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Discussion Starter · #1 ·
Hi everyone,<br><br>
I have a son who is 5 months and a week old and was born about 2 months early. He has more than tripled his birth weight and weighs 15 pounds. My problem is that I can't keep up with his appetite. I have gone back to work and there is no way I can pump every three hours. Thankfully, up until now, I have had a little milk reserve in the freezer, but that is almost finished. He is eating more than I make right now, and I have to supplement with some pumped milk. He eats six ounces at a time. My nipples are killing me from all this pumping. My question is when I run out of milk reserve in the freezer (I'm guessing in about a week or two) should I supplement with formula (ugh <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/greensad.gif" style="border:0px solid;" title="greensad"> ) or should I start him on solids? Because he was almost two months preemie I thought I shouldn't start him on solids until about 8 months. I am so sad and stressed thinking that I won't be able to exclusively breastfeed. Does anyone have any miracle ideas for increasing supply?<br><br>
Thanks for any help!<br><br>
Tara
 

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Sorry you're having a tough time. If you're unable to keep up, a little formula may be more appropriate at this point, but I'm not sure.<br><br>
A few tips that have worked for me when struggling w/supply.<br><br>
-Pump at least once/day on the weekends--you'll get extra milk & keep your supply up.<br>
-Nurse DB several times before you go to work in the morning. Stimulate supply and get him full.<br>
-Pump on the other side during the morning nursings--I get the most milk this way (great let down when DB is nursing).<br>
-See workandpump.com and <a href="http://www.kellymom.com/bf/pumping/index.html" target="_blank">http://www.kellymom.com/bf/pumping/index.html</a> for more suggestions.<br><br>
GL!
 

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i don't have an answer to your question, but I thought I'd chime in on pumping issues. One thing that really helped with me was getting up before ds and pumping before his first feeding. You tend to have a higher supply in the morning, so often you can get more milk then.<br><br>
Also, what pump are you using? That can make a huge difference in output.<br><br>
GL - hope you figure something out!
 

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First of all, good for you for fattening that little guy up! You must be so proud that he has been gaining well on your milk. JaneyHD has some great suggestions, especially to pump at the same times on weekends that you do during the week and pumping while baby is on the other breast. You may find that putting him to the breast as often as possible while you are at home will help to increase your supply as well. It can be hard to pump often at work but depending on your job maybe your boss will help you make arrangements to do so more often? Some La Leche League groups have evening meetings where you will likely find some working moms who have pumping experience and some great ideas. Good luck! And even if you end up supplementing some of the time, the milk that you are giving him is still great for him as well.
 

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I agree with Jeri about pumping in the morning. My dd is 5 months and going through a stage where everything is more interesting then nursing. I have a hand pump and in the morning she can nurse and get the milk let down, then becomes uninterested. I pump and 30 minutes later when she wants to eat I still have enough to feed her. We don't do this often, once or twice a week.
 

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Formula, his tummy is too young for solids.
 

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I would venture to guess that formula would probably work better for a 5 month old who was premie, but only you know your little one. My DS started solids at 4 months b/c of low supply and absolute interest. He had every sign of being ready and my very pro-BF (even beyond age 2) Dr. agreed that solids would be perfect to replace the milk I was not able to make at the time (he got two "meals" while I worked and about 8-12 oz. of BM), but he was also born fullterm at 7'15 oz. so he was no light weight. Also, have you tried all the herbal supplements (alfalfa,fenugreek,blessed thistle, etc.) I've had great luck with those three combined personally. And remember, if you pump daily, most pump parts like tubes, membranes, etc. may need replacing every couple months...small microscopic holes and tears could cause a great decrease. ANd if nothing works, remember...you're a minority for just making it this far and you should be very proud even if you have to supplement with formula for a little while. YOu're doing a great job!! <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/thumb.gif" style="border:0px solid;" title="thumbs up">
 

