beginning relactation and would love some advice/guidance

[@llli*babygirlsmommy]

hello everyone. first of all allow me to apologize for the lack of capital letters. i am writing from my phone and for some reason i cannot create a capital letter! anyway, i am new here and i suppose i will begin with some background information. my daughter will be 3 months old this week. i breastfed her, with a great deal of difficulty, for a little over 2 weeks. i was overwhelmed and emotional, she would scream most of the time when i tried to get her to latch, and i was sleep deprived. i made the decision to switch to formula because i could not emotionally handle the stress of breastfeeding any longer. fast forward 9 weeks to now and i greatly regret that decision. i miss breastfeeding as i always was determined to breastfeed for at least 6 months. my daughter also seems to be having a lot of trouble with formula...gas, reflux, etc.

i desperately want to breastfeed my daughter again. ideally i would like to build up my supply enough that she is only getting breastmilk either through breastfeeding or pumped milk once i return to work. i began this journey 5 days ago and i have 2 months before i have to go back to work. i have started pumping and have managed to do 8 times 2 of the days and between 5 and 6 the other 3 days because we had visitors. i plan to pump every 2 to 3 hours everyday from here on out. i have also started putting my daughter to the breast and she will latch on for about 2 minutes at a time though i am almost positive she is not getting anything and i am also not certain how good her latch is though it feels comfortable. i have also been drinking mothers milk tea twice a day and taking something called lactation blend. i have also been trying to eat oatmeal once a day as well as upping my intake of water.

i do have a few questions if anyone would be so kind as to answer.

1. the supplement im taking has many different ingredients including fenugreek seed extract, red raspberry leaf, goats rue aerial parts, blessed thistle aerial parts and quite a bit more. when i went to the store i had intended to buy fenugreek seed but then i saw this. now i am wondering if i made a mistake as i just saw that this only had 50 mg of fenugreek so i am only getting 100 mg a day which is way, way below what i see is recommended. should i discontinue this supplement and just get fenugreek to take 3 3 times a day?

2. the first day i pumped i got thick, sticky drops of yellow liquid which reminded me of colostrum. is that what it was? does your body remake colostrum even when you have not just given birth?

3. since the 3rd day i was pumping i have gotten a drop of milk from one breast or another at one or two pumping sessions. these drops do not fall off my breast. the rest of the time i get nothing. i assume that i am seeing any milk is good news, yes? i am not known for my patience and am getting a bit frustrated that this isnt increasing. i would be happy to see even a few drops fall off the breast though really i am just anxious to start seeing milk collect in the bottle. i think back to when i pumped after my daughters birth when she was briefly in the nicu and how easy it was to fill a bottle and i get so angry at myself that i stopped. anyway, when can i expect to see this one tiny drop turn into something more substantial?

4. like i said, my daughter will latch for short amounts of time. i have read that babies typically get more out than a pump. so is it possible she is getting any milk even though i am seeing essentially nothing when i pump? how do i know when she is getting something someday?

5. what else should i be doing to try to make this happen quicker? i am just so anxious to start giving my daughter some breastmilk even if it is just a little.

thank you so much to anyone who has time to reply and give me some guidance. i am so determined to do this but am so impatient and want to make sure i am doing everything correctly.

[@llli*mommal]

Welcome to the forum and congratulations on the baby!

It's awesome that you have decided to pursue relactation. It takes a lot of strength to try again! Luckily, it seems like you have a lot of factors in your favor: you have 2 full months before you have to return to work, your baby will latch, you still have milk, and you seem to have a lot of determination!

1. the supplement im taking has many different ingredients including fenugreek seed extract, red raspberry leaf, goats rue aerial parts, blessed thistle aerial parts and quite a bit more. when i went to the store i had intended to buy fenugreek seed but then i saw this. now i am wondering if i made a mistake as i just saw that this only had 50 mg of fenugreek so i am only getting 100 mg a day which is way, way below what i see is recommended. should i discontinue this supplement and just get fenugreek to take 3 3 times a day?

I would simply add in some fenugreek until you are at the recommended level. Just please be aware that while supplements are nice and do provide a supply boost for some moms, they will not do you 1/2 as much good as more pumping. The key to supply is frequent and complete draining of the breast- the more you can do that, the more milk you will see.

