Help!!! Not enough breastmilk for baby???

C

cyberyoda

Registered User
It has been a week after I delivered my baby boy and I am worry that he does not get enough milk as his weight drops by 4.9% until yesterday. He has enough wet diaper and pop pop only when I supplement him with formula by CUP FEED. I am wondering if I am not that successful in the first week, will my milk continue to drop?? Is that true that if breast feed not that successful in teh first week will likely leads to failure in breatfeeding soon??

I delivered by C-section and stayed in the hospital for 3 nights. Except the first day I cannot get out of bed and they dont allow me to room-in baby, I have been trying very best to breast feed. The days in teh hospital I dont not much choice as they put baby in a 4 hour feeding schedule. I can only go in the baby room to breast feed based on the hospital schedule. The rest of the time, the nurse CUP FEED my baby. In fact, I dont have much milk on the first 3 days.

Starting 4th days, I went back home. I was breasfeeding him 8-10 times every day. A lot of time up to 25-30 mins for each breast. But my baby is extremenly sleepy and fall asleep very quick when feeding starts so probably he only get breast feed for 15-10 mins each breast. As he continue to cry after each feed and open his mouth like he wants more milk, I am afraid I dont have enough milk (I pumped 2-3times in teh morning for 10 mins each breast on separate days but can only get 0.5oz in total. I use Medela single pump), so I supplement baby with formula by CUP FEED. I pumped several times in teh past week but not in a regular schedule. Every time, no matter I pump right after feedor before feed, I only get 0.5oz in total after pumping for 10 mins each breast.

Now that I want to try pumping after EVERY FEED for 25 mins every breast, will that help my milk supply even it is already over one week?? Some people say the 1st week is the most important but I am not that successful yet, will I be successful if I continue to try??

Should I continue to supplement formula by CUP FEED?? A lot of time if I dont do so, baby keep crying even after breast feeding for over an hour. Also, there is not enough urine and pop pop. Doctor also concerned that baby weight is not enough. He was born at 36 weeks 6 days and was weighted 6 lbs 11oz. Now he already drops 4.9% and have not regain any weight yet. Doctor asked me to go back to check his weight on his 10th day birth. I would like to measure his weight every day on my own but I dont have any necessary instructment at home. Anybody has any idea how we can measure baby weight by ourselves before going back to the doctor??
 
Also, when I supplement formula, every time, baby takes 1oz - 1.5 oz. How many oz of milk in total should a 7 day baby take each time??

Sometimes when he eat enough, he sleep 3-4 hours without waking up. Should I wake him up every 2 hours for feeding no matter what??

Thanks for any advice in advance.
 
This issue is really too complicated to solve on a forum like this. It would really help for you to have a professional lactation consultant or La Leche League Leader observe you while you are breastfeeding. They will be able to see if your baby is feeding efficiently or not.

Can you see the whole of the baby’s bottom jaw moving while he is feeding?
Does he fall asleep after 5 minutes or can he continue to drink for 20 minutes or more?
Are your nipples sore?
Do you feel relief after your baby has fed? Are your breasts softer after the feed?

Generally a baby loses between 5% and 10% of their birth weight in the first few days of life. And they usually take at least two weeks to regain it. This is the reason that we always calculate grain gain from the lowest weight and not the birth weight.

Please read through the article on the LLL-HK web site, www.lllhk.org called
How to know your Health Full-term Breastfed Baby is Getting Enough Milk
http://www.lllhk.org/566-27HK-Chinese.pdf

Is your baby having six wet nappies a day (in 24 hours)?
Is your baby having two dirty nappies?
Is your baby feeding between 10 and 14 times a day?

Remember that it is very common for a baby to want more milk after it has feed (even just 10 minutes after) this doesn’t mean you don’t have enough milk it means the baby wants to eat in courses with breaks in between.

How much formula have you given in the last 24 hours? If it is only a small amount you could just stop it but if it is more you would probably find it better to talk to someone who has experience of helping mothers reduce formula supplements and return to full breastfeeding.

There are a number of professional LCs who can help.

The Matlida has a Breastfeeding Clinic on Monday Afternoons, ring 2849 1500 for an appointment

Yvonne Heavyside - 2530 1905, 9887 3235

Mrs Chee – 2705 9322

Annerley Midwives – 2983-1558

Or a LLL Leader

MAGGIE 2817-7475
ROCHELLE 2947-7147
MARGARITA 2257-6757
SARAH 2548-7636
余婉玲 9048-1701

Best wishes,
SARAH
 
Please also read the thread,
Not enough milk - Top up bottles
http://www.geobaby.com/forum/thread119515-2.html

On this thread I’ve explained two behaviours which are very common are what I call the Chocolate Cake Syndrome and the Chinese Banquet Syndrome.

