Milk is gone again...

[sehbub]

Many of you know my story, but for those who don't, here it is:

My DD was born at 30 weeks on 4/20/06. She is 8 weeks old as of yesterday. I have been exclusively pumping every 2-3 hours for those 8 weeks. About a week after we brought her home (4 weeks ago) my milk dried up. I was pumping as usual, but getting nothing for it. I tried massage, compression, all of it. I started taking blessed thistle, doubled my fluid intake and was putting fennel oil on my chest. My supply increased very slightly, and I have been able to meet about half of her milk intake need for the last 3 weeks.

As of yesterday, my milk is disappearing. I haven't changed anything about my routine, but I am getting nothing from any form of expression. I have changed the parts on my pump, just in case. We have been using a nipple shield, but DD screams at the breast because she's not getting anything. She won't even suckle for comfort, but prefers to suck on my finger instead. No pacifiers, just fingers, which I'm fine with. I also have had to go back on birth control because AF returned (only 8 weeks pp...not fair!!).

I guess what I need/want to hear is that I'm not a terrible mama for wanting to stop all of this and just enjoy my time with my baby. I feel like we can't leave the house because I have to pump. Any time we go anywhere, I'm paranoid about getting back in time to pump. Even trips to the grocery store are stressful. I carry a manual pump with me at all times, but even after using that, I still feel engorged (even when I feel engorged, I'm only able to express about 2 ounces) and uncomfortable.

I feel like I'm failing her. :gloomy:

[TurboClaudia]

oh mama... it's okay... i'm not feeling very expressive verbally at this moment, so i'm going to go back and quote a post i made to another mama feeling the same way as you on our insanely long low-milk-supply tribe thread...

adrienne: is owen going to breast at all now? do you mean that when you are pumping, you are just getting drops? or do you mean something else? as for should you keep pumping or choose to stop pumping, that is such a personal decision. if you are at the point where trying to pump is creating more stress in your life and you are not able to enjoy owen being who he is and growing into who he will someday be, i think the choice to stop pumping is worth considering.

i remember feeling that stress and wondering if i should just give up the pumping, supplementing, etc. cycle and just give marek alternative milks in a bottle after i nursed him. i would always give myself a day or two to consider the choice and during that time, i remember feeling like i really could go on the way we were and give it one more day or one more week or whatever. it was hard, though. and i have another mama friend here in the portland area who has twins and had supply issues with her older child and then had supply issues with the twins. they were born early, too, and not successful at nursing at the breast. it was so hard for her to come to her choice, but after 5+ weeks of trying to manage a 3 year old, twin newborns, pumping and trying to increase her supply, she realized that she truly felt like she had made the best possible effort at giving her twins mama's milk and that pumping and working to increase her supply was now affecting her relationship with all her children negatively. she has been very active in our LLL group out here in hillsboro and definitely knows the benefits of mama's milk, and she struggled with her choice but definitely chose it and did not let a "decision" just happen.

please know that whatever you choose to feed owen, you are the best mama for your baby owen. you may not believe that all the time (i know people said that to me at times and i certainly didn't feel that way) but i'm just reminding you.

love to you all,
claudia

[alegna]

:hug First, know that what you've done and continue to do is AWESOME. You're a super mama.

That said, a few ideas off the top of my head, in no particular order:

have you tried letting her nurse without the shield? shields are hard for some women to nurse with- they're supply really takes a hit.

Have you tried the nosespray to help you let down for the pump? Usually it's used for getting started, but it might be worth a try.

Are you using bottles? Have you thought about using an sns or lactaid?

What kind of pump are you using? Have you tried a different one? Some women respond much better to one kind or another.

hang in there!

-Angela

[TurboClaudia]

angela, i am not the original poster but your post irked me.

this mama did not ask for suggestions.

as a sister low supply mama, i would be majorly pissed off at you or anyone who offered me suggestions when i specifically did not ask for any.

this mama is sharing her feelings of frustration about her milk supply going away and specifically said she needed/wanted to hear that she is not a bad mama. by offering her suggestions, it seems to me like you invalidate her request.

it is apparent to me that you do not know this mama's story and the extent to which she has gone to provide mama's milk for her little one. i have followed her situation closely, on the other hand.

~claudia

[sehbub]

Claudia, I greatly appreciate your sticking up for me. I was not, however, offended by Angela's post. Thank you though for caring so much.

