Judy’s Advice: Nurse On Demand For Best Milk Supply

Hi all, I have to supplement when feeding my 4 week old. I have been using the Playtex slow flow nipple and it takes him an hour to drink 3 ounces. Sometimes he can’t even get any out. Is it too soon to switch to the medium flow nipple?

(posted on MamaSource message board)

Congratulations on your new baby! If you are supplementing in addition to breastfeeding, then you will want to stick with the slow flow nipple. If you switch to a faster flow, then your baby will be more likely to get nipple confusion and will start to prefer the bottle over the breast.

If you don’t mind my asking, why do you need to supplement? I would be happy to help you get to the point where you no longer need to supplement and can breastfeed exclusively. I have written two articles to help breastfeeding moms which you can see at http://breastfeedingtips.net and http://pumpingtips.com.

I have been trying everything with a lactation specialist. I had a good supply, but a latch problem caused it to deplete. I have tried the supplement device around the neck, but saw no results. I am now pump exclusively, taking fenugreek and reglen. I am getting 8 oz. a day and having to supplement the rest.

Any advice?

Did you try using a nipple shield with your baby? Your baby is always going to be more efficient at getting your milk out than the pump is. Since your baby is so little, my best advice would be to get him to nurse directly on your breast as often as possible.

I had problems with latch with my son when he was born and the nipple shield saved us. I only recommend them as a last resort, but it may be something you will want to try with your baby. If you can get him back on your breast it will make everything easier.

Pumping and feeding is a lot of work – if you take some steps now to get him latched back on, you will have a much easier time in the long run. It may be a difficult few weeks to do it, but it will be so worth it! I went through this with my son too. My milk hadn’t come in, he was dehydrated, I tried the supplemental feeder. What we ended up doing was using the nipple shield (he wouldn’t latch without it) and then I fed him as often as he wanted to at the breast, but I never let him go more than 2 hours without eating (during the day – 3 hours at night) for about a week I would wake him to feed if he was sleeping and it had been more than 2 or 3 hours since his last feed.

This got my milk supply up and got him nursing successfully. We then kept nursing on demand and didn’t start trying to wean off of using the nipple shield until he was nursing regularly.. I also pumped after each nursing session for a week. I got almost nothing out, but the added stimulation was good for helping to build my supply. You can also go to Dr. Newman’s website and tell him you are having supply problems. He can write you a prescription for Domperidone. It is a prescription drug that increases milk supply. You can’t buy it in this country, but you can order it online from Canada. As long as you have a doctors prescription, they will send it to you. You can get a prescription from your own OB or from Dr. Newman online.

How much fenugreek are you taking? Where are you buying it? I found that the one at GNC isn’t very good, but if you buy the kind that they sell at Whole Foods (fenugreek and blessed thistle mixture) that works better. You will need to take about 3 to 4 pills 3-4 times per day. You will know you are taking enough when your skin smells like maple syrup.

My pumping tips article, that I mentioned before, is written for moms who are going back to work – but it has lots of great pumping tips – even if you aren’t worried about going back to work.

My biggest piece of advice is to stop the bottles as quickly as possible– they are hurting your supply. Read this blog post about a client of mine who had supply issues. Her Dr and pediatrician gave her bad advice and were hurting her supply.

Let me know if I can help in any other way.


6 comments to Judy’s Advice: Nurse On Demand For Best Milk Supply

  • Erica

    I always breast fed on demand…Good for the kids…I have 3..my oldest will be 10 on the 18th and my youngest just turned 6..Never got any bad reports from the dr. saying your child was under weight or over weight. I stopped nursing around the age of 1..I wish I had kept it up longer…Good for those who do.

  • A few comments!

    1. I had to use a nipple shield when I was first trying to nurse my little preemie. I think my milk was just coming out too fast for him, and he wasn’t able to nurse without it. I was having such trouble getting him to latch/nurse that finally one of the special care nursery nurses suggested a nipple shield. But, the odd thing was how “clandestine” she was about it. She even told me not to mention it to the other nurses that it was her who suggested it. Wierd. I guess the professionals have some mixed feelings about it, as it can slow down your milk supply. But, as you said, as a last resort, it can work. Overtime, he matured and was better able to deal with my let-down and/or my letdown slowed up a bit and we got him to nurse directly.

    2. Domperidone worked well for a friend of mine. Fenugreek worked well for another friend of mine. There are solutions out there!

    3. I just posted a recipe for a traditional Korean Seaweed soup that is suppposed to help with milk supply. Check it out!


    Thanks Judy!

    .. Diane

  • Ruth N.

    Good advice, Judy. I hate how many peds recommend supplementation, undermining moms’ efforts to breastfeed and ultimately hurting the children.
    And so many moms think that breastfeeding must require pumping! I never pumped even ONE SINGLE TIME with my last two babies.
    You’re right; baby is always best at getting the milk out.:-)

  • I think that what puts mums off when they express their milk is the amount of milk that comes out.Pumping for 10 minutes to find you have only 3oz, would worry anyone.Babies were designed to breastfeed,and as such they do a better job at it than any pump.Remember babies are learning a new skill too.Many takes weeks to get a better latch, and this means actually putting them to the breast.Here in the U.K. nipple shields are only ever recommended as a very last resort for cracked and bleeding nipples and no other reason to use them.Drinking plenty of water, eating a healthy diet to keep you going, lots of skin to skin and night feeds are essential to keeping up a good milk supply.Raspberry leaf tea is also another herbal tea to try.I used with all 3 of my pregnancies and carried on for 6 weeks after.This helps lactation and toning your uterus.The best way to keep breastfeeding going is to breastfeed.I never used bottles with my girls as I fought hard to get my son off his.I have a doidy cup which can be used from 3 months old.Before then use a clean spoon or egg cup.

    Aly Hodge’s last blog post..Choclate Butter Biscuits

  • Great feedback Aly! Thanks for sharing your experiences. –Judy

  • einjel

    Again, I am not experienced with this yet.. but I’m really thinking positive on breastfeeding my baby. I’ve heard tons of horror stories on breastfeeding and I truly am scared when baby comes. I’ve been searching the internet for the best breast pumps, and other breastfeeding accessories that may help when I need to start breastfeeding. I’ve bought most of them already just so I am prepared whatever happens. I bookmarked almost every site I’ve found on breastfeeding and downloaded lots of tips on breastfeeding survival. I’ve been reading a lot of articles too (that’s how I got to this very helpful and informative site). My fingers are crossed that I too will be a successful breastfeeding mom one day.

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