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Thread: "Re-lactating" with a 1mo old

  1. #1
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    Default "Re-lactating" with a 1mo old

    Hello!!! I think I mostly came on here to get a little bit of support and to see if anyone else has experienced something similar.

    Following delivery, there were a number of issues that created a domino effect that led to (formula) supplementation and for my milk supply to be delayed. Due to this fact, the supplementation continued and got to the point where now I am barely producing any milk and my son's main source of nutrition is formula.

    Over the last 2-3 days I saw a lactation consultant (actually spoke to two) who advised me to start pumping every three hours, along with nursing my son when it was productive. Thankfully, I've been successful in doing this but see that I am pumping no more than 1 oz... and this is during the periods where my son has not nursed ahead of pumping. As an FYI, I am also taking fenugreek tablets, drinking "Mother's Milk" Tea, and taking Maylunga supplements.

    I am feeling so discouraged. Obviously this is hard, but I will do whatever it takes if it means that I can get to breastfeeding exclusively. However, I am worried that I am putting in all of this work... and that this goal will always be elusive.

    He is my third baby. I was able to nurse to 2 yrs with #1 and 8 mo with #2. I am at a point with this where I am slowly unraveling... Anyone else have success "re-lactating like this?"

  2. #2
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    Default Re: "Re-lactating" with a 1mo old

    I think you are expecting results much too quickly. Look at it this way. All throughout your pregnancy your body was preparing to make milk. When your baby was born, your body started making milk. But then, milk was not removed from the breasts often enough, and this told your body to STOP making milk, so it did. Biologically, your body was told there was no baby to nurse. Milk production takes energy and suppresses fertility, and biologically we are designed to propagate the species. So biologically-speaking, your body was doing exactly what makes sense- saving the energy for your survival and to speed the time with which you could conceive again.

    Now you are telling your body that there IS a baby and to make milk again. It is going to take time for your body to get this message! Have patience.

    Exclusive nursing can be your goal if you choose. But remember there are mothers who never produce enough milk for their babies and still nurse. There are even mothers who make no milk and nurse. There are mothers whose babies cannot nurse but who give their baby what milk they can express, and every variation you can imagine. These are all breastfeeding mothers and they gain great benefit from doing what they can, even if it is not 'exclusive' breastfeeding. Your goal need not be only the one possibility, is my point. Or there can be an assortment of goals. Personally I think daily goals that you have some realistic control over make more sense (today I will pump one more time than yesterday, today I will encourage baby to nurse one more time than yesterday, today I will pump 10 times...etc.)

    In your specific case, on paper at least, without knowing more about the situation or if there was some specific reason aside from poor breastfeeding management as to why lactogenesis was delayed, you are in a very good - I would even say remarkably good- position to be able to re-lactate to the point of exclusive breastfeeding. Your baby is young. Your baby is nursing. You breastfed two previous children. Of course there are no guarantees, but this all sounds very good.

    I would suggest the book Making More Milk. It will give you lots of tips for handling all that pumping as well as a myriad of ideas for approaching low milk production and mother's stories.

    What kind of pump are you using? It should be the best you can afford, a rented hospital grade the typical recommendation. Many moms find that adding hand expressing to the pump session help.

    Also, keep your expectations of pump output realistic. one ounce is the size of a normal feeding for a one month old. (less than an ounce to about 3 ounces would be normal) And pumps often do not extract as well as a well nursing baby.

    Also be sure baby is being supplemented appropriately. If a baby who is being overfed with bottles or fed incorrectly that is going to eventually lead to issues keeping baby nursing normally.

    Did you actually see a lactation consultant or was this all on the phone? Also, did anyone suggest a lactation aid (at the breast supplementer?) See this: http://cwgenna.com/smartnothard.html
    Last edited by @llli*maddieb; September 4th, 2015 at 10:41 AM.

  3. #3
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    Default Re: "Re-lactating" with a 1mo old

    Quote Originally Posted by @llli*maddieb View Post

    Also, keep your expectations of pump output realistic. one ounce is the size of a normal feeding for a one month old. (less than an ounce to about 3 ounces would be normal) And pumps often do not extract as well as a well nursing baby.

