Hand to Hold's Official Blog: Written by Parents for Parents

Pumping: Low Milk Supply

In February, Afton wrote a terrific post about her pumping experience called “Nessie the Milk Cow.”  Here’s an excerpt:

One day I left the parent’s lounge balancing milk bottles carefully on my way to the freezer when I saw another mother leaving a pumping area with only one little bottle in her hand – and it only had about one ounce in it.  How embarrassing!  Of course, maybe she looked at me and thought that I should feel embarrassed.

Ha!  As I read through the post, I could totally identify with the “other” mother and I’m sure some of you can, too.  There are a large number of reasons why women have a low milk supply, including physical and hormonal conditions, obesity, and medications.  Obviously, as mothers of premature infants, our stress level is at an all-time high, which can also affect milk supply.  My personal reason for low milk supply was a breast reduction surgery.

When I was a freshman in college, nearly ten years before the birth of my premature daughter, I chose to have breast reduction surgery.  I had inherited a petite body build from my father’s side of the family along with large breasts from my mother’s side of the family (my mother is 8 inches taller than I am and much more proportionate).  One of the side effects of the procedure was an almost 0% chance that I would be able to breastfeed my children*, but I found that more palatable than a lifetime of back pain and self-confidence issues.

And then Adeline came 14 weeks early.  The night after she was born, a lactation nurse came into my hospital room with a professional grade breastpump.  “But I’ve had a reduction,” I protested.  She insisted (strongly encouraged?) that I give it a try.  She told me that my breastmilk would be “like gold” to Addie—it would benefit her immune system (fighting both NEC and RSV) and help her gain weight.

It took a few sessions of pumping before I started to see results.  A drop here and there to start, but I was soon expressing 10mLs or ⅓ of an ounce (yes, that’s both breasts for 15-20 minutes!) every three hours.http://www.preemiebabies101.com/wp-content/uploads/2010/06/0151-450x300.jpg

It was hard not to be frustrated—I already felt that my body had failed Addie by going into premature labor, and now I couldn’t even provide breastmilk for her!  I had everything going against me, including stress and the inability to hold her.

The lactation consultant at the children’s hospital met with me every day to talk about my progress.  I carried a lactation journal with me (time and amount expressed) and even charted my supply on an Excel spreadsheet.  When she suggested herbs, I went to the health food store and purchased Fenugreek and Blessed Thistle.  The recommended amount for both herbs was three capsules, three times a day—18 pills total.

And in the end, it didn’t make a bit of difference.  No matter what I did, the most I could produce at one time was 45 mLs (or an ounce and a half).  I stopped taking the herbs (they were expensive, and made me smell funny—which would have been worth it if they had worked!) and realized that I was doing the best I could do.  Sure, I could compare my measly ounce to moms like Afton, but what good would that do me or my daughter?

Slowly but surely, Addie’s milk drawer filled up with half-full milk bottles; I even had to send some to my in-law’s house!  The day we were released from the NICU, we had to borrow a large ice chest to transport all the bottles home.

Whether you are Nessie the Milk Cow or “the other mother,” when it comes to pumping, my best advice is to do what’s best for you and your preemie.  Any mother who has pumped alone at 3:00 in the morning with a critically-ill infant far away in a NICU will understand!


(* I believe that breast reduction technology has improved in the last 12 years, increasing the likelihood that a woman can breastfeed after surgery.)

Thanks to:





  1. I’ve had 2 preemies. But only pumped with the 1st one. I liked this article. And I agree with everything you said in here. I was “the other mother.” My baby was 14 weeks early and weighed 1 lb. even. I don’t have any experience with bigger preemies so I don’t know what they start on…but with my preemie, she hardly took ANY milk at each feeding for a really long time. I think it’s important to realize that even the little amounts help. I pumped for 12 weeks until I totally dried up. And because of the little amounts she “ate” at each feeding, it was enough to last her for the entire 6 month hospital stay. And I was pleased with that. And even though breast milk is like gold for your baby, I think it’s also nice to realize that plenty of babies (even preemie babies) can grow and thrive and do well on formula too. Like you said, it’s important to do what’s best for you and your baby. 🙂 Thanks for posting your thoughts.

    • Thanks for sharing your experiences, Kate!

      Yeah, I totally didn’t even mention that the amount I pumped every three hours was about the amount that Addie drank in her bottle, so it worked out perfectly!

      Plus, since my plastic surgeon had told me it was “nearly impossible” that I would be able to breastfeed, even my nominal amount was a miracle!

      Hope we see you around here again!

