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Three questions today – bringing your milk supply up after you get your period back, feeding an older baby milk pumped when she was much younger, and talking to your doctor about exclusively pumping. (Have a question about pumping breast milk? Ask it here!)

Thank you for your all of your wonderful information.  It helped me get started when I made the emotional decision to start exclusively pumping when my baby was 13 weeks old.  I started off by pumping 6 times a day and gradually decreased to 4 times a day over a 6 week period.  I didn’t see a noticeable change in my supply. My supply dropped by about 6 ounces a day once my period started and I haven’t been able to get it back up.  I’ve been taking fenugreek 3 times a day.  It has helped but I’m not back up to my original volume.  Is it possible to increase my supply again or am I stuck at this new lower volume?Also, I would love to experiment with decreasing to 3 pumps per day in a month or two.  If I notice a large supply drop by doing this, will I be able to increase my supply again if I add a fourth pumping session back in?  I’m afraid to drop a pump since I’ve already seen a drop in my supply.

ask-the-extreme-pumper-milk-supply-after-periodI had the same issue with both of my babies. With both of them, I got my period back at 9 months postpartum, and my supply slowly dropped and there wasn’t much that I could do to bring it back up. (I struggled a bit with it because I had previously had a great supply.) I did have a little success with oatmeal – I got an extra ounce or so on the days that I ate it for breakfast. Anyway, I think you might still be able to bring it up to where it was, but it would be a bit of work – maybe pumping for longer, power pumping, doing a lot of breast compressions, etc. If you felt very strongly about it, you might also try domperidone. (You would have to get a prescription from your OB or your baby’s ped.)

As for dropping to 3 pumps, it’s hard to say if you could bring it back up if you switched back to 4. Honestly, I think my drop was more hormonal than anything else (meaning the number of sessions wouldn’t have made a difference) – my supply would drop by a few ounces every month and never really recover. I think you would have the best luck if you increased your total daily pumping time a bit when you drop the 4th session – so if you are pumping 4 times for 20 minutes, you could pump 3 times for 30 minutes or something. Just a thought. Good luck!

How do I bring it up to my doctor that I want to exclusively pump from the beginning? It’s just personal reasons, I’d rather not breast feed directly. And also how do I go about breast pumping from the beginning (as in at the birthing center)?

I don’t want the doctor to try to talk me into breast feeding. I’ve done my research and I know what I want to do, I just don’t know how to relay that to my doctor. Do I even need to tell my OB?

To be honest, I don’t think you need to tell your OB. If he or she asks you if you plan on breastfeeding, you can honestly say yes (because exclusively pumping is breastfeeding). There is no difference to your health or your baby’s health if you are exclusively pumping or nursing. Therefore, it’s not really something your doctor needs to know.

As far as the birthing center goes, that is a little trickier. If you tell the nurses that you plan on breastfeeding, they will likely want you to try to nurse in the delivery room, if everything is fine with you and your baby. Is this something that you would be up for doing? If so, you can try nursing that once and them just pump in your room once you get a room. If not, you could tell them you want to give the baby a bottle of formula to start with and then try breastfeeding once you’ve recovered a bit from the birth.

What might work best overall is to pump 8 times per day in the birthing center, and give your baby anything you are able to pump, but also feed formula as needed. Then, once your milk comes in, you can hopefully stop using formula. Overall, I would be prepared for two things: one, to supplement with formula in the hospital, since it is difficult to pump much colostrum, and two, for the nurses to pressure you to try nursing and/or supplementing even if you don’t want to. Having said that, it really depends on your birthing center and nurses, as well as how long you are there. (I had one birthing experience with great nurses and another with horrible nurses that kept pushing me to do things that I didn’t feel were right.)

Congratulations on your pregnancy and good luck!

I have a bunch of milk stored in the deep freezer. I know it stays good for 6-12 months. I am wondering if it’s okay to give an older baby milk that was pumped for a 1-3 month old. My baby is 3 mos. and I’m trying to see when I could stop pumping and just use freezer milk. But if I stopped pumping at 9 mos, can she do well for the next 3-6 months on older milk? 

Yes, that is totally fine. Your baby can drink milk pumped for a 1-3 month old when she is older. While the constitution of milk does change a bit as the baby ages, there are no recommendations against feeding older babies milk that was pumped when they were younger. So as long as the milk is in the deep freezer, you’re all set for 12 months, just like you said.