Angela- We have tried nursing with and without a nipple shield, in a myriad of positions. We have tried rebirthing to help make up for the month that we were separated while she was in the NICU. I am currently using a Medela Lactina Select, but also have an Avent Isis (manual pump) and was using various pumps in the hospital while Sam was there. For me, all electric pumps yield basically the same results.

I was experiencing letdown, so that wasn't an issue. We have used an SNS, finger feeding, syringes and spoons. We are now using bottles after all of those failed. She simply can not latch. I have large, flat nipples, so she has to work incredibly hard. We started trying the SNS within a week of her being home, but to no avail.

I viewed your post more as concern, but can see why Claudia feels the way she does. Thank both of you mamas for caring so much about my situation, and my DD.

I guess I'm starting to view this whole thing as a "better luck next time" experience. I told my sister that with the next baby, I'm going on bedrest at 25 weeks to make sure I make it to term, and then I'm attaching the babe to the breast immediately pp. And if anyone comes at me wanting to massage my stomach to make my uterus shrink because it's "policy" I'll smack 'em. :)

I'm hopeful that my supply issues and DD's poor latch are one-time things, and that I will be able to nurse my next baby, if we're lucky enough to have another one. I feel kind of silly continuing to attend LLL meetings, since I'm not able to supply my babe with bm, but I think I can use all the help I can get! Do you think I will be out of place?

[alegna]

I'm sorry you feel irked. I was just trying to help. It is a reasonable expectation that if you post on the breastfeeding challenges forum someone is going to try to help.

-Angela

[alegna]

Crossposted

:hug I'm glad I didn't offend. It does seem that you've run the course of pretty much everything I've ever heard of.

Talk to an LLL leader privately- I would bet you'd be welcomed.

-Angela

[TurboClaudia]

sarah: i'm glad that you are more gracious in your reading of angela's post and read it in a thank-you-for-your-concern way. :hug in my experience, the LLL group i attend has been very open to mamas with milk supply issues. i came one evening and admitted to feeling like a fraud being there and explained why. another mama who i thought was one of the biggest breastfeeding supporters then shared that she, too, had dealt with supply issues when her daughter was young and she managed to overcome them and her daughter was still nursing at age 2.5! the leaders were so supportive, and the other mamas were fantastic, too. however, i would say that every group is different and it really depends on the dynamic at your particular meeting. certainly don't give up without reason simply because you are not breastfeeding 100% of the time. just a week ago at our meeting, that same mama who had shared her supply story came with her now 9 month old twins who are exclusively formula fed at this point because of serious post-birth complications for her that caused low supply she could not regain while caring for newborns and her almost 4 year old. she even fed them with a bottle during the meeting and no one gave her a second look or questioned her at all. we know her story.

and as for this:
It is a reasonable expectation that if you post on the breastfeeding challenges forum someone is going to try to help.
i have a pm out to cynthia mosher about guidelines for this breastfeeding challenges forum as i think my understanding of what it is meant to be and most other mdc users understanding of what it is meant to be are different.

~claudia

[bri276]

it's not too late necessarily, and if you don't want to give up yet, you don't have to. believe me, I'm an EP'er so I understand.

did this latest supply drop happen before or after you started AF? birth control pills can dry up your milk. even the mini pill can decrease it, I've heard. maybe if you quit the pills, used condoms (I know it's a pita), and pump every two hours (20 minutes at a time, hospital grade pump, plus continue taking the herbs you were). I'd say if after a couple more weeks STILL nothing at all comes out, that's the point where I'd feel comfortable quitting and saying you did the best you could, but it's not going to happen this time.

:hug

[sehbub]

The latest drop happened about a week before going back on birth control. I actually quit taking the pill as soon as I noticed a decrease, and started pumping more frequently (great minds think alike ;) and nothing came of it.

I wonder if anyone else has experienced this? Just had their milk disappear after trying to EP?

[TurboClaudia]

yes, Estreetmama (who i wrote that post to above) went through a very similar struggle with pumping. her situation was slightly different, as her son was born at home, full term and then some, but then she developed pre-eclampsia and had to be hospitalized for a few days. i will pm her the link to this thread.

~claudia

[CherryBomb]

I don't think you would be a terrible mom at all, but I also don't think it really sounds like you want to stop, more like you've just hit (another!) rough patch and need some love and support.

Have you tried an SNS? If her frustration at the breast is because she's not getting anything, maybe that would help? It'd would be great for your supply, too. Have you tried domperidone or reglan? (I'm sure I spelled those both wrong!)

