Pumping question

[Brie]

I am officially now EP as he won't latch anymore.  I use a Medela Freestyle, a Medela PISA, and a Medela Harmony depending on where I am.

My problem is that after I'm done pumping and the milk has stopped, I can easily hand express at least another ounce of milk.  I could probably do more but my hands cramp up after awhile.

What am I doing wrong?  I do compressions while pumping, and I wait until the milk has stopped.  This happens whether I pump for 10 minutes or 30.  When I hand express, the milk is still spraying out, not just a dribble.  I have tried different sizes of breastshields and it happens no matter which I use.

[AmyRI]

Are you succeeding at getting multiple letdowns with the pump, or is it just a slow stream the whole time? It sounds to me like you're only letting down once with the pump and then hand express to get a second to really empty.

[glitzy07]

I'm not sure that you're doing anything wrong at all. I was always able to hand express additional milk after it seemed like I was empty from the pump, both the PISA and the Freestyle. I could usually get another full ounce or two this way. I know that doesn't really answer your question, but I don't think it's out of the realm of normal either.

[Brie]

May 22, 2015 10:17:06 GMT -5 AmyRI said:

Are you succeeding at getting multiple letdowns with the pump, or is it just a slow stream the whole time? It sounds to me like you're only letting down once with the pump and then hand express to get a second to really empty.

I get one strong letdown right away that peters out to nothing.  I can get a second letdown at 15 minutes in sometimes, but it's usually pretty weak and stops quickly.

[Deleted]

I don't EP but do pump 3x a day. I am getting similar results to you, one good letdown early then nothing, I can get a bit more if I hand express or turn up the suction on the pump at the end. I rarely get a second letdown and if I do, it's not much at all.

I've just come to learn to use compression to get out what I need.

[AmyRI]

Are you using fast speed, low suction settings to trigger the second letdown and then go back to slow high to express more? If you continue to pump, can you get a 3rd?

It might just be that you're better than the pump, in which case you're kind of stuck

[Ashley&Scott]

What level are you pumping on?

[Brie]

May 22, 2015 10:30:18 GMT -5 AmyRI said:

Are you using fast speed, low suction settings to trigger the second letdown and then go back to slow high to express more? If you continue to pump, can you get a 3rd?

It might just be that you're better than the pump, in which case you're kind of stuck

Yeah, I use the letdown button on my pump about 10 minutes in or so.

[Brie]

May 22, 2015 10:45:03 GMT -5 @littlemoxie said:

I thought this was normal.

Have you looked at the stanford video? Google "maximizing milk production." They made it seem like hand expression at the end was generally going to get everything out, which would make your body make more milk. When I was trying to increase my supply, that's how I ended power pumping sessions.

Yeah, although I don't feel like I get everything out with hand expression?  Like I don't feel empty afterwards.  I usually stop hand expressing because my hands/nipples start to hurt from the motion of expressing, not because the milk stops.

[Brie]

May 22, 2015 10:36:43 GMT -5 Ashley&Scott said:

What level are you pumping on?

Pretty high.  Usually 7-9 on my Freestyle.

[Ashley&Scott]

May 22, 2015 11:04:53 GMT -5 Brie said:

May 22, 2015 10:36:43 GMT -5 Ashley&Scott said:

What level are you pumping on?

Pretty high.  Usually 7-9 on my Freestyle.

Lower the suction & see what happens. I normally pumped on 4-5 on my Freestyle.

Also, are you applying nipple butter or lanolin to your nipples before you pump? If not do it, it will reduce the friction & nipple pain. 

[stacyb1983]

The only way I ever get a second letdown is if I pump longer than recommended I usually pump 25-30 minutes.

[Brie]

May 22, 2015 13:15:57 GMT -5 @simpledog said:

Brie if you use a manual after would that help empty them? Like maybe you wouldn't have to stop because of your hands?

I know the idea of using two pumps is very annoying but I also know it sucks to not feel like you are getting the milk out.

I've tried, but nothing comes out with the manual.

[noodleskooze]

I had the same experience while EPing. Hand expressing at the end always got me a decent amount. Pumps just aren't that efficient, sadly.

[CloudBee]

You're not doing anything wrong. I always got more milk when I squeezed and massaged my breast while pumping, and toward the end. Do you usually massage while you pump, or only at the end? Sounds like you massage better to kneading vs. the suction of pumping.

[ijack]

Ditto CB - do you massage while you pump? And do you hand express right after you stop pumping or wait a couple minutes?

[Brie]

I do massage when I pump and it does help, but even with massage it stops at the end. I hand express right after I finish pumping.

