I can't pump - HELP!

[MamaDiane]

Help! I'm feeling panicked.

I go back to work ft in 3 weeks ( and have started trying to freeze a stash of breastmilk. My DH will be a SAHD and give DS bottles while I'm at work. My DS is a big boy (16 pounds at 12 weeks) and has a big appetite. I'm hoping he'll reverse cycle - until then, I figure I'll need to pump 15-20 oz./day to keep up with his needs.

I'm nowhere near pumping that amount! Even when I pump early in the morning, I can only get 3-4 oz. Any other time of day it's 1-2 oz. or, sometimes, nothing at all. The problem isn't low supply - my breasts are full when I sit down to pump. Problem is that I can't let down for the silly machine. Sometimes I'll have DS nurse from one side while I pump from the other. That helps, but isn't something I'll be able to do at work!

The other problem with building a supply is that I hardly have a chance to pump - my DS takes all his naps on me, and falls asleep at night on me - this only leaves me first thing in the morning, when DH can take him while I pump

I don't know what to do - at this rate, I'm very concerned that I'll have to supplement with formula, something I really don't want to do.

Any ideas or advice? BTW, I have the Advanced Pump in Style.

[tarablesue]

my ds never drank that much from a bottle (usually 4 oz per feeding)he just waited for me to get home and he'd nurse a ton when i was with him.

I also babysat a bf baby and she never took more than a 4 oz bottle at a time. She would nurse though when her mama got here.

I wouldn't worry and just keep pumping as you are.:

[CathMac]

Working & Pumping: Supply & Pumping tips

I have simply copy / pasted my standard spiel for working and pumping Moms. I would really encourage you to pay particular attention to “conservation” and waste minimizing tips, as well as the “Marmet” (massage) technique. Make sure to read the second to last link/article at the very bottom: “How to bottle-feed the breastfed baby...tips for a breastfeeding supportive style of bottle feeding”

If you would like an overview of my Working & Pumping routine, with time saving tips feel free to PM me.

How old is your pump? If you are borrowing it or bought it used the motor may be tired and that may be affecting your pumping now and over the long term it will affect your supply. Demand equals supply; a tired pump doesn't "demand" enough milk to generate a strong supply.

HTH, ~Cath

Kellymom link: Herbal Remedies for Increasing Milk Supply
http://www.kellymom.com/herbal/milks...bal-rem_a.html
EXCERPTS
Blessed thistle is one of the more commonly used galactagogues. Can be taken in combination with red raspberry, alfalfa, marshmallow, and fenugreek. ... ... ... Milk thistle has been used historically to increase milk supply. It contains silibinin, silydianin, and silychristin, which supposedly have liver-protecting properties

How much expressed milk will my baby need? http://www.kellymom.com/bf/pumping/milkcalc.html
EXCERPT
In exclusively breastfed babies, milk intake increases quickly during the first few weeks of life, then stays about the same between one and six months (though it likely increases short term during growth spurts). Current breastfeeding research does not indicate that breastmilk intake changes with baby's age or weight between one and six months.

TIPS & TECHNIQUES FOR WORKING & PUMPING MOMS: AF info, Reverse Cycling / Co-Sleeping, Bottle Feeding, Supply Boosting and Pumping Tips. I know it's a lot of info but I'd rather let you decide what might be helpful to you or not.

AF - SUPPLEMENT RECOMMENDATION
I have heard that supplementing with Calcium/Magnesium may help with AF related supply issues. Here is a Kellymom link for various “Natural Treatments” Jump to the section titled, “Low milk supply associated with menstruation: Calcium/magnesium supplement”.
http://www.kellymom.com/herbal/natural-treatments.html

REVERSE CYCLING
If it is consistent with your sleep needs and parenting philosophy you might want to consider co-sleeping and keeping the self-serve Milk Bar open all night to encourage reverse cycling. The more milk your baby gets overnight the less he should need during the day. If safety is a concern check out Kellymom and look up the family bed. They give lots of safety tips.

