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Old 07-21-2005, 01:55 AM   #1
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Question Breastmilk supply problems?

Hi ladies,
I'm new here, and just learning my way around!
does anybody else here have breastmilk supply problems? I have read recently that having low milk supply is related to obesity (fatty tissue takes up the hormone prolactin, apparently). I have two girls (2 and 3 months), and have had low supply with both.
I am so sad about it, I have cried and cried. I still nurse, but have to supplement with formula and use a nursing supplementer (a bottle with tubes that go into the babe's mouth while she's latched on to the breast).
Strangely, this failure to breastfeed exclusively has made me determined to change my life, and my obsession with food. I also want to be a better example to my girls.
Anybody have experience continuing to nurse while losing weight? Has it affected your supply?
thanks!
Liisa
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Old 07-21-2005, 02:50 AM   #2
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From what I know supplementing will decrease your milk supply also. I have a friend who suppemented and she ended up drying up. Its a supply and demand issue. the more you breastfeed the more your body will produce. I found this out when my son was in the hospital for 2 days, they wouldn't let me breastfeed and they gave him formula. To say the least I was ticked. When we brought our son home, he was nursing all through out the day for about 2 days and finally I was producing what he needed. To top it all off he was going through a growth spirt, a baby will want to nurse more during this time also. Stress will also decrease milk supply.
I also heard someone say that exercising will increase milk supply.
Call your nearest "La Leche League" They are the best.
I would really recommend you call them b/c if its your Doctor telling you, you have a low milk supply when its not, is wrong. Because its making you feel like your not doing enough. My sons doctor told me the same thing, mostly its just Doctors who are ignorate and haven't done any research on breastfeeding. Do you know how many women I've come in contact with who have told me they could not breastfeed b/c they couldn't produce enough, at least 15. My sister-in-law was one of them and she only weighes 95 lbs (very small woman). When she had her 2nd child, after I had my son she saw my experience and was determand to breastfeed. She found out that whatever her previous doctor had said wasn't true. She was producing enough for her baby. The problem with todays doctors is that they want to see immediate results, and that is what they get with formula. Now breastfed babies don't gain weight like formula babies do. My son was gaining weight very slowly up until he turned 3 months, all of a sudden he blew up to 23 lbs (birth weight was 6 lb and 15 oz) totally breastfed. My doctor was worried up until then. All the while my Lactation Consultant was very satisfied with his slow weight gain. She was not worried at all. She told me if she thought anything was wrong she would tell me.
What I want you to remember is when you stop supplementing (but you have to stop supplimenting 100% and not look back) you will not see immediate results. It will take 2 days for you to see an increase in supply. The baby will not dry you up, your body will constantly producing milk with every suck. This is what I have experienced. Just b/c the baby is nursing all day doesn't mean he isn't getting enough, he is going by instincts he know what he has to do to get more. This is what is so beautiful about breastfeeding. It doesn't matter how much you weigh, I have a friend that is 200+lbs who is breastfeeding. You have to trust your body and your baby they both know what they are doing. Remember, You are not a bad mother. You are awesome!!
If you have any questions or need encouragement PM me or call La Leche League.

Last edited by Rakkoon; 07-21-2005 at 03:25 AM.
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Old 07-21-2005, 05:48 AM   #3
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Rakkoon's got some good advice. There is such a thing as low milk supply, but unless you have someone weighing the baby immediately before and immediately after a feeding, it is impossible to diagnose. PLEASE do not let anyone tell you that you have a low supply based on how much you can pump, which seems to be the usual method of "diagnosing" it. Even with my first daughter, when I was leaking copiously from one breast as she fed off the other, I could never pump more than an ounce at a time unless I was engorged. The difference between your baby's efficiency and that of the best pump in the world is massive.

I also don't buy the obesity causes low milk supply theory. Not that I'm trying to attack you; it simply doesn't make sense. If it did, thin women would be known for being better milk-producers than fat ones, and they aren't. (I'd also think that losing 35 pounds between daughters would have resulted in a marked improvement in my supply the second time around, which didn't happen.)

Using an SNS to supplement is smart of you; that way at least you're still getting the nipple stimulation. But the formula your daughter is getting will still fill her up faster and make her nurse less. A quick rundown of the usual methods for increasing supply: get a breast pump and pump between feedings (theory is this will help you supplement with your own milk), take brewer's yeast (in fact, if you can bring yourself to do so, drink a beer a day once the baby's down for the night; the alcohol will be out of your system before her next feeding if she's on about a 3 hour routine), milk thistle, mother's milk tea, fenugreek. I've also heard oatmeal helps, though I'm not familiar with that one. Make sure you nurse on demand, preferably at the first sign of hunger from your daughter. There are also two prescription medications, Reglan & Domperidone, that apparently have the side effect of increasing milk production.

