How to Keep Milk Supply up When Supplementing W/ Formula

Updated on March 13, 2009
A.B. asks from Lathrop, CA
15 answers

I took my youngest to his two month checkup this past Monday and when they weighed him he had lost almost a pound since his one month checkup. I had been exclusively breastfeeding him about every hour or so and waking up 2-3 times each night to breastfeed him. He has reflux as well and is on Zantac and spits up after every feeding. He had been crying all day everyday in what appeared to be pain and we assumed it was the reflux since he pulls his legs in & arches his back frequently. Well it appears he may have been hungry after he breastfed because he was not getting enough. So now the doctor has put him on Similac Sensitive RS (has rice starch in it which makes it easier for babies with reflux to keep it down since it is thicker). My question is this, I have a pump and have been pumping at least 3 times a day to try and help keep my supply up as well as offering him both breasts before I offer him any formula. Yesterday I drank two cups of mothers milk tea & when I pumped I got 3 oz total at one pumping and then 4 oz the other pumping total and the third time only got 1 oz total between both breasts. Plus I of course offered him both breasts before each formula feeding (which is what the pediatrician told me to do). I am afraid I will dry up, I wanted so much to successfully breastfeed this time exclusively, but with his weight loss if he does not improve by next week she wants him to go to Phoenix Children's Hospital so I will do whatever I can for the health and well being of my son. Anything any of you have used to help maintain your milk supply and worked I would be greatly appreciative of the info. Thanks!

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A.K.

answers from Tucson on

I have a very low milk supply as well and found that 1 vitamin called Fenugreek (found at GNC) taken 3 times a day made a huge differnce for me. I no longer use any formula! Good luck!

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J.R.

answers from Phoenix on

A few suggestions...
1) By feeding him every hour you are not allowing your body a chance to build up your supply. Also, it makes it so that your son is not receiving the "hind milk" that contains more calories, which comes a little while after let-down. Try feeding him right when he wakes up, then letting him play for a while, then putting him down for a nap to start the cycle all over again, essentially feeding him every 3 hours, rather than every hour. It gives your body a chance to rest and produce more milk.
2) Try power pumping to build up the supply. Once a day, preferably right after you have nursed, pump for 10 mins, then rest for 10 min, pump for 10, rest for 10, etc for one hour. After a few days your should see some improvement.
3) The mother's milk teas, fenugreek and such help, but it takes a week or two to see a difference from them. The best thing you can do to see a difference sooner is to drink lots and lots of water. I hated drinking water when I was nursing, too, but you have to choke it down. ;) Sometimes adding some lemon would help, or drinking a Gatorade-type drink for a little variety. Just stay away from sodas containing caffeine. They have the opposite effect.

Sorry for the novel. I hope this helps some. E-mail me if you have any questions.

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L.M.

answers from Phoenix on

First of all, I would say to relax about the formula thing. Stress can reduce your milk supply too. And formula isn't the worst thing in the world. My daughter wouldn't latch on (even with all the lactation consultant ideas), so I had to pump, and my supply was never that high. So I gave her both formula and whatever I could pump and she is more than fine.

So I don't have any ideas to increase milk supply, I did beer, I drank this disgusting Chinese concoction, I did the teas, and I think if any of it worked, it was just b/c of the water content. So drink tons of water is all I can suggest, and if nothing works, don't beat yourself up if you do have to use formula, your son will be fine.

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A.D.

answers from Phoenix on

Hi A., I too have a son that has pretty severe reflux. When he was first nursing he didn't lose weight, but he wasn't really gaining as much as the Dr thought he should. The amount you're pumping (3-4 oz total) is about the right amount. His tummy is still really small so it doesn't hold that much.

First I'll tell you about sustaining your milk supply. I had to do this for a very long time. The mother's milk tea worked well for me for quick short term results, but you have to drink a lot of it...more than two cups. I drank about 5 cups a day at first. Doing that helped kick start my supply, but at that rate, it was pretty pricey! I started that when I was out of town, otherwise I would've started normal supplements first. I took 3 fenugreek capsules 3 times a day along with 3 milk thistle capsules 3 times a day. Fenugreek isn't that pricey, but milk thistle is! You might try starting with just the fenugreek and see if it helps, if not, you'll probably need to add the milk thistle. You can get both of these at GNC/hi-health/and sometimes the herbal health food section of grocery stores. I will warn you, taking the supplements may cause flatulence...but it subsides once your body gets used to the pills. Also, there is a pill out there that says it is a combo pill of both of these, but it does not work the same! This should increase your supply a bit and help sustain it. If your son isn't nursing as often as he should then you should increase how frequently you pump. For the first few months I pumped after every nursing session...I know, time consuming! My son had a hard time latching at first which affected my supply. Make sure you feed the pumped milk back to your son. Also, for formula, make sure it is not a dairy derivitive. It should say on the can. If it is, don't use it. Our gastro Dr suggest Alumentum or Nutramagen. Both are crazy expensive, so we opted for neither and kept nursing. Try bumping up your calorie intake so that you're sure he's getting enough from you. I wasn't getting nearly enough calories and once I modified my diet, he started gaining weight better!

