Having to express and give top ups- please help re increasing supple

[Gelsa]

my DS is 9 weeks old and was 10 pounds born. I exclusively BF for 5 weeks but due to cracked and sore nipples mastitis and engorgement went between expressing/nipple shields and then breastfeeding- took ages for nipples to heal. I was also treated for thrush which I think it wasnt and problem was nerve damage to nipple. Also had tongue tie snipped which didtn make a difference which was v upsetting. I had prev breast fed my daughter no problems for 1 year so found this time v upsetting.

Anyway finally decided the only way this to work for us was to express regularly and give top ups as too painful to breastfeed. Have been doing this for last 2 weeks but obviously DS is taking more milk.

Which is best way to increase milk-expressing 2 hourly or doing at night? Does this then settle down? I know about the drugs you can take but am not keen to use these. I am currently expressing 6 times a day and getting about 20oz per day.

If you express more often for a few days will it then get easier or is it likley to occur over few weeks??

Has anyone done this? what worked best for you? I have a 4yr old girl too so i have to be realistic and practical.

Many thanks for your help x

that should say supple at top!

I meant supply

ideally you need to express 2 hourly, including at least once at night

some people express very successfully, but for most it's jolly hard work, especially once your prolactin levels start naturally dropping.

have you seen a breastfeeding counsellor to see if you can get baby back on the breast pain-free?

You name it I have seen them- i have tried numerous times to try get him back on breast then after about 1 week then am in pain again, as I say it has taken a long time for my nipples to heal. I think there may still be an issue with his tongue but I do not want him to have another procedure or assessment for this as if I can do this by expressing I would rather do it.

I am expressing 6 times per day, 9am, 12,3,6,9 and 12 midnight and sometimes 3am.

How long at 2hourly have you found it if done yourself? as 2 hourly is not feasible for weeks on end with looking after a 4yr old too.

i did it myself for a couple of months with ds1, but thankfully didn't need to with either of my others.
i do know someone who expressed for a year for her little girl who had a cleft palate. she was still needing to express every 3 hours though, and take domperidone whenever her baby had a growth spurt or when she had her period (that can lessen milk supply)

it is possible that the tongue tie wasn't completely snipped, or that it has grown back a bit again.
in my, personal, opinion it would definitely be something worth looking at. he is still young enough for it to be a simple procedure to re-snip and it might make all the difference?

are you expressing enough for all his feeds at the moment?

second thisisyesterday, a re-snip can be done at this age with very little trauma - and certainly much easier all round than pumping around the clock, which is very hard going.

If you do decide to carry on expressing, I would say you need to aim for at least 8 sessions per 24 hours and at least one of those should be during the wee small hours :(

thanks both. I will consider another opinion- there are risks with a frenotomy though and I know of someone who does laser therapy which causes an ulcer to be produced which is very successful but am not keen to put him through this procedure and would rather have the hard work of expressing around the clock. Also there is no guarantee this will work so this makes me feel very guilty.

No he is having half ebf and half formula. he must be nearly 14 pound now.

I have alwasy struggled to latch him on. Again tried today but now think he has got used to havign bottles as has had to have bottles for last 2 weeks. Also very uncomfortable having him on breast- I can feel my nipple being squashed.

managed to express 7 times today.

If expresing 8 times per day how does that increase your supply surely your supply will be static at that?

Fenugreek (herbal supplement) is supposed to help increase supply.

Any amount of formula feeding will undermine your supply.

Do what you have to do love, that is a whopper of a baby, I bet he is gorgeous!

The risks with frenotomy are tiny. Really small. Also, if you leave it it can cause speech problems later in life (doesn't always tho). If your son were to end up with speech problems related to TT, then he may need an op at a later date - probably under general anaesthetic and that would be far more risky. My son had it done at around 10 weeks with a dab of lidocaine and hardly even cried, likewise all the other babies that had it done that night (we were the last ones in).

To increase supply you basically need to keep pumping after your breast feels 'empty' although it of course never truly is empty. So, keep pumping after the milk stops coming, for a good 5 mins per breast. Increasing the number of times you pump will increase supply.

Are you using an electric pump? If not, you could hire a hospital-grade one and you can do both breasts at the same time.

When I wanted to increase my supply I took 6 fenugreek tablets a day - they take a couple of days to kick in and your wee smells like maple syrup but it worked for me! I also upped my fluid intake and made sure I had at least 8 large glasses of water a day.

thanks guys- narmada- did your son have the laser or was it done with scissors? my ds already had done with scissors and he definte;y has more mobility of his tongue but still doesnt feel right when latching him on. He manages to get the nipple in his mouth but areola with great difficulty. and now think he has got used to the bottle as have been expressing for 2.5 weeks now.

oh goodness, I think I should get another opinion too as even if breast feeding nevers gets back its right to be concerned re his speech and like you say narmada we dont want him having to have a GA because of that.

He is a very windy baby and his tongue clicks when feeding off the bottle too.

I will pump a bit longer on each side too. Today I have managed t pump 7 times.

Ilovethedoctor thankyou he is really gorgeous

thanks so much for your advice, i really appreciate it

It sounds like his tongue tie wasn't snipped properly or he has another one further back, [[http://milkmatters.org.uk/ Milk Matters] are brilliant and can refer you to someone in your area. My DS had his TT snipped at 3 months (with scissors) and it was really easy, with a little cry and a little bit of blood but that was it. The wind hugely improved after the snip.

Milk Matters

hi gelsa DS had his done with scissors and local anaesthetic gel. Wasn't the least concerned.

I think it's sometimes the case that babies need to learn how to use their 'new' tongue when they've had it snipped. Although the chap who did our sons didn't I also think they are meant to give you exercises to do with your baby to help them come to terms with the new mobility...

Slipping off the breast and clicking can definitely be signs of tongue tie. DS swallowed gallons of air when feeding and I am sure this was partly due to the tie.

Good look whatever you decide to do.

I decided to try bfing again today and again have sore nipples+. It really is so uncomfortable- no tears yet but i know by tomorrow it will!

Decided to see someone again re tongue. Will see how that goes. Thanks for your help.
Narmada, did you notice a difference straight away? how long before the pain improved?

Well to be honest DS wasn't BF by the time we had it done, for reasons largely unconnected to the tongue tie (mostly to do with my dodgy health and he had a few other things going on too). So I can't give you a guarantee that things will improve when it's done. We got DS's done because DP had speech issues as a child and we didn't want to risk it happening again.

in pain again back to expressing and feeding. have an appointment for DS to be assessed again for TT. will keep you posted how it goes.