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Thread: Maintaining supply for son born 3 months early

  1. #1

    Default Maintaining supply for son born 3 months early

    Hello. Can you please offer some help and advice?

    My son was born 5 weeks ago in his 27th week of gestation. The hospital helped me start pumping right away so he can be given my milk via his feeding tube. My milk supply started building well around day 3 and then quickly decreased to almost nothing. With the help of a LC, I was able to build it back up to about 280ml per 24 hours. However, it has started decreasing again and I am currently producing about 200ml per 24 hours.

    I rent a hospital grade Medela pump. I am drinking herbal tea for lactation and taking malt tablets (called Jemalt). These helped build back my supply after the first decrease but they don't seem to be having much effect now. I do a daily Kangaroo Care session with him for about 1.5 hours, but haven't noticed more milk in pumping sessions after the KC.

    I am very worried that my supply will continue to decrease. Or that even if I can keep it at this level, I won't be able to increase it later when he starts eating more. It will still be a month or more before I can try breastfeeding him. Can anyone offer advice? Has anyone successfully kept up supply with only pumping? Any success breastfeeding a baby born this early? I know stressing about it doesn't help but it's something very important to me, since I have to leave a lot of his other care to the nurses and doctors. This is something I can do for him. Thanks for your help.

  2. #2
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    Default Re: Maintaining supply for son born 3 months early

    Hi mama. Congratulations on your baby!

    Will they let you kangaroo him any more than that? Which Medela pump are you renting?

    Are you in the US? With a baby that early it may be a situation that would be helped with a prescription galactagogue such as domperidone. Here is some information about it.

    I'm Hillary
    Wife to Gualberto
    Mom to Nolan
    Born at 32 weeks-3lbs/10oz
    11-25-2007
    Our precious early angel


    Remember, you are not managing an inconvenience; You are raising a human being ~ Kittie Frantz
    Unthinking respect for authority is the greatest enemy of truth ~ Albert Einstein
    First they ignore you, then they ridicule you, then they fight you, then you win ~ Mahatma Gandhi
    Looking for more information about vaccines?

  3. #3

    Default Re: Maintaining supply for son born 3 months early

    Hello. Thanks for your help! We can do 2 kangaroo session per day, each for 1.5 hours. Right now, my husband does one and I do one. However, if it would help my milk supply, I am sure my husband would agree for me to kangaroo more often.

    I have the Medela Symphony double pump, and I pump both breasts together for about 20 - 30 minutes every 3 or 4 hours.

    I am in Europe (but originally from the US). I can ask about prescription medication, though the LC here didn't mention it as an option. I sort of view that as my last resort.

  4. #4
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    Default Re: Maintaining supply for son born 3 months early

    Quote Originally Posted by @llli*monroeb View Post
    Hello. Thanks for your help! We can do 2 kangaroo session per day, each for 1.5 hours. Right now, my husband does one and I do one. However, if it would help my milk supply, I am sure my husband would agree for me to kangaroo more often.

    I have the Medela Symphony double pump, and I pump both breasts together for about 20 - 30 minutes every 3 or 4 hours.

    I am in Europe (but originally from the US). I can ask about prescription medication, though the LC here didn't mention it as an option. I sort of view that as my last resort.
    With a babe that early and if you are struggling with supply I would say for now it might be a better bet for you to do the kangaroo care, or at least a majority of it. It will definitely help with your production, I saw an increase the more I was able to kangaroo my son for sure.

    When I was pumping I had a Medela Lactina Select. It actually has a stronger vacuum rating than the Symphony. It also has variable speed to mimic letdown (I can't remember if the Symphony has this or not). Is it possible to try a different pump to see if you get different results? For a little while can you pump more often than 3-4 hours to try and build up some supply? I know it is exhausting, but in the beginning it can be so important to pump a lot, especially when you aren't able to get stimulation from the baby. When my son was still in the NICU sometimes I pumped every 2 hours just to try and build up my supply.

    Another thing I would do was take little swatches of fabric in to put in his isolette, and then I would swap them out and take one home so I could smell it when I pumped and sleep with it. That way I could smell his smell and I think that really helped not only with hormones but with letdown as well.

    I know generally the prescription galactagogues are held out as a last resort, but it might be worth at least looking into in your case, especially since you are still looking at a good amount of time before you can even try to feed at the breast.

    Hang in there mama. You can do this.
    I'm Hillary
    Wife to Gualberto
    Mom to Nolan
    Born at 32 weeks-3lbs/10oz
    11-25-2007
    Our precious early angel


    Remember, you are not managing an inconvenience; You are raising a human being ~ Kittie Frantz
    Unthinking respect for authority is the greatest enemy of truth ~ Albert Einstein
    First they ignore you, then they ridicule you, then they fight you, then you win ~ Mahatma Gandhi
    Looking for more information about vaccines?

  5. #5

    Default Re: Maintaining supply for son born 3 months early

    Thanks. I will try these suggestions and talk to my doctor about the option of medication.

    When you were pumping every 2 hours, did you still pump for 30 minutes or did you do shorter sessions? The Symphony does mimic the letdown. It seems to be the only model the hospital offers but I will ask if they have others.

    There is one other bit of info that may or may not be important. The decrease is concentrated mostly in one breast. The right side continues to produce almost normally but the left side has gone down to about 5ml per pumping session. Almost nothing! The left side has always produced less but not to this degree. It's also the side I have more trouble getting to let down. I wonder if the tissue in the left breast has been damaged from not letting down enough, or if it's just the "weaker" side and the first to show a big decrease.

