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Thread: Insufficient glandular tissue -- what works, what doesn't?

  1. #1

    Default Insufficient glandular tissue -- what works, what doesn't?

    I would really love some advice from women who've experienced IGT and what was possible with regard to breastfeeding.

    We've been supplement feeding our three-week-old son basically since birth, first because of jaundice, and then because my lactation consultant determined I had low milk supply, most likely because of IGT. (And looking at photos, my breasts look very similar to the classic cases.) But I am producing some milk. Following guidelines in the Nursing Mother's Companion, with a hospital-grade pump, I estimate I'm producing about 16 oz. a day. I of course have no idea how much he's getting. When he was weighed 5 days ago before and after a feeding, he'd taken in about 35 grams. He was not gaining enough weight so the lactation consultant recommended 2 to 2.5 oz of supplement per feeding.

    The consultant is very kind and supportive, but she didn't have any concrete advice about what might work to help increase supply. I've been trying to pump after some feedings (about 4-5x a day), but when I don't have my husband or another second pair of hands to give him his bottle, it's very hard for me to get to the pump right away. And to be honest, I hate pumping, I hate cleaning the parts, I hate all of it. I'm happy to keep breastfeeding plus supplementing but am on the fence about pumping.

    So I have two questions:
    1) If I pump very rigorously, is there any chance I could increase my supply?
    2) If I stop pumping, am I risking losing the milk I currently produce?

    Thank you very much. I've really appreciated the information I've already found on these boards.

  2. #2
    Join Date
    Mar 2014
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    Central FL
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    Default Re: Insufficient glandular tissue -- what works, what doesn'

    Can you use a lactation aid to give the supplement right at the breast?
    Something like a Lactaid or Medela SNS can let you give the supplement through a tube right at the breast while baby nurses from you at the same time so it can save your the time step of nursing and then giving a bottle though you still have something to wash regularly.
    By supplementing right at the breast there is less need to pump in addition to feeding though pumping will help increase your supply more than not.

    I know for myself, I never responded well to the pump so If I were to have added up all I pumped with a hospital grade pump round the clock at 3 weeks I probably would have concluded that I was only producing 8 oz or less a day because I was never able to pump more than an ounce and generally much less. However, by doing weighted feeds around the clock a few times and subtracting the amount I was supplementing I was able to calculate my supply as being between 17 and 24 oz a day.

    I was able to get down to only supplementing about 4-5 oz a day but any less than that and weight gain was too slow even after getting the TT and LT fixed and doing physical therapy.

    My supply problems were due to poor milk transfer because of tongue/lip ties that were not diagnosed early. We supplemented using the Medela SNS mostly and I tried to pump after every feeding. Fenugreek didn't do much for me other than give me gas. I finally started taking Domperidone and haven't needed to supplement at all since several weeks after starting domperidone at 90 mg per day, I'm currently in the process of starting to taper down the dose and see what the minimum amount I need is.

    Now the question of if you need to keep pumping to keep the supply you have, that is mainly a question of if baby is nursing effectively. If baby is effectively removing all the milk that is there and still nurses some to help cue to your body that more milk is required then the pumping on top of nursing may not be doing all that much. However, if you are not nursing very frequently due to supplementing or if baby is not nursing at the breast very long due to getting used to the bottle, then pumping might be needed to keep your body producing. This is why I kinda recommended the lactation aid for supplementing so that you are getting the stimulation at the same time as supplementing and save some time and you may not need to pump so much then either and you reduce the chances of breast refusal due to flow or nipple confusion.

  3. #3
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    Default Re: Insufficient glandular tissue -- what works, what doesn'

    My experience with pumping was very positive. I pumped around 8-10x per day using a hospital-grade pump with correctly sized shields, and had a marked increase in supply within a few days. You estimate you're making 16 oz per day, and the highly reliable kellymom.com says that babies need just 19-30 oz per day. You're close to having all you need! So my personal opinion is that before you throw in the towel with the pump, you give it everything you have.

    Some things that can make pumping easier:
    - Keep a large basin of soapy water by the sink, and throw in used bottles/pump parts as necessary. I found it less challenging to do 1-2 big wash-ups per day than a million little ones.
    - Get a second set of pump parts so that you don't need to wash everything as often.
    - After pumping, leave the pump screwed onto the bottle and pop the whole thing in the fridge. When you need to pump again, you can reuse the set-up and pump new milk over the old milk. My LC said I could do this once before washing everything again.

  4. #4
    Join Date
    Jun 2009
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    Default Re: Insufficient glandular tissue -- what works, what doesn'

    have you looked at the book Making More Milk? it is more specifically about milk production and more recent than the NMC.

  5. #5
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    Default Re: Insufficient glandular tissue -- what works, what doesn'

    Quote Originally Posted by @llli*mommal View Post
    Some things that can make pumping easier:
    - Keep a large basin of soapy water by the sink, and throw in used bottles/pump parts as necessary. I found it less challenging to do 1-2 big wash-ups per day than a million little ones.
    - Get a second set of pump parts so that you don't need to wash everything as often.
    - After pumping, leave the pump screwed onto the bottle and pop the whole thing in the fridge. When you need to pump again, you can reuse the set-up and pump new milk over the old milk. My LC said I could do this once before washing everything again.
    I actually did a version of this where I would put the pumped milk into the fridge sealed up and put a new bottle onto the pump parts and put the pump parts into the fridge as well and I would actually pump several times before washing everything. I often wouldn't have had time to wash even every other time since baby was taking so long to nurse, by the time I pumped it was pretty much time to nurse again and then pump again (even with using the at the breast supplementation I had NO time for a while there.)

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