Questions for all 100% EPing Moms

[@llli*zblessedmom]

I have a few questions for those moms who exclusively pump:

1. I read the Kelly article talking about how 2-4 ounces per pumping session was a good output. Babies my sons age are supposed to drink between 25 and 30 ounces a day. My goal is get my son on 100% breastmilk and 0 formula. I now pump between 6 and 7 times a day. I try to pump 7 times. However, unless I wake myself up every 2 hours at night (and then I'll decrease supply from being tired), how can I produce enough breastmilk to exclusively feed my son? Right now I produce about 16 ounces. I take fenugreek. I do have some Metoclopramide, but before I take more "drugs", I want to see how others up their output. I usually produce 6 ounces for the first morning pump, 3 ounces the next pump and 2 ounces for the rest of the pumps. How does one get more milk per pump?

2. I read that some women used to pump like 7 times a day and then became more effective so they only had to pump like 3 times a day. How does this happen? What's the secret to "getting more "effective" per pump?

3. Lastly, I have a Medula PISA. I've been using it for 4 months, exclusively using it only for a few weeks. What parts do I have to replace regularly? Are the tubes good for awhile? If the values, shields and white suction things seem to be in good shape, is that all that matters?

Thanks so much for your help,
zblessedmom

[@llli*mommal]

I'm not an EP mom, but I think I can answer a couple of your questions.

1. How does one get more milk per pump?

In the following ways:
- pump for longer
- use a better pump
- combine pumping with hand-expression or massage

2. I read that some women used to pump like 7 times a day and then became more effective so they only had to pump like 3 times a day. How does this happen? What's the secret to "getting more "effective" per pump?

The secret is to have a large milk storage capacity, meaning that you can store a lot of milk in your breasts for a long period of time without having a decrease in supply. This is not something all women can do. Most women need to remove milk frequently in order to maintain supply.

[@llli*krystine]

I did not EP but for all my baby was able to remove, I had to pump a lot to make up for her difficulties. I set my alarm for at least every 3 hrs start to start during the night (so if I pumped at 8, went to bed with baby, woke up at 11 pm and then 2 a.m. and then 4 a.m. but could have gone as late as 5 a.m.). I pumped 8-10 times a day until she started nursing quite a bit more. I don't hold a lot of milk at any one time so I am sure pumping 4 times a day would have never been enough for me.

If you are getting 6 oz in the morning I would recommend pumping at least one time during the night if not two. I know it's work, but really to get your supply up I think it's pretty vital.

[@llli*nolies.mama]

How old is your LO?

IMO, as an EP'er, there is no way that you will ever be able to pump just 3x a day and get 30oz a day. Over time, without stimulation from baby and the hormones that are created from that, production goes down, not up with the pump. I EP'd for my son's first two months, and then had to start again at around 11 months or so and continued until he was 22 months. I did eventually have to resort to Domperidone, and I was still pumping roughly 5x a day, even at 22 months. I also had a Medela Lactina (dual hospital grade) pump.

You will need to replace the valves and membranes quite often if you are EP'ing. Even a slight crack in one of them can affect suction. (these jobbers here)


And lastly, I don't know if you have posted it somewhere before, but are you trying to return to exclusively breastfeeding? Just speaking from my experience, I know it can be done. It wasn't the easiest thing I have ever done, but we did it.

[@llli*vtmtbkr]

I am a 100% EP mom with an average supply (Max 34 ounces/day). My right produces twice what my left does.....I call it retard left boob syndrome.

If you are 4-5 months into EPing and still pumping 7x a day in my opinion you are pretty much doing everything you can. Do you do compressions while you pump? That can help to fully empty you and faster. Like the previous poster said you probably just don't have much storage room and therefore are a low volume producer. There are EP moms who have to supplement even after doing everything to up their supply. Follow all the regular advice about upping your supply and if you're a LVP then just know that you did everything you could and are still giving your LO the best even if it's mixed with some formula.

