FAQs- Ask Yours Now!One of the things I would like to do with this website is add more “how to” information and provide information that will assist the many women who visit the site. When I was EPing, information was critical and finding support from other women who were also EPing was invaluable; yet this information and support were not always easy to find. So here’s your chance to get questions answered!! Use the comment form below to ask whatever you like (as long as it relates in some, even remote way to EPing, lactation, breastfeeding, even parenting) and I will do my best to answer your questions or locate the answer for you if it is something beyond my scope of knowledge. I hope that this post will grow into a valuable resource as it progresses! And now here’s the disclaimer-please remember that I am not a medical professional. The information provided on this site is of a general nature only. It is not intended as a replacement for medical advice. Any actions taken as a result of information obtained from this site are done so at the risk of the reader. It is recommended that you discuss your plans with your doctor and your baby’s doctor before taking any actions 139 Responses to “FAQs- Ask Yours Now!” Leave a Reply |
 
 
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February 14th, 2008 at 12:55 pm
I am worried my Medela breast pump accessories and Avent microwave sanitizer have BPA in them. I just switched bottles because of it. Any info about this would be appreciated.
February 14th, 2008 at 2:23 pm
I am admittedly not an expert on this subject and just learning about it as well. It certainly is concerning. From some sources that I have read, it appears that BPA levels generally are at a dangerous level in all of use.
The Environmental Working Groups has information on their site about baby-safe bottles and formula (since formula can have sigh levels of BPA leaching from the can linings). You can read this information at http://www.ewg.org/babysafe. On this page they do state that Medela pump tubes, shields, and jars are BPA and phthalate free which is wonderful news. They say nothing about other pump manufacturers.
I do not currently have any information regarding the Avent microwave sterilizer. Avent bottles were found to be one of the worst in terms of the BPA leaching, but their sterilizer is not made of the same plastic. I will see if I can find out more about it for you and post here if I do get any new info.
Depending on the age and health of your baby, you might consider no longer sterilizing and simply hand wash well with hot soapy water, rinse well, and then allow to air dry. Speak with your doctor about this alternative. Sterilizing is very much a regional thing as well depending on water quality and other such factors.
February 25th, 2008 at 1:42 pm
I have been pumping exclusively for my 8 wk old for about a week now. Nursing wasn’t going well, and my milk supply was dwindling so I began to pump to build back up. Anyway, a couple of days ago, a blister formed on one of my nipples and popped yesterday. Now today, I found this white substance floating on the top of my freshly pumped milk. It wasn’t where the milk had separated as I had just pumped it. I shook it up, and it floated back to the top. It is white and looks sort of like sour milk (curdly). Is this pus, or infection of some sort? Any help would be greatly appreciated.
March 11th, 2008 at 11:18 am
Hello,
Thanks for your question!
It may be a number of things and and will preface anything I say with recommending you see your doctor or an IBCLC if it continues or you are concerned.
It is quite possible that the blister was blocking some flow of milk from the breast and this may have caused a blockage of milk. This milk that had been unable to move then may have solidified somewhat and then was expressed once the blister broke. This isn’t really any concern and you will likely not notice it again or it will happen for only a short time.
It is also possible for infections, such as staph, to cause what is often described as “stringy” milk. Be watchful for signs of infection in the breast such as tenderness, heat, redness, or general fever and malaise and see your doctor if you do have any symptom that may indicate an infection. With the broken skin from the blister, you are more susceptible to infections. You may want to consider some type of topical ointment such as Dr. Jack Newman’s All Purpose Nipple Ointment until your nipple has healed completely.
I think having small “curds” of milk is actually quite common- I know I experienced this numerous times. My guess is that in your case it is likely related to the blister and a subsequent blockage of milk.
You may want to do a little investigative work to figure out what caused the blister. You certainly should not be suffering any nipple trauma from a breast pump.
Hope that helps.
March 12th, 2008 at 10:34 am
Has anyone used the so called “hands free” pumping bra? I do so much while pumping at work and was wondering if it was real and really worked.
March 12th, 2008 at 4:20 pm
Hi Anna,
I did not personally use a hands free pumping bra when I EPed, but I can tell you that they are very much real and many, many women consider them an essential when EPing. Easy Expressions, Made By Moms, and La Leche League all make hands free pumping bras. Medela makes a hands free pumping kit which can be used with their nursing bras. You can also make your own in a number of ways. Some will use a snug fitting sports bra and cut vertical slits into it into which you can slip the pump flanges. The openings can enlarge and sag over time so you might find that reinforcing the opening with either fabric, elastic, or stitching is a good idea. There is also this tutorial on kellymom.com showing how to use simple elastics to hold the flanges. http://www.kellymom.com/bf/pumping/hands-free-pumping.html.
Perhaps others who have used hands free pumping bras will add their thoughts.
March 13th, 2008 at 1:42 am
Hi Anna,
I also found the article Stephanie is talking about, and I created my own hands free bra, and as a result, am typing this with BOTH hands as I pump!!!
Note though, I took the underwire out of an old underwired bra, and this was much sturdier than finding a softer bra to start with. Also, don’t cut holes for the pump shaft to go through, cut a slit with a craft knife (stanley knife??) and then push the pump through the slit, this will cause it to hold much tighter!
Have fun!
April 7th, 2008 at 4:52 am
Hi there
Firstly, delighted to have found this site a couple of days ago! I’ve been exclusively pumping for nearly 19 weeks now and have felt completely alone and lacking in support.
Having browsed through some of your linked web sites, I’ve come across the expression ‘power pumping’. The amount I’m pumping seems to be dwindling recently and I’m terrified that my supply won’t be enough for my nearly 5 month old. Can you please explain what power pumping is and let me know if it’s futile my trying it at this stage as a supply booster?
On the subject of hands free bras, I didn’t buy one when I first started as I was told that exclusive expressing would never last. However, I have developed a repetitive strain injury in my left hand from holding the pump so, providing my supplies aren’t dwindling forever, I intend to buy one very soon.
April 7th, 2008 at 12:10 pm
Hi Melissa,
I’m so happy you found the site. You are definitely not alone in this! Many other women are out there doing exactly what you are doing. Although I know that at times it can certainly seem like you are the only one!
Some women do find that their supply starts to decline a bit around 5-6 months. I suppose there are a number of reasons for that, but the important thing is that it is certainly not futile to try and boost your supply at this stage. Do make sure you look for other causes such as changes to your pumping regime, pump losing efficiency, initiation of medication or herbal remedies, return of menstruation,etc.
To address your question about power pumping, I’ll start by explaining what it means and what it is intended to do. Power pumping is simply increasing your pumping schedule over several hours or days in order to boost your supply. It essentially will mimic a baby’s growth spurts. So for example, you may take one weekend (or some time preferably when you will have some extra help with your baby) and pump very frequently- every 1.5 to 2 hours- around the clock during that time. Since milk supply is largely controlled by supply and demand and we also know that an empty breast produces milk at a faster rate than a full breast and that milk stasis also slows production, this increased frequency of pumping should stimulate an increase in production. I think most women will see the increase within a couple of days- it will not, of course, be immediate.
Of course, if you return to reduced pumping sessions and/or decreased length of sessions, the increase in supply will not be maintained.
Another alternative is cluster pumping, which is similar to a baby cluster nursing. This is something that you can do on a regular/semi-regular basis without the intensity of power pumping. Cluster pumping is simply pumping very frequently over a very short period of time. So for example, pumping every half hour over a 2 or 3 hour period. This sometimes works well if you don’t have as much time through the day to pump but have someone at home at night to help with the baby allowing you to focus on pumping or if you don’t have the ability to do a focused power pumping regime over a day or two. Don’t worry about washing your flanges in between sessions since you will be pumping so often. You can simply place them in the fridge if you’d like.
Do some investigative work into other causes for a reduced supply. There isn’t always a reason, but sometimes there are things that can be altered to boost your supply back up. Make sure your pump is working at maximum efficiency. Consider renting a hospital grade pump if you are not using one. Ensure you are pumping long enough ( you must remove as much milk as possible) and frequently enough throughout the day. Always remember to lengthen your remaining pumping sessions when you drop sessions. Use massage and breast compressions to empty as fully as possible. Find something else to do while you pump- a watched bottle never fills!
You can always consider herbal supplements like fenugreek or anecdotal lactation boosters such as oatmeal.
How unfortunate that you were told pumping exclusively wouldn’t be a long-term option! Sadly, you are not the only one who has been told this and yet there are many, many women who have proven that it is possible! Do go back to that person and share your success with them. Those in positions of power and influence need to know that this is an option and they need to be informed with accurate, supportive, and empowering information!
April 8th, 2008 at 3:41 pm
Wondering how many ounces per feed and per day a 3 month old typically requires. My son seems to eat everything i pump (i am exclusively pumping) and i am wondering if i should be supplementing with formula or if he is getting enough. I usually am able to pump around 32 ounces a day…does this seem on the high or low side? I usually give him whatever i have pumped the next time he is hungry - and he has yet to refuse any amount i give him. Should i try and hold out for a bigger feed fewer times a day?? Any thoughts would be appreciated. thanks.
April 9th, 2008 at 11:58 am
Hi Amanda-
Thanks for your question. Knowing how much our babies are eating can be such a difficult aspect of bottle feeding!
My general advice would be to look at your baby to determine if he is getting enough. Look at his weight gain, dirty and wet diaper counts, alertness, and development. If you and your doctor have no concerns, then he’s likely getting enough.
32 oz./day would seem to be about an average amount. Some women produce more and some less. Most babies will top out at about 32 oz. while many will never reach that amount. My DS for example, never took more than 25 oz./day.
It can be useful to remember that babies also require oral stimulation- breastfed babes nurse for other reasons than hunger. Bottlefed babies can sometimes overeat because they are looking for the oral stimulation of sucking, not necessarily because they are hungry. Also, because the flow of a artificial nipple tends to be quite fast, babies will often ingest more than they normally would when nursing. Along the same idea as an adult eating really fast and not giving the brain a chance to keep up and send signals that indeed the stomach is full.
Paced bottlefeeding http://www.gbmc.org/womenshealth/lactation/forum.cfm?Action=Detail&thisPARENTID=44540 is a very good technique to use when bottlefeeding as it gives the baby more control over how much he eats and allows that time for the brain to catch up and send out that full signal to the baby. It is also important to provide that oral stimulation, so the use of a pacifier is definitely something to consider if you are not already using one.
Another thing that is interesting to note about milk supply and babies’ intake is that recent research has shown a woman’s supply does not change in any significant way from about 4 weeks post-partum to about 6 months. The idea that a woman’s supply must continue to grow to meet the needs of her baby doesn’t seem to be accurate. More important is that she initates a strong supply to begin with.
Be cautious about getting caught up in the numbers of feeding. Again, look at your baby and go by his signs and signals. Fewer feeds but in larger amounts will not change the amount your baby is eating. I, personally, believe that there is a good reason babies tend to eat smaller amounts frequently throughout the day- let’s not mess with a babies feeding instincts
In the end, trust your motherwit/instinct. You know what your baby needs.
Hope that helps.
April 15th, 2008 at 1:09 pm
Hello, I am continuing to nurse my son of 8 months old, along with pumping for him. I have experienced many problems with nursing & pumping, particularily with my let-down reflex. Many times, especially during pumping, I will feel my let-down and barely any milk comes out. I will also pump for at least 15-20 minutes. I am not sure what is happening. I actually “feel full” in my breasts, but after the let down, only about an ounce or 2 will come out. Am I doing something wrong? Could I possibly not relaxing enough? One more question. My son doesn’t like to nurse very long. After he nurses, I try to pump immediately after. If I can’t get to the pump right away, is it ok to pump about 30-45 minutes after he nurses? Is this more common to do? I know he hasn’t emptied my breast and get worried that my supply will go down. So I nurse/pump quite often “if” my son will let me. I would like to continue to a full year. I’m not sure if we’ll make it. I have tried so hard to keep this up and I will keep at it. I am so passionate about it. Thank you for listening.
April 18th, 2008 at 5:49 pm
I posted a reply on the page with the neat article. But I also wanted to ask a question about my age…could age be a factor in my low milk production? I am 43. I have tried power pumping, Fenugreek, Blessed Thistle, Brewer’s Yeast…and I am still having trouble getting more than 3 ounces at a pump. Sometimes closer to 2 ounces. Admittedly, I do not pump at night. My baby is a special needs baby and her neurological issues do cause extreme fussiness, so I don’t get much down time…I relish my night sleeping, as she sleeps well in the middle of the night. (Midnight to 5 a.m.) A recent case of nipple thrush has likely been a culprit in my low production, as the pain has been unbearable. A little tricky to relax for let down when you are passing razor blades through the ends of your nipples. Any hints or advice would be very appreciated. I so want this to be successful. Thank you!
April 30th, 2008 at 1:45 pm
Hello,
I have been exclusively pumping for 3 months now. My son just turned 4 months and I am working full time. I have noticed my supply has decreased a lot since I have returned to work. How can I increase my supply while I am working 8 hour days?
May 5th, 2008 at 12:25 am
My baby is 9 days old and I started exclusively breast pumping because my baby didn’t latch good enough after several tries and I started to develop some blisters. Is it really o.k. to only breast pump and will it have any impact on milk supply or the baby?
Thanks in advance!
May 7th, 2008 at 12:35 pm
my baby is 2 weeks old and I am exclusively pumping. I am unsure as to what is a normal pump - ie: length of time I should be pumping and how many ounces I should be getting. The last couple of days my milk supply seems less - I’m getting less ounces than usual - is there something I can do - I’m scared I’ll run out of milk.
May 8th, 2008 at 6:40 pm
Hi Cristy,
The milk ejection reflex is largely a conditioned response. Your body will get use to responding to your baby or get use to responding to a breast pump but some women can have difficulty responding to both. There are a few things you can try:
1. Use warm compresses on your breasts or have a warm shower prior to pumping.
Take your mind off of what you are doing and do not bottle watch. Watch tv, make a phone call, surf the internet: find something to occupy your mind while you pump.
2. Use breast massage prior to expressing and massage and compressions while you are pumping.
3. Some suggest using a comb and gently “combing” the breast towards the nipple while leaning forward prior to pumping.
4. Modify the settings on your pump. In order to elicit a let-down, use lower suction and higher cycles (suck and release cycle) and then once milk starts to flow, switch to moderate suction and slower cycling. This mimics the nursing patterns of a baby. Once flow slows, you can revert back to the settings that you used at the beginning to elicit a let-down. Remember that you will experience multiple let-downs per session but some women will need to adjust the pump settings in order to do this.
5. Check your pump and how you are using it. Aside from adjusting the settings during the pumping session, ensure that you are not pumping at too high a suction level; this rarely will assist in removing milk and in many cases seems to reduce the output. Are there any problems with the pump itself? Ensure the diaphragms are intact (it is easy to get minute holes in the diaphragms of both the Ameda and Medela pump kits). Even small perforations can affect the pump’s performance. Ensure the tubing is properly attached. Ensure all parts have been thoroughly cleaned (for example if you are using a Pump in Style, I believe the face plate can be removed and the filter behind cleaned). If possible, get the suction checked with a gauge (see if there is a lactation consultant in your area or a pump rental depot that can check this for you.)
6. Consider trying out a different pump. They are not all created equal and what works for one woman will not work for all. They are different. Make sure you are using one that is a good quality pump. There are, unfortunately, many out there that shouldn’t even be sold as they are very inefficient and in some cases can cause damage.
7. Depending on why you are pumping, you could try pumping one breast while your babe is nursing from the other. This makes use of the oxytocin release that elicits milk ejection while your son nurses on one side.
8. Definitely relax!
Depending on how much you are nursing, 1-2 ounces can be very normal. At 8 months of age, many babies are extremely proficient and efficient nursers and do not need to nurse a long time in order to get what they need. If your son is growing well and having sufficient wet and dirty diapers, trust him that he is getting what he needs. One of the most difficult things with breastfeeding in this age of quantifying everything, is simply trusting your baby is getting what they need without having any way to measure the volume of their intake. But there are many ways still to measure: wet diapers, weight gain, developmental growth, etc.
As to your second question, pumping a half hour or so after your nurse is fine. There is no hard and fast rule. Much depends on exactly why you are pumping and how this all works for you. Again, it seems from your email that you are primarily nursing but concerned about your supply. Your baby will not “empty” the breast every time he nurses- sometimes it will seem quite empty and other times not at all. This is all part of the normal pattern of nursing. Most important is to not limit access to the breast and allow your baby to nurse as long as he wishes. At 8 months of age, babies tend to be quite distractable and interested in everything going on around them. They often do a lot of their nursing at night when it is quiet and there are limited distractions.
Hope this answers your questions. Hard to fully answer without more info
Best wishes,
Stephanie
May 8th, 2008 at 6:47 pm
Hi Bren,
While this is certainly not an area of expertise for me, I do believe that age can, in some cases, affect milk production. When you think about the large effect hormones play in milk production and the change in hormone levels that can happen during the early stages of perimenopause and menopause, it is certainly possible that lactation may be affected if your hormone levels have altered since having your other children. I have done a quick search for references, but haven’t found any yet. I will do a more thorough search and send you that info if found.
You do not mention your baby’s age or the type of pump you are using or your pumping routine (both in the early days and currently). It is hard for me to give any type of specific advice without this information. Depending on your baby’s age, not pumping at night can certainly affect supply since the early morning hours are the time of highest prolactin levels. If you can’t fit any more sessions in, you may want to consider dropping one of your less productive sessions (usually in the late afternoon) and instead trying to pump in the early morning (around the time she wakes up- 5 a.m.- would be a good time to add a session.).
Are you familiar with babywearing? Using a wrap carrier or mei tai carrier would be a wonderful solution to meeting your daughter’s needs but gaining a little more freedom. These types of carriers are comfortable and secure for baby. Baby’s with special needs very much benefit from being worn although you might want to check with your baby’s doctor to ensure there are no complications that might make it inadvisable. www.thebabywearer.com is a good place for info and I’m happy to answer any question you may have about carriers and babywearing as well.
I’m hoping that you have had some relief from the thrush by now. Thrush is excruciating! Your supply can certainly be affected by thrush. Gentian violet is a great, quick, and inexpensive treatment. If it is indeed thrush, you should receive some relief within 24 hours when using gentian violet. Please be sure to treat it with the attention it deserves. And ensure you doctor is treating it aggressively if you are seeing your doctor for it. Thrush is, unfortunately, something that can hang on for a while. If you aren’t getting any relief though, consider that it may not be thrush.
Other things to consider when looking at low supply are: the pump you are using, the size of flange you are using, of course your pumping routine, the length of your pumping sessions, the suction and cycling levels you are using, and the extent to which you are “emptying” your breasts when you pump (massage and compressions can be helpful to remove as much milk as possible).
I hope this answers your questions, at least in part. Again, I’ll do a more thorough search for information on maternal age and lactation and will email you if I find anything of value. You are doing such a wonderful, special thing for your daughter. I hope that she is doing well, and I’m sure that you are enjoying her
Best wishes,
Stephanie
May 8th, 2008 at 6:50 pm
Hi Ronetta,
Without knowing more information, it is difficult to give you very specific advice, but I can offer some general information that may be of help. Knowing more information about how you initiated your supply, the kind of pump you are using, your current pumping schedule, length of pumping sessions, and what your previous and current pumping volumes are/were would be helpful in figuring out why you are seeing a decrease.
