Low supply while pumping…

… and how you can come back from it.

So, bit of a specialized post here, but in case in helps someone, here is how I came back from ‘low milk supply’.

[In case it is totally irrelevant to you, here is a picture of Walter wearing a stripper pastie as a hat]:

Poor Walter

Poor Walter

Back to low supply. I will cover:

  1. How it came about (for me)
  2. How I decided to supplement Sam with formula
  3. How to start getting your supply back
  4. Things that did not work for me
  5. Things that did work for me.
  6. A balanced view of it all – some sanity for struggling Mums

How my low supply came about

So, I think my low supply arose out of a number of unhelpful factors.

First, I have one useless boob. Here is some TMI about me you didn’t know: I had a tubular breast, and had a subsequent surgery that fixed it. The former makes breast feeding sufficiently VERY difficult (if not impossible) and the latter can make it harder. So a bad combo.

Second, I could not feed immediately after birth, as after a quick cuddle, I didn’t really have time with Sam for 18 hours. I saw him when I came out of OR, but I was in so much pain he went the nursery pretty quickly. So… no breastfeeding, and no pumping for nearly a whole day did not help.

Poor ol' Sam spent a lot of early days in here.

Poor ol’ Sam spent a lot of early days in here.

Then nights were difficult in ICU. In fact, feeding at all was difficult in ICU. I seemed to be having a transfusion / drug bag changed every 40 mins or so. When that wasn’t happening, I was having check-ups, sponge baths, investigations, fighting sleep from the drugs and what not. I was in pain & stressed (which does NOT help milk supply). I did breastfeed, but it was often interrupted and difficult. A couple of the nights I was knocked out to sleep for the whole night; my body was throwing random fevers with no sign of infection, and I think it was just exhausted. So, they would give me something to sleep and I would wake up better – it seemed the only option for getting out of hospital. So, no feeding at night then.

I came home, and I did exclusively breastfeed for 5 1/2 weeks. But it wasn’t awesome. I was trying to work full time and back in the office part-time (I went to a conference in Houston when Sam was 5 weeks). I pumped while away… but it was difficult. I don’t think I ever really established a good solid supply. But I struggled on.

How I decided to supplement Sam with formula

Breast feeding

Not as easy as it looks for some

I say ‘struggled on’ but I was one of the lucky few who took to breastfeeding, and had a baby who breast fed pretty well. Good latch… good suck… I experienced only the normal nipple pain. I even had some good pumps after feeding. Everything should have been good, except for the pesky start.

But, after about 1 week, Sam was fussy from 3-6pm. It didn’t phase Wes & I, we just assumed that was Sam’s difficult time: when he was  starting to get tired. It got worse and worse and again… we just thought that was Sam. Then his feeding got more and more intense and more and more stressful (he would clamp on my nipple and shake his head like a shark). He also tried to feed constantly – not like a cluster feed, like constant needing the breast. He also went from ‘fussy’ to ‘unhappy’. Now, I did the thing you are really NOT supposed to do: gave him a bottle of formula to see if that was it. I had tried hand expression and seen nothing coming out, so tried some Similac liquid. Sam was 5.5 weeks.

Boom.

Happy baby.

So, I actually struggled on for another 2 weeks trying to get my milk supply up: feeding Sam regularly, trying to pump outside of the difficult time, offering both boobs, upping skin-to-skin – but nothing worked. I hated the idea of formula so much, but I hated the idea of an unhappy baby more. So I figured: one bottle of formula – 2.5 oz – a day… what was the big deal? We’d just use that.

Sooo long to get this

Sooo long to get this

Finally, when Sam was 7.5 weeks I went back to the office full time. I was pumping every 3 hours, but as I was already struggling to produce enough milk, it was tough. If Sam got hungry when I wasn’t there I couldn’t put him to breast… and I couldn’t really pump in a cluster pump at work… and Sam needed something… and so formula reared its ugly head again.

This was OK, until at about 9 weeks I realised that the formula was going up and up and I was pumping less and less. I cried. A lot. I am writing this post because you CAN come back.  I want to be a voice out there that recognizes that feeding is difficult in some circumstances, but if it is important to you, then you can do something about it.

