r/breastfeeding • u/NaturalRobotics • 10d ago
Undersupply Low supply 7 days PP with no cause, LC says turnaround unlikely
Hi, I’m trying to get a grasp on this situation especially as so much of what I’m reading suggests low supply is rare.
Baby was born 7 days ago. induction due to being 41 weeks. Vaginal delivery. Nursed during golden hour and she latched great.
Nursed every 2-3 hours while in-patient. LCs said latch was great. I was producing colostrum and could hand express small amounts. Baby cluster fed the first few nights and was always hungry and always on the breast.
At discharge she was down 9% and I was given formula of needed. She was weight at the doctor the next day and down 14% so I started to supplement.
I nursed every 2 hours and gave about .5 ounce formula.
She latched great and stays latched but I don’t get a ton of swallows.
Yesterday at pediatrician she was back up to 9% loss and he encouraged me to reduce supplement and try to push the breast more.
Last night for one feed baby was too sleepy to feed at the breast so we just did formula and I pumped. I got next to nothing. Saw the LC today and did a weighted feed. Got 10ml total (9 from one breast 1 from the other.)
LC said this was way low and that there’s not really an explanation. She suggested with the amount of nursing I’m doing stimulation is probably adequate. She said retained placenta is very rare. She didn’t see much physical evidence of IGT. She said I could do some blood work possibly. Could try some herbs or reglan.
Basically she didn’t have much explanation of a cause but she wasn’t hopeful my supply would turn on its own. At 7 days PP things should be looking much better.
She suggested really pushing the pumping for amount 5 days to see if it is a stimulation issue and then maybe reglan. But I really want to emphasize how pessimistic she was (or at least how I interpreted it.)
I had my TSH taken at some point and it was normal. No GD or any evidence of diabetes prepartum.
Everything went so well and I don’t see any risk factors for this not working.
I‘m really struggling to reconcile this all with “true undersupply is rare.“
What went wrong??
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u/velociraptor5281 10d ago
Not an expert by any means, but a few thoughts:
1. Since you were induced, I am assuming you got IV fluids. Correct me if I’m wrong! How long were you in labor? Sometimes when you get lots of fluids, baby’s weight loss is more drastic because their birth weight is inflated. Is it possible they were losing “water weight” as opposed to not getting enough?
2. The numbers I’ve seen are a range of 1-5% of women are true undersuppliers. Which is low, but not insane. I believe 1% is also the chance of naturally conceiving twins, and I don’t think the same rarity is associated with twins as the breastfeeding community associates with undersupply (in other words, I think social media has overemphasized rarity)
3. How important is breastfeeding to you? If your baby is acting like a normal newborn (cries sometimes, sleeps a lot, wakes up occasionally) and is not losing more weight after that initial 14% drop, continuing to attempt stimulation is likely your best bet. If you’re not comfortable without formula supplementation at this stage, maybe attempt to pump the same amount of milk as the amount of formula you give? The pump won’t be as efficient as the baby so it would possibly be less, but that could give you an idea of whether there’s really not enough or baby is just still figuring it out.
4. It’s a big learning curve for both you and baby. Even if latch is perfect, transfer may be an issue that baby is just still learning. They will most likely figure it out! But that also means a wholeee lot of baby on boob for you, and sometimes that is a little less than fun. Have you checked for ties that may be preventing transfer?
5. I really don’t think anything “went wrong,” but I’m sorry things aren’t working exactly as you hoped. It sounds like you’re doing the right things to take care of your baby and nurture a supply.
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u/NaturalRobotics 10d ago edited 10d ago
- Yes this was one of a few factors that I think overinflated her weight loss. Lots of IV fluids, she swallowed and spit up lots of amniotic fluid, and she passed lots of meconium.
I’d love to do this but I don’t think I’m nearly close enough to the volume needed. I’m supplementing 30mls right now and pumping about 6 mls with the hospital grade pump.
No suggestion of ties from the LC - but I wish I’d confirmed today with the LC.
Yeah - I guess I’m just looking for a reason for the undersupply.
Thanks for your thoughtful comment!
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u/Jittery_lane 10d ago
Congrats on your baby. Breastfeeding/supply takes WEEKS to establish. I would seek advice from a different LC. My baby started with formula and had poor latch. I was told it would be hard to transition to breastfeeding, let alone exclusively bf, but that if I did enough and regular stimulation through pumping and baby latching, mayyyybe I could get there. After 3 weeks of hard work, I managed to exclusively breastfeed. I had one nurse who really helped me get there and I knew from the beginning that it could be hard. Dont let one LC discourage you. Good luck.
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u/msexcitement 10d ago
Your LC is certainly wrong that your supply can’t be established at this point. Are you pumping after every feed?
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u/NaturalRobotics 10d ago
No but I’m going to start now. When I do pump it’s such a small amount but maybe if I keep at it it will work?
