Breastmilk Not Enough?

Updated on June 25, 2008
N.L. asks from Los Angeles, CA
4 answers

My almost 6 week old has been crying at the top of her lungs for about 2 weeks now. We assumed it was 'normal', colic. After a desperate doctor visit, we were informed that she was hungry and suggested supplementing with formula. She'd been eating fairly regularly but only for about 5-7 minutes at a time. She latches well, but lately has been rejecting the nipple after a few swallows. It seems like it is not enough. When offered a bottle, she reluctantly devours it. I've pumped a couple of times now and can produce 4 oz of milk from 1 breast in 1 half hour sitting! I want to try to keep her on the breast, but am willing to give her the breastmilk bottle if necessary vs formula esp for health reasons.... Any words of wisdom/advice?

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A.M.

answers from Santa Barbara on

N., I'm so sorry for what you're going through. Do you feel like your doctor had the right answer? Was your baby not gaining weight sufficiently? Did she have enough wet/dirty diapers? If hunger truly is the issue, it doesn't sound like it is due to your milk supply. 4 oz from one breast during a pumping session should be MORE than adequate for a 6 week old. I wonder if perhaps you have too much milk. Sometimes, if the flow of milk is too fast or your baby chokes and coughs repeatedly, she may become disinterested in nursing. The bottle flow rate is more regulated, and more "baby driven," since she has to suck in order to get milk. If you have a rapid or intense milk letdown, it could be too much for her. Perhaps she's eating just enough to satisfy her hunger and then quitting. If you think this might be the case, you could try pumping first (for like 5 or 7 minutes), in order to have your milk slow down when you go to nurse. And, that way, you'll have milk pumped and refrigerated or frozen for when you and DH go out for a date or when you just need a break.

Another theory could be that you haven't found a comfortable nursing position for you and the baby. Make sure that her head is even or higher than her body. You could look in your community for a LLL member or lactation consultant to watch you nurse, and see if they can recommend anything.

I'm not a lactation consultant or a doctor, but I have nursed 3 kids. I applaud your commitment to breast feeding, and whether you do it from your breast or from a bottle, your baby gets loads of benefits. I have found that my milk supply drops if I rely solely on pumping, so watch out for that.

Good luck, and if you think I can be of further help, please contact me.

1 mom found this helpful
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H.B.

answers from Las Vegas on

Hi N.,

My name is H. Bushy and I am a Board certified lactation consultant. I would like to respond to your question. But to make a correct assessment I would also like to ask some questions. The first thing I am going to explain is normal things about breastfeeding for the first six weeks. This will include normal growth patterns and phases that will occur. this might let you understand some of this crying is to be expected.

When babies are born, they will loose 7-10% of their birth weight in the first 3-5 days. This is normal. Some of it is saved up poop, water retention ect. Your baby should weigh its birth weight at 14 days old. Sooner would be ok.

Your milk supply will come in some time between 3-5 days. Some women experience engorgement (over fullness). This can cause quite a few problems from refusing to breastfeed, severe painful feelings like your breast is going to pop. Other women experience slight fullness but not to the point of pain. Both are normal. This does not mean the women that didn't feel full will have less milk. At around 3 weeks of age, your hormones are going through fabulous changes (YEAH!!). Your milk supply will decrease but this is normal. You may have been making enough milk for 1-3 babies. Now it is regulating according to needs.

Now for some good news and bad news. Your child should be gaining 4-7 oz. per week after the 14 day mark. Alot of women assume when the breasts no longer feel like popping, they have lost their milk. Not True!!!!! HEARS THE BAD NEWS...... Typically at 10 days, 3 weeks and 6 weeks your baby is going to go thru a growth spurt, this means they can grow as mush as 1 whole inch over night. Typical symptoms of this phase.....
1. wanting to stay attached to the breast as often as every 1/2 hour (which can feel like every minute of your day). When your child is not eating he/she will probable be crying. Don't be surprised if some tears are produced by you. This can be a very challenging time for both of you. Sleep, get it if and when you can. 5 minute power naps don't seem like much but they may help. Good news, This phase should only last 2-3 days. However, sometimes during these 2-3 days can seem like forever.
I assume with out further information this has already happened.

