10 answers

Low Milk Supply - Could It Be Due to Antibiotics

I have two separate questions.
The first one has to do with breastfeeding and the second one with the milk supply.
My beautiful baby boy is 7.5 months old. I was successfully breastfeeding for 4.5 months when I was at home on maternity leave after which I had to return to work and my baby boy went to daycare. Over the last 3 months he has slowly resisted breastfeeding and I attribute that to the fact that he simply got used to being fed bottles in daycare. Could this be the reason? (Bottles are naturally less work and the milk is right there, no need to work hard at suckling...bottles simply provide instant gratification.) He is still exclusively breastfed (I pump at work) and gets one, occasionally two, solid foods a day, no formula ever. Another complication has been that because he had battled moderate reflux and continuous congestion and coughing up until very recently, his pediatrician recommended that he be fed elevated to help drain the mucus build-up. This meant that even at home, not just in daycare, I would pump milk to feed him with a bottle rather than at breast, believing that I was helping him and that it was only temporary. I feel that this way I sabotaged my own ability to be able to breastfeed successfully now that he has gotten over the cough and the reflux. Now, he refuses to breastfeed completely and will only take bottles. I pump at work as well as at night regularly, about every 4 hours. Up until about 2-3 days ago, I was able to pump out about 9-10 ounces at each 15-20 min pumping session. Occasionally, I would be tired and sleep longer at night and if I pumped every 6 hours at night, I would actually be able to pump out about 14-16 ounces at each session. He presently drinks about 8 oz each time he feeds (about every 4 hours) and so I would also be able to stash away gradually the milk that he would not drink to maintain the supply and also because when I need to start traveling for short business trips in a few weeks, I want him to continue getting my own milk and no formula. I have saved about 3 galons of milk in the freezer. My question here is: how can I slowly coax my son back to breastfeeding? Can I be successful at this late stage given that he is 7. months old? Did he forget how to breastfeed? Does he need to learn the skill again? Is this a nursing strike? Is he weaning himself slowly? I hope note as I want to breastfeed for at least 18 months or as long as he remains interested. Any advice on techniques on coaxing baby back to breast, re-establishing breastfeeding would be greatly appreciated. Should I perhaps offer the bottle with pumped milk at first, a small amount to quench the thirst and hunger and perhaps then offer the breast?

This is where my second question comes.
I developed masstitis in my right breast (in the underarm area) about 2 days ago. I was put on Cephalexin antibiotics and I noticed a considerable drop in my supply which has up until now been very steady and bountiful - I feel really blessed that I can provide my son with my own milk. Nothing else has changed (eating habits are the same, drinking lots of fluids, sleeping relatively well when not pumping or taking care of baby, work-related tasks and stress level about the same, etc.) Could the drop be attributed to the antibiotics? Anyone has experienced antibiotics-related drop in milk supply? (Any experience with cephalexin?) Should I pump even more frequently (as impractical as it sounds given that I work full time and have meetings, projects to work on, etc. but I can probably try to increase number of pumping sessions, if only temporarily...) Is it because my body is fighting the infection? I have taken the antibiotics for 2 days and have also been doing hot compresses at night and massaging with each pumping but because I also noticed a lot less pain in the affected area, I stopped taking the antibiotic because I panicked at the decreased milk supply and attributed it to the medication. Should I get back on the antibiotic to clear the infection? (I assume that my body should be able to clear it by itself as long as I drain the area and pump frequently, yes?) Is the drop only temporary or is it because the baby is getting older? (I cannot say that I am attributing the level of supply to the demand-supply issue because he is not breastfeeding per se, and I pump REGULARLY). Any advice on increasing the supply during mastitis? I have taken fenugreek before, in the very beginning. I have also heard of mother's milk tea but have not tried it.
I also wanted to point out that I have had 3 other cases of mastitis but they resolved themselves with hot compresses and my milk supply actually never decreased throughout the healing process so this time around really is different and I am guessing that it is antibiotics. I also asked my OB GYN whether I keep getting the mastitis because pumping is not as efficient as actual breastfeeding and so I am not emptying my breasts properly so to speak even though, really, they feel very limp and empty each time I am done pumping. she said that I am not doing anything wrong that some mothers get it even though they breastfeed every 3 hours and some mothers get it breastfeeding every 8 hours.
Any advice on how to prevent getting mastitis in the future?

