Not Pumping Enough

[tatorhead328]

Hi everyone,

This has been a *very* stressful couple of weeks for me and breastfeeding. My baby is 5 months, and he hasn't been nursing well for about two months now, but lately it's gotten worse. He latches fine, but when he's done eating, he starts thrashing around and crying. I have to comfort him after almost every feeding now, and it's getting exhausting. I'm also feeling like a terrible mother because I'm worried that he's hungry and I haven't been feeding him enough.

I asked day care care how he'd been responding to the bottles I was sending, and they said that he does the same thing with them and has to be comforted after each bottle because he seems like he wants more. (I've been sending 3-3oz bottles for 7:30 - 5:30 and I nurse him on my lunch break.) Today I sent 4 oz bottles with him, and they said he didn't cry at all when he finished. The problem is that I'm not pumping 12 oz a day, and I also still have to deal with him being cranky and hungry after feedings in the evening. I really wanted to make it to a year, but this is disheartening and I don't want to underfeed him. 

I'm trying to drink more water and take fenugreek, but I feel so down now that it's making me unsure if I have it in me to keep going for seven more months of this. It feels like I'm spending so, so much of my time pumping at work and nursing at home that I can't ever do anything else. Anyone else been in this position and have any advice to help me get through this part? 

[tatorhead328]

I use a Medela Pump In Style Advanced when I'm at work.

He turned 5 months today, so I wasn't sure if starting solids would help with how much milk he's taking in. If he starts eating solids once or twice a day, will he need less milk at day care? Also, I've been feeling period cramping for the past couple of days but no sign of it returning just yet. I would think maybe it was just a dip in supply except that he's been fussing while nursing for so long now that it feels like I'm just not making enough for him. He makes a dirty diaper every day, but I'm thinking he must still be hungry. It would be nice if there was a diagnosis button on babies.

[flcl]

Hi there. I'm sorry you're having supply challenges... they can be so stressful. It may seem like all you're doing is nursing and pumping but that is one of the best ways to signal to your body that it needs to make more milk. It sounds like you're doing what you need to. Continue to nurse LO on demand and let him cue to you when he's done. Continue to pump for the feedings that you miss when you're at work. Take good care of yourself, eat well, drink water and try to relax. Kellymom has some great info and other good tips to check out kellymom.com/bf/pumpingmoms/pumping/pumping_decrease/ Hang in there and best of luck!

[lingeringwithcoffee]

I made lactation cookies anytime I was struggling to pump enough, and they seemed to help. This is the recipe I used: www.food.com/recipe/oatmeal-chocolate-chip-lactation-cookies-by-noel-trujillo-192346

Also, try power pumping. Info is on the kellymom.com site.

[casey]

Hugs, mama.

Solids can help, but they don't mean LO needs less milk -- just that there's another source of calories. I wouldn't encrage you to jump to solids as a way of dealing with the supply concern. Here's what I'd do:

Really push the water. Try to get at least 3 quarts a day. Maybe 4.
Start each day with oatmeal and flaxseed.
Make sure you have fresh membranes on your pump.
Consider calcium/magnesium supplement if your cycle does come back.

The biggie:
Power pump at the same time each day for a week. Supply tends to be highest in morning, but I did it in evening because I was more relaxed then. Pump 20 minutes. Rest 10. Pump 10. Rest 10. Pump 10. Alternately, you can watch an hour long tv show - pump when show is on, rest during commercials. Don't watch the bottles. It doesn't matter how much you get. You are simulating a growth spurt, and it will take your body a few days to get the message. If you do this for a week, you should get a boost that lasts a while after you stop the power pumping.

Keep heart.

[tatorhead328]

Thank you so much, everyone! I'm going to really start chugging the water today, and my DH said he'd make a ton of lactation cookies for me this weekend.

For the power pumping, what if my LO is hungry 30 minutes to an hour after I do it, and there isn't anything left for him? Do I still try to let him nurse or feed him whatever was pumped?

