Dear Lactation Consultant,
I had been successfully breastfeeding until about 3 weeks ago. Prior to that, my son ate very well at the breast, I had no problems pumping for times that we would be apart, and seemed to have an abundant supply. Over the last few weeks, it seems as though my supply has gone WAY down. It started out where he would be feeding every 2 to 2.5 hours because he was hungrier than normal, which was fine. Then he wanted to eat almost every hour, and I quit feeling let-down, and could no longer even express any milk. Now he will try feeding but get frustrated after about 5 minutes of sucking with no let-down. I have tried using the electric pump (PIS advanced), a manual pump, and manual expression to help increase milk supply, but I can't get let-down at all any more!
It's a vicious cycle -- I can't get let-down, so my supply decreases, and as the supply decreases, it is harder to get let-down. I'm really concerned about this. I absolutely do not want him on formula, but have had to use it so that he doesn't starve. What can I do? Am I drying up? I have tried all the techniques that I have found online -- relaxation, heat, massage, breastfeeding weekends, etc. -- all to no avail. I am visiting the US, and do not have medical coverage here, so am reluctant to visit the doctor if all he/she will tell me is what I have already tried. Can you suggest anything that I haven't tried yet, or perhaps some variations on what I have tried?
Thank you so much for your help.
It's very difficult to give you any detailed advice regarding your milk supply problems, because I don't have all the information I would need in order to make specific recommendations in your case. For example, I don't know how old your baby is. If he is an older baby and has started solids or is teething, that can cause a decrease in his desire to nurse.
Have either of you been ill recently? Stuffy noses or thrush can make it uncomfortable for babies to nurse, and illness in the mother (especially prolonged bouts of fever, diarrhea, or vomiting) can temporarily have an adverse effect on milk production.
Have there been any recent changes in your routine or schedule, or any particularly stressful events in your life? Baby sleeping through the night, moving, traveling, divorce, or death in the family are all changes that can affect breastfeeding.
Have you started taking birth control pills or other medication? Some medications, especially birth control methods that contain estrogen, can reduce your supply.
Is he losing weight or not gaining? Some older babies can get all the milk they need in just a few minutes, and may fuss and pull off the breast when they are done. Older babies (two months and up) often become distracted by what's going on around them, and won't settle down to nurse effectively unless they are in a quiet room with no distractions. If this is the case, then night feedings or first feedings in the morning often go more smoothly than feedings at other times during the day.
If your baby is nine months or older, he may have decided that he is ready to wean. Even though the AAP recommends nursing for at least the first year, some babies have another agenda. These early weaners often begin to lose interest in nursing around the time that they start solids and become mobile. They are such busy little people that they don't have time to stop and nurse, preferring to suck down a bottle quickly and then go about the business of exploring their environment.
As you can see, there are many factors to consider when trying to figure out the cause of low supply, and how you go about building it back up depends on what the original problem is. You can check out the article on Increasing Your Milk Supply for more detailed suggestions on what might be going on, and ways to increase your milk production.
It would be very unusual for a mother who has been successfully nursing a baby to suddenly "dry up" for no reason. With a little detective work, it should be possible to identify the source of the problem and take steps to correct it. If you don't have access to an IBCLC in your area (or money to pay for a consultation), you might want to consider contacting your local La Leche League. LLL Leaders will be happy to talk to you and give you advice and support, and although they are not health care professionals, they are often able to recommend someone in your area who can work with you. You can contact LLL by calling 1-800-LALECHE, or visit their website at lalecheleague.org.
I wish you and your little one all the best,
-- Anne, IBCLC