    Also be sure baby is being supplemented appropriately. If a baby who is being overfed with bottles or fed incorrectly that is going to eventually lead to issues keeping baby nursing normally.

    Did you actually see a lactation consultant or was this all on the phone? Also, did anyone suggest a lactation aid (at the breast supplementer?) See this: http://cwgenna.com/smartnothard.html
    Thank you for all of your advice! I think you're right about expecting results much too quickly. But obviously it is heart-breaking to think that I may never get to the point where I am able to nurse exclusively (which is my goal).

    I am pumping nearly an oz. after a feeding (combined), and have pumped up to an 1.5 oz after an extended period (3 hours) of no nursing. Unfortunately my 4 week old (who was nearly 11 lbs at birth) is up to 3 oz. of formula each feeding, so I am not even close to making what he needs.

    Do you think I can get to a point where my pumping will yield as much as he will need per a feeding? I am pumping 15 min every three hours... how will this create more volume if I am doing the same around the clock?

    I am planning on seeing a consultant in person by the end of the week of pumping. I was told that it may not be productive to see her in person if I have no volume (as my son becomes very sleeping and unexcited after about 4 min of nursing).

  4. #4
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    Default Re: "Re-lactating" with a 1mo old

    Unfortunately my 4 week old (who was nearly 11 lbs at birth) is up to 3 oz. of formula each feeding, so I am not even close to making what he needs.
    How many times a day is baby fed, and how is baby's weight gain, and how is baby fed (what method?)

    I think there are a possibly a couple misconceptions operating here you will want to look at. First, consider if possibly baby is getting more milk than baby needs with bottles (or however baby is being supplemented.)
    1) Size of the infant, either birth weight or subsequent later weight, has nothing to do with how much milk the baby needs either daily nor per meal. One can tell a baby is getting enough to eat if baby is gaining an AVERAGE of about one ounce a day (6-8 ounces per week) starting at about one week post birth. In other words, if your baby has gained on average more than an ounce a day in the last 3 weeks, you might want to look at whether baby is possibly being over fed.
    2) What a baby "takes" from a bottle has little to do with what the infant actually needs or would "take" if baby was nursing. The younger the baby is, the easier it is to over feed the baby inadvertently.
    3) pump output is a very poor measure of milk production, for many reasons. It is my understanding your baby is nursing as well as getting bottles. So some unknown amount of milk is going straight into baby. Also, pumps simply do not work the way a baby 'works' and often mothers even with entirely normal milk production do not get much milk when pumping for any number of reasons. This is why, when a mom is relactating, or increasing her milk production in order to be able to wean baby off supplements, she need not pump the exact same as her baby 'takes' in a bottle in order for the relactation to lead to 'exclusive' breastfeeding, and certainly she need not pump per pump session exactly what baby is eating every time baby gets a bottle.

    Rather, in order to get to exclusive breastfeeding, she needs to make enough milk for her baby to get enough milk overall for that baby via baby nursing with normal frequency- and that is usually more often than baby was getting a bottle. So this is very different. Pumps are not babies and breasts are not bottles. To put it another way, you could take many mothers who are exclusively nursing their one month olds and the babies are doing just fine. If the moms are told they must stop nursing immediately and instead pump, and the baby be given bottles of what they pump, many of them would find they are not able to pump anywhere near what their babies will 'take' in bottles, and in fact some will find they cannot pump even what their babies actually need.

    Do you think I can get to a point where my pumping will yield as much as he will need per a feeding?
    I have no idea, but again this is a different question than whether you will be able to exclusively nurse. But of course I have no idea about that either. As I said, on paper, based on the history you have given and your baby's young age, the fact baby is nursing at all, the fact you are producing some milk when you pump, and the apparent reason behind the poor milk production, you look like very good candidate for a positive result in your efforts to relactate. Unfortunately that's the best I can give you.

