January 9, 2018
Increasing Low Milk Supply and Best Formula Options

Sharing my story of low milk supply, ways to increase milk supply and best formula options. 

As a Registered Dietitian, I should have known better. I should have known that my child was starving, that my breasts weren’t producing any milk. I should have known that I didn’t have the usual symptoms when milk is supposed to come in. I should have known that his lack of wet and dirty diapers those first few days meant something was wrong.

I was blissfully unaware that while Vander latched well and while two different lactation consultants gave us the thumbs up in the hospital, my body wasn’t producing enough milk. Or, much milk at all.

It wasn’t until we were standing in the pediatricians office on day 5, discussing how much weight he had lost and how dehydrated he was that I came face to face with reality. I wish I knew then what I knew now. I wish I could comfort that new mama who was sobbing uncontrollably that it was going to be OK. That her sweet son was going to thrive, gain back the weight quickly and assure her that you don’t have to have a full supply to have a nursing relationship.

And that’s why I’m sharing this post today. This deeply vulnerable and personal post. To let other moms know that it does get better, it is OK and that it’s not your fault. The reminder that low milk supply isn’t uncommon and to provide tips for increasing. To offer a safe space when yet another stranger comments on feeding your infant out of a bottle. And, to provide my thoughts on formula options.

It’s been three and half months since my breastfeeding hopes and dreams came crashing down on me and I’ve learned so much in the process. I’ve learned that love is not measured in ounces, that I’m still a great mom even if I cannot nourish my child exclusively and that we moms are sometimes our own worst enemy when it comes to laying on the guilt.

In the first week of pumping 8-10 times a day. What I would normally pump in one session.
After trying all of the remedies below, what a pump session looks like for me now.

Low Milk Supply

I’m still sad. While I’ve dealt with so much of the guilt, some of it still lingers when complete strangers question my feeding choices or when my son screams in frustration for not being able to get enough milk when he nurses.

Like most women, I wanted to breastfeed so badly. I had visions of nursing Vander until he wanted to stop; like my sister did to both of her kids until they were almost 2 years old. I wanted to nurse him when he hurt himself; providing my motherly comfort that nothing else could replace. I wanted to give him all of the immune benefits that I knew breastfeeding provided.

For reasons that I’m not quite sure of, I’ll never have a full milk supply. If you’re looking for answers, I don’t have them– but I do have possibilities. Through my experiences and talking with almost a dozen specialists, I’ve learned that low milk supply is likely due to a handful of reasons:

    • Retained Tissue

      Delivering the placenta is what triggers your body to produce more of the hormone prolactin, which is responsible for milk supply. While this is very uncommon, my placenta didn’t detach correctly and I needed surgery two weeks after Vander was born to remove it all. An ultrasound can detect if you have any retained tissue.

    • Hormones

      Apparently, those who have had trouble getting and staying pregnant will likely also have problems with milk supply. I know, it’s not fair. For this same reason, PCOS women may also have trouble with supply.

    • Insufficient Glandular Tissue (IGT)

      I didn’t even know this was a thing until a lactation consultant placed her fingers between my wide breasts and told me that I likely didn’t have enough glandular tissue to make milk. While IGT can look different in all women, if you are having trouble with milk supply, I recommend speaking to a lactation consultant about this. There are a few herbs you can take that help promote glandular growth. More on that below.

    • Hypothyroidism

      If you have a history of thyroid issues, you could also face difficulty in your supply. My thyroid levels were great throughout my entire pregnancy, even though they were low before getting pregnant. If you do have thyroid issues, there are a few herbs you’ll want to stay away from (more below.)

These are just some of the reasons that were brought to my attention on why I couldn’t produce enough and I’m sharing them with you in case you were searching for answers. I know I spent countless hours and meetings with specialists trying to find some reason for why this was happening.

Ways to Increase Supply

This is by no means an exuastive list, just some of the things I’ve done and what has helped me. To my fellow mama’s who are searching and hoping, I suggest discussing all possibilities with your lactation consultant and following your gut. From my experience, some LC’s are better equipped to handle low supply than others. If you don’t think you are getting the support you need, it’s OK to see someone else.

The combination of these items allowed me to go from pumping ~1/8 ounce per session to almost an entire ounce per session.

