Pumping only 9 ounces per day

[@llli*iveehill]

This is my first week back to work. I am away from my baby for approximately 8.5 hours per day. I have a hospital grade Madela Symphony pump. I pump 4 times per work day anywhere from 15 to 40 minutes. I am only able to get an average of 9 ounces per day.

I nurse her twice before work and all evening from 4:15 - 8:30 when she goes to be. She sleeps through the night until I wake her at 6:00. She has many wet diapers and about 2 poopy diapers a day.

I am taking fenugreek and blessed thistle, drinking nursing tea, eating protein, drinking plenty of water and massaging while I pump. I try to pump a few minutes after milk stops being expressed.

Is there anyway that 9 ounces could possibly be enough for her?

Is it possible that I will be able to pump more as the days go on?

Any advice will be very helpful.

[@llli*maddieb]

Hi iveehill. How old is baby? Have you had any issues with low production previously?

9 ounces might be enough. The rule of thumb is that a baby usually takes in about 1 ounce to 1.5 ounces per hour during a separation. Of course some take less and some more, but this is a good general estimate. So, for an 8.5 hour separation, that means intake of between 8 and about 12-13 total ounces per day.

But this average per hour number is based on normal nursing frequency, which would mean baby is nursing a few times overnight. If your baby regularly is not nursing for about a 10 hour stretch every night, I would be concerned that baby might need much more while you are at work. But how much of a shortfall there is would depend on how much baby is taking in when nursing, and that is hard to estimate. You could watch weight gain and behavior to see if baby is continuing to get enough milk.

I am curious if you pump overnight, and if not, do you feel full overnight? It might make sense to add in either nursing or pumping sessions overnight not only to either get more milk overall into baby without having to pump more, or to have more milk to leave for baby while you are at work, but also to protect your milk production going forward.

Yes, it is possible to increase pump output as time goes on. But you also have to be realistic. In fact your pump output is already within normal range. So it may well increase but probably not a huge amount. To increase overall milk expressed may mean more pump sessions- in fact many moms are not able to pump as much as baby needs over a work day, even when their production is normal. Since you are already pumping with high frequency at work, I do not think increasing pumping there is going to help. Some moms pump overnight, on weekends, in the mornings, on their commute, etc.

Pump- You are using a very good pump, but this does not mean it is the best pump for you. Make sure your pump is in perfect working order and that the flanges fit properly. If the pump checks out, you might want to try a different kind of pump.
Adding hand expression and/or breast compressions may increase pump output. Both are not what I would call massage, but may be what you are already doing.

Be very sure that your baby's caregivers know how to bottlefeed the breastfed baby and also how to safely milk handle so that not one precious drop is lost.

If you find you are unable to pump enough and your baby needs donor milk or formula, this does not have to mean that breastfeeding is over. You can continue to nurse your baby even if you are not able to pump enough milk for baby to have over separations.

www.kellymom.com has great articles on pumping and milk production.

[@llli*mommal]

I especially agree with MaddieB's point about overnight pumping. It's normal for babies to feed during the night- they usually need at least some calories overnight, and it helps maintain mom's milk production for the future. Your baby's sleeping habits are enviable- I know I would have loved to have a baby who slept at night!- but they probably aren't great for milk production. So if you can either nurse the baby or pump at night, I think you may have better output at the office.

[@llli*iveehill]

Hi iveehill. How old is baby? Have you had any issues with low production previously?

But this average per hour number is based on normal nursing frequency, which would mean baby is nursing a few times overnight. If your baby regularly is not nursing for about a 10 hour stretch every night, I would be concerned that baby might need much more while you are at work. But how much of a shortfall there is would depend on how much baby is taking in when nursing, and that is hard to estimate. You could watch weight gain and behavior to see if baby is continuing to get enough milk.

I am curious if you pump overnight, and if not, do you feel full overnight?

It might make sense to add in either nursing or pumping sessions overnight not only to either get more milk overall into baby without having to pump more, or to have more milk to leave for baby while you are at work, but also to protect your milk production going forward.