    I am pumping 15 min every three hours... how will this create more volume if I am doing the same around the clock?
    Because the body is told to make milk by the breasts having milk taken out of them, and the more effectively AND THE MORE FREQUENTLY the milk is taken out of the breasts the better one is communicating to the body that milk is needed. How much milk comes out of the breasts each time does not indicate in any way how well you are doing the job of telling your body to make more milk.

    As an example, take two moms who are both pumping, and pretend we can actually tell how much milk they have in the breasts at the moment they pump. One has one ounce in her breasts and pumps it all out, in fact pumps for a few minutes beyond the point any milk is coming out. The other moms has four ounces in her breasts but pumps until she has produced 3 ounces and stops pumping. It would appear, based on output, that the mom who pumped three ounces is "doing better." But in fact, the mom who pumped one ounce is actually communicating most effectively to her body the need to make more milk.
    Frequency of pumping is even more important in this communication with the body. A mom who is pumping on average every two hours but only getting a half ounce each time is MUCH more successfully communicating to her body to make more milk than the mom who "waits" for 4 hours to elapse between pump sessions so she can pump 2-3 ounces each time.

    Also there is no need to pump every such and such hours. A baby would not normally nurse every such and such hours, you can expect a newborn to nurse about 10 or more times per 24 hours, but not on a set such and such hours pattern. When a mom is pumping to bring in a milk production, she is attempting to (as well as possible) replicate what her baby would be doing at the breast. This is why, these days it is usually suggested to set a daily goal and pump as often as possible in an attempt to reach that goal. The goal can be any amount, but 8 times per 24 hours is typically considered the minimum to shoot for.

    Now you may personally prefer to pump on a schedule and that is fine. But it is not necessary. Many moms find they can actually pump more often overall if they do not try to follow a set schedule. In other words, do what works for you in order to pump overall the most times each day, and not in order to pump the most milk out each time you pump.

    As far as how long to pump, that can vary as well depending on what you can do at the moment. 15 to 20 minutes per side is the general recommendation as a starting point, but if you find you have a bit more time and want to pump longer, no reason not to, after all babies often nurse much longer than 15 or 20 minutes per side. (Of course, be careful pumping remains comfortable- generally it is suggested moms not pump longer than 30 minutes per side.) Conversely, if you have a spare 5 minutes and the pump is right there, this is a great opportunity to add in one more quick pump session that day.

    Especially given that your primary issue is low milk production, and not a concern over baby's ability to transfer milk (unless that is indeed part of the issue as well) I am not sure why it would be unproductive to see an LC sooner rather than later, but if the LC told you she wanted you to try pumping for a week first, then I guess there is no harm. Yes of course it would be nice to have baby nurse well at the session, but you want her to see the reality of how baby is nursing, and if the reality baby is sleepy and unexcited after 4 minutes then that is going to be information she can use to advise you and help you come up with a personal specific plan of action. Also, when entering into care with an IBCLC, I would strongly suggest look at is as an ongoing relationship with follow up and not as a one-off, single appointment situation. While many times there is no need for a follow up in person appointment, sometimes there is, and certainly I would say that usually a mom will have questions and concerns that occur after the appointment and it is very important that you are able to communicate with your LC as needed after your consult.

    Here is info about consulting with an IBCLC you may find helpful: http://cwgenna.com/lconsult.html
    Last edited by @llli*maddieb; September 5th, 2015 at 06:10 PM.

  5. #5
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    Default Re: "Re-lactating" with a 1mo old

    Thank you so much for your response. It got me through the next few days. I'm now on about day 7-8 and seem to be on a little slump / plateau. I am hoping that continued effort will help push me forward with my supply.

    I have been reading some information on several websites regarding relactating and I have a question that has been nagging at me for the next few days now. I am attempting to pump 8 times a day. I am trying to be flexible, but it helps me to think of it as "every 3 hours". However, sometimes the pumping comes right before a feeding and I know that the baby will not suck at the breast for long if he is awake (as obviously there is little reward). My question is... is it better to put off pumping and allow baby to be on the breast as long as possible? In other words, should I have baby on the breast over a pumping session?