  • Herbs

    This is where I would generally recommend starting as there are many herbs that have a galactogenic effect. Some are better than others.

    • Fenugreek: According to my LC, you’ve gotta take enough fenugreek to smell like maple syrup, anything less might not be helpful. Do not take fenugreek if you have thyroid issues as it may decrease supply. I took fenugreek almost exclusively during the first week and it did help me. Though I recommend a combination of fenugreek and blessed thistle for maximum results.
    • Blessed Thistle: This herb is usually recommended along fenugreek and I found that the combination of the two was more powerful than either by themselves.
    • Goat’s Rue: If you think you have IGT, this is an herb I would definitely recommend as it’s one of the few that promotes glandular tissue. The tincture is more potent then the pill, though it’s pretty nasty. If you can tolerate the idea of a tincture a few times a day, then start there. If not, get the capsule. (This one combines goat’s rue, blessed thistle and fenugreek.)
    • Go Lacta: This branded supplement contains malunggay, another herb that helps. My lactation consultant recommended this one, though I didn’t see a big difference between Go Lacta and the combination of Fenugreek and Blessed Thistle.
  • Pumping

    I hate pumping. Hate it. I don’t know if it’s because I’m resentful or the fact that it feels like a torture device, but this was the worst for me. In the beginning, it was recommended to do a triple feeding: breastfeeding, bottle feed and then pump afterwards to increase supply. I’ll be honest, during the few weeks that we kept this schedule, I thought I was going to go crazy. The time it took to triple feed felt like an all day affair and eventually, I gave up on this practice. My sanity is worth something too. What did help was power pumping in the evening and morning. I’d pump for 15 minutes, take a 10 minute break, then pump for another 10 minutes. I still occasionally do this, though not as much as I should. Not pumping as often hasn’t increased my supply, but it hasn’t decreased it either. I’m at the place were I’m OK with what we’ve got. I can still latch Vander a few times during the day and he still prefers to nurse throughout the night. That, at this point in time, is perfect. I’m not stressing over a pumping schedule and I’m still getting the bonding benefits of occasional nursing. I know he’s only getting a small amount at each feeding and that’s OK. It’s really more about the connection then it is about the nourishment.

  • Chiropractor

    This was recommended to me by my doula and I’m so glad I went. Apparently, if you have muscle tension in your chest wall, that can effect milk letdown. I noticed a slight difference in my supply right after I saw her. If you do go this route, find a chiropractor in your area who specializes in lactation and pregnancy.

  • Domperidone

    I don’t feel comfortable recommending this, but I’m putting it out there as a possibility. Domperidone is a prescription drug that is illegal in the United States but available through an online pharmacy. I know, how sketchy does that sound? When I told BL that I ordered a prescription drug through a Thai pharmacy, I think he tried a hundred different ways to make me see my crazy. All I saw was my desperation. I’m putting this here because of all the things I tried, this worked the best. Some women have stories of being able to produce a full supply, which is incredible. Currently, I’m almost pumping 1 ounce at a time and am able to nurse Vander when he wants it with this medication. I’m still not producing as much as I’d like, but it’s enough to make a difference.

  • Boobie Bars

    I love these vegan bars! They are made from natural galactagogues (milk-making ingredients) and are dairy and corn-free. The oatmeal chocolate chip one is my favorite. At one point I was taking 16 pills of domperidone a day plus 12 fenugreek and blessed thistle pills and a tincture of goats rue three times a day. Phew. Along with pumping 8-10 times a day and it was all I could do to remember to take these pills. I love that the boobie bars replace most of the supplements in one easy bar. Though they are a little higher in sugar than I’d like, I love how they contain so many beneficial herbs in one easy snack.

  • Assess lip/toungue tie

    Remember mamas, it might not be you after all. No matter what you try, I recommend getting your baby’s latch and possible lip/tongue tie assessed as either of those will affect supply. We didn’t have these issues, but I did take him to a specialists just in case as it helped many of my friends.

  • Dark Beer

    My personal favorite. My sweet doula brought us some yummy chocolate stout the first week home and I drink a small glass on nights I plan on power pumping. I can feel a difference in my letdown on evenings I allow myself to have a little dark beer.

