Could use help, advice, reassurance

[xerxes]

My dd is almost one month old. I have to return to work in four weeks and have just started to pump (medela pump in style). I can't get any significant milk out of this machine and I am extremely frustrated. I've tried feeding her on one breast and pumping the other. I've tried pumping at several different times of the day. The entire amount I've pumped is 5oz. Is that normal? I know that dd is getting fed because she's got milk on her face after BFing. She doesn't have any problems latching and now I'm wondering if I'm not producing enough milk to both feed her and pump. Or maybe the pump I have isn't adequate. I am getting so frustrated and I haven't been able to get a hold of any lactation consultants in my area. They don't seem able to return phone calls and they're never available to talk to me.

My dh (insider) says MDC is the best place to come for support. I don't know if I need advice or just to hear that others have gone through this. I want to BF for at least a year and I have got to figure out whether I'm doing something wrong or if I need a different pump. I am so frustrated, if you have ANYTHING to offer... I have read LLL books, been to a few meetings, although I dont' attend now that I have a newborn. There doesn't seem to be any way for me to get advice on overcoming or adapting to problems with pumping.

[shelbean91]

That sounds about right to me. When I was nursing and pumping before I went back to work, I didn't get more than an oz or two at a time (both breasts combined). Just try to remember, it's a supply and demand operation. Until recently, your breasts were producing enough for your dd only, now they need to adjust to make the extra for the pump. Usually within a few days of pumping at regular times, you'll see an increase, but you generally don't want to pump too much extra or you could get into an oversupply situation, which is no fun from what I've heard.

If you think the pump isn't working properly, check the white membranes that attach to the yellow valves at the bottom of the horns. If those are torn or damaged in any way, it will effect the amount of milk you get. You might want to get a few spare sets to have on hand so you won't have to scramble if you lose one or one gets torn. Usually Medela will send a few for no charge. You can also call them to trouble shoot the pump, but most likely, you're doing just fine.

When you go back to work, you will be pumping INSTEAD of nursing, so you will likely get quite a bit more. Try to pump on the same schedule dd is used to nursing, or every 2-3 hrs while you're gone.

The first time I got milk from the pump, it was about 3 drops. Not long after that, I covered the bottom of the bottle- I was estatic. Then I increased from there. You can combine milk from different pumping sessions, just be sure to cool it first. If you're going to freeze, don't freeze more than 2 oz at a time. It's much easier to thaw more than it is to dump extra down the drain and have to catch up later.

Drink lots of water and try not to stress (I know it's hard). Congrats on the new baby.

[captain optimism]

How much you can pump will never be a good indicator of how much milk your child is getting when she nurses. Your baby is more efficient at sucking than the pump. Also it's easier for your breast to let down for the baby than for the pump. The baby is cute and smells like a baby and you love her. The pump is a pump. Not the same!

If you can afford it, get a copy of the book, Nursing Mother, Working Mother. They have plan for how to get more milk when you are first pumping. It's good to pump one of your breasts in the early morning between your two earliest feedings of the day. This might mean putting the baby down in her bed while you do that. Sorry, I know that's precious time.

I found that in order to get a good yield in pumping, I had to create a slight oversupply. I take lactation herbs, cyclically. (I've taken them on and off through the last 8 months of pumping.) Lately, within the last week, I started taking a B vitamin supplement with inositol in it, on the advice of someone here. This has enabled me to get more when I pump. Apparently inositol helps letdown. Since B vitamins are water-soluble it's hard to overdose on them, so this is worth a try.

The other things I've done that have helped: pumping at home in the morning every day (even on the weekends) drinking a lot of water at my desk during the day, drinking hot drinks including Mother's Milk tea. It's also good to have photos of your baby with you at the office to look at, or even items of her clothing.

I went back to work when my ds was two months part time and was full time by the time he was three months. It can be stressful, worrying about whether you will pump enough to meet demand. But it's been working for me. I've had a lot of support from people here. You can do it.

