Update on p. 5 - Twins are losing weight - help please

[Ann.without.an.e]

 

Peach is down 4 ounces from last week’s weigh in and nectarine is down 3 ounces. 
 
On Wednesday after the weigh in DD decided that she wanted to try breastfeeding only with no bottle afterward since they would get to the next feeding and not be hungry or want to nurse. It felt like a vicious cycle that needed to be broken. They muddled along and then on Saturday morning it clicked. They were nursing great — finally. They are showing strong hunger signs and eating every 2-3 hours for the most part. They seem to be satisfied. Their coloring is great.
We think they may have actually dropped a good bit from last Wednesday until Saturday and then started gaining again but we can’t know for sure. 
 

The doctor put in a request for a lactation consultation and wants another weight check in 2 days. ETA- she also wants us to offer a bottle after each nursing session. 
 

Dd cried all the way back from the ped today. Mostly just discouraged that they are nursing so often and she feels like she’s reading their needs well but somehow has it wrong. 
 

Please help us out with any thoughts you have ❤️

Edited March 13, 2023 by Ann.without.an.e

[cjzimmer1]

Rather than doing a bottle, I would like into supplimenting while nursing.  I can't remember what it was called but basically, it was a small tube of supplimental food that was inserted into their mouth while nursing.  So in essence syringe fed and nursing at the same time.  That way kiddo still had to do the "work" of nursing but got the extra boost of calories.  Doing the separate bottle afterwards not only takes more time and energy from mom, it encourages the baby to wait for the easier bottle food which will only create a downward spiral with nursing.

[73349]

Oh, that's so trying for a new mommy. Hugs to her.

I would try nursing them (or at least offering) at the same time every 90 minutes during the day. This will stimulate milk production and ensure they are eating as often as they would want, even if they're not hungry enough to make a fuss about it yet. Then if either one turns her down, she can pump on that side while the other nurses. And if they eat more during the day, they might not need as much at night, perhaps allowing for more sleep.

(DS was a singleton but 34 weeks and under 6 pounds, so frequent nursing was important. I also block fed--same side for 2 feedings in a row--to make sure he got hindmilk, but I doubt that's an issue with two babies.)

Edited March 8, 2023 by 73349

[prairiewindmomma]

It’s a long haul. They will get there! Breastfeeding just burns more calories. As they get bigger and have more energy, they will be able to take more breast milk. This isn’t a black and white/pass or fail thing. Breast milk is good. Calories are good. They aren’t going to forget how to breastfeed. This just takes time. Preemies are just different.

 

Hugs!! 

[kbutton]

13 minutes ago, Ann.without.an.e said:

We think they may have actually dropped a good bit from last Wednesday until Saturday and then started gaining again but we can’t know for sure. 
 

The doctor put in a request for a lactation consultation and wants another weight check in 2 days. ETA- she also wants us to offer a bottle after each nursing session. 
 

Dd cried all the way back from the ped today. Mostly just discouraged that they are nursing so often and she feels like she’s reading their needs well but somehow has it wrong. 

I feel like the bolded is why my grandmother had her own baby scale back in the day, lol! I don't actually know why she did, though one of her kids was not super robust when he was little, so maybe that's why.

I remember feeling punished with similar dynamics. My older one was too disorganized to nurse well, and we now think he had lip ties top and bottom (they did look at his lips, but he flared well, so they said he was fine--in reality he just had really fleshy lips, and he had all the signs, but I didn't know that then), and he split my nipples every time. I got very little sleep with pumping--he didn't sleep anywhere close to what normal newborns are supposed to sleep. (I should also add that even with formula later, he ate insane amounts--he never had an ounce to spare, but he was not underweight; the pediatrician would ask how much he was eating since he was slim, but when I would tell her, she'd be astonished at his caloric intake. He just burned through it all so, so fast.) Second DS is still underweight. I would nurse him until he'd refuse to eat anything at all. I would even nurse in front of the pediatrician. We did give him concentrated formula for a short time, but that didn't do much.

I ended up not continuing to BF my older one (and was very bitter and depressed about the lack of support for a while), and while I continued with my younger one, I felt like I was always in danger of being told to stop. I think the fact that he would refuse to eat in front of doctors is all that saved BFing with him. 

No practical advice, but I would encourage her to not take it personally. Professionals are working very hard to make sure that the babies stay healthy. Things can be off even when everyone is doing everything right.