  2. My son was 7 weeks early and I also had a low milk supply for whatever reason. I had successfully BF my other children with oodles of milk for them, but my body did not respond to the pump. The most I ever pumped was 4 oz and that was after sleeping all night! I actually was made fun of a little bit by some nurses when they saw my production and told me about other Moms who were producing 6 oz with one pump after only 5 days! As if that helped me out..i was already stressed enough! My little son has a lactose allergy and so after 6 miserable weeks of pumping he started on a special formula and I quit. I never got engorged or uncomfortable after quitting cold turkey which told me my supply really was low!

    • Cheryl,

      How cruel of those nurses! As though you didn’t have enough going on! I lasted six weeks, too and now I’m proud of it. Especially knowing others went through it, too!


  3. I had a placental abruption the doctors held onto for 2 weeks while my son grew in the womb. I got replacement transfusions every couple of days to offset the loss. When they took my son at 28 weeks, it’s because we had walked the line enough, and they were afraid of losing both of us. (Good thing, too, the abruption had gotten so severe it was going to be that night regardless.)

    Well, I worked diligently to meet all the rules: eat, eat a lot pf protein (hard to do in the Ronald McDonald House when you aren’t allowed peanut butter), drink a lot (also hard to do in the NICU when you aren’t allowed to have drinks), sleep a lot, etc. I took my pain pills and tried so hard. 2 weeks after my son’s birth, I wound up in the ER with a bad gallbladder, so a second surgery and more pain pills. Yuck.

    When I had hit my end (my son was getting 90% formula to 10% EBM), I spoke with my original OB (before the abruption) … she said that with the 2 abdominal traumas, the shock from all the blood loss, and the stress from the NICU, it made sense why my milk never came in. If only the lactation consultant had explained these things to me earlier, I might have relaxed about the whole pumping thing, instead of measuring what I was getting compared to what he was eating.

    • Kathryn, you have an incredible journey! I hope your sweet son is doing well!

      I’m sure the breastmilk that he did have was beneficial…and that’s what matters! Good for your OB for giving it to you straight and relieving the guilt!


  4. I had a set of twin boys born at 28 weeks, they were in the nicu for 3 months and pumping was hard. I tried……i tired really hard. I pumped and pumped and pumped some more, drank herbal teas, looked at pictures, anything and everything. I just couldnt produce enough for the two of them. I always saw these mom with bags of milk coming in and i was that “other mom” but i was proud of what i could provide. The NICU ended up supplementing with formula . I was bummed but happy i atleast was trying. Right before they were discharged I was able to have them go to breast two times a day for 5-10 minutes due to aspirating problems. About a month after they came home i dried up. Im glad i atleast got to have them to breast a few times. I am very proud and happy because prior to having the boys i wasnt even going to try breast feeding as every mom in our family has dealt with bf problems.

    • Jeni,

      How wonderful that you were able to experience breastfeeding, even if only a few times!

      I’m glad you’re able to look back on the experience with pride! For me, it’s been a comfort to know others went through the same frustrations…I felt very alone at the time, surrounded by all those “Nessies”. 🙂

  5. JDannhauser says:

    I had troubles too. I pumped every two hours, tried fenugreek, smelling his clothes, photos, videos, etc. I never got more then 2 ounces, usually 1 to 1 1/2. Luckily it was still enough to feed him until he was 3 months old because we stocked it all away and he had some feeding setbacks that let me get ahead. But then it just got less and less so we had to quit. I remember being proud of finally getting 1 1/2 ounces and then I saw a woman come out with 6 bottles and I was crushed.

    • Julianne,

      Oh, it was so hard. That’s why I enjoyed reading Afton’s article and realizing that “6 bottle lady” may have also been feeling crushed.

      It’s amazing that our breastmilk adapts to having a premature infant, in terms of ingredients.

      I finally quit pumping once I was back at work. Taking 20 minutes to pump less than an ounce seemed unfair to my employer…and I was already so tired of it!

  6. Liz Mills says:

    My firstborn is now 33 but when he was born only 2weeks early, but at a low birthweght of 4:7 and having been without fluids internally (as my water broke 2 weeks prior to the birth) the doctor took him to NICU at another hospital. Having already been to allt he La Leche league meetings, I was deternimed to breast feed this tiny little guy. He was to stay in NICU for a series of anibiotics as a safety measure. What with the stress of having to get up the the NICU and trying to pump with limited success, I contacted La Leche league leader with my frustration. She went right to action and called on all the moms in the group who donated from their own supply so my little guy could have plenty of natural milk!! My mom would make “milk runs” for me. As my baby got to come home, he slept VERY little, so being sleep deprived and stressed about this new tiny guy, I was still pumping very little. to top it all off, he got Thrush in his mouth from NICU!! This resulted in him giving it to me and my breasts were REALLY tender!! I then had to paint his mouth and my breasts with gentian violet (sp?) to make it go away and keep us from re-infecting each other. My pediatrician suggested drinking beer!!! Not having ever been a fan of beer, I hesitantly gave it a try. She said that the hops would help with milk production!! Well, it did help and I was able to successfully feed him all he needed. I was more successful with my second child in nursing him. I think any mom that has to experience the stress of having their child away from them for any reason suffers mentally and physically thus presenting MANY challenges!!

