For a few women, when the above measures do not show much improvement, it becomes apparent that their undersupply is something they will need to manage on an ongoing basis. It is still possible to continue breastfeeding, but you may need to consider some additional strategies, as well as the ones suggested for reversible undersupply.
Remember that these strategies should only be necessary if your baby is not gaining weight at a satisfactory rate, despite all your efforts to increase your milk supply.
These may include:
- Starting to give small amounts of formula (around 30 to 60 mls), after 2 or 3 breastfeeds in a 24 hour period, while continuing to breastfeed frequently. There may be times when you decrease the amounts, or you feel you need to increase the amounts of formula supplements.
- Giving your baby one bottle of formula in the evenings, and breastfeed regularly for the rest of the day (and night if needed). This may not need to be given all the time, if your supply looks like it is increasing.
- Starting your baby on solids. If your baby is old enough, (at least 3 to 4 months), you may start to spoon feed your baby small amounts of rice cereal mixed with expressed breast milk or formula, or pureed fruit or vegetables.
- Using a supply line. This is a small pouch containing expressed breast milk or formula, that is worn around your neck. There are 2 fine tubes that come from the bottom of the pouch, taped in place on the woman's breast with surgical Elastoplast, so that the ends of the tubes sit in line with the end of the nipples. Essentially, the baby breastfeeds and drinks milk from the breast, as well as milk from the pouch. This technique helps to continue the stimulus of the baby feeding on the breast, to continue to produce breast milk. Ask your caregiver, or early childhood nurse about this option.
Image 12-37 shows how a baby can be breastfed while using a supply line.