[cutiegal]

Hi there,

My baby is five months old now and he is totally bf. But recently, he seems to lose interest in nursing and taking less and less milk. At first, I try to pump the excess milk out in order to avoid engorgement and keep the milk supply. But now I find out that my milk supply diminishes quickly and I cannot even pump any milk out. I am afraid my milk will be gone. (The same thing happened when I nursed my first son and my milk just dried up.) I do not know what to do . Please anyone give advice and help.

[elaine]

pls check your PM

[LLL_Sarah]

Is there a time of day that your baby is more willing to feed? Often babies who are refusing the breast will aspect it when they are sleepy, either just going to sleep or just waking up, or when they are actually in light sleep.

If there is a time when the baby is happier to take the breast try to imitate those conditions for the other feeds, for example if he’s will to feed at night make the room cool and dark before trying to feed.

Lots of cuddling and skin-to-skin contact can help. Do you have a sling? Sometimes babies are willing to feed in a sling – I think it is something to do with the closeness and the movement together.

If your baby isn’t taking much milk form the breast then hand expression or pumping can keep your milk supply. Most mothers find that they have to express at least eight times a day. Recent research has shown that the peak of most milk is somewhere between two and four hours for most mothers and if they gap between pumping is longer, say five or six hours they will get far less milk. When pumping keep pumping for two minutes after the milk has stopped flowing. Often mothers have more success with a hospital grade pump than with a small handheld one. The Medela agent in Hong Kong will rent these. (Meridian Hong Kong Limited – Tel: 2328 2662 - Email : contact@meridianhk.com.hk – Web site: http://www.meridianhk.com.hk/)

There is an article on the LLLLI web site called
My Baby Is Suddenly Refusing to Nurse. Does That Mean It's Time to Wean?
http://www.lalecheleague.org/FAQ/strike.html

and a number of mothers’ stories from their international magazine, New Beginnings, at http://www.lalecheleague.org/NB/NBstrikes.html

Best wishes,
SARAH

[cyberyoda]

Hi Sarah,

My friend gave me the Medela milk pump so that I dont need to buy the milk pump myself. We have washed it and sterilise it. Do you think it is ok to use somebody's pump?? Is it hyginenic and no harm to baby?? I just dont want to spend money to buy a new one esp my friend dont need it anymore.

Also, do you think I should bring this breast pump to the hospital OR rent the hospital pump. I am not sure if the hospital pump is more powerful or not.

Thanks for your advice

[LLL_Sarah]

Dear Cyberyoda,

If you have sterilised the pump from your friend it should be fine to use. My suggestion would be to use the pump from your friend and see how easy it is for you to use. If you find it satisfactory to collect milk then there is no need to get a more powerful expensive pump.

Remember expressing is like breastfeeding - the more you do it the more milk you will get. Thus if you express six times for 10 minutes you’ll get more milk than it you express once for an hour.

Some mothers have difficulty getting the let-down to work well when pumping. It works with no trouble when the baby is breastfeeding directly but doesn't seem to work at all when using the pump. Many things that don’t matter when breastfeeding directly can affect the quantity when pumping. For example, how tried you feel and how much stress you are under.

You can also encourage the let-down reflex artificially, by looking at your baby, or by having a piece of his clothing next to you.
• Apply a warm wet cloth to your breasts.
• Massage the breasts in small circular motions around the perimeter of the breast.
• Gently stroke your breasts with your fingertips in a downward motion toward the nipple
• Lean forward and gently shake the breasts.
• Gently roll the nipple between your finger and thumb.

It may help to try a hand expression technique called the Marmet Technique, http://www.lactationinstitute.org/MANUALEX.html
This is useful because it helps the let-down and so you get more milk.
The instruction “PUSH straight into the chest wall” is important.

(Please note that the diagram of the breast anatomy is out of date. Recent research has discovered that the milk reservoirs under the areola (the dark coloured part of the breast near the nipple) do not exist. The method, however, still works.)

Some mothers have found that the pumps are not good at getting the let-down to happen and so they use hand expression until the let-down and then swap to pumping. You can also use the times at the end of the Marmet Technique, including the massage, stroke and shake but instead of doing the hand expression use the pump.

Best wishes,
SARAH

[mummybee]

my baby went through a nursing strike too at 9 months when she suffered from a cold. meanwhile i pumped out milk and bottle fed her. do use your friend's pump - after sterilisation everything is dead anyway. is your baby sick or having cold? if so, may help if you clear her mucus before bf.

i helped her get back to my breast by breastfeeding her when she was very sleepy before nap, or before bed. may help if you dim the lights right down and lie down next to bub for some time before offering your breast.

i feel for you, as i remmebered it was stressful for me. i had to pump 8 times in 24 hours including getting up in the middle of the night to pump eery 3 hours to make sure milk supply doesn't diminish.

if you ahve tried everything and your bub still doesn;'t want to get back to bf, perhaps you want to consider giving formula. you have bf for 5 months afterall - not bad at all. it is also time to introduce solids, isn;t it. Good luck.

[cutiegal]

Hi Sarah,

Thanks for your invaluable advice. The Marmet Technique works like miracle. I can easily pump the milk with this technique. Hopefully I can bf as long as i can.