Re: Primary milk insufficiency
First of all, I am so sorry you went through all of that! It is so unfair that a mom can do literally everything right, work her rear end off, and still not get rewarded with the birth she wants or the healthy baby or, as in your case, the milk she needs. I wish the information that is out there could encompass all the complexity and nuance, but with breastfeeding as with all other things, most information is written for the 99% (approximately) of people whose experiences are essentially "normal." For the 99%, the key to breastfeeding is patience, persistence, hard work, and the right tools. For the 1%, it doesn't really matter how hard they work, how patient they are, or what tools they have. So ditch the guilt for not being in the 99%. That's something you have no control over.
How has pregnancy been for you, this time around? Anything different going on with your breasts, that didn't happen the first time?
I don't honestly know that the's much you can do in addition to what you did the first time around, because it sounds like you pretty much tried everything. If you have a problem this time around, and you decide you want to go the herbs/drugs/pump route again, I would suggest pumping more frequently than every 4 hours. When you want to bring milk in, and you're using the pump, you have to pump in a way that mimics the nursing patterns of a newborn, who will typically nurse 10-12 times a day. And use a hospital-grade pump with correctly sized shields- I don't know if you did that or not, the first time?
WRT colostrum, you don't want to pump prior to the baby's birth. Pumping is a great way to induce labor, and you wouldn't want to get the colostrum but end up with a preterm baby or early term baby. You might want to try hand expressing once a day, and see if you can collect anything. If not, I think you'd do best to wait until the baby is born before attempting to collect the colostrum.
Let us know how things go! I really hope you have a great experience this time around, and if not, this is a place whee you can come and know that everyone will understand the magnitude of what you're going through.
Coolest thing my big girl said recently: "How can you tell the world is moving when you are standing on it?"
Coolest thing my little girl sang recently: "I love dat one-two pupples!"