Formula Options

As a dietitian and a new mom, I must have been put on some PR company’s formula list as we received so many samples in the mail before Vander was born. Of course, I planned on exclusively breastfeeding and gave all of the samples to the Food Bank, assured that I wouldn’t need them. In all my years of working with new moms, I didn’t realize how common low milk supply actually was.

My first job after my Master’s was at a WIC program, where I taught the many benefits of breastfeeding and repeated to so many women that “breast is best.” I’m sorry. I had no idea the struggle that breastfeeding can take. I had no idea that even after trying everything to increase supply, it doesn’t always work. I’m sorry for judging you for giving your baby formula and for trying to convince you to try harder.

If you’ve read this far, then you can likely guess that I make nowhere near the amount to fill Vander’s needs. The first time I fed him formula out of a bottle, I cried so hard that BL had to take over and finish the job. In fact, I think I cried every time I fed him formula for at least the first week. I was grieving the loss of the breastfeeding picture in my mind, convinced that I was causing my child harm.

As my dear friend Jill reminded me over and over again- formula is not poison. We are nourishing our children the best way that we can and I refuse to feel any more shame in my path. However, after doing lots of research and talking with many pediatric RD colleagues, I can asses that some formulas are better than others. I won’t call out specific brands by name, but many of the formulas that are available usually contain corn syrup as one of the first ingredients, which didn’t feel right to me. The ones I’ve selected below are all organic and free from corn syrup, pesticides, herbicides, GMO ingredients, hormones and antibiotics.

HiPP: This is the one we eventually settled on and have been using exclusively over the past month. We source it from Europe and I like the fact that it’s organic, starch-free (if this is important to you, some versions are and some versions aren’t), only has lactose as a sweetener (no corn or brown rice syrups!) and contains both pre- and pro- biotics (again, some versions do and some don’t.) It doesn’t smell, doesn’t stain clothes and mixes in seconds– even in cold water. (This is the specific one that we use which is starch free and contains pre- and -pro biotics. If you order from MyOrganicFormula, you can use my referral code here for 20% off your order)

Lebenswert: I bought both Lebenswert and HiPP as a trial to see which one Vander took to best. They are very similar, with Lebenswert being biodynamic as well as organic. In the end, we ended up choosing HiPP as it was a little less expensive, which could add up over time. Both of these products are great.

Baby’s Only Organic: I know that this is marketed as toddler formula, but I’ve been assured by a few pediatric RD’s that they do this because they believe that only breastmilk is best for the first year. I like that this can be found in the United States (we got ours at Whole Foods) and was the first formula that we introduced Vander to. It does take a little longer to mix than the HiPP or Lebenswert versions and does contain brown rice syrup as a first ingredient, which is why we ended up going with the European brands instead.

All of the options I’ve listed here are cow’s milk, which was a tough decision on my part. BL and I don’t drink cow’s milk and while we do eat cheese and yogurt occasionally, we try and follow a mostly plant-based diet. I didn’t think I was going to introduce cow’s milk to Vander until later in life, and here I was giving him a cow’s milk formula on day 5. However, I couldn’t find a soy formula that didn’t contain other questionable ingredients so I eventually settled on a cow’s milk formula.

Three months in and I’m completely at ease with my decision. I’ve become somewhat of a formula champion, helping my other friends with similar issues determine which brand to go with. I feel confident that we are making the best decision we can with what we’ve got. While I will likely always have some sadness that I wasn’t able to breastfeed Vander in the way that I wanted, it’s OK. I gave it a fair shot and in the end, exclusively breastfeeding wasn’t what was meant to be for us.

Whatever decision you make, know that it’s done with love. If you’ve read this post, then I know you too are searching for answers, which alone makes you a great mama. It’s a tough world out there, with so many internal and external judgements. Try and ignore them. I may be a new mama, but I know this: as long as it’s done through love, it’s usually the right approach.

xo

 

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Alex Caspero is a Registered Dietitian, Plant-Based Chef and Yoga Instructor. She aims to cut through the nutrition noise by providing real-life, nourishing tips for body and mind. Learn more about Alex.

7 comments
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  1. Every case is different for sure!! For me there was something about more skin to skin contact, especially in the beginning. I found that baby wearing and cosleeping told my body to produce. Also, my lactation consultant measured and pumping never supplied as much as actual nursing. She said “the body knows plastic from baby”. Not saying this will solve andythibg but just some ideas for anyone struggling.

