Trying to breastfeed, can't pump enough at work

[Mama2Dane]

My baby is 2 months old now and I had to return to work when he was 3 weeks old. We had supply concerns in the beginning and started him on formula supplementation week one. I Despise using the formula while I'm at work, but I don't know what else to do. On my days off, he's satisfied with nursing and doesn't need any extra bottles; but I wasn't able to get any milk stocked up and can only pump about 5-7 ounces total a day. Does anyone have suggestions that I haven't tried?
I am currently taking fenugreek supplements, blessed thistle herb, borage oil, pulsatilla, drinking the tea, and I pump at work 3-4 times a day. I work an hour from home, so although I would love to have my husband bring my son to me to nurse, it's just out of the question. I have a medela pump... I don't know what else to mention. Help?

[akind1]

Have you tried pumping at home? I used to pump after a feeding, especially if I still felt kind of full (I was really engorged the first few weeks) I think this might help your supply some (both boost breast supply and your back up)

are you able to pump comfortably at work? I find it really helps to not focus on pumping as I'm doing it; read a magazine, etc.

I don't know if there is a way to encourage reverse cycling? where the baby eats less while you are away and chows down when you are home - might be worth looking into.

- HTH

[Poodge]

Have you tried renting a hospital grade pump? They are a pain to haul around, but work better at uping supply. Could you rent one and leave it at work?

[Mama2Dane]

I've tried pumping at home a little, but I haven't been very consistent. I never really get much at home. I did try again last night, though, and I think I'm going to keep on it. Will my baby still get enough if I pump at home too?

I have a medela pump that someone gave to me. How do the hospital pumps compare?

[ein328]

It's hard to say how a hospital-grade pump compares to yours without knowing which model you have. I currently rent a Medela Lactina and it has worked out very well. In general, the hospital-grade pumps are more effective at maintaining supply because they are stronger, pump both breasts at once, and beyond that, cycle so that both breasts are used at the same time (i.e. they don't shift from left-right each time).

[jecombs]

A hospital-grade pump is going to be better at getting the milk out. They have a stronger motor. With your pump, when was the last time you changed the membranes? If they get a little worn, it can really affect the suction. Your baby will still get plenty if you pump at home. Remember: supply and demand. Pump after your baby feeds to continue to stimulate your breasts to produce more milk.

You might also want to try having a "nurse-in" (like a sit-in) weekend with your baby. Shelve all committments, don't clean the house or do laundry, eat take-out or make DH cook, and don't have any visitors or do any entertaining. Strip baby down to his diaper and take off your shirt and do constant skin-to-skin contact all weekend. Curl up on the couch under a blanket with LO and watch movies. Take a bath with LO if you feel like it. I had a supply dip due to stress and a nurse-in is what brought my supply back up. Just focus all weekend on baby, baby, baby.

Beyond that, make sure your childcard provider is not over-feeding your LO. On average, LO needs 1oz. of BM per hour you are separated. A lot of childcare providers don't understand how BFing works and that the composition of BM is constantly changing, so LO won't necessarily need to increase the volume of BM they eat as they grow (as is the case with formula). I had a huge problem with a sitter wanting to feed my DD 6oz of BM 3x a day. Holy cow! I couldn't keep up with that! And DD did not need it. Make sure you childcare provider is trying other ways to soothe your LO before offering the bottle (rocking, walking, paci, etc.).

[ein328]

Ahh great points, ladies!

I would also add: ask your sitter to try not to feed baby within an hour (or so) of you coming home, if at all possible. As mentioned above, she can try other methods of soothing. Then she will be hungrier when you get home, nurse for longer, etc. You basically want to minimize the number of bottles and the amount given by bottle.

Also, do you co-sleep? Sorry if you already mentioned! Nursing a lot at night helps, too.

When I first went back to work, my daughter reverse-cycled, and it worked great for us. My nanny basically soothed her back to sleep when I left, and the more she slept, the less she ate. Then most of her eating/activity time was with me, which I loved.

PS The idea of a nurse-in is lovely! Great for working mamas :-)

[CheriK]

In addition to considering a hospital-grade pump, consider having your pumping evaluated. Do the flanges fit well (most of the pump websites have info on fit - and correctly fitted flanges can make a HUGE difference). Sometimes tweaking the way you set the pump can also help w/ output.

