Expressing milk -decline in supply help!

[Immyjimmy]

I an a first time mum to a 12 day old little girl. Through my pregnancy I had intended to breastfeed but after around 10 midwives, both at home and at the hospital, failed to get baby to latch properly I have since expressed exclusively.
Other than initial engorgement issues pumping had been going really well... or so I thought! I'd always been able to keep up with her needs and found using my electric pump easy. Most days I expressed 3 times a day (40 minutes each session, 20 minutes each breast) and would produce around 30oz a day. Unfortunately on Sunday we became really busy with visitors and I only managed to express twice that day. Since then each time I've gone to express I've been getting a maximum of 1oz from each breast in 20 minutes. Sometimes I am getting nothing. I know there is definitely some milk there as when I hand express is comes.
I spoke to the midwife and she said I need to be expressing around 6-8 times a day but so far it hasn't made a difference and I'm concerned that I'm going to have to supplement with formula. :(

Has anyone else had this issue? If so, did you manage to bring back your milk supply successfully?
I have read about a herb called fenugreek. Has anyone used this?

Any help would be much appreciated as I want to get it sorted ASAP :)

Imogen

Your midwife is right, at twelve days you are still building your supply . You definitely need to be expressing at least 8 times a day , at least once during the night, and keep it up for a couple of weeks, only then can you consider reducing how often you express.

I had to express for three weeks as my son was fed through a nose tube and it got better but I did have to express regularly to build it up. For almost everyone, you'll produce what you're telling your body it needs to make. It really is supply and demand. Even now at 18 months, my supply is affected by how much he feeds. If he feeds loads the days before I work, I know about it with very full breasts!
Good luck!

Expressing 3 times a day isn't really a lot to be establishing your supply. I expressed for 6 weeks until my DD finally managed to latch on with shields.

Try expressing 6-8 times a day, maybe when cuddling your baby or looking at a picture. Also it's important to express at night as apparently the night feeds are the most important for building up supply.

And keep trying to latch the baby on - she will get stronger and it might just click at some point.

Has your baby been checked for tongue tie?

I had read there are different guidelines for expressing. Usually, the more you feed, the more you supply as it is built on demand. Check out Kelly's Mom website and it will give you advice on how to express enough.

You should also be expressing with a double pump as this simulates your breasts more efficiently. That way, you can keep each session short, 15 mins for example. Fenugreek, porridge etc. are worth a try but there is no way round expressing often and regularly.

3 times a day at 12 days isn't enough, you need to be doing it 6 times a day and then tailing off when you're more established. I wasn't doing 3 times a day till 4-5 months.

Keep pumping and your body will respond. Drink lots of water. Agree with PP a double pump is much more effective, you should be done within 15 mins of pumping and I found I leaked when I was pumping one breast. Another tip is to dry pump for 5-10 mins after you've finished to stimulate the breast.

make sure you are drinking enough water.

You need to be expressing as much as a baby would be feeding, so easily 8 times a day, with one session being between 1am and 4am.
I pumped every 3hrs for 12 weeks when my girls were in hospital to establish supply.
You need a big glass of juice/water every time you pump and also need to make sure you are eating enough.

Just been thinking and it was every three hours I pumped in hospital with a double pump including overnight-I set an alarm. I was told at the time that the night pumps were really important so not to miss those.

Midwives don't necessarily have any breastfeeding training - I was given conflicting advice by them. If you are still interested in trying to get your baby to latcheck on, you want to see a IBCL certified lactation consultant, see www.lcgb.org/find-an-ibclc/ . The NHS trust I had my son with did have one, but I've been told funding has since been cut so it might have to be private.

If you are happy pumping, other than expressing every 3 hours the only other tip I have is warm compresses (e.g. a hot water bottle) on each breast before you try and express. Good luck!

Firstly, congratulations on your new arrival and well done for going down the expressing route. It's difficult, time-consuming and frustrating (because I'm sure, like me, you would really like your baby to latch). My little girl never did despite the efforts of 2 lactation consultants and the infant feeding team. We tried finger feeding, nipple shields, etc. but ultimately, after 8 weeks, we gave up. I continued to express until after three months, then moved her to formula. No regrets.

As others have said, expressing during the night is key. I used to express at three hour intervals and at night, at midnight and 3 am (my husband gave her a bottle while I expressed). Little and often is better than less frequently and for a long duration. Your nipples will get sore if you leave the machine on for too long - twenty minutes is a long time with an electric pump. Also, don't make the mistake that I did of just turning the setting up - sure road to cracked, bleeding nipples, and it didn't produce more milk.

I'm no lentil weaver, but definitely I produced more milk after skin to skin contact with my baby (advice from lactation consultant) and putting a muslin over the pump so I couldn't see it also helped (don't ask me why - again, advice I took with great skepticism, but it worked). Take her to bed with you for a long cuddle (skin to skin), then try pumping. The skin to skin also supposedly helps with encouraging her to breast feed, but again, that didn't work for us.

Good luck. Whatever you decide to do in the future, feel proud of yourself for putting in the effort now to make sure your little one gets all that good milk. I'll always be a little sad that breast feeding didn't work for us, but I do look back with pride that I persevered for so long with the expressing - between sterilising and just trying to carve out the time to pump with a newborn, it's hard work.

Lastly, when your supply is up, do look into storage and popping a few bags in the freezer. It helps if you have a lag for any reason (when my nipples were cracked and bleeding, the milk was pink and I just couldn't feed it to her), and it's comforting to know you have some reserve in the fridge.

Agree with everyone else, you need to express more frequently. 10oz per session is a lot, a newborn wouldn't have that much in a feed so getting a few ounces out more frequently is better to build up your supply.
Express every time the baby feeds.

I expressed with my first and had to top up with formula as I couldn't make enough. I've managed to breastfeed my second and use the expressed milk when we're out. At 12 days, mine would breastfeed for at least 1 hour out of 3.

If you want to use supplements, you can get domperidone on prescription - I had this when expressing. You can buy it over the counter as motilium but it's expensive to do that as you need a lot.
Warning about fenugreek - it makes you fart like you've never farted before.

Have you tried nipple shields if your baby can't latch? They can really help if you have flat nipples or a tongue tie. Ignore midwives / HVs who say you shouldn't use them, if it helps you feed a baby with a latch problem then just do what works for you.
Having done both, it is worth keeping on trying with the breastfeeding as it is easier in the long run. Exclusively pumping is such hard work. I found that the easiest way to feed was to take the baby to bed on lie on my side.

Good luck with it