[babycaps]

If you have the ability to spend a little money, I HIGHLY recommend you buy this pump: Sepctra S2
I ran into the same issue of not pumping enough right around 6 months and once I switched from my PISA to the Spectra I started getting A LOT more milk in less time. I sill use my Medela PISA parts with the spectra because they fit better than the parts that come WITH the Spectra, but the way the spectra suckles is different and much more effective. It's hospital grade and I found it to be better than the Medela Symphony that I was using at home (I work in the NICU and was able to borrow a hospital grade pump to use at home).
As for the power pumping, If LO is hungry 30min after, I would nursing him and then offer him what you had pumped if he's still hungry.

Please feel free to PM me if you have more questions on the spectra or ask here. It really changed my life to buy that pump! I thought I was going to be done pumping at about 6 months and now I'm going to make it to a year.

[Deleted]

I would rent a hospital pump maybe for a month but I wouldn't buy an unknown brand pump because someone recommended it here.

[babycaps]

@amyg, I know that was directed at me so I'll at least follow with this:
I am an advanced practice nurse in a major metropolitan area in a major university hospital and work in a large Level 3+ NICU. I teach women how to pump frequently. I've worked with the following pumps:
Medela Symphony, Lactina, PISA, Freestyle, Harmony, Swing.
Ameda Platimum, Ameda Purely Yours, and the version before the Platinum that unfortunately I can not recall the name.
Hygeia Q
Spectra S1, Spectra S2

Oh wait wait, I have worked DIRECTLY with Medela on product development and can tell you about the different pattern cards that one can have with the symphony pump while a baby is in the hospital. They have a "preemie" card, a "working mom's" card and a few others that can be used with the symphony to change the pattern of the pumping. It's quite incredible, but the cost of renting those is very high.

Hospital rental of a pump: probably $70/month plus supplies. Cost of a new Spectra, $150 and she already has the supplies.

tatorhead328, I don't expect anyone to buy a pump on a stranger's advice on an online forum. I bought my Spectra after researching the heck out of it and now it's one of the pumps on the list of recommended pumps we offer here at my hospital. It's frequently on sale on Amazon and is cheaper than the PISA at the moment.
You can also check this out:  Baby Gear Lab The reviews there are GREAT and helped me make my decision. I didn't want the external battery pack which is why I went for the S2.

I share my story with the spectra because it really was THAT LIFE CHANGING. And has allowed me to continue through my breastfeeding journey successfully.
OH, and I initially learned about the Spectra from a stranger. On a forum. Online.

I guess this time I'm the one who wrote the novel!

[Deleted]

Rather than either of us suggesting spending another $150 on a pump, or even renting a pump

it's probably better that the OP goes to see an IBCLC lactation consultant for a review. It's also very likely that the pump she has needs new membranes to make it more effective. Most moms don't replace them often enough.


Pumping 9 oz in 10 hours is a reasonable amount of output for a pumping mom, especially since she's ALSO nursing on her lunch break.
This isn't a newborn. If milk transfer was an issue, or he wasn't getting enough milk a weight gain issue would be seen before 5 months. You can alwasy go in for a weight check and see what's goig on.

It is possible that baby is getting ready for solids a bit (just a bit of extra calories IN ADDITION to the SAME amt of breastmilk like an oz or two) if so, a solid like avocado, or oatmeal would be more calorie dense than most solids that we tend to start with. Of course look at other signs of readiness for solids sitting up, interest in food, no tongue thrust reflex.

But it's also likely that the extra fussiness is something else besides amount of food--bottle being given too fast (should take 20 minutes), bottle nipple too fast of flow, no paced feeding being used--

or Silent reflux is often the reason for baby to thrash around after a feeding or want to eat more often or eat more oz because as long as they are swallowing the acid doesn't back up in their throat. so stop more often to burp, burp longer and a bit harder, and keep upright after feeds to see what happens. At home when he's done nursing on both sides, put him back on the first side to see what he does.