Now some thoughts on reflux...you may have already tried these. First, cut dairy and caffeine from your diet. At the very least, try cutting out milk and caffeine. I had to nix dairy all together (I'm counting down until I can have ice cream again!). Dairy and caffeine are the two major culprits of reflux. There are also various holds you can do with your baby to help him feel more comfortable. Our son liked to be held laying face down, but with no pressure on his tummy. He also liked when we would warm up our hands and gently rub his stomach. If the Zantac doesn't seem to be working and you have good insurance coverage, I suggest trying Prevacid. Zantac's benefits wore off for us pretty quickly, the Prevacid has been a big help. If you feel like the reflux just isn't getting under control, I highly recommend making an appt with Dr. Schenkein at Phoenix Children's. She also works out of the East Valley office (Higley and Southern). She is pretty matter of fact in how she deals with things so sometimes she can be a little hard to take, but really, she's great. She doesn't believe in just shoving meds into kids, but she does beleive that if you're going to treat them medicinally then you should do it the right way. Our previous Dr had us on such a low dose of Zantac that it wasn't doing what it should have. Dr. Schenkein's thought is that if you aren't going to give a baby enough medicine to make him feel better, then why medicate at all?? I really like her. She has been so good to us.

I attend a moms' breastfeeding group at Banner Gateway every Thursday morning....I'm usually late (I come from Maricopa) but it starts at 10 and there is a lactation consultant there every week. You don't have to be a patient there or have a baby there to attend. You may think about coming...you can bring your baby with you and meet moms that have had the same or similar issues! Oh...and it's free! If you have any other questions shoot me a message!

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A.V.

answers from Phoenix on

Dear A.,

I just wanted to send you a copy of something a friend of mine wrote. She is a mentor with Birthing From Within in California. I hope it helps you realize that you are doing the very best that you can right now for your son. You may have to do the next best thing for him, which could be formula. But don't give up completely on breastfeeding him.
There is a lactation consultant at Phx Babtist Hospital - sorry I can't remember her name - but she is the GURU of breastfeeding. Perhaps she can help you alont with the pediatricians. Yes, your son's health is a priority, but don't discount your emotions about this. Much good energy to you and your son.

In peace,
A.
mom of 4. Birth and Parenting Mentor
www.birthingfromwithin.com

Breastfeeding From Within
By Virginia Bobro

Birthing From Within encourages and teaches "doing the next best thing" when it comes to making decisions within the flow of labor and birth. The same mind-set is important during postpartum and breastfeeding. In the days, weeks, months, and even years that a woman is breastfeeding, she will face numerous obstacles, detours, and unexpected events. How she prepares prenatally and how she views these challenges can make a difference in her ability to cope.

As a breastfeeding counselor, I support many breastfeeding mothers who have to change their perception of what a "successful" breastfeeding relationship is. Some mothers need to wean much earlier than they hoped. Others need to supplement with bottles or formula. These are opportunities to re-envision what it means to nurture and nourish their babies. Many mothers are humbled when the "breastfeeding fairy" presents them with difficult circumstances and spoils their fantasy that nursing is easy and blissful.

When breastfeeding does not go as expected or hoped for, a mother can feel regret, anger, blame, grief, and guilt. Inevitably, this negative self-talk begins to affect her self-esteem and attitude, her ability to receive support, and her relationships with her baby, partner, and others in her community.

So, what can be done?
In addition to learning practical things that make breastfeeding easier, do this:
♥ Learn and practice mindfulness.
The same pain-coping practices you learn to help you cope with labor can help you postpartum when you need to still your mind, quiet negative self-talk and deal with physical discomfort and stress. (See Birthing From Within, pp. 213-238).
♥ Get a breastfeeding "reality check."
Breastfeeding is natural, but not always straightforward and easy. Very few women sail through breastfeeding on calm seas from beginning to end. Even for the most vigilant captain, storms arise outside of her control, and still, she can do the next best thing. When women know that they can influence but not control what happens, they can see the wisdom of preparing for all possibilities.
♥ Set up your breastfeeding support system.
Having a supportive crew onboard in the first months of motherhood can make all the difference. Welcome meals, errands, and compassionate listeners. When breastfeeding gets rough, support is needed to keep going and not get mired in "what ifs" and judgment. You need to hear acknowledgment that you are doing your best, not more advice and information.

