Expert: ruth kraft - 5/12/2009

Question
My daughter is almost 6 months, and has never had formula, but I work full-time and am having a hard time keeping up with her.  I was hoping if I told you our current routine, you could offer some suggestions in hopes that I can increase supply?

My daughter drinks 4, 4-5 ounce bottles a day at daycare, so I would like to be able to pump that in a day.

Here is our current routine:
Nurse on-demand all night (1-4 times)
5:00 am - pump when I wake up (3-4 ounces)
7:00 am - nurse before going to work
While at work, I try hard to get 3 15-20 minute pumps in, but reality is that some days I only get two:
10:00/12:30/3:00 for a total of around 9 ounces
or
10:30/2:30 for a total of around 8 ounces
I pick-up from daycare and then around 5:30 I nurse on one side while pumping the other (1-2 ounces)
8:00 PM we nurse to sleep
9:30 I pump before bed (1-2 ounces)

This past weekend we spent the entire weekend on the couch, and she happily nursed all weekend.  I  did this in hopes of encouraging production, but it hasn't seemed to help.

I drink 3 cups of mother's milk tea a day, and have oatmeal for breakfast (both things the LC at the hospital suggested)

When I started back to work 2.5 months ago, I had 500+ ounces in the freezer, and that is now down to less than 100 ounces.  I am afraid that if I don't increase my supply we will have to supplement with formula by July.

Thanks for any suggestions you may have!

Answer
congrats on doing so much! if all new moms took nursing as serious as you did, there would be many more healthy kids around :)

I can think of a few that you can do to try to get milk production up more so that when you pump you get a certain number of ounces. However, I am going to suggest something that you may not have considered before. and hopefully put your mind at ease.

your body has done a fabulous job of getting the little one food to this point. so there is no reason to think it would stop now.  looking at where your daughter is developmentally, it makes perfect sense that your milk supply would be "diminishing" although I wouldnt actually call it that rather , its doing exactly what your daughter needs developmentally.

At about 6 months, babies start desiring other forms of nutrition other than breastmilk. they can live exclusively on breastmilk alone for up to a year, but often their system is ready for other foods.  so, instead of stressing about making more and more milk, trust that until this point, your daughter has been able to adjust and still get what she needs for her development. Now and again I run into a mother who has a baby who refuses a bottle. which sends a mom into a great frenzy because how will the baby eat while at day care. even if they can pump enough. and I see babies that will then not drink from a bottle, go home, and nurse half the evening and into the night to make up for what they didnt get in the day.

My guess, is that because you are nursing her through the night , you have no need to worry that she is getting enough. and in fact, if she didnt nurse at all at day care, she would still thrive quite well because you have such an established relationship. Kudos for you again for making it such an important place in your life and hers. Having been in the exact same spot, having the exact same anxiety, I wish I had the same advice when I was going through this...

Pump what you can, give her as much as needed. should you run out of the saved supply by july, she will be having other foods and juice to make up for her thirst during the day. thats still 2 months away. she will be 8 months old by then. you can give her the milk, and also a cup of watered down apple juice. or even, a cup of water. at 8 months old, this will not harm her in any way.

you may also find, that around then, she will want to crawl. and when she crawls, her desire for food wanes... and she is more focused on learning to do physical things. again. not to fear. its just developmentally how things work. and when babies start burning off the baby weight as they grow and learn to become mobile.

then, you wont need another 4 oz of milk. as she wont even drink it.  you do not have to suppliment with formula, she will get all she needs from the foods you add to her diet, and the night nursing and evening nursing. and she is far more efficient at nursing than you realize.

I hope that helped! trust that your baby and body know how to work this out on their own. If you see that she starts not being developmentally where she needs to be etc, something could be up. but the chances that would happen now are so slim.  And as long as she is the healthy child you seem to have portrayed, then I can about guarantee , that she gets all she needs... and you can take a deep breath of relief,knowing , this doesnt have to be hard. and its really rather simple and now you can be at ease knowing you have done phenomenal, and I wouldnt tweak a thing. :)

I hope that helped!