Oversupply and Undersupply

I was one of those lucky women whose milk came in quickly ( 3 days after birth). And I made the correct amount right from the start. The first two weeks I was just engorged enough to meet Jack’s demands during those first few growth spurts but not be leaking all the time. Then I somehow got it in my head I needed to accumulate a massive freezer stash as soon as possible. So I started to pump whenever I could. I also took fenugreek everyday for 2 weeks to boost my supply. By the time Jack was a month old I had over 100 ounces frozen. I was so proud, my baby could eat for several days!

His first milk coma. I should have know if
he was happy, I was making enough milk.

Around this time I got my first clogged duct—and man did it hurt. A few days later I got another. Then another. I also noticed Jack’s diapers where green and frothy. He also started to cough/choke and pull off my breast when my letdown started. I asked my lactation consultant, she said I likely had a strong letdown caused by an oversupply. I told her I was pumping a lot and she said that was really unnecessary. Unless I planned on being away from him often, I didn’t need more than a few bottles worth stashed.

My freezer stash again. I am considering
donating some of it now.

I looked up on La Leche’s website how to correct an oversupply. I stopped taking the fenugreek and right away I stopped getting insanely engorged. Then I didn’t need to pump during the day at all. I only pumped for relief if Jack slept through the night. And when he woke up to nurse at night, I pumped the other side after to keep it from leaking and waking me up. It was painful at first and I got two more clogged duct during the process. Jack’s also stopped choking and his diapers went back to normal. I felt silly for thinking I needed to make so much extra milk everyday. It only caused Jack and I problems.

Then my milk stabilized around 12 weeks postpartum. Many moms mistake this for their milk drying up. Your body figured out how much milk to make for your baby, so you no longer get engorged and will leak a lot less. I knew this was coming and welcomed the relief. I only woke up 1 or 2 times a week to pump at night.
I had just nursed him and he was still giving me the milk face.
About this time I also went back on birth control. I know that exclusively breast feeding can be a very effect form of birth control when done correctly, but I didn’t want to take that chance. Jack is the best surprise of my life, but I am so not ready for any more. I selected Mirena, which the doctor told me repeatedly has little to no chance of interfering with my milk supply. At first there were no issues, so I didn’t think twice about it. Then Jack hit the 4 month sleep regression. He woke every hour to two hours at night, demanding milk. I had plenty so it was not an issue at the start. He was nurse for 5 minutes then would easily go back to sleep. About a week into the sleep regression is when my Mirena took full affect and I noticed right away Jack was nursing for 20 minutes or more. And he getting frustrated. Sometime he even demanded the other side as well. This also started to happen during the day. One day I pumped to make a bottle so I could go out for a bit and hardly anything came out. I mean I spent 30 minutes barely getting 1 ounces from both sides. No wonder Jack was getting frustrated! I know pumping is not a good indication of total output because your baby is better at removing milk, but I always responded well to pumping. Something was wrong.
I realized that it had to be the Mirena, since nothing else changed. I talked to my lactation consultant again. She brought up the whole “most mom mistake stabilization for a loss of supply” thing, despite me telling her I knew the difference. So she weighed him before and after a feeding session right there at the office to show me he was getting enough. Jack nursed for 20 minutes and barely got 1.5 ounces. She said that he will need to nurse more often if that is all he getting. And eventually I might need to supplement with formula if it interferes with his weight gain. She really did not want that to happen though, she urged me to just keep at it.

I asked my local La Leche League for help. A couple moms also experienced a dip in supply when returning to birth control. One mom said that it’s because it signals your body to start having menstrual cycle hormones again. Those interfere with the hormones for milk production. She suggested I take the Mirena out if it becomes a major issue. I didn’t want to take it out, but I also did not want my milk to dry up. I want to nurse Jack until at least two-years-old, and no stupid little medical device was going to prevent me from reaching my goal.