[shelbean91]

I second the Nursing Mother, Working Mother. It's a great book. I also wanted to add I went back to work FT when dd was 9 weeks old and I found once she hit a growth spurt, the 3 times a day I was pumping at work just didn't cut it. She was always a one breast nurser, so in the morning before I left, I would pump one side while she nursed the other, and I would do the same at night. She only got one 4 oz bottle of formula the whole time I she was nursing (after the first month it took for her to learn to nurse and get on the breast exclusively) and that was b/c I was late getting home by about 45 minutes.

But if you just started pumping, and she's only a month old, 5 oz is a great amt to be getting.

[xerxes]

Thank you very much for the support and optimism! I definately needed to hear from other mothers that I am doing things right for my DD. I do not know if it is a little bit of post partum depression or the guilt of having to go back to work when she is only 2 months old, but I just feel like I cannot adequately give her what she needs and will have to go to formula...yuk! I love her so much and I want to give her the best start possible in life. Did anyone else feel like that when having to go back to work? Captain Optimism, I will definately get the book you recommended. I need all the advice and help I can get. I do not want to get frustrated every time I pump.

[xerxes]

Shelbean91, do you recommend that I pump twice a day beginning now? My dd nurses on one side in the morning, which leaves the other breast somewhat full. Should I pump the other side during or after she nurses? Should I than pump in the evening doing the same thing? And this may be a dumb question, but by nursing on one side and pumping the other, is it possible to not have enough milk for dd if she decides to nurse right away again? She will usually go 1 1/2 to 2 hours before nursing, but sometimes she wants to nurse within 1/2 hour of the previous nursing. I am afraid she will be hungry and I will have depleted all of my milk supply.

[phathui5]

This is a good article from kellymom.com.
http://www.kellymom.com/bf/pumping/p..._decrease.html

She talks about different ways to increase your milk supply and your pumping output. She also talks about something called reverse cycling, which is basically feeding baby more often when you're together so he doesn't need as much when you're away. Maybe some other moms on here have had experience doing it.

As for the encouragement: This is something that you can do. Don't get discouraged at this point. You have some time before you have to go back to get some milk stored up in the freezer. You also have enough time to increase your milk supply so that your baby can get your milk when you're away.

[shelbean91]

I think I remember my LC telling me to not pump more than 4-6 oz above and beyond what baby is taking, but I'm not sure I'm remembering that correctly. If I'm wrong, someone will correct me.

If she only nurses one side, you shouldn't have a problem pumping the other side and still having enough for her. Also, the breasts aren't like 'holding tanks' where they just fill up between feedings, but milk is actually produced while baby is nursing. When you feel full, that is the signal to the body to produce less. When your milk supply regulates, you'll most likely lose that full feeling you get between feedings. It doesn't mean you're losing your supply, but that you're making just enough. Not too much, not too little. It is a little bothering, especially as for me, it happened not long after I returned to work.

If you can pump twice a day now, I think that would make you more comfortable when you return b/c you'll be able to build up your 'freezer stash'. Even if you only get an ounce or two (or 1/2 ounce) at a time, it adds up quickly. You can layer the pumped milk in the fridge during the day and freeze it at the end of the day. If you can't pump twice a day, just do what you can, but try to do it at the same general time each day. The morning is usually when you'll be able to get the most.

Also, if you like oatmeal, that's supposed to boost milk supply. It doesn't matter if instant or not, can even be in cookies!! I don't know if it's a mental thing or not, but my pump output increased by a couple of ounces a day when I started eating oatmeal for breakfast and having oatmeal cookies on break.

You'll do fine when you go back. I know it's stressful thinking about it, but you can do it. I pumped for my dd until she was about 13 mos old, and she didn't wean until 20 mos, when I was 5 mos pg w/ds. Ds just weaned at 20 mos. I didn't have the pumping issues w/him as I stayed home after he was born, but we had all sorts of other troubles getting him to nurse.