2. the first day i pumped i got thick, sticky drops of yellow liquid which reminded me of colostrum. is that what it was? does your body remake colostrum even when you have not just given birth?

What you saw was milk, not colostrum. As lactation draws to a close, the milk becomes saltier and very high in protein and in some of the immune support factors found in colostrum, particularly a compound called lactoferrin. If you can get your baby to drink this milk, it will be terrific for her health!

As you relactate, you will find that the milk will become sweeter, less salty, and more watery.

3. since the 3rd day i was pumping i have gotten a drop of milk from one breast or another at one or two pumping sessions. these drops do not fall off my breast. the rest of the time i get nothing. i assume that i am seeing any milk is good news, yes? i am not known for my patience and am getting a bit frustrated that this isnt increasing. i would be happy to see even a few drops fall off the breast though really i am just anxious to start seeing milk collect in the bottle. i think back to when i pumped after my daughters birth when she was briefly in the nicu and how easy it was to fill a bottle and i get so angry at myself that i stopped. anyway, when can i expect to see this one tiny drop turn into something more substantial?

The "when" questions are the hardest to answer. Every woman is different, and responds differently to pumping, nursing, supplements, etc. I know it's hard, but this is a process that requires a lot of patience! The fact that you do have some milk is an excellent sign. Just keep pumping!

4. like i said, my daughter will latch for short amounts of time. i have read that babies typically get more out than a pump. so is it possible she is getting any milk even though i am seeing essentially nothing when i pump? how do i know when she is getting something someday?

It's possible that she is getting milk when she nurses. But because she hasn't nursed since 2 weeks of age, she's probably not one of those babies who can empty the breast better than the pump. Not yet, anyway! She needs practice and time. Once you have more milk, you might find that she will stay on the breast for longer, suck more eagerly, and if she gets good at nursing you will eventually hear swallowing when she nurses. That's how you will know that she is getting something when nursing.

5. what else should i be doing to try to make this happen quicker? i am just so anxious to start giving my daughter some breastmilk even if it is just a little.

1. Pump as often as you can. 8 or more times per day is ideal. But if you can't achieve that, remember that any level of stimulation is good! Even if you only pumped once in a day, it would still be better than not pumping at all.
2. Use a high-quality double electric pump, preferably a hospital grade rental, with correctly sized shields.
3. Keep on with the supplements.
4. If your current program isn't yielding the results you want, you may want to talk to your doctor or midwife about using either Reglan or Domperidone, which are prescription drugs which are used off-label to boost prolactin levels and increase milk supply. Both should be used only with medical supervision.
5. Nurse the baby as much as possible.
6. Bottle-feed in a breastfeeding-supportive way: http://kellymom.com/bf/pumpingmoms/f...ottle-feeding/
7. Check out these tips for getting the baby to nurse more: http://kellymom.com/bf/concerns/child/back-to-breast/
8. Consider trying an at-the-breast feeding system (Medela Supplemental Nursing System, Lact-Aid) so that baby gets all her nutrition at the breast.

[@llli*babygirlsmommy]

Thank you so much for your thorough reply! I am continuing on my journey and it is painfully slow progress but I am making progress. I went from being able to pump 1-2 drops and getting nothing from hand expression to today pumping about 2 ml and being able to hand express a few drops. I am still determined and committed and I am grateful that my supply seems to be increasing, but I am not going to lie; it is extremely discouraging to see the tiny little bottle that I used to be able to fill in about 10 minutes have only the bottom barely covered after a day of hard work. It seems impossible that I will ever be at a point where I'm producing enough milk to feed my daughter and/or pump bottles for her for when I'm away.

I have started taking 2 fenugreek pills 3 times a day in addition to the original supplement that I was taking. I'm not sure if that is what has caused the increase in supply or if it would have increased anyway as time passed. I am trying my hardest to pump 8 times a day but some days I fall short. Today for example I have only managed 4 pumping sessions.

