Expert: Sally Wendkos Olds - 9/21/2005

Question
Hi!

I am nursing 5 mo old twins and have a low supply. I only pump 12 oz/day (3 double pumpings off 1/2 hr. each with a medela pump in style advanced). I need 30-34 oz for the twins while at daycare. I nurse them in the morning, at bedtime and twice each at night. I even do a pumping before I go to bed.

I drink a ton of water (70-80 oz/day) but maybe it is not enough? I eat oatmeal as well. I am going to try fenugreek and blessed thistle.

Also - one of my breasts often times only has one "spray" and mostly only drips. That breast also takes twice as long to empty as the other breast and sometimes still feels full after the milk comes out. I believe my nipple ducts may be blocked but I don't know how to unblock them (do not have any lumps though).

I have even thought about getting up and pumping during the night again (haven't done this in 2-3 months since the twins stopped getting up every 2 hrs) but that means I will get NO SLEEP!.

What can I do to increase my supply (besides more pumping)? Am I drinking enough? What about the fact that my one breast doesn't spray? FYI - my milk comes down 2-3 times during a pumping and 4-5 while nursing...there just isn't a lot of it.  Oh, I replaced the membranes and bought a size large breastshield.  Not sure if the large is big enough though because mi nipple still drags inside the tunnel and part of my areola also gets pulled inside.

Desperate for more milk!! Laura  

Answer
Dear Laura,

First, congratulations for giving your babies a wonderful start in life by breastfeeding them!

Actually, you don't need to drink as much water as you have been -- just drinking to thirst should supply your body with enough liquid. I assume you're getting a good diet (I talk about a healthy diet in my book -- see below). I also assume that if you're working and taking care of twins, you are not getting much rest. If you can get anyone (husband, relative, friend) to help you with the twins or the household, so that you can rest when you come home from work, that might help you produce more milk. I certainly would not suggest that you get up an additional time at night. You will be exhausted. (I also write about nursing for the working mom.)

Some women feel that herbal remedies (like fenugreek) help, although there is no hard medical evidence of that, but it might be worth a try.

I don't know why you are using a breast shield at this point, and that may be part of your problem. Since one of your breasts is showing symptoms of blockage, I strongly suggest that you immediately consult your obstetrician or a lactation consultant (to find one in your area, call the International Lactation Consultants Association, ILCA, at 919-787-5181).

I hardly ever suggest supplementing with formula, but at this point in your babies' lives and with the difficulty you are having, you may want to have someone else give them a daily bottle of formula, perhaps while they are in day care. By now they have received valuable antibodies against illness, they are not likely to suffer from nipple confusion or allergy, and the addition of a little formula might help them -- and you. Of course, if you can get some good local help and can continue nursing, this would be ideal. But remember, the most important thing is a healthy baby (in your case, babies!) and a healthy mother. You should be very proud of the care you have given your babies.

Good luck!

Sally

Sally Wendkos Olds
Author, THE COMPLETE BOOK OF BREASTFEEDING: Eiger & Olds, 3rd edition 1999, published by Workman Publishing & Bantam Books, and available in most public libraries, bookstores & La Leche League chapters.