Increasing expressing output - realistic?

[thehumanegg]

Has anyone gone from expressing next to nothing (with let downs) to a decent amount? And if the amount I'm pumping doesn't increase is it still significantly helping with supply?
I'm guess I'm hoping for some encouraging tales - I'm currently double pumping around 6x a day as well as doing breastfeeds to increase supply, though DD wont latch for long as is a tad impatient when it comes to food (fair enough). 15mins expression gets me 0 to 20mls per boob. I'm wondering what others experiences are.
Background is that I've had breast reduction, and have ended up mainly formula feeding due to supply issues. Have tried hospital grade pumps but didn't get any more out. I've just started a round of domperidone so am using this as a window to increase supply. DD is 3.5 months.

Thanks :)

[chipmonkey]

thehuman, when dd was born at 28 weeks, she was too young to latch on. I started pumping straight away getting around 5-10ml a time. I pumped eight times per day, every day with a hospital grade pump. Gradually I increased to 800-1000 ml per day. I found that if I pumped six times a day, the supply stayed the same, eight times a day I got an increase.

But, I had previously bfed my four boys and ds3 and ds4 were both over 2 when I stopped. Never had breast reduction surgery although I did have to have 10 units of blood when I had dd so didn't have a good start.
Bear in mind that some people do better with hand expressing. I didn't but I know I lot of people who did. Also I found I never got much with a Medela pump but did much better with Avent pumps. Not sure why, think the larger, softer funnel might have been the reason.

[YankNCock]

I used a medala swing with ds1 and had good results, but just wanted to say with ds2 I've finally learned how to hand express (thanks to health visitor and her knitted boob!) and it works even better. Can't believe I ever bothered with a pump now! Worth looking for YouTube videos to see if anyone has done a tutorial. I find it easier to do when baby is feeding off other side.

[thehumanegg]

Chipmonkey - that's an amazing increase, very good to hear. After you mentioned the avent pumps, I realised I have a manual one I never tried properly. I've been assuming that I have to bring out the big guns in my circumstances but I think you're right about the silliconey shield - I got more from this last night than my ameda double electric (that wasn't giving me anything then) and let downs happen easier.
Yank -I agree hand expression would be great to get nailed, I've tried this half heartedly before but gave up quite quickly. I am going to give this a proper go today to give my nips a much needed rest from machinery. Not confident I can get sprays of milk which might be a requirement but who knows. Worth a go.

Thanks both

[lottiegarbanzo]

After dd couldn't latch on properly and expressing while trying to bf (supplemented by formula) for a few days, we moved to full-time expressing, usually six times a day (ideal of seven, so every three hours with a six hour gap at night but usually some slippage made six realistic). I've just stopped after seven months.

I used the Medela freestyle double pump, after using the Medela symphony in hospital. Both very effective.

For the first six weeks supply increased gradually, from about 20mls each side to 100-120, with 150-200 per side first thing in the morning. For those early weeks we had to use formula when a feed was needed before the next lot was ready but from about six weeks supply was ahead of demand and I got into a routine of freezing a bag a day too. Then dd's consumption gradually caught up with my 'max supply'.

So, I don't know about your particular circumstances but I'd say volume can increase and that with expressing, you are taking the maximum your body can produce, because you always take all of what's there, not just what the baby wants to eat and this promotes production (I understand it's not supposed to be as efficient a method of extraction but the point stands that you take everything you possibly can).

[thehumanegg]

lottie I think that's brilliant you managed to work things out like that and kept it up for 7 months. Can I ask - at the beginning did you sometimes get next to nothing for loads of sessions? This is the case with me about half the time and I'm wondering if these pumping sessions still count in the total. I've been doing this about 5 days. I'm prepared to accept I might have got to the point of no return but will give it about a month to see if I can turn things around.

Thanks

[lottiegarbanzo]

Not for loads of sessions, no. I sometimes had one with little result but then I'd get uncomfortable and persist with the next one until it worked. Two in a row was probably the limit of low/no results. I think it is really important to feel relaxed. That gets harder if you're panicking or stressed about it not working of course.

Sometimes it didn't work because the innards of the pump were wet. They needed to be dry for the suction to work, so I'd have to pause, take apart, dry, re-start. Sometimes one side just didn't get a grip somehow. Altering its position might work. If not I'd use the other side's pump twice.