As to what to do to ensure your supply doesn't drop--you have to eat enough, of course, but if you are careful you can diet gently and not affect your supply. (IMO you'd have to get down to starvation levels to affect it.) If you are staying well hydrated and eating enough protein, that should cover it.

Rakkoon's suggestion of consulting with the LLL is a great one. You can also try consulting a lactation consultant on your own, just make sure she is IBCLC certified. The knowledge required for that certification is exhaustive, but too often the 'consultants' at the hospital aren't IBCLC certified, and my experience with them is that they only have slightly more of a clue than the average woman on the street...You might be able to find contact info for a lactation consultant at the IBLCE website. Also, check out Breastfeeding.com for more info on what you can do now.
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Old 07-21-2005, 03:04 PM   #4
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Hi there,
thanks so much for your input! Unfortunately, I have tried everything you both mentioned, and then some, with my first daughter. I was not supplementing until the baby was losing weight at an unacceptable rate. My midwife monitored the nursing, I did the extra pumping, attended LLL, took any and ever herb, nursed until my newborn developed a chapped chin from nursing so much, finally visited Dr. Jack Newman himself (breastfeeding guru) to see if he had any answers for me. He didn't really... just showed me the optimum latch and breast compressions (which I was doing already), then said I was doing an excellent job, and prescribed domperidone. It does increase my supply a bit, but not nearly to a full supply.
I think you're right, that a lot of women MISTAKENLY think they don't have enough milk, thanks to the misinformation that PROFESSIONALS give them! Sadly, I don't think I'm one of those mistaken women... it's really not there.
Whether or not to blame it on my weight, I don't know. I also know a number of thin women, with every intention to breastfeed, who also had insufficient supply. My midwife, however, told me that in her experience it's more often heavy women who don't have enough -- I mean VERY heavy - morbidly obese (like myself). It really upset me to hear that, but it has also made me determined to change.
thanks again for your support! I'm still keeping the baby at the breast. Dr. Newman always says, "there's so much more to breastfeeding than breast milk!".
Liisa
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Old 07-21-2005, 05:35 PM   #5
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I had an overabundant supply of milk and I'm definitely obese. both of my children dropped poundage before gaining. Lilly weighed 8lbs.8oz. at birth and was down to 7lbs. 15 oz. the next day. She got down to 6lbs.12 oz. The next week she had only gained an ounce so her ped suggested I speak back with the lact. consultant and supplement with soy every other feeding and pump the times I gave her soy. We only had to do that for two days because I was pumping about the same amount she was eating. She's now 2 1/2 about 32 pounds and is in the 75th %ile for her weight. She did stay in the 5th %ile until she was about 4 months old before heading up to the 10%. She made it to the 25th by her first birthday.

William also lost weight. He went from 7 lbs. 12 oz. to 6lbs. 6 oz. I blame his loss on the lack of getting care. He wasn't seen by a doc again until he was 3 weeks old. He also had bad reflux.

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Old 07-21-2005, 08:28 PM   #6
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Well, you're doing everything you can, then. I just object to the pat answer of "you have a low supply because you're overweight." (Something I hadn't even heard of until this week!) It's one of those things like "colic", where they're giving a diagnosis that's only a description of the symptoms, not really a look into what is wrong, KWIM? Honestly, I think you're setting a **** of an example for your daughters, because you're not giving up. That's a good thing to teach them.
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Old 07-22-2005, 02:17 PM   #7
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thanks for the support!
I can't help feeling like a freak who just doesn't lactate! I am the youngest of six children, and all of my sisters breastfed with absolutely no problems at all. I am also the only overweight one.
I suppose that's partly why I wanted to know if other "fat chicks" out there are having the same problem, but I guess not so much! In a way, that's good to know, because when I first found this study on the internet, I wept for days with guilt, thinking that my babies were losing out on the benefits of exclusive breastfeeding because of my being so bloody fat. Yet another reason to feel guilty about my weight (like my mother (always thin and glamorous) hasn't given me enough over my lifetime!!!).
phew... got a little of that old childhood resentment off my chest!
I'm still nursing her with the SNS, but am getting a lot of pressure from friends and family to just give her bottles. I'm sure, though, if I do that, my milk will disappear altogether. At this point I think she's still getting at least 1-2 oz of breastmilk per feeding. There are still antibodies in that, right? I think a lot of my family and friends think I'm a nutcase. There might be someting in that!
thanks again for your support!
Liisa
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Old 07-22-2005, 11:52 PM   #8
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Heh, if your friends and relatives think you're a nutcase, you're probably doing something right. Any little bit of breastmilk helps, and like I said before, using an SNS will help you at least a little bit to produce, milk production being so much supply and demand.

