How to increase supply by expressing?

[aamia]

Hi, baby is tongue tied, and while we get that sorted, have been lent a pump to try to keep the milk I have at least (he can't use his tongue to feed at all really so just squeezes with lower jaw to get milk). Using that, I think I know why he only feeds for 15 mins! When pumping I get about 40ml combined from both breasts and this comes in the first 10-15 mins. Then nothing. Even if I give it a decent break, or a shorter break, or... there's just nothing left. If I feed on one breast and pump the other, I get 30ml from that one - but again, only for 10min.

So - what can I do to increase supply? He has to have formula top ups as we've had massive issues with weight, but I can pump to get extra stimulation and give him the expressed milk (still wouldn't be enough, but helps!). I don't know if it's relevant but even with milk in them my boobs are only about an A cup - so not large at all.

[whenwill]

how old is your baby and what was birth like (placenta wise)?
what pump do you have?
I had medela swing and it did work to increase my supply but basically had to go to the stimulating letdown bit for ages before any more would come out and then was only tiney. I aimed for three let downs. Could take 50 mins. Coming off for 2/3 secs a few time in a row with the 'fast ?suck?' cycle of the pump and back on also seemed to help let downs- its also what dd does/did (before tt snip). I did this a couple of times a day. Once in the eve when it really does take ages. everyone is different though.

[aamia]

Baby is two weeks old. Dunno what you mean with the placenta thing - had the injection if that's what you mean as was induced after waters broke early. When I stop the pump it seems to stop the supply and then I get nothing. Have tried putting it on/off like baby sucks and get less milk in the end.

[SarryB]

This is the basic Gina Ford increase supply method...

7am - express 1oz from each side. BF baby.

10am - feed from breast you last used, express 2oz from 2nd breast and then feed from 2nd breast

Before midday nap - give baby the 2oz you expressed to makes sure he sleeps well.

2pm - feed from breast you last used, express 2oz from 2nd breast and then feed from 2nd breast

5pm - feed from both sides.

6.45pm (or just before bedtime) - give baby about 3-5oz of expressed milk if you can, or try another feed, or formula.

8pm - express from both breasts, about 20 minutes each side

10pm - express from both breasts, about 10 minutes each side.

10.30pm - wake and feed baby. Either formula or expressed.

Night feeds, baby should wake around 2.30am. Make sure baby feeds from both sides.

That's what she says anyway! You do this for about a week, by day 4 you should notice a difference.

[SarryB]

Oh, and drink LOTS of water. I mean a glass when you wake up, and another glass every time you feed. This really helped me.

[whenwill]

dd only fed for 10 mins too actually from newborn and now only 5 mins.

Do you feel you get full breasts? dd got enough when I felt i had oversupply. She would never drain a breast and only fed first 'easy oversupplied/early milk' let down and so her demand slowly dipped and it became too hard for her when my milk established (6/7? weeks). She would come off and on, hit me, then scream and never go back on (like growth spurt behaviour but all the time). Had nursing skrike for about 8 hours a few times up to maybe 5 months. Expressing could get much more milk out than she could 'suck'.

Yes, do express after feeding and half way between but don't go too mad.

Intact placenta vaginal delivery helps milk come in and can be milk problems if not. You might not need to do this expressing faff continually once supply is up; just every now and then. But don't worry about how long baby feeds, as long as satisfied don't worry about supply until it's obvious there are problems.

Acutally forgot about manual expressing. Now my milk well established I can't seem to express much except manually; though when it comes to getting another let down only a pump can do it. Seriously there were times I sat there for ages (in tears) before a let down without anything coming out. If I hadn't done it dd would not have been able to feed.

And I would say feed on demand- not gina ford, especially with tt and milk supply issues.

[Iggly]

When will his tie be snipped? Should be done within a week max?

I'd keep letting him try and feed as well as express. You risk nipple confusion and he might prefer a bottle and that could be the end of BF. Was he getting any at all?

[aamia]

Hi, trying to get it done within the week - no-one would answer their phones on Fri when I tried. NHS waiting list till end Oct so will pay and get it done asap. He is still feeding and getting something, I'm expressing the other side when he feeds and then if he's hungry later he gets that before formula. He won't feed from both sides - falls asleep after the first (if he even finishes that). We're having to top up as he was losing weight still, and because of the falling asleep thing that has to be every other feed. So am feeding every 2 hrs, alternating breast and bottle, and expressing when I bottle feed. Will have a look at the Gina Ford schedule and try to fit that in to what we do as it's def worth a try!