Many virtual hugs sent her way.

Edited March 8, 2023 by kbutton

[rebcoola]

Any chance she can do a weighed feed to know they are getting enough? Its so hard to know when to stop supplementing.

[prairiewindmomma]

Also, if you can help mom get good sleep at night—I would have her focus on breastfeeding during the day, but maybe just bottle at night at that 1-4am slot so she is getting some sleep.

Sleep deprivation is not great for emotions. Can dad or someone help out with the middle of the night feeding? I got to where I could doze through pumping. I would just toss the pump stuff into a bin of soapy water and wash and microwave sterilize at the 7am feeding. 

[catz]

Does she have a scale at home? I wouldn't be surprised if they are on the  rebound from the sounds of it.  I"m sorry she's feeling upset and discouraged.  It sounds like she is doing really well to me.  

I brought both my 36 weekers home at sub 6 lbs and it did take a little bit longer to get them on the upswing.  Once it turned around we were good to go.   I did go on to nurse  them for a really long time and exclusively for 6 months.  It will be ok!  ❤️ 

[amyx4]

Can she get a visting nurse to come out and weight them? Can she aquire a baby scale somehow?

[athena1277]

I’ve never had twins, but I always struggled the first week or 2 with nursing.  After all thing things I went through, this is my advice.  Since they seem to finally be getting good at nursing, I would keep doing what she’s doing until you see the lactation consultant.  See what their weight is then and let someone who knows nursing better than the doctor advise her on what to do.  
 

I totally understand the tears and frustration, just remind her that if they have to become bottle babies, it does not in any way make her a bad mother.  

 

 

[Kassia]

No advice but I just wanted to say that breastfeeding twins is hard and your poor dd isn't getting anything wrong.  I feel so bad for her that she's feeling discouraged when giving it her all.  My twins are 28 now and I can't remember those first months that well but I do remember nursing and nursing and it never being enough for my guys and then we started giving them formula supplements after nursing and I'd pump and pump.  It was awful emotionally and physically and I felt so defeated but it eventually all worked out.  A baby scale is a good idea.  We had one from when DH was a baby - a very old fashioned one - and he weighed our babies all the time.  😛

Big hugs to her.  She's doing a great job and is so lucky to have you there for emotional and physical support.  Just make sure she rests as much as she can to save all of her energy for producing milk.

[Miss Tick]

2 minutes ago, athena1277 said:

I’ve never had twins, but I always struggled the first week or 2 with nursing.  After all thing things I went through, this is my advice.  Since they seem to finally be getting good at nursing, I would keep doing what she’s doing until you see the lactation consultant.  See what their weight is then and let someone who knows nursing better than the doctor advise her on what to do.  
 

I totally understand the tears and frustration, just remind her that if they have to become bottle babies, it does not in any way make her a bad mother.  

 

 

^^I agree. I *did* have twins and was in the same situation as your DD. The lactation consultant looked at the babies, weighed them, watched them nurse, weighed them again, and then asked if we might want to buy her twin bike trailer? I said well, I don't think so, but what about the babies? "Oh, they're fine! You are both, probably they will be too."

Stall adding the bottle as long as she is comfortable. That supplemental nursing tube thing mentioned by a pp was a huge PITA! I was taken nursing and trying to use that with one baby but no hands free 😝

[Momof4sweetkids]

My doc had me supplementing after nursing with dd2 but then when we went to the lactation consultant and they weighed her before and after her nursing, the lactation consultant said she was fine. I could barely keep up the nurse, pump,supplement routine with one, idk how your daughter is doing it with twins!

[Lecka]

I think it can be a precaution to do weight checks.  I don’t think it means things are so bad.  If they seem like they are doing well they probably are.  

[Matryoshka]

58 minutes ago, cjzimmer1 said:

Rather than doing a bottle, I would like into supplimenting while nursing.  I can't remember what it was called but basically, it was a small tube of supplimental food that was inserted into their mouth while nursing.  So in essence syringe fed and nursing at the same time.  That way kiddo still had to do the "work" of nursing but got the extra boost of calories.  Doing the separate bottle afterwards not only takes more time and energy from mom, it encourages the baby to wait for the easier bottle food which will only create a downward spiral with nursing.