It is important to try to follow a similar pattern pumping as a baby would have when nursing. So, as with a baby of about 4 months of age, you should be pumping still quite frequently (while it can vary between individuals, at least 6 times a day would be common). You don’t mention whether you are pumping at work, but I assume you are. Obviously, pumping as frequently as you can is recommended. As well, ensure that you are comfortable and relaxed when pumping at work since stress, discomfort, embarrassment, etc. can hinder your let-down response. Use all the methods to ensure you are removing as much milk as possible during each session (compressions, massage, warm heat prior, etc.). Pumping sessions do not necessarily have to be completed all at once or in other words, if you normally pump for 20 minutes/session, as an example, but have difficulty doing this at work, pumping for two 10 minute sessions will work as well. Remember that babies do not always nurse for the same length nor at regular intervals.
Outside of work, pump as frequently as you can. Pump frequently at night between arriving hom and going to bed- the length of time between sessions is not necessarily as important as the number of sessions (although you certainly do not want to be going much longer than 5 or 6 hours between sessions if possible to avoid). Fitting in numerous pumping sessions every night is like the clustering that breastfed babies often do at every and will help to boost your supply. Milk supply at this stage is controlled primarily by supply and demand, so in order to up supply you need to increase the demand.
If additional pumping at night is not possible, try to do a power pumping session on the weekend. Many women find that this will help to give them a boost by about midweek although their supply will likely dip again by the weekend necessitating another power pumping session.
While not particularly enjoyable, pumping during the night can be a useful way to get in an extra session and make use of the high prolactin levels in your body. Pumping between about 1 and 5 a.m. can sometimes help.
Consider if your supply decrease started as a result of some change such as changing pumps, starting a new medication (including birth control) or supplement, or lifestyle change.
You can of course look at taking some type of galactogogue (milk increasing) such as fenugreek, blessed thistle, or alfalfa. There are also prescription medications that can be taken, but in your situation, I would not say they are appropriate.
You definitely need to look at all aspect of your pumping routine such as the pump you are using (ensuring it is in good condition including the tubing and diaphragms), flange size you are using, length of sessions, consistency pumping, etc. While it is definitely possible to maintain a strong supply when exclusively pumping, it is also much easier to lose your supply without good pumping habits. Seemingly small changes or inconsistencies can affect your supply.
Hope that helps.
May 8th, 2008 at 6:53 pm
Hi Doaa Salah,
First off, congratulations on the birth of your baby!! Amid all the stress of new motherhood, enjoy your baby!
At only 9 days old, you have many options available to you. I would strongly encourage you to seek the help of a skilled lactation consultant if you would like to breastfeed. Your baby has the skills and inborn instincts and reflexes necessary to breastfeed and with some help you may be able to transition to breastfeeding exclusively. You have definitely done a wonderful thing by pumping and protecting your milk supply regardless of how you choose to proceed. You may be interested in baby-led breastfeeding as a means of returning your baby to the breast. Please contact me directly if you’re interested in more info on that.
To answer your question, yes, it is really okay to exclusively pump in that it protects your milk supply, provides you with options, and provides your baby with the nutrition he/she is born to expect- his/her mother’s milk. Pumping, however, is hard work and requires a lot of dedication, time, and effort. But the risks of formula feeding, in my opinion, make the challenges of exclusively pumping seem very minimal.
I will always encourage women to breastfeed their babies, however, I do understand that this is not always possible and in these cases, exclusively pumping and feeding your milk by bottle is definitely the next best alternative. Babies will miss some aspects of breastfeeding that assist in normal development such as the development of the oral cavity, but this isn’t to say that babies fed with a bottle necessarily develop difficulties in this respect. (Dr. Brian Palmer’s website is a good resource for more info about this.) Breastfeed babies also have lowered risks of obesity, diabetes, SIDS, and numerous other diseases and conditions. Some of these are a direct result of the milk itself, but certainly some are, at least in part, a result of the method of delivery. When bottle feeding, it is always adviseable to feed as much as possible as a nursing baby would feed- small amounts more frequently, allowing the baby to regulate their own supply by using paced bottle feeding techniques, etc.
With regards to your questions about impact on milk supply, many women are very successful pumping exclusively and are able to maintain a strong supply for as long as they wish often producing more than their baby requires. However, some women do struggle with supply issues and some require supplementation with formula. The best way to ensure success is to use the best pump you can get, be dedicated and consistent, use good pumping protocols, and don’t be in a rush to drop pumping sessions.
Hope that answers your questions.
Stephanie
May 18th, 2008 at 10:36 am
Hi,
I just want to first say I was so happy to find this website, I too thought I was the only weirdo EP for my child. Brody was two weeks early, had a very small mouth, and extra skin holding his little tongue back. They said snip it but I couldn’t do it. I started pumping in the hospital and it took away the stress of nipple extractors, crying (both me and him), and I knew he was getting the best milk out there. Anyway, my question, I am going on a trip to SF- san francisco- and I will be flying. How do I pump in an airport if there are no AC outlets? Both of my pumps require a plug and I don’t have the money to buy a new battery operated single pump.
Thanks so much for this website!
May 22nd, 2008 at 11:20 am
Hi Danielle,
There can be a wide range of normal, but generally you should be seeing your supply peaking by around 3 weeks or so post-partum- at least 750 ml or 25 oz. It has been shown that mothers’ milk supply does not fluctuate significantly between 4 weeks post-partum and 6 months, so you should be reaching a level that will sustain your baby for the first 6 months of his/her life. The average intake is about 32 oz. with a wide range of normal.
At this point you need to be pumping at least 8 times a day with at least one session in the night between 1 and 5 am. Again, while there is a range of normal, you should be aiming for at approximatey 120 minutes/day divided among your sessions- so about 15 minutes per session if you are pumping 8 times a day. Depending on the pump you are using and how you respond to it, you may need to increase this amount.
It is unusual to be seeing a reduction in supply at this point if you are indeed pumping frequently enough, long enough, and with a good quality breast pump. Frequency is absolutely key in the early days and weeks and can greatly impact your supply both now and down the road. You need to evaluate your pumping schedule and pump and ensure you are doing everything necessary to initiate and maintain a supply. If your schedule is good and you are indeed pumping frequently enough and for long enough with a good pump, then you need to evaluate other possible areas that may be impacting your supply.
May 22nd, 2008 at 11:21 am
Hi Alice,
I do not have any personal experience pumping at airports but I know that there are many women who do. I am assuming that you will be taking your pump with you? I would call the airport that you are flying out of on both ends- or perhaps the airline could also help in this regard. See if they have a specific office to help people with special circumstances (I’m thinking things like a child flying alone or an elderly person that needs transportation and accompaniment, etc.). Explain your situation and that you will be requiring an electrical outlet for your pump while you are in the airport. Never hurts to see if they can accomodate you in some way. Many airports have special passenger lounges and such and you may be able to get into one of these.
You do not mention how old your son is now or how often you are pumping. Another option is to simply alter your pumping schedule on the days you are flying. Pump just before you leave and immediately upon arriving at your destination. You may need to add in a couple extra sessions to make up for any missed while in the airports or on planes, and you may need to add an extra session or two for a couple days just to ensure your supply is maintained. This may not be possible though depending on how old your baby is and how often you are pumping.
Hand expression is another option. Some women do very well with it and it certainly can be done anywhere. And depending on your financial situation, a manual pump is not too expensive. You may also be able to find a gently used manual pump that you can sterilize and use. Personally, I think having a manual pump is not a bad idea if you only have an electric pump. (I speak from experience after living through a blackout for two days when I was EPing!)
Perhaps others will add their thoughts and experiences here. And as an aside, be sure you are familiar with guidelines for taking liquids- specifically breast milk- on planes. Here’s a link that may help http://www.tsa.gov/travelers/airtravel/children/formula.shtm
Enjoy San Fransico!
May 22nd, 2008 at 8:57 pm
Hello - What a fabulous website! I am incredibly relieved and delighted that there is now so much support for EPing. My question is: My son is 5 months, and he has been bottle fed (from my EPing) the last 4 months. I DESPERATELY want him to get back to nursing, but he doesn’t want to have anything to do with the breast! I’ve tried everything (nipple shield, different positions, skin-to-skin, while sleeping, you name it). The LC in my area are of no help. Does anyone have experience with this?? I’ll take any suggestions, ideas, anything! Thank you!
June 6th, 2008 at 9:41 am
Question about going from 4 pumping sessions a day to 3. I have been pumping for 20 minutes 4x a day, and am now back and work and trying to switch to 3x a day for 20 minutes each. I have been trying to extend the time between pumping sessions, but haven’t been able to get to eight hrs yet (it’s been a couple days) without starting to leak. I’m wondering if my approach is right and if this will work out soon, or if pumping 20minutes is too much at a session and this is why. I typically get about 10-12 oz total (~4.5-6oz per breast) at each pumping session. Thanks in advance for any insights you can provide.
June 7th, 2008 at 12:55 pm
Hi Susan,
First off, it will take you longer than two days to see any effect from a change in your pumping schedule. While it is sometimes hard to wait, it will likely take at least a week or more before you are comfortably into a new routine. Be consistent and try to be patient.
When dropping a session, it is a good idea to increase the length of the remaining sessions so that you are pumping for about the same total amount of time per day and maintaining that demand on your body. You may be finding it difficult to extend the time between sessions if you are not emptying as fully as possible when you are pumping, and this may be happening if you are not increasing the length of your remaining sessions.
Depending on your supply and your storage capacity, it can sometimes be challenging to drop a pumping session without decreasing your supply. Simply extending the time between sessions and lengthening the time of remaining sessions is usually the best way to go about it. You can also try to drop the least productive session of the day- which is usually the late afternoon- and work out a schedule for the remaining sessions that works for you.
Another consideration is that you do not need to space all sessions out equally in the day. If you, for example, take a 10 hour period for sleep, that leaves you 14 hours for the three pumping sessions which are then about every 5 hours.
You do not mention how old your baby is. Generally, the younger your baby, the more likely you will find it difficult to stretch the length of time between your sessions. Early on, there is still a lot of hormonal involvement in lactation and you can only alter that so much. And if you are still early on in the game, you may want to be cautious about dropping pumping sessions too early since it can impact your supply in the long-term.
Hope that helps!
Best wishes,
Stephanie
June 10th, 2008 at 7:30 am
I am having lots of difficulty getting my 1 month old to latch on correctly and am thinking of going to exclusively pumping (or at least during the day). I am not sure exactly how to do this. He usually eats every 3 hours during the day and can go 4.5-5 hour stretch at night. When I start to pump should I do 1 breast or two? He usually eats only from one. What if I do not get enough ounces for a bottle in one pumping session? How will I ever stay on top of things?
Thanks.
June 16th, 2008 at 12:17 pm
Hi Sarah,
My first advice would be to ensure you have exhausted your local resources in terms of breastfeeding support- health units, lactation consultants, breastfeeding clinics, etc. Breastfeeding is always the best option, if possible, and definitely less work! If your baby is latching and gaining weight appropriately, consider having a consultation with a board certified lactation consultant (IBCLC) to work on improving your baby’s latch.
If you are switching from breastfeeding to exclusively pumping, my advice is usually to get a good pump. A hospital grade is usually the best option, but many women are also able to maintain a supply with a personal double electric pump such as the Medela Pump in Style or the Ameda Purely Yours. Because the milk ejection response is largely a conditioned response, my suggestion is to begin with a pumping schedule similar to what you would do immediately following delivery. So that means double pumping at least 8 times a day for approximately 15 minutes/session.
Double pumping (i.e. expressing milk from both breasts at the same time) is always preferable when exclusively pumping since in doing so you will increase your prolactin levels and you also benefit from the oxytocin release which triggers let-downs in both breasts. When exclusively pumping, it is important to have as strong a supply as possible (within limits) in order to ensure you are producing enough for your baby’s needs, but also to make your pumping as efficient as possible by removing as much milk as possible to ensure both a strong and consistent supply and ample milk for your baby’s needs.
There is so much information that I can share with regards to the logistics of pumping, milk management, etc., but that is outside of the scope of this FAQ section- not to mention it would take a book. I would recommend that you visit one of the message boards dedicated to exclusively pumping such as the one at iVillage and read some of the archives as well as ask some specific question of concern. Here’s a link to the iVillage board http://messageboards.ivillage.com/iv-ppexcluspump and there are many others you will find links to in the Resource section of this website.
July 6th, 2008 at 5:36 pm
Hi,
I have been trying to figure out what is the normal amount to feed my baby. He will be 4 weeks old his week and i have been exclusively pumping since he was 5 days old. He is eating 30oz per day, 3 oz every 2 hours (2 feedings at night 3-4 hours apart). My question is that my doctor said he could have up to 4oz per feeding, but I think this is based on formula and not breastmilk. If I was to give him 4 oz per feeding, would he automatically be full for longer and feedings would change to every 3 hours during the day? I am afraid of feeding him too much, and when we switched him from 2oz to 3oz per feeding he still ate every 2 hours.
Thanks for any help you can give.
July 10th, 2008 at 7:46 pm
I was breastfeeding my daughter for the first 2 weeks then began to combine with pumping for weeks 3 and 4. Now at 8 weeks, I am exclusively pumping (with an occasional breastfeed here and there). I have been pumping approx. 5 times a day (all my fussy daughter will allow) and was getting about 3-4oz per session, enough to feed her daily. There was a very recent period of a few days where I was not able to pump on my schedule. I was only pumping about 2 times a day getting about 5-6 oz at each session. Now that I am back to my schedule, I am only getting about 2oz per session! I am assuming I hurt my milk supply and need to get it back and increase it. What is the best way to do this?
July 11th, 2008 at 6:35 am
Hi,
I am so happy to have found this site. I gave birth to my baby girl at the beginning of May and had terrible problems with breastfeeding. She was born small and wouldn’t latch on. There were problems after problem with this (the breastfeeding consultants weren’t much help either), and after 3 weeks of trying to breastfeed along with pumping, I decided that exclusively pumping was the way I wanted to go. My baby is now 9 weeks old, and I’ve been exclusively pumping for this time. I tend to pump on average 6 to 7 times per day for about 15 to 20 minutes per session. On average I get about 5 oz. per pumping session (early morning, it’s more like 7.5 oz). My daughter tends to feed 5 to 6 times a day at this point, and I’ve got a great stash of milk (about 1 month’s worth) in the freezer for when I get back to work. I am going back to work in 3 weeks, and I’ll have been pumping for 12 weeks at that point. My question is: When can I eliminate some of the pumping sessions? I would like to go to about 3 pumping sessions per day, and I would really like to eliminate the 3am pumping session if at all possible (although I get the most milk at that time). When can I safely change my pumping schedule so that my milk supply does not decrease? Do you have any suggestions for doing this effectively so that I can get down to pumping 3 times per day? Thank you for this web site!
July 11th, 2008 at 1:30 pm
I have a few questions. I have a 7 week old son I have been exclusively pumping for.
I started taking fenugreek to increase my milk supply at the dosage a lactation consultant suggested, 3-4 capsules 4x daily. Now that my milk supply is up (at roughly 30-32 oz daily) can I stop taking the fenugreek altogether or should I continue? Also, is there a risk of taking too much fenugreek?
I also started smoking again, 2 weeks postpartum, unfortunately. I want to quit for both my son and myself. I pump then if I smoke immediately afterwords, I wait 2 hours before I pump again. I was wondering about using the lowest dose nicotine patch though to aid in quitting. However, since that would be a continuous stream of nicotine in my body, is it better to try and quit on my own by cutting the # of cigarettes I smoke daily until I quit or is it ok to use the patch?
Last question, I pump 7 times daily. Is that enough? I pump every 2 1/2 to 3 hours throughout the day and every 4 hours through the night. Should I be pumping more than that?
July 11th, 2008 at 1:58 pm
I accidently hit submit before I finished that last question(s)…I always pump between 11pm-12 midnight before going to bed. That is normally my last and 7th pump in a 24 hour period. I plan on getting up at 3:30 and then at 7:30 to pump the next 2 times. However, sometimes, I’ve found I sleep through my alarm due to exhaustion…I’ll go to bed at midnight and won’t get up to pump until 4 or even once I slept until 5am! I’ll still pump again at 7:30 like I planned. But what are the effects if that happens? Will my milk supply decrease?
July 12th, 2008 at 1:53 pm
Hi Dee,
Congratulations on your new baby! It is important to realize that a normal breastfed baby will control their own food intake if allowed- this is perhaps one of the reasons why formula fed babes have higher incidence of obesity. I think it is important to allow a baby to indicate when they need to eat and be allowed to eat as much as they wish, not to preset volumes and expect that amount to be taken each feed.
Breast milk does digest more quickly than formula- this is normal and preferred. This is also why breastfed/breast milk fed babies usually eat with more frequency. We need to trust mother nature and her reasons for this- remember that breastfeeding is the biological normal, not formula feeding.
It is important to remember that if your baby was breastfeeding, you would not know the amount your baby was ingesting. You do not need to know. What you need to know is that your baby is growing well (consider downloading the World Health Organizations breastfed baby growth charts to ensure your baby’s growth is appropriate for breastfed babes and not being compared to formula fed babies who do not grow in the same way) and hitting developmental milestones on time. As always, the wet and dirty diaper counts give you a good idea of how things are going.
When bottlefeeding (regardless of what is in the bottle), it is important to pace the feeds. There is some information about paced feedings here: http://www.lowmilksupply.org/bottles.shtml The basic idea is to pace the feeding by having baby sit in a fairly upright position, gently removing the nipple every few sucks, and allowing the baby to seek and draw in the nipple again when she or he is ready for more. Regardless of the flow rate, all bottle nipples will pour milk and this can cause babies to ingest far more than they really require or want. Caregivers also have the tendancy to encourage a baby to finish the bottle. There is nothing wrong with leaving milk in the bottle and having to discard it if necessary.
30 oz./day is about average intake for breast milk. I think your baby’s feeding seems to be very typical for a baby his age. Allowing your baby to eat frequently throughout the day may help to encourage the longer rest at night, although only waking twice a night at this age is great! Recent research indicates that a breastfeeding mother’s production does not significantly change from about 4 weeks post-partum to about 6 months. From this we can also assume that a baby’s intake does not alter that much. You will have a few days here and there where he seems hungrier than usual- go with it, but then will go back to the regular intake. Go with your son’s indications and trust him- he knows what he needs!
One other thing to consider with bottlefed babies is their intrinsic need for oral stimulation. Babies are born needing to suck and when they are not breastfeeding they often do not get the stimulation they want and sometimes this can lead to overfeeding because they suck on the bottle even though they are not truly hungry. A pacifier is worth considering if you are not already using one and if you are not trying to return to breastfeeding. Babies will usually give up a pacifier without difficulty at around 4-5 months of age.
I hope that answers your question fully.
July 12th, 2008 at 1:58 pm
Hi Jenn,
Going from consistently pumping 5X a day to only 2X a day will most definitely hurt your supply, especially if this continued for a number of days. It will take some time and commitment to rebuild your supply. Best way to go about rebuilding supply is to increase the demand. Power pumping for a period of 2-3 days is a good way to start off. The basic idea is to pump frequently around the clock- every 1.5 to 2 hours. This works well if you have someone to help you with your baby. If that isn’t possible, you will need to pump as frequently as possible as often as possible. You don’t need to space the sessions out evenly. Just pump as often as you can; I would recommend at least 8 times a day if possible. Frequent stimulation and milk removal are key. Also, ensure that you are removing as much milk as possible each session- ensure you are pumping long enough (usually a minimum of 15 minutes/session with an aim of around 120 minutes/day), using massage and compressions, etc.
Lactation at this point is all about supply and demand. You must increase the demand to build supply and maintain demand to maintain supply. As with any other supply concerns, it is important to be using a good quality breast pump, double pumping, ensuring you are eating and drinking well, getting as much rest as possible, etc. You may also want to try fenugreek or other such galactagogues to help boost your supply. Here’s a link to Kellymom.com with information on galactagogues including information on specific herbs and doses. http://www.kellymom.com/herbal/milksupply/herbal_galactagogue.html
I hope that answers your question.
