Having a hard time creating milk

Hi everyone

I have a 10 day old baby and I am having trouble creating milk. After his birth, I had a serious PPH (bleed) and lost almost 2 litres of blood and needed two transfusions. I was bed bound for 24 hours and I couldn't hold my baby without getting assistance. Baby took to the breast but although he was suckling away, he was not getting enough milk to sustain him and lost 600 grams within days and was looking very unwell. I have a brilliant midwife visiting me in home who promotes breast feeding but due to his serious weight loss/ unhealthy colour, we are topping up with formula.
I am taking Fenucreek, Motolium, brewers yeast and lactation cookies in hope of boosting my breast milk supply. I demand feed (breast and formula) so when baby is showing signs of being hungry he suckles from each breast for 10-15 minutes. He is then provided with formula and I then pump from each breast for 10-15 minutes. I am making breast milk but it is only a tiny amount and my breasts are certainly not showing any signs of being 'full'.
Has anyone else been in a similar situation and do you have any tips to help me? I am sure the bleed has put me behind the ball game but then I worry that my breasts just may not be able to create enough milk. I really wanted a breast feeding relationship with my baby and hope I can have this.

Thanks :)

Hi jessekah :)

Congrats on your little bub. It sounds like you had a tough time post-partum - are you starting to feel like you're on the mend? From what I've heard, PPHs can really knock you about :hug:

By day 10 you'd expect your milk to have changed over from colostrum to the more mature breastmilk. Some mums find when that happens they get the really full, rock hard, leaking dripping shooting milk everywhere experience. But some mums don't. Personally I have never really had super full to the point of painful breasts. Even when my milk came in after all three kids. But it did come in. Some mums never feel engorged but are actually producing enough milk.

You are doing everything right from the sounds of it - breast first, suckle suckle suckle, then top up as required then pump. A few questions about this.

After 10-15 mins at the breast, does he come off, or do you take him off? When he is off the breast, is he still showing hungry signs?

How many times are you feeding him in 24 hours? How many times is he at the breast? Do you top up after every feed?

How many wet and dirty nappies is he producing in 24 hours?

Finally, you say you're only producing a small amount, just wondering what this is based off? How do you know this?

Congratulations on your baby! Sounds like you've had a rough start, I hope things get easier for you soon. Are you getting plenty of rest and help at home?
You're working really hard to feed your baby, well done. Although it may not be as you'd hoped (yet), you are breastfeeding - and I think sometimes it counts for *more* when you're doing it under such difficult circumstances.
OP has already asked you lots of good questions. I'll add one more - is there any chance of retained products?
Also, some mums opt for donor milk from other mothers, rather than formula, which is an option you can explore if you'd like to.
All the best,

Thanks for your reply Oceanprincess. In response to your questions :)

After 10-15 mins at the breast, does he come off, or do you take him off? When he is off the breast, is he still showing hungry signs?

Due to weight loss my midwife has said max 15 minutes so he isn't expending too much energy out vs. energy in. That being said he is now getting stronger/ bigger so I offer the breast for comfort as well. He sometimes comes off, and sometimes I take him off when I can tell he isn't getting any more milk. When he is off, he is still showing hunger signs and eagerly takes the bottle.

How many times are you feeding him in 24 hours? How many times is he at the breast? Do you top up after every feed?

Approximately 7-8 times in 24 hours, plus 'comfort feeds' whenever he shows distress. Sometimes he nods off from the breast and I don't top up.

How many wet and dirty nappies is he producing in 24 hours?

About 2 poos and is wet every 3-4 hours.

Finally, you say you're only producing a small amount, just wondering what this is based off? How do you know this?

This is based off the expressing. I only express 1-2 mls at the moment but I am pretty sure baby is suckling more milk out than the pump. We also know I am not producing a large amount as baby lost 600grams in 4 days when I was exclusively breast feeding him. He also became dehydrated and looked very sickly.

Thanks!

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This is based off the expressing. I only express 1-2 mls at the moment but I am pretty sure baby is suckling more milk out than the pump. We also know I am not producing a large amount as baby lost 600grams in 4 days when I was exclusively breast feeding him. He also became dehydrated and looked very sickly.

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Ok. Now we are getting somewhere.

Feeding him 8 times in 24 hours is great. Keep aiming for 8, up to 12 feeds in 24 hours, the more the better. Sounds like he is having pretty good output too.

Pumping is not a good indication of your supply. You're right - baby will be suckling more from your breast than the pump is able to extract. Also - pumping straight after a feed is not the best way to get milk out. Wait for an hour if you are able, and pump then.

The best indication of your milk supply is your baby. How many feeds in 24 - like I said, aim for 8-12. Wet and dirty nappy count - 5-6 or more in 24 hours is great. Growth - not just weight, but length and head circumference. General appearance and countenance - is baby relatively content?

It sounds like bub is ticking a few of these boxes now, so you might be able to cut back on the top ups and see how you go. The tricky thing about bottles is that baby's natural instinct is to swallow whatever goes into their mouth. Survival instinct - swallow or gag and spit. So even if he seems to be guzzling the bottle, it doesn't necessarily mean he is hungry.

How would you feel about reducing the amount of top ups?

Jessekah, congrstulations! You are doing a fantastic job, really working hard and it looks like lots of small wins. I think MadB and OP have given you really awesome advice. So I'm just dropping by to say keep up the fantastic work. Oh and yes, from experience I agree on waiting a bit to express, and also not everyone has great success expressing even if bubs gets more than enough when he is suckling. Some boobs are too clever to be tricked by an electric machine!

The only other thing I'd add is make sure you are eating properly, even with the milk supply aides, and getting enough hydration. Lots of protein rich, full fat (i.e. Good fat and none of that skim stuff) foods. Nuts, ham, full cream milk, cheese, leafy greens, wholegrains, avocado etc. I was very dehydrated after DD's birth, and it was a pretty standard and uneventful birth aside from being quite long, and this did impact my milk which took longer to fully come in.

Sounds like he's getting back on track now, so giving him more time at the breast sounds like it could be a great idea.
When he feeds, you can also switch back to the first side again, and so on, so you give 3 or 4 sides at a feed, rather than 2.
Frequent feeding will be more effective than expressing, so long as he's feeding well. No issues with his ability to latch and feed?

Sorry for delayed response! We had our fist family outing yesterday :)

MadB, baby is very happy to latch onto the breast and feed. I don't think he is getting much as I cannot hear a swallow, but is suckling away and I figure every suckle helps us get the milk going.

Ladylove, thank you for the advice about the food. I am eating pretty well - lots of vegetables and eating whatever I feel like (not binging on sweets!) without concerning myself about losing baby weight.

Ocean princess, thank you for your advice too. I have upped the breast feeds and doing them even without offering the bottle. We are also monitoring his formula input :)

Thanks!

Jessekah how are you going now? And bubs?