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Thread: Trouble getting volume up, please help!

  1. #1

    Default Trouble getting volume up, please help!

    Hi all,
    I'm a new mom, and new to LLLI. I delivered our daughter via an urgent c-section due to having vasa previa. She was born at 34 weeks and 5 days. Our daughter has been in the NICU since 11/18, and it's been difficult trying to get my milk to come in. I pump about 8 times a day, power pumping in the morning. I've been averaging about 15-20 mL's so far. I've tried to get skin to skin time in, and we've just started putting her to breast when I visit her, but it's been very difficult due to her having been on C-pap at first. We're getting very close to her coming home, but it's just frustrating that nearly 3 weeks later, I'm only producing 15-20. I had a breast reduction in 2003, and they did not remove the nipple from my breast. I've just started fenugreek, and it seems like I'm getting a bit more the last day and half- maybe 22-23 mL a day. I'm looking for more advice, if possible, or any suggestions. I'm totally out of my element with all of this. I really want to breast feed, but I feel like I'm failing miserably. I'm open to all advice!!
    New mom- had Vasa Previa, went into active labor 11/17/14, delivered via emergent C-Section 11/18@01:45 am- Ella Noelle, 34w5d GA

  2. #2
    Join Date
    May 2006
    Posts
    24,794

    Default Re: Trouble getting volume up, please help!

    Welcome to the forum and congratulations on the new baby! I'm sorry that she has to spend time in the NICU and that her birth had to be such an urgent (and probably very scary) event. Are you healing okay? Is your health as it should be, considering what you just went through? Were there any complications with your birth (e.g. problems with the delivery of the placenta, high volume of maternal blood loss)?

    http://www.bfar.org/index.shtml is a website devoted to moms who are nursing after breast procedures. You may find some helpful information there regarding your specific surgery. I know that even in reduction surgeries where the nipple is left alone there is a good likelihood of disrupting or removing milk-producing tissue, leading to problems with supply. If too much tissue is gone, there may be nothing you can do to get a supply that meets your baby's needs 100%. You can, however, maximize the production in the tissue you have. Here are some things which may help:
    - Use the best possible pump. For most moms, that means a hospital-grade rental with correctly sized shields.
    - See a lactation consultant, preferably an IBCLC, for help.
    - Pump frequently. The more you pump, the more you'll signal your body to make. 8 pumping sessions per day is great! But if you can slip in a few more, that would be even better. Most newborns nurse at least 10-12 times a day for the first few weeks.
    - Try power pumping: pump for 10 minutes, rest for 10, pump for 10, rest for 10, and then pump once more for 10 minutes for a total of 30 minutes of pumping in a 60 minute period. This frequency mimics the way a baby feeds during a growth spurt and may therefore increase supply.
    - Consider using herbal galactogogues: oatmeal, fenugreek, blessed thistle. They generally don't hurt may help.
    - Consider using prescription galactogogues (Reglan or Domperidone). This is something you need to discuss with your doctor; both medications have additional side-effects and are not for all moms.
    - Choose your contraceptive carefully. Most moms are offered a choice of contraception at their 6 week postpartum visit, and few are told that all hormonal contraceptives, including the "safe for breastfeeding" methods like Mirena and the minipill, have the potential to negatively impact supply. While trying to build supply and get your baby to the breast, I would choose barrier methods (e.g. condoms, diaphragm, cervical cap). You can always switch to a hormonal method later!
    - If supplementing is necessary, supplement in a breastfeeding-friendly way, see: http://kellymom.com/bf/pumpingmoms/f...ottle-feeding/, http://kellymom.com/bf/pumpingmoms/f...ative-feeding/ (especially check out the section about supplementing at the breast!).

  3. #3
    Join Date
    Mar 2014
    Location
    Central FL
    Posts
    1,575

    Default Re: Trouble getting volume up, please help!

    I will also recommend the use of a Supplemental Nursing System or Lactaid for when you may need to supplement or if you find you have to supplement long term. Breastfeeding is about so much more than JUST MILK so being able to supply necessary supplements right at the breast can be wonderful if your baby latches well and you are able to deal with the tubes.

    I had low milk supply problems probably partially due to baby having a latch problem (tongue/lip ties) and I didn't respond well to pumping or fenugreek. I finally wound up using Domperidone and it has been very effective for me. I am small busted and never had any surgeries to deal with so do look for some support for your particular situation.

    To find an IBCLC http://www.ilca.org/i4a/pages/index.cfm?pageid=3901

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