is that a) different baby will do different things and b) your body having done this before might do it better and easier this time, even if not as perfectly as you would like and c) for me it was easier to accept that the best I could do was enough with the second child. And your best will be enough, too.
posted by zizzle at 10:01 AM on April 25, 2018
I just want to second that eating a lot bumped my supply up from nothing after i got sick during breastfeeding. I ate unbelievable amounts of food, far more than when i was pregnant. I would eat 2 lunches that were the size of my pregnancy dinners, and still have dinner and breakfast, and usually a snack consisting of 2 giant chocolate chip cookies from a bakery near my job. And i was dropping weight. IT was crazy and defied physics, but that's what worked for me. When i wanted to wean i went back to my normal amounts of eating and dried up within a month.
Pumping can increase your production if you are a pump person. It did not help me increase. Eating a shit tonne and just letting my baby suck on me endlessly did.
They make special formulas now a days that are specifically for supplementing breastfed babies, if you want to get some of that to keep on hand in addition to standard full formula.
posted by WeekendJen at 9:23 AM on April 26, 2018
Pumping can increase your production if you are a pump person. It did not help me increase. Eating a shit tonne and just letting my baby suck on me endlessly did.
They make special formulas now a days that are specifically for supplementing breastfed babies, if you want to get some of that to keep on hand in addition to standard full formula.
posted by WeekendJen at 9:23 AM on April 26, 2018
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posted by Mariemma at 12:21 PM on April 24, 2018 [1 favorite]