Nursing Working Mama’s Conundrum: Part II
Betsy's a working nursing mama, and her supply is dwindling. Did you read that? Her supply is dwindling! Ack. She writes:
Dear Mamas,
I need a friendly chorus. My nursling is 9 months old, and I'm working full time out of the house - I've been pumping as regularly as I can, but my supply is just dwindling and she's barely growing. Here's what I'm doing, which covers just about every wives tale remedy I've ever heard:
- - daily oatmeal
- - fenugreek, 3 caps, 3x/day
- - nursing tea, 1x/day
- - pumping 3-4 times/day at work
- - drinking liquids like they're going out of style (only one caffeinated beverage per day)
- - eating like mad - this week, I started a dark beer per day.
My supply has dropped from 16 + ounces in an 8 hour period when I started, to far less than 12 now.
Meanwhile, the baby has gained only 4 ounces since her six month checkup, and my husband who is caring for her at home this summer (with our 3-year-old) reports herculean efforts to get her to eat. She is a social, alert, active baby who is meeting all her developmental milestones. She's just not growing much, and I want to fix that before three more months have gone by with such low weight gain; she's still on the growth charts, but just barely -and she was above the 50th percentile for size at birth. Gauging from what a let-down consists of throughout the day, and comparing that with what she *should* be eating (over 700 calories per day at 16 pounds) is rather alarming; I just don't think she's getting that much, but she doesn't seem to want more.
I want to nurse her as long as I can, but it is brutal to pump so much for so little return. Every session is an exercise in fighting off feeling like a failure (irrational, I know, but it's there). We've begun supplementing with formula, and I'm fine with that, but I don't want my husband to spend all his time trying to jam food into her gob (not that we can force her to eat, anyway).
Mostly I'm writing to whine, but if anyone can look at my tale and say "Aha - that happened to me, and I just did X and fixed it!" or "I understand. My body just quit making milk, too. It's hard."
it sounds like you may not have as great a problem as you think...in which case, rejoice, relax, and pat yourself on the back! it is sooo frustrating when you feel like you're not being able to feed your child, i hear you! but look at it: your little girl is healthy, you're still making quite a bit of milk (it sounds like), and keep in mind that there really doesn't seem to be a true 'normal' when it comes to growth rates and stages for babies. it always seems to me like the best we can up with is a very broad ballpark area-sized norm (and that would fit a LOT of babies!). as long as she seems happy, not fussing that she's hungry, and is continuing to be interactive and growing, i would save my worrying for another day. babies have an uncanny way of doing the right thing for themselves at the right time. and you parents get to have a nice, loooong night out together to congratulate yourselves and each other for your dedication and herculean efforts! best of luck, and really, hang in there, you sound like an awesome mom. we should all be so lucky!
Posted by: ruza | August 01, 2007 at 07:28 AM
your supply is dwindling AND she doesn't want to eat? if I understand that correctly, seems your body is responding to her demand (or lack thereof) I have always been fascinated about the miracle of nursing and the feedback loop b/w mama & baby. does she nurse much when you are home? nights & weekends? I had decent supply but my daughter (who is 6 now) practically refused to eat during the day while I was at work. And I mean she would take 2 oz from a bottle 2, maybe 3 times in an 8 hour day (in addition to a nursing session on my lunch hour.) I worried every day about it. I remember the New Mom's Group facilitator talking about some kids just not eating while their mamas are gone and then "making up for it" when they are home. Is your medical provider concerned? Most studies out there say that kids will get what they need- if she is doing well otherwise, the struggle to jam food into her is probably more for mama and papa's comfort than for baby's. That's just my take. Good luck!
Posted by: amy | August 01, 2007 at 07:29 AM
I had this same situation when my son was that old! It's perfectly normal for breast-fed babies to gain weight slowly. Working and pumping can be exhausting - hand in there. Remember that every baby needs different amounts of breastmilk and that your body is attuned to her needs.
Talk to a lactation consultant! They work on these types of issues all the time and can be really helpful (and reassuring). I love the women at Legacy Emanuel's Lactation Clinic.
