Expert: ruth kraft - 3/9/2009

Question
Hi,

My baby is 4 weeks old and I was breastfeeding her exclusively the first 2 weeks but being a preemie, she was a very sleepy baby and would feed only for 5 mnts at 4 hours interval. The 3rd week I realized my milk almost dried up cause she was crying the whole day even after feeding her and when I pumped I got nothing. I gave her formula cause even if I fed her all day, she was not full and cried and would not sleep. So I had to give her formula.

I called the lactation consultant last week and she told me that with the way she has been feeding, its natural that my milk has dried up. She told me to pump every 2 hours day and night and it will take about a week to get my milk supply going. But she said its not a guarantee that is gonna come up as its already been 3 weeks.

I'm really depressed since I want to totally breastfeed my little one and am helpless. Please let me know the following:

1) If I pump every 2-3 hours, how much chance there is of my milk coming in normal in a few days (I am drinking mothers milk tea 3-4 times a day and taking fenugreek caps twice a day).

2) Is it necessary to pump every 2 hours at night?

3) Even now I do put her on the breast but she falls asleep very soon at the breast. She feeds for hardly 5 mnts (I can hear her swallowing) but she goes to sleep. Its hard to wake her up.

Pls advise.

Answer
Hello!  I am sorry you have had a rough start. I had a preemie and I know the frustration that comes with low milk supply , and a sleepy preemie.. it is not an easy battle... it doesn't sound to me  that if she was 4 weeks old, and you realized at three weeks your milk supply was low, that it would  be completely gone. that was only a week ago.  was she nursing at all and having wet diapers before you gave her formula at week three?  ( that is how I understood it... ) therefore, if that is the case, I think that although you seemed discouraged by her advice, I think she gave you the right advice as to what to do. I would have done the same thing. Having a preemie is not the easiest thing, and pumping milk for the baby is even harder. Don't always judge what you get by the pump . So.. my suggestion would be, to pump every two hours like she suggested. Including in the night. because this is what will stimulate the breasts to make sure you are getting enough milk production. Once it is set and where you want it, you wont have to pump at night, you will just feed her  :) I know it sounds hard to do  , but it is important. It is also important to make sure you have a good and efficient breast pump. If it is a double electric ameda egnell or medela you should be ok. But because of the preemie issue you have been having, I might even suggest to rent a hospital grade pump for a month and use that instead. only for a month  but the power behind them is different than the personal ones.  I would continue doing the tea and fenugreek pills. there is also blessed thistle and such but you should be good with those two that you are taking.

Also, even if she latches only a little, I would still latch her and nurse her only at the breast. I suggest getting a SNS ( supplimental nursing system ) for any supplementing. as when she sucks from that, she will stimulate your breasts and this should help her understand food comes only from breasts and save nipple confusion later as she picks it up more.

You can go to drjacknewman.com and watch his videos there to see what positions and what it looks like to truly see how a baby is getting milk. not only by swallowing. She should be having wet and dirty diapers every day. at least wet ones every day.

Yes, its possible that your milk could come in quicker than a week, but it might take longer. Some bodies react differently, and the amount of stress you are under can delay it some more.. Be patient with yourself. Continue on, as a preemie mom who had to pump 8 days to get even a drop of milk ( every two hours ) I did it. and my daughter latched for the first time at 11 days. allot of practice and she nursed until she was 11 months old... you can do it... be patient with you and her and it will happen...

((hugs)) from one preemie mom to another... it a hard road but she chose you for a reason....