Major supply issues and I desperatly need help

[amyhulen]

I need some serious help in bringing my supply WAY up. Heres the scooop,

DD is 3 1/2 weeks old, EBF with bottles of pumped milk given by dad a couple times a day

I had a very difficult but completely natural delivery of a sunny side up baby (recovery from that took 2 weeks)

8 days after giving birth I got a nasty case of Mastitis in my right breast and I was put on antibiotics for 10 days

I plan to pump full time for another baby whose mom cannot produce, she is due in 5 short weeks and I am looking to play catch up

For the first week I was pumping an additional 6+ ounces of milk per day for the recipient baby and freezing it. But I ended up discontinuing the pumping for a period of time due to being so sick from the mastitis.

Up until a few days ago I had almost no appetite and wasn't eating nearly enough calories to sustain breastfeeding 2 babys, however in the last few days I have been forcing myself to eat hungry or not just to get the calories in.

I have been drinking plenty of water all along and making sure I take my vitamins.

I have never had a supply issue while breastfeeding my other 2 children.

I do have hypothyroidism which I do take medication for.

I have a great Medela PISA that I have been using all along.

In the last week or so my supply has diminished to the point that I am pulling bottles from the freezer to feed our daughter on occasion because I am simply not producing enough for her much less a second child.

I did buy Fenugreek a few days ago and it has helped somewhat, for instance I was able to pump 2 oz from 1 breast this morning which is a big deal, while previous to the mastitis I could have pumped 4 oz from one breast if I hadn't nursed on that side for several hours.

I haven't been pumping on a schedule of any sort because I was very sick during the first 2 weeks postpartum with colds and mastitis, and we also had people in and out of our house constantly trying to help me out with our 3 girls while I healed from my very difficult OP birth.

I am wondering what the problem could be?

Could it be the supplemented bottles of pumped milk?

Am I not pumping often enough? I empty my breast but they just aren't filling back up.

Does the actual time spent at the pump make a difference or is just emptying the breast enough? DD is a speed eater and doesn't spend any time at the breast just nursing for the fun of it. When she is done she is done and if she isn't hungry she won't have anything to do with the breast, she just clenchs her little mouth shut.

I know DD is thriving because she constantly soaks her cloth diapers, is gaining weight, and is almost never fussy except when my breasts are empty and shes looking for chow.

Starting today, now that things have settled down at my house I have set a timer to pump for 15 minutes every 2 hours on 1 breast while EBF from the other, tomorrow I was going to do the same and just pump from the opposite side. I am trying to avoid constantly having to supplement with bottles.

I am looking for any tips from others who have experience with pumping. TIA ladies

[PatioGardener]

Originally Posted by amyhulen 
Could it be the supplemented bottles of pumped milk?

 
  THIS.

Your baby is the right age for a growth spurt.

If I were in this position, I would let baby nurse as often as she wants, and not feed her any bottles. If my pumping output went down during baby's growth spurt I would not worry, and it should bounce back as baby works to increase my supply. I would keep pumping, just not worry about the output.

Good luck with your pumping quest - that's awesome of you, Mama!

[CheriK]

You've had a rough start even without trying to coax your body to make milk for 2 babies!

I would concentrate on your own baby and your own health.  It's incredibly generous of you to want to provide EBM for your friend's baby, but your own family should come first.  If you can add pumping sessions without making yourself crazy, shortchanging your family, and affecting your health, then wonderful.  But you need to heal and take care of yourself, too! 

It's really hard to build and maintain a full milk supply by pumping.  Your baby, if nursed on cue and not supplemented, should signal your body to produce just the right amount of milk for her.  Most women don't respond as well to the pump as to a baby.  So it may be very very difficult to ever produce a full supply for your friend's baby.  You'll have to judge what's realistic as far as how much time you can spend pumping long-term.
 