How to start getting your supply back

OK, personally, I think there are two things everyone has got to do to really up a drastically failing supply:

(1) Get the right attitude.

You have to be positive. My experience of getting supply back is that it is extremely difficult, and takes patience and persistence. So: you have to have the right attitude. You have to decide it is definitely what you want, that you will make some (more) sacrifices to do it, and I think you have to have people around you on board.

Helping me with a PMA (positive mental attitude) was a subtle flip in thinking. I stopped thinking: ‘formula is bad’ and started thinking: ‘breast milk is good’. It kept my spirits up, it kept me at the pump when I knew I was only likely to get .5 oz, and it stopped me thinking ‘Oh God, he is having formula anyway… why am I bothering?’.

And, I think  it is a realistic attitude… all the studies out there looking at formula vs. breast-milk do not show that (modern) formula does any harm…it just doesn’t have ALL the benefits (DHA… antibodies.. whatever) that breast milk has. So I started thinking about getting Sam as many of those benefits  without worrying about the formula side.

Feeding while pumping. Anyone think I could cut out the middle man?

Feeding while pumping. Anyone think I could cut out the middle man?

(2) Start logging your pumps.

Seriously. Log every pump. Log how much comes out of each side. This helped so damn much. It helped me see what was working, what wasn’t, and what was hindering. It helped me be accountable. It helped me see how much I was pumping (i.e. yes, the days where I was only getting 5-10 oz were worth it, because it was 5-10 oz!). It helped me see that Sam is a pig has a large appetite and feel a bit better about the whole thing. It helped me see how supply fluctuates (<— trust me, supply really fluctuates), and so not freak out about the smaller pumps. It was awesome.

I just keep my pump record on a google spreadsheet, so it is always accessible.

So, what didn’t work for me:

These things had no discernible effect, over a couple of days. They may of course had small, incremental effects, or have worked over a longer period. And of course, they may work for you:

*Giving up my evening glass of wine (phew)

*Eating more carbs in the evening

*Eating more

*Eating more protein

Chocolate oatmeal

Eat, eat, eat.

*Eating oatmeal (even steel cut oats TWICE a day).

*Pumping more than once a night (actually resulted in a massive decrease in supply).

*Upping skin-to-skin contact time (but man, was it fun).

Things that worked for me:

Medela pump

My view for literally 35% of my waking hours 😦

*Pumping every 2 hours from 8.30am-6.30 pm. I didn’t get more per pump, but I got more over the whole day. It is a pain in the butt… but it worked for me.

*Fenugreek seed. Thank God for Fenugreek. This made an enormous difference. I went from barely filling 1/2 tube to my tube overflowing the first evening. But I had to take a lot. I have caps of about 500-610mg a day (depending on the brand I get). I started at 9 caps a day (the recommended amount) and moved up to 15 a day (the maximum). It’s a pita to be always be swallowing this stuff, but it really works.

I have to say, it also has a slightly short term effect: the pumps about 2 hours after eating fenugreek are amazing… any longer and there is not much of an effect. So, I try to space mine: 3 caps at 8 am, 12 pm, 6 pm, and 2 am.

It has been slow progress – with small leaps when I started pumping every 2 hours, and when I added Fenugreek. But slow progress. Over 2 weeks, I have finally gone from pumping 15 oz to up to 21-24 oz a day, which is just enough for Sam while I am at work and just before bed. I can then breastfeed him when I get home, in the night, and at breakfast. So we have had several days without formula, and I am pleased.

A balanced view of it all – some sanity for struggling Mums

So happy to wake up this morning and see this was in the fridge :)

So happy to wake up this morning and see this was in the fridge 🙂

So. Here is the thing. Yes, this post shows that for some, you can get your milk supply back. And I have been through the pain of thinking / knowing you are not producing enough milk. It is awful. It is painful and hurtful in a way that I think only another mother could understand. All logic and rationality goes out of the window and you just feel like a failure, and like you are failing your baby.

