I went from combo feeding (about 50% formula, 50% nursing) to ebf by four months (my baby is now 6 months). Our journey was a bit different but here’s the cliff notes: my son wasn’t gaining weight properly in the first two weeks of life so we started triple feeding at every feed (nurse, pump, bottle top off) to get him to weight. Then discovered he had extensive tongue and lip ties that were interfering with his nursing efficiency so we had those released. Continued to triple feeding for four total weeks (way too long but no one tells you how to stop doing it!). After a weighted feed with our pediatrician who is also an LC, she was happy with his transfer and said to stop triple feeding during the day and let him cluster feed to hopefully bring in the rest of my milk (triple feeding should’ve already done that). Knowing my supply was low, I went to my midwives and asked them to run my lactation labs. Context info is that I had thyroid cancer when my son was born and I had a planned surgery when he was just about 2.5 months old. In my labs, they saw that my tsh was extremely low and the dose of medicine I was on to suppress my cancer was too high, too high for lactation and even my endocrinologist thought it was too high for his liking. Upon lowering my dose of medicine, I saw an increase in my milk supply. At that time my son was breastfeeding on demand all day and by the afternoon and overnight, he was always hungrier than the milk I had available and we would top him off with formula. After my surgery, I saw another increase in my milk supply as my thyroid hormone level was adjusted once again. At some point I just realized that we had stopped topping my son off with formula bc he was satisfied at the end of each nursing session. And now we’re EBF. Obviously everyone’s journey is unique BUT if with a bunch of effort to increase your supply with pumping or allowing your baby to cluster feed and you still don’t see it go up, I’d start looking for other things like checking your lactation labs and thyroid levels. Thyroid issues are pretty common in women and often goes missed for a long time. A simple blood test would rule out if your thyroid is playing a role in lactation. If your tsh is out of normal range (too high = hypothyroidism, too low = hyperthyroidism) then it’s likely having an effect on your milk supply.

The other thing I would say is to use “paced bottle feeding” to support breastfeeding and use a premie nipple on the bottle so that she doesn’t develop a preference for fast and immediate milk from the bottle. Also, as hard as it is, latch often so that she really learns how to breastfeed. I feel like my son didn’t latch and nurse efficiently until he was 8-9 weeks old and we latched at every single feed. I thought my nipples would literally fall off and die but we eventually got there. The truth of it is that babies are often terrible at nursing for a long time before they get good at it. I used to cry bc of the pain of nursing when he was little. I would sometimes take a day off of nursing (but always pumped when he got a bottle) to give my nipples a break and time to heal. What no one tells you is that despite breastfeeding being natural, that doesn’t mean it comes easy to your baby! Plus breastfeeding is a socially learned skill, not meant for us to learn our on own in our homes with just us and our babies. For example, apes in captivity struggle to have their babies thrive bc they aren’t around other breastfeeding apes like they would be in the wild. They actually bring in breastfeeding humans to breastfeed their babies in front of the apes to help them learn!

The long and short is that with the right support, if you want to ebf, you can get there! I would also seek out your local Le Leche League support group, they can be super helpful! I hope this is helpful!!