BOTTLE FEEDING TIPS
Are you using slow flow nipples? If not, you might want to pick some up to try and slow down his bottle feedings and give him a chance to recognize that he is full. That may minimize the pressure on you to produce more milk than you should have to. Here is a link to a Kellymom article on how to bottlefeed breastfed babies. One of the best tips is to remove the bottle every couple of swallows to slow the feeding down. Of course this requires more effort on the part of the caregiver. http://www.kellymom.com/bf/pumping/bottle-feeding.html

SUPPLY BOOSTING TIPS
Again, start with the basics, make sure you eat enough protein, drink enough water and limit your caffeine and get enough rest (good luck with the last one). Regarding supplements, consider trying herbal combinations such as "More Milk" or "Rescue Remedy" or have you considered "Mother's Milk Tea?

Or you could try some of the various herbs by themselves: Fenugreek, Red Raspberry Leaf, Nettle, Alfalfa, Etc. (check Kellymom.com for a more complete list and info on dosages).

It is important to do your own research on each of these herbs and decide whether you are comfortable with them or not. I don’t remember much research regarding Alfalfa however, I stopped taking it when I learned it is not recommended for anyone with Lupus. I don't have Lupus and neither does DD but Lupus runs in my husband's family and I don't want to pre-dispose my daughter.

Something else to keep in mind, if I remember correctly Fenugreek is in the peanut family so you may want to avoid that particular herb if you have a history of peanut allergies in your family.

Regarding oatmeal (cereal, cookies, etc.), I have always eaten a lot and couldn't say whether it ever made any difference. You could also try Oatstraw Tea. If you are take oatmeal to help boost supply keep in mind it can be filling so don't let it replace your protein/fat. For instance, you wouldn't want to trade your egg and cheese breakfast sandwich for a bowl of oatmeal. Or if you have the oatmeal add plenty of walnuts &/or peanut butter.

Also, some women seem to respond well to a nice piece of steak. Oddly enough, the steak would seem to work occasionally, but not always, for me.

I have also heard that the milk boosters oatmeal and brewer's yeast have two components in common, Inositol and Choline. Inositol is a B vitamin (It may or may not be unofficially "numbered" B8). Supposedly Inositol and Choline work together to increase the effectiveness of Oxytocin. If you are curious --or for the benefit of anyone else thinking about trying this-- I tried a regimen of 400 - 500 mgs of Inositol and 2.5 grams of Choline.

The first time I tried this regimen I didn’t really stick with it long enough to see if it made any real difference but my impression was that the tea regimen of RRL, Nettle, & Oatstraw worked better for me. I tried the Inositol / Choline regimen again recently and saw a pretty dramatic increase, anywhere from a 50% to 100% increase after about a week to a week and a half. However, it seemed to make me dizzy. The dizziness went away about two days or so after discontinuing the Inositol and Choline regimen. If I were desperate I might try it again on a very reduced dose, which would mean cutting the tablets.

PUMPING TIPS
Make sure to read the Marmet (massage) technique to improve your pumping yield (see link below). I recently read that the ducts extend up to the armpits so you might want to modify the technique to include this area. Another poster, made this additional suggestion to enhance the Marmet technique, I haven't seen it anywhere else: move the horns a little off center in between massaging, in a pattern, (e.g. slightly up, slightly down, slightly right, slightly left) so that the suction is reaching ducts it might not otherwise reach. Try to follow the same pattern each time so you're less likely to skip an area. This increased the amount of "hind" milk I was able to pump, which has a higher ratio of fat and protein so it is probably more filling. Once I go through the first pattern (12:00, 3:00, 6:00, and 9:00) I run through a second pattern (halfway between 12:00 and 3:00, halfway between 3:00 and 6:00, etc.) I was really surprised at how well this worked for me. As much as I would rather just sit down and let the pump do the work it is much more of a "hands on" experience than I would like; but it does work.

Also, if you are coordinated try experimenting with breast compressions and/or massage **while** you are pumping. This saves some time on doing that in between moving the horns around.

