Re-Establishing Milk Supply After Travel

We had an amazing time traveling to California for my brother’s wedding. One of the best parts was being able to spend so much uninterrupted time with Junior! We were able to breastfeed on demand like back in the old days of maternity leave. But that means I didn’t pump.

Typically, I’m on a strict schedule of pumping every 2 hours while at work, without fail! So, I was shocked at my dwindled output when I returned after a week. For a moment, I was anxious that was it for my breastfeeding/pumping journey. But a little determination and sacrifice brought my supply back to it’s normal level. Here’s how I did it.

I returned to work after a week, and started my day with a 15-20 minute pumping session before seeing patients, as usual. I usually pump 7oz between my morning sessions, and 12-13oz total for the day. So you could imagine my dismay when I pumped 4oz in the morning, and only 7oz in total that first day. For a quick second, I was afraid my time breastfeeding/pumping was coming to an end. But I wasn’t ready to just give up.

So on day 2, I committed to power pumping. That meant pumping for 15-20 minutes hourly, and even for a short period of time any time I had a break between patients. I made sure to breastfeed on demand through the night, and increase my intake of healthy fruits, veggies, grains, and most importantly WATER! That day, I pumped 5oz in the morning and 10oz total for the day.

I kept up the hourly pumping, and by day 3 I was back to 7oz pumped in the morning, and 11.5oz for the day. By day 4, I was back to my normal 7oz in the morning, 12.5oz for the day. My usual sensation of let down and fullness also returned. I committed to adding pumping sessions over the weekend, even though I don’t usually pump on Sundays.

This reflects the relationship between supply and demand in breastfeeding. Typically, you will be able to maintain your supply as long as the demand is there. Since I didn’t pump in a week, my body thought the demand wasn’t there. Of course, you may note normal fluctuations in the supply with menstruation, ovulation, or even stress. And as solid food is added to your baby’s diet, the demand for breast milk may also decrease.

But if you notice a drop in your normal supply, don’t throw your hands up and quit (if your goal is to continue breastfeeding). You can usually re-establish your supply with a little work!

Slacker Boob

Most moms I’ve spoken to have experienced this. One boob is an overflowing well of liquid gold. The other boob? Not so much. Why does this happen? And what can you do to remedy this?

Why Do I Have a Slacker Boob?

One myth is that smaller breasts produce less milk. I have itty bitties, and I’ve been able to produce enough milk for Junior for 8 months, with no need to supplement, and even produce enough to have a back up freezer stash. I also know women with D cups who couldn’t produce milk for their babies past 3 months. So size is not a factor. But what determines milk supply?

The biggest is demand. The breast has a feedback mechanism based on demand. That’s why frequent pumping the first few days after birth, even when you’re not yielding much milk, is so important. The breast has to know the milk is needed, otherwise, it won’t produce the milk.

So why is one breast producing more? One reason is preference, of both mom and baby. You may favor feeding on one side, and baby may be more comfortable feeding on one side. This in turn tells the other breast the demand isn’t as great, resulting in it producing less.

One breast, regardless of size, may also have more milk producing tissue and larger ducts. This will result in one side producing milk more readily.

If there’s any history of injury to the breast tissue, that can also impact milk supply.

This was actually from my first pumping session today.
I got about 0.5oz from my left breast and 4.5oz from my right breast.

What Can I Do About My Slacker Boob?

First, keep in mind that your baby is much more efficient at getting breast milk than your pump. So what you’re seeing when pumping isn’t the absolute picture.

But you can always start your feedings with your less efficient breast to increase the demand feedback. I usually switch between breasts, the left during one feeding, then the right during the next, then back to the left, and so on. You can also favor the less efficient breast, using it during back to back feedings. Also, try pumping between regular feedings. The main goal: increase demand, in hopes of increasing supply. Because, science.

Of course, stay hydrated and eat lots of healthy fruits, vegetables, and whole grains. As far as those miracle supplements you see online, I tried them once. I think they initially increased my supply, then it actually seemed to decrease, so I stopped them. The popular milk supply supplement Fenugreek also makes me smell funny, so I don’t really like it.

All in all, slacker boob is totally normal. Don’t give up on it. Just show it a little more attention.

My Breast Milk Donation Journey Part 2: Milk Banking

Since discovering I have high lipase levels in my breast milk and that Junior wouldn’t drink any of the milk I had stored, I’ve been sure to scald the milk I do store or use my pumped milk within 48 hours (See my previous blog My Breast Milk Donation Journey Part 1: High Lipase). So what about the 100 ounces I had stored? I found out about the Human Milk Banking Association of North America and the process through which to donate milk.

Why Donate Breast Milk?

Preterm babies are at risk for necrotizing enterocolotis (NEC), which damages the intestinal tract, often requires risky surgery, and sets the child up for a lifetime of health challenges. Breast milk reduces the incidence of NEC to 1.5% vs. 10-17% in formula fed babies. Donated milk is so important because the baby’s mother’s milk supply may not have come in just yet (it took mine 4-5 days to really come in), she may not have enough of a supply (due to stress), or she may be on medications for infections that may deem her breast milk unusable.

How to Become a Donor

You can search for your closest milk bank on the HMBANA website and contact them by phone. Mine is the Mother’s Milk Bank of Florida (https://milkbankofflorida.org). They will set up a brief phone interview during which they will ask different health and lifestyle questions. Then, you’re sent release forms for you to sign electronically to obtain health records from your OB and your baby’s pediatrician, as well as a follow up questionnaire with additional health and lifestyle questions. Once this is done, the milk bank will send you a package with all you need to ship your milk, as well as paperwork to have blood drawn. They send you information for your closest lab to have the blood work done and pay for it. The only purchase you have to make is the dry ice for shipping, which they reimburse. The dry ice I found was $1 per pound, and they requested the milk be shipped with 7 pounds of dry ice. If you’re lucky, the milk bank may even have a depot near you at which you can drop off the milk and they will do the shipping for you.

You’re given a unique donor number so you can continue to donate if you so wish. Once my milk is used, the milk bank will inform me as to what hospital it was used at. They are super helpful through the entire process and are happy to answer any questions you have along the way. They even keep you up to date on what has been completed in your process and what is still needed via text message. For example, everything was done, but for some reason they hadn’t received the records from my OB. I called my OB and it was complete the same day. All in all, it took about 2 weeks to complete the entire process.

How is Breast Milk Safe to Use?

The donated milk is rigorously tested for different pathogens and for nutrition levels multiple times during the pasteurization process. They use guidelines set up by the Centers for Disease Control, the Food and Drug Administration, and the donor blood and tissue industries. Your milk is used by doctor prescription only.

If you don’t have breast milk to donate, but would like to help, the milk bank accepts donations and you can also volunteer your time.

It feels really good knowing I have helped a little one thrive with my donation. I’m so glad I found out about milk banking and hope I can donate again in the future.

For more information about milk banking, visit the Human Milk Banking Association of North America website at https://www.hmbana.org/