Expert: ruth kraft - 12/21/2009

Question
QUESTION: My milk flow was fine until a couple of days back but i noticed that my breasts are feeling lighter in the last 2 days. While feeding my baby(weeks old) she will be fine during the first few minutes and then she acts as if she is sucking but nothing is coming out( i know this because she acts the same way when given a pacifier when she is hungry) ..when i see this i switch her to the other breast but the same thing happens..so i am guessing my milk supply has reduced. Also my periods started 3 days back..so i wanted to now if this is because of the period? can i do any thing to increase the supply?
i have been nursing as frequently as i can but have to supplement with formula as she is never full..Also wanted to mention that i confirmed the milk amount has decreased by pumping out milk which too has reduced

ANSWER: well at this stage, the babys age is critical for me to know to give you good advice. if the baby is less than 6 weeks old, then the formula , not your period is the cause of your problems. Starting the formula to begin with was the detrimental sign. Yes, your milk will continue to decrease the more formula you give, hence your period starting as well. That means you wernt nursing nearly enough ( assuming the baby is still only weeks old.. ) I assume after 6 weeks maybe 8 weeks. it would make perfect sense that you are giving formula and the baby is frustrated at the breast. She gives up because she cant get the milk fast enough , this is called nipple confusion. So you give formula instead and nothing gets done to establish your milk supply and therefore your milk goes away. I am sorry you were given bad advice to start the formula. It is normal for babies to act as thought they want to eat 24/7 as newborns . It is insticntual to want to eat and sleep and be awake just a little bit here and there. it is to build your milk supply and build the babys immune system. Many people think its because you don't have enough milk so they give you formula, which makes you not have enough milk. Nursing the baby is the best way to get milk going. the pump is second best but will still never give the amount you actually have in your breast. especially if you have a cheaper pump.

Breastfeeding is supply and demand. If you want to continue to nurse, take metamucil twice a day, take fenugreek supplaments or drink mothers milk tea, this will help increase supply. Then , start pumping every 2 hours for the next 2 weeks, perferably three, for at least 10 minutes both sides, with a good pump like the ameda egnell purly yours or medela pump in style. nurse the baby as often as possible, and stop giving bottles. Give supplimental formula and expressed breastmilk  through a SNS system. You can get one from a lactation consultant.

Good luck :) If you want to nurse, this is definatly possible as it was the formula that has caused your problems :)

---------- FOLLOW-UP ----------

QUESTION: Thanks a lot for your advise. I will surely try to avoid formula as much as possible.My baby is currently 7 weeks old. I had been trying to avoid formula but my nipple were very sore after a feeding so i had a very difficult time feeding her.Even now as i m feeding her i have sore nipples after a feeding even though i she latches properly.
Also i had to start the formula because she had jaundice after birth so the doctor advised me to give her formula as my milk had not come in yet.So i started there and it continued.Also can my diet be a reason as i saw a sudden decrease of 5lbs in my weight in 2-3 days as i wasn't eating well.
Can you please advice what is the dosage for the fenugreek supplement and where can i get it.I have also heard that oatmeal can improve milk supply is that true?
thank you

Answer
at 7 weeks  you should be able to follow the regimen I expressed earlier to get more milk and continue to nurse.

Doctors are often confused with jaundice that it is something that has to do with breastmilk when in fact more breasmilk is needed to get the stool out of the babys system. It is a common misunderstanding from the doctors perspective.

What I suggest for you to do because you still have sore nipples as well, is as soon as possible, hire a breastfeeding councelor to come and look at your latching in person. If they are still sore when you nurse, something is wrong in either the latch or position. it might look right but there could be many issues from position to a short frenulem to the baby pulling on and off too much and on and on. this is not something that can be diagnosed over the computer. you need to find someone who can watch you in person. www.llli.org can help you find free support in your area as well.

No, diet will not effect your breastmilk that much, it will deplete you but the baby will still be able to get milk. My guess is because the baby isnt latched correctly also tells me that he wasnt efficent at getting milk out. also could be contributing to your low milk supply.

I cannot advise on dosage as I am not a medical provider. However, the label should tell you how you can use it and so can the woman who helps you nurse more efficiently. You shoudl call ASAP because the longer you wait to call the harder it will be to nurse. every day matters. esp with holidays coming up.

Oatmeal can help increase supply . any type of extra fiber, matamucil seems to work the best, oatmeal and any thing with fiber will help. Eat well to keep your own energy up. High protien in smal quantities throughout the day would be great.

Good luck!

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