Milk fat

by Donna
(Chattanooga tn 37343)

I am 7 weeks into relactaing. i produce about 25 oz per day and seems to be climbing each day. I am an exclusive pumper as baby wont latch. My question is, How do i tell if there is enough fat in the milk. My milk looks like skim milk with very little milk fat to seperate after sitting for a few minutes?
Also I wanted to know if when I look at how long Ive been pumping do I need to look at it as 7 weeks post partum cause thats how long Ive been relactating . My baby is 16 weeks old.
And after 7 weeks would it be safe to go from pumping every 2 hours up to 10 times per day, to maybe every 3 hours 8 times per day? I have an Ameda elite Hospital grade pump, and I take Domperidone 20 mg 3 times per day.

Answer from the lactation consultant
Congratulations on successful relactating.
To answer your first question, there is no way to determine the actual amount of fat in your milk without having it tested in a lab. Unfortunately, it tends to be a less when pumped than when suckled.As long as your baby is gaining weight and meeting developmental milestones, do not be concerned with the exact amount of fat.

You did not say if your baby is taking a bottle or is being tube fed. If he/she is taking a bottle, it is likely he/she would take nurse if coached properly. It would take the help of a LC with experience in this area and the use of a SNS (supplemental nurser) to get it going. I recently worked with a mom who induced lactation for an adopted child. She got the baby at 10 months and was able to train her to suckle at the breast. It took about 3 weeks of hard work but it happened. And I have worked with others with similar stories.

Next to answer your question about pumping schedule. When you pump exclusively, you must pump more frequently than if you were nursing. The pump does not demand more during a growth spurt, it does not give you physiological cues like a baby. It is a machine and can only do so much. If you want to maintain your current supply, you must continue your current pattern. What you empty is what you make. You can try pumping longer but at fewer intervals and see if that works for you. Like instead of pumping for 20 minutes pump for 30 (even if nothing comes out for the last 10, the first few times) and do that every 2.5 hours in stead of every 2. Also, you said "up to 10 times a day" and I want to make sure you are pumping at night, not skipping longer than a 4 hour stretch without emptying. A 16 week breastfed baby would still be eating every 2-3 hours at night and those night emptyings really do great at increasing supply. It would still be normal for a 16 week baby to be nursing somewhere between 8-12 feeds in a 24 hour period. So, I would not recommend only 8 pumping sessions in a 24 hour period unless you are willing to supplement with formula, which I never recommend.
Liz Pevytoe, RN, IBCLC