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Motilium but no increase in supply
How long should it take?


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#1 eleven

Posted 16 February 2013 - 10:22 PM

Hi Ladies,

My LO is 4 weeks old and spent some time in special care so we didn't have a good start with no skin to skin or touching at all for 5 days. I've been expressing using a medela symphony double breast electric pump for about 3 weeks now and have had minimal output- never more than 50mls total.

4 days ago I started taking motilium and fenugreek in the desperate hope my supply would pick up. I've since stopped taking the fenugreek because LO has had shocking, smelly wind and khaki green (instead of mustard yellow) poos since.

I'm still taking the motilium but my supply is no better at all and sometimes I think it's worse than it ever was.

I'm starting to think my bub will end up exclusively formula fed and I feel so awful about that. My LO is 5kg already so should be eating 130mls each feed...there's no way I can supply that and he's so used to bottles that it's rare for him to latch well...

Anyway, please share your experience with me. I feel so disheartened.

#2 pitzinoodles

Posted 16 February 2013 - 10:35 PM

Hi!

Are you breastfeeding? Or expressing and bottle feeding?  When I took motilium my expressing didn't improve much, but my supply must have, because DS finally started putting on weight!  it took 1/2 week before the motilium helped much. So Hang in there!

My dr started me on 3 tablets/day,  but the paed upped it to 8/day and then I noticed an effect.  Don't give up hope, wait and see what your L0s weight is doing, and maybe see dr about increasing the motilium if you are on a low dose.

#3 suline

Posted 16 February 2013 - 10:41 PM

How often are you expressing/breastfeeding?


#4 Liadan

Posted 16 February 2013 - 10:41 PM

Pumps are not as efficient at milk extraction as babies are.

Have you tried breast compressions when you are pumping?
Have you tried pumping more frequently?
Will bub attach with a nipple shield?

Google "galactogogues" there are so many more herbs other than fenugreek that can help with milk supply.

Good luck!

#5 sophiasmum

Posted 17 February 2013 - 06:36 AM

I was on motilium for a long time with DS (lazy sucker) & noticed it was always a juggle as to how many tablets to take. Never the same, sometimes I needed more & then I could cut back & then some time later have to increase again, and so on. So I would speak to your doc about upping the dose for now.

#6 BeakyHoneyButt

Posted 17 February 2013 - 06:53 AM

I am always nervous about replying in threads like this, for fear of being 'shot down'.
That said, it is my humble opinion that if you can work on 'latching on' properly then this may be more beneficial for you both in the long run. I understand there may be a whole host of reasons why you are having to express in the first place, and you may have already exhausted all you options.
But as a PP said, your baby will always extract more from you than the pump. And this in turn is likely to increase your supply. So just incase you haven't already done so, i would speak to the ABA, or a lactation consultant just to see if you can get latching on sorted. If you are certain you want to keep breast feeding, and already tried ABA or a lactation consultant, maybe get a second opinion from a different consultant or midwife?
Again, I am just trying to help, and this information will all be useless to you if you have spent the last month struggling with different help and info on latching on techniques.
I hope,whatever happens, things work out well for both of you.

Edited by foxgirls, 17 February 2013 - 06:54 AM.


#7 Copper and May

Posted 17 February 2013 - 09:32 AM

I agree with foxgirls, so maybe we will be "flamed" together. You really need to get the "latch" sorted early in the breastfeeding journey, or you are going to fail. Try to find a good LC who is internationally certified - they are the best. MCHN's sometimes don't have the expertise or the knowledge and ABA helpline has trained counsellors who have done years of training into breastfeeding as well as breastfeeding babies themselves.
Could you give "Switch Feeding" a go. This is transferring your baby from one breast to the other during one feed. Once latched properly, this method will increase your supply wonderfully well. Let bubs stay on your first breast until after the let-down, have a small feed and then transfer to the other breast. Do the same with that breast and then back to the first one again. It really does work and sends messages to your milk-making memory bank to make more milk. Expressing milk (and the baby gets more than a pump can) and then feeding with bottles is fraught with failure for some mums and babies.