I pump 3x a day at 10 months PP. At first I pumped everytime DD ate. I guess it was just trial and error with dropping pumps and I was lucky not to lose much supply. I'm down to 28 ounces now.

I use a PISA too. I've never replaced the tubing and have replaced the membranes once.

Feel free to ask me questions I'd be happy to answer any of them. ivillage has an exclusively pumping forum also if you're interested.

[@llli*lleonard5]

I have a few questions for those moms who exclusively pump:

1. I read the Kelly article talking about how 2-4 ounces per pumping session was a good output. Babies my sons age are supposed to drink between 25 and 30 ounces a day. My goal is get my son on 100% breastmilk and 0 formula. I now pump between 6 and 7 times a day. I try to pump 7 times. However, unless I wake myself up every 2 hours at night (and then I'll decrease supply from being tired), how can I produce enough breastmilk to exclusively feed my son? Right now I produce about 16 ounces. I take fenugreek. I do have some Metoclopramide, but before I take more "drugs", I want to see how others up their output. I usually produce 6 ounces for the first morning pump, 3 ounces the next pump and 2 ounces for the rest of the pumps. How does one get more milk per pump?

2. I read that some women used to pump like 7 times a day and then became more effective so they only had to pump like 3 times a day. How does this happen? What's the secret to "getting more "effective" per pump?

3. Lastly, I have a Medula PISA. I've been using it for 4 months, exclusively using it only for a few weeks. What parts do I have to replace regularly? Are the tubes good for awhile? If the values, shields and white suction things seem to be in good shape, is that all that matters?

Thanks so much for your help,
zblessedmom

I've been an EP mom for the past almost 8 months. I'd like to make an attempt to answer your questions, although the ladies on here have given you quite a bit of information. All of my answers are what have happened in my particular situation:

1. My output fluctuates every month, even from session to session. I generally have an over-supply, but on "bad" days, I don't make enough milk to keep them fed. I'm suspecting that my "low supply" days are those when I would normally get AF. No AF as of yet, though. As far as how frequently I pump, I started out pumping every time the boys were being fed, including when they were in the NICU. I had an alarm that woke me up every 3 hours to pump. I pretty much maintain that schedule, however, my boys now eat every 5 hours, so I will pump after every feeding (I'm due to pump now) and whenever I can squeeze in a session. On average, I pump probably 8 times a day. My output varies. Since I have a bit of OS, I can pump anywhere from 4-20 oz in a session. No joke. I'm just coming off of a slump for the past couple of days where I was lucky if I got 4 oz TOTAL per session. On those days, I try to make sure that I pump more frequently, drink plenty of fluids, massage and I take More Milk Plus Special Blend (I think that's the name of it). I was taking a combination of Fenugreek and Blessed Thistle (sometimes Fenugreek alone doesn't work for a mom) and I seemed to have become immune to just that blend, so I moved on to the More Milk Plus. The one that I use has Goat's Rue in it, which I've heard helps things along. It tastes AWFUL but seems to work for me. Things to keep in mind are: (a) you can power pump if you have the time. Power Pumping involves pumping for about 10 minutes, taking a 10 minute break, pumping for 10 more minutes, taking another 10 minute break and then pumping again for another 10 minutes. You're basically using an entire hour to pump (on again/off again). It may take a few sessions of doing that to help increase supply. (b) eat oatmeal and increase proteins. That seems to help a LOT. (c) Check your valves and membranes. I have the PISA and I typically change my membranes every 3 months. I have 3 sets of flanges that I rotate around. If you only have one set of flanges, you may need to replace them more often. (d) Make sure that your flanges are the proper size. I was fitted by the LC at the hospital, who told me that the 24 mm was perfect. WRONG. I use the 36 mm and sometimes have to use a smaller size when I have difficulty getting milk out. The smaller flange seems to help express the milk for me.

