Expressing Help

[AussieMum2Be]

Hi, Need some help from those who are exclusively expressing or regularly expressing.

My DD is 4 Months and at 13 week weigh-in hadn't put on any weight for 3 weeks, she is very small, was on the .4th centile so went to Paeditrition who advise to top up after every feed, so for the past month I've been expressing every 2 hours with a 3hour gap thru the night.

After weekly appointments, she has put on weight and is almost back on the .4th centile, gaining about 200g every 10days approx, but she needs about 17/20oz top up each day including BF, which means I'm basically expressing and BF all day. I can only get about 13oz a day and that is with a hospital grade double pump I've hired that I use for about an hour each express, I've also been take 9 fenugreek tablets a day and for past 10 days, mothers milk special blend.

I can't seem to get supply to increase so I don't need to use formula but im also exhausted from the getting up to express.

After all that, my actual question is, if I drop the 3.30am express where I get my biggest collection of 4oz, at my next express at 8am where I usually get 3oz, would impossibly get 7oz if 3.30am dropped or will I just lose that 4oz ? The rest of the day I get 1-2oz per session so cant lose this 4oz.

I'm almost at giving up point and going onto formula top up, but with such a huge top up I'm wondering if she is even getting anything from BF ? I don't want to stop as she likes and I like, but im literally either feeding or expressing all day it seems.

Any advise welcome, sorry re HUGE post !

[sarahev]

Hi,

I really do feel for you. I have been expressing for my 9 month old DD and it really does sound as though you are doing great!

However, if you have been expressing every 2 hours for this long and taking all that medication and your supply is still a problem, then I don't think that formula top ups are such a bad thing and you can still give her the expressed breast milk and nurse her as much as you like.

For reference since my DD was about 16 weeks old I manages on 5 10 minute pumps a day, and now I pump 4 times and get about 800mls. It does sound as though you are doing everything right, but not sure that the effort you are putting in will be sustainable in the long term.

FWIW - my daughter had formula from the beginning as she was prem and taken to a different hospital from me and we were also abroad so a bit difficult with communication. However, I have given her as much breastmlk as I can, and used formula now and again to give me a little break sometime so I only pump 3 times if we are out with friends, and my DD is healthy, has gained loads of weight and I just don't see formula as being a problem........

As for missing a pump - when I do that, I do get a bigger amount at the next pumping session, but not usually as much as I would have got if I had done it twice if you see what I mean.

In short I guess that what I am saying, is that if you want to maximise the amount of breast milk you give your baby, you need a sustainable method, and if that involves a bit of formula too, then I personally really don't see the problem with it, but that is just my personal opinion.

I guess that in 9 months, my DD has probably had 90% breastmilk and 10% formula and weightwise has gone from being bolow the charts at birth to around the 25% of full termers now.

Wishing you good luck, but really try and give yourself a bit of a break to enjoy your baby!

[japhrimel]

Whoa! It seems like your paed isn't taking the bigger picture into account. Particularly, to successfully express for any time, Mum needs to be rested and as unstressed as possible.

IME expressing is heavily affected by stress, exhaustion, dehydration, etc - all the things that shouldn't be able to affect bfing.

If your LO is getting 20oz a day in top-ups, then that is most of her milk intake right there.

Your supply should be able to adjust - unless you have physical issues with breast tissue. But stress may be stopping you effectively empty your breasts when pumping. Having said that, Kellymom says that a realistic amount to express in one go is 1/2 - 2 oz.

I think you could benefit from reading up on relactation. And alse seeing a very good IBCLC to work out how to get your LO to take the milk straight from you.

[AussieMum2Be]

Thats a good idea, i will try to see a IBCLC, what's the best way to contact one ?

And thanks for the support, i think I just need to maybe accept DD will need a little more formula so I can have a bit more freedom.

[stripeybumpsmum]

May be completely random and unhelpful but I find different styles of expressing work better at different times of day: Medela electric in the morning, hand expressed in the evening, especially after a bath. Just might be an idea? Or you could try keeping a record of what you eat/do/rest to see if there is any pattern to indicate if you are not drinking enough, or not eating enough carbs/protein etc?

v admirable effort already - don't be hard on yourself. I do think you need to find a way to rest more to help supply.