My boobs are on strike against my pump.

November 13, 2015 10:19 AM

I'm suddenly getting ever diminishing returns with my breastpump. Do I have to bite the bullet and shell out for a different one?

I breastfed Peanut the first until just shy of her 2nd birthday; we weened her out of necessity when I was on a week of bed/rest following an amniocentesis for Peanut the Second. I was fortunate enough to have no supply problems whatsoever.

Likewise, we've had no supply issues with Peanut the Second, who is now 9.5 months old. In fact at the beginning, with Boob Mite #2 we had a bit of oversupply/fast let down/ slight reflux combo problem that eventually worked itself out over time. She has always refused formula.

Unlike her big sister, Peanuttier is at nursery school during the week and needs a daily supply to cart along to school. And I am getting ever diminishing returns with my pump, a Medala hand pump.

I used to be able to knock out on average 70ml in a solo session, 100-120ml in a really good session. Just over a month ago, I started having to pump in tandem with a feeding session. Then I started getting only about 60ml a tandem session. Then 50ml. I'm now at the point where I get maaaybe 30ml a session, and if I pump at every feed, it just gets even worse.

It's not even a supply problem, because Peanuttier is more than satiated whenever she wants boob, and if stop with the hand pump and switch to expressing by hand, well, I nearly shot hubby in the eye with a wayward jet. I've been trying to perfect the hand expression as such, but it takes me for ever and I get a good amount all over the place. Plus with Peanut the First being a typical 3 year old, and Hubs at work most evenings, I can't always dedicate a goodly chunk of time that hand expression is currently taking me. It's like my boobs have become hyper efficient, responding only to the real deal or hand expression.

I'm hydrating like mad, eating oatmeal, and totally stressing out, in no particular order. Yes, I know that last isn't helping matters, but I'm feeling the pressure because Peanuttier has decided that this baby food mush is passè and it's big kid food, boob, or GTFO. Her school won't switch her to the next menu tier until we're finished introducing a list of foods, including some stuff like eggs and juice that I didn't give to Peanut the First until after her first birthday. Peanuttier is still too small/not enough teeth for some of it.

Anyone else had to combat this problem? What helped you through it? Do I just have to bite the bullet and shell out some bucks for some big honking electric tit milker?

posted by romakimmy to Health & Fitness (17 answers total)

Do you have a Medela pump? If so, have you tried replacing the flaps/membranes (those little white circles)? Doing that fixed things for me when my pumping output dropped unexpectedly.
posted by belladonna at 10:27 AM on November 13, 2015

It might be worth looking into an electric pump to see if it works better for you. You could rent a hospital grade for a bit to see how it goes. FWIW if you do decide to buy one, my friends who are pumping are raving about the Spectra pump. Relatively affordable but hospital grade. If you're in the US the ACA will pay for a pump for you.
posted by goggie at 10:28 AM on November 13, 2015

I hit a weird reduction in output at about 9-10 months. I was using a Medela. I started eating "lactation cookies," and the combo of stuff in the cookies seemed to help.
posted by heathrowga at 10:35 AM on November 13, 2015

I just hit a lactation wall too and was literally pumping drops when I had been pumping about 4 oz each breast, I had started back at work and was at the pump more than actual breast feeding. I was dehydrated and days later I got my period (probably not your reason... I'm on the mini pill). But I kept at it pumping more and more with nothing happening, slowly its creeping back up I don't get the same amount in less time but its working its way up I just kept at it to stimulate, don't give up! I am used the electric double ameda pump...sounds like you have had good luck in the past maybe just try a different pump or keep at it.
posted by MamaBee223 at 10:47 AM on November 13, 2015

Yes I've changed out the membranes before, but your link showed that they sell replacement valves too. I had no idea that was a consumable part.

I live in Italy, so no ACA for me. If I go the different pump route, I'll most likely go straight to purchasing one since I remember the math on renting from Peanut the First provoked the "are you fucking kidding me/better to buy" response.
posted by romakimmy at 10:53 AM on November 13, 2015

Yes, first thing to do is try replacing the valve. If it's wearing out then you're not getting the same suction you used to. If that doesn't work, I'd definitely look into buying a double electric. For me, it was much more effective. For example, in a ten minute session with my hand pump, I'd get about 4 ounces (about 120 mL). In the same amount of time with the electric, I might get 6 ounces per boob, and I could do both boobs at the same time.

