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Thread: Trouble with Pumping- Tried Everything- HELP

  1. #1

    Default Trouble with Pumping- Tried Everything- HELP

    I need some help to identify the problem I am having with pumping.

    My LO is 4 months and I returned to work 1 month ago. I am pumping 4 times a day and averaging 14 ounces. It is extremely hard work to get these 14 ounces. I pump for 30-40 minutes to get 4.5 ounces. I try double pumping/single pumping, hand expressing, positioning the shield etc.I have replaced all parts and tried different shield sizes, nothing seems to make a difference. (I am pumping with a new Medela Pump in Style. I have made sure all parts and components are in working order, but suction doesn't feel that great. I mean it gets the job done but I use it on the highest setting and barely feel it).

    I look at photos of baby while I pump, I try de-stressing techniques etc. I'm eating oatmeal and lactation cookies and chugging water etc. I tried Fungreek (mothers milk tea) and it actually worked great but gave LO horrible gas.

    I'm not sure if I have a pumping issue or a supply issue. I lean towards a pumping issue because I have to work so hard to get the milk out and my last 2 ounces or so usually come from hand expression techniques used in tandem with the pump. However, I am considering supply problems because my LO is nursing much longer and far more frequently. He is nursing every 90 min- 2 hours for 45 minutes each time.

    I need help because I cant live like this. Its affecting my job spending this much time and attention pumping. When I'm home I feel like I have no time to do anything with is causing stress and anxiety. I also cant ever leave because I have no milk in reserves. I made the decision to supplement with formula two days ago. I fed him 4 ounces and he was happy and did not need to eat again for another 4 hours.

    I would love to exclusively BF if I could find a pumping or a supply solution.

    *** Please do not tell me to change the flanges... I know haha. I have asked for help on other blogs and this is the only thing anyone ever says....it feels some what patronizing*****

  2. #2
    Join Date
    Oct 2009
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    Default Re: Trouble with Pumping- Tried Everything- HELP

    Across how many hours are those 4 pump sessions ? How many hrs are you separated and how much is he drinking while you are apart?

  3. #3

    Default Re: Trouble with Pumping- Tried Everything- HELP

    2.5-3 hours in between. 1st session is only one side first thing in the am while he is nursing. next 3 sessions are at work with no nursing in-between. The last one of these 3 is at 4-4:30 ish then he gets nursed around 5:30-6 ish.

  4. #4

    Default Re: Trouble with Pumping- Tried Everything- HELP

    It may help to add that I'm not sure if I have let down. I've never felt what I have heard others describe as Let down.

  5. #5
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    Default Re: Trouble with Pumping- Tried Everything- HELP

    It may help to add that I'm not sure if I have let down. I've never felt what I have heard others describe as Let down.
    Let down is scientifically called the milk ejection reflex. This makes it sound like the milk must "eject" - That word makes me picture spraying. But all it means is that stimulation has caused milk to be released through the ducts and out the nipple. So if milk is coming out of your breasts, you have had a letdown. Letdown sensation is not something all moms feel, and how much a mom might feel it will vary tremendously. Some moms never feel anything, some feel something with some babies and not others, and some feel something sometimes but not all the time. And many moms who felt a letdown early on would no longer feel anything by 4 months. All normal.

    An average of 14 ounces over 4 pump sessions - 3 ounces or so per pump session- is in the range of normal pump output. Your baby may be eating more than that during your separations, but there is nothing inherently problematic with pumping that amount- it does not indicate low milk production, in other words, or even a pumping output problem, necessarily.

    I have a few more questions that may help us help you figure this out.

    How long are you and baby separated each work day?
    About how many times total does baby nurse when you are together each 24 hour period that you also work?
    About how many times does baby nurse each 24 hour period that you are not working or separated?
    How many ounces total is baby being given in bottles each work day, over how many feedings?
    Is your baby gaining slowly or has baby every gained slowly- or, for any reason, did baby ever get supplements previously? Please note gain rate normally slows after 3-4 months of age and continues to gradually slow.

    I'm eating oatmeal and lactation cookies and chugging water etc. I tried Fungreek (mothers milk tea) and it actually worked great but gave LO horrible gas.
    There are many other types of galactagogues. Since you responded well to the fenugreek I think it makes sense to try another one. I would suggest do some research in this area and try supplements in capsule form from a reliable company. Teas and lactation cookies do help some moms, but I personally think it must be hard to ingest enough galactagogues in those forms to get enough dosage to make a difference. I would also suggest maybe trying fenugreek again (in a capsule) and see if it still causes any issues with baby.
    Being normally hydrated is necessary for good milk production. But over hydrating has not been shown to be helpful. In other words, if you feel like you may be over hydrating, you can try reducing water intake a little and see if it makes a difference.