July 12th, 2008 at 1:59 pm
Hi Hillary,
If your supply is strong, you can likely safely drop a session now. I usually would not recommend you drop any more than one session every month or two. Take it slowly. Keep good records of your daily volumes and watch for any indication that your supply is starting to dip. Some women can successfully drop down to only 3 sessions per day and still maintain their volumes, but I wouldn not say that is the vast majority of women. Whether or not you will be one of those who can depends to a large extent on the storage capacity of your breasts.
When you do drop a session, you can do it in a couple of ways. You can simply cut out a session and continue pumping the other sessions at the times you would normally pump. Or you can adjust all remaining pumping sessions so they are spaced evenly- i.e. go from pumping every 2 hours throughout the day to every 3 hours. Regardless of how you choose to do it, it is advisable to increase the length of time you are pumping per session so your total number of minutes pumping/day remains unchanged. You need to continue to signal your body to produce the same amount; continue the same demand.
With regards to the 3am session, pumping in the night will help to maintain supply since it is in the early morning hours that your prolactin levels are the highest and pumping during that time makes use of those high levels. You may want to start extending that time slowly: start pumping at 3:30am, then 4am, then 4:30, etc. until you are at a place that you can live with. It is always best to pump as frequently as possible and not go longer than 6 hours between sessions. But everything is flexible to some extent. Again, keep a close watch on your supply and be ready to make changes if necessary to protect it.
I hope that helps answer your questions.
July 12th, 2008 at 1:59 pm
Hi Holly,
Thanks for your questions. With regards to the nicotine patch, I will have to refer you to your doctor or pharmacist for that. I am not a medical professional and since you are right that there will be a constant flow of nicotine into your system, it may very well affect the baby. Do ask your medical doctor. You should know that smoking can reduce milk supply. Here is an excellent response from Karen Gromada regarding the effects of smoking and breastfeeding http://www.netwellness.org/question.cfm/10103.htm There is a comment in the article regarding using the nicotine patch: “Smoking a cigarette or two a day when wearing a nicotine patch also has been associated with more severe symptoms.”
With regards to fenugreek, according to information on Kellymom.com there have been no studies showing negative effects when using fenugreek long-term: http://www.kellymom.com/herbal/milksupply/fenugreek.html You can often discontinue use once your supply increases to sufficient levels, but some women will need to continue taking it long-term. Fenugreek can sometimes cause intestinal discomfort in mom and/or baby. There are some circumstances in which fenugreek should not be used and some possible drug interaction (please see the link above for this information).
With regards to your current pumping schedule, it sounds good. 7 times a day at 7 weeks should be sufficient; of course many things come into play such as the pump you are using. Ensure your sessions are long enough. A rough guideline is to aim for about 120 minutes/day. And don’t beat yourself up about sleeping through your alarm. We’ve all done that!!
I have even fallen asleep while pumping! There shouldn’t be any negative affect to your supply provided you pump when you do wake up and empty as fully as possible (since you will likely be fuller than usual) and then pump again and your next regular time.
Hope that answers your questions.
July 15th, 2008 at 7:51 am
Hi! I have been EPing for about 6.5 months now and plan to continue until my DS is a year old, so I’m halfway there. I pretty much pump whenever I can, usually every 3 hours, never going more than 5 hours in between, sometimes as soon again as two hours in between. I am still waking up in the middle of the night(no set time). I am trying to build up my frozen supply(feeding him 1 month old frozen milk and freezing the fresh from time to time so that the milk in the freezer doesn’t get old)to at least a three month supply. I try to label the frozen with what I have eaten, so that I can figure out what makes DS gassy. Here are my questions.
How much time passes after eating an offensive food in which my milk will still be offensive for him? I.E. If I eat baked beans, I have enough milk frozen that I can just dump that milk, but I don’t really want to dump if necessary, and I’m really not sure if I need to dump all milk for the next, say 6, 7 hours worth of pumping.
Can offensive milk be “diluted” with non-offensive milk? Say, I go off for the day(DS and pump with me), planning to pump and feed, can I mix that mexican I had for lunch with some “safe” milk to make it less likely to affect my son, or have I just contaminated my good milk? Odd questions I know and probably poorly worded, but I’m hoping you kow what I am trying to ask and that surely somebody out there knows the answers! Thank you for a great website!
May 19th, 2009 at 5:51 pm
Any ideas about exclusivly pumping and return of fertility.. I’ve seen varing thought just wondering what experiances are…
I love this site..very comforting..4th child is 8 weeks and still has latching difficulty…and this site has been a blessing after having bf 3 other children and very much desiring for the 4th but not happening…
May 23rd, 2009 at 6:38 pm
Hi Colleen
With regards to your question on pumping and fertility, breastfeeding does provide protection against pregnancy. Lactational amenorrhea is the name given to the natural period of infertility following pregnancy when a women is not menstruating due to breastfeeding. Exclusive breastfeeding is 98-99.5% effective in preventing pregnancy. However, there are certain conditions under which this holds true: you are less than 6 months post-partum, your menstrual cycle has not yet returned, and baby is being fed on cue (including at night) and is not receiving any other food source.
While exclusive pumping may provide some of the same protection against early pregnancy, it is unlikely that it can be as reliable as for women who are exclusively breastfeeding for a number of reasons. 1. Many women who are EPing choose to drop night pumping sessions as early as possible. 2. As you are not feeding on cue, length between sessions may be longer than when breastfeeding. 3. Many women start to drop pumping sessions before the six month mark. A baby, in most cases, will still be nursing upwards of 7-8 times a day, but few women who EP are pumping that often at six months.
A study by V. Valdez, http://www.ncbi.nlm.nih.gov/pubmed/11172791?dopt=Abstract, suggests that there is an increased risk of pregnancy for women who are exclusively expressing breast milk for their babies.
The second condition mentioned above (your menstrual cycle has not yet returned), will vary from woman to woman. Some women see the return of their cycle within a couple months, while others do not see a return until they wean even as long as a year or more.
If you are wishing to use the lactational amenorrhea method to prevent pregnancy when exclusively pumping, it is wise to be very cautious and consider other forms of birth control.
Source: http://www.kellymom.com/bf/normal/fertility.html
June 16th, 2009 at 7:36 am
Hi, This site is wonderful and it is so nice to have support for mothers who Pump. I started to exclusively pump when my daughter was 1 week old. I had a very challenging time trying to get her to latch on and tried everything in the book. I even had a lactate consultant come to the house for 2 months. My daughter would not latch on and I found very little support for mothers who Epump.
There were many times I wanted to give up and would cry at night because my supply was low or I had to give her a bottle of formula. However I am proud to say that my daughter is 9 months old and I am still going strong. I pump on average 4-5 times a day and once at night. My goal is to continue until she is 1 year old. I want to encourage mothers out there to continue to pump even when you feel like giving up. Just think how wonderful it is to give your baby the best start at life - your milk.
June 16th, 2009 at 8:37 am
I have been exclusively pumping for 9 months now. My daughter has been refusing liquids lately and I find it a real challenge to get her to drink. How many oz. of liquids should a 9 month old be consuming in a 24 hour period. She consumes about 16-21oz in a 24 hour period. Is this enough? She is eating 3-4 meals a day and I give her liquids before she eats but she will only drink about 1-2oz. Now she has gotten into the habit again of drinking 2 full bottles at night. She was sleeping through the night but now wants to drink again. Is this normal or should I be trying other methods to get her to drink during the day. I hate to see her not drinking and having to throw out 2-3 oz of breastmilk that she does not want to drink. Thanks
June 17th, 2009 at 10:55 am
Hi Tanya,
It’s difficult to give an exact figure of how much a baby of 9 months should be drinking. I’m assuming that the 16-21 oz./day is breast milk and you are offering her other liquids with her meals? Depending on how much she is eating in solids, this amount seems okay. Is she having plenty of wet diapers?
Breast milk is partly to quench thrist, but it also serves as a complete food source, so if you are feeding 3-4 meals a day in addition to the 16-21 oz., she is likely receiving more than enough food. Naturally, the more solids she receives, the less milk she will drink. It is also quite common for babies at this age to start nursing or feeding more during the night as their days are filled with excitement and activity and they often have a hard time focusing long enough to take in enough milk during the day, so they will wake at night to get what they need. Sleep patterns often change and it is not uncommon for babies who were sleeping through the night to start night waking again around this age.
I would check with your daughter’s doctor to ensure that her weight gain and development is appropriate for her age, but if all is well in this regard, I would trust your daughter to eat and drink what she needs. As long as you make it available, she will do with it as she needs. You really can’t make them do it
If you are concerned about wasting breast milk, try to warm/thaw only a couple ounces at a time and to use fresh milk when possible since milk that has been previously frozen must be thrown out if the baby doesn’t finish it.
Hope that helps
Stephanie
June 25th, 2009 at 7:11 am
A visitor to the site asked about reducing supply. She has been trying to reduce her supply but keeps suffering from recurrent plugged ducts. Here question and the response is on another thread, but I am also including the response below:
Yours is a problem that many EPing moms wish they had, but I know that doesn’t make it any easier to deal with. Having too much milk and being unable to reduce your supply easily can be a very frustrating problem.
Ultimately, supply is managed through the process of supply and demand. But when you run into difficulty lowering supply and are dealing with recurrent blocked ducts, you may need to change your strategy a little bit. A empty breast produces milk faster than a full breast. When a breast is full, the protein FIL (feedback inhibitor of lactation) is present in higher concentration and signals production to slow. As well, as the breast fills, the walls of the aveoli stretch and do not allow prolactin to enter. These two things combine to slow production. The other aspect that is important to understand in your case is that your body will usually continue to produce as much milk as is being removed. The other factor that comes into play is storage capacity. Some women are “blessed” with a large storage capacity which is great in that they can often pump less often but maintain supply, however, it also often makes it more challenging to reduce their supply and wean.
Your general strategy of extending the time between sessions is good, but you may need to go slower and take a two pronged approached. I would suggest you start simply by reducing the length of time you are pumping each session. So if for example you are pumping 20 minutes per session, drop that to 18 minutes. Always be aware of any areas that seem hard or sore and work at them as you pump using lots of massage and compresesions. You may also want to start using warm compresses prior to pumping to help remove milk and avoid blockages. Go slowly. When you find that you can easily manage with the 18 minutes/session, you can drop another minute or two.
The other part of the strategy is to lengthen the time between sessions, but I would suggest you not necessarily schedule the time. Rather than going from every 4 hours to every 6, judge the time on how your body is reacting. Push the limit a little and pump only when you are feeling full, but not painfully full. Perhaps at first it might only be a half hour off your current schedule and perhaps it might only be 2 of your pumping sessions that you are able to extend. Again, go slowly.
I would start with the first strategy on its own for a while. See how your body responds and then begin the second strategy. It is always a good idea to be pumping more than your baby needs just to ensure you have some cushion in case of unforeseen events and to ensure that you don’t drop your supply too low to the point where it starts to decline gradually since you are not pumping very frequently. As with any attempts to increase or decrease your supply, keep records of your output so you can see any trends that are happening.
Another thing to consider since you have a problem with recurrent blocked ducts is the use of lecithin. It is unclear why lecithin can help. Some suggest that it may reduce the stickiness of the fat. Anecdotally it seems to work for many moms with this problem and there are not any contraindications to taking it. See the following link for more information and dosage information: http://www.kellymom.com/nutrition/vitamins/lecithin.html
Hope that answers your question
Best wishes,
Stephanie
June 25th, 2009 at 7:13 am
A visitor to the site asked about increasing supply- specifically when one side was producing significantly less than the other. Her question and the response are posted on another thread, but I am including response here as well.
Thanks for your comment and question. It is important to know that after 3-4 weeks, lactation is driven primarily by supply and demand. Supply is also controlled locally, meaning each breast produces milk independent of the other. It is quite normal for one breast to produce more than the other, although twice as much is a big difference. Did you have plugged ducts or some other problem in the one side which lead to such a decrease?
Increasing supply usually comes down to pumping more frequently and ensuring you are pumping for a long enough time each session. An empty breast produces milk at a faster rate than a full breast, so keeping your breasts emptied frequently is absolutely necessary to increase supply. If you want to increase supply, add in more pumping sessions and ensure you are pumping approximately 120 min./day. You also need to ensure your pump is functioning properly. It’s never a bad idea to clean it thoroughly (including the face plate) and change the white membranes on the flange kits.
If you simply want to increase production on one side, increase the length of time you are pumping that side. However, you mention that you are not currently producing enough for your baby’s needs, so increasing production on both sides is likely a good idea.
In addition to the ideas above, you may consider using a herbal supplement such as fenugreek or blessed thistle to help increase supply. They are best used in combination with an increased pumping schedule. Look at http://www.kellymom.com for information on these galactogogues.
July 8th, 2009 at 5:53 pm
I have been EPing for 8 weeks. I have decided to stop. I had a significant supply of BM, as much as 10 ounces pumped in 10 mintues and I often put 12 or so ounces in the freezer per day. I reduced the frequency from 5 times per day down to none in just over a week. I last pumped about 30 hours ago. Now my breasts are very painful (as expected). Should I pump again to relieve the pain? Or just stick it out? (I have a trip in 10 days during which pumping will be impossible. I am hoping to be somewhat back to normal by then.) Thanks very much, in advance, for your advice. Julie
July 20th, 2009 at 4:14 am
I have started pumping exclusively. My sone is 2 months and was nursing well until last week. How many times per day and minutes per pumping session is the goal? I am currently pumping about 10 per day 15 to 20 per session. I am only producing about 30cc a day right now. I have only been doing this for about three days. I have a hospital grade pump( medela) and I pumped exclusively with my last( though it was a different set of circumstances.) My questions are as follows:
How many times per day, for a 2 month old, should I be pumping? How long at each session? What interval should I shoot for?(ie every 2 hours or can I go longer since he is older?) How much, range, should a 2 month old take in per day?
July 20th, 2009 at 6:14 am
Sorry I was trying to type one handed before. First thank you for your website. I just purchased your book to have as a reference. In the meantime I just need some guidance to steer me in the right direction.
Currently I am pumping 10 to 11 times per day, about 15 to 20 minutes per session. Is this enough to stimulate milk production long term? My son Charlie is big for his age, he is 2 mos and already 14 lbs. He was nursing well until last week and now won’t nurse past letdown. I was also wondering how much, what the range is for volume, for feedings? I want to give him enough but not over stretch his stomach. Can I make enough for a baby that large this early on? I pumped exclusively with my last son but it was under much different circumstances. I would like to pump but not make myself crazy in the process. I am looking for a bit of guidance to make sure I start off in the right direction. Can you help?
July 20th, 2009 at 9:18 am
Hi Julie,
Weaning should never cause severe discomfort or pain. Don’t pump to remove all the milk in the breasts, but do pump to comfort.
I plan on writing an article soon on weaning from pumping. I’ll put the link in here when it is done.
July 20th, 2009 at 9:19 am
Hi Alexis,
10 to 11 pumping sessions per day for 15-20 minutes per session should be more than enough to maintain milk production, in fact this is likely more than most women are pumping at 2 months. However, it really isn’t a factor of how old your baby is but what your milk supply is like right now. You mention in your first comment that you are only pumping 30 cc ( 30 ml or 1 oz) per day right now. Is this number correct? Or do you mean 30 oz./day? Those are two completely different issues
If your supply is indeed only at 30 ml/day, there are many other issues going on. If it is 30 oz./day, that is better, but you do likely want to increase your supply a bit if possible to cushion any changes in supply down the road.
On average, most EPers pump for approximately 120 minutes/day divided among their pumping sessions. The number of sessions per day is largely determined by individual characteristics, particularly a woman’s breast storage capacity. I think a fair generalization would be to say that around 2 months, 5-8 sessions per day would be average. But if you are having supply concerns or wish to increase supply, then more frequent pumping sessions are necessary. It is also important to recognize that while it is often possible to reduce the number of pumping sessions, babies at this age rarely reduce their nursing sessions and, if you do reduce pumping sessions, it is important to continue pumping for approximately 120 minutes/day.
The time between sessions need not be exactly the same, but if you are trying to increase your supply it is best not to go any longer than 3-4 hours between sessions and never more than 6. Pumping in the early hours of the morning- between 1 and 5am- is still very valuable to increase supply.
Babies’ intake of breast milk is difficult to give an exact number. The calorie/fat content of breast milk will vary from mother to mother to some extent. Formla intake is usually determined by baby’s weight x 2.5 to give you a daily volume. This can be a useful starting point for breast milk intake, but shouldn’t be used as an exact number. A general range for breast milk intake is 24-35 oz./day but there are babies that will fall outside of this range. It is important to recognize that babies will usually consume more from a bottle, but this isn’t to say that they require this amount. Bottles have continuous flow which can often inflate a baby’s intake and babies also have a need for oral stimulation and sucking and some babies will continue to suck on a bottle, and continue to drink the milk, only for the oral stimulation. When bottle feeding, try using a technique called paced bottle feeding. For more information about this read here: http://www.lowmilksupply.org/bottlefeeding.pdf With bottle feeding, it is important to take the baby’s lead. Give them frequent breaks from the bottle and allow them to indicate that they want more by allowing them to pull the nipple into their mouth as opposed to forcing it in.
You ask if you can make enough for a baby that large this early on. Of course. You say that he only stopped nursing last week, so you obviously have been making enough for him in order to get that big!
Of course pumping is a different thing than breastfeeding, but you have already shown yourself that you can provide what he needs. It does take some time for your body to become conditioned to the pump. So you very well may have been producing more than you are at the moment. You are doing the right thing by pumping very frequently and for a good length of time per session. Give yourself another week or two to get into the swing of things and then, if your supply is where you need it, you can begin to think about dropping a couple sessions.
You do not mention if you wish to continue nursing. If you do, please find some breastfeeding support in your area. For a 2 month old who had been nursing well to suddenly start refusing or stopping, there is likely a specific cause that could be solved. Happy to help point you towards some help if you’d like.
Hope that answers your questions!
Best wishes,
Stephanie
July 21st, 2009 at 5:39 pm
Alexis emailed with a couple more questions. Below are her questions with my answers added in.
Hey Stephanie,
I have been pumping for 4 days now and have been pumping every 2 hours from 6am to 10 pm then at 2 am( for my 4 hour break). My questions are as follows:
Do I need to try to shoot for 1-5 for my sleep period or will any 4 hour stretch at night be the same? I am trying to stay on the babies schedule. If I need to change then I will. I will say that is the schedule I had last time( child #2) when I pumped exclusively.
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Generally, it is best to try and pump sometime between 1am and 5 am. The reason for this is that this tends to be the time of highest prolactin in your system. Prolactin is the hormone that allows milk production and in the early days post-partum begins milk production, so pumping when these levels are at their highest is beneficial to production.
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How many more days do I need to keep up the 2 hour schedule during the day? Is it just until I reach a certain number of onces?
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My advice would be to determine if you need to increase your supply and to what extent. Increasing supply at this point may or may not be possible, but given that you had been successfully nursing your son without supply concerns, we can safely assume that you have plenty of milk for him and you may require a bit of time for your body to get conditioned to letting down for the pump as well as for your son. It can take several days to see any increase in production, so if you are are trying to increase your supply, I would continue pumping frequently for at least a week. See how your supply reacts. Once you are happy with your supply, or decided that it is not increasing and you aren’t going to make other efforts to increase it (such as herbal supplements or trying different pumps) then you should be able to drop a session or two from your schedule and see how your supply reacts. When dropping a session, always be sure to add additional time to your remaining sessions so you continue to pump for the same total time each day.
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How many oz should I be pumping out for a 2 month old? I think I have calculated around 30- 35 for him each day? He isn’t taking 35 oz yet but I think he will get there as he is 14lbs now.