You're the second person on this site this week to mention the theory between being overweight and not producing a lot of milk, so that prompted me to take the theory to another board I belong to, where just about everyone agreed with me that it doesn't make sense intuitively. There are conditions that overweight women have, like PCOS, that can negatively affect milk supply. But in the main it is a matter of how many milk-producing glands you have. The vast majority of women have enough. Some don't. Your reaction is exactly what I feared upon hearing this. It is a way to make women blame themselves, and a way for the laziest of healthcare practitioners to not follow through & find out what's really wrong.

And I hate it when women are made to blame themselves like that. You are already doing so much more than most women do. And that's something to be proud of, period.
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Old 07-23-2005, 12:07 AM   #9
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The only two women I've known with verified low supply are both very thin, so don't let anyone tell you it has anything to do with weight. I weighed just over 200 lbs when I gave birth to my daughter and I had TONS of milk. PLEASE, PLEASE don't feel bad about yourself over this! Breastfeeding in & of itself does not make you a good mother, so do not define yourself by it. You do what you know is best for your baby & everything will be fine. No one knows your baby as well as you do.
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Old 07-23-2005, 03:00 PM   #10
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There are safe herbs to take while breastfeeding.

I have used them before with all 4 of my children. Fenugreek and Blessed Thistle are two of the best. You take 3 of each 3 times a day and should notice an increase in 24 hours.

I have lost 12 lbs and have not noticed any affect on my supply but everyone is different.

Supplementing is one of the worst things you can do for your supply. It is all about supply and demand. The more your baby nurses the more milk you produce.

Here is a list of thing you should avoid while breastfeeding. In bold is what can decrease your supply.


Avoid these things that are known to reduce or harm breastmilk supply:

Smoking - Avoid smoking and being around others who are smoking while you are nursing. Nicotine passes through breast milk and both nicotine and second hand smoke are harmful to you and your baby.

Caffeine - (found in coffee, cola drinks, tea) can cause irritability and increased bowel activity in baby and depletes Vitamin B-1, B-6, iron, and potassium in mother.

Birth control pills

Decongestants, antihistamines

Severe weight loss diets


Avoid these herbs that can decrease milk supply: Peppermint (Mentha piperita), Spearmint, Parsley (Petroselinum crispum), Chickweed, Black Walnut, stinging nettles (not nettle - that increases milk supply), Yarrow, Herb Robert (Geranium robertianum), Lemon Balm, Oregano, Periwinkle Herb (Vinca minor), Sorrel (Rumex acetosa).

Sage and jasmine tea, parsley, peppermint candies (Altoids, Starlight mints, etc),

Peppermint essential oil has been used traditionally for decreasing milk supply

Eating parsley will decrease breast milk production. Sage also decreases milk flow. Drinking fennel tea will increase milk flow.

Licorice (the herb)--it has steroid-like ingredients.
The herbs sage, black walnut, and yarrow decrease milk production.


Alcohol - Avoid heavy alcohol consumption. If you have an occasional drink, delay nursing for two hours per drink.

Some fish - You should avoid eating shark, swordfish and marlin and limit the amount of tuna you eat. Donít eat more than one tuna steak a week (weighing about 140g cooked or 170g raw) or two medium-size cans of tuna a week (with a drained weight of about 140g per can). For canned tuna, this means about six rounds of tuna sandwiches or three tuna salads. This is because of the levels of mercury in these fish. Some of the mercury in the fish you eat will pass into your breast milk and high levels of mercury can harm a very young babyís developing nervous system.
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Old 07-23-2005, 03:30 PM   #11
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Thanks again everybody for the ideas and support! I have tried most of the galactogogue herbs mentioned, but to no avail. I even ordered some goat's rue tincture from gaiagarden.com (excellent store for herbs,etc!) - at about $100 for 500mL - but it didn't seem to do anything.
I thought this would be easier to deal with with the second baby, but it's still painful for me to accept. I am so jealous of women who have loads of milk! I spoke about this to a friend who tried for years to get pregnant, and she said she often felt like throwing vegetables at pregnant women at the grocery store, she was so jealous! So I guess I should be grateful that I didn't have any problems conceiving.
For anybody interested in looking at the study on obesity and lactation, here's a link

http://pediatrics.aappublications.or...act/113/5/e465

Anyway, I'm trying not to blame it entirely on my weight... but when my midwife told me that was probably the cause, I took it to heart.

