Need advice on expressing

[kisaki333]

My baby was born recently at 37w and she is really tiny-was only 4lb at birth. We've been in the hospital since birth and we are on a strict 3h feeding cycle as she needs to gain some weight.

Baby's mouth is too small for my nipples, she just can't latch on properly. And even when she does, there's not much there for her so she quickly gives up.

We started with formula as I couldn't produce more than 1 drop of colostrum no matter how hard I tried. I then moved to expressing via machine-still nothing. Eventually some milk came in, I can get about 25ml per session. But that's it, no more than that, it's been constant the last few days. She needs at least double that.

Anybody have similar issues or any ideas what else to try to increase my supply?

Are you pumping at her bedside?
Give her a sniff and a kiss before hand if you can get the oxytocin flowing.

Is she being tube fed at present?

When my ds was on the neonatal ward it took a good 4 days for us not need formula top ups and for his tube to come out so he could feed. However he was bigger and his mouth size didn't cause him any issues.

Hope your supply picks up, you haven't mentioned how many's old she is so hopefully your milk just isn't fully in yet.

HV or midwife at the time told me that around 3am is the best time to be expressing. Not the most convenient especially if baby is asleep. I think you can get biscuits that’s help your body produce milk too but no experience with that. In the end I felt I was expressing too much and not getting enough and not spending enough time with baby

Sorry, to add some more detail (I am functioning on 3h/day sleep lol):
Baby is 6 days old. She is next to me the entire time, no tube feeding or anything like that, thankfully. Routine is every 3h: feed her (bottle with my milk and formula top up), cuddle her to sleep, then express via pump, sometimes with her sleeping in my arms. It kills me that my stupid breasts can't produce even the tiny amount she needs!

My breasts we super swollen and had hard lumps 2days ago. That's around the time I started producing a significant amount (more than a few drops). They all said thatthis is my milk coming in and in a few days I won't need the formula top up at all. Instead, I seem to have plateaued and even gone a bit down. Also my breasts are no longer swollen (and I massaged out all the lumps). I am so frustrated I want to cut off the bloody things! They've been ahinderance my entire life and the one time I need them, they fail miserably!

Are you using a hospital pump or you own?
It should keep increasing but stress of course can affect your supply.
In my experience it's unusual thy they would suggest bottle feeding her when your are hopefully trying to breast feed as it may make the transition to breast harder when she is big enough, however at least it means she should hopefully be able to go home sooner and expressing is still always an option.

Are you getting enough fluids yourself? Don’t let yourself get hungry or thirsty. Eat and drink as often as you feel like and have a glass of water ready to drink while you’re pumping.
Every ounce of breastmilk you feed her is helping her immune system and her intestinal flora. Needing formula top ups for calories isn’t negating those benefits.
There are some drugs that can help lactation too. Have your doctors said anything about the criteria for prescribing those?

Stay hydrated and pump pump pump. Every 2 hours through the day and if you can overnight, at least every 3 hours, as that's when milk production is at its highest. It can take some time for your breasts to get used to pump too and you just need to emulate how much a baby would be feeding. If you haven't already, get a sports bra and cut a couple of holes in it so you can pump hands free. It's a lifesaver.

We had same problem in that DD's mouth was just too small. It took her six weeks to latch and 12 weeks until she was exclusively breastfeeding. She just needed to grow!

How many days PP are you?

Oh and massaging your breasts during pumping can help stimulate flow.

I pumped for both my dc the first was a nicu baby. Firstly be kind to yourself you have been through a lot.
*Water is your friend, drink, drink and drink somemore.

*lots of skin to skin
*pump on a routine every 2-3 hrs until breast feel empty ( I used to pump for 20-30 mins) even though the night ( it's sucks)

• double pump *make sure the flanges are the right size if they are to small or big that can impact ur yield and make your nipples very sore
• ask the hospital to get the nurse specialist to come see you
• try and sleep which I know is very hard and make sure you are eating
• I've seen lady's cover the bottles with socks so you are not watching how much milk is going in
• I found when I was at home just watching crap tv and pumping was good as it took your mind of what your were doing

If your are on fb look at exclusively pumping uk mums: it's a great group full of lady's that will be able to help and guide you
www.facebook.com/groups/566808133515254/?ref=share

Firstly, congratulations on the birth of your baby. NICU / SCBU mum here too - although DD was bigger than your baby at birth. I had horrible problems with supply (i also have PCOS which made things worse), but there was an amazing breastfeeding specialist on the NICU who helped me. Have you got one on your unit?

I was given the following advice:

• the hospital gave me two squares of fabric: one to wear next to my breast and one to put under baby. Every day we swapped them so DD and I would have each others scent.
• put socks over the bottles when expressing so you cant watch them fill up. It really does make a difference!
• you shouldnt pump for more than 20-30mins max. (I would do 10mins each side). It doesn't generate more milk and will stress you out. Also don't miss the 3am pump!
• do you have anyone with you (baby's dad or your mum?) Get them to do nappies, settling etc whilst you pump so you dont feel like you are in a neverending cycle and you get chance to rest.
• Are you using the hospital pump? Most home pumps are not good enough for increasing supply - i hired the hospital grade medela symphony for £47 per month after we were discharged.
• drink loads of water (and i mean LOADS), eat lots of oats and rest. I also tried fenugreek capsules, but DD got very fussy when i was taking these so i got some breastfeeding cookies instead.
• domperidone is a drug that in some women can increase supply but i think the evidence is mixed. Again, if there is a bf specialist on the unit, worth asking. It isn't licensed for this use so the hospital usually give you a letter to get it from the GP.
• dont feel guilty about formula top ups. I was desperate to ebf and was devasted when I couldn't, but DD was just losing huge amounts of weight on my bf alone. We did formula top ups from 9days old and continued them until 6months when i dropped bf back to just breakfast and bedtime. She's 7.5months now and doing great! Every drop of bf she gets will do her good, even with the top ups.

Huge hug to you

Have you tried breast compressions during feeding. It can help keep them interested if they aren't getting milk fast enough.

I found if you run a flannel under hot water and then squeeze it out and put it on your breast for a few minutes while you do the pre-pumping massage it increased the amount of milk I produced. It's suppose to help with let down. If you have a hot shower the heat has the same effect. Try not to get frustrated with yourself and your body, I know it's hard, my breastfeeding journey wasn't what I wanted but my health visitor says fed is best and that's true, you are feeding your baby and doing what is best for her. We are our worst critics and there is so much guilt around breastfeeding, just try and enjoy your baby.