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This depends on how much your babe is eating, what your long-term goals are, and how much time you have for pumping. I usually recommend trying to build your supply a little over what your baby requires to provide a cushion for unexpected supply dips, emergencies where you might not be able to pump as frequently, or drops to supply that can happen when dropping sessions. Usually 5 oz or so above babe’s intake is suficient and will allow you to build a small stash of frozen milk. Recent research has shown that for breastfed babies, a mother’s milk production does not fluctuate between 4 weeks of age and 6 months. It can then be assumed that a baby’s intake doesn’t really fluctuate during this period either. This may be different for formula fed babies due to the fact that formula does not change as a baby gets older as breast milk does. Or it may be that caregivers tend to believe babies require more as they get heavier and encourage babies to drink more milk from a bottle. Breastfed babes have the ability to regulate their own intake to a large extent. So, if your son is eating 30-35 oz. currently, he’ll likely stay around that until he starts on solids at which point as his solid intake increases, his milk intake will slowly start to decrease.
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What should a daily goal be for pumping? What I mean is how much more than what he is taking in should I be trying to get out?
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Again, I usually recommend 5 oz. or so more than a baby is eating. But there is really no “need” to do this nor is this a fixed number. It really comes down to what you are comfortable with. The thing about EPing -which you are obviously already experience with- is that you have little control over how your body reacts to missing pumping sessions, or dropping pumping sessions, or a pump that becomes inefficient, or some stressful event that happens in your life, … whereas with breastfeeding, a baby take control over all those aspects. If they need your supply to increase, they simply indicate the need to nurse more often. So, personally, I always felt comfortable producing more than my son needed, but some women are perfectly okay just making enough.
Thanks again for your questions!
Best wishes,
Stephanie
August 1st, 2009 at 1:15 pm
I am trying to wean myself from pumping breast milk due to my baby not “agreeing” with my milk. How many days should I pump at a certain time? I mean if I cut my pumps down to 8 minutes each time, how many days should I pump at 8 minutes before going to 7 minutes and so on? Then, at what minutes should I decrease the number of times I pump per day? My breasts should still feel slightly full as I’m decreasing the time because I’m not completely emptying them right?
Thank You,
Jessica
August 2nd, 2009 at 12:19 pm
Hi Jessica,
In answer to your question, the speed at which you can drop pumping sessions depends largely on how large your supply currently is. If you have a very strong supply, you will likely need to spend at the very least 3-4 days before you can drop any more time off your sessions. Ideally, you will want to wait to drop more time until you are very comfortable between pumping sessions at the new length. You do not need to drop time by individual minutes, but should be able to drop 2-3 minutes every 3-4 days. Also, if you are also slowly extending the length of time between sessions in addition to dropping time from your sessions, you will find that you will able to reduce your pumping more quickly. Ideally, I would take a least a couple of weeks to wean. Do not try to do it rapidly as this can lead to concerns with blocked ducts and the risk of mastitis. Do not be afraid to pump if you are really full or uncomfortable (especially when you think you are finished pumping), but just remember not to completely empty. You want to leave some milk in the breasts. You are right that your breasts should still feel slightly full. Just ensure that there are no hard spots/blockages developing and to work them out with massage and compressions if they do- even if this means having to pump for a lengthy period.
Hope that answers your question.
Best wishes,
Stephanie
August 13th, 2009 at 2:37 pm
I tried latching my son for 6 weeks and we decided that pumping and bottle feeding was easier bc he has such bad reflux, NOW at 13 weeks would it be stupid if I tried to latch again? I have been pumping 4-5 times a 24 hour day, I feel like my milk is going to decrease if I do not latch him back on bc is it true that a baby empties the breast better than any pump?
August 13th, 2009 at 3:40 pm
Hi Carolann,
It is definitely not “stupid” to try and latch your son again. If he has not breastfed at all for the past 7 weeks, you may find that he has forgotten how as the sucking reflex can be extinguished if it is not used. However, there is certainly no harm in trying and you may be pleasantly surprised.
You don’t mention how large your supply is right now. You may be worrying that your supply is going to decrease as a result of your currently volume. 4-5 times a day at 13 weeks may be on the infrequent side and you may wish to increase the amount you are pumping. It’s hard to give any advice on that without more information. It is certainly possible to maintain your milk supply long-term with just a pump. But it all depends on your management. You must be pumping frequently enough and for long enough per session and ensure that you are using an excellent quality breast pump. Babies may remove milk more efficiently than a pump, but with the proper management you certainly can maintain a strong supply with a pump.
Hope that answers your questions.
Best wishes,
Stephanie
August 14th, 2009 at 6:31 am
thanks stephanie, my supply is pretty good I think. I get about 12 oz that first pump in the morning, then 4-8oz each pump after that throughout the day. So I would say 25-35 oz a day. I might try to re latch him now that his relux is a little better! So with that amount of milk should I up my pumping to 6 times a day? He eats every 2-3 hours about 4-6 oz each time. But is sleeping through the night 9p-7a usually. I do get up around 6a and pump that is my first of the day, my last being around 10p. Do u know if anyone makes a larger bottle to pump in to? I overfill the medela ones in the morning. Oh and I am using the medela 2009 advanced pump.
August 15th, 2009 at 11:49 am
Hi Carolann,
There is quite a difference between 25 and 35 oz/day. 25 oz/day may be on the low side if your plans are to EP/bf long-term. When EPing, it is best to create a cushion if possible and have a supply that is above what your baby requires since many women do lose some milk volume when they drop pumping sessions and pumping at a low number of sessions per day can eventually lead to gradual decline in supply.
My advice would be to add another session into your day if you can manage it. If your supply is consistently 35+ oz/day then you can try dropping a session again and see if you can maintain that volume with only 5 sessions/day. The fact that your baby is already sleeping through the night for such a lengthy stretch also makes me think that adding that extra session through the day would not be a bad thing. Milk that sits in the breast slows production and that is quite a lengthy stretch of time to go without pumping. Long-term, you may see supply decline because of this stretch of time between sessions.
As for the larger bottles, you can use pretty much any baby bottle on the pump. The ones that Medela/Ameda make for milk collection are ideal for storage and for frequent sterilization, but they are not the only ones that will fit onto the pump flanges. When I was pumping, I bought a bunch of inexpensive Gerber bottles and used those in the rotation. You should be able to find some 8 oz. bottles that will fit your flanges. I know how trying it can be trying to switch over bottles in the middle of a pumping session!
Hope this answers your questions
Best wishes,
Stephanie
August 15th, 2009 at 7:50 pm
Thanks so much I will for sure add another pumping session to my day. And that is AWESOME to know that the bottles fit, I had no idea! FYI I did try to relatch him to the breast and he did great, he nursed for about 20 mins, 10 on each breast but was still a little hungry afterwards so not sure how much he got I am so used to bottle, SO now that I know he can do it I might try to start nursing that extra time insted of pumping one extra time! Thanks so much for the advice it was great and so helpful, love the site so glad I found it!
August 16th, 2009 at 5:41 am
You are most welcome, Carolann. That is so fabulous that your little one nursed so readily! You have a good supply, so don’t hesitate to let your babe continue nursing until he fills his tummy. Look for all the usual signs that he is transferring milk well: jaw drop and pause, ears wiggling, swallowing sounds, etc. Making the switch from EPing to nursing can be a challenge for exactly the reason you mention: you don’t know how much they are getting and after focusing on the numbers for so long it can be hard to let them go and just trust your baby and your body to do what is needed. I wrote an article called “The Comfort of Numbers” about this idea which you may find helpful. It’s in the article section of the site.
Best wishes,
Stephanie
August 21st, 2009 at 3:16 pm
This website is great! I have been EPing for four months. I am flying with my baby in two weeks. We will be gone for four days. I am not sure about how much milk I should take with me just in case I can’t pump enough while we are away.
Thank you,
Nakia
August 24th, 2009 at 9:05 am
Hi
I have just heard about expressing as a feeding option. I wish I had heard about it before and I can’t believe I didn’t think of it myself. My son is 12 weeks old, as a bottle feeding mum is it now physically impossible for me to express milk?
Thank you
August 24th, 2009 at 10:21 pm
Hi
I have been EP since my daughter was born in October, 2008. I had so little milk at first. So my daughter lost 1 lb in about 5 days, and didn’t gain her birth weight (7 lb 15 oz) until she was 3 weeks old; and with only supplementing breast milk with some formula. I didn’t give up; I pumped religiously. I also started using Domperidone when she was 2 months old. I was able to produce enough milk when she was 3 months old, so we stopped the formula supplementation. She gained more weight with my breast milk only than when we were supplementing with formula (I think my breast milk has more fat than average). I was also breast feeding (mostly comfort nursing I guess) at the beginning. But after 2 months, she rejected my breast
Right now, I am pumping 3 times, 20 min for each session, and producing 27-29 oz a day. I am planning to EP until my daughter is 1.5 years old, and I want to feed her breast milk until she is 2 years old. So I recently started freezing & storing my breast milk. Right now, I have about 218 oz of frozen breast milk. She currently drinks 15-18 oz of breast milk a day, and she is 22 lb 5 oz at 10.5 months. I was wondering how much I should store for 6 months, when she will be 1.5-2 years old? I was thinking that maybe I might need to increase my pumping sessions to store more milk??
Thanks in advance. This is really a great website.
August 25th, 2009 at 10:37 am
Hi Nakia,
Thanks for your question. First off, I would suggest you make yourself familiar with the requirements for travelling with expressed breast milk. Here’s a link that may be helpful: http://www.tsa.gov/travelers/airtravel/children/formula.shtm. I am in Canada, so am not completely familiar with the regulations in the U.S.A., but always a good idea to cover your bases to avoid unnecessary delays or problems.
I travelled with my son when he was almost a year. At that point I was only pumping 3 times a day and still pumping more than he required for his daily needs. Still, I think I likely took about an additional day’s worth of milk with me “just in case”. In the end I really didn’t need it, but I think often pumping moms feel the need to cover our bases and err on the side of caution. I think I likely also ended up dumping some extra milk prior to the return trip home. We were gone for a couple of weeks and I had built a nice little stash in my mother-in-law’s freezer
As for how much you should take with you, I would suggest this has to do with how much you are currently expressing above your baby’s needs and what your schedule is going to be like while away. If you currently are producing more than your baby’s daily intake, then you likely do not need to bring too much extra milk with you. If you know ahead of time that you are not going to be expressing as often as usual, then you may want to bring a little extra to cover any drop in volumes. I would suggest a half day’s supply would be likely more than sufficient, but again this will depend on the factors mentioned above. You also need to consider your options for storing the milk while away and your ability to bring milk home with you if you have additional milk.
If you are unable to pump as often as you are currently pumping while at home, you may find that as long as you increase your pumping times when you do pump and ensure that you are removing as much milk as possible that you are able to express the same, or close to the same, volume as with more pumping sessions. However, you may find that after those four days away your supply dips a bit. If this happens, you will need to increase the number of pumping sessions for a while to boost up your supply.
Hope that helps some. Have a fantastic trip!
Best wishes,
Stephanie
August 25th, 2009 at 10:37 am
Hi Ce,
Thanks for your question.
Congratulations on the birth of your son! At 12 weeks post-partum, it may be challenging to reestablish your milk supply but it is certainly not impossible. Even adoptive mothers can induce lactation and breastfeed their adoptive babies, so certainly a new mom can do it as well. It will require time and dedication, however. You do not mention if you were breastfeeding initially and whether you established a milk supply in the early weeks post-partum. If this is the case, it will be easier to establish your supply compared to not having established it in the first place.
For someone wanting to reestablish or establish lactation with a breast pump, I would strongly recommend renting a hospital grade breast pump. It will be necessary to begin pumping very frequently- a minimum of 8 times per day- including sessions during the night- and upwards of 10 or 12 times a day is preferable. The general “rule” of pumping 120 minutes/day stands in your case as well. You may pumping for 6-7 minutes and then stopping and doing breast massage and then pumping for another 6-7 minutes to be helpful. Basically for relactation or induced lactation, the pumping schedule needs to be the same as for a mother of a newborn.
The other thing to consider is the hormonal aspect of lactation. Mothers who are inducing lactation usually go through a protocol that helps to establish the required hormone levels condusive to lactation. If you did establish your milk supply and weaned early, then you may not need a lot or any assistance in this area.
Herbal supplements such as fenugreek and/or blessed thistle will likely be helpful in increasing milk supply. And you may need to consider drug therapies such as domperidone or reglan to boost your serum prolactin levels and thereby increase milk supply.
Here is a link to Lenore Goldfarb’s website. She works with women who want to induce lactation for adopted babies. Not all of the information on her site will relate specifically to your situation, but some will be helpful: http://www.asklenore.info/breastfeeding/abindex.html
Here’s a resource list for inducing and relactating: http://kellymom.com/bf/adopt/relactation-resources.html
And a few other links that may help: http://www.alisaikeda.com/Clients_Clips/Relactation/body_relactation.html
http://whqlibdoc.who.int/hq/1998/WHO_CHS_CAH_98.14.pdf (I haven’t actually read through this one, but it may be helpful.)
Other things to consider:
- hold your baby skin to skin as much as possible. Consider using a baby carrier to facilitate this. Even if you do not wish to breastfeed directly, this will help your milk supply.
- things such as birth control pills (especially those containing estrogen), cigarrettes, and high levels of stress may make relactation difficult.
The big message here is that it is definitely possible to relactate or induce lactation. Do your own internet search for “relactation” and you should find additional resources.
I hope this helps answer your question. Let me know if I can be of any more help.
Best wishes,
Stephanie
August 25th, 2009 at 10:59 am
Hi Seda,
There is no quick and easy answer to your question. So much depends on how much table food your babe is eating at that age and whether you are introducing cows’ milk in addition to breast milk or using only expressed breast milk. Children of that age are very different and their intake of food is very different. Cows’ milk certainly isn’t required for a child (I’m of the attitude that cows’ milk is for baby cows) but you certainly can offer other liquids to your baby. Breast milk at that age does not usually provide 100% of the needed liquids.
Breastfed babies of that age may still be nursing several times a day, but this doesn’t mean that they are taking as much milk as they did when they nursed that frequently in the early months. While breastfeeding is still extremely beneficial after a year or 18 months, for babies who are nursing it is also very much a social activity and an opportunity to connect with mom, relax, and be calmed.
I would suggest that 15-20oz./day would be a more than safe range to shoot for, but again, your baby might very well eat a wide range and substantial amount of solid foods and not be as interested in milk.
Another factor is the method you use to feed the milk. Babies who are fed milk via bottles tend to take more than babies who use a sippy cup or cup. If you are using sippy cups, your baby will likely be on the lower end of the scale.
I hope this helps some. I apologize for not giving a definite answer, but there are many factors that play into milk intake at that age. Your daughter will certainly benefit from any amount that is available to her.
Best wishes,
Stephanie
September 1st, 2009 at 11:36 am
I am so pleased to have found this website (thank you for taking the time to do this) - my baby won’t latch and I have been devastated. Through determination I have just started to express my milk, however there is not enough of a supply yet to forfil my babies needs, so I have supplemented some feeds with formula to get ahead of myself. I have just learned to use the breast pump however I only have a few oz’s a time. Do you have any suggestions on how to increase my milk and if so how much time do I allow between pumping and how long do I pump for? I would really appreciate some help as I am desperate to continue to feed my baby breast milk. I would really appreciate some advice as my lactation consultant said that it won’t last long (me expressing) before my milk will run dry. Many thanks
September 1st, 2009 at 11:37 am
Hi Allison,
Thank you for your question. I am so happy that you found the website! Congratulations on your baby. I know how stressful and devastating it is to have a baby who won’t latch. You are obviously a very determined and caring mother!
First off, know that it is possible to exclusively pump full-time and maintain your milk supply. I myself pumped for a year and many women have pumped for longer than that. Your milk supply first needs to be established well. This is accomplished through frequent stimulation and milk removal in the hours and days following the birth of your baby. Once your milk supply is established, the supply is maintained through the removal of milk on a frequent basis. Supply and demand largely controls milk supply, however, milk left to sit in the breast will slow milk production, so it is important not to be lax with your pumping schedule and to maintain a regular schedule.
You do not mention how old your baby is at the moment. The earlier you are starting to pump, the more success you will have establishing a full supply. You should be pumping with the best quality pump you can afford- rent or purchase. Often a hospital grade pump is best, but ultimately you need a pump that your body will respond to and one that will elicit a let-down response. If your babe is very young, you are switching from nursing to pumping, or you are having supply issues, you should begin by pumping on a very frequent schedule: a minimum of 8 times a day around the clock with at least one pumping session between 1 and 5 a.m.. As for the length of time to pump, a rough guide is to aim for approximately 120 minutes/day divided among your sessions. The only way to increase supply is to increase the stimulation to the breasts/nipples and increase the demand for milk. A baby does this by nursing more frequently and a pumping mom does this by pumping more frequently.
You can also try herbal galactogogues such as fenugreek or blessed thistle. Here’s a link with information on herbal supplements for milk supply: http://www.kellymom.com/herbal/milksupply/herbal-rem_a.html
I hope that answers your questions.
Stephanie
September 9th, 2009 at 1:53 pm
I have been exclusively pumping for 4.5 weeks now and my son is 6.5 weeks old. I’ve been giving him 4.5oz and he eats about 7 times per day for a total of about 31.5 oz . Recently I’ve added 1 oz to each feed to make sure he’s getting enough what is the average for a baby of this age?
September 9th, 2009 at 3:32 pm
There are a few ways to respond to your question. The first is by saying that the person that knows the needs of your baby the best is your baby, closely followed by you. Always follow his lead. Also, since a bottle has a much faster flow than direct breastfeeding where a baby has a great deal of control over how fast the flow rate is, it is always a good idea to use the paced bottlefeeding technique which will help your baby control his intake better and allow you to feed only what your baby is needing and not inadvertently overfeeding. Here’s a link to information on paced bottlefeeding: http://www.lowmilksupply.org/bottlefeeding.pdf
A formula that is often used to determine intake for a baby is 2.5 X baby’s weight= ounces per day. However, this is based on infant formula and unlike breast milk that changes as a baby ages, formula never changes. Recent research has shown that a nursing mother’s milk production stays relatively stable from about one month post-partum to about six months post-partum. One can assume from this that a breastfed baby’s milk intake is relatively consistent throughout this time as well and then usually starts to slowly decline as the baby begins complementary foods. Average intake is anywhere from 25-35 oz./day with a few babies falling on either side of this range. From the information you provide, your son is likely doing just fine. As long as you are feeding on cue, he will let you know that he is hungry again. But remember that babies do nurse for other reasons other than hunger: comfort, boredom, to help them fall asleep, etc.. Babies will also drink from a bottle for these reasons if allowed to.
Hope this answers your questions.
Best wishes,
Stephanie
September 14th, 2009 at 4:07 am
Hello, I am in desperate need of advice! I have been EPing for 10 mos now, and have gone through my freezer supply already. I also have been experiencing a significant decrease in amount of milk. I am pumping every four hours, and only get 3-4 oz at a pump. I have recently (3 days ago)started taking Reglan and Fenugreek to increase supply, but haven’t noticed any difference. I am desperate, as my baby won’t take formula. I have been feeding her whole milk organic yogurt, babyfood, and cereal,to make up for the deficit in milk, but don’t want her to starve. I wasn’t able to nurse, as she was born with a cleft palate. I am using a borrowed pump in style that is several years old. Should I use a hospital grade pump? What about frequency? I recently began pumping for 40 mins a session. Thanks in advance for you help.
