# Reverse cycling? (or: do I really need to pump 3x at work?)



## blake201 (May 20, 2010)

So--if baby isn't drinking much milk while I'm away at work, and I have oversupply problems to begin with, can I pump only twice without causing my supply to dip like crazy into undersupply range? Has anyone here had any success with reverse cycling?

A few weeks ago I posted because I was worried because even with my crazy oversupply I couldn't seem to pump enough to keep up with all the bottles of milk my baby was drinking--4 or 5 4 oz bottles per day!

I'm away from my 4-month old for 10 hours per day and I generally pump 3 x for 10 minutes at a time, getting between 18-22 oz total.

Baby used to drink almost ALL of it (whoa!).

But lately Baby has been doing the opposite--I think this is what is called "reverse cycling". She only drinks a little bit during the day--8 oz, or even 4 oz. sometimes--no matter how much she is encouraged to take a bottle. She makes up for it by feeding constantly as soon as I get home and feeding during the night once or twice.

I love this because I HATE pumping and find it tedious/painful/difficult to schedule. And I love nursing and spending time cuddling with baby, even during the night...

So, as long as she isn't drinking that much, is it ok if I just pump twice? I'd go back to three times if she started taking more bottles again...

any advice/experience appreciated!


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## Marissamom (Dec 17, 2009)

I dropped to 2 and then 1 pumping sessions at work, but my DD was older. I would wait until you have a frozen stash and then try dropping a pumping session and see how it goes. if you wait until you have a good stash then if you start not getting enough you have a buffer while you build your supply back up.


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## 3girls1boy (Nov 20, 2001)

Sounds like you have a good supply and the last poster gave spot on advice. I worked only 2 nights a week when I was nursing, but I did find that at about 6 months that I wasn't able to pump much at work so it didn't seem worth it. My kids also took very little while I was gone (I was gone from 3 pm until 10:30 pm). I would keep a clean bottle at work and if I happened to feel a let down during my break, then I would run to the bathroom and hand express into the bottle. I could keep it with a cooler pack in my lunch box until I went home.

JT mom to 3 DDs and 1 DS


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## JudiAU (Jun 29, 2008)

Some women and babies can bit it is myth to think that it is automatic. Unless you've been back at work for 3-4-5 months you have no idea what your baby need when away fro. You. If you stop pumping you probably won't be able to do it later if you need to.

Pumping stinks, but don't compromise your ability to pump when you dint really know what will happen. I wou,d on,y stop pumping after two or three solid months of reverse cycle that is baby led. In ten long term, you will all get more sleep if baby drinks some milk when you are away. Keep at it.

Ed: you are currently pumping about what so e babies need so I wouldn't call it a huge oversupply. You ate very unlikely to keep that up. This is the golden pumping period. You may very while need that frozen milk at 8 or 10 or 12 m.


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## Charmie981 (May 30, 2002)

Quote:


Originally Posted by *JudiAU* 
This is the golden pumping period. You may very while need that frozen milk at 8 or 10 or 12 m.

YES! I wish I had been more consistent in the beginning at 2-4 months when I was able to pump so much because then I could have built up a good freezer stash. Now at 8 months, it's a daily struggle. If I were you, I'd keep pumping as you are now and freeze any extra.


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## blake201 (May 20, 2010)

Well, I guess I'll keep pumping for now 3x per day... but I have vasospasms and other pain and it HURTS like I'm sticking my nipples into a flame (for some reason nursing doesn't really hurt... I'm going to see a rheumatologist about it). So I really wish I didn't have to!

Also, I'm confused about using the freezer stash when supply drops--from what I've read, the freezer stash (I have a bunch in there, but I can't fit a deep freezer in my apartment so it's just what I can squeeze into my fridge-top freezer) is only for emergencies.

If you use the freezer stash to supplement, doesn't that just make your supply plummet even farther, just as if you supplemented with formula (except more nutritious)? Because baby will drink less directly from the breast if they drink some from the stash that day, right?