    One of the lactation consultants advised me to limit the time the baby is on the breast if it looks like he is not being productive. And to pump even while the baby did not nurse for the feeding. What are your thoughts on this?

    Also, I am supplementing every feeding as I see that the baby is not satiated after a feeding. However, if I see that (for example) at night he is able to go an hour on my breastmilk alone in between feedings, should I continue this way and not pump? Or should I go ahead and feed him, supplement, and pump?

    Thank you!!!

  6. #6
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    Default Re: "Re-lactating" with a 1mo old

    Have you seen a board certified lactation consultant yet?
    One of the lactation consultants advised me
    When moms say that an LC said this that or the other, it helps me to know who this was exactly (LLL Leader, Nurse/LC at a hospital, an IBCLC you saw for a private consult, etc.) When it was said, (Day baby was born, two weeks ago, this morning, etc) and if it was said during an in person consult, at a support meeting as a general comment, or on the phone, etc.

    So,
    One of the lactation consultants advised me to limit the time the baby is on the breast if it looks like he is not being productive.
    Was it explained to you what "non-productive means? How to tell whether it "looks like baby is being productive?" Do you know WHY this was suggested to you? (To make time for you to pump, to make time for you to sleep, or because nursing when it looks "non-productive" is somehow bad for the baby? Etc.)
    I am being picky because IN GENERAL this is an instruction I have a problem with. And I have a problem with it because so-called "non-productive" nursing is an entirely normal and expected part of normal nursing behavior. And there is no evidence it is in any way harmful to any baby who is gaining normally.
    Does not mean it is never a good idea to limit time at the breast when there is a low supply issue and mom is pumping? No, I think sometimes, in some cases, it is a good idea, usually simply from a time management/moms exhaustion perspective. But mom needs to understand WHY she is doing this, or how else can she understand when to let baby nurse away and when it might be a good idea to stop nursing so she can pump?

    Look at it this way. Women have probably "re-lactated" or induced lactation and increased their milk production for some reason or another for all of human history, long before there were pumps. They did it by encouraging the baby to nurse, A LOT. So the idea that it is never a good idea to let a baby nurse in a "non=productive" way in such a scenario never made sense to me.

    And to pump even while the baby did not nurse for the feeding. What are your thoughts on this?
    Milk production increases because you tell the body to make more milk. You tell the body to make more milk by taking milk out of the breasts frequently, and trying to not leave much milk IN the breasts for long. So when a mom is trying to increase milk production, what must occur is frequent and effective milk removal.
    What does this mean in practice? It means milk must be taken from the breasts a minimum of 8-12 times in 24 hours, either by baby, hand expression, or pumping.
    It means that if baby is not able to nurse very efficiently, pumping right after nursing makes sense, to be sure as much milk as possible has been extracted so the 'empty' breast tells the body to make more milk. Does this mean a mom has to pump IMMEDIATELY after every nursing session? No, but she will want to pump after as many nursing sessions as she can, as close to the nursing session as possible.
    It also means that if baby is not nursing at least 8-12 times per day, mom should also pump between the nursing sessions. Does this mean sometimes mom pumps right before baby cues to nurse? Probably. But this is not the end of the world, because in that case, you have basically reversed what you did by pumping shortly after nursing, so from a milk production increasing standpoint it is fine if this happens. Might baby not get as much if they nurse right after mom pumps and need a bit more supplement in that case? Probably, but that is not the end of the world. Yes, due to the possibility of frustrating baby and needing to give baby more supplement than otherwise, you probably want to avoid this happening as much as possible, but if it happens, it will not harm the over all goal of increasing your milk production. Again, what must occur in order to increase ,ilk production is frequent and effective milk removal. How exactly this happens will depend on what approach is working best for that mom and baby pair that day.