Stephanie
September 14th, 2009 at 6:58 am
Hi Stephanie,
First off, it is normal for supply to start decreasing as your baby ages. However, when EPing, this can sometimes be a result of relatively infrequent or inefficient pumping over a long period. I encourage you to read the article “Critical Factors in Milk Production” on this site to understand just how milk production works and what things impact it.
The simplest answer to your question is to suggest increasing the frequency of your pumping sessions. Try pumping every 3 hours instead of every 4 hours. That should add a couple sessions to your day and help to increase your supply. Taking fenugreek and Reglan can help your supply but they will not do much in the absence of frequent pumping. You must provide the necessary stimulation and “demand” to indicate that an increase in production is needed. And be patient. It will take a number of days to see any result of the medications.
40 minutes/session is a very long session. Are you doing this in order to remove the milk that is there? Or as an attempt to increase production? When you are pumping every 4 hours you should not need to be pumping for 40 minutes/session. Again, increasing the number of sessions as opposed to the length of time per session is recommended. I would suggest you take a good look at the pump and pump parts. Personal pumps such as the Pump in Style were not intended for heavy long-term use. It’s possible that the pump has lost efficiency. Also, ensure you have changed out the small white membrane on the flange. Even a tiny hole in it will reduce the suction. Remove and clean behind the yellow face plate if there is one on that model. If possible, get the suction on the pump tested. See if an area Lactation Consultant perhaps has the necessary equipment to do this.
You may find that a hospital grade pump is helpful, but there is no guarantee of this. If you have concerns about your present pump, a trial rental of a hospital grade pump might be a good idea.
I am admittedly not familiar with the needs of a cleft palate baby. If she is able to eat solids quite well, you may find that simply offering more soft table foods will increase her intake and remove some of the pressure on you. Also, at 10 months of age, some experts such as Dr. Jack Newman, suggest that offering whole cow’s milk is okay if the baby is taking a variety of solid foods and is still receiving breast milk.
I hope that helps.
Best wishes,
Stephanie
September 24th, 2009 at 9:16 pm
Hi - I plan to exclusively pump, but am wondering if I will have to supplement with formula until my milk comes in or will the colostrum be enough for the baby. Is it even possible to pump the colostrum?
Thanks!
Shauna
September 26th, 2009 at 9:01 am
Hi Shauna,
It is definitely possible to pump colostrum however it can sometimes be a challenge. Since colostrum is present in small quantities (as it should be since a newborn’s tummy is very, very small) it can be difficult to express it with a pump. It is possible however. Use good pumping protocol and collect every possible drop with a syringe. The syringe can also be used to feed the colostrums to the baby. You can also hand express which many find more successful for expressing colostrum. With help you can hand express collecting the colostrum on a small, clean spoon and then use the spoon to feed the baby.
As for your question regarding supplementing with formula, it is not always necessary to do this. Whether or not you will need to supplement will depend a lot on how quickly your milk supply increases. Remember that a breastfed baby is receiving nothing other than colostrum and requires no other supplementation. A newborn requires very little, however they do require to nurse/feed frequently. It is extremely important that if you are not going to breastfeed, you being expressing using a double electric, and preferably hospital grade, breast pump as soon as possible after delivery and certainly within the first 6 hours. You need to pump on a schedule that is similar to a breastfeeding newborn which is at least 8X a day- preferably 10+ X /day- for approximately 10-15 minutes/session. You want to aim for around 120 minutes/day divided between the pumping sessions. You also need to be pumping around the clock.
If there are any interventions during labour such as excess fluids given, oxytocin, epidural, c-section, etc., it is possible for lactogenesis (the beginning of lactation) to be delayed. You will need to make a judgement on how your supply is increasing, the size of your baby, and the health of your baby with regards to whether or not supplementation is necessary. Make this decision in consultation with your baby’s doctor. As I am not a medical doctor, I cannot say one way or the other whether supplementation is absolutely required.
Hope that answers your questions.
Best wishes,
Stephanie
September 26th, 2009 at 6:19 pm
Hi,
My son is 15 days old and I have been EP since he was two days old. I was not able to get him to latch on correctly and as a result, my nipples were painful and bleeding. My nipples are still quite sore and sometimes painful. I try to pump every 3 hours or so for 15-20 minutes at a time. When can I expect my nipples to feel better?
Thank you for your assistance.
Leah
September 27th, 2009 at 5:47 am
Hi Leah,
First off, congratulations on the birth of your baby! I’m sorry to hear about your difficulties breastfeeding. Have you seen a lactation consultant (IBCLC) for a consult to determine the cause of pain and bleeding? There may be an easy solution.
I would be concerned if you are still experiencing bleeding at this stage. It is certainly possible to damage your nipples with a breast pump, so you need to ensure that you are cautious with pumping as well. Ensure you are using a high quality breast pump. Many lower quality pumps can cause trauma to the nipple and breast. You also want to ensure that your pump is operating within normal suction levels. A breast pump should never have much higher than 220 mmHg on its highest setting. When you pump, I would strongly encourage you to be using some type of lubricant- either lanolin or olive oil. Pump using the lowest suction setting that will elicit let-down. For most women, starting with low suction and high cycling speed until you get a let-down and then switching to a slower cycling speed and a slightly higher suction (again only as high as necessary) will work best. Very rarely should you need to use the highest suction setting. If you find you must use the highest, it would be well worth locating someone in your area who can test the suction on the pump to ensure it is working properly.
Another thing to consider is the possibility of infection. Since you had bleeding, there was the possibility that an infection may have started and this, if left untreated, can continue to cause pain. Getting a prescription for Dr. Jack Newman’s All Purpose Nipple Ointment (APNO) or something similar may be a good idea. You can get information about APNO from Dr. Newman’s website http://www.drjacknewman.com/help/Candida-Protocol.asp . Print it out and take it to your doctor to discuss.
Finally, you may consider the type of flanges you are using. Silicone flanges, as opposed to the rigid plastic ones, tend to be much more comfortable. Depending on the type of pump you are using, you will have a number of choices.
With any type of open wound, cleanliness is crucial. You should be ensuring that your pump flanges are sterilized at least once a day and preferably more to ensure that you are not inadvertently introducing a secondary infection.
It is also worth noting that women who are fair and tend to have sensitive/dry skin seem to have more difficulty with sore nipples.
Hope this helps.
Best wishes,
Stephanie
September 29th, 2009 at 11:57 am
Hi there-
I’ve been reading over the FAQ’s over the past couple of days and I have found a lot of useful information! This website is great. I have a 4 week-old baby boy. I nursed him for the first 2 weeks and had little success with that, so I began nursing only during the daytime and pumping at night to give my nipples a break. About 5 days ago I began EPing (I latch him on for about five mins at the end of the day just to get him to sleep), and I’m having a couple of issues with the pumping:
1) he likes to eat between 4-5 ounces every 2-3 hours and I am having difficulty keeping up. I am drinking TONS of water and have increased my pumping to every 2 hours for 10-15 mins (for the past day and a half) and the most I get from that is about 2 ounces on each side. I am using a Pump in Style Advanced. I’m wondering how long it typically takes after you increase the pumping frequency to see an increase in production. My goal is to get to 3 ounces on each side every two hours in order to get ahead.
2) He tends to have green stools at least a few times a week, which I know is a sign of the milk imbalance. However, I pump every last bit from my breasts during my sessions so I am almost positive that he is getting enough of the fat- right? Am I doing something wrong?
3) Do I really have to sterilize my pumping equipment once a day? Is there another way to sterelize them besides boiling them in water? It tends to leave a filmy residue on the parts.
I EP’d for my daughter for 2 months and ended up switching to soy formula because we thought it would help with her colic. I don’t remember having an issue with a weak milk supply. Does the fact that I nursed him for a few weeks have something to do with anything? Thank you in advance for your help!
October 1st, 2009 at 3:41 pm
Hi Nichole,
Congratulations on the birth of your baby boy! I will number my responses to correspond to your questions.
1. You are right to increase your pumping sessions in order to increase supply. This is always the first step to take. It may take up to 5-7 days to see a big change in supply. Always keep detailed records of your pumping sessions and look at your supply over a 24 hour period- never session to session as there are always fluctuations during the day. You may also extend the length of your sessions. I would tend to the upper end of your range and pump 15 minutes/session every 2 hours. A general guideline is to pump 120 minutes/day. You need to consider what your schedule is like. When some women say they are pumping every 2 hours, they mean every two hours day and night. But some women mean every two hours while they are awake which a wide variation during the night. You need to be pumping at least once during the night between 1 and 5 a.m..
2. You are correct that green stool can sometimes indicate an imbalance in the amount of fat the baby is getting. However, this is not always the case and a baby’s stool-particularly a young baby- can have a wide range of normal variations. Personally, I think it is very hard for a baby who is fed expressed breast milk to have any concerns with an imbalance in fats. Ensure you are pumping to remove as much milk as possible every session by using compressions and massage. And you may consider mixing milk from sessions to avoid any milk that may be less fatty than other sessions. You are most definitely not doing anything wrong!
3. Yes, I personally, feel it is important to sterilize your equipment. Do you sterilize your baby’s bottles? I suppose this falls into personal comfort to a certain extent, but especially when you are likely storing milk for a period, it is best to ensure that your equipment is not is not introducing any contaminants into your milk. You can use a microwave steam sterilizer. Avent makes one and Medela makes sterilizing bags that are also used in the microwave. You may also be able to use your dishwasher if it gets hot enough.
The fact that you nursed your son for a couple of weeks may be having an effect on your supply. There are a couple possible reasons for this: 1. If your son was not nursing effectively, this may have impacted how your supply was established. Not getting enough stimulation or lack of frequency of stimulation can affect supply. It is more likely though that your let-down response has been conditioned to letting down for your son and it needs to be “reset” to let down for a pump. It will take some time for this to happen. In the meantime, keep up a rigorous pumping schedule and use excellent pumping practices.
Hope that answers your questions!
Best wishes,
Stephanie
October 1st, 2009 at 5:06 pm
Wow! Thank you so much for your help! You are an angel to so many of us who cannot find support or answers to the many questions that we may have. I am living in a rural area, currently, and have found little if no support, so I greatly appreciate your time. Thank you again!
Nichole
October 4th, 2009 at 9:04 pm
Hello!
I am so happy I have found this website-I have been EP’ing my 5 week old since she was born (we were having latch issues and she was losing too much weight). My hope of figuring out breastfeeding is slowly dwindling but I am very committed to EP’ing if I need to, at least till 6 months.
My question is regarding what I think may be an overproduction problem. I currently pump 6-7 times a day and get 8 oz a session (4-5 oz/breast). This is WAY more than my baby can eat. I seem to read a lot about how to increase your milk supply but I cannot find much info on problems surrounding overproduction. I am worried about obvious problems like mastitis, etc. Is there a point at which my supply might start dwindling, also?
October 5th, 2009 at 7:01 am
Hi Andrea-
Congratulations on the birth of your daughter!
You are right that there is not much information out there regarding lowering your supply. Having overproduction is a problem that many wish they could have, but when you do have a large supply it can cause problems of its own. You mention that you are worried about problems such as mastitis so I’m assuming you haven’t had any problems as of yet? This is a good thing and it may be that you will not experience any such problems. Ensuring that you work out any hard spots while you pump and not going too long between sessions will help to avoid such problems. Some anecdotal evidence suggests taking lecithin can help prevent blocked ducts so if you find you are prone to them you might consider trying that.
From the information you provide, I am assuming you are pumping about 50 oz. or so a day. This is a very ample supply and you are right that your babe will never need that amount. Some women choose to freeze and store for a later date to allow them to wean and continue providing breast milk, however this can bring with it its own set of problems with storage etc.
It is important to realize that many women do begin seeing a slow decline in supply often after 6-8 months. There can be a number of reasons for this: not pumping as much, hormones, sleeping through the night, pump losing efficiency, etc. Most women do start to decrease the amount they are pumping as it is very hard to continue pumping 6-8 times a day long-term. I always suggest that if you have a good supply, you do try to maintain it in the early months to provide a cushion later on if your supply does start to decline. However, 50+ oz./day is likely more than you need even to have a cushion
To lower production, you can approach it in two ways: reducing the length of your pumping sessions and increasing the length of time between pumping sessions. You can also combine approaches. This is the same way you will go about weaning. With a very large supply, the best method is to start simply be reducing the length of the sessions by a couple of minutes. Take it slowly. In order to reduce supply you must leave milk in the breast. This will start a feedback loop telling your body to reduce production. Ensure however, that you are massaging out any hard spots to prevent blocked ducts from forming. Continue reducing the length of the sessions for 2-3 days and if that seems to be going okay, you can reduce again another minute or two. You don’t mention how long you are currently pumping, but I wouldn’t take it much lower than 10-12 minutes per session. Once you are comfortable with that, you can extend the time between sessions if you still need to lower supply. I prefer not to simply drop a session and leave all other sessions where they are, but instead spread out all sessions equally. This prevents one long stretch between sessions and the possibility of developing blocked ducts because of that long stretch.
Do take it slowly when trying to reduce supply. You are in an enviable position not having to worry about producing enough for your baby. You don’t want to take it too far the other way and then have to fight to build your supply back up. Give it at least 3 days before making any other adjustments. Keep detailed records. And look at your production in a 24 hour period as opposed to session by session. Look for overall trends. Once you get to a place you are happy with (personally I wouldn’t drop it below 40-42 oz.) sit there for a while and see how you are adjusting. Given your strong supply, you likely have a little more flexibility in how many sessions you must pump to maintain your level of production, but it is always best to take it slowly. Building your supply is much more difficult than maintaining or dropping it!
When I was EPing, my supply was very similar to yours. I started reducing the length of my sessions when I hit 50 oz./day. At one month I was pumping 7 times a day, by 4 months I was at about 6 times a day, at around 8 months I was down to about 5, by 10 months down to 4, and then at 11 months I dropped to 3 and weaned from there. Each time I dropped a session I lost an ounce or two of supply. When I started actively weaning at close to a year, I was producing about 28-30 oz. per day. I always increased the length of my pumping sessions to ensure I was still pumping the same total length of time per day. Everyone is different, but that might help you give you an idea of how it can progress.
Hope that answers your questions.
Best wishes,
Stephanie
October 8th, 2009 at 9:44 am
Like everyone else, I’m so glad I found your website! I just had my third baby last month at 27 weeks. He’s 5 weeks old today. For the last week I haven’t seen him because I’ve had a cold (and I have mild asthma, so it takes forever to go away). I’m not sure when I’m going to be able to see him again and it is bothering me, especially since he’s the age now where we could begin to “practice” breastfeeding. Is being completely separated from him going to hurt my supply?
Also, ever since he was born, I’ve been so tired and I’ve had THE hardest time waking up when I need to to pump, whether at night or from a nap. I talked to a lactation consultant about a week after he was born and she said I could have ONE 4-6 hour stretch in a 24 hour period IF I made sure to get the right amount of pumps in for the day while I was awake. Trouble is, I sometimes accidentally do TWO long stretches. This morning I was so exhausted that I purposefully didn’t get up and I ended up doing two 5 hour stretches. I was just so tired, I didn’t know what to do (and I have my two other children to take care of, so once they wake up, I can’t sleep). I looked at the chart where I keep track of my pumping and I’ve done this now three mornings in a row (two 4-6 hour stretches) and now I’m upset (was before, but even more now). Sometimes, I’ve accidentally even gone longer… 7-8 hours. My long term goal is to switch to exclusively breastfeeding when my son gets strong enough. But my question is… is this going to hurt my supply long term and get in the way of that? Breastmilk for my babies means everything to me and I truly hate formula.
Just so you know, I’m currently pumping 9-10 times a day (with the occasional 8). I have to pump for 15-20 (with compressions) and then hand express and then finish it up with a 10 minute pump. It is VERY time consuming and leaves me with hardly any time for anything, but that’s what I seem to have to do to empty myself out and to get enough milk for the day. I don’t know what to do about that. I’m renting a hospital grade pump (Lactina Select), but it just doesn’t empty me out. I’ve had to do this to establish my milk supply and if I didn’t still do it, I estimate I’d get about 1/2 or 1/3 of what I’m getting now and that wouldn’t be enough (for when he is older). I’m currently getting between 32-34oz a day (that’s the range it’s been the last few days). For now, it seems to still be slowly increasing. I’m also very paranoid because my first child was also premature by about 5 1/2 - 6 weeks and due to a lot of circumstances out of my control and also just not knowing a lot of things I know now, I had a low milk supply and it took me 3 months and a TON of hard work to fix it and when he was 9 months old, I had to start supplementing him with formula again and my milk dried up about a week before his first birthday and that was just devastating to me. I don’t want to go through that again. (My second was full term and she breastfed until 16 months without issues, but I had to wean her cold turkey because I was pregnant with my third baby and his placenta got a tear in it. So I am capable of breastfeeding a baby exclusively). I have ordered a hands-free device and super shields from pumpinpals.com Hopefully I can doze off a bit while pumping if I need to once those arrive. But I’m very concerned that these long stretches are going to get in the way of me exclusively breastfeeding my new son down the road.
Thanks!
October 9th, 2009 at 3:18 pm
Hi Julie,
First off, congratulations on the birth of your son. As I’m sure you know having already had a preemie, it is easy to get lost in all the stress of the NICU and feeding and medical concerns. Be sure to take some time to just marvel in the birth of your baby. It must be so tough not being able to see your son right now. Focus on taking care of yourself; this is the best way to take care of him at the moment.
Being separated from him shouldn’t hurt your supply. Some women find it helpful to have a picture or article of baby’s clothing with them while they pump, but for some this doesn’t make a difference. Do what you need and want to. But don’t fret over your supply. At 32-35 oz/day, you are doing quite well! Your focus will be to maintain it.
Before I talk about your schedule, I do want to comment about the use of formula. Being a mother of a preemie myself, I completely understand where you are coming from. I think it is easy to look at formula as an enemy and also to view breastfeeding/breast milk as something that we must do for our child; sometimes this becomes something we must do in order to make up for what part we might feel we played in their early start to life. However, formula has its place. Formula is rightfully a lifesaving measure and it is okay to use it when it is medically necessary. Right now, I don’t see any reason why you should need to use formula- you have a good supply and are gaining the knowledge you need to protect that supply- but in the event that it is necessary, please do see it as a medical intervention just as any other intervention. You are doing all you can to make it work and there is no fault to be placed if something does not work out in the way you had hoped. Having a preemie is stressful and challenging. Do what you can, but allow yourself some slack if needed. We mothers cannot be superheroes all the time!
You were given good information by the LC regarding a pumping schedule. But as I just alluded to, you need to factor in all the other aspects of your life right now and give yourself some leeway. While two 6 hours stretches of not pumping through the day is not ideal, there are a lot of other very good things happening. Managing to pump 8-10 times a day is great. Pumping for 15-20 minutes is great. The fact that your supply is still increasing is also a very good sign. Sleeping when you know you need the sleep is okay and will likely help your supply given that you are maintaining a 8-10 times a day schedule. I would not want to necessarily make it a regular thing that you are not pumping for 6 hours twice a day, but don’t worry that once in a while it will tank your supply.
Frequency of pumping is far more important than spacing of sessions. The fact that you are still managing 8-10 sessions a day is most important. You are going to have many things get in the way of a regular pumping schedule with a babe in the NICU and two other children at home. Prioritize. Get in your sessions where you can and try not to stretch them out too much, but recognize that pumping when you can and taking care of yourself and your family need to fit together. I would even suggest that at 5 weeks post-partum and with a decent supply, you could likely aim for only 8 sessions a day which would give you a little more free time and not demand quite so much. Keep good records of each pumping session and look at your volumes per 24 hour period to recognize any decline that may happen.
