Questions about pumping exclusively

Hi all, I have been BF my 2 week old son and pumping with a Medela Pump n Style to build supply.  He is having terrible latch issues and I have intense pain on latch.  I have some questions about pumping exclusively for those who have done it in case that is the route we need to go.

I notice that when I pump several feedings in a row, my output declines about 1/2 oz. each time.  For example, this morning I was getting 4.5 oz total and just now, 2.5 oz total.  I also notice increasing engorgement when I pump, esp. in left breast.  I do massage.  Will this pattern continue?  If so, how can I pump enough for my son?  Especially as he grows.  Thanks for answers to these Q's and any general advice on exclusively pumping from those with experience is appreciated.

-Lynne

[tiredbuthappy]

when i pumped, i noticed my supply naturally increased as her needs increased. i always wondered what would happen when she ate more, but i always matched it as my supply built up and got established. i was religious about pumping regularly though, including during the night. i just automatically pumped as soon as she was done eating- this ensured that i pumped as frequently as she nursed. in the beginning, i tried to pump before feeds, but it was stressful anticipating when she'd be hungry. i then discovered that breastmilk stays fresh at room temp for several hours, so i could just leave what i pump after a feed out at room temp for the next feed.

it's normal for production to vary at different times of day. you'll find your best pumps would be a pump btw 1am and 5 am when prolactin levels are the highest, and in the morning. output may decrease throughout the day.

you output seems very good for 2 weeks post partum- even better than what i was doing at that point. and i ended up producing almost twice what she needed- up to 48 ounces/day by 3 months or so. and if you feel like you're not making enough, you can boost by increase pump time or frequency.

as for engorgement- is it after pumping or before? heat or a warm shower before pumping can help

[tiredbuthappy]

general advice copied from one of my journal entries:

basic rules-

first 12 weeks is when you establish your supply. during this period you need to pump every 2-3 hrs during the day. over night, you can go one 4-5 hr stretch as long as it doesn't seem to affect your supply. be sure to get at least 1 pump in between 1 AM and 5 AM, as that is when your prolactin levels are the highest. those were always my biggest pumps! (i think the rule is to pump 8-10 times in 24 hrs). remember, just like with nursing, you count time from the beginning of the last session, not the end.

after 12 weeks you can start to drop pumps. they say 12 weeks because at that point your supply is no longer hormone driven, but primarily based on supply and demand. i actually started after 8 weeks for my sanity. my supply had been sufficient, and my LC saw the toll pumping was taking on me, so she encouraged me to spread them out more. She said worst comes to worst, i'd have to give a bottle of formula here and there. My supply actually increased after i dropped that first pump. I greatly enjoyed the extra time, and after a week spread them out even more. for me, my max production was when i was pumping every 5-6 hrs (i was making 45-49 oz/day). by that point it's safer to go longer stretches overnight, since like i said it's supply and demand, not hormone driven at that point.  It's important to keep in mind that when you pump less frequently, you need to pump for much longer. throughout my months pumping, i always spent the same number of hours/day pumping. when i was down to 3 pumps i had to pump 45-60 minutes to empty completely. if you do not do this, your supply will go down quickly. so if you are pumping for 15 minutes 10 times/day, you spend a total of 2 1/2 hrs pumping. at 3 times/day i was still pumping about 2 1/2 hrs/day.

the length of time necessary to pump varies from person to person. in general, in the beginning you are advised to go 15-20 min, or 5 minutes past the last drop. this is necessary to build supply. i got away with 10-15 min in the beginning.

i was able to maintain a steady supply pumping 4 times a day. had plenty to feed and freeze. i did see a drop in supply when i went to 3 times a day at around 4 months post partum. still, i had enough to meet dd's needs- i just wasn't freezing extra anymore.

if you plan on exclusively pumping, or mainly pumping, you MUST get a good pump. You can rent a hospital grade pump, or you can purchase a good pump like a medela pump in style or pump in style advanced, the ameda purely yours, or the lansinoh double electric pump. don't waste your money on anything cheaper, as chances are you will lose your supply quickly. always have a hand pump with you in case you get stuck out.

[lmc2132]

Thank you for all this info.  It sounds like you were extremely dedicated to pumping!  Last night was rough, pumping AND feeding, not to mention washing pump parts and trying to get baby to sleep...not sure this is for me, but I will give it a try.

The engorgement is worse before but remains after pumping, esp. in left breast, which produces about 1/2 what the right does.  It's strange b/c both leak equally.  Hot shower helped this morning as I had another 4.5 oz pump.

When you say last drop, is that literal?  Mine slows way down after 20-25 mins but I usually stop pumping before totally dry.  

Also, how do you handle your part-washing routine?

Thank you so much for your help.

[jenkaye21]

Washing parts is such a pain!!  I discovered these steam bags by Medela and i am loving them!  You just rinse the parts, put them in the bag, and microwave for 3-5 minutes.  You can do bottles and nipples too, and you can reuse each bag about 20 times.  Totally worth it to me!!

[tiredbuthappy]

best way to handle part washing is... the fridge trick!!!

you just quickly rinse the parts/run water through it and stick it in the fridge. you can do this for up to 12 hrs. think about it- your milk is good at room temp for several hours, so you could even get 2 or 3 pumps in without even sticking it in the fridge (i do that overnight now when i pump what dd doesn't finish at the boob). on top of that, breast milk has antibiotic properties. by the way, i always pump into a fresh bottle and then combine milk after it's been chilled. pumping into already chilled milk would warm it.

another hint is to have more than 1 set of connectors.

[tiredbuthappy]

oh yea- and for your sanity, invest in pumpin pals angled horns- they allow you to lean back a bit while pumping and are much more comfortable than regular horns. and go hands-free so you can do other things. there are both comercial and homemade solutions for going hands-free

[skepticalpeach]

I found it was easier to pump right after I got out of the shower. I was able to get more when I did that.