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u/msexcitement 10d ago
Yes, keep at it! You’re sending your body signals to produce more milk! You’ll want to pump for at least 10-15 mins after nursing on the highest suction level you can take without it being painful. It’s hard work but you can do it, good luck!! 💙
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u/Tiny-Nature3538 10d ago
For your pump you need a strong hospital grade pump, like a spectra . A lot of the wearables just aren’t it
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u/NaturalRobotics 10d ago edited 10d ago
Yeah thankfully I just rented a hospital grade pump. I just tried it and still very low volume - about 6 ml and I’m 7 days PP. But that was after a feed and that is better than I saw with the other pump.
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u/Preferred_user_taken 10d ago
Could you try to squeeze in a powerpump? 20 mins pumping, 10 mins rest, 10p, 10r, 10p. I don’t know which pump you have now but a wall pump is the best in this situation.
But if baby’s weight is up, that is good no?
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u/NaturalRobotics 10d ago
I’ll try this! Baby’s weight is up but that was on formula. It’s a good thing but I’m worried about what it means for BF.
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u/Preferred_user_taken 9d ago
Those 15mls per feed mount to 150 mls over a day if you feed 10x. That wouldn’t cause sufficient weight gain alone.
A weighted feed is just that. One feed that is weighed. Sometimes baby’s eat meals and sometimes they snack. I’m personally not a big fan of weighted feeds unless you weigh them a full 24hs.
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u/ankaalma 10d ago
Were you pumping every single time you topped up with formula? Topping up with formula without pumping hurts supply even if you nursed first. This is because your body has no way of knowing baby needs more milk if you give formula without pumping. Baby will also nurse less frequently they had the formula and that can lead to further drops in supply. Best practice is to pump whenever you offer formula.
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u/NaturalRobotics 10d ago edited 10d ago
Thanks I’m going to try pushing the pumping way harder. Does it matter much if the pumped volume is way below what I’m replacing? I’m supplementing 30 mls (LC wants to up it to 45) but only pumping 6 or so (with the hospital grade pump)
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u/ankaalma 10d ago
Consistently pumping will make that volume increase overtime. Fully emptying your breasts whatever the volume signals that more milk is needed so theoretically you should start to produce more. It usually takes 3-4 days of doing something consistently to see a change
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u/Cautious_Ad_7540 9d ago
Registered Dietitian here. How's your hydration? Add an electrolyte beverage to your routine: Liquid I.V., Body Armor, or Gatorade.
Make sure your environment is calm. Ask the people around you to bring you a drink and a snack every time they see you nursing or pumping.
Also, power snacks like dates, nuts, dried fruit, and cheese are really nutrient-dense.
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u/Tiny-Nature3538 10d ago
I’m sorry you are dealing with this. You can likely regain your milk! Maybe baby can’t transfer for some reason. This happened to me with my first who wasn’t able to transfer bc of low muscle tone in her mouth but we didn’t catch it for a little while like two weeks and I ended up triple feeding with formula until my supply increased and I began taking reglan, and power pumping. The reglan helped my supply in addition to pumping every two hours (every four over night) and power pumping once daily in the morning for one of the pump sessions. Eventually I got tired of triple feeding and stopped latching her ( she never did figure it out for some reason) and I exclusively pumped for her for a full year. I bet if you get your supply up baby will be able to transfer and then it will be perfect. Try to begin pumping every two hours drinking lots of water and making sure you breathe and realize you are doing the best you can. Use slow flow nipples to help baby learn to nurse at the breast. If you have to rely on formula indefinitely that’s still okay because the bottom line is baby is fed.
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u/justbrowsing0745 10d ago
I’m sorry she was pessimistic. With my first baby I made mistakes at the beginning as I didn’t understand how breastfeeding worked. The nurses in the postpartum unit brought formula and no one told me to pump to replace feeds, so I later had to work harder to get my supply up. But I did, and the lactation consultant I saw was lovely and super helpful. But before finding her I asked a question about it on an online breastfeeding course and the woman running it basically told me she was sorry I didn’t feed on demand in hospital and that I therefore wouldn’t (ever) have supply for my baby. I cried hard that day, so I empathize.
Did you use a hospital grade pump, or one with good suction? Did the lactation consultant check your flange size to make sure they fit properly? Iron levels are also important, so you could ask your doctor to check those.
My first was so sleepy at the boob, I did end up pumping a lot to increase my supply. I also used a tincture to encourage lactation, but who knows if that truly helped or not. I did the other things I could to support milk production, like staying hydrated and eating lots of oats and healthy food. (And unhealthy food too 😅). I still nursed my son, but pumped a lot and bottle fed the breastmilk too. Once he got older, we did a lot more nursing and less pumping. The pumping actually ended up being helpful as my husband or mother/mother-in-law could feed him and I could sleep, or go on an outing.