And here's a recipie for some yummy oatmeal cookies that are supposed to help boost supply. I haven't tried them myself, but everyone I know who has said they really helped!

http://community.livejournal.com/breastfeeding/2288837.html

:Hug to you mama. I had to EP for the first 11 days of dd2s life (she was in the NICU because of a stroke). I can only imagine how draining pumping for this long would be. I know getting out can be really hard, too, trying to make sure you're back in time to pump and everything. You're doing an amazing job, your little one is lucky to have such a great mama.

[EStreetMama]

Yeah......unfortunately this happened to me. I think about it every day and still try to troubleshoot what happened and what I would do differently.

I really feel for you and am so sorry that you have had these struggles. You are obviously a devoted mother for being so concerned for your daughter.

I was severely anemic after a post-partum hemorrhage, and I think that my baby is tongue-tied or maybe has a palate issue. He would just NOT latch or stay latched. He screamed miserably. I had excellent support of 2 experienced lactation consultants, etc. We tried everything except Domperidone. Reglan did temporarily increase my supply.

Hindsight is 20/20, but if I could go back, I would have DEMANDED to see a pediatric oral/facial specialist or ENT to help us understand his anatomy and trouble shoot it. He just couldn't nurse and the SNS, etc did not help that.

Finally I reconciled to just bottle feeding expressed milk until it did finally stop flowing. I pumped for a couple weeks while not even covering the bottom of the bottle before giving up.

In the end, I think the biggest problem could have been simply not pumping enough. I was told to pump 6-8 times a day, and after study, I believe that I really should have been pumping 8-10 times.

But you're right...the pumping schedule was horrible. We could not leave the house for long. And the visitors would just mess up the schedule as well. I was able to keep up if DH was home, but when Owen and I were alone, it was really hard.

I would attempt to nurse, then bottle feed, then go and pump. But my boy did not stand for being put down, and it's hard to juggle the pump and the baby.

In the end, like you, I felt that I had to leave my son to spend time with the pump and it just felt wrong.

I do feel good that he got the milk that he did, but as you can tell by this post, I am still mournful that this happened and would do ABSOLUTELY ANYTHING to go back and change it.

So...yes, your milk can just disappear. And yes, pumping is not a natural way for mother and baby to go through their day. But most importantly, no, you are NOT a bad mother to want to stop pumping!!!! A bad mother would not have agonized over this or spent any time pumping at all. You are not letting her down. You have nourished her and will continue to do so by feeding her lovingly and then offering her good nutritious food when she's ready. You have been heroic and no one could expect more of you!!!

I would just suggest that you take one final look at the whole picture, and see if there is anything left that you can try to increase your milk before you stop. While I could never question your decision to stop, I have to tell you that I do have lingering regrets myself. I would hate for you to stop unless you are 100% sure you have done everything, so you can go forward with peace of mind. At some point it all comes down to that darn serenity prayer..."grant me courage to change the things I can and serenity to accept the things that I cannot change..."

I did attend a LLL meeting and felt mostly comfortable giving Owen a bottle right there with the nursing mamas. The local mamas were very supportive. If anyone gives you any flack then they have their own problems to deal with :p .

Again, I'm sure that you are a wonderful mama and I wish you and your sweet baby girl all the best!! I hope that you are able to be generous and gentle with yourself. It can be kind of traumatic when things go differently than expected. I am still working on it!!!

My son is now 10 months old and is a very healthy, happy little guy!

Take care--
Adrienne

[hopefulfaith]

Sarah, I just wanted to offer a hug. I lost my milk last month, and no amount of pumping helped.

You are not a "terrible" mama, nor are you failing your daughter. It sounds like you are a wonderful mama and have worked so hard for her. Take gentle care of yourself. :hug

[bri276]

yes, being part of an EP'er groups I have seen milk go away, or drop severely. much of the time it has to do with either not pumping enough or not having a hospital grade rental pump- but sometimes no one knows why. MOST EP'ers struggle with supply. I have been incredibly blessed to never have to supplement with formula these past 11 months.

all you can do is give it your best shot. like others the only reason I would even advise you to keep trying as best you can is that you don't want to live with "but what if I had tried this...." once you feel you have done that, move on and live life. children need mothers not martyrs :)

[bobandjess99]

i never had to EP, but my low-supply issues (PCOS, Thyroid) caused me to have to pump to try and increase, and i have to say, pumping never did ANYTHING for me.....Top of the line pump, and i could get...maybe 1/2 ounce out of an ENGORGED breast. The pump simply WOULDN'T get the milk out. Handexpressing would get *some* out. I was seeing multiple LC's, LLLL, my midwife, etc, and every single one of them said that i responded to the pump the worst of anyone they had ever seen. I have HUGE, very saggy, limp breasts (even when engorged, they are barely firm, they LITERALLY hang to my belly button, no exageration) and they all said that they believed it had to do with my breasts size/shape.

