Sometimes nature throws us a curve ball and you simply don’t have enough supply to meet a baby’s nursing needs. The way that breastfeeding is presented (anecdotally and in media) as ‘the most natural thing’ is pretty misleading, especially when – as a new mom – you lay your baby’s head against your breast and just expect the magic to start, for the flow to kick in.
I had a blissful first experience, with K latching eagerly and seemingly drinking (or starting off with the colostrum) happily. But by the end of day two, my enraged and suffering nipples should have been a clue that all was not well; the shards of glass feeling, milk blebs (hardened milk trapped beneath the surface and blocking the exit from the milk ducts) and raw, cracking nipples were more than ample evidence that there were latch issues. Plus, my big baby (10 lb. 3 oz) seemed insatiable.
How does a new mom tell whether this is just normal growing pains and a baby doing what babies do – stimulating more milk – or a case of bad latch and low supply?
It wasn’t until I went to the lactation consultant, after two weeks of suffering and constant feeding (with a baby who would fall asleep at the breast and who seemed mostly content, but always hungry) and nipples I would have cut off rather than suffer with another day, that we found out we had problems. Baby hadn’t regained his birth weight. We did a weighted feed and found he was only getting about 35 ml of milk (way too low for a growing newborn). I would read, with frustration, about moms who talked of ‘squirting their babies with milk; what?! Who has enough milk for that kind of energetic exit? I felt nervous that I was slowly starving our son and defeated that my body, despite a near CONSTANT feeding regimen, wasn’t working properly to feed our child. We got some tips on our latch, position and how to encourage more efficient eating, were given encouragement to start supplementing with formula and then went back to the consultant to check his weight. Still unsatisfied with the amount I was producing, we were referred to the International Breast Feeding Centre. There, the famous boobie specialist, Dr. Jack Newman (namesake of the Newman’s All-Purpose Nipple Ointment), assessed my breasts, the damaged nipples, looked at baby’s latch and did an investigation of baby, weight, mouth, etc. An undiagnosed tongue tie was found and released (a hard thing to watch as a parent, but necessary to help him start to feed effectively). I was also put on Domperidone (9 tablets, spread out over three doses during each day). Eventually I was bumped to 16 tablets a day. This is an off-label use for the drug which has a side-effect of producing lactation and increasing milk supply (probably not ideal if you are a man with digestive issues, but great for moms with low supply).
We returned three times for follow-ups (they watch you feed, weigh baby and monitor your progress, adjust your does of Dom). We had the tongue tie released a second time. Heart-breaking. And became experts in our own mom-baby nursing relationship.
Now our guy is 99th percentile for height. 85th for weight. Steadily gaining weight and eating like a champ, with very little issue. I still have the goal of exclusively breastfeeding, but it has been a blessing that he will a) take a bottle, b) can be fed by someone else, and c) is very easy going with regards to what, where and from whom he will take a feed, breast or bottle. To be clear, it’s from me that he takes the breast.
For moms, or parents, going into this… please know that nursing is hard and can be nerve-wracking. It’s a matter of survival for your child and can feel dire. Meeting their basic needs can provoke tears and uncertainty. If you find yourself in a supply and demand struggle with your little one, here is what I learned and top things that worked:
-feed on demand (as often as he likes). Some people like to get into a schedule and have some routine, but that will come eventually. At the start, let baby dictate when they eat. Offer the breast constantly. I was mostly topless for the first 6 weeks.
-switch sides often to help encourage multiple let downs (don’t drain one side then move to the other, instead switch mid-feed from one side to the other and back again for a second, or third try).
-for a little while, in the beginning, let him comfort feed and stay on the nipple to stimulate more production. This is time consuming, but helped get the milk up to his demand. I still let him ‘hang out’ on the nipple, especially if he is cranky, since the hormones released for baby and mom are calming and soothing. Plus, he is cute as can be and these are the moments of bliss I always thought would accompany nursing.
-when feeding, watch how hungry he seems and when he starts to fuss at the breast use that opportunity to see if he seems ‘very’ hungry still or just a bit, then make formula according to that estimation. Better yet, if you have a partner who can make it while baby stays at the breast, even better. I would literally call out a number ’30 ml, please!’
-Some feeds I’d make just 20 ml. if he seemed a little hungry, other times 80 or 120 if he seemed really ravenous. Yes, sometimes formula gets dumped, but I felt better knowing that he was getting enough and was definitely full.
-For the first while (three weeks) I pumped a little (6-10 minutes per side), after handing him off to my partner or putting him down to nap, after about half the feedings each day. Even if very little came out, it still stimulated the production.
-For the first month I used a lactation aid (a tube that runs from a container of milk or formula, laid against your breast and put into the corner of baby’s mouth) to let him drink the pumped milk, or formula, at the nipple. This was a huge pain in the butt, but it may have helped to get him sucking more at the breast (producing more, while also reminding him that the boob is where the milk is at).
-Take medication if you think it makes sense for you. Some prefer natural remedies like thistle and fennel, Mother’s Milk tea, etc. I do this, too, and eventually want to be off the pills, but found that it definitely worked for me. I have heard that especially with multiples, medication can help remedy low supply. I am now on 9 Domperidone tabs a day (10 mg each), which still feels very high; however, at the early stages I was taking 16 per day and slowly brought that number down as I watched to see if the supply was affected.
I know first-hand what a stress it can be to wonder if baby is eating enough and whether the supply is sufficient…and to wonder if you’ll always have to jump through so many hoops! Trust me, taking a small suitcase of ready-to-serve formula to Mexico, just in case my supply wasn’t enough, was never something I envisioned as part of my parenting reality.
Now, after all those initial trials, my routine is much more …routine. I just take my three tabs, three times a day, and feed him without pumping, with only a bottle/formula top-up when he seems unsatisfied (which maybe only happens once a day now). Some days we don’t need any top-ups at all. I hope others have an easier time; I know I wished that I hadn’t had to go through this when we were in the thick of it. But, with the resolution of most of those issues and a very happy little boy at 5 months old, I hope that if you find yourself similarly stressed and frustrated, these tips provide a bit of a light at the end of the tunnel.
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article sponsered by Northern Michigan certified lactation consulting and Mother Hubbards Country Cupboard
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