    Thanks again for your support and encouragement.

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    Default Re: Maintaining supply for son born 3 months early

    Some other herbals you can try before going to medication too are fenugreek, blessed thistle, fennel (helps with letdown), and of course just regular old oatmeal. This is a good site that I used a lot when I would have issues. www.lowmilksupply.org

    No, when I pumped I generally only pumped for about 15 minutes, maybe 20. I did a lot of compressions with my thumbs during pumping. So when I was holding onto the flanges I would compress from the base of my breast down through toward the nipple, as far as I could reach around the breast. It took a bit to get coordinate doing it all at once, but I think it helped with efficiency. My LC had showed me how to do it.

    My left side was always the weaker side as well. I think it is normal to have one side that doesn't produce the same. But then add in mandatory pumping and an early baby and I think that can compound the issue. Try the fennel for letdown. I think that really did help me respond better to the pump in those first months before my son was able to breastfeed.

    ETA: And alfalfa....that was another herbal one I used as well.
    Last edited by @llli*nolies.mama; February 4th, 2011 at 04:05 PM.
    I'm Hillary
    Wife to Gualberto
    Mom to Nolan
    Born at 32 weeks-3lbs/10oz
    11-25-2007
    Our precious early angel


    Remember, you are not managing an inconvenience; You are raising a human being ~ Kittie Frantz
    Unthinking respect for authority is the greatest enemy of truth ~ Albert Einstein
    First they ignore you, then they ridicule you, then they fight you, then you win ~ Mahatma Gandhi
    Looking for more information about vaccines?

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    Default Re: Maintaining supply for son born 3 months early

    congratulations on your baby!

    I can't speak to pumping specifically for a preemie, but if one of your breasts is smaller than the other that could have an effect on your production when you are pumping. If the size difference is significant you might need to try a smaller/larger size flange on the lower producing breast. If you have an ill-fitting flange it will not empty your breast as well, causing even more of a difference in output between them.
    “We are not put on earth for ourselves, but are placed here for each other. If you are there always for others, then in time of need, someone will be there for you.”
    --Anonymous

  8. #8
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    Default Re: Maintaining supply for son born 3 months early

    Hi there! How is your little boy doing? How are you doing?

    My son was born at almost 30 wks and I pumped for him until he learned to breastfeed, which was about 2 months after his discharge from the NICU. He was not my first baby though - my daughter was still nursing when I had him, so my body had that benefit when producing milk for him and I didn't really have supply issues when pumping for him.

    But, one thing many women use to increase supply (and I did use this as well, when I wanted to make "extra" milk as I was donating to a milk bank) was eating steel cut oats, and lots of them! I've known many women who have had an increase in supply with this, I did as well.

    I recommend pumping more often, like every 2 hours for 15-20 minutes. Are you able to pump next to your baby's isolette? That can help too.

    Here are a few links that might be helpful. The first one has a section on hand expressing, which when done correctly can work better than a pump for some mom's. Sometimes I would combine hand expression with a pumping session.

    http://newborns.stanford.edu/Breastfeeding/

    There's lots of great info on the site below - scroll down about 3/4 of the page to see links about establishing a milk supply when baby isn't nursing.

    http://www.kellymom.com/bf/preemie/preemie-links.html

    Good luck mama! You are doing an awesome thing for your little boy!
    Mommy to:

    Emmalynn Marie
    Born at 37 weeks on 12/22/06
    5lbs 1oz 19 1/2in

    Owen Charles
    Born at 29 wks 6 days on 01/17/09
    2lbs 14oz 15in
    In NICU for 2 months


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    Default Re: Maintaining supply for son born 3 months early

    It is not recommended to take the fenugreek supplements if you are nursing a premature baby. Please check with your LC or doctor before going that route.

    Dr. Jack Newman talks about being able to put preemies to the breast very early. I thought he said as early as 32 weeks. What is preventing you from offering the breast, even for non-nutritive feedings? The act of him suckling from your breast will help your production.

    I second the suggestion of eating oatmeal. Other suggestions you may hear would include hops from beer... would be OK in a term baby, but not a preemie. No alcohol at all is what is recommended for a mother nursing a preemie.

    Try breast compressions during pumping. Pump for about 2 min after you see last drop. Warm showers often, and breast massage.

    Be sure you are eating well and drinking enough water (do NOT drink an abundance of water, some people tell you to drink too much water, that could have the opposite affect) drink to thirst, just be sure you are paying attention to it. NO caffeine.... that is a diuretic.

    That's all I can think of right now. This is a tough time right now for you and your family, hang in there. Even though days seem like weeks, you will be home nursing your baby before you know it.

    Bring in goodies for the NICU staff, they will be more likely to do extras for you (sounds bad, not intended to be... it's just human nature)

  10. #10

    Default Re: Maintaining supply for son born 3 months early

    My DD was born 6 days ago at 25+0. I too am struggling with milk production and my left side just went right down. I need to get a better pump and I'm hoping to kangaroo one day soon. I only just came home and trying to get a routine is so hard. With at least 11 weeks ahead we feel we have mountains to climb. I'm following your thread as I find it comforting to know I'm not alone. Let me know as you find things that help. Thanks and good luck.

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