Breast still full after pumping for 30 mins

[@llli*ruksangel]

Hi,

I am a working Mom, and my LO is 14 weeks old. I have always had this problem with my left breast, even after pumping for 30 mins, I just get about 2 oz, whereas from my right breast i get about 4-5 oz.
This was okay till last week, but my LO is drinking 5oz every 2-3 hours, so the demand is high but my supply is not that great. I had a stash saved up in freezer when I was on Maternity Leave. But I dont want to deplete that. I give 4 bottles of 5oz each to daycare. And she goes to daycare from 8 am to 4:30 pm.
I pump 3 times a day, and try to sneak in a 4th time if possible. My regular pump times are 3 am, 11:30 am and 4 pm. I feed her to 7 am before she leaves home.
But lately I have noticed that my left breast never completely gets emptied. And after pumping for 30 mins, i cant spend more time hand expressing. Also my left breast hurts after pumping/ and during pumping.
I am using Medela PISA, with breast-shields of size 24. I tried shield size 27mm also, but this didnt improve the output.
Is there anything wrong that I am doing? I am really worried now. If I dont keep up to the demand I might have to supplement her. I would not like to do that atleast till she turns 6 months old.
And I have milk in my breast, its just difficult getting it out.
Please help me. I am ready to try all options/tips.
Thanks!
Ruks

[@llli*sonogirl]

Well, I'm going to skip right to the one thing that is glaring to me as the biggest issue: your baby is being overfed by your daycare provider. 20 oz of milk over an 8.5 hr day is just too much milk! They are feeding your baby more like a formula fed infant, and not like a breastfed infant. So there is nothing wrong with what YOU are doing in your pumping. You are pumping plenty of milk--more than most moms could, actually!

The general rule of thumb for expressed milk needs during separations is 1-1.5 oz of milk per hour. And this will never change, baby will never need "more" than that as she gets older. That means that realistically, the maximum you should expect your infant to be drinking while she is at daycare is more in the range of 12-13 oz, not 20. I would suggest that you decrease the amount of milk you are providing in your bottles. Breastfed babies generally like small, frequent feeds. 5 oz is a big bottle for a breastfed baby.

So I would suggest that the place to start is by educating your DCP about the milk needs of a breastfed infant. They should be feeding her small bottles, frequently, using paced feeding techniques. They should not expect her to drink the quantities of milk that a formula fed infant requires. They should also be willing to comfort and soothe baby with techniques that aren't just giving her milk.

These links are helpful:
http://www.kellymom.com/store/freeha...le_feeding.pdf
http://kellymom.com/bf/pumpingmoms/f...ottle-feeding/
http://kellymom.com/bf/pumpingmoms/pumping/milkcalc/

[@llli*mommal]

1.5 oz of milk per hour of separation means that you should be providing around 13 oz of milk for the 8.5 hour separation, particularly if you are nursing right before you drop baby off and right after you pick her up.

Is your baby sleeping for long stretches at night? Maybe you're swaddling her or giving her a pacifier at night, encouraging her to sleep longer without nursing? Night nursing can be a working mom's best friend- more milk taken in at night means less need for it during the day.

[@llli*ruksangel]

@sonogirl: today I have asked daycare provider to at least give a gap of 2.5 to 3 hours before giving her another bottle. from tomorrow I will make smaller bottles, 4 oz each and will give 4 bottle. I thought it was just a growth-spurt that she was going through and didn't say anything.
@Mommal: Yes she sleeps from 10 pm to 6 am, i swaddle her. But when i wake up to pump at night, after pumping as I still feel full on my left side, I do put her on breast and she drinks for 10 -15 mins, like dreamfeeding..
A few more questions:
1. Is it okay to wake her and feed her at night? She doesnt even wakes up, she kind of feeds sleeping
2. How to wean off swaddle?
3. As per your experience which is a better pacifier?

Thanks in advance!
Ruks

[@llli*sonogirl]

You can wake and feed her if you like, or you can keep on "dream feeding" just like you are. I bedshare with my daughter, so I would say 95% of her night feeds were always "dream feeds." She'd just latch on and do her thing, and wouldn't even wake all the way up as long as she found the breast really easily.

[@llli*ruksangel]

ohh cool... thats great to know... even my daughter ... just keeps drinking... doesnt even wake up. thats the cutest! I really feel very knowing this. I just read all the links that you shared with me. I was just thinking the day care providers do know about these basics right? last week, they did feed my baby too much. I hope it was her growth spurt and it will be okay now on... so pumping 6-7 oz per session is really above average? and i was thinking I have a really low supply.
But there is sure some issue me pumping the left breast, I will give it a rest as long as my baby is getting all the correct nutrition

Thanks guys you are the best!!!

[@llli*mommal]

1. Is it okay to wake her and feed her at night? She doesnt even wakes up, she kind of feeds sleeping

Yes, this is wonderful!

2. How to wean off swaddle?

You can simply stop swaddling, or you can start by unwinding her legs. Then unwind her arms one at a time. The goal with taking a way a swaddle is to get her to be a little more wakeful at night, and a little more willing to eat so that she won't be so eager to gorge on bottles at daycare.

3. As per your experience which is a better pacifier?

Mom is the best pacifier. All natural organic materials, guaranteed to work, attractive orthodontic shape.
When mom's not available, you kind of have to try a variety of pacifiers and see which ones your baby likes.

[@llli*sassypants]

My left breast never emptied as well as my right when pumping. I found that some of the milk ducts on my left required some serious outside pressure to "empty" more completely. Sometimes you can feel the locations of fullness while doing compressions, but I had better luck looking at changes in flow while doing compressions to determine where exactly I needed to apply more pressure.

[@llli*ruksangel]

Hi friends,

I just wanted to update on my situation.

My output has increased
After a lot of trial and error I discovered that 27mm Breast-shield works good on my left breast and 24mm on my right side... go figure! I am back to pumping 5-6oz in one session. And pumping 3 times a day.
And my baby is one big eater, from 8 to 5 in daycare she has 3 bottles thats 15 oz.
SO all in all currently the demand is almost equal to supply. I hope this continues till she is 6 months... and once she starts taking in solids she will need a little less BM.
Thanks guys!!!

[@llli*bfwmomof3]

That's great! It's not unusual for breasts to be asymmetric and therefore to need different size shields. Also shield size may change over time, so keep an eye out for that too.