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## Marissamom (Dec 17, 2009)

not if you only dip into the freezer stash while away and are increasing pumping at the same time in order to increase your supply. say you have dropped a pumping session at work and one day you're feeling stressed and come up 3 oz short of what you need to cover the bottles for the next day, then you thaw 3 oz from the freezer to cover the deficit, and if it keeps happening you add back in the dropped pumping session. It would only interfere with your supply if you're using the stash milk when you would normally nurse, or you don't increase pumping if you find yourself short more than just once or twice.


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## JudiAU (Jun 29, 2008)

The greatest luxury in the pumping' moms life is an extra freezer. You can pick them up for $100 small size and fit them anywhere. We have one our patio. I would keep my small freezer over my BED. It is SO NICE to have a clean and empty place to store milk. Seriously, I think everyone should have on their baby registry.

I think most women use their stash like this: pumping is not super effecient for them and it tends to reduce your supply over time, unless you also get extra time at home with your babe (i.e. not work 40 h M-F job). So over time, baby needs 14 oz or so and you can only produce 10 oz every day. You need an extra 4 oz of bm or you have to supplement with formula. It is not like you can say, too bad baby, no third bottle for you. Wait six hours. They need it every day and it usually the same amound more or less from 4m -12m. A lot of babies drop a bottle around 11 or 12m. This is in addition to solids.

A baby who has a lot of bottles will usually have a fairly consistent routine but your pumping routine might not adjust because of stress or period or hard time with the pump. Also, many woman stop pumping at a year but use up the milk after they finish pumping.

What you pump in a day is not necessarily what the baby needs to eat while you are way. And again, many do not reverse cycle in a predictable way to allow you to have variable amounts during the day. They need 14 oz or whatever. *Especially* if you work full time. Much easier to keep up supply if you have a flexible schedule. Breastfeeding is very flexible for most women. Pumping is much less flexible.

And all of this assumes "perfect pumping" i.e. baby is only, ever fed bottles while you are at work and you nurse on demand all other times

With my first I amassed a huge freezer stash (700 oz) and donated almost all of it. With LO, I was able to meet demand by an ounce or two by 9 months. By 11 months I needed at least a whole bottle extra and by 15m I can only produce one of three every day. (Yes, I pump longer than most and yes, I am really glad she still gets a lot of milk.)

Finally, there isn't a whole lot of great information about pumping out there. Pumping is different from pumping. At various points I got good advice from the medela LC that are free. They have lots of pumping experience.,


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## blake201 (May 20, 2010)

Thanks--maybe I will talk to the Medela folks, because I don't think pumping should be SO very painful. Even one month so far has been beyond excruciating--I don't mean discomfort, I mean eye-watering crying pain. So you can see why I don't want to pump any more than necessary.

I'm away from baby 50 hours/week some weeks (including the commute) and 40 hours other weeks (again including commute). At home I ONLY nurse--I refuse to do anything that will mess with that now that I'm back at work.

I haven't made the stash much of a priority because I'm not sure if I have thrush or not (LONG story--been through months of various regimens and have given up trying to treat), so I really hesitate to use the frozen milk and I certainly can't donate it.

And I still don't know where how we'd fit a freezer, but I'll look into it (my husband and baby and I live in one bedroom of a two-bedroom apartment, my mother and sometimes my father stay in the other room... we have no off-site storage or porch or basement, nothing! so everything we own in the world is in one room and a bit in the living room).


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## blake201 (May 20, 2010)

I just contacted Medela, here was my super-long question for them! We'll see what they say:

Hi,

I am a new breastfeeding and pumping mom, and I've been having some serious pumping challenges I was hoping I could get some advice on.

Background: My baby is 4 months old (born 6/22/10) and is thriving on breastmilk--very healthy and already over 15 lbs. I went back to work full-time at 12 weeks and am generally away from her 10 hours/day 5 days per week. When I am home and on weekends I nurse her on demand, including once or twice during the night (she cosleeps next to our bed). I plan to nurse and pump for at least a year so she never has a drop of formula; I plan to continue nursing with or without pumping for at least two years total.