As far as replacing parts on the PISA, I didn't have to replace my hoses, but I always have a second set for when I'm cleaning the first set. I use my sterilizing bags to clean out my hoses, then attach back to the pump (without the flanges attached) and let the pump run for a while. If there's still water in them, you can hang them, run alcohol through them, wave them around, etc. Other than the membranes on the pump, the rest of the parts *should* be good to go for a while. My pump is 4 years old, the parts were given to me brand new (still in packaging) and the only thing that I've replaced is the membranes.

Hope the info helps!

[@llli*zbee04]

A awesome trick I learned from a lactation consultant, pop the face plate off of your PISA pump, clean the inside of the face plate and the white membrane part (carefully!) with rubbing alcohol, even if it doesn't look dirty. I loaned my pump to my girlfriend for a year, only to be really bummed when it didn't seem like it was pumping as well as it had. Our lactation consultant suggested this, I didn't think it would work because it didn't look dirty, but OH MY did it, I wasn't able to use it on full suction anymore. I also used compressed air to blow out the holes on the face plate where the tubes connect. She said if even a little bit of grim get in there, it reduces the suction. I started just cleaning it every month or so.

[@llli*zblessedmom]

I am so thankful for this board and all the other moms! What great advice. Thanks to your input I have realized my milk output is "normal". I always thought it was low. I was trying to trouble shoot the wrong thing.

I know this is a stupid question, but how do I get good milk output from hand expression? I don't even know how to do it and when I try, it's painful.

My LO (little one, I'm guessing is 4 months old. I really appreciate the pictures too because I'm not always sure what the pump parts are called! Yes, I'm trying to go back to breastfedding, but my LO is on an extended nursing strike. I'm constantly trying to get him back to the breast, but it's not easy. Even when he does breastfeed (first thing in the morning), he is not effective at it since he's used to the bottle. Sigh.

When does AF come back? I gave birth 4 months ago. When should I start to be prepared for it to return?

Wow! To the mom would could pump 20 ounces in a session-that's amazing! thanks for all the great tips! I am going to try them! Also, I'm going to try cleaning the pump...it couldn't hurt!

[@llli*mommal]

I know this is a stupid question, but how do I get good milk output from hand expression? I don't even know how to do it and when I try, it's painful.

Not a stupid question. Learning to hand-express is all about trial and error.

When you pump, I suggest trying to gently but firmly squeeze different parts of your breast. Watch what's coming out as you do- if you see a correspondence between what you're squeezing and how much milk is coming out, then you're figuring it out. This link looks helpful: http://newborns.stanford.edu/Breastf...xpression.html

My LO (little one, I'm guessing

LO = little one

Yes, I'm trying to go back to breastfedding, but my LO is on an extended nursing strike. I'm constantly trying to get him back to the breast, but it's not easy. Even when he does breastfeed (first thing in the morning), he is not effective at it since he's used to the bottle. Sigh.

Sorry about the nursing strike! Have you seen this link: Help- My baby won't nurse!?

Also, are you co-sleeping? Some babies who resist nursing during the day will nurse during the night, when they are too sleepy to fight.

When does AF come back? I gave birth 4 months ago. When should I start to be prepared for it to return?

The answer is different for every mom. Some moms see their cycles return very swiftly, within a few months. I think the average time until return of fertility in a breastfeeding mom is about 15 months. And some moms will not see AF again until their babies wean.

The longer you go without nursing or pumping, the more likely it is that your cycle will return. This is why many moms get AF again when their babies start sleeping through the night.

[@llli*krystine]

I think the average return of cycles is 15 mos post baby but really varies per mommy.

20 oz in one session might sound awesome but over supply is a problem, just like low supply. A baby can't drink 20 oz in one feeding so I really don't think that is wonderful...not trying to be negative but ideally a mom is making just what baby needs and over supply can lead to gassiness and too much foremilk not enough hind milk.

http://newborns.stanford.edu/Breastf...xpression.html

Awesome video on hand expression. I didn't know what I was doing until I watched it, either. It's not like something we naturally know how to do properly.