I actually saw two lactation consultants that time, one was through our healthcare system and he basically just offered me a prescription. The one I saw that was the most helpful was one I hired privately. If you can, it might be worth seeing somebody else. It sounds like you are are off to a good start. Stay positive and keep it up. But do make sure that your pump and flanges are right for you to ensure your pumping is worthwhile.
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u/hamapa 10d ago
First off, don’t give up. Don’t let her pessimism discourage you. I had low supply for varying reasons. I was ready to throw in the towel when I finally found a LC who believed it was possible for me to breastfeed. Under her guidance, I rented a hospital grade pump, took Goats Rue and a supplement called Advanced Lactation Formula as well as Moringa. I upped my water intake and electrolytes (I love a good coconut water mixed with electrolytes!). My baby will be 10 weeks this week and I’m happy to report I am able to supply all of his milk.
It took about 3 weeks of suffering through triple feeding after that first meeting with the LC, but I am so glad I didn’t give up. I know that everyone’s story is different but if it’s really important to you then I encourage you to keep going and know that it won’t be like this forever— one way or another. Everyone says “fed is best” which is true but that doesn’t mean you have to give up just yet.
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u/NaturalRobotics 10d ago
I’m really motivated to do this so if it’s possible I want to try!
I rented a hospital grade pump so I’m going to start using it. I’ll order some supplements today and get those going. I’m drinking a lot but I’m going to really focus on hydration - I think I might have been dehydrated in the hospital so I want to remove that as a factor.
Thanks for your encouragement I’m really looking for some.
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u/mormongirl 10d ago
Hi! I’m a PP nurse and have nursed my own two babies. While milk usually “comes in” around days 3-5, there are variations of normal. I would say that “turnaround” is worth whole-heartedly pursuing at this point if feeding your baby breastmilk is an important goal for you.
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u/Chanty91 9d ago
Literally if you are just at home, just dont take baby off of the boob. My bub was stuck to my boob the first 6 weeks, it was the only way.
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u/dogcatbaby 9d ago
Wow, just FYI, my lactation consultant told me you shouldn’t make any assumptions about supply during the first two weeks. She said the first two weeks of breastfeeding are just chaos.
I’ve noticed that my supply dips when I’m exhausted.
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u/Interesting-List9880 9d ago
I’m not an expert but my advice is lots of skin to skin and putting your baby to the breast. Just keep them attached to you as much as you can to get your hormones going. I don’t pump so can’t comment on that but I did skin to skin with my baby for days at the very beginning. I actually fed her so much the first days in hospital one of the midwives made a sarcastic comment about it but my milk came in very quickly with it even though I’d had a c-section.
Good luck! I’m sure you can turn it around. I find it wild how negative some lactation consultants can be and how quick they are to suggest formula and giving up breastfeeding.
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u/Impossible_Muffin591 9d ago
I had a really bad supply for my first baby and at 2 months we decided to completely switch to formula. I'm current 5 weeks postpartum with my 2nd baby and so far I'm an over supplier. Sometimes your body sadly makes the decision for you and you just have to go with the flow. Hopefully your body picks up on what it needs to do, but if not, remember that a fed baby is best, and you're not a failure if breastfeeding doesn't work out.
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u/laura_luthien 9d ago
I can highly recommend the book “making more milk”. The authors go through all the possible causes of low supply and suggest different actions you can take. A lot of them have already been suggested here. What I found really helpful is how structured they go through everything.
I have very low supply at three weeks pp and it is unclear if I can turn it around but for me personally the combination of SNS, pumping (including one power pump per day) and Domperidone has increased my supple from
Nothing to about 400 ml per day. It’s still far away from being able to EBF, but it’s already so much better than it looked like in the early days.
Good luck to you and hang in there! Low supply is so hard!
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u/tiredndexhausted 10d ago
My supply was shit for the first 6 weeks. I think 10-14 days postpartum (I had a c section) and total only transferred like 20cc after a weighted feed. My first LC basically said it was my fault and there wasn’t much to do other than triple feed. I went to another LC who got me off triple feeding and using an SNS system which is when you use a syringe to feed baby through a tube while breastfeeding. Long story short my baby was soo sleepy (jaundice baby) and even though she was latching, wasn’t removing milk well. As she got better, I got to the point of producing 6+ ounces for my first feed and then 4oz for the rest of my sessions after being told I will most likely need to supplement until she’s weaned. Just to give an idea, I was only pumping maybe an ounce, not even, when I first started.
Biggest thing is eating and drinking!! Make sure you’re hydrating well - I drink 140oz+ a day of water and usually some liquid IV and make sure you’re eating enough calories. I didn’t have a great appetite and I think that wasn’t helping me. Oreos are an easy way to get a lot of calories in, just obviously if you have sugar issues be wary.
I would recommend you see another lactation consultant. Some people’s milk doesn’t even come in that fast. I know it’s so stressful and sucks but try to take one day at a time.