Not producing enough?

iVillage Member
Registered: 02-23-2013
Not producing enough?
1
Sat, 02-23-2013 - 4:57am

I EP because my little boy has been in the NICU since birth 9 days ago. The lactation consultant at the hospital gave me a chart to keep track of when I pump and how much I get. Up until 2 days ago I was near the top of the daily total target amount, but then two days ago and yesterday I barely reached or missed the minimum. In fact, from two days ago to yesterday my amount only increased 8mL. Because of my son's condition they are feeding him 65mLs every 3 hours and I only produced 394mL. What can I do to increase this amount? I pump 9 times a day- at midnight, 3a, 6a, 9a, 11a, 1p, 3p, sometime between 5 and 7, and then again at 9. Am I not pumping enough? I pump for at least 30 minutes each time on a lower suction of the Medela symphony (the hospital grade pump they sent me home with). I spoke with the lactation consultant yesterday and she said that maybe I'm not emptying my breast. But how can I tell if I'm emptying it? Also, when I pump at home, in order to be "hands free" I often lean against the table to press the pumps into my breast and keep them in place that way. Could that be an issue? Help! I'm getting discouraged since my little one isn't even here but I don't want them to keep supplementing him with formula!

iVillage Member
Registered: 09-21-2011
Mon, 02-25-2013 - 12:31pm

Good for you!!!  This is such hard work.  Take a deep breath.  Be kind to yourself.  You are doing so much for your LO in a very hard situation. 

I think your pumping schedule sounds good.  I would stick with that as long as possible, even though it is exhausting.  The more time you put in now, the better off you will be in the long run.  It can take some time for your supply to build up...for some people it can take a week or more to respond to changes, so please don't get down on your self in that time.

How to tell if you are empty?  For me it was three things.  1) milk came out less.  With each pull from the pump, the flow of milk would get shorter and shorter.  2) Milk would look more white.  The hind milk is more fatty, so it looks thicker and whiter--the way heavy cream looks compared to skim cows milk.  Once the milk is chilled, the fatty layer will float to the top.  3) The breast gets softer.  As you empty out, the breast will be less full and feel softer to the touch.  If you press, it will feel more like it did before you got pregnant...as least this was how it felt for me.  If these sorts of things are happening for you, then chances are you are emptying out just fine.  If these things are not happening, you may be having trouble emptying.

It is possible to pump without getting a good let down to force the milk out and so you would not empty.  For me, when I was stressed, I could not let down well and could not pump effectively.  I had to try to relax consciously to do it.  I got special music and did some deep breathing before I started pumping to help me.  I also used warm packs to help get the milk flowing and help me relax.  Sometime, if I had time, I would have a cup of tea and look at a picture of my LO so that I could get in the right mindset to pump.  I also think it helps to try to do something pleasant while you are pumping if that is possible.  Read something good or watch a pleasant tv show, knit, sip some herbal tea (mother' s milk tea was my choice), enjoy the music....whatever you need to do to relax and just let the milk flow.

As for improving supply at this point--you are very early on.  Not sure if it is time to look into supplementing yet, but drinking lots of water, eating oats, doing massage before pumping and using heat can all help encourage good production.  Here is a link for massage to encourage milk flow.

www.youtube.com/watch?v=w1S9Y3ndqE4

Aside from massage, you might also want to try doing some breast compressions while you pump to help move the milk outward or do some hand expression since it can also help.  Here is another link that might be useful.

http://newborns.stanford.edu/Breastfeeding/MaxProduction.html

Also, I would encourage you to think about a hands free pumping bra so you don't have to lean into the table the way you describe. It could slow up the flow a bit, but I would be more concerned about getting a clog since they are painful and generally bad.

Hope that helps!!  Good luck to you and your LO!!