Could use help, advice, reassurance - Mothering Forums
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Breastfeeding > Could use help, advice, reassurance
xerxes's Avatar xerxes 06:28 PM 12-14-2003
My dd is almost one month old. I have to return to work in four weeks and have just started to pump (medela pump in style). I can't get any significant milk out of this machine and I am extremely frustrated. I've tried feeding her on one breast and pumping the other. I've tried pumping at several different times of the day. The entire amount I've pumped is 5oz. Is that normal? I know that dd is getting fed because she's got milk on her face after BFing. She doesn't have any problems latching and now I'm wondering if I'm not producing enough milk to both feed her and pump. Or maybe the pump I have isn't adequate. I am getting so frustrated and I haven't been able to get a hold of any lactation consultants in my area. They don't seem able to return phone calls and they're never available to talk to me.

My dh (insider) says MDC is the best place to come for support. I don't know if I need advice or just to hear that others have gone through this. I want to BF for at least a year and I have got to figure out whether I'm doing something wrong or if I need a different pump. I am so frustrated, if you have ANYTHING to offer... I have read LLL books, been to a few meetings, although I dont' attend now that I have a newborn. There doesn't seem to be any way for me to get advice on overcoming or adapting to problems with pumping.

shelbean91's Avatar shelbean91 06:51 PM 12-14-2003
That sounds about right to me. When I was nursing and pumping before I went back to work, I didn't get more than an oz or two at a time (both breasts combined). Just try to remember, it's a supply and demand operation. Until recently, your breasts were producing enough for your dd only, now they need to adjust to make the extra for the pump. Usually within a few days of pumping at regular times, you'll see an increase, but you generally don't want to pump too much extra or you could get into an oversupply situation, which is no fun from what I've heard.

If you think the pump isn't working properly, check the white membranes that attach to the yellow valves at the bottom of the horns. If those are torn or damaged in any way, it will effect the amount of milk you get. You might want to get a few spare sets to have on hand so you won't have to scramble if you lose one or one gets torn. Usually Medela will send a few for no charge. You can also call them to trouble shoot the pump, but most likely, you're doing just fine.

When you go back to work, you will be pumping INSTEAD of nursing, so you will likely get quite a bit more. Try to pump on the same schedule dd is used to nursing, or every 2-3 hrs while you're gone.

The first time I got milk from the pump, it was about 3 drops. Not long after that, I covered the bottom of the bottle- I was estatic. Then I increased from there. You can combine milk from different pumping sessions, just be sure to cool it first. If you're going to freeze, don't freeze more than 2 oz at a time. It's much easier to thaw more than it is to dump extra down the drain and have to catch up later.

Drink lots of water and try not to stress (I know it's hard). Congrats on the new baby.
captain optimism's Avatar captain optimism 08:16 PM 12-14-2003
How much you can pump will never be a good indicator of how much milk your child is getting when she nurses. Your baby is more efficient at sucking than the pump. Also it's easier for your breast to let down for the baby than for the pump. The baby is cute and smells like a baby and you love her. The pump is a pump. Not the same!

If you can afford it, get a copy of the book, Nursing Mother, Working Mother. They have plan for how to get more milk when you are first pumping. It's good to pump one of your breasts in the early morning between your two earliest feedings of the day. This might mean putting the baby down in her bed while you do that. Sorry, I know that's precious time.

I found that in order to get a good yield in pumping, I had to create a slight oversupply. I take lactation herbs, cyclically. (I've taken them on and off through the last 8 months of pumping.) Lately, within the last week, I started taking a B vitamin supplement with inositol in it, on the advice of someone here. This has enabled me to get more when I pump. Apparently inositol helps letdown. Since B vitamins are water-soluble it's hard to overdose on them, so this is worth a try.

The other things I've done that have helped: pumping at home in the morning every day (even on the weekends) drinking a lot of water at my desk during the day, drinking hot drinks including Mother's Milk tea. It's also good to have photos of your baby with you at the office to look at, or even items of her clothing.