Also, if your nipples are blanched (white) after pumping you may need bigger horns (aka funnels, shields, etc.). One of the Medela web pages has a picture of what it looks like if your nipples are getting squished. (link below)

Finally, here are a couple of miscellaneous tips I read recently that I’ve never tried myself but may be helpful: 1) a hot shower between your shoulder blades before pumping. 2) non-alcoholic beer, and 3) smelling your baby’s head, looking at her picture (to facilitate Visualization), etc.

With DD 1, when my supply issues were the worst, I would nurse on one side and pump on the other before going to work. This has a couple of advantages: 1) Your Prolactin leveles are probably higher, 2) You pump more efficiently this way if you are more conditioned to the baby than you are the pump , 3) You may be squeezing in half a pumping that you otherwise wouldn't be able to, 4) etc.

Also, give some consideration to additional "conservation" methods besides those tips on bottlefeeding a BF fed baby. Such as trying to store milk in "serving sizes" to avoid waste if the caregiver isn't cautious about pouring out only what is needed. This is especially important for the milk that gets frozen because you only have 24 hours to use it once it's thawed. Try storing half portions for the same reason. If baby is extra hungry the caregiver won't always have to waste a whole frozen bag if only half a bag is necessary. Note, the serving size will probably change over time. Depending upon your pumping routine you may be able to tell when you are pumping fore milk versus hind milk or a combination of the two. The hind milk usually comes in towards the end of a feeding/pumping it is higher in fat and protein and it looks more like whole milk. That milk tends to be more filling so you might want to put a little less of that in a serving size, and vice versa. So I mark the bag accordingly. As an added bonus, when DD2 was younger DH would notice she'd fall asleep more easily after a serving of hind milk which is nice for the caregiver when it comes time to planning a nap.

OTHER LINKS
What is a galactagogue? Do I need one?...Herbal remedies for increasing milk
http://www.kellymom.com/herbal/milks...actagogue.html

Increasing Low Milk Supply
http://www.kellymom.com/bf/supply/low-supply.html

Let-down Reflex: Too slow?
http://www.kellymom.com/bf/supply/letdown.html

Marmet Technique
http://www.lactationinstitute.org/MANUALEX.html

I'm not pumping enough milk. What can I do?
http://www.kellymom.com/bf/pumping/p..._decrease.html

Pumping Tips
http://www.breastfeed-essentials.com...mpingtips.html

Choosing a Correctly-Fitted Breastshield http://www.medela.com/NewFiles/faq/b...hield_fit.html

How to bottle-feed the breastfed baby
...tips for a breastfeeding supportive style of bottle feeding http://www.kellymom.com/bf/pumping/bottle-feeding.html

Co-Sleeping – Making it Work and Making it Safe http://www.kellymom.com/pantley/pantley21.html

[MeepyCat]

I didn't manage to pump enough for DS during the day in a single day until I was away from him during the day. Before that (and still, on weekends), he was nursing, and there wasn't much supply for the pump.

Keep pumping, build up as much of a freezer stash as you can. When you go back to work, pack some pics of your son with the breast pump (get a few of him screaming to be fed if you can). Also pack something to eat and drink while you pump.

Have you tried hand expressing to get letdown going before you start the pump?

[mrs_mandolini]

Being tense while pumping does NOT help. :-(

First of all, I'd set up a routine. Pump at the same time and in the same location whenever you can. I found that helped me immensely.. my body "got used to" pumping time & the milk would let down easier.

A picture of your baby or something that smells like baby might help also. And try to make it a relaxing experience. If you are staring at the pump or the bottles waiting for something to happen, that makes it harder IMHO. I would read a book or play on the laptop sometimes and that would help take my mind off pumping & the milk seemed to let down on its own.

ALso, I don't know what settings are available on your pump, but maybe you can adjust them. For me, having the speed as HIGH as it would go, and keeping the suction fairly low (so as not to traumatize my nipples) , worked best, but YMMV. Talking to an LC might be good as well. In fact if you can talk to SEVERAL LC's that's how I always got my best advice.

