"Nikki Simmons" <[log in to unmask]> wrote:
(SNIP)
> To restate what I believe is her main concern:  She has a goal of nursing
> exclusively for 6 months.  She works full time and is concerned that the
> dramatic decrease in her supply will not sustain the baby nor her long
term
> milk supply.  It looks like her period returned today.
>
> We would both like to be educated on her options and the pros and cons.
> While you all "chew" on this; I will continue reading the archives. :-)
> -----Original Message-----
> From: Patty
> I am currently breastfeeding my 3 1/2 month old daughter. My question is
at
> my 6 week follow up appointment my doctor prescribed Ortho Micronor birth
> control pills with the understanding that I was to nurse and/or pump at
> least 8 times a day. When I returned to work (approximately 3 weeks ago) I
> contacted the doctor stating that I would not be able to nurse and/or pump
8
> times a day and my birth control pills were to changed to Apri. There was
no
> limit on the nursing and/or pumping. Now I have been on the pills 3 weeks
> and have noticed that my milk supply is starting to dimish.(SNIP)

I tried to snip down to the most pertinent parts.  Sorry in advance for
repeating so much of the post.

These concerns appear to me to be classic THREE MONTH ISSUES.  The first
thing that I noticed is this baby is 3.5 months old.  Many moms experience a
perceived diminishing milk supply when the baby gets about 3 months of age.
Breasts appear softer and less full between nursings.  A woman's body is
moving farther into the *milk on demand* mode versus the *milkmaid* mode of
all milk, all the time.  Milk needs to be removed from the breast for the
breast to make more milk.  I'm not surprised her milk pumping production has
gone from 4 ounces every 2-3 hours to 3 ounces every 4-5 hours.  Baby may be
hitting a growth spurt and demanding to nurse more frequently to up milk
production.  Pumps are not as efficient as baby at removing milk from the
breasts.  It may appear to her that her supply has diminished while in fact
it hasn't.  The pump just isn't as great at removing milk as her baby is,
her MER has probably relaxed some, her body is changing its underlying
method of production.

Many moms find continued pumping while at work and reverse cycle nursing
works wonderfully for keeping the number of nursings/pumpings at the breast
up.  Eight *events* at the breast per day would be a minimum (IMO) for a 3.5
month old baby.  Babies this age still need lots of milk and mom for growth.
Maybe she would be open to family bedding for a while until this baby is a
bit older, eating solids, etc.?  This would give the baby more opportunities
to get to the breast and help increase milk supply.  Weekend nursing fests
are a great way to increase milk supply too.  Mom and baby stay home and
relax and nurse, nurse, nurse.  Mom will be *bursting* by Monday morning.

If this mom is wanting to investigate her fertility signals I would heartily
recommend the book *Taking Charge of Your Fertility* by Toni Weschler.  I
use this book myself.  I also teach young women about their bodies using
this book.  My husband even likes this book!

The following website is has an excellent spreadsheet for tracking fertility
signs as well as a wealth of information on fertility.
http://www.fertilityplus.org/  While it is written by fertility patients for
fertility patients it is very comprehensive for a woman wanting information
on how her fertility works for achieving and avoiding pregnancy.
-Monique
Oregon

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