Also, what growth chart are you consulting? The World Health Organization just released new breastfed baby growth charts in the last year (the old charts everyone uses are based on formula-fed babies).
I found this book to be incredibly helpful and reassuring: "My Child Won't Eat: How to Prevent & Solve the Problem" by Dr. Carlos Gonzales
Don't beat yourself up - you're doing a great job!
Posted by: Scotti | August 01, 2007 at 07:58 AM
I wish I had a solution for you because I know how frustrating (and slightly alarmed) you can feel. I am writing instead to say "I hear you sister!". I am not ready to give up getting breastmilk into my just-about-one-year-old daughter but my supply also seems to be slowing down. I too do the daily oatmeal (yuck) and the tea etc. I am only 5' and about 105 lbs so I've been trying to split the daily beer with my stay-at-home husband (no complaints on his side, he usually needs one by the time I get home!) and am very sad when I can only squeeze 10-12 ounces out of my poor little boobs on a work-daily basis.
But there is a lot of wisdom in the above posts. Like you, my daughter has never been comfortably in the weight percentiles so I chucked those out the window. Who cares how "average" she is if she is happy and healthy? Just keep offering her a variety of food choices and when she is hungry she will eat! My little girls LOVES avocados and, thankfully, yogurt so I give her plenty of both (whole milk yogurt at that) and between the two she is getting quite a bit of fat which she needs (perhaps that is why she loves them so? her little body is telling her something?). I think your little girl will soon be grabbing fistfuls of little chunks and then you won't be able to stop her!
Not to mention that I believe pumping and nursing can send different messages to your body because you aren't pumping EVERY day, only when you are at work (I'm assuming you are like me and pump at work but nurse when you are home evenings and weekends). So you are demanding one supply at work but your baby demands another supply over the weekend. These mixed messages can confuse your system so don't forget to cut yourself some slack!
You and your husband are doing a fantastic job. Don't sweat this one as long as your baby seems happy and healthy, active and alert.
Good luck!
Posted by: Melissa | August 01, 2007 at 08:07 AM
Other suggestions if you'd like to increase your milk supply:
1. Deep breathing/stretches/something to relax yourself for a few minutes prior to nursing/pumping.
2. Looking at a picture of your daughter while pumping/thinking positive, loving thoughts about her while pumping (I know it's awkward and contrived, but "they" say it helps increase the milk - it's worth a shot.)
3. (of all the things I tried when I was in your situation, this worked the best for me) During one of your pumping days either pump every hour for 10-15 minutes, or for 3-4 40 minute pumping sessions. Although you aren't going to get extra milk from that grueling day (or much work done), this imitates the nursing pattern of a child in a growth spurt and will stimulate your body to produce extra.
4. A person typically should eat a meal that could fit into the palm of their hand - the idea that a tiny baby should suck down large bottles of formula/milk is wrong. That small amount of breastmilk is actually right on.
I've been there and been so stressed out about it, and it never seemed like I was getting enough milk out of my breasts (although I did get more after trying #3). My daughter, however, was always on the other side of the growth chart - off the charts and "too big", even though it seemed like I was never producing enough milk to satisfy her. Her friends who had 24-7 access to the breast were off the charts in the small range, and above posters are correct that each baby is different (and the charts don't know everything).
I've read, and am inclined to agree with, the idea that babies of pumping moms take most of their nourishment when the breasts are available to them. My daughter did nurse often in the evening and at night. If your daughter is nursing regularly when you are around it's even more likely that she's growing at her own pace, charts be damned.
Posted by: rachel | August 01, 2007 at 08:53 AM
My daughter also didn't have a strong appetite around that age and her growth slowed. I wasn't worried because she seemed happy and healthy and I know that growth rates tail off for breastfed babies. We went in for her 1 yr check up and our pediatrician said he wanted to check her iron levels because a lack of appetite and slowed growth can be indicators of low iron levels. I thought it seemed unlikely but allowed them to draw some blood. She ended up having low iron and we put her on daily iron supplements and her appetite and growth have skyrocketed in the last few months. The iron drops taste terrible, it's like feeding her rust, so we have to hide them in juice (which I don't like to give her). We certainly haven't given iron to her every day but I figure every little bit helps. We also try to make sure that we are feeding her foods that contain iron.
