Should I hire a hospital grade breast pump?

[Thandeka]

Story of my breastfeeding challenges here

Anyhow while expressing for baby's nasogastric tube in hospital the pumps were fab, fast and efficient and I got a decent yield. At home I have the medela swing which I believe is one of best home pumps but am finding my supply is decreasing from fairly easily getting 40ml to struggling to get 20ml and it takes ages. I express after a feed so it maybe DD (4weeks) is going through a growth spurt and taking any extra or it maybe my supply is decreasing due to the 3-4 or so 60ml formula top ups we have to give per 24hours as bub lost 14% of birthweight and we are on forcefeeding regime of 40ml top ups after every feed but am not able to produce what she needs at mo.

Want to try and build up supply further to meet as much of her needs as possible so we can get rid of icky formula so thought hiring a hospital grade pump for some hardcore pumping sessions (that dont take forever like with my medela) may help?

anyone done this? I think my hospital do rent them but since it was such a battle re. pumps with them while in hospital i may go through nct hire instead. Any other stockists?

I guess i would be able to double pump which i can't with my medela and that should boost supply. Am also taking fenugreek and drinking raspberry leaf tea and may look at a few other galactogogues.

Any other suggestions? any help gratefully received as so want to master this exclusive breastfeeding malarky!

You really are doing an amazing job given your story.

How is your dd doing? How are you doing?

Sorry no answers for you but hope someone comes along to help soon.

I'm a bit short on time so can't read the whole old thread, IIRC you are pumping but don't have the baby on the breast yet. Is that right?

I'd say you definitely need a hospital grade pump ASAP. The medela swing is excellent but no good for exclusive expressing, certainly not in the early days. You absolutely need a double pump of some sort. The medela pump in style is very good, if you can't get hold of a hospital grade pump.

You are doing an excellent job! Your determination is fantastic, stick with it

The medela pump on the NCT site would be ideal, the two phase expression (like the swing has) is great.

Cluster pumping really helps increase supply, so, if you can pump for 10 minutes every 1/2 an hour or so for a few hours each day, your supply should rocket!

With a 2 phase pump you can often get a second (and sometimes 3rd and 4th) let down by returning to the first stage of rapid 'sucks' once the milk flow slows. Have you tried that?

Sorry to do so many short posts, things are really hectic here but I want to help

Waves at flyingcloud- how you and LO doing?

Baby has been on breast for 3 weeks reasonably successfully but first week of life was on nasogastric tube hourly feeds and just didn't want to latch and second week bfeeding was abit hit and miss while we worked it all out.

Cluster pumping- great tip ta!

I had to exclusively pump for dd and found the swing not as effective for me as the hospital grade one (symphony). I think I needed the double pump as my supply was particularly poor. In the end I needed to take domperidone as well as all the more natural galactagogues were pretty ineffective - though think fennel tea helped.

another good tip- will try that ta driventodistraction!

I can't actually feel my letdown due to breast surgery- not a problem with pump when i can see it but I do worry sometimes DD is sucking and nothing is coming out! although often the nipple shield (flat nipples have to use em to get a latch) is full of milk so hopefully okay most of time.

Do you know how to hand express? Hand expressing after pumping will also massively increase your supply, it ensures the breast is as empty as possible, which is just what you need.

There's a 'how to' on KellyMom, which I'll try to dig out if you want...

A lot of women can't feel the let down, I often don't. Try not to worry about it, if your DD is sucking she WILL be getting milk.

If you get really paranoid about what she's getting you can hire some scales and weigh her before and after a feed. 1 gram = 1 milliliter. There really is no need, as long as she has plenty of wet and dirty nappies, but better to weigh and weigh and weigh than to end up having to stop because your too worried about her getting enough!

Hi

I have to exclusively pump. Started off with an Avent electric pump. Quickly ditched that and hired an Ameda hospital grade double pump from NCT for £48 for one month. I now (ds 3.5 weeks) pump 5 -10 oz in 10 -15 mins (depending on time of day - lots more first thing in the morning). I hate pumping but this has stopped me from giving up!

KellyMom:

Increasing pumping output inc link for hand expressing.

flat nipple tips

Hi Thandeka, I hired the blue Ameda double pump (as on your link) with my first dc and it was incredibly effective. But I ended up keeping it for months so the hire costs did stack up. Before having dd last year I bought the Ameda Lactaline instead and it's also really good - hospital standard. Fortunately I haven't needed to pump so much this time, but when I do I get a good yield.