  2. Within 24 hours of starting “Healthy Nursing Tea”, my milk increased substantially! When I was getting a half an oz to an oz from each side when I pumped, after a feeding, now I get 2-3 ounces! It’s great for building a freezer stash!

  3. Thank you so much for sharing your story. I had a baby girl in July 2017, and my milk was very slow to come in – likely because she was almost three weeks early and delivered by c-section because she was breech. I was lucky that it eventually did, after six weeks of supplementing with formula, trying every tincture in the book, constant pumping (oh, how I hate the pumping!), feeding baby with a syringe and tubes, and eventually starting domperidone. Our girl was very slow to gain, and was in the third percentile for weight for a long while, and it was all extremely stressful. I also built up a sleep debt that really affected me for months afterward.

    All to say, while breastfeeding is the ideal, I wish it was better understand that it’s not easy for everyone and posts like this really help. We were lucky that our midwives and doctors really stressed that FED is best.
    Good for you for taking care of yourself and stopping the pumping madness earlier than I did – I think it would have saved my sanity in the months following had I done the same. And finally, I’ve had the same results with domperidone! Fortunately, it is legal here in Canada, and was really key to bringing in my milk supply.

  4. I totally teared up reading this. Thanks for sharing these intimate details…I too thought I was going to have a wonderful breastfeeding relationship with my daughter. Fast forward to her having to be resuscitated at birth and spending. 4 days in NICU. She wasn’t placed on my chest when she was born and we didn’t get to attempt breastfeeding like I had envisioned…until days later. And when we did she was hooked up to monitors and we weren’t allowed to be “aggressive” just let her “nuzzle” per the neonatologist. We were then given the choice to either keep her hooked up to an IV for days until my milk came in or wean her off the iv/ give her formula in bottles so we could take her home. My heart broke but I chose formula in bottles bc I wanted to bring her home now, not in a few days. Before discharge, We had one session w a LC who told me to breastfeed her then give her 15mls after if she was still hungry. At home, My baby was having a hard time latching, even with a nipple shield, and would suck down the 15mls of formula and scream for more. I remember pouring the formula into a bottle thinking I can’t believe I am giving my kid formula! Our attempts to directly breastfeed didn’t seem to satisfy her. I was supposed to breastfeed five minutes then bottlefeed pumped milk. Unfortunately, those five minutes were often torture for us both. Baby in tears because she couldn’t draw milk out or latch well and Mom in tears bc I couldn’t fix the situation. Eventually, though, I was slowly able to switch to complete pumped breastmilk-maybe within a week or two. However, I had to pump every 2-4 hours which was a challenge w a newborn. Fast forward ten weeks and I am still exclusively pumping. We saw four LCs , a baby chiropractor, but my baby still wouldn’t latch well (no tongue or lip tie) and when she did, the majority of the time she couldn’t draw enough milk out to be satisfied. The last LC i saw recommended exclusively pumping to make it easier on us both. So now I’m pumping five times per day and make enough to feed her and freeze a bit. But like you, I did have to mourn the breastfeeding relationship we didn’t get to have. We still try here and there. Sometimes it works, sometimes it doesn’t and it may be more for me than her. I have accepted this is how it is for us and am grateful I have enough milk to feed her even though It isn’t in the way I wanted. I too am sorry for Judging any other mother for not breastfeeding. I now know some times it just isn’t possible and yes, formula isn’t poison. I will never say breast is best again as I now truly believe fed is best.

    • Ah Rosey, thank YOU so much for sharing your story. I really think that’s what it’s all about- and what motivated me to tell mine. Even though it’s personal, even though it still sometimes hurts- it’s beneficial to share the struggles and the success. I’m so glad that you’ve found a solution that works for you and her. At the end of the day, that’s really all that matters. Hugs! Alex

  5. We adopted so breast milk was ultimately not going to happen. The hospital had Similac which Sam loved but soon had a ton of tummy trouble. We found the Lebenswert and it was the best thing ever!!!! The doc said to give him the sensitive but when corn syrup is the first ingredient, I’m not having it. Thanks so much for sharing your story!!! Lots of friends I’ll be passing this on to!

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