When I mentioned the low iron levels to my mom, who has always had iron levels on the low side, she said that my older brother had low iron as a baby as well. We're bringing our daughter in to have her iron levels checked again soon but with her increased appetite and growth I can't imagine that she still has low iron levels.
Anyway, I had never heard about the relationship to low appetite and growth with low iron prior to our experience. I thought I would just add a different angle to the discussion.
Posted by: tracy | August 01, 2007 at 09:42 AM
Been there too. I know those thoughts (however irrational) of personal failure and concern for weight gain. My daughter followed your 9-mo-old's pattern - 50% at birth and all other visits, then 10% at her 9-month check-up, 2% at her 12-month check-up. My supply dropped at 9 months too, but she didn't seem to mind. And trust me, this kid has never had any trouble communicating her needs, likes and dislikes.
I would say drop the formula (unless she's indicating that she is hungry w/o it), and ditch the growth charts. Your baby is an individual, and if she's hitting her developmental milestones and is otherwise healthy, there is really no cause for concern. It took me a while to truly believe this myself, but once I did, I could simply celebrate my little petite flower.
Also, consider your family's genes. My husband and I are both on the small side, so it's no surprise that Thea would eventually gravitate towards the small side too. Our pediatrician said that the first 6 - 9 months growth pattern are more indicative of environment (sleep, food intake, mental stimulation), and after that, it becomes more about genetic potential - i.e., if you are 5'2" and 110 pounds and your husband is 5'8" and 150 pounds, you probably aren't going to have a giant, or even average, kid.
Hang in there. You are already being a super mom!
Posted by: Colleen | August 01, 2007 at 09:42 AM
Having gone through 9 months of pumping as a full time working mom, that is a wonderful accomplishment to be where you are right now! My milk supply decreased significantly about the same time and perhaps also that is because naturally at that age they begin to eat other foods as well? My daughter was a preemie and had acid reflux, she was small (and still is). She would cry for hours due to hunger/pain, but didn't like to eat because it would hurt (or perceived from past experience). So, if you baby is generally happy and you don't see signs of delayed development or 'pain' with eating, then things are looking up! The reality of pumping is that it is not the same as breastfeeding and our bodies respond differently. Mainly, doing the best you can is all you can expect from yourself - and relax in knowing you are doing great! All the best-
Posted by: Harper | August 01, 2007 at 09:43 AM
A similar thing happened with us and we just waited it out. Our breastfed daughter was 50% for weight at birth... by six months she was down to 5%, and at 12 months she was below the chart. AND, she was perfectly healthy, vibrant, developmentally ahead of the game, and all-around outstanding, so we quit worrying.
All of the previous posts have excellent advice. Good job on breastfeeding/pumping for as long as you have and good luck!
Posted by: Allison | August 01, 2007 at 10:00 AM
Not only have I been there but I *AM* there now! I just bought the fenugreek and the oatmeal last week...
I think that Breastfed babies really taper off on growth right around 6 mo as they start becoming mobile. It's also hitting me that the little man is eating more during the day than I'm producing. I think it doesn't sound like you have an immediate need to up your supply but there are ways. A month or so ago I was only nursing on one side because of a tooth-related nursing injury (ow). So on the injured side I pumped all day, once at night, and once in the early morning. Only nursed from the non-injured side. This went on for a couple of weeks until the injury healed. During that time, after about a week of ONLY pumping on one side... I got engorged on that side! It's almost as if my milk had a second coming-in. It sounds a little whacky but if you can put up with growth-spurt like nursing schedules on one side and pump the other side, it might work to up production... although it seems like it might not really be necessary.
I also agree about the eating other foods thing... even though other foods don't contribute as much to actual nourishment.
Oh and one other thought -- make sure that all your pump bits are working properly. There might be a bent/degrading valve or something... so maybe as a precaution replace some parts that might be worn?
Good luck and *hugs* from a mama in the same boat as you!
