Pumping enough for my babe (sigh).

[ashleyc]

I have just returned to work and I am cannot pump enough to cover all of my baby's feedings while at day care.

He has been growing fine.  He's 15 lbs at 4 months and was gaining over an ounce a day until the last few weeks when it's been more like 3/4 of an ounce, but I think this is normal.

Given his weight he needs 4-6 ounces per feed and, if I'm very lucky, I might pump 3 ounces but usually it's more like 2.5.  It is SO frustrating.  I know, I need to relax and not be frustrated and imagine my baby while pumping.

I am taking Fenugreek, Goats Rue tincture, Mother Milk Tincture, making a tea of Shativari Root and drinking that (the only thing that seems to help) and just ordered some Milkin' Cookies to see if those will help too.

I feed him first thing in the morning, when I get home from work, before bed and then usually twice during the night.  And I pump twice while I'm at work.  I could try to increase this to 3 times.  Also, when I pump I will pump for maybe 10 minutes - that's until my breasts seem empty and a little longer, but I do not pump for 20 minutes.  That is a LONG time but is it really important I extend the length of how often I pump?

At the moment, we've been supplementing with organic formula, which I am NOT giving myself a hard time about.  I'm doing the best I can do.  BUT I would love knowing I can provide everything he needs :)

And thoughts would be great!  Thanks!

[Megan73]

What makes you think you're not pumping enough?
I ask because BF babies (unlike FF babies) do NOT take in more milk as they get bigger, taking in between 19 and 30 ounces (25 is average) a day from one month until they start solids. If I were you, I'd check out the handy milk calculator at kellymom.com and the fact sheet for caregivers on how to bottle feed the breastfed baby to prevent overfeeding.
If your pumping output is truly low, the book "The Nursing Mothers Guide to Making More Milk" has good tips.

[Monkey Keeper]

Originally Posted by ashleyc 

Given his weight he needs 4-6 ounces per feed and, if I'm very lucky, I might pump 3 ounces but usually it's more like 2.5.  

This may not be true, depending upon how much he gets when nursing directly the 4x he does. BF babies don't necessarily take level feedings. IME, my DD2 was over 15lbs at 2 months, and she NEVER took a bottle bigger than 4oz in her first year of life. ITA with the previous poster to find out *how* the DCP are feeding your son--it could be the way they are giving the bottle that is forcing him to eat a lot more than he needs.

Quote:

Originally Posted by ashleyc 

 Also, when I pump I will pump for maybe 10 minutes - that's until my breasts seem empty and a little longer, but I do not pump for 20 minutes.  That is a LONG time but is it really important I extend the length of how often I pump?

It's possible you could get another letdown later. And the more you pump, the more you stimulate your supply. I personally would pump longer AND add a 3rd session til you get your supply up.

 

Another good option for boosting supply is having a "nurse-in" for a weekend while you are off work. Lots of skin-to-skin, on demand nursing for a good couple days. Finally, remember to eat enough AND drink enough--you can't make milk if you're not fueling your body, and I know it's hard when you're back in the whirlwind of working. 

 

Good luck!

[LynnS6]

When I was pumping at work, I found the resources on kellymom.com invaluable. I had one child who I produced (barely) enough milk for, and one child who reverse cycled. So, even though I was gone 8 hours a day, she did most of her feeding in the morning before I left, in the evening when I got home, and every 2 hours during the night. Some kids just don't eat that much during the dya. I'd start with this page: I'm not pumping enough milk. And here's the calculator: http://www.kellymom.com/bf/pumping/milkcalc.html#calculator

And for what it's worth, my reverse cycler was very healthy and gained weight at a good clip. Here she is one month after I started back to work. Those rolls of fat are still there.

And here she is 6 months after I started back to work. Those chubby cheeks are still going...

[JulieInChicago]

You might want to try to post this in the "breastfeeding challenges" forum too?

I've been pumping at work since mid-December last year.  I'm no expert, but my immediate thoughts:

- My son, too, never drank a bottle more than 4oz, and at 1yo, still hasn't.  He usually eats about 7-9 oz while I'm away for 8.5 hours.  He reverse cycles but only slightly.

- It's super easy to freak out about how much milk you're producing, but remember that both your baby and you can help regulate.  When I'm freaked out I remind myself that on Saturday and Sunday my son resets my boobs to produce what he wants, so on Monday, as long as I'm pumping at about the time he eats, I'm getting exactly what he was taking on Sunday.  Which is good!  Like PinkBunch said, make sure your baby is eating on-demand from you (no formula) all weekend long and it should reset you to meet supply by Monday.

- I always pump for 20 minutes.  I'd rather get too much than too little- and usually by Friday I'm producing a full bottle more than I need.  Which is good!  I also noticed that I usually have a 3rd let-down around 15 min in, and I don't want to switch off before it's over.