[Brie]

May 22, 2015 11:06:09 GMT -5 Ashley&Scott said:

May 22, 2015 11:04:53 GMT -5 Brie said:

Pretty high.  Usually 7-9 on my Freestyle.

Lower the suction & see what happens. I normally pumped on 4-5 on my Freestyle.

Also, are you applying nipple butter or lanolin to your nipples before you pump? If not do it, it will reduce the friction & nipple pain. 

I am going to try the nipple butter next time, thanks!  I haven't done that yet.

[ijack]

I think it's probably pretty normal, so people just respond better to a warm hand than a *cold* pump. One of our NICU nurses told us a story about a mom who couldn't get anything out with a pump so she hand expressed for weeks while her kid was in the NICU - I can't even imagine!

[celiacmom]

Normal. The hind milk is much harder to get with the pump. The MOO n Cookies also make your milk fattier so harder to get with the pump (though more finning for baby so he'll need less) I'd try a heating pad or warm compress on your breasts halfway through pumping to help loosen and release that milk.

[Brie]

May 23, 2015 9:29:51 GMT -5 celiacmom said:

Normal. The hind milk is much harder to get with the pump. The MOO n Cookies also make your milk fattier so harder to get with the pump (though more finning for baby so he'll need less) I'd try a heating pad or warm compress on your breasts halfway through pumping to help loosen and release that milk.

He has chunked up like crazy lately! Finally cracked 12 lb. I need to order more!

[celiacmom]

He is so adorable!!!!!

[Deleted]

I'm sorry P won't latch. I know that is sad:(

I have lots of pumping experience to share at least:)

I rent a Symphony that I use most of the time. SMMC rents them for $55 a month but I bet other hospitals do too. It is gentler on my nipples and quieter.

I would highly recommend using a nipple cream of some sort. I think I like the Honest brand best. I've tried coconut oil, Angel Mama (it smells like chocolate chip cookies which may be appealing) and just plain lanolin. The Honest is a medium thickness and I found the smell pleasant. I mostly just use it before pumping but after is useful sometimes too.

I have never been able to hand express more than a few drops. But I can always tell there's some milk still in there. Once in a blue moon they'll drain super good but it's rare.

I find that often my output and pumping experience changes for absolutely no detectable reason. So just expect that.

My sister said being cold would make it so she couldn't pump and I've noticed it definitely doesn't help. I put on a cardigan or robe if I feel at all chilly.

Using multiple pumps seems to help, so keep doing that. I've found that different pump levels and lengths of time work best on different days, so keep experimenting.

If your milk is fattier now, you might take some lecithin. It's an emulsifier. I'm not really a big fan of supplements since they are not well tested but this one had basically no reports of side effects and the recommended dose is 1/10th of what is tolerated in people.

A lot of people do drain really fast, so the fact that you are mostly done in 10 minutes seems normal. How much are you getting? It has varied so much for me over time. A couple of weeks ago I was getting 3-5 oz with maybe 1 6 overnight and now I get 5-7 just about every time with sometimes even an 8oz.

Weird things that sometimes help--leaning over, taking off my bra, putting on a bra, switching bras. Heat doesn't seem to help me much unfortunately. Also changing the angles the bottles are will adjust how the flanges pull.

It's definitely not fun, but hopefully you'll be spared the plugs and medical issues I've had. I expect nursing through your supply regulation will have been to your benefit.

[sent]

I used to get 3 letdowns in 25 minutes to get the max amount of milk my body was going to give, but I was never able to hand express a single drop. So apparently my body was ok with the pump but not cool with normal nursing or normal hand expressing, ugh. I pumped at the highest speed my breasts could tolerate while still feeling comfortable and without any pain. Whenever the milk came to a dribble and then stopped, I'd hit the letdown button. Like kcpokergal wrote, my amount produced also jump by about 4 oz at like the 3 month mark.

[Deleted]

I see this come up a lot on my bf twins boards. Many, many women talk about hand expressing an extra ounce or two after they finish pumping. I'm not sure there is any way to get it out with the pump. Honestly, I'd just hand express that extra ounce or so through hand expression if you can.

[jewel]

Have you tried heat? My pumping sessions were significantly easier and quicker when I applied heat to the breast for a couple minutes before, and then during pumping. I bought reusable hand warmers (like these www.amazon.com/Pro-Hand-Warmers-Hotsy-Count/dp/B00DT1DAJU/ref=sr_1_4?ie=UTF8&qid=1432414384&sr=8-4&keywords=reusable+heat#customerReviews ) and would just stick them in the bra while I pumped. I think I had 5 or 6 pairs, would use them, then boil them all at the end of the day to get them back to ready-to-heat. Easy to pack and take with you, too.