Pumping: low supply, no let-down

[thelady]

In my first thread I asked for help with low supply and a baby on top-ups who refused to take from the breast.

After lots of heartache, we've decided to move to bottles and express what little there seems to be - she was getting too stressed when put to the breast and I was getting desperate.

Pumping is, however, soul-destroying. The first pump I was loaned appears to be broken, as it gets precisely nothing. The new one I've had for 24h is getting 5 - 15 mL every 4 hours, though sometimes nothing at all.

Is there any point to pumping if I don't get a let-down? Equally, is there anything besides massage/hot flannels that will encourage the milk out?

I so wanted to breastfeed, but as usual this body of mine has let me down.

How old is your baby now and have you spoken to a breastfeeding counsellor?

Have posted on your other thread, sorry for confusion!

The only way to get a milk supply going by expressing is to use an effective pump (or hand expressing) at least 8 times in 24 hours.

Trickles and no spurts show it is not working - this might partly be the pump not being very good, and it might also be lack of stimulation....maybe hand expressing might be better for you, alongside much, much more frequent expressing sessions.

This isn't what you want to hear, sorry, but it's better to know what's what, don't you think? It's not too late to turn things round, but you need a lot of motivation, a good team encouraging you, and good information, too.

Hope things work out.

Hi Thelady

I've just skimmed your last thread and wanted to send loads of support. Well done on getting so far. You have done all that you can and got as much of your milk - abd therefore your antibodies - into your little one as you could.

Breastfeeding can be sooo difficult in the early days. It isn't your body that has let you down. Your body would have responded if baby were latched on correctly. But mine, like yours, just didn't get it, and I didn't even have CS scars to work around. You have done brilliantly.

I pumped for weeks, although ds1 was able to feed using nipple shields inbetween pumping, so the breasts were getting some stimulation too. (Didn't notice if you had tried them. They got ds1 feeding when I had no help to hand)

I found there was no point in pumping in the evenings, but I got more out in the mornings, after some sleep. Go for the time that suits you best. The more you get out, the longer your supply will hang on in there. I also found that drinking a glass of water helped me, even though I am advised that it was psychological and shouldnt make a difference. Finally, of course, your supply will be best stimilated by baby, so if you can let her suckle occasionally - perhaps trying shields to help you - that might help.

Finally though, loads of congratulations on getting this far, despite the loony midwives, and lack of local support. You and your dd will move on from this. Breastfeeding is very convenient, but not the beginning and end of it all. Enjoy your little one, and best of luck to you both.

We used the Avent Isis hand pump by the way. It had a suck like a dyson cleaner on it.

(I think I still have it somewhere if you would like me to post it to you. Its old, but was working fine last time I saw it. Do CAT me if it would be any use to you.)

NotquiteChristmasyet: I'd love the use of your pump, and can send postage costs/donation to a charity of your choice if you like. I don't have the CAT facility yet, so if you could email me at ljnoble @ gmail . com that would be wonderful.

I don't think there's anything wrong with the pump I've been loaned, to be honest, just with the supply. The pump sucks hard enough that anything over 1/2 suction and I get red and sore around the areola, and I can see the nipple being moved in/out by the pump. Hand expressing gets a few tiny tiny jets, particularly if I do it in the shower, but nothing more than a few drips in total.

I don't think I can realistically pump more than every 4 hours, when she feeds, as it's taking her a good hour in total to settle after a feed, and I'm exhausted. I'm taking a nursing tea (fenugreek) and also a tonic (Weleda elixir) recommended by a cousin to try and perk myself up.

TheLady, please don't get too downhearted. There is hope. My experience has been not too disimilar to yours. I had an elective c-section, giving birth to my 8 pound 10 oz dd, who's now nine weeks two days old. I had the most awful time in hospital. Right from the very start she would go mad at the breast because - I am absolutely convinced - of my appallingly low milk supply. She also had a terrible latch. I so wanted to breastfeed and had no reason to think I'd have any problems, but the whole experience was utterly traumatic, with me in tears the entire time and her just going insane. I felt sick to the pit of my stomach a lot of the time due to the stress of it all. She was (and still is) a big hungry baby, and wasn't going to be satisfied with the few teaspoonsful I had to give her.

It became clear in the hospital (I was in for five days) that something had to be done, so she was cup fed formula. Things didn't improve when we got home and, for my own sanity and hers, we also made the decision to bottle feed and for me to express. This was also soul-destroying at the start. I only managed to get 10 to 15 mls a session at first with my Medela Swing, so she would have mostly formula with the small amount of ebm I produced.

