Returning to Work and Now Have Decreased Supply

I am a full time working mom as well (of three) and have breastfed all of my children. Drinking lots of water during the day should help a lot. The other thing that I have always done with all of my kids, is I both pumped and fed the baby in the morning before work (pumped on one side, let the baby nurse on the other) and I pumped once in the evening (in addition to pumping at home). This both increased my milk supply and allowed me to pump enough to provide the baby with sufficient breastmilk while I was at work.

Good luck.

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Hi B., going back to work is hard, but you can do it. I went back at 4 weeks with all 3 of mine. Keep pumping! Milk supply is based on supply and demand, the more you empty your breast, the more they will fillup. Make sure when you pump that you empty your breasts completely, then keep pumping for 2 minutes. Sometimes on a good day, you'll have a second let down and get more out. Check out the Kellymom website, and read as much of the science about supply as you can. The more information you have about the biology you have, the better you will be able to work with your body and make it work better for you and your baby. I did use fenugreek for awhile. It worked great. The directions that I found said to start with 2 capsules every two hours, for two days. If you didn't smell like pancake syrup up the dosage. I did and it took about 3 days of taking more and more, but when I started to smell like syrup, my milk supply did increase. Of course once you get it increased, you have to keep it there by nursing and pumping alot, or it will go back down again. Milk produciton is greatest in the AM so make sure you are nursing and pumping then. YOu can do it! Good luck.

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Britney,

I have breastfed both of my children and I always experience a decrease supply when I return to work. What has worked for me is to drink plenty of liquids throughout the day and I decreased my pumping to 1 time at work (normally late in the day) when I am the fullest. I can usually get 10 oz from that one pumping (5oz from each breast). Then when I get home, I feed my son on one breast only and when he goes to bed (since yours is around midnight) pump the other breast and I can usually get 4oz's at that time. This way you will have at least 3 bottles for your son the next day and this is the process I stick with. If you still can not pump enough milk, there are dietary supplements with Fenugreek in them that helps Lactation (milk production). I have never used them but a friend of mine here at work has and swears by it.

Hope this helps.

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I never had much success with pumping with my youngest. I just always thought it was because I was not gettig it just right. I always got an average of 2 to 3 oz each time too. He was such a hungrey fatty guy I thought also that he just kept me drained. With the oldest I could have feed 10 kids. I had more milk than he could drink and constantly leaked. Good luck.

Hi B.,

I think you are doing a great job!! Pat yourself and your fiance on the back!

Make sure you are eating and drinking and resting enough. Lots of water and juice for you should help with supply.

You could also contact a La Leche League leader about ways to increase your supply. You don't have to be a member of LLL to call a leader or attend meetings. The toll free number is 1 800 LALECHE, they can refer you to a leader in your area. Or visit the website (I don't know the exact web address).

When you are home, nurse, nurse nurse! you say he is on demand then--you might even want to encourage him to nurse. Nursing is the best way to build your supply.

When you pump, someone mentioned bringing a picture of the baby. Maybe one of his onesies would help too so you could smell that sweet baby smell as you pump. Being as relaxed as possible is good too.

Re weight gain--I wouldn't stress over it too much. Dr. Katherine Dettwiler (sp?) has done a lot of research on breastfeeding both here in the US and in other cultures. (Her website is good too.) I heard her give a talk where she explained how there are many factors that affect the measurement of your baby's weight that have nothing to do with the actual weight of the baby--e.g., when comparing two weigh-ins, was baby naked or clothed? if clothed both times, same type/weight of clothing? was diaper full or empty? was same scale used? when was it last calibrated? a lot can happen to a scale in a month. If, at the first weigh-in, there are a lot of factors pushing your baby's weight toward the heavy side, and at the second weighing, toward the light side, it may look like he hasn't gained any.

Re the bowel movement--the rectal temp worked for us. Or get a baby suppository, and just put it in partway, then remove it. If that doesn't help, leave it in to do its work!

I wonder if the "colic hold" would help? That's where you hold the baby along your arm, with his head in your hand, his tummy along your forearm, his right arm and leg hanging off one side of your arm, and his left arm and leg hanging off the other side of your arm. (Believe me, easier to do than to describe--lol!) Another way of stimulating the tumm. You can walk around and do other stuff with your free hand while you do this.

He might also be getting to the stage where he doesn't poop as often. But I understand if he's uncomfortable you want to help with that.

Sorry this is long. I hope some of it was helpful! Keep up the good work!

