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-   -   Help with Ameda pump/posterior TT, etc. ***New update** (http://www.diaperswappers.com/forum/showthread.php?t=1381898)

Lizmarie 04-17-2012 06:52 PM

Help with Ameda pump/posterior TT, etc. ***New update**
 
LO arrived 10 days ago, and after latch issues and other things I'm finding the need to pump often. I purchased an Ameda Purely Yours Ultra, which overall I do really like. However, I'm finding that I seem to be getting more suction on one side than the other when dual pumping. Does anyone have any experience with this or any ideas on how to correct it? I'm trying to fix a decreasing supply, so at this point I REALLY need to it be working as I'm pumping every two hours after feeding the LO (who takes 45 mins to feed what little he can get, as he's not nursing efficiently according to the LC). Between his 45 mins, and then pumping, if I have to single pump I don't ever get a break really. :banghead:


In addition to that, does anyone have any suggestions on increasing supply other than pumping and taking fenugreek? I've ordered fenugreek and it should arrive on Thursday, so I'll be starting it then. In the meantime we're having to supplement with formula :crying:

tmunky 04-17-2012 07:01 PM

I have that pump as well and I find the same thing, seems like one side has a higher suction. I also have large breasts and find it hard to dual pump so I've solved the problem by pumping one side at a time while the lo nurses the other side. Sorry I can't help you more.

BSWmama 04-17-2012 07:07 PM

Re: Help with Ameda pump and increasing supply
 
Check all the parts. For me, it was almost always that little white rubbery thingee that needed replacing when I wasn't getting good suction. Otherwise, re-connect and check that all the parts are dry and correctly put together.

I'm sure a true expert will chime in on this. Fenugreek and Blessed Thistle work well in conjunction with each other. They had both at my regular grocery store with the vitamins. Make sure to take care of yourself - fluids, food, rest (as much as possible, anyway!) Supposedly, beer doesn't hurt - I think it worked for me. I also took Reglan, a prescription which your midwife or OB will prescribe - and I think that helped. It is not for long term use (I think it is usually something like a two week course) and some people experience depression-like side effects. The earlier you take it, the better it will work. In Canada and Europe, they use Domperidone to increase supply - I ordered some online at a desperate moment but never ended up needing to take it.

It certainly was and felt like an uphill battle to get my supply up while supplementing a smidge after a rocky start. (For me, it just kind of felt like my supply never came in with full force). But we made it to exclusively breast fed - good luck! Do you have a La Leche League or lactation consultant available to you?

clarinetb 04-17-2012 09:05 PM

Re: Help with Ameda pump and increasing supply
 
Call Ameda and talk to them, see if they can trouble shoot better, they should have some experts for you to talk to! You're probably been told this, but you want to pump at the highest suction level you can tolerate for getting maximum milk. Also see if you can do compressions while pumping to get as much as possible (also when nursing if you aren't already - google Jack Newman if you don't know what I'm talking about, there are videos)

For supply, make sure you're drinking enough (Not crazy amounts, just be conscience of it is you're having supply issues) Oats are good, especially steele cut oats, but others are good if you don't have them.

Herbs the main ones are Fenugreek and Blessed Thistle.

Anyway you can get Domperidone? It really works, but I know there are issues with getting it in the US :( :(

How often are you feeding/pumping? Are you getting much when you pump? Are you supplementing at the breast with a tube (SNS?) to add more stimulation?

Also, I'm with the above, are you seeing a good lactation consultant? That is a definite must!

If your little one isn't efficient, have a look at info on "biological nurturing" and "relaxed breastfeeding" - the positioning is more condusive to them getting more, the idea is that you sit in a more reclined position so baby winds up positioned more on top than in front of the breast, with gentle pressure on their upper back you can help them open a bit more and get their chin in deeper so they take in more of the breast and get more milk, plus stimulate the breast more.

Lizmarie 04-18-2012 03:11 PM

Re: Help with Ameda pump and increasing supply
 
I spoke with Ameda directly this morning, and not five minutes into the conversation they offered to overnight me a new pump at no cost to me and to pick up the old one two weeks from now so that I wouldn't be w/o a pump at all. They are also going to be sending the piston seal that I was missing from the handpump conversion.

