Question for all BF experts or BTDT moms (re: having to supplement when baby not gaining weight and supply issues)

Pls don't quote - I am asking for a friend and want to make sure my info is correct and I am helping best I can.

Here is the situation - First time Mom wants to EBF and is committed to doing so. On Day 4 of baby's life the ped said the baby has lost so much weight (13% of body weight) and jaundice issues and mom must supplement with formula and bottles. That is what mom started doing and at this point milk supply really hadn't full come in. So now starting day 4 mom is still trying to BF while giving formula bottles after each feeding (because baby isn't getting enough or is refusing to nurse at all) and baby needs to gain weight. Mom is trying to pump but getting nothing. Now we are at day 8 and still supply is not good - baby eating really only from formula bottles. What would you advise in this situation if Mom desperately wants milk supply to come in and wants to EBF and not give formula.

TIA!

Eta: she has seen a lactation consultant a few times and has only been advised with the above.

Message edited 9/29/2014 8:47:00 PM.

Re: Question for all BF experts or BTDT moms (re: having to supplement when baby not gaining weight and supply issues)

Have her speak to a lactation consultant.

Re: Question for all BF experts or BTDT moms (re: having to supplement when baby not gaining weight and supply issues)

This was my routine: nurse, bottle then pump. I never knew what the baby got on the breast but I assume it was very little b/c she always took a good amount from the bottle. After pumping that would go into the next bottle along with formula to get to 4ounces. I tried Fenugreek but it didn't help my supply. I just did the best I could and gave her whatever I pumped supplemented with formula. 13/ seems like a lot of weight loss and they need to eat, pee and poop to clear the jaundice. I would follow the doctor's advice and keep nursing g and pumping.

Re: Question for all BF experts or BTDT moms (re: having to supplement when baby not gaining weight and supply issues)

Have her see an international board certified lactation consultant. Supplementing leads to supply issues and its a cycle. Her supply won't increase until the formula is phased out. Also it sounds like the baby is getting used to the fast flow of the bottle. I would suggest supplementing through an SNS.

Re: Question for all BF experts or BTDT moms (re: having to supplement when baby not gaining weight and supply issues)

I had this exact problem with my DD. She lost sooo much weight the first week because my milk never came in right so I had to start giving her formula. I kept trying to BF too but it just wasn't working so instead I just pumped and whenever I had enough BM to make a bottle I'd give her that instead of the formula. I did this for about 8-10 wks until I pretty much dried up. I was disappointed at first but in the end I did what was best for her.

Question for all BF experts or BTDT moms (re: having to supplement when baby not gaining weight and supply issues)

I would go to a different LC as a PP suggested since she isn't getting any help from the one she's seen. Once formula is introduced the demand for bm goes down and so the supply goes down too but a good LC should be able to give her ways to improve the situation if she is determined.

Question for all BF experts or BTDT moms (re: having to supplement when baby not gaining weight and supply issues)

She needs to have her child on the boob constantly. When my son was first born, he was nursing all day, every day. If she continues to supplement, it will be hard for her to get her supply established. It took my son more than 2 weeks to get back to his birthweight, but my doctor had us come in for constant weight checks to make sure he was progressing.

Re: Question for all BF experts or BTDT moms (re: having to supplement when baby not gaining weight and supply issues)

Message edited 9/29/2014 9:08:40 PM.

Re: Question for all BF experts or BTDT moms (re: having to supplement when baby not gaining weight and supply issues)

Re: Question for all BF experts or BTDT moms (re: having to supplement when baby not gaining weight and supply issues)

Pump every time kid gets a bottle.
My kids both needed supplementation & I moved on to EBF after a few weeks.
Sometimes supply is just not enough for ? What reasons. Better IMO not to starve babies in the meanwhile.

Question for all BF experts or BTDT moms (re: having to supplement when baby not gaining weight and supply issues)

Not an expert, but here are some ideas.
Nurse as much as possible. Work with someone on baby's latch if necessary. Get a hospital grade pump and pump after nursing. Get a baby scale and weigh baby before and after feeding to get an idea of how many ounces of milk baby gets. There are alternative ways to feed formula that might be better for nursing (to prevent latch problems).
Some people say oatmeal helps supply. Some people use fenugreek to increase supply.
My favorite online resource is kellymom.

Message edited 9/29/2014 10:21:38 PM.

Question for all BF experts or BTDT moms (re: having to supplement when baby not gaining weight and supply issues)

What bottles and nipples is she using? First thing I would make sure the nipple is similar to the breast. I had luck with the playtex bottles and nipples.

Second I would recommend a hospital grade pump asap. I used the medela symphony (rented it once from BRU and once from a local pharmacy). The hospital had me use it with my twins. When I had my third, I had a regular pump and I hated it! I made DH run and get me the hospital grade one. It was like night and day. And once I started flowing, my supply was great.

I never EBF. I always supplemented, so I don't have experience there. But when my twins lost more than 5% of their weight, they automatically went on formula. So 13% def sounds like a lot.

My routine was always nurse first. For me I had to be relaxed, and drink a lot. I drank so much water. After I nursed, if they still seemed hungry I topped off with a small bottle (sometimes pumped BM, sometimes formula-whatever I had). My LC in the hospital told me to give the bottle last. She said it is so much easier for the baby to suck from the bottle and they don't have to latch or work at it, so if you give them the bottle first they won't be inclined to try to latch after that. But if they have the breast first, they have to work at getting the milk, so they will try. Hope that made sense.

Message edited 9/29/2014 10:40:19 PM.

Question for all BF experts or BTDT moms (re: having to supplement when baby not gaining weight and supply issues)

I was in a similar situation minus the baby being jaundice. I tried everything to get my supply up but nearly 7 months later, still haven't succeeded to get beyond 18oz/day. DD has been supplementing with formula from day 1. I've only been able to get her to latch about 3 times.

Unfortunately there are some women, myself included, who no matter what they do, have a supply issue. I've tried fenugreek, mothers milkmaid tea, more milk plus supplements, lactation support supplements, eating steel cut oatmeal, lactation cookies (3 different recipes), and domperidone all while pumping every 2-3 hours round the clock (and have tried 3 different breast pumps, including a hospital grade Medela Symphony). If she wants to give her baby BM but baby won't latch, she can always do what so many have done, and become an EP'er (exclusive pumper). I'm almost 7 months into it. I have pretty much come to terms that DD won't nurse directly from me but she still gets at least 2 bottles of BM per day. It is what it is, unfortunately.

There are times I'm grateful though... like when she's up at 3am and hungry - DH can give her a bottle!

Question for all BF experts or BTDT moms (re: having to supplement when baby not gaining weight and supply issues)

This was me two weeks ago. Jaundice and not getting enough from breast. After nursing I gVe her formula.
When jaundice went Way I was still supplementing until supply increased. I bought mothers milk tea and drink it twice a day. I now exclusively pump so I know how much she's getting - but we are at the point where she takes bottled breast only from 8 am- 8 pm and formula at night. She nurses when she's having a fit and needs to be soothed.

Tell your friend to hang in and make sure she pumps or nurses every two hours even if she isn't giving it to baby - at first I just did that and saved it to be one complete serving.

Also - it's my opinion - but any breast milk is better then none. She's doing what she can!