    Also, I am supplementing every feeding as I see that the baby is not satiated after a feeding. However, if I see that (for example) at night he is able to go an hour on my breastmilk alone in between feedings, should I continue this way and not pump? Or should I go ahead and feed him, supplement, and pump?
    First, (ideally) baby should be supplemented the amount per day of supplement baby requires to gain, and not based on a guess of whether baby is satiated or not. How are you deciding whether the baby is "satiated' ?
    But more to your question, there is no need to supplement every time you pump! Again, you are pumping to build your milk production, and basically that means, the more often you pump, the better. But as long as baby is getting enough supplement to gain well overall, then any time you can avoid supplementing is probably a good thing, as not getting a supplement every nursing session will act to encourage baby to nurse more often and "better."
    So in the case you describe, as long as baby is gaining ok, I would suggest do not supplement at that time but go ahead and pump if you can. If you need sleep more, then a feeding where baby takes no supplement is a good time to just nurse.
    Last edited by @llli*maddieb; September 10th, 2015 at 06:18 PM.

  7. #7
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    Default Re: "Re-lactating" with a 1mo old

    Hello! Just checking in here. It looks like my supply is not building enough volume. I have given it my all, and while I am going to continue to nurse/pump/supplement for at least a few days until a follow up appointment... I know whats coming.

    My question here is: Is there anything I can do, short of pumping every 3 hours to continue my supply? I guess "drying out" is an inevitability, but will I at least keep some of my milk if I continue to nurse him ahead of his supplement?

    Thank you as always for your help!!!

  8. #8
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    Default Re: "Re-lactating" with a 1mo old

    Have you seen a board certified lactation consultant yet? (IBCLC) On what are you basing the belief that your milk production is not increasing in volume?

    The only thing that increases milk production is frequent and effective milk removal from the breasts, which I explained in detail above does not necessarily mean pump every three hours. This can mean pumping, or hand expression, or baby nursing, or some combination, and it can be in a pattern that is different than every three hours. But it has to be frequent, and it has to be effective. Additionally, some moms take galactagogues to help, these are foods, herbs, and even medications that are often (but not always) helpful. But what galactagogue to try in what dose depends in part on why a mother has low milk production. Additionally, some moms have underlying conditions that impede milk production and treatment of that issue is required so mom can make more milk. This is something a good lactation consultant should be able to help you figure out, or you could talk to your doctor about getting hormonal tests, thyroid tests, being looked at to rule out retained placenta, etc.

    You can go to the website kellymom.com for more info on increasing milk production inclusing some info on galactagogues. The book Making More Milk is another excellent resource on low milk production issues. You could also ask your doctor about prescribing medication that increase milk production.

  9. #9
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    Default Re: "Re-lactating" with a 1mo old

    [QUOTE=@llli*maddieb;1358922]Have you seen a board certified lactation consultant yet? (IBCLC)

    Yes, I have seen both an MD / certified lactation consultant, and a lactation consultant found through the LLL website. Both saw a questionable tongue tie, but baby was able to extract milk pretty efficiently (we did a weigh in).

    My milk supply IS increasing... albeit very, very gradually. Initially, my goal was to get to a point where I would be able to breastfeed exclusively. However, It is now about 17 days into the project and I have only just once or twice been able to produce enough to satisfy him. I know this based on the fact that he will continue to cry and root for more... Only at night (when he seems to eat less and when I am producing more milk) have we been able to nurse without supplement for any period of time.

    When I began pumping I was able to make up to nearly 2 oz every three hours. Now It is consistently about 2 oz every three hours and up to 2.5.

    I was ready to call the pumping project quits today, but during a 10am pumping session I was able to extract 3oz (This is the most I have ever objectively produced, with the exception of one pumping session in the middle of the night that I was able to get 3.5 oz from)! Then at 1pm it was back to only 2oz of milk. I pumped for two sessions today without bringing baby to the breast to get a feel for how much milk I am making.

    I understand that pumping does not always extract all of your milk, but again... I have not been able to produce enough milk for a full feed.

    SO now I am questioning whether I should adjust my goals: should I now just try to "keep up" my milk supply for as long as possible? I do not see pumping the way I am (8 times a day, including during the night) as a sustainable thing for me.

    Any advice?

  10. #10
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    Default Re: "Re-lactating" with a 1mo old

    I should mention that the baby is now 6 weeks old and weighs 12 lbs.

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