There is another thread called
Breastfeeding in hospital
http://www.geobaby.com/forum/thread120061-2.html

Where I’ve given details of videos you can watch on the internet and two techniques that you may find helpful, Breast Compression and Switch Nursing.

Since writing that post I’ve discovered a link which will let you download the NHS pamphlet (in lot of languages!)
http://www.dh.gov.uk/en/Publication...ions/PublicationsPolicyAndGuidance/DH_4084370

Best wishes,
SARAH
 
I already have lataction consultant coached me for breast feeding. She thinks baby lach on well. In fact, baby always open wide his mouth and his jaw move while I feed him. But he falls asleep quick. I tried to massage and supress my breast while breastfeeding. This increase milk flow to baby mouth. When baby fall asleep, I also tried to wake baby by moving his hands, massaging his back, put cold towel on his forehead...etc. When he stop swallowing and I fail to wake him, I just put him back to bed but he wil cry in 5 minutes. His head and face looking for nipple to suck again. I then feed him more for 5 or 10 mins and then he fall asleep again. If he can continue sucking (I can feel it), I will continue to feed him as long as possible.

I dont have sour nipple. My breast feel relief after feeding BUT not very significant because I never have any serious engorging at all. Just a bit hard. After feeding, a little bit softer.

Up to now, baby has enough wet diaper and popo pop as I keep on supplement formula. I tried NOT supplement for over 6 hours one day, but he does not have any popo pop and only a little urine that few hours so I started supplement him again.

I read some book mentioned that I can pump to estimate the amount of milk I produce every day. I pumped each breast twice for 25 mins in total when I wake up in the morning. I then pump again after 2 hours. For the 2nd time pumping, I only got 0.75oz for both breasts. It means 0.75 x 12 = I only produce 9 oz per day. This is too scary.

Is the above calculation and pumping to estimate milk supply is correct?? Any suggestion is appreciated. Thanks a lot
 
Your estimate of how much milk you produce is flawed. You are not just pumping your milk but breastfeeding your baby as well.

Remember that pumping is not the same as breastfeeding. The amount of milk you get from pumping is not the amount you have ? it is only the amount you managed to get out by pumping. Your baby will get a lot more milk when breastfeeding directly from you than you can pump out.

Being able to express 20 mls is already very good. If you need more simply express on more occasions and add the milk together. In this respect expressing is like breastfeeding - the more you do it with more milk you will get. Thus if you express six times for 10 minutes you?ll get more milk than it you express once for an hour.

If you are really worried about the amount of milk you have try expressing after every feed for about ten minutes, or for two minutes after the milk stops. Don?t worry if your baby wakes up and asks to fed when you?ve just pumped simply put the baby to the breast, he will be able to get more milk because there is always more milk and this is the quickest way to tell your body to make more.

When you breastfeed directly three things are working together to help the milk leave your body and enter the baby?s body.
  • Your hormone levels are raised, especially oxytocin. Oxytocin helps the milk ejection reflex ? this is the reflex that squeezes the milk out of the aveoli, the milk producing cells, and pushes it into the ducts which take the milk to your nipple. When you pump or hand express the levels of oxytocin are much lower.
  • The baby uses suction to help the milk come out ? the pump tries to duplicate this but hand expression doesn?t.
  • The baby?s mouth milks the breast with its tongue and jaw movements. Hand expression tries to duplicate this but the pump doesn?t.

On top of this many mothers have difficulty getting the let-down to work well when pumping. It works with no trouble when the baby is breastfeeding directly but doesn't seem to work at all when using the pump.

Many things that don?t matter when breastfeeding directly can affect the quantity when pumping. For example, how tried you feel and how much stress you are under.

You can also encourage the let-down reflex artificially, by looking at your baby, or by having a piece of his clothing next to you.
  • Apply a warm wet cloth to your breasts.
  • Massage the breasts in small circular motions around the perimeter of the breast.
  • Gently stroke your breasts with your fingernails in a downward motion toward the nipple
  • Lean forward and gently shake the breasts.
  • Gently roll the nipple between your finger and thumb.