    However, I am considering supply problems because my LO is nursing much longer and far more frequently. He is nursing every 90 min- 2 hours for 45 minutes each time.
    This can be a normal nursing pattern. Babies often nurse more as 4 month olds than they did before, and also many moms notice an uptick in nursing frequency/duration after they return to work.

    I fed him 4 ounces and he was happy and did not need to eat again for another 4 hours.
    How long a baby sleeps is not usually an accurate indicator that supplements were needed.

    If it turns out you cannot pump enough milk for your caregivers to give to baby while you are at work, then formula to offset that may be a good option. Also of course if you really cannot make enough milk for your baby, then supplements will be needed.
    But the problem with giving supplements when they are not needed is that doing so is very likely to act to decrease milk production over time. Milk production depends on frequent and effective milk removal. If baby is not doing this because baby got a bottle (so did not nurse) and then slept much longer than normal (so did not nurse again) then mom has to pump or hand express to make up for that, or else over time her milk production will decrease. If it is true that your body is not responding well to pumping, then that would make this situation even more problematic for you, potentially.

    *** Please do not tell me to change the flanges... I know haha. I have asked for help on other blogs and this is the only thing anyone ever says....it feels some what patronizing*****
    Since you said you already tried different size flanges, I will not tell you to do this! But in fact the flange not fitting is a common cause of poor milk removal, and it is remarkable how much it can harm the pumps performance. So it is something that is legitimately mentioned as a trouble shooting tip. Another thing mentioned a lot is to change the membranes- again, sounds ridiculously simple but something as simple as a worn or torn membrane will destroy pump performance.

    The sad fact is pumps are at best an imperfect substitute for nursing. Yes it is always important to make sure your pump is the best one for YOU and is in perfect working condition- the whole pump, motor and all, and not just the flanges. But even if the pump you are using is working perfectly, frustratingly, some moms just do not respond all that well to the pump.

    Kellymom has several excellent articles on increasing milk production and pump output. The book Making More Milk is also very informative.

  6. #6

    Default Re: Trouble with Pumping- Tried Everything- HELP

    Thank you so much for all of the time you put in responding.

    From what I read I agree my output while pumping seems normal. My concern is that it is so labored to achieve this. I have to pump on average for 45 minutes and I need to use massaging techniques virtually the entire time. My pump alone will not express more than an ounce per breast. Obviously, this is not an ideal scenario while working.

    We are separated about 9 hours Monday through Friday.

    I don't have an exact number of how many times he nurses when we are together for a full 24 hours as I nurse him on demand. But I would say he eats about every 2 hours for 20 min per feeding. Much better then when I feed him in the evenings after being gone all day. After being separated he will eat every 90 min averaging 40 min per feeding. He goes to bed at 9 and sometimes will sleep through to 7:30 when I wake him but most times he wakes between 3-4 and nurses for about 20 min. We are blessed with a good sleeper. Before we are separated I nurse him one time in the am after he wakes up. So total when we are seperated he nurses 5 times in a 24 hour period.


    A daycare it ranges how much he won't eat . Sometimes he eats 3 4ounce bottles and sometimes he napped through a feeding and then eats 9 ounces. But he eats a total of 12 ounces at day care. Last feeding is normally at 4:30 and regardless of the amount he eats he is always ready to nurse as soon as he sees me at 5:30.


    I will try the capusels, thank you for the suggestion.

    I change my membranes every two weeks.


    If I could find a way to better efficiently pump where it wasn't affecting my work I think I would be feeling much more confident about this.


    Thanks again!
    Last edited by @llli*lisamk; November 19th, 2016 at 09:05 AM. Reason: Forgot something

  7. #7
    Join Date
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    Default Re: Trouble with Pumping- Tried Everything- HELP

    Ugh that pumping routine does sound very difficult. You are right, it is not 'normal' for pumping to be so hard- but again, this is something that happens. Pumps remove milk from the breasts in a way entirely different than baby does. This is why so many moms struggle to pump enough milk and also face low milk production after returning to work.

    Baby's intake when at daycare sounds normal, so overfeeding baby is not the problem.

    If you are sure your pump is working correctly, another idea that works for some moms is increasing milk production even beyond "enough" seems to help with pump output. So again, you could look at galactagogues. But the most effective way to increase or maintain milk production is with frequent nursing.

    I would suggest consider encouraging baby to nurse more overnight. Either that, or pump or hand express overnight, but nursing is probably better. More than ~6 hours without nursing (or pumping) as a regular thing is probably going to start to impact milk production. Baby sleeping longer hours overnight without nursing will also tend to cause mom's fertility to return sooner rather than later, and while that is usually fine, some moms find that they experience a dip in production around their period or ovulation. Many working moms find that overnight nursing helps their milk production.

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