Breastfeeding/Lactation Consultant

Good Morning,

I have written in the past and your advice has been invaluable.  I have an adorable healthy 10+ month old.  He has been EBF.  He was sick about three weeks ago for about a week and his appetite went way down.  Since then, he has not been interested in nursing at all except at night before bed and when he wakes up in the morning (he sleeps through).  His old nursing schedule during the week was nurse at 7 am, bottle 4 ounces at 9, bottle 4 ounces at 12 with lunch, bottle at 3ish 4 ounces, nurse at 5:30, nurse at 7:30 before bed.  He gets solids in the morning, lunch, and dinner.

I was pumping three a day and was getting between 3.5 and 4 ounces each time.  I have upped to five times a day and am only getting 1 to 2.5 ounces each session.  So I barely get enough for three 3.5 ounce bottles. 

I am really discouraged.  Six weeks away from my goal and I am thinking I need to supplement with formula.  Please any advice would be great!

Have you done any routine pump maintenance lately?  If not, try replacing the little white membranes on your pump.  They can get little micro-tears in them, which negatively impacts your pumping output.  Some women see a big difference in pumping when they replace the membranes.

Increasing the number of pumping sessions is also a good start to increasing supply.  You may also start fenugreek, which many women find helpful (keeping in mind that the fenugreek won't do anything w/o the increased pumping).  Oatmeal is also thought to be a good galactagogue.  The fact that you've already increased pumping (when did you do that by the way), combined w/ a galactagogue may give you the boost you need.  It can take up to a week w/ increased pumping to see a difference.

And - for me - rather than introduce formula at this point, which I think he would likely reject anyway, I would send as much breastmilk as I could pump and then make up the difference w/ slightly more solid foods (think high cal options such as avocado) and then encourage more nursing during your together time.  A good weekend of direct nursing would probably go along way in giving you a supply boost.  I know you said he's been less interested (this can go with the age), but try times when he's feeling low key and relaxed.  Try hanging out in bed, snuggling (both my girls would nurse on and off for hours on lazy weekend mornings when we all just refused to get dressed and get busy).  I know he sleeps through the night, but you might also consider a dream feed to help w/ your supply and to get him the extra milk he might be missing during the day.

HTH

I forgot to mention that I started taking the Fenugreek capsules four times a day.  The extra pumping and Fenugreek started this week like on Monday.  I will give it more time.  I also have a small freezer supply.  I am also going to try replacing the white membranes as soon as I get done writing this.  Thanks for the help.  I know that my son will not turn away extra food that is for sure, he loves to eat! 

The PP gave great tips.

You may already be doing this, but are you pumping after baby goes to bed and before you hit the hay (at least once)? Or even better for boosting supply do a dreamfeed of baby right before you go to bed. Baby won't wake but it will boost his total intake.

How much fenugreek are you taking? you might also add Blessed Thistle - they work well together. From Dr. Newman: "Two herbal treatments that seem to increase the milk supply are fenugreek and blessed thistle, in the following dosages:
Fenugreek: 3 capsules 3 times a day
Blessed thistle: 3 capsules 3 times a day, or 20 drops of the tincture 3 times a day

The tincture container states that blessed thistle should not be taken by nursing mothers, presumably because of the tiny amount of alcohol the mother would get. There are some preparations of both herbs that are labelled “not for use by nursing mothers”. Don’t worry about this; these herbs are safe for the mother to take because so little gets into the milk. Teas also seem to work, but to take enough to make a difference, you will be drinking tea all day and night, since the amount of the herbs you get is much less.

Fenugreek and blessed thistle seem to work better if you take both, not just one or the other."

Hang in there.