Pumping struggles

[@llli*yx1000]

After 6 months, I just returned to work on June 1 and luckily get to work from home. The first week, I had a good start. I was pumping 10 oz each day usually (3-4 times from 8am-5pm; there was one day where I even got 14.5oz). I nurse on demand outside of work hours and weekends. I co-sleep with the baby who wakes up at least twice to nurse around 11pm and 2am and comfort nurse often from 4am-7am.

Then I got a cold (chills/fever, bronchitis, runny nose) in the second week. I can still get almost 3 oz in my 8am pump but then all others vary from drops to 1 oz each session. I understand how being sick can affect supply but I think my real problem is no longer getting let downs. I tried all the recommendations: massage, warm compress, visualizations, videos of baby nursing on me, hot drink, relaxation (as much as possible!!), and have been taking fenugreek since she was 1 month old. I hand express for several minutes after each session and can get milk out (but don't have time or energy to do this instead of pumping). I tried power pumping and restarting sessions too. So now, I often pump 15-20, take a break and try another 15min. I also checked the pump and parts. I had been using the Spectra2 and even opened up a new Mendela PISA that insurance company sent me. No better luck so I went back to the Spectra.

When nursing, baby never was a great eater. Every 2.5-3hrs, she nurses 10 min each side and latch is not perfect. When I correct her, she re-adjusts herself every time. Her wet diapers are at the minimum side of ok: 4-5 wet. She gained 1lb/month and is about 10th percentile in weight but 90th in height. Pediatrician didn't think that was a problem since she's a happy baby meeting all her milestones. When we give her the 4 oz bottles during my workday, we definitely do see wetter diapers.

My questions are: If I can't get enough milk out pumping during the week, supply will drop. Is this the end of my breastfeeding?
Or, is this only a slump and I should keep going? (I need a lot of encouragement. Hubby (out of good intentions) is already telling me 6-7 mo of breastfeeding is good enough and not to force and be unhappy/stressed, but I really want to get close to the 1 year mark). Sorry for such a long post. Would appreciate any feedback. Thanks,

[@llli*maddieb]

Hi and welcome to the forum. I have a few thoughts, sorry if it is a little jumbled.

Sorry if this is a dumb question, but if you can work from home, why don't you nurse instead of pumping?

How long has the reduced pump output been going on? If your production was hit from being ill (or any other reason) then it might take several days to see your pump output increase.

Are you making sure you are well hydrated?

Is it possible your pump flange is too large? Size can change. Is it comfortable to pump?

I nurse on demand outside of work hours and weekends. I co-sleep with the baby who wakes up at least twice to nurse around 11pm and 2am and comfort nurse often from 4am-7am.

Would you say on average milk is removed from the breasts at least 8 times in 24 hours?

My questions are: If I can't get enough milk out pumping during the week, supply will drop. Is this the end of my breastfeeding?

It does not have to be. Breastfeeding means baby nurses from the breasts. If a baby cannot get enough to eat only from breastfeeding, then baby can be supplemented with formula and at this age (post 6 months) your baby can also be offered solid foods.

Many moms who do not make enough milk still breastfeed. If nursing your baby during the work day is not possible and you cannot pump enough milk for bottles, baby can get formula or donated breastmilk during the workday and nurse the rest of the time. I would not suggest not expressing at all during your workday, but you may find that being able to give your baby formula or donated milk relieves some of the stress of trying to pump enough.

Yes if your production reduces, that may cause your baby to not want to nurse. But that does not always happen.

For very complete information on low milk production, why it happens, what you can do to correct it, and how to live with it and still breastfeed, I strongly suggest the book Making More Milk.

[@llli*yx1000]

Thanks for the help on this, and on another one of my posts. I had missed giving a timely thank you.
That dumb question, I have asked myself that often too. Would that confuse her? Like, I'm around for feeding but not around the rest of the work day? Also, she can typically feed 20 min total, sometimes less. But she also likes to sit back and sip for an hour. When I was on leave, she liked to feed every 2.5 hours (in a dim quiet room), would feeding her every 4 hours encourage more concentrated feeding?

I'm been sick for almost a week. I had this pumping problem since then except on day 2 of being sick where I got 8.5 oz from 4 pumps. I had tried to stay hydrated and made sure I ate and took the daily vitamin pill. Yes, on average milk is removed 8 times in 24 hours but very little during the work day.

As you recommended, I ordered a smaller flange size. I was suspecting that back when I pumped months ago but I was getting milk plus saw another posts where a mommy was using various sizes and was still getting result so I didn't change mine. Also, wasn't convinced this was a problem since work week 1, I was fine (even getting multiple let downs) then suddenly work week 2 began being bad. I did notice more of the areola was getting sucked up.

Thanks also for the encouragement/advice on supplementing. I had to supplement at the beginning when I had low supply. It took 2.5 months for me to back totally back to breast. It was devastating to supplement back then. So I keep thinking it's such a shame to "give up" now.

Regarding the recommendation that babies should get breastmilk for the first year, does that mean any amount of breastmilk? Like, if she can get breastmilk 3 times a day (and formula to supplement), that still counts?