Posted by: Shetha | August 01, 2007 at 10:08 AM
Though I am the crazy woman who pumped and stored 3 gallons in the freezer, I was actually never a prolific producer and would have days where I produced a measly 8 ounces. So you're doing really great by my measure! Everyone has on/off days, too. Try not to judge yourself by your milk production. I am a huge breastfeeding proponent, and I do believe we carry the guilt of working into our relationship with our pump. If you can shed that guilt and cut yourself some slack, I think you may feel better. Consider what my friend with 4 kids did by the time her youngest (twin boys) came into the picture: she still pumped at work, but if it wasn't enough, she supplemented with formula. So, 80% of the time the boys got breastmilk and 20% of the time they got some formula. That saved her a lot of grief and anxiety.
Good luck!
Posted by: Suz | August 01, 2007 at 10:40 AM
Wow, I just went through a temporary dwindle in my supply and it shook me up. I second the suggestion to dump the formula and let your baby tell your body how much milk she wants.
You didn't mention sleep. When I am sleep deprived (I know, I know, we are all sleep deprived), my milk supply shows it. Try to nap during the weekends with your daughter. It's great bonding and having her near your body will help your hormones make more milk. I also like to wear my baby more when my supply goes down. Even just around the house is great. And she really likes the view from up high.
Good luck!
Posted by: Jessica (from NYC and hoping to be from PDX soon). | August 01, 2007 at 11:09 AM
Oh yes, I was there too. I'm sure you've tried it, but the picture of my baby *really* helped me. Especially when I was traveling. I had this stack of really cute recent photos that I'd look at. It felt funny -- like I was looking at porn or something -- but it worked!
And like everyone else has already said, you're doing great! I struggled with production issues all along, I SO know how you feel. Hang in there!
One more suggestion that I found worked somewhat and might be easier to implement in the summer: lots of skin to skin contact with the babe stimulates milk production. Snuggle naked!
Posted by: christinadw | August 01, 2007 at 11:10 AM
I'm also a working and pumping mom. I've had some supply issues on and off for the last couple of months I've been pumping. It seems that when I'm at a point where my supply has dropped I sit there and fret about it the whole time I'm pumping and am staring at the bottles trying to see how much I'm getting (did I have letdown?) and watching the clock and seeing how long it's taking, and then one day I realized just how stressed I was about my supply while I was pumping. So, I started bringing in a book, crossword or sudoku (and a picture of the baby, of course) and tried to take my mind off of the pumping and it's seemed to work wonders. See if there is something you can do to get your mind off of it while you are pumping. It helped me.
And since it's a supply and demand thing, my other suggestion is to see if you can take a few days off and just nurse as much as possible with no pumping, doing that has also helped my supply quite a bit.
Posted by: Andy | August 01, 2007 at 11:38 AM
THANK YOU!
To all the mamas with advice and commiseration. It really is so nice to feel like there are others out there who know of what I speak.
Am working on dropping the guilt - and just letting it go a little more.
Since I wrote my rant, we've discovered that 1) she loves chunkier foods 2) she loves to feed herself (including cheese) and 3) she really only seems to WANT 12 ounces/day. Huh. Perhaps she really DOES know what she needs...sometimes it takes a while to get it through my head.
Posted by: Betsy | August 01, 2007 at 11:44 AM
I work with alot of spanish speaking moms who use a drink called atole to increase breastmilk production. They swear by it and it is cheap.
Posted by: ann in MN | August 01, 2007 at 01:30 PM
Betsy - my daughter (who has always been small but totally vibrant and healthy) went through the same dramatic drop in milk intake at that age (two months ago). I fretted a lot, but finally decided to stop worrying (as much), since she was eating solids with good nutrition and fluids in them, and seemed perfectly happy and strong - I think a drop in liquid intake makes sense once they're filling their bellies with some other things. As long as the focus is on the milk before solids, and overall nutrition, I bet everything is fine!
Posted by: Amy | August 01, 2007 at 01:50 PM
You are amazing for working & pumping this long! I heard recently that a glass of red wine a day helps increase your milk supply....but have not tried it. Good luck!