I was going back to work in 2 weeks and did not want to use up my freezer stash. I knew that if I turned to the stash I would be demanding less of my breasts, causing them to make even less. This would only make the problem worse. So I pulled out all the stops. The lactation consultant told me to go back on fenugreek. I could up to 4 pills 3 times a day if I needed. I ordered a two-pack of the big bottles off of Amazon Mom. I also made lactation cookies (check out my food blog for the recipe) and devoured of them all. I also ate oatmeal with a big scoop of brewer’s yeast (also got off of Amazon Mom) for breakfast every morning. I drank Mother’s Milk Tea and a ton of water daily too. I also let Jack nurse all he wanted. I even let him stay latch for 5-10 minutes once he fell asleep for a nap to increase the demand on my body. I also pumped every chance I got.

It took 12 days of being vigilant, but it worked! One night I got up to pump at 3 AM and got my normal 3-4 ounces. Jack stopped fussing at my breast during the day and fell asleep easily again at night (though he still woke up often because of the sleep regression). I cut back on the marathon nursing sessions and only make lactation cookies when I want a treat. I am still taking the fenugreek to keep my supply from dipping again. I scaled back though, only 2 pills 2 times a day.

It came just in time too, the next day I started back at work. The milk I pumped that night became his bottles for my first evening back. It’s been 4 weeks now and my supply is back to normal. I stabilized again and don’t get engorged often at all. I never had to touch my freezer stash (I am actually considering donating my stash now) and I didn’t need to supplement with formula either. Stubbornness paid off big time!

How cute is the romper I got in Napa?

I shared this story because I couldn’t find another one like it. I am not judging anyone who chooses to give formula or needs to supplement at all. Always do what’s best for you and your baby. But I hear from friends and other moms who didn’t get the support and information they needed to push through breastfeeding hurdles. Breastfeeding is not always easy and does not always come naturally. It’s work and takes a commitment. It is possible to succeed, don’t discouraged! If your baby is gaining weight and making enough dirt/wet diapers, don’t worry about needing to supplement. Your body is amazing and can fix the issue if you let it. I have fixed an oversupply and undersupply in the span of 4 months now. Get help and seek out support like I did.

Here are resources I used:
How Does Milk Production Work, KellyMom
Fenugreek Seeds For Increasing Milk Supply, KellyMom
Oversupply, La Leche League
Engorgement, La Leche League
Brestfeeding and Fertility, KellyMom
Increasing Low Milk Supply, KellyMom
Is Baby Getting Enough Milk?, Kellymom

Pumping at Work

In my last post I mentioned that I went back to work two weeks ago. Michael feeds Jack bottles while I am gone, so I have to pump at work. Before I returned to work, I did pump a little. Mostly because Jack was sleeping through the night (stupid sleep regression) and I pumped for relief. I never set an alarm to pump, usually Jack woke around 4 AM, ate from one side and I got up to pump the other. I froze that milk so I had a stash for when my parent watch him next month when we go on a trip for anniversary. Side note: I love the Up& Up and Lansinoh freezer bags. But make sure you seal the Lansinoh really tight or they can leak when you thaw them. The Up& Up are cheaper and have never leaked for me though.

The first bag I ever pumped, I was so proud.

The first time you pump is really weird. It might hurt if your nipples haven’t toughen up yet (or were horribly bruised from nursing like mine). To ease the pain, I put a little bit olive oil on my nipples and the flanges first. And once I finished, I put on lots of lanolin. It hurt way less than nursing did at first though. But like I said, it’s weird. You really will feel like a cow. But just remember you are doing something amazing for your little one.

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Anyways, I first bought an Evenflo Deluxe Advanced Double Electric Breast Pump. I knew nothing about pumps so I just went by price. For the price the machine is not bad and did get the job done. It comes with a tote bag,  a separate mini cooler with ice packs, 2 bottles and 2 different flanges sizes. I also like that it’s not that loud. But, it’s not that powerful. I have a really strong letdown, then afterwards it goes to a weak stream. Without a strong suction to boost the stream up, it just takes forever to drain my boobs. To be honest, I think I wasted my money on it. If you are just going to pump on occasion or don’t need that much suction, it is worth the money. However, for me personally, it just didn’t cut it.