An SNS system (Supplemental Nursing System).  One of the women in my twins' club did it the whole time her twins nursed, but for most people it's just used for a little bit till supply increases.  It can ensure the babies are getting enough calories but also are suckling enough to increase the mother's own supply.

It could also be that the babies lost weight while she was getting them off bottles and becoming enthusiastic nursers, and now that that goal is reached, they will naturally regain the weight without having to supplement and everything is already peachy. 

[Clarita]

My singleton son had the same problem. In hindsight, he just burned a lot of calories. I was pumping at the time so I could tell the Dr. exactly how much actual milk he was taking in; it was more than what a normal baby would be eating. I see the suggestion is nurse first then bottle. I would get a reputable bottle (not a freebie one from a formula company) then do as they say. Just to get the doctors and stuff off her back; also so she knows she's keeping the babies fed.

My babies always preferred the books. Breastmilk is actually tastier and sweeter than formula and it's not always the case that bottle is easier than breast for the baby to nurse from. 

Honestly though she's doing just fine; to me it's a super narrow range of you are doing great. Same books, same me and my second baby was too chubby. 

[Katy]

I was given an SNS for my premature baby. She never developed a strong latch, but as long as the twins are otherwise healthy they should eventually. I’d also try to get a scale or a nurse and weigh them before & after for more data. 

[Ann.without.an.e]

Thanks for all of the thoughts y’all ❤️

There is an issue we’re facing that I should have mentioned …

they are stubborn and if they don’t want to eat, they won’t eat. Since they’ve been nursing good we’ve tried to offer a smaller portion from the bottle as was suggested but they both press their lips closed with disinterest. I tried again today after the appointment with some pumped milk and nope, not happening. This has to mean they’re getting plenty right ?

I ordered a scale last week but it seems to be highly inaccurate. I laid peach on there four times and got four totally different weights. So I started a rerun label with Amazon. Is there a scale y’all recommend?

The lactation consultant called and left a message about scheduling a time for dd to nurse there so they could weigh before and after. 

Edited March 8, 2023 by Ann.without.an.e

[Ann.without.an.e]

1 hour ago, prairiewindmomma said:

Also, if you can help mom get good sleep at night—I would have her focus on breastfeeding during the day, but maybe just bottle at night at that 1-4am slot so she is getting some sleep.

Sleep deprivation is not great for emotions. Can dad or someone help out with the middle of the night feeding? I got to where I could doze through pumping. I would just toss the pump stuff into a bin of soapy water and wash and microwave sterilize at the 7am feeding. 

I’ve asked her how to help but she doesn’t want to go more than 3 hours without feeding out of fear of a milk supply reduction. We did talk today about maybe not pumping so much after feedings? Her supply seems good? The pumping wears her out 

[Scarlett]

Poor girl.  She sounds exhausted. This is the roughest time…..everything is all so new.  
 

[Ann.without.an.e]

2 minutes ago, Scarlett said:

Poor girl.  She sounds exhausted. This is the roughest time…..everything is all so new.  
 

I think she’s most exhausted over the emotions of feeling like they were doing well and had the hang of it? You know? The girls seem to be nursing great. It is making her question herself as their mom. All I can do is encourage her that it’ll be ok. It’s just a learning curve. 

[Ann.without.an.e]

Also the doctor made two or three comments today about dd’s complexion being so white? She did lose a lot of blood in the hemorrhage and she’s been taking a large dose of iron. The doctor thinks its a supply issue and potentially from anemia but again they seem to be getting enough and then she’s pumping more after ?

[Lecka]

Well, at a certain point it is going to be nice if they will drink from a bottle.  My daughter would drink from a little cup.  I don’t know how old she was, but less than 6 months.  Then she was fine with a sippy cup.  
 

But it made it hard for me to leave them, which at a certain point is a problem.  
 

But yeah — they don’t sound hungry.  
 

But my daughter did cry and refuse a bottle for a little while when someone else would try to feed her.  
 

I don’t know what I could have really done differently, for my situation.  I am sure she would have adjusted if she had to, but she didn’t need to, so I just  wasn’t away from her for more than a couple of hours, for the most part, which worked for us.  
 

So I don’t definitely think it means that they are full and don’t want a formula top-off, but it sounds like it’s likely.  
 

And then depending on her situation and the big picture, maybe you do want to try to see if they will take a bottle feeding from somebody. 
 