My daughter will still latch and I try to do so each time before or after she has her bottle. Though some times I do skip it if she seems cranky as I don't want her to associate my breast with anything negative. The part I am still struggling with is how I will know when/if she is getting any milk. I have tried to listen for her swallowing and sometimes I think I hear one or two swallows but to be honest I'm not sure because I don't really hear her swallowing when she's eating from her bottle either. I can see her swallowing but I can't really hear it. And when I'm breastfeeding her I'm not in a position as to where I can see if she's swallowing or not. I see other threads from other moms who have relactated and they say things like "she is completely breastfed in the morning" or "we are up to x amount of breastfeedings a day" and I am just so confused as to how they got there. I don't know how I will ever know if my daughter is getting enough for me to eliminate her formula at a feeding. She has always been a very eager eater so I don't think I could ever count on her turning away a bottle even if she was full from my breastmilk. I think she would always accept more food to be honest. So I guess my question is how will I ever know if/when I can replace a formula feed with a breastfeed? Or how to I know when to lower the amount of formula I'm giving her after each attempt at breastfeeding?

Another question I had was, I should eventually see sprays/streams from my breast correct? When I was pumping after my daughter was born I never really watched to see how my breastmilk came out. But I assume that it was doing more than the drips that I am getting now. I just am curious what I should be watching for to know that I am getting closer to a full supply.

I want to thank you again for your reply. I greatly appreciate the support and knowing that I am not alone in this journey.

[@llli*mommal]

I am continuing on my journey and it is painfully slow progress but I am making progress. I went from being able to pump 1-2 drops and getting nothing from hand expression to today pumping about 2 ml and being able to hand express a few drops.

Awesome! I know it too a lot of hard work to get to this point.

I am still determined and committed and I am grateful that my supply seems to be increasing, but I am not going to lie; it is extremely discouraging to see the tiny little bottle that I used to be able to fill in about 10 minutes have only the bottom barely covered after a day of hard work. It seems impossible that I will ever be at a point where I'm producing enough milk to feed my daughter and/or pump bottles for her for when I'm away.

I think that if you can keep on nursing and pumping, you will get to your goal. And even if you don't, I think you are going to be so glad to have given this project your all. You're not going to wonder "What if I had tried?"

I have started taking 2 fenugreek pills 3 times a day in addition to the original supplement that I was taking. I'm not sure if that is what has caused the increase in supply or if it would have increased anyway as time passed.

My guess is that the pumping and nursing is responsible for the increase in supply. You could eat fenugreek all day but if you weren't pumping/nursing, you wouldn't make a drop of milk.

My daughter will still latch and I try to do so each time before or after she has her bottle.

This is awesome! Truly a huge advantage. If she will nurse, you are getting a lot of the benefits of nursing even if there is little or no milk present. You both get the closeness and bonding time, she gets some milk and the jaw development benefits of nursing.

Though some times I do skip it if she seems cranky as I don't want her to associate my breast with anything negative

Think that's a good decision.

The part I am still struggling with is how I will know when/if she is getting any milk.

If hand expression and pumping is only yielding drops, I think you have to assume that her milk intake at the breast is still pretty low. But once you find that hand expression/pumping is yielding more milk, you can start to really listen for swallowing, and you can start looking for evidence of breastmilk in her poop. Breastmilk poops tend to be yellowish, whereas formula poops are kind of olive. So the more yellow her poop becomes, the more milk she's getting.

She has always been a very eager eater so I don't think I could ever count on her turning away a bottle even if she was full from my breastmilk. I think she would always accept more food to be honest. So I guess my question is how will I ever know if/when I can replace a formula feed with a breastfeed? Or how to I know when to lower the amount of formula I'm giving her after each attempt at breastfeeding?

Again, I think you need to wait until pumping is yielding more milk. You want to decrease the amount of formula your baby is getting as you start filling your baby's bottles with your milk. If you produce 1 oz of milk per day, bring the formula down by 1 oz. If you produce 2 oz, reduce the formula by 2 oz. Etc.

Now, when your supply is getting close to what your baby needs over the course of the day (19-30 oz), you start experimenting with reducing the size of the bottles. Instead of giving a 3 oz bottle, you give a 2.5 oz bottle and then put the baby back to the breast if she still seems hungry after finishing the bottle. Then you watch her diaper output. If it continues to be normal, you reduce the bottle size by another .5 oz and watch diaper output again. You repeat the process until all the supplements are gone.

