Breastfeeding insufficient milk supply

Hi there


My newborn was still losing weight at 10 days and we started to supplement with formula and she immediately began to gain weight. I continued to start breastfeeding and then to top up with formula, but my milk has now diminished considerably - to the point that there's very little at all.


I don't want to put her exclusively on formula - especially as she often throws up after a feed. Does anyone have any advice for increasing my milk supply? Any advice on how to stop her vomiting after feeds would also be appreciated.


Thanks so much

Vomiting after feeds is very common in small children. Our #1 had a cleft palate so was more susceptible than most. Here are some observations and tips. Gravity is your best friend.


- It will get better so don't worry. Your child will learn to keep it down and once you start on solids the situation improves due to the changed consistency.

- Feed your daughter while upright or reclining a bit. Never more than 45 degree angle.

- For 30 minutes after a feed, keep her upright or almost.

- Raise the head of her crib by 10-15 cm. Sleeping slightly inclined decreases the throwing up. You can either use some pieces of wood under the top legs or put stuff under the top of the mattress.



Milk supply:

- Being well rested helps. I know this is a bit much to ask of a new mother. Make sure daddy takes some of the night shifts so you can sleep.

- Eat and drink a varied diet. Make sure you stay hydrated.

- My mother swears that beer helps. Like ½ a beer a day. Limited empirical testing by my wife suggests she may have a point, but I wouldn't call it a scientific certainty.

"Don't know about the third point, though. ;)"


Hehe. Well as I said it's not scientific. ;) Beer does have proven beneficial effects (iron in porter for example) but I would take this one with a grain of salt.

Hi,

I had twins last year and after a stressful visit from the in-laws my milk really diminished. I can suggest three things that helped me a lot.

Fenugreek, a Guinness ( helps to keep you relaxed, my paediatrician recommended that one) and regular massages. A couple of hours after the massage I would get a big let down of milk.

You can also try expressing after a feed to stimulate the milk. Theoretically the more you ask the more you make.


Good luck

To increase your milk supply, after every feed, express with a pump for about 10-15 minutes each breast. Don't worry if you don't get much milk or any, just as long as you are stimulating the glands.


If you are giving a supplement feed instead of breastfeeding, then make sure you still express at those feed times as well. If you don't express at that feed time, your body adjusts, so does not produce the milk. Just keep expressing to make more milk. Any milk you express, simply keep it for later when you want to comp feed with breastmilk.


I agree to definitely contact a lactation consultant, you will really benefit from it.


If your baby is only throwing up when you give her formula, then maybe she cannot tolerate it. Does she vomit/possett on breastmilk? It is normal for babies to possett, but I would look into it if it's only on formula though.

I have 3 suggestions. If you do all of them you will almost certainly improve your milk supply.


1. Have a blood test to check for iron deficiency anaemia. Ask for your haemoglobin levels AND ferritin levels to be checked. If either are low your doctor may prescribe iron supplements, and prescription iron supplements are a much higher dose (and therefore much more effective) than anything you can get over the counter. If anaemia is your problem, take your supplements religiously every day and always with a large glass of orange juice.


2. Take Fenugreek capusules (not the tea, it doesn't work as well). There's a store called "Health-Gate" and it's open M-F 9.30 - 6.30, Sat 9.30 - 5.30. 8th Floor, Hung Tak Building, 106 - 108 Des Voeux Road Central. Tel: 2545 2286/9. Fax 2854 0770. Get your hubby to pick them up for you.


3. Consult a lactation expert. I can recommend the following:

Hulda Thorey, head of Annerley Midwives. I think I paid about $600 per home visit about 5 years ago. You can look up her fees on the webpage.

Crystal Beddard, make an appointment to see her at the Matilda Hospital Baby Clinic. I think it's $120 per appointment. She is an excellent woman. Tel:

2849 1515.


