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I used to make 40 ounces a day for my son, who was eating 32 ounces a day at the time. Around 6 months post-partum, AF came back and my supply DROPPED. Now I average 32 ounces a day, and go lower with AF.

I tried Reglan at that time, and was not able to tolerate it - brain side effects like akathesia - I couldn't sit still!

I have been pumping up to 7 times a day and taking Fenugreek (but quit a week ago when my stomach went South on me). So I'm making 30 ounces a day, and DS eats 40 ounces a day. We're supplementing with formula (the F word!) and seeing some green poop and some gas.
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DS is almost 15 months and is not a good eater of solids. He seems to choke a little more than other kids. I suspect that part of the problem is this strange birthmark in the roof of his mouth. It looks like an extra tooth trying to come down from the middle of his palate. The cosmetic surgeon is aware of it and says it's common birthmark that will go away on it's own.

So, I WANT to be making 40 ounces a day of milk, and more would be better if I could get it. I can freeze and build a stash. I plan to go back to Fenugreek and keep up the pumping. I plan to ask my doc for a Domeperidone script on Wednesday when I see him.

But I'm hearing that hospital grade pumps can REALLY make a difference for some. I DESPISED my PIS. I love my WhisperWear and Avent Isis. Could a Medela Symphony really do that much for me?
 

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I got good tips over in the Working Moms forum, and one of them to up supply was pumping in the evening after the little one is in bed until you're empty, and then pumping again 30 mins later. Apparently the close spacing in the evening helps stimulate extra production.

Probiotics may help with the digestive issues. I've found them easy to give to my kids--I use Jarrow Baby-Dophilus.

I know someone who swears a hospital-grade pump (we had them at work, just had to supply our own accessories) was a lot better than her PIS. I can't remember the name, it was an older Medela (not sure how often they change the names/details for the multi-user ones). And I've heard oatmeal helps some moms.

I just depleted my knowledge. Good luck!
 

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Do you have the PIS original or advanced?
If you have the original, I would say you might want to try the hospital grade (I'm guessing symphony?) because of the flutter suck that it provides to stimulate let down. I would repeat flutter suck (I think it goes for 2 minutes on the PIS advanced and symphony) until you get a let down, then switch to regular suck/swallow action. Also, make sure you have the right sized flanges and that all your parts are good, especially the membranes, they need to be flat agaist the valve thingy.

Other thoughts - the whisper wear and isis depend more on breast compression, where other pumps (medela products included) depend on suction. That may be why you are having better luck with them. Since you can do the whisper wear while being more active perhaps you can add extra sessions?
 
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