If you want, you can rotate the milk (you feed your baby some of the older frozen milk and freeze new milk), to keep your stash more recent, but it’s not necessary.

Please feel free to add any suggestions or thoughts in comments!

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Two questions today! The first has to do with how to drop a middle of the night pump when you’re prone to clogs, and the second covers bringing up your milk supply with a newborn. (Have a question about pumping breast milk? Ask it here!)

Hi there! I wish I’d found your site sooner. My son is 7.5 months old, and I’ve been EPing he was 5 weeks old. I wanted to nurse so badly, and we had such a difficult beginning. After $400 worth of lactation visits, pediatric dentists, cranial sacral appts, etc, I was very depressed, in serious pain and starting to actually dread breastfeeding my baby. I started pumping on a whim with a hand pump, thinking I was just taking a break, and pumped around the clock to build a stash. I’m shocked I made it this long thinking back to how it all started. I love my Medela Pump in Style, and I’ve actually donated over 1,000 oz of breastmilk because it turned out I have a great supply!

I’m down to 4 pumps a day, 6 hours a part. My schedule is 8am, 2pm, 8pm, 2am. I could justify getting up in the night to pump because my son would be waking up for a bottle around then (my husband always does that feeding) but just recently he’s started sleeping great and sometimes sleeps through without a feeding (I never ever thought the day would come!) I’ve tried stretching out the time between pumps to every 8 hours so I could go down to 3 pumps but I got so painfully engorged I couldn’t. I get clogs often and have had mastitis and terrified of getting it again. Any suggestions? I’d love to get down to 3 but for now I’ve just been cutting down to 12 mins a pump vs 15, or when I get just 8 oz because he drinks 4 oz every 3 hours. Thank you!

dropping-middle-of-the-night-pumping-sessionsI definitely hear you on wanting to get rid of that 2am pump, and I also 100% understand not wanting to get mastitis again! Mastitis is the worst – getting knocked down by it and having to take care of a baby AND having to pump is just not cool.

My first thought – what if you keep four pumping sessions at first, but respace them so that you can sleep 8 hours at a time? So something like 6am, 8am, 2pm, 10pm? The first few nights, you could even do a quick pumping session at 4am (or whenever it will be 6 hours since your pre-bed pumping session) to take the edge off? I’m thinking like 5 minutes or so. Then, you could move it back by 15-30 minutes a day to make it more gradual until you get to your wake-up time.

Then, once you can get through the night okay, you can drop a session (probably the 8am one, and maybe move up the 2pm if you can)? My thinking is that it might be easier to separate going 8 hours with dropping a pumping session since you are so prone to clogged ducts.

Great job pumping for this long and donating all of that breastmilk!

(More information on dropping pumping sessions here and here.)

I gave birth 3 weeks ago. I pump 8 times a day with a brand new electric pump and I supplement with formula. My baby now drinks 3 oz. at a time. I only pump 2 oz. at a time. I spend 20 minutes pumping because that is what I have been told and in the middle of the night that is all I have patience for. I would love to be able to pump the full 3 oz and not have to use formula but I am not sure what to do. Will my supply be increasing soon? I don’t want to spend an hour pumping each time. At what point is my overall supply quantity pretty much established?

Congrats on your new baby! I think you definitely still have time to bring up your supply if you want, as  most of the things that I’ve read gives 12 weeks as the timeframe when your supply is established and it’s hard to bring it up after that. So 3 weeks is still so early! However, I do think that you will probably need to actively try to bring it up. My first suggestion in your case would be to try fenugreek. I tried it at 3 weeks post-partum, and had a really positive experience with it. The good thing about it, too, is that if it works you just have to take it for a few days and then your supply is up going forward.

Another thing that I might try is power pumping, if you can (this depends on how well your baby sleeps/if you have help caring for him). While your baby is sleeping or someone else is watching him, watch a hour length show, and pump on and off during the show, 10 min on/10 mins off.  (Maybe you could find something on Netflix, or a DVD that you can look forward to watching every night while you power pump? That might help make it somewhat fun.) This will simulate cluster feeding and hopefully tell your body to make more milk.