I don't actually know if it's the pump that's the issue or if it's the white valves that someone mentioned. I've only been using the pump for ten days and rotating two sets of the white valves but, I went ahead and opened and used the third set that came with the pump and I can at least pump on one side with good suction now....as even pumping one side at a time had become impossible this morning. So, I'm not sure if it's the pump or the valves or a combination, but I have a new pump coming tomorrow and the third set of valves seems to be working for now, so if I get the new pump and try the original two sets of valves don't work then I guess I'll be purchasing a couple of sets of those as well.

I was quite impressed with their customer service, and if it does happen to be the valves, I definitely couldn't blame it on then, as it's entirely possible that they got damaged when MIL was helping out cleaning things as there is a language barrier between us so explaining certain things is a bit difficult.




HOWEVER - I do have another slight issue now. LO is spitting up multiple times during and after EVERY feeding. Whether it's breastmilk straight from me, pumped and bottle fed, or bottle fed formula. I know that spitting up is "normal" but this is a "if we lay him down even a little bit he spits up what appears to be everything he just ate" He's also not taking in enough. The lactation consultant told me yesterday that he should be taking in two ounces. He managed that at the feed yesterday during the support group meeting, but now other than one feed just now he takes an ounce and a half and then refuses any more (from a bottle, no idea what he's taking from me obviousl)". He also has hiccups pretty much from sun up to sun down w/o more than a 20 minutes break all day. Is it possible for him to have reflux so soon? We have a drs appointment tomorrow afternoon, so I'll definitely be asking then, but I wanted to gain some insight now. We are keeping him upright after feeding, and burping him just by rubbing his back rather than patting as that seems to aggravate things. But even an hour after feeding, laying him down on the changing table to change him causes him to spit up. :headscratch:

clarinetb 04-20-2012 10:47 PM

Re: Help with Ameda pump and increasing supply
 
Sorry, I didn't see you'd posted a reply!!

What did the doctor say? And yes, they can have reflux issues from the beginning in that respect. It can be hard to say, my first puked non-stop, seemed like more than being fed very often, moving her, laying her and just about anything else resulted in vomiting.... and she grew like crazy! My second has had less vomiting and much more trouble with reflux, could lay her down for quiet awhile after, she was better in the swing, as it was clearly causing pain and some vomiting (mostly you could see it coming up before going back down...)

Glad they sent a new pump - is it any better?

I didn't realize you were talking about exclusive pumping, you might consider renting a hospital grade one for a few days if you're exclusively pumping this early on and want to get him back to breastmilk only. It cost a bit, but formula costs a lot more for a lot longer!

How much does baby weight? I think I mentioned on the other thread, but 8lbs would be 50 mL every two hours, so 1 1/2 oz is about 45 mL, so that's about right, if it is every two hours around the clock.

One thing, is the vomiting more running out or is it projectile vomiting?

How much of what he is getting is breastmilk versus formula?
What supplements are you taking now?

Hang in there! The first while is tough at the best of times and you're on a bumpier road that you'd like, I'm sure! My little one it was an intake issue on her end in terms of the ability for whatever reason, but we finally managed to get her all on the breast after weeks of having to do top-ups with the bottles of my milk after every feed.

It is exhausting, it sucks to be feeding and pumping around the clock! If you have a support network, now is the time to USE THEM! Many times we have people who would love to help but want to know what to do. Please, ask them! If you're up around the clock, every two hours feeding, pumping, trying to get baby back on the breast, etc, your entire life becomes feeding baby ;) If someone wants to visit and bring food, run a load of laundry, etc, go for it!

Lizmarie 04-21-2012 07:32 AM

Re: Help with Ameda pump and increasing supply
 
Quote:

Originally Posted by clarinetb (Post 14980098)
Sorry, I didn't see you'd posted a reply!!

What did the doctor say? And yes, they can have reflux issues from the beginning in that respect. It can be hard to say, my first puked non-stop, seemed like more than being fed very often, moving her, laying her and just about anything else resulted in vomiting.... and she grew like crazy! My second has had less vomiting and much more trouble with reflux, could lay her down for quiet awhile after, she was better in the swing, as it was clearly causing pain and some vomiting (mostly you could see it coming up before going back down...)