I initially purchased and used a Medela Pump In Style, but found it painful to use and switched to renting a Medela Symphony.

I have been having breastfeeding issues since the beginning, and have been seeing a lactation consultant for them, but I am writing here for specifically pump-related questions.

The non-pumping issues I have are:
--oversupply/overactive let down. Even at 4 months along my milk still leaks, shoots and sprays constantly, and I go through many nursing pads per day. The spraying sometimes overwhelms the baby when she nurses, and I have to let it spray into a burp cloth before latching the baby on
--mysterious nipple and areola pain and vasospasm. I found nursing and pumping painful from the beginning, especially in the first week. I worked closely with a lactation consultant and breastfeeding doctor, but haven't had relief. At first we thought it was thrush, since my nipples are bright pink... but after three months of carefully trying various anti-thrush medications and regimens for both myself and baby with no improvement, my LC cultured my nipples and found no sign of yeast, bacterial issues, etc. I definitely have vasospasms--my nipples frequently turn white and then various other colors, accompanied by pain.

OK, with that background, here are my questions:

(1) How can I make pumping less painful?

Pumping is EXTREMELY painful for me, but nursing is not. Not just uncomfortable, but outright cringing crying painful. Nursing is only vaguely slightly uncomfortable, but pumping just HURTS, even on the gentlest pump setting. The pump sucks in the nipple, all of the areola, and also part of my breast itself into the tube. (fyi I am large-breasted--I wear a 32I bra).

I currently double pump 3x/day for 10 minutes per session, producing 4-9 oz total per session for a daily total of 18-22 oz. Every minute is a struggle, and I cry and wince throughout. I pump hands-free with a pumping bra but even distracting myself with work or a book doesn't help.

The pain increases as the week goes on, becoming more and more painful. I tend to recover a bit over the weekend just from nursing and it is painful on Mondays, but not as bad as Friday.

I have tried switching from a Pump In Style to a Symphony, and it helped, but not significantly.

I have tried many different sizes of pump flange, but they all hurt--the one that seems to hurt the least is the 27mm flange, even though it is much bigger than my nipple.

I use a little bit of Lansinoh to lubricate the flange but it doesn't help much.

What else can I do?

Related to that:

(2) Since I have oversupply, do I HAVE to pump 3x/day if the baby isn't drinking it all? My baby prefers the breast and her intake has varied. There was a week where she drank it ALL, but she currently drinks only 4-12 oz while I am away, and has done so for two weeks.

I would love to cut back to 2x per day to reduce the pain, but worry that I will have a supply drop. Is it possible to reduce?

Thanks so much in advance!


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## blake201 (May 20, 2010)

The Medela LC got back to me almost right away. She felt that I am definitely overpumping, and probably making my oversupply issues worse. I have to look over all of her tips and try them, and also ask her some followup questions. Here's what she said: I've bolded the biggest takeaway.

---
=========== ANSWER ===========

I think that it's hard to address just the pumping issues without the breastfeeding ones, as they may be tied in.

*I see no reason why you need to pump 3 times while at work, as this just encourages the oversupply that you have and probably makes the overactive let-down worse too.* You will have a supply drop if you pump less frequently, but that would be a good thing. Oversupply can cause a number of problems for the baby (as you know) and probably for the mom. You don't mention that you have had any problems with chronic plugged ducts or mastitis, *but chronic engorgement may be contributing to the pumping pain.* I wouldn't suggest that you cut out the one pumping session all at once, as you will probably be sick with either plugged ducts or mastitis and miserable if you do. *So, can you try pumping an oz. less each day until you have weaned from that pumping session? You may not be able to go that fast. You may need to pump 6 oz. for a few days, then 5 oz. for a few days, etc...Babies only need 9-12 oz in a nine-hour separation (assuming 8 feedings in 24 hours) and at 18-22 oz. a day, you are pumping about twice that.*

I assume that you and your LC are exploring Raynauds, but here is a good (very long) article on this:

For information on Nipple Vasospasm and Raynaud's Syndrome, please see:

http://www.sdgp.com.au/client_images/18175.pdf

www.drjacknewman.com also has information on nipples that turn white and blanch during feedings.