If your supply is low the sooner you try to improve your milk production the more likely you are to succeed. There is a "window of opportunity" and it can close on you. If you are really serious about breastfeeding, take one or more of the above steps tomorrow, do all of them in 3 days. Really.


Lastly, another little gem of advice that no professional will ever admit to you: take a reality check. If you are presently trying to work a strenuous or stressful job, stick to a fitness regime, look after your other 5 children with no DH etc and breastfeed, you may need to accept that you can't do both. The Chinese custom of a month in bed after delivering the baby was invented for a reason, although you don't actually need bed rest you might need to be very sedentary to let your body focus on making enough milk. Sorry.


I hope the above is helpful to you and wish you luck.

Hi Kate71,

Just wondering... when you were breastfeeding initially and the baby was losing weight... were you feeding the baby from one breast each time? I had a friend who thought that you were supposed to do ten minutes on each breast and keep switching after that time. But this meant the baby was only getting the foremilk, and so was also losing weight at the start.


Anyway, I agree with pumping after each feed, so that your body thinks more milk is needed and eventually will produce more.


From other posts you've made, I know you only have a small baby so there's plenty of time for you to increase your milk supply - you'll be fine!


Something I read in a book too: if you want to increase milk supply, pump more often... not for longer. ie. don't pump once a day for a long time, but pump more times, even for just shorter time.

Meant to also add, make sure you drain one breast before moving onto the other if needed. It is important for the baby to get the hind-milk which is the nice fatty milk. Basically you need your boob to feel nice and soft, once that happens, then put the baby onto the other. Don't clock-watch either, take the cue from her. She may be a lazy feeder.


I am sending you a PM with some info.

I suggest you visit a lactation consultant with your baby to assess latch and positioning and review strategies to maintain and increase your milk supply. The Matilda International Hospital has a breastfeeding clinic on Tuesday and Thursday from 0900 to 1600. Appointments are one hour and cost $300.00. To make an appointment call 2849-1500.



Matilda Well Baby Clinic

Matilda International Hospital

Hong Kong

http://www.matilda.org

Is it true, that fenugreek capsules noticeably increase milk supply?

And who else supports the guinness comment - that it can also increase milk supply?

Not big on beer, so I don't think I'm try the latter but I'm happy to take some pills!

"And who else supports the guinness comment - that it can also increase milk supply?"


I support that. Has to do with iron if nothing else.



"Is it true, that fenugreek capsules noticeably increase milk supply?"


It can have a noticeable effect, but your results may of course vary.

kate and please dont worry about vomitting - mine two did prejectile vomitting - what seemed to be quite a lot at the time - and they did it for months! all pretty normal. Also if your milk does not come back - please dont worry you did your best, the best stuff comes in the first few days they say anyway. There are tons and tons of babies out there who have not been breastfed at all -not even one day and they are just fine!

It does get easier, hang in there. Definitely see Crystal at the Matilda Baby Clinic, she is kind and patient and does a great job - very supportive. Fresh beetroot is also excellent for building up a good milk supply. Good luck, most people have difficulties so you are not alone.

The more you breastfeed her, the more milk your body will make. It will only take a couple of days for your body to increase the supply the more you feed her. By supplementing with formula, your body will only produce what it thinks is enough for her. supply = demand. Try putting her to the breast as much as possible over the next few days, and your supply will come right back up.

It really does get easier. I supplemented my firstborn as i didnt think he was getting enough milk. (i was given incorrect advice). My second born i exclusively breastfed, and had no problems with supply as I just fed her whenever she demanded. Also, papaya helps with supply, plenty of rest, and lots to drink! Hope this helps.

southside says it well...


Breasfeed frequently and rest a lot, try to relax and enjoy the closeness and not to worry about it. Avoid the formula as much as you can, and rather supplement by feeding from a cup/spoon than bottle to avoid nipple confusion. Consulting a lactation expert to check on latch is a good idea. Correct latch is important. Your baby has already received many valuable nutrients, antibodies and other benefits from your milk so as long or as short as the time breastfeeding will be, you have already done great!


