Pumping advice

[flymo79]

Hi all, am confused by pumping! Midwife suggested to boost my supply, so have been expressing using elec pump after morning and evening feeds. I only get about 1oz a time so in 48 hrs have just enough to give dd a top up feed if she has a fussy evening and the boob doesn't seem enough. So the thing is, my pumping sessions don't seem to be improving on output, and I am stuck because I pump after she feeds. But I can't bear for her to miss a feed for me to pump, so I'm confused about how this is supposed to work!!!
TIA

[Imeg]

I don't know how old your baby is or how long you have been pumping but it took me ages to get to 30ml... I always found I got more in the mornings.

[Imeg]

PS if the aim is to boost your supply rather than to give top-ups of expressed milk then as far as I understand it the extra stimulation of pumping should help supply even if you get very little out. Also, I found that I got more out with the pump if I was relaxed eg watching TV at the same time rather than obsessively watching every little drop....!

[tiktok]

flymo, can you share more info? Age, weight of baby, why the midwife has suggested this, what other things you have tried (best way to boost supply is to increase frequency and effeciveness of breastfeeding eg by ensuring at least both breasts are offered each time).

[flymo79]

Thanks both. Dd is 4 weeks, was born 9lb 5oz, lost 8% and only gained 1oz back in first 2 weeks. Midwife suggested topping up with formula.

[SaggyAndLucy]

any gain is a gain. DD is 6 months old and 2 oz a week is her average.
You're doing the right thing. feed and then pump. Even dry pumping will help. The more you ask for the more you get. If it's weight gain your after I personally would feed from one side per feed. its not the new thinking, but if you feed off both sides in one feed you'll get 2 lots of fore milk. fore milk is less fatty and calorific than hind milk.

[tiktok]

Saggy, please don't tell OP to feed one sided. It's absolutely not the way to improve production or weight gain. In fact it does the opposite, and while many women are fine feeding one sided if that's what their babies are fine doing, it's not something to do deliberately if weight or supply is in doubt.

OP, are you saying your baby is not at birthweight yet?

[bouncinbean]

Hi I needed to top up like you and my tips are: pump when you feel fullest - for me that was first feed of morning, I did it at the same time as DD was feeding - a bit of juggling but it was the only way to get a decent amount (oh and for me a decent amount was 1- 1.5 ozs), if DD was still nuzzling for milk I would then put her on the boob I'd just expressed as I heard babies are better than pumps for extracting milk! A big element was also headspace - you really need to feel calm, happy and so wrapped up in love with little one - which meant I had to sort out my warring DP and DM and banish them till they stopped stressing me out! Good luck it does get better...

[SaggyAndLucy]

Tiktok can you explain which parts of my advice are incorrect please and why?

[tiktok]

thefunnyshapedwoman.blogspot.co.uk/2011/05/foremilk-and-hindmilk-in-quest-of.html
www.analyticalarmadillo.co.uk/2010/07/foremilkhindmilk-and-lot-of-confusion.html

Two well-written and clear blogposts will help - ask if you want more info :)

[flymo79]

Thanks all, great articles tiktok. yes dd is not yet back to birthweight and is a month old. She is pooing and weeing and otherwise fine but put on max 5 oz in 8 days which is a pretty slow gain, right? I am by now quite obsessed with other babies overtaking her in terms of gain and every time she cries I feel like she's still hungry

[hollie84]

Every time she cries I would assume she is hungry at this age and just feed at every squeak!

There's some information on the kellymom website too about why limited a baby to one side to make them "get the hind milk" doesn't help weight gain - it's actually just the volume of milk consumed that is important, not the fat content. So feeding really frequently and offering at least both sides every feed is the way to go.

[crikeybadger]

Not to be back at birthweight by a month old is unusual flymo and could indicate that something needs addressing.

Is breastfeeding comfortable? Does your nipple come out the same shape it went in?

How often are you feeding? Are you trying to feed to a schedule or are you being led by your baby?

Do you offer both breasts (or more). at each feed? ( I mean the first side, the other and then back to the first again)

Has anyone looked at how your baby comes on to the breast, how they feed and what they look like after the feed? (Ie. are they fairly content)

Finally, has anyone checked your baby for tongue tie?

Sorry for all the questions, but they might throw up something that could help.

Regarding your initial question about pumping, I've heard that hand expressing after pumping can increase volumes of milk by up to 40%.

Hth

[SaggyAndLucy]

Tiktok Ive PMed you.

[tiktok]

OP, not to be at birthweight at a month is a concern. It could be all fine - some bigger babies are 'catching down' to a lighter centile in the first weeks, but you can't assume that.