Good luck

Hi Thandeka, sorry to hear you're still battling! I used the Medela Symphony in hospital which was fab, before managing with the Swing at home. I was prescribed domperidone which did help boost supply for me until LO regained weight and then managed to wean off it.
Perhaps a double pump might be the answer, at least you'll hopefully not spend so long pumping!
Have you got any help in RL like breastfeeding coordinator or babycafe?

Hi Thandeka - wow, you've had a rocky road! I can sympathise with large chunks of your story. I too had a breast reduction (approx 12 years ago) and so had no idea if I would be able to breast feed at all.

I'm currently 38 weeks pregnant with number 2 but I faced some of these issues with my DS. (who is now 3). I was able to breast feed partially - at first all was going well. I had a c-section and to my delight he latched on really well in the recovery room. All was well till about day 5 when it transpired that he'd lost 15% of his birth weight. Whilst they were examining him at the hospital he had a small fit (maybe a febrile convulsion?) and so they went into emergency mode and did a lumbar puncture and a canula for antibiotics etc.

We were readmitted for 5 days and I fed him through a nasal gastric tube too (lots of similarities with your story here!) a mix of EBM and formula. On the last day, they asked me to do a yield and whilst I could express some milk, it wasn't quite enough for what they wanted me to give him to get his weight up so they advised formula top ups. I was told not to over rely on the formula top ups as ultimately it would kill my supply but inevitably I did (I was too nervous by then that I didn't have sufficient milk to meet his needs). I topped up after every feed but as his needs increased, the quantity of top up increased. We struggled on for about 11 weeks but my supply dwindled. I think I'd give top ups again, but not necessarily at every feed.

I never got on with the hand held breast pumps and so never pumped at home but was able to express with the hospital's breast pump when we were readmitted. That's one thing that I want to master this time. Have you read the Diana West book ("Defining your own success - breast feeding after breast reduction surgery")? I dipped into it last time and have just picked it up again. One thing that I've just read is that she doesn't think hand held breast pumps will suffice and says that hospital grade ones are the way forward when breast feeding after a reduction. I'm going to hire one I think - probably from the NCT, as you suggest.

I too took Fenugreek and also Blessed Thistle. Out of interest, did you take fenugreek straight after the birth? I definitely did last time but then read the other day somewhere that you should wait until the milk comes in as it may make your breasts more engorged - did that happen to you? I was really engorged last time and I don't think that DS could get anything from me (this was the day before he was readmitted). I'm going to try to read up some more on this - to see whether I should wait a few days before taking the galactagues.

Anyway, I do definitely recommend the Diana West, "Breastfeeding after breast reduction surgery" book. As I say, I haven't read all of it but it is useful and specially tailored for our circumstances.

I'm keen to give breast feeding a go again this time but am nervous. We'll never really know why he lost so much weight (breast reduction? c-section meaning milk late coming in? slight jaundice? just one of those things?) but its inevitable that I felt guilty. I'm determined to give it a go this time but not to beat myself up too much if I can't do it. I'll have the added complication of a toddler to look after this time - not sure how much that will hamper any efforts!

I'm so impressed with your efforts - it sounds like you have been really persistent and determined. Long may it continue!

Sorry for the essay, but your post really struck a chord with me, and as I'm due to have my baby next week (c-section scheduled for a week tomorrow), I guess it's all upfront in my mind again.

Hi Wicks,
Yep I have the BFAR book and another fab one "making more milk" by same author- both courtesy of some fab mumsnetters.

Our formula top ups are now 60ml every three hours (were 40ml and DH wants to increase them to 90ml which I am refusing at mo) but if i have any ebm she gets less formula but at min EBM yield (using medla swing) can be as little as 10ml so defo need a hospital grade pump. Want to try and get her to reduce the top ups but guess that also means her having hours on the boob to increase supply and much as i love breastfeeding and want it to succeed i find the hardest part is the marathon feeding sessions- if she feeds for longer than 45 mins at a go I get quit antsy and worried there is nowt in my boobs etc so end up topping up to give boobs a rest and allow em time to refill- tis a vicious cycle as ultimately will be decreasing supply!