I understand and sympathize. I don't think it's wrong at all to feel like you want to give up and focus on your baby, instead of pumping, which any of us who've been there (even a little bit) know how tough it is.
hugs!
(lol, i too had the "birth control" thought....does that mean I'm a great mind too? LOL!!)

On another note, and this is sort of a suggestion, I just wanted to put out there that i experience EXTREME supply issues during my cycle...before AF, it drops dramatically, and I literally spend a week struggling to get it back up, it's okay (as okay as it gets) for about 2 weeks, then dips again. Perhaps your dip in supply is related to getting your period back? I have heard *most* women report some degree of supply changes related to their cycle, and after all my struggles, I have come to believe that for low-supply moms, or moms with challenges, the "normal" cyclical supply changes can be devastating. All of my LC's/LLLL's that i have talked with have agreed with me that your period really can affect things.....although, again, most had never heard of such a drastic change as I get (almost NOTHING for several days, very painful, i hate it)

Hugs!

[mom2ken1cam2]

Sarah,
My eyes are full of tears right now reading all of these posts! I think we have supported each other before, so when I saw your "milk is gone again" title, my heart broke for you. I too am an EPer (as you probably remember from previous threads) for 11 weeks now. I can truly feel your pain and know where you are coming from! Please try not to feel guilt over this. Your sweet baby girl needs her mommy right now and if you feel like you can't give her what she needs emotionally while pumping full time, then by all means STOP PUMPING! Just make sure that whatever you decide is YOUR decision and look at this as a learning experience. I want to tell you something my LC told me. She said that she views the familly as a unit and even though a newborn is dependent on you they are not more important than any other member of the family (including yourself). So if any other member of the family begins to suffer (including yourself) from the way you are living then something needs to change. Remember that you cannot care for her properly if you are not taking care of yourself properly (emotionally, physically, mentally, spiritually,etc). So big, gigantic :Hug to you, mama! Keep us posted on how you are doing!:thumb

[TurboClaudia]

wow...

all these wonderful posts make me believe that THIS is what this new Breastfeeding Challenges forum is about. :heartbeat

thanks for sharing, every-mama. :grouphug

~claudia

[sehbub]

So, after not pumping for 24 hours, I was incredibly painfully engorged, and decided to try and pump. Suprisingly, I got almost 5 oz, so two feedings for DD. I think I'll try pumping every 12 hours and see what happens. If I pump my normal schedule (every 2-3 hours) I only get drops that don't even add up enough to cover the bottom of the bottle, but if I wait a long time, I can get enough to feed her at least once a day. Worth a try.

The only thing I haven't tried is Domperidone or Reglan, and that's only because neither DD's ped or my midwife will write a script for it, and we can't afford to buy it on the internet. It's a shame too...it might really work for me.

[EStreetMama]

Awesome!!! 5 oz is fantastic!!!

I did discover at the end of pumping that I could get more by pumping every 3-4 instead of 2-3, but then I'm not sure it was enough stimulation to keep producing milk over the long run.

Lots of people have horrible side effects with Reglan, but I did not. In fact, it helped my appetite because I was also not eating and drinking enough, so that was good. I had a huge bottle of it that I threw away or else I would send it to you. Can you find another doctor to prescribe it??? It's really worth a try!!!

I could not find ANYONE who would prescribe domperidone, and I didn't have any money to buy it online. Also, studies show that it was not really effective for women who's milk never really came in well. It is most effective in women who initially had good supply, and then it started dwindling. I would try it if you can't get Reglan!!

Good job, mama! Isn't it wonderful to feel a full bottle of your milk???

Take care--
Adrienne

[MarcyC]

5 oz! :bow

5 oz! :bgbounce

5 oz! :jaw

5 oz! :balloons

5 oz! :banana :carrot :broc:

You know, seriously, I was reading a book by Dr. Newman and he wrote that breastmilk does not have to be "all or nothing." Maybe you can just feed 5 - 10 oz. a day of breastmilk and the rest formula. At least you'll feel good knowing you're providing something even if it's not 100%.