Good luck!

And a few more bonus “questions” from the search engines:

How much extra do your boobs weigh when you’re breastfeeding?

Excellent question! They might weigh a bit more from pregnancy (as part of pregnancy weight gain), but I think that the weight that is specific to breastfeeding is likely to be just the milk you have in there. If you want to eliminate that from the number on the scale you could try weighing yourself right after you pump or just subtracting a pound.

When to discontinue fenugreek?

There are a few scenarios:

  • You have started pumping the amount of milk that you want to be pumping: In this case, you’re all set! You can discontinue it.
  • You haven’t seen an increase, but you also don’t smell like maple syrup: Consider increasing your dosage (it’s a good idea to talk to a lactation consultant or your OB first).
  • You’ve smelled like maple syrup for awhile (at least a few days), but are not seeing the increase that you’d like: You can keep taking it for a few more days if you want, or you could  discontinue it now and try some other options, like power pumping or domeriphone.

Please feel free to add any suggestions or thoughts in comments!

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So you have a baby – yay! She’s cute, you’re pumping for her, everything is good: and then you get mastitis. Mastitis, in short, is terrible – you are knocked down as if you have the flu (complete with a fever, chills, and pain), you boob feels like it’s going to explode, and oh, you still have to take care of a baby and pump every two hours.

I was lucky enough to not get mastitis with my son, but I got it twice with my daughter. Here is everything you need to know about it.

What is mastitis?

pain-in-the-boob-mastitisMastitis is an inflammation of the breast. Generally speaking, it has two causes: obstruction of milk coming out of the breast (essentially, a clogged duct), or infection. Mastitis that is caused by obstruction can lead to infection, so it can be one or both that is causing the issue.

How can I tell if I have mastitis?

There are two kinds of symptoms – those specific to your breast and those that affect all of you.

Your breast (the affected one – normally mastitis only hits one breast at a time) will feel painful and very tender to the touch. Sometimes you can feel a lump, which is likely the clogged duct that caused the mastitis. You may see red streaks on your breast, and it might be warm and a bit swollen.

The rest of you will feel as though you have the flu, minus the nasal congestion – generally, if you have mastitis, you’ll have a fever, chills, and aches. (I also had a dull headache and what I would describe as “general malaise”: I just did not feel well. That was the only way I could describe it.)

How do I treat mastitis?

If your symptoms have been present for less than 24 hours, only one breast is affected, your baby is more than two weeks old, and you are not acutely ill, you should rest as much as you can, pump as much as you can, drink a lot of fluids, and take ibuprofen for your breast pain.

Regarding pumping as often as you can – the goal is to keep the breast causing the mastitis as empty as possible. Use a warm compress on your breast before you pump. (If it makes it easier to get more pumping sessions in, you can hook yourself up for some sessions on just the affected side. Just make sure you don’t forget about the other side and get yourself a double case of mastitis.)

It can be painful to pump on the affected side, especially in the beginning before letdown. Try hooking yourself up to pump only on the good side (cover the “bad” side with a breast pad of something) and then hook up the affected side after letdown.  Then make sure you empty the “bad” side by doing breast compressions.

If your symptoms have been present for more than 24 hours, both breasts are affected (you poor thing), your baby is less than two weeks old, or you are very sick, call your doctor. (You can call your OB/midwife or primary care doctor, whatever you prefer). It is likely that he or she will put you on an antibiotic, usually for 10-14 days. You should also continue to rest and keep your breasts as empty as you can.

Untreated mastitis can lead to an abscess (which can require surgery to resolve), so be sure to call your doctor if you feel sick for more than 24 hours or are really ill.

How can I make sure that this never happens to me and my boobs again?

To avoid mastitis as an exclusive pumper, your best bet is to avoid obstruction of milk ducts (i.e., clogged ducts) by sticking to a pumping schedule and making sure that you empty your breasts completely. (Unless you are weaning - while weaning you should stick to a schedule but not empty your breasts, just very gradually decrease the amount that is “left” in them after pumping.) In addition, if you do get a clogged duct, do everything you can to clear it before it becomes mastitis.

If you are prone to getting mastitis only in one breast, one option is to wean from just the affected breast and continue pumping on your other side.

Have you had mastitis? Share your tale of woe with us.

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