Expert: Sally Wendkos Olds - 1/29/2008

Question
I need some serious help. I have a 3 week old little girl and I don't think I am producing enough milk for her. My pediatrician told me to only nurse from the breast until we both got into a routine, my original plan was to feed breastmilk through a bottle/pumping. So I was doing that untill she told to me stop. At that time she was a week old and eating 1 1/2 to 2 oz every 4 hours on the dot. But I did what the doctor told me to do, and she began to eat every 2 hours. Now I have to head back to work soon (two more weeks) and I work 24 hour shifts, so I need to start pumping.

However, I've recently noticed a problem, and the doctor first pointed it out. Her weight gain is slightly below the average daily recommended amount. So the doctor (pediatrician, who has breastfed all her children) put me on Brewers Yeast...and allot of it. She said I'm getting worn out, and not getting enough sleep, which is why I'm not making enough milk...I am a bit of a stresser, but I feel like I am doing everything I can to take good care of my daughter. I take vitamins, eat well, I am not getting enough sleep (an average 4-6 hours a day) but who gets sleep with a newborn?? She eats every two hours, I feed on demand. This is why the doc reccomened the Brewers Yeast, she said it would help me make more milk, and thicker so she should reset a schedule and eat more like every 4ish hours again. It didn't work.

Now I've noticed shes become more gassy as well. She nurses for about 10-15 minutes on each side. But recently has been fussy an hour or so after she eats because shes still hungry! When my husband trys to help and feed bottles that I have pumped (it takes two or three pumping sessions for me to pump enough for one bottle, I pump a little before one feeding and a little after the next feeding) I still have to feed her after he gives her a bottle, she is now eating about 4oz, and the doc said she should only be eating 2ish! I don't know what to do...I'm trying to make her happy, but she is draining me, literally. I cant sleep, because shes always hungry. And the gassiness is getting worse, does it have anything to do with the Brewers Yeast?...and is there anything I can do to avoid having to supplement with formula? I really want to breastfeed only. But I'm running out of energy, and ideas. Please help!

Answer
Dear Brianne,

I have since consulted about your question with pediatrician Dr. Laura Marks, who expressed concern about your baby's slow weight gain. In a situation like this she, like many pediatricians, would  recommend supplementing breastfeeding with formula to be sure the baby is getting enough nourishment. It's still good to nurse as frequently as you can and also to pump your milk, since breast stimulation is the best way to increase your milk supply. Also, in the couple of weeks before you go back to work, you should try to eat well and to rest as much as possible. I know it's hard -- but 4 to 6 hours a day is not enough sleep for you. (I'm sure you know that too!) If you can sleep while the baby is sleeping, instead of doing housework, etc., that would be good.

Three weeks of age is a common time to see gassiness increase in a baby. It's hard to tell if your daughter's gassiness is due to the yeast you are taking, or just something that is occurring. Many babies are gassy at this age.

With a 24-hour work shift and your baby's current slow weight gain, it may not be possible for you to breastfeed exclusively. But many babies do well with a combination of breast milk and formula, and of course, many thrive on formula alone. As I write in my book (see below), "A baby raised in a loving home can grow up to be healthy and psychologically secure no matter how she or he receives nourishment." If you do have to make the shift to formula, I think you can congratulate yourself for having given your daughter a great start in life, especially by providing her with your valuable colostrum, with all its disease-fighting antibodies.

I wish you the very best of luck!

Sally
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Sally Wendkos Olds
Author, THE COMPLETE BOOK OF BREASTFEEDING: Eiger & Olds, 3rd edition 1999, published by Workman Publishing & Bantam Books, and available in most public libraries, bookstores & La Leche League chapters. Now in revision for a fourth edition, with Laura M. Marks, M.D.