As for your experiences pumping, there are a number of things you could try. The Lactina is a good pump but there are many other pumps out there and from personal experience I can say that they are not all equal nor are they all as effective for an individual. What works for one may not work for another. I would encourage you to keep using a hospital grade pump if possible, but if you can you may want to try a different one. I recommend trying a different brand. The Ameda Elite, for example, is a very good pump and Ameda pumps are different in their operation. You may find them to work better for you.
You could also try pumping for 10, resting for 5, and then pumping for another 10. This sometimes helps to get a stronger second letdown. And in regards to letdowns, you should be adjusting the suction and cycling while you are pumping to assist in eliciting a letdown response. Use fast cycling and low suction to begin and then once you letdown switch these so you are using a slower cycling speed and a higher suction, but only high enough to do the job.
Warm compresses and massage prior to pumping can also help. A warm drink and something to take your mind off the “job” can also help by allowing your to relax. You need to ensure you are as relaxed as possible which I know can be difficult in your situation.
I’m sure I could go on and on, but hopefully this will give you a place to start and put your mind at ease a bit. Hang in there! I know how difficult a journey this is. Take care of yourself.
Best wishes to you and your family,
Stephanie
October 19th, 2009 at 6:35 pm
Hi -
How do you know if you have removed all the milk in your breasts during each pumping session? I was reading through your comments, and you suggested that you try pumping for a longer period of time (in addition to frequency), but my milk stops coming out after 10-15 minutes per breast. I try compressing the breast and that gets just a little more out, but it still feels like there is more milk in there but I can’t get it out…
I am still hanging in there pumping for my 4 month old twins. I had been able to provide them with breast milk for about 20 percent of their total food for the day - the rest supplementing with formula. Currently they eat about 5-6 ounces at each feeding.
I recently had to take a course of antibiotics and pumped and dumped for 10 days and admittedly was not as diligent as I had been about pumping and my supply has gone way down. I’ve tried to increase my frequency, but also thought that a longer pumping session might work, but nothing comes out after 10 -15 minutes… Am I getting everything out at each session?
Thanks,
Joan
October 20th, 2009 at 9:43 am
Hi Joan,
Thanks for your question. If we are talking specifically about increasing supply, increasing the frequency is foremost. Adding time to pumping sessions without increasing the frequency of sessions will usually not give good results. It is important to realize that most women will have multiple let-downs per nursing/pumping session. A let-down is caused by the release of oxytocin and it is released in waves. As the first wave of oxytocin passes, milk flow will slow and possibly stop, but then if nursing/pumping continues, another wave of oxytocin will be released and another let-down begins.
When pumping, you can help to elicit another let-down response in a number of waves. Use a high cycling speed and low suction until milk starts to flow. At this point, change the pump settings by increasing the suction and lower the cycling. Once milk flow slows or stops, repeat. Usually, you will get at least a couple let-downs per session. Another strategy is to stop pumping when your flow stops at 10-15 minutes and take a break for 5 minutes or so and then return to pump another 10 minutes or so. This should help to get another let-down.
As well, you can try using warm compresses and massage prior to pumping.
Of course, you can always look at the pump. Ensure that it is working efficiently. Change any parts that routinely wear. You should also be using the best quality, double electric pump that you can afford. And finally, if you feel that your pump isn’t doing the job for you, consider trying out a different type of pump. Different brands do work differently and one might be more effective than another for you.
Hope that helps.
Best wishes,
Stephanie
October 22nd, 2009 at 4:22 pm
Hi,
I have been exclusively pumping for 3 months now, my daughter is 3 months old. I pump every 4 hours during the day and every 6 during the night. I have been taking Domperidone for the last 2 months and my milk supply is more than enough for my daughter. My concern is the colour of her stools. They have been green since a few weeks after she was born. Not every bowel movement is green, but most of them are. Can you please let me know what may be causing her green stools
Thank you!
October 23rd, 2009 at 5:14 pm
Hi Vesna,
Most breastfeeding literature suggests that a baby’s stool can be a wide range of hues and be considered normal. Green stools in and of themselves, may not mean a thing. If there any other signs or symptoms that your baby is exhibiting such as explosive bowel movements, mucousy stool, extreme gas and tummy pain, rashes, eczema, slow weight gain,… then you may be dealing with something that is outside of normal. If your daughter is gaining weight well, hitting all her milestones on time, and generally a happy girl, then there is likely nothing to be concerned with. If you have concerns, or she is showing other indications that there is a problem, it is best to discuss it with her doctor. To my knowledge, domperidone shouldn’t cause any digestive issues in babies, but again, this is perhaps something you need to ask either your doctor or pharmacist.
There is always the possibility of foods you are eating upsetting or disrupting your baby’s tummy. Common culprits are dairy, caffeine, and chocolate. If you feel there is a problem, you may consider eliminating these foods from your diet for a week or two to see if it makes any difference.
I’m not a medical professional, and checking with your baby’s doctor is always the best course of action if you are concerned about her health.
Hope that helps!
Best wishes,
Stephanie
www.exclusivelypumping.com
November 12th, 2009 at 9:40 am
Hi Stephanie,
I would like to thank you very much for your advice. I stopped eating chocolate for 3 weeks and my baby’s stools have retured to a normal yellow colour. It was the chocolate that was making her stools green and upsetting her tummy. Thank you again!
Vesna
December 21st, 2009 at 1:57 pm
I am exclusively pumping milk for my daughter who is 2 months old. She takes a bottle every 3 hours (except overnight which she only takes one) and I have so much breast milk stored already (125 - 5 oz. bags) and want to cut back on my supply but still continue to pump. I have tried to both extend the number of hours between pumping and to decrease the time period at which I pump but I am still uncomfortable and not sure what to do.
December 25th, 2009 at 3:59 am
Hi again,
I got pregnant while EPing (not an accident, on purpose :))). After I got pregnant, I stopped using Domperidone. And my milk started getting really low (it seems to be decreasing each day). My daughter is 14 months old right now, and drinks 12 oz of milk/day. I have been using my frozen milk for a while (adding couple of ounces of cow’s milk as well), and there is only left for maybe a month or less. Now I am getting only 1 oz of breastmilk a day after pumping. I was wondering if I should quit pumping, or whether my milk will increase again in time (14 weeks pregnant right now). Another thing I wonder is, if I continue pumping will there be colostrum for the new baby when I give birth?
Thanks.
December 26th, 2009 at 12:03 pm
Hi Karen,
You are in a position that many EPing moms would envy, but I know that when you want to reduce your supply but have difficulties doing so it can be very frustrating.
You have mentioned the two main strategies that when used in combination usually will help to reduce supply. If you are finding that you are uncomfortable when trying to extend the sessions, my advice would be to pump. You do not need to pump for a full session, but simply pump to remove enough that you are no longer uncomfortable. You will likely need to experience some discomfort in order to reduce your supply. Discomfort however does not mean pain or extreme engorgement.
There are also some herbal supplements you can try that may assist in reducing supply. However, the concern here is that you do not know how effective these may be and what impact they will have, so you need to proceed cautiously. Here is a link from kellymom.com with some info: http://www.kellymom.com/herbal/milksupply/herbs-oversupply.html
You do not mention your current pumping schedule nor how much milk you are currently producing/24 hour period, but on a positive note remember that every ounce you pump is allowing you to continue pumping longer- even if you have to dump some old milk to make room for more. With a strong supply, you will have many options including pumping long-term, weaning and feeding frozen milk for quite an extended period, opportunity to be more mobile without worrying about pumping sessions or missing sessions once in a while.
Hope this helps.
Best wishes,
Stephanie
December 26th, 2009 at 12:04 pm
Hi Seda,
Congratulations on your pregnancy! Whether or not you quit pumping is really your decision. There is certainly no harm in breastfeeding during pregnancy although I’ve never seen any data on pumping during pregnancy I would think it would fall into the same advice. If you do have a high risk pregnancy of any type, you would want to discuss this with your doctor as nipple stimulation can sometimes cause contractions and increase the risk of preterm labour.
Milk supply does usually diminish during pregnancy often largely due to hormonal changes in your body, and it is not uncommon for nursing babes to wean when their mothers become pregnant. Milk supply will often increase towards the end of the pregnancy as your body starts producing colostrum for the new baby. I think it is safe to say that your body will take care of the needs of your new baby first.
Here is a link that may provide some additional information for you: http://www.kellymom.com/nursingtwo/faq/16milkchanges.html
Hope that answers your questions.
Best wishes,
Stephanie
December 29th, 2009 at 8:32 am
I have a 4 wk old premie (born at 34 wks). I have been attempting to breastfeed 1-2x a day with supplementing milk afterwards. I am pumping 8x a day every 3 hours around the clock. I pump about 32 oz a day sometimes a little more and was wondering if I could go to pumping every four hours and still produce the same amount. If my supply is established will I produce the the same amount of milk with 6 sessions a day compared to 8 a day? When is a reasonable time to know your milk supply is established and when you can pump less frequently? Our goal is to have breastmilk for a minimum of six months. Right now she is taking a little more than 2 oz every 3 hours. Thank you so much!!!
Jennie
December 29th, 2009 at 8:33 am
One last question - can you explain switching the cycliing and suction levels on the pump to increase let downs? I am renting a Medela Symphony hospital grade pump. Which is he cycling and which is the suction cycles?
December 29th, 2009 at 9:53 am
Hi Jennie,
Congratulations on the birth of your baby! It sounds as though things are going quite well. 32 oz. At 4 weeks is a good supply. Whether or not you can drop sessions is not a science. If you plan to switch to breastfeeding your babe in the next few weeks, it may be possible to do a test and see if dropping sessions affects your supply. If you feel that you are likely to continue pumping for the next 6 months at least, I would likely suggest that you not drop sessions right now, but wait another few weeks and see if your supply increases a bit more. When pumping exclusively, it is good practice to try to increase your supply beyond what your baby will require at their highest intake- which can range from 24-36 oz./day. Given your baby’s age, you can’t know yet just how much milk your baby will need. Having a cushion makes it easier in the long run.
If you would like to try dropping sessions, I would recommend that you not go from 8 to 6. If you are currently pumping every 3 hours around the clock, you may be able to stretch the time out at night and take a 4-6 hour break and then complete the remaining sessions during the day. You do not need to divide your sessions evenly. But do avoid not pumping for long stretches of time. One 6 hour stretch would be the maximum and other sessions should not stretch more than 4 hours apart.
Also, it is important when dropping sessions that you add time to your remaining sessions so that you are pumping for the same total amount of time/24 hour period.
Regarding cycling and suction, cycling is the suck and release aspect of the pump and suction is the strength of the suction or draw of the pump. The Symphony has a program built into it to help maximum let-downs, however, not everyone is the same and you may want to change how this works to best stimulate let-down. Generally, you want to start with fast cycling and low suction and then once let-down begins, switch to slower cycling and slighter higher suction levels. You can play around with the levels to see which work best for you. Unfortunately, I am not familiar with the particulars of the Symphony pump and cannot speak directly to that pump.
I hope this answers your questions.
Best wishes,
Stephanie
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January 8th, 2010 at 5:58 pm
I have been exclusively pumping since my baby was 2 weeks. She is almost 6 weeks now. I wish I would have found this website sooner because I have not been able to keep up with her demand for most of the 4 weeks I have been pumping. We now give her about 1/2 of her feedings breast milk and 1/2 formula. I want to continue giving her at least some breast milk as long as I can. I go back to work next week and will only be able to pump there 1 time per shift that I work. I am going to pump only 3-4 times per day. Will I be able to maintain the supply I have right now if I pump only 3 times on the days that I work? I will try to pump 4 on the days I am not working.
January 9th, 2010 at 8:31 am
Hi Betsy,
Congratulations on your new baby girl! Without information about your current supply, pumping schedule, and the type of pump you are using, I can only give a general answer.
First of all, please remember that this is not an exact science. There are many different things that come into play with regards to milk supply. However, having said that, I would be very concerned about maintaining a good milk supply at only six weeks post-partum and only pumping four times a day. You may be able to maintain the supply you currently have, but I think that you will likely continue to see a decline. At this stage, in order to maintain a supply sufficient for your baby’s needs, you would likely need to be pumping a minimum of six times a day (there are some women who can pump fewer, but they are in the minority). In order to increase supply, you should be pumping at least eight times a day. Having said that, any increase in your pumping schedule should help to increase supply, but in order to really boost supply, you need to really boost the frequency of pumping.
You have just entered the stage of lactation that is locally controlled, meaning milk supply is regulated by a process of supply and demand. In the first few weeks post-partum, there is still a strong hormonally controlled component of lactation and milk production will happen regardless of breastfeeding or pumping. Once you get to the supply and demand stage, it is all about frequency and milk removal.
Please remember that pumping sessions do not need to be equally distributed. If you can only manage one session while at work, pump with extreme frequency while at home- at least every 2 hours. Never go any longer than 6 hours between sessions. Waking up during the night to pump will also help supply.
Another thing to consider is your right to have time to pump at work. I’m not sure where you live- I am assuming somewhere in the U.S.A.. I am admittedly not completely knowledgeable about laws in the U.S.A. as I live in Canada, but I do know that many states do have requirements for employers to provide time and accommodations to allow breastfeeding moms the opportunity to pump at work. You may want to look into your rights in the state you live.
I hope that helps. Feel free to write back if you have any further questions.
Best wishes,
Stephanie
January 17th, 2010 at 8:44 am
So glad to find this website!!!
I am currently exclusively breastfeeding my 11-day-old son, who is my 7th child. I breastfed all of my others except my first for at least a year, and my last 3 for at least 2 years. Nursing this baby has been an exhausting and painful experience. He has latch issues, and I’m already struggling with my supply, despite doing everything “right.” So I’m considering going to EPing just to decrease the stress.
My main concern is that I won’t be able to EP for as long as I breastfed my other kids. I typically see that “long-term” EPing means 6 months or thereabouts - to me that isn’t very long-term at all. Is it just a pipe dream that I might be able to EP for at least a year and preferably closer to 2 years? What might I need to do in order to do that? Would the key be to keep a frequent pumping schedule longer than most?
January 17th, 2010 at 9:41 am
Hi Kirsten,
I’m happy that you found the website! Congratulations on your new baby. I’m sorry to hear that your little one is having difficulties breastfeeding. Have you had the opportunity to see a lactation consultant? They may be able to help with his latch difficulties.
EPing gives you options and protects your milk supply. If you are able to solve your son’s latch issues you will then hopefully be able to return to exclusive breastfeeding. If you can not overcome the latch issues, then your milk supply has still been maintained and you can shore up your supports to EP long-term.
I would not say that long-term EPing means only 6 months. I pumped for a year and only weaned at that point due to other health concerns. I know of many women who have pumped well over a year. There is no reason to think that there is a limit to EPing. Women lactate for years if the demand is there. Having already breastfed your children for a couple of years you will already understand that milk supply will naturally decline as your baby ages. A baby’s intake of milk at 18 months is much different than a baby at 4 months and their reasons for nursing are also very different. It is important to remember this when EPing past a year. A supply of 30+oz. is likely not necessary as it is in the early months.
In order to EP long-term, there are a few things I would recommend. The first is to strongly consider what type of breast pump you are using. Ensure that you are using the best quality pump you can afford and ensure that you maintain it and change out all wearable parts on a frequent and consistent basis. The second thing I would recommend is to build as strong a supply as you can early on. While it is possible to increase supply later, it isn’t always so easy. It is much easier to deal with a larger supply than you need than to have to increase it down the road. It is important to realize that the frequency of stimulation in the early hours and days after delivery will set your supply long-term. I would also suggest you not be in a rush to drop pumping session- or as you mention maintain a more frequent schedule longer. Supply is controlled by supply and demand and milk left sitting in the breasts will signal the body to slow production. So more frequent expressing will help to maintain supply. Once you drop much below 5 sessions/day, it is more likely that your supply will start to decline. This isn’t to say that you can’t go below 5 and maintain supply, but it is more likely you will start to see a gradual decline at this point simply due to the extended periods between pumping sessions. If you are looking towards pumping past a year, I would encourage you not to drop sessions any quicker than once every couple of months and then monitor your production very closely to see how the drop is affecting you. Also, it is important that when you drop a pumping session from your schedule you add time to your remaining sessions. There is of course really no reason you need to drop sessions, however, it is very tiring maintaining a very frequent pumping schedule and most women will eventually need or want to drop sessions as a means of self-preservation.
The other thing that will require effort on your part is figuring out how to EP with 7 kids in the house. It will take a lot of support, cooperation, and understanding on everyone’s part. However, you have a lot of extra hands which might very well help to lighten the load. I’m sure there is a lot of love and support in your family!
I hope that answers your question.
Best wishes,
Stephanie
January 19th, 2010 at 11:20 am
I had a couple questions:
There are several benefits of breastfeeding listed (post pregnancy weight loss, etc.) for the mother (not just for baby), are the same true of EPing?
EPing requires several pumping sessions throughout the day, if freezing the expressed milk can you mix from several sessions and then freeze or does each session need to be frozen by itself? (For instance: If you are pumping 8 times a day would you need to freeze 8 containers for that day or can you mix all from that day and freeze 1 container?)
January 19th, 2010 at 12:12 pm
Hi Miranda,
Yes, for the most part the benefits for a breastfeeding mother are the same as for an EPing mother. The benefits primarily are due to lactation and not the delivery method. The extended period of low estrogen during lactation is also cause of some of the benefits and these are, again, due to lactation and not the act of breastfeeding itself.
And to answer your second question, yes, it is absolutely fine to add milk from different pumping sessions. It is usually best to store in smaller quantities to make it easier to thaw frozen milk and prevent wasting milk, but combining milk is not a problem. It is also okay to add cooled milk to frozen milk as long as the amount of cooled milk is less than the frozen milk. In all cases you need to use the milk appropriately for the earliest expressed milk.
I hope that answers your questions.
Best wishes,
Stephanie
January 26th, 2010 at 2:59 pm
Under another thread a visitor asked about breast massage and compressions. I thought I would post my response here as well since it may help others. My response is as follows:
Hi Lynn,
Breast compressions are done by placing your hands in a C hold with thumb on top of the breast and fingers underneath. Keep your hands well back from the nipple. You need to be placing your fingers behind the milk ducts which you will easily feel if your breasts are quite full of milk. Gently apply pressure. You can apply a slight forward movement as well if you find this helps- similar to hand expressing. You will often see a substantial increase of milk flow when you are applying pressure. Here is a video of Dr. Jack Newman’s showing breast compressions: http://www.youtube.com/watch?v=HJrBRYxDNSE It is with a breastfeeding mom, but the technique is the same and shows hand placement. You may find that by moving your hand around the breast to apply pressure in different areas, it will help to remove milk better.
Breast massage can be done with the tips of your fingers. Apply gentle pressure while massaging in a circular motion. Work around the breast. This technique is very helpful if you have any areas that are slow to release milk or blocked ducts. Here is a link to another video that shows briefly massage: http://video.about.com/breastfeeding/Breast-Feeding-Problems.htm
Thanks for your question! I hope this answers it fully.
Best wishes,
Stephanie
January 28th, 2010 at 4:33 pm
Hi Stephanie,
Help! My daughter is 2 weeks old and I have decided to EP because it is quite a challenge dealing with latch-on issues, sleepy baby, etc. I still try to breastfeed directly but it has been more of comfort nursing. I end up pumping anyways after each nursing session. Everything seems to be going well..I got so excited when I finally saw my supply increasing. I was pumping 2-2.5 ounces at each session and I pump at least 8 times a day. Unfortunately, 2 days ago..I made a mistake of going for 8 hours without nursing or pumping. (i was not home and did not bring a pump). That was the first time I felt the pain of engorgement. Boy it hurts! I pumped right away as soon as I got home. But since then, it pains me to see my supply dwindling down. I could only get less than an ounce at each pump session! I use the Medela PIS Advanced and pump for 20 mins. I could not keep up with my daughter’s needs and sadly, I need to supplement with formula. Please help! Can one mistake like that really have such tremendous consequences? What do I do to increase my supply again??