[@llli*maddieb]

Well, I am really not understanding how nursing your baby during your workday could possibly confuse her. Even moms who work outside the home find it very helpful to have baby brought to them at lunch or other breaks to nurse or they even go to baby. (One reason on-site childcare could be so helpful for breastfeeding.) Many moms take part in all sorts of activities that take them away from baby for short periods of time and never find they need to pump or supplement at all. If baby is taking too long when nursing and you need to get back to work, you could give baby back to caregiver and if needed, pump for 10 minutes. Pumping after nursing is a good overall way to increase milk production and you might want to be doing that at least at some sessions anyway.

As far as every 4 hours- I don't understand why you would nurse every 4 hours when it sounds like you are pumping more often than that...? Of course I do not know your work situation but if you could only nurse at certain times, then you could nurse at those times and baby also be fed bottles if needed whenever...right? I guess I am not clear on what the concern is.

Regarding the recommendation that babies should get breastmilk for the first year, does that mean any amount of breastmilk? Like, if she can get breastmilk 3 times a day (and formula to supplement), that still counts?

Yes, every drop of breastmilk and every moment at the breast "counts." Of course, that does not mean it is not important to maximize both. It is, for many reasons. And if a baby is getting any formula, then scientifically they should not be considered exclusively breastfed in a study comparing formula fed babies to breastmilk fed babies (although they often are.) But that has nothing to do with the real world. When a mom does not make enough or baby has difficulty nursing or for whatever reason exclusive nursing cannot happen, you have to accept the reality of the situation and not throw the baby out with the bathwater by thinking that if baby cannot be "exclusively" fed breastmilk then there is no point to nursing or giving baby breastmilk in bottles to the extent you can. It just is not true.

Let's look at it this way. I think the current recommendation is that vegetables be eaten 5 times a day, or 5 cups, something like that. I can assure you that many children do not eat that many vegetables or anything like it. Some kids refuse all vegetables. Would you say that those kids should not even bother ever eating a carrot? Of course not.

Well breastmilk is much more nutritionally important than that carrot or any other vegetable, and so is beneficial in any amount. Also breastfeeding itself- nursing at the breast- has real benefits, again, those can be seen in any amount.

Also there is nothing magical about a year. The year goal is not even universal, what most recommendations suggest is that nursing continue past a year as long as baby and mom wish. I think what is lost is that there is more to breastfeeding than being 'exclusive" about it and there is more to breastfeeding longevity than this year goal. If that goal is working for you, great. No problems. But sometimes what the year goal does is stress mom to the point it robs her and baby of a potentially much longer nursing relationship- well into todderlhood, when nursing becomes less about the milk and more about comfort and connection, in other words, it is a time low milk production becomes much less of an issue!

I have had three kids and nursed them all for a long time. I can say without hesitation that if the choice were to either nurse exclusively (except for solids) for one year and then needing to stop because doing that was so stressful and exhausting breastfeeding had no pleasures, or supplementing during that first year as needed in order to make nursing less stressful and more pleasurable overall so my baby and I could continue nursing into toddlerhood for as long as we liked, I would choose the latter. Please note I am not saying "oh you should really nurse past a year." There is no "shoulds." I am trying to offer a perspective of how supplementing now if needed might not only decrease your stress but also have benefits you may not have considered.

[@llli*yx1000]

Hi Maddieb, as I was reading your responses the other day, my output has picked up again. I got over 9oz, 10 oz, and 11 oz and last 3 days. Not sure if it was my body getting over the cold, or having taken some fennel pills, or talking to you about it, or all the prayers, but glad to be producing a decent amount again. And today, with the new smaller flange, I got 10 oz. I will continue with the smaller flange to see if I can improve on the output.

Regarding your question about why I will have to limit nursing to every 4 hours when I can pump anytime. It's because I can still work at my laptop when pumping but when nursing, I can't.

Thank you so much for answering my other questions too. I really appreciate you (and all the other mommies) who spend so much time and energy sharing your experience and point of view. Ever chasing that exclusivity during the first 6 months and getting to the 1 year mark is a lot of pressure (sometimes motivating too). Reading your perspective put my mind at more ease with supplementing. I think the "magic" we read into the 1 year milestone is from the recommendation that under 1, babies should make breastmilk or formula their primary food. That makes it magical.

[@llli*maddieb]

So glad to hear you pump output is increasing!

Ok if nursing at a laptop is not possible then if you want you could nurse baby at breaks and pump as needed, if that works for you. You can also probably not worry about doing the same thing every day. In other words depending on your choice and day to day work reality, you could nurse once during your work day, twice or more, or not nurse at all during work day in any random pattern you like. Most babies can handle differing patterns because differing eating patterns and sleep patterns are normal for babies. It is the adults involved who have trouble with random patterns for the most part! Of course, this all depends on what actually works for you and baby in practice.

I think the "magic" we read into the 1 year milestone is from the recommendation that under 1, babies should make breastmilk or formula their primary food. That makes it magical.

Yes I agree. And because of this I think many moms gain great satisfaction and pride in "making it a year" and that is great, I am all for satisfied and proud moms as we all should be giving ourselves more credit most of the time. I just wanted to suggest moms can (if they choose) make their own different goals, and sometimes moms find it works better for them to not set a long term goal but rather take each day as it comes.