#8 lucky 2

Posted 17 February 2013 - 10:17 AM

Is your baby able to suckle now? Are you seeing a LC?
Give the medication some time, often 2-4 weeks to get the full effect, often noticing some effect as early as 3-4 days.
I'd see a LC if you haven't (I suspect you have though) and breast feed as much as possible if baby can attach well and suckle.
Expressing, the double pump is great to have, if you can express as much as possible if baby isn't feeding at all and after feeds if he is.
Expressing ideally 2-3 hrly in the day and 1-2 times at night.
You sound stressed and worried, sorry to hear things are difficult for you.
Was your baby born prem or term?
All the best bbighug.gif

#9 mandala

Posted 17 February 2013 - 10:30 AM

It took about two weeks to get the full effect, on maximum dosge of 6 tablets a day. I would BF, express, BF top up, and I found that the expressed volume didn't really increase - because DS was taking the extra milk produced before I could express it. On the occasions where I just expressed, I noticed that the volumes did increase after about a week.

I would also suggest that the real measure of good attachment is no pain for you, and your DS gaining weight. DS's attachment was always a bit iffy, and I had heaps of professionals (midwives, MCHNx3, OB, GP) all tell me it was wrong and needed work. When I saw an LC when DS was three weeks old, she said that as long as it wasn't hurting, to let DS try to attach himself. I'm not sure if that would work if your DS was born prematurely, but once I let him control the attachment things got much easier for us.

If it were me, I'd give the motilium two weeks and see if there's a response. It's so hard - and you've done well to manage four weeks. I hope your DS is doing well now.

#10 Red nut

Posted 17 February 2013 - 10:30 AM

Don't be hung up on the number of ml's, 5 kg is great for a 4 weeker, so you must be doing something right!

#11 bronhilda

Posted 17 February 2013 - 10:40 AM

I noticed an increase in the amount I expressed in about 3 days, and about a week to hit its peak (1 tablet x 3 times a day).

My GP and the MCHN both told me that it doesn't work for everyone. My GP told me it didn't work for her at all. Fenugreek does not work for me. Everybody is different.



#12 mandala

Posted 17 February 2013 - 10:44 AM

QUOTE (Red nut @ 17/02/2013, 11:30 AM) <{POST_SNAPBACK}>
Don't be hung up on the number of ml's, 5 kg is great for a 4 weeker, so you must be doing something right!



Yes, it's awesome! I guess your baby didn't come early at that kind of weight. DS didn't hit 5kg until he was 3 months!

#13 eleven

Posted 17 February 2013 - 11:40 AM

Hi ladies,
Thanks so much for your replies. My LO was born full term at 5.2kg. He spent 10 days in special care on IV fluids and lost about 500g. Only now is he getting back to his birth weight.
I'm expressing and bottle feeding EBM but he's mostly having formula because of my supply issues. I offer the breast a few times each day but he usually resists, works himself into a state because he's not getting enough and we end up back on the bottle. I really want him to have the benefits of breast milk. Im expressing roughly every 2-3 hours and 4 hourly overnight. I have seen an internationally certified LC and will try and see her again this week. I appreciate your comments and guess I might just need to give it longer and try and 'make' my LO take the breast....

#14 TwiceThe Woman

Posted 17 February 2013 - 11:53 AM

First of congratulations on your birth!  It has certainly been a rocky start being separated from your LO and given there was no contact for 5 days means s/he was needing that acute care.  I'm very glad for you that you had access to such good medical care.  Take heart, many women have experienced the same and get through it all to successfully BF.

