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Thread: Pumping often but no supply increase?!

  1. #1

    Default Pumping often but no supply increase?!

    Hello! Brief intro: I am a FTM with a 5.5 week old, EBF starting Day 1 without pacifier (so Baby nurses when he needs), and this is my first post I have four questions that fall into different categories, but my pumping/supply question is most pertinent so I'm posting this here.

    Baby's weight records:
    12/21 8lbs.4oz hanging scale (DOB, midwife)
    12/26 7.12 hanging scale (nurse check)
    12/30 7.12 digital scale (CLEC)
    1/5 8.2 digital scale (pediatrician)
    1/20 8.6 digital scale (IBCLC)
    1/23 8.9 digital scale (IBCLC)
    2/2-2/3 TBD at IBCLC's office or 6wk PP check up

    The Long Story: I had really bad pain when feeding on left nipple (right nipple has always been fine and pleasant), and it was a lipstick nipple after each feeding. My nipple was pink and "raw," I dreaded BFing and felt resentment and desperation for weeks despite CLEC visit. Finally I couldn't take it anymore, and at the encouragement of my local LLL leaders, I consulted an IBCLC who recommended pumping the left to allow the nipple to heal and nurse exclusively on right. I finally felt myself again, after four weeks of excrutiating pain and misery. Regimen was to pump left for 15 min after each right feeding, offer bottle, and apply lanolin or hydrogel. I've followed regimen for about ten days now, and my left nipple is finally about 90% healed (no longer super sensitive and tender or raw and "angry"). However, I'm still only pumping 1-1.5oz from left each time (nursing and pumping 8x/day). Sometimes I pump and nurse, other times I'm looking at pictures/video of baby, and also massaging while pumping.

    Question 1: IBCLC expected my nipple to heal in a couple of days, but it's been over a week, and it's still a bit pink, not back to 100%. Is the length of healing time indicative of anything problematic??
    Question 2: Why am I still only getting so little when I'm pumping exclusively on left? IBCLC is expecting 3-4oz per session, I'm barely getting half of that after a week of 8x pumping/day! And Baby would love at least a couple ounces after feeding on the right, as evident by his contentment after the rare occasions when he DOES get the 2oz from my left...

    Baby has many wet diapers (5+) and poopy diapers (at least three at substantial ones per day, my husband and I call them "blow outs" because it gets through his diaper covers!) per day since the beginning. I am getting about 7h sleep per day (about six hours total during the night in 2-3h stretches and another 1-1.5h nap during the day). Baby is allowed to nurse whenever (I basically walk around topless, have not really left house in 5.5 weeks), and we do skin-to-skin during our naps in the afternoon. We also bedshare, baby wakes a couple times to nurse at night, and I pump at least once per night. Also drinking Mothers Milk, eating a TON of good food, and my pee is very light yellow so I'm assuming that means I'm hydrated enough. Only possible thing stressing me out is my mom is here and sometimes she makes passive aggressive remarks about my milk supply (she did not BF me), or maybe it's the vicious cycle of worrying about supply ↔ actual low supply...

    Question 3: kellymom says the only accurate measure of whether Baby is getting enough is baby's weight, and if we can't get to a scale, then the number of wet+dirty diapers is next best indicator. Well, Baby definitely met the "required" numbers since the beginning, but he also hasn't been gaining as rapidly as the average, so what do I believe?!
    Question 4: IBCLC mentioned mild tongue tie, but if that's the case, why the low pumping output?

    Phew!! That was a lot of info!! Please share any thoughts you may have, I need all the tips and advice and reassurance I can get

  2. #2
    Join Date
    Jan 2017
    Posts
    31

    Default Re: Pumping often but no supply increase?!

    Hey,

    ad 1) If the nipples do not heal for a long time, it may be a sign of a yeast infection or a staph infection. Does the expressing feel comfortable for you, no damage from the pump?
    ad 2) Sometimes the mothers just cannot express a lot of milk. There are even cases when expressing does not yield anything yet the mother is successfully breastfeeding. Expressing milk is not a manual process, it is hormone driven. If you feel pain during expressing, that will inhibit the milk flow. You may want to try oxytocine nasal spray or drops to see if then the milk flows better. Another thing is the amount of milk - in this case it is essential to keep pumping at night. During the night time more prolactine (the hormone responsible for milk supply) is produced. The "rules" are not to have a break of more than 4 hours at night and to pump long enough. When you say you're massaging when pumping, do you mean something like this: https://med.stanford.edu/newborns/pr...roduction.html ? Do you also continue with hand expression? If no, perhaps it's an idea.
    One more important thing here is that no pump is going to extract milk as well as the baby. So you could simply stop worrying about this fact and go back to nursing If your baby has learnt to latch properly, your nipple will not suffer.
    ad 3) some babies gain more, some gain less; consider also how you and your husband look like, maybe your baby is genetically programmed to be a smaller one; what is important - that the baby stays on the same growth curve. You should have more clue whether this is the case with the next weighing. You also had a lot of weighings at different places with different scales. This brings some measurement error. On the other hand, it is usually expected that the baby returns to his birth weight within two weeks. It seems that this was a tough target for you. Which could be explained by the tongue tie.
    ad 4) Tongue tie can cause poor latch and nipple trauma, inefficient and ineffective feeding and emptying of the breast and as a consequence poor weight gain. Sometimes babies with severe tie still manage to feed. In other cases even a mild tongue tie can cause problems. If your baby cannot empty the breast he is feeding on properly, then your brain gets the signal "this was enough". So indirectly it can affect also your pumping outcome. And what you pump is likely even less than what the baby takes. You may want to take care of this tongue tie (and only then to start breastfeeding from your injured side)

    But overall you're doing a great job. Really. You know what you want and you go for it. I think the remarks from your mom may even work in your advantage: it gives you additional motivation to prove that you can

    So to conclude, my advice would be to stop worrying about pumping (at least as long as there are enough wet and soiled diapers and given that the next weighing is satisfying), take care of the tongue tie and get back to breastfeeding from both breasts. Good luck!

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