I went back to work when my ds was two months part time and was full time by the time he was three months. It can be stressful, worrying about whether you will pump enough to meet demand. But it's been working for me. I've had a lot of support from people here. You can do it.
shelbean91's Avatar shelbean91 08:21 PM 12-14-2003
I second the Nursing Mother, Working Mother. It's a great book. I also wanted to add I went back to work FT when dd was 9 weeks old and I found once she hit a growth spurt, the 3 times a day I was pumping at work just didn't cut it. She was always a one breast nurser, so in the morning before I left, I would pump one side while she nursed the other, and I would do the same at night. She only got one 4 oz bottle of formula the whole time I she was nursing (after the first month it took for her to learn to nurse and get on the breast exclusively) and that was b/c I was late getting home by about 45 minutes.

But if you just started pumping, and she's only a month old, 5 oz is a great amt to be getting.
xerxes's Avatar xerxes 09:31 PM 12-14-2003
Thank you very much for the support and optimism! I definately needed to hear from other mothers that I am doing things right for my DD. I do not know if it is a little bit of post partum depression or the guilt of having to go back to work when she is only 2 months old, but I just feel like I cannot adequately give her what she needs and will have to go to formula...yuk! I love her so much and I want to give her the best start possible in life. Did anyone else feel like that when having to go back to work? Captain Optimism, I will definately get the book you recommended. I need all the advice and help I can get. I do not want to get frustrated every time I pump.
xerxes's Avatar xerxes 09:40 PM 12-14-2003
Shelbean91, do you recommend that I pump twice a day beginning now? My dd nurses on one side in the morning, which leaves the other breast somewhat full. Should I pump the other side during or after she nurses? Should I than pump in the evening doing the same thing? And this may be a dumb question, but by nursing on one side and pumping the other, is it possible to not have enough milk for dd if she decides to nurse right away again? She will usually go 1 1/2 to 2 hours before nursing, but sometimes she wants to nurse within 1/2 hour of the previous nursing. I am afraid she will be hungry and I will have depleted all of my milk supply.
phathui5's Avatar phathui5 09:58 PM 12-14-2003
This is a good article from

She talks about different ways to increase your milk supply and your pumping output. She also talks about something called reverse cycling, which is basically feeding baby more often when you're together so he doesn't need as much when you're away. Maybe some other moms on here have had experience doing it.

As for the encouragement: This is something that you can do. Don't get discouraged at this point. You have some time before you have to go back to get some milk stored up in the freezer. You also have enough time to increase your milk supply so that your baby can get your milk when you're away.
shelbean91's Avatar shelbean91 10:06 PM 12-14-2003
I think I remember my LC telling me to not pump more than 4-6 oz above and beyond what baby is taking, but I'm not sure I'm remembering that correctly. If I'm wrong, someone will correct me.

If she only nurses one side, you shouldn't have a problem pumping the other side and still having enough for her. Also, the breasts aren't like 'holding tanks' where they just fill up between feedings, but milk is actually produced while baby is nursing. When you feel full, that is the signal to the body to produce less. When your milk supply regulates, you'll most likely lose that full feeling you get between feedings. It doesn't mean you're losing your supply, but that you're making just enough. Not too much, not too little. It is a little bothering, especially as for me, it happened not long after I returned to work.

If you can pump twice a day now, I think that would make you more comfortable when you return b/c you'll be able to build up your 'freezer stash'. Even if you only get an ounce or two (or 1/2 ounce) at a time, it adds up quickly. You can layer the pumped milk in the fridge during the day and freeze it at the end of the day. If you can't pump twice a day, just do what you can, but try to do it at the same general time each day. The morning is usually when you'll be able to get the most.

Also, if you like oatmeal, that's supposed to boost milk supply. It doesn't matter if instant or not, can even be in cookies!! I don't know if it's a mental thing or not, but my pump output increased by a couple of ounces a day when I started eating oatmeal for breakfast and having oatmeal cookies on break.

You'll do fine when you go back. I know it's stressful thinking about it, but you can do it. I pumped for my dd until she was about 13 mos old, and she didn't wean until 20 mos, when I was 5 mos pg w/ds. Ds just weaned at 20 mos. I didn't have the pumping issues w/him as I stayed home after he was born, but we had all sorts of other troubles getting him to nurse.