♥ Focus on connecting with your baby and yourself as a mother
Come to breastfeeding with an open heart. To the degree that you can, let go of your ideals and goals, such as breastfeeding exclusively for six months. Just hold the intention to do the best you can. When you love yourself and feed your baby in love, this is the heart of breastfeeding from within

EXERCISE: Feeding with Love

When sitting (or lying down) to feed your baby, try this:

Begin to notice all the sensations around you, beginning with your baby:
Look at her face, notice the touch of her skin, take in her smell and her sounds.

Then begin to bring your attention to your own body: Where does your body touch your baby's body? How is your breath moving in and out of your body?
Where do you feel relaxed and open?
Where does your body feel tight, tense, or closed?

Gently and mindfully breathe into those places, softening and releasing anything that is unneeded in this moment. This may take several minutes. Go slowly and do not expect perfection!

As your body lets go of anything extra, feel your heart opening.
Allow yourself to inhale the presence of your baby, loving her in this moment and loving yourself as well. With each new breath, feel into your baby's heart, visualizing a connection that endures beyond feeding time.

If feeding is difficult, your focus may return to the task of latching or monitoring the feed. Do what needs to be done, then, when you are ready, take another conscious breath and return to your opening heart.

Resources
Local La Leche League
Lactation Consultants
Other Supportive Breastfeeding Moms

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R.C.

answers from Phoenix on

Your situation sounds so much like mine in 2005 with my first child. At 2 months my daughter was barely birthweight and crying constantly. Turns out she had developed an abnormal suck and my milk supply was dangerously low. I saw a Lactation Consultant and was able to continue nursing to age 15 months. At 6 months she topped the charts at 90th percentile on weight and was by then breastfeeding exclusively. I tell you this to give you hope. With three little ones at home you are obviously not able to rest much and likely stressed. Both effect your ability to produce. Please contact a lactation consultant today and she can help guide you. Often the hospital where you gave birth will be glad to either refer you to a LC in your area or take you on as their client. Please get help immediately. If you supplement with formula and baby doesn't nurse regularly, even pumping won't be able to keep your milk supply in the adequate range. A hospital grade pump might help and they can be rented for as low as $20 dollars a month at Baby Mother and More on Gilbert Rd and Southern in Mesa. Best wishes and my prayers are with you today. Your post brought back a lot of memories. R., nurse midwife married mom of 2.

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J.V.

answers from Phoenix on

I"m sorry you are going through all this! Here are some ideas.....

= Go buy a supplemental nursing system (SNS). Put the formula in there and nurse. Your baby will get your BM and the formula at once. That way you still get full nipple stimulation. I also think instead of doing formula at all, you could pump a little in between feeds. Use this milk and mix it with just a little bit of rice cereal (ask your doctor how much), put it in the supplimental feeder system, and you can weight down feeds and cut out formula. http://www.medelabreastfeedingus.com/products/breastfeedi...

- Go buy a good wrap (check out www.gypsymama.com). I have the bali breeze from that site. I wore my son around in it all day and his reflux was so many millions of times better, it was amazing! You can also make your own wrap for very cheap. Just google "make your own wrap" and a bunch of instructions will come up.

- Find a good chiropractor for your baby. My son had terrible reflux and we were able to not medicate because of the naturopathic doctor and the chiropractor. His neck and back were out in two spots... one that effects the stomach and one that effects the esophagus. No wonder he spit up! We see Dr. Kirk VanMetre of VanMetre Chiropractic. He's a gonstead chiropractor and has 4 girls of his own. If you have no insurance, he'll work out something affordable for you.

- Look in to NEAT testing for your baby. It might be allergies to food you are eating... http://www.azadvancedmed.com/allergy.html. It's not cheap, but worth it!

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W.B.

answers from Phoenix on

To get your milk supply up - nurse & drink water. I was in your spot with my first baby.He was failure to thrive by 3 mo. and we ended up entirely formula. By the time I had my 5th I finally figured the nursing thing out. At about 6 wks when they go thru the growth spurt( and every other growth spurt) you have to nurse constantly for about 2 days to get the milk supply up. I mean I would just hunker down in the house for two day when he had a growth spurt and nurse every time he made a peep - sometimes 3 times an hour. Then after 48-72 hours my milk was up and we were good to get back to our every 2-3 hour schedule. Also you have to drink LOTS of water. Every time he would nurse I would drink 8 oz. AND - a good lactation consultant is worth every penny. Best of luck.

