Can't pump enough milk :(

[medmom7]

A bit sad this evening. I'm trying hard to pump milk for my little one (4 months) but my supply is way way down. I have been working 12 hour days 6 days a week and not getting a whole lot of sleep or hydration. I know what I need to do: rest, drink more, pump more but am having a really hard time doing it. So baby is now having to drink some formula.

What would help the most? Pumping more frequently? Longer pumping sessions? Drinking tons of water? I am taking fenugreek (I keep it in my pump bag) and that helps a bit I think. Or maybe there is nothing I can do, that there is no substitute for just being with my baby....

[BridgetC]

Of course, feeding more often is the best way to boost supply, but after that pumping more often would be the next best option. Frequency is much more important than length of session. There is no such thing as too frequent. If you can get two minutes of pumping on each side every hour for a day or two, you can probably boost supply fairly quickly.

If you can cosleep and let him nurse throughout the night, it is really useful for building up supply (don't know if that is workable for you or not, but it is something to consider.) Even if you can let him nurse a little while in bed with you and then return him to his crib, that can help.

If you do have to supplement, always pump whenever you give the baby a bottle. If you skip pumping sessions, it can decrease your milk supply.

Can you bring a bottle of water with you to work and try to finish it during your work day? That might at least get a little more water in you.

Good luck!

[kitchensqueen]

I don't know what your pumping schedule is, but if you're not already doing it every two hours, bump it up to that. I've been there, and that worked for me. You cannot skip a pump when you're trying to rebuild supply. And you should really wake up in the night for at least one pump if you can (that's the hardest, I know). Also, make sure you get everything ready to go for the next time you pump as soon as you're finished - that way when it's time you don't have to scramble to wash the parts or find a bottle, further delaying the process. 

[mambera]

Sigh.  Hugs to you medmom7 - I saw your other thread and understand you are a resident (I'm just finishing with residency and into a fellowship).  Unfortunately the answer to this issue is: get the heck out of residency.  Residency with a young child is hard, hard, hard.  It is beyond difficult to keep up a milk supply when away from baby 12h/6d as you describe.

If you cannot rest more or pump more, perhaps you can try lesser measures like eating lots of oatmeal (does the hospital cafeteria carry it?), drinking lots of water (put a tiny bottle in your white coat pocket and take a swig every time your pager beeps, refill at water fountains), or taking a supplement like More Milk, More Milk Plus, or shatavari?  (I've tried all of those as well as fenugreek and honestly never got results from any of them but everyone is different and some people see good improvement so it's worth a try.)

Something else I've done is hand express when I could not pump - you can carry a little bottle around with you and hand express an oz or so in the restroom whenever you get a moment, instead of having to find 15-20 minutes to sit down in a private place with a double electric.  Or if the bottle is too much to deal with you can actually just hand express over the toilet - you waste the milk but at least it is additional stimulation.

Other than that I would just not beat yourself up about a little formula.  I think once you are past gut closure at 4-6 months a little formula supplement is not a big deal at all, you could consider it just like any other non-breastmilk food you might offer.  As long as the formula is given only while you are at work and not when you are with baby it won't make a difference for supply since all your stimulation is pump-based during that time anyway.  Good for you for making it this far!

[Megan73]

Have you thought about trying domperidone? It's a drug for gastric motility that has the side effect of raising prolactin levels. It's one of only two evidence-based galactagogues that I know of and without the nasty potential side effects of Reglan. It might help.
Hang in there, mama.

[emilysmama]

Originally Posted by mambera 

Something else I've done is hand express when I could not pump - you can carry a little bottle around with you and hand express an oz or so in the restroom whenever you get a moment, instead of having to find 15-20 minutes to sit down in a private place with a double electric.  Or if the bottle is too much to deal with you can actually just hand express over the toilet - you waste the milk but at least it is additional stimulation.

Other than that I would just not beat yourself up about a little formula.  I think once you are past gut closure at 4-6 months a little formula supplement is not a big deal at all, you could consider it just like any other non-breastmilk food you might offer.  As long as the formula is given only while you are at work and not when you are with baby it won't make a difference for supply since all your stimulation is pump-based during that time anyway.  Good for you for making it this far!

Well, when I was pumping, my schedule was not nearly as bad, but there were some bad parts.  I worked 15 hour days for three days a week, and the other two weekdays were 9 to 5. 

Definitely pumping more often is much better than pumping for a longer duration pumping session.

I think, were I in your shoes, I would consider doing three things. 

First, I would change my goal.  I would just concentrate on keeping my supply up enough so that the baby could have breastmilk when I am not actually at work.  One day is much better than zero days, I would think.

Second, are you allowed to pop into the bathroom?  (Or are you like elementary school teachers, who are not allowed to go to the bathroom all day long?)  It sounds gross, but I think that I would run into the bathroom as often as I could get away with.  (Every 30 or 45 minutes or hour?)  I would dash into the toilet stall, hand express into the toilet for sixty seconds, and flush away the milk.  It takes way too long to save this liquid gold, keep the milk sanitary, and store the milk at the proper temperature.  The goal is just to empty the breasts as frequently as possible. You want to keep your supply up so that you can nurse your child when you are with your baby, or so that you can save the milk when you are not actually at work. 

Third, I think I would try to come to peace about the formula while you are at work.  I'm a mother who breastfed and pumped for my dd for three years, but I know how difficult it is to keep the supply up during long work days, and I think formula would be fine if it allows you to have enough supply in your breasts when you are at home with your baby.

It's hard, but you are doing it wonderfully.
 

[babynicholstobe]

I was having the same issue and was also taking the fenugreek. I was then referred to "Lactate Support", I bought mine at Whole Foods, and within about a day or so my milk supply increased expoententially. I went from having to supplement quite a bit every day down to almost nothing. I'm now going days without any formula at all, which I'm so grateful for. Also, the above posters are right, frequency is what matters, not the duration of session. My LC said that it's better to pump for two minutes every hour-2 hours than for 30 minutes every five hours.

In the meantime, don't stress about the supplmentation. I have struggled as well, but stuck to it and now everything has improved drastically.

Good luck!