thanks again, mamas!
Liisa
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Old 07-23-2005, 10:12 PM   #12
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Here is what I think is the key to the study:

Quote:
As expected, prolactin values decreased from 48 hours to 7 days postpartum. Women who were overweight or obese (using the Institute of Medicineís cutoff for women of a BMI >26 kg/m2) before conception had a lower prolactin response to suckling than normal-weight women at 48 hours but not at day 7.
What this means, without the big words, is the difference disappears after a week. If your supply problems continue, then being overweight is NOT the problem for you, and your midwife did you a grave disservice by saying so. All this study points to is that overweight and obese women may have greater difficulty in beginning to breastfeed, and thus will need extra help if they're to make it over that hump (the study suggests making sure the mother meets with a lactation consultant, calling her at home & offering breastfeeding support, scheduling an early pediatric appointment, and having a public health nurse make a home visit).
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Old 07-24-2005, 03:30 AM   #13
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Hi Liisa,
I just wanted to give you a little bit of my experience.
I had low supply with both my kids...it actually got frightening with my daughter, as she got VERY thin.
I don't know about the link between obesity and supply..I can't offer anything there, I've never heard that before.
Anyway, with my son, my doctor "diagnosed" it pretty quickly and put me right on Domperidone...I did great on it and continued to nurse him (and pump) until he was 11 months and self weaned...MUCH to my dismay and tears.

With my daughter, she lost a great deal of weight for a baby...scared us to death..there was talk of cystic fibrosis..(thank heavens it wasn't that!). She lost so much so quickly, that I was put back on Domperidone again and did the SNS along with that and constant pumping and so much Fenugreek that I stunk..

It turned out fine...I guess my supply came back and we nursed to over 18 months..I was so thrilled about that! She became a very strong, perfectly healthy little girl who is big for her age and we celebrated her fourth birthday today (real day is Monday).

I just wanted to say good for you for being so dedicated to your little one, and don't blame yourself You have clearly done so much to give her the best start in life...and just the fact that you are so concerned, shows what a wonderful Mother you are!

All the very best to you and your family
Linda
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Old 07-25-2005, 12:12 PM   #14
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hi again,
I think in some ways my midwife was a little too eager to blame my weight -- she just ran out of answers or ideas concerning my low supply. Dr. Newman didn't mention my weight when I saw him - he just said that this happens sometimes, though not often.
I realize that the study talks about lactogenesis II (milk not "coming in" during the first week), but because my milk never really did come in - in spite of constant nursing, pumping, herbs, and domperidone - I wrote the whole problem down to my weight. Maybe it's some other glandular/hormonal irregularity.
I keep hoping with each pregnancy that I will somehow magically produce more milk! Part of me hoped that if I could just lose all this extra weight before having another kid, I'll have sufficient milk to finally exclusively breastfeed... I'm still so sad about it. But life goes on! My oldest daughter is fine, after all, and did get whatever breastmilk she got. But I will always mourn that lost milk for her - is that bizarre?
I do feel a lot better hearing from all of you, thanks so much! I have enormous respect for my midwife (who is in all other ways an incredibly strong and wise individual), but I have to say her treatment of my breastfeeding problems left a little to be desired. The births were great though!
cheers,
Liisa
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Old 07-25-2005, 05:32 PM   #15
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I don't have more advice to give you but just wanted to say that I think you are doing great. Most women in your situation would have given up long before you did.

As for weight and the study my theory is cause and effect... like with PCOS years ago when I was diagnosed with it I was told the cure would be to lose weight only years later I found out that my issues losing weight were caused by the same symptoms as PCOS. I think that could be it for the milk production issue as well. There are numerous hormonal things causing women to be overweight and some of them may cause women to not produce milk as well but I don't think its a direct link. ANyways thats just my theory... either way I think you've done great and it sounds like you've tried so much.
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