Low Supply in the Evening?

by Staci
(Hobbs, NM)

Hey Liz,

I have a 10 week old daughter who is and has been exclusively breastfed on demand. Periodically (once a week), I'll pump an early morning feeding and my husband will bottle feed. I was an epic fail at breastfeeding with DD#1, so I'll admit I'm a little bit afraid of my breastpump... completely with out good reason ;o/ ;o)

Currently she seems to be nursing every 1-2 hours during the day and every 3-4 during the night. Usually one side at a time.

A handful of times in the past few weeks (and tonight!) she has become inconsolable and acts irritated at the breast, it's always in the early evening between 5-8pm. Sometimes she will latch during her frustration but most of the time she won't. During these times I feel like I give it a my all for 30-45 minutes; attempting different positions, giving her a break, sitting her up, burping, laying her down, putting her to the breast again... all to no avail. In the end thawing 2-3 oz of breastmilk does the trick and gets her calmed down and to sleep.

These times seem different than when she clusterfeeds and don't seem to be related to anything that I've eaten. I try hard to get 80-100 oz of water a day- at a minimum I'm getting 60oz.

Could I generally have a lower supply during certain times of the day? Should I pump several times during this time frame... add fenugreek and/or blessed thistle... a combination of both or something different altogether?

Thank you so much for your help!

Staci

Answer from the lactation consultant
Hello there,

A couple questions for you:
1. On the occasion that your husband bottle feeds, are you pumping in place of that feed? And when she misses feeds due to the crying episodes, are you pumping then as well?
2. A bottle once a week should not be causing a problem, but if it is becoming daily, it could in fact be having an effect on your supply. Is it more than once a week?
3. My guess, since it is during the same times of the day is that it is one of a couple of things:
a. diet related, begin keeping a food journal, pay special attention to what you are eating for lunch. It could be something random like tomatoes or chocolate, different babies are sensitive to different things.
b. has your cycle returned? sometimes hormonal fluctuations will cause the milk supply and flavor to change.
c. but my guess is simply your supply is low by afternoon because of her odd schedule. It is unusual for a baby her age to be 1-2 hours day and 3-4 at night. She is giving your body mixed signals, make this much at night and this much during the day. It would seem that if she is feeding that often during the day, you would be getting engorged at night. If you are and she is not emptying you, this engorgement will indeed cause your body to reduce supply the next day. it will be a pain, but night pumping would really help supply. One 3-4 hour stretch is fine but not 2-3 sets of 3-4 hours.
Fenugreek usually only works in the first few weeks after delivery. If this is not happening daily, then I would not suggest taking anything. You don't want to overproduce, that could cause way more problems.
I would just try distracting her when it happens: swing, walk, car ride but I would not suggest bottles. It does not help your supply, nursing helps your supply. If she is absolutely panicky, then give her an ounce MAYBE, just to calm her down then put her on the breast.
During the day, make sure she is feeding the whole time at the breast, not suckling/sleeping. Do breast compressions during your feeds to ensure she is emptying the breast effectively.
As far as how much water to drink, my general recommendation is to take your weight and divide in half for how many ounces per 24 hours.
150 pounds = 75 ounces per day. And just as important are Sleep and eating. Minimum of 1800 Kcal/day.

Liz Pevytoe, RN, IBCLC
www.askthelactationconsultant.com