It may help to try a hand expression technique called the Marmet Technique, http://www.lactationinstitute.org/MANUALEX.html
This is useful because it helps the let-down and so you get more milk.
(Please note that the diagram of the breast anatomy is out of date. Recent research has discovered that the milk reservoirs under the areola (the dark coloured part of the breast near the nipple) do not exist. The method, however, still works.)

Some mothers have found that the pumps are not good at getting the let-down to happen, especially in the first couple of weeks, and so they use hand expression until the let-down and then swap to pumping. You can also use the times at the end of the Marmet Technique, including the massage, stroke and shake but instead of doing the hand expression use the pump.

Remember that your breasts being empty isn?t a problem as this is a signal to your body to make more milk. It is leaving your breasts full of milk that tells your body to stop making the milk.

Best wishes,
SARAH
 
If you can send me your e-mail address I'll send you a pamphlet called Increase Your Milk. (My address is [email protected])
I like this pamphlet because at the beginning it explains how the breast makes milk and then goes on to discuss false alarms, reasons mothers worry about not having enough milk. Then it talks about real problems and finally how to help the situation.

As you current LC is happy with the latch and you can see your baby's jaw moving it sounds like he is feeding correctly. (Remember we ask how many wet nappies over 24 hours not 6 hours)

How much formula are you giving in 24 hours?
It is important to reduce the formula you give if you want to fully breastfeed.
I usually suggest putting the formula on a schedule. This way you know exactly what you are doing with it. Also it stops the temptation to feed formula after each breastfeed, which is the quickest way to having a fully formula fed baby.

Kellymom.com has information about weaning from supplements to the breast and a useful form to fill in which helps you know exactly where you are and what the next stage is.

Weaning from Supplements Instructions
http://www.kellymom.com/store/handouts/concerns/wean-supplements.pdf

Weaning from Supplements Log
http://www.kellymom.com/store/freehandouts/wean-supplements-log-sample.pdf

SARAH
 
i had a lot of blocked ducts in the beginning & baby wasn't gaining weight well although i had a lactation consultant helping me (i later found out that she was tortally useless, so i'm gonna pm you her name). then i found mrs chee, who helped me solved all my problems. if you're not already getting help from her, i suggest you give her a call.

to increas emilk supply, drink "mother's milk tea" sold at mothercare, health quest, bumps to babes. it starts working after 2 days. than drink fish soup & tons of water. i was downing 2-3 litres of water/day.

good luck! && hope eventually your problems will be solved.
 
cyberyoda,

i have unopened sachets of mother's milk tea. please pm me if you want them... it's free.
 
Thanks so much for your kind offer, Elaine. A friend sent me a gift of mother's milk. It is from the "Traditional Medicinals" Organic Mother's Milk produced in the USA. I have no experience on mother's milk before?? Is it ok to drink a short time after C-section?? Do I need to consult my medical provider in advance?? ANy advice is appreciated.
 
ask your LC, she'll know. but from experience, a lot of my friends drink it right after gviing birth. should be ok.
 
I also had plugged ducts because my DD spent an extra few days in the hospital due to jaundice and she was losing so much weight due to my decreasing milk supply that I gave in and supplemented with formula. I only saw Mrs. Chee after this and she helped solve my plugged ducts problem and my milk supply didn't become a problem after this. I drank Mother's Milk tea. In addition it is important to keep yourself hydrated so I drank lots of soup (esp fish and papya soup) and water. Eating oatmeal helps too either in the form of hot oatmeal for breakfast or even oatmeal cookies. Mrs. Chee told me that.
 
I tried to contact Mrs Chee with the Tel no I obtained (93176366) but the person answer phone said that it is a wrong number. Would anybody be able to give me the contact no of Mrs Chee?? I would like to change the lactation consultant urgently.

What is plugged ducts?? I have a white dot on my left nipple today. Seems like quite difficult to remove it. Not sure what it is and how to remove it. Thinking it may block the milk outflow at the spot. Need to solve these problems asap....

Thanks all of your advice,
 
Mrs. Chee's no. is 9417 6366, not 9317 6366. Your white dot definitely sounds like blocked duct, hope you can solve your problem soon. By the way, Mrs. Chee's mobile phone is usually on voicemail, so do leave her a message and not ring off, she will get back to you as soon as she can.
 
Talked to Mrs Chee. Her schedule is full the whole week....I don't want to wait any more...anybody knows how to solve the blocked duct??

Thanks a billion.
 