It's great you're getting all this sorted out before you go back. One less thing to worry about when you return. I read somewhere to return to work on a Thurs or Friday to ease the transition, rather than return on a Monday. I would recommend that if possible. It really helped me quite a bit. I figured even if the day sucked, I'd be able to have the weekend to recover and regroup. Surprisingly, it wasn't too bad.

[Quirky]

I third the recommendation for the book Nursing Mother, Working Mother. I would definitely pump the other breast first thing in the morning. If you get only an ounce or two a day, that's 30 to 60 ounces in the freezer when you go back to work, which is quite a respectable stash!

Keep in mind that your freezer stash will be your emergency backup supply. Your dd will be drinking the fresh stuff you've pumped the day before, so you only need frozen milk for when she has a growth spurt and gets super hungry or some other unusual situation.

Your dd may also reverse cycle, ie wait for you to get home and only take a little from the bottle during the day. So you may end up with an enormous freezer stash from all the milk you pump (which you need to do to keep your supply up) but she doesn't take. You just won't know until you get there.

In about two weeks or so you'll want to start introducing dd to a bottle to make sure she'll take it when you go back to work. Make sure to use a #5 plastic bottle like the Medela bottles, not #7 polycarbonate like Avent, because of the plastic leaching issues.

Also, on the pump - what speed/suction do you have it set at? And do you think you might need a bigger or smaller flange than the one the pump came with? Some women with bigger or smaller breasts/nipples find that a different size flange is more comfortable and more effective at expressing milk.

Don't worry, you can do it!

[DaryLLL]

Hi Xerxes,

And congratulations!

That is Bach (not Back) Flower Rescue Remedy Hilary is talking about. It can calm your nerves, should you need that.

NO, you will not need artificial baby milk. Millions of mothers every day, nourish their babies on their own pumped milk while they are at work. And you will too.

It can take time to learn how to let down to a pump. Some moms run water in the sink, or take to work an item of baby's clothes and smell it. Or a picture of the baby.

Why not go bqck to LLL? There will almost certainly be a couple working moms at the mtg for more moral support and BTDT info. If your IBCLCs won't return your calls, call your LLL Leader(s). They mayb well have the above reced book in their library to borrow.

Good luck!

[tnrsmom]

Xerxes, I just want to say congratulations. You sound like such a loving mom. I think you have gotten some great advice from the mamas here. I had great success pumping while I was nursing. The letdown reflex was already there so I was able to catch that milk *naturally. Maybe that would also help your body get used to the pump. I am sure you will be able to pump successfully when you go back to work, it just takes practice. I have a great friend who has pumped for all three of her children while she works as a nurse and none have ever had formula. She has always told me that pumping is an art and it takes practice.
I would have your dh assist in giving the bottles before you return to work. Often babies refuse a bottle from the mother because they know that is the *real source*. If your dd seems to have trouble with a bottle, you might want to try a different nipple.
Good luck to you. I can feel it in my bones that you will do great!

[xerxes]

Thanks everyone for the great advice and support! Jane, I am using 1 to 2 speed and middle suction. What do you mean by the flange? Is that the actual piece you place on the breast? Thanks for the advice on the plastic to store in...my dh and I have a chart on the fridge that tells the good plastic from the avoidable plastic. It is amazing how many things I had to change based on that chart! We started all of the changes while I was pregnant. It is also amazing at how many of my friends think I am crazy when I constantly check to see the recycle code before eating or drinking something! One can never be to safe when it comes to the health of our little ones! I am going to call medela today because I cannot read the recycle code on the bottles that came with my pump. It actually looks like a 6. DH and I both could not make it out. I am going to order the Nursing Mother, Working Mother book today! My dh is very excited because he gets to also order a book, so that I can get free shipping! And good news...I feed dd on the left breast only last night and pumped the right side after her 6am feeding...I was able to get 1 1/2 ounces! I was so excited! I have been taking Fenugreek for 2 days now, so that may have helped. Anyone have advice on Fenugreek? How long should I continue to take it? And is it a good idea to only feed on one side at night and pump the other in the am?

