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Date: | Tue, 14 Aug 2018 13:57:22 -0400 |
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Re: low milk supply
Genevieve writes that she has recently had several mothers that have not
been able to build milk supplies past 250 ml.
I take it these moms are not breastfeeding? IE the total milk obtained
is from pumping?
In Canada, most women have a years maternity leave so I see very few who
are exclusively pumping. Most are breastfeeding and pumping because of
low supply due to poor start including tongue tie (they too delivered @
a BF hospital), poor latch (long stretchy nipples or lower lip tucked
in) or baby inefficient at the breast because of difficult deliveries
but usually because of poor positioning and the use of bottles and or
pacifiers.
But in the last 3 or 4 years I too have seen moms whose supply seems
stuck with the amount they can pump despite the good info and help
available. I have never done any advertising, (and cannot bill the
health care system) so babies are often 7 - 10 weeks old, after the
mother has exhausted all her free avenues, that she finds me.
What has changed over the last 3 or 4 years? I have found mothers are
often using hands free pumping and are busy working on their electronic
devices instead of thinking about their babies and visualizing they are
Mother Venus. Many of them too, stop pumping as soon as the milk stops
flowing instead of continuing to pump an extra 5 - 10 min to send the
message to increase the supply. Many do not realize they need to do a
pump in the middle of the night. I also ask about what is going on in
her life and her diet (usually have her add a protein snack each time
she pumps).
Mothers always ask how long it will take to make sufficient milk for
their babies. They would like me to wave a magic wand but I have found
it usually takes about the same amount of time to fix the problem as it
took to make the problem but I don't tell them that (7 -10 weeks is too
much to hear for even a very motivated mother). Instead I ask them to
keep records and check in with me most days (free f/u phones calls is
the volunteer part of my work). We total up the daily pump amounts and
within 3 - 4 days she can start to see small increases in output. As the
milk increases to 35 or 40 ml per pump I tell her she is not a mother
who can't make sufficient milk.
Making milk is such a confidence game. When she feels discouraged, we
look back a week or so, at her numbers, and she can see dramatic
increases. It takes such a long time to meet her goal to have enough
milk because her supply was likely very low when I first saw her and her
baby needs a little more each day but as she makes more, her baby needs
more. I tell her the "gate post" keeps getting moved but she is getting
closer to it all the time. She becomes much more patient when she
understands what is happening. It is exciting for us both when supply
meets demand.
After almost 30 years of private practice (approx 300 clients a month) I
have also found that if for 4 days she pumps (properly as I suggest) for
7x per 24 hours and can make more than 30 ml per pumping she will likely
be able to build her supply. (I tell her "likely" but in my experience
it is "will").
Renee, in Vancouver, Canada
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