It's great you're getting all this sorted out before you go back. One less thing to worry about when you return. I read somewhere to return to work on a Thurs or Friday to ease the transition, rather than return on a Monday. I would recommend that if possible. It really helped me quite a bit. I figured even if the day sucked, I'd be able to have the weekend to recover and regroup. Surprisingly, it wasn't too bad.
Quirky's Avatar Quirky 01:59 AM 12-15-2003
I third the recommendation for the book Nursing Mother, Working Mother. I would definitely pump the other breast first thing in the morning. If you get only an ounce or two a day, that's 30 to 60 ounces in the freezer when you go back to work, which is quite a respectable stash!

Keep in mind that your freezer stash will be your emergency backup supply. Your dd will be drinking the fresh stuff you've pumped the day before, so you only need frozen milk for when she has a growth spurt and gets super hungry or some other unusual situation.

Your dd may also reverse cycle, ie wait for you to get home and only take a little from the bottle during the day. So you may end up with an enormous freezer stash from all the milk you pump (which you need to do to keep your supply up) but she doesn't take. You just won't know until you get there.

In about two weeks or so you'll want to start introducing dd to a bottle to make sure she'll take it when you go back to work. Make sure to use a #5 plastic bottle like the Medela bottles, not #7 polycarbonate like Avent, because of the plastic leaching issues.

Also, on the pump - what speed/suction do you have it set at? And do you think you might need a bigger or smaller flange than the one the pump came with? Some women with bigger or smaller breasts/nipples find that a different size flange is more comfortable and more effective at expressing milk.

Don't worry, you can do it!
DaryLLL's Avatar DaryLLL 11:26 AM 12-15-2003
Hi Xerxes,

And congratulations!

That is Bach (not Back) Flower Rescue Remedy Hilary is talking about. It can calm your nerves, should you need that.

NO, you will not need artificial baby milk. Millions of mothers every day, nourish their babies on their own pumped milk while they are at work. And you will too.

It can take time to learn how to let down to a pump. Some moms run water in the sink, or take to work an item of baby's clothes and smell it. Or a picture of the baby.

Why not go bqck to LLL? There will almost certainly be a couple working moms at the mtg for more moral support and BTDT info. If your IBCLCs won't return your calls, call your LLL Leader(s). They mayb well have the above reced book in their library to borrow.

Good luck!
tnrsmom's Avatar tnrsmom 12:05 PM 12-15-2003
Xerxes, I just want to say congratulations. You sound like such a loving mom. I think you have gotten some great advice from the mamas here. I had great success pumping while I was nursing. The letdown reflex was already there so I was able to catch that milk *naturally. Maybe that would also help your body get used to the pump. I am sure you will be able to pump successfully when you go back to work, it just takes practice. I have a great friend who has pumped for all three of her children while she works as a nurse and none have ever had formula. She has always told me that pumping is an art and it takes practice.
I would have your dh assist in giving the bottles before you return to work. Often babies refuse a bottle from the mother because they know that is the *real source*. If your dd seems to have trouble with a bottle, you might want to try a different nipple.
Good luck to you. I can feel it in my bones that you will do great!
xerxes's Avatar xerxes 02:09 PM 12-15-2003
Thanks everyone for the great advice and support! Jane, I am using 1 to 2 speed and middle suction. What do you mean by the flange? Is that the actual piece you place on the breast? Thanks for the advice on the plastic to store dh and I have a chart on the fridge that tells the good plastic from the avoidable plastic. It is amazing how many things I had to change based on that chart! We started all of the changes while I was pregnant. It is also amazing at how many of my friends think I am crazy when I constantly check to see the recycle code before eating or drinking something! One can never be to safe when it comes to the health of our little ones! I am going to call medela today because I cannot read the recycle code on the bottles that came with my pump. It actually looks like a 6. DH and I both could not make it out. I am going to order the Nursing Mother, Working Mother book today! My dh is very excited because he gets to also order a book, so that I can get free shipping! And good news...I feed dd on the left breast only last night and pumped the right side after her 6am feeding...I was able to get 1 1/2 ounces! I was so excited! I have been taking Fenugreek for 2 days now, so that may have helped. Anyone have advice on Fenugreek? How long should I continue to take it? And is it a good idea to only feed on one side at night and pump the other in the am?
xerxes's Avatar xerxes 02:13 PM 12-15-2003
Hilary, I forgot to mention in my last post... where do you find U-bags? Do you just attach them to the breast and the let-down fills it? That would be great because I do leak quite a bit if I do not have a breast pad on!
captain optimism's Avatar captain optimism 05:18 PM 12-15-2003
I don't find the smell of fenugreek in my sweat too oppressive. It's like maple syrup. I thought it would be really annoying, but it's not. Not as weird as the way my urine is fluorescent yellow since i started taking the B vitamins!

