*Edit i repasted article as mobile bump took out the dashes making it look like you need to pump 23 times for 1 feeding! LOL
You dd'd before I could respond. I was not implying you didn't have a problem, I was saying you don't have a supply problem.
Pump output is not an indicator of supply unless you are exclusively pumping.
Domperidone has fewer side effects and is safer for you than reglan.
Please read this article. I wanted to correct your misconception because I don't want other moms thinking they have a supply problem when they really have an average pump response! .5 oz per pumping session is the low end of normal!
This is from kellymom: http://kellymom.com/bf/pumpingmoms/pumping/pumping_decrease/
Im not pumping enough milk. What can I do?
By Kelly Bonyata, BS, IBCLC
Image credit: Mrs. Flinger on flickr
Introduction
Milk supply normally varies somewhat throughout the day and over
weeks and months. As long as baby is allowed to nurse on cue, your milk
supply will accomodate baby?s needs. However, when mom is pumping
part-time or full-time, pumping output can become an issue due to a few
factors:
- The ability to measure how much milk you are pumping makes
any decrease in pumping output more obvious and more worrying, even if
it?s a normal variation.
- Pumping moms generally need to pump x amount of milk for baby for a particular day, and it can be quite stressful when mom does not pump this amount.
- No pump can remove milk from the breast as well as an effectively
nursing baby, so pumping does not maintain milk supply as well as a
nursing baby. Because of this, the greater the percentage of baby?s
nourishment provided by pumping (rather than direct breastfeeding), the
greater the possibility that mom may have to work harder to maintain
supply.
What is normal when it comes to pumping output and changes in pumping output?
It is typical for a mother who is nursing full-time to be able to
pump around 1/2 to 2 ounces total (for both breasts) per pumping
session. Moms who pump more milk per session may have an oversupply of
milk, or may respond better than average to the pump, or may have been
able to increase pump output with practice. Many moms think that they
should be able to pump 4 to 8 ounces per pumping session, but even 4 ounces
is a rather large pumping output for a mom who is breastfeeding
full-time.
It is quite normal to need to pump 2 to 3 times to get enough milk for
one feeding for baby (remember that the pump cannot get as much milk as a
baby who nurses effectively).
Many moms are able to pump more milk per session when they are
separated from baby. Milk pumped when you are nursing full-time is
?extra? milk ? over and beyond what baby needs. Don?t get discouraged if
you are trying to build up a freezer stash when nursing full time and
don?t get much milk per pumping session ? this is perfectly normal and
expected.
It is very common to have more milk than baby needs in the early
weeks, which regulates down to baby?s needs over the first few weeks or
months. When your milk supply regulates
(this change may occur either gradually or rather suddenly), it is
normal for pumping output to decrease. For moms who have oversupply,
this change often occurs later (6 to 9+ months postpartum rather than 6 to 12
weeks).
It is normal for pumping output to vary from session to session and
day to day. Having an occasional low volume day is not unusual.
During a growth spurt,
don?t be surprised if baby drinks more expressed milk than usual,
making it harder for mom to provide enough expressed milk. Growth spurts
are temporary, try increasing nursing and adding a pumping session or
two at home until the growth spurt is over.
Menstruation
or ovulation can result in a temporary drop in milk supply. You might
also notice cyclical dips in milk supply before your period returns, as
your body begins the return to fertility. Hormonal changes also cause milk supply to decrease during pregnancy.
Remember that the amount of milk that you pump is not a measure of your milk supply!
What can cause a decrease in pumping output?
First, consider the possibility that baby is being overfed when
you?re apart. If this is the case, you may actually not need to be
expressing as much milk as is being requested. This is certainly not
always the case, but it is not at all uncommon. See How much expressed milk will my baby need? for additional information.
Image credit: Jerry Bunkers on flickr
When you do need to pump more milk, the first thing to check is your pump:
- Are you using an appropriate pump for the amount of pumping that you do?
- How old is your pump? If you have an older electric pump
(particularly older than a year), or if you are pumping more often than
the pump was designed for, the motor may be wearing out.
- Many times a decrease in pumping output is because pump parts need
to be replaced. Have you checked your pump and replaced any parts that
are worn or that haven?t been replaced in the last 3 to 6 months?
- Do you have a type of pump (like the Avent Isis) that benefits from occasionally boiling the boilable parts?
- Switching to a larger pump flange makes a difference in pumping comfort and/or output for some moms. See Choosing a Correctly-Fitted Breastshield for more information.
Supply-demand cycle:
- Have you reduced the number of pumping or nursing sessions recently, or cut back on nursing/pumping in other ways? Milk production
is a demand-supply process. More nursing/pumping results in a greater
milk supply. If you consistently decrease nursing or pumping for several
days, your overall milk supply will decrease and you can expect to see a
decrease in pumped amounts.
- Has baby started solids
recently? As baby eats more solids and takes in less milk, overall milk
supply naturally decreases and you may see a decrease in pumping
output. You may not notice a change in nursing pattern, as some babies
nurse just as often, but take in less milk during those sessions. If
baby started solids early
(before around 6 months) or is eating lots of solids early on, you are
more likely to notice a drop in supply. A very gradual start to solids
around 6 months or later is less likely to affect milk supply.
Hormonal causes of decreased milk supply:
- Have you started hormonal birth control recently? Hormonal birth control, particularly that containing estrogen, can significantly decrease milk supply.
- Are you expecting either ovulation or your period soon, or has it recently started?
- Are you pregnant?
Taking care of mom:
- Have you started a strict diet? Are you getting enough calories? Snacking during the day on healthy, protein-rich foods may be helpful.