K. Z.

When my daughter was 2 months old I had to give up brest feeding. I pumped in the beginning since my daughter did not latch on. This caused me to have a decreased milk supply. I was happy to put her on brest milk since it was a big hassle.
I have heard of some working mom's only brest feeding when home and then giving formula during the day. This works out for some.
My daughter did have problems pooping when she was little. My pediatitrician (sp?) told me to give her brown sugar water. I am not sure of the dosage however the idea of 4 oz of water to a teaspoon of brown sugar may be it.

I was lucky with my two. I was able to stay at home with them until my son was 2yrs old. My daughter I nursed for 18 months.

The key is frequency or demand on your breasts and pumping doesn't always stimulate the breasts as well as actually nursing does. You didn't mention when his last feeding is at night. You could try pumping before you go to bed or stay up a little later to pump if it's too soon after your son feeds last. You can also try getting up at least once during the night to stimulate and then pump. Frequency of demand stimulates the supply best.

Have you been manually stimulating your breasts every time before you start pumping at work? Be sure that you are completely emptying when you pump at work? But do be careful not to overpump, you'll know you have if your breast feels sore inside.

My two are now 9 and 5. I had trouble with them latching on at first because of my nipples not "proudly strutting themselves," chuckle. It got painful there for a few days at first, but we figured it out.

Anyhow, frequency of demand builds the supply and manually stimulate your breasts before you pump. I wouldn't panic over your sons lack of weight gain just yet. Most children are heavier now than when my mother nursed me and my two siblings. I will be 47 in July. My sister just turned 43 (last month) and is nursing her son(her first). He will be 1 yr old in early June and she went back to work a few months ago.

An afterthought, make sure you are eating properly and especially DRINKING ENOUGH WATER/LIQUIDS. That will also have an effect on your supply.

Yes it is a hard job, but you also get a lot of precious memories and moments that fill your heart to bursting with love and joy along with the aggravations and weariness. Good luck and blessings to you.

I nursed both of my children and my milk supply decreased significantly when I went back to work. I just pumped as much as I could. Somedays I would get 15 ounces and then the next day I would only get 6 ounces. When I get stressed, my body really responds and in this case my milk supply would swing significantly. What we did with both of our children when our back up supply would be low was to make bottles that were half formula and half breastmilk. Then when we got a good supply built back up we would give more breastmilk. I hope this helps.

I breastfed both of my children and and they were both slow weight gainers. My second child, my son, even lost a little bit of weight! That is when I started supplementing with formula. I would still pump though for every feeding and whatever I got I just mixed it with the formula. I figured he was still getting the immunity builders from breastmilk that way. I did that until he was a year old. I plan on doing that with my next one too. So you could just mix whatever you pump at work with formula to make enough for a feeding. That would also make the formula a little easier to digest.
As for the less frequent bowel movements, I would take a rectal temperature. Sometimes that stimulates things and gets things moving. You could also try a little bit of prune juice. That is what I did and since he is so young just use a medicine dropper or you could even add a little to a bottle every once in awhile. Seems to work pretty well. Good Luck!

The baby nursing on you is what increases your milk supply. Pumping may not be as strong as his sucking, but sounds like he is thriving anyway. If he gets hungry and you don't have a supply of breast milk, supplement with formula. As for his weight, missing a couple of feedings can make a difference in a baby this young. Sounds like you are doing a good job.

Congratulations on your new son! And big pats on the back for going back to work. Being a new Mom is stressful enough without dealing with the stress of work. I would also suggest looking for a breastfeeding support group at your local hospital or womens health center. I attend one during the day and it is great for answering questions and providing support. They also have one at night for working Moms. There is a lactation consultant who is available to answer questions. There is also a scale to do pre/post feeding weight checks. As far as the weight, if your doctor isn't concerned, then don't worry about it. My son was, and still is a peanut since he was born. He is only in the 5th percentile for weight and the 15th for height. I was constantly comparing him to other babies and feeling like he wasn't growing and I was a terrible Mom. He's now a very happy and thriving 6 1/2 mth old. He's also been growing longer rather than heavier, which means less weight gain. You are doing a great job, keep being good to yourself!