I just re-read the thread and see that you used Medela single pump. I know of many who do not get much from it. The Avent Hand pump is actually much better and there have been times where my milkducts were unblocked by the avent manual pump when it seemed nothing worked. In the meantime, before you have a chance to see a lactation consultant, maybe you can try taking an Advil, wait for a couple of hours, apply a warm compress, then try to pump with Avent hand pump. This was actually advice from Mrs. Chee before she had a chance to see me. Fingers crossed it will work for you! By the way, I once was so desperate cos Mrs. Chee could not fit me it, I went to Canossa Hospital as they told me that they also had lactation consultant. Ended up, they just put my baby to my breast in the hope that she could unblock it. Complete waste of my time!
 
Yes the Medela single pump didn't get as much milk for me as the Avent Isis handpump, which was recommended to me by Mrs. Chee. The Medela also gave me bad pain on my nipples. Once I switched to the Avent, I had no problem getting milk.

As for plugged ducts, warm compress helps as does massaging your breasts towards the direction of your nipple, if you feel a small lump, that's where the plugged duct is and try to see if you can smooth it out. Or even letting the baby nurse more on the breast with the plugged ducts can help unclog it.
 
the white spot sounds like a yeast infection. you probably won't be unable to open it up cos the yeast is right at the opening of the duct. mrs chee would use a sterilised needle & poke it so the milk opening unblocked. meanwhile, buy NutriBiotic GCE (Grapefruit seed extract). it's a very strong anti-oxidant & it kills bad yeast (the ones that you have in your ducts) follow the instructions to take it orally. put 15 drops diluted in 1 oz water, paint this solution on your nipple after each feed, then cover your infected nipple with PLAIN yogurt & cover with breastpad until the next feed. Remove & rinse nipple & areola well before each feed cos the GSE is VERY bitter.
NutriBiotic is sold at Health Quest, they have a branch in HappyValley Yik Yam Street (across from Hk Sanatorium) & Times Square Basement LogOn (across from Citysuper). Meanwhile , refrain from eating anything sweet, made with yeast or grapes. So no bread, dessert, wines, grapes, anything that promotes yeast growth. put baby's chin at where you have the white spot & hopefully baby can help suck it out. what i did was i hand express at that duct (but i was pretty good at hand-expressing then & mrs chee had been teaching me a lot), so the duct clears out.

bte, i gave you the wrong no, must'v been a typo. do tell mrs chee about your yeast infection & book her for next week to come to see you.

a lot of us had yeast infection, but not much ppl know about them besides LCs. if you go to your ped or ob about it, they'll probably giv eyou anti-biotic. DO NOT TAKE ANTI-BIOTIC. cos it kills the good yeast in your body & your yeast infection will become worse.

good luck!
 
First of all, congratulations on the arrival of your new born.

There are some very detailed advice in the prior posts, so I want to share something else instead.

Personally I find the Medela electric breast pump not too helpful for expressing milk unless you have very engorged breasts. If you want to express milk (in particular when your supply is towards the low side), try using one of the manual ones instead (I use Avent), and/or using your hands to express (a lactation consultant would be able to teach you this).

According to my Chinese maternity nurse, there are a few types of food that would increase your milk supply: fish soup, papaya, fish, squid. Generally down lots of fluid (soup (better), milk, mothers' milk tea etc. ). However, there are also are a few things that you should avoid too: wheat, pork liver, pigeon, black beans, and grapes.

Hope this helps. Good luck and enjoy breastfeeding.
 
The white spot on the nipple sounds as though it is a milk bleb. These can be caused by a plugged duct, thrush or skin blocking the milk duct and may oocur after a trauma to the nipple.

If the bleb doesn't hurt, nothing needs to be done. If it is painful, try to apply wet heat either with a warm compress or by soaking the nipple in warm water. Another approach is to wear a cotton ball soaked in olive oil in your bra to soften the skin and then attempt to peel away the thickened layer of skin. After the feed attempt to express from the nipple the remaining material by compressing the nipple behind the plug. Sometimes it is possible to express a thickened string of milk, which will help open the duct and keep it open.

If the above treatment doesn't bring quick relief, I'd suggest going o see your doctor or a nurse to open the blister. It is easy to get infection when you do this yourself as there is a correct technique to opening a blister. If you do have to open the blister use a little lansinoh cream afterwards as this will speed the healing and reduce the scar tissue.

Best wishes,
SARAH
 
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