- Are you drinking to thirst? Some moms, particularly when they are at work, will get busy and forget to drink enough fluids.
- Are you getting enough rest? This can be hard to do when you have a
baby. Try to go to bed a little earlier and to take a nap each day on
your days off. Consider co-sleeping so you can get more sleep. Just a little added rest may make a big difference.
- Have you been under an unusually large amount of stress? Stress can affect let-down and pumping output.
- Have you been sick? Illness, especially if you have a fever, mastitis
or get dehydrated, can result in a temporary decrease in milk supply.
Some medications can also decrease milk supply (hormonal birth control,
pseudoephedrine, ethanol/alcoholic beverages, bromocriptine, ergotamine,
cabergoline).
See also Hidden Hindrances to a Healthy Milk Supply
How can I increase pumping output?
To speed milk production and increase overall milk supply, the key is to remove more milk from the breast and to do this frequently, so that less milk accumulates in the breast between feedings.
Increasing frequency
- Nurse more often when you are with your baby.
- Are you pumping frequently enough? Is there any way you can add a
pumping session at work? If necessary, when pumping times are very
limited, adding even a short 5 minute pumping session is better than not
pumping at all.
- Add a pumping session or two outside of work hours or on the
weekend. Try pumping after baby nurses, or pump one side while baby
nurses on the other side. You might also try pumping while baby is
napping, at night, or when baby goes longer than usual between nursings.
- Does your baby complain about slower milk flow when you pump between
nursings? If so, try single pumping between nursings, instead of double
pumping. Although single pumping is not as effective for increasing
milk supply, this leaves one breast more full, so the milk will flow
more quickly. See also these tips for babies who want a faster milk flow.
- Try cluster pumping, instead of a regular nursing/pumping
session. Sit down with your baby and your pump, and nurse and pump every
half-hour to hour for several hours.
- Some moms find it helpful to do a 2-3 day long power pump every couple of weeks to ?super charge? their milk supply. This is simply a nursing vacation with pumping added in. On these days, get lots of rest, nurse very frequently and pump after as many nursing sessions as possible.
Removing more milk from the breasts
- Are you pumping long enough? When pumping to increase milk supply,
it?s recommended that you (double) pump for at least 15 minutes; to
ensure that the pump removes an optimum amount of milk from the breast,
keep pumping for 2 to 5 minutes after the last drops of milk. If
you don?t always have time to pump this long, remember that adding even a
short pumping session (increasing frequency but perhaps not removing
milk thoroughly) is helpful.
- Use a good double pump. Double pumping generally results in better
pumping output and is better for maintaining milk supply. Pump quality
can make a huge difference in pumping output, and different moms have
better results with different pumps. However, some moms with abundant
milk supplies do not respond well to pumping (even using the best of
pumps) and do not get much milk when pumping. These moms may get better
results using manual expression.
- Use breast massage and breast compression.
- If your pump has a soft shield or shield insert available (for
example, the Medela SoftFit breastshield or the Avent ?Petal? massager
insert), then try using the pump with and without it. Some moms have
also found that they can use the Avent ?Petal? massager inserts with
other brands of pumps (for example, Medela or Ameda). Some moms get
better results with the softer shield; some get better results without
it.
- Switching to a larger pump flange increases pumping output for some moms.
Galactagogues
- Many working and pumping moms have found that eating oatmeal
is very helpful for increasing pumping output. It can also be helpful
to snack on protein-rich foods during the day and to have something to
drink every time you sit down to pump or nurse.
- Many moms have gotten good results using fenugreek or other herbs to increase supply, either on a short- or long-term basis. This is most effective when combined with increased nursing/pumping.
Other things to try
The following things are useful for maximizing nursing and minimizing
the amount of expressed milk that baby needs while you are away.
Nurse right before you leave baby and immediately after you return
from work. Make sure your care provider does not feed baby right before
you are due to return.
Has your baby started solids?
If so, have your care provider offer all (or most) solids, and only (or
mainly) breastfeed when you are with baby. By doing this, baby may need
less milk when you are apart (due to the solids) and will nurse more
when you are together. This can both help your supply (more nursing) and decrease the amount of pumped milk you need to provide.
Encourage baby to ?reverse cycle?
? reverse cycling is when baby nurses frequently when mom and baby are
together (usually at night) and takes little milk when mom & baby
are separated.
One study
has shown that the moms of hospitalized babies who listened to guided
relaxation or soothing music while pumping had an increased pumping
output. When mom listened to a recording that included both music and
guided relaxation while pumping, in addition to looking at photos of her
baby, pumping output was increased even more. In this study, the
interventions led to moms producing 2-3 times their normal pumping
output. Milk fat content also increased for these moms in the early days
of the study.
Additional information
Increasing Low Milk Supply
Let-down Reflex: Too slow?
How much milk should I be able to express? by Debbi Donovan, IBCLC
What to Expect When Pumping by Paula Yount
Optimizing Your Milk Supply After Returning to Work or School by Becky Flora, IBCLC
Decreased pumping amounts info from Kathy Kuhn, IBCLC on why this happens and some tips for pumping more milk; more on declining pumping amounts
Breastpumps ? troubleshooting and general info
Working & Pumping Tips
See the Working, Pumping, Bottle Feeding menu for information on formula and other foods
Keith DR, Weaver BS, Vogel RL. The
effect of music-based listening interventions on the volume, fat
content, and caloric content of breast milk-produced by mothers of
premature and critically ill infants. Adv Neonatal Care. 2012 Apr;12(2):112-9.