How much of the galactogogues are you taking? 3 capsules 3 times a day of the fenugreek, and the same for the blessed thistle is what's usually recommended. Your milk, sweat, and urine will smell like maple syrup! And unless you drink a LOT of the tea, brewing it for a long time in very hot water, a tincture like More Milk is probably a better choice as you can be sure you're getting an active amount of the herbs. Teas usually don't provide enough active herbs unless you're steeping them to make an infusion (the book Nursing Mother's Herbal has several galactogogue recipes if you want to try different combinations of herbs).

Some other ideas that can help:
Keep up your pump schedule at home, even on the weekends. So if you normally pump at work at 10, 1, and 3, pump at home then too. You won't get much (after all, baby is more effective than the pump and you'll be nursing also), but it will help boost your overall supply. And if you can collect a few extra ounces over the weekend, wonderful!
Pump regularly at home. When I was working and pumping for my twins, I pumped every morning. I'd nurse them in bed (they'd fall back asleep), get up and shower, then pump while having my morning tea. Again, not a ton of milk but my body adapted to that regular routine and I gradually increased the amount I got. It made the difference.
For some mothers, it works well to pump one breast while baby nurses the other. Then, switch baby and pump. Baby will trigger letdowns more effectively than pumping alone, and there's still milk in the second breast for baby as the pump isn't as effective as baby.

Many women aren't great producers for the pump, so it's wonderful that you've realized your baby gets plenty of milk when nursing directly and that low pumping output doesn't mean low supply. Anything you can do to get baby to nurse more while you're together will help. Wake baby for an extra feed in the morning before you start getting ready for work. Nurse immediately before leaving, and immediately after getting back to baby. Sleep with baby and nap with baby on the weekends. Wear baby in a sling so he can nurse while you go about your evening routine.

Good luck! He's getting MOSTLY your milk, and every little bit counts. Even if you do have to supplement occassionally, you're doing a great job.

[abiyhayil]

It would help me a little to do compressions while I pumped (squeeze as it sucked)

[Mama2Dane]

Thankyou so much for all the helpful suggestions! It's unbelievably comforting just finding support on here. The Medela I use is the pump in style. I've only had it for a couple months, but the woman I got it from used it for her second child and about a week for her third. I don't really know how much she used it overall. I know that I haven't changed any of the parts since I've owned it, so I guess new membranes are probably in order. Can pumps wear out? How would I know if it has?

We do co-sleep with our son, but he sleeps too well! He'll usually go about 6-7 hours straight without nursing at night. Should I be setting an alarm to nurse? I've been thinking about that anyway, just so he'll sleep more during the day and get more milk when he's with me. Is that a part of reverse-cycling? I need to look into that more... this is the first I've heard of it.

I've been taking 3 caps of each the fenugreek and the blessed thistle herb 3 times a day. I noticed the strong maple smell for a few weeks, but if it's still there I can't tell anymore. I've been taking the supplements for about seven weeks now.

[CheriK]

Yes, pumps do wear out. At the very least, I'd replace the membranes. A pump retailer can test the suction of your pump, since the motors do wear out eventually and it could be simply the end of its productive life. These pumps are designed for single-users - so one mom pumping part-time for one or maybe two babies.

I'd nurse him at night if you can. Does he go to sleep before you do? You might try nursing when you go to bed. He probably won't even wake up all the way. Best is if you can watch his sleep cycle and offer to nurse when he's in a light stage of sleep (you see eye movement under his lids, limb movement, nursing in his sleep). Otherwise he's going to be harder to rouse. Yes, that's part of reverse cycling. Many babies will increase nursing while Mom is home and increase sleeping during the day. You could definitely encourage that if you want! Certainly something to weigh - the need for formula supplement vs. the benefit of a full night's sleep. Not every mom will choose reverse cycling! And as he gets older, he might naturally start to wake more as he starts teething and the like.

[PatioGardener]

Getting in one nursing between 1 am and 5 am is really important to keep supply up - your natural milk producing hormone is highest at that point, so taking advantage of it is a good idea!

[smpayne]

Originally Posted by abiyhayil

It would help me a little to do compressions while I pumped (squeeze as it sucked)