Home Forums Induced Lactation aka Adoptive Breastfeeding Medical Interventions to Induce Lactation/Increase Milk Supply So many questions

I have so many questions.
I have been on the regular protocol since November 2012. I was on Yasmin for 4 months and began pumping early this month, March 4th. I am currenlty taking 90mg of Domperidone and Fenugreek/Blessed Thistle 3X/day. We are nearly at 4 weeks of pumping and each day the amt pumped is increasing. I got 18oz yesterday. I know it is going very well, but I still don't know some things.

1) I never get a "let down". I have to massage and compress the entire time. Milk flows and drips while I massage/compress, but will the let down reflex ever happen? My arms are oh-so tired and I don't feel comfortable pumping with other moms because of all the compression/jiggling/massaging. When will the let down reflex happen?

2) Will I have to compress or massage when my baby is at the breast or will she be able to get the milk? (...she is due in 3 and a half weeks!)

3) When my milk plataus, what should I do? Should I increase the Dom? What should I increase it to...increase it incrementally and add just 10mg/day or increase it 10mg each time I take it?

Thanks in advance!

That is great!

1) Have you bf before? Do you know what a letdown feels like? It is kind of tingly. I felt them strongly for a while, but then couldn't really feel them. Have you tried not massaging from the start of a pumping session? What happens? Do you get milk at all? If you do, then you are having a let down and just aren't feeling it.

2) I did find myself massaging more when bf my girls that we adopted than I did with my bio son. I don't know if I needed to or if it just made me feel better. They were small, so I held my breast when bf them at the beginning, so I got used to it. She should be able to get the milk out more easily than a pump and you might start feeling let down when she is bf.

3) I increased to 120 mg when the baby was a couple weeks old. I would wait and see if you need to. If you are making 18 oz already, you have more than she will need in the first few weeks. See after that point if you need to increase. I increased 10 mg each time I took it.

Good luck!
Jennifer

Jenmarko,
Thanks for responding. I'm sorry I am not responding as promptly as I wanted...but I really appreciate your response!

No, I've never breastfed before. Thus I have no idea what a letdown feels like. Now that you described it to me, I never feel it at all. What I thought it was is a release of the milk with no force. Since you responded, I did try pumping without massaging and each time I get .75oz of milk from one breast and .5oz from the other. But after I get that amt, it stops dripping unless massaged.

I've not increased the amt of domperidone at your recommendation, but I kinda thought that the goal was to make a larger supply before the baby arrived. Do you know how long this daily supply should last typically? I'm still making 20-21oz each day. Do most babies eat that amt for about a month or two?

Thank you again for your response. It's so good to connect with someone about this!

Hi Lilwoman. If you were not having a letdown, the milk would not come out of your breast at all. It is common for many women never to feel anything when the letdown happens, even if they've birthed children. You could consult with your doctor about trying an oxytocin nasal spray. The research is mixed on whether this will help, but anecdotally some women have found it helpful.

It sounds like your volumes are amazing. Once the baby arrives, he/she will do a much better job at removing the milk from the breasts than the pump does. It sounds like you are well on your way!

I agree with Carrie. I wouldn't worry about let down, you are obviously having them without knowing it.

I would not increase your domperidone now. You will probably keep increasing your supply without it and may never need to increase the dom.

I don't think you need a larger supply than the baby needs before they arrive. You will increase to keep up with their need. Most of the literature says that the average breastfed baby from 1 month old until they start eating solids (around 6 months) will eat an average of 24 oz a day. That is about what my two daughters ate (usually a little less). I think my bio son probably ate more, but he was a bigger baby.

I would just keep doing what you are doing. You will probably need to pump some after the baby is born to keep your supply higher since they won't be eating all you have available right away. You are doing great!

Jennifer

Thank you both so much! I am now making 24oz/day and glad to know that I can feed my baby for some time on that amt.

I had read that I should pump for 10 minutes after each time that I breastfeed. I will do just that.

Just to let you know -- Baby Eliana is due April 21st, but the mother will likely be induced sooner. I am going to be a mom soon and because of this website I will be able to breastfeed my wonderful little adopted baby.

I don't think you need to pump after each time you bf. I was doing that when I started nursing, even when I was able to ebf, and it was too much. The second time we adopted, I didn't pump much at all after we got to the point I could ebf (around 2 weeks old).

The only reason I think it would be a good idea for you to pump some is that you will be making much more than she will need in the beginning. I would only plan to pump after 3-4 feeds a day and I would only do it for a couple weeks. By a month old, she should be drinking about what she will need and then your body should just keep up with the demand.

Jennifer

I have another question. Is it possible to get thrush on the nipples when inducing lactation?...or does it require a baby breastfeeding to get thrush?

I don't know the answer to this one. You could try e-mailing Lenore or Dr. Newman.
Jennifer

Unfortunately you can get thrush without a baby to share it with. If you are having new pain, that may be an indication of thrush. It also tends to be a burning or stabbing-type pain. Find the info here on candida protocol and gentian violet. If you think it's thrush, I would recommend trying to get rid of it before the baby arrives and you are having to treat both of you for it. http://www.breastfeedinginc.ca/content.php?pagename=information