Expert: ruth kraft - 4/29/2010

Question
I am a 33 year old mom, nursing my now 5 month old daughter.  This is my third child.  I very successfully nursed my first two for just over a year, but #3 is leaving me to question if we'll make it.  I went back to work 6 weeks ago, pump in hand, and was shocked at my poor supply.  At a LC's suggestion, I started taking fenugreek (3 caps/3x per day) and believe I did see some improvement.  After weeks on the supplement though, I was suffering terrible stomachaches and weaned off them.  It seems that my supply has gone down again to the point where my once 12-hour sleeper is waking every 3 hours on the nose.  She is frustrated at the breast and I am upset that I am not satisfying her.  I feed her at about 7 each morning.  I then pump at 10:30 and will get 5 oz in all if I am lucky.  I then pump again at 1:30 and struggle to get 2 - 3 oz in all.  I use breast massage and always pump until several minutes after the last drop has fallen.  Whereas I absolutely experienced leaking and needed to use breast pads with my first two, I've not leaked a drop this go around.  For the first time since returning to work, I missed a pumping session at 10:30 and my breasts showed no signs of "talking to me" by the time I finally was able to pump at 12:30.  This week, my daughter started taking more my bottle while I am at work than I am pumping while away from her.  I nurse her as soon as I get back to her at about 4 pm, and as often as she likes in the evening.  If she has just had a bottle before I get home, I pump - and again - only get 2 - 3 ounces total.  I am floored by this after the nursing success I have experienced previously.  The only change (other than my age) is that I take 10 mg of lexapro daily.  I've never been great with water - but I'm always trying - and I do make time to eat healthy meals.  Like any other working mother of three, I am tired, but not anymore than I was when nursing my second child. Is it possible that I do not have the supply my 15 lb baby needs?  What can I do to improve supply (we already nurse constantly on weekends)?  At what point will I need to "suck it up" and supplement with formula?  Suggestions please!

Many Thanks.

Answer
ok first....

Take a deep breath.

now... take another.

now, listen.... you are doing FABULOUS!  you don't need to suppliment with formula. you are absolutly making enough milk for the baby.

a few notes... if you want to try something to boost supply you can try takeing metamucil. or eating alot of fiber. the more gastro-intentional moving we have going on, the more milk you will make. which is why fenugreek works. however, it tastes bad, makes people belch and gassy so tehy don't like it. Metamucil doesn't do this but will give the same effect.

Second, the face that you are 5 months into it would not suprise me that you don't get that full feeling. This is normal. If you stopped pumping all together for half a day, you would be fuller. but at this point the body adjusts better than it used to. So don't be alarmed.

Third, if you never pumped during the day, and your baby refused a bottle, and you fed her only in the evenings and morning, directly from you, she would still get enough milk. SHE is a MASTER at getting milk out of you far more than your pump will ever dream of being able to do. She will make up for any milk she wants when she is with you. nursing all weekend especially.

most babies gulp bottles down because they have such a strong suck reflex that they don't know they are guzzling a bottle. it takes 15-20 minutes for a baby's belly to feel full if she were nursing. my guess is, she takes her bottle much quicker than that. SO even though she has enough, she doesnt feel it.

It is normal to get more milk in the am  than in the afternoon. so 3 ounces in late afternoon is fine :)

Suggestions... watch and make sure she has 6 wet diapers a day and acts normal and is developmentaly where she needs to be. If she is, you are doing FABULOUS! and she is getting plenty. After 6 months you can start with maybe some natural foods , continuing with breastmilk, and it will all even itself out.

No need to fear. You are doing far better than you realize ;)

I hope that helped!
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