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Thread: Reduced production

  1. #1
    Join Date
    Mar 2013
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    Default Reduced production

    I have a 5 month old and I combo feed. As much breast milk as possible, supplemented with formula. I pump at work and nurse and pump at home. I keep my pumping stats on my i-pad, so know exactly. I have struggled with production and maxed out at about 20-25 ounces per day.
    I pump every 3-4 hours around the clock, unless able to nurse. I've never been able to give up the motn pump because that is when I get 1/3 to 1/2 of my production for the day. (4-8 oz). For the last week that's the only pump I get much of anything. At the others I'm getting 0.5-1 oz.
    I think that eliminates the pump as a cause. My baby acts frustrated at any except morning feeds, too.
    I am 5 years post menopause (donor baby) so that eliminates my cycle. I have taken galactagogues the whole time, read More milk and implemented almost all the suggestions months ago. I eat well and plan as many meals as possible to include galactagogue foods. (oatmeal every am, garlic, ginger, tumeric, barley drinks,spinach,asparagus, etc).
    I power pump weekly when I can and try to maximize baby time on the weekend. I use heat and massage when I pump and compress after. I can sometimes get 0.5 ounce more this way. My pumping sessions are a minimum of 30 mins, avg 40 and max 1 hour plus. I've always been "slow" to empty with the pump. Looking at pics etc, does not change the timing for me.
    I'm seriously considering domperidone but don't want to go this route if I don't have to. I do keep a check on my thyroid. I'm wondering if the night pump is significant, since prolactin is highest? Maybe I have a prolactin issue?

  2. #2
    Join Date
    May 2006
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    21,004

    Default Re: Reduced production

    20-25 oz per day is excellent output. It's a whole day's worth of milk, according to kellymom: http://kellymom.com/bf/pumpingmoms/pumping/milkcalc/

    How long are you at work? And does the baby take the entire 20-25 oz while you're there?
    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!"

  3. #3
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    Mar 2013
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    Default Re: Reduced production

    20-25 oz is wonderful for me. For the last week I'm making 1/2 to 1/3 of that. My daily totals have been: yesterday 9.5 oz (that's the Whole day worth). Day before 7 oz, day before that, 13, day before that 12 oz and so on. I'm at work 9 hours plus commute, about 10.5 hours, except when I have evening work meetings which are dinner meetings and I will be gone 14-15 hours. My baby is over 20 pounds and we do paced feelings but she takes every bit I make and several supplemental formula bottles. our pediatrician is bf friendly and says we are not over feeding.

  4. #4
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    May 2006
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    Default Re: Reduced production

    Sorry, I didn't mean to sound critical- it's just that so many moms struggle because their daycare providers overfeed, so that's usually the direction I go in.

    It sounds like you've experienced a fairly severe decline in production. Long hours in the office could definitely explain that- the pump doesn't empty the breast as well as the baby and most babies nurse a lot more often than every 3-4 hours when they're with their moms. What sort of pump are you using and is there any chance of you pumping more frequently? I'm thinking every 2-3 hours instead of every 3-4, particularly on those very long days.
    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!"

  5. #5
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    Mar 2013
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    Default Re: Reduced production

    Hi thanks. I have a Madela pump in style. I think it is working ok. Particularly as it does great at the middle of the night pump. I honestly can't pump more often. As I said I have to pump 30 mins minimum to get anything. They are very patient at work but I am a vet and the only one at work so I can't disappear more often. I pump in the car too while driving. None of this has changed. I went back to work when my baby was 8 weeks. When I am home she is frustrated about nursing except in the early am when supply is still good. She has slept thru the night for months.

  6. #6
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    May 2006
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    Default Re: Reduced production

    Drat, I keep hoping the solution will be an easy one!

    Okay, you have a good pump and I assume it's either new or fairly new, right? It's not one you got used from a friend?

    At this point, I'd say your options are:
    - getting a better pump- think hospital-grade rental- which might provide a step up in stimulation from the PIS
    - pumping more frequently- if you can't do it during work, do it after feedings when home with your baby
    - try the Domperidone/Reglan route
    - maybe try an oxytocin nasal spray and see if that decreases the time it takes to get a letdown- see your doc about this one!

    I know you had considered the possibility of a prolactin issue... I don't know if that's common or likely. Maybe see an endocrinologist about that one? If you have a problem with your pituitary, or perhaps some other hormonal function, that could explain things. But you know the adage: if you hear hoofbeats, think horses, not zebras. Milk production issues are more likely to be related to breastfeeding management (i.e. nursing frequency, pump frequency, pump response, etc.) than to hormonal issues.
    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!"

  7. #7
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    Mar 2013
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    Default Re: Reduced production

    Thanks for the reply. I just wanted to make sure I wasn't missing anything. It would be hard for me to pump more at home unless I could do it while I do other things. I think I can get a free pump from insurance 7/1 when the new fiscal year starts for the policy. I may get a Freestyle. In the meantime I can check into a rental for home and use my PIS at work and in the car. In answer to your question, I bought my pump new. What is still puzzling me, is why my motn pump is so good. There are only 2 variables there: that is when prolactin is highest and that is after some sleep. I know I am sleep deprived. I haven't slept all night since 2nd trimester. I had gestational diabetes and had to get up hourly to visit the loo! Maybe naps when I'm home would help as much as pumping/nursing. I will explore the med route too.

  8. #8
    Join Date
    May 2006
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    Default Re: Reduced production

    The middle-of-the night pump session is probably good because prolactin production tends to be highest at night. But I wonder if stress doesn't pay in to it, too... Stress and the adrenaline that comes with it can inhibit letdown. At night, you're nice and relaxed, and maybe that makes your letdown happen faster? Do you have an iPad or smartphone that you can use at work? There are apps-for example, there's one called a Breathing Zone- that can reduce stress and maybe they would help you get faster letdowns.
    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!"

  9. #9
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    Mar 2013
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    Default Re: Reduced production

    I'll look into that. I carry my iPad to track pumping. I'll check out the app!

  10. #10
    Join Date
    Mar 2013
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    Default Re: Reduced production

    Just thought I'd give an update. I've emailed the lactation consultant that I've used to ask where to rent a hosp. Grade pump. Have not heard back so I decided just to get "back to basics" and see what happens.
    Home with my little one this weekend. Doing as much skin to skin as possible. She is only nursing well in the am around 5 or 6 and 8. After that she seems frustrated, which is not surprising given the small amounts at the pump. Yesterday she nursed twice and my ounces pumped in 24 hours was 9.5. I downloaded the app, but I don't think it's a pump let down issue as my breasts feel soft and empty later in the day, but hopefully the relaxation will help production as well.
    I also increased my More Milk tincture to 1 mL every hour or so as often as I think bout it. I have confidence my persistance will pay off and hopefully get me back to 20-25 opd.

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