Stimulation mode is awesome and the
suction is good for such a small device.

After awhile it became such a pain to set-up and use an electric pump at night when I was only doing one side. So I thought I’d try a hand pump. I got a Medela Harmony and it worked fantastic! It’s easy to clean and use when I am half asleep at 4 in the morning. I love that it has two pumping modes, stimulation and normal. The stimulation mode starts my letdown way more efficiently than the Evenflo one did. And because I controlled the pumping speed, I could change the suction instantly to my needs. I got way more out with just this simple little pump than I did before. They are fairly inexpensive and totally worth the money. And great to keep with you when are travelling or if you start leaking while away from your baby.

I LOVE this pump. And yeah, I am using the treadmill
as table for my stuff. Joys of pumping in public.

Then when I turned to work I got the Medela Double Electric for free (your insurance company and WIC will provide you with a pump for free). I LOVE IT! It has great suction power, stimulation mode, and several speeding settings to keep my stream going as needed. It comes in its own portable bag too. You never need to take it out, there is a zipper opening on the side to access the controls.

There is a pocket inside to store all the parts. And a cooler with ice packs to store the expressed milk for up to 10 hours. I should have just waited for this pump. It’s more expensive (if you don’t get it for free) but SO worth the money.

As far as pumping at work, first you need to know your rights. All employers MUST give you a break to express milk, a reasonable amount of time to do it in, and a place that is not a restroom to do. This is all under Federal law. Check out the Department of Labor website here for more information. My husband was nice and talked to our HR guy for me while I was on maternity leave. He suggested that the gym was the best place for me to pump. Not many people actually use the gym so it don’t have to worry about people barging in. Plus the door locks and there is a shade on the window next to the door for privacy. A couple people have asked why I keep going into the gym, so I just politely explained and they understood. I also talked with my boss before I went on leave and before I got back. He approved my pumping schedule. It was pretty easy overall, but I really suggest working this stuff out beforehand and making sure everyone who might be affected is on board. That way there are no issues to stress you out (stress hurts your supply) when you get back to work.

I pump every two hours for 20 minutes. Once at 5 PM and again at 7 PM. I chose these times because this is normally when Jack eats each day. I suggest (if possible) having a pumping schedule similar to your feeding schedule so it does not effect your supply.

I suggest either buying or making your own hand-free pumping bra. It really sucks to be sitting there holding  your boobs for 20 minutes. I made one out of an old sports bra by cutting slits wide enough for the flanges to go through.  And bring something with you to do while you pump, it can get boring. I either play on my phone or take some paper work with me.

Since breast milk can be left at room temperature for up to 8 hours, I don’t fully wash the pumping parts after each session. I rinse off them in the breakroom (once again, no one cares, just do it calmly and quietly). Then I put them back in the bag with and use them again for the second session. After the second session I just stick back in the bag and give them a thorough cleaning when I get home.

I first started pumping into the storage bottles that came with the pump. But it got annoying washing 2 or 3 extra bottles at night. I realized that the bottles Jack drinks from fit onto the pump so I started pumping straight into them. I bring an extra storage bottle just in case I make extra.

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Jack likes the Evenflo Classic Glass 4 Ounce Bottles. I got great advice from a friend when I was pregnant on what bottles to start with—pick ones that look most like your nipples. After some trips to the store and awkwardly trying to decide what looks the closest, I settled on these.  However, you may have better luck with bottles designed for breast feeding babies, like these suggestions from Baby Center. Also, don’t wait to introduce a bottle until you go back to work. They might get too used to the breast and not take it. However, don’t introduce it too until they have latched correctly and repeatedly, or else they may get too used the bottle and reject your breast. We introduced a bottle slowly starting at 3 weeks. He would get maybe one a week. Then a few weeks before I went back to work he started to get several more a week to help ease the transition.

