[louisouis]

I had been breastfeeding my son for the past 3 weeks. As he had jaundice, the hospital recommended that I supplement my breastmilk with formula. And since then I had been feeding him breastmilk followed by formula... but I seem to have a rather pitiful amount of breastmilk, i usually breastfeed straight from the breast but when I pump, I noticed that my milk supply is a rather sad 10 ml for both breasts (combined)! I understand that breast milk is based on supply and demand and I might have jeopardized my supply by supplementing with formula... what can i do to remedy this?
Cutting out formula is not an option as I am worried that my baby will not gain the appropriate amount of weight. Please help!

[LLL_Sarah]

In order to build your supply up you need to stimulate your breasts more. There are basically two ways to do this. The first is to get the baby to feed more at the breast and the second is to pump or hand express (as well as breastfeeding) until baby is drinking enough at the breast.

You need to be pumping at least eight times a day (in 24 hours). This is an average of every three hours, usually we suggest every two hours during the day and every four hours at night.

How you give the formula milk to your baby also makes a big difference. Bottles are likely to make breastfeeding directly much harder, especially when your supply is low because the flow of milk is slower than the bottle. This means that the baby has to work harder at the breast to get the milk and usually they are unwilling to do this after getting used to the faster flowing bottle.

There are other methods of giving the formula, for example, cups and spoons. These avoid the faster flow at the bottle problem but they still as not helping you stimulate your breasts.

The best method to stimulate your breasts and give the baby formula is by a lactation aid. Dr. Jack Newman has a video of a lactation aid at work on his web site at http://www.breastfeedingonline.com/newman.shtml
The video is under the heading At-Breast Supplementer. With this lactation aid the baby can get the formula, learn to breastfeed correctly and stimulate your breast all at the same time.

If you can I’d get help from a lactation consultant or LLL leader. They will be able to review your positioning and latch-on technique and also show you how to use the lactation aid.

To contact me call 2548-7636 or e-mail sihung7@netvigator.com

There is a story called Nursing Della in Late-year 2005 (Vol.6 No. 3) issue of Close to the Heart available at http://www.lllhk.org/Publications.html which talks about using a lactation aid. This story is actually about adoptive breastfeeding rather than building your supply back up.

Best wishes,
SARAH

[Frenchy]

Hello Louisouis,

Hospitals recommend a bit too quickly to complete with formula... They did with my son and I refused, hopefully !
You can drink Mother's Milk tea, fennel tea, and I've had the breastfeed mix made with plants at IMI (Stanley Street in Central, Kailey Tower 17F), it's been working really good !
Keep on pumping, even after each feed. As soon as your milk supply is back to normal, there is no reason to go on with formula if it's not your wish.
You can also have a look and contact someone at The Leache League (www.lllhk.org).
Good luck !

[peainpod]

There is a lot of pressure in bfing moms to supplement when their babies are diagnosed with jaundice. I had the same thing happen to me too, where my paeditrician wanted me to pump one breast to test how much milk I was producing as he said that if I didn't have enough, I would have to consider supplementing. Luckily I had enough so we didn't have to explore that route but doctors/hospitals do tend to worry about jaundiced babies not gaining enough weight - and I guess one quick-fix way is to fatten them with formula.

[Buckeroo]

My second baby had severe jaundice (where they got blood from me just in case we had to have a blood transfusion) and I had to supplement with formula while she was at the hospital, but the nurses were given instructions to feed only with a cup or a Haberman feeder. I was there at the hospital during feeding times to b'feed directly and then at home I would pump some more, but at the early days, it wasn't enough. When we got her back home, I went back to b'feeding exclusively --feeding on demand --at least every two hours (12x a day). Because I was b'feeding, it did take a while for the bilirubin level to get back to normal levels (over 1.5 months) and she looked yellow for quite some time, but regular check ups showed that she was out of the "danger" zone and that she was gaining quite steadily.

She's 11 months now and I'm still b'feeding exclusively. My supply went down a few months ago because I was hospitalized, but with the help of fenugreek capsules, I'm able to get back on track. Like what Sarah said, best way to build up the supply is to get the baby to directly b'feed more.

With my first one, new mom and all, I very quickly supplemented with formula; I wish I had "trusted" more that my supply would build up by directly b'feeding, because it really works, as I found out with my second one. It's hard to tell how much baby is getting if one b'feeds directly and as a new mom it was easy to second-guess and err on the side of caution (esp. if you have well-meaning family members around you telling you each time the baby is crying that she's hungry!).

Sorry for the long post... but good luck. Check with a lactation consultant or attend one of the LLL meetings/tea breaks. Not only will you get expert advice, but you will also get the support (very important!) you need to keep breastfeeding.

[arismom]

Buckeroo,

Where did you get the fenugreek capsules from?

Thanks

[Buckeroo]

I got them from Health Quest Pharmacy (CitySuper Times Square- Lifestyle Section, next to the supermarket). It's HK$168per bottle (90 capsules), but you get a 10% discount if you have a CitySuper card.

[buddhafun]

I agree-Fenugreek does the trick. I took 12 capsules the first day and 6 the next, as advised by my son's pediatrician. Also, you should try doing about 5 minutes on each breast, this really stimulates them. Avoid formula. The more that he nurses, the more you will produce! Good luck!