To clarify goggie's comment, the ACA doesn't pay for a pump, it just tells your insurance company that they must pay for a pump. Most insurance companies have a list of pumps and/or medical suppliers who they will deal with. Possibly you might get them to partially pay for a pump of your choice from a vendor of your choice if they're not on the list. I was quite happy with the pump selection from my insurance company and got a good output from my Hygeia Enjoye.

I'm guessing that since you're saying mL instead of ounces, you're not in the US, though, and will be looking at buying your own pump. It's totally safe to buy used if you shop for a closed system pump. Hygeia is one, I think there are a few others. Then you could just buy replacement tubes and filters and whatnot for quite a bit less than buying the pump itself new.
posted by Kriesa at 10:53 AM on November 13, 2015

Since the hand pumps are fairly cheap in comparison to double electrics (about $40 where I am), frankly I'd buy a whole new hand pump and try that first. Each piece is subject to wear and tear, from the flanges to the valves to the diaphragm, the flexible plastic part that provides the suction in the pumper part (and which, as far as I can tell, does not seem to be something you can purchase independently, but mine developed a teeny tiny little hole that I was only able to find with water).

My experience with double electrics is that renting a hospital grade pump is better - the trade off for production and efficiency was well worth the higher cost. I'd rather spend an extra $50 a month than 50 hours chained to a pump and not spending time with my kids.
posted by peanut_mcgillicuty at 11:05 AM on November 13, 2015

If you're using the flanges that come with the pump, try Pumpin' Pal. The diagram at the top of their page explains really well why they're so great, especially since this doesn't seem like a supply issue per se.
posted by teremala at 11:11 AM on November 13, 2015

I never had much luck with hand-pumps at all, so I'm not, perhaps, the best person to give advice here. (I do want to put in a word for Hygeia double electric, which I found to be more affordable than the "hospital grade" pumps, but with the same kind of performance -- and it can be re-used for another baby or lent to a friend, unlike the Medela personal pumps.)

But mostly I want to tell my story to maybe to relieve some of your stress. My younger daughter, who couldn't have formula due to a medical issue and who was in daycare ~10 hours a day, never drank pumped milk. Like any. Ever. I pumped every day for a year! She just never drank it.

And you know what? She's fine. When she was < 6 months old, she wanted to nurse all night long, and it sucked because I got no sleep. After that, she did move rapidly from baby-food to "big kid food," I admit. (Her older sister has food allergies, and the allergist told me that newer studies suggest that the earlier you introduce foods, the less likely the child is to develop an allergy, so we did move her through the "new food list" a lot faster than we had her big sister.) But she was never malnourished.

What I'm saying is, your baby will be okay no matter what happens with this. If you can't keep pumping enough, she'll either get hungry enough to try the mush, or you'll move her to big kid foods sooner than you had planned, or she'll keep you up all night nursing, or you'll end up supplementing with formula, but really none of those is the end of the world... She won't starve. That's the important part. She, and you will be okay, and in a few months it'll be something else you'll be worried about.
posted by OnceUponATime at 11:52 AM on November 13, 2015

My friends w hand pump said it actually diminished supply (hand pump doesn't stimulate like straight nursing) so they had to double pump to maintain supply.

I've had good luck w medela electric.

Here is an article from la Leche that addresses your exact problem.
posted by St. Peepsburg at 12:37 PM on November 13, 2015

Just as a data point, my supply was fine and I nursed until my son was 3. I pumped until he was one, but from when he was about nine months onward I just got less and less at each pump. I tried all of the advice (switching membranes, times of pumping, holding a picture of my baby, whatever). I just could not get a great letdown for the pump (this was a Medela Pump in Style electric pump).
posted by JenMarie at 1:22 PM on November 13, 2015

Is it possible you can just drop out pumping since you have such great supply, and only do it in emergencies? That would save you $$$. On the other hand, I can't imagine how much time you'd save with a double electric pump, you might find it super worthwhile. If I had to hand pump I would have quit breastfeeding after like 2 weeks. Life's too short to spend it being milked! Remember handsfree bra and you can work or read or look at Metafilter while pumping. It might be a revelation. Consider buying used. I bought mine refurbished for considerable savings and it's lasted me 3 years.
posted by treehorn+bunny at 2:27 PM on November 13, 2015