[SarryB]

I did forget to add to that Gina Ford post - obviously it's just a rough guide. I had to adjust it a little for me, because my LO will never feed from both breasts. In fact, aged almost 6 months, he still will only feed from one side at a time. I mostly fed him from one side, then expressed from both sides. Then switched for the next feed.

I ended up manually expressing too. Once I'd done a week of that basic routine, I just kept a bottle handy in the fridge and expressed straight into it whenever I was sitting on my bum for about 10 minutes in front of the telly. I would then give LO that bottle at his 7pm bedtime feed, along with formula.

[Iggly]

I'd be wary of gina's expressing/feeding guide. If you can ring a lactation consultant they can advise. Where abouts are you OP?

[whenwill]

Please don't do gina ford schedule feeding with tongue tie!

[SarryB]

Can I ask why not do it with tongue tie? (not being arsey, genuine question!)

I don't want to start a Gina Ford war BTW, I just know that it's sometimes good to have a routine to follow if you're a little bit lost. And that's a very modified version I posted, leaving out the "feed for 25 minutes on one side, feed for 10 minutes on the next", which I really don't agree with.

[ishchel]

SarryB, Gina Ford knows (next to) nothing about how breastfeeding works. or expressing works.

Yes breast size has nothing to do with how much milk you can make.

There is something called an exaggerated latch which may help a TT baby latch on better.

It doesn't matter if your baby feeds for only 15mins long just feed him. Feed as often as he cues and keeping him close in a sling can keep him from becoming fussy because he wants to be close and to catch cues early.

You can also hand express into a clean bowl. It is a marvelous skill to learn and women can express as fast and as much by hand expressing as they can with a pump. Since he may not be draining the breast, hand express straight after a feed, even if it is an oz you get it is still good.
Women who are expressing for non latching babies eg those in neo natal units and who combine hand expressing after the pump has stopped removing milk find that they can up to double the amount of milk removed. (consider your baby to be the pump)

By removing milk you tell your body to make more milk. hand expressing

[whenwill]

tt babies often don't/can't get the milk they would if they could suckle efficiently (to drain breast), might stop feeding before 'drunk'/completely satisfied and would therefore 1. struggle going so long between feeds and then 2. not be able to up supply (as breast said 'oh you were full from not draining me so i'll make less next time') by staying on for a good length of time (if exhausted). Sometimes they will get more or less depending on how much energy/sleep they have had. They may also struggle more with sleeping (reflux, not full enough to last/go back to sleep/wake up if shattered etc.) so her sleep routine is out too i would say. I would argue this might apply to many babies but especially tt ones.

[didireallysaythat]

I had two tt babies and (tried to) bf them both. My first had a more severe tt (but by tt standards really not bad) which was released at around 2 weeks. He continued to have 1-2 hour feeds and was generally a miserable baby. I couldn't express so when I went back to work at 12 weeks, I was happy to move to ff. My second had a less severe tt, released at 6 weeks but fed quite nicely (15-30 mins) from the beginning. And I still couldn't express. We even spent a weekend in hospital so I had a midwife set me up with the super-duper breast pumps and after 30 mins I'd managed 15ml. Yet I breastfed for around 6 months, so it must have worked for my son.

So I don't really know what to suggest other than LLL were absolutely bloody marvellous, so supportive. And I went to every breast feeding clinic I could find - if nothing than just for the tea, cake and company they offered. However most bf clinics had no suggestions for tt - they were just shocked by our longer feeds. And not everyone produces milk easily and can express easily. My breasts were never engorged, I didn't have that day three thing, and I never had to use a breast pad. As the extremely charitable bf counciller said, I must be very clever to make just enough milk for my baby and not a drop extra.

If you are still waiting for a tt release, I'd make contact with LLL to get advice on before and after the release (it may not be a transformational event). Drink lots, try nursing after hot showers, baths, immerse yourself in lavender oil (or whatever to help you relax), try not to obsess about it (easier said than done), oh and I drank fennel tea (probably an old wives tale but the placebo effect is not to be underestimated). The best thing is to try and stick with it - just seek out advice to help you.

Good luck