On 26/05/2005, at 10:44, Jennifer tieman wrote:

> My friend continues to pump for her baby who has anoxic  
> encephalopathy and
> is unable to feed.  He is G-tube fed.  I hope some of you with  
> experience
> with ill babies and exclusive pumping may be able to help me with a  
> couple
> questions.  He is a few days shy of 7 mos now.
>
> First, when a woman is exclusively pumping, how does supply usually  
> fare?
> She  pumps with a rented Lactina most of the time, occasionally  
> uses an
> Avent Isis when out and about.  She now pumps 6 times a day, with  
> about a 6
> hour gap overnight.  She has followed this pattern for about the  
> last 3 mos,
> but in the last month she's had a harder and harder time with  
> supply.  She
> has been taking Domperidone for 4 mos or so, and has increased to  
> 80 mg a
> day total, and is just barely making his needs, and occasionally  
> not quite
> keeping up.  Is it common to see a decrease in supply despite  
> keeping the
> same pumping schedule?

Just barely meeting the baby's needs is pretty good - "feed the baby,  
not the freezer". EPing while caring for a baby with a disability  
must be incredibly challenging.

If she pumped very often for the first four months, in general she  
_might_ be able to maintain her supply with a 6 times a day schedule.  
However mums vary just so much in storage capacity and pump response  
that there is no solid answer to the "how often" question - it might  
be eight times for one mum, and twice for another. How long does she  
pump for? Most of the EPers I know find that the 10-15 minutes  
traditionally advised is way too short; they pump for 30-40 minutes  
per session, sometimes more, once they start reducing to well below 8 
+ per day.

The other easy-to-fix thing you haven't mentioned is the pump. With  
the Lactina, the most obvious parts that would need replacing by now  
are the piston gasket, white membranes, and yellow valves. Is she  
using the correct size of flanges? Lubricating the flanges before  
pumping? Fiddling with the vacuum-speed settings to optimise her flow?

No other obvious supply busters? (hormonal birth control,  
decongestants, lack of sleep/calories/water, etc)?

There are dozens (hundreds?) of other supply tips along with pumping  
more often. Is this mum in touch with an online support group such as  
pumpmoms, mobi or EPers? I'm happy to put her in touch if she'd like  
to access a true peer-peer support network.


Lara Hopkins
EPed for 14.5 months, EPers listmum

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