Here are some questions needed to determine next steps to decrease or eliminate the crying. Two weeks of non stop crying should be continued evaluated. Do not take this phase personal. You have done nothing wrong but to try to fullfill your wish to provide breastmilk for your baby.

1. What was your childs birth date and weight and height?
2. What was your babies lowest weight?
3. What did your baby weigh at his/her 14 day checkup?
4. Does your milk come out very fast? Does your baby gag or choke and then pull off the breast?
5. Does your baby stay at the breast for the first couple of sucks and start to fuss?
6. Is your baby biting or gumming your nipples while trying to nurse?
7. How often are you pumping and or nursing? This should be a minimum of 8 times in 24 hours.
8. How much formula or pumped breastmilk is she eating in 24 hrs?
9. What kind of pump do you have? is it electric or manual? Do you know the brand name?
10. How many wet and poopy diapers in 24 hours?
11. Last weight and date?

I hope this helps some. For now, I suggest giving as much skin to skin contact. This means taking off your shirt and bra, bare from the waist up. Then undress the baby so only has a diaper on. This is for your own protection. And now place the baby on your chest. You do not need to offer the breast but this will reinforce how happy it feels to be this close to you. If you are chilly then place a blanket or towel over you and the baby. Your breasts will increase in temperature if the body temp drops in the baby. Another amazing fact about breastfeeding. Breastfeeding has possibly become attached to not the happiest feelings with the baby. We need to reinforce
happy, happy, happy. Ok don't over do it. Wrap you and the baby up even after feeding and just lay with the baby. If time is a challenge consider it doctors orders.

Before offering the breast.... pump 2-3 minutes. This will help your milk let down and she won't have to work so hard to get the milk. Last but not least...TAKE YOUR POINTER FINGER AND PLACE IT UPSIDE DOWN IN THE BABIES MOUTH. YOU WILL FEEL THE TONGUE THRUST FORWARD TO THE ROOF OF ITS MOUTH. GENTLY PRESS FINGER DOWN FOR 30-60 SECONDS. THIS WILL REMIND THE BABY HOW TO SUCK CORRECTLY AND REMOVE MILK FROM THE BREAST. YOU MIGHT NEED TO DO THIS EACH BREAST AND FOR A COUPLE 2-3 DAYS. ITS ONE OF THE EASIEST BREASTFEEDING INTERVENTION. ALSO SUBSTITUTE PACIFIERS FOR FINGER SUCKING. I KNOW TIME CONSUMING, BUT IT HELPS. THESE PROBLEMS WILL NOT LAST FOREVER. YOU ARE ALREADY ALMOST PAST THE MOST DIFFICULT TIME OF BREASTFEEDING. NOW WE JUST NEED A LITTLE TWEAKING TO DECREASE CRYING AND POSSIBLE GASSINESS. LAST BUT NOT LEAST (ANOTHER TIME CONSUMING BUT REAL TEMPORARY PHASE) INSTEAD OF USING BABY BOTTLES TO SUPPLEMENT, TRY A MEDICINE DROPPER. FILL THE DROPPER WITH BREASTMILK OR FORMULA AND PLACE IT TO THE BABIES LIPS. SHE WILL WRAP HER LIPS AROUND AND SUCK IT OUT. DO NOT SQUEEZE. THIS WILL TAKE AWAY THE SUCKING EXCEPT FOR THE BREAST. SUCKING IS SOOTHING AND WILL MAKE THE TRANISTION TO BREASTFEEDING EASIER IN THE LONG RUN.
GOOD LUCK! PLEASE FEEL FREE TO WRITE BACK.

H. Bushy
IBCLC

1 mom found this helpful
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J.L.

answers from San Diego on

Hi N., i had thr same problem with my first child, except i was bottle/formula feeding, but it was not enought, so my mom told me to start him onrice cereal in an infant feeder and i did, worked like a charm, so all 3 of my kids were on rice cereal at six weeks old. J.

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R.M.

answers from San Diego on

Hi there I have a 1 year old whom I just weened off the breast. I know early on when I was breast feeding her first thing in the morning while I was nursing her on one side I would be pumping the other side to tell my body to produce more milk and to save some away in the freezer. Before long I had a freezer full of breast milk. If you are able to I hope this will help.

Bye, Becca

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