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    Suggest treatment for low production of breast milk

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Posted on Tue, 11 Jul 2017 in Child Health
Question: Hello Doctor, we are facing issues with lactation for our new born baby. Our baby was born 2 weeks back. Then, my wife wasn't able to produce enough milk. Therefore, we had to put the baby on formula. My wife was also treated so that her milk production would improve. The milk production has improved and even though the baby was reluctant to take milk from the mother, it did consume some mother's milk along with the formula.

Now, coming to the problem. My wife couldn't feed the baby for the last 2 days and the baby was completely on formula. When she tried to feed the baby today, baby wouldn't even take a drop of mother's milk. We then realized that the milk produced by the mother had a salty taste to it. What to do now? What is the solution to our problem? Can we express the salty milk and feed the baby with it?
doctor
Answered by Dr. Sumanth Amperayani 30 minutes later
Brief Answer:
Bottle feeding is the culprit - please stop bottle feeding

Detailed Answer:
Hi.... I understand your concern. This is a very common scenario. The main culprit is the bottle. As the baby has been given bottle feeding and formula feeding the baby started to like the taste of the formula feeding which will be more sweeter than the mother milk. This is common. At the same time the baby has to do some work by sucking at the Mother's breast while feeding at the breast. But in a bottle the milk will directly drip down without any sucking movement by the baby. So the baby as naturally chosen an easier way to feed. The best way to end this and improve direct breastfeed is to stop bottle feeding and formula feeding immediately and give the baby only mother's milk and that too directly from the breast and not expressed breast milk.

Coming to your query.... even though it is salty you can give the baby mother milk.

Regards - Dr. Sumanth
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Sumanth Amperayani 15 hours later
Hello Doctor,

Thanks for your fast reply.

Just to add one point which I missed in my query, we use the 'paladai' to feed formula (Lactogen) to the baby.

I have few questions based on your earlier response:
1. If we stop feeding formula for the baby, he will start crying continuously and take very little mother's milk. Consequently, he will lose weight. We tried this earlier and he lost 200 grams of weight in 2 days, after which we had to reintroduce the formula. How can we safely transition from formula to mother's milk?

2. We are also stuck in an endless loop where the baby does not consume enough milk from the mother, due to which, the mother cannot produce more milk. Therefore, we cannot reduce the dependency on formula at all. How to break out of this?

3. Our baby is 2 weeks old. Are we too late to make the transition from formula to mother's milk?

Thanks and Regards,
XXXX
doctor
Answered by Dr. Sumanth Amperayani 12 minutes later
Brief Answer:
I have a few questions - please get back to me with answers

Detailed Answer:
Hi... I understand your concern. I need more information before answering your queries. Please get back to me with answers.

Questions -

1. How long does the baby feed at the mother's breast each time?
2. After feeding how long does the baby sleep or keep quiet?
3. While feeding from one breast is the milk dripping from the other breast?
4. How many times the baby used to pass urine while in exclusive breast feeding?
5.What is the birth weight and the weight of the baby before starting formula feeds?
6. At what age were the formula feeds started?
7. What is the exact date of birth and current weight of the baby?

Please revert back to me with answers so that I can guide you better>

Regards - Dr. Sumanth
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sumanth Amperayani 3 hours later
Hello Doctor,

Here are the answers to your questions:

1. How long does the baby feed at the mother's breast each time?
A: Less than 5 minutes

2. After feeding how long does the baby sleep or keep quiet?
A: He does not keep quiet since his requirement is not met. He keeps crying.

3. While feeding from one breast is the milk dripping from the other breast?
A: No.

4. How many times the baby used to pass urine while in exclusive breast feeding?
A: 4-5 times (He now passes urine around 10 times per day and bowel movement almost once a day).

5.What is the birth weight and the weight of the baby before starting formula feeds?
A: Birth weight is 3.1kg. Before we started the formula (on third day) the weight was 2.8kg.

6. At what age were the formula feeds started?
A: On the third day.

7. What is the exact date of birth and current weight of the baby?
A: Date of Birth: 08-June-2017. As of Sunday (18-Jun), his weight was 2.9kg.

Let me put up a brief history:
08-Jun - Born 3.1kg
09-Jun - 2.9kg
10-Jun - 2.8kg (formula started on this day, 1 scoop, 30ml)
11-Jun - 2.88kg
12-Jun - 2.94kg (exclusive breastfeed started)
14-Jun - 2.73kg (formula resumed, 1 scoop, 30ml)
16-Jun - 2.79kg (formula increased, 2 scoops, 60ml)
18-Jun - 2.9kg

The mother is being treated with Galact granules and Lactare capsules. Her milk production has indeed increased but the baby is not taking it.

I hope I have answered your questions.

Thanks
XXXX
doctor
Answered by Dr. Sumanth Amperayani 1 hour later
Brief Answer:
Suggestions on breast feeding

Detailed Answer:
Hi.... i understand your concern. i have gone through all your answers.

I understand that because the baby was not accepting direct breast feed, you have started on formula feeds and also that you are giving formula feed through paladey and not by bottle.

There are two issues here -

1. The baby has started to like the formula feeds rather than breastfeeds.

2. From what you say I understand that the milk production for the mother is low and also the baby has started to lose weight on exclusive breastfeeding.

Will tell you a scientific fact before giving you my suggestions.

All the newborn babies lose 10% of their body weight in the first 10 days and regain it by 10th to 14th day of life. So assuming that the baby has lost 200 grams in 2 days might not have been appropriate, as those 2 days are within these 2 weeks.

Coming to my suggestions for your queries -

1. You are not too late to make the transition from formula feed to mother's milk.

2. The best way to do the transition is by gradually making the baby feed on mother's breast and waiting at least for 1 to 2 hours for the baby to accept this and if not giving formula milk.

3. You need not try to break the dependency on formula feed. It will automatically break as the baby forgets the taste of formula feed due to continuous direct breastfeeding.

Regards - Dr. Sumanth
Above answer was peer-reviewed by : Dr. Kampana
doctor
Answered by
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Dr. Sumanth Amperayani

Pediatrician, Pulmonology

Practicing since :2003

Answered : 8250 Questions

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