Yes, it is possible to increase pump output as time goes on. But you also have to be realistic. In fact your pump output is already within normal range. So it may well increase but probably not a huge amount. To increase overall milk expressed may mean more pump sessions- in fact many moms are not able to pump as much as baby needs over a work day, even when their production is normal. Since you are already pumping with high frequency at work, I do not think increasing pumping there is going to help. Some moms pump overnight, on weekends, in the mornings, on their commute, etc.

Be very sure that your baby's caregivers know how to bottlefeed the breastfed baby and also how to safely milk handle so that not one precious drop is lost.

If you find you are unable to pump enough and your baby needs donor milk or formula, this does not have to mean that breastfeeding is over. You can continue to nurse your baby even if you are not able to pump enough milk for baby to have over separations.

www.kellymom.com has great articles on pumping and milk production.

She is almost 14 weeks old but has been sleeping through the night since 8 weeks.

According to my caregivers, she seems to acting happy and seems satisfied. I'm not sure how this can be though, since, as you said, she sleeps so long at night.

I nurse at the following times on days that I work:

6:00 am - 40 minutes
7:25 am - 20 minutes
4:20 pm - 20 minutes
5:40 pm - 20 minutes
6:45 pm - 20 minutes
8:00 pm - 30 minutes

I basically try to breastfeed her constantly in the evenings.

Thankfully I just found out that I will only be working 4 days a week, so I'll at least have 3 full days of breastfeeding per week.

I do not pump over night. I do normally do not leak overnight anymore, but did last night. I began taking fenugreek and blessed thistle two days ago. This may be why. My breasts always feel full in the morning when I go to wake her at 6 for our first nursing of the day.

Do you think it would be better to nurse or pump? I have severe insomnia so I am very afraid to wake in the middle of the night if I am actually sleeping. Its so hard to know what to do.

I try to pump at 9:00 after she goes to bed at 8:30, but do not get anything unfortunately.

Thankfully her caregivers are great and understand the importance of the breast milk and paced bottle feeding.

I was hoping that I would have enough, but I'm realizing that this may not be possible, as heartbreaking as this is. I feel guilty enough going back to work, I thought at least I could do this for her

I really found the kellymom site helpful.

[@llli*mommal]

It may be that she is able to make up for lower or no intake during the workday and at night by nursing up a storm in the early morning and in the evenings. On average, breastfed babies nurse a minimum of 8x per day. You're nursing 6x per day and pumping, as well, so it seems quite possible to me that your baby has figured out how to get most of her needs met in a very limited amount of time. Very cool!

The question is, will this be sustainable going forward? It's very difficult to say, because we are all so individual when it comes to how our bodies will respond to a given regime of nursing and pumping. What we can say is that for most moms, nursing or pumping overnight is good for supply, and for some moms, it's vital for keeping daytime production sufficient to the baby's needs. What you do with this information is up to you. Insomnia is no joke, and if it is bad enough that waking at night to nurse or pump would really harm you, then you don't have to wake up at night. There is a risk to production associated with this, but for some moms that is going to be a worthwhile price to pay for decent sleep. Only you can decide what works best for you!

It's terrific that you're going to be working just 4 days a week. Cramming in as many nursing sessions as possible on your 3 days at home should be really helpful in maintaining production for the long haul.

[@llli*iveehill]

@mommal - I'm hoping that is the case, but I'm going to give bedsharing a try again this weekend and see how it goes. The few times I've tried it I have gotten little to no sleep, but that seems pretty par for the course anyway! At least this way she will get to eat during the night

If I do this, do you think that my pumping output may increase as well? If bedsharing isn't working, I may just wake her up around 1:00am to nurse and deal with the insomnia consequences.

Thanks for your response. I hope I can figure it out without having to supplement! I'm willing to try anything at this point.

[@llli*maddieb]

EDIT: I was writing while you and mommal posted, so sorry for any repetition...

I think whether to pump or to nurse at night is endlessly debatable. It just depends on what is going to work better in your situation. And that might differ night to night or change as baby ages.