Nipple vasospasm can be treated with medication, but additional measures are also helpful. Can you make sure that you keep your breasts and nipples warm before and after pumping? Keep your shoulders covered and your feet should be warm too. Milk will flow better when mothers are warm--and milk that flows faster means quicker pumping sessions.

Also, on the pumping pain, it sounds that your nipples are small, despite being large breasted (but with a small frame). Have you tried the 21 mm breast shields? It sounds like you have a lot of "give" to your skin, and if the nipple will fit in the tunnel for this size, perhaps less of the breast would be yanked in.

Make sure that your nipples are absolutely centered in the tunnel. It can be big problem if they aren't.

I am sending you some information on overactive let-down (though you probably know all this) and also a list of some anti-galactagogues--a fancy word meaning things that the mom can take to reduce her supply.

Here is some information for you from La Leche League International's Breastfeeding Answer Book, by Stock and Mohrbacher, '03 ed.

Some mothers with a forceful let-down or an overabundant milk supply have found that the nursing positions that work best are those that allow the baby to nurse "uphill," with his head and throat higher than the mother's nipple. In the football hold, the mother can lean back. In the cradle hold, the mother can prop the baby in her lap on two pillows and lean back in a rocking chair or recliner.

Other mothers have found that side-lying position work best, because it is easier for the baby to let the milk dribble out of his mouth if it is coming too fast rather than having to swallow quickly to prevent choking.

If the baby has a difficult time coping with his mother's let-down or milk supply after trying the above suggestions, the baby may do better with one breast per feeding. Nursing the baby from just one breast may help prevent him from being overwhelmed with milk. For the mother with an overabundant supply nursing on only one side at each feeding helps reduce her milk supply and bring it closer to her baby's demands. If the baby wants to nurse again within an hour to an hour-and-a half, the mother can continue to offer the same breast. If the mother finds that restricting nursing to one breast leaves her other breast feeling overly full, she can either express just enough milk to make her comfortable or she can offer that breast to her baby and nurse just long enough to alleviate the feeling of fullness. It is important to express or pump only a little bit of milk&#8230;just until the mother is barely comfortable-not ounces and ounces, which will only encourage more milk to be produced.

After four to seven days of this change, if the baby continues to have trouble coping with milk flow at feedings and/or continues to have other symptoms, the mother can limit the baby to one breast for a longer time to give the baby more hindmilk and further decrease the supply. Depending on the mother's supply, she may start by keeping the baby on one breast for 3 hours and see if that helps. If the baby still seems overwhelmed at feedings and is having other symptoms, she can go to four hours or longer, switching to the other breast after this period of time and limited baby to that breast for the same period.

Rather than postponing nursing sessions, which is often the first impulse for the mother whose baby is having problems coping with a fast flow of milk, feedings may be easier if the baby is nursed more frequently. This will reduce the amount of milk accumulated in the breast, making feedings more manageable for the baby.

In many cases the problems associated with a forceful let-down are a result of a combination of characteristics of both mother and baby--a mother who naturally has a fast flow of milk and a baby with a very strong suck. Nursing immediately upon baby's waking--even before the baby is fully awake, if possible--can be helpful because the baby may suck more gently in his relaxed state, making the flow of milk slower and reducing the likelihood of the baby gulping air.

In addition to the above:

Frequent burping can be helpful to the baby, particularly if he tends to gulp air during feedings, because it will reduce gas and fussiness.

When the milk does let-down, you can let it spurt out onto a cloth diaper or towel for a minute, then put the baby back on. He may feed better if you do this.

Some lactation consultants recommend that mothers use a "scissors hold" or "cigarette hold" to support the breast and to apply pressure to restrict milk flow during let-down to slow the flow.

Antigalactagogues are herbs, foods, or medications that can reduce the milk supply. Please consult an herbalist and/or your doctor before using.