Some "Special Care Unit" babies just take a little longer to get the hang of things after discharge and require that extra focus for a while.  Offering the breast while he is still sleepy may help.
As it seems you are only 4 days into using Motilum, keep going with this - stress may be inhibiting it's function thus far and that's normal and perfectly understandable.
A few little tips here may help.......
Try not to be down-heartened about the volumes you express -  any breastmilk you can give your baby is worthwhile. Babies can draw far more from the breast than any pump will - so that is no indicator of supply - it's the regular breast / nipple stimulation that is important for now- just don't focus so much on supply.
I do hear you - in that you're worried about volumes of breastmilk per feed, but you can hand that responsibility over to your LC for guidance and she will come up with something that will serve you well over this transition time.
Ask your LC about using a "Supply Line" - the baby will get enough calories with EBM & formula and be stimulating the breast at the same time, as the liquid comes via a small tube taped beside the nipple.
As anxiety is the greatest inhibitor of the let down reflex, sometimes it helps to tell yourself (and others) "I'm moving mountains here to make this happen.  The rest is up to mother nature / God / the universe" (whatever comes naturally to you).  Take heart that you are doing all you can....
Some of the best things to help the let down relflex and milk production are (but oft forgotten);
1. have your favourite baby photos to look at, or
2. watch a funny show / movie whilst pumping;
3. if you have a trusted and encourging friend or your mother to chat with may be helpful
4. rest as much as possible
The best advice from PP's is to get a Lactation Consultant asap for a thorough assessment (they do home visits).  She will work together with you, your M&CHN and the ABA where you can be put in contact with other mothers who had experienced the same as you and had success.
It is still early times with your LO and we know how frustrating and exhausting it can be but the effects of persevering can be worth the elation when it all comes together.  There have been many mums in your similar circumstances and it can work out - I'm hoping lots will post here for you.
Take a day at a time.  Don't try to do it all with the housekeeping. Get any sort of home help that's offered - cooked meals are a great help.  Pay for a housekeeper if you have to (someone, or a few people may want to give you this as a gift).  Ask for help when and where you need it - you'll find that people are more than happy to help.  Sometimes local councils will give help too - so make some enquiries there.
Think - rest, rest, rest, as much as possible.
Your little one had a very rocky start and I'm so happy for you that s/he pulled through that ok.  It seems to me that he may still be in "recovery phase"  and you are doing everything you can to make this all come together.  Congratulations and well done on all your efforts!

Edited by TwiceThe Woman, 17 February 2013 - 11:59 AM.


#15 Feral-as-Meggs

Posted 17 February 2013 - 12:30 PM

I was going to suggest a supply line, like PP.  you want bub believing that you have the good stuff again.

#16 SnazzyFeral

Posted 17 February 2013 - 12:30 PM

The ABA is not very helpful in situations like this so I would just rely on the information from your LC.
I ended up hand expressing because although it took longer I got more, I could also express for longer periods which helped my milk supply. That said even taking the max dose I only ever managed to express 40mls a time with a double pump and slightly more by hand.

I would recommend getting a SNS, http://www.medelabreastfeedingus.com/produ...sing-system-sns they are stupidly expensive for what they are but at least they are easier to use rather than supply lines and syringes.

Also look in to breastfeeding friendly bottle feeding. You can give your baby lots of the benefits of breastfeeding by holding the baby skin to skin by your breast when bottle feeding, this can also help supply.
  
You can also go to Tresillian for breastfeeding help and get a week residential stay to give you 24 hour support with breastfeeding. To do that you need to get a referral from you MCHN as soon as possible because you need to do the day stay first.

#17 TheVapours

Posted 17 February 2013 - 02:27 PM

I was also going to suggest a supply line/ SNS.  TBH, I found it a pretty horrible experience, but obviously not everyone does and it can be very good for getting baby to get that sucking action on your breasts whilst still getting the feed.  DS was such a lazy sucker but when he was getting FF through the supply line I could really feel the difference.

Motillium didn't work for me.  Nor did anything else, and boy I tried.  But at the end of the day I reached a point where I was satisfied that I had tried all avenues, and it was best for the both of us for me to give up spending so many hours a day trying to establish supply when I could be spending better time with DS.  I really hope it works for you, but I guess what I'm saying is that sometimes it doesn't and that's ok too.




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