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Yep, formula. If you honestly can't get your supply up with pumping, herbs(have you tried Mother's Milk tea????), etc, I'd go with formula. My dd was a 34weeker and I know that she pretty much follows her adjusted age for milestones instead of her chronological age. She didn't have head control until 4 months(2 1/2months adjusted), didn't roll over until 5 months(3 1/2months adjusted), etc. She certainly wasn't even close to ready for solids until 8 months(which would be 6 1/2months adjusted). Even at 9 1/2months chronological, she isn't really doing much in the way of solids. Your son is probably like that as well. And formula will be digested better than solids probably because he's really only 3months old. Check with your neonatologist if you are still on the fence about it but I really think formula would be best. Their guts are so immature at that young age and especially being premature that I would stick with formula if you really cannot keep up with him. Remember though, YOU are what has sustained him this long. He's truly a miracle baby, all preemies are. I remember my baby sick and in the NICU at just under 5lbs. Those round-the-clock pumpings aren't easy. And it's hard to keep at it with all the emotional stress and the medical mumbo jumbo you need to learn that's associated with your fragile little baby. Your milk is what has gotten him this far and fattened him up. YOU brought him from red, fragile, skinny, and hairy to a chubby, sturdy 15lb baby. You've done so well giving him breastmilk this long. It's okay for him to get formula if you really can't get your supply up enough. Don't beat yourself up!<br><br>
Meg
 

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My vote is for solids. I heard Dr. Newman speak at a recent conference and his opinion was to supplement with solids in your case instead of formula. I agree with him. YOu can see if your dc is ready for food (sitting up, opening his mouth for food, etc). Of course it's your call--I have done formula with 3 of my babies and I just wouldn't choose it again. <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/smile.gif" style="border:0px solid;" title="smile">
 

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Someone had posted a link about this a few weeks ago, to either kellymom or LLL.org. They recommend a bit of mashed banana or avacado as opposed to formula to tide baby over as long as he is getting enough nursing sessions in and getting enough breast milk through you and the bottles you are able to pump.<br><br>
I was looking into this When I first went back to work. Sage was born 7 weeks early and I have Crohn's so I really want to stay away from anything other than Breast milk. I decided that some avacado would be less offensive to her system than formula. Luckily we didn't have to do any of it! Instead I increased my pumping to 4 times a day. I pump the right side in the am, she nurses the left; at my lunch at school (10:45); I pump the right side at 3:30 before I leave school (by the time I pick her up and we sit down to nurse it is 4:30, she takes the full left side and then gets topped off by the right side that has filled up fairly well inthe 1 1/2 hours since I pumped; then I nurse her to sleep around 8:30 and pump again at 10:30 before I go to bed. I get about 16 ounces a day this way. She is a small eater though so she only takes 8-10 ounces while I am gone. I have about 400 ounces in the freezer. I plan on cutting out one pumping session after Christmas.
 

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First, let me say something important:<br><br><i>Formula is not evil as a necessary supplement.</i><br><br>
That said, it may not be necessary in your case. Look on Kellymom for tips for increasing your supply while pumping. Certain herbs (fenugreek, nettle, alfalfa) and certain foods (whole grains, oatmeal, garbanzos) can help increase supply naturally. You can also do breast compressions while pumping... they help empty the breast more completely. The more your breasts are emptyed by pumping, the more your brain gets the signal to make more milk.<br><br>
Also, I would run, not walk to the nearest IBCLC (lactation consultant). They can get you on the right track with increasing your supply... as is with nursing, you should NOT be sore from pumping. Are you 'greasing' the horns of the pump, and are they a right fit in terms of size? Could you be setting the suction too high? What kind of pump do you use? The LC may also recommend a drug (domperidone) to increase your supply. It increased mine by almost 50% when nothing else was working.<br><br>
Pumping is really hard work, I commend you for doing it!!! And I'll repeat this 'cause it bears repeating:<br><br><i>Formula is not evil as a necessary supplement.</i><br><br><img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/hug.gif" style="border:0px solid;" title="hug">
 

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Tara, if he's three months corrected it's probably the three month growth spurt!<br><br>
You may find you'll be up to his needs in a week, but if not, and if blessed thistle/fenugreek/all these pumping tips don't help, I would supplement w/ formula (ugh, I feel your pain!) rather than solids.
 