You can offer both breasts several times during one feeding, the empty breast will fill up again while you are feeding from the other one, and the milk is even better in quality. One feed may take a long time, even a hour if the baby is a slow eater. Or you may choose to feed often just in order to increase the supply and for a day or two offer breast in short intervals, even every half an hour. At least do not try to space the baby's feeding rhythm to a set schedule and feed if he/she is hungry. At first the hindmilk rising may feel strange or almost even painful, but when you get used to it you are likely to enjoy the rush. Hindmilk (the milk at the end of the feeding, 'back of the breast milk' that will even spray out from the breast without the baby sucking when the ejection reflex is triggered) has more nutrients and for the milk supply it is important that baby would actually get to consume it. Rest in between. Have a lot of skin contact with the baby. It is more likely to help than the artificial pump (at least get a hospital grade pump if you need to - available for rent/purchase for example at Celki p. 29153388 www.celkicare.com.hk. Medela Lactina is one good basic choice, Medela Symphony is even better with more natural suction rhythm). Night breastfeeding is said to be very important. It has even greater value for the hormonal response to produce milk, so while you do need rest, you should follow the baby's natural feeding rhythm and offer breast at night too (father offering the bottle at night and letting you catch sleep may be counterproductive). Letting the baby sleep next to you in the same bed, or at least in the same room will make it much easier and provide you both with the snuggly closeness that is so enjoyable and good for bonding.


Some weight loss is actually normal for babies in the beginning and if the baby seems fine you should not be too anxious about weight gain. Some studies show that babies who lost weight according to natural curve while milk supply was adjusting to future need grew up to be healthier than babies that were fed extra just in case to avoid any weight loss. Surely if the baby seems unwell or is not thriving, then it is another issue.


Papaya is considered to increase milk supply in Chinese medicine and seemed to work for me. Stay hydrated and eat well. Warm bath before feeding may be helpful. Some herbal tees are said to help. You can find a lot of products at Celki Home Care shops or other such outlets.


Some useful links: http://www.llli.org/NB/NBmilksupplyissues.html

http://www.thebirthden.com/Newman.html (video clips of latching and advice)

http://www.breastfeeding.nhs.uk/en/fe/page.asp?n1=3

http://www.emedicinehealth.com/breastfeeding/page10_em.htm


If you decide you need to supply formula after giving it a good try with the breastfeeding only for a few days, then that will be another fine choice too. But usually the supply picks up in a few days, and there will be several times when the demand increase and mother may feel there is temporary shortage in the future too if you keep breastfeeding. Then just increase the amount of feeding for a few days, and feed the same breast for example at least twice in the same feeding switching the sides when you feel the breast is empty. Even some adoptive mothers may be able to breastfeed, so if it might happen that your supply seems to cease at some time, you may still be able to pick up again.


Good luck and enjoy your bundle of joy!

Hi, I had similar problems. I suggest you pump every 3 hours to get milk supply up. Best to pump after you try to feed baby. Fenegreek is a good complement but is only a complement. You need to stimulate milk production by feeding or pumping more frequently. It is a question of supply and demand. Also, relax....stress can kill your milk production. good luck!

yes kelly andrewsjohnson is right, pump and feed baby often. I would ofen pump on one side and feed on the other, it somehow helps with let down. i always pumpèed less milk when i was pumping only.


for me what worked was

Fenugreek - i'd soak a teaspoon of seeds and chew them quickly and wash them down with water (am absed in SZ, and have lots of the stuff in my kitchen, so didnt bother going to buy the capules)

Fish curry, fried fish, fish head soup all helped (though they are all temporary, like u eat the fish and then next day you have more milk, but the effect wont necessarily hold. The advantage is that when you ahve more milk, u dont need to top up baby with formula and it has a follow on effect of increasing supply.


i dont drink beer at all, so no idea how that works.


but drink lots of water, always sit down for a feed with a big mug of water or someother liquid stuff.