The doctor said that while it could be reflux that it didn't matter at this point because he's too young for reflux meds anyway. She first told me to switch him to a soy formula, and then when I asked about soy intolerances in the family she wanted to put him on an alimentum formula that is supposedly soy and milk free. Which, it's not. It's lactose free, but has casein as one of the ingredients, which is actually milk so I'm a bit confused there. She also told me to cut soy and dairy out of my diet if I wanted to try and keep breastfeeding....which I'm working on but being that I already have to be gluten free, is a bit difficult. So, I'm working on milk first and then soy

Glad they sent a new pump - is it any better? The new pump is a bit better, but I believe the white valves are also part of the problem. I'll be making a babies r us run this afternoon to try replacing those as well.

I didn't realize you were talking about exclusive pumping, you might consider renting a hospital grade one for a few days if you're exclusively pumping this early on and want to get him back to breastmilk only. It cost a bit, but formula costs a lot more for a lot longer! I thought about this, but the LC seemed to think it wouldn't matter too much. I did keep him downstairs in the living room last night and latched him on for every feed. I figure with the pump not working, then that was the only was I was going to keep my supply up anyway, and the formula just seems to be making him sick. So, as frustrating as it was for both of us, it actually went fairly well overall. The only problem is, I'm cracked and bleeding yet again. I KNOW his latch is not right, I just don't know how to correct it. Both of the LCs that I talked to keep saying just to pop him off and back on, but that isn't fixing the problem. Part of the problem is that he isn't opening wide enough, I get that. But, he's also "biting" if that makes any sense. It seems like he does more biting than actual sucking and it HURTS! Both LCs asked me if I was getting a "crease" on my nipple after him feeding, and I am...but neither could really tell me how to correct it. Any thoughts or suggestions? Is it possible he's tongue-tied or something?

How much does baby weight? I think I mentioned on the other thread, but 8lbs would be 50 mL every two hours, so 1 1/2 oz is about 45 mL, so that's about right, if it is every two hours around the clock. He was born at 8lbs 8 oz and as of yesterday he's back up to 8lbs 4oz. They were happy with his weight at the peds office. And when I asked the doctor directly how much he should be taking in she said 1-2 oz was fine, but the LC consultant told me it needed to be 2-3 oz. The LC actually weighed him, had me feed, re-weighed him and he was only at 1.5 oz, so she made me go back and continue to feed until we got him to 2 oz.

One thing, is the vomiting more running out or is it projectile vomiting? This varies. It's not what I would consider exorcist projectile vomiting, but about half the time it just runs out, the other half the time he's laying down and it looks like a fountain coming straight up and out

How much of what he is getting is breastmilk versus formula? Up until yesterday, since we had been told 2oz per feed he was getting all formula with the exception of two bottles of breastmilk a day, because it was taking me all day to pump four oz. Last night he was all breastmilk, and has been so far today. He seems to be hungry more often, but he's not hysterical or anything. We still have formula here if it seems like he's not getting enough, but I don't want to supplement unnecessarily which I think is what we did in the beginning that started us down this road.
What supplements are you taking now? Right now, I'm taking 3 fenugreek capsules 3x a day. The LC told me I should start smelling syrupy (as did my research), and I haven't noticed that yet, so I don't know if I need to increase or not. I'm also trying to get oatmeal in at least once a day. I have not and cannot try the mother's milk tea because licorice makes ME projectile vomit :) Is there anything else that I can try? I'm trying to get my water and food intake up as well. I've done ok with hydrating since leaving the hospital, but I just haven't had an appetite at all and I'm sure that's not helping matters. I was eating fine until I had that day with a fever/nausea/lightheadedness and my appetite just hasn't bounced back from that which is very unlike me :/ I have called my doctor on this and they keep telling me that it is normal

Hang in there! The first while is tough at the best of times and you're on a bumpier road that you'd like, I'm sure! My little one it was an intake issue on her end in terms of the ability for whatever reason, but we finally managed to get her all on the breast after weeks of having to do top-ups with the bottles of my milk after every feed. Was she just not an efficient nurser? That's what they keep telling me with him, that he's not efficient because however he's latching, he's creasing my nipple and not allowing him to empty my breast, but no one can tell me how to fix that?