Whether all is fine or not, your baby needs the opportunity to feed frequently, and if your midwife is concerned enough to judge you need to express as well, then at this stage it would be sensible to follow that. More frequent expressing will boost quantity. But the key is to bf more often and to use more 'sides' when you can.

[cookiefiend]

I had to top up with formula and pump to increase my supply. I pumped after each feed as the idea is to send a message to your body that it needs to produce more milk than it is. I usually got less than ten mls at your stage. But if you get nothing then your body should hopefully make a bit more tomorrow, though since your baby may drink it direct you may not see a huge difference in pumping volume. Also just pump for ten minutes or so each side if you aren't getting much. I was advised short expressing often was better than one or two really long sessions and I do think that made a difference.

Unfortunately it is also important to try and pump overnight too if you can when you feed- something to do with hormones. again just a quick few minutes on each side.

I also used fengreek to increase supply and domperidone. mostly what is important is perseverance. I got there eventually, but it is tough. you are doing really well. Keep going.

[flymo79]

Thanks again for advice and support, to answer q's: I offer both sides at each feed, dd is normally content for first few minutes then fusses on and off so I switch sides and of this a few times during feed. Feeding is more comfortable on one side than other. Nipple doesn't come out same shape, I have raised this with MW and HV's and breastfeeding supporter at local children's centre. None seem concerned and say 'she's got a good latch'. I'm worried we are getting into bad habits... Can't seem to get anyone to observe a full feed, how do I do this?

[bouncinbean]

I found there was bf support from midwives and hv's but they did not seem as experienced as the ladies I met through la leche league (as if their knowledge came from books not their own experience). Maybe worth checking out if there is a la leche group near you if you are feeling up to going out - I had to travel a bit further but was worth it when I was worried about bf. They were able to offer some practical tips and reassure me that actually we were doing better than I thought, and def were happy to observe a full feed...

[flymo79]

Thanks bean, will def look into LLL, I think nearest is about 20 miles away but might be best option

[crikeybadger]

Ok, sounds like nipple is getting squashed, hence coming out different shape.

Can you ask if there is an infant feeding specialist around who you can see? Something isn't right and your midwives are dismissing it.

[jeee]

Flymo79, my DD1 had the same problems. Like you, I never managed to express successfully - in fact I never managed to get as much as an ounce out.

DD's weight remained an issue throughout her first year - in fact, although she was a long baby, she fell off the bottom of the charts (and the medical description 'failure to thrive' really made me feel like the world's worst mother). She's now a tall teenager.

Please feel free to ignore this next paragraph - but when DD1 was about one month old I eventually introduced an evening formula top up. I found this took the pressure off me. Her weight gain was still atrocious, but when I was tired and worried I knew she was taking some food in. And (contrary to what a lot of people told me) I think this meant I was able to keep up the breast feeding. In fact, I continued to feed her until she was about 10 months (I was heavily pregnant with DC2 by then).

[flymo79]

Thanks all. Have called LLL but went to answer phone and the next person never picked up. Going to my third group of the week tomorrow, seriously hope someone there takes an interest! It's been all. 'Sounds like you're doing fine' again today!!
Jeee, I do give her a bottle of formula before bed, it gives us all a good few hours sleep and me some peace of mind about the calories. I am hoping expressing improves and I will be able to give her ebm as her bottle eventually

[Heatherbell1978]

Just to say I agree with saggy on the one boob thing. My DS is 17 days old and is thriving. Put on weight since day 1 - born 7lb 8 and 8lb 5 at 2 weeks. We've only ever done one boob as he likes feeding little and often - it's rare I get a feed longer than 10 mins. So we stick to one boob to make sure he gets some hind milk in him. And I'm expressing 3oz each morning to build up a freezer stash so we can introduce a bottle at some point.

[cookiefiend]

In this city there was great breastfeeding support, but actually for latching on I was often unable to remember what they had said by the time I got home. One of the most helpful things I found was videos on youtube and information sheets on I think it was kellymom as well as lll. They were really helpful in improving my latch and I could watch it every time I latched her on so it might be worth a google.

[tiktok]

Please read the links, heatherbell.

It is fine to follow your baby's lead with regard to one side or two.

It is not fine to deliberately restrict a baby whose weight is causing concern to one sided feeding.

But read the links :)

[cookiefiend]

I found this technique helpful. It may be that your problem is different, but on youtube it suggests other related videos down the side so one of them may suit you. I unlatched her each time it looked wrong- so for me I realised she needed to look like a little Hoover or limpit with lot of breast in her mouth- more underneath than above. I watched this video and some others constantly it seemed. We got there in the end. You will too.

Flipple Video