But, it has been so difficult building my supply. I have had to pump until dry, which often takes 40 mins – an hour. I seem to spend my life washing pump parts and setting up / dismantling. I have all but given up doing up my shirt in my office (door closed, window blocked, obviously). Looking at a baby on breast milk only vs. mixed feeding (no freakin’ difference), I do think you have to think if it is worth it to you. If exclusive breast milk is really important to you: go for it. Really do.

But if it is not: think about the knock-on effects. Think about the added tiredness, and the added time away from your baby (hard to really interact when pumping). When I was pumping twice a night (as well as feeding three times) and working full-time, after a few days of it, I started to ask Wes to look after Sam in the evening  as I was so tired: what good is breast milk galore, if Sam is not with his Mum? Loving, interactive parents > breast milk IMHO.

Can't believe I passed this up just for a few extra oz of milk...

Can’t believe I passed this up just for a few extra oz of milk…

Look at the research and accept that the ‘good’ effects of breastmilk vs. modern day formula are  tiny, and that there is currently no reason to think the good effects of breast milk can’t also be gained from an enriched environment. Think of all the people who have grown up wonderfully well on formula (myself included 😉 ).

I cannot keep this schedule up much longer. It is killing me. I literally spend 1/3 my working day attached to a pump 😦 It interrupts my evenings and night. So, I am going to keep it up for a week or so, try to get my supply ‘established’. Then something manageable has to be instated. I am also waiting for a galactalogue called domperidone (Motilium in the UK) to arrive by mail. I am hoping that this will help up my supply enough to only have to pump every 3 hours i.e. twice at work. If not, I am working on being at peace with saying ‘I did my best’. Otherwise, I am going to start resenting Sam, which is going to do him far more harm than some formula.

If you are still reading, and issues of milk supply are not that relevant to you (I am the kind of person who reads the most RANDOM stuff on blogs)… here is a picture of Sam being ridiculous, just to make it more worth your while:

IMG_0324

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*******************EDIT*******************
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So, in the spirit of honesty, I feel I should share what happened the day after I drafted this post. It got off to a bad start. After feeding Sam, I fell asleep at my desk at 3 am before I had turned the pump on. So no nighttime pump. Then it seemed to go downhill throughout the day. I didn’t log (for the first time EVER) but I seemed to be producing less. For every pump. One pump got delayed an hour.  Then it seemed to be less and less coming out.

“I know what she did” you are all thinking. “She followed her advice and knew that it was hard, and there are natural fluctuations, and just kept on knowing she was doing the best for her son. She reminded herself that if she has to use some formula its not bad, and that plenty of people grow up just fine on it. Formula is not bad! It is just that breast milk is good.”.

Yeah.

Um.

No.

I worried. I fretted. I got stressed. Eventually I cried. I went to a friend’s house and probably bored her stupid wittering about milk and fussing about not doing the best for Sam. I was *this* close to giving up. Really. I looked ahead at a life without this stress, and without the bother and with the ease of mixing up a bottle of perfectly good nutritious formula. It is only the fact that I have $40 of Domperidone (a galactalogue) in the mail, and I don’t want to utterly waste my money, that got me leaving the ball game to pump.

Then I got home to a sweet email from a friend who said “I am not sure I would be as strong as you after going through so much”. And I cut myself some slack. She said: “I think the benefits of breast milk diminish after 4 months so you’ve done brilliantly to have got Sam this far”. And I thought “4 months? That’s just about a month away! I can get to that!”. And she said “Better for Sam to have a Mum who tried hard to do her best in difficult circumstances than wasn’t here at all”. And somehow that made it click. So if it helps: we are all just doing our best under difficult circumstances. We can all cut ourselves some slack.

I hooked myself up to the pump, and lo! 6 oz came out. My biggest pump yet. I went to put it in the fridge and found that by some miracle there is 10 oz in there, just waiting for Sam. I may even be able to replenish my freezer stash.

I am back at it 🙂

Now I am going to hit send before it goes downhill again 😉

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***********END      OF     EDIT********************
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Still reading? Here is Walter wearing pasties as pasties, to reward you for your efforts 🙂

P1010461

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One thought on “Low supply while pumping…

  1. Pingback: The end of my breastfeeding journey « This Academic's Life

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