All of the following have an A or B safety rating from The Nursing Mother's Herbal, c. 2003, by Sheila Humphrey.

Barley sprout
Cabbage (external anti-galactagogue-to be put on the breasts. Use only inner washed leaves, and do not place over the nipple and/or areola.)
European corn mint
Jasmine flowers (external antigalactagogue-like cabbage)
Mugwort
Osha
Parsley leaves, only in large amounts, NOT the essential oil

Peppermint. Can add of ¼ tsp of essential oil or spirits of peppermint immediately before drinking peppermint tea. Several cups a day are recommended. Can also try strong peppermint candies. Don't use peppermint if mother has heartburn or reflux,
gall bladder or liver disease.

Pigeon pea
Pygeum
Sage (leaf). A trick here is to make a peanut butter and honey sandwich, peel down one corner, put on 1 tablespoon of powdered sage and eat that corner first.

Also can use 1 tablespoon of sage in a cup of broth, steeped for 10-15 minutes.
Drinking carrot juice in the mornings

Pseudoephedrine, in some preparations of many over-the-counter medications for colds and allergies. (Be careful, this can make you feel very wakeful and jittery).

Birth control medications (pills or injections or IUDs with hormones) containing estrogen. Some mothers also have a reduced supply when taking the combination estrogen/progesterone pill or the progestin-only mini-pill. This can be too much, however, and may drop your supply too much, so be very careful, and start slowly, with the weakest herbs that can drop supply, and proceed with the help of your doctor and IBCLC, who can weigh your baby frequently and make sure that you get to the right amount of milk, not more , and not less.

Basically, I am wondering if the possible Raynaud's Syndrome and an oversupply are contributing greatly to your pumping pain.

I hope that this helps you out. Can you please write back and let me know how things are going for you?


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## JudiAU (Jun 29, 2008)

Good information and yes, you can pump more than a lot of women but I wouldn't actually call it an pumping oversupply.You work long days. That is about what I would think your baby might drink with a bit extra for the stash. I could easily pump that amount when I first went back to work but your pumping supply will start to taper off pretty soon and will continue to decline. If you can pump that in two months I would be suprised.

I am sorry I can't help with the pain.


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## crystal_buffaloe (Apr 30, 2010)

I know you said that distraction is important for you to get through a pumping session, but would it be possible to perhaps hold the horn on one boob and pump one side at a time? If you were holding it (as opposed to the hands-free), you might have it more centered and secure. Also, doing one side at a time should help any over-supply (since double pumping increases supply), and if you were doing one side at a time, you could probably keep a good hold/good position with one hand and still do something with the other hand to still be somewhat distracting. Has your LC looked at you with various sizes of horns to see which is the best fit for you?

I agree with keeping warm! I had some nipple vasospasm, and keeping warm helped soo soo much.

I would not be comfortable trying any birth control methods to reduce supply at this point, though! I really hope that you can get it figured out and be able to pump with less (idealy NO) pain, but I'm afraid that you're going to experience a supply regulation really soon and start producing less for the pump -- since you do work long hours and the pump is just so much less effective than the baby.


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## blake201 (May 20, 2010)

Thanks again everyone. I don't actually plan to try any of the Antigalactagogues, but I am showing all the info she provided to my LC to see what she thinks.

I'm fairly certain what I have is indeed oversupply--22 oz. in three sessions isn't crazy, but that's only because I'm restricting pumping to 10 minutes or less per each session--if I went even a few more minutes, I'd probably have a LOT more, as the milk is still spraying when I stop pumping.

Also, I'm uncomfortably engorged ALL the time, and my milk is always shooting and spraying and leaking. Luckily I've only ever had one plugged duct and never had mastitis, but it still hurts.

I have tried several different horn sizes for the pump but all seemed pretty equally painful. And just due to the pain, I wouldn't pump one-sided--I would have to pump twice as long to get the same amount, and that would be twice as much horrible pain.

I'll update if I have luck with any of this.