- My son has been at 49-51 percentile for height and weight, so whatever we're doing is working...

One more tip... make sure you're in the right frame of mind when pumping.  Some women can use a hands-free bra and pump while working but that's unusual.  Most women need to shut down the computer, relax, pull out a photo of baby, walk away from their desk/workspace.  I have a big photo of my son plus it helps if I focus on what he smells like- think about the smell when you sniff baby's head- and then I'm good to go.

[katebovi]

You've already gotten great advice--my 6 month old girl also has never taken a pumped bottle of more than 4 oz.

My pump goal at work is to produce an ounce for every hour that alice and I are apart. I was 2-3 oz shy of that goal every day even though I pumped 3 times per day. I started using a hospital grade pump, taking more milk plus, and working hard to trigger a second letdown. Now I get 2 oz over Alice's daily pumped bottle needs (7 oz vs 12 oz) and I can use the extra to mix up her cereal. And I only pump twice a day now. It might be worth trying a hospital grade pump and fiddling with the controls to figure out if you can trigger a good second letdown.

Good luck!

[Snapdragon]

I think pumping for 20 minutes insead of 10 each time would help a lot. If you can do it. I notice an increase in supply in general when I pump for longer times.  Also, drinking water (1-2 glasses ) before you pump helps.

[askins]

*Hug*  This must be nervewracking.

I would try to get a more accurate estimate of what your baby takes in per feeding than going by the guidelines of "4-6oz"  The difference between pumping 4 and 6 oz per feeding is HUGE when summed over the day!  Babies volumetric intake doesn't change much after it stabilizes around 6-8 weeks, just the formulation of the milk changes to provide more or less calories/fat/protien/sugar.  So take him to your pediatrician's office or lactation consultant or midwife - anyone with a baby scale - when he should be good and hungry.  Weigh him (with diaper, so in case he pees or poops, the only change measured is the milk you added), then nurse him, then weigh him again.  The change in weight is the milk you added (since the density of milk is approximately 1).  My baby takes 4 oz per feeding. I've done this test several times and it seems like however hungry I think he should or shouldn't be, he always take the same 3.8-4 oz.

If your baby typically eats every 3 hours-ish, I would do all you can to pump 3x/day at work.  Maybe your boobs just have a slightly smaller than average storage capacity.  If this is the case, you'll need to pump more often.

In addition to making sure you are relaxed and hydrated for pumping, make sure you are warm enough (I usually need to throw a sweater over my bare shoulders), and that you don't have to pee or hold anything else in.

Best of luck - I hope it gets better!

[askins]

Oh, I was also going to add, try doing breast compressions while you pump - just a gentle massaging action.  This gets me about 1.5x as much as pumping alone. 

[AnkaJones]

Hi, I just wanted to second about checking in on how the daycare is giving bottles.  I started giving my daycare provider 2 oz bottles rather than 4 oz bottles... and suddenly my baby only needed 2 oz at a time!  I leave the exact same amount of milk but now it's enough rather than running out at noon. My caregiver (who is really wonderful, by the way, just not used to breastfed babies) is in the mindset that a baby should take 'a bottle'.   I also agree with the Kelly mom thing, where you figure your baby is taking at most 30 oz per day, so if you're gone for 8 hours, figure 10 oz at most.  If you're off by a little bit, your baby will make up for it at the other feeds. 

Also, if you can, get someone to look at you and your pump IRL. I had some funky breast sheild fitting issues early on.  Didn't hurt me at all, but I wasn't able to pump as much milk.

Finally, regarding  pre and post feed baby weighing: keep in mind that if you do the starvation approach, you're getting an overestimate of how much he takes at each feeding... you really need to know what an average feed is, which you can do if you are willing and able to rent a baby scale for 24 hours or if your LC or pediatrician is willing to just let you weigh the baby without going through a big check in process.  Or, you can often use one of the scales at the supermarket if yours has the right kind of scales -- just go a few days in a row at different times.  It's quite the conversation starter .

Best,

Anka

[greenmulberry]

Originally Posted by Snapdragon 

I think pumping for 20 minutes insead of 10 each time would help a lot. If you can do it. I notice an increase in supply in general when I pump for longer times.  Also, drinking water (1-2 glasses ) before you pump helps.

This is true! I just pumped 8 ounces earlier at work. I had only pumped perhaps 4 ounces at most in the first ten minutes, but I pumped for a full 25 minutes and kept getting let downs.

Yes, you feel empty between letdowns. Have a book or a laptop or something to read so you don't think about your milk. Pumping longer tells your body you need to make more milk for those times.

I also find I get more milk if I drink water while I pump. I have no idea but it seems to help so I keep doing it.