To reassure you about the weight, scales can weigh differently when you are that little, it can make a huge difference. That is why your doctor may not have been concerned. The ER scale may have weighed him lighter.
AS for supply, I also nursed all 4 of my children, and pumped at work twice, but couldn't keep up with my children. I worked part time, and the days I wasnt' at work I had enough milk for my babies, but when I pumped, there wasn't enough to keep up. Some people don't let down well for a mechanical pump. Babies do a much better job of getting the milk out. I would give the 4 oz of breastmilk, and then offer a bottle of formula to supplement. He may want more than 4 oz. There is no way to tell how much he is getting when he breastfeeds. That may also help with is weight gain.
For my last baby, I had a hospital grade pump at home. Breastmilk production is diurnal, so you produce more in the morning than later in the day. In the morning, I would feed on one breast, and pump the other one. I would then be able to combine those small amounts to produce another bottle for him. He ended up being my only child who didnt' have to have formula supplement.
Good luck, don't stress. Remember babies grow well on formula also, and by getting mostly breastmilk, he is still getting the immunities, and good stuff breastmilk provides.
As for the stooling, my last son pooped once a week, whether he needed it or not. He would grunt, out it came and then off for another 7-8 days. We tried a small bottle of apple juice every day, but it didnt' make a difference, and made him hate apple juice until he was 4 yrs. old It made me feel better, but did nothing for my son. Breastmilk is pretty efficient for the body so there may be less waste. (my other kids were quite produtive, even when they were breastmilk only, so each child is different.)
Congrats on your new son.
R.

Hi B.! I can totally relate to your going back to work/decreased supply issue. I had the same thing happen to me. Once I returned to work it became harder to pump and slowly my supply decreased. I did some online research (search "Exclusively Pumping") and contacted a lactation consultant from a local hospital who advised that I try to pump more often (whether at work or at home) and pump for a longer period of time. The more you pump and the longer you pump, the better your supply will be. I was told that you should pump every 2-3 hours (which is not always possible) and that you should pump for at least 15 minutes or a few minutes after your milk stops producing, that will tell your body that it needs to produce more. Also, I read online that you can pump and then try again in an hour or so, it doesn't have to be a set schedule. Even if you don't think you'll get anything, you might (I really didn't have time to try this but you may). It's not easy and it's very time consumming. And, of course, stressing over it doesn't help either. After returning to work I was exclusively pumping and tried to pump more often and for longer periods and it worked for a little while, then work started to interfer with my ability to pump during the day and be away from my desk (working 40 hr/wk). Also, if you haven't already let your employer know that you are nursing and need to have time set aside to do this at work, you might want to talk to your boss (if you can). There are laws out there that require employers to provide a space/time for their employees to nurse. There are some over the counter supplements that are supposed to help (Blessed Thistle and Fenugreek (sp?)). I bought them but never used them, I was afraid they might have an adverse affect on the baby even though it says they won't. After you are done nursing, maybe try pumping a little bit just to see if you can get anymore out. The more you pump/nurse, the more your body thinks it needs to produce. The lactation consultant told me not to stress too much so long as I was pumping enough for her daily feedings. At 6 months I changed her over to formula and that has gone really well too. It's a lot of work that you are putting into this for your little one and it sounds like you are doing a great job trying to make it work. Hang in there! I hope you are able to find something that works and get some good suggestions from other mothers. And, of course, make sure you have a great pump (dual pump/electric - hospital grade). I highly recommend the Medela brand. And, if you don't already have a pumping bra, I would suggest that as well so that you do not have to hold the cones yourself. They have a really good one out that looks like a tube top that zips up the front and holds the cones for you so you at least have your hands free to do something else). Good luck! :-)

Hi! I too breastfeed (mommy to an 8 month old baby girl) and I do think your supply is probably dwindling... I say this because pumping is not the same as your baby actually nursing, it doesnt stimulate your body near like your baby would unfortunately so therefore you'll produce less and less.
As far as the tummy pain goes, have you tried Mylicon or an off brand infant gas drop? That always seemed to help my little one, she too doesnt have a bowel movement for days at a time. It could even be from the formula? My nephew had a terrible time with formula! :( maybe a sensitive formula would help, I'd talk with your doctor and see what he/she reccomends! I hope this helps! Your right, being a new mommy is a hard job I feel ya! But it only gets better though the more you get to know your little one and what he likes and what works for the two of you :) Good luck and congrats!

Be sure that you are drinking enough liquids every day.
Also continue nursing him on demand when you get home.
I am sure that just the daily stress of returning to work has affected your milk supply.
I would not worry about his weight right now but just see what the doctor says at the next checkup.
Worry and stress are your biggest enemies in this regard.
Relax and enjoy your baby when you get home.
Whatever other "stuff" you think you must do will be there when he is old enough to eat other food and not rely on you exclusively.
It is not an easy task to nurse a tiny baby while working outside the home, so hang in there for his sake.
Best wishes.

