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Thread: Low Breastmilk Supply (Help)

  1. #1

    Default Low Breastmilk Supply (Help)

    Hi everyone,

    Need advice. I have a 4 month old baby and I'm exclusively pumping because my baby refuses to nurse. On a good day, I can get him to nurse once. My breastmilk have significantly dropped in the last two months. I was able to pump at least 3 oz a session and now I can barely pump and ounce and I am renting a hospital grade pump (medela symphony). I was able to feed him mostly breastmilk for at least two months. He's now eating about 4-6 oz of formula each feeding and now it takes me a day two pump 2 oz. ;(

    I have tried fenugreek, doesn't work for me. Fenugreek made him really gassy as well. I have power pumped every two hours for three straight days. I keep myself hydrated. I eat healthy. I exercise daily. I know that getting your period temporarily drops your supply but when I first had mine post partum last month, it didn't make a difference with my supply. I really don't know why my milk supply has dropped. I don't want to give up breastfeeding him and feeding him my breastmilk. And I feel like I have exhausted all my resources. Please tell me there is hope...

    Please help! I appreciate all your input. Sorry, my post was long.

  2. #2
    Join Date
    Jun 2009
    Posts
    10,670

    Default Re: Low Breastmilk Supply (Help)

    Hi cherrr. I am a little confused about the numbers so I am going to ask a few questions first, I hope that is ok

    1) How many bottles does baby get in 24 hours and how much total (formula and breastmilk) does baby drink in 24 hours from bottles?
    2) Is baby's weight gain- average? Slow? Fast? 4 month olds gain about 5 ounces a week on average. Up to 3-4 months the average is higher, more like 6-8 ounces per week.
    3) How many times in 24 hours do you pump and how much milk over that period of time are you able to express when pumping? I mean usually.
    4) Has your overall daily pump output increased at all when pumping every 2 hours?
    5) Have you tried any other galactagogues?
    6) Power pumping is not very clearly defined anywhere that I know of, but pumping all day and all night every two hours would be exhausting. The idea with power pumping is to replicate what a baby might do at the breast, so usually it means pumping very frequently (even every one hour or so) for part of the day, then reverting to normal pump routine (ever 3-4 hours) the rest of the day.
    7) Even hospital grade pumps can be ill-fitting or have a worn part. Have you had your pump checked out or contacted where you rented it for troubleshooting help?
    Last edited by @llli*maddieb; July 28th, 2017 at 03:06 PM.

  3. #3

    Default Re: Low Breastmilk Supply (Help)

    Hi Maddieb,

    Thanks for replaying back. I don't mind at all. Apologies for the confusion on my post. I posted it in the wee hours at 230 am and my brain was a bit scattered.


    1. He eats more or less 30 ounces of milk in 24 hours and of those 30 ounces is 3 to 4 ounces of breastmilk. So basically I supplement about 26 ounces of formula.

    2. We just came back from his well baby checkup today and he is on the 15% percentile in weight. He weighs 12.5 lbs. According to his PD, he is on track. I think he's weight gain is steady... a bit small but PD said it's expected with preemies. We also feed him in demand.

    3. I have been pumping every 2 hours during the day. I think I avg about 8 times because I only pump at 3 am when he wakes up for his feeding.

    4. No not really. It has stayed the same in the last month or two. I pumped less than an ounce every two hours.

    5. I have tried oatmeal. Going to try papaya this weekend as well. Most of the galactagogues out there contain fenugreek and baby was super gassy and miserable when I took it.

    6. Yes, you're right. I have also read that and it's a bit unclear. They say pump for 20 mins and pump every 10 mins after that for an hour. Some say pump every 2 to 3 hours. I've tried both and nada...

    7. Yes, I thought it was my pump as well so I had them switch the rental. They also replaced the parts that go with it (tubing, flanges, etc). I also have a manual pump and I get more or less the same output. And a store bought one. (Sigh)

  4. #4
    Join Date
    Jun 2009
    Posts
    10,670

    Default Re: Low Breastmilk Supply (Help)

    Hi, ok so baby is eating a normal amount overall, gaining fine, and you are pumping about one tenth of what baby needs daily. Do I have all that correct? If so, here are my thoughts.

    Some meals in the bottles sounds like they are a little large, and if you wanted you might consider getting baby eating more frequently, smaller amounts at a time, but if what you are doing now is working for you and baby, no worries.

    I think it is amazing you have kept up the pumping this long. I believe firmly that any amount of breastmilk is good for baby. You could continue this as long as you wanted. Your could also try to encourage nursing if you wanted, reduce pumping, while supplementing as needed. If nursing baby at the breast is important to you, you could consider using a lactation aid so baby can be supplemented while nursing. There are many variations you could consider. Also, I think it is possible you could increase your production somewhat, more on that in a moment.

    But at this point I think the difference between baby's needs and what you are producing is quite vast and unlikely to be made up entirely at this point.

    Why your production dropped is anyone's guess, but I think an obvious factor is that due to your baby's refusal to nurse, you have needed to pump rather than nurse. What you have done with this is, imo, simply heroic, but the fact it is it is very hard to maintain normal production longer term when eping, and even harder to increase production when eping. There are many reasons why, but it basically boils down to babies being completely different than pumps in how they extract milk from the breasts.

    I think at this point your best chance for increasing production would be to try a pharmaceutical prescription galactagogue - domperidone, specifically. If that is not possible, you can consider reglan but reglan tends to have more side effects. If neither of those are possible, I would suggest giving fenugreek another try. If that is not appealing to you, I suggest try looking into goats rue or some other usually effective individual herbal galactagogue rather than a blend if you cannot find a blend that does not include fenugreek. Also, if you have any doubts about your hydration levels, drink more water.

    You have worked really hard with the pumping alone and it is simply not doing what it should, so a strong galactagogue is probably the next logical step. Of course you could also talk to your doctor about thyroid issues or other health issues that might have impacted your ability to make milk.

    I would strongly suggest the book Making More Milk. It may help you find answers to why it has been such a struggle for you to make enough milk. When this happens it is often some combination of not great breastfeeding management (such as baby being unable/unwilling to nurse) and some underlying condition that keeps the body from making enough milk.

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