Your baby is eating 6 times (plus a nice evening cluster) when with you, and I assume about 3 times when are at work? So that would amount to normal overall eating frequency, on the lower end of the spectrum but normal. If baby continues to gain fine on this amount of meals, then there is no need to nurse overnight. You COULD, it would not hurt anything and it would help your overall milk production, but pumping instead is a reasonable alternative given the situation as it is right now.

One thing you should know is that babies who sleep long hours early on will often stop doing so after about 4-5 months. It is a myth that infants who sleep long stretches early on will continue to do so. Some might, many do not. So, you may find you have a more frequently waking at night baby in a few weeks or months anyway, and will have to figure out how to deal with that while getting enough sleep.

As far as finding time to pump or nurse when you have sleep issues, I would suggest pumping or nursing as a last thing you do before you go to bed, assuming you are not going to bed at 9.

If you are and you do have to wake up overnight, then you can try to minimize how long you are up and how disruptive that waking is with several tips:

Assuming you are not bedsharing with baby, if nursing, have someone bring baby to you, nurse sidelying in bed, and have that person take baby back to where baby sleeps when you are done. Of course you could also explore bedsharing for all or part of the night as this can be very helpful for overall sleep.

Another trick that tends to be less disruptive to sleep patterns is to drink a large glass of water just before going to sleep. This way you are waking naturally due to a full bladder, and have to get up anyway to take care of that. If pumping, have your pump already set up somewhere where you can see well enough with a dim light (bright lights are more disruptive for sleep.) After pumping ,you can even just leave the whole set up until morning including your milk in a sealed bottle or bag. Freshly expressed milk is fine at room temp for 8 hours and pump parts can be washed in the morning. If you wish, put them in a bowl of soapy water that you also have set up but I doubt that is needed. If you are afraid of bugs or something, seal pump parts in a large ziplock until morning. The idea is to shave off as much movement and time as possible so that you can almost 'pump in your sleep."

Even if it turns out you cannot provide "enough" of your expressed milk for your baby for when you are at work, you can certainly continue to nurse baby and provide as much expressed milk as you can! How long a baby is nursed is just as important as how much overall milk baby gets...if that makes sense. My point is everything about breastfeeding is good for babies, and if your milk cannot be 100 percent of your baby's nutrition, that does not in any way negate that goodness. Try to not become disheartened over having to give your baby a little formula (should it come to that) when you have been and are doing so much for your baby! If you are determined to avoid formula, you can explore the idea that early solids might make sense instead. Jack Newman writes about this.

[@llli*mommal]

For many moms, bed-sharing and night-nursing do lead to increased pump output at the office. It might take a while to see a noticeable effect, but if you are willing to deal with interrupted sleep, it is worth a try. Think of it as an experiment, that will hopefully work out for you.

Are you practicing good sleep hygeine? No phones, tablets, or blue lights at night? Keeping the clock turned to the wall? Doing deep breathing when you wake and can't get back to sleep? (I know those are novice approaches to insomnia, but I figure it can't hurt to mention them.)

[@llli*iveehill]

Thanks everyone! All of your responses are so helpful. I've been waiting for her uninterrupted sleep to change around the 4-5 month mark, so I'm prepared for that.

@maddieb - I do go to bed at 9! I lay her down and get my things ready for the next morning and jump into bed and read for a bit then try to fall asleep. It seems as though I can only sleep for some period between the hours of 9pm to 2am, whether it be 2 hours or for 5 hours (rare). Once I wake up at 2:00am my sleep is done for! Those tips about minimizing up time when waking are very good. I will try them. My husband is out of town for 3 nights a week (also a source of much anxiety for me), but the others he is very helpful.

Thank you for your words of encouragement. I will keep nursing and pumping even if I have to supplement with formula (although I know I'll cry alot!).

@mommal - I've tried evvvvery sleep technique I've heard about. I think I'm dealing with some postpartum depression manifesting itself in the form of anxiety. I have a doctor's appointment on Monday to see if I can get that worked out. Maybe then sleep won't be such an issue.

Thanks again everyone. I'll keep experimenting and trying to figure this out

[@llli*iveehill]

Ps. I got 10.75 ounces today! That's an improvement