Congratulations B.! I completely understand your situation. I returned to work as well as a nursing/pumping mother. Firstly, I would buy or rent an Ameda Elite breast pump (or any hospital grade pump). It was amazing. However, my milk supply decreased because of stress of working in an all male environment and the stress of being a working-nursing mother. In all honesty, I wanted nothing more than to give my baby my milk (food is love). However, she was suffering because of my lack of milk. I made the very difficult switch from my milk to formula. It was the best decision I could have made. My daughter was fuller and happier and I was less stressed. The lack of stress made my work, home and personal life so much better.

Best of luck!

B.,

Keep up the great work that you are doing. I breast fed both of my kids until they were about one year old. However, like you, I had a lot of difficulty pumping. My babies would feed very well from me, but when I tried to pump, I wouldn't get very much. I struggled through it with my first. Then, with my second I started supplementing with formula when I needed to. It wasn't that often, but it definitely helped me and him. I know if you are like me, you don't want to give formula, but it is better to give them something to get by without you! Hang in there. I know it seems overwhelming and very difficult now to deal with this, but it will all be fine!

Yes, pumping doesn't stimulate the breast like the baby does, so your supply can decrease. However, that doesn't mean you don't produce enough. Start a fenungreek and blessed thistle supplement (look at Whole Foods or another natural foods store). 3-4 capsules 3 times a day. That will help up your supply pick up.
Stop supplementing and go back to 3 ounce bottles for now.
Pump extra on weekends even when he's nursing. Pump for 5-10 minutes after each nursing session and your supply will come up some.
Make sure you have pictures of him to look at to help get a faster and stronger let-down.

Your pediatrician is wrong. Most breastfed babies never take more than 3-4 ounces and if he's fine with a 3oz bottle, then don't up it to four. The best way to find out how much he needs is to use a digital scale and weigh him before and after a feeding. Ask the Dr's office if you can just come in for a weight check and stip him to a clean diaper. Weigh him, nurse him, and weigh him again - don't change the diaper even if he poops until after he's been weighed, what was in before nursing needs to counted in the count after nursing. You can also see if the hospital lactation consultants have a scale you can use for the same purpose. If he weighs 3 ounces more, then that's all he needs in a bottle. If you are worried about it or if the Dr. hounds you about giving him more, you can do this same weight check each month to see if he's taking more, but many babies who nurse well-past a year still only take 3 ounces from mom at a time. When you start supplementing and adding volume, their stomach stretches making them NEED more to fill their bellies when they otherwise wouldn't need more for nutrition.
Lastly, the worst thing you can do it worry about how much you are pumping while you pump because stress affects both supply and let-down. So, you need to relax, hydrate, and be happy with whatever you can pump. Pick up a pumping session before bed or first thing in the morning if you have to.
Good Luck:)

Bless your heart! It is very hard to work to be a mom, let alone a working mom. With my first child I went through the same thing. I used the fenugreek and also blessed thissle. You can found both of these safe natural supplements at a health food store. I had to go back to work when my son was only 4 weeks old. I was very disappointed in the timing but needed to keep my job. I learned about these supplements from my lactation consultant. I found that with taking them and taking care of myself I was able to increase my supply. Make sure you are getting enough food and water too! It's always easy to forget to take care of yourself when you are consumed by your new miracle. I also kept a picture of my baby in with my pump so I could look at him and that also helped. I hope that this advice helps you both. Good Luck!

Keep up the good work! I know how hard it is to pump at work! When my supply goes down (as it always does at some point when I go back to work) I use Fenugreek and it works wonderfully! I haven't had to use it yet, but if I remember right, you take like 3 pills 3 times per day or something like that. Also, the lactation consultants at Riverside are FABULOUS (not sure if you're in the Columbus area or not)!! They have helped me with my two oldest kids whenever I had any issues with breastfeeding. They are free and a wonderful resource!