    • What a great story, Liz…I love that the other La Leche moms jumped in. I’ve heard that some NICUs now offer donated breastmilk for moms with low milk supply or other health issues. I’m not sure how I would have felt about that with Addie, but it’s nice to know it’s an option. Thank you for sharing! 😉

    • I actually talked with the NICU about the donated milk. Most hospitals no longer do it now because of the cost of screeing the milk for diseases since HIV and other diseases can be passed through breastmilk. I don’t think I’d want my baby to have another mother’s milk honestly 🙂

  7. I saw this on Facebook today; an acquaintance is donating her breastmilk to the depot: http://www.kansascity.com/2010/06/23/2040258/st-lukes-opens-depot-for-human.html

  8. I had enough milk to feed the whole NICU, The only problem my son kept getting sick on it. He did great with the feeding tub it was when he had to drink from a bottle. He had a hard time to drink from me he had poor mouth cordination.

  9. I had next to nothing 🙁

  10. I had almost nothing.. and the hospital where Brooke was born still did the bacteria testing (i was told by several nurses they hated the testing, it was completely unnecissary, and only like 3% of hospitals use it) Every time I would get enough to feed her, they wouldn’t be able to use it. It was so frustrating!

  11. i had ALOT of milk i was making 18 bottles a day so he always had milk when he needed it. there were mother`s in there that would give me dirty looks because they cldnt produce nothing for their babies.

  12. I pumped pretty much every 2 hours and was lucky to get maybe 8 cc’s each time (30 cc’s is one ounce). We were in the NICU 126 days and I kept it up till the end. We purchased donor milk to supplement what I could get.

  13. My daugther was born 10 weeks early due to me developing severe preeclampsia. I pumped for four months and am now weaning myself off of the pump – due to going back to work and generally being stressed out. The stress of pumping to only get 1 ounce ended up being too much to handle – it was affecting my work and homelife. I’m glad that I found this blog bc it has given me a sense of accomplishment that I was able to provide for my daugther as long as I have and that I’m not the only mother who has had to adapt to such a stressful situation. Now that I have started to stop pumping I am feeling much better about myself and feel more confident overall. Everyone has a different situation all we can do as mothers is adapt and do what is best for us. Thank you again for all of your stories they are truely comforting in this time of transittion. Sending positive mommy thoughts to all!!

    • Jessica,

      You did great! Pumping for 4 months is HARD work, and every little bit helped your daughter. And you’re right, no amount of breastmilk is worth it if you’re too stressed to enjoy your life!

      Thanks for sharing!

  14. My son was born 10 weeks early via emergency c-section. While recovering in the intensive care unit, I was also met by the lactation consultant and provided with a hospital breast pump to begin pumping milk for my son. It started off slow but was assured that eventually my milk will come in within a few days and at that time the amount he needed at each feeding were small. I was in the hospital for a week and was able to go from 3ml to 15ml by the time I was discharged. Needless to say I was very happy with what I could produce and that they wouldn’t have to use donor’s milk or formula. I felt very positive that my milk supply would continue to increase. It’s been over two weeks since having my son and despite my pumping, I’ve only been able to produce on average 10 ml pumping both breasts for 20 mins every 3 hours. If I don’t pump at night I get 20 ml the next morning. It’s hard and I’m becoming more discouraged as the days go by. I try to remain positive but It is crushing when I go to the NICU and see freezer shelves filled with 5 oz bottles from other mothers and I am only able to provide 4 bottles of 10 ml each. My son’s feedings have increased to an ounce and since I’ve been unable to produce that at each pumping session they are now using formula. Everyone says it’s just a matter of trying to relax, but the stress of everything makes it pretty difficult to. Regardless, I continue to keep pumping to provide what breast milk I can for my son. I am so glad to have found this site. It was very comforting to read everyone’s stories and know that I’m not alone in this.

  15. Thank you all for your stories! I wanted to cry because they mimic mine so much. The LC said I should be getting 24 ounces a day but I’m lucky to get 6:( thanks for letting me know I’m not alone

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