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Thread: About to give up

  1. #1

    Unhappy About to give up

    I am truly at my wits end and am grasping at straws for anything else I might be able to do to increase my milk supply. My baby is now 5 weeks old and I am only able to pump 1-10mL (yes, mL...not ounces!) total. Here is my story, sorry its a long one!

    In the beginning, while still in the hospital (was there for 5 days due to c-section) I had a terrible time getting LO to latch and was told to do skin-to-skin, attempt breastfeeding, then have husband give bottle while I pump. I did this while in the hospital but by the time I got home my nipples were so bruised and tender that I could not put baby to the breast but pumping was tolerable so I had husband give a bottle while I pumped. After doing this for a few days, my nipples healed and I attempted to put baby to the breast but after having a bottle he wanted nothing to do with the breast. I was pumping around 10-20mL total (including hand expressing afterwards) and had a couple of times that I got 40-50mL total but was still not able to get LO to stay at the breast for more than a few seconds to a minute without becoming completely inconsolable. I really tried keeping him at the breast, but it would get to the point where we would be minutes in and he just would not calm down or even attempt to latch.

    At that point I got with a lactation consultant who gave me a supplemental nursing system and fenugreek (3 pills, 3x/day). I had all the hope in the world when I left that consultation. I went and got the fenugreek that day and began using the sytem right away. With the help of my husband during feedings, I was able to get LO to latch and taking a feeding at the breast. During this time I was also pumping about 30min after a feeding a couple times a day and was only getting a few drops, but just assumed this was due to baby drinking all my milk. However, I was not told this was only a starter system and within about a week LO once again became inconsolable at the breast, even with increasing the amount of formula given with the supplemental system. I made another appointment with a lactation consultant and in the mean time had to give LO bottles again while pumping and getting only a few drops to a few mL's at a time. At the second consultation I was told the supplemental nursing system I was using was just a starter kit and that LO was probably not happy at the breast because the tubing was too small and he was not getting milk fast enough. I was instructed to increase my fenugreek to 4 pills 3x/day and to add goats rue. The lactation consultant had no ideas as to why I was not producing much milk and suggested I buy a different supplemental nursing system with a larger tubing to satisfy the flow my LO was looking for.

    I have ordered the new system online but have not received it yet (I ordered it 4 days ago) and have increased the herbal supplements as instructed (so I have been on the goats rue for 4 days). In the mean time I am giving a bottle (LO would still refuse the breast, even with starter kit supplemental system...I was even bolusing the system throughout the feeding) and pumping about every 3 hours during the day and every 4 at night. I am currently getting anywhere from 1-10mL total, with the exception of getting 20-22mL total twice within the past two days (random, didn't do anything different that I can think of).

    During all my times pumping I have tried pumping every 2 hours religiously for 2 days straight with no change in supply and left exhausted (I was also having to mix formula and feed LO a bottle so by the time I did that, cleaned the bottles, pumped, cleaned by pump parts...I literally did not sleep). I have tried warm compresses, pumping after the shower, skin-to-skin (although I will admit I did not do this much), and hand expressed after every pumping session to ensure I was emptying the breast thoroughly (my right breast sometimes only gives milk by hand expressing).

    At this point I need to mention that I have had a breast augmentation, 6 years ago. Under the muscle silicone implants with incision underneath the breast. I was told by my surgeon and 4 separate lactation consultants that this should not be affecting my milk supply.

    At my second lactation consultation I was basically told I could continue to use a supplemental nursing system to get the experience of breastfeeding but if I truly cannot produce enough milk to actually feed my LO I plan to quit altogether because it actually hurts my heart more to "fake" breastfeed than to just give him formula, not to mention it is extremely time consuming to use the supplemental nursing system (a price I was willing to pay when I thought it would increase my milk supply). The only thing I have not tried is the new supplemental nursing system with the faster flow, but I have low hopes that this will increase my milk supply since I used the other system for a week and saw no changes while pumping (I know pumping isn't a good indication of milk supply but I saw a decrease from what I was pumping before so it clearly wasn't increasing).

    My questions are:
    1. Are there any suggestions as to why I am not producing much (if any) milk?
    2. Has anyone heard of low prolactin or oxytocin levels and if there are medications to make up for this?
    3. What, if anything, can I do at this point to increase my milk supply? Or is it too late being that LO is 5 weeks old and used to the bottle?

    Since I was (although just once) able to pump 50mL total, I don't see why I am unable to do that again?

    Any suggestions or even just some reassurance would be nice at this point. I have cried and cried over this since I so desperately wanted to breastfeed. Sorry for the incredibly long post.

    P.S. I am also worried that once I go back to work my milk will dry up completely. I work in an emergency room and would only have an opportunity to pump maybe twice in a 12hr shift. I work three 12hr shifts in a row and am thinking by the third day my milk supply will be done for, considering I am already getting so little.