B., I've seen this tiny breastpumps that fit inside your bra and are meant to be for people that can't pump due to work or other reasons. I'm not sure how loud they could be but they supposed to be very discreet and to fit under your clothes. You can pump while you are at your desk or while driving. I think you probably need to pump more often to increase your supply. As a first time mom I would really recommend you to contact La Leche League. They are very helpful with all of those problems you might encounter with breastfeeding. My biggest advice is do not pressure yourself. I have 3 children and no matter how hard I tried I couldn't pass the 3 months line. I just couldn't produce enough breastmilk. While trying, I wouldn't give my 2 first kids any formula to supplement, which I think impacted their weight gain and would make them feel hungry all the time (they would cry a lot). I felt like so frustrated. With my third one I didn't try as hard and I just enjoyed the time I was able to breastfeed and if she was hungry, I supplemented with formula. This made it so much more relaxing and I enjoyed the whole experience much more. Plus our baby rarely cried and we were all much happier :)

First off, GREAT FOR YOU FOR GIVING YOUR CHILD HUMAN MILK!!!
There is nothing that even comes close to being healthy for your child except milk designed esp for him, and it changes day to day depending on what HE needs.

A red flag to me is any doctor telling you your baby needs a certain amount of milk. First of all, how would they know this? Every baby grows at very different rates-some babies are going to be 6'5" some babies 4'10, all babies were not created equal (in size) so I think that doc is way off base. Plus, doctors know illness and how to help with illness using drugs, they do not know 'parenting' or how to mother a child-only YOU know that. Trust your mothering instinct, your God-given instinct, and feed your son how much he needs and when he is hungry/thirsty. That might be 4 ounces at 6 am and 6 ounces at 8 (maybe he was more thirsty than hungry at 6, you get the point). My point is, babies need mama milk when they are hungry AND thirsty, just like we head to the water when we need a drink, they head to mom (or moms milk pumped :)). Try to feed him as soon as he gets up in the am, even if you have to wake him and as soon as you get home. If you sit and just read to him and put him to the breast, you will find he will want to nurse, it's natures greatest comfort food!! :) I would def recommend at his very young age to at least nurse him once through the night, he is still very young and his stomach is emptying out often, so he isn't getting nutrition through the night and that might be causing the slow weight gain. Also make sure you are ONLY using weight charts for healthy breastfed babies, not formula-fed babies as formula fed babies get an unnatural amount of unhealthy fats and calories that is why they are usually heavier (and have a high correlation of obesity later in life).

About the constipation-that usually is totally related to formula use. Breastmilk is a natural laxative so it's very very unusual to have contipated babies who are only breastmilk-fed. Formula has cows-milk proteins and that is linked to all kinds of health issues, one biggee being constipation (see Kellymom.com because I bet the research is on that site). Now having said that...many breastfed babies can go for days with no BM then BAM, they have a massive poopy diaper. But, the difference is it's not true 'constipation' as the BM is not hard, it's just delayed. All 4 of my children had weeks where they would go only once a week or so, and I at first would worry but then they would have a huge, loose breastmilk-BM. If your child is hurting though, and only you know this, then that is most likely constipation or maybe even hurting from the cows milk (but please don't switch to soy formula, there are a ton of cancers related to the massive amount of processed soy, see Mothering.com and do a 'search' for research on this).

Some great links to bookmark-

www.kellymom.com

this above site has a TON of answers for moms like yourself-great moms helping their child have the proper start in life, GREAT JOB again!!!

Another great site is

www.mothering.com/discussions

there are tons of links on this site, another one to bookmark for future use.

Hang in there, it gets so easy and you won't believe the bond you and your son will have, nothing else like it. Plus he won't be nearly as sick as an artificially-fed baby and YOU are protecting yourself from breastcancer in the process.

:)

I had the same problem last year. My son also slowed down weight gain, and my physician wasn't worried about it. I also ran out of frozen milk, and began mixing bottles with 1/2 breastmilk and 1/2 formula.
I did try Fenugreek tea and Gatorade, and both seemed to help supply somewhat. I know it's frustrating! I also nursed my son more on the weekends.

First, let me tell you good job! Being a mom is work and such a wonderful blessing and you are doing great :)
With my daughter, I breastfed for ~3 mos. She was in the NICU for quite a while and when I came home, my supply diminished. I later found out that my thyroid was underactive, which can cause a diminished supply. A normal thyroid range from a typical endocrinologist can range from 1-3. (If you have question, feel free to message me.)
During this, I would talk to the doctor about using formula perhaps every other bottle or such, so you have a back up route. It will put less stress on you too. I had a NICU nurse tell me that the more I pump the more supply I will make. (this didn't work for me). As far as him having a bowel movement, our daughter did this and I called the ped, who instructed me to give her part of an enema. I would ask the ped dr. though, 8 weeks is young for that.

Hope this helps. :)