I didn't start with fenugreek until a day or so after milk had come in, have also just ordered a load of other herbal galactogues from holland and barratt but bit wary of overdosing in case it causes bad stuff in breastmilk!
I ordered:
Stinging nettle
Milk Thistle
Marshmallow root
Fennel Tea

(I have raspberry leaf tea and fenugreek at home)

All of those were recommended by the making more milk book. Have my 6 week check in two weeks and may see if i can get a prescription for domperidone instead then (or Dom Perignon as i like to call it!)

She is getting weighed again by the midwives this morning and if her gain is okay i may try and ease off on the top ups- thing is she seems so hungry after a 40 min feed and the 60ml top up sates her. if only more of that 60ml could be EBM! Although I managed to get 30ml EBM for this mornings top up (she is on boob as I type one handed!)

Am debating buying the ameda lactaline as cost is about same as three months hospital grade pump hire but I don't think it is quite as good but at least it offers option of double pumping.

Ho hum it's all a big adventure innit!

Sounds like you are doing an amazing job.

Out of interest - when do you do the expressing? After each feed? I'm not too clear on when the best time to do it is. Do you then mix the EBM and any formula top up together in a bottle?

Good news that you managed to get 30 ml today.

Yes, wouldn't it be great if Dom Perignon itself was the answer! One can but dream.

I think I'll follow your example and hold off on the fenugreek until my milk goes in - I was downing the capsules on the day he was born last time but I think it's advisable to hold off.

Good luck for the weigh-in - keep us posted!

Off to research hospital grade pump hire now...

I express after a big feed but if she is cluster feeding i dont as would prefer milk to go into her instead! my pumping yield is much better during the night (boo means less sleep) and early morning and i discovered this morning I get a great yield (45ml and had to stop pumping as she needed it but probably could have got 60ml) if i massage my boobs loads with shower puff in morning shower plus direct shower head onto them for a bit. Not practical for every session but good to know! I also do breast compression and massage while pumping to get more out. I try to pump in advance so DH will give last feeds top up while i pump next feeds top up- although sometimes it ends up she is still hungry so she gets this feeds top up too and then unless i can pump more her next top up has to be formula!

I dont tend to mix the ebm and formula as we give her the ebm hope she is sated- she isnt so we then resort to formula as my boobs have been sucked and pumped dry and need at least half an hour!

She has been on boob loads this am (is on now) which is great as her weigh in she should be heavier (sometimes wish bmilk was weight of molten lead to get the hcp's off our back about her weight!) and the great news is we are managing at least half her feeds without a nipple shield (was one in 7 feeds before) now which should boost my supply further and hoping to get rid of them completely soon.

I am picking up hospital grade pump this eve from local nct hire person who is also bfeeding counsellor i have been phoning a lot! link here

thandeka you are doing so well. I am really impressed Expressing is very hard when you have your baby to look after as well.

Great that you can get hold of a hospital grade pump today. I reckon you'll be pumping even larger quantities once you switch.

I'm going to call the NCT tomorrow to see if I can find a "dealer" in my area. Probably won't hire it just yet - after all, the baby is not even arriving until next week!

Out of interest, which pump did you go for in the end? I'm thinkin of hiring an Ameda pump.

I got the green ameda is the same one i used in hospital and is awesome! (the scary glass one i used too and is a tad better but can hurt and is harder to control so i prefer the green)
it was the only one my stockist had. another advantage to the pump is its quiet so midlle of night you dont wake street up with pump!

Last night I got 50ml both times i used pump (and one of those at a time i usually only get 10ml using medela) already my boobs feel fuller this morning two hours after last emptying them when normally is 4 hours- so hopefully this is going to work to increase supply and hopefully we can now elimate the formula top ups as i should be able to express enough for only ebm top ups! yay! (i hate formula so much - it tastes and smells horrid compared to breastmilk- have tried! it gives DD bad wind and smelly poos- and she cries a lot more and is colicky after formula.)

Have already picked up tips thanks to mumsnet about handsfree double pumping using hairbands tied in special way to bra- and alsp hand expressing at end of pump to further drain boobs and increase supply.

my plan now is to use this pump for at least two months and in meantime get a lactaline to continue double pumping once my supply is better established and dd is gaining weight properly. Will use the medela for pumping when out and about as much more transportable!

