Expert: Sally Wendkos Olds - 1/6/2012

Question
Hi Sally,
I hope you can help me i seem to have hit a brickwall.  I gave birth to my son Thomas on 9th August 2011 he weighed 7lb 1oz and have been exclusively breastfeeding him since birth.  He has been making steady weight gain however over the last few weeks his weight gain has began to slow.  He weighs 10lb 14oz today and is being fed roughly every 4 hours or more often when he seems to have a growth spurt.  I was advised by health visitor to take him to see my DR which i have on 2 separate occasions,  he gave domperidone tablets 3 weeks ago to increase my supply and this week has referred my son to see a paediatrician as his weight is low and advised me to top him up on formula even though he is satisfied on my milk and is now much more active.  I am considering in trying to wean him but wanted an expert opinion on this as i feel like im not meeting his dietry needs.  thanks Lindsay :)

Answer
Dear Lindsay,

First, congratulations for giving your son the best start in life by breastfeeding him!

On your present situation, if your doctor recommends adding formula you should follow his advice, but that does not mean you need to wean your baby. It's possible that the formula supplement will be only a temporary measure and that you will be able to go back to exclusive breastfeeding for another month or so. Since Thomas is now 5 months old you might even want to start giving him some solid foods.

I am attaching an excerpt from my book (see below) on building up your milk supply, and also about supplementing to get the most benefit.

Good luck!

Sally
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Sally Wendkos Olds
Author, THE COMPLETE BOOK OF BREASTFEEDING: Olds & Marks, 4th edition, September 2010, published by Workman Publishing, and available in most public libraries, bookstores & La Leche League chapters.
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Ways to Build Up Your Milk Production

Following one or more of the suggestions below should increase your milk supply within a few days.
• Nurse your baby more frequently for several days, using both breasts at each feeding. This is the single best way to enhance your milk supply.
• Wake your baby, if necessary, to feed him more often -- about every two to three hours during the day and at four-hour intervals during the night.
* Pump or express milk between feedings. But don’t get discouraged if your pumping yields as little as half an ounce of breast milk. Your baby is almost certainly getting more than this. Even the best pump is less effective than a vigorously nursing baby. (More about pumping in Chapters 16 and 17.)
• See a lactation specialist if your baby is not suckling well or nurses only a few minutes at a time.
• Cut back on your schedule. Do less. Rest more. Nap at least once a day, more often if you can manage it. Or at least put your feet up. Ask someone else to help with marketing, cooking simple meals (or getting take-out food), and doing basic laundry. Most people like to help a new mother, so take advantage of this willingness now. You can always reciprocate later on. Although people often want to help, they may not know just what you need. It may help to post a running To-Do list on your refrigerator for all to see.
• Check your diet. Are you eating enough? Are you drinking enough? Some women find that eating or drinking more seems to produce more milk. Keeping a glass of water or juice near the spot where you nurse is a good idea. You don’t need to drink any more than you need to meet your thirst, but some nursing moms find that they are thirstier than usual.
• Make a special effort to relax, as suggested in the box on page tk. Of course, this is hard when you’re concerned that your baby isn’t getting enough milk—but the more you can relax, the more milk your baby is likely to receive.
• Develop a few affirmations that you can repeat to yourself, such as: “I am a bounteous supplier of milk for my baby”; “I am doing the best thing I can as a mother”; “My baby is growing fit and healthy from my milk”; “My milk is my baby’s perfect food.”
* Visualize your baby at a little older age, looking well fed and  happy.
• Believe in yourself and trust your body.
If you do supplement with formula, you might try offering a couple of ounces of formula in the bottle first before nursing him. This practice, which reverses previous guidelines for supplementation in the order of breast-followed-by-supplement, has become more widely recommended in recent years. This reversal satisfies the baby’s immediate hunger and gives him the nourishment he needs, but ensures that he will get his final sense of fullness from breast milk, and associate this good feeling with his mother. Another way of supplementing is to use a nursing supplementer, a device that lets your baby suckle at your breast (thus stimulating your milk production) while at the same time receiving formula (see page 328 for a description).
  Once breastfeeding is well established, you may want to give your baby an occasional bottle of breast milk or formula. Ideally, you should wait until your baby is six months old to feed anything besides your good breast milk  (see Chapters 11, 12, and 17).