Posted by: Tana | August 01, 2007 at 08:45 PM
I've had a low milk supply since the beginning and have supplemented with formula. However, something that did increase my milk supply was a reglan prescription...something you may want to check into.
This whole milk supply thing is a mystery to me, so a lactation consultant (as suggested enough) might be really helpful too!
My daughter dropped down to the 5% in weight gain before I gave in to supplementing with formula, and it was absolutely the right decision. She had gotten to the point where it really wasn't healthy for her, or for me. I think anything you can do to decrease the stress helps both of you in the long run.
Posted by: Jillian | August 02, 2007 at 05:36 AM
I went through the same thing when my daughter was the same age. I remember being in tears trying to pump at work and only getting a few ozs. I thought my supply was dwindling even though I seemed to have plenty when she nursed. She was also eating solids all day long and just didn't take in that much milk during the day. Unfortunately I ended up weaning at 10 1/2mos because we had started supplementing with formula and my supply really dwindled after that. With baby #2, I have more info and think we'll be able to avoid the same thing.
Posted by: Marsina | August 02, 2007 at 08:50 AM
We also struggled with low pumping supply, so our daughter has been supplemented with formula (we divide all the BM I can pump among her 4 bottles to go to daycare, then top them off with formula).
A few weeks ago my supply plummeted but then I discovered it was likely caused by my taking Sudafed for the horrible cold I got from my daughter. I've rebounded a bit but at 11 months, some days are better than others.
I have observed that my supply is better at the beginning of the week (pumping is never as good as baby!) and best first thing in the morning, so I usually pump before she wakes up. Then feed her breakfast & play for a little while before nursing, so that it's a couple of hours since I pumped. I get more in that pumping session than at any point in the day.
Posted by: Susan in OR | August 02, 2007 at 09:02 AM
I worked fulltime with my first daughter and had all the same issues, treatments and feelings. I pumped until she was 14 months old (by then we were supplementing with goat's milk) and then I stopped and just nursed when I was with her until she weaned at 22 months.
I promised myself that I would not be so hard on myself the second time around.
With Iris (now 14 months old) I work at home part time with a nanny. But get this: despite the fact that I'm with Iris a lot more, my supply started changing at about the same time--9 months and then in the last month. She's now the age Clara was when I stopped pumping and there really isn't much milk during the daytime.
So I can't help but wonder if some supply cycles are just pre-programmed. This isn't a statement of fact, but merely a musing. Perhaps for me, 9 months and then 14 months are some milestones.
I wonder if anyone has had a similar experience?
Posted by: thisKat | August 02, 2007 at 11:51 AM
I wonder if some of the stress you're having over this could be contributing? I'm glad you say you're trying to relax about it a bit. I had similar issues. I consistently have pumped about half of what either of my boys would eat. I was only working about two days a week when they were nursing for nutrition (my 18 month old still does, but I think it's more about comfort at this point!) so I would nurse more days than not. But I would just pump what I could and then use formula for the rest. I know some folks are saying to dump it, but if that's all the nanny has because you can't pump enough otherwise, it's certainly better than a hungry baby. I was lucky my boys would eat either, and when I was at home I didn't really need to use it. On occasion, but it was the exception. Frankly, it was kind of freeing to do that because then I wasn't pumping obsessed at work. Granted, it was only two days/week and not full time, but I've been able to keep up a nursing relationship with both of them as long as they're interested. It's amazing what the body will do. I hear from others who don't pump when they're at work but nurse fine when they're home. Our bodies adjust to whatever the need is. Do what works to keep her happy and healthy.
Posted by: Tracy | August 02, 2007 at 02:40 PM
I don't have time to read through all the other posts, but at 9 months, my son stopped nursing more than twice a day, morning and night. I don't know how much that was in ounces, but i know he wasn't getting much from me (and I stayed home...so working wasn't an issue). His growth did slow down a bit, but he was just moving around so much more and burning more calories.
I saw not to worry too much...
Posted by: Laura | August 06, 2007 at 10:16 AM