Another question I had was, I should eventually see sprays/streams from my breast correct?

Yes, when you have more milk you will see trickles, sprays and streams.

[@llli*babygirlsmommy]

thank you again for your reply (and again apologies for lack of capitalization...no idea why the combination of my phone and this forum makes that happen!) i greatly appreciate all the time you have taken to help me.

your answer about how to know when and how to reduce formula makes perfect sense. i could not quite wrap my mind around how to approach that but now with your explanation it makes perfect sense. i would say i am still awhile away from attempting it anyway. i am still only pumping about 5 ml a day which is frustrating but i am trying to focus on the positive that it is an increase. i was hopeful that i would be one of the women who had a full supply back in a month but that seems unlikely since i am already 2 weeks in and am only producing this much. i am still committed and wil keep it up for at least the month and possibly more if it is not interfering too much with life and time with my baby.

i do have a couple more questions if you do not mind as you have been so very helpful thus far. they are basically centered around let down. when i breastfed my daughter i was so sleep deprived and uneducated about breastfeeding that i didnt know what to look for or what i was doing. so i really do not know if i ever felt a let down feeling. i do know that i do not feel any sort of sensation now when i am pumping or breastfeeding. is it possible to be getting milk without having a let down? the reason i ask is that i always seem to be able to get drops immediately out of my breasts when i squeeze even the slightest bit and i am still only getting drops no matter how long i pump or express. so do i have more milk but am not having a let down and therefore am getting very little milk. or do i have so little milk that my let down is just drops? and if so then why can i always immediately express drops...i thought you needed a let down first?

my other question is, why can i always get more milk out of my breasts no matter how much i pump or hand express? i have read that producing more milk depends on completely emptying my breasts but it doesnt seem possible. i pump and pump and pump and express and express...you get the idea...and there always seems to be more milk. which i guess i should be happy about but i am really not considering that never seems to result in more milk in the bottles.

[@llli*mommal]

i am still only pumping about 5 ml a day which is frustrating but i am trying to focus on the positive that it is an increase.

That's terrific! 5 ml represents a lot of hard work on your part and whatever you can give your baby- 5 ml or 500 ml- it's all good!

so i really do not know if i ever felt a let down feeling. i do know that i do not feel any sort of sensation now when i am pumping or breastfeeding. is it possible to be getting milk without having a let down? the reason i ask is that i always seem to be able to get drops immediately out of my breasts when i squeeze even the slightest bit and i am still only getting drops no matter how long i pump or express. so do i have more milk but am not having a let down and therefore am getting very little milk. or do i have so little milk that my let down is just drops? and if so then why can i always immediately express drops...i thought you needed a let down first?

Not all moms experience the letdown sensation. I nursed 2 kids for 3 years apiece and never felt one. That doesn't mean I didn't have them, though! When you find that you're getting a little more milk out of the breast, you're probably having a letdown- it just happens to be a rather undramatic one due to the relatively low amount of milk in the breast.

The way letdown (a.k.a. milk ejection reflex) works is this: stimulation to the breast via nursing or pumping results in 2 things: first, the withdrawal of whatever milk is close to the surface, and second, the release of the hormone oxytocin. Oxytocin travels to the brain where it causes the release of prolactin. Prolactin travels to the breast and causes the contraction of milk-producing tissue- and as the milk-filled tissue contracts, milk is pushed towards the nipple and, if there is enough of it, out of the breast. So the first drops you see are probably pre-letdown, and as you continue to express, you are getting a hormonally-driven milk ejection. Again, it just isn't very dramatic right now, so it looks like more drops.

my other question is, why can i always get more milk out of my breasts no matter how much i pump or hand express? i have read that producing more milk depends on completely emptying my breasts but it doesnt seem possible. i pump and pump and pump and express and express...you get the idea...and there always seems to be more milk. which i guess i should be happy about but i am really not considering that never seems to result in more milk in the bottles.

Milk is always being made. The more milk you take out of the breast, the more you will make, and the faster you remove milk the faster more will be made to replace is. The idea that you can "completely empty" your breasts is a myth. When a mom is trying to increase supply, she wants to aim to get her breasts as empty as possible, as frequently as possible. She'll never entirely drain her breasts, though!