The amount of milk you are getting, considering that your baby is also nursing, sounds not that out of line. Keep in mind that when you're at work, he won't be eating from you all day so you'll probably get a bit more. If you can start consistently pumping 6-8 times a day, you should start seeing an improvement.

I know it's hard- I pumped for my preemie for months & even after he came home I still had to pump every time he ate because by then I had humongous oversupply for a while. Good luck!

[LoveChild421]

I never could get a good milk stash built up either, I would always pretty much break even, pump two times while I was away at school and that would be what he drank the next day. The most I could ever get ahead was maybe two 4oz bags frozen in case of an emergency. I had a hard time letting down for the pump unless ds hadn't nursed in a while and my breasts were FULL. Since ds wasn't nursing during the day, my breasts filled up quickly and it was easy to pump 8 oz each time I pumped.

I found that looking at a picture of him and taking deep breaths while thinking of the sensation of nursing would always help me have easier let downs.

Also if you drink more water and make sure you eat plenty, you will make more milk. I could always tell if I wasn't drinking enough water because I would pump about 2oz less at a time. So definately keep plenty of water and snacks with you even if you're busy working.

[Electra375]

Has anyone mentioned Flange Size? Forgive me for a repeat, if so. If you are large busted (bigger than a C) or have large areola/ nipples a larger flange size might help. I did not know they came in a larger size until I asked for help at the hospital w my FTT baby and the pump was just pinching, plus out put was lower than what I'd expect.

As for 3-4oz at a time and then later 1 to 2oz that is completely normal for me. I didn't have a "freezer" stash even started w/ 1 bottle until he hit 6 mo old and we introduced solids. Now I have 4 servings in my freezer which I need to rotate out. Fresh is always better, frozen is just the reserve, which will probably come in handing if your cycles return on you (my milk supply goes WAY down right before AF).

Kellymom site stuff is all really great. Hang in there, it is worth it. And if you end up needing to supplement here and there, it is not the end of the world. Sometimes it helps just to relax about things like that. When I was at the hospital under the watchful eye to produce milk they could see and count, I was producing 2 oz regularly. Once I was off the clock I pumped 3 1/2 oz!!! While still in the hospital before we left.

The suggestion on the cross post to take a breath and sigh, as in release, might be a very good techinque to try or other releasing type relaxing mechanism.

Oh, and check your valves often, those white things on the Medela, if they are not getting a seal, poof, little to no milk. Also the newer tubing seem to be more prone to holes : I had holes in the Symphony rental tubing kit in less than 3weeks. I pulled out my old tubes from 98 or 02 that I used for the Lactina and used those on the PIS I bought. It's just thicker grade tubing.

[kathypa]

Some good advice above on getting let-down. You must have good supply to have a 16 lb babe at 12 weeks! What works for me to get let-down (I'm a full-time wohm, just started pumping at 5 1/2 weeks for my second child, pumped for #1 until pregnancy hormones with #2 decimated my supply at 11 months): look at a picture of my child close-up nursing (or close my eyes and bring up an image in my mind of how his mouth and face look when I look down while he is nursing, particularly the milk at the corner of his mouth and his jaw moving), relaxing my shoulders and taking a deep breath. Once I hear the milk coming, I do something else (read a book or, at work, make a phone call) so I distract myself and stay relaxed. After a while with #1 it got much easier, I'd get letdown by looking at the pump! Good luck!

[MamaDiane]

Thanks so much for all the great advice, tips and thoughts. They are very, very helpful. Now that I hear it from you all, it makes perfect sense that I'll be able to pump more when I'm not nursing on demand at the same time. That just didn't occur to me, and gives me such relief to hear. The relief, I think, has resulted in less tension and higher yield pumping yesterday and today.

I also had never before tried expressing my milk by hand before - it's much easier than I thought it would be. This is also a great relief, because it means that on days when I have to be out of the office in meetings all day, I don't have to lug the pump around with me - just a couple of bottles and my hands!

Using a cue and lots of pictures is also great advice. I'm also going to make a recording on my cell phone of DS nursing, and listen to his sweet suckling noises when nursing.

THanks again!