It is exhausting, it sucks to be feeding and pumping around the clock! If you have a support network, now is the time to USE THEM! Many times we have people who would love to help but want to know what to do. Please, ask them! If you're up around the clock, every two hours feeding, pumping, trying to get baby back on the breast, etc, your entire life becomes feeding baby ;) If someone wants to visit and bring food, run a load of laundry, etc, go for it!

I have been, and my husband has been a great help, but it's frustrating to miss out on everything else just to be sitting in my little corner pumping. That's part of the reason I want to get him back on the breast at least, because with the pumping I felt like I wasn't even getting to see LO at all. I am however tired of using the other help because I'm kind of a control freak and things are not getting run around the house the way they should! And people keep trying to wash my diapers and drying everything ARGH!

clarinetb 04-21-2012 08:14 AM

Re: Help with Ameda pump and increasing supply
 
will post more later, but alimentum is all broken down, no whole proteins, so nothing to be allergic too. It is a very high quality formula, but very expensive ;)

clarinetb 04-21-2012 02:05 PM

Re: Help with Ameda pump and increasing supply
 
Tricky to describe, but my first her main issue was that she just didn't open wide enough. At first we were having my husband try and help pull her chin down just before she latched and it helped a lot. The best suggestion I was given is that while you're getting them on, presuming that you're doing a cross cradle and have your hand holding the breast, you usually have you thumb on the outside of the breast and the rest of your fingers on the inside of the breast, you can use your pointer finger to help pull the chin down a bit just as they go to latch. You want him open WIDE before latching and the hard part is you don't want them getting really frustrated by pulling them on and off as that has the potential to cause problems too. Sometimes you can pull down gently on their chin to 'correct' the latch if they didnt' latch properly at first - again it might be easier to get someone else to help.

If he changes his latch and bites down, maybe see if you can coax him to open more again while latch, if not you probably do need to take him off as you're right, that is going to cause more damage!

Tongue-tie, can your little one get their tip of the tongue to the lips? That seems to be the defintion that I've been told. See if you can get the little tongue to stick out and also look in the mouth to see what it looks like.

Soy formula is not nutritionally complete, so be careful if you choose to try it... many aren't good at giving you the information about the additional supplements they would need if they were on soy formula. As I mentioned above, alimentum is a good choice in that it has no whole proteins, they are all broken down, so there aren't proteins to react to and it is easy to digest.

Lactose free usually isn't worth it, from what practioners that I trust have told me it is more of a gimmick, there is lactose in breastmilk, the chances of having a lactose intolerance is almost zero.... (the milk protein allergy, as you seem to know, is that it is the dairy milk protein in the breastmilk because mom is consuming dairy...)

If you're still having trouble with your pump, I would say renting a hospital grade would most definitely make a difference! If you're not sure if your one is working properly, I'd say that is a problem! I have a Medela, not an Ameda so I'm not familiar with the rings you are talking about, but you shouldnt' need to be continually replacing, doesn't sound right! Can you rent one even for a week to compare? Just sooner is better than later for establishing a supply!!

Lizmarie 04-21-2012 05:58 PM

Re: Help with Ameda pump and increasing supply
 
I'm having better luck with the pump, I think it was a combination of factors. My supply has tanked though for sure. I get next to nothing out of my left side, but I am getting almost an ounce out of my right per pumping. I'm hoping that I can improve this.

We're still going to work on our latch issues, and I will try what you've said. I can't get a hold of the LC again until Monday, so I'll page her first thing then and see if we can do a one on one meeting and figure out exactly what's going on.

I'm also going to call the dr back and ask about the vomiting again. I don't know what constitutes "projectile" but where it was initially just "rolling out of his mouth", it's now got some force behind it. Last night it was like a fountain out of him while laying down (over an hour after his feeding), and just now he managed to cover my entire chest from holding him in a cradle hold (like up higher than my breast). This was almost an hour and a half after a feed. Both times were after being burped and held upright for a minimum of 30 minutes... He also seems to fuss more after throwing/spitting up than he does before? I would think if he's just "too full" and spitting up then he would be more comfortable after, no?

This is all very confusing and I feel so entirely clueless about fixing this :headscratch:


We've started the new formula, the alimentum that she gave us samples of....and I've cut milk out, but I've read that takes up to three weeks to leave my system entirely.....do I not give him breastmilk during that time? or do I continue to do so even if it's making him sick? It seems like a catch-22 either way :banghead:


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