Lynne
January 30th, 2010 at 8:33 am
Hi Lynne,
Going on what you have told me, my guess would be that you have developed some very nasty plugged ducts due to the extended length of time you went without pumping. Yes, most definitely, going 8 hours without nursing or pumping in the early weeks can do a number on your supply as you are unfortunately experiencing. Consider a nursing baby; would a two week old go 8 hours without nursing? Nature has reasons for this and one of them is to protect mom’s milk supply.
You need to get the milk flowing and work out any blockages that may have formed. The longer they stay, the lower your supply will go.
You had previously asked about breast compression and massage; these are going to be your best friends right now! Here’s what I’d suggest:
1. Pump very frequently around the clock- every two hours at the outside. And do not go longer than 3 or 4 hours at night without pumping. Sleep is important, but right now you need to focus on rescuing your supply.
2. Use warm compresses on both breasts for about 15 minutes prior to pumping. You can use one of those heating bags you warm in the microwave, a wash cloth soaked in hot water, or you can even pour some water into a disposable diaper and then heat it in the microwave- not too hot! Another alternative is to take a nice warm shower and let the water hit your back for 5 minutes or so.
3. Use lots of compression and massage when you are pumping. Feel for any spots that are hard or warm and work at them! The video link I provided to you regarding breast massage will be helpful. You may need to provide some firm pressure to any hard spots, but with consistent massage you should start to feel it breaking down.
4. It may be helpful to pump until the first let-down of milk has slowed and then take a break for 5 minutes and then continue pumping for the remainder of your session. This may help remove more milk.
5. Herbal galactogogues such as fenugreek may be considered.
6. If you baby is latching and nursing well, nurse! A baby is wonderful at loosening and removing blockages in the milk ducts.
7. If you start feeling feverish or unwell, you may have developed mastitis. Do not mess around with this. Go see your doctor. If mastitis lasts longer than 24 hours you will likely require antibiotics.
Hopefully you will start to see an increase in your supply soon. You are still early in the game and will good management, you should be able to see your supply rebound.
Hope that helps.
Best wishes,
Stephanie
February 8th, 2010 at 5:22 pm
Hi Stephanie,
First, thank you so much for this website and for this particular feature. I am exclusively pumping for my one week old daughter and have some questions. Background: my daughter was born full term on January 28th. I breastfed with a nipple shield while we were in the hospital for two days. Both of my nipples are inverted and even when pulled out with the shield they would not stay that way for more than a minute or two. She started to reject the shield on our last day in the hospital and once we returned home I only got her latched on one final time (after about an hour of crying… by both of us). I sent my husband to the store for a breast pump and have been EPing ever since.
I’ve read a million times that you need to pump 8 to 10 times a day to establish a supply but I am having a really hard time doing that. Between caring for a newborn and trying to sleep more than 30 minutes a day I haven’t been able to pump more than 5 times a day and that’s on a good day. I have very large breasts and am able to pump about 25-28 ounces per day on 4 to 5 sessions. Each session takes at least 40 minutes because the milk never seems to stop flowing which is the other reason I’m having trouble pumping more often. Will this supply continue or is it eventually going to drop because of the infrequency of sessions? Is it the number of ounces or the number of sessions that establishes your supply? Is it okay to pump more frequently but not empty the breasts each time?
Thank you for any advice you can offer!
Alison
February 10th, 2010 at 1:59 pm
My DS is 5 wks old and we have started EP because he was not gaining enough weight. He has had issues latching.
My question is, I seem to have a low supply, and I have been pumping right after each of his feedings and then leaving that BM on the counter until his next (he’s on a 3 hour cycle). Is this alright? I seem to have trouble getting a let down if I try to pump 30 minutes before he feeds because I am concerned he will wake up early, hungry before I am done (which he does half the time). I’m afraid the mental pressure is affecting my let down.
I am pumping every 3 hours all day and night (8 times) for 20-30 min and only getting 1-2 oz total at each pumping. The milk never stops completely, just continues to slowly drip out, but after 30 min, my nipples can’t handle anymore. Is this often enough to increase my supply? The doctor wants him taking 3 ozs at each feeding, so I have been supplementing with formlua. Can I mix it right into the BM? Or should I give him a bottle of BM, and then offer more formula. He doesn’t always finish the full 3 ozs, so I hate to waste BM.
Thanks for the help!
Chelsea
February 11th, 2010 at 9:26 am
Hi Alison,
Congratulations on your new baby girl! I’m happy that you’ve found the website.
You have hit upon an area that is very important in terms of understanding milk production and long-term supply. If you haven’t already read the article on this site “Critical Factors in Milk Production” I encourage you to do so. You will find it in the Resources section.
Initially, milk supply is controlled entirely by hormones. You will produce milk regardless of stimulation. However, prolactin levels (the hormone that is largely responsible for the initiation of supply) begin to decrease after only a couple of days post-partum and by about 4 weeks post-partum, prolactin levels are comparatively low. At this point, supply and demand processes take over.
The initial frequency of stimulation is crucial to developing and maintaining a strong supply. In fact, it has been suggested that the frequency in the early days will “set” supply months down the road. One of the reasons for this is the prolactin receptor theory which you can read about in the article referred to above. So, the recommendation to pump 8-10 times per day in the early days and weeks is partially a reflection of this knowledge. There are of course always exceptions, but I think it is safest to follow the guidelines.
The volume of milk you express is important and will help to maintain at least that level, but the frequency is also key. Milk left sitting in the breast signals production to slow/stop. The longer you go between sessions, the more likely your supply will start to down regulate and this can start a cycle that is very difficult to get out of.
At only a couple weeks post-partum, current supply is still largely controlled by hormones, but it is slowly shifting to supply and demand. 25-28 oz. is a decent supply, but I really would be concerned that you will see a drop in supply in the coming weeks only pumping 4X a day. I, of course, cannot see in the future, but in my experience, this is likely. You may have a very large storage capacity which can help to maintain supply on only a limited number of sessions, but your current daily volume is not that large, so I wouldn’t be betting on that to support your supply. I normally suggest that you build as strong a supply is possible and above the maximum that your baby is likely to need (around 32-35 oz/day). Building a supply at or above this level will give you options and allow a cushion in the future when you want to drop pumping sessions and supply may drop as a result. When EPing, it is a mistake to only try to match your baby’s current intake since you do not have the luxury of a baby’s growth spurts and more frequent nursing to increase supply and to do this with a breast pump means adding pumping sessions when your baby is older and your time commitments are greater.
40 minutes/session is a very long time and I can see where it would be taxing on you. You say the milk never stops flowing. Is it a steady stream or drips? You can never truly “empty” your breasts. There will always be milk production.
If you are not suffering from engorgement or blocked ducts, my advice would be to cut the length of your sessions in half and increase the number of sessions to at least 7 per day. This will actually reduce the length of time you are pumping down to about 140 minutes from 160+ minutes. Keep accurate records of your output for each session and look at your daily totals to see any type of increase or decrease in supply.
In addition to that, use all the techniques you can to remove as much milk as possible: warm compresses, massage, and compressions, etc.
The other issue is the type of breast pump you are using. You do not mention this in your email. This can have a huge impact on how efficiently milk is being removed and may explain the length of your sessions. Be sure you are using a quality pump.
Hope that helps.
Best wishes,
Stephanie
February 11th, 2010 at 9:55 am
Hi Chelsea,
You mention that you have just started EPing because of weight gain and latch issues. There may very well be some milk supply issues because of this fact.
Have you been pumping for a portion of that 5 weeks? Let-down is largely conditioned and it can take some time for your body to respond to a breast pump. You are right that stress and pressure can affect let-down. You need to let go of your worry about your son waking up. If you are supplementing with formula already, my advice would be to start a regular pumping schedule and if your son wakes up and you haven’t pumped and you don’t have milk, then use formula. Whether he gets breast milk every feed compared to breast milk one feed and formula another will make little difference. This may allow you to focus solely on your pumping schedule and increasing your supply without concerns about your son’s feeding schedule.
I would strongly suggest you increase your pumping schedule to every 2 hours throughout the day and at least one session at night between 1 and 5 am. Try to go no longer and 4 hours between sessions. This will still work out to about 8 sessions a day, but will increase the frequency and hopefully also increase your volumes. The longer milk sits in the breast, the slower production becomes, so frequency is very important when wanting to increase supply.
You can also try herbal supplements such as fenugreek or blessed thistle. Look at www.kellymom.com for info on these.
And as always, using warm compresses prior to pumping, and breast massage and compressions while pumping can help to remove more milk. Also, ensure you are using a very good quality double electric pump.
Don’t get too caught up in the numbers of feeding. Feed your son until he is no longer hungry. That’s the key. Your baby knows how much he needs. Allowing him to determine his own intake is important. And remember that babies have a need to suck. Providing a soother can ensure they are not overeating as a means of meeting this need.
You can mix formula and breast milk, however, you are right in your thoughts to feed them separately. Formula must be thrown away if it is not finished, however, milk can be used again within an hour or so. Mixing the two often results in some wasted breast milk and when you are working so hard for every drop, it’s a shame to waste it. Also there is some research that suggests feeding the two together prevents some elements of the breast milk from being properly absorbed. For this reason, it is not a bad idea, as I already suggested, to feed them completely separately at different feeding sessions.
Hope that helps.
Best wishes,
Stephanie
February 23rd, 2010 at 2:39 pm
Hi! I am so excited to have found this site, but am afraid I might be too late.
My DD was born 3 weeks early on 4 Dec 09. She was in ICU for a few days so they bottle fed her because I was also on antibiotics for a fever. As soon as I was able (2 days old) I tried to BF to no avail. She would latch, but only comfort nurse. I saw the LC numerous times and tried all kinds of tricks (nipple shield, etc.). I felt like a failure and cried and cried and had to resort to EP. As soon as my milk came in I started pumping. I was home for 8 weeks so I could pump every 3 hours but never was able to express more than 4 ounces at a time. As soon as I went back to work, I sadly had to start DD on formula because I ran out of the few bottles I had in the freezer and I could not pump enough for every feeding. I told myself that I did all I could. I am in the military and it is really hard to “slip” away and pump. Right now I pump as soon as I wake up, once at work, and then 3 times at home in the evening. I cannot for teh life of me get more than 2 ounces on an average of 30 minutes of pumping. I drink lots of water, take fenugreek and try to relax as much as possible.
I know 1-2 feedings a day of BM is not the optimal plan, but I think it is better than nothing. As a mommy its hard to not be able to provide this wonderful benefit to the fullest and I struggle with guilt. My husband sees how overwhelmed I am since I seem to just be pumping on the little free time I have and wants me to just stop. I cant.
Any suggestions on how I can increase the output? I really want my baby girl to get as much BM as possible.
Thanks ladies!
Julie
February 24th, 2010 at 8:58 am
Hi Julie,
Congratulations on the birth of your daughter. First off, you are absolutely right that two feedings of breast milk a day is better than none! You are still giving your baby a wonderful gift and should feel very proud of your determination and effort to provide what you are providing. Your daughter is benefitting! It sounds as though you did all that you could given your circumstances and you need to give yourself credit for that. From my experience, it is very common for mothers to feel the need to continue pumping not so much out of guilt but loss. It is important to recognize the loss that you and your daughter have experienced. You have lost something that you expected and likely very much desired. Grief is very normal under these circumstances. And often mothers deal with this loss through pumping and the feeling of being able to provide something and have control of something even if it wasn’t what was expected and hoped for.
As for increasing your supply, really the thing that needs to be done is to increase the number of pumping sessions. At this point, lactation is controlled by supply and demand, so if you want a bigger supply you must increase the demand. I realize that with your work this may be challenging, but I think you could likely still find some alternative ways to try and increase your schedule. 30 minutes/session seems a little high. I would encourage you to decrease this time and increase the number of session. For example, would it be possible to pump twice in the mornings but to decrease the length of the sessions? Mornings can be tricky if you have a large supply first thing in the morning and are finding you need this amount of time to remove the milk, but by using breast compressions and massage while you are pumping, you may be able to speed the flow of milk. You can also try cluster pumping at night. This basically means pumping very frequently over a short period. So at night pump every 1-1 ½ hours for about 15-20 minutes. Even doing this every other night may show some benefits. The other possibility is to power pump on the weekends or on your days off. This is basically pumping very frequently over a period of a couple days. So pump every 2 hours around the clock on the weekends. Some working moms find that by doing this on the weekend it will bost their supply a bit through the week and help them through that period when they are unable to pump as often. Pumping during the night can also help.
The pump you are using is important. Ensure you are using a quality double electric pump and do not rely on the battery power. Batteries can drain sufficiently to reduce the pumps effectiveness after just one session. Also ensure you maintain it well and switch out all wearable parts on a frequent schedule.
As for your husband, his sentiments are very common. Men often do not understand the emotions that are tied to breastfeeding. They often want to solve problems and always want their wives to be okay. Suggesting you quit pumping is his way of solving the problem for you and ensuring that you are okay since he sees the pumping as the problem and there is nothing he can do to help with pumping more milk. Help him to understand the emotions that you are going through and what it means for you to be able to provide breast milk for your baby. Let him know what you need.
Hope that helps.
Best wishes,
Stephanie
February 25th, 2010 at 6:20 am
Hello again! I wrote to you here back in April 2008 and was sooooo pleased to have a knowledgeable reply from you. I pumped exclusively for my daughter until she was 14 months old (what a year and a bit!) and have lived to tell the tale. I am still coming to terms with that year and the effect it had on me, my daughter and my partner but have another question for you based more in the present!
So I weaned from the pump nearly a year ago but have discovered I am still producing some milk (just a bit if I squeeze when showering). My menstrual cycle which only restarted when my daughter was one, is wonky (longer, irregular cycles, heavier) and I am not convinced that I am regularly ovulating. What I was wondering was if EPing can affect you hormonally for such a long time after. When I went to my doctor, she kind of assumed I was only asking because I hadn’t yet conceived a second child and simply told me I was on the right side of 40 and to have more sex. Not helpful!
I would love to know if you have heard other EPers report similar experiences with regard to milk production and periods / ovulation, but I do realise that this is more a medical issue… Any info most gratefully accepted!
Thank you again for this great site
Melissa
March 4th, 2010 at 1:34 pm
Hi Melissa,
Great to hear from you! What a great accomplishment EPing for 14 months. Well done. I can completely related to your comment about still coming to terms with the year. Seven years after the fact, I think I’m still coming to terms with it.
To answer your question, yes it is normal to still be producing a bit of milk. Some women will still be able to express small amounts of milk months or even a couple years after they have weaned. I don’t know that this is common, but it is not abnormal. Here’s a link that may be helpful: http://www.kellymom.com/bf/supply/galactorrhea.html
This may very well be having some impact on your cycles and ovulation. Estrogen levels are very low during lactation and it may take some time for your hormones levels to get back to pre-lactation levels. Cycles do certainly change after pregnancy and will usually be heavier. If you are concerned, you may consider having hormone testing done to determine where your levels are at. Another option is to see a naturopathic doctor who can help to normalize hormone levels and cycles with natural means such as herbal supplements.
I don’t think your experiences are a result of EPing but instead are quite common for all women who have lactated. However, I would say that if it is bothering you or you have other symptoms that may be related you should investigate it further. Our bodies undergo quite a change during pregnancy and lactation and sometimes it takes a bit for things to balance out again.
Hope that helps some. Best wishes to you and your family!
Stephanie
March 4th, 2010 at 9:04 pm
Hi! I just starting EPing for my 3 week old baby 3 days ago. I was looking on the internet to find more information and support and am so glad to have come across this site. I was exclusively breastfeeding up until 3 days ago but although my little girl was feeding well and gaining weight really well, it just became too time consuming. Sometimes she would take 45 min to one hour to feed. At night she was also more of a cluster eater so it left me very little time to rest and also care for my 2.5 year old.
I have rented a hospital grade Ameda double pump for pumping and currently pump every 2-3 hours for 10-15 minutes per session. I’ve been pumping at least 10 times everyday. In the middle of the night, I pump every 3 hours. I have enough milk to feed my little girl but am really trying to bring up my milk supply even more so I have more of a stock. For the past 3 days I’ve only been able to pump anywhere between 60-100ml per session. She’s eating about once every 3-4 hours and about 80-90 ml each time so I’m definitely pumping more than she’s eating which is helping me build up a small stock. While pumping I also make sure to massage my breast at the same time to ensure I’m emptying them as much as possible. However I haven’t seen an increase in supply yet. So I’m just wondering how long does it take for one to start seeing an increase in milk production? When should I look into taking herbal supplements like fenugreek or blessed thistle to help? I’m hesitant to try fenugreek cause my little girl is very gassy to start with and I’m afraid that my taking fenugreek might make it worse. With my son, my milk supply was definitely much higher but I was also much better about pumping after each feed during the initial days. Is it too late for me to try and bring up milk production?
Thanks for your help!
Best,
Alice
March 7th, 2010 at 7:43 am
hi stephanie
i’m very glad i found this website. i’ve been Ep’ing for my son since he was one week old, he is now 5 weeks. my problem is that i’ve been pumping anywhere from 8 to 11 sessions per day,20 minutes per session with a medela PIS i’ve been taking reglan and fenugreek for a couple of weeks now and even tough i’ve been doing all the ‘right’ things to increase my supply i’ve never been able to produce more than 22 ounces in a 24 hour period, and that was just one day that i produced that amount, typically i produce 16 to 19 ounces. i’ve changed the wearable parts of my pump, i tried breast compressions, massage, medications, etc, nothing seems to work. for these 5 days i’ve been trying power pumping but haven’t seen any results yet. is there any hope for me? my son is increasing his intake and i’m afraid i’m not going to meet his needs when he is older.
thanks for the help
frances
March 7th, 2010 at 9:43 am
Hi Alice,
Congratulations on your new baby! To answer your main question, it will usually take anywhere from four to seven days to start seeing an increase in supply. Consistency is important. If you are pumping 10 times a day and ensuring that you are removing as much milk as possible each session, you should be doing everything right. It may take a little time for your body to become conditioned to let-down for a breast pump since you have been breastfeeding for three weeks. Many women who switch to EPing will find that their supply will gradually increase over the first couple of months if they remain consistent with pumping.
It sounds as though everything was going very well with breastfeeding. It can often seem very time consuming in the beginning- and often bottle feeding is less work in the early weeks- but breastfeeding, after a couple of months, does become much quicker and far more convenient. The early days and weeks can be overwhelming just due to the addition of a newborn into your life. If you would like to continue breastfeeding, I would encourage you to continue nursing your little one. You should find as she gets older, her nursing sessions will shorten and she will become more efficient. It is also important to remember that babies nurse for many reasons other than food. Is it possible your baby is nursing for comfort and closeness or to meet her need to suck? You may consider using a baby carrier such as a sling or wrap to give your baby the closeness she needs. This can also really help when it comes to meeting the needs of your older child (I speak from experience with regards to that). And if you feel your baby may be nursing in order to meet her need to suck, you may consider trying a soother if you are not already. Just be cautious not to use it as a replacement for nursing. Another suggestion would be to see a lactation consultant to get ideas on how to meet your daughter’s needs while at the same time your own. As always, watch your baby for signs that her intake is sufficient.
Hope that helps.
Best wishes,
Stephanie
March 7th, 2010 at 9:44 am
Hi Frances,
Wow. It does seems as though you are doing all the right things. I’ll just throw out a few thoughts.
