Expert: ruth kraft - 3/2/2011

Question
My daughter is 2 weeks old and I have been having issues nursing since she was born. She was 3 weeks early and was really sleepy and didn't suck well. Even though I was nursing every 2-3 hours, she wasn't having many wet or dirty diapers so the nurses recommended that I start supplementing. I did this while continuing to nurse and pump and she is doing ok now. Ever since they recommended I supplement with formula I have been worried that I have a low milk supply. The last few days I have pumped exclusively to see much I am making. The pediatrician said I should get about 2-3 oz each pumping session. I have only been able to pump 1-1.5 each time I pump (every 2-3 hours). I don't know what to do. I would like to nurse instead of pump, but I worry that she is not an effective nurser (still falls asleep after sucking for a bit) and think I might pull out more by pumping, but I have also heard that babies are more effective than the pump and what one can pump is not a true indicator of their supply. Since I am not pumping as much as she needs though, I am scared to start nursing since I won't know how much she is getting. I know I can count wet diapers and weigh her and stuff, but am wondering if it is even a good idea to try exclusively nursing when I know I have a low supply.  I have been taking Fenugreek for 4 days and it has not seemed to help.  I have no medical conditions that would cause a low supply, so not sure what the problem is. What should I do?

Answer
It is likely your supply is a little low because they suggested formula not the other way around. UNfortunatly very few nurses and even fewer pediatricians have a clue about breastfeeding. However, it is not too late. You can try to do something called power pumping. if you can handle it, for the next 3-5 days, pump every hour during the day and 2 at night. even after you nurse. You should see an increase in milk within 48 hours at least a little and it should continue growing after that.

Eat lots of fiber or take fiber supplements and the more gastric motility you have, the more milk you will make. You don't want to make yourself crampy or sick, but enough fiber to keep things moving for you. Drink lots of water as well  :)  

You should see someone in person to make sure the baby's latch is effective. Being that the baby has had so many bottles that might be a bit of a chore as well, but the earlier you start the better off you will be. Seek out a lactation consultant or a doula who knows breastfeeding. Breastfeeding counselor, Lactation educator etc. La Leche league gives free advice also.

It is not too late. It seems from what you have told me, there should be no reason you cannot exclusivly nurse and not give formula at all with some effort. A baby who effectivly nurses, does get more than a pump will ever dream of. :) But effective is key.

Best of luck!