I do think weight checks are a precaution, too.  I have taken a toddler for weight checks when we had concerns about dehydration, and then when I wasn’t worried I called to cancel and it was fine.  He was obviously fine after having been obviously sick.  
 

If they seem okay, have wet diapers, stuff like that, the weight check is just to see if they got worse, it’s not because something is bad right now.  It’s not like the doctor said “we are checking you into the hospital, nurse, get the IV.”  
 

If there are more signs of concern that is so different!  But I think a weight check can be for YOUR peace of mind or to already be on the schedule if they seem to get worse or seem sick, and you don’t have to try to get an appointment then.  

[BlsdMama]

I had little babies (6-7lbs) because they were usually four weeks early. They were beautiful healthy babies but they weren’t always quite strong enough to take in enough via breast in those early weeks. I was a passionate pro breastfeed only until 2009 baby failed to gain and then started to lose. Because once they’re losing they’re getting weaker and you lose ground. If she supplements for two weeks so she can breastfeed the rest of their babyhood, these two weeks are a micro-blip. Or Cate was in the NICU for two weeks, I pumped like a crazy person but didn’t hesitate to use the bottle.  Was it bumpy? Yeah but well worth It

[Lecka]

Is she going to increase her supply more than she needs if she keeps pumping extra?  This seems bad to me?

I had oversupply with my firstborn and it is no fun.  

[Lecka]

I agree with pp about trying a bottle from someone else at night?  It’s something I never got to work but I think it sounds like a good idea!  Now might be a good time.  
 

 

[Lucy the Valiant]

[Intentionally didn't read any prior comments.]

As a mama who DID nurse twins, I will say that giving 1 of them 1 bottle each day was actually the thing that made it possible for me to actually nurse them. They had 1st solid food at 6mo. It was HARD. I know that baby-feeding is so controversial, but . . . please hear from another twin mama, that SHE matters, too, and there are MANY right options for this. It's not exclusively A or B. She will find a way. ❤️ Hang in there. Twins are one of the sweetest gigs going, and . . . nutrition is important, but NOT the most important of all, kwim?

[Katy]

If you have a Mexican restaurant near you, order DD some beef fajitas, and ask them to make the beef mostly liver. I try to eat mostly plant based, but when I get anemic nothing brings my iron up faster than beef fajitas. If you can stand to cook liver yourself you can also make them, but I find ones from a restaurant are just better. Maybe they use more salt or cumin than I would, idk. The vitamin C from the veggies helps you absorb all those minerals much faster. 

[Ann.without.an.e]

Just now, Lucy the Valiant said:

[Intentionally didn't read any prior comments.]

As a mama who DID nurse twins, I will say that giving 1 of them 1 bottle each day was actually the thing that made it possible for me to actually nurse them. They had 1st solid food at 6mo. It was HARD. I know that baby-feeding is so controversial, but . . . please hear from another twin mama, that SHE matters, too, and there are MANY right options for this. It's not exclusively A or B. She will find a way. ❤️ Hang in there. Twins are one of the sweetest gigs going, and . . . nutrition is important, but NOT the most important of all, kwim?

I agree with you. When did you give the bottle? Did you nurse one while the other had a bottle? If so then did the one who nursed take both sides for that feeding? She’s worried about skipping feedings and her milk supply. I offered to bottle feed at night so she could sleep but she’s too worried about her supply

[Ann.without.an.e]

12 minutes ago, Lecka said:

I agree with pp about trying a bottle from someone else at night?  It’s something I never got to work but I think it sounds like a good idea!  Now might be a good time.  
 

 

They are willing to take a bottle when they’re hungry and they took one from me for quite a while. It’s just we’re supposed to offer it after they nurse and they clearly aren’t hungry?

[Ann.without.an.e]

1 minute ago, Katy said:

If you have a Mexican restaurant near you, order DD some beef fajitas, and ask them to make the beef mostly liver. I try to eat mostly plant based, but when I get anemic nothing brings my iron up faster than beef fajitas. If you can stand to cook liver yourself you can also make them, but I find ones from a restaurant are just better. Maybe they use more salt or cumin than I would, idk. The vitamin C from the veggies helps you absorb all those minerals much faster. 

she’s terribly allergic to both beef and cow’s milk or I’d totally look into that 

[Lecka]

With my twins I think I was induced at 37 1/2 weeks.  My son had tiny bottles in the hospital but also nursed, he had less brown fat than they liked.  My nursing was established by my daughter.  Once we were home my son was quickly fine.  He had also spent almost one day in the special care nursery and my older son fed him a bottle before I was allowed to hold him!  
 

