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Thread: Increasing Supply After Gastric Bypass - Exclusive Pumping

  1. #1

    Default Increasing Supply After Gastric Bypass - Exclusive Pumping

    My baby was born at 37+6, IUGR and classified as a preemie for size after having Hyperemesis Gravidarum my whole pregnancy. She dropped too much weight after discharge while EBFing and her pediatrician put her on NeoSure until weight picks back up. She is one week old and I started pumping three days ago. I only seem to be getting an ounce to an ounce and a half after each pumping session. I am averaging one session every 3-4 hours. My vitamin regimen is back in place and I am drinking a lot, and eating every 2-3 hours. I am 4 years out from my bypass and this is my second baby since. My first baby, I wasn't successful pumping or EBFing or even supplementing. I had her a year and 9 months after surgery, so I feel that my body may have been adjusting still.

    I know about fenugreek and the mothers milk tea and will start fenugreek tonight. What else can I do? Or, is this par for the gastric bypass course? Pediatrician told me my milk was good, just not enough for now and encouraged me to keep going.

  2. #2
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    Default Re: Increasing Supply After Gastric Bypass - Exclusive Pumpi

    Hi! a 1 week old baby would usually eat about 1-2 ounces at a time at the breast. So that per session output is not bad at all for so early.

    Are you using a hospital grade rental pump or something else? Have you tried adding hand expression or compressions to pumping? Especially in early days hand expression can be very helpful and even work better than the pump. It is also important your pump fits properly.

    Can you pump more often? A one week old baby would typically be nursing about 10-12 times or more in 24 hours. If you can possibly pump 8-10 times a day, that would be ideal. It does not have to be every such and such hours. In other words, you can pump more often part of the day so you can get a few hours consecutive sleep and still pump often enough overall.

    Also are you taking B12? Breastfeeding babies whose moms have had gastric bypass may be lacking in B12. I forget if that means mom should take B12 or if baby needs it too. It is the same recommendation as with vegan moms. But I am not aware of any reason a mom post gastric bypass would not make enough milk generally speaking. I suggest the book Making More Milk as an excellent resource for any mom facing milk production issues.

    Fenugreek (like any medicinal herb) is contraindicated in some cases, but there are many other herbs that act as galactagogues. But I would suggest read up on possible side effects of any medicinal herb.

    Is it you choice to EP or are you interested in also nursing at the breast?
    Last edited by @llli*maddieb; January 1st, 2017 at 10:53 PM.

  3. #3

    Default Re: Increasing Supply After Gastric Bypass - Exclusive Pumpi

    Thank you for responding!

    She actually has a rockstar latch, but until she gains a bit more, the pediatrician asked me to go exclusively on the bottle or only one feed a day. I have the Medela PISA and also have the correct size breastshield. I can pump more often, I feel it will be working it into the schedule that is challenging, as I also have a 2 year old. I am taking a full vitamin regimen with prenatals, calcium, iron, b12 and d3.

    I have considered fenugreek and lactation cookies, and will probably try them this week.

    My hubby let me sleep last night so I went 12 hours between pumping sessions and still only yielded 2oz. I am upping my fluids, I just really want to make sure I put in all the reasonable effort possible this time, especially since she is my last.

  4. #4
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    Default Re: Increasing Supply After Gastric Bypass - Exclusive Pumpi

    You are not pumping enough. An exclusively breastfed baby eat 8-12 times in 24hour period. So your child would be at your breast every hour or two while awake. It's all supply and demand and your supply is not yet regulated. So if you are only sending a message to your body to make milk every 3-4hours, your body will never catch up to the demand the baby would actually be making. At the very LEAST you should be pumping as often as she eats. And even that is skewed because formula takes longer to digest than breastmilk. But you should try to work in at least 8 pumping sessions right away. Like tomorrow. And keep at it and don't give up or become discouraged when those extra pumping session don't yield much at 1st. It's all supply and demand. And you haven't been asking your body to make much. So it will take a few days to a week for your body to get the message that it needs to make more milk. But it has to get those stimulation ques to begin with or it won't happen. All the extra fluids and vitamins in the world will make no difference if your breasts don't get the stimulation to make more milk at more times during the day.
    As Maddie said the amount yielded at your sessions is right on target with what the baby would actually be eating. So the issue is that you need to make the milk as often as she would actually be requesting it. The only way to make that happen is to pump to mimic actual new born feeding.

    Way too lazy for formula

  5. #5
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    Default Re: Increasing Supply After Gastric Bypass - Exclusive Pumpi

    the pediatrician asked me to go exclusively on the bottle or only one feed a day.
    Why? How do you feel about this? This is unfortunately likely to lead to breast refusal, and is not doing your milk production any favors either. It should not be necessary. Babies can be supplemented as needed while they also nurse with normal frequency.

    I went 12 hours between pumping sessions and still only yielded 2oz.
    going 12 hours without milk removal is not going to increase what you get when you pump, certainly not at this early stage especially. All that did is tell your body to stop making milk. It is also possible it put you at risk for plugs or mastitis. It is of course very important to get some sleep but maybe try to keep it more like 4-6 hours at most at a time.

    What tells the body to make milk is frequent and effective milk removal. There is no way for any mother to have normal milk production unless that happens. It is really hard in the early weeks to nurse or pump that much especially if you have other responsibilities. (And it is much harder to pump that much than to nurse that much, for most moms.) But this is the biology and there is no way around it. Our bodies do not know there is such a thing as formula or bottles. If we do not tell our bodies to make milk with frequent milk removal, our body gets the message there is no reason to make milk. A living newborn baby would never go 12 hours without nursing, and would instead typically nurse 10 times a day at least. So less frequent milk removal, especially long stretches of no milk removal, will give your body a big loud message to not make milk. This is simply the biology.

    I would strongly suggest seeing a lactation consultant if that is at all possible so you can discuss how to get baby nursing while supplementing as needed.
    Last edited by @llli*maddieb; January 2nd, 2017 at 05:24 PM.

  6. #6
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    Default Re: Increasing Supply After Gastric Bypass - Exclusive Pumpi

    Quote Originally Posted by @llli*gapchic400 View Post
    She actually has a rockstar latch, but until she gains a bit more, the pediatrician asked me to go exclusively on the bottle or only one feed a day.
    Sounds like it's time to see a lactation consultant, preferably an IBCLC, and work on a plan for supplementing and breastfeeding. It should be possible to supplement as necessary while also breastfeeding, or maybe even to do without supplementation if you can measure sufficient intake at the breast.

  7. #7

    Default Re: Increasing Supply After Gastric Bypass - Exclusive Pumpi

    Hi I haven't had a gastric bypass but I had a gastric sleeve 2 years ago. I had a baby 5 weeks ago and my supply does seem a little less than my son (who was pre-surgery) but not by much. This bub was prem with a poor latch so I pumped for the first 2 weeks to increase my supply.

    What I have found helps me is drinking a lot of water - I actually have to force myself to drink enough but find that my supply dips if I don't drink enough.
    Also pumping a lot - I increased my supply when I was exclusively pumping by pumping for 15-20 mins every 2-3 hours during the day and 3-4 hrs during the night. I understand that this may be difficult with another, younger child.
    Plus on advice of my GP/LC I am taking fenugreek and eating lactation cookies.

    As others have said a LC is a great idea .

    I hope all goes well for you

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