Yes, replacing bf sessions with bottles could be impacting your supply.  Your DD may be getting more milk from the bottle than she would at your breast and then delaying her next nursing session.  Your baby may be developing a preference for the fast, easy milk flow from the bottle & becoming fussy at the breast, not because there's not enough milk, but because she's learned that she doesn't have to work for it.  Pumping is NEVER as effective as a baby nursing, so replacing a nursing session with a pumping session isn't an even trade.  Encouraging your DD to nurse more often, nursing instead of giving bottles, and taking a "nursing vacation" (spend a weekend in bed with your baby, skin-to-skin, encouraging her to nurse as often as she wants) will help get your supply back up to speed.  If you're still struggling to make enough for her needs, there may be other issues causing low supply.

Mastitis can decrease supply.  Inflammation can lead to decreased milk production so your body needs to recover from that.  More time nursing will help.  Nursing on the right breast first and doing any comfort nursing she'll allow on that side will help.

Have you had your thyroid tested since you gave birth?  Your need can change during pregnancy and postpartum; hypothyroidism is a known cause of low milk supply so do make sure your level of supplement is adequate.

Does your DD normally only nurse from one breast?  Pumping one side while nursing the other is a good way to trigger a letdown and get more milk with the pump, but again, make sure you're not short-changing your own baby.  Still offer her both sides.  Remember that even after pumping there will still be milk in your breast & she's going to do a better job of removing it than the pump will. If this is leading to her being fussy at the breast, then she probably needs more milk than she can get from one side, at least until your supply is bigger.

Often, when moms are working to build supply, it's recommended to pump immediately after breastfeeding.  It's normal for baby to leave a small amount (1/2 - 1 oz) in the breast; removing that milk signals your body to start producing more.  You won't get a lot this way, but you're sending a signal to your body to make more.  You don't have to pump every single time, though.

Usually, if mom is pumping instead of breastfeeding, it's recommended that she aim for 120 minutes of pumping a day.  That works out to 10-20 minutes 8-12 times a day, or about what we'd expect a newborn to nurse (although most newborns are very happy to nurse more ;-).  Pumping for at least 15-20 minutes, or until you're only getting occassional drops of milk, is often recommended.  For some moms, "power pumping" (keeping your pump equipment set up and doing many very short sessions throughout the day) can also help build supply.  But, what's realistic in your situation?  You're breastfeeding a baby full-time, and mothering 3 children, so this might not be realistic.  You might want to read the information about pumping to increase supply at http://www.lowmilksupply.org/pumping.shtml. 

[amyhulen]

Thanks for the support ladies. I have come to the conclusion that I desperatly need to take a vacation from pumping. I honestly believe that supplementing with the bottles is having an impact on my own daughters desire to nurse directly from the breast. Today after pumping I had to supplement with the pumped milk for the next two feedings and as a breast feeding mom that was a pretty hard pill to swallow.

I did have my thyroid levels checked at my 2 week PP check up and my dose of Synthroid at that time seemed just a little high but we are going to check again at the 6 week check. I have been on this current dose for several years so we are hoping things will settle back out on thier own.

I am finding the constant pressure I have put on myself to produce milk for a second baby is definatly impacting my day to day life. Squeezing in even 15 minutes every 2 hours with 3 kids and errands has become a huge task and not something I look forward to even after a day and a half. Besides its really hard to enjoy the breast feeding experience when your constantly thinking in the back of your mind is my LO getting enough to eat (granted I know she is because she is definatly thriving).

I think the best move for us is to simply take a break for a week or two and possibly try again after my body has had more time to heal and rather than spending my days pumping I could probably benefit from a daily kangaroo nap with my baby. Babies are only babies once after all and I want to make the most of this time I have with her being so small and snuggly.

Perhaps in a few weeks my body will get with the program and be more cooperative in my desire to help another mom in need. Thankfully I still have some time to figure out if this is going to work for us or not.   

[PatioGardener]

It sounds like you are going to take a well deserved break! I hope that you enjoy the time with your snuggly baby

[kanga1622]

Mastitis took a big toll on my supply and even 2 months after I have been off the antibiotics, I still pump fewer ounces that I did before. Have fun with your nursling and enjoy your pumping break. I love the days I don't have to pump.