1. Do you feel as though the pump you are using is removing milk efficiently? Do you feel like there is still a significant amount of milk left in the breasts after pumping? You may consider renting a hospital grade pump on a trial basis to see if it has any impact. I would suggest renting one from a different manufacturer (such as an Ameda Elite) as they do definitely work differently.
2. Were there any interventions during delivery that may have impacted initiation of your supply? Epidurals, pitocin, IV fluids, c-sections, etc.?
3. How soon after delivery did you begin breastfeeding? How often did you nurse during the first day? The first week? How did your son nurse? Was he nursing efficiently or did he have problems with milk removal?
4. Are you on any type of medication including birth control?
5. Do you have a history of PCOS? Do you smoke? Do you have hypoplastic breasts?
Have you had a consultation with a lactation consultant? In this type of situation it may be helpful as she can take a more complete history than I am able to do.
On the positive side, research has shown that a nursing mom’s milk supply does not change significantly from about 4 weeks post-partum to about 6 months post-partum. A breastfeeding baby’s intake does not increase significantly over this time. As opposed to formula when amounts must be increased, a mother’s milk changes as the baby ages so it is not the amount of milk that changes but its composition. While your supply is low, you may find that if you can maintain it, you may very well be able to provide a substantial portion of what your baby requires.
You sound as though you are doing everything right! Give yourself credit for that. You may be able to find a cause of the low supply but you may not. In the end, you should be very proud of your obvious dedication and love for your son. Hang in there. If you want to provide information to the questions asked above and send it back to me feel free. I can try to make further suggestions if anything jumps out at me.
Best wishes,
Stephanie
March 7th, 2010 at 3:22 pm
Hi…
I will be going back to work full time (8 to 5) in mid May and want to start pumping bm.Have bought madela breast pump.My baby is 9 months old and has never been on a bottle before.I give her water in a sippy cup.Should I start her on a bottle or should i go straight to a sippy cup for bm? or will that be too much of a transition?
Have 4 madela bottles for storing bm.I will be breast feeding her during the time she is with me. How many more will i need? Can i mix bm from two pumping times together or will it spoil?
Is there any other brand of bottles in the market that fits the madela pump? can the bottle be converted into a sippy cup style bottle?
Am very worried and scared about how my baby will adjust.
Thanks and Regards
Lakshmi
March 10th, 2010 at 7:38 am
Hi Lakshmi,
There is no reason you need to give your baby a bottle. If she is already using a sippy cup and is use to it, I would stick with that. There is no transition there- she is using a sippy cup and is used to it. The transition of having to have her breast milk in a cup instead of from you will be a transition regardless of how you provide it to her.
How many bottles you need depends on how long you are away and how much you are pumping. You will always need two empty ones to pump into, so consider that in addition to how long you will be away from your daughter. If you are away for 3 feedings, then you will need bottles for at least 3 pumping sessions, plus you will need to leave bottles with your daughter. So you will likely need twice as many pairs of bottles as pumping sessions.
You can absolutely mix milk from two pumping sessions. When labelling the milk, you simply use the date/time of the milk that was first expressed.
Most narrow mouth bottles will fit the Medela pump, to my knowledge. Most bottles are standard sized. If you use a wide mouth bottle, you may be able to find an adapter that will allow you to use it with your pump.
I understand how difficult it can be to return to work and face the prospects of leaving your baby while trying to pump and maintain the breastfeeding relationship. There are some very good books out there that may help you with your transition such as The Milk Memos at http://www.milkmemos.com/ and Working without Weaning at http://www.workandpump.com/
Be sure to plan and prepare ahead of time. If you are not already using the pump, start a few weeks before you go back to work. The let-down response is largely conditioned and it may take you some time for your body to react well to the pump. It never hurts to boost your supply up a bit before you return to work to help cushion and drops you might experience. And definitely breastfeed your daughter as much as possible when you are with her. Do not limit her access at all and allowing her to nurse through the night will help you to maintain your supply and the closeness with your daughter.
Hope that helps.
Best wishes,
Stephanie
March 17th, 2010 at 2:36 pm
Thanks a lot Stephanie.
March 18th, 2010 at 2:40 pm
Hi…
Though I bought the pump some time back i got the time and nerve to start only yesterday..I have one doubt …Each time I pump ( that is yesterday and today one time per day ) I got only a very little bm…Less than 1 ounce…Is that natural?? Or am i doin this wrong???
Anyways my little one sobbed every time the sippy cup was offered instead of the breast…That was yesterday…Today I gave it when she wasnt too hungry and she was willing to try but just a few sips..Inspite of all the encouragement…Lets see where this leads…
Thanks in advance
Regards
Lakshmi
March 18th, 2010 at 5:12 pm
Hi Stephanie,
I have been EPing for my daughter for 8 months, and will be going back to work in one month. I have been pumping every 4 hours during the day and every 6 at night. I want to increase the time between my pumping sessions so that I will eventually be pumping only 3 times per day. My question is: if I only pump 3 times/24 hours will I be able to maintain some sort of a supply to at least give my baby breast milk 3 times per day? I am concerned that if I only pump 3 times/24 hrs, my milk will completely dry up.
In addition, if I am not feeling too uncomfortable, can I simply increase the time between pumping sessions from 4hrs to 6 hrs and then to 8, or is there a reason I should not do this
Thank you!
Vesna
March 24th, 2010 at 9:46 am
Hi Stephanie,
I had my son at 34 weeks, I went into labor on tue & they tried stopping labor with magnisium sulfrat for 48hours and then took me off and i gave birth on friday morning. I started pumping friday night and didnt get anything more than drops till sunday night when i got 5cc. On monday I got around 40 and started to slowly increase. I’m now at about 260cc per 24hrs and its been 13days since my son was born and i’m worried that i wont have enought milk for him and that i’m not producing as well as i should be. Thankfully my son is doing great other than not being able to take a full feeding of 45cc every 3hours has been his only set back. I try to put him to breast every day and he seems to use it as a human pacifire but at least he’s latched on for a good 30min. I have tried power pumping these last 2 days but it hasnt done much except make my nipples really sore. Any advice on how to increase my milk supply? should i try herbs like fenugreek or others? please help!
April 12th, 2010 at 5:09 pm
Hello, I have been wanting to ask this question and looks like I found the right place. I have been exclusively pumping for the past 3 months for my 7 month old. I am currently pumping every 4-5 hrs and sometimes it may go even to 6 hrs. I have noticed that my milk does not accumulate the fat as it used to when I was pumping every 3 hrs until about a month ago. Can you tell me if it si okay to feed my baby less fatty milk and if indeed my milk is less fatty because of the long intervals between pumping sessions?
April 13th, 2010 at 8:34 am
Hi Sophie,
Congratulations on the birth of your son! Sounds like you’ve had a rough couple of weeks. Hang in there; it will get better.
It would be nice to see a larger supply at this point, but you have to remember that your body has gone through quite a trauma with early labour, mag sulphate (which is nasty stuff- I was on it for 24 hours), IV fluids, and likely a few other interventions along the way. Milk production can sometimes be delayed due to some of these interventions, but usually will right itself given time and persistence.
While I know it is difficult not to worry about it, try to focus instead on doing what you can. The rest will happen or not. The key at this point is to be frequent and consistent with your pumping schedule. I would strongly recommend using a hospital grade pump given your situation. Pump at least 8 X a day with at least one session during the night between 1 and 5 a.m. Pump for about 120 minutes/day divided among your sessions. Use warm compresses prior to pumping if it’s convenient, and use massage and compressions during your pumping sessions to help remove milk. Make sure your pump is comfortable. Use some type of lubrication such as lanolin or olive oil.
Enjoy the time with your baby. Lots of skin to skin contact and “practice” breastfeeding is all good. That close contact will help you with your production. Even if your son isn’t latching well yet, it is all good for both of you.
Power pumping is all relative. You should be pumping every couple of hours anyhow given that you are only in the first days of lactation, so it is pretty difficult to increase too much more. It will however take several days for you to see any effect from an increased pumping schedule.
Other things to think about are whether you are taking any type of medication (including birth control), have any type of history that may affect supply such as PCOS or diabetes, are a smoker, etc. Do you have access to a lactation consultant at the hospital? They should be able to take a good history and ensure everything is physiologically normal.
You can certainly try herbal galactagogues such as fenugreek. Another option, if you are pumping frequently and not seeing any increase is to try domperidone. You will want to speak to a lactation consultant or doctor about that.
Hope that helps!
Best wishes,
Stephanie
April 13th, 2010 at 8:35 am
Hello Gayathri,
While it is normal for the amount of fat in milk to reduce as your baby ages, it is possible that the reduction of fat also has to do with the length of time between pumping sessions.
Fat is released from the breast as the breast empties. Therefore, if you are pumping at long intervals and your breasts are full, the milk that is first removed will have a relatively small amount of fat. As the breast empties, more and more fat will be released. Conversely, if you are pumping frequently and your breasts are not too full, the fat will be released into the milk from the start and the level of fat will be fairly consistent throughout the pumping session.
If the reduction of fat is due to the long intervals, it is important that you are emptying your breasts as much as possible when pumping. Leaving milk in the breasts will also cause your production to drop.
It is okay to feed your baby the milk. Ensure that you are emptying as much as possible when pumping and since the milk from a session is usually mixed, the fat will even out.
Hope that helps.
Best wishes,
Stephanie
May 1st, 2010 at 8:34 pm
Just wanted to say again that i love this site and i am so grateful to have found it. Our Mackenna is 3 months old, i’ve been exclusively pumping since about 2 weeks. I’ve never had a problem with my supply and now that my milk supply is well established i can easily get 40 oz a day, even when i pump on an irregular schedule.
I had to post because i had been using a First Years Mi double electric pump and because my volume was so high I had to do compressions and massage the whole time to drain properly. It was becoming such a burden to pump that i told my husband something i needed to change or i was going to give up. So for an early mothers day present he got the families to go in and purchase me a Medela Freestyle double electric pump. and i LOVE it. i can drain completely, with no added assistance from me in less than 10 minutes!!!! I can not tell you how wonderful that is. It’s completely revitalized my commitment to pumping long term.
I’ve been reading about the issue of lipase and freezing milk. People recommend scalding the milk before freezing. My question is what exactly is scalding and how do you do it???
Thanks for all the hard work on the site!
Shannon M
May 3rd, 2010 at 8:50 pm
Hello!
I have been struggling for the past week with issues related to one breast. I am exclusively pumping for my 6 week old daughter. Everything was great (much more milk than with my first daughter) until about a week ago. I started having shooting, stinging pains in my right breast. I noticed there was some sort of blood blister on the end of my nipple, and attributed it to that. The blister healed within a couple days, but the shooting “electrical pulses” continue. They happen no more than once per day, but bring me to tears when they happen. I also have had a significantly lower output from that breast since all the pain started, and now get maybe 1/2 - 1 oz per pumping. This one breast is obviously not emptying, and also seems engorged now. When I went for my 6 week check up, the doctor simply told me that I wasn’t “letting down” and emptying the breast. However, my left breast is able to let down just fine, pumping between 4 to 8 ounces at each pumping with no pain and no problems. I am staying relaxed while pumping and using a hot compress and hot showers/baths to help loosen things up. I am considering discontinuing to pump on the affected side so it will dry up and just pump from the left (is this even okay?). Has anyone ever heard of this and have any suggestions for me? I am feeling quite frustrated and don’t know what to do!
May 5th, 2010 at 9:21 pm
So I have been EP for about a month now and am down to 4 pumps a day getting between 7-8 oz a time. Sometimes I feel like I can’t empty my breast even though there is no more milk coming out. I also tend to get clogged ducts quite frequently. I feel this is partly because I am not fully emptying the breast. Any suggestions?? Thanks, Angie
May 6th, 2010 at 3:20 am
Hi Shannon,
Thank you for your comments and your kind words about the site. I am so happy that you have made to switch to the Freestyle. Having a good pump is certainly half the battle. You are very fortunate to have been able to establish such a strong supply with the first pump.
To answer your question regarding high lipase levels, scalding can be effective in reducing the effects of lipase. However, for the most part, high lipase levels do not have a great impact. Many babies do not care or notice when the lipase activity has been high and so for most women they will never need to worry about the lipase levels. However, if you have a baby that is bothered by the milk after it has been frozen and you think high lipase levels are the problem, scalding can reduce the lipase activity. To scald, simply place the milk in a pot over medium heat and warm it until small bubbles start to form on the surface and then remove from the heat. You do not want to bring the milk to a full boil. Scalding the milk will reduce some of the beneficial components to the milk, so again, only do this if you need to. Of course even scalded milk is preferred to formula if there is a choice.
Best wishes,
Stephanie
May 6th, 2010 at 3:21 am
Dear Emily,
Did you lance the blister or just let it heal on its own? It may be that you still have a blockage in the duct which is not allowing milk to empty. Definitely continue using the compresses prior to pumping and use lots of massage and compressions while pumping. Do you have a certified lactation consultant nearby? I would seek out a consult with a lactation consultant. Often doctors are not experienced in the actual process of lactation or the breast during lactation. A lactation consultant should be able to do an examine and take a history to get an idea of what is going on. If it is a blocked duct, there are a few other treatments for more serious cases, but again, a lactation consultant would be able to advise you.
Another thing that can cause shooting pain is yeast, but if you are only experiencing the pain once a day or so, this likely isn’t the cause.
Be sure to check your pump carefully and replace any wearable parts. If the pump isn’t working optimally, this can definitely affect milk removal.
Best wishes,
Stephanie
May 6th, 2010 at 3:22 am
Dear Angie,
You mention that you have been EPing for a month. Does this also mean that your baby is a month old? If so, pumping only 4 times a day at 4 weeks is very few. This is most likely the cause of your concerns. I would recommend increasing the number of pumping sessions by at least two. Ensure that you are pumping long enough; this will depend on the pump you use but will likely be around 20 minutes/session. Also, use warm compresses prior to pumping and lots of massage and compressions during pumping.
Hope that helps.
Best wishes,
Stephanie
June 5th, 2010 at 10:37 am
Hi Stephanie,
I currently have a 2 week old and have been EPing because of latch problems. I’ve talked to two LC who recommend continuing to offer the breast but to supplement with expressed BM to ensure she gets enough to eat. I’m currently pumping 8x a day, 15 min per session with 2.5 hour intervals during the day and 4 hour intervals at night. The problem is that my husband will be going back to work next week and it will be difficult to maintain a strict pumping schedule. How frequently can I pump during the day? The LC recommended no more than every 2.5 hours, but that makes it very difficult to maintain the recommended 8x a day.
June 30th, 2010 at 6:39 pm
Hi,
I’ve been partial breastfeeding and partial pumping breastmilk for my 7 month baby boy. He’s been fed so far only with breastmilk. I would like to continue to exclusively pump only because that’s the only way to stop him suckling for comfort. I’m a fulltime working mother. My menstrual hasn’t return yet. Will exclusive pumping also further delay the return of my menstrual? How soon will my menstrual return? Appreciate your sharing of thoughts here.
July 9th, 2010 at 12:54 pm
Hi,
I have been having problems breastfeeding my 8 week old baby girl. It all started when she was 3 weeks old and she was not gaining enough weight. The doctor asked me to pump my milk to see how much I was producing. At that time I was pumping only one ounce per session so I started supplementing with formula. I started taking fenugreek and Reglan, eating oatmeal and drinking mother’s tea but nothing helped.
I started pumping every session after feeding and supplementing with formula. I did see an increase on my milk but I also noticed my baby was refusing to nurse for long periods of time. The LC said it was a latch-on problem what caused my milk supply to drop and we tried to correct the problem for a week, unfortunately we did not succeed and my milk supply dropped again.
Currently I’m trying to exclusively pump but my milk supply is too low. I’m pumping every 2 to 2 1/2 hours for 20 minutes and expressing about 1 to 2 oz. per session which is not enough for my 8 week old baby. Since I’m using the free style Medela pump, I have been thinking on renting a hospital grade pump but I don’t know if it would make a big impact on my milk supply.
I really don’t know what else to do, I hope you can help me. Thank you.
August 20th, 2010 at 9:40 am
I am almost 4 months post partum. I breastfed exclusively for 1 month and have been pumping and feeding my baby from a bottle since then. I have not seen my period return yet. Is this normal or cause for concern. thanks!
September 17th, 2010 at 11:58 am
Hi,
First of all thank you for such a wonderful and informative page! I got a lot of information from this wonderful site!
Second, I have been EP since my baby was 3 months old. Now he is 7 months and I started weaning him off breast milk because I could no longer keep up with the 8 times a day pumping. Now I am down to 4X and I was still pumping enough with a hospital grade pump to only feed him breast milk. I am in a working trip with my baby, out of the country, and my freestyle medela (which I used for trips) broke down. I found a place where I could by a pump but where twice the price so I could only afford an electric single pump (the Medela swing). I need to pump almost for 1.5 hours to get 3/4 of the amount I was pumping with a double pump. Does this mean I am going to dry out? Pumping 4X a day was feasible and I was hoping to pump at least for 1 more month. I need some suggestions with respect of how to keep my supply up for this week that I am out of the country and with a single pump. I hope you can help me! Thank you…
September 28th, 2010 at 9:02 am
Hello,
My son is almost 5 months old and I now exclusively pump. I have gone back to work and my son was getting frustrated on my breast so now he just gets breast milk in bottles. However, he now is spitting up consistently. Sometimes it’s clear other times it’s white and thick. Someone mentioned it might be acid reflux. I mentioned it to my son’s pediatrician and she didn’t think it was anything. She said that is what bibs are for. But he is spitting up so much. Sometimes 3-4 times after a feeding. Any recommendations?
March 14th, 2011 at 5:16 pm
I’ve been EPing for the last 7.5 months after 3 months of supplementing with pumped milk after very long nursing sessions. When I developed open bleeding sores, I gave up nursing completely (began pumping exclusively) and saw a dermatologist. She prescribed Desonate for the redness and irritation and Vusion for possible yeast related complications. She explained that I would have the redness and sores until I gave up pumping. I used the creams for months with minor improvement and finally gave them up as I hated having to scrub it off prior to pumping. It just doesn’t seem right to me to have red, itchy, burning, scabby nipples. I’ve been sanitizing all of my pump stuff nightly. I’m committed to making it to the 1 year mark, but am pregnant with #2 and am worried about having to repeat this all over again. Is this normal for EPers?
March 22nd, 2011 at 4:23 am
My daughter is 1 week old and I.have decided to EP. I have been breastfeeding and giving an occassional formula bottle but have decidedvto just pump and feed.
Currently I am pumping about an ounce between my two breasts but have now begun to be more vigilant with a schedule. I have read your site and was excited to see that this is possible. I am going to work to increase my supply based on your suggestions.
My question is….how much should my daugter be eating. If I am pumping one ounce for now is that enough for more at every feeding? When should she be eatifeeding.
Thank you.
April 10th, 2011 at 3:31 pm
Hi,
I have a 1.5 week year old and have decided that I will be exclusively pumping. I have a couple of questions and am thankful for your tips/help.
A first question - I started by pumping 20-25 minutes every 2-3 hours. It has been about a week since my milk has come in and I am getting more than enough for what she needs (sometimes even double and a little more). I am filling up the freezer fast with extra milk! I was hoping that I could either skip a pump or pump less time since I have more than enough for her now? Would that begin to hurt the supply that I do have? I had hoped that I could then pump more often/minutes again when the supply I have are not enough for her (to increase it to match her consumption)? I don’t want to mess up my supply for later when she is drinking more - but it seems like I’m spending so much time making so much milk that I don’t need! (also, I don’t want to have issues with plugged ducts)
A second question is - what constitutes a drained breast? Does it need to be dry-dry - no more coming out — or just a very slowed down production? (5 - 10 pumps to get a single drop?)
Thank you again for your help!