We discovered dd was tongue tied, and took her to have the procedure to have it fixed, me convinced it would be the answer to all my problems. But it made no difference at all. Another kick in the teeth.

I had been expressing exclusively up to eight weeks old, and a couple of weeks in made the decision to hire a state-of-the-art Symphony double pump from Medela. This I credit with increasing my supply hugely. I'll never be a milk goddess, but at the 3am session I have been able to produce 100mls the past few weeks - a huge improvement on what I was producing at the start. I was determined to continue with the expressing, as I couldn't bear to think of my darling dd getting just formula while all her little friends from my antenal group get lovely breastmilk. My life has been absolutely insane with the constant feedings and expressings (and blocked milk ducts), and I almost called it a day last week when I got mastitis in both breasts. But having given myself permission to give up, it actually made me all the more determined to continue.

And a minor miracle has now taken place - at over nine weeks, my daughter has finally learned how to breastfeed! I have been able to get her on the breast again during the past week, and we've had a lot of success. I have the NCT breastfeeding counsellor coming in on Monday to help me with latch and positioning, as I'm effectively a novice at all this! I have been able to ditch the pump apart from in the evenings, when I use it to increase supply. Dd still needs formula (I'm going to try to cut down on it, without causing her any undue trauma - I had enough of that at the start!), but my supply has already increased a lot from having her on the boob, and I'm really hopeful. I don't know if I'll ever be able to drop the formula completely, but I'm not going to obsess about that. Just being able to feed her a decent amount of breastmilk from my own breasts at each feed is enough for me to be ecstatic.

Anyway, I guess what I'm trying to say is there is always hope. Just because things are bad at the start, that doesn't mean things will necessarily stay bad. I was a breastfeeding basket case, and if I can do this anyone can! Take the pressure off yourself. Feed her the formula, enjoy the calm, enjoy her, and get expressing. You can still put her to the breast, which will be nice for her, and nice for you - and help with your supply. See what happens down the line. You might be surprised.

Good luck!

Kate x

You can actually hire the Symphony breastpumps as well at a monthly rate. Might be worth doing to see if it does help? Possibly if you increase your supply, baby might be more willing to latch? Have you tried the breastfeeding crawl? I'll see if I can find a link.

Breast crawl Obviously that is a newborn baby but apparently it can work with an older baby too.

God found breast feeding a nightmare for the first 12-13 weeks!!!!I always felt she hadn't had enough milk and she was 6lb 6 when born. She wouldn't latch on properly. I tried expressing with Avent electric pump ( you are welcome to this) and got 15 ml. Kept going and eventualy she just got it and we are still doing it now at night time at 13 months. Her weight suddenly increased at 3 months and I went from feeding every 2 hours to every 3.5 hours. Minor miracle! They were bleak days... is there a breast feeding group near you? Definitley worth a visit. You will get there!

piggysgal: thanks for sharing your experience. It really helps to hear that you got through it.

chipmonkey: we've tried the breastcrawl but she just gets totally frustrated.

Still struggling with the pumping. Sigh. Hand expressing only seems to work under the shower. Bigger sigh.

What the %&$% is my body playing at now.

Mw/health visitor keep telling me I've made the right decision, and not to beat myself up - I'm not. There's a very big difference between being bitterly disappointed and beating yourself up. Off to see the GP on Weds (made the appt last week) to see what, if anything, I can do to stop being miserable.

I meant to add that you could always try domperidone, a well-known treatment to increase milk supply. You can buy it over the counter as Motilium 10. I've used it for a couple of stints and it has certainly worked for me. Might kick start things? You can look it up on previous threads.

I persuaded 2 out of 3 GPs to prescribe me domperidone as it can be expensive. I printed off the Jack Newman info, and something from an NHS website to support my case and both women GPs were open to trying it. The male GP refused point blank.

For me it was simply the last thing I could think of to try to "fix" my slow weight gaining baby.

Good luck.

thelady, I had to exclusively pump for ds1 and it can be challenging at first. Most important, try to relax! I know it's hard but watch TV or listen to music. Do not sit there staring to see the first drop(s) come out. Also, make sure you are properly hydrated. Keep a glass of water handy as you are pumping in case you need it. Use breast compression (firm, gentle, constant pressure) and make sure you have a really good quality double electric pump.

