What am I doing wrong? Not enough milk...HELP!

Christa - posted on 02/22/2014 ( 5 moms have responded )

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I am a first time mom and really stressed out about my supply....I need some advice please!!!

Background: My preemie was born @ 32 weeks and was in the NICU for 40 days. She just came home and is now 38 weeks. No issues, just a little reflux and frequent gas from the Similac Neosure I have to use to fortify my breastmilk. She's eating 2.5-3oz every 4 hours. I also breastfeed her 2-3x a day for around 30 min but still trying to get the hang of it. I hear her swallowing, but she'll usually still take 80-100% of her full feeding on bottle after that.

I have not been able to supply her with 100% BM because I just got off to a bad start with her being in the NICU for 5 weeks. I was severely stressed and not able to be with her all the time. I had to supplement around 30-40% of her feedings with neosure and now that she is home, I'm still not making enough milk because its like my boobs are on the same programming or something. I know this neosure is giving her really bad uncomfortable gas and I desperately want to get her off of it. I know I am supposed to pump every 2-3 hours but its hard because if I pump, I'm worried they'll be empty for breastfeeding. I have not been pumping during the night because for some reason my boobs are trained to give me around 3oz when I wake up and pump, yet if I get up and pump through the night, combined with my first pump of the morning I STILL only get 3oz. So why torture myself to pump in the night if it doesnt make a difference in volume? After my morning pump I am only getting around 1oz or less per pump (both breasts) for the rest of the day. I have not been doing the recommended 6-8 pump sessions per day because I am also breastfeeding when I can and worried this will not leave enough for her. I was thinking maybe I can feed her and then pump afterward every 4 hours (when she eats) but not sure if that is enough to increase my supply. I know one MAJOR issue is water, so I am working really hard to drink more which is an area I need to improve. In terms of sleep, I get it where I can and things are stressful at home sometimes. Am I just being lazy? Do I just need to pump every 2 hours and drink water like crazy - regardless of how much milk is left for breastfeeding? Have I made it impossible for my supply to increase at this point? Are my boobs now programmed for this amount or can I actually get it to go up? Any advice is appreciated!!!!

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Celeste - posted on 02/22/2014

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You're right, Jodi. OP, Definitely talk to your pediatrician first then decrease supplements. I had to do this as well with my preemie twins. It's hard but you can definitely nurse your baby.

Jodi - posted on 02/22/2014

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Celeste, unfortunately, the OP needs to supplement with an iron fortified formula because a premmie is not born with the iron storage that a full term baby is. Stopping supplementing at all can actually negatively affect the baby's iron levels. So while I agree with you that the supplementing can negatively affect supply, she also needs to do this regularly for the health of her baby.

To the OP, Celeste is right in that the supplementing will be affecting your supply and demand, but you should not cut back the supplementing without discussing with your child's pediatrician. If I were you, to build up supply, I would feed her on your breasts every time, then feed her the bottle, then pump what is left. This should be every single feed.

Celeste - posted on 02/22/2014

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First, breasts aren't empty. Think of them like factories not storage units. Also average output is 1/2 oz to 2 oz total. But be aware the pump output is not reflective of supply.

Supplementing can hurt supply. Supply works on supply and demand. The more you nurse, the more you will make. Supplementing takes away that stimulation. But, I wouldn't stop supplementing cold turkey since you've been supplementing quite a bit. Your goal will be to decrease the formula while getting more feedings at the breast.

Here is a link on how to decrease supplements:

. http://kellymom.com/bf/got-milk/basics/d...

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Christa - posted on 02/22/2014

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Celeste- I like your plan. Here's what I am going to do at every feeding:

(1) breastfeed her for 30 min (I was told no longer than 30 min because for preemies breastfeeding is like running a marathon, plus its rare I can get her to even stay awake more than 20-30 min when she is BF’ing)

(2) give her a bottle after breastfeeding to make sure she is full and supplement with stored breastmilk that is fortified with 24CAL (if not enough milk is stored use neosure, but hopefully by breastfeeding every feed this wont be an issue much longer)

3) pump and drink a liter of water when I am finished, and store the milk

I know she may lose a bit of weight initially, but I will also run past my pedi on Monday.

Christa - posted on 02/22/2014

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Thanks Celeste and Jodi. I appreciate the comments! Its interesting you bring up iron levels and supplementing. When I referenced supplementing below, I meant that I was lacking supply and mixing some of my feedings with neosure or doing a full feeding of neosure. But I am also supposed to be fortifying my BM with neosure to make it 24cal. However, its been giving her bad gas and as soon as I gave her straight breast milk without the fortification for several feedings in a row, the uncomfortable gas stopped and she was able to have 3 back-to-back bowel movements after 2.5 days. Even though my pediatrician advised me to work with her to slow it down gradually, I feel like I know my baby and its too much for her. Am I wrong? And considering she’s still getting a couple feedings of neosure formula anyway, how can a few teaspoons make a difference (which is what goes in the BM). I am battling a lot of guilt bc I cannot get my supply up and giving her neo for both fortification and some feedings is making me feel horrible. I keep hearing these horror stories about people’s mik drying up and I am so worried if I don’t jump on the program asap, it could happen to me. There’s so much advise out there its hard to know the sure fire method – which is all I am looking for. And again, with a preemie it’s a whole different ball game. Also – when I breastfed her for 30 minutes today she didn’t take her bottle afterward and even spit up a little like she was full. So that was a first! She stayed awake for a good 45 minutes happy and alert, then my husband and I took her on a walk around the block. Normally she eats every 4 hours, but since she breastfed, she got full and was ready to feed again 2 hours later when we got back from the walk. That seems the natural way, and I would do it instantly, but I obviously cannot fortify that milk. I just need to know what I am doing wrong, what I can improve and how to do it. Thank you again!!!!

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