Supply Management

I can’t stop thinking about milk production, so I thought I might as well write about it. Though my supply is low, I still could continue nursing Alya into toddlerhood, and that is my current goal. To do that, I will need to maximize and maintain my existing milk supply. And to do that, given the barriers I’ve faced, I’ll need to be conscious and proactive. I’ve realized that there is no one who cares as much about my milk production as I do, and no one to monitor my actions or create a program for me – I need to do it myself. Wow … this is what motherhood is like!
To that end: these are the activities/supplements/foods that will maximize milk production:

Activities: Feeding on demand; breastfeeding before supplementing; use of an SNS system; emptying my breasts at least every 3 hours; pumping/expressing milk, especially at night when prolactin levels are higher; skin to skin contact.

Foods: lots of water/hydration; nursing or fennel tea; protein; iron; dark/leafy greens; other galactogogues including oatmeal, macadamia nuts (chosen at random from the list – one of my favourites!), and others; and eating lots and regularly.

Supplements: fenugreek; blessed thistle; goat’s rue; probiotics.

Medication: domperidone; possibly natural progesterone; possibly thyroid boosting supplements.

So how am I doing? In terms of activities: I do feed on demand and breastfeed before giving her a bottle. I’ve given up on the SNS as too cumbersome and I feel so negative about it that it taints my entire feeding experience. I do empty my breasts every few hours with the exception of her longer sleeping stretches at night (sometimes up to 6 hours – I’m not going to set an alarm to wake up!!). I either breastfeed and compress until it’s clear there’s no milk left; or express extra after. If I express, there’s usually less than half an ounce total that comes out. I could make a point of expressing more regularly and systematically. And I could boost skin to skin contact – it’s just so convenient, especially in colder winter weather, to dress her and myself in the morning rather than wandering around naked all day. We usually do skin to skin at night, though.

Foods: I need to drink more (which means drinking a glass AND filling a glass before I nurse each time). I need to eat more – which means more menu planning and putting snacks by the bed at night again. I also could print out the list of galactogogues as a reminder of good foods to include in my diet.

Supplements: I don’t know if these work, so I don’t know if it’s worth the money to keep using them. I do want to try goat’s rue, which isn’t widely available in BC, but is supposed to help build breast tissue – my main need. I will use up the fenugreek & blessed thistle that I have.

Medication: similarly, I don’t know if the domperidone is working. I stopped taking it a couple of days ago because it was becoming too hard to time it and I missed some doses (I learned you’re supposed to take it 30 minutes to an hour before baby nurses. That’s like directions to get off the bus one stop before I do. We’ll see if I notice a change in milk availability). The doctor is testing my progesterone levels so we’ll know if I should continue with the natural progesterone. And he’s checking my thyroid, pituitary, etc. so we’ll know if there are any other interventions I should try.

My milk supply has seemed lower in the past couple of weeks than it was previously: less gulping, needing to supplement through the night again. This is discouraging, of course, and also incredibly hard to track as there are so many factors at play. I may go back and try acupuncture again as the nursing-only through the night started up after my third acupuncture visit. The gulping was before that, and during it as well. Who knows?! I wish there were a way to know for sure what to do, but I will just have to do my best and live with the results.

In the meantime, sweetest baby is sleeping on my chest in a new kangaroo wrap we bought the other day (finally used up our Toys R Us gift certificates – wrap, bottles, bags). She is adorable, smiley, healthy, gorgeous and a wonderful person. At some point we’ll be supplementing with real food, and eventually – within a year, most likely – will not be supplementing with formula or donated milk at all. And I should be able to continue to nurse my sweet girl beyond that, giving her ongoing benefits from the milk I can supply. Though it could be a lot better, things certainly could be worse.

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