Teething can be also be part of the issue, as while they are nursing or uscking on a bottle they don't realize the pain of their gums, the warm fluids feels good as well as the pressure. when you stop, they realize it hurts.

Is baby waking up all night to nurse? If they aren't getting enough to eat at daycare by this age they'll reverse cycle and demand more food all night long to make up the difference. If baby is sleeping well at night, it is unlikely to be just not enough milk, something else is usually part of the equation.

(FYI to OP if you do think it's a type of pump issue--often insurance will cover a month or more of rental if you have rx from Dr, they usually won't cover cost of a second pump if they already provided one, but health care reimbursement account if you have $ there may allow you to buy one pump a year check your plan documents)

[casey]

Jan 30, 2015 9:24:30 GMT -5 tatorhead328 said:

Thank you so much, everyone! I'm going to really start chugging the water today, and my DH said he'd make a ton of lactation cookies for me this weekend.

For the power pumping, what if my LO is hungry 30 minutes to an hour after I do it, and there isn't anything left for him? Do I still try to let him nurse or feed him whatever was pumped?

I'd let him nurse so that the pumping you do is in addition to meeting everyday needs.  If he doesn't settle after a while of nursing, then I'd use what you pumped in the bottle.

[Deleted]

Also be sure you check the sizing of your pump horns/flanges/shields. it is common for you to need a larger size at first while your nips are a bit extra fluffy/puffy, but as time goes on you may find you need to change to a bit smaller sized horn to get the right amount of milk.

Of course be sure you aren't setting the suction too high or you can temporarily collapse the milk ducts and less milk will come out, as well as make some swelling occur within the breast tissue. as you get frustrated trying to get more milk you may be tempted to begin to set the pump on a higher suction setting than is really good for you.

It's still helpful to use breast compressions and massage as you pump as well as looking at pictures and videos of baby crying and cooing. it may be that the best answer is to try to signal another let down during your existing pump sessions--so as the milk flow slows, bend over at the waist and let the boobahs hang down, give em a shake and a bit of massage and a warm washcloth or nuked rice sock may help to get you another let down of more milk when your resume pumping. try to pump 5 minutes after the milk stops flowing to signal a higher supply and another let down as well.

If you think it may be due to your cycle trying to ramp up, or if your period has already returned add in a calcium/magnesium supplement.

Formula is not an evil thing, if you need to try an oz or two of formula here or there to fill baby up and see if more oz is really what he needs to be happy, then use it judiciously ALONG WITH efforts to increase your supply. it can help to remove that part of the stress so you can focus only on your supply/pumping and not have to worry about the is baby getting enough part of the equation for a while. Just be sure it's given after the regular sized bottles are given slowly, burping is done, and some pacifier use to see if that will satisfy.

[babycaps]

Op, I use the same recipe above as well and AmyG has some good advice above as well.

[melody330]

Jan 29, 2015 15:27:36 GMT -5 tatorhead328 said:

Hi everyone,

This has been a *very* stressful couple of weeks for me and breastfeeding. My baby is 5 months, and he hasn't been nursing well for about two months now, but lately it's gotten worse. He latches fine, but when he's done eating, he starts thrashing around and crying. I have to comfort him after almost every feeding now, and it's getting exhausting. I'm also feeling like a terrible mother because I'm worried that he's hungry and I haven't been feeding him enough.

I asked day care care how he'd been responding to the bottles I was sending, and they said that he does the same thing with them and has to be comforted after each bottle because he seems like he wants more. (I've been sending 3-3oz bottles for 7:30 - 5:30 and I nurse him on my lunch break.) Today I sent 4 oz bottles with him, and they said he didn't cry at all when he finished. The problem is that I'm not pumping 12 oz a day, and I also still have to deal with him being cranky and hungry after feedings in the evening. I really wanted to make it to a year, but this is disheartening and I don't want to underfeed him. 

