Low milk supply- any ideas?

[TheDisillusionedAnarchist]

My dd was born 9 days ago and is currently in Nicu doing really well. I am expressing for her and that is not going so well.

The milk has never 'come in' no breast fullness, although it has changed to watery and white. I can express 10-15mls in hour pumping sessions but am not keeping up with her so she is having donor ebm

Things I have tried
Hospital grade breast pump
Switch pumping
Double pumping (found this difficult)
Domperidone since day 5
Lots of fenugreek
Pumping by her cot
Skin to skin
Breast compressions and massage
I'm pumping every 2 or 3 hours, sometimes a 4 hour gap overnight

Would really appreciate any ideas anyone might have. She has trisomy 18 and immune issues so would like to give her more breastmilk. Due to her disabilities she is also unlikely to ever directly breastfeed so can't count on that to increase supply.

Just to add I have Pcos, am on
Metformin and had few breast changes in pregnancy so this is probably why but would just like to maximise supply.

Congratulations on your daughter.

I've done the Nicu expressing thing. I know it can be tough. My advice would be to maximise the skin to skin and have a photo of her to look at while expressing. Make sure you eat and drink enough. Hospital environments are dry and it is easy to forget to look after yourself. Oats and fennel tea are supposed to be good for supply. I found lots of calories from any source was good though! And I was downing can after can of fizzy drink from the hospital vending machine ( I don't usually drink them).

Porridge. I swear by it. My milk supply was low and I just ate porridge and drank lots of water and it really increased my milk, for sure. I will never be the envy of wet nurses, but at least I got my last DC to 6 months on my milk. I really think porridge helped. Stress is a milk supply killer, so try and keep it to a minimum... not easy with your blessing in NICU. Edward's is a tough diagnosis. I send you hugs and wish you joy and strength.

Congrats on your daughter

Sounds like you are doing all the right things so far. One thought that you may want to discuss with a lactation consultant (or similar) would be more frequent but shorter pumping sessions. I know some women find this improves supply more than less frequent but longer sessions.

Little & often pumping is better.
As much skin to skin as allowed

Congratulations on her arrival x

Congratulations! Without wanting to sound gloomy - I'm saying this because I wish someone had said it to me - sometimes nothing you can do boosts supply.

I spent a full two months doing absolutely everything in terms of feeds/pumping/diet/supplements/drugs/massage/supplemental feeding system as advised by gP, midwife, HV, LA Leche League peer supporter, NCT ditto, expensive lactation consultant, and nothing worked. Supply dwindled if anything.

There's no reason to think your experience will mirror mine, but - should it happen - don't torment yourself like I did. You sound as if you're being extraordinarily competent and all-round fabulous at a difficult time. My best wishes to you and your new daughter.

Congratulations on your daughter. You seem to be doing everything right, I know how tough it is (DS was on NNU for 4.5weeks). Hope the milk supply increases

Some fab advice here. Have you spoken to a lactation specialist in hospital.

Congratulations on your baby.

What times are you pumping at night? Apparently the late night sessions are the ones that stimulate your supply to increase (hence evening cluster feeding).

I was told yesterday you should feed/express between 11-1 at night as that's when a hormone is released that encourages more milk production for the next. That was at antenatal classes. In my experience they tend to spend day 10 ish just constantly on the breast, so it might be a time to really persevere? (Which it sounds like you are!) Also fenugreek tea apparently?
Congratulations and good luck!

Your milk supply may be fine, it may just be pumping which is difficult for you.

I very rarely suffer with engorgement and I never felt my milk come in. I can only pump 1 Oz at a time so I f don't bother and feed from the breast (I appreciate this isn't an option for you).

Have you tried hand expressing? I find I can obtain more that way.

Prolactin levels are highest from 1am-5am, so you should try and pump during them hours.

Many thanks have been trying a few of these suggestions plus more sleep and power pumping. Supply is still low but possibly increasing. Sleep seems to make a difference

Sleep, pump in the wee small hours when your hormones will give you a hand.

I used to get much more off with a hand pump than an electric. Do a few small quick pumps to start, perhaps for 30 seconds as this imitates the way that a baby would suck quickly at the start of a feed to get supply going. Then when you feel the let down, slow the pumps down and try to let your chest relax - sitting hunched and tense over the pump is very easy to do but doesn't help.
When the milk slows, switch to the other side and repeat - maximum of 10 minutes per side. Then get some rest, eat something, cuddle your daughter and have another go 2 hours later.

hang in there, and congratulations on your baby :)