I did not go to a twin group very long, my tale of woe of almost one day in the special care nursery while I only had my daughter with me did NOT fit in.  It fit in great with other women with minor but So Emotional And Meaningful birth stories, but not the level of birth story at the twin group.  Then there were identical twins and I had fraternal twins.  
 

Anyway, maybe everything is fine, and you need “everything is fine, everything can be pretty okay with twins” advice.  
 

Or maybe everything is not fine!  
 

I don’t know if you know, or if it’s known, or what.  
 

But there is no reason to think there has to be a feeding problem and big concern just because it’s twins.  

[Lecka]

Well — you did offer, they didn’t want it, problem solved.

 

Maybe?

 

It is nice they will take a bottle.  

[Katy]

1 minute ago, Ann.without.an.e said:

she’s terribly allergic to both beef and cow’s milk or I’d totally look into that 

Oh no!  Is there another meat she could eat? Idk the iron levels of say, sheep or chicken livers, but it would be worth a try to me. 

[Katy]

4 minutes ago, Ann.without.an.e said:

They are willing to take a bottle when they’re hungry and they took one from me for quite a while. It’s just we’re supposed to offer it after they nurse and they clearly aren’t hungry?

It sounds like they turned the corner to me too

[itsheresomewhere]

Have your daughter call her doctor and get a visit with blood work done. I wonder if she is just producing enough calories in her milk due to not being well herself.   

[Lecka]

Also for me personally, I have fraternal twins, and when they got closer to 6 months my son was very interested in solids and he would like to eat more when it was offered.  My daughter wasn’t interested and didn’t really take much.  
 

So there is no reason to think that they will both want to top-off with a bottle, if one did want to, and one didn’t.

 

That was unexpected to me at the time.  

But she was more similar to how my older son had been.  

[rebcoola]

Yeah if they take a bottle but refuse after nursing would say they are good.  

[Scarlett]

41 minutes ago, Ann.without.an.e said:

I think she’s most exhausted over the emotions of feeling like they were doing well and had the hang of it? You know? The girls seem to be nursing great. It is making her question herself as their mom. All I can do is encourage her that it’ll be ok. It’s just a learning curve. 

I am no expert but I am not convinced there is really anything wrong. Sounds like the lactation specialist is just a precaution. 

[freesia]

Try to get her liquid Floradix for iron. It’s better absorbed than the pills. I used it after I list a lot of blood when dd2 was born. 

[kbutton]

46 minutes ago, Ann.without.an.e said:

they are stubborn and if they don’t want to eat, they won’t eat. Since they’ve been nursing good we’ve tried to offer a smaller portion from the bottle as was suggested but they both press their lips closed with disinterest. I tried again today after the appointment with some pumped milk and nope, not happening. This has to mean they’re getting plenty right ?

My second one did this. I would even nurse right in front of the pediatrician. He'd be chewing his hand off, and he wouldn't take bottle or breast. No one had any thoughts on how to fix this. 🙄

36 minutes ago, Ann.without.an.e said:

Also the doctor made two or three comments today about dd’s complexion being so white? She did lose a lot of blood in the hemorrhage and she’s been taking a large dose of iron. The doctor thinks its a supply issue and potentially from anemia but again they seem to be getting enough and then she’s pumping more after ?

I would try to find out if that's an evidence-based concern or just conjecture they are adding in for fun. Or suggest that if they are worried, please do bloodwork before making that leap. But I am crochety about doctors just tossing out ideas without facts behind them. Blood tests aren't that hard and probably easier to arrange than a before and after feed with a lactation person.

10 minutes ago, Ann.without.an.e said:

They are willing to take a bottle when they’re hungry and they took one from me for quite a while. It’s just we’re supposed to offer it after they nurse and they clearly aren’t hungry?

Probably. I will offer one alternative, but it's outside the realm of typical. I mention it only because if it's happening, then you need a totally different approach. They could have tired jaws. My son had a hypermobile jaw, but no one knew that until many years later; it was more fun for them to just look at all the facts and put the worry and doubt back on me. The SLP that noticed the hypermobile jaw at age 8 or so was LIVID that the lactation consultants when he was little thought his quivering jaw during feeding was cute rather than a sign of major fatigue. If something like this is happening, then the solution needs to fit the problem, not just the random concerns and guesses. 