I'm trying to drink more water and take fenugreek, but I feel so down now that it's making me unsure if I have it in me to keep going for seven more months of this. It feels like I'm spending so, so much of my time pumping at work and nursing at home that I can't ever do anything else. Anyone else been in this position and have any advice to help me get through this part? 

A few things - make sure you are nursing as close to drop off and pick up as possible. Let your DC provider know to plan bottles so they don't interfere with nursing.

Also, comforting a BF baby after a bottle is normal. They like to suck, and with a boob they can control the flow of milk. With a bottle they can't. If they suck they are forced to drink. I don't see a problem with having to comfort him after a bottle.

[SpinsOffResonance]

In addition to what everyone said, when you're pumping at work keep
pumping for 10min after the milk stops flowing. You might get a second letdown. Even if you don't it will stimulate more milk production.
Remember that if you have to you can supplement one bottle of formula at daycare in addition to the bottles of BM. Toe LOOP will still get all the benefit of BM. This will allow you to send larger bottles without the stress of not pumping enough. Once I realized that and wasn't so freaked out about having to pump more and not pumping enough everyday, I was able to relax and it actually helped me pump more.

[tatorhead328]

After a couple of days of sending 4 oz bottles to day care, my LO hasn't been getting super upset after night feedings anymore, so it looks like I'll just be 3 oz short a day if I keep pumping how I normally pump at work. Today I'm going to try pumping for a bit longer than normal (I usually get two let downs in the morning, but not on my last afternoon pump), and I've got my water and fenugreek ready to go today. My DH made me a huge batch of lactation cookies with that recipe last night, so I'm going to see if I can notice any improvement in my pumping in the next couple of weeks.

I'm usually really bad about quitting things right when they get hard, so I'm determined not to quit this because it's one of the first things I've really committed to even when the going got rough. It's so nice to have online communities that help.

[mama2a]

I agree with AmyG as I was wondering if maybe your LO would benefit more milk but from less amount of bottles. If you're nursing on your lunch break then you are unable to produce enough output for next day bottles. Personally, if you're producing 9oz and then also nursing on your lunch break I think you're producing quite a bit!

[audrey1787]

I think everyone has covered everything but I've been there with not pumping enough to keep up and trying to balance how many ounces in how many bottles and how often to pump and when and it's a lot sometimes. You're doing great. I hit a few rough spots and got through them and then when Dd was 8 months old I was over the power pumping, extra pumping on weekends, extra pumping before work, pumping, pumping, pumping and I started supplementing with a few ounces of formula a few days a week when I was short and having someone tell me that I was doing fine meant a lot to me. People told me supplementing would be fine earlier on but I wasn't ready yet and I'm glad I had support with whatever I chose to do.

[ashanne88]

Feb 2, 2015 9:26:23 GMT -5 tatorhead328 said:

After a couple of days of sending 4 oz bottles to day care, my LO hasn't been getting super upset after night feedings anymore, so it looks like I'll just be 3 oz short a day if I keep pumping how I normally pump at work. Today I'm going to try pumping for a bit longer than normal (I usually get two let downs in the morning, but not on my last afternoon pump), and I've got my water and fenugreek ready to go today. My DH made me a huge batch of lactation cookies with that recipe last night, so I'm going to see if I can notice any improvement in my pumping in the next couple of weeks.

I'm usually really bad about quitting things right when they get hard, so I'm determined not to quit this because it's one of the first things I've really committed to even when the going got rough. It's so nice to have online communities that help.

Those cookies are delicious and really helped me!  I eat them with my mother's milk tea.  

Just wanted to give you encouragement.  It's easy to want to give up on BF when supply problems come up, I really struggled (and sometimes still do).  There were a lot of times in the first few months when I thought I was going to lose my supply and just wanted to give up too.  Hang in there and know you're not alone.  Glad LO is doing better too!