Home Forums Induced Lactation aka Adoptive Breastfeeding Medical Interventions to Induce Lactation/Increase Milk Supply Q's: pump settings, liver enzymes & funnel size

Hello everyone,

I have been pumping for 3 1/2 months after a late miscarriage (no protocol so far for this next adoption). Recently my milk quantities have been dropping. I reached 18 oz/day after 2 months pumping around the clock and then summer hit. My schedule became unpredictable, I couldn't wake up to pump at night (tired), my cycle/AF started back up again, my breasts felt less full so I'd "forget" to pump as frequently. All of these things have taken their toll to a certain extent, but I get frustrated with 10 - 12 oz/day. (I know it's silly; I should just be thankful for that much milk / day plus a lot in the freezer, but it could be months before we get a baby.) This is all background info. So, I have been thinking and I have some questions:

1) What is the best setting to pump at? I am renting a Lactina Select hospital grade pump. Do I start at 7 speed, medium suction and then lower it to 4 or 1? What happens if I turn the suction up? The nurse who rents me the pump says that you can "suck" the milk sinuses until they collapse (which is painful and damaging to them). What if the "girls" don't hurt when I turn the suction up? Why is there a higher suction setting if we're not supposed to use it? Or, should I start it at a lower suction and fast speed and then increase the suction to medium? Currently, I keep the suction at medium, speed at 7 and then turn the speed down to 5ish. I am wondering if I am doing something wrong now that my milk is diminishing.

2)I had a physical exam at the doctors for purposes of adopting. My liver enzymes came back slightly elevated (in the 50s when high / normal is 40). We suspect that the fenugreek and fennel that I was taking may be the culprit. I have stopped the herbs for the time being and I'm really hoping I can start them again. Does anyone know anything about the effect of herbs on liver enzyme tests?

3) This question might be TMI... but I can't find information elsewhere. When I looked over the info for the rental pump, I saw that you can buy different funnel sizes (to fit the nipples). How do you know if you have the right size? I don't know how much more to write on this topic... but I think there must be an answer somewhere. Would we women be more successful if we have the right fit?

4) One more question: I am scheduled to have a myomectomy on my fibroids the end of this month. I'll be in the hospital for 2 - 3 days. I plan to use my pump there as much as possible and dump the milk b/c of anesthesia, pain meds and the inconvenience of storing milk while away from home. BUT, I don't want my supply to drop any more. Does anyone have any suggestions for maintaining my supply after surgery? I might use the surgery as an excuse to get an Rx for something to help with breastfeeding.

Thanks for letting me ramble,
Nancy

Nancy,
I give you credit for pumping for so long. I don't think I could do it. Remember that 10-12 oz will probably be enough for a baby jus out of the hospital. Your supply should increase again when you have a baby breastfeeding.
Here are my answers to your questions
1. I don't have that kind of pump so I can't be specific, but I would say turn the level to what is comfortable. Harder doesn't necessarily mean more milk.
2. I don't know about this. I would e-mail Lenore or Dr. Newman for the answer.
3. I would have a Lactation consultant check you to see if you are using the right size funnels. That can make a big difference.
4. I had an appendicitis when dd was 3 months old. My supply definitely took a dip. I had to pump and dump after surgery and after a CT scan for 24 hours. Other than that I checked with a lactation consultant and the meds I were on were fine, so I continued to feed the baby. I had to work after the surgery to get my supply back up. More nursing more frequently. I was back up after a week or two.
Good luck.
Jennifer

Hi Jennifer, thanks for the comments. I don't know how long I can keep pumping... but I have to remind myself of how hard it is to induce lactation and get to 10 oz / day that way. I just don't want it to keep dropping.

Is it counter-productive to keep the pump on the same speed and suction the whole 15 minutes? If harder doesn't necessarily mean more milk, then can I turn the suction down and get the girls accustomed to produce with less suction?

I think I really need to concentrate on pumping more frequently since it is a supply / demand thing. If I can get my supply up before the surgery, I'll have a better chance of keeping up the milk afterwards.

Nancy

Have you taken Tylenol? That can affect liver enzymes.

I hadn't taken tylenol recently and I don't take pain medicine regularly. I was told to stay away from tylenol.

I got some bloodwork done after going off the fenugreek/fennel herbs and my liver enzymes were within normal ranges again.

Today I found an answer to one of my questions about the funnel / flange size. Someone on ebay sells Super Shields and by following her website I found more info on sizing.

"When breast pumping, the vacuum causes movement of the nipple within the tunnel or cylinder of the breast shield, and you should see a gentle pulling movement in the areola with each pump cycle. The nipple should be moving freely, without touching the sides of the tunnel. If you do not see any movement of the areola or if the nipple is rubbing the sides of the tunnel, your breast shields are too small. After pumping you may see a ring of skin flecks within the tunnel, and you may feel that there is still milk in your breasts that needs to be expressed. You may experience discomfort immediately on the sides of your nipples or it may take several pumpings before you notice soreness. These are all signs of a poor fit."

That info was on www dot babylovesyourmilk dot com /breast-shield-fit.htm

I hope that helps someone. I think I need a larger flange.

Nancy