Tell me it will be okay (pumping related)

[oswin]

I'm stressing about my pumping output. I've been struggling to keep up with DD's intake since she went to daycare four weeks ago. She's 3.5 months old and just had a big growth spurt last week. I was able to keep up with her last week by pumping 4 times a day of 20min on, 10min off, 10-15min on. It was 3x during the work day and then once before bed. By Friday, my supply had increased significantly and I only needed to pump 3 times (yay). She's now eating 19-21oz in the 8.5 hours she spends at daycare (up from 14-15oz two weeks ago). Yesterday I was an ounce short, and this morning I'm already 2oz behind what I need. It's so frustrating and upsetting to be so short. I have something like 100oz of freezer stash, so I have some cushion, but I don't want to just run through it.

Anyway, I suspect my recent drop in supply is due to illness and lack of sleep. I had a fever on Friday and have had a bad cold since. I also haven't been getting as much sleep the past couple of nights. Do you think my supply will bounce back as I get better and get more rest? Has this happened to anyone else? Logically I know that it's okay if I have to supplement with formula, but emotionally I'm not ready to give up just yet. 

[AmyRI]

19-21 oz in 8.5 hours is an overfeeding problem, not a supply problem, assuming she is still nursing a reasonable number of times when you're together. Reasonable meaning 2+.

eta: Hit submit too quickly.

Yes, your supply will likely bounce back if you're well again and you keep up with pumping and nursing. 

Look at milk supply (highs and lows) on a weekly basis, not daily.

And I always pumped less at the beginning of the week, after having nursed on demand all weekend. I know my kids ate more when bottle fed, and I pumped more than I would have nursed when together, so I was making more after 5 days of pumping and they ate less when just nursing from me on weekends. It was an obvious pattern when I started actually tracking output in an app.

[Jalapeñomel]

Wow, she's eating a lot at daycare. Is that what she ate when you were at home with her?

Edit: I see from AmyRI's post above that babies eat more from the bottle than the breast.

[oswin]

Feb 18, 2014 12:06:43 GMT -5 AmyRI said:

19-21 oz in 8.5 hours is an overfeeding problem, not a supply problem, assuming she is still nursing a reasonable number of times when you're together. Reasonable meaning 2+.

I was wondering about that , but according to this chart it's about right: www.best-breastpumps.com/Milk_Intake.htm
DD weighs just under 14.5lbs, so according to this she should be eating 38.5oz per day. She only nurses 3x per day - when she wakes up in the morning, right before bed, and usually once in the middle of the night. 

[countthestars]

I agree with AmyRI, that seems like a lot especially for a 3.5 month old. Is your provider doing paced bottle feedings? Kellymom has a great explanation of how to do it.

[oswin]

Feb 18, 2014 12:06:43 GMT -5 AmyRI said:

19-21 oz in 8.5 hours is an overfeeding problem, not a supply problem, assuming she is still nursing a reasonable number of times when you're together. Reasonable meaning 2+.

eta: Hit submit too quickly.

Yes, your supply will likely bounce back if you're well again and you keep up with pumping and nursing. 

Look at milk supply (highs and lows) on a weekly basis, not daily.

And I always pumped less at the beginning of the week, after having nursed on demand all weekend. I know my kids ate more when bottle fed, and I pumped more than I would have nursed when together, so I was making more after 5 days of pumping and they ate less when just nursing from me on weekends. It was an obvious pattern when I started actually tracking output in an app.

Thanks for the insights.

[cilantro]

Feb 18, 2014 12:12:55 GMT -5 oswin said:

Feb 18, 2014 12:06:43 GMT -5 AmyRI said:

19-21 oz in 8.5 hours is an overfeeding problem, not a supply problem, assuming she is still nursing a reasonable number of times when you're together. Reasonable meaning 2+.

I was wondering about that , but according to this chart it's about right: www.best-breastpumps.com/Milk_Intake.htm
DD weighs just under 14.5lbs, so according to this she should be eating 38.5oz per day. She only nurses 3x per day - when she wakes up in the morning, right before bed, and usually once in the middle of the night. 

This chart is crazypants.

[Deleted]

I don't know if I would say it's an over feeding problem since both of my kids were/are big eaters, but that is on the higher end. How soon after you pick up can you feed her? And when is she getting her last bottle? Can they drop that one and just wait for you?

