Pumping after Breast Reduction

[@llli*lielush]

Hi there, Just wondering if anyone has any thoughts..
I had a breast reduction about 8 years ago and have had my first baby who will be 4 weeks old soon. I also have flat nipples adding to the problem. I put baby to breast with a nipple shield for most feeds and then supplement with a bottle and I pump 5 times a day. I do not think there is much milk transfer with the shiled but we try anyways as for pumping I can get up to an once for some pumps from both sides but most times I am only getting 10-15 mls or about half an ounce. Just wondering why the fluctuations and how to consistently pump a higher amount. Also starting to wonder if this is all worth it is this small amount of breast milke (about 5 ounces a day) really that beneficial to my baby? Any advice is appreciated!

Thanks!

[@llli*mommal]

Welcome to the forum!

This first resource you might want to check out it BFAR.org: http://bfar.org/index.shtml. Lots of information there about brestfeeding after breast surgeries, including reductions.

I also suggest checking out this resource on shields and weaning from the shield: http://kellymom.com/bf/concerns/child/wean-shield/. If the shields are causing slow transfer, getting rid of them should improve things for you.

It's normal to have milk supply fluctuate over the course of the day. The milk-producing hormone, Prolactin, is not produced at a constant rate. Most moms have more Prolactin (and hence more milk) overnight and in the early hours of the day, and less as the day wears on. However, the body is trainable: if you can increase frequency and intensity of milk removal from and stimulation to the breast, you will signal your body to increase milk production no matter what time of day it is.

In your shoes, I would do the following:
- Try to ditch the shield
- Pump more often
- Use the best possible pump (think hospital grade rental with correctly sized shields)
- See a lactation consultant, preferably an IBCLC
- Try herbal galactogogues (milk increasers) like fenugreek and oatmeal
- Talk to your midwife or doctor about prescription drugs which may increase supply (Reglan in the US, Domperidone in the EU and Canada)

Any amount of breastmilk is worthwhile! Producing milk is good for you and drinking milk is good for your baby, even in small amounts, and nursing is an amazing mothering tool. If you can soothe your baby with the breast, you will never be without a way to comfort her. Please remember that breastfeeding doesn't have to be all or nothing. If you need to redefine what success means for you, that's fine!

[@llli*lielush]

Thanks for your reply and the resources. I cannot get baby to latch on to my nipple without the shield. Without the shield he will latch for a matter of seconds and then go off the nipple. At least with the shiled he will latch and suck even though he is not getting any milk. Not quite sure how to get him to get on without the shield.
I am on Domperidone and have been trying the herbs but nothing really seems to boost my supply. I am also seeing a breast feeding GP at a clinic as I was unsuccessful in finding an LC that seems to be knowledgable in this area out here (Vancouver Canada).
I guess plan is now to keep pumping - is it worth increaseing the frequency if that means a lower yeild at each pump? (for example I seem to pump quite a bit less at each pump if I pump more often. Secondly any advice to get baby to latch and stay latched to a flat nipple? I have also tried SNS and that was a messy mess!

Thanks!

[@llli*mommal]

Yes, pumping more often is good for supply even if that means you get less milk. Milk production depends on 2 things: the frequency with which milk is taken from the breast and the completeness of milk removal. So increasing frequency is always a good way to get more milk overall. The first few times you pump more often, you'll probably not get a significant increase in milk volume. But keeping the breast as empty as possible should be training your body to produce more, and with time you should see production increase.

I think the key to ditching the shield- and also to mastering that frustrating SNS- is patience and persistence. So keep offering the bare breast. One day your LO will probably surprise you! Did anyone suggest the nipple sandwich technique to you? That can really help a baby latch onto a flatter surface.

[@llli*lielush]

Hi,
Trying without the shield but it just leads to a very unhappy baby. I think my nipples are very flat and baby just cant get a latch - yes have tried sandwich technique.. Tried after pumping when my nipples seem to be a little more protruding but baby still protests. Just dont know how much to push it or just let him latch and suck with the shield just to maintain some breastfeeding technique instead of losing it all.

[@llli*lielush]

You were so right... after going to a BF clinic yesterday baby finally latched!!! Im so excited! I posted now in the feeding your 1-3 month old with some more questions but I just wanted to say thank you and the shields are gone! Now just to get more milk!!

[@llli*auderey]

AWESOME!! good job!!!