I wasn't BFing too though, beyond trying for the first few days. That must affect how much is available. I'd say keep trying, make sure you're eating and especially drinking plenty. Do you have access to good advisors?

[thehumanegg]

Thanks for expanding Lottie, all useful info. You're right about feeling relaxed - have been going at it a bit much and my boobs are slightly on strike I think.
I gave up on advisors after a few weeks pp as the surgery's not something people have come across much, and the only advice really is pump/ feed, possibly take galactagogues and see what happens. Though looking back I realise the issue I should have been asking about isn't regarding the surgery but how to get expressing working efficiently! I know this just doesn't work for loads of people who haven't the structural problems I have - I'd love to know all the reasons it works for some and not others. I do think another session with a bf specialist might be good so am looking at that now.
Thanks

[TheNameisNOTZiggy]

Out of interest what dosage of domperidone are you on? 3 tabs a day made no difference to me (different reasons to yours). However 9 tabs a day (per dr jack Newman paper from tinternet) +aiming to pump 8x a day + bf on demand worked for me.
Also is there is a la leche league group near you? Mine had fab trained counsellors to support me & a librRy of useful books. Incl making more milk & the art of bf. both v helpful at my darkest moments. their bf helpline is good too.
Good luck.

[TheNameisNOTZiggy]

Oh & if pfb has fed I can only get 50-70 mls using a double pump. Late at night or first thing in the morning.
However I did have a few days away & without him there I was stunned to get nearly 200mls one morning!!!!

[Londonmrss]

I had to start with exclusive pumping because jaundice baby was too sleepy to latch, and still struggles as a result. Have plenty of milk because I pump every 2-3 hours round the clock.
Would thoroughly recommend renting a Medela Symphony- it's £45 per month.

[thehumanegg]

TheName Domperidone's great isn't it! Encouraged that your plan worked, thanks for the info. This time I'm on 8 tabs/day. I agree, Jack Newman seems to know what he's saying and theres no point in doing this half arsed is there considering all the effort.
It's the second time I've taken it - first time was at around 6 weeks at the lower 3x dose. I did notice some effect but not enough to make a big dent in the formula. I didn't have enough tabs to wean off slowly so my supply crashed when I ran out. Hated asking the doc for more as he was quite reluctant in the first place so kind of gave up. This time by fluke I got a great doctor who had no objection at all to giving me a higher dose for longer. Did you wean yourself off these or have you had to keep taking them to keep supply up? Also how long till it really took effect? I remember having more leaking previously which I'm not getting now but maybe it was after I'd taken it longer, I can't remember.
Londonmrss same story here re jaundice, wish I'd been more religious about pumping like you as I also got v v engorged for about 5 days, too much for baby to latch properly. This might have killed supply as much as the surgery, who knows. Next time will def pump as you've done. Did rent a symphony but it didn't get any more out for me than medela swing or current ameda pump, so sent it back. I know this makes a difference for lots of people so was disappointed.

[TheNameisNOTZiggy]

Hi egg. Started taking it at around 4-6 weeks and have just been too scared to wean off earlier!!!!! However LO is still gaining weight & I am down to 3 tabs a day now. I reduce the dose by 1 tab every week, after I've weighed him.
It took him til about 12 weeks for his weight to come back to the centile he was born on. This also coincided with him losing the house-elf look and his cheeks filling out, thighs getting pudgy etc. so I would only consider weaning off the drugs after that.
It was such a fraught time. Family telling me I was starving him. Dr & HV saying is was doing a great job, keep it up etc. & feeling like I was in over my head!!!! I only stopped pumping & daily top ups at around 11 weeks.
Good luck. I am so pleased with the progress we have made. Knowing I did all I could to make this work is very satisfying. & it was bloody hard work!!!!!

[thehumanegg]

That's really brilliant, it's a complete uphill struggle isn't it. Good to know it pays off. Hope you and your LO enjoy a smoother ride from now on

[TheNameisNOTZiggy]

Good luck egg. As someone else said do try double pumping if y have not already. You can hire a hospital grade on - the Medea symphony. Made a big difference to us. I then bought a normal Medeka doubl pump so I could return the hospital grade one. £45 a month was a lot!!