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## carepear (Nov 16, 2010)

I'm having a lot of the same issues as you. I know that people will consistently tell you that oversupply is better than not having enough but I think they are equally bad. I've had oversupply issues and the biggest concern is that my milk tends to be not as fatty as it was before I started pumping. This has caused all sorts of problems for my little one including upset tummies, rumbling, green poop, etc. Also, nursing can be difficult because she'll start choking and sputtering and I'm just pouring milk out at a crazy rate. And on top of the oversupply during the day she is reverse cycling so she eats a ton at night but not a whole lot at school. She'll eat anywhere from 4 to 8 ounces at school but then she nurses non-stop when I'm home. And before she started daycare she was sleeping through the night - now she is waking anywhere from 1 to 3 times to nurse. Which is fine by me since I need the nursing time as much as she does.

What has helped for us is to restrict my pumping time and block feeding. I have tried a lot of different ways but what I am doing now is basically block feeding when I'm with her - so only offering one breast for 2 or 3 nursing sessions and then switching to the other. So night time is all on my left, morning till lunch is my right, lunch till about 5 is on my left and then back to right until bedtime. I nurse on demand but just stay on one side. She seems much happier with this than getting drenched. As for pumping I pump 4x a day - at 9:30, 11:30, 1:30 and 3:30. But ONLY ONE SIDE at a time. And I only pump until I have about 3 ounces. So I'm still getting way more than she is eating but this is keeping me from pumping 6 ounces in one sitting. I have also done just 2 pumping sessions a day and doing both sides at a time but I think I'm liking one side at a time better. I stay much more comfortable. I try not to pump more than one extra bottle a day. Any more than that and our non work days are miserable and nursing is an awful experience for me and her between choking, crying, getting soaked with milk, etc. Plus mega mommy guilt from giving her an upset tummy.

If I could just freeze the extra milk with no effects to her than I would do it but she has physical symptoms caused by the oversupply and I can SEE the difference in the fat content of my milk.

Good luck with this - and try experimenting with other pumping schedules. If you have a good freezer stash for emergencies I wouldn't worry too much about decreasing your supply too much. If you are like me you can just pump a little extra and it will ramp back up into psycho milk territory. 

This is just my two cents - the kid is only 3 months old and has only been away from me during the day for 6 weeks. I'm totally not an expert but this is what has been working for me. Oversupply is no joke - if I'm not supper careful with my pumping I would have 3 times what she is eating in a day. And have a sick, pissed off kid. And be in pain.

Oh yea, and having her sit in my lap facing me while nursing has helped also - the whole nursing uphill thing.


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## carepear (Nov 16, 2010)

Oh, and you might do only 5 minutes per session. That's what I was doing for about a week and it helped get my supply under control pretty quickly. Plus, my LLL leader said most people get about 90% of your pumped milk in the first 5 minutes anyways. I know I would get a ton more if I kept goign but I stopped at 5 minutes and it helped.


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## Anna Phor (Jun 20, 2009)

My $0.02: My baby just turned 12 months, I went back to work at 16 weeks, and we haven't had to supplement with formula. I've never pumped consistently more than 12oz per day. I've seen a bunch of numbers for how much bm babies need in a 24h period--the highest number I've seen is 30oz. So if you are away from baby 10/24 hours (or about 40% of the hours in a 24h period), and baby is drinking 22oz (or about 75% of their total 24h intake), you can probably manage to skip a pumping period. You might get more night wake-ups, though.

One thing I also found; I got the same volume from 2 pumps/day as I did from 3 pumps/day. My supply did go down at around 10 months--but my baby was also drinking less by then. You could experiment with pumping twice for a couple days & see how much milk you get.

Also, if the pump is hurting the skin on your breast/areolae, try lube! I know it sounds weird, but I had a horrible bite injury at about 7 months, and I lubed up the inside of the pump horn with lanisoh. Made a world of difference to me, and I did it just at the entrance of the tube, so it wasn't in direct contact with the milk. And even if a wee smear had gotten in the milk, it was lanisoh, so I didn't feel too bad.


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