How to increase BM supply...

[Ginfox]

DD is on SCBU, born at 31wks, now 33wks adj and doing really well. Problem is I can't keep up with her! She was delivered by EMCS, I bled badly and needed a blood transfusion, so took me a while to get back on my feet. Initially I seemed to be able to express well (while still in hosp), and my milk "came in" on day 5. Since I was discharged I've struggled to get more than 20mls in 15-20mins of pumping.

Any advice would be appreciated. TIA

Hi Ginfox. I know it's easy to say this but try not to panic. The following worked for me when DS was in NICU:

Prescription for Domperidone (ask doctor or hospital)
Fennel tea
Drinking and eating really well - eating a lot, even if you don't feel like it and lots of water
Try pumping next to DD's cot if possible. Didn't actually help me, but can work
Don't pump for longer than 15-20 mins on each side.

It took me several weeks to get my supply going well, but in the end I had too much milk so was able to donate some of it , so it can be done.
Good luck and congrats on your DD x

Thanks New. I know that stressing about it is the worst thing I can do, but hard not to isn't it? The nurses on SCBU are - understandably - concerned that I'm not expressing enough, but the midwives I've seen for my check-ups all say I'm doing really well considering.

I'd rather not go down the domperidone route, but if things haven't improved by the end of the week I will ask about it.

Funny you say to eat even if I don't feel like it. My appetite has been really poor since dd arrived, which is the complete opposite of what happened with dd1, when I continued to eat cake whatever I wanted for far too long .

I'm having a couple of days off from SCBU to try and relax and recharge a bit (DH will be there instead), so maybe that will help. Although I've heard that mums who don't visit every day are flagged as high-risk for PND , so can't win really.

Hiya Ginfox heres some stuff that worked tor me: lemon barley water by the bucketload, used breast massage before each session, and I ditched the pump as I could get barely anything out and expressed by hand. I'd express from one side for a few mins, then when the flow slowed go to the other side and keep swapping for up to 20 mins. I expressed at 1am and 4am if I needed to grow my supply, then every 2-3 hours during the day and every 1-2 hours during the evening while watching telly to mimic cluster feeding. My dd arrived at 27 weeks and at first it took me 30 mins to get 0.1ml but by the time she came home 80 days later I was producing 1200mls a day and had enough to donate to the milk bank. Good luck its as much a mental game as a physical one. Keep positive. You can do this!

Two thoughts in addition:
-have you got a hospital grade pump at home? The twin electric ones are very good. I also found expressing whilst looking at a photo of DD helpful.
-are you expressing every 3 hours at least, night and day? The night 'feeds' are especially important for promoting supply, painful though they are.

Other than that, there isn't much more you can do, apart from try to rest as much as possible, and keep your food and fluids up. If you don't feel like eating, then make sure what you do eat is very high calorie and nutrient (eg cake with lots of nuts and bananas in, etc). Its a horrible stressful situation, and you must be kind to yourself . And congratulations!

Different things work for different people and you seem determined to find what works for you. I hope you manage to soon.

For me eating oats seemed to really increase my milk. So porridge for breakfast and snacking on hob nobs. You must eat and drink well to make milk. Even if you don't have much of an appetite keep snacking on things like dried fruit, bananas etc and drink water.

Good luck and congratulations x

Thank you all for taking the time to reply. I did think the evening "cluster feed" would be a good idea, if only because it will be easier when dd comes home. I feel as if I am generally doing everything right, but can't seem to get much more than 20mls at a sitting. DD started on 2 hourly bottle feeds last night - which is brilliant of course - but is not helping the feeling that I can't keep up with her.

But I'm a stubborn sort of bird, and I found BFing DD1 incredibly hard to start with, but in the end only stopped when she was 2 (and only because I was pregnant and it hurt like buggery).

So I will persevere!

Is your dd stable enough to be held? Lying her on you skin to skin even if she isn't feeding yet might help

Hi Ginfox! I'm so glad your dd is doing well. It's such a shock when they arrive so early and then, instead of recovering, one has to spend all day chained to the pump :(

My ds was born at 29 weeks and is still breastfed 8 months later. What worked for me:
*hopital-grade double pump (Medela or Ameda)
*religiously expressing 8 times a day, including twice during the night (the exact times don't matter). I dropped down to 6 times a day (including once during the night) after about six weeks, once I was confident my supply was well established.
*continue pumping until the last drop and then a couple of minutes afterwards (within reason - I don't think I ever pumped for more than 30mins at the start, and I was down to about 5mins by the time ds left the NICU)

Looking at pictures of ds didn't work for me, and I found expressing near the incubator a lot more stressful than expressing at home, but a lot of people find those things useful. For me it was very much a mechanical thing - if I got enough pumping sessions in, my supply went up.

Let us know how you get on!

Update: still struggling a bit, but today stopped using the pump, and found that by hand-expressing I doubled the amount I was getting each time. The pump was uncomfortable even on lowest setting.

Fortunately today I saw a specialist nurse, who was brilliant, really positive, and gave me some good advice, including drinking barley water (stimulates Prolactin production apparently), and reflexology. Other than these, it was mostly common sense, but sometimes you just need someone to spell it out for you.

She mentioned that getting into too rigid a routine can be counterproductive, and it can help to vary it a bit, to give your system a bit of a jolt, and to more closely mimic the variations in times and volumes required to feed a baby.

Other than that she said to keep working at it, and focus on the positives i.e. "any BM I produce is really good for dd", rather than "I'm not producing enough for dd".

I've also had lots of skin-to-skin, and dd has had a few good goes at latching - thought it'd be a struggle to persuade her, but she just did it first time! So I'm sure that will help too.

Thanks again for your replies everyone