We are also traveling (for about 10 days) with our baby son for the first time internationally in a few days and I have been hearing and reading that milk supply can go down as a result of traveling which provides a change to the routine in itself. Any advice or thoughts on the two questions above and maintaining milk supply while traveling would be appreciated. I assume that I just simply have to keep on pumping...

What can I do next?

Featured Answers

I don't think the low milk supply is due to the antibiotics but it might be making it distasteful. I had some of the same issues you are having, but the baby boy never went back to the bottle.

You are a saint for working and pumping and bottlefeeding.
That's is a yeoman's work.

More Answers

M.,

Babies do indeed self-wean. At 6 months, my son stopped completely. He's been on formula ever since (started solids at 4 months), and he's doing well. (He's almost a year.)

Nursing is not easy on the body, especially if you're working. So I'd say that you've done enough. Furthermore, you sound miserable, especially since you've been suffering from mastitis, which can really make you ill if it's not treated.

And although La Leche is often recommended, they did tell my working friend that she had to quit her job in order to nurse successfully. So it's not everyone's cup of tea.

Start your baby on formula. (I'm sure I'll be flamed here for suggesting that. Both of my children were on formula for much of their first year and I've seen no dramatic differences between them and their peers. They are healthy and growing well!)

You've got to find a balance at this point. And if you have frozen breast milk, use it. But begin by slowly introducing formula, too, so that he gets used to it. And you really only have a very short time left before he's on whole milk if that's any consolation.

Good luck. Your baby will be fine! Remember that it's all about balance, and if nursing is this difficult, then perhaps you need to examine other options.

I don't think the low milk supply is due to the antibiotics but it might be making it distasteful. I had some of the same issues you are having, but the baby boy never went back to the bottle.

You are a saint for working and pumping and bottlefeeding.
That's is a yeoman's work.

Sounds hard...
Alot to deal with...
Have you tried a lactation consultant yet? Pat Shelley at the Breastfeeding Center of Washington is superb, particularly with working moms. She can do a consultation in office, in home, or by phone (less useful).
Also, your local La Leche League leader would also be able to help with advice and ideas.

Call La Leache League. They have a web site too. AF

I am exclusively pumping milk for my 4month old twins. I cannot answer your other questions, but I just thought I would let you know that I took a supplement called "Goat's Rue" and that really got my milk supply up. Adoptive mothers take it to start lactating. So if you really want to get your supply up, then maybe it will work for you. Clear it with your pediatrician first of course. Mine said it was fine. Good luck.

I believe he is weaning himself. Normally children stop eating milk exclusively at about 6mo. By 12mo. they are only taking milk at night before bed. than by 18mo. they are off completely. Unless of course they are attached to it because of security issues. Which you don't want and don't want to cause by forcing him to breastfeed longer than he wants. In my opinion i would let him wean and start feeding him food slowly so that when you leave on business trips he's satisfied with what he is getting and half way through your trip he doesn't stop eating it completely since you are away. Because no one is going to be determined as you are. Good luck

My experience with masstitis was really bad, and it was when my daughter was 2 weeks old. I had to quit nursing for two weeks because the pain was so terrible. I had a hard time nursing my son, and just figured the little pain I felt (while on meds from the hospital) was normal. Then the pain meds ran out and it was unbearable. I didn't know if my milk quit b/c of the antibiotics or b/c I couldn't nurse, but she did fine iwth two weeks of bottles of formula and already pumped breastmilk, and I was able to nurse again with no problem. My milk supply came back almost in full-not enough for lots of extra bottles, but more than she wanted. I did get sick when my son was 5 mo though, and after taking meds for that infection, my milk never came back in. It was never fully in with him though, for some reason, in the first place.

Sounds like you're doing a wonderful job thinking about all the different angles. I just have one idea to share. Sometimes babies prefer the bottle to the breast because it gives them more "instant gratification"--they get milk from the first suck instead of having to suck for a minute or so to stimulate the let down reflex. You might try expressing some milk to get the flow going before putting the baby to the breast. If you express enough to stimulate that letdown, then when you put him to the breast he'll get milk from the first suck, so he won't get frustrated.
To boost your milk supply, make sure you get plenty of fluids and try pumping a little more frequently than usual. Be sure to pump til you get the thicker, creamier "hind milk." Also, toward the end, stroke from the outer edges of the breast toward the nipple to help the milk down from
the outermost milk ducts. Good luck!

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