If you think anything like that is off at all, I would consider asking for a feeding evaluation with an SLP that specializes in feeding issues. 

[kbutton]

Hemaplex has also been recommended on here, and my son's iron came up really fast while taking it.

[KSera]

3 hours ago, cjzimmer1 said:

Rather than doing a bottle, I would like into supplimenting while nursing.  I can't remember what it was called but basically, it was a small tube of supplimental food that was inserted into their mouth while nursing.  So in essence syringe fed and nursing at the same time.  That way kiddo still had to do the "work" of nursing but got the extra boost of calories.  Doing the separate bottle afterwards not only takes more time and energy from mom, it encourages the baby to wait for the easier bottle food which will only create a downward spiral with nursing.

Agree with the SNS advice. It’s a pain, but she could probably eliminate some pumping if the supplementing was happening from an SNS. Just an extra couple ounces of pumped milk in them once a day for another  week or two could end up being all they need. 

2 hours ago, prairiewindmomma said:

Also, if you can help mom get good sleep at night—I would have her focus on breastfeeding during the day, but maybe just bottle at night at that 1-4am slot so she is getting some sleep.

Sleep deprivation is not great for emotions. Can dad or someone help out with the middle of the night feeding? I got to where I could doze through pumping. I would just toss the pump stuff into a bin of soapy water and wash and microwave sterilize at the 7am feeding. 

This is a hard one if supply might in any way be an issue, since night feedings/pumping have a larger impact on supply (according to everything I read when I was pumping—I really wanted to not pump at night though, so I believe I dropped that as soon as I possibly could, but I had baby right there and nursing all night). 
 

Also a big +1 for kbutton’s jaw stability advice. It could be an SLP or an OT that might assess for that. You’d want an infant feeding specialist, not just any speech or OT. 
 

That’s too bad your scale didn’t seem accurate. I assume she was having them dressed exactly the same before and after?
 

Hopefully they’re getting close to having it all worked out. 

[kbutton]

9 minutes ago, KSera said:

You’d want an infant feeding specialist, not just any speech or OT. 

Yes! I didn't realize that an OT might do this too. But at any rate, it's definitely not just any SLP or OT. 

[Ann.without.an.e]

47 minutes ago, kbutton said:

Hemaplex has also been recommended on here, and my son's iron came up really fast while taking it.

I’m probably the one who recommended it lol. It was a miracle worker for my younger dd and that is exactly what older dd is now taking. I’ve recommended it here several times since it isn’t constipating and brings levels up fast. She was only taking half a tablet but increased it tonight to a whole. 

[kbutton]

Just now, Ann.without.an.e said:

I’m probably the one who recommended it lol. It was a miracle worker for my younger dd and that is exactly what older dd is now taking. I’ve recommended it here several times since it isn’t constipating and brings levels up fast. She was only taking half a tablet but increased it tonight to a whole. 

Oh, that's funny! Thank you!!! It's great stuff. His levels came up fast enough that we have extra bottles now.

[Ann.without.an.e]

1 minute ago, kbutton said:

Oh, that's funny! Thank you!!! It's great stuff. His levels came up fast enough that we have extra bottles now.

Yes I’m so thankful for it. The doctor prescribed a high dose of iron. I went into vitamin shoppe and mentioned it in passing and the lady working at the time struggled with anemia. She said that prescription iron would tear her tummy up and suggested hemaplex. The doctor was a little perturbed at first that she wasn’t on the pharmacy iron but after the one month check her levels increased way better than the doctor said she’d ever seen so I never heard another complaint lol. 

[Ann.without.an.e]

I have a very accurate kitchen scale. Would it work??

[Eos]

Echoing the SNS tube with formula or pumped milk if needed.

[prairiewindmomma]

1 hour ago, freesia said:

Try to get her liquid Floradix for iron. It’s better absorbed than the pills. I used it after I list a lot of blood when dd2 was born. 

This, and chase it with orange juice to bump absorption. I can see the improvement after just three days in my blood work, but I usually need 6 weeks on it to really build up to a good number before I start to drop again. 
 

ETA: oops, just caught up on reading. Glad she is supplementing!

Edited March 9, 2023 by prairiewindmomma