I also take nettles and blessed thistle, all in capsules. The tincture is stronger but I didn't take the stuff when I got tincture, so I went over to everything in a pill. Usually I take two of each herb at meals. But sometimes I forget. I didn't start taking lactation herbs until I went to work, though. My breasts produced quite well for the baby, it's the pump they don't like. Funny, because the pump has never bit me () and the pump is relatively gentle. The thing is, breasts were designed for babies, not pumps. I said that before, but it's still true. (But I typed this while pumping! )

Try this page for more on lactation herbs (aka galactalogues):

Lots of nice links.

Anyway, tell us more about this plastic stuff. I want to know which kind is which.
Tracy's Avatar Tracy 07:10 PM 12-15-2003
I'm so glad you got some good postings. I shook the tree a little bit and asked a few kind moms who know more about nursing than me and asked if they would be kind enough to make sure you weren't neglected.

One thing I can tell you is that you do need to double check the suction on your machine. I had a problem on I recall there was a tiny hole in the tube that I could not see but it was enough to alter the suction. when I got a new hose it was a whole new day in our house... Milk by the gallons..well, maybe not gallons but a sure heck of a lot.

here is some more on lactation teas:

also, I'm with darylll on trying out LLL again and see if you can get some more advice on the pumping and the machine.

I had a great lactation consultant in our area and she was easy to access, I"m bummed the ones in your area aren't returning calls. And they get pissed when moms ditch nursing!!!! Gee maybe if you returned calls...anyway, no soap box here.

keep us updated. Tell your husband we're all crazy about him still.
Candide's Avatar Candide 12:38 AM 12-16-2003
Hilary, Xerxes already mentioned that insider is her dh. I'm guessing it doesn't matter that we know. Sorry to jump in on this thread but I did want to post about the dangers of certain plastics that Jane mentioned.

Here's a link to the plastic recycling codes and which numbers to avoid:
Quirky's Avatar Quirky 03:24 AM 12-16-2003
Originally posted by xerxes
Thanks everyone for the great advice and support! Jane, I am using 1 to 2 speed and middle suction. What do you mean by the flange? Is that the actual piece you place on the breast?
Yes, aka the horn. Some women find that a bigger or smaller size is more effective for them. In other words, are your breasts getting lost or totally squished in the horns, or do they seem comfortable?

You could probably try upping the speed and see how that works for you. I found the PIS to be pretty mild in suction compared to the hospital grade pump I had to use at the beginning. It worked fine when I went back to work at 5 months and my supply was up, but it didn't work when my milk wasn't in and then when I had low supply issues. Not all of us are blessed like Hilary with enough milk to feed the village.

I am going to call medela today because I cannot read the recycle code on the bottles that came with my pump. It actually looks like a 6. DH and I both could not make it out.
Medela bottles are #5, polypropylene, and are fine.

On the fenugreek front - are you taking 3-4 pills 3 times a day? You should definitely notice the smell, otherwise you're not taking enough. Adding blessed thistle (same dosage) is a good choice too.

Tracy's Avatar Tracy 04:31 AM 12-16-2003
My dh (insider) says MDC is the best place to come for support.
See..Hilary... I didn't spill any beans. thought I'd take the opportunity to share the ....
PumpkinSeeds's Avatar PumpkinSeeds 12:08 PM 12-16-2003
Just wanted to caution that fenugreek gave my ds the worst rash all over his body. If you start to see spots all over your babe.....
PumpkinSeeds's Avatar PumpkinSeeds 12:12 PM 12-16-2003
I pumped for fourteen months and I wanted to add that what really helped me so much is drinking AT LEAST a gallon of water a day. No joke.
schatz's Avatar schatz 02:51 PM 12-16-2003
I know you've gotten lots of replies but I had to jump in as I pump at work.

lots of great advice already, I can't add much more other than to tag onto the possibility that your dc might become a reverse cycler like mine. My pump output has never gone up from about 10-12 oz during a work day and that has been fine for my dd ever since she was 4 months old. We delayed solids until 9 months so I know she wasn't filling up on those. It wasn't until I had to go out of town for a week when she was 9 months old that I found out just how much milk she was taking in overnight.