DS takes 20 oz while I'm away, but I'm gone 11 hrs.

[elocrates]

I'm not certain that 20ish ounces in 8.5 hours is necessarily overfeeding, especially if she is going through a growth spurt. My DS3 took 15-20 ounces in 9 or so hours at daycare from 3 months on.

Regarding your supply, I can only anecdotally say that I had major supply dips (half, sometimes less) each time I was sick or work got busy and I had to pump less. It always rebounded within a few weeks. I really had to up my water and calorie intake and make sure not to miss my last pumping session.

Regarding supplementing with formula, of course it is okay (as you mentioned). The supplementing itself shouldn't further decrease your supply as long as you keep up your pumping schedule and don't use the formula to replace a pumping session (but simply to make up the difference while you are ill and your supply is temporarily down).

Hugs. Pumping is hard. And I hope you feel better soon.

[AmyRI]

Feb 18, 2014 12:12:55 GMT -5 oswin said:

Feb 18, 2014 12:06:43 GMT -5 AmyRI said:

19-21 oz in 8.5 hours is an overfeeding problem, not a supply problem, assuming she is still nursing a reasonable number of times when you're together. Reasonable meaning 2+.

I was wondering about that , but according to this chart it's about right: www.best-breastpumps.com/Milk_Intake.htm
DD weighs just under 14.5lbs, so according to this she should be eating 38.5oz per day. She only nurses 3x per day - when she wakes up in the morning, right before bed, and usually once in the middle of the night. 

No no no - that webpage is awful.

Average intake for a breastfed baby is 25 oz, range of 20 to 30 oz and this DOES NOT CHANGE based on weight. It might be less as a newborn, but by 3+ months it remains basically steady. 38 oz is way overfeeding!

[oswin]

Feb 18, 2014 12:16:12 GMT -5 AmyRI said:

Feb 18, 2014 12:12:55 GMT -5 oswin said:

I was wondering about that , but according to this chart it's about right: www.best-breastpumps.com/Milk_Intake.htm
DD weighs just under 14.5lbs, so according to this she should be eating 38.5oz per day. She only nurses 3x per day - when she wakes up in the morning, right before bed, and usually once in the middle of the night. 

No no no - that webpage is awful.

Average intake for a breastfed baby is 25 oz, range of 20 to 30 oz and this DOES NOT CHANGE based on weight. It might be less as a newborn, but by 3+ months it remains basically steady. 38 oz is way overfeeding!

Ah, okay. I was having a hard time finding guidelines on how much she should be eating, and the chart did seems to align with what she's been eating. On a normal day at home, she'll eat every 3 hours - 7am, 10am, 1pm, 4pm, 7pm, then once in the MOTN, around 1 or 2am. She's at daycare from 8:45am to 5:15pm, so I normally send 3 bottles. Before the growth spurt, she was taking 140ml (just under 5oz) per feeding, but then daycare starting having to feed her an extra bottle in the afternoon (I had sent in frozen as spare) because she was hungry. I started sending in 155ml bottles plus an extra with 120ml and she was eating all of it. Since she still kept to her usual schedule this weekend and wasn't demanding an extra feeding, should I just try to send bigger bottles with 6 or 6.5oz and hope that keeps her full enough (without a fourth bottle)?

[oswin]

Feb 18, 2014 12:15:37 GMT -5 elocrates said:

I'm not certain that 20ish ounces in 8.5 hours is necessarily overfeeding, especially if she is going through a growth spurt. My DS3 took 15-20 ounces in 9 or so hours at daycare from 3 months on.

Regarding your supply, I can only anecdotally say that I had major supply dips (half, sometimes less) each time I was sick or work got busy and I had to pump less. It always rebounded within a few weeks. I really had to up my water and calorie intake and make sure not to miss my last pumping session.

Regarding supplementing with formula, of course it is okay (as you mentioned). The supplementing itself shouldn't further decrease your supply as long as you keep up your pumping schedule and don't use the formula to replace a pumping session (but simply to make up the difference while you are ill and your supply is temporarily down).

Hugs. Pumping is hard. And I hope you feel better soon.

Thanks.