Hugs & Magic Milk Dust to you!!!
:Hug :dust

[CherryBomb]

I think that MarcyC has a great point. I think a lot of women get the "all or nothing" attitude, that if they can't get 100% BM to their babies, there's no point. That's not true! ANY amount of BM is beneficial for your baby! I got my first very small amount of BM for most of her first year (you can read my nursing stories here- http://sparrow77.livejournal.com/356094.html#cutid1) and I definitely think that's why she's been as healthy as she has. She's almost 5 years old and has never had an ear infection and only been sick a handful of times.

My only concern with only pumping every 12 hours is that that's just not nearly enough to keep a supply up. You might get more total the first couple days, but that's such a drastic difference from every 2-3 hours that it won't take long to dry your milk up completely (or almost completely). Maybe instead you could try every 3-4 hours, and once at night? That might ease up the stress enough that it's doable, ykwim? Maybe you could also set short term goals. It's daunting to think of pumping for a year or two year, maybe you could set goals by weeks? "I'll do it for 3 more weeks and the reevaluate" or whatever.

Good luck mama, I'm rooting for you!

[Mama Poot]

If my milk kept coming and going like yours is, I would get into a doctor immediately and get my thyroid and everything else checked. In the meantime, don't give up, continue nursing and pumping and taking your supplements. But I would definitely get checked out. I just have a hunch something isn't quite right.

[sehbub]

I have a doctor's appointment on Thursday, MamaPoot, so we'll see if they fimd anything. I have a sneaking suspicion that the majority of my problem is stress related. We can't nurse, she's a preemie, we didn't get to bond after birth, my brother moved in to my house for the summer, I have two other kids, my DH works 70-80hrs/week, so I do all the nighttime feedings, and I'm feeling incredibly guilty that I can't provide enough for her. Oh! Plus, we're starting a home business and I'm trying to get back to some semblance of normal life (working out, talking to adults...) in the meantime.

I'm actually taking it hour by hour. Yesterday, I pumped every 6 hours, and today I'm pumping every 3. I'm getting about 10ccs every 3 hours, so I should have an ounce after 6 pumping sessions. 12 sessions will give me almost enough for one feeding for DD.

Hard to believe she is almost full term (next Tuesday) but will be 2 months old tomorrow!! When we try and go to breast, my nipple is still almost the same size as her mouth. Poor kid's gonna be 12 before she can nurse. :innocent

How much Blessed Thistle can I take in a day? It says to take 2 capsules 3 times a day, but can I double that maybe?

[faithfulmama]

I just wanted to say a few things. First of all you are doing such a good job at an extremely difficult thing. We went through a similar ordeal with my ds. He was full term but had to be hospitalized for a few weeks after birth and he came home not latching at all. My supply dropped about 4 weeks after he was born to pretty much nothing. I just remember staring at the pump and feeling so inadequate as I went through the whole routine, and like 2 drops came out, knowing I just didn't have any milk and he was going to have to get formula. This after we had offered the breast, he screamed and thrashed, calmed him down, tried again. With the sleep deprivation, it really was like a horrible nightmare! We did herbs, increased pumping, got stronger pump, skin to skin, coslept. I think everything short of rx meds to increase my supply, and nothing worked until he started latching, which was around 10 weeks. From there my supply gradually increased, and he was EBF from about 3 1/2 months.

A few things that really helped me: my lactation consultant. she didn't really tell me much that I hadn't read somewhere, but she had this cool confidence about the whole thing, like blah blah blah UNTIL he starts latching on. just keep offering she said. she just acted like it was a matter of time and he would do it and everything would be fine, when I felt like he hated me and my boobs and he was never going to latch. Your babe is still very young. It will become easier for her to latch when she is bigger and stronger.

The SNS and herbs helped a ton once he started latching. And as far as blessed thistle goes, kellymom.com recommends up to 4 capsules 3x daily. Also, I'm sure that you've already done it, but this herb works particularly well with fenugreek, also 2-4, 3x daily.

Something that didn't occur to me then, but has since is that if you have someone who could possibly pump mama's milk for you, which you certainly may not, that may ease the stress a bit. I had several nursing friends at the time and it never occured to me to ask them, though I'm sure that they would have obliged.

Just my experience. You are doing a really tough thing. Wherever you end up, don't let guilt creep in! No one else can totally relate to your particular set of circumstances. Good luck mama!