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may i ask why you think you don't have enough breastmilk anymore?<br><br>
often the breasts stop feeling "full" after a few months, even when they are. it's also very common for people to not be able to pump as much as they used to be able to when their babies are a bit older. these things are not indications that your supply has changed, though.<br><br>
since he's still quite young and you're not nursing him during the day, though, you are right to wonder about supplementing. whether it's with solids or formula, that is a totally personal decision. have you spoken to your ped about it?<br><br>
rowan
 

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Discussion Starter · #14 ·
Thank you so much everyone for your encouragement, support, and knowledge. I am still undecided about what to do. I just got some 'mothers milk' tea and some lactate support tablets. I don't think I have enough breastmilk because my son wants to eat more than I can produce. I work a lot in the evenings so I am home with him most of the days. I try to nurse as much as possible and then pump after nursing. He is always hungry after nursing a few sessions, and when the babysitter comes in the evening he ends up eating around 15 ounces of milk in a 3-4 hour time period. I read that he should be getting 2-3 ounces for every pound of body weight so with him being 15 lbs, that would be 30-45 ounces in a day. I can't produce that amount.<br><br>
My nipples are killing me- they have never not been sore and I am really not enjoying this process much. I'm sad saying that. I know this is what is best for my son, and I will persevere with the pain and the pumping. My son also has a dairy and soy allergy (or at least he did- maybe he has outgrown it?) so that is stressing me out as well.<br><br>
Thanks again for the help and suggestions.<br><br>
Tara
 

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Tara- remember when he is nursing he is probably getting much much more than what you get from the pump. Could it be a sucking issue with the sitter? Sage's first few days with the sitter she was taking 20 ounces in 8 hours (she only weighed about 10 pounds then) I started freaking about how to pump enough for her and then started analyzing things and realized that when she nursed she would spend 20-30 minutes sucking, she downs a bottle in less than 10. The sitter started giving her a Paci if it had been less than 2 1/2 hours from the last time she ate (sitter is very AP also so the Paci was just used quickly, if she continued to fuss for more than 30 seconds she got the bottle) Turns out she just wanted to suck suck suck, not actually take in all that milk. As I said previously she is now taking 8-10 ounces a day. She has given up the paci in favor of her thumb though!
 

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I'd say formula or goat's milk. He sounds too little for solids. His adjusted age is only 3 months, right?<br><br>
Have you tried pumping at night? I always get a ton more milk at night.<br><br>
Also if you aren't pumping often at work it will definitely affect your supply. I'd try to add some pumping in there somewhere.
 

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My nipples are killing me- they have never not been sore and I am really not enjoying this process much. I'm sad saying that. I know this is what is best for my son, and I will persevere with the pain and the pumping.<br><br>
Tara</div>
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This made me wonder---have you had an LC watch you nurse? The fact that your nipples have always been sore makes me wonder if DS has a less-than-perfect latch. In that case, he may not be getting milk out effectively, which in turn would down-regulate your supply.<br><br>
I would seriously consider looking into this! It really shouldn't hurt at this point. Are you in NYC? I saw a fabulous LC here for latch issues. I can give you her name if you're interested.<br><br>
You're doing a great job, BTW!<br><br>
Janey
 

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I would also say to switch to the slowest flow nipple you can find for the bottle. 6 oz is a lot for a breastfed infant at 5 months, much less at 3. You may find that if you switch to a super slow flow nipple, (avent's newborn nipple is nice and slow) that He may not take so much from the bottles. This will help you be able to meet his needs in your absence. He should then nurse MORE in the eveniing and night when you are home. I would really work at doing this rather than introducing either formula or solids.<br>
Why can't you pump every three hours? you're supposed to get a break for every 4 hours and a lunch on a 5 hour or more shift. That means 3 breaks in 8 hours.That's pumping 2 hours after you get there, two hours later for lunch, two hours later for break again, and the you'd be leaving after that.
 

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Everyone else has given such good advice so I'll just offer a <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/hug.gif" style="border:0px solid;" title="hug"><br>
I'm a preemie mom too.
 
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