Lactation Question (warning this is long)

[Mòrag Elasaid Ní Dhòmhnaill]

Lately my son has been wanting to eat more milk during the day than I am able to produce and I'm starting to get worried about it because it was around this same time we started to have issues with Niko and his breastfeeding. The problems actually started a little over a month ago just before he turned two months. That's when I started back to work.

I'm at work all day and he stays with grandma. I can only pump three times a day at work for twenty minutes. I pump at 9:45, 12:45, and 3:45, so about every three hours. I feed before we leave at about 6:00 or 6:15 and as soon as we get home at about 7:00. Yes it's a long day, I work unfortunately a long way from home - but dropping Niko off at daycare/preschool and Maks at grandma's makes it longer because I have to go a different direction than I normally would.

Maks takes usually four four ounce bottles during the day and according to grandma looking for more. When I pump at work, like I said, it's only three times a day and I'm lucky if I can get four onces per session. Usually it works out to something like five (six if I'm lucky) ounces in the morning, four ounces the second time, and only two and a half in the late afternoon. This is at least four ounces less than he eats during the day. If I didn't occassionally pump at night after he goes to sleep grandma would have to be supplementing with a formula bottle once a day. I can't always pump at night because it depends on when he goes to sleep. He used to regularly go to sleep at about 8:30 and wouldn't eat after that 7:00 feeding until he woke at about 2:00. His schedule seems to have changing lately as he stays awake later, until about 9:30 or 10:00 and sleeping through the night till about 4:45 or 5:00. When he does this he nurses at about 9:00 usually. When I pump at night I try to do it at about 10 or 10:30 but if he is eating at 9:00 there usually isn't much of anything to pump at that time. Pumping anyhow doesn't seem to increase production at all. I can't stay up any later to do it because I'm already waking up at 5:00 at the latest every morning and I need the sleep to get through my long day.

I feed on demand during the evening hours and on the weekend but he always seems to still be hungry following nursing. I've been taking fenugreek for the past two weeks and it doesn't seem to have increased production at all. Right now I'm taking the maximum recommended dosage and there is no change. I've thought about drinking some teas like milk thistle that are also supposed to help, but tea is almost impossible for me to drink because my gag reflex kicks in as soon as it hits the back of my throat and it's virtually impossible for me to swallow. Beer is also not an option for similar reasons.

When my husband took Maks to his two month check-up he discussed it with the pediatrician who said he could prescribe me something that is actually for reflux but seems to also increase lactation. I'm loathe to go on a prescription, especially for something I don't have, but I'm almost ready to give it a try because I don't want to have to give up on nursing or even supplement if it can be avoided.

Are there any other suggestions for what I can do? I'm really concerned about this and don't want it ti wind up like it did with Nikolas where I literally dried up at about three and a half months despite nursing him and pumping.

[RainInanna]

Kellymom has some other galactagogues - I'm sure somewhere I read fenugreek is best taken with another herb. http://www.kellymom.com/herbal/milksupply/index.html I took it with milk thistle (thought my supply was low, but really my son just liked to snack).

I know some mothers also checked to ensure they were getting lots of water, ate oatmeal for breakfast, or tried drinking beer as well.

[Brigid Rowan]

Oooh, this is a tricky one.

My first thought is are you hydrated? Before we even get into supply/pumping/etc, how much are you drinking in a day?

My kids went through phases of nursing but seeming hungry after, so they'd nurse again in an hour or so. These seemed to last a few days, and then right about the time I had gallons of milk being made, the baby would be done with the growth-spurt feeding frenzy. What I found to help with increasing production was what I called a "nursing holiday"..lol..What i did is went to bed with baby.

I'd get in comfy nursing clothes, climb into bed with the infant, and let them nurse all they wanted for 2 days. We napped together, I'd read while they nursed, and I drank a ton of fruit juice and water and ate every 2-3 hours too. Basically, I put nursing first, and took a break from the rest of the world for the weekend. It never failed to work...I always had a good rich supply back in 2 days. I think the constant contact of warm baby, smelling them, feeling them, really stimulated my brain to lactate more.

