Expert: Sally Wendkos Olds - 4/19/2008

Question
Hi,

I have been exclusively breastfeeding my daughter for the past 3 months.  She is currently drinking 4.5 ounce of expressed milk at 2 hrs interval. I prefer to nurse her directly as my pump output can never meet the amount she needs.  My average pump output is 5 ounce (total for both sides) at every 3 hrs interval. I have tried all possible methods to up the supply (tandem pumping/ power pumping/ pump after feedings/ massaging) but there is no significant increase in the volume.  I have started to take Yogi Nursing tea once every day but volume still remains low.

I juz started work a few days back, and the expressed milk I have stock up is getting lesser by the day (as the total volume I pumped at work is not enough to meet her required feedings for each day, thus I need to supplement with the frozen supply).  

I am really at my wits end, as I really hope to breastfeed her for min 6 months.  Hope you can offer me some advice on my problem.  

Answer
Dear Rei,

First, congratulations for giving your daughter the best start in life by breastfeeding her!

Although you say that your pump output is 5 ounces, you have to remember that even the best pump is not as efficient in extracting milk as a vigorously nursing baby, so your daughter is undoubtedly getting more than that during her feedings.

The best way to increase your milk supply is to nurse frequently, so if you are not already nursing often during the times you are home (evening, night, morning, and weekends), try doing this and see if there will be an increase in your pumped milk also.

I am attaching an excerpt from my book (see below) about increasing your milk output from pumping. I hope some of the suggestions help.

Good luck!

Sally
----------------
  BOX 17-2 ENHANCING MILK PRODUCTION WHEN EXPRESSING OR PUMPING

You may want to try one or more of the following methods to increase the amount of milk you can collect for your baby. Different ones work well for different women in different situations. If you're pumping at work, for example, some of these suggestions will not apply. As with the rest of this book, take the suggestions that make sense to you, see which ones work, and stick with them.
  * First, take care of yourself: get as much rest as possible, and be sure you're drinking enough liquid throughout the day.
  * For two to five minutes before you begin, do deep breathing or some other relaxation exercise.
  * Drink a cup of hot tea before beginning. If your baby is not sensitive to cow's milk products that you eat or drink, you might try warm milk or cocoa.
  * Make yourself as comfortable as possible. If you can, sit with your feet up.
  * If you have time, massage your breasts. Just before you begin, if possible, lay a warm towel on your breasts for a minute or two. (The towel is helpful, but not essential.) Then massage your breasts gently, one at a time, starting from the top and moving around the sides and the bottom, moving your fingers in a circular motion. With your fingertips, stroke yourself lightly from the armpit, from above and below the breast, and from the middle of the chest toward the nipple. You don't need to massage or stroke the nipples themselves. (If necessary, you can massage your breasts even while you're dressed.)
  * Pump both breasts at the same time, using a good electric pump.
  * If you are expressing one breast at a time, switch breasts at least once during each session and preferably twice, to insure maximum draining. Usually the second expression on each breast is briefer than the first.
  * Pump frequently. It's better to pump three times for no more than 10 minutes each time than to pump twice for 15 minutes each time. It yields more milk, it's more efficient, and it's also more comfortable, since it will cut down the likelihood of trauma from too much pressure exerted for too long a time. Some women get sore nipples from pumping more than seven or eight minutes on a breast.
  * Prop a photo of your baby in front of you. Look at it and remember what it feels like (or imagine what it will feel like) to have him at your breast. (Or use a photo of you nursing your baby.)
  * Visualize your baby in your mind. Imagine what she looks like, sounds like, feels like, smells like when she nurses.
  * Make the time go faster while you're expressing or pumping by talking with a friend, listening to the radio, reading something light, or watching television.
  * If your baby is present but cannot suckle and if you don't need two hands to express, hold him while you're pumping.
  * Wear comfortable clothes that open up or pull up but still cover your shoulders, so you don't get chilled.
  * Listen to a musical record that you associate with nursing. This works best if you play the record initially during actual breastfeeding sessions; then when you're expressing, hearing the same music may help evoke the memory and the sensations you felt then. (Handel's "Water Music" gets high marks from women who enjoy classical music.)
  END OF BOX