Could also be the tubes or the motor. I always got milk in the tubes and had to pry off the cover to get milk out of the motor.
Pro tip on washing tubes - a big needless syringe. In the U.S. They are called flavor injectors; push soap and water though the tubes to clean, flush out with lots of water, then whip them around to centrifuge the water out (hang to dry).
posted by tilde at 3:01 PM on November 13, 2015

I'd try a double electric. But if that doesn't work, or if you want to try something free first, give hand expression a try. This is going to sound ridiculous, but really feel yourself up. Massage the breast tissue and pinch and twiddle your nipples (since you've nursed an older kiddo this might resonate: touch yourself like a toddler would--that awful, grabby behavior is actually them stimulating another letdown). This is good even if you're pumping (see hands on pumping). You know you have milk so the idea is to really get oxytocin flowing before you start to express, and stimulate a letdown.

Once you start hand expressing, feel your boobs for full or hard spots and squeeze toward the nipple starting at your armpit. Keep doing this on one milk duct until your nipple stops spraying or dripping, then move to the next one. The videos on youtube weren't that helpful for me--most of the women have smaller boobs or something. You know what was helpful? Videos of people milking cows. Oh well, we're all mammals. A friend who was having trouble both pumping and hand expressing said that this video from Meet the Parents was the magic bullet to finding and expressing the milk in her boobs.

Basically, keep playing with yourself until you find a way to get the milk out. It's in there, so it's a matter of figuring out how to trigger a letdown. That oversupply in the first few months is hormonally regulated; at this point, you're on a supply and demand system. Especially since your kid refuses formula, it's a good idea to do what you can to keep expressing.

Hand expressing is a little messier, so you might want to get a wide mouthed jar. But with practice, and the right rhythm (I hand express to music in my head), you might be able to get a lot of milk out this way, with surprising speed, too. In cultures where women are taught hand expression rather than pumping, chronic oversupply is a bigger problem than undersupply. Not all women respond well to pumping, and physical touch--hands, baby--are much more likely to kickstart the biological processes that trigger letdown.

I'm a big fan of hand expression, ever since I went on a work trip for four days last month. My daughter is 22 months, still breastfeeds a lot, and has been in the 95th percentile for most of her life so I know she gets a lot of milk. I brought both a double electric and a manual, and was getting less than an ounce from each breast with either. My boobs were rock hard. It sucked. I switched to hand expression and was getting 3-4 ounces a session. Huge, huge difference.
posted by PhoBWanKenobi at 7:54 AM on November 14, 2015

And now I see that you get milk with hand expression. That's great! Just keep practicing. It's possible to be just as efficient with it as it is with pumping. A wide mouthed jar really helps with the mess, too. Plus it's free.
posted by PhoBWanKenobi at 7:57 AM on November 14, 2015

I think the life expectancy on these things is around 6 months; replace it. My experience:

I use my Medela hand pump for my last PM pump every day. I actually get more milk with it than I do with the double electric I use throughout the day at work. Around 5 months my PM output started dropping and I noticed the suction didn't feel as strong. I inspected the clear rubbery membrane this pump uses and found a tiny tear in one of the folds. A replacement membrane was almost as much as a totally new hand pump that came with two bottles, so I bought a brand new Medela. hand pump and all is back in order.
posted by marmago at 4:35 PM on November 14, 2015

Alrighty then. Tomorrow's mission is to buy a new hand pimp as a first troubleshooting measure and then we'll go on from there. I was going to do just the valves until I read some further replies and realized the stupid thing is 3 years old now. Y'all gave me a perspective realignment in that I was thinking it's purely a my-boobs problem when it might be more of a my-pump problem. I'll be marking best answers as I go.

Thanks as well for the specific electric pump suggestions; unfortunately it looks like neither spectra nor hygeia isn't available here. Not too surprising, unfortunately. Those tilted breast shields also look interesting, but I can't figure out on the fly here on my phone if they too would be unavailable to me.

Cheers y'all!
posted by romakimmy at 10:37 AM on November 15, 2015