It takes a little guessing on how much to leave. The lactation consultant told me an ounce for every hour I’m gone. I last nurse him 6 hours before I get home, so 6 ounces. So the first day I left two 3-ounce bottles. Jack plowed right through those, obviously this kids needs more than 1 ounce an hour. So the next day I left two 4-ounce bottles, plus a little spare. He plowed through the first, and then happily suck the other down slowly later. I found the winning combination. And sometimes he doesn’t need all of the last one either, I think he knows I’m coming soon and waits for me. To make this all easier on Michael, I line them up in order of use in the fridge.

All lined up and ready to go in the fridge.

Then there is the storage issue. Some moms rotate their freezer stash. They pumped milk while on maternity leave and thaw out as needed each day, using the oldest bags first. Then replenish the stash with what they pumped that day. Others don’t have a stash and just use what they pumped the day before. This is what I do, even though I do have a stash. What I pump on Monday gets bottle up and fed on Tuesday. Tuesday gets fed on Wednesday, & etc.. And since breast milk lasts up to 6 days in the fridge, Friday’s get fed on Monday.

My freezer stash of about 350 ounces.

Before I went back to work I read some other blogs about pumping and it really helped. Happy Home Fairy’s Extreme Pumping- Confessions of an Exclusive Pumper is SUPER helpful. Although I’m not a teacher, I really like Healthful Mama’s Back-to-School Breastfeeding: Pumping in Your Classroom.

So far I have been able to comfortably pump at work and make enough milk each night without having to touch my freezer stash. However, check out my next post about the supply issue I had a few weeks ago that also had me reaching for my stash.

Back to Work After Maternity Leave

I returned to work after 17 weeks of maternity leave. The State of California allows up to 4 weeks off before your due date, plus 12 weeks off for bonding time. The extra week off came from vacation time. I have the same job, but I am working second shift for only part-time hours right now. As Jack gets bigger I might slowly add more hours back to full time, but no rush from my boss as long as stuff gets done.

Michael and I worked it out so we avoid paying for childcare. He works first shift while I stay home with Jack. Then I put Jack in the car, bring him to our work and we trade cars. Then he drives home with Jack and I go to work. Then I get off just in time to get Jack ready for bed. I like this solution for two reasons: we avoid the $1000 a month bill for childcare and we both get time to bond with our son. And so far Jack doesn’t seem to mind. He usually falls asleep in the car with me and wakes up when Michael gets home.
How could I leave this face?
But the first day back was hard. The night before I bawled my eyes out over it. Jack had been my whole world for three and half months, how could I leave him? That day I brought Jack in the building with me because he was awake when I got there. Michael was ready to go so he quickly took Jack from me and kissed me goodbye. I just stood there thinking No! Bring me my baby back!  I went to my desk and started to work, but I kept worrying about my baby. What if he wont take the bottles? What if he wont nap? What if Michael doesn’t do tummy time? What if he just cries the whole time? What if he forgets me in these next 5 hours and never wants me to hold him again!?!?
 

When it was time to clock out, I rushed home. My boys were standing at the door to greet me, and Jack lit up when he saw me. Everything was alright. Michael is an excellent dad and takes great care of him. I had nothing to worry about. That being said, I am a mom and I will worry about them both every day still.

Michael sent me this on my first day.
He was just fine, and even started to grasp his bottle!

But am I exhausted? Yes (especially with the sleep regression still going on). Are there some days I feel like Jack and I are never going to get out the door on time? Yup. Does it suck I get even less time with my husband now? Totally. As much as I wish I could be a stay-at-home-mom all the time, it’s not feasible right now. And everyone at work is so accommodating for what our family needs that there is no reason for me to quit.

I get to come home to this face every evening!

Being back at work also means I’m pumping at work too. I will do a post about how that’d going next, so look out for that.