It sounds like with all the juggling of work, and pumping (I stunk at pumping,you are doing far more, ounce wise, thatn I ever managed) that maybe your body could benefit with "bed time"...just ask hubby to help, and invite your other child to snuggle in too. Mine would join me in the bed nest with books and crayons and even watch a video together there.

[RainInanna]

Oh, maybe as well a lactation consultant or local La Leche League would have additional ideas? Just a thought.

[Ceres]

First of all, let me say, KUDOS to you; this is a difficult thing you are trying to do!

BR is exactly right - take him to bed with you on the weekend and your supply will increase sooner and more effectively than any drug or herb will cause. The simple fact about milk supply is that your baby's nursing habits are the best control for it. In this case, that is working against you because you have to be away so long during the day, but knowing it can help you find ways to make it work for you as well.

Many mothers find that if they have to be away from their babies during the day , they can still maintain a full supply by frequent night nursing. It makes sense as well, because some babies sleep through the night at this age and manage to get their feedings all in during the day, so you what you could do is just reverse that and see that he is getting the bulk of his feeds during the night instead. This will also help you be able to pump more during the day so you arent having to come home and do it as well (hopefully), which will also help boost that supply. IMO - pumping doesnt increase supply for most women.

Of course, you will be a wreck if you try to get up out of bed, fed him and then try to get back to sleep to do this. How do you feel about co-sleeping to facilitate thisplan? It wont be forever; after all, by spring you will be supplementing his diet with solids anyway. Would this work for you? If not I can make other suggestions....

[Ariste]

I've heard eating leafy greens can really help. I know some other people mentioned co-sleeping, and I'm not here to offend anyone but I'm really really really against it. 1. it's very dangerous 2. I think it can have a huge negative impact on marriage.

We worked out the nighttime feedings..My husband would go get Tana and change her and bring her to me to nurse. I would nurse her in the bed while kinda still dozing. When I was done hubby would change her again if needed and then put her back to bed. She slept in the same room as us in a cradle the first couple months...just not in our bed.

Anyways that's my two cents. Sorry to those who disagree.

[Mòrag Elasaid Ní Dhòmhnaill]

Sorry it's taken so long for me to get back to these responses. Things have been rather hectic lately.

Rain Inanna, I actually eat granola made with oatmeal every morning. I was doing that before, but when I found out that it could help with lactation, I made doubly sure I was getting it. Beer is out because the taste is just too vile for me to contemplate drinking. I do have the number of a lactation consultant I got while at the hospital and was planning on calling if things didn't start improving.

Brigid Rowan, I typically drink about 60-70 ounces of fluids throughout the day and evening, most of it water. I should probably try to get some more in, but it's hard because I'm usually so busy at work that I don't even think about drinking. I really like the idea of a nursing holiday and will have to give that a try sometime soon. I can't this weekend due to several commitments that I need to keep.

Ceres I'm not crazy about the idea of reverse cycling with giving him the majority of his feedings at night just because I'm already getting very little sleep as it is. While he was initially a good sleeper he now unfortunately will not sleep much at all. This week he's not been going to sleep until 1:00 am and awake at 5:00. While he might fall asleep earlier than that he usually wakes within 10 minutes and will not go back down. He used to put himself to sleep when put down too, but we can no longer seem to get him to do that. Four total hours of sleep is not cutting it for me and I'd hate to reduce that any further. When he's awake at night like that I do feed him several times, usually at 7:00, 9:00, and 11:00. I usually throw in a 12:30. He has always slept in our room next to the bed in his bassinet and will occasionally sleep in the bed if he is being real persnickety and will not sleep without being held, but we in general prefer to keep him out of the bed as his father is a very heavy sleeper and is afraid he will roll over onto the baby, so when he knows Maks is there he doesn't sleep at all.