Ask the IBCLC Breastfeeding Help: Low Supply and Breastfeeding in Pregnancy

The Leakies with Shari Criso, MSN, RN, CNM, IBCLC

This post made possible by the support of EvenFlo Feeding

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We’ve asked Shari Criso to share her answers to Leakies questions about feeding their babies. If you have any questions you’d like to ask Shari, leave a comment!

 

My little 4 month old is refusing to take bottles. I’ve started taking him to daycare, and he is refusing bottles, not even taking a full ounce while he’s there for 6-7 hours. When we’re together he’s still drinking well from the breast and nursing frequently at night. His weight is good and we’ve had no issues other than this. I’m worried about him becoming dehydrated during the day. What can I do and what can I tell the daycare to do?

Mama to a hungry but stubborn baby.

 

Hi Mama,

I totally feel your pain and the anxiety that comes when your breastfed baby refuses the bottle and does not eat when you are not around. I had one myself! Reading your question, my first thought is that this transition may take a little time for not only you to get used to leaving but for your little guy to get into a new routine, new people, and a NEW way of eating! This is one of the reasons that I really recommend introducing your breastfed baby to a bottle earlier than most will (like within the first 2 weeks!) which makes this transition much easier. I actually have an entire chapter dedicated to this very thing in my online breastfeeding class “Simply Breastfeeding” because I know there are so many moms that need to return to work and this issue can be so distressing. I know that is not helping you now…so my best advice is this: First, try different types of nipples to see if there is one that he will take over another. Try offering the milk cold instead of warm. Sometimes this can also make a difference (not exactly sure why, but it worked with my own and other mamas I have worked with). Try feeding him in different positions instead of cradling him. Holding him outward and distracting him by moving around, staring at a picture on the wall, etc. Try an infant feeding cup. YES…babies can be fed through a cup and don’t need to take an artificial nipple! Lastly, if all of these things fail don’t stress. This may just take a little time and a few more feedings during the time you’re home and at night. Let him co-sleep with you and try to get as many feedings in that you can while you are together. Watch wet diapers, signs of dehydration and weight loss. If all seems normal, just let it be and allow your baby to adjust at his own pace. In the meantime, you should still continue to pump on schedule as to not decrease your supply and also not get too engorged while you are away.

I hope this helps and that things start to smooth out very soon for you!

Xoxo,
Shari

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Dear Shari,

I am 7 weeks with my 3rd and my son is 8 months old today, so I am still nursing very much so for nutritional purposes. He doesn’t like solids, of course, so I’m lucky if he eats 1 additional solid meal per day. I have noticed a drop in my supply already, just now I was up to nurse him and it took a good 10 minutes before he got a let down and they definitely aren’t as strong. Please tell me it won’t drop any further than it is now, I want to tandem, I nursed my daughter until 22 months so him and I would both be devastated if it just went away!!

You’ve been so encouraging before, thank you!

Not ready to stop!

 

Dear Not Ready To Stop,

First, congratulations on your new pregnancy! Having you children close in age has many benefits and can also present certain challenges as you are experiencing, however this does NOT need to be the end of your breastfeeding relationship with your older child. Many, many mothers are able to continue breastfeeding safely during pregnancy and way beyond, going on to tandem after birth. Most moms will have a decrease in their milk supply during pregnancy. This is especially common in the second trimester but can start as early as the first. It is thought that increased levels of Progesterone during pregnancy is what causes the milk supply to drop. This typically begins to resolve towards the 3rd trimester and especially at birth when the placenta is delivered and prolactin levels rise. AS always, it is important to continue to offer the breast to your nursling frequently and not decreasing “demand.” This will only add to your decreased production. Co-sleeping and night feedings can help here. Be careful on any herbal supplements that you are considering as they may help your supply, but they are not all safe during pregnancy. Always consult your doctor, midwife, and lactation consultant. The decreased supply may actually encourage your little one to start taking mores solids, as he will naturally be hungrier. This is fine as long as your are getting in at least 3-4 feedings per 24 hours. Take this opportunity to experiment with new and yummy foods, and keep trying even if he rejects it at first. It can take 5-7 “rejections” of a certain food before a child will accept and even learn to love it. As always, monitor wet diapers, signs of dehydration, weight loss, etc. Most of all, try not to stress. This is temporary and your milk WILL come back so that you can go on to provide for both of your babies! 

All the best to you and your family.

Good luck,
Shari

AskTheIBCLC_26JUL16

Dear Shari,

My little is almost 6 months old. My supply has taken a huge turn for the worse. I am barely producing anything. I Had a huge over-supply in the beginning. This has all started about a month ago. I know that you are supposed to adjust and pump more of what baby needs close to 3mo plus. Well I started doing that. Was pumping like 20-25 ounces a day.. Then it decreased to 10-15 and now I’m at 1-6… The past two days have been around 2 ounces the whole day. I have done pretty much everything I have read to do. I have also switched pumps. I have tried switching flanges. Replaced membranes, replaced hoses. I know stress is a horrible killer for your supply. I honestly am not stressing. I do not feel stressed, do not feel worried. I have a freezer full of milk so I know my little girl will have momma milk for a while longer even if I am done producing. I just would like to know if I am done ya know. I have tried nursing her more too. Day before yesterday I nursed her more and she didn’t seem satisfied at all. Today I nursed her more and she seemed fine. What is going on?

I appreciate any light you can shed on this!

Dwindling supply and hungry baby.

 

Hello Dwindling,

It sounds like you are trying to pump in addition to fully nursing your baby at the breast. It is completely normal for milk supply to fluctuate and for there to be times when your supply may seem lower. This will naturally happen as your child ages and also during times of growth spurts when they are eating ALL THAT YOU HAVE! That will of course leave less to be pumped. Normal growth spurts occur around 2-3 weeks, 6 weeks, 3 months, and 6 months. There is also a very common decrease that happens around 6 months postpartum for many moms. This can be due to hormonal changes, the return of you period, nursing less frequently, returning to work, introduction to solid foods, etc. I talk about this a lot in my online class “Breast Pump & Briefcases,” as it is something that so many breastfeeding and pumping mothers face. It is important to understand that while there may be times where you are able to produce way more than your baby is eating (which leads to being able to pump a lot of extra feedings for storage or donation…like your freezer full of milk), there will be other times where you may just be making exactly what your baby needs in the moment and not any more. This is not abnormal, and also not a problem as long as you feel that your baby is getting what she needs at the breast (which it sounds like she it). Your pumping and storing may have to take a back seat until the growth spurt is over. This will usually pass within a few days of concentration and baby led feedings. Small but frequent feedings whenever the baby wants to go back to the breast without supplementing, will usually have your supply back within a few days. Delaying feedings or supplementing with your freezer supply or formula during theses times will have the opposite effect, delaying the decrease or decreasing it further. This is SO important to understand. There are also foods like oatmeal and herbal supplements like Fenugreek that can help during these times, but I would always consult a Lactation Consultant before using anything. 

I hope this helps you and congrats on doing such a great job feeding your little girl!

Much love,
Shari

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Shari Criso 2016

 

For over 23 years, Shari Criso has been a Registered Nurse, Certified Nurse Midwife, International Board Certified Lactation Consultant, nationally recognized parenting educator, entrepreneur, and most importantly, loving wife and proud mother of two amazing breastfed daughters. You can find her on Facebook or her own personal site.
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