  2. #2
    Join Date
    Jun 2009
    Posts
    10,387

    Default Re: About to give up

    Hi I just have time for a couple brief comments-
    First I am so sorry you are having this struggle.
    I strongly suggest the book Making More Milk. You need better answers as to what conditions might cause inadequate milk production. Also has many real world tips for pumping in real life without exhausting oneself.
    Has anyone mentioned domperidone or reglan to you? Prescription pharmaceutical galactagogues.
    What kind of pump are you using? Sorry if you already said.
    Nursing with a lactation aid is not fake nursing. It may or may not be something you want to do, but there are many benefits to both mother and baby of nursing at the breast, even if baby is getting donor milk or formula and not any of her mother's milk. Lactation aids were invented so a baby whose mom did not make enough or any milk could still nurse, and not as a milk production increasing tool (even though it can help with that if it means baby nurses at the breast rather than mom only pumping.) Especially since you have invested in the lactation aid already I would suggest at least using it some of the time for a while and not make any immediate decisions about tossing that idea at this highly emotional time.

  3. #3
    Join Date
    May 2006
    Posts
    24,912

    Default Re: About to give up

    with all the above. In addition to the PP's questions, I have a few more:?
    - Do you have any health conditions which could be relevant? PCOS, thyroid, or other endocrine disorders would be of particular interest.
    - Aside from the implants, have you ever had any surgery on or damage to the breast?
    - Can you tell us a bit more about your birth? Was the c-section uncomplicated or was it an emergency, were there any problems with the placenta, any high-volume blood loss?
    - Are you taking any sort of hormonal birth control, including the hormonal IUD (Mirena) or the contraceptive implant?

    I want to tell you to both dry your tears because you should be so proud of what you are accomplishing, and also to cry as much as you want. What you are going through some extremely difficult. Having a newborn is difficult even when breastfeeding is going great, or when a mom has decided to bottlefeed formula instead of breastfeeding. It's a ton of work, it's exhausting, and having to struggle with supply and pumping on top of normal newborn care is just... Well, it's huge.

    Hang in there, mama. It's all going to be okay.

  4. #4

    Default Re: About to give up

    First of all, thank you for the suggestions and encouragement! To answer your questions....

    I am using the hospital grade Medela Symphony pump.

    After your suggestion Reglan I looked it up and will mention it do my OB.

    I have no health conditions aside from anxiety which I have not been on medication for in about a year due to the pregnancy. I do have a significant history of thyroid problems that runs on my mother's side of the family but I have had my levels checked in the past and they were fine, and I am not having any symptoms of thyroid issues.

    Aside from the implants, I have never had any other surgeries or damage to my breasts. I don't recall having much of a change in my breasts during puberty, but I did notice a difference in them during my second/third trimester and I did get engorged around my 5-6 day postpartum, which resolved after some warm compresses and breast massages.

    The c-section was not planned. I had it due to failure to progress after 3 hrs of pushing and the baby's heart rate started to decel during contractions. There were no problems with the placenta that I am aware of and no abnormal amount of blood loss.

    I am not taking any form of birth control at this point. I am currently only taking a prenatal, the fenugreek and the goats rue.

    Thanks again!

  5. #5
    Join Date
    May 2006
    Posts
    24,912

    Default Re: About to give up

    Thanks for answering those questions!

    You have a good pump- moms who are exclusively pumping (EP) typically do best with a hospital grade machine. Some things which might help with pumping:
    - Make sure your shields are correctly sized. You may want to try a size up and a size down, and be open to the possibility that you may need different sizes for different breasts.
    - Incorporate breast massage as you pump.
    - Use relaxation techniques like deep breathing and visualization while pumping. Stress hormones can inhibit letdown, so the more you can get into a relaxed state, the easier it should be to get the milk flowing.
    - Smell your baby or an item of her clothing as you pump. Smell is a powerful instinctual trigger.

    In addition to the above, I would see the doc for 2 things. First, contact your obstetrician and find out if the placenta came away intact, or if it broke up into pieces. Retained placenta fragements can cause your body to act as if it was still pregnant, and inhibit milk production. Second, go in and and get checked for thyroid issues. They are startlingly common in postpartum, and often go undiagnosed because many of the symptoms of thyroid disfunction match expected norms in postpartum. Like tiredness, hair loss, anxiety- all normal in postpartum, but also normal with thyroid problems. When you have a strong family history, I think it pays to be very proactive and get tested more than someone without that family history.

    Wait, make that 3 things. When you go in to see the OB, talk to her/him about that scrip for Reglan or Domperidone. You are doing pretty much all that LLL would recommend in terms of increasing supply, so I think that in your case a little pharmaceutical assistance is a very rational choice.

  6. #6

    Default Re: About to give up

    Sorry for the late response, thank you so much for all the advice and support!

  7. #7
    Join Date
    May 2006
    Posts
    24,912

    Default Re: About to give up

    Keep us updated on your progress- if you feel like it, of course! We're rooting for you.

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