18 answers

Breastfeeding and Birth Control - Decrease in Milk Supply

My milk supply has decreased dramatically lately, and I'm wondering if this is due to me going back on combination estrogen/progesterone birth control. At my 6-week postpartum check, my OB gave me a 6-month prescription for the minipill but said I'd need to go back to my previous brand of birth control (Ortho-cyclen) around 6-7 months, as my daughter would have started solids by then and would be nursing less. She said that by that point my milk supply should be well established, and the pill shouldn't affect it. I work and have to pump during the day, so I was expecting to see some decrease in my milk supply around 5-6 months, as other working mom friends said this had happened to them (and I did start struggling to pump enough during the day at around 5 months, at which point I started taking herbal Mothers Milk tea - I've also been trying very hard to drink tons of water during the day). However, in the past couple of weeks, I've fallen way behind on what I'm able to produce when pumping, to the point where now I'm not even getting out 8 ounces in an 8-hour work-day!! It finally occurred to me that this might be due to the Ortho-cyclen, which I started 3 1/2 weeks ago. So my questions are: has this ever happened to any of you? If so, were you able to get your supply back, or was it gone for good? I'm thinking of calling my OB and asking her to prescribe the minipill again, but I'm wondering if it's not too late - honestly, today, I'm feeling all the signs of my period coming on, so if my cycle is back, does that mean my milk will be gone soon no matter what steps I take? I'm not sure how I feel about resorting to extreme measures like Reglan. I was happy that I was able to exclusively breastfeed for 6 months and was looking forward to nursing her at bedtime and in the morning to a year, but I don't think I'd be heartbroken if my supply dried up - but if there are a couple of easy steps I can take to increase my supply, I'm all for it! Thanks in advance for your advice!

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Featured Answers

I have a three-month old and I've struggled with my milk supply since she was born. I take Fenugreek, as many others recommended, and also Blessed Thistle (not milk thistle) per my lactation consultant's suggestion and it seemed to help. I take Reglan also but still can only pump about 4-5 oz per session now that I'm back at work. I haven't had any side effects at all from the Reglan or from the herbs.

C.,
My personal experience was that once I went back to work and got more stressed with the daily stuff, my supply dropped significantly. I tried fenugreek, which did nothing, and I talked to the pediatrician, who prescribed Reglan. It really was a wonder drug, and increased my supply again. I decided to stop @ 7 months (actually, I had been pumping the whole time, as my daughter never learned to latch on correctly), as it was stressing me out trying to fit the pumpings in with my daily work schedule. I'm pregnant now (5 years later), and wonder about having the same problems.

I can tell you that I didn't have any problems with the Reglan, and my daughter didn't, either, so don't rule it out, if you want to keep going.

Good luck,
D.

More Answers

I would strongly suggest contacting a lactation consultant or at the very least contacting a le leche league group leader. You can find a list of local groups on the le leche league website lllusa.org
Anything you put into your body might impact your supply but please do not stress about it. That might only make it worse. You can get your supply back. It is not gone. You sound very determined to give your baby breastmilk for at least a year and that is wonderful. The first thing should be to get off estrogen-containing contraceptives until you are finished nursing. They very often impact milk supply even after 6 months.
You are doing some great things like the herbal tea and drinking lots of water. There is a food grade herb called fenugreek that you can take. (it is used as and additive in syrups and similar food products so for most women it is safe to take)
There is a lot of advice that you can get from other moms and a lot of it will be good but PLEASE contact your local le leache group or a certified lactation consultant. They are the experts in these matters. You sound like breastfeeding is important you and these are the people to talk to!!
Good luck.

1 mom found this helpful

Hey C.,

I could write a lot about this, but I think this article will answer all of your questions. Hope it helps!!

http://www.kellymom.com/health/meds/birthcontrol.html

We also chose to use condoms until I stopped pumping and nursing all together.

1 mom found this helpful

I'm still breastfeeding my 6 month old and my doctor said not to start a BCP containing estrogen until I was done nursing--the estrogen will decrease your milk. I tried Fenugreek several months ago to increase my supply with some success. Good luck!!

Hi - Lots of information is available out there. Your milk will not necessarily dry up if your period returns naturally, but the pill often has a dry up effect because it manipulates your hormones. I don't know how open you are to alternatives, but there's some wonderful information available about fertility awareness that can be just as effective as the pill or barrier methods without any of the side effects of the pill or its counter-parts.

Look up Katie Singer - The Garden of Fertility, and Honoring Our Cycles - excellent, detailed resources about fertility - whether you're looking to avoid pregnancy or get pregnant - and there's special information about breastfeeding in The Garden of Fertility, too.

Also, to maintain milk supply, make sure you're getting enough high quality fats and proteins - real butter, fish oils, etc.. And enough sunshine on your face to have sufficient Vit D, too.

Good luck!

My first son was a preemie and spent about 6 weeks in the hospital learning to feed/breathe. So I spent a lot of time there with with lactation consultants and neonatal occupational therapists. They said that it is possible to drink too much, which can shut down milk production. I don't remember how much is appropriate to drink, but you might take note and make sure you aren't drinking too much. Also, being nervous or worried about it can have a profound effect as well. If you can learn to relax when you are pumping (maybe look at a picture of your daughter) that might help as well. I pumped for a year at work with that same son. The most I ever got in a single pumping was about 10 oz, which is insane. I had quite the milk supply, probably from having to pump around the clock the first three months until he learned to nurse.

I'm surprised your OB would put you on a combo pill at all while you were still bfing.

My daughter is 20 months and we're still bfing. I had been on the mini-pill until recently when my cycles started getting really short. When I saw my OB about this she said to stop taking the pill and when I was ready to stop bfing she would prescribe ortho-tricycline. So even at 20 months she won't prescribe a combo pill for me because of what it does to your milk supply.

As far as your period goes, it doesn't mean you'll lose your milk. I started getting my period when my daughter was 14 months and still have milk 6 months later. I do notice a decrease right before I get my period but it comes back after AF is gone.

I would call your OB and discuss this with her. I doubt that you are "too far gone."

Good luck!

I breastfed both my boys until they were each 12 months old. With my first my milk supply was plentiful the entire time. With my second it wasn't quite enough and I had to supplement after about 6 mths. My doctor doesn't recommend the minipill and absolutely does not prescribe regular birth control during breastfeeding. With both my sons I got my period back around 5-6mths. We used othe control methods, like condoms, since my doctor doesn't prescribe the pill, until they baby was 1 yr and weaned. With both boys I notice a slight decrease in milk occuring with my period every month. If you are about to get your period then the decrease could be due to that. However, if it is a serious decrease that seems to have started with the pills then I think it is the likely cause.

C.,
My personal experience was that once I went back to work and got more stressed with the daily stuff, my supply dropped significantly. I tried fenugreek, which did nothing, and I talked to the pediatrician, who prescribed Reglan. It really was a wonder drug, and increased my supply again. I decided to stop @ 7 months (actually, I had been pumping the whole time, as my daughter never learned to latch on correctly), as it was stressing me out trying to fit the pumpings in with my daily work schedule. I'm pregnant now (5 years later), and wonder about having the same problems.

I can tell you that I didn't have any problems with the Reglan, and my daughter didn't, either, so don't rule it out, if you want to keep going.

Good luck,
D.

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