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A.

answers from Albuquerque on

Nursing is a supply/demand relationship. The best thing to increase supply is more nursing. Pumping just isn't the same and is NOT as efficient. So first, take heart because though you're only seeing a small amount when you pump, that does NOT mean that's all your baby is getting.

Are these medical solutions working and decreasing his discomfort? If not, then nursing is no worse and probably actually better and I'd return to that. If so, learn all you can about his condition and find natural remedies that allow you to continue nursing. Read the ingredients on the formula and find out WHAT they are!

I would also strongly suggest seeking out a lactation consultant. Her modest fee will be much less than a year on formula and your heartache. As your bio says, you're trying to go green for your pocketbook and environment, and probably your health. This is controversial, but you could research making your own formula, as well. But nothing is greener than nursing. I think, with the help of a lactation consultant, you could definitely keep your supply up and keep nursing. Don't wait too long to get help. It'll be easy NOW than later! Good luck!

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C.E.

answers from Las Cruces on

Many great suggestions here so I'm a little hesitant to give mine but I swear it works. Drink a beer or at least half and pump a little bit later. Make sure you chase with some water. There's not enough alcohol to be harmful according to one of my docs. I didn't have to do it often but I drank about half a beer and it made me lactate something fierce. There's something in the grains or the fermentation I guess.

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C.R.

answers from Las Cruces on

I had to supplement with formula also when my son was infant due to weight loss issues. Just keep offering him the breast and pumping as much as you can. I did the mother's milk tea and a natural breastfeeding supplement for a while. I finally relented and went on a prescription medication to increase milk supply. I wish I could remember what it's called but your OB office would know if your pediatrician doesn't. It was an endless cycle of, offer breast, feed formula, pump - every hour and a half or so. This may be hard to do with two older kids.

Do the best you can and try not to beat yourself up if he weans himself early from breastfeeding. There is only so much you can do. I hope he gains LOTS of weight VERY quickly.

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D.H.

answers from Santa Fe on

I had the same experience! My daughter had reflux. She lost weight and had very poor weight gain in the first 2 months. Here is what helped. I used a S&S supplemental feeder when I breastfed. This was a little bottle that I hung around my neck, had little tubes that attached to the nipple. When my daughter fed, she got a little more food at the beginning while she was waiting for the let down to happen. She began to gain weight quickly. We also worked on making the reflux less uncomfortable. We kept her propped up most of the time. On the floor we rested her on her boppy pillow. In bed, we propped her crib mattress up at an angle with a wedge we got from the hospital. I also visited with a lactation consultant-she was the one who helped me with the supplementer. We used the supplementer with both breast milk and with formula. She responded better to breast milk. For about 2 months I felt like I was either nursing or pumping! But it worked! Stick with it. If your goal is to breastfeed then go and see a lactation consultant. They can really help. Good luck. I know how challenging this can be. Remember most mama bodies are able to feed their babies, sometimes it just takes doing things differently. Feel free to email me if you have any other questions. Blessings to you and your newest baby!

L.W.

answers from Phoenix on

Try taking fenugreek (you can get it at Sprouts or many other natural food stores- it will be over by the vitamins.) That helped to increase my supply when I was nursing my son.

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T.S.

answers from Phoenix on

Hi A.!

In the beginning I had milk supply problems and had to do some supplementing. I was referred to a lactation consultant who is amazing and helped me build up my milk supply to the point where I am no longer supplementing except for when she's baby sat by my mom. So, if you are up for it, here's her information. She is worth every penny.

All About Breastfeeding
Lori Isenstadt
###-###-####
www.aabreastfeeding.com

Good Luck!

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T.N.

answers from Phoenix on

Lots of great advice before this and I'll be brief. Debbie Gillespie is a lactation consultant that has worked with me for both of my children. Last I saw her, she was working out of Baby Mother and More in Mesa which is an AWESOME breastfeeding support store! She'll tell you that "priority number one is feed the baby, even if it means supplementing with formula while we work on your production". I've been there and gone through all the lovely emotions that go along with it. Debbie as gone through LOTS of strange and crazy things with my breastfeeding issues (if you want details, email me) and still helped me get to the point of my being able to breastfeed my oldest until she was 15.5 months and still am with my 8.5 month old. I highly recommend her and she'll even travel to you (at least in the phoenix metro area - call her for additional info). She is a Godsend! Her email address is ____@____.com Good luck!

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