Expert: ruth kraft - 1/21/2009

Question
Hi, I'm a first time mom trying to breastfeed exclusively. My baby boy is 7 weeks old, I've been trying to breastfeed exclusively since day 1, but we had a rough start with supply issues. For the past 6 weeks, he has never been truely contented at breast even though I try to feed for at least 20 mins on each side every 2- 2.5 hrs. He cries and fusses and nuzzles at my breast.

I've tried all means to increase supply including eating Fenugreek and Domperidone. After week 4, we've supplemented with formula because he's still hungry, I try to keep up by latching as often as possible and pumping to make up for offering the formula. I'm not sure if its working.

Beginning of week 7, I finally (never before) experienced a let-down and was very happy to hear baby gulping and swallowing. Does this mean that my milk supply is becoming more established? How long does it take for supply to be established?

Also, as of this week, he would only last about 7 mins at each breast, after which he would pull away. Is he full? I try supplementing via SNS if I feel he still wants more, he takes about 30 mls and dozes off. Is supply still low? Will it get better? What else can I do?

Also, if the interval between feeds is too short e.g 1.5 hrs, I feel that my breasts are very soft and I am not sure if there's anything for baby. Are my breasts empty? I'm apprehensive about pumping after feeds, worrying that there may not be enough should baby wake up earlier than expected.  Does it work this way? Do breasts need a minimum time to "fill up"?

Please help!! Really want to breastfeed exclusively.

Answer
In most nursing relationships it takes 6 weeks for the milk supply to be established. often times mothers think the baby is starving and not getting enough because he is fussy and wants more etc... up till they are 6 weeks of age, this is normal. they have an instinctual desire to nurse all the time that is as strong as your desire to make sure he is safe and happy. The more he nurses, the  more his immune system builds, he gets  nourished and he get nurtured by you. babies often struggle getting used to not having nurturing 24/7 as he did in utero. So we get it confused that he isn't getting enough. but his needs go far beyond food intake.  His wet and dirty diapers are the best sure fire way to know he is doing well.

also know that there are many women who never feel a let down. Some women feel it, some don't. you have have finally felt it because he went through a growth spurt at 6 weeks which makes him even more cranky and want to nurse more..  that increased your milk and now you might have more than you know :)

Babies often doze at the breast, so if he does after 7 minutes, he might wake up again a bit later and want more...  

It sounds as though you must have enough milk in there... and often times if the milk continues to be low there is maybe a latch or position issue. I would have that evaluated by a lactation consultant or a La leche league person in your area to see the whole thing. I don't suspect your milk is as low as you think, but after doing the physical evaluation, she will be able to tell you exactly what to do from there... I feel like I am missing several key peices of information , mainly being how the baby is latching .  

even when your breasts are soft, they are never truly empty. the baby will always be able to get milk, as long as he is patient enough for the next let down. in the morning they tend to be more full, and then towards the evening they are less full. as he ages, they may never seem full at all.  

that being said, please feel free to pump after feeds or even before hand. as this will not only increase your milk supply, but it will help you see that you are doing ok. at this point, getting between a half ounce and ounce would be perfect.  and even if you pumped before a feed, and he did wake up and become impatient, you can feed what you just pumped through the sns.

most breasts to "fill back up" remembering they are never really empty, about an hour... but there is always will. its more of a reset rather than a fill up. LOL.

I hope this helped!
Ruth Kraft
www.honoringwomen.com