Just wondering how you'd be getting on Thandeka.

I've sourced an ameda elite pump too (from the UK dealers - who courier them out next day, as my local NCT agent only has the medela one) and so am feeling a bit more relaxed. I got myself into a bit of a panic about it all last night - in anticipation of the baby coming next week.

I really want to give breast feeding a go, despite the breast reduction, but don't want to be so single minded that I am irresponsible. I had a long chat with the hospital's bf advisor who is going to come and visit me on the ward. She said that they will monitor the baby's weight closely so we don't end up in the same situation as last time (15% weight loss) and they may even keep me in hospital till my milk comes in (last time, I was so engorged that DS couldn't get anything from me, I don't think). That's no bad thing in a way - I think that 2 nights is quite quick after a c-section so in theory I don't mind staying in another day or so.

I haven't ordered the hospital grade pump yet as I don't know how long I will be in hospital but the fact that I should be able to call up from hospital next week and get one the next day gives me comfort. I know from last time that if I do need/want to express, I will get on better with a hospital grade pump rather than a handheld.

Just curious how you are doing? Are you still going great guns with the ameda pump? How was the weigh-in? I hope all is going well.

Last weigh in she gained 200g in 6 days which is awesome and above average (average is 30g a day so was hoping for/expecting an absolute max of 180 considering her previous gain had only been 80g). The hospital pump is working a treat on boosting supply cept am currently back to being engorged every 2-3 hours so sometimes having to pump before as well as after a feed just to relieve the pressure- means I can easily give her all her top ups as ebm most of the time (although there have been a couple of times where we still have to go for formula as run out of ebm), think madam is also going through a growth spurt as she is eating loads, on thursday she spent 6hours pn the boob (in 24 hours) , resulting in very ouchy nipples so yesterday I gave her more ebm than feeding (she still had 4.5hours) to give my nips a bit of a chance to recover! Getting her weighed again Monday- if she keeps gaining at this rate she will have regained her birthweight at end of the week and hopefully this will mean we can ease up on top ups if my supply stays being as good. Will mean it has taken her almost 6 weeks to regain birthweight but since the midwives think her birthweight was artificially inflated due to my labour drips then am not worried. (she was a ridiculously puffy baby for first 24 hours and looked normal after that so it must have been odema). Have an appointment with a breastfeeding specialist on tues to work out how to reduce the top ups/increase supply. Also going to breastfeeding drop ins which are lovely although am finding the peer supporters didn't really know enough to help me as mine is such a specific support hence making appt with specialist.

Anyhow I have an iPhone app which is really helping me monitor madam's input/output, it's called total baby and once you get the hang of it it's a doddle to record the data and loads easier than pen and paper and then a calculator to do totals! (I was using that till I got the hang of this on tues). If you have an iPhone I strongly recommend you get this app for piece if mind in early days- tells you how long since last feed etc. Also using the data you can work out if she is getting enough using the formula in the bfar book which also tells you how to work out any top up. But basically babies need equiv to about 30ml an hour or 90ml per 3 hours after first couple weeks -720ml in 24hpurs. Basically as I have to give almost half that in top ups then my boobs are only supplying her with half that but as time goes on she seems more satisfied on boob so we can reduce top ups and see what happens with the data.

Btw you should demand a hospital grade pump while in hospital as they will defo have them. Do you know how to hand express colostrum? You could start doing that now into a syringe (well spoon then syringe- making you look like a heroin addict!) and freeze it ready- both stimulating your boobs and trying to develop a store. Then again aren't you booked in for c-section? Maybe not then as can bring on labour! Good luck though and please keep me posted!

This stupidly long post is due to baby on boob but she just fell asleep and so must I- if my iPod eats this post I will cry!

Thankdeka - her weight gain is fantastic! You must be thrilled.

That's interesting what you say re birth weight being inflated. Just adds to the confusion doesn't it.

Great idea re the iPhone app - I do have an iPhone so I may well get on the case with that

I don't know how to hand express colostrum but as you say, I probably should avoid doing that in advance on the c-section on Monday.

I do remember last time that I checked in advance (not really properly expressing as such but just seeing if there was anything there) and there was colostrum. Haven't seen anything similar this time - who knows, it may not pan out in the same way this time.

I will definitely keep you posted.

Best if luck with your continued efforts!