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Thread: Could oversupply be (at least one of) our problem(s)?

  1. #1
    Join Date
    Apr 2008
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    13

    Default Could oversupply be (at least one of) our problem(s)?

    Hi folks,

    I'm new around here and hope you can give me some advice. My 3 month old dd has some pretty serious feeding problems (aspiration, severe reflux) and difficulty gaining weight which means that she can't take milk directly from the breast because her feeds need to be thickened (to prevent aspiration) and fortified with formula (for extra calories). Of course, I've been devastated because I loved nursing my older child so much . And even with all of this effort, my lo is still only gaining 1-2 ounces a week, so we're in "failure to thrive" territory.

    Anyway, I'm pumping for her with the hopes that she will eventually be able to grow out of her problems and can go back to nursing, at least a few feedings a day. I'm producing more than enough milk -- I pump 6 times a day and just stop when I get 8 oz, which usually takes about 5 minutes!

    I'm starting to wonder if I'm not producing enough hind milk with this system. After I leave a bottle of milk in the fridge overnight, the amount of cream that precipitates to the top is generally only about .5-1 mL. Is this normal? And does anyone know of a way to increase the amount of hindmilk produced when you're exclusively pumping? I could cut back on the amount I'm pumping each day but I'm terrified of my supply dropping and then I can't get it back . . .

  2. #2
    Join Date
    Mar 2008
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    62

    Default Re: Could oversupply be (at least one of) our problem(s)?

    okay, this is the way I understood about hindmilk and foremilk...if I'm off ladies chime in and let me know!

    your breast really only makes one kind of milk.. hindmilk. your breast makes milk and it travels down toward the nipple as this movement occurs the fat gets stuck in the back. as you have a let down it causes the fat to move forward. for you to get the fat or hindmilk you must empty your breast. also the more often you nurse or pump the quicker you will get the hindmilk. I think the illustration on kellymom is great: think of your hindmilk as hot water comming out of the faucet. when you first turn it on it takes a little bit to come out and it is a gradual process. if you turn the water back on in a little while the water is still hot or only takes a second to become hot, but if you wait a longer time it takes longer to get hot again.

    so, if it were me... I would pump until I was empty and not pay as much attention to the amount. it might take a while longer but it's worth it. plus if you pump again before your breast begin to feel full it won't take as long to empty them.

    hth and I didn't confuse you!
    Exclusively , , and when we find the time !!! And now loving Totally bleesed with born 2-25-08.

  3. #3
    Join Date
    Jan 2006
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    Default Re: Could oversupply be (at least one of) our problem(s)?

    You're pumping about 48 ounces per day, correct? How much is above and beyond your baby's needs?

  4. #4
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    Jan 2006
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    Default Re: Could oversupply be (at least one of) our problem(s)?

    Hi,

    A typical breastfed baby will take in about 25 oz of milk per day. That is significantly less than the 48 oz you are pumping right now. It is possible that a foremilk/hindmilk imbalance could be part of your problem.

    Sometimes, slow weight gain/failure to thrive are caused by a more serious physical condition that has nothing to do with mother's milk supply/inadequate caloric intake. Is your baby's doctor aware of how much milk you are producing? Has your daughter been tested for any possible physical causes of her slow weight gain, or is the doctor assuming that it must be your milk? Do you have a supportive IBCLC or local LLL leader with whom you could consult?

    Hang in there, and keep us posted,

    Tiana

  5. #5
    Join Date
    Apr 2008
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    13

    Default Re: Could oversupply be (at least one of) our problem(s)?

    Yes, unfortunately my baby has a number of physical problems that are the culprit in her failure to thrive. She has very severe laryngomalacia, if any of you are familiar with that, which makes it hard for her to coordinate breathing and swallowing, hence her problems with aspiration. The bottom line is that she just doesn't have enough energy or coordination to take in enough calories to support her metabolic needs without increasing the caloric concentration in her breastmilk by adding formula. We have a number of docs -- ENT, Pulmo, GI -- who are managing her care, and thankfully they've all been very supportive of my feeding her expressed breastmilk.

    So when I first started pumping for her I would pump for each feeding (e.g. 8 times a day), draining both breasts, but over the period of a week or so I found that each day I was making more and more milk. It was really out of control. I figured that if I stopped after getting 4 oz from each breast, eventually my body would adjust and only produce that much. But I suppose that's not happening . . .

    So it sounds like I need to a) pump until the milk stops every time, and b) try to pump more frequently. I can do that, but as you can imagine exclusively pumping is time consuming and depressing, and I have a 2 year old to chase around as well . . . .

  6. #6
    Join Date
    Apr 2008
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    Default Re: Could oversupply be (at least one of) our problem(s)?

    Oh, and I meant to say that on a GOOD day she will take about 20 ounces (this is fortified to 27 calories/ounce by adding formula). And thankfully I do have a great IBLC I have been checking in with!

  7. #7
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    Jan 2006
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    Default Re: Could oversupply be (at least one of) our problem(s)?

    At this point, pumping for longer periods of time is not likely to help you. You are certainly producing large enough quantities of milk. If your goal is to get more hindmilk, there are a few things you can do.

    The first thing would be to pump only one breast at a time. This gives your other breast the opportunity to get "full"--and leaving the breast full for a period of time will help to decrease milk production.

    Secondly, you might try pumping more frequently, but for shorter amounts of time. Shorter, more frequent feedings are associated with a greater intake of hindmilk.

    Some mothers have had success by doing something called "full drainage block feeding". With this techinque, you start the morning by pumping both breasts until you are "empty". Then, for the rest of the day, you would only pump as much as your baby is eating. Block feeding is admittedly easier when baby is exclusively breastfeeding, but it is still possible while exclusively pumping. You start by pumping on one side, and you pump on that same side every time you pump for a period of time (say, every 4 hours). Then, after the 4 hours are up, you switch to pumping on the other side every time you pump for the next 4 hours. This should help to decrease your overall milk supply while increasing the amount of hindmilk your baby gets at each feeding. Hopefully, this will help her to gain weight.

    I am happy to hear that you are working closely with your baby's doctors and an IBCLC. This is the kind of situation that really warrants close attention from your health care provider.

    I hope that helps. Hang in there and keep us posted.

    Tiana

  8. #8
    Join Date
    Dec 2007
    Posts
    39

    Default Re: Could oversupply be (at least one of) our problem(s)?

    You can pump 1/2 the time and set that milk aside to freeze for mixing with solids when baby is older. Then finish pumping. The milk you produce the second half of your pump session will have the most fat. That is what you want to feed your little one. I did that with dd.

  9. #9
    Join Date
    Jan 2006
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    Default Re: Could oversupply be (at least one of) our problem(s)?

    Pump more frequently, one side at a time. Double pumping means extra stimulation (good if you need MORE milk, not so good if you need less).

    You could try compressing the side you pump to help bring down more fatty hindmilk when pumping.

    If you find that pumping more frequently (but for less time) is difficult, perhaps try keeping the pump set up so that when you have 5 minutes, you can use that time to pump (or hand express if your pump isn't set up!).

    Are you aware that it is possible to fortify with your own milk? An experienced IBCLC would be able to give you some guidance.

    You're doing an amazing job. Hang in there!

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