[oswin]

Feb 18, 2014 12:15:15 GMT -5 cilantro said:

Feb 18, 2014 12:12:55 GMT -5 oswin said:

I was wondering about that , but according to this chart it's about right: www.best-breastpumps.com/Milk_Intake.htm
DD weighs just under 14.5lbs, so according to this she should be eating 38.5oz per day. She only nurses 3x per day - when she wakes up in the morning, right before bed, and usually once in the middle of the night. 

This chart is crazypants.

Noted, thanks.

[mpc]

At that age my DS was taking 12 oz (4 3oz bottles) during a similar time. Max he ever took during the whole work-day was 15oz (3 5 oz bottles). I agree that it sounds like they're giving her too much.

What times are they feeding her and when are they squeezing in that extra bottle? In the early months I think my daycare would sometimes jump to a bottle to soothe a fussy baby rather than trying other things. I stopped sending that extra and then suddenly they were fine. I don't know if that's your problem, but it might be something to consider.

[mrshandy]

Feb 18, 2014 12:06:43 GMT -5 AmyRI said:

And I always pumped less at the beginning of the week, after having nursed on demand all weekend. I know my kids ate more when bottle fed, and I pumped more than I would have nursed when together, so I was making more after 5 days of pumping and they ate less when just nursing from me on weekends. It was an obvious pattern when I started actually tracking output in an app.

This is definitely true.

I think you're on the right track. I would just give it a week or two and see how pumping is going.

My supply has tanked when I've gotten sick and come back. You might try a few methods to increase supply. Like Mother's Milk tea, lactation cookies or power pumping.

I can totally sympathize I'm going through the same thing. It's frustrating.

[AmyRI]

I would start by asking them why they think she's still hungry, and if they are pacing her bottles or just letting her drink them as fast as possible.

I hate to post kellymom sites because I think she does underestimate intake for many babies. For example, both of my kids took 4 4oz bottles in 10 hours, so they were over the 1-1.5 oz "rule." But, I think 2+ oz per hour is a lot and I would bet money on your DCP's overfeeding, since you don't need to supplement on weekends when you're nursing. And there may be growth spurts where she really needs more, but it should go back down again.
Milk intake info: kellymom.com/bf/pumpingmoms/pumping/milkcalc/

Really great article on paced bottle feeding: kellymom.com/bf/pumpingmoms/feeding-tools/bottle-feeding/

And I will also add that my kids reacted very differently to being bottle fed. My DS would not have any of the paced bottle feeding techniques - he wanted to guzzle milk and if you tried to stop him, he would rage. DD paces herself. Daycare was constantly trying to get me to up DS's bottles, but we agreed to a simple rule - they would give him the 4 oz bottle, and then offer a pacifier and distract him for 5 minutes. He would always cry for more initially, but he needed to wait and give himself a chance to feel his belly get full. After we instituted that rule, he only took extra 1 time during a growth spurt. He was super chubby, so they really couldn't argue that I was being unreasonable and starving him, and he could go 2.5 hours between bottles without issue.

[oswin]

Feb 18, 2014 12:35:52 GMT -5 mpc said:

At that age my DS was taking 12 oz (4 3oz bottles) during a similar time. Max he ever took during the whole work-day was 15oz (3 5 oz bottles). I agree that it sounds like they're giving her too much.

What times are they feeding her and when are they squeezing in that extra bottle? In the early months I think my daycare would sometimes jump to a bottle to soothe a fussy baby rather than trying other things. I stopped sending that extra and then suddenly they were fine. I don't know if that's your problem, but it might be something to consider.

It's usually in the afternoon. Sometimes they give the 1pm bottle at 12:30pm, then feed at 3pm and 4:30pm instead of just 4. It's true that her naps are all over the place - she's supposed to nap the last hour before a feeding, but she hasn't been consistent about it either at home or daycare (she wakes up early). We just ditched the swaddle at home (she busts out) and daycare wasn't ever allowed to swaddle her (state rule), so that could be affecting her sleep habits, creating a cranky baby in the afternoon. She's always cranky from 6-7pm unless we can get her to nap when she gets home at 5:30ish.

[oswin]

Thanks everyone for the notes on paced feedings. I'll have DH ask them tonight about her hunger cues. I'm pretty sure she's done with her growth spurt now, but should I expect that she'll go back down to what she was eating before or should it be slightly more than before but not as much as during the spurt?