Hang in there, it will get better.

HTH

Haven't had time to read all messages so sorry if I'm repeating anything. Well done for persevering so hard! I expressed exclusively for ds in SCBU and it was bloody hard work without even having a baby at home. I'm sure this isn't what you want to hear, but I had a lot of problems with getting enough out and solved it by turning the pump up so that it was agonising (had tears in my eyes at the beginning of every session) and my nipple was shooting down the tube. It made a huge difference, I went from a little trickle to spurting and loads of milk. Also made sure I expressed 3 hourly during the day and 5 hourly at night (can't imagine doing this AND having to be up with a baby!). I never felt a let down with the pump, nothing like the almost painful let down I had with ds latched on, but still produced a fair amount of milk.

When ds came home I gave back the hospital pump and used an Avent Isis one - I got just as much milk out with a LOT less pain - don't know if it was easy because expressing was already well established though. Oh and also DON'T LOOK AT THE PUMP!!! A watched nipple never produces any milk... Lots of luck, you have all my sympathies.

Hmm. The pumps I've used don't seem to have a setting that goes that high...? I never get the 'ouch' factor and am seldom aware of suction. Maybe I'm doing something wrong . I've tried turning them up, but don't feel/see any difference.

Dead horses and flogging spring to mind rather a lot at the moment.

If you're not aware of suction maybe that is a problem. Even with the Avent, which didn't hurt, I could definitely feel firm "sucking". Is there anyone you could get to come and see you use the pump, a bf councillor or someone like that? The pump that hurt was a giant industrial hospital one, so may not be the same for home ones. What pump are you using?

I've popped the Avent Isis into the post to you today, Lady! Hang on in there.

I had a turquoise hospital one which didn't seem to work at all. I now have a lactaline personal (ameda) on loan from the SCBU. My nipple moves about 1/2 to 3/4 cm down the 'funnel' when it's on max.

NotquiteChristmasyet: thank you!

TheLady - I have a dd 5 weeks old tomorrow. i have been expressing since day 2 when they realised she was jaundice and wasn't breastfeeding properly. She still doesn't.

I pump several times per day and also give a couple of formula feeds at night. I'm totally fed up with expressing. My nipples are sore, it's so time consuming and I'm now going to scale it back.

The paed in hospital told me he had ff one of his children who couldn't bf. He said the most important thing my daughter needed was a happy mummy, he urged me to express only until I got totally fed up with it. He said please enjoy yr baby, this time is so precious you will only live it once.

He was right. I have to go back to work in feb - so my time with Megan is limited. I want to enjoy it and spend quality time with her not just attached to a bloody machine being milked. It really doesn't matter what the rest of the antenatal group are doing.

Good luck

silkcushion: I know exactly what you mean, though in my case I'm not sore, just fed up of getting little/nothing after 15 mins attached to a milking machine.

Today my mum has had Frances almost all the time between feeds so that I could sleep. I feel like a cop-out, but DH was right in saying that I needed sleep more than I needed to spend 2h travelling to see a breasfeeding counsellor.

Definitely not a cop-out! Having a new baby is exhausting and must be doubly so when you're trying to express at the same time. I'm not sure what the pump you have is like, but I found the Avent brilliant so hope you have better luck with that. I think my nipple used to move much further than that (or certainly felt like it!), when it was only moving a small distance the pump didn't work for me. Don't know how this fits in with other people's experiences. Good luck with the Avent, let us know how you get on.

Definitely something wrong with the interface between me and the pump - sore boobs yesterday, and hand expressing in the shower, with nothing coming out in the pump. Two different pumps, and the same problem.

I think I've wept myself out and decided that this just isn't going to happen for us. Frances is so obviously thriving on the bottles that, although it leaves me feeling desperate, the pumping is going to stop. I'm getting nothing out at all with the pump and sore boobs with lumps in them (!), despite making the effort to pump every 3 hours-ish and have to accept that the pump just doesn't work for me.

This is so not what I wanted, and DH has been incredibly supportive all through it, but I think I need to accept reality and give myself
space to heal physically and emotionally.

i know this doesn't really help you much - but just wanted to say that my son is now 5 months and i am exclusively bf him but whenever i try and express milk NOTHING comes out and he is a healthy,happy baby gaining weight and the pump looks and feels like it is working fine.

so i understand the sheer frustration of knowing u have milk in there but it won't come out!