Just keep on pumping and it will work out - glad to see it already is getting better.

xerxes's Avatar xerxes 07:58 PM 12-16-2003
sorry it has taken me so long to respond to all of the great advice! I am not good with computers really and mine was slow as heck last night and I just got frustrated and quit! Today, I ventured out of the house for about 1 1/2 hours...I never seem to have much fun leaving dd at home! I miss her way too much!
I do not think I am taking enough fenugreek because in my opinion I do not smell like curry or maple syrup...I guess I will up my dosage to 4 three times a day? It appears to me that my breasts are fuller, however, it may just be wishful thinking! I am able to pump between 1/2 to 1 ounce per pump session now. Still less than I want to be able to pump, but anything is great for me. I also put a bottle under my opposite breast as she fed and was able to collect 3/4 ounce. Go me!
xerxes's Avatar xerxes 11:37 AM 12-17-2003 mentioned that you are able to get the hind milk out. How do you know that there is hind milk mixed in there? Does it seperate or look different? Also, you talked about dd should be eating about 3 1/2 ounces per meal, otherwise she will get a belly ache/colic. Well, my dd eats and sleeps really well in the morning with very little fussing, but around 1pm if she isn't constantly on my breast she will cry hesterically. We cannot even put her down to sleep...she will doze off while eating and then if we put her down she cries really hard again. This continues until about 8-9pm when I finally resign myself to bed just so she will calm down and sleep. I hate it when she cries so hard... she will actually spit up after her crying spell! It is awful, so I just put her right to my breast and let her eat! This calms her down right away, but I wonder if she is getting a belly ache from eating almost non-stop for about 6 hours. Should I not be letting her eat at the breast all afternoon/evening? And if not, how do you handle the uncontrollable crying?
chellemarie's Avatar chellemarie 01:49 PM 12-17-2003
xerxes...congratulations on your new wee one.

When I pump, one bottle will generally be more opaque, whole milk. The other will be a bit thinner, like the first bottle mixed with water or like skim milk. Sometimes it will have a blue or greenish cast, too. The thicker, whiter stuff is hindmilk.

RE: baby's marathon nursing sessions. My son did this from about 4pm til 10pm. He was always fussiest around 6:30 (about the time of his birth). The marathon nursing sessions stopped about the time he turned 2.5-3 months.
chellemarie's Avatar chellemarie 01:53 PM 12-17-2003
I wanted to add...if baby falls asleep but then wakes when you put her down, don't put her down. Do you have a sling or a pouch you could tote her around in?
captain optimism's Avatar captain optimism 02:22 PM 12-17-2003
Originally posted by Hilary

You don't want to be an over-producing freisan cow like me.
If you are, then over-feeding is a very common problem. That is why I had to restrict every feed while feeding another baby, to a total of six minutes.
Because that's the time it took for my hose-type production to fill his tummy....
Wait, isn't your baby about a month old? There is a growth spurt around week three or four. Just let her eat, don't worry about it. She'll slack off for a bit--and then do it again at six weeks! She's trying to increase your milk production for when she gets bigger, so don't limit her time at the breast. At your baby's age, you can leave her on the breast and do other stuff. Like Chelle said, use the sling. Or nurse and surf the net. Or read a book.

Fortunately or unfortunately, most of us aren't like Hilary! I never get a drippy boob on the non-nursing side when I'm nursing anymore. My baby always ate until he was done, and never got colic. But it is true that for most feedings, he eats between 3 and 4 oz. and this is still true at 10 months. Every so often he would want to eat a lot more, and my dh would just feed him more.

My milk comes in according to how hard the baby sucks. Another reason why I didn't need galactalogues when I was at home most of the time, but started to need them when I was at work more. When I was at work part time and home part time, I used to get 16 oz. in two double pumping sessions! Easily! As soon as I went back to full time, that stopped happening. And that's why I went over to herbs.

I wish I had known about the B vitamin thing months ago, though.

