Today our expert owner Dr. Kathleen F. McCue is sharing her thoughts on low milk supply and some of the underlying reasons.
It’s fair to say that I make a living regulating milk supply. The number one complaint we hear from clients is, “I don’t have enough milk!” Sometimes I’m in agreement and other times, expectations are totally unrealistic. There are so many things that come into play; storage capacity of the breasts (meaning amount of glandular tissue and milk-making alveoli within the breast itself); adequate nipple stimulation to help produce prolactin (a hormone that promotes milk production); suckling ability of the baby (big strong baby or jaundiced baby with a low birth weight); frequency of stimulation by either baby or breastpump.
Here are some of the issues I look for, and as always, a consultation with an International Board Certified Lactation Consultant (IBCLC) will help determine what’s happening and how to assist:
- Do you have adequate breast tissue, in other words, do you have very small or conical shaped (meaning tubular-shaped) breasts? Did your breasts increase with size during pregnancy? You should have gone up approximately one cup size.
- Are you bleeding for a prolonged period or passing clots in addition to not making enough breast milk? These are signs of retained placenta, which can prevent the milk from fully coming in.
- Are you using a personal use pump to express milk more than 3-5 times a week? The pumps from insurance companies are rarely adequate to pump when separated from babies for extended periods. This means if you’re exclusively pumping, or back at work, leaving the house at 8 and returning at 6, you’re going to most likely need a hospital grade pump. Insurance pumps that you own are sometimes called “hospital grade” but in the world of lactation consultants, we mean the kind that you rent from your lactation consultant or hospital. My favorite is the Medela Symphony because it’s only seven pounds and has a soft stimulation phase that helps moms produce prolactin.
- Are your flanges the correct size? The flanges are the funnels that cover your breasts and nipples. I can’t tell you how many times we’ve seen JUMBO flanges that are totally unnecessary. You want some stimulation for the nipples. You can size your flanges properly by looking at the nipple when you pump. There should be clearance enough around the entire perimeter of the nipple (mid base to tip) and you should not have a large part of the areola or breast itself being sucked in. You also don’t want them too small or you could cause damage (read: soreness) from pumping, and prevent milk from draining well from the breast. This can be tricky, so again, find a local lactation consultant to help you.
- I always recommend double pumping (both breasts at once) for 20-30 minutes when back at work or when pumping to substitute for direct breastfeeding. Fifteen minutes rarely cuts it unless you have an oversupply but again, if that’s your problem you’re not my reader! Yes, I know the milk stops coming but if you can hang in there a few minutes longer, you’ll get another letdown, meaning the milk will start to squirt out again. It’s great to have at least two or three letdowns. Some moms can initiate another letdown but putting the pump back on the stimulation (or letdown) phase, or by taking a short pause to massage the breasts before resuming pumping.
- Have you had a low supply since baby’s birth? Maybe you’re dealing with a tongue tie or lip tie or both. Is baby a good feeder, meaning is he/she gaining at least an ounce a day? If you suspect your baby is having difficulty latching onto your breast and emptying them well enough to bring your supply in, an in-person evaluation with an IBCLC will help you figure out how best to help.
- Is your baby sleeping through the night? If they are in bed by 7 or 8pm, you should pump before going to bed at 10 or 11pm. If you go to bed when baby does, you should optimally not go longer than 6 hours without stimulation to the breasts.
- Do you have PCOS, thyroid problems, low iron or insulin resistance? These can all cause low milk supply.
- Are you on ANY type of hormonal contraception? OBs and midwives sometimes aren’t aware that even progesterone only (mini-pill) or IUDs like the Mirena can really impact milk supply negatively.
- Are you drinking more than what you’re thirsty for? More water than you need actually works against you and you’ll end up peeing more and making less milk.
If you’ve ticked through this entire list and are still unable to increase your milk supply, visit your local IBCLC or contact us!
If you’re experiencing an issue with your Medela Symphony rental pump, our troubleshooting guide may help you resolve the issue. If you’re still having difficulty with your pump after following these troubleshooting steps, please contact us at 301-943-9293, or firstname.lastname@example.org for assistance! If necessary, we will make arrangements to exchange your pump.
Issue #1: My pump won’t turn on!
Please make sure the back of the Medela Symphony pump is plugged in properly – the short black cord needs to be plugged back into the pump itself, while the long cord is plugged into a power source. See the photos below for an example:
Issue #2: My pump has low suction!
There are several possible causes for low breastpump suction. First, please check your pieces. The valves and membranes should be free from defects. Make sure the white membranes lay flat against the yellow valve and don’t have any tears. Over time, these membranes will need to be replaced. If you pump often (4 times a day or more), the membranes may need to be changed every 2 weeks or so. If you pump less frequently, every few months should be sufficient.
Your tubing should be purchased from a Medela-authorized retailer. It is common for generic tubing to not work well. If your tubing appears to have any crimps, punctures, or mold growth, please purchase another set of tubing.
