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Breast Feeding

Breastfeeding difficulty

03/13/2007

Question:

My baby is 2 1/2 months old and has been only breastfed except for a brief period of 5 days where I supplemented formula. It seems that it has been nothing but an uphill battle. When I gave birth, I lost almost half my blood and had to have a hystorectomy. I was told that it would probably have an effect on my breastmilk. It did come in, but not enough, so I`ve been on Domperidone for almost a month. It helps a bit with my production, but breastfeeding is still such a challenge. My baby really isn`t content during the day and is very colicky. Those five days of bottle feeding (breastmilk and formula) were the most peaceful we`ve had. I`m trying to perservere through the trouble, but it is getting tiring. She only nurses properly from one breast, because the other one produces very little milk, so I am really lopsided now. I`m considering supplementing the formula again, but trying to nurse as well. My mom suggested just give one bottle a day and then nurse the rest. What kind of effect will this have? Also, what kind of formula should I supplement? She has a very sensitive tummy, and I am really allergic to milk, so I think it should be lactose free. Any ideas would be helpful. And also any tips on how to even my breasts out, it`s really noticible. Thanks

Answer:

Your 2 1/2 month old baby is very fortunate to have such a dedicated mom.

It is indeed true that significant blood loss at delivery can decrease pituitary hormonal production because of temporary decrease in blood flow to the gland, but it usually recovers nicely with a blood transfusion, which I assume you must have had. If you are no longer anemic, then the hormonal problem should be almost completely recovered, depending upon how low and for how long your blood count was down.

As for your milk supply, it would help to pump after all feeds, and to use your pumped milk to supplement the baby if she is still hungry after breastfeeding. The sequence should be: Breastfeed, bottle feed, and then pump. That way you will have milk available for the Next feeding, that is, try to stay one pumping session ahead, so that your baby can be sleeping while you pump. As long as you always breastfeed first and pump after all feedings, the bottle feedings will not interfere with your milk production or your baby's ability to breastfeed. If you are not yet producing enough milk to satisfy her, it is OK to add a little formula to the pumped milk.

As for the breast asymmetry, you might try feeding the baby first on the smaller side, pumping the smaller one for 5 extra minutes each time you pump, and including at least one night-time pumping session.

To further enhance your milk production, try to nap for at least an hour each afternoon, and be sure to vary your beverages to include juices and Gatorade and the like, and not too much water.

As for her sensitive tummy, she is probably allergic to milk just as you are, so the best formula to supplement with would be a soy formula such as Isomil or Prosobee. You yourself should avoid all dairy products including cheese, yogurt, etc. Soy products should be OK, unless you know you are allergic to soy as well as milk.

Best of luck, and feel free to write again if you have any further questions

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Response by:

Jeanne L Ballard, MD, FAAP, FABM Jeanne L Ballard, MD, FAAP, FABM
Professor Emeritus, Pediatrics, Obstetrics and Gynecology
College of Medicine
University of Cincinnati