Seemingly T Maybe you also need some good analytic detective novels to read, while feeding, to relax you and given you something to analyse. A good whodunnit, that applies detective skills is a wonderful relaxer for intellectual people. Which I think you are....
Yes! When my baby was small, I did this! I re-read the entire Patrick O'Brian Aubrey-Maturin series (now known as Master and Commander because of the movie!) At some point my child developed a book fetish and I couldn't do that anymore. But I don't need to do anything special to relax anymore, so that's okay. It's nice just to be with my baby, who takes little breaks to smile at me.

At work I come to MDC while I'm pumping. Or I just do my work.
xerxes's Avatar xerxes 04:03 PM 12-17-2003
Thanks everyone for all the great advice!! I am feeling much more confident in the things I am doing for dd! I have been around/babysat plenty of babies, but it is really different when it is your own! I tend to worry about so much! I am in the process of looking for a sling...I looked on the internet to see which ones are the best. I will hopefully order one by the end of the seems like the best thing for us! I had no idea that dd could actually bf in the sling.
Quirky's Avatar Quirky 12:09 PM 12-18-2003
Colic/evening fussiness is also linked to developmental immaturity (aka "the fourth trimester"), the fact that human babies are born so prematurely, biologically speaking, so that their heads can fit through our pelvises. Check out Dr Harvey Karp's book (and video) The Happiest Baby on the Block, for his recipe for calming colicky babies:

Shhhhing (loud white noise)
Side lying

These closely replicate the conditions in the womb and make baby's brain calm down. Give it a shot - it really worked for us!
pumpkinhead's Avatar pumpkinhead 05:00 PM 12-19-2003
First of all, Congratulations on your baby girl Xerxes!

You've gotten tons of great advice on this thread and, tho you probably don't really need it, I'm gonna add my two cents .

I had absolute DISMAL luck with my PIS. Hated the thing! I got far more milk from the Avent Isis manual pump then I ever did from the electric ones (even the hospital grade ones). That said, the Avent bottles are made out of 'no no' plastic and so I NEVER stored the milk in them. I found the Avent to be easier on my nipples as well and more comfortable to use. Granted, a manual pump *is* more work, but the fact that I could regulate the strength of the suction and the speed myself, personally helped me. Just another idea to throw in there .

I also wanted to add that my ds had a 'fussy time' at night. It wasn't 'colic' but it started when he was about 2 weeks old and lasted until he was 6 or 8 weeks old. It'd start in the evening (7 or 8) and end around midnight. I just had to be in constant motion with him and/or he want to be permanently attached to the boob or he'd have a fit. One thing that he would do was nurse for 5 min then pull off and cry. He'd do this ENDLESSLY! I finally figured out that he was 'comfort nursing' (maybe from overstimulation or gas) and annoyed when he'd trigger my letdown. Poor kid just wanted to suck. He'd get more milk, and I daresay he was making his poor little tummy even more uncomfortable.(I like Hilary, was a bit of a cow, with overactive let down issues to boot ). When 'dummie mummy' finally figured this out (at around 4 or 5 weeks)and gave him a pacifier (ahh the dreaded 'p' word) we were all much happier people. As ds was a champion nurser and gaining lots of weight, this didn't hinder milk supply or cause nipple confusion. That said, every babe is different. You'll figure out what works for yours Mama s. Oh, have you tried a swing? Not that I minded holding and walking with/rocking ds, but a girl's gotta pee sometime right? :LOL This also did wonders for ds during his fussy time. Some babes hate 'em tho, so it's best to borrow one or try one out in the store first before making the investment. I second (or third?) the reccomendation for a sling, esp if your wee one is a snuggler and likes to be swaddled.

It's not unusual for a newborn to have a fussy time and this doesn't last forever! IT sounds like you're already in tune with your daughter and have a good handle on her wants and needs!

Good luck to you Mama!
pumpkinhead's Avatar pumpkinhead 05:04 PM 12-19-2003
P.S. That stuff that Jane wrote about the shushing and swaddling and sucking REALLY does work! Just keep in mind that you have to 'shhhhhhh' quite loudly right next to babe's ear or she won't be able to hear you over her own crying. The womb is a REALLY noisy place. The sound of your heart beat and the blood rushing though your veins is actually very like that of a vaccum cleaner or a hair dryer. (running both of these does wonders for a fussy babe as well BTW). All this 'shhhhhhh, the baby is sleeping' stuff is a foriegn concept for the poor little dears! They're used to NOISE!
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