[xerxes]

Hilary, I forgot to mention in my last post... where do you find U-bags? Do you just attach them to the breast and the let-down fills it? That would be great because I do leak quite a bit if I do not have a breast pad on!

[captain optimism]

I don't find the smell of fenugreek in my sweat too oppressive. It's like maple syrup. I thought it would be really annoying, but it's not. Not as weird as the way my urine is fluorescent yellow since i started taking the B vitamins!

I also take nettles and blessed thistle, all in capsules. The tincture is stronger but I didn't take the stuff when I got tincture, so I went over to everything in a pill. Usually I take two of each herb at meals. But sometimes I forget. I didn't start taking lactation herbs until I went to work, though. My breasts produced quite well for the baby, it's the pump they don't like. Funny, because the pump has never bit me () and the pump is relatively gentle. The thing is, breasts were designed for babies, not pumps. I said that before, but it's still true. (But I typed this while pumping! )

Try this page for more on lactation herbs (aka galactalogues):

http://www.kellymom.com/herbal/herbal_galactagogue.html

Lots of nice links.

Anyway, tell us more about this plastic stuff. I want to know which kind is which.

[Tracy]

I'm so glad you got some good postings. I shook the tree a little bit and asked a few kind moms who know more about nursing than me and asked if they would be kind enough to make sure you weren't neglected.

One thing I can tell you is that you do need to double check the suction on your machine. I had a problem on mine..as I recall there was a tiny hole in the tube that I could not see but it was enough to alter the suction. when I got a new hose it was a whole new day in our house... Milk by the gallons..well, maybe not gallons but a sure heck of a lot.

here is some more on lactation teas:

http://www.momsinmind.com.sg/tea4two.html


also, I'm with darylll on trying out LLL again and see if you can get some more advice on the pumping and the machine.

I had a great lactation consultant in our area and she was easy to access, I"m bummed the ones in your area aren't returning calls. And they get pissed when moms ditch nursing!!!! Gee maybe if you returned calls...anyway, no soap box here.

keep us updated. Tell your husband we're all crazy about him still.
hugs
tracy

[Candide]

Hilary, Xerxes already mentioned that insider is her dh. I'm guessing it doesn't matter that we know. Sorry to jump in on this thread but I did want to post about the dangers of certain plastics that Jane mentioned.

Here's a link to the plastic recycling codes and which numbers to avoid:

http://www.thegreenguide.com/doc.mhtml?i=77&s=plastics

[Quirky]

Originally posted by xerxes
Thanks everyone for the great advice and support! Jane, I am using 1 to 2 speed and middle suction. What do you mean by the flange? Is that the actual piece you place on the breast?

Yes, aka the horn. Some women find that a bigger or smaller size is more effective for them. In other words, are your breasts getting lost or totally squished in the horns, or do they seem comfortable?

You could probably try upping the speed and see how that works for you. I found the PIS to be pretty mild in suction compared to the hospital grade pump I had to use at the beginning. It worked fine when I went back to work at 5 months and my supply was up, but it didn't work when my milk wasn't in and then when I had low supply issues. Not all of us are blessed like Hilary with enough milk to feed the village.

I am going to call medela today because I cannot read the recycle code on the bottles that came with my pump. It actually looks like a 6. DH and I both could not make it out.

Medela bottles are #5, polypropylene, and are fine.

On the fenugreek front - are you taking 3-4 pills 3 times a day? You should definitely notice the smell, otherwise you're not taking enough. Adding blessed thistle (same dosage) is a good choice too.

HTH!

[Tracy]

My dh (insider) says MDC is the best place to come for support.

See..Hilary... I didn't spill any beans. thought I'd take the opportunity to share the ....

[PumpkinSeeds]

Just wanted to caution that fenugreek gave my ds the worst rash all over his body. If you start to see spots all over your babe.....

[PumpkinSeeds]

I pumped for fourteen months and I wanted to add that what really helped me so much is drinking AT LEAST a gallon of water a day. No joke.