Poor Supply Last Pregnancy

Kathleen Tackett's picture

QUESTION

Dear Lactation Consultant,
I am pregnant with my second child. Before the birth of my first child, I had concerns about being able to breastfeed due to my inverted nipples and I worked with an LC prior to birth. In the hospital, all the LCs told me that my baby and I deserved gold stars for perfect positioning, strong suck, etc. But Rachel kept losing weight.

I started pumping and feeding her at the breast with a supplemental nursing system. Through weighing her before and after each feeding we found that she was getting very little from me directly, despite a strong suck.

At 11 days, I started Fenugreek. At two weeks, my supply was not enough to meet demand and we started supplementing formula. By about 3 weeks old, I started pumping exclusively, instead of putting her at my breast.

At one month, it would take 25 minutes to pump 90 mL and I was pumping 5 times a day. At two months, it would take 1 hour to pump 160 mL, three times a day -- but that was only half of what she was eating. About two weeks after that, at 2.5 months, the amount of milk I was producing wasn't worth the 3+ hours of pumping I was doing.

I think I had both a supply and an extraction problem. For supply, I know I can take Fenugreek again or try to get some Domperidone. I'm more concerned with the lengthy extraction. I seemed to take much long to extract my milk via pump as compared to other friends who would pump the same amount in 5 or 10 minutes.

Is there anything I can do about this?
Dawn

ANSWER

Hi Dawn,
Thanks for writing. I'm sorry to hear that breastfeeding was so challenging the last time around. But I'm amazed at all your efforts to continue. Hopefully, things will be easier this time around.

Milk supply can be challenging. There could be a couple of things going on. Let me briefly summarize here, but I'd also refer you to our BreastfeedingMadeSimple.com Web site that has more information.

  1. I assume that you were emptying your breasts 8-12 times a day. Since supply is an issue, you may want to empty your breasts 12 or more times a day from the start.
  2. Use lots of skin-to-skin contact as soon as possible after birth. And try to breastfeed that very first day if you can.
  3. You may want to take to your doctor about Domperidone (see our web site for more information on it). It is stronger than fenugreek and can be helpful in some situations.
  4. Has your doctor/LC evaluated you for any physical problems that could be causing a low supply? Some of those causes could be PCOS (poly-cystic ovarian syndrome), breast injury and breast surgery.
  5. I assume you were using a hospital-grade pump. Were you? If not, you will want to think about doing that this time.

I'm happy to help brainstorm with you more about this. And I really hope that things go more smoothly for you next time around.
-- Kathy Kendall-Tackett, PhD, IBCLC