The flanges (the pieces that come in contact with your breasts) should fit properly. Not every woman will need the 24mm flanges that are included with the kit. Aside from some discomfort, your pump may appear to have suction issues if you are using the wrong flange size. You can view Medela’s sizing guide here to determine if you need a different size. If you are still unable to determine your best size, please contact us to set up a time to visit us in our office for a professional fitting.
The caps under the lid will sometimes come loose during regular use. Make sure that the caps are properly secured. When you put them in the breastpump, you should hear and feel a small “pop”, and that means they are secured correctly. See the photos below:
If you think only one side of your breastpump is having suction issues, you can do a quick test to determine the cause. Open the lid and switch out the parts from one side to the other, caps and all. If the side with the suction issues is suddenly better and the other side is worse, you should inspect your parts for defects; there is likely nothing wrong with your breastpump. If you’re still experiencing low suction on the side you initially thought was the problem, contact us to arrange an exchange.
Issue #3: My pump displays an error message, chirps, then shuts down!
Sometimes unavoidable problems occur with the pumps as they age. If your pump is displaying an error message, you can reset the pump to get you through the next couple of pumping sessions, but you should make arrangements to exchange the pump as soon as possible.
To reset your pump, follow the steps outlined below:
- Press the let-down button and hold.
- While holding the let-down button, press the on/off button.
- Release both buttons when pump reads “please wait.”
You can also do a hard reset of the breastpump by removing and reinserting the program card. To do that, disconnect the plug from the wall outlet, remove the screw from the cord protector, and slide everything up until it comes off. Remove the card, gently dust it off with a clean, dry cloth, then reinsert it. Put the cord protector back on the breastpump and screw it in place. Refer to the pictures below:
This is what the back of the cord protector should look like before you put it back on the breastpump:
Keep in mind, it is normal for your Symphony breastpump to shut off automatically after 30 minutes.
Issue #4: My battery-operated Symphony breastpump keeps saying “battery flat” or “battery low” even though it just finished charging!
Just like a laptop, sometimes the internal batteries in the Symphony Plus model need to be replaced. If your pump has charged for the recommended amount of time (12 hours) and will not remain on for at least two full 30-minute pumping sessions throughout the day, please make arrangments to exchange it as soon as possible. The pump will continue to work while plugged in, but you shouldn’t depend on a spent battery for continued cordless operation.
Here are some tips to extend the life of your Symphony Plus pump:
- Charge the pump for a full 12 hours upon receipt.
- Do not fully drain the battery on a regular basis.
- Allow the pump to charge when not in use.
- Charge the pump for 12 hours each night at a minimum. Pumps will still work while they are plugged in.
Issue #5: My Medela breastpump is making strange noises, movements, or noticeably fluctuates in suction while pumping.
Some noises and lid movements are normal, especially if you’re using higher suction settings. Unless you notice a decrease in performance, it is not always necessary to contact us about these issues. However, if the suction on your breastpump fluctuates without any user input or if you become concerned with noises/lid movements, please do not hesitate to contact us for troubleshooting, or an exchange. We want you to be completely satisfied with the services you receive from us!
If you are having any other problems with your pump that haven’t been discussed in this article and would like to discuss a solution, please don’t hesitate to contact us.
Knowledge is power, and a breastfeeding parent needs all the power they can get in their journey! Breastfeeding and pumping can seem alien to new nursing parents, so we’ve decided to break down 10 lactation tidbits into the following categories: breastmilk, pumping and cool facts. Let’s begin!
- Colostrum: The first type of milk that will come in is called colostrum. It’s like a superfood that coats your baby’s stomach.
- Antibodies: Breastmilk has antibodies in it and when your baby is ill your breastmilk will change its antibody composition to act as a type of medicine.
- Use breastmilk in recipes when you begin solids: When your baby is ready for solid foods and you have breastmilk stored, feel free to substitute breastmilk for cow’s milk in your recipes.
- Manual and Electric: There are manual breast pumps, like the easy-to-use Haakaa and Medela Harmony. There are also electric breast pumps (outlet and battery-powered.)
- Insurance and Hospital: Metropolitan Breastfeeding provides hospital-grade pump rentals, but your insurance may offer free personal use breast pumps!
- Donate Milk if you have excess: If you pump and have more milk than you know what to do with, consider donating to a milk bank – for example, the New York Milk Bank! These milk banks provide breastmilk to babies in need.
- Oxytocin released: The famous ‘love’ hormone is released when a breastfeeding baby is nursing. This hormone can lower stress, blood pressure and anxiety, while increasing relaxation.
- Thirty! Some women report becoming extremely thirsty during and after breastfeeding, so keep in mind to have that bottle of water nearby!
- Righty or lefty? Some believed that they produced more milk on their right side than their left. They may be right! A study found that it is common for the right breast to have a greater output than the left.
- It’s Alive! In 2007, Dr. Kakulas discovered that breastmilk has stem cells! Stem cells are basically cells that have the potential to become different types of cells inn the body. How cool is that?
Whew, that was a lot! And all of that really only scratches the surface of the lactation world, but it’s a start! We hope that you found out at least one thing about your liquid gold that you may not have known before. Have any other facts? Let us know on Facebook!